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HennigesAutomotiveBenefitBooklet

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Henniges Automotive Benefit Book

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Accident Insurance Preferred Plan If you are in an accident your focus should be on recovery not how you re going to pay your bills Colonial Life Accident Insurance can pay benefits directly to you to use however you like from medical costs to everyday expenses offering financial support when you need it Our coverage includes Bene ts payable directly to you No medical questions to qualify for coverage Coverage for simple and complex injuries Bene ts payable regardless of other insurance Worldwide coverage Works alongside your Health Savings Account HSA BENEFITS STORY Jacob was running on the playground when he tripped and injured his hand With Colonial Life accident bene ts Jacob s parents were able to pay the annual deductible and co payments JACOB S ACCIDENT BENEFITS Jacob went to an urgent care facility and received immediate care Accident emergency treatment 125 The doctor ordered an X ray and discovered Jacob had fractured his hand X ray Fracture hand 30 375 The doctor also found that Jacob had a cut on his hand Laceration no stitches 30 Jacob was discharged with a splint Medical equipment splint 30 Over the next several weeks Jacob had three follow up appointments with his doctor Accident follow up treatment 3 visits 165 Total 755 For illustrative purposes only for covered accidents Bene t amounts may vary and may not cover all expenses IAC4000 PREFERRED PLAN

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BENEFITS STORY Olivia was driving to the store when she got into a car accident Olivia s accident benefits helped cover her annual deductible and co payments OLIVIA S ACCIDENT BENEFITS Olivia arrived by ambulance at the nearest emergency room and received immediate care Ambulance ground or water Accident emergency treatment Injury due to auto accident 200 125 250 The doctor ordered an X ray and discovered Olivia had fractured her thigh femur He also ordered a CT scan of her head to check for a brain injury X ray Medical imaging CT Thigh fracture femur surgical 30 200 4 400 Olivia was admitted to the hospital for surgery on her leg She was confined for three days Hospital admission Surgery exploratory arthroscopic Hospital confinement 3 days 1 000 300 750 Olivia had eight sessions of physical therapy to help regain the strength in her leg Physical therapy 8 days Medical equipment crutches 280 100 Over the next several weeks she had six follow up appointments with her doctor Accident follow up treatment 6 visits 330 Total 7 965 For illustrative purposes only for covered accidents Benefit amounts may vary and may not cover all expenses Summary of Benefits Benefits are per covered person per covered accident unless stated otherwise Initial care Accident emergency treatment 125 Hospital emergency room urgent care facility or physician s office Accidental injury due to an automobile accident1 250 Air ambulance2 2 000 Ambulance ground or water2 200 Observation room 150 per day up to two days per calendar year X ray 30 Dislocation separated joint Non surgical repair 100 2 250 Examples elbow 500 ankle 1 000 hip 2 250 Incomplete dislocation or dislocation without anesthesia 25 payable as a of the applicable dislocation benefit Surgical repair 200 4 500 Examples elbow 1 000 ankle 2 000 hip 4 500 Emergency dental work 100 300 Dental extraction or dental crown denture or implant Common accidental injuries Eye injury with surgical repair or removal of a foreign object 200 Burn 1 000 12 000 based on size and degree Fracture complete Burn skin graft 50 of applicable burn benefit Non surgical repair 250 3 000 Examples hand foot 375 collarbone 625 leg 1 000 Coma 12 500 lasting for seven or more consecutive days Chip fracture 25 payable as a of the applicable fracture benefit Concussion 150 Surgical repair 450 5 000 Examples hand foot 750 collarbone 1 250 leg 2 000

