Plan Benefits and Underwriting Guidelines. disability life vision medical dental

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1 Plan Benefits and Underwriting Guidelines disability life vision medical dental

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3 Table of Contents PPO Dental and IndemnityPlus Plans 4 PPO Dental Plan Summary - National 4 IndemnityPlus Dental Plan Summary - National 5 PPO Dental Plan Summary - Utah 6 IndemnityPlus Dental Plan Summary - Utah 7 Dental s 8 The Fine Print 8 Exclusions 9 HDHP Medical Plans 10 HSA-Compatible High Deductible Health Plan Summary 10 The Fine Print 11 Exclusions 11 Vision PPO and Indemnity Plans 12 Vision PPO Plan Summary 12 Vision Indemnity Plan Summary 12 The Fine Print 13 Access Vision Exclusions 14 Vision PPO Exclusions 14 Group Term Life Plans 15 Group Term Life Plan Summary 15 The Fine Print 16 Short Term Disability 17 Short Term Disability Plan Summary 17 The Fine Print 18

4 PPO Dental and IndemnityPlus Plans Group Sizes 2 or More PPO Dental Plan Summary - National Available in AZ, CA, DC, FL, IL, IN, MD, MI, MO, NE, NV, OH, TX AND PA. Texas reimbursement is based on Maximum Allowable Charge (MAC) only. Out-of- for Texas is paid as In-. MAC is available in AZ, CA, NV and TX only. UCR is available in all states except Texas. Plan Design Benefits Calendar Year Maximum Calendar Year Deductible (3 per family max) Class I: Preventive Services Routine oral exam, cleanings, fluoride treatment for children, bitewing x-rays, panoramic/full mouth x-rays, sealants Class II: Basic Services Fillings (amalgam, porcelain & plastic), anterior & posterior composites, anesthesia (general or IV sedation), emergency palliative treatment, space maintainers for children, limited oral exam, pathology, oral surgery Class III: Major Services Crowns & gold fillings, inlays, onlays and pontics, fixed bridges, implants, complete and partial dentures Endodontics Periodontics Waiting Periods Special Dental Accident Benefit Out-of- Reimbursement In- PPO Dental High Plan Mid Plan Basic Plan Value Plan Out-of- (Does not apply to TX) In- Out-of- (Does not apply to TX) In- Out-of- (Does not apply to TX) In- Out-of- (Does not apply to TX) $2,500 $2,000 $2,000 $1,500 $1,500 $1,500 $1,500 $1,500 $2,000 $1,500 $1,500 $1,000 $1,000 $1,000 $1,000 $1,000 $1,500 $1,000 $1,000 $1,000 $500 $500 $500 $500 $1,000 $1,000 $0, $25, $50, $75 or $100 (Waived on Preventive Services.) 100% 100% 100% 80% 100% 80% 100% 80% 90% 80% 80% 80% 80% 50% 50% 20% 60% 50% 50% 50% 0% 0% 0% 0% 12 month waiting period applies to major and orthodontic services (Waived for qualifying groups.) Class II or Class III Class II or Class III None $1,000 maximum per accident to sound, natural teeth UCR at 80th or 90th Percentile or MAC (MAC available in Arizona, California and Nevada. Texas is MAC only and is paid as in-network.) Orthodontics (optional) 50% Child Only Orthodontic Benefit Option (Dependent children through age 18) Adult/Child Orthodontia Benefit Option Child Good Vision Benefit (Included with orthodontia) $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum $1,000 Lifetime / $500 Calendar Year Maximum Covers 50% of UCR for an eye exam once every 12 months for children through 18 Not offered Child Orthodontia is available for groups with 5 or more employees enrolling. Adult Orthodontia is available for employer-sponsored groups with 25 or more employees enrolling

5 IndemnityPlus Dental Plan Summary - National Available in AK, AL, AR, AZ, CA, CO, DC, FL, GA, HI, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, VA, WA and WY. MAC is available in AZ, CA and NV. Plan Design Calendar Year Maximum Calendar Year Deductible (3 per family max) IndemnityPlus Benefits High Plan Mid Plan Basic Plan Value Plan $2,500 $2,000 $1,500 $1,500 $2,000 $1,500 $1,000 $1,000 $1,500 $1,200 $500 $500 $1,000 $1,000 $0, $25, $50, $75 or $100 (Waived on Preventive Services.) Class I: Preventive Services Routine oral exam, cleanings, fluoride treatment for children, bitewing x-rays, panoramic/full mouth x-rays, sealants Class II: Basic Services Fillings (amalgam, porcelain & plastic), anterior & posterior composites, anesthesia (general or IV sedation), emergency palliative treatment, space maintainers for children, limited oral exam, pathology, oral surgery Class III: Major Services Crowns & gold fillings, inlays, onlays and pontics, fixed bridges, implants, complete and partial dentures Endodontics Periodontics Waiting Periods Special Dental Accident Benefit Out-of- Reimbursement 100% 100% 100% 100% 90% 80% 80% 50% 60% 50% 0% 0% 12 month waiting period applies to major and orthodontic services (Waived for qualifying groups.) Class II or Class III Class II or Class III None $1,000 maximum per accident to sound, natural teeth UCR at 80th or 90th Percentile or MAC (MAC available in Arizona, California and Nevada) Orthodontics (optional) 50% Child Only Orthodontic Benefit Option (Dependent children through age 18) Adult/Child Orthodontia Benefit Option Child Good Vision Benefit (Included with orthodontia) $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum $1,000 Lifetime / $500 Calendar Year Maximum Covers 50% of UCR for an eye exam once every 12 months for children through 18 Not offered Child Orthodontia is available for groups with 5 or more employees enrolling. Adult Orthodontia is available for employer-sponsored groups with 25 or more employees enrolling

