Group Short Term Disability Insurance Plan Highlights

www.reliancematrix.com This Plan Highlight is not a complete description of the insurance coverage. Insurance is provided under group policy form LRS-6451, et al. This is not a binding contract. Should there be a difference between this Plan Highlight and the contract, the contract will govern. The Certificate of Coverage will be made available to you that describes the benefits in greater detail; however a benefit will not be paid if caused or contributed by an exclusion listed in the Certificate. Reliance Standard Life Insurance Company is licensed in all states (except New York), the District of Columbia, Puerto Rico, the U.S. Virgin Islands and Guam. In New York, insurance products and services are provided through First Reliance Standard Life Insurance Company, Home Office: New York, NY. Product features and availability may vary by state. Plan Highlights The Life is Good Company FEATURES  Maternity covered as any other illness  Non-occupational coverage  Partial Disability  Zero Day Residual: You can accumulate time toward the elimination period even while partially disabled  Transfer of Coverage provision  FMLA Continuation  Military Services Leave of Absence Continuation  W-2 Services LIMITATIONS  Offsets: Your benefit may be reduced by other income sources such as, but not limited to, Social Security, Workers Compensation, State Disability Plans. Group Short Term Disability Insurance COVERAGE Disability income protection insurance provides a benefit for short term disability resulting from a covered injury or sickness. Benefits begin at the end of the elimination period and continue while you are disabled up to the maximum benefit duration. ELIGIBILITY All Active Full-Time and Part-Time Employees working 30 hours or more per week, except for any person working on a temporary or seasonal basis. BENEFIT AMOUNT The benefit amount is equal to 60% of your weekly covered earnings, from a minimum of $25, to a maximum benefit of $1,200 per week. DAY BENEFITS BEGIN Injury (accident) and Sickness (illness): benefits begin on the 8th consecutive day of disability. MAXIMUM BENEFIT DURATION Benefits for one period of disability will be paid up to a maximum of 12 weeks. CONTRIBUTION REQUIREMENTS Coverage is 100% Employee Paid. RATES See attached Rate Sheet  Pre-Existing Limitation: 3/12

www.reliancematrix.com Plan Highlights The Life is Good Company The benefit amount is equal to 60% of your weekly covered earnings, to a maximum benefit of $1,200 per week. To calculate your weekly payroll deduction, use the formula indicated below: 1. Enter your Weekly Earnings, not to exceed $2,000. 1. $ Rate per $10 benefit $0.46 2. Multiply the amount on Line 1 by 0.60. 2. $ 3. Multiply the amount on Line 2 by $0.46. 3. $ 4. Divide the amount on Line 3 by 10 and enter the amount on Line 4 to get your monthly payroll deduction. 4. $ 5. Multiply the amount on Line 4 by 12, then Divide by 52 to get your weekly payroll deduction. 5. $ Example Calculation: 1. Enter your Weekly Earnings, not to exceed $2,000. 1. $ 400 2. Multiply the amount on Line 1 by 0.60. 2. $ 240 (maximum weekly benefit) 3. Multiply the amount on Line 2 by $0.46. 3. $ 110.40 4. Divide the amount on Line 3 by 10 and enter the amount on Line 4 to get your monthly payroll deduction. 4. $ 11.04 (monthly payroll deduction) 5. Multiply the amount on Line 4 by 12, then Divide by 52 to get your weekly payroll deduction. 5. $ 2.55 (weekly payroll deduction) Group Short Term Disability Insurance