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Follow up care Accident follow up treatment including transportation telemedicine 55 up to six benefits per covered person per covered accident and up to 12 benefits per covered person per calendar year Medical equipment Tier 1 30 Arm sling cane medical ring cushion neck brace or wrist ankle splint Tier 2 100 Bedside commode cold therapy system cryotherapy crutches leg brace shower chair walker or walking boot Tier 3 200 Back brace body jacket continuous passive movement CPM halo electric scooter hospital bed including rental knee scooter stair lift chair or wheelchair Medical imaging study CT CAT scan EEG EMG MR or MRI 200 one per calendar year Pain management for epidural anesthesia non surgical 100 Post traumatic stress disorder PTSD 200 Prosthetic device artificial limb Hearing loss injuries 120 One 750 Knee cartilage torn with surgical repair 650 More than one 1 500 Laceration 30 600 based on repair and length Repair replacement4 375 750 3 Ruptured disc with surgical repair 750 Tendon ligament rotator cuff with surgical repair One 650 Two or more 1 300 Hospital care Hospital admission 1 000 Hospital confinement 250 per day up to 365 days Hospital sub acute intensive care unit confinement 325 per day up to 30 days Intensive care unit admission 2 000 Intensive care unit confinement 450 per day up to 15 days Surgical care Blood plasma platelets transfusion 300 Surgery 200 1 500 based on type of repair and surgery Transportation and lodging Transportation for hospital confinement 600 per round trip up to three round trips 50 miles from home Lodging companion 125 per day up to 30 days Rehabilitation unit confinement 150 per day up to 15 days not to exceed 30 days per calendar year Therapy occupational physical or speech 35 per day up to 10 days Accidental dismemberment Accidental dismemberment 4505 20 000 Loss loss of use or paralysis hand arm foot leg sight of eye Loss loss of use finger toe partial dismemberment of finger or toe Accidental dismemberment due to a catastrophic accident Named insured spouse or child 25 0006 Total and irrecoverable loss loss of use or paralysis 180 day elimination period Loss of both hands arms feet legs or the sight of both eyes or any combination or Loss of hearing in both ears or loss of ability to speak Accidental death Accidental death Named insured spouse 40 000 Child 10 000 Accidental death common carrier Examples of common carriers are mass transit trains buses and planes Named insured spouse 160 000 Child 30 000

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Hospital Indemnity Insurance How will you pay for what your health insurance won t cover No matter how well you plan you can t predict when sudden medical expenses could impact your way of life Health insurance helps but it doesn t cover everything For instance the average family has more than 4 500 in out of pocket medical costs each year 1 If you re admitted to the hospital for a covered accident or covered sickness Medical Bridge Colonial Life Accident Insurance Company s hospital indemnity insurance could help pay for out of pocket expenses It s coverage that can help protect what you ve worked so hard to build 13 of Americans have medical debt in collections 2 1 Milliman Milliman Medical Index 2022 2 Urban Institute Debt in America An Interactive Map 2022 GROUP MEDICAL BRIDGE IMB7000

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One family s journey Nathan was doing yard work with his wife when his chest pains began After he was examined by a doctor the couple was relieved to learn it was just a false alarm EMERGENCY ROOM VISIT Nathan received immediate care at the nearest emergency room DIAGNOSTIC PROCEDURE The doctor ordered an MRI to determine the cause of Nathan s pain HOSPITAL CONFINEMENT Nathan was admitted to the hospital for a 24 hour stay while the doctors ran additional tests After the tests confirmed there were no issues he was released the following day DOCTOR S OFFICE VISIT A few weeks later he had a follow up appointment with his family doctor NATHAN S OUT OF POCKET EXPENSES Emergency room co pay Deductible Doctor s visit co pay Co insurance 100 1 500 25 1 800 3 425 NATHAN S BENEFITS Emergency room visit 100 Diagnostic procedure 250 Hospital confinement 1 500 Doctor s office visit 25 1 875 In this scenario Nathan s Medical Bridge insurance benefits helped pay for the out of pocket expenses associated with his medical care For illustrative purposes only Cost of treatment benefits and benefit amounts may vary Benefits may not cover all expenses The policy has exclusions and limitations Coverage advantages Benefits are payable directly to you unless you specify otherwise and can be used as you see fit 1 Coverage is available for you your spouse and eligible dependent children Benefits are payable regardless of any other insurance you may have with other companies All benefits are indemnity based which means you will know the benefit amount payable for covered accidents or covered sicknesses

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Meet with a benefits counselor By attending a 1 to 1 counseling session with your Colonial Life benefits counselor you can learn more about Medical Bridge insurance and how it can help protect your family s way of life Your benefits counselor can also review the rest of your insurance coverage and help you determine where you may need additional financial protection Based on the plan design available you may receive benefits to help cover the costs associated with Hospital confinement Outpatient surgical procedures Diagnostic procedures Doctor s office visits Emergency room visits The average family has more than 4 500 in out of pocket medical costs each year Milliman Research Report 2020 Milliman Medical Index May 2022

