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Benefit Booklet - 2024-2025

Colonial Life provides benets that employees want for the unexpected moments in life. Whether planning for retirement, growing their families, or saving for college, they know an injury or illness won’t derail their dreams. Learn More ContactKitty MelloneKmellone@coloniallifenc.com704-907-3944Life is anything but expected. That’s why we’re here.ProductsDisability InsuranceProvides financial protection to cover income loss from a covered disability. Hospital Confinement Indemnity Insurance (Medical Bridge)Provides benefits to help cover the cost of a hospital stay and other medical procedures for a covered accident or sickness, regardless of what health insurance pays. Accident InsuranceFrom a fall to a car accident, this coverage offers a range of benefits to help cover medical or non-medical related expenses due to a covered accident.Cancer InsuranceProvides benefits for a cancer diagnosis and treatment. Option to add cancer screening benefit.Critical Illness InsuranceProvides lumpsum benefits for a covered critical illness, such as a heart attack or stroke.Whole Life InsuranceProvides protection for a lifetime. Features guaranteed level premiums and increasing cash values over time. Option to increase coverage on the second, fifth and eighth year of the policy’s anniversary.

Individual Short-Term Disability Insurance ISTD3000 BASEYou never know when a disability could impact your way of life. Fortunately, there’s a way to help protect your income. If a covered accident or sickness prevents you from earning a paycheck, disability insurance can provide a monthly benefit to help you cover your ongoing expenses.Can you aord to not protect your income? You don’t have the same lifestyle expenses as the next person. That’s why you need disability coverage that can be customized to fit your specific needs.Aer calculating your monthly expenses, your benefits counselor can help you complete the benefits worksheet.ColonialLife.comMONTHLY EXPENSESRound to the nearest hundred.1 Rent or mortgage $2 Transportation $3 Utilities (phone, internet, electricity/gas, water, etc.) $4 Food and necessities $5 Other expenses $ Total monthly expenses (add lines 1-5 together) $Benefits worksheetHow much coverage do I need?Monthly benefit amount for o-job accident and o-job sickness: ______________Choose a monthly benefit amount between $400 and $6,500.*If your plan includes on-job accident/sickness benefits, the benefit is 50% of the o-job amount.What is the benefit period?Benefit period: _______ monthsThe partial disability benefit period is three months.When may my total disability benefits start?Aer an accident: _______ days Aer a sickness: _______ days*Subject to income requirements

EXCLUSIONS AND LIMITATIONS We will not pay benefits for losses that are caused by, contributed to by or occur as the result of: cosmetic surgery, felonies or illegal occupations, flying, hazardous avocations, intoxicants and narcotics, psychiatric or psychological conditions, racing, semi-professional or professional sports, substance abuse, suicide or injuries which you intentionally do to yourself, war or armed conflict. We will not pay for losses due to you giving birth within the first nine months aer the coverage eective date of the policy. We will not pay for loss when the disability is a pre-existing condition as described in the policy.Pre-existing condition means a sickness or physical condition, whether diagnosed or not, for which you were treated, had medical testing, received medical advice or had taken medication within 12 months before the policy coverage eective date shown on the policy schedule.Aer this policy has been in force for 12 months from the policy coverage eective date shown on the policy schedule, we will pay benefits for any pre-existing condition not excluded by name or specific description if the covered disability began at least 12 months aer the policy coverage eective date and the elimination period has been satisfied.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy form ISTD3000-SC and rider form ISTD3000-ADIB. This is not an insurance contract and only the actual policy and rider provisions will control.Product information Total disability definitionIf the benefit period shown on the policy schedule is 12 months or less, totally disabled or total disability means you are: unable to perform the material and substantial duties of your occupation; and not, in fact, working at any occupation for wage or profit; and under the regular and appropriate care of a physician.Aer the first year of disability, total disability means you are unable to engage in any employment or occupation for which you are qualified by reason of education, training or experience and under the regular and appropriate care of a physician.How partial disability worksIf you are able to return to work part-time aer at least 14 days of being paid for a total disability, you may be able to still receive 50% of your total disability benefit.Waiver of premiumWe will waive your premium payments aer 90 consecutive days of a covered disability.Geographical limitationsIf you are disabled while outside of the United States, Canada or Mexico, you may receive benefits for up to 60 days before you have to return to the U.S. in order to continue receiving benefits.Issue ageCoverage is available from ages 17 to 74.Keep your coverage You can keep your coverage to age 75 at no additional cost, even if you change jobs, as long as you pay your premiums when they are due.9-17 | 101629-1-SCUnderwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2017 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.For more information, talk with your benefits counselor.

For more information, talk with your benefits counselor.Hospital Confinement Indemnity InsurancePlan 3IMB7000 – PLAN 3Our Individual Medical BridgeSM insurance can help with medical costs that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children. Hospital confinement ..................................................................$ 1,000/ $2,000Maximum of one benefit per covered person per calendar yearObservation room .................................................................................. $100 per visitMaximum of two visits per covered person per calendar yearRehabilitation unit confinement .................................................................$100 per dayMaximum of 15 days per confinement with a 30-day maximum per covered person per calendar yearWaiver of premiumAvailable aer 30 continuous days of a covered hospital confinement of the named insuredDiagnostic procedure  Tier 1................................................................................................................ $250  Tier 2................................................................................................................ $500 Maximum of $500 per covered person per calendar year for all covered diagnostic procedures combinedOutpatient surgical procedure  Tier 1............................................................................................ $_500______________  Tier 2............................................................................................$1,000_______________Maximum of $2,500.00 per covered person per calendar year for all covered outpatient surgical procedures combinedThe following is a list of common diagnostic procedures that may be covered.Tier 1 diagnostic procedures  Breast– Biopsy (incisional, needle, stereotactic)  Diagnostic radiology– Nuclear medicine test  Digestive– Barium enema/lower GI series– Barium swallow/upper GI series– Esophagogastroduodenoscopy (EGD)  Ear, nose, throat, mouth– Laryngoscopy  Gynecological– Amniocentesis– Cervical biopsy– Cone biopsy– Endometrial biopsyTier 2 diagnostic procedures  Cardiac– Angiogram– Arteriogram– Thallium stress test– Transesophageal echocardiogram (TEE)  Liver – biopsy  Lymphatic – biopsy  Miscellaneous– Bone marrow aspiration/biopsy  Renal – biopsy  Respiratory– Biopsy– Bronchoscopy– Pulmonary function test (PFT)  Skin– Biopsy– Excision of lesion  Thyroid – biopsy  Urologic– Cystoscopy  Diagnostic radiology– Computerized tomography scan (CT scan)– Electroencephalogram (EEG)– Magnetic resonance imaging (MRI)– Myelogram– Positron emission tomography scan (PET scan)– Hysteroscopy– Loop electrosurgical excisional procedure(LEEP)