6 PPO Dental Plan Summary - Utah Available in UT only. Plan Design Benefits Dental PPO Plans Premium Plan Classic Plan Basic Plan Value Plan In- Out-of- In- Out-of- In- Out-of- In- Out-of- $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 $1,500 Calendar Year Maximum Individual Calendar Year Deductible (3 per family max) Lifetime Deductible Option Class I: Preventive Services - Routine oral exam, cleanings, fluoride treatment for children, bitewing x-rays, panoramic/full mouth x-rays, sealants Class II: Basic Services - Fillings (amalgam, porcelain & plastic), anterior & posterior composites, anesthesia (general or IV sedation), emergency palliative treatment, space maintainers for children, limited oral exam, pathology, oral surgery Class III: Major Services - Crowns & gold fillings, inlays, onlays & pontics, fixed bridges, implants, complete & partial dentures Oral Surgery Endodontics $1,500 $1,000 $1,500 $1,000 $1,000 $1,000 $1,000 $1,000 $1,000 $1,000 $1,000 $1,000 $500 $500 $500 $500 $0, $25, $50, $75 or $100 (Waived on Preventive Services.) $100 Lifetime Deductible in lieu of a Calendar Year Deductible 100% 100% 100% 80% 100% 80% 100% 80% 90% 80% 80% 60% 80% 50% 50% 20% 60% 50% 50% 50% 0% 0% 0% 0% Class II or Class III Class II or Class III Periodontics Waiting Periods 12 month waiting period applies to major and orthodontic services (Waived for qualifying groups.) Class II or Class III None Special Dental Accident Benefit Out-of- Reimbursement $1,000 maximum per accident to sound, natural teeth UCR at 80th, 90th Percentile or MAC Orthodontics (optional) 50% Child Only Orthodontic Benefit Option (Dependent children through age 18) Adult/Child Orthodontia Benefit Option Child Good Vision Benefit (Included with orthodontia) $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum Covers 50% of UCR for an eye exam once every 12 months for children through 18 Not offered Child Orthodontia is available for groups with 5 or more employees enrolling. Adult Orthodontia is available for employer-contributory groups with 25 or more employees enrolling

7 IndemnityPlus Dental Plan Summary - Utah Available in UT only. Plan Design Dental Indemnity Plans Benefits Premium Plan Classic Plan Basic Plan Value Plan $1,500 $1,500 $1,500 $1,500 Calendar Year Maximum Individual Calendar Year Deductible (3 per family max) Lifetime Deductible Option Class I: Preventive Services - Routine oral exam, cleanings, fluoride treatment for children, bitewing x-rays, panoramic/full mouth x-rays, sealants Class II: Basic Services - Fillings (amalgam, porcelain & plastic), anterior & posterior composites, anesthesia (general or IV sedation), emergency palliative treatment, space maintainers for children, limited oral exam, pathology, oral surgery Class III: Major Services - Crowns & gold fillings, inlays, onlays & pontics, fixed bridges, implants, complete & partial dentures $1,000 $1,000 $1,000 $1,000 $500 $500 $0, $25, $50, $75 or $100 (Waived on Preventive Services.) $100 Lifetime Deductible in lieu of a Calendar Year Deductible 100% 100% 100% 100% 90% 80% 80% 50% 60% 50% 0% 0% Oral Surgery Endodontics Periodontics Waiting Periods 12 month waiting period applies to major and orthodontic services (Waived for qualifying groups.) Class II or Class III Class II or Class III Class II or Class III None Special Dental Accident Benefit Out-of- Reimbursement $1,000 maximum per accident to sound, natural teeth UCR at 80th, 90th Percentile or MAC Orthodontics (optional) 50% Child Only Orthodontic Benefit Option (Dependent children through age 18) Adult/Child Orthodontia Benefit Option Child Good Vision Benefit (Included with orthodontia) $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum $1,000 Lifetime / $500 Calendar Year Maximum or $1,500 Lifetime / $750 Calendar Year Maximum Covers 50% of UCR for an eye exam once every 12 months for children through 18 Not offered Child Orthodontia is available for groups with 5 or more employees enrolling. Adult Orthodontia is available for employer-contributory groups with 25 or more employees enrolling

8 Dental s The BEST Life dental plans offer access to national and regional PPO networks. States of Coverage Products/Plans DenteMax National PPO & Indemnity Diversified Dental Services (DDS) First Dental Health (FDH) Maverest Dental Alliance Total Dental Administrators (TDA) CONNECTION Dental * available for PPO plans only. The Fine Print NV CA IN AZ*, UT D.C., FL, MD, MO, NE, PA & TX Employee Effective Date An employee s coverage will take effect: PPO & Indemnity PPO & Indemnity PPO & Indemnity PPO & Indemnity PPO Plans Only On the date the group s coverage takes effect if the employee s enrollment card is received within 31 days of that date and if there are no waiting periods to satisfy. On the first day of the calendar month following the date the waiting period is met. The employee s enrollment card must be received within 31 days after satisfying the waiting period. If an employee is not working full-time on the date he or she would otherwise become covered, the employee will not be eligible for coverage until he or she returns to active work. New employee hires can join the plan the first of the month after the date of hire, if elected by the employer on the employer application. Dependent Eligibility Eligible dependents include spouse and dependent children. The definition of dependent may vary by state. Refer to the certificate of insurance or your sales representative for details. Dependent Effective Date An eligible dependent s insurance will take effect on the later of the following: Usual, Customary and Reasonable Claims payments are based on the usual, customary and reasonable (UCR) charge for covered dental services and supplies. UCR is determined by the fee commonly charged specifically for the severity and nature of the treatment within the dentist s particular geographic area. In-network claims are paid by the UCR fees listed in the preferred provider fee schedule. Out-of-network claims payments are based either on the UCR or on a fee level that is within the same range of fees customarily charged for the services or supplies in the geographic area concerned. Maximum Allowable Charge (MAC) On plans with the MAC option, bases claims payments are based on the fees listed in the preferred provider fee schedule, or on a set fee level based on what is customarily charged for dental services or supplies in the geographic area. For in-network claims, preferred providers have agreed to accept payment based on the preferred provider fee schedule as payment in full. Any amounts over the maximum allowable charge (MAC) for out-of-network claims will be the responsibility of the patient. Advance Notice of Dental Treatment Any course of treatment a provider estimates to be in excess of $500 must be reported to the company for predetermination prior to the treatment being rendered. A predetermination is an estimate of how benefits will be processed. Extension of Dental Benefits We will continue to pay dental benefits for 30 days following the termination date of the employee or dependent coverage if the expenses incurred would have been eligible for payment had coverage remained in effect; and (1) the impression for a prosthetic device or modification had been taken before termination and delivered and installed within 30 days following the termination of coverage; or (2) in the treatment of root canal therapy, where the pulp chamber was opened before termination. Termination of Coverage Employee and dependent coverage will terminate on the earliest of the following events: 1. The last day of the month in which active employment ceases, unless the employee is on leave of absence, temporary layoff or total disability and the employer decides to continue paying for coverage. 2. The last day of the month in which the employee and/or dependent ceases to be eligible for insurance. 3. The date the employer ceases to be a participating employer. 4. The day before the due date of any premium that remains unpaid at the end of the grace period. 5. The date the policy terminates. 6. The date the number of insured employees of a participating employer falls below two. If an eligible employee enrolls their eligible dependents at the time of the employee s initial enrollment, then the dependent effective date is the same as the employee s effective date. If after the eligible employee s initial enrollment, the employee acquires an eligible dependent, then the acquired dependent effective date is the first day of the calendar month following the dependent enrollment date provided the enrollment is made within 31 days of the dependent initial eligibility date. Late Entrants To The Plan If an employee or dependent enrolls for coverage 31 days or more after becoming eligible, he or she will be considered a late entrant and only eligible for: Preventive services during the first 12 months of continuous coverage. Preventive services and 50% of Basic services not to exceed a maximum of $500 during the second 12 months of continuous coverage. Major services when the employee or dependent is no longer a late entrant

