GenesisBenefitBooklet : simplebooklet.com

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 Products Accident Insurance From 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 Hospital Confinement Indemnity Insurance Medical Bridge Provides benefits to help cover the cost of a hospital stay and other medical procedures Disability Insurance Provides financial protection to cover income loss from a covered disability Critical Illness Insurance Provides lumpsum benefits for a covered critical illness such as a heart attack or stroke Dental Insurance Dental insurance provides benefits for a variety of procedures from routine cleanings to more advanced procedures Learn more online at ColonialLife com BROKER EMPLOYER 2 23 NS 1017472

Page 3

Page 4

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

Page 5

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

Page 6

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

Page 7

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

Page 8

For more information talk with your benefits counselor ColonialLife com Hospital Confinement Indemnity Insurance Plan 1 Our 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__0_0_0_____________ Maximum of one benefit per covered person per calendar year Observation room 100 per visit Maximum of two visits per covered person per calendar year Rehabilitation unit confinement 100 per day Maximum of 15 days per confinement with a 30 day maximum per covered person per calendar year Waiver of premium Available a er 30 continuous days of a covered hospital confinement of the named insured Health savings account HSA compatible This 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 THIS POLICY PROVIDES LIMITED BENEFITS EXCLUSIONS We will not pay benefits for injuries received in accidents or for sicknesses which are caused by a alcoholism or drug addiction b dental procedures c elective procedures and cosmetic surgery d felonies or illegal occupations e pregnancy of a dependent child f psychiatric or psychological conditions g suicide or injuries which any covered person intentionally does to himself or herself or h war We will not pay benefits for hospital confinement i due to giving birth within the first nine months a er the e ective date of the policy or j for a newborn who is neither injured nor sick k The policy may have additional exclusions and limitations which may a ect any benefits payable PRE EXISTING CONDITION LIMITATION l We will not pay benefits for loss during the first 12 months a er the e ective date due to a pre existing condition m A preexisting 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 n This limitation applies to the following benefits if applicable Hospital Confinement Daily Hospital Confinement Enhanced Intensive Care Unit Confinement and Rehabilitation Unit Confinement This information is not intended to be a complete description of the insurance coverage available The insurance or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may a ect any benefits payable Applicable to policy form IMB7000 including state abbreviations where used for example IMB7000 TX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company This form is not complete without form 562973 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 IMB7000 PLAN 1 1 21 562880

