Anotech Energy USA Inc Benefit G : simplebooklet.com

Group Accident Insurance Premier Plan If you are in an accident your focus should be on recovery not how you re going to pay your bills Colonial Life accident insurance can pay benefits directly to you to use however you like from medical costs to everyday expenses Whether you ve had a fall or a car accident these benefits can offer financial support when you need it Our coverage includes Benefits payable directly to you No medical questions to qualify for coverage Coverage for simple and complex injuries Benefits payable regardless of other insurance BENEFITS STORY Milo was working in his yard when he tripped and injured his hand Worldwide coverage Works alongside your Health Savings Account HSA With Colonial Life accident benefits Milo was able to pay the annual deductible and co payments for his health insurance plan without using his savings or taking on debt MILO S ACCIDENT BENEFITS Milo went to an urgent care facility and received immediate care Treatment in a physician s office or urgent care facility 150 The doctor ordered an X ray and discovered Milo had fractured his hand X ray Fracture hand 60 1 200 The doctor also found that Milo had a cut on his hand but did not require stitches Laceration no repair 75 Milo was discharged with a splint Durable medical equipment 65 Over the next several weeks Milo had two follow up appointments with his doctor For illustrative purposes only Benefit amounts may vary and may not cover all expenses Physician follow up visits 2 visits 50 x 2 100 Total 1 650 GROUP ACCIDENT GAC4100 PREMIER PLAN

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Give your benefits a boost We know that more complicated or severe accidents result in more expensive medical bills and more disruption in your life Group Accident includes a Benefit Booster to provide additional financial support for serious accidents If you have more than 5 000 in payable benefits for a covered accident we will give you a 500 boost to your benefits to help you with whatever expenses you have Payable once per Insured per covered accident BENEFITS STORY Olivia was driving to the store when she got into a car accident Olivia s benefits helped her cover her medical expenses when she was injured in a car accident helping her to focus on her recovery Olivia arrived by ambulance at the nearest emergency room and received immediate care The doctor ordered an X ray and discovered Olivia had fractured her thigh femur He also ordered a CT scan of her head to check for brain injury Olivia required surgery for her leg Olivia boarded her pet for two nights after her surgery Olivia had eight sessions of physical therapy to help regain the strength in her leg and two follow up appointments with her doctor Olivia s benefits for this accident totaled more than 5 000 For illustrative purposes only Benefit amounts may vary and may not cover all expenses OLIVIA S ACCIDENT BENEFITS Ambulance Emergency department visit Injury due to auto accident X ray Medical imaging Fracture thigh Surgical repair thigh fracture General anesthesia Pet boarding 2 days 400 250 250 60 400 4 200 4 200 300 20 x 2 40 Therapy services 8 sessions Physician follow up visits 2 visits 55 x 8 440 50 x 2 100 Benefit Booster Total 500 11 140 Benefits are per covered person per covered accident unless stated otherwise Injury benefits Burns based on size and degree 750 21 000 Concussion 500 Connective tissue damage 100 200 Eye injury 400 Hearing loss injuries 120 Maximum once per lifetime per ear per insured Injury due to auto accident 250 Internal injuries 200 Knee cartilage meniscus injury 200 Lacerations 75 1 200 Loss of a digit partial 400 800 Loss of a digit 1 000 3 000 Ruptured or herniated disc 200 400

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Fracture benefits Injury 200 5 000 Examples finger 200 wrist 1 200 hip 4 200 Surgical repair of fracture 100 Payable as an additional of the applicable fractures benefit Chip fracture 25 Payable as a of the applicable fractures benefit Dislocation benefits Injury 260 4 000 Examples elbow 600 ankle 1 600 hip 4 000 Surgical repair of dislocation 100 Payable as an additional of the applicable dislocations benefit Incomplete dislocation 25 Payable as a of the applicable dislocations benefit Treatment benefits Air ambulance 2 000 Ambulance ground or water 400 Durable medical equipment 65 250 Emergency dental repair 200 600 Emergency department 250 Maximum 4 per year Family care 50 per day Maximum of one benefit per day for all insureds combined up to a maximum of three days per covered accident regardless of the number of children Injections to prevent or limit infection 50 Lodging 250 per day Maximum 30 days Medical imaging 400 Pain management injections 150 Pet boarding 20 per day Maximum of one benefit per day for all insureds combined up to a maximum of three days per covered accident regardless of the number of pets that are boarded Prosthetic device or artificial limb 1 750 3 500 Skin grafts due to burns 50 Payable as a of the applicable burn benefit Skin grafts not due to burns 375 750 Transfusions 500 Transportation 200 per trip Maximum 6 one way trips Treatment in a physician s office or urgent care facility 150 Maximum 4 per year X ray or ultrasound 60 Surgery benefits Anesthesia 150 300 Connective tissue surgery 150 2 200 Eye surgery 400 General surgery Abdominal thoracic or cranial 2 000 Exploratory surgery 275 Hernia surgery 400 Knee cartilage meniscus surgery 150 1 050 Outpatient surgical facility 400 Ruptured or herniated disc surgery 150 2 000 Recovery care benefits At home care 125 per day Maximum 5 days Benefit Booster 500 Physician follow up visits 50 Maximum 6 days per covered accident and 24 days per calendar year Rehabilitation or sub acute rehabilitation unit confinement 200 per day Maximum 15 days per covered accident and 30 days per calendar year Therapy services speech physical therapy occupational therapy 55 per day Maximum 15 days Options checked below have been chosen by your employer to enhance your Group Accident Coverage Recovery Plus package Behavioral health therapy 55 per day Maximum 15 days Post traumatic stress disorder PTSD 200 Prescription drug 25 Additional therapy services chiropractic acupuncture alternative therapy 55 Existing therapy services benefit maximum applies to additional therapy services maximum 15 days Injury due to felonious act of violence or sexual assault 250 Maximum once per insured per calendar year with an accompanying police report Gunshot wound benefit This benefit can help pay your medical expenses if you receive a non fatal gunshot wound It offers you a lump sum for a covered injury regardless of any other insurance you may have and includes on off job coverage Gunshot wound _________ This benefit covers a non fatal gunshot wound from a conventional firearm that requires treatment by a doctor and overnight hospitalization within 24 hours of the injury If you are shot more than once in a 24 hour period we can pay benefits only for the first wound

