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Benefit Booklet - 2024

Colonial Life provides benefits that employees want for the unexpected moments in life Whether planning for retirement growing their families or saving for college they know an injury or illness won t derail their dreams Life is anything but expected That s why we re here Products Disability Insurance Provides financial protection to cover income loss from a covered disability 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 Cancer Insurance Provides benefits for a cancer diagnosis and treatment Option to add cancer screening benefit Critical Illness Insurance Provides lumpsum benefits for a covered critical illness such as a heart attack stroke organ transplants and more Group Term Life Insurance Provides a predictable way to provide life coverage at more affordable prices during high need years Includes AD D Catastrophic Suite and a Health Advocate Employee Assistance Progrm LearKnimttyorMeeollnolninee at KmellConoelo nciaolloLnifieal lcifoemnc com 704 907 3944

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

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

Accident Insurance Accidents happen in places where you and your family spend the most time at work in the home and on the playground and they re unexpected How you care for them shouldn t be In your lifetime which of these accidental injuries have happened to you or someone you know l Sports related accidental injury 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 Preferred with Health Screening Benefit

Benefits listed are for each covered person per covered accident unless otherwise specified Initial Care l Accident Emergency Treatment 125 l X ray Benefit 30 l Ambulance 200 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 2 200 1 100 880 550 330 330 110 110 Surgical 4 400 2 200 1 760 1 100 660 660 220 220 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 2 750 1 100 1 650 825 385 385 385 330 330 330 275 220 110 Surgical 5 500 2 200 3 300 1 650 770 770 770 660 660 660 550 440 220 Your Colonial Life policy also provides benefits for the following injuries received as a result of a covered accident l Burn based on size and degree 1 000 to 12 000 l Coma 10 000 l Concussion 60 l Emergency Dental Work 75 Extraction 300 Crown Implant or Denture l Lacerations based on size 30 to 500 Requires Surgery l Eye Injury 300 l Tendon Ligament Rotator Cuff 500 one 1 000 two or more l Ruptured Disc 500 l Torn Knee Cartilage 500 Surgical Care l Surgery cranial open abdominal or thoracic 1 500 l Surgery hernia 150 l Surgery arthroscopic or exploratory 200 l Blood Plasma Platelets 300

Transportation Lodging Assistance If injured covered person must travel more than 50 miles from residence to receive special treatment and confinement in a hospital l Transportation 500 per round trip up to 3 round trips l Lodging family member or companion 125 per night up to 30 days for a hotel motel lodging costs Accident Hospital Care l Hospital Admission 1 000 per accident l Hospital ICU Admission 2 000 per accident We will pay either the Hospital Admission or Hospital Intensive Care Unit ICU Admission but not both l Hospital Confinement 225 per day up to 365 days per accident l Hospital ICU Confinement 450 per day up to 15 days per accident Accident Follow Up Care l Accident Follow Up Doctor Visit 50 up to 3 visits per accident l Medical Imaging Study 150 per accident limit 1 per covered accident and 1 per calendar year l Occupational or Physical Therapy 25 per treatment up to 10 days l Appliances 100 such as wheelchair crutches l Prosthetic Devices Artificial Limb 500 one 1 000 more than 1 l Rehabilitation Unit 100 per day up to 15 days per covered accident and 30 days per calendar year Maximum of 30 days per calendar year Accidental Dismemberment l Loss of Finger Toe 750 one 1 500 two or more l Loss or Loss of Use of Hand Foot Sight of Eye 7 500 one 15 000 two or more Catastrophic Accident For severe injuries that result in the total and irrecoverable l Loss of one hand and one foot l Loss of 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 25 000 25 000 5 000 Common Carrier 100 000 100 000 20 000

Health Screening Benefit l 50 per covered person per calendar year Provides a benefit if the covered person has one of the health screening tests performed This benefit is payable once per calendar year per person and is subject to a 30 day waiting period Tests include l Blood test for triglycerides l 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 Accident 1 0 Preferred with Health Screening Benefit 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 felonies or illegal occupations sickness suicide or self inflicted injuries war or armed conflict in addition to the exclusions listed above we also will not pay the Catastrophic Accident benefit for injuries that are caused by or are the result of birth intoxication For cost and complete details see your Colonial Life benefits counselor Applicable to policy form Accident 1 0 HS SC This is not an insurance contract and only the actual policy provisions will control Colonial Life 1200 Colonial Life Boulevard Columbia South Carolina 29210 coloniallife com 10 11 2011 Colonial Life Accident Insurance Company Colonial Life products are underwritten by Colonial Life Accident Insurance Company for which Colonial Life is the marketing brand Colonial Life and Making benefits count are registered service marks of Colonial Life Accident Insurance Company 71740 2 SC

