Comprehensive Rate Book

Transcription

1 Comprehensive Rate Book January, 2016

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3 American Retirement Counselors Comprehensive Rate Book, January 2016 Table of Contents 1. ARC Product Grid 2. Medicare Supplement a. AARP/UnitedHealthcare b. Mutual of Omaha c. Standard Life 3. Supplemental Health a. Guarantee Trust Life - Advantage Plus - Hospital Indemnity b. Standard Life Savers Home Health Care c. Kemper Senior Solutions Home Health Care d. Guarantee Trust Life Cancer Plans i. Schedule of s ii. Lump Sum 4. Final Expense/Whole Life a. Foresters PlanRight b. Royal Neighbors Simplified Issue Whole Life c. Standard Life Advantage Guard d. Lafayette Life The Protector 15 e. Gerber Guaranteed Issue Whole Life f. Kemper Senior Solutions Modified Whole Life g. United of Omaha Whole Life i. Living Promise Whole Life ii. Children s Whole Life 5. Short-Term Care a. Guarantee Trust Life Recover Cash b. Standard Life RecoveryCare II

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5 Each company has downloadable quoting software. You should register with each company agent portal and download software to your computer. Wi-Fi may be required for use when running software. You may be able to utilize your phone as a hot spot for in-home presentations. (Charges may apply check with your phone service company). ** Mobile apps are available for some companies noted in blue. You can check on Google Play Store or Apple App Store for more information. ARC Product Grid Medicare Supplement AARP Plans A B C F K L N Must be a member of AARP Added benefits: Vision /Nurse Line/Silver Sneakers United of Omaha Plans A F G 12% Discount offered Mobile App Medicare Advantage Hospital Indemnity & Home Health Care United Health Care Guarantee Trust Life AARP (GTL) (UHC) Indemnity Plus PPO/HMO/SNP Coventry/Aetna PPO Savers Advantage Home Health Care Cancer Final Expense Life Insurance Guarantee Trust Life Foresters Life (GTL) Plan Right Schedule of s Level/Graded/Modified Treatment Plans Options Available Guarantee Trust Life (GTL) Lump Sum Cancer Mobile App Forestersquotes.com Royal Neighbors Simplified Issue Plan Member s Mobile App Short Term Care Standard Life Recovery Care Pays for Facility Based Care Rider: Home Care Guarantee Trust Life (GTL) Recovery Cash Facility Care Rider: Home Care Standard Life High Deductible Plan F Humana HMO/PPO/PFFS Kemper Life Home Health Care Standard Life Simplified Issue For younger person w/ health issues Age Regional Adv. Plans Forsyth Co.- Cigna Triad Co. - HTA Lafayette Life The Protector Accepts 1035 Exchange Gerber Life Guarantee Issue

6 One America Asset Care I, II, III & IV Annuity Care North American Visit website for plan options ( 10 & 14 Income option with LTC bonus option) Athene Income solutions LTC bonus options Each company has downloadable quoting software. You should register with each company agent portal and download software to your computer. Wi-Fi may be required for use when running software. You may be able to utilize your phone as a hot spot for in-home presentations. (Charges may apply check with your phone service company). ** Mobile apps are available for some companies noted in blue. You can check on Google Play Store or Apple App Store for more information. ARC Product Grid Long Term Care Universal Life and Term Life Whole Life Insurance (and Children Plans) Fixed Annuities Indexed Annuities Life, Annuity and Long Term Care Combo Plans John Hancock Custom Care Full Comprehensive State Partnership Approved United of Omaha Mutual Plus Plan Full Comprehensive North American Life Term Life Universal Life Index Universal Life Living Riders Protective Life Term Life Universal Life Index Universal Life Living Riders Lafayette Life Heritage Liberty Centennial Royal Neighbors Essential Level Pay 10 Pay 20 Pay Equitrust MYGA Series 3yr,4yr,5yr,7yr,8yr,10yr Royal Neighbors Traditional Annuity MYGA Flexible Plan Great American Growth Solution Income Riders Legacy Riders North American Fixed Indexed Income Legacy Foresters Term Life Universal Life Index Universal Life Living Riders Non-Med Option Mobile App Royal Neighbors Youth Plans Mobile App North American MYGA Traditional Equitrust Income Solution Growth Solution w the Participation Option Standard Life Term Life Mutual of Omaha Children Plans Mobile App North American Indexed Income Legacy

