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Benefit Booklet - 2024

Learn more online at:ColonialLife.comColonial Life provides benets that employees want for the unexpected moments in life. Whether planning for retirement, growing their families, or saving for college, they know an injury or illness won’t derail their dreams. <b>Kitty Mellone</b>Kmellone@coloniallifenc.com704-907-3944Life is anything but expected. That’s why we’re here.ProductsDisability InsuranceProvides financial protection to cover income loss from a covered disability.Hospital Confinement Indemnity Insurance (Medical Bridge)Provides benefits to help cover the cost of a hospital stay and other medical procedures for a covered accident or sickness, regardless of what health insurance pays.Accident InsuranceFrom a fall to a car accident, this coverage offers a range of benefits to help cover medical or non-medical related expenses due to a covered accident.Cancer InsuranceProvides benefits for a cancer diagnosis and treatment. Option to add cancer screening benefit.Critical Illness InsuranceProvides lumpsum benefits for a covered critical illness, such as a heart attack or stroke.Term Life InsuranceProvides a predictable way to provide life coverage at more affordable prices during high-need years.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

For more information, talk with your benefits counselor.Hospital Confinement Indemnity InsurancePlan 1EXCLUSIONS We will not pay benefits for losses which are caused by: alcoholism or drug addiction, dental procedures, elective procedures and cosmetic surgery, felonies or illegal occupations, pregnancy of a dependent child, psychiatric or psychological conditions, suicide or injuries which any covered person intentionally does to himself or herself, or war. We will not pay benefits for hospital confinement of a newborn who is neither injured nor sick. We will not pay benefits for loss during the first 12 months aer the eective date due to a pre-existing condition. Pre-exisiting conditions are those conditions whether diagnosed or not, for which a covered person received medical advice, diagnosis or care, or treatment was received or recommended within the one-year period immediately preceding the eective date of the policy. If a covered person is 65 or older when the policy is issued, pre-existing conditions will include only conditions specifically eliminated by rider.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy number IMB7000-NC. This is not an insurance contract and only the actual policy provisions will control.©2015 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.IMB7000 – PLAN 1 | 7-15 | 101576-NCColonialLife.comOur Individual Medical BridgeSM insurance can help with medical costs that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children. Hospital confinement ........................................................$_2500 / 1500_________________Maximum of one benefit per covered person per calendar yearObservation room .................................................................................. $100 per visitMaximum of two visits per covered person per calendar yearRehabilitation unit confinement .................................................................$100 per dayMaximum of 15 days per confinement with a 30-day maximum per covered person per calendar yearWaiver of premiumAvailable aer 30 continuous days of a covered hospital confinement of the named insuredHealth savings account (HSA) compatibleThis plan is compatible with HSA guidelines. This plan may also be oered to employees who do not have HSAs.Colonial Life & Accident Insurance Company’s Individual Medical Bridge oers an HSA compatible plan in most states.

For more information, talk with your benefits counselor.Hospital Confinement Indemnity InsurancePlan 2IMB7000 – PLAN 2The surgeries listed below are only a sampling of the surgeries that may be covered. Surgeries must be performed by a doctor in a hospital or ambulatory surgical center. For complete details and definitions, please refer to your policy.Tier 1 outpatient surgical procedures  Breast– Axillary node dissection– Breast capsulotomy– Lumpectomy  Cardiac– Pacemaker insertion  Digestive– Colonoscopy– Fistulotomy– Hemorrhoidectomy– Lysis of adhesions  Skin– Laparoscopic hernia repair– Skin graing  Ear, nose, throat, mouth– Adenoidectomy– Removal of oral lesions– Myringotomy– Tonsillectomy– Tracheostomy– Tympanotomy  Gynecological– Dilation and curettage (D&C)– Endometrial ablation– Lysis of adhesions  Liver– Paracentesis  Musculoskeletal system– Carpal/cubital repair or release– Foot surgery (bunionectomy, exostectomy, arthroplasty, hammertoe repair)– Removal of orthopedic hardware– Removal of tendon lesionOur Individual Medical BridgeSM insurance can help with medical costs that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children. Hospital confinement .............................................................$_2,500/ 1,500______________ Maximum of one benefit per covered person per calendar yearObservation room .................................................................................. $100 per visitMaximum of two visits per covered person per calendar yearRehabilitation unit confinement .................................................................$100 per dayMaximum of 15 days per confinement with a 30-day maximum per covered person per calendar yearWaiver of premiumAvailable aer 30 continuous days of a covered hospital confinement of the named insuredOutpatient surgical procedure  Tier 1.............................................................................................. $___500____________  Tier 2...............................................................................................$___1000____________Maximum of $___1500_____________ per covered person per calendar year for all covered outpatient surgical procedures combined

