Page 2 Group name: Betenbough Homes, LLC Policy number: 024883 Form created: 08/28/2025 Benefit plan and features Class definition: Class 1 – All Active Full Time Employees Included Benefits Benefit Amount First Day Hospital $500, once per year First Day Hospital Intensive Care Unit (ICU) Confinement $1,000, once per year Daily Hospital Confinement $100, up to 365 days per year Daily Hospital ICU Confinement $200, up to 60 days per year Daily Hospital Rehabilitation Unit $50, up to 60 days per year Annual Wellness Screening $50, once per year per insured Admission and Confinement benefits are not additive.