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Contact your Colonial Life benefits counselor to learn more CT We will pay the air ambulance or ambulance benefits directly to the licensed professional ambulance company CT includes a benefit for outpatient emergency medical care for accidental ingestion of a controlled substance The at home care benefit maximum is 80 days KS Chiropractic therapy is not available NH NH includes a burn benefit for 2nd degree burns under 5 of skin surface The minimum benefit for the loss or partial loss of a digit is 1 000 MD The prescription drug benefit is not available PA The pet boarding benefit is not available TN The therapy services benefit includes chiropractic TX The concussion benefit is replaced by the concussion and acquired brain injuries benefit The therapy services benefit includes the following services cognitive communication therapy cognitive rehabilitation therapy community reintegration services neurobehavioral neurocognitive therapy and rehabilitation neurofeedback therapy neurophysiological neuropsychological post acute transition services psychophysiological testing or treatment and remediation HEALTH SAVINGS ACCOUNT HSA COMPATIBLE This plan is compatible with HSA guidelines and any other HSA plan in which a covered family member may participate It may also be offered to employees who do not have HSAs THIS INSURANCE PROVIDES LIMITED BENEFITS This coverage is a supplement to health insurance It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law Insureds in some states must be covered by comprehensive health insurance before applying for this insurance EXCLUSIONS We will not pay benefits for claims that are caused by contributed to by or resulting from elective procedures felonies or illegal occupations hazardous avocations impaired driving incarceration racing semiprofessional or professional sports sickness suicide or self inflicted injuries war or armed conflict ID Semi professional sports or professional sports exclusion is replaced by professional sports exclusion IL We will not pay benefits for claims that are caused by or resulting from Exclusions MD Includes an exclusion for Prohibited referrals The felonies or illegal occupations and impaired driving exclusions apply only to Accidental Death and Dismemberment benefits MI Impaired driving and suicide or self inflicted injuries exclusions do not apply MN Suicide or self inflicted injuries exclusion does not apply NH Incarceration and racing exclusions do not apply UT We will not pay benefits for claims that are caused by or resulting from Exclusions VT Impaired driving exclusion does not apply This information is not intended to be a complete description of the insurance coverage available The insurance or its provisions may vary or be unavailable in some states The insurance has exclusions and limitations which may affect any benefits payable Applicable to policy form GAC4100 P and certificate form GAC4100 C including state abbreviations where used for example GAC4100 P TX and GAC4100 CTX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company ColonialLife com Underwritten by Colonial Life Accident Insurance Company Columbia SC 2023 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company FOR EMPLOYEES 3 23 1212553

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Group Hospital Indemnity Insurance Plan 1 HSA Compliant Group Medical BridgeSM insurance can help with medical costs associated with a hospital stay that your health insurance may not cover These benefits are available for you your spouse and eligible dependent children Hospital confinement _______________ per day Maximum of one day per covered person per calendar year Waiver of premium Available after 30 continuous days of a covered confinement of the named insured Daily hospital confinement 100 per day Maximum of 365 days per covered person per confinement Re confinement for the same or related condition within 90 days of discharge is considered a continuation of a previous confinement For more information talk with your benefits counselor ColonialLife com Health savings account HSA compatible This plan is compatible with HSA guidelines and any other HSA plan that a covered family member may participate in It may also be offered to employees who do not have HSAs Colonial Life Accident Insurance Company s Group Medical Bridge offers an HSA compatible plan in most states PA Hospital Confinement Admission benefit replaces the Hospital Confinement benefit THIS POLICY PROVIDES LIMITED BENEFITS EXCLUSIONS We will not pay any benefits for injuries received in accidents or for sicknesses which are caused by contributed to by or occur as a result of the following exclusions and limitations a alcoholism or drug addiction b dental procedures c elective procedures and cosmetic surgery d felonies or illegal occupations e mental or nervous disorders f pregnancy of a dependent child g suicide or injuries which any covered person intentionally does to himself or herself h war or i giving birth within the first nine months after the effective date of the certificate j We will not pay benefits for hospital confinement or daily hospital confinement if included of a newborn child following his birth unless he is injured or sick k The policy may have additional exclusions and limitations which may affect any benefits payable PRE EXISTING CONDITION LIMITATIONS l We will not pay benefits for loss during the first 12 months after the certificate effective date due to a pre existing condition m A pre existing condition is a sickness or physical condition whether diagnosed or not for which a covered person was treated had medical testing received medical advice or had taken medication within the 12 months before the certificate effective date n This limitation applies to the following benefits if applicable Hospital Confinement and Daily Hospital Confinement This information is not intended to be a complete description of the insurance coverage available This coverage has exclusions and limitations that may affect benefits payable For cost and complete details see your Colonial Life benefits counselor This brochure is applicable to policy form GMB7000 P and certificate form GMB7000 C including state abbreviations where applicable such as policy forms GMB7000 P AU TX and GMB7000 P EE TX and certificate forms GMB7000 C AU TX and GMB7000 C EE TX Coverage may vary by state and may not be available in all states This form is not complete without form 101733 Underwritten by Colonial Life Accident Insurance Company Columbia SC 2018 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company GMB7000 PLAN 1 11 18 101917