THIS POLICY PROVIDES LIMITED BENEFITS. EXCLUSIONS We will not pay benefits for losses which are caused by: alcoholism or drug addiction, dental procedures, elective procedures and cosmetic surgery, felonies or illegal occupations, mental or emotional disorders, pregnancy of a dependent child, suicide or injuries which any covered person intentionally does to himself or herself, war, or giving birth within the first nine months aer the eective date of the policy. We will not pay benefits for hospital confinement of a newborn who is neither injured nor sick. We will not pay benefits for loss during the first 12 months aer the eective date due to a pre-existing condition. 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 the 12 months before the eective date of the policy.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy number IMB7000-SC. This is not an insurance contract and only the actual policy provisions will control.ColonialLife.com©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. 1-16 | 101578 -SC  Breast– Breast reconstruction– Breast reduction  Cardiac– Angioplasty– Cardiac catheterization  Digestive– Exploratory laparoscopy– Laparoscopic appendectomy– Laparoscopic cholecystectomy  Ear, nose, throat, mouth– Ethmoidectomy– Mastoidectomy– Septoplasty– Stapedectomy– Tympanoplasty  Eye– Cataract surgery– Corneal surgery (penetrating keratoplasty)– Glaucoma surgery (trabeculectomy)– Vitrectomy Tier 2 outpatient surgical procedures  Gynecological– Hysterectomy– Myomectomy  Musculoskeletal system– Arthroscopic knee surgery with meniscectomy (knee cartilage repair)– Arthroscopic shoulder surgery– Clavicle resection– Dislocations (open reduction with internal fixation)– Fracture (open reduction with internal fixation)– Removal or implantation of cartilage– Tendon/ligament repair  Thyroid– Excision of a mass  Urologic– Lithotripsy

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

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

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 l Sports related accidental injury Broken bone Burn Concussion Laceration l Back or knee injuries l l l l Car accidents l Falls spills l Dislocation l 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 125 l Ambulance 200 l X ray Benefit 30 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 2 200 1 100 880 550 330 330 110 110 4 400 2 200 1 760 1 100 660 660 220 220 Non Surgical Surgical 2 750 1 100 1 650 825 385 385 385 330 330 330 275 220 110 5 500 2 200 3 300 1 650 770 770 770 660 660 660 550 440 220 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 60 Emergency Dental Work 75 Extraction 300 Crown Implant or Denture l Lacerations based on size 30 to 500 l 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 Surgery cranial open abdominal or thoracic 1 500 l l Surgery hernia 150 l Surgery arthroscopic or exploratory 200 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 Transportation 500 per round trip up to 3 round trips l Lodging family member or companion 125 per night up to 30 days for a hotel motel lodging costs l Accident Hospital Care Hospital Admission 1 000 per accident l Hospital ICU Admission 2 000 per accident We will pay either the Hospital Admission or Hospital Intensive Care Unit ICU Admission but not both l l Hospital Confinement 225 per day up to 365 days per accident l Hospital ICU Confinement 450 per day up to 15 days per accident Accident Follow Up Care l Accident Follow Up Doctor Visit 50 up to 3 visits per accident Medical Imaging Study 150 per accident limit 1 per covered accident and 1 per calendar year l l Occupational or Physical Therapy 25 per treatment up to 10 days l Appliances 100 such as wheelchair crutches l Prosthetic Devices Artificial Limb 500 one 1 000 more than 1 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 l 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 felonies or illegal occupations 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 SC 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 10 11 2011 Colonial Life Accident Insurance Company Colonial Life products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand Colonial Life and Making benefits count are registered service marks of Colonial Life Accident Insurance Company 71740 2 SC Accident 1 0 Preferred with Health Screening Benefit When are covered accident benefits available check one

