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YOUR HEALTH YOUR WAY 2023 2024 BENEFITS ENROLLMENT GUIDE BENEFITS We will be offering Short Term Disability Accident Critical Illness Cancer Hospital Confinement and Life Insurance as benefits of your Employment AArraannsassas County Human Resources 2840 Highway 35 N Rockport Tx 78382 361 790 0135 Our Role Eablikd i 192 GSM I i ladi p i amlQagkalzdi a Human Resources HR serves as a and retain quality employees partner to departments with the This includes utilizing a organization to provide advice competitive compensation and support and recommendations to benefits package and a effectively utilize and manage the recommending short term and County s most valuable asset its long term human resource people HR s strategic role is to management provide department heads and elected officials a means to attract ENROLLMENT We will be working with Colonial Benefits this year to provide you with the best enrollment experience possible WHAT TO EXPECT You will be able to complete your enrollment on August 17th and 18th

_________T__h__e__A__r_a__n_s__a__s__C__o__u_n__t_y_______ __ The Aransas County thrives on balance balancing professional and personal worlds balancing work and rest while always balancing cost and value We also understand that balance must be individualized What is right for one person may not be appropriate for another It is our goal to offer choices allowing you to tailor your benefits plan specifically to what is best for you and your family members Your Choices T_h_e_ Aransas County provides a complete package of benefits aimed at providing flexible insurance protection and programs to meet your ever changing needs _T_h_e Aransas County shares the cost of some benefits with you while making additional benefits available that you pay for if you choose to enroll The part of the benefit costs that you are responsible for will be automatically deducted from your paycheck either before or after your taxes are calculated Benefit Voluntary Life Insurance Short Term Disability Critical Illness Pre Tax or Post Tax Post Tax Post Tax Post Tax Who pays the cost Employee Employee Employee Accident Insurance Hospital Insurance Post Tax Post Tax Employee Employee Why do I pay for some benefits with before tax money While not all benefits qualify for pre tax contribution there is a definite advantage to paying for those that do Taking the money out before your taxes are calculated lowers the amount of your taxable income Therefore you pay less in taxes ____________________________ How Your Benefits Work Full time employees are eligible for most benefits on first of the month following the date of hire Making Changes Generally you can only change your benefits choices during the annual Benefits Enrollment Period However you can change your benefits choices during the year if you have a life event change Life event changes include but are not limited to Marriage Divorce Birth adoption or placement for adoption of an eligible child Death of your spouse or covered child Change in you or your spouse s work status that results in cancellation of your benefits Becoming eligible for Medicare or Medicaid during the year If you have a life event change you must notify Human Resources within 31 days of the change for example a marriage or birth certificate If you do not notify Human Resources within 31 days you will have to wait until the next annual Open Enrollment period to make benefits changes unless you have another life event change Any changes you make to your benefit choices must be directly related to the life event change

Portability If you leave the company some of your benefits end and some of your benefits are portable This means you can take them with you if you leave as long as you continue to pay the premiums yourself Once terminated you will be notified through the mail if any of your benefits are portable When Coverage Ends Benefits end on the last day of the month following termination or when you cease to meet eligibility guidelines Continuing Your Coverage Under certain circumstances you may continue your health care coverage when it would otherwise end This is called _______C__o_b_ra________ _________C_o_b_r_a_________ applies to these plans Health Insurance Dental Insurance Vision Insurance When can I continue coverage under _________C_ob_ra_________ You and or your dependents are eligible to continue health care coverage under __________C_o_b_r_a__________ If coverage is lost because Your employment ends for any reason other than gross misconduct Your work hours are significantly reduced You die You become entitled to and enroll in Medicare prior to losing coverage You divorce or become legally separated from your spouse Your dependent loses dependent status NOTES _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ Looking ahead Now let s look at each benefit that makes up the The Aransas County benefits program In the following pages you ll learn more about the valuable benefits your employer offers You ll also see how choosing the right combination of benefits can help protect you and your family s health

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IndividualShort Term DisabilityInsurance ColonialLife com Youneverknowwhenadisabilitycouldimpactyourwayoflife Fortunately there sawaytohelpprotectyourincome Ifacoveredaccidentorsickness preventsyoufromearningapaycheck disabilityinsurancecanprovidea monthlybenefittohelpyoucoveryourongoingexpenses Canyoua ordtonotprotectyourincome Youdon thavethesamelifestyleexpensesasthenextperson That swhyyouneed disabilitycoveragethatcanbecustomizedtofityourspecificneeds Aercalculatingyourmonthlyexpenses yourbenefitscounselorcanhelpyou completethebenefitsworksheet 1 Rentormortgage MONTHLYEXPENSES Roundtothenearesthundred 2 Transportation 3 Utilities phone internet electricity gas water etc 4 Foodandnecessities 5 Otherexpenses Totalmonthlyexpenses addlines1 5together Benefitsworksheet HowmuchcoveragedoIneed Monthlybenefitamountforo jobaccidentando jobsickness ______________ Chooseamonthlybenefitamountbetween 400and 6 500 Ifyourplanincludeson jobaccident sicknessbenefits thebenefitis50 oftheo jobamount Whatisthebenefitperiod Benefitperiod _______months Thepartialdisabilitybenefitperiodisthreemonths Whenmaymytotaldisabilitybenefitsstart Aeranaccident _______days Aerasickness _______days Subjecttoincomerequirements ISTD3000 BASE

Productinformation Totaldisabilitydefinition Totallydisabledortotaldisabilitymeansyouare unabletoperformthematerial andsubstantialdutiesofyouroccupation not infact workingatanyoccupation andundertheregularandappropriatecareofaphysician Howpartialdisabilityworks Ifyouareabletoreturntoworkparttimeaeratleast14daysofbeingpaidfora totaldisability youmaybeabletostillreceive50 ofyourtotaldisabilitybenefit Waiverofpremium Wewillwaiveyourpremiumpaymentsaer90consecutivedaysofa covered disability Geographicallimitations IfyouaredisabledwhileoutsideoftheUnitedStates CanadaorMexico youmay receivebenefitsforupto60daysbeforeyouhavetoreturntotheU S inorderto continue receiving benefits Issue age Coverage is available from ages 17 to 74 Keepyourcoverage Youcankeepyourcoveragetoage75atnoadditionalcost evenifyouchange jobs aslongasyoupayyourpremiumswhentheyaredue Formoreinformation talkwithyourbenefitscounselor EXCLUSIONSANDLIMITATIONS Wewillnotpaybenefitsforlossesthatarecausedby contributedtobyoroccurastheresultof cosmeticsurgery felonies orillegaloccupations flying hazardousavocations intoxicantsandnarcotics mentalornervousdisorders racing semi professionalorprofessionalsports substanceabuse suicideorinjurieswhichyouintentionallydotoyourself war orarmedconflict Wewillnotpayforlossesduetoyougivingbirthwithinthefirstninemonthsaerthecoverageeective dateofthepolicy Wewillnotpayforlosswhenthedisabilityisapre existingconditionasdescribedinthepolicy Pre existingconditionmeansasicknessorphysicalcondition whetherdiagnosedornot forwhichyouweretreated hadmedicaltesting receivedmedicaladviceorhadtakenmedicationwithin12monthsbeforethepolicycoverage eectivedateshownonthepolicyschedule A erthispolicyhasbeeninforcefor12months six 6 monthsifyouareage65orolderonthepolicycoverageeective date fromthepolicycoverageeectivedateshownonthepolicyschedule wewillpaybenefitsforanypre existing conditionnotexcludedbynameorspecificdescriptionifthecovereddisabilitybeganatleast12months six 6 monthsifyouareage65orolderonthePolicyCoverageEectiveDate aerthepolicycoverageeectivedate andtheeliminationperiodhasbeensatisfied Forcostandcompletedetails seeyourColonialLifebenefitscounselor ApplicabletopolicyformISTD3000 TXandrider formISTD3000 ADIB TX Thisisnotaninsurancecontractandonlytheactualpolicyandriderprovisionswillcontrol UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2019ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 10 19 101629 3 TX