9 Exclusions No payments will be made for and covered dental expenses do not include: 1. Treatment by someone other than a doctor of medical dentistry or a doctor of dental surgery, except where performed by a licensed hygienist under the direction of a doctor of medical dentistry or a doctor of dental surgery. 2. Expenses incurred while on active duty with any military, naval or air force of any country or international organization. 3. An appliance used to repair or replace missing teeth, or modification of an appliance, where an impression was made before the patient was covered; a crown, bridge or other lab fabricated restorations for which the tooth was prepared before the patient was covered; root canal therapy if the pulp chamber was opened before the patient was covered. 4. Pulp capping, if in conjunction with the installation of inlays, onlays or crowns, fillings or other lab fabricated restorations; including but not limited to inlays, onlays and crowns, preventative tests and examinations diagnostic casts and oral cancer screenings, and expenses incurred for sedative fillings, including charges for prescribed drugs, pre medication or analgesia. 5. Replacement of a lost or stolen or discarded prosthetic device. 6. Dental services and supplies which are given primarily for cosmetic reasons including alteration or extraction of functional natural teeth for the purpose of changing appearance and replacement of restorations previously performed for cosmetic reasons. 7. The initial installation of a prosthetic device (a fixed bridge, implant, or denture), including crowns and inlays which form abutments, to replace teeth missing before coverage under the policy, except when it also replaces a tooth that is extracted while covered unless such installation commences after remained continuously covered under this plan for at least three years immediately prior to the date such installation commences. 8. Expenses incurred for orthodontic treatment and orthodontia type procedures unless such procedures are covered under an orthodontic rider. 9. Expenses incurred as a result of participating in a riot or insurrection or the commission of a felony. 10. Charges in excess of usual, reasonable and customary charges or in excess of the calendar year maximum amount stated in the schedule of dental benefits section of this plan, or in excess of the preferred provider fee schedule. 11. Services and supplies not reasonably necessary, or not otherwise specifically listed as an eligible expense. 12. Charges for service provided for temporomandibular joint dysfunction (TMJ), expenses incurred for congenital or developmental malformations. 13. Services and supplies covered under any workers compensation act or similar law, expenses incurred due to treatment rendered by the employer. 14. Services and supplies performed outside of the U.S. 15. Implants, implant services and implant supported prosthetics are not covered for patients under the age of Any services or supplies for correction or alteration of occlusion, or any occlusal adjustments, expenses incurred for night guards or any other appliances for the correction of harmful habits. 17. Expenses for safe fees (gloves, masks, surgical scrubs and sterilization). 18. Expenses incurred due to treatment rendered by a family member. For the purpose of this limitation, family member includes, but is not limited to, the insured s lawful spouse, child, parent, step-parent, grandparent, brother, sister, cousin or in-law. 19. Expenses for services for which the insured would not legally have to pay if there were no insurance. 20. Services not completed on or before the date of termination must be completed within 30-days of the termination date, unless such services are covered under the extension of dental benefits. 21. If the insured or any dependents transfer from the care of one dentist to another dentist during the course of treatment, or if more than one dentist renders services for one dental procedure, the amount liable is only for the amount it would have been had one dentist rendered the services. 22. Expenses that are applied toward satisfaction of a deductible, if any. 23. For all procedures that are begun prior to your effective date but not completed. 24. Adjustment, repairs or relines of prostheses for a period of one year from initial placement if the prostheses were paid for under this plan. 25. If multiple endodontic treatments are necessary on the same tooth within a period of one year, the allowance will be made for only one procedure. 26. The extraction of immature erupting third molars and non-pathologic, asymptomatic third molar extractions. 27. Expenses for gross debridement allowed one time at the beginning of the periodontal treatment plan prior to pocket depth charting. 28. Surgical procedures incidental to orthodontic treatment, including but not limited to, extraction of teeth solely for orthodontic reasons, exposure of impacted teeth, correction of micrognathia or macrognathia or repair of cleft palate. 29. Any service or procedure not commonly found within the scope of practice by a licensed dentist. Such procedures are identified within the current CDT codes. 30. Temporary services are considered an integral part of the final services rather than a separate service and are therefore not eligible for benefits. 31. X-rays are considered an integral part of the endodontic procedure rather than a separate service and are therefore not eligible for benefits. 32. Expenses incurred for a core buildup will only be considered in conjunction with a crown. 33. Chemotherapeutic agents and any other experimental procedures. 34. Expenses incurred for veneers and related procedures