Page 9

Hospital Confinement Indemnity Insurance Exclusions and Limitations STATE SPECIFIC EXCLUSIONS AK a Replaced by intoxicants and narcotics CA a Replaced by intoxicants or controlled substances c Replaced by cosmetic surgery CT a Replaced by intoxication or drug addiction d Replaced by felonies e Exclusion does not apply DE a Exclusion does not apply IL a Replaced by alcoholism intoxication or drug addiction e Exclusion does not apply g Exclusion does not apply KS a Replaced by intoxicants and narcotics f Exclusion does not apply h Replaced by war or armed conflict i Exclusion does not apply j or requires necessary care and treatment of medically diagnosed congenital defects birth abnormalities or routine and necessary immunizations KY a Replaced by intoxicants narcotics and hallucinogenics LA a Replaced by intoxicants and narcotics MI g Exclusion does not apply MN a Replaced by narcotic addiction e Exclusion does not apply g Exclusion does not apply MO a Replaced by drug addiction NC i Exclusion does not apply OR a Exclusion does not apply d Replaced by felony i Replace nine months with six months SC f Replaced by mental or emotional disorders SD a Exclusion does not apply TN a Replaced by intoxicants and narcotics e Exclusion does not apply TX a Replaced by intoxicants and narcotics WA a Only sicknesses caused by alcoholism or drug addiction are excluded not accidents STATE SPECIFIC PRE EXISTING CONDITION LIMITATIONS NV WY m applies within the six months before the policy e ective date CT m Pre existing Condition means having a sickness or physical condition for which any covered person was treated received medical advice or had taken medication within 12 months before the e ective date of this policy FL m Pre existing Condition means any covered person having a sickness or physical condition that during the 12 months immediately preceding the e ective date of this policy had manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice diagnosis care or treatment or for which medical advice diagnosis care or treatment was recommended or received Routine follow up care during the 12 months immediately preceding the e ective date of this policy to determine whether a breast cancer has recurred in a covered person who has been previously determined to be free of breast cancer does not constitute medical advice diagnosis care or treatment for purposes of determining pre existing conditions unless evidence of breast cancer is found during or as a result of the follow up care GA m Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken prescription medication within 12 months before the e ective date of this policy IL m Pre existing Condition means having a sickness or physical condition for which any covered person was diagnosed treated had medical testing by a legally qualified physician or received medical advice or had taken medication within 12 months prior to the e ective date of this policy ME m Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing or received medical advice within 12 months before the e ective date of this policy NC m Pre existing Condition means having those conditions whether diagnosed or not for which any covered person received medical advice diagnosis care or treatment was received or recommended within one year period immediately preceding the e ective date of this policy If you are 65 or older when this policy is issued pre existing conditions will include only conditions specifically eliminated by rider OR Pre existing Condition means having a sickness or physical condition for which any covered person was diagnosed received treatment care or medical advice within the 6 month period immediately preceding the e ective date of this policy Insureds in California Oregon and South Dakota must be covered by comprehensive health insurance before applying for hospital indemnity insurance This information is not intended to be a complete description of the insurance coverage available The insurance or its provisions may vary or be unavailable in some states The insurance has exclusions and limitations which may a ect any benefits payable Applicable to policy form IMB7000 including state abbreviations where used for example IMB7000 TX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company This form is not complete without base form 562880 562911 or 562942 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 IMB7000 EXCLUSIONS AND LIMITATIONS 3 22 562973 1

Page 10

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

Page 11

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

Page 12

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

Page 13

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

Page 14

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

Page 15

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 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 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 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 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

Page 16

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 Critical illness accelerated death benefit rider Guaranteed purchase option rider Waiver of premium 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 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 1 Loan should be repaid to protect the policy s value 2 Any payout would reduce the death benefit Benefits may be taxable as income Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits To learn more talk with your benefits counselor ColonialLife com EXCLUSIONS AND LIMITATIONS 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

Page 17

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

Page 18

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

Page 19

2022 Genesis A New Beginning Last Name First M I DOB Street Address Apartment Unit City Phone Job Title Sex Spouse s Name State E mail Address Date of Hire Social Security No Sex ZIP Tobacco Y or N Spouse s DOB Height Weight Dependent 1 Sex Dependent DOB Dependent 2 Sex Dependent DOB Beneficiary Name Address DOB phone relationship Bi Weekly RATES Colonial Accident Everyday mishaps to broken bones burns cuts to more extensive accidents 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 12 24 Ind Spouse 16 76 Ind Child 18 32 Family 22 85 Colonial Hospital Colonial pays 2000 for a 24 hr hospital admission Sick Accident Ind 17 49 12 05 50 59 16 75 60 64 22 89 65 75 33 60 Ind Sp 17 49 22 85 50 59 31 87 60 64 43 48 65 75 63 72 Ind Child 17 49 16 89 50 59 21 60 60 64 27 74 65 75 38 93 Family 17 49 27 69 50 59 36 72 60 64 48 32 65 75 69 05 Colonial Short Term Disability Provides a source of income while out of work 1000 monthly 3 months 0 7 Age 17 49 18 83 50 64 23 03 65 74 33 42 I would like a rate based on annual hourly income Amount allowed _____Rate ____ Critical Care Cancer Pays in a lump sum 10K 75K for diagnosis Ex 25K pay out 35 39 yr old non tobacco 14 84 I would like a rate Dental 2 annual cleanings x rays major services Individual 16 32 Ind Spouse 30 94 Ind Child 39 45 Family 58 35

