Baumann Propellers Benefit Guide : simplebooklet.com

Employees You are eligible to participate in the Benefits Program if you are a regular full-time employee who works 30 hours or more per week. Dependents When you enroll in the Benefits Program, you may also cover your eligible dependents for medical, dental, and vision insurance. Eligible dependents include your: n Legal spouse n Child(ren) up to age 26 regardless of student status, marital status, residence of financial dependence on you (medical, dental and vision) n Unmarried child who is incapable of self-support due to total physical or mental disability What Happens if You Do Not Enroll Existing employees If you do not complete your enrollment during the initial enrollment period, you will have no benefit coverage (except as described below) until the following Open Enrollment period unless you experience a “Qualified Life Event” that qualifies you for a mid-year change. New hires and newly eligible employees You will have 60 days from your date of hire to complete your enrollment. If you do not enroll within 60 days of eligibility, you must wait until the next Open Enrollment period. When Coverage Begins for New Employees Coverage for you and your dependents becomes effective the first of the month following 60 days from your date of hire. Changing Your Benefits During the Year Your benefit elections remain in effect for the entire plan year, unless you have an IRS qualified life event (proof will be required). All changes as a result of a qualified life event must be made within 30 days of the event. Eligible qualified life events include the following: n Legal marital status – any event that changes your legal marital status, including marriage, death of spouse, divorce, legal separation, or annulment. n Number of dependents – any event that changes the number of your dependents, including birth, adoption, placement for adoption, divorce or death of a dependent, or assuming primary support of the child of an unmarried dependent child. n Employment status – any event in which an eligible dependent gain or loses access to employer-sponsored coverage. n Dependent status – any event, due to age or similar circumstances, which causes your dependent to satisfy or cease to satisfy eligibility requirements under the plan which you receive coverage. n Medicare or Medicaid eligible status – you or your spouse become Medicare or Medicaid eligible. Who’s Eligible Our benefit plans use the IRS definition for eligible dependents, and we may request proof of dependent eligibility. If at any time during the year your enrolled dependents no longer meet eligibility requirements, you must notify the Human Resources Department to remove the individual from coverage.

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Coverage Period: 01/01/2022-12/31/2022Coverage for: Individual/Family | Plan Type; PPOSummary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services: S665CHC Blue Choice Silver PPQsm 834BlurCro.ss BlueShield ol'Texas .The Summary of Benefits and Coverage (SBC) document will help you choose a health The SBC shows you how you and the wouldshare the cost for covered health care services. NOTE: Information about the cost of this pjan (called the premium) will be provided separately.This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, visit www.bcbstx.com/niember/pQlicv-forms/2022 or by calling 1-800-521-2227. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider,or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare,qov/sbc-qlossarv/ or call 1 -855-756-4448 to request a copy.Why This Matters:Important QuestionsAnswers[What is the overalldeductible?Network: $3,250 lndividual/$9,750FamilyOut-of-Network: $6,500lndividual/$19,50Q FamilyGenerally, you must pay all of the costs from providers up to the deductible amount before this planbegins to pay. If you have other family members on the plan, each family member must meet their ownindividual deductible until the total amount of deductible expenses paid by all family members meetsthe overall family deductible.This covers some items and services even if you haven’t yet met the deductible amount. But acopayment or coinsurance may apply. For example, this covers certain preventive serviceswithout cost-sharing and before you meet vour deductible. See a list of covered preventive services atwww.healthcare.qov/coveraae/preventive-care-benefits/.Are there services coveredbefore you meet yourdeductible?Yes. In-Network Preventive HealthCare services, certain services with acopayment, and some prescriptiondrugs are covered before you meetvour deductible.You don’t have to meet deductibles for specific services.I Are there other deductiblesfor specific services?What is the out-of-pocketlimit for this plan?No.Network: $8,550 lndivldual/$17,100FamilyOut-of-Network: UnlimitedIndividual/Unlimited FamilyThe out-of-pocket limit is the most you could pay in a year for covered services. If you have other familymembers in this pl^, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met.Even though you pay these expenses, they don't count toward the out-of-pocket limit.Premiums, balance-billed charges, andhealth care this plan doesn't cover.What is not included in theout-of-pocket limit?Will you pay less if you usea network provider?This Plan uses a provider network. You will pay less if you use a provider in the plan’s network. You willpay the most if you use an out-of-network provider, and you might receive a bill from a provider for thedifference between the provider’s charge and what your plan pays (balance billing). Be aware, yournetwork provider might use an out-of-network provider for some services (such as lab work). Checkwith vour provider before you get services.Yes. See www.bcbstx.com/ao/bcppoor call 1-800-521-2227 for a list ofnetwork providers.You can see the specialist you choose without a referral.Do you need a referral tosee a specialist?No,Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Crossand Blue Shield AssociationPage 1 of 8

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All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.What You Will PayLimitations, Exceptions, & OtherImportant InformationServices You MayNeedCommonMedical EventOut-of-NetworkProviders(You will pay the most)Network Providers(You will pay the least)$50/visit; deductible does not applyVirtual Visits are available. See your benefitbooklet* for details.40% coinsurancePrimary care visit totreat an injury orillness$80/visit; deductible does not apply40% coinsuranceNoneSpecialist visitIf you visit a health careprovider’s office or clinic40% coinsuranceYou may have to pay for services that aren'tpreventive. Ask your provider if the servicesneeded are preventive. Then check whatyour elan will pay for.Preauthorization may be required. See yourbenefit booklet* for details.Preventivecare/screeninq/immunizationNo Charge; deductible does not apply40% coinsuranceDiaanostic test (x-ray, blood work)40% coinsuranceIf you have a test40% coinsurance40% coinsurancePreauthorization may be required. See yourbenefit booklet* for details.Imaging (CT/PETscans, MRIs)‘For more information about limitations and exceptions, see the plan or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 2 of 8

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What You Will PayLimitations, Exceptions, & Otherimportant informationCommonMedical EventServices You MayNeedOut-of-NetworkProviders(You will pay the most)Network Providers(You will pay the least)Retail-$10/prescription;deductible does not applyplus 50% additionalchargePreferred genericdrugsRetail - Preferred Participating - No ChargeParticipating - $10/prescriptionMail - No Charge: deductible does not applyRetail - $20/prescription:deductible does not applyplus 50% additionalchargeNon-preferredgeneric drugsRetail - Preferred Participating -$10/prescriptionParticipating - $20/prescriptionMail - $30/prescription; deductible does notapplyLimited to a 30-day supply at retail (or a 90-day supply at a network of select retailpharmacies). Up to a 90-day supply at mailorder. Specialty drugs limited to a 30-daysupply. Payment of the difference betweenthe cost of a brand name drug and a genericmay also be required if a generic drug isavailable. Additional Out-of-Network chargewill not apply to any deductible or out-of-pocket amounts. Certain drugs requireapproval before they will be covered.Cost-sharing for insulin included in the druglist will not exceed $25 per prescription for a30-day supply, regardless of the amount ortype of insulin needed to fill the prescription.Retail - $70/prescription;deductible does not applyplus 50% additionalchargeRetail - Preferred Participating -$50/prescriptionParticipating - $70/prescriptionMail - $150/prescription; deductible does notapplyRetail - Preferred Participating -$ 100/prescriptionParticipating - $ 120/prescriptionMail - $300/prescription; deductible does notapplyPreferred branddrugsIf you need drugs to treatyour illness or conditionMore information aboutprescription drug coverageis available atwww.bcbstx.com/rx22Retail-$120/prescription;deductible does not applyplus 50% additionalchargeNon-preferred branddrugs$150/prescription; deductible does not apply$150/prescription:deductible does not applyplus 50% additionalchargePreferred specialtydrugs$250/prescription; deductible does not apply$250/prescription;deductible does not applyplus 50% additionalchargeNon-preferredspecialty drugs$300/visit plus 40%coinsurancePreauthorization may be required. ForOutpatient Infusion Therapy, see your benefitbooklet* for details,$200/visit plus 40% coinsuranceFacility fee (e.g.,ambulatory surgerycenter)If you have outpatientsurgery40% coinsurancePhysician/surgeon40% coinsurancefees*For more information about limitations and exceptions, see the pl^ or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 3 of 8

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What You Will PayLimitations, Exceptions, & OtherImportant informationServices You MayNeedCommonMedical EventOut-of-NetworkProviders(You will pay the most)Network Providers(You will pay the least)$500/visit plus 40%coinsurance$500/visit plus 40% coinsuranceCopayment waived if admitted. Out-of-Network ^t share is subject to Networkdeductible.Preauthorization may be required for nonemergency transportation; see your benefitbooklet* for details.Emergency roomcareIf you need immediatemedical attentionEmergency medicaltransportation40% coinsurance40% coinsurance$1 OO/visit; deductible does not apply$250/visit plus 40% coinsuranceUrgent care40% coinsuranceNone$350/visit plus 40%coinsuranceFacility fee (e.g.,hospital room)Preauthorization required. Preauthorizationpenalty: $250 Out-of-Network. See yourbenefit booklet* for details.if you have a hospital stayPhysician/surgeon40% coinsurance40% coinsurancePreauthorization required. See your benefitbooklet* for details.fees$50/office visit; deductible does not apply; 40%coinsurance for other outpatient servicesOutpatient services40% coinsurancePreauthorization may be required; see yourbenefit booklet* for details.If you need mental health,behavioral health, orsubstance abuse services$250/visit plus 40% coinsurance$350/visit plus 40%coinsurancePreauthorization required. Preauthorizationpenalty: $250 Out-of-Network. See your; benefit booklet* for details.Inpatient services*For more information about limitations and exceptions, see the gjan or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 4 of 8

