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Colonial Benefit Booklet - 2024

Colonial Life provides benefits that employees want for the unexpected moments in life. Whether planning for retirement, growing their families, or saving for college, they know an injury or illness won’t derail their dreams. Learn More ContactRich Mellone Richmellone@gmail.com704-907-3997Life is anything but expected. That’s why we’re here.ProductsDisability InsuranceProvides financial protection to cover income loss from a covered disability.Hospital Confinement Indemnity Insurance (Medical Bridge)Provides benefits to help cover the cost of a hospital stay and other medical procedures for a covered accident or sickness, regardless of what health insurance pays.Accident InsuranceFrom a fall to a car accident, this coverage offers a range of benefits to help cover medical or non-medical related expenses due to a covered accident.Cancer InsuranceProvides benefits for a cancer diagnosis and treatment. Option to add cancer screening benefit.Whole Life InsuranceProvides protection for a lifetime. Features guaranteed level premiums and increasing cash values over time. Option to increase coverage on the second, fifth and eighth year of the policy’s anniversary.

Individual Short Term Disability Insurance You never know when a disability could impact your way of life Fortunately there s a way to help protect your income If a covered accident or sickness prevents you from earning a paycheck disability insurance can provide a monthly benefit to help you cover your ongoing expenses Can you afford to not protect your income You don t have the same lifestyle expenses as the next person That s why you need disability coverage that can be customized to fit your specific needs After calculating your monthly expenses your benefits counselor can help you complete the benefits worksheet MONTHLY EXPENSES Round to the nearest hundred ColonialLife com 1 Rent or mortgage 2 Transportation 3 Utilities phone internet electricity gas water etc 4 Food and necessities 5 Other expenses Total monthly expenses add lines 1 5 together Benefits worksheet How much coverage do I need Monthly benefit amount for off job accident and off job sickness ______________ Choose a monthly benefit amount between 400 and 6 500 If your plan includes on job accident sickness benefits the benefit is 50 of the off job amount What is the benefit period Benefit period _______ months The partial disability benefit period is three months When may my total disability benefits start After an accident _______ days After a sickness _______ days Subject to income requirements ISTD3000 BASE

Product information Total disability definition Totally disabled or total disability means you are unable to perform the material and substantial duties of your job not working at any job and under the regular and appropriate care of a physician How partial disability works If you are able to return to work part time after at least 14 days of being paid for a total disability you may be able to still receive 50 of your total disability benefit Waiver of premium We will waive your premium payments after 90 consecutive days of a covered disability Geographical limitations If you are disabled while outside of the United States Canada or Mexico you may receive benefits for up to 60 days before you have to return to the U S in order to continue receiving benefits Issue age Coverage is available from ages 17 to 74 Keep your coverage You can keep your coverage to age 75 at no additional cost even if you change jobs as long as you pay your premiums when they are due For more information talk with your benefits counselor EXCLUSIONS AND LIMITATIONS We will not pay benefits for losses that are caused by contributed to by or occur as the result of cosmetic surgery felonies or illegal occupations flying hazardous avocations intoxicants and narcotics psychiatric or psychological conditions racing semi professional or professional sports substance abuse suicide or injuries which you intentionally do to yourself war or armed conflict We will not pay for benefits due to being pregnant before the policy coverage effective date shown in the policy schedule if medical advice diagnosis care or treatment was received or recommended within the one year period immediately preceding the policy coverage effective date shown on the policy schedule We will not pay for loss when the disability is a pre existing condition as described in the policy Pre existing condition means those conditions for which medical advice diagnosis care or treatment was received or recommended with the one year period immediately preceding the Policy Coverage Effective Date shown on the Policy Schedule If you are age 65 or older when this policy is issued pre existing conditions will include only conditions specifically eliminated by rider After this policy has been in force for 12 months from the policy coverage effective date shown on the policy schedule we will pay benefits for any pre existing condition not excluded by name or specific description if the covered disability began at least 12 months after the policy coverage effective date and the elimination period has been satisfied For cost and complete details see your Colonial Life benefits counselor Applicable to policy form ISTD3000 NC and rider form ISTD3000 ADIB NC This is not an insurance contract and only the actual policy and rider provisions will control Underwritten by Colonial Life Accident Insurance Company Columbia SC 2018 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company 1 18 101629 2 NC