EXCLUSIONS We will not pay benefits for losses which are caused by: alcoholism or drug addiction, dental procedures, elective procedures and cosmetic surgery, felonies or illegal occupations, pregnancy of a dependent child, psychiatric or psychological conditions, suicide or injuries which any covered person intentionally does to himself or herself, or war. We will not pay benefits for hospital confinement of a newborn who is neither injured nor sick. We will not pay benefits for loss during the first 12 months aer the eective date due to a pre-existing condition. Pre-exisiting conditions are those conditions whether diagnosed or not, for which a covered person received medical advice, diagnosis or care, or treatment was received or recommended within the one-year period immediately preceding the eective date of the policy. If a covered person is 65 or older when the policy is issued, pre-existing conditions will include only conditions specifically eliminated by rider.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy number IMB7000-NC. This is not an insurance contract and only the actual policy provisions will control.ColonialLife.com©2015 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 7-15 | 101581-NC  Breast– Breast reconstruction– Breast reduction  Cardiac– Angioplasty– Cardiac catheterization  Digestive– Exploratory laparoscopy– Laparoscopic appendectomy– Laparoscopic cholecystectomy  Ear, nose, throat, mouth– Ethmoidectomy– Mastoidectomy– Septoplasty– Stapedectomy– Tympanoplasty  Eye– Cataract surgery– Corneal surgery (penetrating keratoplasty)– Glaucoma surgery (trabeculectomy)– Vitrectomy Tier 2 outpatient surgical procedures  Gynecological– Hysterectomy– Myomectomy  Musculoskeletal system– Arthroscopic knee surgery with meniscectomy(knee cartilage repair)– Arthroscopic shoulder surgery– Clavicle resection– Dislocations (open reduction with internal fixation)– Fracture (open reduction withinternal fixation)– Removal or implantation of cartilage– Tendon/ligament repair  Thyroid– Excision of a mass  Urologic– LithotripsyThe surgeries listed below are only a sampling of the surgeries that may be covered. Surgeries must be performed by a doctor in a hospital or ambulatory surgical center. For complete details and definitions, please refer to your policy. Tier 1 outpatient surgical procedures  Breast– Axillary node dissection– Breast capsulotomy– Lumpectomy  Cardiac– Pacemaker insertion  Digestive– Colonoscopy– Fistulotomy– Hemorrhoidectomy– Lysis of adhesions  Skin– Laparoscopic hernia repair– Skin graing  Ear, nose, throat, mouth– Adenoidectomy– Removal of oral lesions– Myringotomy– Tonsillectomy– Tracheostomy– Tympanotomy  Gynecological– Dilation and curettage (D&C)– Endometrial ablation– Lysis of adhesions  Liver– Paracentesis  Musculoskeletal system– Carpal/cubital repair or release– Foot surgery (bunionectomy, exostectomy,arthroplasty, hammertoe repair)– Removal of orthopedic hardware– Removal of tendon lesion

For more information, talk with your benefits counselor.Hospital Confinement Indemnity InsuranceMedical Treatment PackageTHIS POLICY PROVIDES LIMITED BENEFITS. EXCLUSIONS We will not pay benefits for losses which are caused by: alcoholism or drug addiction, dental procedures, elective procedures and cosmetic surgery, felonies or illegal occupations, mental or emotional disorders, pregnancy of a dependent child, suicide or injuries which any covered person intentionally does to himself or herself, or war.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy number IMB7000-SC. This is not an insurance contract and only the actual policy provisions will control.©2016 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.IMB7000 – MEDICAL TREATMENT PACKAGE | 1-16 | 101596-SCColonialLife.comThe medical treatment package for Individual Medical BridgeSM coverage can help pay for deductibles, co-payments and other out-of-pocket expenses related to a covered accident or covered sickness.The medical treatment package paired with Plan 1 provides accident-only coverage.Air ambulance ............................................................................................. $1,000Maximum of one benefit per covered person per calendar yearAmbulance ....................................................................................................$100Maximum of one benefit per covered person per calendar yearAppliance ......................................................................................................$100Maximum of one benefit per covered person per calendar yearDoctor’s oice visit ...................................................................................$25 per visitMaximum of three visits per calendar year for named insured coverage or maximum of five visits per calendar year for all covered persons combinedEmergency room visit ............................................................................. $100 per visitMaximum of two visits per covered person per calendar yearX-ray ................................................................................................ $25 per benefitMaximum of two benefits per covered person per calendar year

For more information, talk with your benefits counselor.Hospital Confinement Indemnity InsuranceHealth ScreeningWaiting period means the first 30 days following any covered person’s policy coverage eective date, during which no benefits are payable. For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy number IMB7000 (including state abbreviations where used, for example: IMB7000-TX). Coverage may vary by state and may not be available in all states. This is not an insurance contract and only the actual policy provisions will control.©2015 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.IMB7000 – HEALTH SCREENING BENEFIT | 2-15 | 101579ColonialLife.comHealth screening ............................................................................$100_____________Maximum of one health screening test per covered person per calendar year; subject to a 30-day waiting period  Blood test for triglycerides  Bone marrow testing  Breast ultrasound  CA 15-3 (blood test for breast cancer)  CA 125 (blood test for ovarian cancer)  CEA (blood test for colon cancer)  Carotid Doppler  Chest X-ray  Colonoscopy  Echocardiogram (ECHO)  Electrocardiogram (EKG, ECG)  Fasting blood glucose test  Flexible sigmoidoscopy  Hemoccult stool analysis  Mammography  Pap smear  PSA (blood test for prostate cancer)  Serum cholesterol test for HDL and LDL levels  Serum protein electrophoresis(blood test for myeloma)  Skin cancer biopsy  Stress test on a bicycleor treadmill  Thermography  ThinPrep pap test  Virtual colonoscopyIndividual Medical BridgeSM insurance’s health screening benefit can help pay for health and wellness tests you have each year.

Accident 1.0 -Preferred with Health Screening BenetAccidents happen in places where you and your family spend the most time – at work, in the home and on the playground – and they’re unexpected. How you care for them shouldn’t be. In your lifetime, which of these accidental injuries have happened to you or someone you know?l Sports-related accidental injuryl Broken bonel Burnl Concussionl Lacerationl Back or knee injuriesColonial Life’s Accident Insurance is designed to help you ll some of the gaps caused by increasing deductibles, co-payments and out-of-pocket costs related to an accidental injury. The benet to you is that you may not need to use your savings or secure a loan to pay expenses. Plus you’ll feel better knowing you can have greater nancial security.l Car accidentsl Falls & spillsl Dislocationl Accidental injuries that send youto the Emergency Room, Urgent Careor doctor’s oceWhat additional features are included?l Worldwide coveragel Portablel Compliant with Healthcare SpendingAccount (HSA) guidelinesWill my accident claim payment be reduced if I have other insurance?You’re paid regardless of any other insurance you may have with other insurance companies, and the benets are paid directly to you (unless you specify otherwise).What if I change employers?If you change jobs or leave your employer, you can take your coverage with you at no additional cost. Your coverage is guaranteed renewable as long as you pay your premiums when they are due or within the grace period. Can my premium change?Colonial Life can change your premium only if we change it on all policies of this kind in the state where your policy was issued. How do I le a claim?Visit coloniallife.com or call our Customer Service Department at 1.800.325.4368 for additional information.Accident Insurance

Your Colonial Life policy also provides benets for the following injuries received as a result of a covered accident.l Burn (based on size and degree) ....................................................................................$1,000 to $12,000l Coma .............................................................................................................................................................$10,000l Concussion .......................................................................................................................................................$150l Emergency Dental Work .......................................$75 Extraction, $300 Crown, Implant, or Denturel Lacerations (based on size) ........................................................................................................... $50 to $800Requires Surgeryl Eye Injury ...........................................................................................................................................................$300l Tendon/Ligament/Rotator Cu .......................................................... $500 - one, $1,000 - two or morel Ruptured Disc ..................................................................................................................................................$500l Torn Knee Cartilage .......................................................................................................................................$500Surgical Carel Surgery (cranial, open abdominal or thoracic) ................................................................................$1,500l Surgery (hernia) ..............................................................................................................................................$150l Surgery (arthroscopic or exploratory) ....................................................................................................$250l Blood/Plasma/Platelets ................................................................................................................................$300Benets listed are for each covered person per covered accident unless otherwise specied.Initial Carel Accident Emergency Treatment........... $150 l Ambulance .......................................$400l X-ray Benet ...................................................$50 l Air Ambulance ............................. $2,000Common Accidental InjuriesDislocations (Separated Joint) Non-Surgical SurgicalHip $6,600 $13,200 Knee (except patella) $3,300 $6,600 Ankle – Bone or Bones of the Foot (other than Toes) $2,640 $5,280 Collarbone (Sternoclavicular) $1,650 $3,300 Lower Jaw, Shoulder, Elbow, Wrist $990 $1,980 Bone or Bones of the Hand $990 $1,980 Collarbone (Acromioclavicular and Separation) $330 $660 One Toe or Finger $330 $660 Fractures Non-Surgical Surgical Depressed Skull $5,500 $11,000 Non-Depressed Skull $2,200 $4,400 Hip, Thigh $3,300 $6,600 Body of Vertebrae, Pelvis, Leg $1,650 $3,300 Bones of Face or Nose (except mandible or maxilla) $770 $1,540 Upper Jaw, Maxilla $770 $1,540 Upper Arm between Elbow and Shoulder $770 $1,540 Lower Jaw, Mandible, Kneecap, Ankle, Foot $660 $1,320 Shoulder Blade, Collarbone, Vertebral Process $660 $1,320 Forearm, Wrist, Hand $660 $1,320 Rib $550 $1,100 Coccyx $440 $880 Finger, Toe $220 $440