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Hospital Confinement Indemnity Insurance Medical Treatment Package The medical treatment package for Individual Medical BridgeTM 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 1 000 Maximum of one benefit per covered person per calendar year Ambulance 100 Maximum of one benefit per covered person per calendar year Appliance 100 Maximum of one benefit per covered person per calendar year Doctor s office visit 25 per visit Maximum of three visits per calendar year for named insured coverage or maximum of five visits per calendar year for all covered persons combined Emergency room visit 100 per visit For more information talk with your benefits counselor Maximum of two visits per covered person per calendar year X ray 25 per benefit Maximum of two benefits per covered person per calendar year VA Not available with Plan 1 THIS POLICY PROVIDES LIMITED BENEFITS This coverage is a supplement to health insurance It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law Insureds in some states must be covered by comprehensive health insurance before applying for this insurance EXCLUSIONS ColonialLife com 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 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 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 a base form 101576 101578 101581 562880 562911 or 562942 Underwritten by Colonial Life Accident Insurance Company Columbia SC 2023 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company IMB7000 MEDICAL TREATMENT PACKAGE 2 23 101596 4

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Group Hospital Indemnity Insurance Wellbeing Assistance Standard Benefit The Group Medical BridgeTM wellbeing assistance standard benefit can help pay for routine preventive tests you have each year Wellbeing assistance standard _____________ per day Maximum of one day per covered person per calendar year subject to a 30 day waiting period Blood test for triglycerides Mammography Bone marrow testing Pap smear Breast ultrasound PSA blood test for prostate cancer CA 15 3 blood test for breast cancer Serum cholesterol test for HDL and LDL levels CA 125 blood test for ovarian cancer Carotid Doppler Serum protein electrophoresis blood test for myeloma CEA blood test for colon cancer Skin cancer biopsy Chest X ray Stress test on a bicycle or treadmill Colonoscopy Thermography Echocardiogram ECHO ThinPrep pap test Electrocardiogram EKG ECG Virtual colonoscopy Fasting blood glucose test Flexible sigmoidoscopy For more information talk with your benefits counselor Hemoccult stool analysis CA Includes any generally accepted cancer screening test not listed cervical cancer screening tests approved by the federal FDA upon the referral of the insured s health care provider and human papillomavirus screening test ID MD MO ND Waiting period does not apply WV Includes human papillomavirus screening test THIS INSURANCE PROVIDES LIMITED BENEFITS ColonialLife com This coverage is a supplement to health insurance It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law Insureds in some states must be covered by comprehensive health insurance before applying for this insurance WAITING PERIOD Waiting period means the first 30 days following any covered person s coverage effective date during which no benefits are payable 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 affect any benefits payable Applicable to policy form GMB7000 P and certificate form GMB7000 C including state abbreviations where used for example GMB7000 P AU TX and GMB7000 P EE TX and certificate forms GMB7000C AU TX and GMB7000 C EE 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 2023 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company GMB7000 WELLBEING ASSISTANCE STANDARD BENEFIT 2 23 101730 5 100

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Disability Insurance Help protect your income from the unexpected It s important to be financially prepared for the future That s why you have insurance for your house your car and your health But do you have insurance for the thing you use to pay for these expenses your income If an accident or illness prevented you from earning an income how would you pay for your everyday expenses Colonial Life disability insurance helps protect your way of life by providing a benefit for a covered disability It s a smart way to prepare for the unexpected More than one in four 20 year olds will become disabled before reaching retirement age The Faces and Facts of Disability https www ssa gov disabilityfacts facts html Accessed April 2023 DISABILITY INSURANCE