Accident Insurance Accidents happen in places where you and your family spend the most time at work in the home and on the playground and they re unexpected How you care for them shouldn t be In your lifetime which of these accidental injuries have happened to you or someone you know l Sports related accidental injury Broken bone Burn Concussion Laceration l Back or knee injuries l l l l l l l l Car accidents Falls spills Dislocation Accidental injuries that send you to the Emergency Room Urgent Care or doctor s office Accident 1 0 Preferred with Health Screening Benefit Colonial Life s Accident Insurance is designed to help you fill some of the gaps caused by increasing deductibles co payments and out of pocket costs related to an accidental injury The benefit to you is that you may not need to use your savings or secure a loan to pay expenses Plus you ll feel better knowing you can have greater financial security What additional features are included l Worldwide coverage l Portable l Compliant with Healthcare Spending Account HSA guidelines Will my accident claim payment be reduced if I have other insurance You re paid regardless of any other insurance you may have with other insurance companies and the benefits are paid directly to you unless you specify otherwise What if I change employers If you change jobs or leave your employer you can take your coverage with you at no additional cost Your coverage is guaranteed renewable as long as you pay your premiums when they are due or within the grace period Can my premium change Colonial Life can change your premium only if we change it on all policies of this kind in the state where your policy was issued How do I file a claim Visit coloniallife com or call our Customer Service Department at 1 800 325 4368 for additional information

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

Transportation Lodging Assistance If injured covered person must travel more than 50 miles from residence to receive special treatment and confinement in a hospital l l Transportation 500 per round trip up to 3 round trips Lodging family member or companion 125 per night up to 30 days for a hotel motel lodging costs Accident Hospital Care l Hospital Admission 1 500 per accident Hospital ICU Admission 3 000 per accident We will pay either the Hospital Admission or Hospital Intensive Care Unit ICU Admission but not both l l Hospital Confinement 250 per day up to 365 days per accident l Hospital ICU Confinement 500 per day up to 15 days per accident Accident Follow Up Care l l Accident Follow Up Doctor Visit 50 up to 3 visits per accident Medical Imaging Study 250 per accident limit 1 per covered accident and 1 per calendar year l Occupational or Physical Therapy 35 per treatment up to 10 days l Appliances 125 such as wheelchair crutches l Prosthetic Devices Artificial Limb 500 one 1 000 more than 1 l Rehabilitation Unit 100 per day up to 15 days per covered accident and 30 days per calendar year Maximum of 30 days per calendar year Accidental Dismemberment l Loss of Finger Toe 750 one 1 500 two or more l Loss or Loss of Use of Hand Foot Sight of Eye 7 500 one 15 000 two or more Catastrophic Accident For severe injuries that result in the total and irrecoverable l Loss of one hand and one foot l Loss of the sight of both eyes l Loss of both hands or both feet l Loss of the hearing of both ears l Loss or loss of use of one arm and one leg or l Loss of the ability to speak l Loss or loss of use of both arms or both legs Named Insured 25 000 Spouse 25 000 Child ren 12 500 365 day elimination period Amounts reduced for covered persons age 65 and over Payable once per lifetime for each covered person Accidental Death Accidental Death Common Carrier l Named Insured 25 000 100 000 l Spouse 25 000 100 000 l Child ren 5 000 20 000