AccidentInsurance Preferred Plan Youneverexpectanaccidenttohappen Butifitdoes yourfocusshouldbe onrecovery notmedicalbills ColonialLifeaccidentinsurancecanhelpcover medicalcosts Whethertheaccidentisassimpleasacuthandfromafalloras complexasacaraccident youcancountonustosupportyou OUR COVERAGE INCLUDES Benefitspayable directly to you Nomedicalquestions toqualifyforcoverage Coverageforsimple andcomplexinjuries Benefitspayable regardlessofother insurance Worldwidecoverage Keepcoverageno matterwhereyougo Worksalongsideyour health savings account HSA Allofthiscanhelpyouget backonyourfeet M ilowasrunningontheplaygroundwhen he tripped and injured his hand URGENT CARE CENTER VISIT Milowenttoanurgentcarecenter andreceivedimmediatecare DIAGNOSTIC PROCEDURE ThedoctororderedanX ray and discovered Milo had fractured his hand LACERATION ThedoctoralsofoundthatMilo hadacutonhishand MEDICALEQUIPMENT Milowasdischargedwithasplint DOCTORS OFFICE VISIT Overthenextseveralweeks hehadthreefollow up appointmentswithhisdoctor MILOSBENEFITS WithColonialLifeaccidentbenefits Milo s parentswereabletopaytheannual deductibleandco payments Accidentemergencytreatment 125 X ray 30 Laceration no stitches 30 Fracture hand 375 Medicalequipment splint 30 Accidentfollow uptreatment 3 visits 165 Total 755 Forillustrativepurposesonly Benefitamountsmayvaryandmaynotcoverallexpenses Thepolicyhasexclusionsandlimitations IAC4000 PREFERRED PLAN

Olivia w asdriving to the store w hen she gotinto a caraccident AMBULANCEANDEMERGENCY ROOM VISIT Oliviaarrivedbyambulancetothenearest emergencyroomandreceivedimmediatecare DIAGNOSTIC PROCEDURES ThedoctororderedanX rayanddiscovered Oliviahadfracturedherthigh femur He alsoorderedaCTscanofherheadtocheck forbraininjury HOSPITALADMISSION CONFINEMENTANDSURGERY Oliviawasadmittedtothehospitalforsurgery onherleg Shewasconfinedforthreedays PHYSICALTHERAPY Oliviahadeightsessionsofphysicaltherapyto helpregainthestrengthinherleg DOCTORS OFFICE VISITS Overthenextseveralweeks shehadsix follow upappointmentswithherdoctor OLIVIA S BENEFITS Olivia saccidentbenefitshelpedcoverher annualdeductibleandco payments Ambulance 200 Accidentalinjuryduetoan automobileaccident 250 Accidentemergencytreatment 125 X ray 30 Medicalimagingstudy CT 200 Hospitaladmission 1 000 Hospitalconfinement 3days 750 Thighfracture femur surgical 4 400 Surgery exploratory arthroscopic 300 Medicalequipment crutches Accidentfollow uptreatment 6 visits Physicaltherapy 8days 100 330 280 Total 7 965 Forillustrativepurposesonly Benefitamountsmayvaryandmaynotcoverallexpenses Thepolicyhasexclusionsandlimitations Benefitsarepercoveredpersonpercoveredaccidentunlessstatedotherwise INITIAL CARE Accidentemergencytreatment 125 Hospitalemergencyroom urgentcarefacilityorphysician so ice Accidentalinjuryduetoanautomobileaccident 250 Airambulance1 2 000 Ambulance groundorwater1 200 Observationroom uptotwodayspercalendaryear 150perday X ray 30 COMMONACCIDENTALINJURIES Burn based on size and degree 1 000 12 000 Burn skingra 50 ofapplicableburnbenefit Coma lastingforsevenormoreconsecutivedays 12 500 Concussion 150 Dislocation separated joint Non surgical repair 100 2 250 Incompletedislocation ordislocationwithoutanesthesia 25 ofbenefit Examples elbow 500 ankle 1 000 knee 1 125 hip 2 250 Surgical repair 200 4 500 Examples elbow 1 000 ankle 2 000 knee 2 250 hip 4 500 Emergencydentalwork 100 300 Dentalextractionordentalcrown dentureorimplant Eyeinjury withsurgicalrepairorremovalofaforeignobject 300 Fracture complete Non surgical repair 250 3 000 Chipfracture 25 ofbenefit Examples hand 375 foot 375 collarbone 625 leg 1 000 Surgical repair 500 6 000 Examples hand 750 foot 750 collarbone 1 250 leg 2 000 Hearing lossinjuries2 120 Kneecartilage torn withsurgicalrepair 650 Laceration basedonrepairandlength 30 600 Ruptureddisc withsurgicalrepair 750 Tendon ligament rotatorcu withsurgicalrepair One 650 Twoormore 1 300 HOSPITAL CARE Hospitaladmission 1 000 Hospitalconfinement upto365days 250perday Hospitalsub acuteintensivecareunitconfinement upto30days 325perday Intensivecareunitadmission 2 000 Intensivecareunitconfinement upto15days 450perday SURGICAL CARE Blood plasma platelets transfusion 300 Surgery basedontypeofrepairandsurgery 200 1 500

TRANSPORTATION LODGING Transportationforhospitalconfinement 600perroundtrip uptothreeroundtrips 50 milesfromhome Lodging companion upto30days 125perday FOLLOW UP CARE Accidentfollow uptreatment includingtransportation telemedicine 55 uptosixbenefitspercoveredpersonpercoveredaccidentand upto12benefitspercoveredpersonpercalendaryear Medicalequipment Tier1 30 Armsling cane medicalringcushion neckbraceorwrist anklesplint Tier2 100 Bedsidecommode coldtherapysystem cryotherapy crutches legbrace showerchair walkerorwalkingboot Tier3 200 Backbrace bodyjacket continuouspassivemovement CPM halo electricscooter hospitalbed includingrental kneescooter stairlichair wheelchair Medicalimagingstudy CT CATscan EEG EMG MRorMRI 200 onepercalendaryear Painmanagementforepiduralanesthesia non surgical 100 Post traumaticstressdisorder PTSD 200 Prostheticdevice artificiallimb One 750 Morethanone 1 500 Repair replacement3 375 750 Rehabilitationunitconfinement 150perday upto15days nottoexceed30dayspercalendaryear Therapy occupational physicalorspeech uptotendays 35perday ACCIDENTALDISMEMBERMENT Accidentaldismemberment 4504 20 000 Loss lossofuseorparalysis hand arm foot leg sightofeye Loss lossofuse finger toe partialdismembermentoffingerortoe Accidentaldismembermentduetoacatastrophicaccident Namedinsured spouseorchild 25 0005 Totalandirrecoverableloss lossofuseorparalysis 180 dayeliminationperiod Bothhands arms feet legsorthesightofbotheyes oranycombination or Lossofhearinginbothears orlossofabilitytospeak ACCIDENTAL DEATH Accidentaldeath Namedinsured spouse 40 000 Child 10 000 Accidentaldeathcommoncarrier Examplesofcommoncarriersaremasstransittrains busesandplanes Namedinsured spouse 160 000 Child 30 000 Formoreinformation talkwithyour benefits counselor IAC4000 PREFERRED PLAN

ColonialLife com 1InNevada airambulanceorambulance Wewillpaythisbenefitdirectlytotheproviderunlesstheairambulanceorambulancebill showsthatallchargeshavebeenpaidinfull 2Onebenefitforeachinjuredearpercoveredpersonperlifetime 3Onerepairorreplacementperprostheticdevice artificiallimbpercoveredpersonperlifetime 4InMaine accidentaldismembermentrangeisaccurate Minimumbenefitforfulldismembermentoffingerortoeis 1 000 5Payableonceperlifetimepercoveredperson HEALTHSAVINGSACCOUNT HSA COMPATIBLE ThisplaniscompatiblewithHSAguidelinesandanyotherHSAplaninwhichacoveredfamilymembermayparticipate ItmayalsobeoeredtoemployeeswhodonothaveHSAs THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONS Wewillnotpaybenefitsforlossesthatarecausedby contributedtobyoroccurastheresultofacoveredpersons feloniesorillegaloccupations hazardousavocations racing semi professionalorprofessionalsports sickness suicide orinjurieswhichanycoveredpersonintentionallydoestohimself warorarmedconflict Inaddition wewillnotpay AccidentalDismembermentDuetoCatastrophicAccidentbenefitsforinjuriesachildsustainsduringbirth orforinjuries thataretheresultofintoxicationoruseofnarcotics StateVariationsforExclusionsandLimitations IL Notapplicableto hazardousavocations racing semi professionalorprofessionalsports MT Notapplicableto suicideorinjurieswhichyouintentionallydotoyourselfandinjuriesachildsustainsduringbirth OK Notapplicableto hazardousavocations racingandsemi professionalorprofessionalsports ForAccidental DismembermentDuetoCatastrophicAccidents replace injuriesachildsustainsduringbirth orforinjuriesthatarethe resultofintoxication with alcoholismordrugaddiction ornarcotics UT Alsoincludes aviation Notapplicableto hazardousavocations racing semi professionalorprofessionalsports Thisinformationisnotintendedtobeacompletedescriptionoftheinsurancecoverageavailable Thiscoveragehas exclusionsandlimitationsthatmayaectbenefitspayable Forcostandcompletedetails seeyourColonialLifebenefits counselor ThisbrochureisapplicabletopolicyformsIAC4000 plusstateabbreviationswhereapplicable suchas IAC4000 TX Coveragemayvarybystateandmaynotbeavailableinallstates Premiumwillvaryaccordingtothefamily coverage type UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2019ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 8 19 101776 2