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What You will PayLimitations, Exceptions, & OtherImportant informationCommonMedical EventServices You MayNeedOut-of-NetworkProviders(You will pay the most)Network Providers(You will pay the least)Copayment applies to first prenatal visit (perpregnancy). Cost sharing does not apply forpreventive services. Depending on the typeof services, copayment, coinsurance ordeductible may apply. Maternity care mayinclude tests and services describedelsewhere in the SBC (i.e., ultrasound).Primary Care: $50/initial visitSpecialist: $80/initial visit; deductible does notapply40% coinsuranceOffice visits40% coinsuranceIf you are pregnantChildbirth/deliveryprofessional servicesChildbirth/deliveryfacility services40% coinsurance$250/visit plus 40% coinsurance$350/visit plus 40%coinsurance60 visits/year. Preauthorization may berequired.40% coinsurance40% coinsuranceHome health careSeparate 35 visit maximum per benefit periodfor Habilitation and Rehabilitation services,including chiropractic care. Preauthorizationmay be required; see your benefit booklet* fordetails.40% coinsurance40% coinsuranceRehabilitationservices40% coinsuranceHabilitation services40% coinsuranceIf you need help recoveringor have other special healthneeds25 days/year. Preauthorization may berequired.40% coinsurance40% coinsuranceSkilled nursing carePreauthorization may be required.40% coinsurance40% coinsuranceDurable medicalequipmentPreauthorization may be required.40% coinsurance40% coinsuranceHospice servicesUp to a $30reimbursement isavailable; deductible doesnot applyOne visit per year. Out-of-Networkreimbursement will not exceed the retail cost.See your benefit booklet* (Pediatric VisionCare Benefits) for details.No Charge; deductible does not applyChildren’s eye examIf your child needs dental oreye careOne pair of glasses every 12 months,Reimbursement for frames, lenses, and lensoptions purchased Out-of-Network isavailable (not to exceed the retail cost). Seeyour benefit booklet* (Pediatric Vision CareBenefits) for details.Reimbursement isavailable; deductible doesnot applyChildren’s glassesNo Charge; deductible does not apply*For more information about limitations and exceptions, see the or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 5 of 8

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What You Will PayLimitations, Exceptions, & OtherImportant InformationCommonMedical EventServices You MayNeedOut-of-NetworkProviders(You will pay the most)Network Providers(You will pay the least)Oral exams are limited to two every benefitperiod. Benefits for periodic andcomprehensive oral evaluations are limitedto a combined maximum of two every 12months. See your benefit booklet*(Pediatric Dental Benefits Rider) for details.Children’s dentalcheck-up30% coinsurance30% coinsuranceExcluded Services & Other Covered Services:Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)Routine eye care (Adult)Routine foot care (except in connection withdiabetes, circulatory disorders of the lowerextremities, peripheral vascular disease, peripheralneuropathy, or chronic arterial or venousinsufficiency)Weight loss programsAbortion (except for a pregnancy that, as certified ●by a physician, places the woman in danger ofdeath or a serious risk of substantial impairment of ●a major bodily function unless an abortion is ●performed)Acupuncture ●Bariatric surgeryCosmetic surgery (except for the correction ofcongenital deformities or for conditions resultingfrom accidental injuries, scars, tumors, or diseaseswhen medically necessary)Dental care (Adult) Infertility treatment (diagnosis and treatmentcovered; in vitro not covered)Long-term careNon-emergency care when traveling outside theU.S,Private-duty nursing (except for extended care)Other Covered Services (Limitations may apply to these services. This isn’t a complete list Please see your plan document.)● Chiropractic care (35 visits/year combined withhabilitation and rehabilitation services)● Hearing aids (limited to one hearing aid per earevery 36 months)Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: theplan at Blue Cross and Blue Shield of Texas at 1 -888-697-0683 or visit www.bcbstx.com. For group health coverage subject to ERISA, contact the U.S. Department ofLabor’s Employee Benefits Security Administration at 1 -866-444-EBSA (3272) or wvw/.dol.qov/ebsa/healthreform. For non-federal governmental group health plans, contactDepartment of Health and Human Services, Center for Consumer Information and Insurance Oversight, at 1-877-267-2323 x61565 or vww.cciio.cms.qov. Church plans arenot covered by the Federal COBRA continuation coverage rules. If the coverage Is insured, individuals should contact their State insurance regulator regarding their possiblerights to continuation coverage under State law. Other coverage options may be available to you, too, including buying individual insurance coverage through the HealthInsurance Marketplace. For more information about the Marketplace, visit vw/w.HealthCare.qov or call 1 -800-318-2596.*For more information about limitations and exceptions, see the or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 6 of 8

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Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your glan for a denial of a claim. This complaint is called agrievance or appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim, Your p|p documents also providecomplete information on how to submit a claim, appeal, or a grievance for any reason to your For more information about your rights, this notice, or assistance, contact:For group health coverage subject to ERISA: Blue Cross and Blue Shield of Texas at or visit vw/w.bcbstx.com. the U.S. Department of Labor's Employee Benefits SecurityAdministration at 1-866444-EBSA (3272) or wvw.dol.gov/ebsa/healthreform. and the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 orvww.tdi.texas.gov. For non-federal governmental group health plans and church plans that are group health plans. Blue Cross and Blue Shield of Texas at 1 -800-521-2227orwww.bcbstx.com or contact the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 orwww.tdi.texas.gov. Additionally, a consumer assistanceprogram can help you file your appeal. Contact the Texas Department of Insurance's Consumer Health Assistance Program at 1 -800-252-3439 or visitwww.cms.gov/CCilO/Resources/Consumer-Assistance-Grants/tx.html.Does this plan provide Minimum Essential Coverage? YesMinimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.Does this plan meet the Minimum Value Standards? YesIf your doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a ^jan through the Marketplace.Language Access Services;Spanish (Espahol): Para obtener asistencia en Espahol, llame al 1-800-521-2227.Tagalog (Tagalog): Kung kailangan ninyo ang tuiong sa Tagalog tumawag sa 1 -800-521 -2227.Chinese {^X): If 1-800-521-2227.Navajo (Dine): Dinek'ehgo shika at’ohwol ninisingo, kwiijigo holne' 1-800-521-2227.To see examples of how this plan might cover costs for a sampie medical situation, see the next section.Page 7 of 8

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About these Coverage Examples:This is not a cost estimator. Treatments shown are just examples of how this might cover medical care. Your actual costs will bedifferent depending on the actual care you receive, the prices your providers charge, and many other factors. Focus on the cost-sharingamounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion ofcosts you might pay under different health plans. Please note these coverage examples are based on self-only coverage.Peg is Having a Baby(9 months of in-network pre-natal care and ahospital delivery)Managing Joe’s Type 2 Diabetes(a year of routine in-network care of a well-controlled condition)Mia’s Simple Fracture(in-network emergency room visit and followup care)$3,250$3,250$3,250■ The plan’s overall deductible■ Specialist copayment■ Hospital (facility) copav/coins■ Other coinsurance■ The plan’s overall deductible■ Specialist copayment■ Hospital (facility) copav/coins■ Other coinsurance■ The plan’s overall deductible■ Specialist copayment■ Hospital ffacilitvl copav/coins■ Other coinsurance$80 $80$80$250+40%$250+40%$250+40%40%40%40%This EXAMPLE event includes services like:Specialist office visits {prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests {ultrasounds and blood work)Specialist visit (anesthesia)This EXAMPLE event includes services like:Primary care physician office visits {Includingdisease education)Diagnostic tests (blood work)Prescription drugsDurable medical eguipment (glucose meter)This EXAMPLE event includes services like:Emergency room care (including medical supplies)Diagnostic test fx-rayjDurable medical eguipment (crutches)Rehabilitation sen/ices (physical therapy)$12,700$5,600$2,800Total Example CostTotal Example CostTotal Example CostIn this example, Peg would pay: CostShaiingIn this example, Joe would pay: Cost Sharingin this example, Mia would pay: Cost Sharing$3,250$900$2,100DeductiblesDeductiblesDeductibles$300$900CopaymentsCoinsurance$600CopaymentsCoinsuranceCopayments$3,600$0$0CoinsuranceWhat isn’t coveredWhat isn’t coveredWhat isn't covered$60$20$0Limits or exclusionsLimits or exclusionsThe total Joe would pay isLimits or exclusionsThe total Mia would pay is$7,210The total Peg would pay is$2,700$1,820The plan would be responsible for the other costs of these EXAMPLE covered services.Page 8 of 8

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Coverage Period: 01/01/2022 -12/31/2022Coverage for: Individual/Family | Plan Type: HMOSummary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services: S644ADT Blue Advantage Silver HMO^m 846BhieCross BliU’Shield ol’Tcxas .The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the ^1^ wouldshare the cost for covered health care services. NOTE; Information about the cost of this plan (called the premium) will be provided separately.This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, visit www.bcbstx.com/member/policv-foims/2Q22 or by calling 1 -877-299-2377. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider,or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.qov/sbc-alossarv/ or call 1 -855-7564448 to request a copy.AnswersWhy This Matters:Important Questions$7,900 lndividual/$15,800 FamilyGenerally, you must pay all of the costs from providers up to the deductible amount before thisbegins to pay. If you have other family members on the p!^, each family member must meet their ownindividual deductible until the total amount of deductible expenses paid by all family members meetsthe overall family deductible.This plan covers some items and services even if you haven't yet met the deductible amount. But acopayment or coinsurance may apply. For example, this plan covers certain preventive serviceswithout cost-sharing and before you meet your deductible. See a list of covered preventive services atwww.healthcare.qov/coveraqe/preventive-care-benefits/.What is the overaiideductible?Yes. In-Network Preventive HealthCare services, certain services with acopayment, and some prescriptiondmqs are covered before you meetyour deductible.Are there services coveredbefore you meet your'deductible?You don’t have to meet deductibles for specific services.I Are there other deductiblesfor specific services? What is the out-of-pocketlimit for this plan?No.$7,900 lndividual/$15,800 FamilyThe out-of-pocket limit is the most you could pay in a year for covered services, If you have other familymembers in this plan, they have to meet their own out-of-pocket iimits until the overall family out-of-pocket limit has been met.Even though you pay these expenses, they don't count toward the out-of-pocket limit.Premiums, baiance-biiled charges, andhealth care this plan doesn’t cover.What is not inciuded in theout-of-pocket limit?Will you pay less if you usea network provider?Yes. See www.bcbstx.com/qo/bahmoor call 1 -877-299-2377 for a list ofParticipating providers.This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You willpay the most if you use an out-of-network provider, and you might receive a bill from a provider for thedifference between the provider’s charge and what your plan pays (balance billing). Be aware, yournetwork provider might use an out-of-network provider for some services (such as lab work). Checkwith your provider before you get services.This Plan will pay some or all of the costs to see a specialist for covered services but only if you have areferral before you see the specialist. Do you need a referral tosee a specialist?Yes.Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Crossand Blue Shield AssociationPage 1 of 8

