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Benefit Booklet 2023

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 Life is anything but expected That s why we re here Plan options Accident insurance Helps offset unexpected medical expenses such as emergency room fees deductibles and co payments that can result from a fracture dislocation or other covered accidental injury Disability insurance Helps replace a portion of your income to help make ends meet if you become disabled from a covered accident or covered sickness Critical illness Cancer insurance Supplements your major medical coverage by providing a lump sum benefit you can use to pay the direct and indirect costs related to a covered critical illness or Cancer For more information David Neeley 704 369 6247

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 l Broken bone l Burn l Concussion l Laceration l Back or knee injuries l Car accidents l Falls spills l Dislocation l Accidental injuries that send you to the Emergency Room Urgent Care or doctor s office 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 Accident 1 0 Premier with Health Screening Benefit

Benefits listed are for each covered person per covered accident unless otherwise specified Initial Care l Accident Emergency Treatment 200 l X ray Benefit 60 l Ambulance 600 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 Non Surgical 9 600 4 800 3 840 2 400 1 440 1 440 480 480 Surgical 19 200 9 600 7 680 4 800 2 880 2 880 960 960 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 9 000 3 600 5 400 2 700 1 260 1 260 1 260 1 080 1 080 1 080 900 720 360 Surgical 18 000 7 200 10 800 5 400 2 520 2 520 2 520 2 160 2 160 2 160 1 800 1 440 720 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 12 500 l Concussion 150 l Emergency Dental Work 100 Extraction 400 Crown Implant or Denture l Lacerations based on size 50 to 800 Requires Surgery l Eye Injury 300 l Tendon Ligament Rotator Cuff 750 one 1 500 two or more l Ruptured Disc 750 l Torn Knee Cartilage 750 Surgical Care l Surgery cranial open abdominal or thoracic 1 500 l Surgery hernia 150 l Surgery arthroscopic or exploratory 300 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 Transportation 600 per round trip up to 3 round trips l Lodging family member or companion 150 per night up to 30 days for a hotel motel lodging costs Accident Hospital Care l Hospital Admission 2 000 per accident l Hospital ICU Admission 4 000 per accident We will pay either the Hospital Admission or Hospital Intensive Care Unit ICU Admission but not both l Hospital Confinement 300 per day up to 365 days per accident l Hospital ICU Confinement 600 per day up to 15 days per accident Accident Follow Up Care l Accident Follow Up Doctor Visit 50 up to 4 visits per accident l Medical Imaging Study 300 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 750 one 1 500 more than 1 l Rehabilitation Unit 150 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 1 250 one 2 400 two or more l Loss or Loss of Use of Hand Foot Sight of Eye 12 000 one 24 000 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 both hands or both feet l Loss or loss of use of one arm and one leg or l Loss or loss of use of both arms or both legs l Loss of the sight of both eyes l Loss of the hearing of both ears l Loss of the ability to speak 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 l Named Insured l Spouse l Child ren Accidental Death 50 000 50 000 10 000 Common Carrier 200 000 200 000 40 000

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 Bone marrow testing l Breast ultrasound l CA 15 3 blood test for breast cancer l CA125 blood test for ovarian cancer l Carotid doppler l CEA blood test for colon cancer l Chest x ray l Colonoscopy l Echocardiogram ECHO l Electrocardiogram EKG ECG l Fasting blood glucose test l Flexible sigmoidoscopy l Hemoccult stool analysis l Mammography l Pap smear l PSA blood test for prostate cancer l Serum cholesterol test to determine level of HDL and LDL l Serum protein electrophoresis blood test for myeloma l Stress test on a bicycle or treadmill l Skin cancer biopsy l Thermography l ThinPrep pap test 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 Child Only Employee Spouse One Parent Family with Employee One Parent Family with Spouse Two Parent Family When are covered accident benefits available check one 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 Accident 1 0 Premier with Health Screening Benefit 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 71741 NC