AccidentInsurance Prem ierPlan Youneverexpectanaccidenttohappen Butifitdoes yourfocusshouldbe onrecovery notmedicalbills ColonialLifeaccidentinsurancecanhelpcover medicalcosts Whethertheaccidentisassimpleasacuthandfromafalloras complexasacaraccident youcancountonustosupportyou OUR COVERAGE INCLUDES Benefitspayable directly to you Nomedicalquestions toqualifyforcoverage Coverageforsimple andcomplexinjuries Benefitspayable regardlessofother insurance Worldwidecoverage Keepcoverageno matterwhereyougo Worksalongsideyour health savings account HSA Allofthiscanhelpyouget backonyourfeet M ilowasrunningontheplaygroundwhen he tripped and injured his hand URGENT CARE CENTER VISIT Milowenttoanurgentcarecenter andreceivedimmediatecare DIAGNOSTIC PROCEDURE ThedoctororderedanX ray and discovered Milo had fractured his hand LACERATION ThedoctoralsofoundthatMilo hadacutonhishand MEDICALEQUIPMENT Milowasdischargedwithasplint DOCTORS OFFICE VISIT Overthenextseveralweeks hehadthreefollow up appointmentswithhisdoctor MILOSBENEFITS WithColonialLifeaccidentbenefits Milo s parentswereabletopaytheannual deductibleandco payments Accidentemergencytreatment 150 X ray 40 Laceration no stitches 30 Fracture hand 425 Medicalequipment splint 30 Accidentfollow uptreatment 3 visits 195 Total 870 Forillustrativepurposesonly Benefitamountsmayvaryandmaynotcoverallexpenses Thepolicyhasexclusionsandlimitations IAC4000 PREMIERPLAN

Olivia w asdriving to the store w hen she gotinto a caraccident AMBULANCEANDEMERGENCY ROOM VISIT Oliviaarrivedbyambulancetothenearest emergencyroomandreceivedimmediatecare DIAGNOSTIC PROCEDURES ThedoctororderedanX rayanddiscovered Oliviahadfracturedherthigh femur He alsoorderedaCTscanofherheadtocheck forbraininjury HOSPITALADMISSION CONFINEMENTANDSURGERY Oliviawasadmittedtothehospitalforsurgery onherleg Shewasconfinedforthreedays PHYSICALTHERAPY Oliviahadeightsessionsofphysicaltherapyto helpregainthestrengthinherleg DOCTORS OFFICE VISITS Overthenextseveralweeks shehadsix follow upappointmentswithherdoctor OLIVIA S BENEFITS Olivia saccidentbenefitshelpedcoverher annualdeductibleandco payments Ambulance 300 Accidentalinjuryduetoan automobileaccident 250 Accidentemergencytreatment 150 X ray 40 Medicalimagingstudy CT 250 Hospitaladmission 1 500 Hospitalconfinement 3days 900 Thighfracture femur surgical 6 000 Surgery exploratory arthroscopic 300 Medicalequipment crutches Accidentfollow uptreatment 6 visits Physicaltherapy 8days 150 390 320 Total 10 550 Forillustrativepurposesonly Benefitamountsmayvaryandmaynotcoverallexpenses Thepolicyhasexclusionsandlimitations Benefitsarepercoveredpersonpercoveredaccidentunlessstatedotherwise INITIAL CARE Accidentemergencytreatment 150 Hospitalemergencyroom urgentcarefacilityorphysician so ice Accidentalinjuryduetoanautomobileaccident 250 Airambulance1 2 000 Ambulance groundorwater1 300 Observationroom uptotwodayspercalendaryear 150perday X ray 40 COMMONACCIDENTALINJURIES Burn based on size and degree 2 000 18 000 Burn skingra 50 ofapplicableburnbenefit Coma lastingforsevenormoreconsecutivedays 15 000 Concussion 200 Dislocation separated joint Non surgical repair 125 2 500 Incompletedislocation ordislocationwithoutanesthesia 25 ofbenefit Examples elbow 600 ankle 1 250 knee 1 250 hip 2 500 Surgical repair 250 5 000 Examples elbow 1 200 ankle 2 500 knee 2 500 hip 5 000 Emergencydentalwork 200 600 Dentalextractionordentalcrown dentureorimplant Eyeinjury withsurgicalrepairorremovalofaforeignobject 400 Fracture complete Non surgical repair 275 3 750 Chipfracture 25 ofbenefit Examples hand 425 foot 425 collarbone 750 leg 1 250 Surgical repair 550 7 500 Examples hand 850 foot 850 collarbone 1 500 leg 2 500 Hearing lossinjuries2 120 Kneecartilage torn withsurgicalrepair 750 Laceration basedonrepairandlength 30 600 Ruptureddisc withsurgicalrepair 1 250 Tendon ligament rotatorcu withsurgicalrepair One 750 Twoormore 1 500 HOSPITAL CARE Hospitaladmission 1 500 Hospitalconfinement upto365days 300perday Hospitalsub acuteintensivecareunitconfinement upto30days 400perday Intensivecareunitadmission 2 500 Intensivecareunitconfinement upto15days 500perday SURGICAL CARE Blood plasma platelets transfusion 500 Surgery basedontypeofrepairandsurgery 250 1 500

TRANSPORTATION LODGING Transportationforhospitalconfinement 700perroundtrip uptothreeroundtrips 50 milesfromhome Lodging companion upto30days 150perday FOLLOW UP CARE Accidentfollow uptreatment includingtransportation telemedicine 65 uptosixbenefitspercoveredpersonpercoveredaccidentand upto12benefitspercoveredpersonpercalendaryear Medicalequipment Tier1 30 Armsling cane medicalringcushion neckbraceorwrist anklesplint Tier2 150 Bedsidecommode coldtherapysystem cryotherapy crutches legbrace showerchair walkerorwalkingboot Tier3 300 Backbrace bodyjacket continuouspassivemovement CPM halo electricscooter hospitalbed includingrental kneescooter stairlichair wheelchair Medicalimagingstudy CT CATscan EEG EMG MRorMRI 250 onepercalendaryear Painmanagementforepiduralanesthesia non surgical 150 Post traumaticstressdisorder PTSD 200 Prostheticdevice artificiallimb One 1 000 Morethanone 2 000 Repair replacement3 500 1 000 Rehabilitationunitconfinement 200perday upto15days nottoexceed30dayspercalendaryear Therapy occupational physicalorspeech uptotendays 40perday ACCIDENTALDISMEMBERMENT Accidentaldismemberment 600 30 000 Loss lossofuseorparalysis hand arm foot leg sightofeye Loss lossofuse finger toe partialdismembermentoffingerortoe Accidentaldismembermentduetoacatastrophicaccident Namedinsured spouseorchild 25 0004 Totalandirrecoverableloss lossofuseorparalysis 180 dayeliminationperiod Bothhands arms feet legsorthesightofbotheyes oranycombination or Lossofhearinginbothears orlossofabilitytospeak ACCIDENTAL DEATH Accidentaldeath Namedinsured spouse 50 000 Child 15 000 Accidentaldeathcommoncarrier Examplesofcommoncarriersaremasstransittrains busesandplanes Namedinsured spouse 200 000 Child 45 000 Formoreinformation talkwithyour benefits counselor IAC4000 PREMIERPLAN