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ii All copayment and coinsurance costs shown in this chart are after your deductible has been met, if adeductible applies.What You Will PayLimitations, Exceptions, & Otherimportant informationServices You MayNeedCommonMedical EventNon-ParticipatingProviders(You will pay the most)Participating Providers(You will pay the least)$30/visit; deductible does not applyNot CoveredVirtual Visits are available. See your benefitbooklet* for details.Primary care visit totreat an injury orillness$60/visit; deductible does not applyReferral required.Specialist visitNot CoveredIf you visit a health careprovider*s office or clinicYou may have to pay for services that aren'tpreventive. Ask your provider if the servicesneeded are preventive. Then check whatyour will pay for. Preauthorization maybe required; see your benefit booklet* fordetails.No Charge: deductible does not applyNot CoveredPreventivecare/screeninq/immunizationNot CoveredReferral may be required. Preauthorizationmay also be required; see your benefitbooklet* for details.Diagnostic test (x-ray, blood work)No Charge after deductibleIf you have a test$250/test; deductible does not applyNot CoveredReferral may be required. Preauthorizationmay also be required; see your benefitbooklet* for details.Imaging (CT/PETscans, MRIs)u*For more information about limitations and exceptions, see the pl^ or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 2 of 8

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What You Will PayLimitations, Exceptions, & OtherImportant InformationServices You MayNeedCommonMedical EventNon-ParticipatingProviders(You will pay the most)Participating Providers(You will pay the least)Not CoveredPreferred genericdrugsRetail - Preferred Participating - No ChargeParticipating - $10/prescriptionMail - No Charge: deductible does not applyNot CoveredNon-preferredgeneric drugsRetail - Preferred Participating -$10/prescriptionParticipating - $20/prescriptionMail - $30/prescription: deductible does notapplyLimited to a 30-day supply at retail (or a 90-day supply at a network of select retailpharmacies). Up to a 90-day supply at mailorder. Specialty drugs limited to a 30-daysupply. Payment of the difference betweenthe cost of a brand name drug and a genericmay also be required if a generic drug isavailable. Certain drugs require approvalbefore they will be covered.Cost-sharing for insulin included in the druglist will not exceed $25 per prescription for a30-day supply, regardless of the amount ortype of insulin needed to fill the prescription.If you need drugs to treatyour illness or conditionMore information aboutprescription drug coverageis available atwww.bcbstx.com/rx22Preferred branddrugsRetail - Preferred Participating -$50/prescriptionParticipating - $70/prescriptionMail - $150/prescription; deductible does notapplyRetail - Preferred Participating -$100/prescriptionParticipating - $ 120/prescriptionMail - $300/prescription; deductible does notapplyNot CoveredNot CoveredNon-preferred branddrugs$150/prescription; deductible does not applyNot CoveredPreferred specialtydrugs$250/prescription; deductible does not applyNot CoveredNon-preferredspecialty drugs$200/visit plus elm deductibleNot CoveredReferral required. Preauthorization may alsobe required. For Outpatient Infusion Therapy,see your benefit booklet* for details.Facility fee (e.g.,ambulatory surgerycenter)If you have outpatientsurgeryNot CoveredPhysician/surgeonNo Charge after deductiblefees$500/visit plus plandeductible$500/visit plus 2lan deductibleCopayment waived if admitted.Emergency roomcareNo Charge afterdeductiblePreauthorization may be required for nonemergency transportation: see your benefitbooklet* for details.Emergency medicaltransportationNo Charge after deductibleIf you need immediatemedical attention$75/visit; deductible does not applyNot CoveredNoneUrgent care*For more information about limitations and exceptions, see the plm or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 3 of 8

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What You Will PayLimitations, Exceptions, & Otherimportant informationServices You MayNeedCommonMedical EventNon-ParticipatingProviders(You will pay the most)Participating Providers(You will pay the least)Primary Care: $30/initial visitSpecialist: $60/initial visit; deductible does notapplyCopayment applies to first prenatal visit (perpregnancy). Cost sharing does not apply forpreventive services. Depending on the typeof services, copayment or deductible mayapply. Maternity care may include tests andservices described elsewhere in the SBC(i.e., ultrasound).Not CoveredOffice visitsChildbirth/deliveryprofessional servicesNo Charge after deductibleNot CoveredIf you are pregnant$250/visit plus plan deductibleNot CoveredChildbirth/deliveryfacility services60 visits/year. Referral required.Preauthorization may also be required; seeyour benefit booklet* for details.No Charge after deductibleNot CoveredHome health careNot CoveredSeparate 35 visit maximum per benefit periodfor Habilitation and Rehabilitation services,including chiropractic care. Referral required.Preauthorization may also be required; seeyour benefit booklet* for details.25 days/year. Referral required.Preauthorization may also be required; seeyour benefit booklet* for details.No Charge after deductibleRehabilitationservicesNot CoveredHabilitation servicesNo Charge after deductibleIf you need help recoveringor have other special healthneedsNo Charge after deductibleNot CoveredSkilled nursing careReferral required. Preauthorization may alsobe required; see your benefit booklet* fordetails.Durable medicalNo Charge after deductibleNot CoveredequipmentNot CoveredReferral required. Preauthorization may alsobe required; see your benefit booklet* fordetails.No Charge after deductibleHospice servicesUp to a $30reimbursement isavailable: deductible doesnot applyOne visit per year. Out-of-Networkreimbursement will not exceed the retail cost.See your benefit booklet* (Pediatric VisionCare Benefits) for details.No Charge: deductible does not applyChildren’s eye examIf your child needs dental oreye care*For more information about limitations and exceptions, see the glan or policy document at www.bcbstx.com/member/policv-forms/2Q22.Page 5 of 8

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What You Will PayLimitations, Exceptions, & OtherImportant InformationServices You MayNeedCommonMedical EventNon-ParticipatingProviders(You will pay the most)Participating Providers(You will pay the least)Reimbursement isavailable; deductible doesnot applyOne pair of glasses every 12 months,Reimbursement for frames, lenses, and lensoptions purchased Out-of-Network isavailable (not to exceed the retail cost). Seeyour benefit booklet* (Pediatric Vision CareBenefits) for details,No Charge; deductible does not applyChildren's glassesNo Charge afterdeductibleOral exams are limited to two every benefitperiod. Benefits for periodic andcomprehensive oral evaluations are limitedto a combined maximum of two every 12months. See your benefit booklet*(Pediatric Dental Benefits Rider) for details.No Charge after deductibleChildren’s dentalcheck-upExcluded Services & Other Covered Services:Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)Infertility treatment (diagnosis and treatmentcovered; in vitro not covered)Long-term careNon-emergency care when traveling outside theRoutine eye care (Adult)Routine foot care (except in connection withdiabetes, circulatory disorders of the lowerextremities, peripheral vascular disease, peripheralneuropathy, or chronic arterial or venousinsufficiency)Weight loss programsAbortion (except for a pregnancy that, as certified ●by a physician, places the woman in danger ofdeath or a serious risk of substantial impairment of ●a major bodily function unless an abortion is ●performed)Acupuncture ●Bariatric surgeryCosmetic surgery (except for the correction ofcongenital deformities or for conditions resultingfrom accidental injuries, scars, tumors, or diseaseswhen medically necessary)Dental care (Adult) U.S,Private-duty nursing (unless medically necessary)Other Covered Services (Limitations may apply to these services. This Isn’t a complete list. Please see your plan document.)● Hearing aids (limited to one hearing aid per earevery 36 months)● Chiropractic care (35 visits/year combined withhabilitation and rehabilitation services)*For more information about limitations and exceptions, see the pjan or policy document atwww.bcbstx.com/member/Dolicv-forms/2Q22.Page 6 of 8