Health Screening Benefit l 50 per covered person per calendar year Provides a benefit if the covered person has one of the health screening tests performed This benefit is payable once per calendar year per person and is subject to a 30 day waiting period Tests include l Blood test for triglycerides l Hemoccult stool analysis l Bone marrow testing l Mammography l Breast ultrasound l Pap smear l CA 15 3 blood test for breast cancer l PSA blood test for prostate cancer l CA125 blood test for ovarian cancer l l Carotid doppler Serum cholesterol test to determine level of HDL and LDL l CEA blood test for colon cancer l l Chest x ray Serum protein electrophoresis blood test for myeloma Colonoscopy l l Stress test on a bicycle or treadmill Echocardiogram ECHO l l Skin cancer biopsy Electrocardiogram EKG ECG l l Thermography Fasting blood glucose test l l ThinPrep pap test Flexible sigmoidoscopy l l Virtual colonoscopy My Coverage Worksheet For use with your Colonial Life benefits counselor Who will be covered check one Employee Only Spouse Only One Parent Family with Employee One Child Only One Parent Family with Spouse Employee Spouse Two Parent Family On and Off Job Benefits Off Job Only Benefits EXCLUSIONS We will not pay benefits for losses that are caused by or are the result of hazardous avocations felonies or illegal occupations racing semi professional or professional sports sickness suicide or self inflicted injuries war or armed conflict in addition to the exclusions listed above we also will not pay the Catastrophic Accident benefit for injuries that are caused by or are the result of birth intoxication For cost and complete details see your Colonial Life benefits counselor Applicable to policy form Accident 1 0 HS NC This is not an insurance contract and only the actual policy provisions will control Colonial Life 1200 Colonial Life Boulevard Columbia South Carolina 29210 coloniallife com 2014 Colonial Life Accident Insurance Company Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand 6 14 71740 NC Accident 1 0 Preferred with Health Screening Benefit When are covered accident benefits available check one

For more information, talk with your benefits counselor.Group Hospital Indemnity InsurancePlan 2ColonialLife.comGroup Medical BridgeSM insurance can help with medical costs associated with a hospital stay that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children.Hospital confinement .................................................... $__1,000_____________ per dayMaximum of one day per covered person per calendar yearWaiver of premiumAvailable aer 30 continuous days of a covered confinement of the named insured£ Daily hospital confinement ...................................................................$100 per dayMaximum of 365 days per covered person per confinement. Re-confinement for the same or related condition within 90 days of discharge is considered a continuation of a previous confinement.£ Diagnostic procedure ........................................................ .$ 500______________ per dayMaximum of one day per covered person per calendar year£ Outpatient surgical procedure¾ Tier 1 ................................................................................$500.00______________ per day¾ Tier 2 .............................................................................$_1,000.00______________ per dayMaximum of $__1,500.00______________ per covered person per calendar year for Tier 1 and 2 combined Maximum of one day per outpatient surgical procedureGMB7000 – PLAN 2Diagnostic proceduresThe following is a list of common diagnostic procedures that may be covered if the diagnostic procedure benefit is selected.  Breast– Biopsy (incisional, needle, stereotactic)  Cardiac– Angiogram– Arteriogram– Thallium stress test– Transesophageal echocardiogram (TEE)  Diagnostic radiology– Computerized tomography scan (CT scan)– Electroencephalogram (EEG)– Magnetic resonance imaging (MRI)– Myelogram– Nuclear medicine test– Positron emission tomography scan (PET scan)  Digestive– Barium enema/lower GI series– Barium swallow/upper GI series– Esophagogastroduodenoscopy (EGD)  Ear, nose, throat, mouth– Laryngoscopy  Gynecological– Amniocentesis– Cervical biopsy– Cone biopsy– Endometrial biopsy  Liver– Biopsy  Lymphatic– Biopsy  Miscellaneous– Bone marrow aspiration/biopsy  Renal– Biopsy  Respiratory– Biopsy– Bronchoscopy– Pulmonary function test (PFT)  Skin– Biopsy– Excision of lesion  Thyroid– Biopsy  Urologic– Cystoscopy– Hysteroscopy– Loop electrosurgical excisional procedure(LEEP)