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

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

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

Specified Critical Illness Insurance If you re diagnosed with a covered critical illness specified critical illness insurance from Colonial Life can help with your expenses so you can concentrate on what s most important your treatment care and recovery 10 000 Face amount _______________ Critical illness benefit For the diagnosis of this covered critical illness condition 1 For more information talk with your benefits counselor ColonialLife com This percentage of the face amount is payable Heart attack myocardial infarction 100 Stroke 100 End stage renal kidney failure 100 Major organ failure 100 Permanent paralysis due to a covered accident 100 Coma 100 Blindness 100 Occupational infectious HIV or occupational infectious hepatitis B C or D 100 Coronary artery bypass graft surgery disease2 25 The maximum benefit amount for this policy is 3x the face amount for the named insured for all covered persons combined The policy will terminate when the maximum benefit amount for specified critical illness has been paid Subsequent diagnosis of a different critical illness3 If you receive a benefit for a specified critical illness and later you are diagnosed with a different specified critical illness the original percentage of the face amount is payable for that particular specified critical illness Subsequent diagnosis of the same critical illness3 If you receive a benefit for a specified critical illness and later you are diagnosed with the same specified critical illness 25 of the original face amount is payable Critical illness conditions that do not qualify are coronary artery bypass graft surgery disease2 and occupational infectious HIV or occupational infectious hepatitis B C or D CRITICAL ILLNESS 1 0 WITH SUBSEQUENT DIAGNOSIS

ColonialLife com 1 Please refer to the policy for complete definitions of covered conditions 2 Benefit for coronary artery disease applicable in lieu of benefit for coronary artery bypass graft surgery when health savings account HSA compliant plan is selected 3 Dates of diagnoses of a covered specified critical illness must be separated by at least 180 days THIS POLICY PROVIDES LIMITED BENEFITS EXCLUSIONS AND LIMITATIONS FOR SPECIFIED CRITICAL ILLNESS We will not pay benefits for a specified critical illness that occurs as a result of a covered person s alcoholism or drug addiction felonies or illegal occupations intoxicants and narcotics pre existing condition psychiatric or psychological condition suicide or self inflicted injuries or war or armed conflict This is not an insurance contract and only the actual policy provisions will control Applicable to policy form CI 1 0 CI 1 0 PL5 CI 1 0 PL6 or CI 1 0 PL9 including state abbreviations where used The policy or its provisions may vary or be unavailable in some states Please see your Colonial Life benefits counselor for details Underwritten by Colonial Life Accident Insurance Company Columbia SC 2019 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company 10 19 101824 1

Critical Illness Insurance Health Screening Benefit The optional health screening benefit can help you reduce the risk of serious illness through early detection Health screening benefit __50 00_____________ Maximum of one screening test per covered person per calendar year Blood test for triglycerides Pap smear Bone marrow testing PSA blood test for prostate cancer Breast ultrasound Serum cholesterol test for HDL and LDL levels CA 15 3 blood test for breast cancer CA 125 blood test for ovarian cancer Carotid Doppler CEA blood test for colon cancer Chest X ray Colonoscopy Echocardiogram ECHO Electrocardiogram EKG ECG For more information talk with your benefits counselor Fasting blood glucose test Serum protein electrophoresis blood test for myeloma Skin cancer biopsy Stress test on a bicycle or treadmill Thermography ThinPrep pap test Virtual colonoscopy Flexible sigmoidoscopy Hemoccult stool analysis Mammography ColonialLife com THIS POLICY INSURANCE PROVIDES LIMITED BENEFITS Insureds in GA MA MN and VT must be covered by comprehensive health insurance before applying for critical illness or cancer insurance This information is not intended to be a complete description of the insurance coverage available The policy insurance or its provisions may vary or be unavailable in some states The policy insurance has exclusions and limitations which may affect any benefits payable Applicable to policy form CI 1 0 P and GCC1 0 P and certificate form GCC1 0 C including state abbreviations where used for example CI 1 0 P TX GCC1 0 P TX and GCC1 0 C TX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company Underwritten by Colonial Life Accident Insurance Company Columbia SC 2021 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company GROUP CRITICAL CARE CRITICAL ILLNESS 1 0 HEALTH SCREENING BENEFIT 5 21 100355 4