48 ONLY of American adults say they have enough savings to cover three months of living expenses in the event they re not earning any income 1 Talk with your Colonial Life benefits counselor to learn more More than one in four of today s 20 year olds can expect to be out of work for at least a year because of a disabling condition before they reach the normal retirement age 1 How can you protect your income If you become disabled you could be out of work for a period of time Without your income how would you pay for your everyday living expenses Fortunately Colonial Life Accident Insurance Company offers financial protection options that can help you What can cause a disability Regardless of your age or health a disability could keep you out of work for weeks or months Some of the most common conditions associated with short term disability claims are arthritis pregnancy back problems dislocations sprains and fractures 2 How reliable is your safety net While many with disabilities look to workers compensation or Social Security Disability Insurance for help these resources aren t always reliable Even if they can help you still might be unable to meet all of your financial obligations More than 65 of workers who apply for Social Security Disability Insurance are denied 3 At least 51 million working adults in the United States are without disability insurance other than the basic coverage available through Social Security 1 The disability worksheet on the back can help you determine your income needs

Disability needs worksheet Colonial Life and the Council for Disability Awareness CDA are working together to increase awareness of the need for benefits to help protect employees income Use this worksheet to help figure out how much income you would need to sustain your standard of living if you were disabled This worksheet is only meant to give you a rough estimate and may not include every expense in your budget 1 Rent or mortgage 2 Transportation gas car bus etc 3 Utilities phone internet TV electricity gas water 4 Food and necessities 5 Other expenses Total monthly expenses add lines 1 5 together MONTHLY EXPENSES Round to the nearest hundred ColonialLife com Help preserve your way of life With short term disability insurance You may receive monthly benefits if you become disabled because of a covered accident or sickness Partial disability could enable you to work part time and still receive 50 of the total disability benefits In most cases you can keep your coverage even if you leave your employer Learn more about how disability insurance can help protect your income by talking with your benefits counselor 1 Council for Disability Awareness The Crisis of Disability Coverage in America 2018 2 Colonial Life internal data 2018 3 Social Security Administration Selected Data from Social Security s Disability Program 2018 Insurance products are 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 11 19 101165 7

Specified Critical Illness Insurance For more information talk with your benefits counselor ColonialLife com If 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 15K 25K 50 Critical illness benefit For the diagnosis of this covered critical illness condition 1 Cancer Heart attack myocardial infarction Stroke End stage renal kidney failure Major organ failure Permanent paralysis due to a covered accident Coma Blindness Occupational infectious HIV or occupational infectious hepatitis B C or D Coronary artery bypass graft surgery disease2 Carcinoma in situ This percentage of the face amount is payable 100 100 100 100 100 100 100 100 100 25 25 The maximum benefit amount for this policy is 3x the face amount for the named insured for all covered persons combined The policy will terminate when the maximum benefit amount for specified critical illness has been paid Subsequent diagnosis of a different critical illness3 If you receive a benefit for a specified critical illness and later you are diagnosed with a different specified critical illness the original percentage of the face amount is payable for that particular specified critical illness Subsequent diagnosis of the same critical illness3 If you receive a benefit for a specified critical illness and later you are diagnosed with the same specified critical illness 25 of the original face amount is payable Critical illness conditions that do not qualify are cancer coronary artery bypass graft surgery disease 2 carcinoma in situ and occupational infectious HIV or occupational infectious hepatitis B C or D CRITICAL ILLNESS 1 0 WITH CANCER AND SUBSEQUENT DIAGNOSIS