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Your Rights to Continue Coverage; There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is: theplan at Blue Cross and Blue Shield of Texas at 1-888-697-0683 or visit www.bcbstx.com. For group health coverage subject to ERISA, contact the U.S. Department ofLabor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.qov/ebsa/heaithreform. For non-federal governmental group health plans, contactDepartment of Health and Human Services, Center for Consumer Information and Insurance Oversight, at 1-877-267-2323 x61565 or www.cciio.cms.QOv. Church plans arenot covered by the Federal COBRA continuation coverage rules. If the coverage is insured, individuals should contact their State insurance regulator regarding their possiblerights to continuation coverage under State law. Other coverage options may be available to you, too, including buying individual insurance coverage through the HealthInsurance Marketplace. For more information about the Marketplace, visit www.HealthCare.qov or call 1 -800-318-2596.Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your ejan for a denial of a claim. This complaint is called agrievance or appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your p|pn documents also providecomplete information on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact:For group health coverage subject to ERISA: Blue Cross and Blue Shield of Texas at orvisitwww.bcbstx.com. the U.S. Department of Labor’s Employee Benefits SecurityAdministration at 1 -866-444-EBSA (3272) or vww.dol.qov/ebsa/healthreform. and the Texas Department of Insurance, Consumer Protection at 1 -800-252-3439 orvww.tdi.texas.gov. For non-federal governmental group health plans and church plans that are group health plans. Blue Cross and Blue Shield of Texas at 1-877-299-2377Qrwww.bcbstx.com or contact the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 or www.tdi.texas.qov. Additionally, a consumer assistanceprogram can help you file your appeal. Contact the Texas Department of Insurance's Consumer Health Assistance Program at 1-800-252-3439 or visitvww.cms.qov/CCIIO/Resources/Consumer-Assistance-Grants/tx.html.Does this plan provide Minimum Essentia! Coverage? YesMinimum Essential Coveraqe generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coveraqe. you may not be eligible for the premium tax credit.Does this plan meet the Minimum Value Standards? YesIf your plan doesn't meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.Language Access Services:Spanish (Espahol): Para obtener asistencia en Espahol, llame al 1 -877-299-2377.Tagalog (Tagalog): Kung kailangan ninyo ang tulong sa Tagalog tumawag sa 1-877-299-2377.Chinese (^^): 1-877-299-2377.Navajo (Dine): Dinek'ehgo shika at'ohwol ninisingo, kwiijigo holne' 1 -877-299-2377.To see examples of how this plan might cover costs for a sample medical situation, see the next section.*For more information about limitations and exceptions, see the plan or policy document at www.bcbstx.com/member/policv-forms/2Q22,Page 7 of 8

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About these Coverage Examples;This is not a cost estimator. Treatments shown are Just examples of how this ^Jan might cover medical care. Your actual costs will bedifferent depending on the actual care you receive, the prices your providers charge, and many other factors. Focus on the cost-sharingamounts (deductibles, copayments and coinsurance) and excluded services under the £lan. Use this information to compare the portion ofcosts you might pay under different health plans. Please note these coverage examples are based on self-only coverage.Mia’s Simple Fracture(in-network emergency room visit and followup care)Managing Joe’s Type 2 Diabetes(a year of routine in-network care of a well-controlled condition)Peg is Having a Baby(9 months of in-network pre-natal care and ahospital delivery)$7,900$7,900$7,900■ The plan’s overall deductibleM Specialist copayment■ Hospital (facility) copayment■ Other■ The plan’s overall deductible■ Specialist copayment■ Hospital (facility) copayment■ Other■ The plan’s oyerall deductible■ Specialist copayment■ Hospital (facility) copayment■ Other$60$60$60$250 $250$250$0 $0$0This EXAMPLE event includes services like:Primary care physician office visits {includingdisease education)Diagnostic tests (blood work)Prescription drugsDurable medical eouipment (glucose meter)This EXAMPLE event includes services like;Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical eouipment (crutches)Rehabilitation services (physical therapy)This EXAMPLE event includes services like:Specialist office visits {prenatal care)Chiidbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests {ultrasounds and blood work)Specialist visit (anesthesia)$5,600$2,800Total Example CostI $12,700Total Example CostTotal Example CostIn this example, Joe would pay: Cost SharingIn this example, Mia would pay; Cost SharingIn this example, Peg would pay:Cost Sharing$900$2,300$7,600DeductiblesDeductiblesDeductibles$700$300$300CopaymentsCoinsuranceCopaymentsCoinsuranceCopaymentsCoinsurance$0$0$0What isn’t coveredWhat isn’t coveredWhat isn’t covered$20$0$60Limits or exclusionsThe total Mia would pay isLimits or exclusionsThe total Joe would pay isLimits or exclusion's _The total Peg would pay is$2,600$7,960$1,6201The plan would be responsible for the other costs of these EXAMPLE covered services.Page 8 of 8

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Dental Notes for:Dental Plan NotesCo-Pay Plans (Available in Texas and Utah only)● ●●●●●*Please contact Dental Select's Customer Care at 800-999-9789 or consult your provider to confirm availability.Co-Insurance MAC PlansContracted: All payments made to contracted General Dentists and Specialists are based on the contracted dental fee schedule and are accepted as payment in full after the required deductible amount, as shown. Dental procedures not covered under your plan may also be subject to a discounted fee in accordance with a participating provider's contract and subject to state law.*Non-Contracted: All payments made to non-contracted General Dentists are based on the contracted dental fee schedule for co-pay plans. The member is responsible for paying the difference between the plan payment and the General Dentist’s usual charges. Baumann Propellers LLCCo-Insurance R&C PlansContracted: All payments made to contracted General Dentists and Specialists are based on the contracted dental fee schedule and are accepted as payment in full after the required deductible amount, as shown. Dental procedures not covered under your plan may also be subject to a discounted fee in accordance with a participating provider's contract and subject to state law.*Contracted: All payments made to contracted General Dentists are based on the contracted dental fee schedule for co-pay plans. Contracted General Dentists accept a combination of fixed co-payments and insurance plan payments as payment in full. Dental procedures not covered under your plan may also be subject to a discounted fee in accordance with a participating provider's contract and subject to state law*. Non-Contracted: Dental Select will allow up to the Reasonable & Customary (R&C) amount for dental procedures and services after the required deductible amount, as shown. Charges above the plan payment are the patient's responsibility.Non-Contracted: Dental Select will allow up to the contracted dental fee schedule amount for dental procedures and services after the required deductible amount, as shown. Charges above the plan payment are the patient's responsibility. MAC refers to the Maximum Allowable Charge in Utah and Texas. Contracted Dentist refers to a network dentist in UT and TX.MAB refers to the Maximum Allowable Benefit in all other states. Participating Provider refers to a network dentist in all other states.This summary of benefits is current as of 05/10/2022. To verify up to date benefits, please contact Dental Select Customer Care at 800-999-9789.This is not a certificate of insurance or guarantee of coverage. Plan designs may not be available in all areas and are subject to individual state regulations. Group dental and vision products are issued by Ameritas Life Insurance Corp. Ameritas, the bison design, “fulfilling life” and product names designated with SM or ® are service marks or registered service marks of Ameritas Life, affiliate Ameritas Holding Company or Ameritas Mutual Holding Company. © 2020 Ameritas Mutual Holding Company.R&C refers to the Reasonable & Customary amount in Utah and Texas. Non-Contracted Dentist refers to a non-network dentist in UT and TX.U&C refers to or Usual & Customary amount in all other states. Non-Participating Provider refers to a non-network dentist in all other states.5/10/2022 2:00 PM

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Summary of Benefits for:Vision 12 EyeMed Select NetworkExam with Dilation as NecessaryContact Lens OptionsStandard fit & follow-upPremium fit & follow-upFramesAny frame at provider locationStandard Plastic LensesSingle VisionBifocalTrifocalStandard progressivePremium progressiveLens OptionsUV CoatingTint (Solid and Gradient)Standard Scratch-ResistanceStandard PolycarbonateStandard Anti-ReflectivePolarizedOther Add-ons and ServicesContact LensesConventionalDisposablesMedically NecessaryLaser Correction (US Laser Network)Lasik or PRK FrequencyExaminationFramesLenses AND Contact LensesUp to $40 Not coveredBaumann Propellers LLCIn-Network (Member Cost) Out-of-Network (Reimbursement)$10 Up to $3510% off retail price Not coveredUp to $50$0 copay, $100 allowance; 20% off balance over $100$10 Up to $25$10 Up to $40$10 Up to $55$75 Up to $40$15 Not covered$15 Not covered$15 Not covered$0 copay: paid in full Up to $200$40 Not covered$4520% off retail price Not covered-- Declining Balance Allowance --Up to $100$0 copay: $120 allowance; member responsible for balance over $120Up to $100$0 copay: $120 allowance; 15% off balance over $120Once every 12 months Once every 12 monthsOnce every 12 months Once every 12 months$75: $120 Allowance; 20% off balance over $120Up to $40Not covered20% off retail price Not covered15% off retail price -or- 5% off promotional priceNot coveredOnce every 12 months Once every 12 months5/10/20222:00 PMemployee $ 1.71employee + spouse $ 2.93 employee + child(ren) $ 3.06family $4.82

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Dental Notes for:Vision Plan NotesDiscounts●Lasik & PRK●Allowances●●●Member Co-Pay in Utah and Texas, deductible in all other states ●Vision Plan ExclusionsLimitations and Exclusions may vary by state. Refer to your Policy or contact Us.(1(9)(2Plano lenses. (10)(3Two pair of glasses, in lieu of bifocals or trifocals.(4Medical or surgical treatment of the eye, eyes or supporting structures. (11)(5(12)(6(13)(14)(7Sub-normal vision aids or non-prescription lenses. (15)(8)(16)(17)This summary of benefits is current as of 05/10/2022. To verify up to date benefits, please contact Dental Select Customer Care at 800-999-9789.Discounts on products and Services are not insured benefits and not underwritten by Ameritas Life Insurance Corp. Orthoptic or vision training, subnormal vision aids and any associated supplemental testing.Charges in excess of the Reasonable and Customary charge for the Service or Materials.Charges incurred after: (a) the Policy ends; or (b) the Insured’s coverage under the Policy ends, except as stated in the Policy.Experimental or non-conventional treatment or devices.Baumann Propellers LLCMembers will receive a 20% discount on items not covered by the plan when using contracted providers. Since Lasik or PRK vision correction is an elective procedure, performed by specially trained providers, this discount may not always be available from a provider in your immediate location. For a location near you and the discount authorization, please call 1-877-5LASER6This discount may not be combined with any other discounts or promotional offers and does not apply to EyeMed Provider's professional services or contact lenses.Retail prices may vary by location. Allowances are one-time use benefits; no remaining balance except for contact lens materials, when applicable. Lost or broken materials are not covered.Discounts do not apply to benefits provided by other group benefit plans. When enrolled on the vision plans, Members receive a 40% discount off complete eyeglass purchases and a 15% discount off conventional contact lenses at unlimited frequency after the initial benefit has been used. After initial purchase, replacement contact lenses may be obtained via the internet at substantial savings and mailed directly to the member. Details are available at www.eyemedvisioncare.com. The contact lens benefit allowance is not applicable to this service.Based on applicable laws, reduced costs may vary by doctor location.This is not a certificate of insurance or guarantee of coverage. Plan designs may not be available in all areas and are subject to individual state regulations. Group dental and vision products are issued by Ameritas Life Insurance Corp. Ameritas, the bison design, “fulfilling life” and product names designated with SM or ® are service marks or registered service marks of Ameritas Life, affiliate Ameritas Holding Company or Ameritas Mutual Holding Company. © 2020 Ameritas Mutual Holding Company.Any eye examination, or any corrective eyewear, safety eyewear required by an employer as a condition of employment, unless specifically covered under the Plan.Lost or broken Materials, except when replaced at normal intervals when Services are available.Services provided as a result of any Workers’ Compensation law, or similar legislation, or required by any governmental agency or program whether federal, state or subdivisions thereof.Photorefractive Keratectomy (PRK) surgery or Laser-assisted in Situ Keratomileusis (LASIK) surgery.Aniseikonic lenses.Non-prescription sunglasses. - Certain name brand Vision Materials for which the manufacturer maintains a no-discount practice.Services rendered or Materials purchased outside the U.S. or Canada, unless: (a) the Insured resides in the U.S. or Canada; and (b) the charges are incurred while on a business or pleasure trip.Services or Materials provided by any other group benefit providing for Vision care.Care or treatment rendered by You, Your insured Dependent, or a member of Your Immediate Family or household.5/10/2022 2:00 PM