ColonialLife.com8-19 | 101918-1THIS POLICY PROVIDES LIMITED BENEFITS.EXCLUSIONSWe will not pay any benefits for injuries received in accidents or for sicknesses which are caused by, contributed to by or occur as a result of the following exclusions and limitations. (a) alcoholism or drug addiction; (b) dental procedures; (c) elective procedures and cosmetic surgery; (d) felonies or illegal occupations; (e) mental or nervous disorders; (f) pregnancy of a dependent child; (g) suicide or injuries which any covered person intentionally does to himself or herself; (h) war, or (i) giving birth within the first nine months aer the eective date of the certificate. (j) We will not pay benefits for hospital confinementor daily hospital confinement, if included, of a newborn child following his birth unless he is injured or sick. (k) The policy may have additional exclusions and limitations which may aect any benefits payable.PRE-EXISTING CONDITION LIMITATIONS(l) We will not pay benefits for loss during the first 12 months aer the certificate eective date due to a pre-existing condition. (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, received medical advice or had taken medication within the 12 months before the certificate eective date. (n) This limitation applies to the following benefits, if applicable: Hospital Confinement, Daily Hospital Confinement, Inpatient Mental and Nervous, Rehabilitation Unit Confinement, Specified Critical Illness, DiagnosticProcedure, and Outpatient Surgical Procedure.This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy form GMB7000-P and certificate form GMB7000-C (including state abbreviations where applicable, such as policy forms GMB7000-P-AU-TX and GMB7000-P-EE-TX, and certificate forms GMB7000-C-AU-TX and GMB7000-C-EE-TX). Coverage may vary by state and may not be available in all states. This form is not complete without form #101733.  Breast– Breast reconstruction– Breast reduction  Cardiac– Angioplasty– Cardiac catheterization  Digestive– Exploratory laparoscopy– Laparoscopic appendectomy– Laparoscopic cholecystectomy  Ear, nose, throat, mouth– Ethmoidectomy– Mastoidectomy– Septoplasty– Stapedectomy– TympanoplastyTier 2 outpatient surgical procedures  Eye– Cataract surgery– Corneal surgery (penetrating keratoplasty)– Glaucoma surgery (trabeculectomy)– Vitrectomy  Gynecological– Hysterectomy– Myomectomy  Musculoskeletal system– Arthroscopic knee surgery with meniscectomy(knee cartilage repair)– Arthroscopic shoulder surgery– Clavicle resection– Dislocations (open reduction with internal fixation)– Fracture (open reduction with internal fixation)– Removal or implantation of cartilage– Tendon/ligament repairThe procedures listed below are only a sampling of the procedures that may be covered if the outpatient surgical procedure benefit is selected. Procedures must be performed by a doctor in a hospital or ambulatory surgical center. For complete details and definitions, refer to your certificate.Tier 1 outpatient surgical procedures  Breast– Axillary node dissection– Breast capsulotomy– Lumpectomy  Cardiac– Pacemaker insertion  Digestive– Colonoscopy* – Fistulotomy– Hemorrhoidectomy– Lysis of adhesions  Ear, nose, throat, mouth– Adenoidectomy– Removal of oral lesions– Myringotomy– Tonsillectomy– Tracheostomy– Tympanotomy  Gynecological– Dilation and curettage (D&C)– Endometrial ablation– Lysis of adhesions  Liver– Paracentesis  Musculoskeletal system– Carpal/cubital repair or release– Foot surgery (bunionectomy, exostectomy, arthroplasty, hammertoe repair)– Removal of orthopedic hardware– Removal of tendon lesion  Skin– Laparoscopic hernia repair– Skin graingKS: "Surgical Procedure" benefit replaces "Outpatient Surgical Procedure." Diagnostic Procedures must be performed in a hospital or an ambulatory surgical center.PA: "Hospital Confinement Admission" benefit replaces the "Hospital Confinement" benefit* Colonoscopy must result in polyp removal or be recommended by a physician for the purposes of treating or diagnosing a sickness.If a covered family member has a qualified high deductible health plan (HDHP) and actively contributes to a health savings account (HSA), their HSA can be disqualified with this coverage.  Thyroid– Excision of a mass  Urologic– LithotripsyUnderwritten 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.