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

Specified Critical Illness Insurance If you re diagnosed with a covered critical illness specified critical illness insurance from Colonial Life can help with your expenses so you can concentrate on what s most important your treatment care and recovery 10 000 Face amount _______________ Critical illness benefit For the diagnosis of this covered critical illness condition 1 For more information talk with your benefits counselor ColonialLife com This percentage of the face amount is payable Heart attack myocardial infarction 100 Stroke 100 End stage renal kidney failure 100 Major organ failure 100 Permanent paralysis due to a covered accident 100 Coma 100 Blindness 100 Occupational infectious HIV or occupational infectious hepatitis B C or D 100 Coronary artery bypass graft surgery disease2 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 coronary artery bypass graft surgery disease2 and occupational infectious HIV or occupational infectious hepatitis B C or D CRITICAL ILLNESS 1 0 WITH SUBSEQUENT DIAGNOSIS

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 PL5 CI 1 0 PL6 or CI 1 0 PL9 including state abbreviations where used 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 10 19 101824 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

Term Life Insurance Peace of mind for you and your loved ones You want what s best for your family and that includes making sure they re prepared for the future With term life insurance from Colonial Life Accident Insurance Company you can provide financial security to help them cover their ongoing living expenses Advantages of term life insurance Lower cost when compared to cash value life insurance Same benefit payout throughout the duration of the policy Several term period options for flexibility during high need years 44 of Americans say their household would face financial hardship within six months should a wage earner die unexpectedly LIMRA 2022 Life Insurance Barometer Study Benefit for the beneficiary that is typically tax free Benefits and features Stand alone spouse policy available whether or not you buy a policy for yourself GA P Guaranteed premiums that do not increase during the selected term Ability to convert all or a portion of the benefit amount into cash value life insurance Flexibility to keep the policy if you change jobs or retire Built in terminal illness accelerated death benefit that provides up to 75 of the policy s death benefit up to 150 000 if you re diagnosed with a terminal illness1 Premium savings for face amounts over 250 000 based on your health 54 of Americans have life insurance coverage with an average coverage gap of 200 000 LIMRA 2021 Industry Associations Unite to Help Address the Life Insurance Coverage Gap in the United States TERM LIFE ITL5000

How much coverage do you need YOU __________________ Select the term period 10 year 15 year 20 year 30 year SPOUSE ______________ Select the term period 10 year 15 year 20 year 30 year Select any optional riders Spouse term life rider _____________ face amount for ______ year term period Children s term life rider _____________ face amount Accidental death benefit rider Optional riders At an additional cost you can purchase the following riders for even more financial protection Spouse term life rider Your spouse can have up to 50 000 of coverage for a 10 year or 20 year term period Children s term life rider You can purchase up to 20 000 in term life coverage for all of your eligible dependent children and pay one premium The children s term life rider may be added to either your policy or your spouse s policy not both Accidental death benefit rider The 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 rider If 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 1 A chronic illness means you require substantial supervision due to a severe cognitive impairment or you may be unable to perform at least two of the six Activities of Daily Living Premiums are waived during the benefit period Critical illness accelerated death benefit rider Chronic care accelerated If you suffer a heart attack myocardial infarction stroke or end stage renal kidney failure a 5 000 benefit is payable 1 A subsequent diagnosis benefit is included Critical illness Waiver of premium benefit rider Waiver of premium Premiums 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 3 death benefit rider accelerated death benefit rider benefit rider 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 Activities of daily living are bathing continence dressing eating toileting and transferring 3 You must resume premium payments once you are no longer disabled EXCLUSIONS AND LIMITATIONS To learn more talk with your Colonial Life benefits counselor If the insured dies by suicide whether sane or insane within two years one year in ND from the coverage effective 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 This information is not intended to be a complete description of the insurance coverage available The policy or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may affect any benefits payable Applicable to policy forms ICC18 ITL5000 ITL5000 and rider forms ICC18 R ITL5000 STR R ITL5000 STR ICC18 R ITL5000 CTR RITL5000 CTR ICC18 R ITL5000 WP R ITL5000 WP ICC18 R ITL5000 ACCD R ITL5000 ACCD ICC18 R ITL5000 CI R ITL5000 CI ICC18 R ITL5000 CC R ITL5000 CC plus state abbreviations where applicable for example ITL5000 TX For cost and complete details of the coverage call or write your Colonial Life benefits counselor or the company 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 ColonialLife com FOR EMPLOYEES 6 22 101895 3