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How much coverage do I need?Your employer is helping provide you basic term life coverage in the amount of$___________________________You$____________________n Available in $1,000 incrementsn Minimum of $10,000 to a maximum of five times your salary to $300,000Your spouse$____________________n Available in $1,000 incrementsn Minimum of $5,000 to a maximum of $300,000n Spouse coverage cannot exceed your coverage amount2Your dependent children(up to age 26)$____________________nAvailable in $1,000 incrementsn Minimum of $1,000 to a maximumof $10,000 per dependent childn Each dependent child is covered for the same amount, except children from live birth to six months for whom the death benefit is $1,000Why consider more coverage?While the basic coverage your employer provides is a solid start, it may not cover all of your family’s ongoing needs. If something happened to you, your family could benefit from additional coverage to help with:n Immediate costs– Funeral expenses– Medical billsn Ongoing living expenses– Mortgage– Utilities– Groceriesn Future needs– College tuition– Money for retirementWhy is group term life insurance a good option?Term life insurance provides protection for a specified period of time, typically oering the greatest amount of coverage for the lowest initial premium. It can provide additional, aordable coverage during life stages when your obligations are higher, such as when children are young. It’s a good option for families on a tight budget because you can purchase more coverage for lower premiums.$50,000$50,000$15,000$10,000

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Get the most out of your coverage n Portability: If you retire or change jobs, you may still be able to take your coverage with you at an aordable rate. Eligibility may be based on your health. n Conversion: You may be eligible to convert your coverage to a whole life policy without proof of good health when coverage ends under the group certificate. n Waiver of Premium: If included in your plan, premium payments are waived if you become disabled.Whatever your personal situation, Colonial Life group term life insurance can provide protection by helping to ensure your loved ones get the daily care and lifestyle you intended for them. Additional benefits and services n Built-in Accelerated Death Benefit provides an advance of up to 75% of the death benefit, to a maximum of $150,000, if the covered person is diagnosed with a terminal illness.3 n Health Advocate Employee Assistance Program provides 24-hour confidential personal support and referral service, including a medical bill saver service. Face-to-face sessions and video counseling with mental health professionals are available. 4 n Life Planning Services oer financial and legal counseling services, as well as grief support and referral for up to 12 months aer a claim.4TELEPHONE1-888-645-1772ONLINEColonialLife.com/EAPLIMRA, 2020 Insurance Barometer.Half the population overestimates the cost of life insurance at more than three-times the actual cost.

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1 Spouse and dependent coverage will not be eective if they are currently totally disabled. Being totally disabled means the inability to perform two or more activities of daily living, being confined to a hospital or similar institution, or being unable to attend school outside the home (for a dependent child age 5 up to age 26). In ID, NH and TX, the definition of total disability does not include Activities of Daily Living (ADL) requirements. The ability to work does not determine disability. You can pay premiums on insurance for your dependents with no health questions asked. Coverage isn’t eective until the earlier of the date they are no longer totally disabled or two years aer the date that coverage would have otherwise become eective for the spouse or dependent child. This provision does not apply to newborn children born while dependent insurance is in eect.2 The maximum benefit is 50% of your benefit in NE.3 Terminal illness means an injury or sickness that results in the covered person having a life expectancy of 12 months or less and from which there is no reasonable prospect of recovery. A life expectancy of 24 months or less in IL, KS, MA, TX and WA. Accelerated death benefit payments will reduce the amount the policy pays upon the recipient’s death, may adversely aect the recipient’s eligibility for Medicaid or other government benefits or entitlements, and may be taxable. Recipients should consult their tax attorney or advisor before utilizing accelerated benefit payments.4 The Employee Assistance Program and Life Planning Services, provided by Health Advocate, are available with Colonial Life & Accident Insurance Company’s Group Term Life oering. Terms and availability of service are subject to change. The service provider does not provide legal advice; please consult your attorney for guidance. Services are not valid aer coverage terminates. Please contact the company for full details. The consultants must abide by federal regulations regarding duty to warn of harm to self or others. In these instances, the consultant may be mandated to report a situation to the appropriate authority.This information is not intended to be a complete description of the insurance coverage available. The insurance or its provisions may vary or be unavailable in some states. The insurance has exclusions and limitations which may aect any benefits payable. Applicable to policy form GTL1.0-P and certificate form GTL1.0-C (including state abbreviations where used, for example: GTL1.0-P-TX and GTL1.0-C-TX). For cost and complete details of coverage, call or write your Colonial Life benefits counselor or the companyFinancial protection for your familyDon’t miss this opportunity to obtain additional term life coverage for you and your family. Talk with your Colonial Life benefits counselor to learn how this coverage can help protect what you’ve worked so hard to build.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2020 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 11-20 | 101527-4ColonialLife.com

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Deductions per year: 52Individual Accident (IAC4000) for TXApplicable to Policy Forms IAC4000lOn/Off-Job Accident CoverageBENEFIT LEVEL ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred 0-80 $4.37 $6.45 $7.89 $9.87Critical Illness 1.0 for TXApplicable to policy form CI-1.0lwith Health Screening Benefit, Cancer BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $1.42 $2.19 $1.82 $2.5825-29 $1.88 $2.91 $2.28 $3.2830-34 $2.37 $3.62 $2.76 $4.0135-39 $2.90 $4.45 $3.29 $4.8440-44 $3.64 $5.58 $4.01 $5.9545-49 $4.72 $7.24 $5.12 $7.6450-54 $6.50 $9.97 $6.87 $10.3655-59 $7.93 $12.18 $8.32 $12.5860-64 $10.49 $16.13 $10.88 $16.5065-70 $12.34 $18.94 $12.75 $19.36$20,000 17-24 $2.35 $3.62 $3.13 $4.4125-29 $3.27 $5.05 $4.05 $5.7930-34 $4.24 $6.48 $5.02 $7.2735-39 $5.30 $8.14 $6.08 $8.9340-44 $6.78 $10.41 $7.52 $11.1445-49 $8.95 $13.73 $9.73 $14.5150-54 $12.50 $19.18 $13.24 $19.9655-59 $15.36 $23.61 $16.15 $24.3960-64 $20.48 $31.50 $21.27 $32.2465-70 $24.18 $37.13 $25.01 $37.96Baumann Propellers Martin BenefitsPage 1 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 4 for Important Notice

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Critical Illness 1.0 for TXApplicable to policy form CI-1.0lwith Health Screening Benefit, Cancer BenefitTobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $1.84 $2.81 $2.21 $3.1825-29 $2.60 $3.99 $2.97 $4.3630-34 $3.55 $5.42 $3.92 $5.8135-39 $4.61 $7.08 $5.00 $7.4840-44 $5.72 $8.79 $6.11 $9.1645-49 $7.31 $11.21 $7.70 $11.6150-54 $9.87 $15.14 $10.24 $15.5355-59 $12.43 $19.08 $12.80 $19.4560-64 $15.87 $24.37 $16.26 $24.7665-70 $18.82 $28.91 $19.24 $29.33$20,000 17-24 $3.18 $4.87 $3.92 $5.6125-29 $4.70 $7.22 $5.44 $7.9630-34 $6.59 $10.08 $7.33 $10.8735-39 $8.72 $13.41 $9.50 $14.1940-44 $10.93 $16.82 $11.72 $17.5645-49 $14.12 $21.67 $14.90 $22.4550-54 $19.24 $29.51 $19.98 $30.3055-59 $24.36 $37.41 $25.10 $38.1460-64 $31.24 $47.98 $32.02 $48.7665-70 $37.15 $57.07 $37.98 $57.90Disability 1000 for TX AA Risk ClassApplicable to policy form DIS1000lOn/Off-Job Accident and Sickness3 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $500* $800* $1,000* $1,200* $1,500**monthly benefit amount0 days Accident / 7 days Sickness 17-49 $4.04 $6.46 $8.08 $9.69 $12.1250-69 $4.67 $7.48 $9.35 $11.22 $14.026 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $500* $800* $1,000* $1,200* $1,500**monthly benefit amount0 days Accident / 7 days Sickness 17-49 $5.25 $8.40 $10.50 $12.60 $15.7550-69 $6.52 $10.43 $13.04 $15.65 $19.56Baumann Propellers Martin Benefits(Continued...)Page 2 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 4 for Important Notice