ColonialLife com 1InNevada airambulanceorambulance Wewillpaythisbenefitdirectlytotheproviderunlesstheairambulanceorambulancebill showsthatallchargeshavebeenpaidinfull 2Onebenefitforeachinjuredearpercoveredpersonperlifetime 3Onerepairorreplacementperprostheticdevice artificiallimbpercoveredpersonperlifetime 4Payableonceperlifetimepercoveredperson HEALTHSAVINGSACCOUNT HSA COMPATIBLE ThisplaniscompatiblewithHSAguidelinesandanyotherHSAplaninwhichacoveredfamilymembermayparticipate ItmayalsobeoeredtoemployeeswhodonothaveHSAs THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONS Wewillnotpaybenefitsforlossesthatarecausedby contributedtobyoroccurastheresultofacoveredpersons feloniesorillegaloccupations hazardousavocations racing semi professionalorprofessionalsports sickness suicide orinjurieswhichanycoveredpersonintentionallydoestohimself warorarmedconflict Inaddition wewillnotpay AccidentalDismembermentDuetoCatastrophicAccidentbenefitsforinjuriesachildsustainsduringbirth orforinjuries thataretheresultofintoxicationoruseofnarcotics StateVariationsforExclusionsandLimitations IL Notapplicableto hazardousavocations racing semi professionalorprofessionalsports MT Notapplicableto suicideorinjurieswhichyouintentionallydotoyourselfandinjuriesachildsustainsduringbirth OK Notapplicableto hazardousavocations racingandsemi professionalorprofessionalsports ForAccidental DismembermentDuetoCatastrophicAccidents replace injuriesachildsustainsduringbirth orforinjuriesthatarethe resultofintoxication with alcoholismordrugaddiction ornarcotics UT Alsoincludes aviation Notapplicableto hazardousavocations racing semi professionalorprofessionalsports Thisinformationisnotintendedtobeacompletedescriptionoftheinsurancecoverageavailable Thiscoveragehas exclusionsandlimitationsthatmayaectbenefitspayable Forcostandcompletedetails seeyourColonialLifebenefits counselor ThisbrochureisapplicabletopolicyformsIAC4000 plusstateabbreviationswhereapplicable suchas IAC4000 TX Coveragemayvarybystateandmaynotbeavailableinallstates Premiumwillvaryaccordingtothefamily coverage type UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2019ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 8 19 101777 2

AccidentInsurance W ellbeing AssistanceStandard Benefit IncludedwithPreferredandPremierPlans Thisbenefitcanhelppayforroutinepreventivetestsandservices Formoreinformation talkwithyour benefits counselor Wellbeingassistancestandard _5_0___________ Payableoncepercoveredpersonpercalendaryear Subjecttoa30 daywaitingperiod __________________________ Bloodtestfortriglycerides Bonemarrowtesting Breastultrasound CA15 3 bloodtestforbreastcancer CA125 bloodtestforovariancancer CarotidDoppler CEA bloodtestforcoloncancer ChestX ray Colonoscopy Echocardiogram ECHO Electrocardiogram EKG ECG Fastingbloodglucosetest Flexiblesigmoidoscopy Hemoccultstoolanalysis Mammography Papsmear PSA bloodtestforprostatecancer SerumcholesteroltestforHDLandLDLlevels Serumproteinelectrophoresis bloodtestformyeloma Skincancerbiopsy Stresstestonabicycleortreadmill Thermography ThinPreppaptest Virtualcolonoscopy ColonialLife com IAC4000 WELLBEINGASSISTANCESTANDARDBENEFIT

HEALTHSAVINGSACCOUNT HSA COMPATIBLE ThisplaniscompatiblewithHSAguidelinesandanyotherHSAplaninwhichacoveredfamilymembermayparticipate ItmayalsobeoeredtoemployeeswhodonothaveHSAs THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONS Wewillnotpaybenefitsforlossesthatarecausedby contributedtobyoroccurastheresultofacoveredperson s feloniesorillegaloccupations hazardousavocations racing semi professionalorprofessionalsports sickness suicide orinjurieswhichanycoveredpersonintentionallydoestohimself warorarmedconflict Inaddition wewillnotpay AccidentalDismembermentDuetoCatastrophicAccidentbenefitsforinjuriesachildsustainsduringbirth orforinjuries thataretheresultofintoxicationoruseofnarcotics STATEVARIATIONSFOREXCLUSIONSANDLIMITATIONS IL Notapplicableto hazardousavocations racing semi professionalorprofessionalsports KS Notapplicableto forinjuriesachildsustainsduringbirth MI Notapplicableto suicideorinjurieswhichanycoveredpersonintentionallydoestohimself orforinjuriesthat aretheresultofintoxicationoruseofnarcotics MT Notapplicableto suicideorinjurieswhichanycoveredpersonintentionallydoestohimself forinjuriesachild sustains during birth NV Notapplicableto orforinjuriesthataretheresultofintoxicationoruseofnarcotics OH ThisisariderformR WBB4000 OK Notapplicableto hazardousavocations racing semi professionalorprofessionalsports Inaddition wewill notpayAccidentalDismembermentDuetoCatastrophicAccidentbenefitsforinjuriesachildsustainsduringbirth orforinjuriesthataretheresultofintoxicationoruseofnarcotics Alsoapplicableto Inaddition wewillnotpay AccidentalDismembermentDuetoCatastrophicAccidentbenefitsforalcoholismordrugaddiction ornarcotics OR Notapplicableto orillegaloccupations PA Notapplicableto Inaddition wewillnotpayAccidentalDismembermentDuetoCatastrophicAccidentbenefits forinjuriesachildsustainsduringbirth orforinjuriesthataretheresultofintoxicationoruseofnarcotics SC Notapplicableto hazardousavocations racing semi professionalorprofessionalsports SD Notapplicableto orforinjuriesthataretheresultofintoxicationoruseofnarcotics UT Notapplicableto hazardousavocations racing semi professionalorprofessionalsports Alsoapplicable to aviation Thisinformationisnotintendedtobeacompletedescriptionoftheinsurancecoverageavailable Thiscoveragehas exclusionsandlimitationsthatmayaectbenefitspayable Forcostandcompletedetails seeyourColonialLife benefitscounselor ThisbrochureisapplicabletopolicyformIAC4000 plusstateabbreviationswhereapplicable such asIAC4000 TX Coveragemayvarybystateandmaynotbeavailableinallstates Premiumwillvaryaccordingtofamily coveragetypeandbenefitamountselected UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2019ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 8 19 101781 1

SpecifiedCriticalIllnessInsurance Formoreinformation talkwithyour benefits counselor ColonialLife com Ifyou rediagnosedwithacoveredcriticalillness specifiedcriticalillness insurancefromColonialLifecanhelpwithyourexpenses soyoucanconcentrate onwhat smostimportant yourtreatment careandrecovery Faceamount __ _5_0_0_0_ _ _7_5_ 0_0_0__ Criticalillnessbenefit Forthediagnosisofthiscoveredcriticalillnesscondition 1 Heartattack myocardialinfarction Thispercentageoftheface amountispayable 100 Stroke 100 End stagerenal kidney failure 100 Majororganfailure 100 Permanentparalysisduetoacoveredaccident 100 Coma 100 Blindness OccupationalinfectiousHIVoroccupational infectioushepatitisB CorD Coronaryarterybypassgra surgery disease2 100 100 25 Themaximumbenefitamountforthispolicyis3xthefaceamountforthenamedinsuredforall coveredpersonscombined Thepolicywillterminatewhenthemaximumbenefitamountfor specifiedcriticalillnesshasbeenpaid Subsequentdiagnosisofadierentcriticalillness3 Ifyoureceiveabenefitforaspecifiedcriticalillness andlateryouarediagnosedwithadierent specifiedcriticalillness theoriginalpercentageofthefaceamountispayableforthatparticular specifiedcriticalillness Subsequentdiagnosisofthesamecriticalillness3 Ifyoureceiveabenefitforaspecifiedcriticalillness andlateryouarediagnosedwiththesame specifiedcriticalillness 25 oftheoriginalfaceamountispayable Criticalillnessconditions thatdonotqualifyare coronaryarterybypassgra surgery disease2andoccupationalinfectious HIVoroccupationalinfectioushepatitisB CorD CRITICALILLNESS1 0WITHSUBSEQUENTDIAGNOSIS

ColonialLife com 1Pleaserefertothepolicyforcompletedefinitionsofcoveredconditions 2Benefitforcoronaryarterydiseaseapplicableinlieuofbenefitforcoronaryarterybypassgra surgerywhenhealth savingsaccount HSA compliantplanisselected 3Datesofdiagnosesofacoveredspecifiedcriticalillnessmustbeseparatedbyatleast180days THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONSANDLIMITATIONSFORSPECIFIEDCRITICALILLNESS Wewillnotpaybenefitsforaspecifiedcriticalillnessthatoccursasaresultofacoveredperson s feloniesorillegal occupations intoxicantsandnarcotics pre existingcondition psychiatricorpsychologicalcondition suicideorself inflicted injuries orwarorarmedconflict Thisisnotaninsurancecontractandonlytheactualpolicyprovisionswillcontrol ApplicabletopolicyformCI 1 0 AK CI 1 0 DEorCI 1 0 TX PleaseseeyourColonialLifebenefitscounselorfordetails UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2017ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 6 17 101824 AK DE TX