7 Each company has downloadable quoting software. You should register with each company agent portal and download software to your computer. Wi-Fi may be required for use when running software. You may be able to utilize your phone as a hot spot for in-home presentations. (Charges may apply check with your phone service company). ** Mobile apps are available for some companies noted in blue. You can check on Google Play Store or Apple App Store for more information. ARC Product Grid Under Age Health Limited Plans Affordable Health Care Plans Exchange Plans Humana UHC Aetna Coventry UHC One Standard Health Insurance High Deductible Options Golden Rule Short Term Medical Insurance

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9 Cover Page - Rates for North Carolina Non-Tobacco Monthly Plan Rates AARP Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company Applies to individuals whose plan effective date will be within three years Group 1 following their 65th birthday or Medicare Part B effective date, if later Age 1 Plan A Plan B Plan C Select C 2 Plan F Select F 2 Plan K Plan L Plan N Standard Rates with Enrollment Discount 3 for individuals ages $83.30 $ $ $ $ $ $49.87 $84.35 $ $86.87 $ $ $ $ $ $52.01 $87.96 $ $90.44 $ $ $ $ $ $54.15 $91.58 $ $94.01 $ $ $ $ $ $56.28 $95.19 $ $97.58 $ $ $ $ $ $58.42 $98.81 $ $ $ $ $ $ $ $60.56 $ $ $ $ $ $ $ $ $62.70 $ $ $ $ $ $ $ $ $64.83 $ $ $ $ $ $ $ $ $66.97 $ $ $ $ $ $ $ $ $69.11 $ $ Standard Rates for ages 75 and older 75+ $ $ $ $ $ $ $71.25 $ $ Group 2 Applies to individuals whose plan effective date will be 3 or more years following their 65th birthday or Medicare Part B effective date, if later Age 1 Plan A Plan B Plan C Select C 2 Plan F Select F 2 Plan K Plan L Plan N Standard Rates with Enrollment Discount 3 for individuals ages who do not have any of the medical conditions on the application $94.01 $ $ $ $ $ $56.28 $95.19 $ $97.58 $ $ $ $ $ $58.42 $98.81 $ $ $ $ $ $ $ $60.56 $ $ $ $ $ $ $ $ $62.70 $ $ $ $ $ $ $ $ $64.83 $ $ $ $ $ $ $ $ $66.97 $ $ $ $ $ $ $ $ $69.11 $ $ Standard Rates for individuals ages 75 and older who do not have any of the medical conditions on the application $ $ $ $ $ $ $71.25 $ $ Level 2 Rates with Enrollment Discount 3 for individuals ages who have one or more of the medical conditions on the application $ $ $ $ $ $ $84.42 $ $ $ $ $ $ $ $ $87.63 $ $ $ $ $ $ $ $ $90.83 $ $ $ $ $ $ $ $ $94.04 $ $ $ $ $ $ $ $ $97.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Level 2 Rates for individuals ages 75 and older who have one or more of the medical conditions on the application $ $ $ $ $ $ $ $ $ The rates above are for plan effective dates from January December 2016 and may change. MRP0036 NC