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Term Life (ITL5000) for TXApplicable to policy form ITL5000l10-Year Term Base PlanNon-Tobacco RatesISSUE AGE $10,000 $20,000 $50,00025 $1.53 $2.14 $2.3535 $1.74 $2.57 $2.5945 $2.11 $3.30 $4.2955 $3.73 $6.54 $8.3965 $8.04 $8.55 $20.0075 $21.09 $25.17 $61.55Tobacco RatesISSUE AGE $10,000 $20,000 $50,00025 $2.40 $3.87 $4.0935 $2.66 $4.39 $4.5545 $3.45 $5.99 $9.4455 $7.43 $13.94 $22.6365 $15.15 $17.47 $42.3075 $31.68 $37.51 $92.40Whole Life Plus (IWL5000) for TXApplicable 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 100Non-Tobacco RatesISSUE AGE $10,000 $15,000 $20,000 $25,00025 $2.12 $3.18 $4.25 $5.3135 $2.89 $4.33 $5.78 $7.2245 $4.59 $6.88 $9.18 $11.4755 $7.49 $11.23 $14.98 $18.7265 $13.33 $19.99 $26.65 $33.32Tobacco RatesISSUE AGE $10,000 $15,000 $20,000 $25,00025 $3.71 $5.56 $7.41 $9.2735 $4.51 $6.77 $9.02 $11.2845 $6.72 $10.08 $13.43 $16.7955 $11.32 $16.98 $22.65 $28.3165 $19.36 $29.05 $38.73 $48.41Baumann Propellers Martin Benefits(Continued...)Page 3 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

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For more information, talk with your benefits counselor.Accident InsurancePreferred PlanColonialLife.comIAC4000 – PREFERRED PLANAccident insurance can help with medical or other costs associated with a covered accident or injury that your health insurance may not cover. Coverage options are available for you, your spouse and eligible dependent children. Benefits are per covered person per covered accident unless stated otherwiseAccident emergency treatment ................................................................................................ $125 One visit per covered person per covered accidentAccident follow-up treatment (including transportation/telemedicine) ...................................................$55Up to six benefits per covered person per covered accident and up to 12 benefits per covered person per calendar yearAccidental death Accidental deathPer covered person Accidental death common carrier¾ Named insured .....................................................................$40,000 .................. $160,000¾ Spouse ...............................................................................$40,000 .................. $160,000¾ Dependent child(ren) .............................................................. $10,000 ....................$30,000Examples of common carriers are mass transit trains, buses and planesAccidental dismembermentLoss, loss of use or paralysis¾ One hand, arm, foot, leg or sight of an eye ........................................................................$10,000¾ Both hands, arms, feet, legs or the sight of both eyes; or any combination ................................ $20,000Loss or loss of use¾ One finger or one toe ......................................................................................................$900¾ Two or more fingers; two or more toes; or any combination ................................................... $1,800¾ Partial dismemberment of one finger or toe .........................................................................$450¾ Partial dismemberment of two or more fingers or toes; or any combination ...................................$900Accidental dismemberment due to a catastrophic accidentSubject to a 180-day elimination period; payable once per lifetime per covered person¾ Named insured ........................................................................................................ $25,000¾ Spouse .................................................................................................................. $25,000 ¾ Dependent child(ren) ................................................................................................. $25,000 Accidental injury due to an automobile accident .......................................................................... $250 Requires transportation to a hospital or medical facility by ambulance Payable once per calendar year for all covered persons combinedAir ambulance .................................................................................................................. $2,000 Transportation to or from a hospital or medical facilityAmbulance (ground or water)................................................................................................... $200 Transportation to or from a hospital or medical facilityBlood/plasma/platelets (transfusion) .........................................................................................$300 A transfusion required during treatment of a covered accidentBurn¾ 2nd-degree burns (covering at least 36% of the body’s surface) ..................................................$1,000 ¾ 3rd-degree burns (based on size) ......................................................................... $2,000 – $12,000

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Burn – skin gra .................................................................... 50% of applicable burn benefitAs a result of 2nd-degree or 3rd-degree burnsComa ...............................................................................................................$12,500Lasting for seven or more consecutive daysConcussion ............................................................................................................ $150Dislocation (separated joint) Non-surgical Surgical¾ Hip ........................................................................................$2,250 $4,500¾ Knee (except patella) ..................................................................$1,125 $2,250¾ Ankle, bone or bones of the foot (other than toes) ...............................$1,000 $2,000¾ Collarbone (sternoclavicular) ..........................................................$750 $1,500¾ Collarbone (acromioclavicular and separation) ....................................$500 $1,000¾ Lower jaw, shoulder, elbow, wrist, bone(s) of the hand ............................ $500 $1,000¾ Finger, toe ..................................................................................$100 $200¾ Incomplete dislocation or dislocation reduction.................................. 25% of the applicable without anesthesia non-surgical amountEmergency dental work ¾ Dental crown, denture or implant .........................................................................$300 ¾ Dental extraction .............................................................................................$100 Eye injury ..............................................................................................................$300 With surgical repair or removal of a foreign objectFracture (complete) Non-surgical Surgical¾ Skull, depressed fracture (except face/nose) ......................................$3,000 $6,000¾ Skull, simple non-depressed fracture ..............................................$1,200 $2,400¾ Hip, thigh (femur) ......................................................................$2,200 $4,400¾ Body of vertebrae (excluding vertebral processes), pelvis, leg .................$1,000 $2,000¾ Bones of the face or nose (except mandible or maxilla) ...........................$500 $1,000¾ Upper jaw, maxilla, upper arm between .............................................$450 $900 elbow and shoulder¾ Lower jaw, mandible ....................................................................$375 $750¾ Kneecap, ankle, foot or heel ............................................................$375 $750¾ Shoulder blade ...........................................................................$375 $750¾ Collarbone, vertebral processes .......................................................$625 $1,250¾ Forearm, hand, wrist ....................................................................$375 $750¾ Rib ..........................................................................................$625 $1,250¾ Coccyx .....................................................................................$250 $500¾ Finger ......................................................................................$325 $650¾ Toe .......................................................................................... $325 $650¾ Chip fracture .................................................25% of the applicable non-surgical amountHearing-loss injuries ................................................................................................$120 Maximum of one benefit for each injured ear per covered person per lifetimeHospital admission ............................................................................................... $1,000 Per covered person per covered accidentHospital confinement .................................................................................... $250 per dayUp to 365 days per covered person per covered accidentHospital sub-acute intensive care unit confinement .............................................. $325 per dayUp to 30 days per covered person per covered accidentIntensive care unit admission .................................................................................. $2,000 Per covered person per covered accidentIntensive care unit confinement ....................................................................... $450 per dayUp to 15 days per covered person per covered accidentJohn was cleaning out the gutters when he fell. EMERGENCY ROOM VISITJohn was admitted to the hospital for surgery on his leg.Over the next several weeks, he had three follow-up appointments with his doctor.John had eight sessions of PT to help him regain the strength in his leg.The doctor ordered an X-ray and discovered John had fractured his leg.John was taken by ambulance to the nearest emergency room and received immediate care.DIAGNOSTIC PROCEDUREHOSPITAL CONFINEMENTDOCTORʼS OFFICE VISITPHYSICAL THERAPYFor illustrative purposes only.Benefit amounts may vary and may not cover all expenses. The policy has exclusions and limitations.JOHN’S BENEFITS Ambulance $200Emergency room visit $125X-ray $30Hospital admission $1,000Hospital confinement $750Leg fracture (surgical) $2,000Physical therapy $280Medical equipment (crutches) $100Doctor’s oice visit $165$4,650JOHNʼS OUT-OF-POCKET EXPENSESWhen John totaled up the bills, he had to pay his annual deductible, as well as co-payments for the ambulance, emergency room, hospital, surgery, physical therapy and follow-up visits. Luckily, John had accident coverage to help with these expenses.

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For more information, talk with your benefits counselor.IAC4000 – PREFERRED PLANKnee cartilage (torn) ............................................................................................................. $650 Laceration (no repair, without stitches) ..........................................................................................$30 Laceration (repaired by stitches)¾ Total of all lacerations is less than two inches long .....................................................................$75¾ Total of all lacerations is at least two but less than six inches long .................................................$275¾ Total of all lacerations is six inches or longer ...........................................................................$600 Lodging (companion) ..................................................................................................$125 per dayUp to 30 days per covered person per covered accident Medical equipment¾ Tier 1 ..........................................................................................................................$30 Arm sling, cane, medical ring cushion, neck brace or wrist/ankle splint¾ Tier 2 ........................................................................................................................ $100 Bedside commode, cold therapy system (cryotherapy), crutches, leg brace, shower chair, walker or walking boot¾ Tier 3 ........................................................................................................................ $200 Back brace, body jacket, Continuous Passive Movement (CPM), halo, electric scooter, hospital bed (including rental), knee scooter, stair li chair, wheelchairMedical imaging study (CT, CAT scan, EEG, EMG, MR or MRI) ..............................................................$200 One benefit per covered person per covered accident per calendar yearObservation room ..................................................................................................... $150 per day Up to two days per covered person per calendar yearPain management for epidural anesthesia (non-surgical) ................................................................ $100 Post-Traumatic Stress Disorder (PTSD) ....................................................................................... $200 Diagnosed from a covered accident with one benefit per covered person per calendar yearProsthetic device/artificial limb¾ One ..........................................................................................................................$750 ¾ More than one ........................................................................................................... $1,500 Repair or replacement¾ Repair .......................................................................................................................$375 ¾ Replacement ...............................................................................................................$750 One repair or replacement per prosthetic device/artificial limb per covered person per lifetimeRehabilitation unit confinement ....................................................................................$150 per day Immediately aer a period of hospital confinement due to a covered accident; up to 15 days per covered person per covered accident, not to exceed 30 days per covered person per calendar yearRuptured disc with surgical repair ............................................................................................$750 Surgery¾ Cranial, open abdominal and thoracic .............................................................................. $1,500 ¾ Hernia with surgical repair ...............................................................................................$200Surgery (exploratory and arthroscopic) ....................................................................................... $300 Tendon/ligament/rotator cu¾ One with surgical repair ..................................................................................................$650 ¾ Two or more with surgical repair ..................................................................................... $1,300 Therapy (occupational, physical or speech) ......................................................................... $35 per day Up to 10 days per covered person per covered accidentTransportation for hospital confinement (per round trip) ................................................................$600 Up to 3 round trips for more than 50 miles from home per covered person per covered accidentX-ray ...................................................................................................................................$30