CriticalIllnessInsurance Health ScreeningBenefit Formoreinformation talkwithyour benefits counselor Theoptionalhealthscreeningbenefitcanhelpyoureducetheriskofserious illness through early detection Healthscreeningbenefit _5__0____________ Maximumofonescreeningtestpercoveredpersonpercalendaryear Bloodtestfortriglycerides Bonemarrowtesting Breastultrasound CA15 3 bloodtestforbreastcancer CA125 bloodtestforovariancancer CarotidDoppler CEA bloodtestforcoloncancer ChestX ray Colonoscopy Echocardiogram ECHO Electrocardiogram EKG ECG Fastingbloodglucosetest Flexiblesigmoidoscopy Hemoccultstoolanalysis Mammography Papsmear PSA bloodtestforprostatecancer SerumcholesteroltestforHDL and LDL levels Serumproteinelectrophoresis bloodtestformyeloma Skincancerbiopsy Stresstestonabicycle ortreadmill Thermography ThinPreppaptest Virtualcolonoscopy ColonialLife com Forcostandcompletedetails seeyourColonialLifebenefitscounselor ApplicabletoformCI 1 0 PandGCC1 0 P including stateabbreviationswhereused forexample CI 1 0 P TXandGCC1 0 P TX Coveragemayvarybystateandmaynotbe availableinallstates UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2016ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany GROUPCRITICALCARE CRITICALILLNESS1 0 HEALTHSCREENINGBENEFIT 10 16 100355 2

CancerInsurance Level2 Benefits Cancerinsurancehelps providefinancialprotection throughavarietyofbenefits Thesebenefitsarenotonlyfor youbutalsoforyourcovered familymembers Formoreinformation talkwithyour benefits counselor BENEFIT DESCRIPTION BENEFITAMOUNT Airambulance 2 000pertrip Transportationtoorfromahospitalormedicalfacility max oftwotripsperconfinement Ambulance 250pertrip Transportationtoorfromahospitalormedicalfacility max oftwotripsperconfinement Anesthesia Administeredduringasurgicalprocedureforcancertreatment Generalanesthesia 25 ofsurgicalproceduresbenefit Localanesthesia 30perprocedure Anti nauseamedication 40perdayadministeredor Doctor prescribedmedicationforradiationorchemotherapy 160monthlymax per prescription filled Blood plasma platelets immunoglobulins 150perday Atransfusionrequiredduringcancertreatment 10 000calendaryearmax Bonemarrowdonorscreening 50 Testinginconnectionwithbeingapotentialdonor onceperlifetime Bonemarroworperipheralstemcelldonation 500 Receivinganotherperson sbonemarroworstemcellsforatransplant onceperlifetime Bonemarroworperipheralstemcelltransplant 4 000pertransplant Transplantyoureceiveinconnectionwithcancertreatment max oftwobonemarrowtransplantbenefitsperlifetime Cancervaccine 50 AnFDA approvedvaccineforthepreventionofcancer onceperlifetime Companiontransportation 0 50permile Companiontravelsbyplane trainorbustoaccompanyacoveredcancerpatientmore than50milesonewayfortreatment upto 1 000perroundtrip Egg s extractionorharvesting spermcollectionandstorage Extracted harvestedorcollectedbeforechemotherapyorradiation onceperlifetime Egg s extractionorharvesting spermcollection 700 Egg s orspermstorage cryopreservation 200 Experimentaltreatment 250perday Hospital medicalorsurgicalcareforcancer 12 500lifetimemax Familycare 40perday Inpatientoroutpatienttreatmentforacovereddependentchild 2 000calendaryearmax Hair externalbreast voiceboxprosthesis 200percalendaryear Prosthesisneededasadirectresultofcancer Homehealthcareservices 75perday Examplesincludephysicaltherapy occupationaltherapy speechtherapyand audiology prosthesisandorthopedicappliances rentalorpurchaseofdurable medicalequipment upto30dayspercalendaryearortwicethenumberofdays hospitalconfined whicheverisgreater Hospice initialordailycare Aninitial one timebenefitandadailybenefitfortreatment 15 000lifetimemax forboth Initialhospicecare onceperlifetime 1 000 Dailyhospicecare 50perday CANCERASSIST LEVEL2

ColonialLife com BENEFITDESCRIPTION BENEFITAMOUNT Hospitalconfinement Hospitalstay includingintensivecare requiredforcancertreatment 30daysorless 150perday 31daysormore 300perday Lodging 50perday Hotel motelexpenseswhenbeingtreatedforcancermorethan50milesfromhome 70 daycalendaryearmax Medicalimagingstudies 125perstudy Specificstudiesforcancertreatment 250calendaryearmax Outpatientsurgicalcenter 200perday Surgeryatanoutpatientcenterforcancertreatment 600calendaryearmax Privatefull timenursingservices 75perday Serviceswhilehospitalconfinedotherthanthoseregularlyfurnishedbythehospital Prostheticdevice artificiallimb 1 500perdeviceorlimb Asurgicalimplantneededbecauseofcancersurgery payableonepersite 3 000lifetimemax Radiation chemotherapy Weeklybenefit max onceperweek Injectedchemotherapybymedicalpersonnel 500 Radiationdeliveredbymedicalpersonnel 500 Monthlychemotherapybenefit max oncepermonth Self injected 200 Pump 200 Topical 200 Oralhormonal 1 24months 200 Oralhormonal 25 months 100 Oralnon hormonal 200 Reconstructivesurgery 40persurgicalunit Asurgerytoreconstructanatomicdefectsthatresultfromcancertreatment upto 2 500perprocedure including25 forgeneralanesthesia Secondmedicalopinion 200 Asecondphysician sopiniononcancersurgeryortreatment onceperlifetime Skillednursingcarefacility 100perday Confinementtoacoveredfacilityaerhospitalrelease uptothenumberofdayspaidfor hospitalconfinement Skincancerinitialdiagnosis 300 Askincancerdiagnosiswhilethepolicyisinforce onceperlifetime Supportiveorprotectivecaredrugsandcolonystimulatingfactors 100perday Doctor prescribeddrugstoenhanceormodifyradiation chemotherapytreatments 800calendaryearmax Surgicalprocedures 50persurgicalunit Inpatientoroutpatientsurgeryforcancertreatment 3 000max perprocedure Transportation 0 50permile Travelexpenseswhenbeingtreatedforcancermorethan50milesfromhome upto 1 000perroundtrip Waiverofpremium Isavailable Nopremiumsdueifthenamedinsuredisdisabledlongerthan90consecutivedays Thepolicyhaslimitationsandexclusionsthatmayaectbenefitspayable Mostbenefitsrequirethatacharge beincurred Coveragemayvarybystateandmaynotbeavailableinallstates Forcostandcompletedetails seeyourbenefitscounselor ThischarthighlightsthebenefitsofpolicyformCanAssist includingstateabbreviationswhereused forexample CanAssist TX Thischartisnotcompletewithoutformnumber101481 2015ColonialLife AccidentInsuranceCompany Columbia SC ColonialLifeinsuranceproductsare underwrittenbyColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand 5 15 101483 1