10 Cover Page - Rates for North Carolina Tobacco Monthly Plan Rates AARP Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company Applies to individuals whose plan effective date will be within three years Group 1 following their 65th birthday or Medicare Part B effective date, if later Age 1 Plan A Plan B Plan C Select C 2 Plan F Select F 2 Plan K Plan L Plan N Standard Rates with Enrollment Discount 3 for individuals ages $91.63 $ $ $ $ $ $54.85 $92.78 $ $95.55 $ $ $ $ $ $57.21 $96.76 $ $99.48 $ $ $ $ $ $59.56 $ $ $ $ $ $ $ $ $61.91 $ $ $ $ $ $ $ $ $64.26 $ $ $ $ $ $ $ $ $66.61 $ $ $ $ $ $ $ $ $68.96 $ $ $ $ $ $ $ $ $71.31 $ $ $ $ $ $ $ $ $73.66 $ $ $ $ $ $ $ $ $76.01 $ $ $ $ $ $ $ $ $78.37 $ $ Group 2 Applies to individuals whose plan effective date will be 3 or more years following their 65th birthday or Medicare Part B effective date, if later Age 1 Plan A Plan B Plan C Select C 2 Plan F Select F 2 Plan K Plan L Plan N Standard Rates with Enrollment Discount 3 for individuals ages who do not have any of the medical conditions on the application $ $ $ $ $ $ $61.91 $ $ $ $ $ $ $ $ $64.26 $ $ $ $ $ $ $ $ $66.61 $ $ $ $ $ $ $ $ $68.96 $ $ $ $ $ $ $ $ $71.31 $ $ $ $ $ $ $ $ $73.66 $ $ $ $ $ $ $ $ $76.01 $ $ Standard Rates for individuals ages 75 and older who do not have any of the medical conditions on the application $ $ $ $ $ $ $78.37 $ $ Level 2 Rates with Enrollment Discount 3 for individuals ages who have one or more of the medical conditions on the application $ $ $ $ $ $ $92.86 $ $ $ $ $ $ $ $ $96.39 $ $ $ $ $ $ $ $ $99.91 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Level 2 Rates for individuals ages 75 and older who have one or more of the medical conditions on the application $ $ $ $ $ $ $ $ $ The rates above are for plan effective dates from January December 2016 and may change. MRP0036 NC

11 Cover Page - Rates for North Carolina Under 65 Monthly Plan Rates AARP Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company Group 3 Applies to individuals under the age of 65 who are eligible for Medicare by reason of disability Age 1 Plan A Plan C $ $ The rates above are for plan effective dates from January December 2016 and may change. 1 Your age as of your plan effective date. 2 You must use a network hospital with Select Plans C and F 3 The Enrollment Discount is available to applicants age 65 and over. You may qualify for an Enrollment Discount based on your age. Who is eligible You are eligible for the enrollment discount if you are between the ages of 65 and 74. How it works The Enrollment Discount is applied to the current Standard Rate if your plan effective date is either: Within 3 years of your Medicare Part B effective date OR After 3 years from your Medicare Part B effective date and you do not have any medical conditions on the application that would qualify you for the Level 2 rate. The Enrollment Discount is applied to the Level 2 rate if your plan effective date is 3 or more years following your 65th birthday or your Medicare Part B effective date and you have one or more of the medical conditions on the application. The Standard Rates usually change each year. The discount you receive in your first year of coverage depends on your age on your plan effective date. The discount percentage reduces 3% each year on the anniversary date of your plan until the discount runs out. 4 Refer to Section 6 of the application. MRP0036 NC

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13 MUTUAL OF OMAHA INSURANCE COMPANY OUTLINE OF MEDICARE SUPPLEMENT COVERAGE- COVER PAGE BENEFIT PLANS A, F, AND G This chart shows the benefits included in each of the standard Medicare supplement plans. Every company must make Plan A available. Some plans may not be available in your state. Basic s: Hospitalization: Medical Expenses: Blood: H ~ PlanA Plan B asic, Basic, includ including in~ 100% 10 % Part B Co- Part B insurance Co insur ance Part A Deductible Part A coinsurance plus coverage for 365 additional days after Medicare benefits end. Part B coinsurance (generally 20% of Medicare-approved expenses) or co payments for hospital outpatient services. Plans K, L, and N require insureds to pay a portion of Part B coinsurance or copayments. First 3 pints of blood each year. PartA. Plane Plan D PlanG PlanK Plan L Plan M Plan N Basic, Basic, asic, asic including including including including 100% 100% 100% 100% Part B Co- Part B Co- Part B Co Part B Co insurance insurance insurance* insurance Skilled Nursing racility Co- Insurance Skilled Nursing Facility Coinsurance Hospitalization and Hospitalization Basic, Basic, including preventive care and preventive including 100% Part B paid at 100%; other care paid at 100% Part Coinsurance, basic benefits paid 100%; other basic B Co- except up to at 50% benefits paid at insurance $20 copayment 75% for office visit, and up to $50 copayment for ER 50% Skilled 75% Skilled Skilled Skilled Nursing Nursing Facility Nursing Facility Nursing Facility Coinsurance Coinsurance Facility Co- Coinsurance insurance Part A Part A 50% Part A 75% Part A 50% Part A Part A Deductible Deductible Deductible Deductible Deductible Deductible Part B Deductible Foreign Foreign Foreign Foreign Travel Travel Travel Travel Emergency Emer- Emer- Emergency Out-of-pocket Out-of-pocket limit limit$4,960; paid $2,480; paid at at 100% after limit 100% after limit reached reached *Plan F also has an option called a high deductible Plan F. This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,180 deductible. s from high deductible Plan F will not begin until out-of-pocket expenses exceed $2,180. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy/certificate. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible. NCMOOAGY001 1 NC_MOO_AGY_010116