Group Term Life Insurance Voluntary Coverage How secure is your family s financial future If something happened to you would your family be able to maintain their way of life Funeral expenses and medical bills could be just the beginning How would they cover ongoing living expenses such as a mortgage utilities and health care Colonial Life s group term life insurance can help provide financial security for your family You can also apply for coverage for your spouse and eligible dependent children with no health questions 1 How much group term life coverage do I need You 50 000 Your spouse ____________________ Your dependent children up to age 26 ____________________ n A vailable in 1 000 increments n M inimum of 10 000 to a maximum of five times your salary to 500 000 n Available in 1 000 increments n Minimum of 5 000 to a maximum of 500 000 n Spouse coverage cannot exceed your coverage amount2 n Available in 1 000 increments n Minimum of 1 000 to a maximum of 10 000 per dependent child n Each dependent child is covered for the same amount except children from live birth to six months for whom the death benefit is 1 000 VOLUNTARY GROUP TERM LIFE

Why is group term life insurance a good option Death benefit protection Lower cost option Coverage for specified periods of time which can be during high need years Benefit is typically paid tax free to your beneficiaries To learn more talk with your Colonial Life benefits counselor ColonialLife com Additional benefits and services Built in Accelerated Death Benefit payments will reduce the amount the policy pays upon the covered person s death 3 Health Advocate Employee Assistance Program5 provides 24 hour confidential personal support and referral service including a medical bill saver service Face to face sessions and video counseling with mental health professionals are available 4 ONLINE ColonialLife com EAP TELEPHONE 1 888 645 1772 Life Planning Services5 offer financial and legal counseling services as well as grief support and referral for up to 12 months after a claim 4 Get the most out of your coverage Portability If you retire or change jobs you may still be able to take your coverage with you Eligibility may be based on your health Conversion You may be eligible to convert your coverage to an individual whole life insurance policy without proof of good health when coverage ends under the group certificate Waiver of Premium If included in your plan premium payments can be waived if you become disabled 1 Spouse and dependent coverage will not be effective if they are currently totally disabled Being totally disabled means the inability to perform two or more activities of daily living such as bathing continence dressing eating transferring toileting and being confined to a hospital or similar institution or being unable to attend school outside the home for a dependent child age 5 up to age 26 In CT ID NH and TX the definition of total disability does not include Activities of Daily Living ADL requirements such as bathing continence dressing eating transferring and toileting The ability to work does not determine disability You can pay premiums on insurance for your dependents with no health questions asked Coverage isn t effective until the earlier of the date they are no longer totally disabled or two years after the date that coverage would have otherwise become effective for the spouse or dependent child This provision does not apply to newborn children born while dependent insurance is in effect 2 The maximum benefit is 50 of your benefit in NE 3 Terminal illness means an injury or sickness that results in the covered person having a life expectancy of 12 months or less and from which there is no reasonable prospect of recovery A life expectancy of 24 months or less in IL KS MA TX and WA 4 The Employee Assistance Program and Life Planning Services provided by Health Advocate are available with Colonial Life Accident Insurance Company s Group Term Life offering Terms and availability of service are subject to change The service provider does not provide legal advice please consult your attorney for guidance Services are not valid after coverage terminates Please contact the company for full details 5 State mandated limitations for legal services in WA apply BENEFIT AGE REDUCTION SCHEDULE When a covered person reaches age 70 but not 75 the amount of insurance will be 65 of the amount of insurance prior to age 70 or 65 of the amount of insurance applied for on or after age 70 but before age 75 When a covered person reaches age 75 or more the amount of insurance will be 50 of the amount of insurance prior to the first reduction or 50 of the amount of insurance the employee applied for on or after age 75 Once the benefit reduction schedule begins there will be no further increases in insurance for a covered person If the proposed insured is age 70 but not age 75 at the time of enrollment the amount of insurance applied for will be reduced by 65 If the proposed insured is age 75 or older at the time of enrollment the amount applied for will be reduced by 50 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 GTL1 0 P and certificate form GTL1 0 C including state abbreviations where used for example GTL1 0 P AU TX GTL1 0 P EE TX GTL1 0 C AU TX and GTL1 0 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 6 23 100272 6