10 HDHP Medical Plans Group Sizes 2-50 HSA-Compatible High Deductible Health Plan Summary Available in AZ, GA, ID, IL, IN, MO, MT, NV, OH, OK, TN, TX and UT. In- Out-of- Preventive Office Visits (includes annual routine physical exam, screenings and immunizations, prostate and colorectal cancer screening/ 100% 100% testing, flu shot, pap smear and mammogram) Baby/Child Wellness Visits (includes exams, screenings, immunizations and vaccinations, lab and X-ray through age 17) 100% 100% Physician Office Visit - Professional Fee (includes Lab and X-ray when performed by Physician on the same day of visit) Deductible, then Coinsurance Deductible, then Coinsurance Physician Office Visit, Other than Professional Fee Deductible, then Coinsurance Deductible, then Coinsurance Lab and X-ray Services Deductible, then Coinsurance Deductible, then Coinsurance Emergency Ambulance Services Deductible, then Coinsurance Deductible, then Coinsurance Hospital Charges Deductible, then Coinsurance Deductible, then Coinsurance Emergency Room Deductible, then Coinsurance Deductible, then In-network Coinsurance Urgent Care (facility or clinic) Deductible, then Coinsurance Deductible, then Coinsurance Outpatient Surgery (facility or hospital) Deductible, then Coinsurance Deductible, then Coinsurance CVS Caremark Prescription Coverage Deductible, then Coinsurance Deductible, then Coinsurance These services are subject to change upon notification of the United States Department of Health and Human Services. Our high deductible health plans are HSA-compatible. Contributions to an HSA are tax deductible and employer contributions are not counted as taxable income. Account withdrawals also are not taxed when used for qualifying medical expenses. Meanwhile, the money remaining in the account at the end of the year belongs to the member and is rolled over to the next year. Even if the member changes jobs, the account stays with that individual. Check current HSA limits at Individual Calendar Year Deductible (2 member family max) Health Solutions - High Deductible Health Plans $2,500 $3,000 $4,000 $5,000 Family Deductible Aggregate Aggregate Coinsurance Levels and Out-of- Pocket Maximum 1 (2 member family max) Prescription Coverage Coinsurance Individual Out-of- Pocket Max Coinsurance 100% In / 80% Out $0 In / $2K Out 100% In / 80% Out 90% In / 70% Out $500 In / $3K Out 90% In / 70% Out 80% In / 60% Out $1K In / $4K Out Discount Card, costs will be applied to deductible, then coinsurance Individual Out-of- Pocket Max $0 In / $2K Out $500 In / $3K Out Maternity As any other illness or sickness (optional for groups of 2-14; mandatory for groups with 15+ may vary by state) q Yes q No 1 Deductible does not apply to out-of-pocket maximum

11 The Fine Print Business Eligibility Applications from all industries will be reviewed for eligibility. Some businesses or industries may be subject to special rates, based on the hazards associated with certain industries. Any special rates applied because of industry or health conditions are applied in accordance with the small group laws of your state. For specific details, please refer to the medical underwriting guidelines. Employee Eligibility Eligible employees are defined as: Full-time. Active employees working at least 30 hours a week (may vary by state). Who are paid a salary or earnings from which federal, state and Social Security taxes are withheld (may vary by state). Partners and owners working 30 hours a week or more are also eligible for coverage (may vary by state). There must be an employer-employee relationship in a bona-fide, full-time business pursuit individuals are not eligible unless permitted by the state. States permitting 1099 individuals include ID, IL, MO, NV, TN, TX and UT. Dependent Eligibility Eligible dependents include spouses and dependent children. Dependent children are eligible for coverage until they reach 26, which may be extended under certain circumstances according to your state law. The definition of dependent may vary by state. Refer to the certificate of insurance or your sales representative for details. Out-of- Charges Covered expenses incurred for out-of-network services where in-network or wraparound network benefits do not apply are limited to: the limited fee schedule, or if no schedule exists for the services, the average cost of service based on the RBRVS. Benefit payables are subject to the plan deductibles and coinsurance percentages. The covered person is responsible for any uncovered out-of-pocket expenses. Review Program The following covered services will require a review before a member receives them: All inpatient admissions. Emergency admissions. Must obtain review within 24 hours, or as soon as possible, after the admission. Non-emergency inpatient admissions. Must obtain review at least 5 days before the admission date. Extended stay review for continued stays after a review is obtained for an inpatient admission and member is admitted as an inpatient. Must obtain review before original admission period expires. For any outpatient surgery procedures, MRIs, CAT scans, PET Scans, nuclear imaging and transplants. Must obtain review at least 5 days prior to scheduled procedure. For any outpatient procedures requiring review. Must obtain review at least 5 days prior to scheduled procedure. Failure to obtain a required review for a procedure could result in a reduction of benefits and additional financial responsibility to the member. Pre-existing Conditions A pre-existing condition is a condition, other than pregnancy, for which a provider recommended or provided medical advice, diagnosis, care or treatment within the six month period prior to the effective date. Expenses incurred for pre-existing conditions are not considered eligible until coverage has been in effect for 12 consecutive months or 18 months for a late enrollee. The pre-existing condition exclusion period will be reduced by the number of days under credible coverage without a 63-day break, immediately prior to their effective date. The period of continuous coverage shall not include any waiting period. The exclusionary time periods, prior treatment periods, time periods between prior coverage and new coverage, and credit for qualifying prior coverage may vary according to the applicable laws of the employer s state. Exclusions The following is a summary list of services and supplies that are not generally covered. Please note that the certificate of insurance may contain exceptions to this list based on state mandates or the plan design purchased and should be consulted. Unless provided by endorsement or specifically included as a covered service, the following are not covered: Acupuncture, unless used in lieu of anesthesia. Administration of drugs. An injury or illness that occurs in the course of or during participation in a criminal activity or riot, or that is self-inflicted, including attempted suicide. Breast reduction. Chelation therapy services or supplies. Complications arising out of services or supplies or injuries or illnesses not covered. Cosmetic services or supplies. Court order services or supplies. Dental care. Durable medical equipment charges not specifically named as a covered service. Eligible expenses in excess of Medicare RBRVS fee schedule or usual and customary. Employer provided services or supplies. Injury or illness arising out of employment for wage or profit, or service or supply required as a prerequisite to or as a part of employment. Expenses where payment is not required, due to coverage by other insurance, except Medicaid, or which would not have been billed if no insurance coverage were in place. Expenses incurred before the effective date of coverage under the Policy or after coverage under the Policy terminates, regardless of the date of the injury or illness. Experimental or investigational services or supplies. Foot care services in connection with corns, calluses, fallen arches, weak feet, foot strain, symptomatic foot complaints or other foot care, including orthopedic, orthoses, shoe or orthotics. Government facility services or supplies, unless there is a legal obligation to pay. Growth hormones. Services or supplies provided in preparation of or for a gender change. Hearing impairment or loss. Hospital admission room and board charges for diagnostic or evaluation procedures. Infertility services, including impotence, erectile dysfunction and fertilization. Services or supplies provided by a member of the employee s family or a person residing in the employee s residence. Injury or illness that occurs during active service in any armed forces or auxiliary units. Injuries or Illnesses arising out of any war, declared or undeclared, or act of war or terrorism. Learning disability or impairment services. Non-covered services. Non-covered expenses for transportation. Non-medically necessary services or supplies. Over the counter supplies, except diabetic supplies. Services or supplies for the care of a pre-existing condition. Private duty nursing services, except for covered home health care services. Reversal of sterilization. Unbundled charges. Uvulopalatopharyngoplasty. Veterans Administration hospital services or supplies for armed service connected disabilities. Vision impairment or loss services or supplies. Treatment for addiction to tobacco, alcohol, drugs or any addictive substances