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Group Hospital Indemnity Insurance Exclusions and Limitations STATE SPECIFIC EXCLUSIONS AK a Replaced by intoxicants and narcotics CA k Additional exclusions include intoxicants and controlled substances CT a Replaced by intoxication or drug addiction d Replaced by felonies f Exclusion does not apply DE a Exclusion does not apply IL a Replaced by alcoholism intoxication or drug addiction f Exclusion does not apply g Exclusion does not apply KS a Replaced by intoxicants and narcotics h Replaced by war or armed conflict i Exclusion does not apply KY a Replaced by intoxicants narcotics and hallucinogenics LA a Replaced by intoxicants and narcotics MI g Exclusion does not apply MO a Replaced by drug addiction d Replaced by illegal activities MS a Replaced by intoxicants and narcotics NC i Exclusion does not apply ND a Exclusion does not apply e Exclusion does not apply NV a Exclusion does not apply OH f Exclusion does not apply i Replaced by 270 days PA a Replaced by intoxicants and narcotics c Replaced by cosmetic surgery e Replaced by mental nervous or emotional disorders h Replaced by war or armed conflict SD a Exclusion does not apply TN f Exclusion does not apply TX a Replaced by intoxicants and narcotics VA i Pregnancy resulting from the rape of any covered person which was reported to the police within seven days following its occurrence will be covered to the same extent as any other covered accident The seven day requirement will be extended to 180 days in the case of an act of rape or incest of a female under 13 years of age STATE SPECIFIC PRE EXISTING CONDITION LIMITATIONS IN SD and WY m applies within the six months before the certificate effective date CA m A pre existing condition is a sickness or physical condition for which a covered person was diagnosed or treated within 12 months before the coverage effective date FL m A pre existing condition is a sickness or physical condition for which a covered person was treated had medical testing received medical advice or had taken medication within six months before the coverage effective date Genetic information is not a pre existing condition in the absence of a diagnosis of the condition related to such information IL m A pre existing condition is a sickness or physical condition whether diagnosed or not for which a covered person was treated had medical testing by a legally qualified physician or received medical advice produced symptoms or had taken medication within 12 months before the coverage effective date KS n Surgical Procedure replaces Outpatient Surgical Procedure ME m A pre existing condition is a sickness or physical condition whether diagnosed or not for which a covered person was treated had medical testing or received medical advice within 12 months before the coverage effective date MI l Applies during the first six months after the certificate effective date m applies within the six months before the certificate effective date MO m A pre existing condition means having a sickness or physical condition whether diagnosed or not for which a covered person was treated had medical testing received medical advice or had taken medication within 12 months before the coverage effective date of this certificate NC m A pre existing condition is those conditions whether diagnosed or not for which a covered person received medical advice diagnosis care or treatment that was received or recommended within the one year period immediately preceding the coverage effective date If you are 65 or older when this certificate is issued preexisting conditions will include only conditions specifically eliminated by a rider ND m A pre existing condition is a sickness or physical condition for which a covered person was treated had medical testing received medical advice or had taken medication within 12 months before the coverage effective date NV m applies within the six months before the certificate effective date Additionally pre existing condition does not include genetic information in the absence of a diagnosis of the condition related to such information OR m A pre existing condition is a sickness or physical condition whether diagnosed or not for which a covered person was treated by a doctor received advice from a physician or had taken medication prescribed by a doctor within the 12 months period immediately preceding the coverage effective date PA m A pre existing condition is a disease or physical condition for which you received medical advice or treatment within 90 days before the coverage effective date n Hospital Confinement Admission replaces Hospital Confinement CA Lic if applicable _________________ This information is not intended to be a complete description of the insurance coverage available This coverage has exclusions and limitations that may affect benefits payable For cost and complete details see your Colonial Life benefits counselor This brochure is applicable to policy form GMB7000 P and certificate form GMB7000 C including state abbreviations where applicable such as policy forms GMB7000 P AU TX and GMB7000 P EE TX and certificate forms GMB7000 C AU TX and GMB7000 C EE TX Coverage may vary by state and may not be available in all states Underwritten by Colonial Life Accident Insurance Company Columbia SC 2018 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company 11 18 101733 2 GMB7000 EXCLUSIONS AND LIMITATIONS

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Deductions per year 12 These rates were prepared on 3 22 2024 and are valid for 90 days Group Accident GAC4100 for TX l Additional Benefits On Off Job Accident Coverage BENEFIT LEVEL AD D BENEFIT LEVEL ISSUE AGE EMPLOYEE Premier Premier 17 99 15 75 Applicable to policy forms GAC4100 P GAC4100 C EMPLOYEE AND SPOUSE 24 56 EMPLOYEE AND DEPENDENT CHILD REN 35 18 EMPLOYEE SPOUSE AND DEPENDENT CHILD REN 44 20 Group Medical Bridge GMB7000 for TX Age Banded l Without Wellbeing Assistance Applicable to Policy Forms GMB7000 P GMB7000 C HOSPITAL CONFINEMENT LEVEL Level 2 1000 ISSUE AGE 17 49 50 59 60 64 65 99 NAMED INSURED 9 50 12 30 17 20 24 10 EMPLOYEE SPOUSE 17 10 24 40 35 80 50 10 ONE PARENT FAMILY 13 55 16 35 21 25 28 15 TWO PARENT FAMILY 21 15 28 45 39 85 54 15 HOSPITAL CONFINEMENT LEVEL Level 4 2000 ISSUE AGE 17 49 50 59 60 64 65 99 NAMED INSURED 18 90 24 50 34 30 48 10 EMPLOYEE SPOUSE 34 00 48 60 71 40 100 00 ONE PARENT FAMILY 26 95 32 55 42 35 56 15 TWO PARENT FAMILY 42 05 56 65 79 45 108 05 Group Critical Illness GCI6000 for TX l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD Non Tobacco Rates ISSUE AGE 15 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 NAMED INSURED 8 90 11 45 14 15 20 15 26 15 36 05 45 80 59 30 79 85 97 25 97 25 NAMED INSURED AND SPOUSE 13 05 16 95 20 85 30 00 39 00 54 30 69 60 90 15 121 35 148 05 148 05 NAMED INSURED AND DEPENDENT CHILD REN 8 90 11 45 14 15 20 15 26 15 36 05 45 80 59 30 79 85 97 25 97 25 NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 13 05 16 95 20 85 30 00 39 00 54 30 69 60 90 15 121 35 148 05 148 05 Underwritten by Colonial Life Accident Insurance Company See page 2 for Important Notice