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For more information, talk with your benefits counselor.ColonialLife.comCancer vaccine benefit: ................................................................. $50 This benefit is payable if you or your covered family members incur a charge for any FDA-approved cancer vaccine while your policy is inforce.Specified Critical Illness InsuranceIf you’re diagnosed with a covered critical illness or cancer, 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: $_______________ CRITICAL ILLNESS 1.0 WITH CANCER The maximum benefit amount for this policy is 100% of the face amount for each covered person. We will not pay more than 100% of the face amount for all covered specified critical illnesses combined. The policy will terminate when the maximum benefit amount for specified critical illness has been paid. For the diagnosis of this covered critical illness condition:1This percentage of the face amount is payable:Cancer 100%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%Carcinoma in situ 25%Critical illness benefit

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For more information, talk with your benefits counselor.Critical Illness InsuranceHealth Screening Benefit For cost and complete details, see your Colonial Life benefits counselor. Applicable to form CI-1.0-P and GCC1.0-P (including state abbreviations where used, for example: CI-1.0-P-TX and GCC1.0-P-TX). Coverage may vary by state and may not be available in all states. GROUP CRITICAL CARE, CRITICAL ILLNESS 1.0 – HEALTH SCREENING BENEFIT | 10-16 | 100355-2ColonialLife.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 ©2016 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

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Disability 1000-TXHow long could you aord to go without a paycheck?Help protect your paycheck with Colonial Life’s short-term disability insurance.You use your paycheck mainly to pay for your home, your car, groceries, medical bills and utilities. What if you couldn’t go to work due to an accident or sickness?Monthly Expenses: $_________________ $_________________ $_________________ $_________________ $_________________ $_________________ Total $_________________My Coverage Worksheet (For use with your Colonial Life Benets Counselor)Short-TermDisability InsuranceHow much coverage do I need? On-Job Accident and On-Job Sickness $________ O-Job Accident and O-Job Sickness $________How long will I receive benets? Total Disability: ___________ months Partial Disability: 3 months* *Partial Disability is 50% of the Total Disability AmountWhen will my benets start? After an Accident: ___________ days After a Sickness: ___________ daysHow much will it cost? Your cost will vary based on the level of coverage you select. What additional features are included?l Waiver of Premiuml Worldwide Coverage

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Will my disability income payment be reduced if I have other insurance?You’re paid regardless of any other insurance you may have with other insurance companies. Benets are paid directly to you (unless you specify otherwise).When am I considered totally disabled?Totally disabled means you are:l Unable to perform the material and substantial duties of your regular occupation;l Not in fact, working at any occupation for wage or prot; andl Under the regular and appropriate care of a doctor, unless the doctor states that continued treatment in the future would be of no benet to you.What if I want to return to work part-time after I am totally disabled?You may be able to return to work part-time and still receive benets. We call this “Partial Disability.” Partially disabled means:l You are unable to perform the material and substantial duties of your regular occupation for 20 hours or more per week;l You are able to work at your regular occupation or any other occupation for less than 20 hours per week;l Your employer will allow you to work for less than 20 hours per week; andl You are under the regular and appropriate care of a doctor.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 to age 70 as long as you continue to pay your premiums when they are due. Here are some What is a pre-existing condition?Pre-existing condition is when you have a sickness or physical condition for which you were treated, received medical advice or had taken medication within 12 months before the eective date of the policy.If you become disabled because of a pre-existing condition, we will not pay for any disability period if it begins during the rst 12 months (6 months if you are age 65 or older on the eective date of the policy) the policy is in force. Can my premium change?You may choose the amount of coverage to meet your needs (subject to your income). You can elect more or less coverage which will change your premium. 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. What is a covered accident or a covered sickness?A covered accident is an accident. A covered sickness means an illness, infection, disease or any other abnormal physical condition, not caused by an injury.A covered accident or covered sickness:l Occurs after the eective date of the policy;l Is of a type listed on the Policy Schedule;l Occurs while the policy is in force; andl Is not excluded by name or specic description in the policy. How do I le a claim?Visit coloniallife.com or call our Policyholder Service Center at 1.800.325.4368 for additional information.frequently asked questionsabout Colonial Life’s disability insurance:Colonial Life 1200 Colonial Life BoulevardColumbia, South Carolina 29210coloniallife.com5/11©2011 Colonial Life & Accident Insurance Company.Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.Colonial Life and Making benets count are registered service marks of Colonial Life & Accident Insurance Company. EXCLUSIONSWe will not pay benets for losses that are caused by or are the result of: ying; giving birth within the rst nine months after the eective date of the policy; hazardous avocations; felonies and illegal occupation; intoxicants and narcotics; having a pre-existing condition as described and limited by the policy; racing; semi-professional or professional sports; suicide or self-inicted injuries; war or armed conict. For cost and complete details, see your Colonial Life benets counselor. Applicable to policy forms DIS1000-TX and DIS 1000-3M-TX. This is not an insurance contract and only the actual policy provisions will control.59212-10Disability 1000-TX

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Term Life InsuranceHelp protect the people who depend on youIf something happened to you, the last thing your family should have to worry about is financial burdens. Funeral expenses, medical bills and taxes could be just the beginning. How would they cover ongoing living expenses, such as a mortgage, utilities and health care?Plan for the future with term life insurance from Colonial Life & Accident Insurance Company.The advantages of term life insurance  Level death benefit.  Lower cost option compared with cash value insurance.  Coverage for specified periods of time, which can be during high-need years.  Benefit for the beneficiary that is typically free from income tax.Benefits and features  Guaranteed premiums do not increase during the term.  Coverage is guaranteed renewable to age 95 as long as premiums are paid when due.  You can convert it to cash value insurance.  Portability allows you to take it with you if you change jobs or retire.  An accelerated death benefit is included.Your cost will vary based on the level of coverage you select. Talk with your Colonial Life benefits counselor for information about what level of coverage would work best for you.TERM LIFE 1000

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Benefits worksheetFor use with your Colonial Life benefits counselor£ YOU $ __________________ FACE AMOUNTSelect the term period£ 10-year term£ 20-year term£ 30-year term£ SPOUSE $ ______________ FACE AMOUNTSelect the term period£ 10-year term£ 20-year term£ 30-year termSelect any optional riders:£ Spouse term life rider $ _____________ face amount for ________-year term period£ Children’s term life rider $ _____________ face amount£ Waiver of premium benefit rider£ Accidental death benefit riderHOW MUCH COVERAGE DO YOU NEED?To learn more, talk with your Colonial Life benefits counselor.EXCLUSIONS AND LIMITATIONSIf the insured commits suicide within two years (one year in CO and ND) from the coverage eective date, whether he is sane or insane (not applicable in AZ), we will not pay the death benefit. We will terminate this policy and return the premiums paid, without interest. In MO, should death occur as a result of suicide, our company is responsible only for the return of premiums paid when application is made with intent to commit suicide.You will receive a policy summary or illustration (whichever is applicable to your state) when your policy is issued if this policy has exclusions, limitations or reductions of benefits. For costs and complete details, call or write your Colonial Life benefits counselor or the company. This brochure is applicable to policy forms TERM1000, R-TERM1000-ADB, R-TERM1000-CTR, R-TERM1000-STR, R-TERM1000-WAIVER (and applicable state variations, for example: TERM1000-TX, R-TERM1000-ADB-TX-1, R-TERM1000-CTR-TX, R-TERM1000-STR-TX and R-TERM1000-WAIVER-TX-1). See your Colonial Life benefits counselor for additional information specific for your state. This coverage contains limitations and exclusions that may aect benefits payable. Product may vary by state.Cash value policy conversionYou can convert your policy to a Colonial Life cash value life insurance policy any time through age 75 (unless you have used the accelerated death benefit or waiver of premium benefit rider) with no evidence of insurability. Premiums will be based on your age at the time you convert your policy.Accelerated death benefitIf you are diagnosed with a terminal illness, you can request up to 75% of the policy’s death benefit, not to exceed $150,000. We deduct a fee only if you use the benefit, and your death benefit will then be reduced by the amount you receive. In addition, there may be tax consequences for receiving the accelerated benefit; ask your tax advisor for advice. Please refer to your policy for details.Spouse coverage optionsTwo options are available for spouse coverage at an additional cost:1. Spouse term life policy: Oers guaranteed premiums and level death benefits equivalent to those available to you – whether or not you buy a policy for yourself.2. Spouse term life rider: Add a term rider for your spouse to your policy, up to a maximum death benefit of $50,000; 10-year and 20-year are available (20-year rider only available with a 20- or 30-year term policy).Dependent coverageYou may add a children’s term life rider to cover all of your eligible dependent children with up to $10,000 in coverage each for one premium. The children’s term life rider may be added to either the primary or spouse policy, not both.Waiver of premium benefit riderThis rider waives all premiums (for the policy and any riders) if you become totally and permanently disabled before the age of 65. To be considered permanent, your total disability must continue with no interruptions for at least six consecutive months. Premiums waived by this rider do not have to be repaid. This rider is available for the spouse policy as well, subject to home oice approval.Accidental death benefit riderThis rider provides an additional benefit to the beneficiary if the insured dies as a result of an accident before age 70. The benefit doubles if the injury resulting in death occurs while insured is a fare-paying passenger on a public conveyance, such as a commercial aircra or taxicab. An additional seatbelt benefit is also payable.©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 | 64815-10ColonialLife.com

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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 $80,000 per person.$

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£ 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.