12 Vision PPO and Indemnity Plans Group Sizes 5 or More Vision PPO Plan Summary Available in AK, AL, AR, AZ, CA, CO, DC, FL, GA, HI, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT VA, WA and WY. Option 1 In- Out-of- Annual Eye Exam $10 copay Up to $42 Fit and Follow-up Exams Covered in full Up to $40 Frames Lenses $130 allowance, 20% off amount over allowance Up to $65 Single $10 copay Up to $35 Bifocal $10 copay Up to $40 Trifocal $10 copay Up to $65 Progressive $75 copay Up to $40 Premium Progressive Contacts Elective - Conventional $75 copay, $120 allowance, 20% off amount over allowance $130 allowance, 15% off amount over allowance Up to $40 Up to $104 Elective - Disposable $130 allowance Up to $104 Medically Necessary Covered in full Up to $200 Lens Options UV Coating $15 copay No benefit Tine - Solid and Gradient $15 copay No benefit Scratch-resistant $15 copay No benefit Polycarbonate $40 copay No benefit Anti-reflective $45 copay No benefit Other add-ons and services Frequencies in Months 20% off amount No benefit Lenses or Contacts 12 Frames 12 or 24 Lenses or Contacts 12 Frames 12 or 24 Option 2 In- Out-of- Annual Eye Exam $10 copay Up to $42 Fit and Follow-up Exams Up to $55 copay No benefit Frames Lenses $130 allowance, 20% off amount over allowance Up to $65 Single $25 copay Up to $35 Bifocal $25 copay Up to $40 Trifocal $25 copay Up to $65 Progressive $90 copay Up to $40 Premium Progressive Contacts Elective - Conventional $90 copay, $120 allowance, 20% off amount over allowance $130 allowance, 15% off amount over allowance Up to $40 Up to $104 Elective - Disposable $130 allowance Up to $104 Medically Necessary Covered in full Up to $200 Lens Options UV Coating $15 copay No benefit Tine - Solid and Gradient $15 copay No benefit Scratch-resistant $15 copay No benefit Polycarbonate $40 copay No benefit Anti-reflective $45 copay No benefit Other add-ons and services Frequencies in Months 20% off amount No benefit Lenses or Contacts 12 Frames 12 or 24 Lenses or Contacts 12 Frames 12 or 24 Vision Indemnity Plan Summary Available in AK, AL, AR, AZ, CA, CO, DC, FL, GA, HI, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT VA, WA and WY. Option 1 Plan Benefit Frequency Options A B C D Yearly Deductible Options $0, $10 or $25 Annual Eye Exam $60 Allowance Frames $80 Allowance Lenses Single $35 Allowance Bifocal $55 Allowance Trifocal $65 Allowance Contacts Elective $125 Allowance Medically Necessary $200 Allowance Option 2 Plan Benefit Frequency Options A B C D Yearly Deductible Options $0, $10 or $25 Annual Eye Exam $60 Allowance Frames $100 Allowance Lenses Single $45 Allowance Bifocal $65 Allowance Trifocal $75 Allowance Contacts Elective $125 Allowance Medically Necessary $200 Allowance

13 Option 3 Plan Benefit Yearly Deductible Options $0, $10 or $25 Frequency Options A B C D Annual Eye Exam $60 Allowance Frames $115 Allowance Lenses EyeMed Discount EyeMed Vision Care discount program includes discounts off of exams, eyeglasses, progressive lenses, UV coating, tints, polycarbonates, contacts and laser vision correction. QualSight LASIK Members are automatically eligible to access the QualSight LASIK network for discounts of 40-50% off the national average charge for laser eye surgery. Single Bifocal Trifocal Contacts Option 3 In- $55 Allowance $75 Allowance $85 Allowance Out-of- Annual Eye Exam $10 copay Up to $42 Fit and Follow-up Exams Up to $55 copay No benefit Frames Lenses $100 allowance, 20% off amount over allowance Up to $50 Single $25 copay Up to $35 Bifocal $25 copay Up to $40 Trifocal $25 copay Up to $65 Progressive $90 copay Up to $40 Premium Progressive Contacts Elective - Conventional $90 copay, $120 allowance, 20% off amount over allowance $115 allowance, 15% off amount over allowance Up to $40 Up to $92 Elective - Disposable $115 allowance Up to $92 Medically Necessary Covered in full Up to $200 Lens Options UV Coating $15 copay No benefit Tine - Solid and Gradient $15 copay No benefit Scratch-resistant $15 copay No benefit Polycarbonate $40 copay No benefit Anti-reflective $45 copay No benefit Other add-ons and services Frequencies in Months 20% off amount No benefit Lenses or Contacts 12 Frames 12 or 24 Lenses or Contacts 12 Frames 12 or Elective $125 Allowance Medically Necessary $200 Allowance The Fine Print Employee Eligibility Eligibility is based on, but not limited to the following: There must be an employee-employer relationship. A central office and a regular place of business where the maintenance of payroll and insurance is performed. All eligible employees must be full-time and working at least 30 hours per week. The following employees are generally not eligible: Part-time, seasonal, retired or pensioned employees, leased, consultants, employees covered under collective bargaining agreements and employees who are paid as 1099 employees. Directors or stockholders who do not work full-time or at least 30 hours per week in the business. Employee Effective Date Insurance will take effect on the later of: The date the employer group becomes effective if initial enrollment cards are received within 31 days of this date. The first day of the next calendar month following the date a full-time employee completes the waiting period as elected by the employer an enrollment card must be received within 31 days of this day. The first of the month after the date of hire, if this option is elected by the employer on the master application. Dependent Eligibility Eligible dependents include spouse and dependent children. The definition of dependent may vary by state. Refer to the certificate of insurance or your sales representative for details. Dependent Effective Date Dependent insurance will take effect on the later of: The date the insurance is effective if the enrollment card is received within 31 days of that date. The first day of the next calendar month following the date the employee enrolled his or her dependents, provided the enrollment is made within 31 days of the dependents first becoming eligible (must be provided in writing). Late Entrants to the Plan If an employee or a dependent enrolls for coverage 31 days or more after becoming eligible, he or she will be considered a late entrant and eligible for no more than $75 of vision care benefits during the first 12 months of continuous coverage. Coordination of Benefits Benefits will be coordinated with the benefits of any other group vision plan to which the individual is entitled. Termination of Coverage Employee and dependent coverage will terminate on the earliest of the following events: 1. The last day of the month in which active employment ceases, unless the employee is on leave of absence, temporary layoff or total disability and the employer decides to continue paying for coverage. 2. The last day of the month in which the employee and/or dependent ceases to be eligible for insurance. 3. The date the employer ceases to be a Participating Employer. 4. The day before the due date of any premium that remains unpaid at the end of the grace period. 5. The date the policy terminates. 6. The date the number of insured employees of a Participating Employer falls below five