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Continued Group Critical Illness GCI6000 for TX l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Non Tobacco Rates Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND NAMED INSURED SPOUSE DEPENDENT CHILD REN AND DEPENDENT CHILD REN 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 14 90 20 00 25 40 37 40 49 40 69 20 88 70 115 70 156 80 191 60 191 60 21 60 29 40 37 20 55 50 73 50 104 10 134 70 175 80 238 20 291 60 291 60 14 90 20 00 25 40 37 40 49 40 69 20 88 70 115 70 156 80 191 60 191 60 21 60 29 40 37 20 55 50 73 50 104 10 134 70 175 80 238 20 291 60 291 60 Tobacco Rates ISSUE AGE 15 000 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 NAMED INSURED 12 50 16 70 20 90 30 50 40 10 55 85 71 45 93 05 125 90 153 80 153 80 22 10 30 50 38 90 58 10 77 30 108 80 140 00 183 20 248 90 304 70 304 70 NAMED INSURED AND SPOUSE 18 15 24 45 30 75 45 15 59 70 84 15 108 60 141 60 191 55 234 00 234 00 31 80 44 40 57 00 85 80 114 90 163 80 212 70 278 70 378 60 463 50 463 50 NAMED INSURED AND DEPENDENT CHILD REN 12 50 16 70 20 90 30 50 40 10 55 85 71 45 93 05 125 90 153 80 153 95 22 10 30 50 38 90 58 10 77 30 108 80 140 00 183 20 248 90 304 70 305 00 NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 18 15 24 45 30 75 45 15 59 70 84 15 108 60 141 60 191 55 234 00 234 15 31 80 44 40 57 00 85 80 114 90 163 80 212 70 278 70 378 60 463 50 463 80 Important Notice Insurance coverage has exclusions and limitations that may affect benefits payable For a complete description of benefits limitations and exclusions please refer to an outline of coverage sample policy certificate proposal description or see your Colonial Life benefits counselor Coverage type benefits and rates vary by state Coverage may not be available in all states Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices Colonial Life products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand Underwritten by Colonial Life Accident Insurance Company See page 2 for Important Notice

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Effective Date January 01 2025 Rate Guarantee 24 Months Situs State TX Group Dental Insurance Premier High Plan Employee Dental Insurance Monthly Premium Employee Only Employee Spouse Employee Children Employee Family Employees 25 MAC Plan Benefit Year Maximum CoInsurance Class A Preventive Class B Basic Class C Major Class D Orthodontics Deductible Covered Services Class A Preventive No waiting period 32 70 64 84 78 16 120 16 Minimum Participation 60 of total eligible employees Minimum Hours for Eligibility 30 In Network Applies to Class A B C Services 1 500 per person 100 80 50 50 Applies to Class B C Services 50 per person Maximum 3 per family Out of Network Applies to Class A B C Services 1 500 per person 100 80 50 50 Applies to Class B C Services 50 per person Maximum 3 per family Details Oral evaluations 2 in 12 Months Prophylaxis 2 in 12 Months additional cleaning for verified health conditions Bitewing x rays maximum of 4 films per 12 months Full mouth x rays 1 per 36 months Emergency pain Fluoride children up to age 16 Sealants children up to age 16 Space maintainers Oral cancer screening for ages 40 4 of 21

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Class B Basic No waiting period Class C Major No waiting period Class D Orthodontics No waiting period Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Fillings Posterior composite restorations Simple extractions Surgical extractions General anesthesia in conjunction with complex oral surgery Non surgical periodontics Surgical periodontics Periodontal maintenance in combination with prophylaxis Oral surgery Endodontics Crown denture and bridge repairs Inlays and onlays Crowns Bridges Dentures and Implants Separate lifetime maximum 1 500 This benefit is available only for those dependent children under the age of 19 Orthodontic Refresh Full lifetime maximum is available even if treatment is in progress at time of enrollment Benefits will not be reduced if banded under prior insurance coverage Plan Benefits and Information Rollover Benefit The rollover benefit is determined at the beginning a new benefit year and may be used to pay for Class A B and C services only To qualify for the Rollover benefit in the previous benefit year benefits were paid and the member has at least one cleaning and benefits paid for Class A B and C services did not exceed the rollover threshold If there is a break in coverage for any reason the rollover benefit amount accumulated will be lost The rollover benefit may vary or be unavailable in some states Rollover Threshold 700 Rollover Amount 325 Rollover Maximum 1 300 Takeover Takeover applies if we are taking over a comparable Policy from another carrier For takeover to apply the member must be insured under the prior Policy on the day before the effective date of this Policy Member will receive waiting period credit for covered procedures identified in the Takeover provision of the Certificate of Coverage Takeover is also available for new hires who enroll during open enrollment or due to a qualifying event if they had a comparable Policy there has not been a lapse in coverage and subject to proof Reimbursements In Network The network providers negotiated PPO fee schedule Out of Network Reimbursement is based on network dentists negotiated fees in the same geographic area for the similar services as determined by Pacific Life 5 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Effective Date January 01 2025 Rate Guarantee 24 Months Situs State TX Group Dental Insurance Select Low Plan Employee Dental Insurance Monthly Premium Employee Only Employee Spouse Employee Children Employee Family Employees 25 MAC Plan Benefit Year Maximum CoInsurance Class A Preventive Class B Basic Class C Major Deductible Covered Services Class A Preventive No waiting period 18 28 35 06 45 02 61 80 Minimum Participation 60 of total eligible employees Minimum Hours for Eligibility 30 In Network Applies to Class A B C Services 1 000 per person 100 80 Applies to Class B C Services 50 per person Maximum 3 per family Out of Network Applies to Class A B C Services 1 000 per person 100 80 Applies to Class B C Services 50 per person Maximum 3 per family Details Oral evaluations 2 in 12 Months Prophylaxis 2 in 12 Months additional cleaning for verified health conditions Bitewing x rays maximum of 4 films per 12 months Full mouth x rays 1 per 36 months Emergency pain Fluoride children up to age 16 Sealants children up to age 16 Space maintainers Oral cancer screening for ages 40 7 of 21