Whole Life Insurance You 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 In the U S medical spending in the last 12 months of life is nearly 80 000 per person HealthAffairs org End Of Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported July 2017 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 emergencies1 Benefit for the beneficiary that is typically tax free Benefits 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 Your cost will vary based on the level of coverage you select Talk with your benefits counselor for information about what level of coverage would work best for you 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 illness2 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

Benefits worksheet For use with your benefits counselor HOW MUCH COVERAGE DO YOU NEED 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 100 DEPENDENT STUDENT ____________ Paid Up at Age 70 Paid Up at Age 100 Select any optional riders S pouse 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 Additional coverage options Spouse term life rider Cover your spouse up to a maximum death benefit of 50 000 10 year and 20 year spouse term riders are available Juvenile whole life policy You 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 rider You 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 rider The 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 rider If 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 2 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 rider If you suffer a heart attack myocardial infarction stroke or end stage renal kidney failure a 5 000 benefit is payable 2 A subsequent diagnosis benefit is included Guaranteed purchase option rider If 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 different 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 Critical illness accelerated death benefit rider Waiver of premium benefit rider Premiums 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 Guaranteed purchase option rider 1 Loan should be repaid to protect the policy s value Waiver of premium benefit rider 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 EXCLUSIONS AND LIMITATIONS To learn more talk with your benefits counselor ColonialLife com If the insured dies by suicide whether sane or insane within two years one year in ND from the coverage effective 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 RIWL5000 ACCD ICC19 R IWL5000 CI R IWL5000 CI ICC19 R IWL5000 CC R IWL5000 CC ICC19 RIWL5000 GPO R IWL5000 GPO and applicable state variations 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 6 19 101935

Deductions per year: 12Individual Disability - ISTD3000 for NC AA Risk ClasslOff Job Accident & Off Job Sickness3 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $23.60 $29.50 $35.40 $44.25 $59.0050-64 $28.00 $35.00 $42.00 $52.50 $70.0065-74 $39.28 $49.10 $58.92 $73.65 $98.206 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $800* $1,000* $1,200* $1,500* $2,000**monthly benefit amount0 days Accident/7 days Sickness 17-49 $29.60 $37.00 $44.40 $55.50 $74.0050-64 $38.40 $48.00 $57.60 $72.00 $96.0065-74 $59.92 $74.90 $89.88 $112.35 $149.80Individual Medical Bridge for NCl$2500 Hospital Confinement Benefit, Medical Treatment Package: Accident Only, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $40.80 $76.20 $57.05 $92.4550-59 $53.45 $100.40 $69.70 $116.6560-64 $70.50 $132.65 $86.75 $148.9065-75 $102.05 $192.30 $119.95 $210.20Individual Medical Bridge for NCl$1500 Hospital Confinement Benefit, Medical Treatment Package: Accident Only, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $26.40 $49.00 $36.15 $58.7550-59 $33.75 $62.85 $43.50 $72.6060-64 $43.65 $81.65 $53.40 $91.4065-75 $62.60 $117.60 $73.35 $128.35Individual Medical Bridge for NCl$2500 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $49.50 $92.70 $71.00 $114.2050-59 $65.20 $122.75 $86.70 $144.2560-64 $84.95 $160.15 $106.45 $181.6565-75 $122.30 $230.70 $145.95 $254.35Page 1 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important NoticeEntelegent SolutionsCompliments HSA Medical PlanCompliments HSA Medical PlanCompliments PPO Medical Plan