14 Underwriting Information Participation Requirements On groups where the employer pays 100% of the employee and/or dependent premiums, 100% of all employees/dependents must participate. (Waived if other lines of coverage are purchased.) Employer-sponsored: For 5 or more lives, 60% participation of eligible employees for employees with other group vision coverage, a refusal card must be completed. These employees will not be counted toward the participation requirement. Voluntary: For 5 or more lives, 20% participation of eligible employees Contribution Requirements Employer-sponsored: 50% and above for EEs and 0% and above for Dependents Voluntary: Less than 50% of EE premium Underwriting Rights Reserved The insurance company reserves the right to require additional information before acting on an individual s or group s request for coverage. The insurance company reserves the right to decline any particular case or applicant regardless of size. Approval of all enrollment and employee eligibility requirements must be met before insurance can be put in force. Access Vision Exclusions To be entitled to benefits for lenses and visual analysis, lenses must be prescribed and visual analysis must be performed by a legally qualified ophthalmologist or legally qualified optometrist. No payments will be made for and covered vision expenses do not include: Services for which no charge is made or for which the insured is not required to pay, or any eye examination furnished by or paid for by any government. This includes glasses or frames for which the individual has been reimbursed under any group hospitalization or medical reimbursement insurance plan. Charges due to occupational accidents or sickness covered by workers compensation. Cosmetic lens enhancements such as tints, UV coating, scratch coating or anti-reflective coating. Safety glasses or goggles. Services performed by an optometrist or ophthalmologist beyond the scope of their applicable licenses. Services incurred as a result of sickness or injury. Special procedures such as orthoptics, vision training or subnormal vision aids. Plain or prescription sunglasses or other special purpose vision aids. Medical or surgical treatment of eyes. Replacement of lost or broken frames and lenses. Duplicate glasses or frames. Services or materials not specifically listed in the schedule of vision care benefits. Care (including prescribed medication) that would be deemed an eligible expense under major medical or other insurance programs, including workers compensation. Any service performed prior to the effective date or after the coverage termination date. Services not recommended by a provider or which are not required for necessary care and treatment; or which do not have uniform professional endorsement. Services performed by a member of the patient s immediate family, or a person who resides in the patient s home. Charges for failure to keep a scheduled appointment or for completion of claim forms. Vision PPO Exclusions To be entitled to benefits for lenses and visual analysis, lenses must be prescribed and visual analysis must be performed by a legally qualified ophthalmologist, optometrist or physician acting within the scope of his or her license. No benefit shall be payable except as otherwise provided herein or on account of: 1. Services for which no charge is made or for which the insured is not required to pay or any eye examination furnished by or paid under or for any government, federal or state, dominion or provincial, or any political subdivisions thereof, or any glasses or frames for which the insured has been or may be reimbursed under any group hospitalization or medical expense reimbursement insurance plan, to the extent of any such payment or reimbursement. 2. Charges for services due to occupational accidents or sickness covered by workers compensation. 3. More than one pair of lenses, frames, contact lenses or examination per person per benefit period. 4. Cosmetic lens enhancements such as tints, ultraviolet coating, scratch coating or anti-reflection coating. 5. Safety glasses or goggles. 6. Services performed by an optometrist, ophthalmologist or physician beyond the scope of their applicable licenses. 7. Services incurred as a result of sickness or injury. 8. Special procedures such as orthoptics, vision training or subnormal vision aids. 9. Plain or prescription sunglasses or other special purpose vision aids. 10. Medical or surgical treatment of eyes. 11. Replacement of lost or broken lenses and/or frames. 12. Duplicate glasses or frames. 13. Services or materials not specifically listed in the schedule of vision benefits. 14. Care, including prescribed medications, that would be deemed an eligible expense under major medical or other insurance program. 15. Any services performed prior to the effective date, or after the coverage termination date. 16. Services not recommended by a provider or which are not required for necessary care and treatment, or which do not have uniform professional endorsement. 17. Services performed by a member of the patient s immediate family, or a person who resides in the patient s home. 18. Charges for failure to keep a scheduled appointment, or for completion of claim forms. 19. Orthoptic or vision training, subnormal vision aids and any associated supplemental testing. 20. Aniseikonic lenses. 21. Medical and/or surgical treatment of the eye, eyes or supporting structure. 22. Non-prescription lenses and non-prescription sunglasses. 23. Two pair of glasses in lieu of bifocals. 24. Comprehensive eye exams not performed by either an optometrist, ophthalmologist or a physician acting within the scope of his or her license. 25. Lenses that are not prescribed by either an optometrist, ophthalmogist or physician acting within the scope of his or her license

