Overview of Group Supplemental & Dependent Life/AD&D Insurance

www.reliancematrix.com This Plan Highlight is not a complete description of the insurance coverage. Insurance is provided under group policy form LRS-6422, 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 ELIGIBILITY All Other 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. Dependents: You must be insured for your Dependents to be covered. Dependents are:  Your legal spouse who is not legally separated or divorced from you;  Your legally-recognized domestic or civil union partner;  Your unmarried financially dependent children birth to 26 years;  A person may not have coverage as both an Employee and Dependent;  Only one insured spouse may cover dependent children; BENEFIT AMOUNT Supplemental Life: Choose from a minimum of $10,000 to a maximum of $500,000 in $10,000 increments. Spouse: Choose from a minimum of $5,000, a maximum of $250,000 in $5,000 increments, not to exceed 50% of employee amount. Child(ren): Birth to age 26 years: A choice of $2,500, $5,000, $7,500 or $10,000. GUARANTEED ISSUE Initial eligibility period only Employee: Under age 60: $150,000 Age 60 but less than age 70: $150,000 Age 70 and over: $10,000 Spouse: Under age 60: $30,000 Age 60 but less than age 70: $30,000 Age 70 and over: $10,000 Child(ren): $10,000 CONTRIBUTION REQUIREMENTS Coverage is 100% Employee Paid. AD&D SCHEDULE For Accidental Loss of Amount Payable Life 100% Both Hands 100% Both Feet 100% Sight of Both Eyes 100% One Hand and One Foot 100% One Hand and Sight of One Eye 100% One Foot and Sight of One Eye 100% Speech and Hearing 100% One Hand 50% One Foot 50% Sight of One Eye 50% Speech 50% Hearing 50% For Total Loss of Amount Payable Both Arms and Both Legs 100% Both Arms and One Leg or Both Legs and One Arm 75% Both Arms 67% Both Legs 67% One Arm and One Leg 67% One Arm or One Leg 50% BENEFIT REDUCTION DUE TO AGE Age Original Benefit Reduced to 65 65% 70 50% RATES See attached Rate Sheet Group Supplemental & Dependent Life / AD&D Insurance