Transportation/Lodging AssistanceIf injured, covered person must travel more than 50 miles from residence to receive special treatment and connement in a hospital.l Transportation ............................................................................. $500 per round trip up to 3 round tripsl Lodging (family member or companion) ............................................... $125 per night up to 30 days for a hotel/motel lodging costsAccident Hospital Carel Hospital Admission* ........................................................................................................$1,500 per accidentl. Hospital ICU Admission* ................................................................................................$3,000 per accident* We will pay either the Hospital Admission or Hospital Intensive Care Unit (ICU) Admission, but not both.l Hospital Connement .........................................................$250 per day up to 365 days per accidentl Hospital ICU Connement ...................................................$500 per day up to 15 days per accidentAccident Follow-Up Carel Accident Follow-Up Doctor Visit ..........................................................$50 (up to 3 visits per accident)l Medical Imaging Study ......................................................................................................$250 per accident (limit 1 per covered accident and 1 per calendar year)l Occupational or Physical Therapy ..................................................... $35 per treatment up to 10 daysl Appliances ..........................................................................................$125 (such as wheelchair, crutches)l Prosthetic Devices/Articial Limb ....................................................$500 - one, $1,000 - more than 1l Rehabilitation Unit .................................................$100 per day up to 15 days per covered accident, and 30 days per calendar year. Maximum of 30 days per calendar yearAccidental Dismembermentl Loss of Finger/Toe .................................................................................$750 – one, $1,500 – two or morel Loss or Loss of Use of Hand/Foot/Sight of Eye .....................$7,500 – one, $15,000 – two or moreCatastrophic AccidentFor severe injuries that result in the total and irrecoverable:l Loss of one hand and one foot l Loss of the sight of both eyesl Loss of both hands or both feet l Loss of the hearing of both earsl Loss or loss of use of one arm and one leg or l Loss of the ability to speakl Loss or loss of use of both arms or both legsNamed Insured ................ $25,000 Spouse ..............$25,000 Child(ren) ......... $12,500365-day elimination period. Amounts reduced for covered persons age 65 and over.Payable once per lifetime for each covered person.Accidental DeathAccidental Death Common Carrierl Named Insured $25,000 $100,000l Spouse $25,000 $100,000l Child(ren) $5,000 $20,000

EXCLUSIONS We will not pay benets for losses that are caused by or are the result of: hazardous avocations; felonies or illegal occupations; racing; semi-professional or professional sports; sickness; suicide or self-inicted injuries; war or armed conict; in addition to the exclusions listed above, we also will not pay the Catastrophic Accident benet for injuries that are caused by or are the result of: birth; intoxication.For cost and complete details, see your Colonial Life benets counselor. Applicable to policy form Accident 1.0-HS-NC. This is not an insurance contract and only the actual policy provisions will control. Colonial Life 1200 Colonial Life BoulevardColumbia, South Carolina 29210coloniallife.com71740-NC©2014 Colonial Life & Accident Insurance Company | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 6-14Health Screening Benet l $50 per covered person per calendar yearProvides a benet if the covered person has one of the health screening tests performed. This benet is payable once per calendar year per person and is subject to a 30-day waiting period.Tests include:l. Blood test for triglyceridesl. Bone marrow testingl. Breast ultrasoundl. CA 15-3 (blood test for breast cancer)l. CA125 (blood test for ovarian cancer)l. Carotid dopplerl. CEA (blood test for colon cancer)l. Chest x-rayl. Colonoscopyl. Echocardiogram (ECHO)l. Electrocardiogram (EKG, ECG)l. Fasting blood glucose testl. Flexible sigmoidoscopyl. Hemoccult stool analysisl. Mammographyl. Pap smearl. PSA (blood test for prostate cancer)l. Serum cholesterol test to determinelevel of HDL and LDLl. Serum protein electrophoresis(blood test for myeloma)l. Stress test on a bicycle or treadmilll. Skin cancer biopsyl. Thermographyl. ThinPrep pap testl. Virtual colonoscopyAccident 1.0 -Preferred with Health Screening BenetMy Coverage Worksheet (For use with your Colonial Life benets counselor)Who will be covered? (check one) Employee Only Spouse Only One Child Only Employee & Spouse One-Parent Family, with Employee One-Parent Family, with Spouse Two-Parent FamilyWhen are covered accident benets available? (check one) On and O -Job Benets O -Job Only Benets

BENEFIT DESCRIPTION BENEFIT AMOUNTCancer insurance helps provide financial protection through a variety of benefits. These benefits are not only for you but also for your covered family members.For more information, talk with your benefits counselor.CANCER ASSIST – LEVEL 3Air ambulance .................................................................................$2,000 per tripTransportation to or from a hospital or medical facility [max. of two trips per confinement]Ambulance .....................................................................................$250 per tripTransportation to or from a hospital or medical facility [max. of two trips per confinement]AnesthesiaAdministered during a surgical procedure for cancer treatment ■ General anesthesia ......................................................................... 25% of surgical procedures benefit■ Local anesthesia ............................................................................$40 per procedureAnti-nausea medication .....................................................................$50 per day administered orDoctor-prescribed medication for radiation or chemotherapy [$200 monthly max.] per prescription filledBlood/plasma/platelets/immunoglobulins .............................................. $175 per dayA transfusion required during cancer treatment [$10,000 calendar year max.]Bone marrow donor screening .............................................................$50Testing in connection with being a potential donor [once per lifetime]Bone marrow or peripheral stem cell donation .........................................$750Receiving another person’s bone marrow or stem cells for a transplant [once per lifetime]Bone marrow or peripheral stem cell transplant .......................................$7,000 per transplantTransplant you receive in connection with cancer treatment [max. of two bone marrow transplant benefits per lifetime]Cancer vaccine .................................................................................$50An FDA-approved vaccine for the prevention of cancer [once per lifetime]Companion transportation .................................................................$0.50 per mileCompanion travels by plane, train or bus to accompany a covered cancer patient more than 50 miles one way for treatment [up to $1,200 per round trip]Egg(s) extraction or harvesting/sperm collection and storageExtracted/harvested or collected before chemotherapy or radiation [once per lifetime]■ Egg(s) extraction or harvesting/sperm collection .........................................$1,000■ Egg(s) or sperm storage (cryopreservation) ...............................................$350Experimental treatment .....................................................................$300 per dayHospital, medical or surgical care for cancer [$15,000 lifetime max.]Family care .....................................................................................$50 per dayInpatient or outpatient treatment for a covered dependent child [$2,500 calendar year max.]Hair/external breast/voice box prosthesis ...............................................$350 per calendar yearProsthesis needed as a direct result of cancerHome health care services ..................................................................$100 per dayExamples include physical therapy, occupational therapy, speech therapy and audiology; prosthesis and orthopedic appliances; rental or purchase of durable medical equipment [up to 30 days per calendar year or twice the number of days hospital confined, whichever is greater]Hospice (initial or daily care)An initial, one-time benefit and a daily benefit for treatment [$15,000 lifetime max. for both]■ Initial hospice care [once per lifetime] .....................................................$1,000■ Daily hospice care ..........................................................................$50 per dayCancer InsuranceLevel 3 Benefits