Group Term Life Insurance Accidental Death Dismemberment Insurance Additional coverage options are available Optional AD D coverage may be added to Colonial Life Accident Insurance Company s Group Term Life coverage at an additional charge This coverage is available for you as well as your spouse and dependent children if they are covered under your group term life certificate To learn more talk with your Colonial Life benefits counselor ColonialLife com Accidental Death Dismemberment AD D Insurance provides benefits to help cover the additional expenses associated with an accidental death as well as the high costs of recovery and rehabilitation required by an accidental dismemberment What is my AD D full benefit amount 100 000 The AD D full benefit amount is equal to your group term life insurance death benefit amount What is paid under the AD D benefit If the loss is Loss of life Loss or loss of use of both hands or both feet or sight of both eyes Loss or loss of use of one hand and one foot Loss or loss of use of one hand and sight of one eye Loss or loss of use of one foot and sight of one eye Loss of speech and hearing Loss or loss of use of one hand or one foot Loss of sight of one eye Loss of speech or hearing Loss of thumb and index finger of the same hand of the full amount paid 100 100 100 100 100 100 50 50 50 25 What other benefits are included Talk with your benefits counselor for details on each benefit listed below Seatbelts and Airbags Paralysis available for employee only Burn available for employee only Coma available for employee only This coverage has limitations and exclusions For cost and complete details see your Colonial Life benefits counselor Applicable to policy number GTL1 0 P and certificate number GTL1 0 C including state abbreviations where used Coverage may vary by state and may not be available in all states This is not an insurance contract and only the actual policy provisions will control Underwritten by Colonial Life Accident Insurance Company Columbia SC 2020 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company GROUP TERM LIFE AD D BENEFIT WITH CATASTROPHIC SUITE 3 20 100266 2

Health Advocate Employee Assistance Work Life Programs Included in your Colonial Life group term life insurance Each day comes with its own set of challenges expected and unexpected At Colonial Life we re here to help you That s why we re o ering Health Advocate s Employee Assistance Program and Work Life Balance Program EAP Work Life with our group term life insurance at no additional cost More assistance more ways to find balance Health Advocate provides confidential counseling and resources via phone in person or online chat for a variety of personal and work issues Stress anxiety and depression Substance dependency addiction Child care camps and a er school care Grief and loss Special needs services Identity the resources Retirement planning Staying healthy To access call or go online 1 888 645 1772 ColonialLife com EAP Access an expert team for life s biggest headaches One of Health Advocate s many services can help relieve the burden of your medical and dental bills not covered by insurance Medical Bill SaverTM can Negotiate to help reduce non covered medical and dental bills over 400 on the balance due and or payment plans on your behalf Provide a Saving Results Statement summarizing the outcome Explain how to maximize savings and get the most value from your benefits Using trend information provider specialty procedure type and geographic region their experienced negotiators can o en obtain significant savings GROUP TERM LIFE

Life Planning Services Included in your Colonial Life group term life insurance Colonial Life has partnered with Health Advocate to o er a helping hand to an insured terminally ill employee or spouse or designated beneficiaries of an employee or spouse Life Planning Services can provide guidance when you may have many financial and legal decisions to make and are not sure where to begin At no additional cost for 12 months you have access to Health Advocate s Life Planning Services that can provide Impartial confidential consultations A Life Planning Resource Guide that contains a tasks and decisions checklist the basics on settling an estate and more Access to legal and financial experts who can help with decisions such as dealing with creditors and financial changes Tips and downloadable forms relating to wills estates survivor benefits and budgeting To access call or go online 1 800 422 5142 HealthAdvocate com members ColonialLife lifeplanning Talk with your Colonial Life benefits counselor to learn more about how these valuable services can help during challenging times The Employee Assistance Program and Life Planning Services provided by Health Advocate are available with Colonial Life Accident Insurance Company s group term life o ering Terms and availability of service are subject to change The service provider does not provide legal advice please consult your attorney for guidance Services are not valid a er coverage terminates Please contact the company for full details The consultants must abide by federal regulations regarding duty to warn of harm to self or others In these instances the consultant may be mandated to report a situation to the appropriate authority Insurance products are underwritten by Colonial Life Accident Insurance Company 2018 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company 3 18 101868