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Class B Basic No waiting period Class C Major No waiting period Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Fillings Posterior composite restorations Simple extractions Surgical extractions General anesthesia in conjunction with complex oral surgery Non surgical periodontics Surgical periodontics Periodontal maintenance in combination with prophylaxis Oral surgery Endodontics Crown denture and bridge repairs Implants Plan Benefits and Information Rollover Benefit The rollover benefit is determined at the beginning a new benefit year and may be used to pay for Class A B and C services only To qualify for the Rollover benefit in the previous benefit year benefits were paid and the member has at least one cleaning and benefits paid for Class A B and C services did not exceed the rollover threshold If there is a break in coverage for any reason the rollover benefit amount accumulated will be lost The rollover benefit may vary or be unavailable in some states Rollover Threshold 500 Rollover Amount 250 Rollover Maximum 1 000 Takeover Takeover applies if we are taking over a comparable Policy from another carrier For takeover to apply the member must be insured under the prior Policy on the day before the effective date of this Policy Member will receive waiting period credit for covered procedures identified in the Takeover provision of the Certificate of Coverage Takeover is also available for new hires who enroll during open enrollment or due to a qualifying event if they had a comparable Policy there has not been a lapse in coverage and subject to proof Reimbursements In Network The network providers negotiated PPO fee schedule Out of Network Reimbursement is based on network dentists negotiated fees in the same geographic area for the similar services as determined by Pacific Life 8 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 EXCLUSIONS AND LIMITATIONS We encourage members to request a pre treatment estimate for major services or services that are expected to exceed 300 The Policy contains exclusions and limitations and unless identified in the Schedule of Covered Procedures no benefits will be paid for the following Any service that doesn t meet professionally recognized standards of dental practice or is considered to be experimental Any service on a tooth with a guarded questionable or poor prognosis Any service used solely to alter occlusal vertical dimensions restore or maintain occlusion treat a condition resulting from attrition abrasion erosion or abfraction or splint or stabilize teeth for periodontal reasons Any service provided solely for cosmetic reasons such as teeth whitening characterization or personalization of a dental prosthesis or odontoplasty Replacement of a lost missing or stolen appliance or dental prosthesis or the fabrication of a spare appliance or dental prosthesis Upgrading from one appliance or dental prosthesis to another appliance or dental prosthesis such as replacing a bridge with a dental implant or replacing a denture with a bridge A temporary or provisional appliance or dental prosthesis unless it is an interim partial denture that replaces anterior teeth extracted while this coverage was in place These are the incisor and cuspid teeth located in the front of the mouth Overdentures and related services including root canal therapy on teeth supporting the overdenture Any educational or instructional service such as oral hygiene instruction tobacco counseling or nutritional counseling Bite registration bite analysis or occlusion analysis mounted case Maxillofacial prosthetics to repair facial or skeletal anomalies maxillofacial surgery orthognathic surgery or any oral surgery requiring the setting of a fracture or dislocation that results from or is incidental to a medical condition Any service intended to treat or diagnose disorders of the temporomandibular joint TMJ Charges for implants unless specified in the Covered Procedures and all related procedures removal of implants precision or semi precision attachments denture duplication overdentures and any associated surgery or other customized services or attachments Treatment of malignancies cysts and neoplasms Replacement of 3rd molars Restorations used to restore teeth with micro fractures or fracture lines undermined cusps or large existing restorations without over pathology Other exclusions may apply refer to the Schedule of Covered Procedures for a complete list Multiple restorations on one surface are payable as one surface Multiple surfaces on a single tooth will not be paid as separate restorations During a single visit multiple periapical and bitewing x rays may be paid as a full mouth x ray Alternate Benefit There are multiple options for dental treatment all of which provide acceptable results An alternate benefit may be applied if there is a less expensive Covered Procedure appropriate for the course of treatment capable of producing acceptable results When an Alternate Benefit is applied the less expensive Alternate Benefit is used to determine the amount payable under the certificate 10 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 ADDITIONAL INFORMATION Dependent Children Eligibility varies by state Benefit Annual Maximum The maximum benefit amount available for services depends on the use of In Network and Out of Network dentists Benefits paid for services from an In Network dentist will count toward the maximum amount available for services received from an Out of Network dentist Benefits paid for services from an Out of Network dentist will also count toward the maximum amount available for services received from an In Network dentist Dental Termination We can cancel or modify the Policy at any time for any reason if we provide 75 days written notice We can also decline to renew the Policy on its anniversary for any reason The policyholder may cancel the Policy at any time by submitting written request 45 days prior to the cancellation date Cancellation will take effect the later of the date requested by the