Cancer 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 ColonialLife com 1 Please refer to the policy for complete definitions of covered conditions 2 Benefit for coronary artery disease applicable in lieu of benefit for coronary artery bypass graft surgery when health savings account HSA compliant plan is selected 3 Dates of diagnoses of a covered specified critical illness must be separated by at least 180 days THIS POLICY PROVIDES LIMITED BENEFITS EXCLUSIONS AND LIMITATIONS FOR SPECIFIED CRITICAL ILLNESS We will not pay benefits for a specified critical illness that occurs as a result of a covered person s alcoholism or drug addiction felonies or illegal occupations intoxicants and narcotics pre existing condition psychiatric or psychological condition suicide or self inflicted injuries or war or armed conflict This is not an insurance contract and only the actual policy provisions will control Applicable to policy form CI 1 0 CI 1 0 PL7 CI 1 0 PL8 or CI 1 0 PL10 including state abbreviations where used for example CI 1 0 TX The policy or its provisions may vary or be unavailable in some states Please see your Colonial Life benefits counselor for details 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 4 19 101825 1

Critical Illness Insurance Health Screening Benefit The optional health screening benefit can help you reduce the risk of serious illness through early detection Health screening benefit __50 00_____________ Maximum of one screening test per covered person per calendar year Blood test for triglycerides Pap smear Bone marrow testing PSA blood test for prostate cancer Breast ultrasound Serum cholesterol test for HDL and LDL levels 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 For more information talk with your benefits counselor Fasting blood glucose test Serum protein electrophoresis blood test for myeloma Skin cancer biopsy Stress test on a bicycle or treadmill Thermography ThinPrep pap test Virtual colonoscopy Flexible sigmoidoscopy Hemoccult stool analysis Mammography ColonialLife com THIS POLICY INSURANCE PROVIDES LIMITED BENEFITS Insureds in GA MA MN and VT must be covered by comprehensive health insurance before applying for critical illness or cancer insurance This information is not intended to be a complete description of the insurance coverage available The policy insurance or its provisions may vary or be unavailable in some states The policy insurance has exclusions and limitations which may affect any benefits payable Applicable to policy form CI 1 0 P and GCC1 0 P and certificate form GCC1 0 C including state abbreviations where used for example CI 1 0 P TX GCC1 0 P TX and GCC1 0 C TX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company Underwritten by Colonial Life Accident Insurance Company Columbia SC 2021 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company GROUP CRITICAL CARE CRITICAL ILLNESS 1 0 HEALTH SCREENING BENEFIT 5 21 100355 4

Life insurance Term or Whole Life insurance for all phases of your employees lives If you re wondering which life insurance to offer your employees term or whole life The answer is They need both options Term and Whole Life work hand in hand Term and Whole Life insurance work together to provide financial protection for your employees and their loved ones at all phases of life whether they re just starting out raising a family or planning for retirement Term Life offers financial protection and peace of mind for employees and their families during their working years Whole Life provides coverage employees can keep into retirement at competitive rates when they buy it early Young professional Mid career Childhood Retirement Whole life Term life When employees purchase both types of life insurance they have valuable financial protection that can last a lifetime By offering these benefits at work with premiums paid by payroll deduction you provide valuable coverage options for employees without added costs to your bottom line Coverage for spouse and children also provides critical protection for your employees family LIFE INSURANCE