Page 20

Deductions per year 26 Accident 1 0 for NC l On Off Job Accident Coverage Premier with health screening These rates were prepared on 9 4 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 12 24 EMPLOYEE SPOUSE ONE PARENT FAMILY TWO PARENT FAMILY 16 76 18 32 22 85 Individual Medical Bridge for NC Applicable to policy form Individual Medical Bridge l 2000 Hospital Confinement Benefit and Outpatient Surgical Procedure Benefit with a calendar year maximum of 1500 Daily Hospital Confinement benefit ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENT CHILDREN EMPLOYEE SPOUSE AND DEPENDENT CHILDREN 17 49 50 59 60 64 65 75 17 75 24 57 34 10 49 76 33 67 46 73 64 81 94 36 25 22 32 06 41 59 57 97 41 14 54 21 72 27 102 58 Individual Disability ISTD3000 for NC A Risk Class Applicable to policy form Individual Disability l Off Job Accident Off Job Sickness with First Day Hospital and Psychiatric and Psychological Condition 3 Month Benefit Period ELIMINATION PERIOD ISSUE AGE 1 000 1 200 1 400 1 600 1 800 0 days Accident 7 days Sickness monthly benefit amount 17 49 50 64 65 74 18 83 23 03 33 42 22 60 27 64 40 10 26 36 32 24 46 78 30 13 36 85 53 46 33 90 41 46 60 15 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 10 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 2 88 3 81 4 77 6 21 7 45 9 71 13 45 16 54 21 90 26 01 4 38 5 81 7 29 9 50 11 40 14 95 20 67 25 43 33 64 39 97 3 62 4 54 5 51 6 94 8 19 10 50 14 19 17 33 22 68 26 84 Applicable to policy form CI 1 0 TWO PARENT FAMILY 5 17 6 60 8 07 10 29 12 18 15 69 21 41 26 21 34 43 40 80 Page 1 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 21

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 15 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 3 83 5 21 6 67 8 81 10 68 14 07 19 68 24 32 32 35 38 51 5 81 7 96 10 17 13 50 16 34 21 67 30 25 37 38 49 70 59 19 4 94 6 32 7 77 9 92 11 79 15 25 20 79 25 50 33 53 39 76 20 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 4 77 6 62 8 56 11 42 13 91 18 44 25 91 32 10 42 81 51 02 7 24 10 10 13 06 17 49 21 27 28 38 39 83 49 34 65 77 78 41 6 25 8 10 10 04 12 90 15 39 20 01 27 39 33 67 44 37 52 68 25 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 5 72 8 03 10 45 14 03 17 14 22 80 32 14 39 87 53 26 63 53 8 67 12 25 15 94 21 48 26 21 35 10 49 40 61 29 81 83 97 64 7 57 9 87 12 30 15 87 18 99 24 76 33 99 41 84 55 22 65 61 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 6 67 9 44 12 34 16 64 20 37 27 16 38 37 47 65 63 71 76 04 10 10 14 40 18 83 25 47 31 15 41 81 58 98 73 24 97 89 116 86 8 88 11 65 14 56 18 85 22 59 29 51 40 59 50 01 66 07 78 53 Applicable to policy form CI 1 0 TWO PARENT FAMILY 6 99 9 14 11 35 14 67 17 51 22 77 31 36 38 56 50 88 60 44 8 81 11 67 14 63 19 06 22 84 29 86 41 30 50 90 67 34 80 07 10 64 14 21 17 90 23 44 28 17 36 94 51 25 63 25 83 79 99 71 12 46 16 75 21 18 27 83 33 50 44 03 61 20 75 60 100 24 119 35 Page 2 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 22