policyholder or the date we receive written request of cancellation The policyholder is responsible for payment of premiums for any time the Policy was in place Cancellation will not impact any claims that arise prior to the cancellation date Final rates are subject to home office underwriting verification Pacific Life reserves the right to rerate if final enrollment deviates by 15 and or if participation requirements are not satisfied Dental Policy Form Series PLADNPOL22 and PLADNCERT22 Form numbers provisions and availability may vary by state The state approved form is the governing document Dental policy forms issued in Idaho include PLADNPOL22 and PLADNCERT22 Producer Commission Level 10 11 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Effective Date January 01 2025 Rate Guarantee 48 Months Situs State TX Vision Insurance Group Vision Insurance Classic 16 Powered by EyeMed Classic 16 Employee Vision Insurance Monthly Premiums Employee Only Employee Spouse Employee Children Employee Family 6 56 11 82 12 14 17 40 Employees Eligible for Coverage 25 Minimum Participation Requirement 50 of total eligible employees Minimum Hours for Eligibility 30 Covered Services Exams Diabetic Exam Benefit Frames Eyeglass Lenses Contact Lenses Benefit Frequencies Once Every Calendar Year Once Every 6 Months Once Every Two Calendar Years Once Every Calendar Year Once Every Calendar Year EyeMed Insight Network Members have the freedom to choose any provider with the EyeMed Insight network Our network offers the right mix of independent providers regional retailers and national retailers including LensCrafters Pearle Vision Target Optical Visit pacifilife com vision to search for nearby providers Shop online and stay in network LensCrafters com Glasses com Ray ban com Targetoptical com Contactsdirect com 12 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 Vision Insurance Powered by EyeMed Employee Vision Insurance EXAMS Vision exam includes dilation if necessary Retinal Imaging Diabetic Exam if diagnosed with type 1 or type 2 diabetes Medical follow up Fundus photography Extended opthalmoscopy Gonioscopy Scanning Laser EYEGLASSES Frames Eyeglass Lenses Single vision Bifocal Trifocal Lenticular Standard progressive Premium progressive tier 1 Premium progressive tier 2 Premium progressive tier 3 Premium progressive tier 4 Lens Options Polycarbonate Lenses under age 19 Scratch resistant coating CONTACT LENSES in lieu of eyeglass lenses Elective contacts Non elective contacts Standard contact lens fit follow up Premium contact lens fit follow up 10 copay Up to 39 In Network Covered Covered Covered Covered Covered 130 allowance 20 off balance less allowance 25 copay 25 copay 25 copay 25 copay 90 copay 110 copay 120 copay 135 copay 90 copay 20 off charge less 120 allowance Covered Covered 130 allowance Covered in Full Up to 40 10 discount Out of Network 35 Not covered 73 61 23 23 40 60 40 50 80 80 50 50 50 50 50 32 12 104 300 Not Covered Not Covered 13 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 ADDITIONAL DISCOUNTS Employees and covered family members receive additional discounts when they visit an in network provider including 40 off additional complete pair of prescription eyeglasses 15 off additional conventional contact lenses after benefit has been used 20 off non covered items including non prescription sunglasses 15 off retail or 5 off promotional price for LASIK or PRK from U S Laser Network Also members receive additional savings on non covered lens options at in network providers UV Treatment 15 Tint solid and gradient 15 Adult polycarbonate 40 Anti reflective coating Standard 45 Tier 1 57 Tier 2 68 Photochromic transition plastic lenses 75 Discounts on hearing care through Amplifon hearing health care 64 off hearing aids at thousands of locations nationwide 60 day hearing aid trial period with no restocking fees Free batteries for 2 years with initial purchase Lasik special pricing is not an insured benefit and may not be combined with any other discounts Laser vision correction is an elective procedure performed by specially trained providers Discounts may not be available at all locations Hearing discounts are not an insured benefit are subject to change EXCLUSIONS AND LIMITATIONS Limitations Fees charged by provider for services other than a covered benefit and any local state or federal taxes must be paid in full by the member to the provider Such fees taxes or materials are not covered under the Policy Allowances provide no remaining balance for future use within the same benefit frequency Plan discounts cannot be combined with any other discounts or promotional offers In certain states members may be required to pay the full retail rate and not the negotiated discount rate with certain participating providers Please see online provider locator to determine which participating providers have agreed to the discounted rate Exclusions No benefits will be paid for services or materials connected with or charges arising from medical or surgical treatment services or supplies for the treatment of the eye eyes or supporting structures refraction when not provided as part of a comprehensive eye examination services provided as a result of any Workers Compensation law or similar legislation or required by any governmental agency or program whether federal state or subdivisions thereof orthoptic or vision training subnormal vision aids and any associated supplemental testing Aniseikonic lenses occupational safety eyewear non prescription sunglasses plano non prescription lenses two pair of glasses in lieu of bifocals services rendered after the date an member ceases to be covered under the Policy except when vision materials ordered before coverage ended are delivered and the services rendered to the member are within 31 days from the date of such order lost or broken lenses frames glasses or contact lenses that are replaced before the next benefit frequency when vision materials would next become available Other exclusions may apply see the Certificate of Coverage for a complete list 14 of 21

