Voluntary Group Term Life _ Accidental Death and Dismemberment

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                       Group Term Life
                       & Accidental Death
                       and Dismemberment
VGTL | Custom w/AD&D

                                            Would your family
                                            have a secure future
                                            without you?
Plan for tomorrow with Colonial Life’s Group Term Life
and Accidental Death and Dismemberment Insurance.
                                                      We know it’s a struggle when you lose someone you love, but it doesn’t need to
                                                      be complicated by financial concerns. To help you determine how much coverage
                                                      your family may need, ask yourself the following questions:
                                                        Will they have the money to pay for final expenses, such as funeral costs,
                                                            outstanding medical bills and taxes?
                                                        Can they meet ongoing living expenses like the mortgage payment,
                                                            utilities and healthcare costs?
                                                        Will the children have enough money to pay for college?
                                                     The Group Term Life and Accidental Death and Dismemberment (AD&D) plan from
                                                     Colonial Life & Accident Insurance Company is a lower cost option that can provide
                                                     higher coverage amounts. It can help you make the most of your insurance dollars
                                                     during times of high protection needs, when the family is growing. Group term life
                                                     and AD&D insurance can provide the most coverage at low group rates, with the
                                                     convenience of payroll deduction.

                                                     Term Life Insurance
                                                     Term life insurance provides death-benefit-only protection at a reasonable cost
                                                     during a specified period of time. With the affordable premiums, you can purchase
                                                     the full amount of life insurance coverage you need now. And the death benefit is
                                                     paid tax-free to your beneficiaries.

                                                      AD&D Insurance
                                                     AD&D insurance provides additional benefits to help cover the additional
                                                     expenditures associated with an accidental death, as well as the high costs of
                                                     recovery and rehabilitation required by an accidental dismemberment.

 Group Term Life Choose the coverage that is right for you.
                  You                                       Your Spouse                                Your Dependent Children
                                                                                                       (up to age 18, 24 if a full-time student)

                  $______________________                   $______________________                    $______________________

Maximum           Choose from a minimum of                  Choose from a minimum of                   Benefits available in $1,000 increments, up
                  $10,000, up to 5 times your               $5,000, up to 100% of your                 to a maximum of $10,000 for each child (or
                  salary, to the maximum shown              benefit amount in all states               up to a maximum of 50% of the amount
                  on the coverage options                   except the three listed below              you choose for yourself in the three states
                  insert.                                   (or up to a maximum of 50%                 listed below)1. Each child is covered for the
                                                            of the amount you choose for               same amount, except: the maximum death
                                                            yourself in the three states               benefit for a child between birth and six
                                                            listed below).1                            months is $1,000.

  The maximum benefit is 50% of your benefit, up to $250,000 in FL, KS and NE.

   Life Planning Financial & Legal Resources is provided by Ceridian Corporation. This service is available with Colonial Life & Accident Insurance Company’s
  Voluntary Group Term Life offering. Exclusions, limitations and prior notice requirements may apply, and service features, terms and eligibility criteria are
  subject to change. Ceridian Corporation is not engaged in rendering legal advice. Users should consult with their own attorneys. The services are not valid
  after termination of coverage and may be withdrawn at any time. Please contact your Colonial Life benefits counselor for full details.

  24 months or less to live in CO and ND.
Accidental Death & Dismemberment
If you purchase group term life insurance, you can also choose AD&D insurance that will cover you, as well as your
spouse (if covered under group term life) and your dependent children (if covered under group term life).
Your AD&D insurance will be in the same amount you choose for the group term life insurance.

   Full Benefit                                                         One-Half Benefit

   •   Loss of life                                                     •   Loss of one hand
   •   Loss of both hands or both feet or the sight of both eyes        •   Loss of one foot
   •   Loss of one hand and one foot                                    •   Loss of the sight of one eye
   •   Loss of one hand or foot and the sight of one eye                •   Loss of speech or hearing
   •   Total loss of both speech and hearing

AD&D coverage includes:
         Repatriation Benefit—to help pay the mortuary expenses incurred if the cause of death is an accident at
           least 75 miles from the town where you live.
         Seat Belt/Air Bag Benefit—if the cause of death or dismemberment is a car accident and if the insured was
           using a seat belt or air bag. (Not available in MN.)
         Education Benefit—to aid in your dependent children’s post-secondary education in the case of your
           accidental death.

Coverage includes these special features:

        If you retire, reduce your hours or leave your employment, you can still keep your coverage at the same affordable
        group rates. Eligibility for portable coverage may be based on your health at time of portability. If you are not
        eligible for portability, you may be eligible to convert coverage to a cash value life policy.

        Life Planning Financial & Legal Resources2
        This service provides support during a time when you may have many decisions to make and may not be sure where
        to begin. Provided by Ceridian and sponsored by Colonial Life, this service can provide the following support when a
        certificate holder or spouse dies or is diagnosed with a terminal illness:
         Financial and legal resources
         Impartial, accurate, professional consultation
         Emotional support
         Personalized service

        The service is available at no cost for 12 months with Voluntary Group Term Life insurance coverage for beneficiaries
        and certificate holders.