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How disability insurance helps people Many people make plans for their income and savings Yet when they least expect it some of them will have an accident or illness that can change their plans dramatically Here are a few stories BENEFITS STORIES ARIA Aria is a recent college grad in her first full time job She injured her leg jogging after work one evening Her doctor advised her to stay off her leg for three weeks After using paid time off for a week Aria stopped receiving a paycheck How her disability policy helped Aria used her disability benefits to help with her rent and monthly student loan payment MIA AND ALEX After having a baby Mia took maternity leave The couple was worried about how they d pay for everyday expenses without her income Fortunately Mia purchased a disability policy through work two years ago How her disability policy helped Mia s benefits helped the couple pay for their growing family s ongoing expenses and they didn t have to use any of the money they d been saving for a bigger house WILLIAM A 50 year old father of the bride William suffered an unexpected heart attack and had to have surgery He needed unpaid leave from work to recover but his usual monthly bills didn t stop How his disability policy helped William s disability benefits gave him some comfort in knowing that his bills wouldn t get in the way of giving his daughter the wedding they planned KIM Kim fell in her home and couldn t work for three months Watch a video for Kim s story and learn how Colonial Life disability insurance helps families with unexpected moments Scan the code or go to ColonialLife com ee disability All benefits stories are for illustrative purposes only They are not intended to depict real people

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How Colonial Life Disability Insurance works If you can t work because of an illness or injury you might use savings to help cover ongoing monthly expenses But would you have enough And what would that do to your savings goals Disability insurance can help replace missing income so you can focus on what s most important recovery Here s how it works At enrollment you can choose the disability benefit amount to best meet your needs subject to income If you can t work because of a covered illness or injury a benefit is payable in regular payments after a predetermined waiting period called an elimination period TOP CAUSES OF DISABILITIES IN WORKING AGE ADULTS IN THE U S Injuries 2 Exposure to harmful substances or environments at work Overexertion Falls slips trips Contact with objects or equipment Transportation incidents Benefits are payable directly to you unless otherwise specified and you can use them however you d like Illnesses 3 Benefit payments do not coordinate at the time of claim with other insurance or state paid medical leave benefits 1 Heart disease Disability benefits may also be available if you return to work part time Musculoskeletal pain Cancer Stroke Kidney disease

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Group Critical Illness and Cancer Insurance Plan 2 When life takes an unexpected turn your focus should be on recovery not finances Colonial Life s group critical illness and cancer insurance helps relieve financial worries by providing a lump sum benefit payable directly to you to use as needed Coverage amount ____________________________ Critical illness and cancer benefits COVERED CONDITION1 PERCENTAGE OF APPLICABLE COVERAGE AMOUNT Benign brain tumor 100 Coma 100 End stage renal kidney failure 100 Heart attack myocardial infarction 100 Loss of hearing 100 Loss of sight 100 Loss of speech 100 Major organ failure requiring transplant 100 Occupational infectious HIV or occupational infectious hepatitis B C or D 100 Permanent paralysis due to a covered accident2 100 Stroke 100 Sudden cardiac arrest 100 Coronary artery disease 25 COVERED CANCER CONDITION BENEFITS STORY Preparing for a lifelong journey Rebecca was born with Down syndrome Her parents critical illness and cancer coverage provided a benefit that can help cover expenses related to Rebecca s care and her changing needs How their coverage helped A hospital stay and treatment for corrective heart surgery Physical therapy to build muscle strength Special needs daycare For illustrative purposes only PERCENTAGE OF APPLICABLE COVERAGE AMOUNT Invasive cancer including all breast cancer 100 Non invasive cancer 25 Skin cancer initial diagnosis 400 per lifetime GCI6000 PLAN 2 $10,000 - $30,000