Continued Critical Illness 1 0 for NC l with Subsequent Diagnosis Coverage Health Screening Benefit Cancer Benefit Tobacco Rates ISSUE AGE 10 000 15 000 20 000 25 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 NAMED INSURED 3 67 5 19 7 08 9 34 11 70 15 02 20 42 25 96 33 11 39 71 5 01 7 29 10 13 13 52 17 05 22 04 30 14 38 44 49 17 59 07 6 34 9 39 13 17 17 70 22 41 29 05 39 85 50 93 65 24 78 44 7 68 11 49 16 22 21 87 27 76 36 07 49 57 63 41 81 30 97 80 EMPLOYEE SPOUSE 5 63 7 98 10 89 14 35 18 00 23 12 31 38 39 87 50 86 61 01 7 68 11 21 15 57 20 77 26 24 33 92 46 31 59 05 75 53 90 76 9 74 14 44 20 26 27 18 34 47 44 72 61 24 78 23 100 20 120 50 11 79 17 67 24 94 33 60 42 71 55 52 76 17 97 40 124 87 150 25 ONE PARENT FAMILY 4 45 5 97 7 87 10 13 12 48 15 81 21 21 26 70 33 90 40 54 6 18 8 47 11 31 14 70 18 23 23 21 31 31 39 55 50 35 60 32 7 91 10 96 14 74 19 27 23 97 30 62 41 42 52 41 66 81 80 10 9 64 13 45 18 18 23 84 29 72 38 03 51 53 65 26 83 26 99 87 Applicable to policy form CI 1 0 TWO PARENT FAMILY 6 41 8 72 11 67 15 14 18 78 23 86 32 17 40 61 51 64 61 84 8 86 12 32 16 75 21 94 27 41 35 03 47 49 60 16 76 70 92 00 11 30 15 92 21 83 28 75 36 04 46 20 62 81 79 70 101 77 122 17 13 75 19 52 26 90 35 56 44 67 57 37 78 14 99 25 126 83 152 33 Page 3 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 23

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 30 000 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 70 9 02 13 59 19 27 26 05 33 11 43 08 59 28 75 90 97 36 117 16 13 84 20 90 29 63 40 01 50 95 66 32 91 10 116 58 149 54 180 00 11 37 15 94 21 62 28 41 35 47 45 44 61 64 78 11 99 71 119 65 Applicable to policy form CI 1 0 TWO PARENT FAMILY 16 20 23 12 31 98 42 37 53 30 68 54 93 46 118 80 151 89 182 49 Individual Dental PPO IDN8000 for NC Applicable to policy form Individual Dental PPO IDN8000 Zip Codes 270 271 272 273 274 275 276 277 278 280 281 282 283 284 285 286 287 288 289 COVERAGE LEVEL INDIVIDUAL INDIVIDUAL AND SPOUSE INDIVIDUAL AND CHILDREN Plan 2 100 80 50 1 000 MAC 16 32 30 94 39 45 INDIVIDUAL AND FAMILY 58 35 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 10 57 21 15 31 73 19 10 59 21 19 31 78 20 10 61 21 23 31 84 21 10 63 21 27 31 90 22 10 66 21 33 31 99 23 10 68 21 37 32 05 24 10 72 21 45 32 16 25 10 80 21 59 32 40 26 10 95 21 90 32 86 27 11 20 22 40 33 60 28 11 52 23 04 34 55 29 11 89 23 78 35 68 30 12 29 24 59 36 89 31 12 72 25 44 38 16 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 42 30 42 38 42 45 42 53 42 66 42 73 42 88 43 19 43 81 44 81 46 07 47 58 49 19 50 88 125 000 52 88 52 98 53 08 53 17 53 32 53 41 53 60 53 99 54 76 56 01 57 60 59 47 61 48 63 60 Page 4 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 24