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Notice of Special Enrollment Rights If you are declining enrollment for yourself or your dependents because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 30 days of when you or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days of the marriage, birth, adoption, or placement for adoption. Continued Coverage Under COBRA Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), you and your covered dependents may be able to continue your medical, dental, and vision coverage if you lose your health care coverage as the result of certain qualifying events. Contact the Human Resources Department for more information. HIPAA Regulations Help to Protect Your Privacy The privacy provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) help to ensure that your healthcare-related information stays private. New employees will receive a Privacy Practice Notice which outlines the ways in which the medical plan may use and disclose protected health information (PHI). The notice also describes your rights. For more information, contact the Human Resources Department. Newborns’ and Mothers’ Health Protection Act Under Federal law, healthcare plans may not restrict any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a normal delivery, or less than 96 hours following a Cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother and with the mother’s consent, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). Women’s Health and Cancer Rights Act of1998 Under the Women’s Health and Cancer Rights Act, group health plans must make certain benefits available to participants of health plans who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for: n Reconstruction of the breast on which the mastectomy was performed; n Any necessary surgery and reconstruction of the other breast to produce a symmetrical appearance; n Prostheses; and n Treatment of physical conditions related to the mastectomy, including lymphedema. Benefits required by law will be provided in consultation between the patient and the attending physician. These benefits are subject to the health plan’s regular coinsurance, copayments and deductibles. Additional Information

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The Patient Protection and Affordability Care Act (PPACA) Extension of Dependent Coverage to Age 26 The Medical Plan will cover eligible dependent children of an employee to age 26, regardless of student status, marital status, residence or financial dependence on the employee, if not eligible to access coverage through his/her employer’s plan. Your Rights Under Michelle’s Law Full-time students covered under the group health plan, that would otherwise lose eligibility under the plan because of a reduction in their full-time class status due to a medically necessary leave of absence from school, may be eligible to extend their coverage under the plan for up to one year, or to age 26, whichever occurs first. The child must be a dependent child of a plan participant and be enrolled in the company group health plan on the basis of being a student at a postsecondary educational institution immediately before the first day of the leave. Lifetime Limit The lifetime limit on the dollar value of benefits under the medical plan no longer applies. Individuals whose coverage ended by reason of reaching a lifetime limit under the plan are eligible to enroll in the plan. Individuals have 30 days from the date of this notice to request enrollment. For more information contact the Human Resources Department. Women’s Preventive Care Services Provision The Department of Health and Human Services (DHHS) released health plan coverage guidelines that require health insurance plans to cover women’s preventive services such as woman visits, domestic violence screening and FDA approved contraception without charging a copayment, coinsurance or a deductible. Your coverage now provides expanded coverage for women’s preventive care services for eight additional services when received from an in- network provider. Additional Information

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Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov or by calling toll-free 1-866-444-EBSA (3272). If you live in one of the following States, you may be eligible for assistance paying your employer heal th plan premiums. The following list of States is current as of July 31, 2015. You should contact your State for further information on eligibility: ALABAMA – Medicaid Website: http://www.medicaid.alabama.gov Phone: 1-855-692-5447 ALASKA – Medicaid Website: http://health.hss.state.ak.us/dpa/programs/medicaid/ Phone (Outside of Anchorage): 1-888-318-8890 Phone (Anchorage): 907-269-6529 ARIZONA – CHIP Website: http://www.azahcccs.gov/applicants Phone (Outside of Maricopa County): 1-877-764-5437 Phone (Maricopa County): 602-417-5437 COLORADO – Medicaid Medicaid Website: http://www.colorado.gov/ Medicaid Phone (In state): 1-800-866-3513 Medicaid Phone (Out of state): 1-800-221-3943 FLORIDA – Medicaid Website:https://www.flmedicaidtplrecovery.com/ Phone: 1-877-357-3268 GEORGIA – Medicaid Website: http://dch.georgia.gov/ Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: 1-800-869-1150 IDAHO – Medicaid and CHIP Medicaid Website: www.accesstohealthinsurance.idaho.gov Medicaid Phone: 1-800-926-2588 CHIP Website: www.medicaid.idaho.gov CHIP Phone: 1-800-926-2588 INDIANA – Medicaid Website: http://www.in.gov/fssa Phone: 1-800-889-9949 IOWA – Medicaid Website: www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562 KANSAS – Medicaid Website:http://www.kdheks.gov/hcf/ Phone: 1-800-792-4884 KENTUCKY –Medicaid Website:http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570 LOUISIANA – Medicaid Website: http://www.lahipp.dhh.louisiana.gov Phone: 1-888-695-2447 MAINE – Medicaid Website: http://www.maine.gov/dhhs/ofi/public-assistance/ index.html Phone: 1-800-977-6740 TTY: 1-800-977-6741 MASSACHUSETTS – Medicaid and CHIP Website: http://www.mass.gov/MassHealth Phone: 1-800-462-1120 MINNESOTA – Medicaid Website: http://www.dhs.state.mn.us/ Click on Health Care, then Medical Assistance Phone: 1-800-657-3629 Additional Information

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MISSOURI – Medicaid Website:http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 MONTANA – Medicaid Website: http://medicaidprovider.hhs.mt.gov/clientpages/ clientindex.shtml Phone: 1-800-694-3084 NEBRASKA – Medicaid Website:www.ACCESSNebraska.ne.gov Phone: 1-800-383-4278 NEVADA – Medicaid Medicaid Website: http://dwss.nv.gov/ Medicaid Phone: 1-800-992-0900 NEW HAMPSHIRE – Medicaid Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf Phone: 603-271-5218 NEW JERSEY – Medicaid and CHIP Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 NEW YORK – Medicaid Website:http://www.nyhealth.gov/health_care/medicaid/ Phone: 1-800-541-2831 NORTH CAROLINA – Medicaid Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100 NORTH DAKOTA – Medicaid Website:http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-800-755-2604 OKLAHOMA – Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 OREGON – Medicaid and CHIP Website: http://www.oregonhealthykids.gov http://www.hijossaludablesoregon.gov Phone: 1-877-314-5678PENNSYLVANIA – Medicaid Website: http://www.dpw.state.pa.us/hipp Phone: 1-800-692-7462 RHODE ISLAND – Medicaid Website:www.ohhs.ri.gov Phone: 401-462-5300 SOUTH CAROLINA – Medicaid Website: http://www.scdhhs.gov Phone: 1-888-549-0820 SOUTH DAKOTA – Medicaid Website: http://dss.sd.gov Phone: 1-888-828-0059 TEXAS – Medicaid Website: https://www.gethipptexas.com/ Phone: 1-800-440-0493 UTAH – Medicaid and CHIP Website: http://health.utah.gov/upp Phone: 1-866-435-7414 VERMONT– Medicaid Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427 VIRGINIA – Medicaid and CHIP Medicaid Website: http://www.dmas.virginia.gov/rcp-HIPP.htm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.famis.org/ CHIP Phone: 1-866-873-2647 WASHINGTON – Medicaid Website: http://hrsa.dshs.wa.gov/premiumpymt/Apply.shtm Phone: 1-800-562-3022 ext.15473 WEST VIRGINIA – Medicaid Website: www.dhhr.wv.gov/bms/ Phone: 1-877-598-5820, HMS Third PartyLiabilityWISCONSIN – Medicaid Website:http://www.badgercareplus.org/pubs/p-10095.htm Phone: 1-800-362-3002 WYOMING – Medicaid Website:http://health.wyo.gov/healthcarefin/equalitycare Phone: 307-777-7531 To see if any more States have added a premium assistance program since July 31, 2015, or for more information on special enrollment rights, you can contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-EBSA (3272) U.S.D Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565 OMB Control Number 1210-0137 (expires 10/31/2016) Additional Information

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Baumann Propellers Where state or local law conflicts with a particular policy the law of that jurisdiction will apply. Nothing in the employee policies contained in this guide is intended or shall be construed to create any contractual obligation (express or implied) or to constitute a contract or promise of continued employment. Employment with the Company is at will and, therefore, for no definite period. Nothing in the employee policies contained in the guide limits or restricts the right of the Company or any employee to terminate the employment relationship at any time, with or without cause, with or without notice, and for any reason, at the sole discretion of the Company or the employee. This Guide contains a non-technical explanation of some of the important features of certain benefit plans that are covered in detail in official plan documents. Copies of the governing instruments of these plan documents, and the Summary Plan Descriptions, which are modified from time to time, are readily available for inspection during normal business hours in the Human Resources Department. These documents are determinative of the precise benefits, terms, conditions, exclusions, and restrictions that apply to coverage under the aforementioned plans. They supersede all other documents. If a question should arise concerning the nature of these benefits, the actual legal documents will govern and not the contents of this guide. No supervisor has any authority to interpret the plan documents or to make any promises about the plans. The Company and its Plan Administrators and Fiduciaries reserve the maximum discretion permitted by law to administer, interpret, enhance, modify, discontinue, or otherwise change any benefit plan, practice, or procedure. While you may receive feedback in response to your questions about the benefit plans we offer, none of those responses can modify the terms of the official plan documents and, consequently, do not represent a promise or guarantee of benefits. Please always refer to the plan documents rather than relying on anyone’s interpretation of the benefit plans. The Company reserves the right to modify or eliminate any of its benefits, plans, policies, procedures or practices at any time, as to present employees, future employees and/or retirees, generally or in individual cases, with or without advance notice.