BENEFIT DESCRIPTION BENEFIT AMOUNTColonialLife.com4-15 | 101484-1©2015 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.The policy has limitations and exclusions that may aect benefits payable. Most benefits require that a charge be incurred. Coverage may vary by state and may not be available in all states. For cost and complete details, see your benefits counselor.This chart highlights the benefits of policy form CanAssist (including state abbreviations where used, for example: CanAssist-TX). This chart is not complete without form number 101481. Hospital confinementHospital stay (including intensive care) required for cancer treatment■ 30 days or less ..........................................................................................$250 per day■ 31 days or more ........................................................................................$500 per dayLodging .....................................................................................................$75 per dayHotel/motel expenses when being treated for cancer more than 50 miles from home [70-day calendar year max.]Medical imaging studies .................................................................................$175 per studySpecific studies for cancer treatment [$350 calendar year max.]Outpatient surgical center ..............................................................................$300 per daySurgery at an outpatient center for cancer treatment [$900 calendar year max.]Private full-time nursing services ......................................................................$125 per dayServices while hospital confined other than those regularly furnished by the hospitalProsthetic device/artificial limb ........................................................................$2,000 per device or limbA surgical implant needed because of cancer surgery [payable one per site, $4,000 lifetime max.]Radiation/chemotherapyWeekly benefit [max. once per week]■ Injected chemotherapy by medical personnel ........................................................$750■ Radiation delivered by medical personnel ............................................................$750Monthly chemotherapy benefit [max. once per month]■ Self-injected ............................................................................................$300■ Pump ...................................................................................................$300■ Topical ..................................................................................................$300■ Oral hormonal [1-24 months] ..........................................................................$300■ Oral hormonal [25+ months] ...........................................................................$150■ Oral non-hormonal ..................................................................................... $300Reconstructive surgery ..................................................................................$60 per surgical unitA surgery to reconstruct anatomic defects that result from cancer treatment[up to $3,000 per procedure, including 25% for general anesthesia]Second medical opinion .................................................................................$300A second physician’s opinion on cancer surgery or treatment [once per lifetime]Skilled nursing care facility .............................................................................$100 per dayConfinement to a covered facility aer hospital release [up to the number of days paid for hospital confinement]Skin cancer initial diagnosis ............................................................................$400A skin cancer diagnosis while the policy is in force [once per lifetime]Supportive or protective care drugs and colony stimulating factors ...........................$150 per dayDoctor-prescribed drugs to enhance or modify radiation/chemotherapy treatments [$1,200 calendar year max.] Surgical procedures ......................................................................................$60 per surgical unitInpatient or outpatient surgery for cancer treatment [$5,000 max. per procedure]Transportation ............................................................................................$0.50 per mileTravel expenses when being treated for cancer more than 50 miles from home [up to $1,200 per round trip]Waiver of premium .......................................................................................Is availableNo premiums due if the named insured is disabled longer than 90 consecutive days

For more information, talk with your benefits counselor.To encourage early detection,our cancer insurance oers benefits for wellness and health screening tests. Part one: Cancer wellness/health screening $100/per Yr.Provided when one of the tests listed below is performed aer the waiting period and while the policy is in force. Payable once per calendar year, per covered person.Cancer wellness tests■ Bone marrow testing■ Breast ultrasound■ CA 15-3 (blood test for breast cancer)■ CA 125 (blood test for ovarian cancer)■ CEA (blood test for colon cancer)■ Chest X-ray■ Colonoscopy■ Flexible sigmoidoscopy■ Hemoccult stool analysis■ Mammography■ Pap smear■ PSA (blood test for prostate cancer)■ Serum protein electrophoresis(blood test for myeloma)■ Skin biopsy■ Thermography■ ThinPrep pap test■ Virtual colonoscopyPart two: Cancer wellness — additional invasive diagnostic test or surgical procedureProvided when a doctor performs a diagnostic test or surgical procedure aer the waiting period as the result of an abnormal result from one of the covered cancer wellness tests in part one. We will pay the benefit regardless of the test results. Payable once per calendar year, per covered person.Health screening tests■ Blood test for triglycerides■ Carotid Doppler■ Echocardiogram (ECHO)■ Electrocardiogram (EKG, ECG)■ Fasting blood glucose test■ Serum cholesterol test for HDL and LDL levels■ Stress test on a bicycle or treadmillCancer InsuranceWellness BenefitsWaiting period means the first 30 days following the policy’s coverage eective date during which no benefits are payable.The policy has exclusions and limitations. For cost and complete details of the coverage, see your Colonial Life benefits counselor. Coverage may vary by state and may not be available in all states. Applicable to policy form CanAssist (and state abbreviations where applicable, for example: CanAssist-TX).©2015 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.CANCER ASSIST WELLNESS | 3-15 | 101486-1

For more information, talk with your benefits counselor.ColonialLife.comSubsequent diagnosis of a dierent critical illness3If you receive a benefit for a specified critical illness, and later you are diagnosed with a dierent specified critical illness, the original percentage of the face amount is payable for that particular specified critical illness.Subsequent diagnosis of the same critical illness3If you receive a benefit for a specified critical illness, and later you are diagnosed with the same specified critical illness, 25% of the original face amount is payable. Critical illness conditions that do not qualify are: coronary artery bypass gra surgery/disease2 and occupational infectious HIV or occupational infectious hepatitis B, C or D.Specified Critical Illness InsuranceFor the diagnosis of this covered critical illness condition:1This percentage of the face amount is payable:Heart attack (myocardial infarction) 100%Stroke 100%End-stage renal (kidney) failure 100%Major organ failure 100%Permanent paralysis due to a covered accident 100%Coma 100%Blindness 100%Occupational infectious HIV or occupational infectious hepatitis B, C or D100%Coronary artery bypass gra surgery/disease225%If you’re diagnosed with a covered critical illness, specified critical illness insurance from Colonial Life can help with your expenses, so you can concentrate on what’s most important – your treatment, care and recovery.Face amount: $10K, $15K, $20KCritical illness benefitCRITICAL ILLNESS 1.0 WITH SUBSEQUENT DIAGNOSIS The maximum benefit amount for this policy is 3x the face amount for the named insured for all covered persons combined. The policy will terminate when the maximum benefit amount for specified critical illness has been paid.

ColonialLife.com1 Please refer to the policy for complete definitions of covered conditions. 2 Benefit for coronary artery disease applicable in lieu of benefit for coronary artery bypass gra surgery when health savings account (HSA) compliant plan is selected.3 Dates of diagnoses of a covered specified critical illness must be separated by at least 180 days.THIS POLICY PROVIDES LIMITED BENEFITS.EXCLUSIONS AND LIMITATIONS FOR SPECIFIED CRITICAL ILLNESSWe will not pay benefits for a specified critical illness that occurs as a result of a covered person’s: felonies or illegal occupations; intoxicants and narcotics; mental or emotional disorders; pre-existing condition; suicide or self-inflicted injuries; or war or armed conflict.This is not an insurance contract and only the actual policy provisions will control. Applicable to policy form CI-1.0-ID or CI-1.0-SC. Please see your Colonial Life benefits counselor for details.6-17 | 101824-ID-SCUnderwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2017 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

For more information, talk with your benefits counselor.Critical Illness InsuranceHealth Screening Benefit THIS POLICY/INSURANCE PROVIDES LIMITED BENEFITS.Insureds in GA, MA, MN and VT must be covered by comprehensive health insurance before applying for critical illness or cancer insurance.This information is not intended to be a complete description of the insurance coverage available. The policy/insurance or its provisions may vary or be unavailable in some states. The policy/insurance has exclusions and limitations which may aect any benefits payable. Applicable to policy form CI-1.0-P and GCC1.0-P and certificate form GCC1.0-C (including state abbreviations where used, for example: CI-1.0-P-TX, GCC1.0-P-TX and GCC1.0-C-TX). For cost and complete details of coverage, call or write your Colonial Life benefits counselor or the company.GROUP CRITICAL CARE, CRITICAL ILLNESS 1.0 – HEALTH SCREENING BENEFIT | 5-21 | 100355-4ColonialLife.comHealth screening benefit ................................................................ $__50.00_____________ Maximum of one screening test per covered person per calendar year. Blood test for triglycerides Bone marrow testing Breast ultrasound CA 15-3 (blood test for breast cancer) CA 125 (blood test for ovarian cancer) Carotid Doppler CEA (blood test for colon cancer) Chest X-ray Colonoscopy Echocardiogram (ECHO) Electrocardiogram (EKG, ECG) Fasting blood glucose test Flexible sigmoidoscopy Hemoccult stool analysis Mammography Pap smear PSA (blood test for prostate cancer) Serum cholesterol test for HDL and LDL levels Serum protein electrophoresis(blood test for myeloma) Skin cancer biopsy Stress test on a bicycleor treadmill Thermography ThinPrep pap test Virtual colonoscopyThe optional health screening benefit can help you reduce the risk of serious illness through early detection.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC©2021 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

Term Life InsurancePeace of mind for you and your loved onesYou want what’s best for your family, and that includes making sure they’re prepared for the future. With term life insurance from Colonial Life & Accident Insurance Company, you can provide financial security to help them cover their ongoing living expenses.Advantages of term life insurance  Lower cost when compared to cash value life insurance  Same benefit payout throughout the duration of the policy  Several term period options for flexibility during high-need years  Benefit for the beneficiary that is typically tax-freeBenefits and features  Stand-alone spouse policy available whether or not you buy a policy for yourself  Guaranteed premiums that do not increase during the selected term  Ability to convert all or a portion of the benefit amount into cash value life insurance  Flexibility to keep the policy if you change jobs or retire  Built-in terminal illness accelerated death benefit that provides up to 75% of the policy’s death benefit (up to $150,000) if you’re diagnosed with a terminal illness  Premium savings for face amounts over $250,000 based on your healthTERM LIFE (ITL5000)LIMRA, 2017 Insurance Barometer Study.of Americans would have trouble paying living expenses immediately or within several months if the primary wage-earner died.54%married/partnered consumersLIMRA, 2018 Insurance Barometer Study.1-in-3wish their spouse or partner would purchase more life insurance.