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 32 13 17 26 35 39 52 33 13 65 27 31 40 96 34 14 17 28 35 42 52 35 14 73 29 46 44 18 36 15 32 30 64 45 96 37 15 96 31 92 47 88 38 16 66 33 32 49 99 39 17 44 34 86 52 30 40 18 26 36 54 54 81 41 19 17 38 35 57 52 42 20 15 40 30 60 46 43 21 20 42 40 63 61 44 22 31 44 61 66 92 45 23 45 46 90 70 35 46 24 61 49 23 73 85 47 25 81 51 62 77 42 48 27 03 54 07 81 12 49 28 31 56 61 84 92 50 29 64 59 29 88 93 51 31 09 62 19 93 28 52 32 69 65 38 98 07 53 34 45 68 90 103 36 54 36 38 72 76 109 15 55 38 46 76 92 115 38 56 40 68 81 34 122 02 57 43 02 86 05 129 07 58 45 54 91 08 136 61 59 48 22 96 46 144 69 60 51 12 102 25 153 36 61 54 25 108 49 162 74 62 57 62 115 25 172 86 63 61 26 122 53 183 80 64 65 19 130 38 195 57 65 69 39 138 78 208 18 66 73 88 147 77 221 64 67 78 69 157 38 236 07 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 52 69 54 62 56 70 58 92 61 26 63 85 66 65 69 72 73 08 76 69 80 61 84 81 89 22 93 81 98 46 103 23 108 14 113 23 118 57 124 38 130 76 137 80 145 53 153 84 162 68 172 11 182 15 192 91 204 49 216 99 230 49 245 07 260 76 277 57 295 52 314 76 125 000 65 86 68 27 70 87 73 65 76 58 79 81 83 31 87 16 91 34 95 86 100 76 106 00 111 53 117 26 123 07 129 04 135 19 141 53 148 22 155 48 163 45 172 25 181 91 192 30 203 36 215 14 227 69 241 15 255 62 271 24 288 11 306 33 325 95 346 96 369 41 393 44 Page 5 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 25

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 68 83 84 167 69 251 53 69 89 39 178 78 268 17 70 95 46 190 92 286 37 71 102 23 204 47 306 71 72 109 88 219 78 329 66 73 118 58 237 16 355 75 74 128 46 256 91 385 37 75 139 62 279 24 418 86 76 152 16 304 33 456 50 77 166 19 332 39 498 59 78 181 79 363 58 545 37 79 199 04 398 08 597 12 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 25 000 15 97 16 43 16 87 17 29 17 70 18 06 18 41 18 72 18 99 19 26 19 53 19 81 20 13 20 53 21 00 21 55 22 17 22 85 23 57 24 36 25 20 50 000 31 94 32 87 33 75 34 60 35 41 36 14 36 83 37 44 37 98 38 51 39 05 39 61 40 27 41 05 42 00 43 10 44 33 45 70 47 14 48 70 50 40 75 000 47 91 49 30 50 62 51 89 53 11 54 20 55 24 56 17 56 97 57 77 58 58 59 42 60 40 61 58 63 00 64 64 66 49 68 53 70 70 73 06 75 60 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 100 000 335 37 357 57 381 83 408 95 439 56 474 33 513 82 558 48 608 67 664 78 727 17 796 16 125 000 419 21 446 94 477 29 511 18 549 44 592 91 642 28 698 09 760 83 830 98 908 95 995 20 100 000 63 88 65 72 67 49 69 19 70 81 72 27 73 65 74 88 75 96 77 04 78 11 79 23 80 53 82 11 84 00 86 19 88 65 91 38 94 26 97 42 100 81 125 000 79 85 82 16 84 37 86 49 88 51 90 34 92 06 93 60 94 95 96 29 97 64 99 04 100 67 102 64 104 99 107 74 110 82 114 23 117 83 121 78 126 00 Page 6 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 26

