EX-10.11





 Exhibit 10.11 

 
 



 
 unum?~ Supplemental Individual Disability Insurance Plan Covemge mtdenvritten by the foUOIJiing !11bsidiary if Umn1 January 4, 2022
Provident life and Accident Insurance Company 1 Fountain Square Chattanooga, TN 37402 Developed Specifically For: ZimVie, Inc. Unum Life Insurance Company of America 2211 Congress Street Portland, ME 04122 Presented by: Bill Deuink Provident life
and Casualty Insurance Company 1 Fountain Square Prepared by: Kelly Swallow Wolfe Chattanooga, TN 37402 Chicago Sales Office www.unum.com Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. Thank you for
considering Unum for your Supplemental Individual Disability Insurance Plan. Enclosed All rights reserved with your plan offering are detailed plan specifications and an offer request document. Unum is pleased to partner with ZimVie to provide these
benefits to your employees . Specifically, your customized plan design includes: Guaranteed Standard Issue (GSI) Supplemental Individual Disability Insurance Plan Summary Eligibility All Active Full Time Employees Classified as Z01-Z07 after 180
days of continuous employment (15 Eligibles) Insurable Income Base Sala!}’, bonus and commissions Plan Design 70% of monthly insurable income less LTD to amount of the GSI offer LTD Plan Unum: 60% of Base Salary, Commission to a maximum of
$15,000, 100% E mployer Paid GSI Benefit Maximum $10,000 Elimination Period 180 days Benefit Period To Age 65 Contract Type Income II Select / Non-Cancellable Contract Contributory Status Employer Paid Participation Requirement 100% of all eligible
lives _(15 total live~ Discount 25% Multilife Optional Additional Benefits: Guaranteed Coverage Increase (GCI) -Annual to cap of GSI offer Catastrophic Disability Benefit - 30% to $8,000 (not to exceed 100% income replacement) 












 



 
 ••• ZimVie unum~ Supplemental Individual Disability Insurance Plan Income II Select Non-Cancellable Contract Benefit
Period To Age 65 • Recovery Benefit: paid for up to 6 Elimination Period months after you return to work full time Benefits begin after a waiting period of 180 in your own occupation but continue to days have a loss of earnings while you
rebuild Income Replacement for Total your business or customer business Other Features Disability • Lifetime Continuation:* you can • 1•’ Two Years of Disability: a monthly exchange your income protection for long-income benefit
will be paid if you are term care insurance coverage between the disabled in your own occupation, not ages of 60 and 70. Your base policy LTC working in another occupation and under benefit will be $3,000 per month (or $100 a physician’s care
per day, if state-required). Your LTC • Remainder ofYour Benefit Period: a monthly income benefit will be paid if you benefit period will be six years *Not available in CA, Cf & TX and on!J available ar rider cannot work in any
“gainful” occupation inFL for which you are suited based on education, training or experience and • Purchase Option Guarantee: you can which could be expected to generate at exchange your income protection for long-least 60% of your
prior earnings; and term care insurance coverage between the under a physician’s care. If the insured ages of 60 and 75. Your base policy LTC individual can return to this “gainful” benefit will be $3,000 per month (or $100 occupation
but does not do so, a monthly per day, if state-required). Your LTC income benefit of 50% is payable for up benefit period will be six years to the remainder of the benefit period *Onfy available in TX. • 2 Years Mental Disorder Benefit
Optional Benefits Return-To-Work Benefits • Guaranteed Coverage Increase: allows • Rehabilitation Services: available to you employer or employees to increase monthly while you are totally or partially disabled benefit without evidence of
medical and designed to help you return to work. insurability up to the GSI Benefit Include coordination of physical therapy, Maximum as salary increases occur vocation testing, retraining, career • Monthly Catastrophic Benefit: added to
counseling, placement services, worksite your income benefit, replacing up to 100% modifications, etc. of your prior income and paying in the • Work Incentive Benefit: when you event of certain very serious disabilities that return to work, you
will receive a short- are likely to increase your living expenses term incentive for up to 6 months equal to (your insurance professional can provide the difference between your prior income information on physical conditions that and your current
income, for up to 100% apply) income replacement (subject to the maximum benefit amount) • Residual Benefits: monthly benefits for less-than-total disability, based on your proportionate loss of income, for the duration of the Benefit Period
you chose for your policy This is a brief summary of the general coverage provided by the Income II (Select) coverage package of Unum’s Income Series (policy 600 or 601). Contract Provisions, Features and Optional Benefits are based on our
standard published issue ages. The policy or its provisions may vary or be unavailable in some states. The policy also has exclusions and limitations that may affect any benefits payable. See your insurance professional for complete details on
provisions and availability. 












 



 
 ••• unum~ ZimVie Supplemental Individual Disability Insurance Plan TERMS & CONDITIONS Who is eligible This offer
is extended to all eligible individuals (as defined under “Eligibility” on page 1) who are U.S. citizens or permanent U.S. residents possessing a green card. For a period of time commencing 180 Days prior to and including the date of
application, applicants must not have missed one or more days of work or been homebound or admitted to a medical facility due to injury or sickness, or had any restrictions or limitations on their ability to work on a full time basis (30 hours or
more per week) due to injury or sickness. Basis oflssue A standard offer means no modifications can be made to the contract’s premium rate, elimination period, benefit period or monthly benefit amounts to adjust for a pre-existing medical
condition. Ifthe Lifetime Continuation and/ or Catastrophic Disability benefit is included in the offering, all applicants will be asked questions for current Activities of Daily Living (ADL) losses. If any ADL loss or applicable pre-existing
condition exists on the date of the application, no Lifetime Continuation Option to exchange for long term care policy (Purchase Option Guarantee in Texas and Option to Exchange for Long Term Care Policy in California) and/or Catastrophic Disability
benefit will be included in the policy. Similarly, if the Serious Illness Benefit is included in the offering, applicants will be asked questions pertinent to the underwriting of this benefit. A yes answer to any of those specific questions will
result in no Serious Illness Benefit being included in the policy. The IDI benefit will coordinate with any other disability coverage applied for; and any disability coverage already inforce. Coverage applied for on a GSI basis cannot exceed this
plan design and total coverage to be in-force (includes Group Long Term Disability and Individual Disability Insurance) cannot exceed our issue and participation limits. The GSI benefit may be directly reduced by any inforce individual coverage that
was issued by Unum or its affiliated companies on a GSI basis. Unum will not participate with any other active employer-sponsored individual disability GSI program that provides long-term coverage through a non-cancellable or guaranteed renewable
contract. Minimum policy size is $300. Any additional amounts purchased beyond this offer amount will be considered to be outside the plan design and subject to our normal medical and financial underwriting guidelines. Financial Requirements We will
accept a company-provided census (electronic preferred) listing employee name, date of birth, job title, date of hire and compensation (defined as Insurable Income on Page 1) as income documentation. For purposes of insurable income, base salary is
defined as stable annual salary. Variable compensation may include bonus, commissions, K-1 earnings and other forms of incentive compensation, and is defined as a two-year average of compensation or last year’s files. If only a one-year history
of variable compensation documentation is available due to an individual not having been employed long enough to generate a two-year history, we will consider 75% of the variable compensation as insurable. Insurable income should be broken down into
base salary and variable compensation in the census, if applicable. Net Worth and Unearned Income considerations will be disregarded. Application Type GSI App Form: AE-1090 (short form GSI)