Group Hospital Indemnity InsuranceExclusions and LimitationsSTATE-SPECIFIC EXCLUSIONSAK: (a) Replaced by intoxicants and narcotics CA: (k) Additional exclusions include intoxicants and controlled substancesCT: (a) Replaced by intoxication or drug addiction; (d) Replaced by felonies; (f) Exclusion does not applyDE: (a) Exclusion does not apply IL: (a) Replaced by alcoholism, intoxication, or drug addiction; (f) Exclusion does not apply; (g) Exclusion does not applyKS: (a) Replaced by intoxicants and narcotics; (h) Replaced by war or armed conflict; (i) Exclusion does not applyKY: (a) Replaced by intoxicants, narcotics and hallucinogenics LA: (a) Replaced by intoxicants and narcotics MI: (g) Exclusion does not applyMO: (a) Replaced by drug addiction; (d) Replaced by illegal activitiesMS: (a) Replaced by intoxicants and narcoticsNC: (i) Exclusion does not applyND: (a) Exclusion does not apply; (e) Exclusion does not applyNV: (a) Exclusion does not apply OH: (f) Exclusion does not apply; (i) Replaced by 270 daysPA: (a) Replaced by intoxicants and narcotics; (c) Replaced by cosmetic surgery; (e) Replaced by mental, nervous or emotional disorders; (h) Replaced by war or armed conflictSD:(a) Exclusion does not apply TN: (f) Exclusion does not applyTX: (a) Replaced by intoxicants and narcotics VA: (i) Pregnancy resulting from the rape of any covered person, which was reported to the police within seven days following its occurrence, will be covered to the same extent as any other covered accident. The seven-day requirement will be extended to 180 days in the case of an act of rape or incest of a female under 13 years of age.STATE-SPECIFIC PRE-EXISTING CONDITION LIMITATIONSIN, SD, and WY: (m) applies within the six months before the certificate eective date.CA: (m) A pre-existing condition is a sickness or physical condition for which a covered person was diagnosed or treated within 12 months before the coverage eective date.FL: (m) A pre-existing condition is a sickness or physical condition for which a covered person was treated, had medical testing, received medical advice or had taken medication within six months before the coverage eective date. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information. IL: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing by a legally qualified physician or, received medical advice, produced symptoms or had taken medication within 12 months before the coverage eective date.KS: (n) Surgical Procedure replaces Outpatient Surgical Procedure ME: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, or received medical advice within 12 months before the coverage eective date.MI: (l) Applies during the first six months aer the certificate eective date (m) applies within the six months before the certificate eective date.MO: (m) A pre-existing condition means having a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, received medical advice or had taken medication within 12 months before the coverage eective date of this certificate.NC: (m) A pre-existing condition is those conditions, whether diagnosed or not, for which a covered person received medical advice, diagnosis, care or treatment that was received or recommended within the one-year period immediately preceding the coverage eective date. If you are 65 or older when this certificate is issued, pre-existing conditions will include only conditions specifically eliminated by a rider.ND: (m) A pre-existing condition is a sickness or physical condition for which a covered person was treated, had medical testing, received medical advice or had taken medication within 12 months before the coverage eective date.NV: (m) applies within the six months before the certificate eective date. Additionally, pre-existing condition does not include genetic information in the absence of a diagnosis of the condition related to such information.OR: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated by a doctor, received advice from a physician or had taken medication prescribed by a doctor within the 12 months period immediately preceding the coverage eective date.PA: (m) A pre-existing condition is a disease or physical condition for which you received medical advice or treatment within 90 days before the coverage eective date. (n) Hospital Confinement Admission replaces Hospital Confinement. CA Lic # (if applicable): _________________This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy form GMB7000-P and certificate form GMB7000-C (including state abbreviations where applicable, such as policy forms GMB7000-P-AU-TX and GMB7000-P-EE-TX, and certificate forms GMB7000-C-AU-TX and GMB7000-C-EE-TX). Coverage may vary by state and may not be available in all states. This form is not complete without base form 101917 or 101918.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.GMB7000 – EXCLUSIONS AND LIMITATIONS | 10-18 | 101733-3