Term Life WHAT IS TERM LIFE Offers financial protection for loved ones during an employee s working years Offers highest amount of life insurance coverage for the lowest premiums KEY BENEFITS Income replacement if the insured passes away Can help pay ongoing expenses for the family such as Mortgage or rent Education Saving for retirement HOW IT WORKS Group Term Life Employer owned Limited portability options Flexible coverage that normally ends at retirement Benefit typically decreases after age 70 Guaranteed issue coverage with no health questions or exams Individual Term Life Employee can continue their coverage if they change jobs or retire The insured chooses a term period of 10 15 20 or 30 years Guaranteed level premiums that do not increase during the selected term period After the term period the insured can end or renew coverage or convert to a whole life policy Whole Life WHAT IS WHOLE LIFE Provides financial protection for loved ones through their retirement KEY BENEFITS Can help with final expenses Can provide a living benefit to help pay for expenses associated with a terminal illness chronic illness or critical illness1 Accumulates cash value at a guaranteed interest rate employees can borrow against this value during times of need2 HOW IT WORKS Guaranteed issue coverage with no health questions or exams Permanent coverage for life with level premiums that can be paid up at age 70 or 100 Death benefit stays the same as long as the employee makes payments How they work together Term Life and Whole Life provide comprehensive life insurance with financial protection during working years and benefits that carry into retirement Together Term Life and Whole Life can help your employees and their loved ones give each other stronger financial security and perhaps some peace of mind after they re gone To learn more talk with your Colonial Life benefits representative ColonialLife com 1 Any payout would reduce the death benefit Benefits may be taxable as income Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits 2 Accessing the accumulated cash value reduces the death benefit by the amount accessed Cash value will be reduced by any outstanding loans against the policy This information is not intended to be a complete description of the insurance coverage available The policies or their provisions may vary or be unavailable in some states The policies have exclusions and limitations which may affect any benefits payable Applicable to policy forms GTL1 0 P and certificate number GTL1 0 C ICC18 ITL5000 ITL5000 ICC19IWL5000 70 IWL5000 70 ICC19 IWL5000 100 IWL5000 100 and ICC19 IWL5000J IWL5000J and applicable state variations For cost and complete details of the coverage call or write your Colonial Life benefits counselor or the company Underwritten by Colonial Life Accident Insurance Company Columbia SC 2021 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company FOR BROKERS AND EMPLOYERS 7 21 691150

Comprehensive Interventions 2023 Last Name First Street Address City Phone Job Title State E mail Address Date of Hire Sex Social Security No Spouse s Name Sex Dependent 1 Sex Dependent 2 Sex Beneficiary Name Address DOB phone relationship Monthly RATES M I DOB Apartment Unit ZIP Tobacco Y or N Spouse s DOB Height Weight Dependent DOB Dependent DOB Accident From everyday mishaps to broken bones burns cuts to more extensive accidents Colonial pays 200 for seeking treatment The more severe the accident the more money paid 50K Life insurance 50 Wellness for each family member on the plan Individual 26 51 Ind Spouse 36 32 Ind Child 39 70 Family 49 50 Short Term Disability This provides a source of income while you re out of work Psychiatric and Psychological care covered If hospital admission 24hr or more will start day 1 of hospitalization 1000 monthly 3 months 0 7 Age 17 49 40 80 50 64 49 90 65 74 72 40 I would like a rate based on annual hourly income Amount allowed _____Rate ____ Critical Care Cancer Provides Lump sum payment for diagnosis of Heart attack stroke heart disease Cancer etc Ex 25K payout 38yr old 30 40 Amount chosen _______ Rate ________ Individual Ind Spouse Ind Child Family Whole Life Provides protection for a lifetime for your family in the event of a death I understand benefits are offered annually I choose to waive participation for the 2023 year Signature _______________________________ Date ___________________

Deductions per year 12 Accident 1 0 for NC l On Off Job Accident Coverage Premier with health screening These rates were prepared on 9 17 2023 and are valid for 90 days Applicable to policy forms ACCIDENT 1 0 HS and ACCIDENT 1 0 NS ISSUE AGE 17 80 NAMED INSURED 26 51 EMPLOYEE SPOUSE ONE PARENT FAMILY TWO PARENT FAMILY 36 32 39 70 49 50 Individual Disability ISTD3000 for NC A Risk Class Applicable to policy form Individual Disability l Off Job Accident Off Job Sickness with Psychiatric and Psychological Condition and First Day Hospital 3 Month Benefit Period ELIMINATION PERIOD ISSUE AGE 1 000 1 500 2 000 2 300 2 500 0 days Accident 7 days Sickness monthly benefit amount 17 49 50 64 65 74 40 80 49 90 72 40 61 20 74 85 108 60 81 60 99 80 144 80 93 84 114 77 166 52 102 00 124 75 181 00 Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Non Tobacco Rates ISSUE AGE NAMED INSURED EMPLOYEE SPOUSE ONE PARENT FAMILY 15 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 8 30 11 30 14 45 19 10 23 15 30 50 42 65 52 70 70 10 83 45 12 60 17 25 22 05 29 25 35 40 46 95 65 55 81 00 107 70 128 25 10 70 13 70 16 85 21 50 25 55 33 05 45 05 55 25 72 65 86 15 25 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 12 40 17 40 22 65 30 40 37 15 49 40 69 65 86 40 115 40 137 65 18 80 26 55 34 55 46 55 56 80 76 05 107 05 132 80 177 30 211 55 16 40 21 40 26 65 34 40 41 15 53 65 73 65 90 65 119 65 142 15 Applicable to policy form CI 1 0 TWO PARENT FAMILY 15 15 19 80 24 60 31 80 37 95 49 35 67 95 83 55 110 25 130 95 23 05 30 80 38 80 50 80 61 05 80 05 111 05 137 05 181 55 216 05 Page 1 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