14 i -- FEMALE.. Plan-A- :MM2o- -.. _- Plan_:F_. _: MM24_ "95.79.: '134.92: ' ' -.._ ': ' ' ' ' ~ ~ : ' ; ' ~15-,"..: : ~ ' -- ~ ~ :.. - -_,.- MONTHLY NON-TOBACCO PREMIUMS* ZIP CODES: PlanG Attained PlanA -. MM25. Ao-e _ MM20 Thru ' 65 l ': "10L : '.. 2'54~ ' MALE PlanF PlanG MM24 MM AO _7~ To obtain annual, semiannual, and quarterly premiums, multiply the above-quoted premiums by 12, 6, and 3, respectively. *See PREMIUM INFORMATION regarding Risk Class and Household Premium Discount rating. NC MOO AGY NC_MOO_AGY _

15 Mutual of Omaha Insurance Company North Carolina Plans A, F & 0 Life Expectancy* at Issuance and Increase** In Monthly Premium after 1 0 Policy Years Female Non-Tobacco Male Non-Tobacco Age at Life Age at Life Issue Expectancy PlanA PlanF PlanO Issue Expectancy PlanA Plan F PlanO *Life expectancy includes only mortality **Increase in premium is based on rates at the time of Issue. Increase is subject to premium change provisions. NC MOO AGY NC_MOO_AGY_

16 ~~--~----~------FE-. -MAL---.-.E-.Plan: A<.;,.. l\1m2o : : ' : '_ ~ ' ~ : ' MONTHLY TOBACCO PREMIUMS* ZIP CODES: ~~ ~~ ~MAL~~E~ ~1 _:Plan F :.,..j_.._plan G....,.Attaine~~-. Plan A _,. Plan F MM24.. MM25 Aile MM20 MM I I Thru 64 I I ~86 _._, _ l JJ7.02 _ I I I 66 I I I L 67 I I I I 68 I I ~ I I 69 I I I I 70 I I ".50,:. :. J~ 116~ I I I I 72 I I ,. I. t24a6 I 73_j I I I 74 I I ~ I 75 I I I I 76 I I I _ ~ 1_7 j l_61.79 _ I I I 78 I I L 79 I I I L 80 I I ;26:. J< " 162.2_1 I 81 I I I I 82 I I I _L 83 J I I I 84 I I I I 85 I I I I 86 I I I I 87 _I I I I 88 I I , I L 89 I 2A2.41 I I I 90 I I r. :. : _6. L 9t j _ I I I 92 I I ~02 I : _ ~ _93 j I I L 94 I 2_85.76 I " L.. 9_5_ I I I I 96 I I ' ' I,. 97 I I I I 98 I I :11, ,_ ~414~24... ~: :, I -... : I 99+, I I To obtain annual, semiannual, and quarterly premiums, multiply the above-quoted premiums by 12, 6, and 3, respectively. *See PREMIUM INFORMATION regarding Risk Class and Household Premium Discount rat~ng. Plan G MM ~ ~ : : NC MOO AGY NC_MOO_AGY _

17 Mutual of Omaha Insurance Company North Carolina Plans A, F & G Life Expectancy* at Issuance and Increase** In Monthly Premium after I 0 Policy Years Female Tobacco Male Tobacco Age at Life Age at Life Issue Expectancy PlanA Plan F PlanG Issue Expectancy PlanA PlanF Plan G 65 I I I2 66 I IO 67 I I I I I I I I I I I I I I IO.I I I I II II5.55 8I I I I I I I *Life expectancy includes only mortality **Increase in premium is based on rates at the time of Issue. Increase is subject to premium change provisions. NC MOO AGY NC_MOO_AGY_