15 Group Term Life Plans Group Sizes 2 or More Group Term Life Plan Summary Available in AK, AL, AR, AZ, CA, CO, DC, FL, GA, HI, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WA and WY. BEST Life Gold (Employer-contributory) BEST Life Silver (Voluntary) BEST Life Bronze (Employer-contributory) Employer Contribution 25% minimum Not applicable 25% minimum Basic Life Schedules Flat schedules up to $100,000 Class Schedules Salaried Schedules Additional amounts available with Evidence of Insurability 2-9: $10,000 or $15, : Increments of $10,000 to $500,000, not to exceed 5 times employee salary Additional amounts available with Evidence of Insurability $10,000, $15,000, $20,000 or $25,000 Guarantee Issue Upwards of $75,000, based on participation and group size 2-9: $15, : Upwards of $75,000 based on participation and group size 2-4: $15, : $25,000 Participation Non-contributory: 100% Contributory: 75% minimum Not Applicable Non-contributory: 100% Contributory: 75% minimum Plan Features Waiver of Premium Provision to Age 60 Accelerated Death Benefit 75% to $250,000 max Conversion Waiver of Premium Provision to Age 60 Accelerated Death Benefit 75% to $250,000 max Conversion Waiver of Premium Provision to Age 60 Conversion Age Reductions (From original amount) 65-35% 70-50% 75-65% 80-80% 85-90% 65-35% 70-50% 75-65% 80-80% 85-90% 65-35% 70-50% 75-65% 80-80% 85-90% Dependent Basic Life Coverage Spouse: $5,000 or $10,000 Children ages 6 months to 25: increments of $1,000 up to $5,000 Children 14 days to 6 months: $1,000 Spouse: increments of $5,000, up to $10,000 or 50% of employee coverage, not to exceed $50,000 Children ages 6 months to 25: increments of $1,000 up to $5,000 Children 14 days to 6 months: $1,000 Spouse: $10,000 Children ages 6 months to 25: increments of $1,000 up to $5,000 Children 14 days to 6 months: $1,000 AD&D Option (For employees only) Includes Seat Belt & Air Bag Benefit Available on basic and supplemental Includes Seat Belt & Air Bag Benefit Available on basic and supplemental Available on basic and supplemental Accelerated Death Benefit Allows up to 75% or a maximum of $250,000 of life insurance benefits to be paid prior to the death of the participant. Available for 10+ only Supplemental / Voluntary Life for employee and dependents Other Options The following available to groups of 50+ only: Critical Illness Cancer Care Supplemental / Voluntary Life for employee and dependents Supplemental / Voluntary Life for employee and dependents Day Care Benefit Repatriation of Remains Benefit Exposure and Disappearance Disclaimer: Life insurance applications submitted in conjunction with a BEST Life medical plan application are subject to evidence of insurability

16 The Fine Print Employee Effective Date Insurance coverage will take effect on the later of: The date the employer becomes a participating employer if the employee s enrollment card is received within 31 days after that date. The first day of the next calendar month following the date the waiting period elected by the participating employer is completed. The employee s enrollment card must be received within 31 days after satisfying the waiting period. If an employee is not working full-time for the firm on the date he or she would otherwise become covered, the employee will not be covered until he or she returns to full-time work. The first day of the next calendar month following the date evidence of insurability is approved, if required. Evidence of insurability will be required if the enrollment card is received more than 31 days after first becoming eligible or if applying for Supplemental Life Insurance coverage. Dependent Coverage Eligible dependents include spouse and unmarried dependent children. Dependent children are covered until age 20, extended through age 25 if they are full-time students. The definition of dependent may vary by state. Refer to the certificate of insurance or your sales representative for details. Dependent Effective Date Dependent coverage will take effect on the later of: The date the employee s insurance is effective if the enrollment card is received within 31 days after that date. The first day of the next calendar year month following the date the employee enrolled, in writing, his or her dependents for insurance, provided the enrollment is made within 31 days of the dependents first becoming eligible. The first of the month following the date the dependent evidence of insurability is approved, if required. Evidence of insurability will be required if the dependent enrollment card is received more than 31 days after first becoming eligible. Late Entrants To The Plan If an employee or dependent enrolls for coverage 31 days or more after becoming eligible, he or she will be considered a late entrant. The employee or dependent must complete and submit evidence of insurability. Termination of Coverage Group Term Life benefits will terminate on the earliest of the following dates: The last day of the month in which the employee ceases active employment, unless the employee is on leave of absence, temporary layoff, injured or sick. The employer may continue insurance by paying the required premiums, but not beyond the following limits. --Three months approved leave of absence. --Temporary layoff, the end of the month following the month in which the layoff occurred. --Three months of approved leave due to a disease or injury. The last day of the month in which employee ceases to be in an eligible class. The date of the expiration of the period for which the last required premium payment was due and not paid. The date the policy terminates. Conversion Privilege Conversion privilege to individual policy is available without evidence of insurability if an employee has been covered under the policy continuously for five years. The individual policy will be issued only if application is made and first premium is paid within 31 days after the termination of insurance. See schedule of benefits for complete information. For more information, please refer to the group term life underwriting guidelines. Ineligible Industries for 2-9 SIC Description Mining Tobacco products Logging and sawmills 2431 Millwork 2892 Explosives 3111 Leather tanning and finishing 3292 Asbestos products Local and interurban passenger transit Aviation and related services Electric, gas, water, etc Florists 7231 Beauty shop 7241 Barber shops 7381 Detective and armored car services 7382 Security systems services 7542 Car washes Amusement and recreation 7948 Racing, including track operations 8059 Drug and alcohol treatment centers 8111 Legal services Membership organizations/associations 8811 Private households Correctional institutions, fire protection, public order and safety, n.e.c. Ineligible Industries for 10+ SIC Description Mining Tobacco products Logging and sawmills 2892 Explosives 3111 Leather tanning and finishing Aviation and related services 7381 Detective and armored car services Amusement and recreation 7948 Racing, including track operations 8059 Drug and alcohol treatment centers Membership organizations/associations 8811 Private households Correctional institutions, fire protection, public order and safety, n.e.c. AD&D Exclusions No amount will be payable for loss caused or contributed to by: Suicide, or any attempt thereof, while sane or insane. Drugs, poison, gas or fumes voluntarily taken, absorbed or inhaled which are not administered on the advice of a physician. Bodily or mental infirmity or disease in any form, or medical or surgical treatment therefore. Bacterial infection, other than infection occurring simultaneously with or through an accidental cut or wound. Commission of any crime. Riot, insurrection or war, declared or undeclared. Service in the military, naval or air forces of any country at war, declared or undeclared. Travel or flight in any kind of aircraft including falling or otherwise descending from or with any aircraft in flight, while participating in aviation training in any aircraft, or as a pilot, officer or other member of the crew of any aircraft. Bodily injury resulting from intoxication or from the voluntary use of narcotics which are not administered on the advice of a physician