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 39 26 12 52 23 78 35 40 27 10 54 21 81 32 41 28 21 56 42 84 63 42 29 46 58 93 88 41 43 30 88 61 76 92 65 44 32 44 64 88 97 32 45 34 10 68 19 102 28 46 35 80 71 60 107 40 47 37 53 75 06 112 58 48 39 30 78 61 117 92 49 41 15 82 29 123 43 50 43 08 86 17 129 25 51 45 28 90 55 135 83 52 47 83 95 66 143 47 53 50 78 101 57 152 36 54 54 10 108 20 162 31 55 57 63 115 26 172 90 56 61 22 122 44 183 66 57 64 81 129 63 194 44 58 68 42 136 84 205 26 59 72 03 144 08 216 11 60 75 76 151 52 227 27 61 79 76 159 51 239 27 62 84 16 168 33 252 48 63 88 96 177 93 266 91 64 94 14 188 28 282 42 65 99 58 199 17 298 75 66 105 18 210 36 315 53 67 110 93 221 85 332 79 68 116 85 233 72 350 58 69 123 03 246 07 369 10 70 129 70 259 39 389 09 71 137 36 274 74 412 11 72 146 36 292 74 439 10 73 156 64 313 27 469 92 74 167 94 335 87 503 80 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 100 000 104 45 108 42 112 84 117 88 123 54 129 76 136 38 143 19 150 11 157 22 164 58 172 34 181 11 191 30 203 14 216 41 230 53 244 87 259 26 273 68 288 14 303 03 319 02 336 64 355 87 376 57 398 33 420 71 443 72 467 44 492 14 518 79 549 48 585 48 626 55 671 74 125 000 130 57 135 52 141 05 147 34 154 42 162 20 170 48 178 98 187 64 196 53 205 71 215 43 226 39 239 12 253 94 270 52 288 17 306 09 324 07 342 10 360 18 378 78 398 78 420 80 444 84 470 71 497 92 525 89 554 64 584 30 615 16 648 48 686 85 731 84 783 19 839 68 Page 7 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 27

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 75 180 16 360 33 540 49 76 193 23 386 46 579 70 77 207 05 414 10 621 15 78 221 53 443 06 664 59 79 236 59 473 19 709 78 Term Life ITL5000 for NC l 30 Year Term Base Plan Chronic Care Accelerated Death Benefit Non Tobacco Rates ISSUE AGE 25 000 40 000 16 5 26 7 31 17 5 26 7 31 18 5 26 7 31 19 5 26 7 31 20 5 26 7 31 21 5 26 7 31 22 5 26 7 31 23 5 26 7 31 24 5 26 25 5 26 7 31 7 31 26 5 36 27 5 47 7 47 7 63 28 5 57 7 81 29 5 68 7 97 30 5 80 8 16 31 5 94 8 39 32 6 12 8 68 33 6 33 34 6 55 9 00 9 36 35 6 77 9 73 36 6 99 10 08 37 7 22 10 45 38 7 47 10 83 39 7 73 11 26 40 8 04 11 75 41 8 40 12 32 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 100 000 720 66 772 93 828 19 886 12 946 39 125 000 900 82 966 16 1 035 25 1 107 65 1 182 98 Applicable to policy form ITL5000 Page 8 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 28

Page 29

Continued Term Life ITL5000 for NC l 30 Year Term Base Plan Chronic Care Accelerated Death Benefit Tobacco Rates ISSUE AGE 25 000 40 000 45 18 66 28 74 46 20 19 31 20 47 21 78 33 75 48 23 39 36 33 49 25 05 38 97 50 26 72 41 65 Applicable to policy form ITL5000 Important Notice Insurance coverage has exclusions and limitations that may affect benefits payable For a complete description of benefits limitations and exclusions please refer to an outline of coverage sample policy certificate proposal description or see your Colonial Life benefits counselor Coverage type benefits and rates vary by state Coverage may not 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 2023 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 Shelley Hartsell Shelley Hartsell ColonialLifeSales com 704 883 4838 Page 10 of 10 Underwritten by Colonial Life Accident Insurance Company See page 10 for Important Notice

Page 30

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

Page 31

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

Page 32

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