Continued Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Non Tobacco Rates ISSUE AGE NAMED INSURED EMPLOYEE SPOUSE ONE PARENT FAMILY 50 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 22 65 32 65 43 15 58 65 72 15 96 65 137 15 170 65 228 65 273 15 34 30 49 80 65 80 89 80 110 30 148 80 210 80 262 30 351 30 419 80 30 65 40 65 51 15 66 65 80 15 105 15 145 15 179 15 237 15 282 15 Tobacco Rates ISSUE AGE 15 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 25 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 NAMED INSURED 10 85 15 80 21 95 29 30 36 95 47 75 65 30 83 30 106 55 128 00 16 65 24 90 35 15 47 40 60 15 78 15 107 40 137 40 176 15 211 90 EMPLOYEE SPOUSE 16 65 24 30 33 75 45 00 56 85 73 50 100 35 127 95 163 65 196 65 25 55 38 30 54 05 72 80 92 55 120 30 165 05 211 05 270 55 325 55 ONE PARENT FAMILY 13 40 18 35 24 50 31 85 39 50 50 30 67 85 85 70 109 10 130 70 20 90 29 15 39 40 51 65 64 40 82 40 111 65 141 40 180 40 216 40 Applicable to policy form CI 1 0 TWO PARENT FAMILY 42 80 58 30 74 30 98 30 118 80 156 80 218 80 270 80 359 80 428 80 TWO PARENT FAMILY 19 20 26 70 36 30 47 55 59 40 75 90 102 90 130 35 166 20 199 35 29 80 42 30 58 30 77 05 96 80 124 30 169 30 215 05 274 80 330 05 Page 2 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

Continued Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Tobacco Rates ISSUE AGE NAMED INSURED EMPLOYEE SPOUSE ONE PARENT FAMILY 50 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 31 15 47 65 68 15 92 65 118 15 154 15 212 65 272 65 350 15 421 65 47 80 73 30 104 80 142 30 181 80 237 30 326 80 418 80 537 80 647 80 39 65 56 15 76 65 101 15 126 65 162 65 221 15 280 65 358 65 430 65 Applicable to policy form CI 1 0 TWO PARENT FAMILY 56 30 81 30 113 30 150 80 190 30 245 30 335 30 426 80 546 30 656 80 Whole Life Plus IWL5000 for NC l Adult Base Plan Paid Up at Age 100 Chronic Care Accelerated Death Benefit Non Tobacco Rates ISSUE AGE 25 000 50 000 75 000 18 22 91 45 83 68 75 19 22 95 45 92 68 87 20 23 00 46 00 69 00 21 23 04 46 08 22 23 10 46 21 69 12 69 31 23 23 14 46 29 69 43 24 23 22 46 46 69 68 25 23 40 46 79 70 19 26 23 73 47 45 71 18 27 24 27 48 53 72 81 28 24 96 49 92 74 87 29 25 77 51 54 77 31 30 26 64 53 29 31 27 56 55 12 79 93 82 68 32 28 54 57 08 85 62 33 29 58 59 16 88 75 34 30 70 61 42 92 12 35 31 91 63 83 95 74 36 33 19 66 37 99 56 37 34 58 69 16 103 74 38 36 10 72 21 108 31 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 ICC23 IWL5000 LTC IWL5000 LTC 100 000 91 66 91 83 91 99 92 16 92 42 92 58 92 91 93 58 94 92 97 08 99 83 103 08 106 58 110 24 114 17 118 33 122 83 127 66 132 74 138 33 144 41 Page 3 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