CancerInsurance Level3 Benefits Ourcancerinsurancehelps providefinancialprotection throughavarietyofbenefits Thesebenefitsarenotonlyfor youbutalsoforyourcovered familymembers Formoreinformation talkwithyour benefits counselor BENEFIT DESCRIPTION BENEFITAMOUNT AirAmbulance 2 000pertrip Transportationtoorfromahospitalormedicalfacility max oftwotripsperconfinement Ambulance 250pertrip Transportationtoorfromahospitalormedicalfacility max oftwotripsperconfinement Anesthesia Administeredduringasurgicalprocedureforcancertreatment GeneralAnesthesia 25 ofSurgicalProceduresBenefit LocalAnesthesia 40perprocedure Anti nauseaMedication 50perdayadministeredor Doctor prescribedmedicationforradiationorchemotherapy 200monthlymax per prescription filled Blood Plasma Platelets Immunoglobulins 175perday Atransfusionrequiredduringcancertreatment 10 000calendaryearmax BoneMarrowDonorScreening 50 Testinginconnectionwithbeingapotentialdonor onceperlifetime BoneMarroworPeripheralStemCellDonation 750 Receivinganotherperson sbonemarroworstemcellsforatransplant onceperlifetime BoneMarroworPeripheralStemCellTransplant 7 000pertransplant Transplantyoureceiveinconnectionwithcancertreatment max oftwobonemarrowtransplantbenefitsperlifetime CancerVaccine 50 AnFDA approvedvaccineforthepreventionofcancer onceperlifetime CompanionTransportation 0 50permile Companiontravelsbyplane trainorbustoaccompanyacoveredcancerpatientmore than50milesonewayfortreatment upto 1 200perroundtrip Egg s ExtractionorHarvesting SpermCollectionandStorage Extracted harvestedorcollectedbeforechemotherapyorradiation onceperlifetime Egg s ExtractionorHarvesting SpermCollection 1 000 Egg s orSpermStorage Cryopreservation 350 ExperimentalTreatment 300perday Hospital medicalorsurgicalcareforcancer 15 000lifetimemax FamilyCare 50perday Inpatientoroutpatienttreatmentforacovereddependentchild 2 500calendaryearmax Hair ExternalBreast VoiceBoxProsthesis 350percalendaryear Prosthesisneededasadirectresultofcancer HomeHealthCareServices 100perday Examplesincludephysicaltherapy occupationaltherapy speechtherapyand audiology prosthesisandorthopedicappliances rentalorpurchaseofdurable medicalequipment upto30dayspercalendaryearortwicethenumberofdays hospitalconfined whicheverisgreater Hospice InitialorDailyCare Aninitial one timebenefitandadailybenefitfortreatment 15 000lifetimemax forboth Initialhospicecare onceperlifetime 1 000 Dailyhospicecare 50perday CANCERASSISTLEVEL3

ColonialLife com BENEFIT DESCRIPTION BENEFITAMOUNT HospitalConfinement Hospitalstay includingintensivecare requiredforcancertreatment 30daysorless 250perday 31daysormore 500perday Lodging 75perday Hotel motelexpenseswhenbeingtreatedforcancermorethan50milesfromhome 70 daycalendaryearmax MedicalImagingStudies 175perstudy Specificstudiesforcancertreatment 350calendaryearmax OutpatientSurgicalCenter 300perday Surgeryatanoutpatientcenterforcancertreatment 900calendaryearmax PrivateFull timeNursingServices 125perday Serviceswhilehospitalconfinedotherthanthoseregularlyfurnishedbythehospital ProstheticDevice ArtificialLimb 2 000perdeviceorlimb Asurgicalimplantneededbecauseofcancersurgery payableonepersite 4 000lifetimemax Radiation Chemotherapy WeeklyBenefit max onceperweek Injectedchemotherapybymedicalpersonnel 750 Radiationdeliveredbymedicalpersonnel 750 MonthlyChemotherapyBenefit max oncepermonth Self Injected 300 Pump 300 Topical 300 OralHormonal 1 24months 300 OralHormonal 25 months 150 OralNon Hormonal 300 ReconstructiveSurgery 60persurgicalunit Asurgerytoreconstructanatomicdefectsthatresultfromcancertreatment upto 3 000perprocedure including25 forgeneralanesthesia SecondMedicalOpinion 300 Asecondphysician sopiniononcancersurgeryortreatment onceperlifetime SkilledNursingCareFacility 100perday Confinementtoacoveredfacilityaerhospitalrelease uptothenumberofdayspaidfor hospitalconfinement SkinCancerInitialDiagnosis 400 Askincancerdiagnosiswhilethepolicyisinforce onceperlifetime SupportiveorProtectiveCareDrugsandColonyStimulatingFactors 150perday Doctor prescribeddrugstoenhanceormodifyradiation chemotherapytreatments 1 200calendaryearmax SurgicalProcedures 60persurgicalunit Inpatientoroutpatientsurgeryforcancertreatment 5 000max perprocedure Transportation 0 50permile Travelexpenseswhenbeingtreatedforcancermorethan50milesfromhome upto 1 200perroundtrip WaiverofPremium Isavailable Nopremiumsdueifthenamedinsuredisdisabledlongerthan90consecutivedays 2014ColonialLife AccidentInsuranceCompany ColonialLifeproductsareunderwrittenby ColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand 1 14 Thepolicyhaslimitationsandexclusionsthatmayaectbenefitspayable Mostbenefitsrequirethatachargebe incurred Policymaynotbeavailableinallstatesandmayvarybystate Forcostandcompletedetails seeyour benefits counselor ThischarthighlightsthebenefitsofpolicyformCanAssist includingstateabbreviationswhereused forexample CanAssist TX Thischartisnotcompletewithoutform 101481 101484

CancerInsurance W ellnessBenefits IncludedwithLevel2and3 To encourage early detection ourcancerinsuranceoers benefitsforwellnessandhealth screening tests PartOne CancerWellness HealthScreening Providedwhenoneofthetestslistedbelowisperformedaerthewaitingperiodandwhile thepolicyisinforce Payableoncepercalendaryear percoveredperson CancerWellnessTests Bonemarrowtesting Breastultrasound CA15 3 bloodtestforbreastcancer CA125 bloodtestforovariancancer CEA bloodtestforcoloncancer ChestX ray Colonoscopy Flexiblesigmoidoscopy Hemoccultstoolanalysis Mammography Papsmear PSA bloodtestforprostatecancer Serum proteinelectrophoresis bloodtestformyeloma Skinbiopsy Thermography ThinPreppaptest Virtualcolonoscopy Health Screening Tests Bloodtestfortriglycerides CarotidDoppler Echocardiogram ECHO Electrocardiogram EKG ECG Fastingbloodglucosetest SerumcholesteroltestforHDL and LDL levels Stresstestonabicycleortreadmill Formoreinformation talkwithyour benefits counselor PartTwo CancerWellness AdditionalInvasiveDiagnostic TestorSurgicalProcedure Providedwhenadoctorperformsadiagnostictestorsurgicalprocedureaerthewaiting periodastheresultofanabnormalresultfromoneofthecoveredcancerwellnesstestsin PartOne Wewillpaythebenefitregardlessofthetestresults Payableoncepercalendaryear percoveredperson 2014ColonialLife AccidentInsuranceCompany ColonialLifeproductsareunderwrittenby ColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand 1 14 Waitingperiodmeansthefirst30daysfollowingthepolicy scoverageeectivedateduringwhichnobenefits are payable Thepolicyhasexclusionsandlimitations Forcostandcompletedetailsofthecoverage seeyourColonialLife benefitscounselor Coveragemayvarybystateandmaynotbeavailableinallstates Applicabletopolicyform CanAssist andstateabbreviationswhereapplicable forexample CanAssist TX CANCERASSISTWELLNESS 101486

HospitalConfinem entIndem nityInsurance Plan 1 OurIndividualMedicalBridgeSMinsurancecanhelpwithmedicalcoststhatyour healthinsurancemaynotcover Thesebenefitsareavailableforyou yourspouse andeligibledependentchildren Hospitalconfinement 1000 or 1500 Maximumofonebenefitpercoveredpersonpercalendaryear Observationroom 100pervisit Maximumoftwovisitspercoveredpersonpercalendaryear Rehabilitationunitconfinement 100perday Maximumof15daysperconfinementwitha30 daymaximumpercoveredpersonpercalendaryear Waiverofpremium Availableaer30continuousdaysofacoveredhospitalconfinementofthenamedinsured Formoreinformation talkwithyour benefits counselor Healthsavingsaccount HSA compatible ThisplaniscompatiblewithHSAguidelines Thisplanmayalsobeoeredtoemployees whodonothaveHSAs ColonialLife AccidentInsuranceCompany sIndividualMedicalBridgeoersanHSA compatibleplaninmoststates ColonialLife com THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONS Wewillnotpaybenefitsforlosseswhicharecausedby dentalprocedures electiveproceduresandcosmeticsurgery felonies orillegaloccupations intoxicantsornarcotics pregnancyofadependentchild psychiatricorpsychologicalconditions suicideorinjurieswhichanycoveredpersonintentionallydoestohimselforherself war orgivingbirthwithinthefirstnine monthsaertheeectivedateofthepolicy Wewillnotpaybenefitsforhospitalconfinementofanewbornwhoisneither injurednorsick Wewillnotpaybenefitsforlossduringthefirst12monthsa ertheeectivedateduetoapre existing condition Apre existingconditionisasicknessorphysicalconditionforwhichacoveredpersonwastreated hadmedical testing receivedmedicaladviceorhadtakenmedicationwithinthe12monthsbeforetheeectivedateofthepolicy Forcostandcompletedetails seeyourColonialLifebenefitscounselor ApplicabletopolicynumberIMB7000 AKand IMB7000 TX Thisisnotaninsurancecontractandonlytheactualpolicyprovisionswillcontrol 2016ColonialLife AccidentInsuranceCompany Columbia SC ColonialLifeinsuranceproductsare underwrittenbyColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand IMB7000 PLAN1 6 16 101576 AK TX