18 pjsclosyres Use this outline to compare benefits and premiums among policies. premjym lnformatjon We, Mutual of Omaha, can only raise your premium if we raise the premium for all the policies like yours in the same geographic area of the state where you live. Until you are age 90, your premium may change each year. This change will only be made on the first renewal date that coincides with or follows each anniversary of the policy date. Schedules of rates may vary depending upon your policy date. Premiums are based on attained age rating which means premiums increase as your age increases. Premiums that are based on issue age do not increase as your age increases. Policies on an issue age basis should be compared to policies on an attained age basis. Rjsk Class Ratjng If, according to our underwriting standards, you are overweight or underweight for your height, you will be considered to be a greater insurable risk. In such a case, your premium will be priced either as Class I /o or Class II- 20o/o higher than the rates illustrated, based on your Body Mass Index (BMI) reading. Risk class rating will not be applicable when you apply for coverage during an open enrollment or guaranteed issue period. Hoysebold Premjym Qjscount You are eligible for a household premium discount if for the past year you have resided with at least one, but no more than three adults who are age 60 or older. The discounted premium will be priced 12% lower than the rates illustrated. The policy's household premium discount will be removed if the other adult no longer resides with you (other than in the case of his or her death). Read voyr policv Verv CarefullY This is only an outline describing your policy's most important features. The policy is your insurance contract. You must read the policy itself to understand all of the rights and duties of both you and your insurance company. Rjght to Retyrn policcy If you find that you are not satisfied with your policy, you may return it us at Mutual of Omaha Plaza, Omaha, NE If you send the policy back to us within 30 days after you receive it, we will treat the policy as if it had never been issued and return all of your payments. policy Replacement If you are replacing another health insurance policy, do NOT cancel it until you have actually received your new policy and are sure you want to keep it. Notjce The policy may not fully cover all of your medical costs. Neither Mutual of Omaha nor its agents are connected with Medicare. This outline of coverage does not give all the details of Medicare coverage. Contact your local Social Security office or consult "Medicare & You" for more details. Complete Answers Are Verv Important When you fill out the application for the new policy, be sure to answer truthfully and completely all questions about your medical and health history. The Company may cancel your policy and refuse to pay any claims if you leave out or falsify important medical information. Review the application carefully before you sign it. Be certain that all information has been properly recorded. NC MOO AGY NC_MOO_AGY_

19 PLANA MEDICARE {PART A)- HOSPITAL SERVICES- PER BENEFIT PERIOD *A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hosoital and have not received skilled care in anv other facilitv for 60 d I " " Services Medicare Pays Plan A Pays You Pay HOSPITALIZATION* Semiprivate room and board, general nursing, and miscellaneous services and supplies First 60 days All but $1,288 $0 $1,288 (Part A deductible) through 9Qlh day All but $322 a day $322 a dav $0 91 st day and after: While using 60 lifetime reserve days All but $644 a day $644 a dav $0 Once lifetime reserve days are used: Additional 365 days $0 100% of Medicare- $0** eligible expenses Beyond the additional 365 days $0 $0 All costs SKILLED NURSING FACILITY CARE* You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital. First 20 days All approved amounts $0 $ through 100th day All but $ a day $0 Up to $ a day day and after $0 $0 All costs BLOOD First 3 R_ints $0 3 pints $0 Additional amounts 100% $0 $0 HOSPICE CARE All but very limited Medicare copayment/ $0 You must meet Medicare's requirements, including a docto~s certification of copayment/coinsurance coinsurance terminal illness. for outpatient drugs and in~atient respite care -- **NOTICE: When your Medicare Part A hospital benefits are exhausted, we stand in the place of Medicare and will pay whatever amount Medicare would have paid up to an additional 365 days as provided in the policy's/certificate's "Core s." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid. NC MOO AGY NC_MOO_AGY _