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Anotech Energy USA Inc Proposal 7 Dental TL Vision Proposal ID P1691093939 ADDITIONAL INFORMATION Dependent Children Dependent children eligibility varies by state Vision Termination We can cancel or modify the Policy at any time for any reason if we provide 75 days written notice We can also decline to renew the Policy on its anniversary for any reason The policyholder may cancel the Policy at any time by submitting written request 45 days prior to the cancellation date Cancellation will take effect the later of the date requested by the policyholder or the date we receive written request of cancellation The policyholder is responsible for payment of premiums for any time the Policy was in place Cancellation will not impact any claims that arise prior to the cancellation date Plan Information Final rates are subject to home office underwriting verification Pacific Life reserves the right to rerate if final enrollment deviates by 15 and or if participation requirements are not satisfied Vision Policy Form Series PLAVIPOL22 and PLAVICERT22 Form numbers provisions and availability may vary by state The state approved form is the governing document Vision Policy Form issued in Idaho include PLAVIPOL22 ID and PLAVICERT22 ID Producer Commission Level 10 15 of 21

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HEALTH SAVINGS ACCOUNT HSA An HSA is a tax exempt savings account you establish exclusively for the purpose of paying for qualified medical expenses HSAs are only available to individuals who are enrolled in a High Deductible Health Plan HDHP HSA dollars can be used to pay for medical and prescription drug expenses that are applied toward deductibles over the counter medications if purchased with a prescription and noncovered medical dental and vision expenses all subject to IRS guidelines HSA dollars may only be used for expenses incurred while covered under an HDHP and after your HSA Bank account is opened Here s How an HSA Works START IT BUILD IT USE IT GROW IT KEEP IT After you enroll in the HSA Plan you need to set up your account through HSA Bank Visit www hsabank com to get started Your contributions to your HSA are pre tax through payroll contributions limits apply You can change the amount you contribute at any time You can use the money in your HSA to pay for covered health care for you and your qualified dependents like the deductible and coinsurance Withdrawals from your HSA for qualified medical expenses are also tax free Unused money in your account will roll over to the next year Your account will earn interest and grow over time You always own the money in your HSA including any interest and other investment earnings You can take the account with you if you are no longer employed by the company Contributing and Using HSA Funds You can contribute to your HSA up to the 2024 IRS limits Those limits are as follows Employee Only Coverage 4 150 All Other Levels of Coverage 8 300 Age 55 and older can contribute an extra 1 000 in catch up contributions All the money in your account is yours to spend on qualified health care expenses or to save for future expenses Remember you may not use HSA funds to reimburse expenses incurred prior to your HSA being opened or expenses incurred prior to being enrolled in a High Deductible Health Plan HDHP Changing Your Contributions Once you establish your HSA you can change your contributions at any time during the year This flexibility enables you to contribute as much as your budget allows up to the annual maximums listed above and adjust your contributions to fit your household budge t throughout the year When can you access your funds Funds are made available as you contribute to your account on a per pay period basis KEEP YOUR RECEIPTS Since your HSA is tax advantaged it is subject to IRS regulations and a possible audit 6

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FLEXIBLE SPENDING ACCOUNTS FSA Flexible Spending Accounts FSAs allow you to have money deducted from your paycheck on a pre tax basis to pay for certain unreimbursed medical expenses and dependent care costs Since contributions are made through payroll deductions with pre tax dollars you decrease your taxable income and increase your take home pay by taking advantage of this benefit Anotech offer s two types of accounts a Health Care FSA and a Dependent Care FSA Your FSA elections do not roll over You must re enroll each year during open enrollment Healthcare FSA Dependent Care FSA A Health Care FSA pays for the uncovered or unreimbursed portions of qualified medical expenses Using pre tax payroll contributions you can receive reimbursement from your Health Care FSA for eligible medical dental and vision expenses incurred by you or an eligible dependent as long as the expenses are not covered or reimbursed by other plans If you elect the Health Care FSA you will receive a debit card to pay for medical expenses at the point of service Please be sure to obtain itemized receipts for all services paid for by the debit card You may be required to submit them to WEX to validate if your purchase is eligible under the plan Only office visit copayments prescription drug copayments and over the counter medicines or supplies purchased from a vendor that has completed the IRS validation process will not require receipts Note The FSA is for those enrolled in the Premium or Mid PPO medical plans If you elect the High Deductible Health plan you are NOT eligible for the Health Care FSA A Dependent Care FSA pays for daycare for eligible dependents You decide how much to contribute up to 5 000 per year per household combined To be eligible to use the account you and your spouse if married must work outside the home You may claim dependent care expenses for a dependent that lives with you and relies on you for more than half of his or her financial support You must also claim the person as a dependent on your federal income tax return Eligible dependents include your legal dependent children spouse or parents Maximum Contribution Amounts The maximum amount that you may contribute to your Dependent Care FSA is 5 000 per plan year There is no carry over of funds associated with the Dependent Care FSA so again estimate your needs conservatively Maximum Contribution Amounts The maximum amount you may contribute to your Healthcare FSA is 3 200 per plan year When can you access your funds Funds are made available as you contribute to your account on a per pay period basis When can you access your funds Funds are available at the beginning of the plan year 7 Message

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HSA FSA COMPARISON HSA Account Funded By Employee through pre tax payroll deductions Health Care FSA Employee through pre tax payroll deductions Dependent Care FSA Employee through pre tax payroll deductions Enrollment Integrated with Medical Plan Yes No No Contribution Limits Up to 4 150 for individual coverage and 8 300 for family coverage 55 and older additional 1 000 catch up allowance 3 200 5 000 Can Be Used To Pay For Qualified Health Care Expenses Yes cannot be enrolled in the FSA Yes cannot be enrolled in the HSA No can only be used to pay for qualified child adult care expenses Can Be Used To Pay For Copayments And Coinsurance Debit Card Online Bill Pay Funds RollOver From Year To Year Funds Availability Yes Yes No Yes Yes No Yes Yes No Yes No No All funds in the account are available once they are deposited accrued All funds are available on the first day of the plan year All funds in the account are available once they are deposited accrued Portability All deposits belong to employee immediately Unused FSA dollars remain in the account until the end of the plan year or until your employment ends Unused FSA dollars remain in the account until the end of the plan year or until your employment ends Time Limit On Reimbursement No time limit for reimbursement of qualified medical expenses Expenses must be incurred in 2024 and be filed by March 31 2025 Expenses must be incurred in 2024 and be filed by March 31 2025 Use It Or Lose It Rule Applies No your funds are yours to keep Yes you will forfeit any funds Yes you will forfeit any funds and use the following year even leftover in the account at the end leftover in the account at the end if you leave the company of the plan year of the plan year 8