HospitalConfinem entIndem nityInsurance Health Screening IndividualMedicalBridgeSMinsurance shealthscreeningbenefitcanhelppayfor healthandwellnesstestsyouhaveeachyear Formoreinformation talkwithyour benefits counselor Health screening __5_0__________ Maximumofonehealthscreeningtestpercoveredpersonpercalendaryear subjecttoa30 daywaitingperiod Bloodtestfortriglycerides Bonemarrowtesting Breastultrasound CA15 3 bloodtestforbreastcancer CA125 bloodtestforovariancancer CEA bloodtestforcoloncancer CarotidDoppler ChestX ray Colonoscopy Echocardiogram ECHO Electrocardiogram EKG ECG Fastingbloodglucosetest Flexiblesigmoidoscopy Hemoccultstoolanalysis Mammography Papsmear PSA bloodtestforprostatecancer SerumcholesteroltestforHDL and LDL levels Serumproteinelectrophoresis bloodtestformyeloma Skincancerbiopsy Stresstestonabicycle ortreadmill Thermography ThinPreppaptest Virtualcolonoscopy ColonialLife com Waitingperiodmeansthefirst30daysfollowinganycoveredperson spolicycoverageeectivedate duringwhichno benefitsarepayable Forcostandcompletedetails seeyourColonialLifebenefitscounselor Applicabletopolicynumber IMB7000 includingstateabbreviationswhereused forexample IMB7000 TX Coveragemayvarybystateandmaynot beavailableinallstates Thisisnotaninsurancecontractandonlytheactualpolicyprovisionswillcontrol 2016ColonialLife AccidentInsuranceCompany Columbia SC ColonialLifeinsuranceproductsare underwrittenbyColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand IMB7000 HEALTHSCREENINGBENEFIT 5 16 101579 1

HospitalConfinem entIndem nityInsurance Plan 2 Formoreinformation talkwithyour benefits counselor OurIndividualMedicalBridgeSMinsurancecanhelpwithmedicalcoststhatyour healthinsurancemaynotcover Thesebenefitsareavailableforyou yourspouse andeligibledependentchildren Hospitalconfinement Maximumofonebenefitpercoveredpersonpercalendaryear Observationroom 100pervisit Maximumoftwovisitspercoveredpersonpercalendaryear Rehabilitationunitconfinement 100perday Maximumof15daysperconfinementwitha30 daymaximumpercoveredpersonpercalendaryear Waiverofpremium Availableaer30continuousdaysofacoveredhospitalconfinementofthenamedinsured Outpatientsurgicalprocedure Tier1 _5_0__0___________ Tier2 _1_ 0__0_0__________ Maximumof __1_ _5_0_0__________percoveredpersonpercalendaryearforallcovered outpatientsurgicalprocedurescombined Thesurgerieslistedbelowareonlyasamplingofthesurgeriesthatmaybecovered Surgeriesmustbe performedbyadoctorinahospitalorambulatorysurgicalcenter Forcompletedetailsanddefinitions pleaserefertoyourpolicy Tier1outpatientsurgicalprocedures Breast Axillary node dissection Breastcapsulotomy Lumpectomy Cardiac Pacemakerinsertion Digestive Colonoscopy Fistulotomy Hemorrhoidectomy Lysisofadhesions Skin Laparoscopic hernia repair Skingra ing Ear nose throat mouth Adenoidectomy Removaloforallesions Myringotomy Tonsillectomy Tracheostomy Tympanotomy Gynecological Dilation and curettage D C Endometrialablation Lysisofadhesions Liver Paracentesis Musculoskeletalsystem Carpal cubitalrepairorrelease Footsurgery bunionectomy exostectomy arthroplasty hammertoerepair Removaloforthopedichardware Removaloftendonlesion IMB7000 PLAN2

Tier2outpatientsurgicalprocedures Breast Breastreconstruction Breastreduction Cardiac Angioplasty Cardiac catheterization Digestive Exploratory laparoscopy Laparoscopicappendectomy Laparoscopiccholecystectomy Ear nose throat mouth Ethmoidectomy Mastoidectomy Septoplasty Stapedectomy Tympanoplasty Eye Cataractsurgery Cornealsurgery penetratingkeratoplasty Glaucomasurgery trabeculectomy Vitrectomy Gynecological Hysterectomy Myomectomy Musculoskeletalsystem Arthroscopickneesurgerywithmeniscectomy knee cartilage repair Arthroscopicshouldersurgery Clavicle resection Dislocations openreductionwith internalfixation Fracture openreductionwith internalfixation Removalorimplantationofcartilage Tendon ligamentrepair Thyroid Excisionofamass Urologic Lithotripsy ColonialLife com THISPOLICYPROVIDESLIMITEDBENEFITS EXCLUSIONS Wewillnotpaybenefitsforlosseswhicharecausedby dentalprocedures electiveproceduresandcosmeticsurgery felonies orillegaloccupations intoxicantsornarcotics pregnancyofadependentchild psychiatricorpsychologicalconditions suicideorinjurieswhichanycoveredpersonintentionallydoestohimselforherself war orgivingbirthwithinthefirstnine monthsaertheeectivedateofthepolicy Wewillnotpaybenefitsforhospitalconfinementofanewbornwhoisneither injurednorsick Wewillnotpaybenefitsforlossduringthefirst12monthsa ertheeectivedateduetoapre existing condition Apre existingconditionisasicknessorphysicalconditionforwhichacoveredpersonwastreated hadmedical testing receivedmedicaladviceorhadtakenmedicationwithinthe12monthsbeforetheeectivedateofthepolicy Forcostandcompletedetails seeyourColonialLifebenefitscounselor ApplicabletopolicynumberIMB7000 AKand IMB7000 TX Thisisnotaninsurancecontractandonlytheactualpolicyprovisionswillcontrol 2016ColonialLife AccidentInsuranceCompany Columbia SC ColonialLifeinsuranceproductsare underwrittenbyColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand 6 16 101578 AK TX

HospitalConfinem entIndem nityInsurance Health Screening IndividualMedicalBridgeSMinsurance shealthscreeningbenefitcanhelppayfor healthandwellnesstestsyouhaveeachyear Formoreinformation talkwithyour benefits counselor Health screening _5_0___________ Maximumofonehealthscreeningtestpercoveredpersonpercalendaryear subjecttoa30 daywaitingperiod Bloodtestfortriglycerides Bonemarrowtesting Breastultrasound CA15 3 bloodtestforbreastcancer CA125 bloodtestforovariancancer CEA bloodtestforcoloncancer CarotidDoppler ChestX ray Colonoscopy Echocardiogram ECHO Electrocardiogram EKG ECG Fastingbloodglucosetest Flexiblesigmoidoscopy Hemoccultstoolanalysis Mammography Papsmear PSA bloodtestforprostatecancer SerumcholesteroltestforHDL and LDL levels Serumproteinelectrophoresis bloodtestformyeloma Skincancerbiopsy Stresstestonabicycle ortreadmill Thermography ThinPreppaptest Virtualcolonoscopy ColonialLife com Waitingperiodmeansthefirst30daysfollowinganycoveredperson spolicycoverageeectivedate duringwhichno benefitsarepayable Forcostandcompletedetails seeyourColonialLifebenefitscounselor Applicabletopolicynumber IMB7000 includingstateabbreviationswhereused forexample IMB7000 TX Coveragemayvarybystateandmaynot beavailableinallstates Thisisnotaninsurancecontractandonlytheactualpolicyprovisionswillcontrol 2016ColonialLife AccidentInsuranceCompany Columbia SC ColonialLifeinsuranceproductsare underwrittenbyColonialLife AccidentInsuranceCompany forwhichColonialLifeisthemarketingbrand IMB7000 HEALTHSCREENINGBENEFIT 5 16 101579 1

