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PLAN SUMMARY Accident Insurance Benefits that may help cover costs such as those not covered by your medical plan. Salus Homecare ADF# AI664.14 Accident Insurance Benefits With MetLife, you’ll have a choice a plan (called the “Low Plan” that provide payments in addition to any other insurance payments you may receive1. Here are just some of the covered events/services2. This plan provides protection 24 hours a day—while on or off the job. Benefit Typ0065 Low Plan Benefits Accidental Injury Benefits Fracture Benefit* $100 – $8,000 depending on the fracture and type of repair Dislocation Benefit* $100 – $8,000 depending on the dislocation and type of repair Second or Third Degree Burn Benefit $75 – $10,000 depending on the degree of the burn and the percentage of burnt skin Concussion Benefit $250 Coma Benefit $10,000 Laceration Benefit $50 – $400 depending on the length of the cut and type of repair Puncture Wound Benefit $250 Broken Tooth Benefit Crown: $200 Filling: $25 Extraction: $100 Eye Injury Benefit $300 Accident - Medical Services & Treatment Benefits Ambulance Benefit Ground: $300 Air: $1,000 Emergency Care Benefit $100 – $200 depending on location of care Non-Emergency Initial Care Benefit $100 Physician Follow-Up Visit Benefit $100 Therapy Services Benefit $50 (including physical therapy) Medical Testing Benefit $150 Medical Appliance Benefit $75 – $750 depending on the appliance Transportation Benefit $300 Pain Management Benefit $75 (for epidural anesthesia) Prosthetic Device Benefit One device: $750 More than one device: $1,500

Accident Insurance Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L0924043620[exp0926][All States][DC,GU,MP,PR,VI] © 2024 MetLife Services and Solutions, LLC Modification Benefit $1,000 Blood/Plasma/Platelets Benefit $400 Surgical Repair Benefit $150 – $1,500 depending on the type of surgery Exploratory Surgery Benefit $150 Other Outpatient Surgery Benefit $300 Hospital Benefits Admission Benefit $1,000 for the day of admission ICU Supplemental Admission Benefit $1,000 for the day of admission Confinement Benefit $200 per day (paid for up to 180 days per accident) ICU Supplemental Confinement Benefit $200 per day (paid for up to 180 days per accident) Inpatient Rehabilitation Benefit $150 per day (paid for up to 15 days per accident) Accidental Death Benefit Accidental Death Benefit* $25,000 $75,000 for accidental death on common carrier Accidental Dismemberment, Functional Loss & Paralysis Benefits Dismemberment/Functional Loss $750 – $20,000 depending on the injury Paralysis $10,000 – $20,000 depending on the number of limbs Other Benefits Health Screening Benefit* - $50 benefit provided for certain screening/prevention tests Paid 1 time per calendar year Lodging Benefit* - for a companion of a covered person who is hospitalized $100 per day Organized Sports Activity Injury Benefit Rider This coverage includes an Organized Sports Activity Benefit Rider. The rider increases the amount payable under the Certificate for certain benefits by 25% for injuries resulting from an accident that occurred while participating as a player in an organized sports activity. The rider sets forth terms, conditions and limitations, including the covered persons to whom the rider applies. * Notes Regarding Certain Benefits • Fracture and Dislocation benefits – Chip fractures are paid at 25% of Fracture Benefit and partial dislocations are paid at 25% of Dislocation Benefit • Hospital Benefits – Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details. The Admission Benefit is not payable for Emergency Room treatment or outpatient treatment. The payment of the admission benefit requires a Confinement. Hospital Confinement requires the assignment to a bed as a resident inpatient in a Hospital (including an Intensive Care Unit of a Hospital) on the advice of a Physician or confinement in an observation area within a Hospital for a period of no less than 20 continuous hours on the advice of a Physician. Please consult your certificate for details. • Accidental Death Benefit – The benefit amount will be reduced by the amount of any accidental dismemberment/functional loss/paralysis benefits and modification benefit paid for injuries sustained by the covered person in the same accident for which the accidental death benefit is being paid.