20 PLANA MEDICARE (PART B) -MEDICAL SERVICES -PER CALENDAR YEAR *Once you have been billed $166 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year. Services Medicare Pays Plan A Pays You Pay MEDICAL EXPENSES-IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment First $166 of Medicare-approved amounts* $0 $0 $166 (Part 8 deductible) Remainder of Medicare-approved amounts Generally 80% Generally 20% $0 Part B Excess Charges (above Medicare-approved amounts) $0 $0 All costs BLOOD First 3 pints $0 All costs $0 Next $166 of Medicare-approved amounts* $0 $0 $166 (Part 8 deductible) Remainder of Medicare-approved amounts 80% 20% $0 CLINICAL LABORATORY SERVICES-TESTS FOR DIAGNOSTIC SERVICES % $0 $ PARTS A AND B HOME HEALTH CARE-MEDICARE-APPROVED SERVICES Medical! necessa skilled care services and medical su lies 100% $0 $0 Durable medical equipment First $166 of Medicare-a roved amounts $0 $0 Remainder of Medicare-a roved amounts 80% 20% NC MOO AGY NC_MOO_AGY_

21 I PLANS FAND G MEDICARE {PART A) -HOSPITAL SERVICES -PER BENEFIT PERIOD *A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hosoital and have not received skilled care in anv other facilitv for 60 d "' "' "' Services Medicare Pays Plan F Pays You Pay Plan G Pays You Pay HOSPITALIZATION* Semiprivate room and board, general nursing, and miscellaneous services and supplies First 60 days All but $1,288 $1,288 (Part A $0 $1,288 (Part A $0 deductible) deductible) through 90th day All but $322 a day $322 a dav $0 $322 a day $ day and after: While using 60 lifetime reserve days All but $644 a day $644 a day $0 $644 a day $0 Once lifetime reserve days are used: Additional 365 days $0 100% of Medicare- $0** 100% of Medicareeligible expenses eligible expenses $0** Beyond the additional 365 days $0 $0 All costs $0 All costs SKILLED NURSING FACILITY CARE* You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital. First 20 days All approved amounts $0 $0 $0 $0 21st through 1 QQth day All but $ a day Up to $ a day $0 Up to $ a day $ day and after $0 $0 All costs $0 All costs BLOOD First 3 pints $0 3 pints $0 3 pints $0 Additional amounts 100% $0 $0 $0 $0 HOSPICE CARE All but very limited Medicare copayment/ $0 Medicare copayment/ $0 You must meet Medicare's requirements, copayment/ coinsurance coinsurance including a docto~s certification of terminal coinsurance for illness. outpatient drugs and inpatient respite care ~- - **NOTICE: When your Medicare Part A hospital benefits are exhausted, we stand in the place of Medicare and will pay whatever amount Medicare would have paid up to an additional 365 days as provided in the policy's/certificate's "Core s." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid. NC MOO AGY NC_MOO_AGY _

22 PLANS FAND G MEDICARE (PART B) - MEDICAL SERVICES - PER CALENDAR YEAR *Once you have been billed $166 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year. Services Medicare Pays Plan F Pays You Pay Plan G Pays You Pay MEDICAL EXPENSES-IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment First $166 of Medicare-approved amounts* $0 $166 (Part 8 $0 $0 deductible) $166 (Part 8 deductible) Remainder of Medicare-approved amounts Generally 80% Generally 20% $0 Generally 20% $0 Part B Excess Charges (above Medicare-approved amounts) $0 100% $0 100% $0 BLOOD First 3 pints $0 All costs $0 All costs $0 Next $166 of Medicare-approved amounts* $0 $166 (Part 8 $0 $0 deductible) $166 (Part 8 deductible) Remainder of Medicare-approved amounts 80% 20% $0 20% $0 CLINICAL LABORATORY SERVICES-TESTS FOR DIAGNOSTIC SERVICES 100% $0 $0 $0 $0 PARTS A AND B HOME HEALTH CARE-MEDICARE-APPROVED SERVICES Medically necessary skilled care services and medical supplies 100% $0 $0 $0 $0 Durable medical equipment First $166 of Medicare-approved amounts* $0 $166 (Part 8 $0 $0 deductible) $166 (Part 8 deductible) Remainder of Medicare-approved amounts 80% 20% $0 20% $0 NC MOO AGY NC_MOO_AGY_