£ YOU $ ___________________ Select the option:£ Paid-Up at Age 70£ Paid-Up at Age 100£ SPOUSE $ _______________ Select the option:£ Paid-Up at Age 70£ Paid-Up at Age 100EXCLUSIONS AND LIMITATIONSIf the insured dies by suicide, whether sane or insane, within two years (one year in ND) from the coverage eective date or the date of reinstatement, we will not pay the death benefit. We will terminate this policy and return the premiums paid without interest, minus any loans and loan interest to you. Product may vary by state. For costs and complete details of the coverage, call or write your Colonial Life benefits counselor or the company.This brochure is applicable to policy forms ICC19-IWL5000-70/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 and applicable state variations.Additional coverage optionsSpouse term life riderCover your spouse up to a maximum death benefit of $50,000; 10-year and 20-year spouse term riders are available.Juvenile whole life policyYou can purchase a policy while children are young and premiums are low – whether or not you buy a policy on yourself. You may also increase the coverage when the child is 18, 21 and 24 without providing proof of good health. The plan is paid-up at age 70.Children’s term life riderYou may purchase up to $20,000 in term life coverage for all of your eligible dependent children and pay one premium. The children’s term life rider may be added to either your policy or your spouse’s policy – not both.Accidental death benefit riderThe beneficiary may receive an additional benefit if the covered person dies as a result of an accident before age 70. The benefit doubles if the accidental bodily injury occurs while riding as a fare-paying passenger using public transportation, such as ride-sharing services. An additional 25% will be payable if the injury is sustained while driving or riding in a private passenger vehicle and wearing a seatbelt.Chronic care accelerated death benefit riderIf a licensed health care practitioner certifies that you have a chronic illness, you may receive an advance on all or a portion of the death benefit, available in a one-time lump sum or monthly payments. A chronic illness means you require substantial supervision due to a severe cognitive impairment or you 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 benefit period.Critical illness accelerated death benefit riderIf you suer a heart attack (myocardial infarction), stroke or end-stage renal (kidney) failure, a $5,000 benefit is payable. A subsequent diagnosis benefit is included.Guaranteed purchase option riderIf you are age 50 or younger when you purchase the policy, you can add the rider, which allows you to purchase additional whole life coverage – without having to answer health questions – at three dierent points in the future. 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 benefit riderPremiums are waived (for the policy and riders) if you become totally disabled before the policy anniversary following your 65th birthday and you satisfy the six-month elimination period. Once you are no longer disabled, premium payments will resume.Benefits worksheetFor use with your benefits counselorSelect any optional riders:£ Spouse term life rider $ _____________ face amount for ________-year term period£ Children’s term life rider $ _____________ face amount£ Accidental death benefit rider£ Chronic care accelerated death benefit rider£ Critical illness accelerated death benefit rider£ Guaranteed purchase option rider£ Waiver of premium benefit riderHOW MUCH COVERAGE DO YOU NEED?To learn more, talk with your benefits counselor.ColonialLife.com6-19 | 101935£ DEPENDENT STUDENT $____________£ Paid-Up at Age 70 £ Paid-Up at Age 100 1 Loan should be repaid to protect the policy’s value. 2 Any payout would reduce the death benefit. Benefits may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2019 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

Your cost will vary based on the level of coverage you select. Whole Life InsuranceYou can’t predict your family’s future, but you can be prepared for it.You like to think that you’ll be there for your family in the years to come. But if something happened to you, would your family have the income they need?It’s not easy to think about such serious circumstances, but it’s important to make sure your family is financially protected. You can gain peace of mind with whole life insurance from Colonial Life.Advantages of whole life insurance  Permanent coverage that stays the same throughout the life of the policy  Guaranteed level premiums that do not increase because of changes in health or age  Access to the policy’s cash value through a policy loan for emergencies  Benefit for the beneficiary that is typically tax-freeBenefits and features  Two plan options to choose what age your premium payments will end – Paid-Up at Age 70 or Paid-Up at Age 100  Stand-alone spouse policy available whether or not you buy a policy for yourself  Flexibility to keep the policy if you change jobs or retire  Built-in terminal illness accelerated death benefit that provides up to 75% of the policy’s death benefit (up to $150,000) if you’re diagnosed with a terminal illness  Immediate $3,000 claim payment that can help your designated beneficiary pay for funeral costs or other expenses  Pays cash surrender value at age 100 (when the policy endows)WHOLE LIFE (IWL5000)HealthAairs.org, End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported, July 2017.Talk with your benefits counselor for information about what level of coverage would work best for you.In the U.S., medical spending in the last 12 months of life is nearly $80,000 per person.$

How much term life insurance do you need?Funeral expensesThe median cost of a funeral is $7,360.*Outstanding debts(including mortgage)Replacement incomeEducation fundAvailable assets (savings, investments, present amount of life insurance)Estimated amount of life insurance needed To learn more, talk with your Colonial Life benefits counselor.EXCLUSIONS AND LIMITATIONSIf the insured dies by suicide, whether sane or insane, within two years (one year in ND) from the coverage eective date or the date of reinstatement, we will not pay the death benefit. We will terminate this policy and return the premiums paid, without interest. Product may vary by state. For cost and complete details of the coverage, call or write your Colonial Life benefits counselor or the company. This brochure is applicable to policy forms ICC18-ITL5000/ITL5000 and rider forms ICC18-R-ITL5000-STR/R-ITL5000-STR, ICC18-R-ITL5000-CTR/R-ITL5000-CTR, ICC18-R-ITL5000-WP/R-ITL5000-WP, ICC18-R-ITL5000-ACCD/R-ITL5000-ACCD, ICC18-R-ITL5000-CI/R-ITL5000-CI, ICC18-R-ITL5000-CC/R-ITL5000-CC and applicable state variations. Spouse term life riderYour spouse may receive a maximum death benefit of $50,000; 10-year and 20-year spouse term riders are available. Children’s term life riderYou can purchase up to $20,000 in term life coverage for all of your eligible dependent children and pay one premium. The children’s term life rider may be added to either your policy or your spouse’s policy – not both.Accidental death benefit riderThe beneficiary may receive an additional benefit if the covered person dies as a result of an accident before age 70. The benefit doubles if the accidental bodily injury occurs while riding as a fare-paying passenger using public transportation, such as ride-sharing services. An additional 25% will be payable if the injury is sustained while driving or riding in a private passenger vehicle and wearing a seatbelt.Chronic care accelerated death benefit riderIf a licensed health care practitioner certifies that you have a chronic illness, you may receive an advance on all or a portion of the death benefit, available in a one-time lump sum or monthly payments. A chronic illness means you require substantial supervision due to a severe cognitive impairment or you may be unable to perform at least two of the six Activities of Daily Living. Premiums are waived during the benefit period. Critical illness accelerated death benefit riderIf you suer a heart attack (myocardial infarction), stroke or end-stage renal (kidney) failure, a $5,000 benefit is payable. A subsequent diagnosis benefit is included.Waiver of premium benefit riderPremiums are waived (for the policy and riders) if you become totally disabled before the policy anniversary following your 65th birthday and you satisfy the six-month elimination period. 2-19 | 101895ColonialLife.com1 Any payout would reduce the death benefit. Benefits may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits.2 Activities of daily living are bathing, continence, dressing, eating, toileting and transferring.3 You must resume premium payments once you are no longer disabled.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC©2019 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.*Includes viewing and burial.National Funeral Directors Association, Statistics, 2018. ++–+Optional ridersAt an additional cost, you can purchase the following riders for even more financial protection.=