For more information, talk with your benefits counselor.ColonialLife.comGroup Hospital Indemnity InsuranceMedical Treatment PackageTHIS POLICY PROVIDES LIMITED BENEFITS. This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy forms GMB7000-P and GMB7000-P-TX. Coverage may vary by state and may not be available in all states.©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.GMB7000 – MEDICAL TREATMENT PACKAGE | 6-16 | 101725The Group Medical BridgeSM medical treatment package can help pay for deductibles, co-payments and other out-of-pocket expenses related to the treatment of a covered accident or covered sickness.The medical treatment package paired with Plan 1 provides accident-only coverage. When paired with Plan 2, it provides accident and sickness coverage.Medical treatment package¾ Air ambulance ............................................................................ $1,000 per dayMaximum of one day per covered person per calendar year¾ Ambulance ....................................................................................$100 per dayMaximum of one day per covered person per calendar year¾ Appliance ......................................................................................$100 per dayMaximum of one day per covered person per calendar year¾ Doctor’s oice visit/telemedicine .......................................................... $25 per dayMaximum of three days per calendar year for named insured coverage or maximum of five days per calendar year for all covered persons combined¾ Emergency room visit .......................................................................$100 per dayMaximum of two days per covered person per calendar year¾ X-ray ............................................................................................. $25 per dayMaximum of two days per covered person per calendar year

For more information, talk with your benefits counselor.ColonialLife.comGroup Hospital Indemnity InsuranceWellbeing Assistance Standard BenefitTHIS POLICY PROVIDES LIMITED BENEFITS. WAITING PERIODWaiting period means the first 30 days following any covered person’s coverage eective date, during which no benefits are payable. This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy forms GMB7000-P and GMB7000-P-TX. Coverage may vary by state and may not be available in all states. ©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.GMB7000 – WELLBEING ASSISTANCE STANDARD BENEFIT | 6-16 | 101730The Group Medical BridgeSM wellbeing assistance standard benefit can help pay for routine preventive tests you have each year.Wellbeing assistance standard....................................................... $__100_______ per dayMaximum of one day per covered person per calendar year; subject to a 30-day waiting period  Blood test for triglycerides  Bone marrow testing  Breast ultrasound  CA 15-3 (blood test for breast cancer)  CA 125 (blood test for ovarian cancer)  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 bicycle or treadmill  Thermography  ThinPrep pap test  Virtual colonoscopy

Cancer Insurance Level 3 Benefits BENEFIT DESCRIPTION Cancer insurance helps provide financial protection through a variety of benefits These benefits are not only for you but also for your covered family members BENEFIT AMOUNT Air ambulance 2 000 per trip Transportation to or from a hospital or medical facility max of two trips per confinement Ambulance 250 per trip Transportation to or from a hospital or medical facility max of two trips per confinement Anesthesia Administered during a surgical procedure for cancer treatment General anesthesia 25 of surgical procedures benefit Local anesthesia 40 per procedure Anti nausea medication 50 per day administered or Doctor prescribed medication for radiation or chemotherapy 200 monthly max per prescription filled Blood plasma platelets immunoglobulins 175 per day A transfusion required during cancer treatment 10 000 calendar year max Bone marrow donor screening 50 Testing in connection with being a potential donor once per lifetime Bone marrow or peripheral stem cell donation 750 Receiving another person s bone marrow or stem cells for a transplant once per lifetime Bone marrow or peripheral stem cell transplant 7 000 per transplant Transplant you receive in connection with cancer treatment max of two bone marrow transplant benefits per lifetime Cancer vaccine 50 An FDA approved vaccine for the prevention of cancer once per lifetime Companion transportation 0 50 per mile Companion travels by plane train or bus to accompany a covered cancer patient more than 50 miles one way for treatment up to 1 200 per round trip Egg s extraction or harvesting sperm collection and storage Extracted harvested or collected before chemotherapy or radiation once per lifetime Egg s extraction or harvesting sperm collection 1 000 Egg s or sperm storage cryopreservation 350 Experimental treatment 300 per day Hospital medical or surgical care for cancer 15 000 lifetime max For more information talk with your benefits counselor Family care 50 per day Inpatient or outpatient treatment for a covered dependent child 2 500 calendar year max Hair external breast voice box prosthesis 350 per calendar year Prosthesis needed as a direct result of cancer Home health care services 100 per day Examples include physical therapy occupational therapy speech therapy and audiology prosthesis and orthopedic appliances rental or purchase of durable medical equipment up to 30 days per calendar year or twice the number of days hospital confined whichever is greater Hospice initial or daily care An initial one time benefit and a daily benefit for treatment 15 000 lifetime max for both Initial hospice care once per lifetime 1 000 Daily hospice care 50 per day CANCER ASSIST LEVEL 3