23 PLANS FAND G MEDICARE (PART B) -MEDICAL SERVICES -PER CALENDAR YEAR OTHER BENEFITS - NOT COVERED BY MEDICARE Services Medicare Pays Plan F Pays You Pay Plan G Pays You Pay FOREIGN TRAVEL-NOT COVERED BY MEDICARE Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA First $250 each calendar year $0 $0 $250 $0 $250 Remainder of charges $0 80% to a lifetime 20% and amounts 80% to a lifetime 20% and amounts maximum benefit over the $50,000 maximum benefit of over the $50,000 of$50,000 lifetime maximum $50,000 lifetime maximum benefit benefit NC MOO AGY NC _MOO _AGY _

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25 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , 283, ) 2016 PLAN A RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $6, $3, $1, $ $7, $3, $1, $ $6, $3, $1, $ $7, $3, $1, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN B RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 2

26 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , 283, ) 2016 PLAN C RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $8, $4, $2, $ $9, $4, $2, $ $8, $4, $2, $ $9, $4, $2, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN D RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $ $ $ $2, $1, $ $ $1, $ $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 3

27 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , 283, ) 2016 PLAN F RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN F (HIGH DEDUCTIBLE) RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $32.02 $ $ $ $35.58 $ $ $ $32.02 $ $ $ $ Page 4

28 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , 283, ) 2016 PLAN F (HIGH DEDUCTIBLE) INNOVATIVE RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $45.63 $ $ $ $50.70 $ $ $ $45.63 $ $ $ $ , , , PLAN G RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $ $ $ $2, $1, $ $ $1, $ $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 5

29 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , 283, ) 2016 PLAN N RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 6

30 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , , 284, 285, 289) 2016 PLAN A RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $6, $3, $1, $ $7, $3, $2, $ $6, $3, $1, $ $7, $3, $2, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN B RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $3, $1, $ $ $2, $1, $ $ $3, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 7

31 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , , 284, 285, 289) 2016 PLAN C RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $8, $4, $2, $ $9, $5, $2, $ $8, $4, $2, $ $9, $5, $2, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN D RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $1, $ $ $2, $1, $ $ $1, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 8

32 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , , 284, 285, 289) 2016 PLAN F RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN F (HIGH DEDUCTIBLE) RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $33.80 $ $ $ $37.56 $ $ $ $33.80 $ $ $ $ Page 9

33 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , , 284, 285, 289) 2016 PLAN F (HIGH DEDUCTIBLE) INNOVATIVE RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $48.16 $ $ $ $53.52 $ $ $ $48.16 $ $ $ $ , , , , , , PLAN G RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $1, $ $ $2, $1, $ $ $1, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 10

34 NORTH CAROLINA PREMIUMS FOR ZIP CODES ( , , 284, 285, 289) 2016 PLAN N RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 11

35 NORTH CAROLINA PREMIUMS FOR ZIP CODES (278, 279) 2016 PLAN A RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $7, $3, $1, $ $7, $4, $2, $ $7, $3, $1, $ $7, $4, $2, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN B RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $3, $1, $ $ $2, $1, $ $ $3, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 12

36 NORTH CAROLINA PREMIUMS FOR ZIP CODES (278, 279) 2016 PLAN C RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability $9, $4, $2, $ $10, $5, $2, $ $9, $4, $2, $ $10, $5, $2, $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN D RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 13

37 NORTH CAROLINA PREMIUMS FOR ZIP CODES (278, 279) 2016 PLAN F RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $3, $1, $ $ $2, $1, $ $ $3, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , PLAN F (HIGH DEDUCTIBLE) RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $35.58 $ $ $ $39.53 $ $ $ $35.58 $ $ $ $ Page 14

38 NORTH CAROLINA PREMIUMS FOR ZIP CODES (278, 279) 2016 PLAN F (HIGH DEDUCTIBLE) INNOVATIVE RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $ $ $ $50.70 $ $ $ $56.33 $ $ $ $50.70 $ $ $ $ , , , , , , , , , , , PLAN G RATES 2016 Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ $2, $1, $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 15

39 NORTH CAROLINA PREMIUMS FOR ZIP CODES (278, 279) 2016 PLAN N RATES 2016 Attained Age FEMALE RATES MALE RATES Non Tobacco User Tobacco User Non Tobacco User Tobacco User Semi- Semi- Semi- Semi- Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Annual Annual Quarterly PAC Under 65 Disability N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 65 $1, $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $ , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Page 16

40

41 3-Day s* 6-Day s* 10-Day Hospital Confinement s (per $10/Day) 21-Day s (per $10/Day) AGE (per $10/Day) AGE (per $10/Day) AGE $ $ $ $ $ $ *Minimum/maximum daily benefit for 3-day plan is $350 to $600. For the 6-day plan the minimum/maximum is $250 to $600. The 3 and 6 day Plans include Short Stay benefits.