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Subsequent diagnosis of a different critical illness3 Key benefits Available coverage for spouse and eligible dependent children at 50 of your coverage amount Cover your eligible dependent children at no additional cost Receive coverage regardless of medical history within specified limits Works alongside your health savings account HSA Benefits payable regardless of other insurance For more information talk with your benefits counselor If you receive a benefit for a critical illness and are later diagnosed with a different critical illness 100 of the coverage amount may be payable for that particular critical illness Subsequent diagnosis of the same critical illness3 If you receive a benefit for a critical illness and are later diagnosed with the same critical illness 4 25 of the coverage amount is payable for that critical illness Reoccurrence of invasive cancer including all breast cancer If you receive a benefit for invasive cancer and are later diagnosed with a reoccurrence of invasive cancer 25 of the coverage amount is payable if treatment free for at least 12 months and in complete remission prior to the date of reoccurrence excludes non invasive or skin cancer Additional covered conditions for dependent children COVERED CONDITION1 PERCENTAGE OF APPLICABLE COVERAGE AMOUNT Cerebral palsy 100 Cleft lip or palate 100 Cystic fibrosis 100 Down syndrome 100 Spina bifida 100 1 Please refer to the certificate for complete definitions of covered conditions 2 In WA the covered condition is called Permanent Paralysis 3 Dates of diagnoses of a covered critical illness must be separated by more than 180 days 4 Critical illnesses that do not qualify include coronary artery disease loss of hearing loss of sight loss of speech and occupational infectious HIV or occupational infectious hepatitis B C or D The filed product name in FL and VT is Group Critical Illness and Cancer Limited Benefit Insurance THIS INSURANCE PROVIDES LIMITED BENEFITS This coverage is a supplement to health insurance It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law Insureds in some states must be covered by comprehensive health insurance before applying for this insurance EXCLUSIONS AND LIMITATIONS FOR CRITICAL ILLNESS We will not pay the Critical Illness Benefit Benefits Payable Upon Subsequent Diagnosis of a Critical Illness or Additional Critical Illness Benefit for Dependent Children that occurs as a result of a covered person s alcoholism or drug addiction felonies or illegal occupations intoxicants and narcotics suicide or injuring oneself intentionally whether sane or not war or armed conflict or pre existing condition unless the covered person has satisfied the pre existing condition limitation period shown on the Certificate Schedule on the date the covered person is diagnosed with a critical illness EXCLUSIONS AND LIMITATIONS FOR CANCER We will not pay the Invasive Cancer including all Breast Cancer Benefit Non Invasive Cancer Benefit Benefit Payable Upon Reoccurrence of Invasive Cancer including all Breast Cancer or Skin Cancer Initial Diagnosis Benefit for a covered person s invasive cancer or non invasive cancer that is diagnosed or treated outside the territorial limits of the United States its possessions or the countries of Canada and Mexico is a pre existing condition unless the covered person has satisfied the preexisting condition limitation period shown on the Certificate Schedule on the date the covered person is initially diagnosed as having invasive or non invasive cancer No pre existing condition limitation will be applied for dependent children who are born or adopted while the named insured is covered under the certificate and who are continuously covered from the date of birth or adoption PRE EXISTING CONDITION LIMITATION We will not pay a benefit for a pre existing condition that occurs during the 12 month period after the coverage effective date Pre existing condition means a sickness or physical condition for which a covered person was treated had medical testing received medical advice or had taken medication within 12 months before the coverage effective date 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 affect any benefits payable Applicable to policy form GCI6000 P and certificate form GCI6000 C including state abbreviations where used for example GCI6000 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 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 11 22 387100 2

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

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

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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

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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

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HENNIGES Deductions per year 52 These rates were prepared on 6 19 2025 based off of 200 eligible lives and are valid for 90 days Group Accident GAC4100 for NC Applicable to policy forms GAC4100 P GAC4100 C l Additional Benefits Accident Hospital Benefits Preferred Recovery Plus Package Active Lifestyles Wellbeing Assistance Standard 100 On Off Job Accident Coverage BENEFIT LEVEL ISSUE AGE EMPLOYEE EMPLOYEE AND SPOUSE EMPLOYEE AND DEPENDENT CHILD REN EMPLOYEE SPOUSE AND DEPENDENT CHILD REN 17 99 3 48 5 60 7 46 9 62 Preferred Group Medical Bridge GMB7000 for NC Composite Applicable to Policy Forms GMB7000 P GMB7000 C l Wellbeing Assistance Standard 100 Diagnostic Procedure Option 1 250 Medical Treatment Package Accident Sickness Observation Room Rehabilitation Unit Confinement HOSPITAL CONFINEMENT LEVEL ISSUE AGE Level 3 1500 17 99 NAMED INSURED EMPLOYEE SPOUSE ONE PARENT FAMILY TWO PARENT FAMILY 15 32 10 88 18 64 7 55 Group Medical Bridge GMB7000 for NC Composite Applicable to Policy Forms GMB7000 P GMB7000 C l Wellbeing Assistance Standard 100 Observation Room Rehabilitation Unit Confinement HOSPITAL CONFINEMENT LEVEL ISSUE AGE Level 4 2000 17 99 NAMED INSURED EMPLOYEE SPOUSE 6 74 13 82 ONE PARENT FAMILY TWO PARENT FAMILY 8 60 Group Disability for NC AA Risk Class 15 68 Applicable to policy forms GDIS P GDIS C l Off Job Accident and Off Job Sickness 3 Month Benefit Period ELIMINATION PERIOD 0 days Accident 7 days Sickness 7 days Accident 7 days Sickness ISSUE AGE 800 1 000 1 200 1 300 1 500 17 49 50 64 65 74 17 49 50 64 65 74 5 17 6 13 8 90 5 02 5 78 8 40 6 46 7 66 11 12 6 28 7 22 10 50 7 75 9 19 13 35 7 53 8 67 12 60 8 40 9 96 14 46 8 16 9 39 13 65 9 69 11 49 16 68 9 42 10 83 15 75 monthly benefit amount Page 1 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