       Accelerated Death Benefit
       With the accelerated death benefit, you may request an advance benefit if you are diagnosed with a terminal illness
       with less than 12 months to live.3 We will pay up to 60% of your life insurance benefit to a maximum of $250,000 (up
       to 50% with a maximum of $25,000 in TX). The remaining amount of your benefit is paid to your beneficiary upon
       your death. This feature also applies to your spouse and dependent children covered under the plan.
Accelerated Death Benefit                                                 Age Reduction Schedule
  Your Accelerated Death Benefit will be discounted for one year as          The amount of insurance for you or your covered spouse will reduce
  described in your certificate.                                             when you reach age 70 or 75, according to the schedule in your
  State Variations                                                           certificate.
  In NC: Accelerated death benefits may be taxable or may affect          AD&D Exclusions
  eligibility for benefits under state or federal law. You should            1. Disease of the body, mental infirmity, or diagnostic, medical or
  consult your tax advisor to determine the effect on you.                       surgical treatment.
  In TX: The Accelerated Death Benefit offered under this certificate        2. Suicide or intentionally self-inflicted injury, while sane or insane.
  may or may not qualify for favorable tax treatment under the               3. War, declared or undeclared, or any act of war.
  Internal Revenue Code of 1986. You are advised to consult with a           4. Active participation in a riot.
  qualified tax advisor about circumstances under which you could            5. An attempt to commit or commission of a crime (felony in SD)
  receive accelerated death benefits excludable from income under                under state or federal law.
  federal law. Also, you are advised to consult with social service          6. Voluntary use of any controlled substance except as prescribed
  agencies concerning how receipt of such a payment will affect                  by a doctor and taken as prescribed.*
  you, your spouse and your family’s eligibility for public assistance.      7. Being under the influence of alcohol.*
Premium                                                                      *These exclusions do not apply in SD.
  Employee/Spouse—Your and your spouse’s initial premium will be             State Variations (In addition to or as replacements for the exclusions listed above.)
  based on current age and will change with age, based on five-year age      In CT: replaces #5 and #6 above.
  bands.                                                                     5. An attempt to commit or commission of a felony for which you
  Dependent Children—Your child’s premium is based on the                        or your dependent has been convicted under state or federal law.
  cost of coverage for one child regardless of how many children             6. Voluntary use of any controlled substance. (This is defined in Title
  you have. Premium will also change if the rates we offer to your               II of the Comprehensive Drug Abuse Prevention and Control Act of
  employer change.                                                               1970 and all amendments.) This exclusion will not apply if the drug
Participation Requirements                                                       is prescribed by a doctor and taken as prescribed.
  A specified number of your group’s employees must maintain                 In MD: replaces #2, #5 and #6 above.
  coverage in this plan to keep it in force.                                 2. Suicide, intentional self-destruction, while sane, intentionally self-
Exclusions and Limitations                                                       inflicted injury while sane, or self-inflicted injury while insane.
  Delayed Effective Date                                                     5. Committing or attempting to commit an assault or felony.
  Employee—Insurance will be delayed if you are not in active                6. Illegal use of any drug. (This is defined in Title II of the
  employment because of an injury, sickness, temporary layoff, or                Comprehensive Drug Abuse Prevention and Control Act of
  leave of absence on the date that insurance would otherwise be                 1970 and all amendments.) This exclusion will not apply if the drug
  effective.                                                                     is prescribed by a doctor and taken as prescribed.
  Dependents—Spouse and dependent children are eligible                      In MO: replaces #2 above.
  to apply for coverage under guaranteed issue at the initial                2. Suicide while sane or intentionally self-inflicted injury while sane.
  enrollment, but their coverage will not be effective if they are
                                                                                 NOTE: Suicide while insane is no defense to payment for insureds
  currently disabled. Being disabled includes the inability to
                                                                                 who are Missouri citizens, unless the insurance company can
  perform activities of daily living (not applicable in NH), being
                                                                                 show that the insured intended suicide when the insured applied
  cognitively impaired, confined in a hospital or similar institution,
                                                                                 for Accidental Death and Dismemberment Insurance, regardless
  or the existence of any life-threatening conditions. The ability to
                                                                                 of any language to the contrary in the Summary of Benefits.
  work does not determine disability. You can pay premiums on
                                                                                 Suicide while sane is a defense.
  insurance for your dependents with no health questions asked;
  however, coverage isn’t effective until they are no longer disabled.           Should death occur as a result of suicide, our company is
                                                                                 responsible only for return of premiums paid when application is
  This provision does not apply to a newborn child while
                                                                                 made with intent to commit suicide.
  dependent insurance is in effect.
                                                                             In ND: replaces #7 above.
                                                                             7. The presence of that percentage of alcohol in the insured’s blood
  Your plan does not cover any losses where death is caused by,
                                                                                 that raises the insured’s blood alcohol level beyond the legal limit
  contributed to by or results from:
                                                                                 governed by the laws of the state in which the accident occurred.
    suicide occurring within 24 months (12 months in CO and ND)
                                                                             In SC: replaces #3 and #5 above.
    after an insured’s initial effective date of insurance; and
                                                                             3. Participation in a war, declared or undeclared, or any act of war.
    suicide occurring within 24 months (12 months in CO and
    ND) after the date any increases or additional insurance become          5. An attempt to commit or commission of a crime under state or
    effective.                                                                   federal law, except in self-defense.
  State Variation                                                            Please see your certificate of coverage for additional information.
  In MO:                                                                     Applicable to Certificate Form VGTL.C (including state
    Should death occur as a result of suicide, our company is
                                                                                                                                                                      VGTL | Custom w/AD&D

    responsible only for return of premiums paid when application            abbreviations, where applicable).
    is made with intent to commit suicide.

                         Colonial Life
                         1200 Colonial Life Boulevard
                         Columbia, South Carolina 29210                                         Colonial Life products are underwritten by Colonial Life & Accident
                                                                      Insurance Company, for which Colonial Life is the marketing brand.

                         11/09                                                                  57156-4

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