BENEFIT DESCRIPTION BENEFIT AMOUNT Hospital confinement Hospital stay including intensive care required for cancer treatment 30 days or less 250 per day 31 days or more 500 per day Lodging 75 per day Hotel motel expenses when being treated for cancer more than 50 miles from home 70 day calendar year max Medical imaging studies 175 per study Specific studies for cancer treatment 350 calendar year max Outpatient surgical center 300 per day Surgery at an outpatient center for cancer treatment 900 calendar year max Private full time nursing services 125 per day Services while hospital confined other than those regularly furnished by the hospital Prosthetic device artificial limb 2 000 per device or limb A surgical implant needed because of cancer surgery payable one per site 4 000 lifetime max Radiation chemotherapy Weekly benefit max once per week Injected chemotherapy by medical personnel 750 Radiation delivered by medical personnel 750 Monthly chemotherapy benefit max once per month Self injected 300 Pump 300 Topical 300 Oral hormonal 1 24 months 300 Oral hormonal 25 months 150 Oral non hormonal 300 Reconstructive surgery 60 per surgical unit ColonialLife com A surgery to reconstruct anatomic defects that result from cancer treatment up to 3 000 per procedure including 25 for general anesthesia Second medical opinion 300 A second physician s opinion on cancer surgery or treatment once per lifetime Skilled nursing care facility 100 per day Confinement to a covered facility after hospital release up to the number of days paid for hospital confinement Skin cancer initial diagnosis 400 A skin cancer diagnosis while the policy is in force once per lifetime Supportive or protective care drugs and colony stimulating factors 150 per day Doctor prescribed drugs to enhance or modify radiation chemotherapy treatments 1 200 calendar year max Surgical procedures 60 per surgical unit Inpatient or outpatient surgery for cancer treatment 5 000 max per procedure Transportation 0 50 per mile Travel expenses when being treated for cancer more than 50 miles from home up to 1 200 per round trip Waiver of premium Is available No premiums due if the named insured is disabled longer than 90 consecutive days The policy has limitations and exclusions that may affect benefits payable Most benefits require that a charge be incurred Coverage may vary by state and may not be available in all states For cost and complete details see your benefits counselor This chart highlights the benefits of policy form CanAssist including state abbreviations where used for example CanAssist TX This chart is not complete without form number 101481 2015 Colonial Life Accident Insurance Company Columbia SC Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand 4 15 101484 1

Cancer Insurance Wellness Benefits To encourage early detection our cancer insurance offers benefits for wellness and health screening tests For more information talk with your benefits counselor Part one Cancer wellness health screening 100 per Yr Provided when one of the tests listed below is performed after the waiting period and while the policy is in force Payable once per calendar year per covered person Cancer wellness tests Health screening tests B one marrow testing B lood test for triglycerides B reast ultrasound C arotid Doppler C A 15 3 blood test for breast cancer E chocardiogram ECHO C A 125 blood test for ovarian cancer E lectrocardiogram EKG ECG C EA blood test for colon cancer F asting blood glucose test C hest X ray C olonoscopy S erum cholesterol test for HDL and LDL levels F lexible sigmoidoscopy S tress test on a bicycle or treadmill H emoccult stool analysis M ammography P ap smear P SA blood test for prostate cancer S erum protein electrophoresis blood test for myeloma S kin biopsy T hermography T hinPrep pap test V irtual colonoscopy Part two Cancer wellness additional invasive diagnostic test or surgical procedure Provided when a doctor performs a diagnostic test or surgical procedure after the waiting period as the result of an abnormal result from one of the covered cancer wellness tests in part one We will pay the benefit regardless of the test results Payable once per calendar year per covered person Waiting period means the first 30 days following the policy s coverage effective date during which no benefits are payable The policy has exclusions and limitations For cost and complete details of the coverage see your Colonial Life benefits counselor Coverage may vary by state and may not be available in all states Applicable to policy form CanAssist and state abbreviations where applicable for example CanAssist TX 2015 Colonial Life Accident Insurance Company Columbia SC Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand CANCER ASSIST WELLNESS 3 15 101486 1