Accident Insurance Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L0924043620[exp0926][All States][DC,GU,MP,PR,VI] © 2024 MetLife Services and Solutions, LLC • Common Carrier Benefit - Common Carrier refers to airplanes, trains, buses, trolleys, subways and boats. Certain conditions apply. See your Disclosure Statement or Outline of Coverage/Disclosure Document for specific details. Be sure to review other information contained in this booklet for more details about plan benefits, monthly rates and other terms and conditions. • Lodging Benefit – The lodging benefit is not available in all states. It provides a benefit for a companion accompanying a covered insured while hospitalized, provided that lodging is at least 50 miles from the insured’s primary residence. • Organized Sports Activity Injury Benefit Rider – The rider is not available in all states. Proof of registration in an Organized Sports Activity in which an Accident occurred is required at time of claim. See your certificate for details. Benefit Payment Example Kathy’s daughter, Molly, was riding her bike to school. On her way there she fell to the ground, was knocked unconscious, and was taken to the local emergency room (ER) by ambulance for treatment. The ER doctor diagnosed a concussion and a broken tooth. He ordered a CT scan to check for facial fractures too, since Molly’s face was very swollen. Molly was released to her primary care physician for follow-up treatment, and her dentist repaired her broken tooth with a crown. Depending on her health insurance, Kathy’s out-of-pocket costs could run into hundreds of dollars to cover expenses like insurance co-payments and deductibles. MetLife Group Accident Insurance payments can be used to help cover these unexpected costs. Benefit amount is based on a sample MetLife plan design. Actual plan design and benefits may vary. Questions & Answers Q. How do I enroll? A. Enroll for coverage at Employer website. Q. Who is eligible to enroll for this accident coverage? A. You are eligible to enroll yourself and your eligible family members!4 You need to enroll during your Enrollment Period and to be actively at work for your coverage to be effective. Q. How do I pay for my accident coverage? A. Premiums will be paid through payroll deduction, so you don’t have to worry about writing a check or missing a payment. Q. What happens if my employment status changes? Can I take my coverage with me? A. Yes, you can take your coverage with you.5 You will need to continue to pay your premiums to keep your coverage in force. Your coverage will only end if you stop paying your premium or if your employer offers you similar coverage with a different insurance carrier. Q. Who do I call for assistance? A. Contact a MetLife Customer Service Representative at 1 800- GET-MET8 (1-800-438-6388), Monday through Friday from 8:00 a.m. to 8:00 p.m., EST. Or visit our website: mybenefits.metlife.com. Covered Event3 Benefit Amount Ambulance (ground) $300 Emergency Care $100 Physician Follow-Up ($100 x 2) $200 Medical Testing $150 Concussion $250 Broken Tooth (repaired by crown) $200 Benefits paid by MetLife Group Accident Insurance $1,200

Accident Insurance Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L0924043620[exp0926][All States][DC,GU,MP,PR,VI] © 2024 MetLife Services and Solutions, LLC Insurance Rates MetLife offers group rates and payroll deduction, so you don’t have to worry about writing a check or missing a payment! Your employee rates are outlined below. 1 Availability of benefits varies by state. See your Disclosure Statement or Outline of Coverage/Disclosure Document for state variations. 2 Covered services/treatments must be the result of an accident or sickness as defined in the group policy/certificate. See your Disclosure Statement or Outline of Coverage/Disclosure Document for more details. 3 Benefits and amounts are based on sample MetLife plan design. Plan design and plan benefits may vary. 4 Eligible Family Members means all persons eligible for coverage as defined in the Certificate. [5 Eligibility for portability through the Continuation of Insurance with Premium Payment provision may be subject to certain eligibility requirements and limitations. For more information, contact your MetLife representative. METLIFE’S ACCIDENT INSURANCE IS A LIMITED BENEFIT GROUP INSURANCE POLICY. The policy is not intended to be a substitute for medical coverage and certain states may require the insured to have medical coverage to enroll for the coverage. The policy or its provisions may vary or be unavailable in some states. Like most group accident and health insurance policies, policies offered by MetLife may include waiting periods and contain certain exclusions, limitations and terms for keeping them in force. For complete details of coverage and availability, please refer to the group policy form GPNP12-AX or contact MetLife. Benefits are underwritten by Metropolitan Life Insurance Company, New York, NY. Hospital does not include certain facilities such as nursing homes, convalescent care or extended care facilities. See MetLife’s Disclosure Statement or Outline of Coverage/Disclosure Document for full details. Accident Insurance Monthly Cost to You Coverage Options Low Plan Employee $6.76 Spouse $4.02 Child(ren) $6.24 Spouse & Child(ren) $13.44