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LIFE ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Employer Paid Life and AD D New York Life Basic Life and AD D Benefits Employee Life and AD D Your employer provides Basic Life and AD D coverage in the amount of 1x salary up to 100 000 at no cost to you Voluntary Life and AD D For an added layer of income protection you have the opportunity to purchase Life and AD D Insurance for yourself and your covered dependents You must enroll yourself in coverage in order to enroll your spouse and or children Benefits reduce by age New York Life Voluntary Life Benefits Employee Life and AD D You can purchase units of 10 000 to a maximum of 5x salary up to 500 000 Guarantee Issue 150 000 for new hires only Spouse Life and AD D You may elect units of 5 000 to a maximum of 500 000 not to exceed 100 of the employee s election Guarantee Issue 25 000 for new hires only Child ren Life Birth to 6 months 1 000 benefit 6 months to age 26 Flat 10 000 One election covers all dependent children at the elected benefit level All child amounts are Guarantee Issue No Evidence of Insurability is required Evidence of Insurability EOI is also known as proof of good health It is a document that must be filled out and submitted confirming your state of health EOIs are administered and approved by New York Life After your initial new hire eligibili ty period EOI must be completed for any requested increase in your life insurance benefit Disability Without disability coverage you and your family may struggle to get by if you miss work due to an injury or illness Employees are given both short and long term disability income benefits at no cost to you New York Life Short Term Disability Weekly Benefit 60 of your basic weekly earnings Benefit Maximum 2 500 per week Elimination Period 7 days for injury or sickness Maximum Benefit Duration New York Life Monthly Benefit Up to the earlier of 13 weeks or whenever LTD benefits begin Long Term Disability 60 of your basic monthly earnings Benefit Maximum 10 000 per month Elimination Period 90 days Maximum Benefit Duration As long as you remain disabled or to Social Security Normal Retirement Age whichever is shorter Pre existing Conditions A pre existing condition means a sickness or injury for which you have received treatment within 3 months prior to your effective date Any disability contributed to or caused by a pre existing condition within the first 12 months of your effective date will not be covered 13

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ADDITIONAL BENEFITS Employee Assistance Program EAP When it is difficult to cope with family work related personal or substance abuse problems at work and at home we often turn to family or friends for support Sometimes you need the ear of an experienced professional one who will keep your concerns confidential and help guide you in the right direction One set price regardless of the pet s age The best deal anywhere an average savings of 40 over similar plans from other pet insurers A wellness plan option that includes spay neuter preventive dental cleaning and more Enrollment is Easy You can call the EAP toll free during standard operating hours or 24 7 in an emergency situation When you call you ll be connected Call 877 738 7874 to talk to a helpful representative or Go to www PetsNationwide com to get started to a consultant You can also log on to guidanceresources com to find basic information on a number of services LegalShield and IDShield Protect yourself with the most powerful comprehensive identity With the EAP you ll receive theft protection available today Because your digital and financial Counseling to address your specific needs identity are at constant risk you need constant protection Unlimited telephonic consultation Limited in person appointments LegalShield Plan Features Help with care giving Dedicated Law Firm Direct access no call center Special needs Legal Advice Consultation on unlimited personal issues Adult dependent care Letters Calls made on your behalf Sickness and care giving Contracts Documents Reviewed up to 15 pages Parenting information Adoption Residential Loan Document Assistance for the purchase of your primary residence Child development Will Preparation will living will health care power of attorney Parenting skills Contact the EAP Phone 800 344 9752 Website guidanceresources com Web ID NYLGBS Speeding Ticket Assistance 15 day waiting period IRS Audit Assistance begins with the tax return due April 15th of the year you enroll Trial Defense if named defendant respondent in a covered civil action suit Uncontested Divorce Separation Adoption and or Name 401 k Plan Change Representation available 90 days after enrollment 25 Preferred Member Discount bankruptcy criminal The 401 k plan is administered through Fidelity and allows you to charges DUI personal injury etc save money that is tax deferred Your 401 k enrollment is separate 24 7 Emergency Access for covered situations from the enrollment of the rest of your benefits Contact Fidelity at 1 800 835 5097 for more information IDShield Plan Features Features of the Plan New hires are eligible to enroll the first day of the month after date of hire All new employees will receive a Fidelity packet in the mail with plan documents and login instructions Go to www 401k com to manage your benefits You can contribute 1 to 90 of your eligible pre tax pay You can borrow the lesser of 50 of your vested account balance High Risk Application and Transaction Monitoring can detect fraud up to 90 days earlier than credit monitoring services Social Medial Monitoring for privacy concerns and reputational risks Credit Monitoring continuous credit monitoring Monthly Score Tracker watch your credit score and map your credit trends Consultation on any cyber security question 1 Million Insurance coverage for lost wages legal defense or 50 000 The minimum amount you may borrow is 1 000 fees stolen funds and more Loan repayments plus interest to your plan account are automatically deducted from your pay through after tax deductions Full Service Restoration Unlimited Service Guarantee We don t give up until your identity is restored 24 7 Emergency Access in the event of an identity theft emergency Pet Insurance Plan You care about your pets and consider them members of your family So whether your family includes kids with two feet or kids with four paws or both you know what responsibility looks like So why not give your pets the best health care available The My Pet Protection suite of pet insurance plans is composed of the only plans specifically designed for employees and gives you superior protection at an unbeatable price featuring 90 back on vet bills Exclusivity unavailable to the general public 14

Anotech Energy USA Inc Benefit G

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