Continued Whole Life Plus IWL5000 for NC l Adult Base Plan Paid Up at Age 100 Chronic Care Accelerated Death Benefit Non Tobacco Rates ISSUE AGE 25 000 50 000 75 000 39 37 77 75 54 40 39 58 79 16 41 41 54 83 08 42 43 67 87 33 43 45 94 91 87 44 48 33 96 66 45 50 81 101 62 46 53 33 106 66 47 55 92 111 83 48 58 58 117 16 49 61 34 122 66 50 64 23 128 45 51 67 37 134 75 52 70 83 141 66 53 74 64 149 29 54 78 83 157 66 55 83 33 166 66 56 88 13 176 24 57 93 22 186 45 58 98 66 197 33 59 104 49 209 00 60 110 76 221 53 61 117 54 235 07 62 124 85 249 70 63 132 74 265 49 64 141 24 282 49 65 150 35 300 70 66 160 07 320 16 67 170 49 340 99 68 181 66 363 32 69 193 68 387 36 70 206 83 413 65 71 221 51 443 02 72 238 09 476 19 73 256 93 513 85 74 278 33 556 64 113 31 118 75 124 62 130 99 137 81 144 99 152 43 159 99 167 75 175 75 184 00 192 68 202 12 212 49 223 93 236 49 249 99 264 37 279 67 295 99 313 49 332 29 352 61 374 54 398 23 423 73 451 05 480 23 511 48 544 98 581 04 620 47 664 54 714 28 770 79 834 97 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 ICC23 IWL5000 LTC IWL5000 LTC 100 000 151 07 158 33 166 16 174 66 183 75 193 33 203 25 213 33 223 66 234 32 245 32 256 91 269 49 283 32 298 58 315 32 333 32 352 48 372 91 394 65 417 98 443 07 470 15 499 39 530 98 564 98 601 40 640 31 681 98 726 64 774 72 827 30 886 05 952 37 1 027 71 1 113 28 Page 4 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

Continued Whole Life Plus IWL5000 for NC l Adult Base Plan Paid Up at Age 100 Chronic Care Accelerated Death Benefit Non Tobacco Rates ISSUE AGE 25 000 50 000 75 000 75 302 50 605 02 907 52 76 329 70 659 39 989 09 77 360 09 720 18 1 080 27 78 393 88 787 76 1 181 64 79 431 25 862 51 1 293 76 Tobacco Rates ISSUE AGE 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 25 000 34 60 35 60 36 56 37 47 38 35 39 14 39 89 40 57 41 15 41 73 42 31 42 92 43 62 44 48 45 50 46 68 48 02 49 49 51 06 52 77 54 60 56 58 58 72 61 12 63 85 66 91 70 29 73 87 50 000 69 21 71 21 73 13 74 96 76 71 78 29 79 79 81 12 82 29 83 45 84 62 85 83 87 25 88 95 90 99 93 37 96 04 99 00 102 12 105 53 109 21 113 16 117 45 122 25 127 70 133 83 140 57 147 75 75 000 103 81 106 81 109 68 112 43 115 06 117 43 119 68 121 69 123 43 125 18 126 93 128 75 130 87 133 43 136 49 140 06 144 06 148 49 153 18 158 30 163 81 169 74 176 18 183 37 191 55 200 74 210 86 221 61 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 ICC23 IWL5000 LTC IWL5000 LTC 100 000 1 210 04 1 318 78 1 440 36 1 575 52 1 725 01 100 000 138 41 142 41 146 24 149 91 153 41 156 58 159 58 162 24 164 58 166 91 169 24 171 66 174 49 177 91 182 00 186 74 192 07 197 99 204 24 211 08 218 41 226 32 234 91 244 49 255 41 267 66 281 16 295 49 Page 5 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