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 $80,000 per person.$

£ 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.

Deductions per year: 26City of Lenoir Rates Per 26 Pay PeriodsIndividual Disability - OFF The JOBlOff Job Accident & Off Job Sickness6 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $600* $800* $1,000* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $9.14 $12.18 $15.23 $22.85 $30.4650-64 $11.91 $15.88 $19.85 $29.77 $39.6965-74 $18.58 $24.78 $30.97 $46.45 $61.94Individual Disability - ON / OFF the JOBlOn/Off Job Accident and On/Off Job Sickness6 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $600* $800* $1,000* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $11.22 $14.95 $18.69 $28.04 $37.3850-64 $13.29 $17.72 $22.15 $33.23 $44.3165-74 $22.65 $30.20 $37.75 $56.63 $75.51Accident 1.0 for NCl On/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with $50/Yr.health screening 17-80 $9.76 $13.37 $15.08 $18.68Group Medical Bridge Guarentee Issue & Pre-Ex Waived this enrollment ONLY!lWellbeing Assistance: Standard - $100, Outpatient Surgical Procedure: Option 1 - ($500 / $1000 / $1500), DiagnosticProcedure: Option 2 - $500, Medical Treatment Package (Accident / Sickness)HOSPITAL CONFINEMENT LEVEL ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE PARENT FAMILY TWO PARENT FAMILYLevel 2: $100017-99 $15.92 $32.58 $23.55 $40.20Cancer Assist for NClwith $100 Health Screening Benefit$5,000 Initial Diagnosis BenefitCOVERAGE LEVEL ISSUE AGE NAMED INSURED EMPLOYEE AND SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYLevel 3 17-75 $15.76 $26.26 $16.20 $26.70Page 1 of 2Underwritten by Colonial Life & Accident Insurance CompanySee page 2 for Important Notice

Whole Life Plus (IWL5000) for NClAdult Base Plan Paid-Up at Age 100, Accelerated Death Benefit for Long-Term Care Services, Accidental Death Benefit,Guaranteed Purchase Option Benefit, Waiver of Premium BenefitNon-Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $12.13 $24.27 $36.40 $48.5435 $16.32 $32.66 $48.98 $65.3145 $25.94 $51.90 $77.85 $103.8055 $42.98 $85.98 $128.96 $171.9565 $71.31 $142.63 $213.95 $285.26Tobacco RatesISSUE AGE $25,000 $50,000 $75,000 $100,00025 $20.18 $40.37 $60.55 $80.7435 $24.64 $49.30 $73.93 $98.5845 $37.09 $74.19 $111.28 $148.3755 $62.22 $124.45 $186.68 $248.9165 $101.69 $203.40 $305.10 $406.79Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage maynot be available in all states. Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices.Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.© 2024 Colonial Life & Accident Insurance Company"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.Rich Mellone | Richmellone@gmail.com | (704) 907-3997(Continued...)Page 2 of 2

Deadline To Submit The Form To HR Will Be May 10, 2024 Colonial Interest FormName___________________________________SS#____________________Address_____________________________City___________________St.__________Zip_______Cell Phone_________________________ Email___________________________________Date Of Birth____________________ Date Of Hire____________________ Beneficiary___________________________ Date of Birth___________Relationship___________Spouse_______________________________ DOB________________ Child_________________________________DOB________________Relationship____________Child_________________________________DOB________________Relationship_______Child_________________________________DOB________________Relationship____________https://simplebooklet.com/cityoflenoircolonialbenefitbooklet

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

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