Term Life Insurance 1 in 3 m arried partneredconsum ers w ishtheirspouseorpartnerw ould purchasem orelifeinsurance LIMRA 2019InsuranceBarometerStudy 54 ofAm ericanshavelife insurancecoverage with an average coverage gap of 200 000 LIMRA 2021 IndustryAssociationsUnitetoHelpAddress the Life Insurance Coverage Gap in the United States Peaceofm indforyouandyourlovedones Youwantwhat sbestforyourfamily andthatincludesmakingsure they repreparedforthefuture WithtermlifeinsurancefromColonialLife AccidentInsuranceCompany youcanprovidefinancialsecuritytohelp themcovertheirongoinglivingexpenses Advantagesoftermlifeinsurance Lowercostwhencomparedtocashvaluelifeinsurance Samebenefitpayoutthroughoutthedurationofthepolicy Severaltermperiodoptionsforflexibilityduringhigh needyears Benefitforthebeneficiarythatistypicallytax free Benefits and features Stand alonespousepolicyavailablewhetherornotyoubuya policyforyourself Guaranteedpremiumsthatdonotincreaseduringthe selected term Abilitytoconvertalloraportionofthebenefitamountintocash value life insurance Flexibilitytokeepthepolicyifyouchangejobsorretire Built interminalillnessaccelerateddeathbenefitthatprovidesupto 75 ofthepolicy sdeathbenefit upto 150 000 ifyou rediagnosed withaterminalillness Premiumsavingsforfaceamountsover 250 000basedon yourhealth TERM LIFE ITL5000

How m uchcoverage do you need YOU ___________________ Selectthetermperiod 10 year 15 year 20 year 30 year SPOUSE ___________________ Selectthetermperiod 10 year 15 year 20 year 30 year Selectanyoptionalriders Spouseterm liferider _____________faceamount for________ yeartermperiod Children stermliferider _____________faceamount Accidentaldeathbenefitrider Chroniccareaccelerateddeath benefitrider Criticalillnessaccelerateddeath benefitrider Waiverofpremiumbenefitrider Tolearnmore talkwithyourColonialLife benefits counselor ColonialLife com Optionalriders Atanadditionalcost youcanpurchasethefollowingridersforevenmore financialprotection Spouse term life rider Yourspousemayreceiveamaximumdeathbenefitof 50 000 10 yearand20 year spouse term riders are available Children s term life rider Youcanpurchaseupto 20 000intermlifecoverageforallofyoureligibledependent childrenandpayonepremium Thechildren stermliferidermaybeaddedtoeither yourpolicyoryourspouse spolicy notboth Accidentaldeathbenefitrider Thebeneficiarymayreceiveanadditionalbenefitifthecoveredpersondiesasaresult ofanaccidentbeforeage70 Thebenefitdoublesiftheaccidentalbodilyinjuryoccurs whileridingasafare payingpassengerusingpublictransportation suchasride sharing services Anadditional25 willbepayableiftheinjuryissustainedwhiledrivingor ridinginaprivatepassengervehicleandwearingaseatbelt Chroniccareaccelerateddeathbenefitrider Ifalicensedhealthcarepractitionercertifiesthatyouhaveachronicillness youmay receiveanadvanceonalloraportionofthedeathbenefit availableinaone timelump sumormonthlypayments Achronicillnessmeansyourequiresubstantialsupervision duetoaseverecognitiveimpairmentoryoumaybeunabletoperformatleasttwoof thesixActivitiesofDailyLiving Premiumsarewaivedduringthebenefitperiod Criticalillnessaccelerateddeathbenefitrider Ifyousueraheartattack myocardialinfarction strokeorend stagerenal kidney failure a 5 000benefitispayable Asubsequentdiagnosisbenefitisincluded Waiverofpremiumbenefitrider Premiumsarewaived forthepolicyandriders ifyoubecometotallydisabledbefore thepolicyanniversaryfollowingyour65thbirthdayandyousatisfythesix month eliminationperiod 3 1Anypayoutwouldreducethedeathbenefit Benefitsmaybetaxableasincome Individualsshouldconsultwiththeir legalortaxcounselwhendecidingtoapplyforacceleratedbenefits 2Activitiesofdailylivingarebathing continence dressing eating toiletingandtransferring 3Youmustresumepremiumpaymentsonceyouarenolongerdisabled EXCLUSIONSANDLIMITATIONS Iftheinsureddiesbysuicide whethersaneorinsane withintwoyears oneyearinND fromthecoverageeective dateorthedateofreinstatement wewillnotpaythedeathbenefit Wewillterminatethispolicyandreturnthe premiumspaidwithoutinterest minusanyloansandloaninteresttoyou Thisinformationisnotintendedtobeacompletedescriptionoftheinsurancecoverageavailable Thepolicyorits provisionsmayvaryorbeunavailableinsomestates Thepolicyhasexclusionsandlimitationswhichmayaect anybenefitspayable ApplicabletopolicyformsICC18 ITL5000 ITL5000andriderformsICC18 R ITL5000 STR RITL5000 STR ICC18 R ITL5000 CTR R ITL5000 CTR ICC18 R ITL5000 WP R ITL5000 WP ICC18 R ITL5000 ACCD RITL5000 ACCD ICC18 R ITL5000 CI R ITL5000 CI ICC18 R ITL5000 CC R ITL5000 CC Forcostandcompletedetails ofthecoverage callorwriteyourColonialLifebenefitscounselororthecompany UnderwrittenbyColonialLife AccidentInsuranceCompany Columbia SC 2021ColonialLife AccidentInsuranceCompany Allrightsreserved ColonialLifeisa registeredtrademarkandmarketingbrandofColonialLife AccidentInsuranceCompany 9 21 101895 2

qA Give your family peace of mind and coverage for nal expenses q U Aw U tw q q w Built in terminal illness accelerated death bene t that provides up to 75 of the policy s death bene t up to 150 000 if you re Immediate 3 000 claim payment that can help your designated bene ciary pay for funeral costs or other expenses Provides cash surrender value at age 100 when the policy endows AAUO t A Uw w Cover your spouse with a death bene t up to 50 000 for 10 or 20 years L O Purchase a policy Paid Up at Age 70 while children are young and premiums the coverage when the child is 18 21 and 24 without proof of good health You may purchase up to 20 000 in term life coverage for all of your eligible U w O OA O w AUw t U q q interest rate of 3 75 2 q Bene t for the bene ciary that is typically tax free WHOLE LIFE PLUS IWL5000

Bene ts worksheet For use with your bene ts counselor o w oq oq ow w w oq oq o U Uw U w oq oq w ow _____________face amount o ________ o Accidental death bene t rider o death bene t rider o death bene t rider o o bene t rider To learn more talk with your bene ts counselor O AAUO t A Uw U AU Accidental death bene t rider The bene ciary may receive an additional bene t if the covered person dies as a result of an accident before age 70 The bene t doubles if the accidental transportation such as ride sharing services An additional 25 will be Chronic care accelerated death bene t rider If a licensed health care practitioner certi es that you have a chronic illness you may receive an advance on all or a portion of the death bene t available may be unable to perform at least two of the six Activities of Daily Living bathing continence dressing eating toileting and transferring Premiums are waived during the bene t period Critical illness accelerated death bene t rider If you suffer a heart attack myocardial infarction stroke or end stage renal kidney failure a 5 000 bene t is payable A subsequent diagnosis bene t policy You may purchase up to your initial face amount not to exceed a total combined maximum of 100 000 for all options Waiver of premium bene t rider Premiums are waived for the policy and riders if you become totally disabled the six month elimination period Once you are no longer disabled premium Any payout would reduce the death bene t Bene ts may be taxable as income Individuals should consult with their legal or tax counsel when deciding to apply for accelerated bene ts 2 Accessing the accumulated cash value reduces the death bene t by the amount accessed O wA Uw U OATA A Uw A years one year in ND from the coverage effective date or the date of reinstatement we will not pay the death bene t We will terminate this policy and return the premiums paid without interest The policy or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may affect any bene ts payable Applicable to policy forms ICC19IWL5000 70 IWL5000 70 ICC19 IWL5000 100 IWL5000 100 ICC19 IWL5000J IWL5000J and rider forms ICC19 R IWL5000 STR R IWL5000 STR ICC19 R IWL5000 CTR R IWL5000 CTR ICC19 R IWL5000 WP R IWL5000 WP ICC19 R IWL5000 ACCD R IWL5000 ACCD ICC19 R IWL5000 CI R IWL5000 CI ICC19 R IWL5000 CC R IWL5000 CC ICC19 R IWL5000 GPO R IWL5000 GPO For cost and complete details of the coverage call or write your Colonial Life bene ts counselor or the company A w 2021 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a A FOR EMPLOYEES 10 21 642298 1