How does it work? It's simple. Your annual election is deducted pre-tax from your paycheck in equal amounts during the plan year.Swipe your card for eligible expenses or submit a claim for reimbursement.Choose your annual election for each flex plan, based on your anticipated expenses.No matter which health insurance plan you enroll in this year, you will likely have out-of-pocket costs. Save up to 30% on qualifying out-of-pocket expenses by setting aside pre-tax dollars from your paycheck with a flex account! Flexible Spending AccountPlan Enrollment Materials Questions? Contact us at info@flexfacts.com or 877-943-2287This lowers your taxable income!Plan Year: 12/1/2023- 12/31/2024Dependent Care Account (DCA) Medical FSA Medical Pharmacy Dental Vision Over-the- Counter Childcare Expenses

Swipe your Flex Facts debit card to pay for eligible expenses or pay with your personal funds and submit a claim for reimbursement.Medical FSASave up to $915 on medical expenses this year!Participating in an FSA is like receiving a 30% discount from your medical providers.*based on 2023 IRS Contribution Limit. Please note: Your employer may limit the maximum annual limit to a lesser amount.• Copays, deductible, coinsurance• Doctor office visits, lab work, x-rays• Hospital charges• Dental and orthodontia• Vision exams, glasses, contactlenses, laser vision correction• Physical therapy• Chiropractic care• Medical supplies and first aid kits• Rx and over-the-counter meds• And much more...Visit http://fsastore.com/FlexfactsEL for full list.How does an FSA work?A medical FSA is a flexible spending account that allows you to set aside pre-tax dollars for eligible medical, dental, and vision expenses for you and your dependents.Choose an annual election amount, up to 1,000*. This amount will be deducted from your paychecks in equal installments throughout the year. Your full election will be available for spending on the first day of the plan year!Why should I enroll in an FSA?Almost everyone has some level of out of pocket medical costs. If you expect to incur medical expenses, you’ll want to take advantage of the savings this plan offers. Money contributed to a healthcare FSA is free from federal and most state taxes. On average, participants enjoy a 30% tax savings on their annual contribution, saving up to $915 per year!Helpful hints...Your election can only be changed during the plan year if you experience a qualifying event.Save your receipts. You may need itemized invoices to verify card swipes or for claim reimbursements.If your employment terminates, your account will be terminated.Up to $610 of unused funds will rollover into the next plan year. Unused funds over this amount will be forfeited at the end of the plan year.Reminder: You can't contribute to an FSA and HSA within the same plan year.Search 'Flex Facts' on the App Store or Google Play.Spending your FSA fundsCommon eligible expensesDownload our app..... Questions? Contact us at info@flexfacts.com or 877-943-2287

Flex Facts Enrollment Form Please return this form to your human resources representative Personal Information Employer: Full Name: Last First M.I.Address: Street Address Apartment/Unit # City State ZIP Code Phone: Social Security Number: Birth Date: E-mail Address:Effective Date: Plan Year Start:Benefit Election I ELECT THE FOLLOWING: Amount Per Pay Period # of Pay Periods Annual Election $ ____________ _______ $ _________ $ ____________ _______ $ _________ $ ____________ _______ $ _________ Medical FSA Account Dependent Care Account Limited Purpose FSA (HSA only)Frequency of Pay: Weekly Bi-Weekly Semi-Monthly Monthly Other Date of First Deduction: ____________________________ Spouse or Dependent Card Information Full Name: Last First M.I.Mail Card to: Address listed above Alternate Address: Street Address Apt. /Unit # City State ZIP Code Soc. Sec. Number: Relationship: Employee Authorization ▪If this form is not returned to your employer by your effective date, you will not be able to participate in the plan until the followingplan year.▪Your accounts will not automatically renew. You must sign a new election form each year at open enrollment.▪You cannot change the FSA election during the plan year unless you have an eligible change in status.▪This agreement is subject to the terms of the company’s Flexible Benefits Plan.▪By signing this form, I agree that my cash compensation will be redirected by the amounts set forth above.Signature: Date: Flex Facts | 1200 River Avenue, Suite 10E | Lakewood, NJ 08701 | www.flexfacts.com | 877-94-FACTS Date of Birth:

