Hospital Indemnity Benefits Summary Beam Hospita

Hospital Indemnity Benefit Summary Dash Delivery Inc. Plan: Beam Hospital Indemnity - Ultra Policy effective date: 2024-10-01 GROUP #: OR00704 Policy length: 12 months Hours worked: 30+ hours/week* Plan overview information Employee coverage: Voluntary Provides a per-day benefit for inpatient Eligible group size: 50 - 100 eligible employees confinement in a hospital due to a Participation requirement: nonoccupational accident or illness. Payment is 10 lives for groups with 50 - 100 eligible employees made directly to the employee, regardless of *An employee must be actively at work on the effective other health insurance coverage. date in order to be eligible for benefits. Employers located in New York may elect a minimum of 20 or 30 hours. Benefit per day per covered person $500 ($1,000 for ICU admissions) Benefit maximum Maximum confinement days (Calendar year): 30 days per covered person Pre-existing condition Pre-Existing condition lookback 12 months* Pre-Existing condition exclusion period 12 months** *6 months in CA, CO, FL, ID, IN, NV, OK; 3 months in PA **6 months in CA, CO Termination age Employee 65 Spouse 65 Child 26 (unmarried) BEAM SUPPORT LEARN MORE [email protected] | (800) 648 1179 beambenefits.com BM-SOB-0038-202401 1 of 3

Additional summary details Eligibility waiting period Defined by the Policyholder Annual enrollment and late entrant rules Employees have 31 days from the plan effective date or their eligibility date, whichever is later, to enroll or they are considered a late entrant. Late entrants must wait until the next annual enrollment to enroll in the plan. These rules apply to both employees and dependent options. Ambulance Benefit (For policies issued in DC only) $50 per plan year, per individual BEAM SUPPORT LEARN MORE [email protected] | (800) 648 1179 beambenefits.com BM-SOB-0038-202401 2 of 3

This benefit summary is not a complete description of the insurance coverage. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern. Hospital only Indemnity insurance product is underwritten by Nationwide Life Insurance Company, Columbus, OH, marketed by Beam Insurance Services LLC (Beam Benefits Insurance Services LLC, in CA) and administered by Beam Insurance Administrators LLC (Beam Dental Insurance Administrators LLC in Texas). Hospital coverage applicable to policy form GHOI AO L20, or state equivalent. Products are not available to members living in Puerto Rico and product availability may vary by state. Program restrictions and exclusions apply. 1099 contractors are not eligible for coverage. Nationwide and Beam Insurance Services LLC are separate and non-affiliated companies. Nationwide Life Insurance Company, One Nationwide Plaza, Columbus, OH 43215 BEAM SUPPORT LEARN MORE [email protected] | (800) 648 1179 beambenefits.com BM-SOB-0038-202401 3 of 3