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HENNIGES Continued Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD Group Critical Illness GCI6000 for NC l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Non Tobacco Rates 10 000 15 000 20 000 ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND DEPENDENT CHILD REN NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 1 59 1 99 2 40 3 32 4 25 5 77 7 27 9 35 12 51 15 19 15 19 2 05 2 64 3 27 4 65 6 04 8 32 10 57 13 69 18 43 22 44 22 44 2 52 3 30 4 13 5 98 7 82 10 87 13 87 18 02 24 35 29 70 29 70 2 36 2 96 3 56 4 96 6 35 8 70 11 06 14 22 19 02 23 12 23 12 3 01 3 91 4 81 6 92 9 00 12 53 16 06 20 81 28 01 34 17 34 17 3 67 4 87 6 07 8 89 11 66 16 36 21 07 27 39 36 99 45 21 45 21 1 59 1 99 2 40 3 32 4 25 5 77 7 27 9 35 12 51 15 19 15 19 2 05 2 64 3 27 4 65 6 04 8 32 10 57 13 69 18 43 22 44 22 44 2 52 3 30 4 13 5 98 7 82 10 87 13 87 18 02 24 35 29 70 29 70 2 36 2 96 3 56 4 96 6 35 8 70 11 06 14 22 19 02 23 12 23 12 3 01 3 91 4 81 6 92 9 00 12 53 16 06 20 81 28 01 34 17 34 17 3 67 4 87 6 07 8 89 11 66 16 36 21 07 27 39 36 99 45 21 45 21 Page 2 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

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HENNIGES Continued Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD Group Critical Illness GCI6000 for NC l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Non Tobacco Rates 25 000 30 000 ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND DEPENDENT CHILD REN NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 2 98 3 96 5 00 7 30 9 61 13 42 17 17 22 36 30 27 36 96 36 96 3 44 4 62 5 86 8 63 11 40 15 97 20 47 26 70 36 19 44 22 44 22 4 33 5 83 7 33 10 85 14 31 20 19 26 08 33 98 45 98 56 25 56 25 4 99 6 79 8 59 12 81 16 96 24 02 31 09 40 57 54 97 67 29 67 29 2 98 3 96 5 00 7 30 9 61 13 42 17 17 22 36 30 27 36 96 36 96 3 44 4 62 5 86 8 63 11 40 15 97 20 47 26 70 36 19 44 22 44 22 4 33 5 83 7 33 10 85 14 31 20 19 26 08 33 98 45 98 56 25 56 25 4 99 6 79 8 59 12 81 16 96 24 02 31 09 40 57 54 97 67 29 67 29 ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND DEPENDENT CHILD REN NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 2 15 2 79 3 44 4 92 6 39 8 82 11 22 14 54 19 59 23 89 23 89 3 14 4 11 5 08 7 29 9 53 13 29 17 06 22 13 29 82 36 35 36 35 2 15 2 79 3 44 4 92 6 39 8 82 11 22 14 54 19 59 23 89 23 91 3 14 4 11 5 08 7 29 9 53 13 29 17 06 22 13 29 82 36 35 36 37 Tobacco Rates 10 000 Page 3 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