Individual Medical Bridge for NCl$1500 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of $1500,Medical Treatment Package, $100 Health Screening Benefit.ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENTCHILDRENEMPLOYEE, SPOUSE ANDDEPENDENT CHILDREN17-49 $35.10 $65.50 $50.10 $80.5050-59 $45.50 $85.20 $60.50 $100.2060-64 $58.10 $109.15 $73.10 $124.1565-75 $82.85 $156.00 $99.35 $172.50Accident 1.0 for NClOn/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with health screening 17-80 $21.15 $28.97 $32.67 $40.48Cancer 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 $34.15 $56.90 $35.10 $57.85Critical Illness 1.0 for NClwith Subsequent Diagnosis Coverage, Health Screening BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $4.55 $6.90 $4.55 $6.9025-29 $5.25 $8.10 $5.25 $8.1030-34 $6.05 $9.40 $6.05 $9.4035-39 $8.45 $13.00 $8.45 $13.0040-44 $10.05 $15.40 $10.05 $15.4045-49 $13.05 $20.00 $13.05 $20.0050-54 $16.65 $25.60 $16.65 $25.6055-59 $20.55 $31.50 $20.55 $31.5060-64 $25.45 $39.10 $25.45 $39.1065-70 $30.85 $47.40 $30.85 $47.40(Continued...)Page 2 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important NoticeCompliments PPO Medical Plan

Critical Illness 1.0 for NClwith Subsequent Diagnosis Coverage, Health Screening BenefitTobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$10,000 17-24 $5.55 $8.50 $5.55 $8.5025-29 $6.85 $10.50 $6.85 $10.5030-34 $8.55 $13.20 $8.55 $13.2035-39 $11.85 $18.20 $11.85 $18.2040-44 $15.35 $23.60 $15.35 $23.6045-49 $19.75 $30.30 $19.75 $30.3050-54 $24.85 $38.10 $24.85 $38.1055-59 $31.55 $48.50 $31.55 $48.5060-64 $37.95 $58.30 $37.95 $58.3065-70 $46.45 $71.40 $46.45 $71.40Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage maynot be available in all states. Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices.Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.© 2014 Colonial Life & Accident Insurance Company"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.Kitty Mellone | Kmellone@coloniallifenc.com | (704) 907-3944(Continued...)Page 3 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important NoticeWhole Life Plus (IWL5000) for NCl Adult Base Plan Paid-Up at Age 100, Accidental Death Benefit, Chronic Care Accelerated Death Benefit, Guaranteed Purchase Option Benefit, Waiver of Premium BenefitNon-Tobacco RatesISSUE AGE $10,000 $25,000 $50,000 $75,000 $100,00025 $10.48 $26.21 $52.42 $78.63 $104.8335 $14.07 $35.18 $70.37 $105.55 $140.7445 $22.40 $56.01 $112.04 $168.05 $224.0855 $36.93 $92.33 $184.66 $276.99 $369.3265 $60.94 $152.35 $304.70 $457.05 $609.40Tobacco RatesISSUE AGE $10,000 $25,000 $50,000 $75,000 $100,00025 $17.46 $43.65 $87.29 $130.94 $174.5835 $21.27 $53.18 $106.38 $159.55 $212.7445 $32.06 $80.14 $160.29 $240.42 $320.5755 $53.54 $133.87 $267.74 $401.61 $535.4865 $87.10 $217.76 $435.53 $653.29 $871.05

EnTelegent Solutions Colonial Interest FormName_____________________________________ Job Title__________ Social Security #_________________ Annual Income $________________________ Address________________________________ City ___________________St. __________Zip_______ Work Phone___________________ Cell Phone________________ Email Address____________________________________________________ Date of Birth (DOB) ________________ Tobacco______ Non Tobacco_____ Date of Hire____________________ Job Title____________________________ Beneficiary__________________________________DOB___________Relationship____________ Dependent Information: Spouse________________________________DOB_______________ Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ ____ Waive Colonial Coverage. I understand that I can only enroll during Annual Enrollment unless I have a qualified event during the year. _____Keep Colonial Life plans the same _____Add Colonial Life plans Signature__________________________________________Date____________ Questions or Assistance Contact: Kitty Mellone 704-907-3944 (D) Email: Kmellone@coloniallifenc.comFax Completed Form with Rate Sheet & elected coverage’s circled fax to: 704-413-3034(FAX)

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

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