Deductions per year: 52 AC Widenhouse RatesIndividual Disability - ISTD3000 for NC A Risk ClassApplicable to policy form Individual DisabilitylOff Job Accident & Off Job Sickness3 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $5.89 $7.36 $8.83 $11.04 $14.7250-64 $7.20 $9.00 $10.80 $13.50 $18.0065-74 $10.45 $13.06 $15.67 $19.59 $26.126 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $7.57 $9.46 $11.35 $14.19 $18.9250-64 $9.99 $12.48 $14.98 $18.73 $24.9765-74 $15.40 $19.25 $23.10 $28.87 $38.49Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$2000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $12.28 $23.01 $17.06 $27.8150-59 $15.76 $29.68 $20.55 $34.4760-64 $19.95 $37.62 $24.74 $42.4065-75 $27.68 $52.24 $32.96 $57.51Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$1000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $9.09 $16.99 $12.49 $20.4050-59 $11.40 $21.37 $14.80 $24.7860-64 $14.00 $26.31 $17.40 $29.7165-75 $18.93 $35.67 $22.69 $39.42Accident 1.0 for NCApplicable to policy forms ACCIDENT 1.0-HS and ACCIDENT1.0-NSlOn/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with health screening 17-80 $4.88 $6.69 $7.54 $9.34Page 1 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Cancer Assist for NCApplicable to policy form CanAssistlwith $100 Health Screening Benefit$5,000 Initial Diagnosis BenefitCOVERAGE LEVEL ISSUE AGE NAMED INSURED EMPLOYEE AND SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYLevel 3 17-75 $7.88 $13.13 $8.10 $13.35Critical Illness 1.0 for NCApplicable to policy form CI-1.0lwith Subsequent Diagnosis Coverage, Health Screening BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $1.05 $1.59 $1.05 $1.5925-29 $1.22 $1.87 $1.22 $1.8730-34 $1.40 $2.17 $1.40 $2.1735-39 $1.95 $3.00 $1.95 $3.0040-44 $2.32 $3.55 $2.32 $3.5545-49 $3.02 $4.61 $3.02 $4.6150-54 $3.85 $5.91 $3.85 $5.9155-59 $4.75 $7.27 $4.75 $7.2760-64 $5.88 $9.02 $5.88 $9.0265-70 $7.12 $10.94 $7.12 $10.94Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $1.28 $1.96 $1.28 $1.9625-29 $1.58 $2.42 $1.58 $2.4230-34 $1.98 $3.04 $1.98 $3.0435-39 $2.74 $4.20 $2.74 $4.2040-44 $3.55 $5.44 $3.55 $5.4445-49 $4.56 $6.99 $4.56 $6.9950-54 $5.74 $8.79 $5.74 $8.7955-59 $7.28 $11.19 $7.28 $11.1960-64 $8.76 $13.45 $8.76 $13.4565-70 $10.72 $16.48 $10.72 $16.48Term Life (ITL5000) for NCApplicable to policy form ITL5000l20-Year Term Base Plan, Waiver of Premium Benefit, Accidental Death Benefit, Critical Illness Accelerated Death Benefit,Chronic Care Accelerated Death BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $3.57 $4.20 $5.62 $7.0735 $4.33 $4.69 $6.31 $7.9445 $6.06 $7.85 $10.86 $13.8855 $12.56 $15.98 $22.62 $29.2765 $18.32 $33.33 $48.33 $63.34(Continued...)Page 2 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Term Life (ITL5000) for NCApplicable to policy form ITL5000l20-Year Term Base Plan, Waiver of Premium Benefit, Accidental Death Benefit, Critical Illness Accelerated Death Benefit,Chronic Care Accelerated Death BenefitTobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $5.75 $5.97 $8.28 $10.6135 $6.65 $6.78 $9.45 $12.1145 $9.64 $13.31 $19.05 $24.8055 $21.72 $29.76 $43.29 $56.8365 $28.04 $52.78 $77.50 $102.24Whole Life Plus (IWL5000) for NCApplicable to policy forms ICC19-IWL5000-70/IWL5000-70,ICC19-IWL5000-100/IWL5000-100,ICC19-IWL5000J/IWL5000J and rider formsICC19-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-GPOlAdult Base Plan Paid-Up at Age 100, Accidental Death Benefit, Chronic Care Accelerated Death Benefit, Critical IllnessAccelerated Death Benefit, Guaranteed Purchase Option Benefit, Waiver of Premium BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $6.45 $12.49 $18.53 $24.5935 $8.64 $16.77 $24.88 $33.0145 $13.74 $26.68 $39.60 $52.5455 $22.33 $43.63 $64.94 $86.2565 $36.39 $71.54 $106.70 $141.86Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $10.47 $20.54 $30.61 $40.6935 $12.80 $25.08 $37.35 $49.6245 $19.31 $37.82 $56.30 $74.8155 $31.92 $62.80 $93.70 $124.6065 $51.48 $101.73 $151.98 $202.25Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage maynot 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.© 2021 Colonial Life & Accident Insurance Company"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.Kitty Mellone| Kmellone@coloniallifenc.com (704) 907-3944(Continued...)Page 3 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Deductions per year: 26 Carolina Oil RatesIndividual Disability - ISTD3000 for NC AA Risk ClassApplicable to policy form Individual DisabilitylOff Job Accident & Off Job Sickness6 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount7 days Accident/7 days Sickness 17-49 $12.74 $15.92 $19.11 $23.88 $31.8550-64 $16.80 $21.00 $25.20 $31.50 $42.0065-74 $26.18 $32.72 $39.27 $49.08 $65.4514 days Accident/14 days Sickness 17-49 $8.94 $11.17 $13.40 $16.75 $22.3450-64 $11.41 $14.26 $17.11 $21.39 $28.5265-74 $18.09 $22.62 $27.14 $33.92 $45.2312 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount7 days Accident/7 days Sickness 17-49 $17.65 $22.06 $26.47 $33.09 $44.1250-64 $22.49 $28.11 $33.73 $42.16 $56.2265-74 $43.16 $53.95 $64.74 $80.93 $107.9114 days Accident/14 days Sickness 17-49 $12.59 $15.74 $18.89 $23.61 $31.4850-64 $16.69 $20.86 $25.03 $31.29 $41.7265-74 $31.98 $39.97 $47.96 $59.95 $79.94Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$2000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $24.56 $46.04 $34.13 $55.6250-59 $31.53 $59.35 $41.10 $68.9360-64 $39.90 $75.23 $49.48 $84.8165-75 $55.36 $104.47 $65.91 $115.01Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$1000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $18.19 $33.99 $25.00 $40.8050-59 $22.80 $42.74 $29.61 $49.5460-64 $28.00 $52.62 $34.80 $59.4365-75 $37.87 $71.34 $45.37 $78.83Page 1 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Accident 1.0 for NCApplicable to policy forms ACCIDENT 1.0-HS and ACCIDENT1.0-NSlOn/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with health screening 17-80 $9.76 $13.37 $15.08 $18.68Cancer Assist for NCApplicable to policy form CanAssistlwith $100 Health Screening Benefit$5,000 Initial Diagnosis BenefitCOVERAGE LEVEL ISSUE AGE NAMED INSURED EMPLOYEE AND SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYLevel 3 17-75 $15.76 $26.26 $16.20 $26.70Critical Illness 1.0 for NCApplicable to policy form CI-1.0lwith Subsequent Diagnosis Coverage, Health Screening BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $2.10 $3.18 $2.10 $3.1825-29 $2.42 $3.74 $2.42 $3.7430-34 $2.79 $4.34 $2.79 $4.3435-39 $3.90 $6.00 $3.90 $6.0040-44 $4.64 $7.10 $4.64 $7.1045-49 $6.02 $9.23 $6.02 $9.2350-54 $7.68 $11.81 $7.68 $11.8155-59 $9.48 $14.54 $9.48 $14.5460-64 $11.74 $18.04 $11.74 $18.0465-70 $14.24 $21.87 $14.24 $21.87Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $2.56 $3.92 $2.56 $3.9225-29 $3.16 $4.84 $3.16 $4.8430-34 $3.94 $6.09 $3.94 $6.0935-39 $5.47 $8.40 $5.47 $8.4040-44 $7.08 $10.89 $7.08 $10.8945-49 $9.11 $13.98 $9.11 $13.9850-54 $11.47 $17.58 $11.47 $17.5855-59 $14.56 $22.38 $14.56 $22.3860-64 $17.51 $26.90 $17.51 $26.9065-70 $21.44 $32.95 $21.44 $32.95(Continued...)Page 2 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Term Life (ITL5000) for NCApplicable to policy form ITL5000l20-Year Term Base Plan, Waiver of Premium Benefit, Accidental Death Benefit, Critical Illness Accelerated Death Benefit,Chronic Care Accelerated Death BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $7.16 $8.42 $11.29 $14.1535 $8.67 $9.41 $12.64 $15.8945 $12.14 $15.71 $21.75 $27.7755 $25.13 $31.97 $45.26 $58.5365 $36.67 $66.68 $96.69 $126.70Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $11.52 $11.96 $16.60 $21.2335 $13.31 $13.58 $18.90 $24.2445 $19.30 $26.64 $38.13 $49.6255 $43.45 $59.53 $86.59 $113.6565 $56.12 $105.59 $155.04 $204.50Whole Life Plus (IWL5000) for NCApplicable to policy forms ICC19-IWL5000-70/IWL5000-70,ICC19-IWL5000-100/IWL5000-100,ICC19-IWL5000J/IWL5000J and rider formsICC19-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-GPOlAdult Base Plan Paid-Up at Age 100, Accidental Death Benefit, Chronic Care Accelerated Death Benefit, Critical IllnessAccelerated Death Benefit, Guaranteed Purchase Option Benefit, Waiver of Premium BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $12.90 $25.00 $37.10 $49.1935 $17.30 $33.55 $49.77 $66.0245 $27.50 $53.36 $79.21 $105.0755 $44.65 $87.27 $129.88 $172.4965 $72.77 $143.09 $213.41 $283.72Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $20.95 $41.10 $61.25 $81.3935 $25.61 $50.17 $74.70 $99.2545 $38.64 $75.63 $112.61 $149.6055 $63.82 $125.61 $187.40 $249.1865 $102.96 $203.48 $303.98 $404.48Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage may(Continued...)Page 3 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Deductions per year: 24Barefoot Oil Rate SheetIndividual Disability - ISTD3000 for NC AA Risk ClassApplicable to policy form Individual DisabilitylOff Job Accident & Off Job Sickness3 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $11.80 $14.75 $17.70 $22.13 $29.5050-64 $14.00 $17.50 $21.00 $26.25 $35.0065-74 $19.64 $24.55 $29.46 $36.83 $49.106 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $14.80 $18.50 $22.20 $27.75 $37.0050-64 $19.20 $24.00 $28.80 $36.00 $48.0065-74 $29.96 $37.45 $44.94 $56.18 $74.90Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$1000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $19.70 $36.83 $27.08 $44.2050-59 $24.71 $46.31 $32.08 $53.6860-64 $30.33 $57.00 $37.70 $64.3865-75 $41.03 $77.28 $49.15 $85.40Individual Medical Bridge for NCApplicable to policy form Individual Medical Bridgel$2000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Diagnostic Procedure Benefit, Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $26.60 $49.88 $36.98 $60.2550-59 $34.16 $64.31 $44.53 $74.6860-64 $43.23 $81.50 $53.60 $91.8865-75 $59.98 $113.18 $71.40 $124.60Accident 1.0 for NCApplicable to policy forms ACCIDENT 1.0-HS and ACCIDENT1.0-NSlOn/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with health screening 17-80 $10.58 $14.49 $16.34 $20.24Page 1 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Cancer Assist for NCApplicable to policy form CanAssistlwith $100 Health Screening Benefit$5,000 Initial Diagnosis BenefitCOVERAGE LEVEL ISSUE AGE NAMED INSURED EMPLOYEE AND SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYLevel 3 17-75 $17.08 $28.45 $17.55 $28.93Critical Illness 1.0 for NCApplicable to policy form CI-1.0lwith Subsequent Diagnosis Coverage, Health Screening BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $2.28 $3.45 $2.28 $3.4525-29 $2.63 $4.05 $2.63 $4.0530-34 $3.03 $4.70 $3.03 $4.7035-39 $4.23 $6.50 $4.23 $6.5040-44 $5.03 $7.70 $5.03 $7.7045-49 $6.53 $10.00 $6.53 $10.0050-54 $8.33 $12.80 $8.33 $12.8055-59 $10.28 $15.75 $10.28 $15.7560-64 $12.73 $19.55 $12.73 $19.5565-70 $15.43 $23.70 $15.43 $23.70Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $2.78 $4.25 $2.78 $4.2525-29 $3.43 $5.25 $3.43 $5.2530-34 $4.28 $6.60 $4.28 $6.6035-39 $5.93 $9.10 $5.93 $9.1040-44 $7.68 $11.80 $7.68 $11.8045-49 $9.88 $15.15 $9.88 $15.1550-54 $12.43 $19.05 $12.43 $19.0555-59 $15.78 $24.25 $15.78 $24.2560-64 $18.98 $29.15 $18.98 $29.1565-70 $23.23 $35.70 $23.23 $35.70Term Life (ITL5000) for NCApplicable to policy form ITL5000l20-Year Term Base Plan, Waiver of Premium Benefit, Accidental Death Benefit, Critical Illness Accelerated Death Benefit,Chronic Care Accelerated Death BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $7.78 $9.13 $12.24 $15.3435 $9.41 $10.19 $13.71 $17.2345 $13.16 $17.03 $23.57 $30.0955 $27.23 $34.64 $49.03 $63.4265 $39.72 $72.23 $104.74 $137.25(Continued...)Page 2 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Term Life (ITL5000) for NCApplicable to policy form ITL5000l20-Year Term Base Plan, Waiver of Premium Benefit, Accidental Death Benefit, Critical Illness Accelerated Death Benefit,Chronic Care Accelerated Death BenefitTobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $12.50 $12.97 $17.99 $23.0135 $14.44 $14.71 $20.49 $26.2745 $20.92 $28.86 $41.32 $53.7655 $47.08 $64.49 $93.81 $123.1365 $60.79 $114.38 $167.96 $221.54Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage maynot 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.© 2014 Colonial Life & Accident Insurance Company"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved. Kitty Mellone |Kmellone@coloniallifenc.com | (704) 907-3944(Continued...)Page 3 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important NoticeWhole Life Plus (IWL5000) for NCl Adult Base Plan Paid-Up at Age 100, Accidental Death Benefit, Chronic Care Accelerated Death Benefit, GuaranteedPurchase Option Benefit, Waiver of Premium BenefitNon-Tobacco RatesISSUE AGE $10,000 $25,000 $50,000 $75,000 $100,00025 $5.25 $13.11 $26.22 $39.32 $52.4235 $7.04 $17.60 $35.19 $52.79 $70.3845 $11.21 $28.01 $56.04 $84.04 $112.0555 $18.47 $46.17 $92.33 $138.50 $184.6765 $30.48 $76.18 $152.35 $228.53 $304.70Tobacco RatesISSUE AGE $10,000 $25,000 $50,000 $75,000 $100,00025 $8.74 $21.83 $43.66 $65.48 $87.2935 $10.65 $26.60 $53.20 $79.78 $106.3845 $16.04 $40.08 $80.16 $120.22 $160.2955 $26.77 $66.94 $133.87 $200.81 $267.7565 $43.56 $108.88 $217.77 $326.65 $435.53