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HENNIGES Continued Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD Group Critical Illness GCI6000 for NC l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Tobacco Rates 15 000 20 000 25 000 ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND DEPENDENT CHILD REN NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 2 89 3 85 4 82 7 04 9 25 12 89 16 49 21 47 29 05 35 49 35 49 3 62 4 92 6 21 9 16 12 12 16 96 21 76 28 41 38 52 47 10 47 10 4 36 5 98 7 59 11 29 14 98 21 04 27 04 35 34 47 98 58 71 58 71 4 19 5 64 7 10 10 42 13 78 19 42 25 06 32 68 44 21 54 00 54 00 5 24 7 18 9 12 13 55 18 02 25 55 33 07 43 22 58 59 71 66 71 66 6 29 8 71 11 14 16 67 22 27 31 67 41 08 53 77 72 98 89 31 89 31 2 89 3 85 4 82 7 04 9 25 12 89 16 49 21 47 29 05 35 49 35 53 3 62 4 92 6 21 9 16 12 12 16 96 21 76 28 41 38 52 47 10 47 15 4 36 5 98 7 59 11 29 14 98 21 04 27 04 35 34 47 98 58 71 58 77 4 19 5 64 7 10 10 42 13 78 19 42 25 06 32 68 44 21 54 00 54 04 5 24 7 18 9 12 13 55 18 02 25 55 33 07 43 22 58 59 71 66 71 70 6 29 8 71 11 14 16 67 22 27 31 67 41 08 53 77 72 98 89 31 89 37 Page 4 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

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HENNIGES Continued Applicable to policy forms GCI6000 P GCI6000 C R GCI6000 CB R GCI6000 BB R GCI6000 HB R GCI6000 INF R GCI6000 PD Group Critical Illness GCI6000 for NC l Plan 2 Critical Illness Cancer Wellbeing Assistance Benefit 50 Benefit Tobacco Rates 30 000 ISSUE AGE NAMED INSURED NAMED INSURED AND SPOUSE NAMED INSURED AND DEPENDENT CHILD REN NAMED INSURED SPOUSE AND DEPENDENT CHILD REN 17 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 5 10 7 04 8 98 13 41 17 84 25 11 32 31 42 28 57 44 70 32 70 32 7 34 10 25 13 16 19 80 26 52 37 80 49 09 64 32 87 37 106 96 106 96 5 10 7 04 8 98 13 41 17 84 25 11 32 31 42 28 57 44 70 32 70 39 7 34 10 25 13 16 19 80 26 52 37 80 49 09 64 32 87 37 106 96 107 03 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 IWL5000 ROB 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 10 000 20 000 30 000 40 000 50 000 25 35 45 55 65 2 02 2 76 4 21 7 29 13 69 4 04 5 53 8 43 14 59 27 38 6 06 8 28 12 64 21 89 41 06 8 09 11 04 16 86 29 18 54 76 10 10 13 81 21 08 36 48 68 45 ISSUE AGE 10 000 20 000 30 000 40 000 50 000 25 35 45 55 65 3 03 4 09 6 07 10 39 17 43 6 05 8 17 12 13 20 79 34 85 9 09 12 25 18 20 31 18 52 28 12 12 16 34 24 28 41 58 69 71 15 14 20 42 30 35 51 98 87 14 Tobacco Rates Page 5 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice

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HENNIGES Continued Term Life ITL5000 for NC Applicable to policy form ITL5000 l 20 Year Term Base Plan Non Tobacco Rates ISSUE AGE 10 000 20 000 30 000 40 000 50 000 25 35 45 55 65 1 55 1 77 2 23 4 16 9 46 2 17 2 62 3 54 7 41 11 54 2 79 3 47 4 85 6 78 16 85 3 42 4 33 6 17 8 74 22 16 2 43 2 67 5 03 10 69 27 48 ISSUE AGE 10 000 20 000 30 000 40 000 50 000 25 35 45 55 65 2 42 2 70 3 66 7 83 16 18 3 91 4 48 6 41 14 73 19 32 5 41 6 26 9 15 15 05 28 52 6 90 8 04 11 90 19 76 37 73 4 20 4 76 10 49 24 47 46 93 Tobacco Rates 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 2025 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 6 of 6 Underwritten by Colonial Life Accident Insurance Company See page 6 for Important Notice