Continued Whole Life Plus IWL5000 for NC l Adult Base Plan Paid Up at Age 100 Chronic Care Accelerated Death Benefit Tobacco Rates ISSUE AGE 25 000 50 000 75 000 46 77 56 155 12 232 68 47 81 31 162 62 243 93 48 85 16 170 32 255 49 49 89 15 178 28 267 43 50 93 35 186 70 280 05 51 98 10 196 20 294 30 52 103 62 207 25 310 86 53 110 03 220 08 330 11 54 117 22 234 45 351 67 55 124 87 249 74 374 61 56 132 64 265 28 397 92 57 140 43 280 87 421 29 58 148 24 296 49 444 73 59 156 07 312 16 468 23 60 164 13 328 28 492 41 61 172 81 345 61 518 42 62 182 35 364 70 547 04 63 192 76 385 53 578 29 64 203 97 407 94 611 91 65 215 76 431 53 647 29 66 227 88 455 78 683 66 67 240 35 480 69 721 04 68 253 19 506 40 759 59 69 266 57 533 15 799 72 70 281 01 562 01 843 03 71 297 63 595 26 892 91 72 317 13 634 27 951 40 73 339 38 678 76 1 018 15 74 363 86 727 72 1 091 58 75 390 35 780 72 1 171 07 76 418 68 837 34 1 256 02 77 448 61 897 22 1 345 82 78 479 98 959 96 1 439 94 79 512 62 1 025 25 1 537 87 Important Notice 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 ICC23 IWL5000 LTC IWL5000 LTC 100 000 310 24 325 24 340 65 356 57 373 41 392 40 414 48 440 15 468 89 499 48 530 56 561 73 592 97 624 31 656 56 691 22 729 38 771 05 815 89 863 05 911 55 961 38 1 012 80 1 066 30 1 124 04 1 190 54 1 268 53 1 357 53 1 455 44 1 561 44 1 674 68 1 794 43 1 919 92 2 050 50 Page 6 of 7 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

How to File a Claim for Colonial Life Benefits FOR FASTEST RESULTS FILE ONLINE 1 Go to ColonialLife com access to login or register 2 Fill out the required information and click Submit 3 Enjoy streamlined claims management and faster service online DIGITALLY FILE ALL TYPES OF CLAIMS Disability Insurance Accident Hospital Insurance Life Insurance Critical Illness Cancer Insurance Wellness benefits for screening tests Not sure which type of claim to file No problem Just answer a few questions on the portal and we ll help you figure everything out BEFORE YOU FILE Review the appropriate claims checklist at ColonialLife com and have this information handy to make the process go smoothly Proper documentation must be submitted when filing your claim AFTER YOU FILE Check your claim status and manage your claim by logging into your account at ColonialLife com access Live chat is also available 9 a m 5 p m EST OTHER WAYS TO FILE A CLAIM Fax 1 800 880 9325 Mail P O Box 100195 Columbia SC 29202 Colonial Life is committed to providing you our valued customer a market leading claims experience We look forward to serving you on ColonialLife com On the policyholder portal you can View benefit details Here you ll find a copy of your policy to see what s covered and benefit amounts Track your claim Log in anytime to view status or opt in to receive status alerts by email or text so you know instantly if we require additional information Sign up for direct deposit to get approved payments up to a week faster than paper check Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company Columbia SC 2022 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company ADR 1312251

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

Thank you Colonial Life Voluntary Benefits Please contact David Neeley Benefits Specialist 704 369 6247 David Neeley ColonialLifeSales com