_______Barefoot Oil Colonial Interest Form_______ Carolina Oil_______ AC WidenhouseName_________________________________ Job Title ______________ Social Security #_________________ Annual Income $________________________ Address________________________________ City ___________________St. __________Zip_______ Work Phone___________________ Cell Phone________________ Email Address____________________________________________________ Date of Birth (DOB) ________________ Tobacco______ Non Tobacco_____ Date of Hire____________________ Beneficiary__________________________________DOB___________Relationship____________ Dependent Information: Spouse________________________________DOB_______________ Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ ____ Waive Colonial Coverage. I understand that I can only enroll during Annual Enrollment unless I have a qualified event during the year. Add Flex Spending $________________/ Annual Amount _____Keep all Colonial Benefits the same_____ Cancel all Colonial Benefits for 2024Signature__________________________________________Date____________ Questions or Assistance Contact: Kitty Mellone 704-907-3944 (D) Email: Kmellone@coloniallifenc.comFax Completed Form with Rate Sheet & elected coverage’s circled fax to: 704-413-3034(FAX)

Policyholder Service Guide At Colonial Life our goal is to give you an excellent customer experience that is simple modern and personal Getting started Consider your options The easiest way to manage your business with us is through the My Colonial Life policyholder section of ColonialLife com Whether online or by phone we ll provide the service you need To sign up for the website 1 Visit ColonialLife com 2 Click Register at the top right 3 On the sign up page click Join the Policyholder Website Need ColonialLife com Submit your claim using our eClaims system 3 File health screening wellness and doctor s office visit claims up to 18 months 3 3 Check the status of your claim 3 3 Review print or download a copy of your policy certificate 3 Access claim and service forms 3 3 Access your claim correspondence 3 3 3 Complete a notification for a life claim 3 3 Update your contact information After providing some basic information you ll be ready to go 800 325 4368 Filing claims eClaims With the eClaims feature on ColonialLife com you can file claims online by simply answering a few questions and uploading your supporting documentation You re able to spend less time on paperwork and we re able to process your claim faster With eClaims you can file most claims online including Accident Hospital confinement indemnity Disability Critical illness Cancer Vision You can access eClaims through your computer or mobile device and upload any required supporting documentation Once you re logged in to ColonialLife com visit the Claims Center and select File an Online Claim to get started

Contact us Online ColonialLife com Log in and click on Contact Us to email us Telephone 1 800 325 4368 Contact Center representatives are available Monday through Friday 8 a m to 8 p m ET Information is available 24 7 through our automated phone system Please have your Social Security or policy number ready when you call Hearing impaired customers Customers with a Telecommunications Device for the Deaf TDD should call 803 798 4040 If you do not have a TDD call Voiance Telephone Interpretation Services at 844 495 6105 to reach us Health screening wellness claims The quickest way to receive the applicable benefits for your health screening wellness services is to file online For health screening wellness claims within 18 months of the date you are filing the claim click on File a Wellness Claim Online on the Claims Center page If you do not want to file online you can use the automated customer service center at 1 800 325 4368 For health screening wellness claims over 18 months you ll be directed to print out a paper claim form under the claims and service forms section on the Claims Center page Paper claims If you don t want to file online download the form you need by visiting the Claims Center page on ColonialLife com and clicking on claims and service forms For instructions on how to correctly complete your claim form view the claims videos on the Claims Center page Be sure that you complete all sections of the claim form Also include a diagnosis from your doctor along with copies of any appropriate bills if required Keep a copy of your claim information for your records When we receive information regarding your claim you ll be notified by telephone or email If you select the electronic messaging option you ll receive a call when the claim is processed Claim tips and information When submitting your claim make sure to include all required supporting documentation as this will allow us to process your claim quicker To view correspondence pertaining to your claim visit ColonialLife com Once you log in to your secure account select My Correspondence from the home page Whether you submit your claims online or by paper form you can select optional services that authorize us to Communicate claims information via electronic messaging to your phone number Send claim benefits overnight by deducting a fee from your claim payment Release information to your benefits representative plan administrator or family member You can always check the status of your claim on the My Colonial Life site at ColonialLife com ColonialLife com Applicable to vision rider on the individual dental plan 2016 Colonial Life Accident Insurance Company Columbia SC Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand 4 16 43233 37