17 Short Term Disability Group Sizes 5 or More Short Term Disability Plan Summary Available in AR, DC, HI, ID, IL, IN, KY, MO, MS, NE, NM, OH, PA, SC, SD, TX, UT and WY. Employer-Sponsored Voluntary Custom Groups Group Sizes 5-49 Employees Enrolling 5-49 Employees Enrolling 50+ Employees Enrolling Employer-sponsored: Minimum Participation & Contribution Requirements 100% contribution requires 100% eligible employee enrollment. 25% - 99% contribution requires 75% eligible employee enrollment. No employer contribution required. A minimum of 25% of eligible employees enrolling. 100% contribution requires 100% eligible employee enrollment. 25% - 99% contribution requires 75% eligible employee enrollment. Voluntary: No employer contribution required. A minimum of 25% of eligible employees enrolling. Benefit Choices Percentage of Salary: 60%, 67% or 70% Or Flat Amount: $250 up to $1,000 per week Percentage of Salary: 60%, 67% or 70% Or Flat Amount: $250 up to $1,000 per week Percentage of Salary: 60%, 67% or 70% Or Flat Amount: $250 up to $2,500 per week Maximum Weekly Benefit Minimum Weekly Benefit Up to $1,000 Up to $1,000 Up to $2,500 $25 $25 $10 to $100 Maximum Period of Payments (Benefit Duration) 13 weeks 26 weeks 13 weeks 26 weeks 52 weeks 13 weeks 26 weeks 52 weeks Elimination Period 0/7 7/7 14/14 29/29 0/7 7/7 14/14 29/29 0/7 7/7 14/14 29/29 Additional Options Partial Disability Maternity Pre-existing Condition Limitation Maternity Pre-existing Condition Limitation Partial Disability Maternity Pre-existing Condition Limitation Rate Guarantee 2 years 2 years 2 years 3 years

18 The Fine Print Recurrence If an employee returns to work and has a recurrent disability, disability is treated as part of the prior claim and the elimination period will be waived if: The employee was continuously insured. The recurrent disability occurs within 14 days of the end of the employee s prior claim. Weekly benefits will be based on weekly earnings reported at the time of the prior claim. Employee Effective Date Insurance will take effect on the later of: The date the employer group becomes effective if initial applications are received within 31 days of this date. The first day of the calendar month following the date a full-time employee completes the waiting period as elected by the employer. Application must be received within 31 days of this day. If the application is received after the 31st day of eligibility and evidence of insurability is provided, coverage will take effect on the first day of the month following approval. Evidence of Insurability Evidence of insurability is required for: Groups without previous coverage. Employees that enroll after the initial 31-day eligibility period and enroll in a plan where the employer is contributing less than 100%. Exclusions and Limitations The plan does not cover any disabilities caused by, contributed to or resulting from: Loss of professional license, occupational license or certification. Intentional self-inflicted injuries or attempted suicide, regardless of mental capacity. Active participation in a riot or insurrection, or in attempting to commit or commission of a felony or crime for which the employee has been convicted under federal or state law. While incarcerated. Resulting from war, declared or undeclared, or any act of war or terrorism. Pre-existing condition, if elected. Voluntarily electing a surgical procedure, elective cosmetic or plastic surgery, except when required due to injury or sickness. Occupational injury or sickness. Ineligible Employees The following are considered ineligible if. Full-time employees not actively at work at the group s initial effective date. Non-resident aliens. Consultants, directors or stockholders. Employees employed on a temporary, seasonal or part-time basis, including 1099s. Employees subject to collective bargaining agreements. Ineligible Industries SIC Description Mining 21 Tobacco products Logging and sawmills 2431 Millwork 2892 Explosives 3111 Leather tanning and finishing 3292 Asbestos products Primary metal industries Local and interurban passenger transit 431 U.S. Postal Service Aviation and related services 7231 Beauty shops 7241 Barber shops 7381 Disinfecting and exterminating 7382 Security systems services 7542 Car washes Amusement and recreation 7948 Racing, including track operations 7993 Coin operated amusement devices 8811 Private households 9221 Police protection Correctional institutions, fire protection, public order and safety, n.e.c. Underwriting Highlights 1. Minimum Group Size 5 or more eligible employees enrolling. 2. Employer Eligibility Must have 5 or more employees enrolling. Be located in a state where short term disability is offered. No more than 50% of enrolling employees located out of the state. Actively in business for one year or more. Businesses not eligible for coverage include: Businesses that are conducted in the home of the employer or employee. Seasonal or in a hazardous industry. Unions, associations, self-funded groups or ASOs. 3. Employee Eligibility Employees must be actively employed full-time, working at least 30 hours per week and paid a salary or earnings from which Federal, State and Social Security taxes are withheld. Minimum hours required may vary by the laws of your state. Partners and owners are also eligible if they work 30 hours or more per week. Must be between the ages of 18 and 69. Individuals not eligible for coverage include. Non-resident aliens. Full-time employees not actively at work on the initial effective date. Consultants, directors or stockholders. Employees subject to collective bargaining agreements. Seasonal, part-time, 1099 or temporary employees. 4. Participation and Contribution Requirements Employer-sponsored (100% contribution): 100% eligible employees. Employer-sponsored (minimum of 25% contribution): 75% of eligible employees. Voluntary: minimum of 25% of eligible employees. 5. Evidence of Insurability Requirements Groups without prior coverage. Employees enrolling after the initial 31-day of eligibility. If the employer is contributing 100%, then evidence of insurability is not required. 6. New Case Effective Dates May be effective on the 1st or 15th of the month. Cases are accepted seven days after the requested effective date. 7. Wage Report Requirements Required for groups with 10 or less employees enrolling

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20 BEST Life and Health Insurance Company 2505 McCabe Way Irvine, CA BEST Life and Health Insurance Company