Deductions per year: 12 These rates were prepared on 5/2/2024 and are valid for 90 days.Individual Disability - ISTD3000 for SC AA Risk ClassApplicable to policy form Individual DisabilitylOff Job Accident & Off Job Sickness6 Month Benefit PeriodELIMINATION PERIOD ISSUE AGE $1,200**monthly benefit amount0 days Accident/7 days Sickness 17-49 $44.4050-64 $57.6065-74 $74.88Accident 1.0 for SCApplicable to policy forms ACCIDENT 1.0-HS and ACCIDENT1.0-NSlOn/Off-Job Accident CoverageISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYPreferred with health screening 17-80 $21.15 $28.97 $32.67 $40.48Cancer Assist for SCApplicable to policy form CanAssistlwith $100 Health Screening Benefit$5,000 Initial Diagnosis BenefitCOVERAGE LEVEL ISSUE AGE NAMED INSURED EMPLOYEE AND SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILYLevel 3 17-75 $34.15 $56.90 $35.10 $57.85Critical Illness 1.0 for SCApplicable to policy form CI-1.0lwith Subsequent Diagnosis Coverage, Health Screening BenefitNon-Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$20,000 17-24 $6.95 $10.50 $6.95 $10.5025-29 $8.35 $12.90 $8.35 $12.9030-34 $9.95 $15.50 $9.95 $15.5035-39 $14.75 $22.70 $14.75 $22.7040-44 $17.95 $27.50 $17.95 $27.5045-49 $23.95 $36.70 $23.95 $36.7050-54 $31.15 $47.90 $31.15 $47.9055-59 $38.95 $59.70 $38.95 $59.7060-64 $48.75 $74.90 $48.75 $74.9065-70 $55.55 $85.30 $55.55 $85.30Page 1 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Critical Illness 1.0 for SCApplicable to policy form CI-1.0lwith Subsequent Diagnosis Coverage, Health Screening BenefitTobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$20,000 17-24 $8.95 $13.70 $8.95 $13.7025-29 $11.55 $17.70 $11.55 $17.7030-34 $14.95 $23.10 $14.95 $23.1035-39 $21.55 $33.10 $21.55 $33.1040-44 $28.55 $43.90 $28.55 $43.9045-49 $37.35 $57.30 $37.35 $57.3050-54 $47.55 $72.90 $47.55 $72.9055-59 $60.95 $93.70 $60.95 $93.7060-64 $73.75 $113.30 $73.75 $113.3065-70 $84.55 $130.10 $84.55 $130.10Group Term Life for SCRate Table G7XApplicable to Policy Forms GTL1.0-P & GTL1.0-Clwith Waiver of Premium and AD&DNon-Tobacco RatesISSUE AGE $50,00016-24 $6.8025-29 $7.5530-34 $8.8535-39 $11.6540-44 $15.3045-49 $23.2550-54 $34.5555-59 $55.1060-64 $86.8065-69 $150.8070-74 $175.9075-99 $273.15Tobacco RatesISSUE AGE $50,00016-24 $9.1525-29 $10.3030-34 $12.2535-39 $17.5040-44 $25.4545-49 $39.2550-54 $64.6555-59 $90.3560-64 $134.1065-69 $222.60(Continued...)Page 2 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Group Term Life for SCRate Table G7XApplicable to Policy Forms GTL1.0-P & GTL1.0-Clwith Waiver of Premium and AD&DTobacco RatesISSUE AGE $50,00070-74 $253.5075-99 $352.15Important NoticeInsurance coverage has exclusions and limitations that may affect benefits payable. For a complete description of benefits, limitations and exclusions, please refer to anoutline of coverage, sample policy/certificate, proposal description or see your Colonial Life benefits counselor. Coverage type, benefits and rates vary by state. Coverage maynot be available in all states. Rates provided are illustrative and your actual premium may be different depending on your particular situation and plan choices.Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.© 2024 Colonial Life & Accident Insurance Company"Colonial Life," and the Colonial Life logo, separately and in combination, are service marks of Colonial Life & Accident Insurance Company. All rights reserved.Rich Mellone | Richmellone@gmail.com | (704) 907-3997(Continued...)Page 3 of 3Underwritten by Colonial Life & Accident Insurance CompanySee page 3 for Important Notice

Puckerbutt Pepper Company Colonial Interest FormName_____________________________________ Job Title _________ Social Security #_________________ Annual Income $________________________ Address________________________________ City ___________________St. __________Zip_______ Work Phone___________________ Cell Phone________________ Email Address____________________________________________________ Date of Birth (DOB) ________________ Tobacco______ Non Tobacco_____ Date of Hire____________________ Beneficiary__________________________________DOB___________Relationship____________ Dependent Information: Spouse________________________________DOB_______________ Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ Child_________________________________DOB________________Relationship____________ Signature__________________________________________Date____________ Questions or Assistance Contact: Kitty Mellone 704-907-3944 (D) Email: Kmellone@coloniallifenc.comFax Completed Form with Rate Sheet & elected coverage’s circled fax to: 704-413-3034(FAX)

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

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