42 Short Stay Rider* Ambulance Rider Hospital Confinement not required Dental & Vision Rider** AGE (per $10/Day) $200 per service AGE $400 $800 $1, N/A N/A N/A N/A N/A *Available for 10 and 21 Day Only **Dental/Vision Rider is not available in New Mexico and Tennesse.

43 Lump Sum Cancer Rider AGE $2,500 $5,000 $10,000 $15,000 $20, $31.48 $54.85 $ $ $ $33.69 $58.81 $ $ $ $35.45 $61.90 $ $ $ $37.53 $65.48 $ $ $ $39.86 $69.61 $ $ $ $42.54 $74.29 $ $ $ $44.92 $78.42 $ $ $ $47.77 $83.34 $ $ $ $50.47 $88.04 $ $ $ $53.64 $93.51 $ $ $ $56.76 $98.96 $ $ $ $60.01 $ $ $ $ $63.17 $ $ $ $ $66.45 $ $ $ $ $70.08 $ $ $ $ $73.72 $ $ $ $ $77.42 $ $ $ $ $81.36 $ $ $ $ $85.16 $ $ $ $ $89.08 $ $ $ $ $93.02 $ $ $ $ $97.15 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Lump Sum Cancer Rider with Recurrence AGE $2,500 $5,000 $10,000 $15,000 $20, $34.98 $61.85 $ $ $ $37.46 $66.36 $ $ $ $39.43 $69.85 $ $ $ $41.73 $73.88 $ $ $ $44.34 $78.56 $ $ $ $47.32 $83.84 $ $ $ $49.95 $88.47 $ $ $ $53.09 $93.99 $ $ $ $56.09 $99.29 $ $ $ $59.61 $ $ $ $ $63.09 $ $ $ $ $66.69 $ $ $ $ $70.20 $ $ $ $ $73.80 $ $ $ $ $77.80 $ $ $ $ $81.84 $ $ $ $ $85.92 $ $ $ $ $90.29 $ $ $ $ $94.46 $ $ $ $ $98.75 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1, $ $ $ $ $1,087.80

44 Skilled Nursing Facility Rider (Days 1-50)* Outpatient Surgical Rider** Lump Sum Hospital Confinement Rider AGE $100/Day $150/Day $200/Day $250 $500 $750 $1,000 $250 $500 $ , , , , , , *Skilled Nursing Facility Rider is not available in Mississippi. **Outpatient Surgical Rider is not available in Iowa.

45 State Rate Sheet Monthly Bank Draft Savers Advantage Home Health Care Insurance North Carolina Attained Age Classic Deluxe Extra s Rider $12.15 $24.30 $ $12.15 $24.30 $ $12.15 $24.30 $ $12.55 $25.10 $ $14.45 $28.90 $ $14.60 $29.20 $ $18.85 $37.70 $ $21.55 $43.10 $ $25.30 $50.60 $9.14 Premium Mode Factors Monthly Bank Draft 1.00 Quarterly 3.20 Semi-Annual 6.33 Annual PROPRIETARY AND CONFIDENTIAL ~ FOR AGENT USE ONLY (2/2015) North Carolina

46

47 Home Health Care Rates Kemper Home Health Care s Attained Age Monthly Bank Draft Annual $11.65 $ $11.65 $ $11.65 $ $12.05 $ $13.95 $ $14.10 $ $18.35 $ $21.05 $ $24.80 $ Home Health Care with EXTRA BENEFITS Attained Age Monthly Bank Draft Annual $17.45 $ $17.45 $ $17.50 $ $17.90 $ $19.85 $ $20.05 $ $24.40 $ $27.15 $ $30.90 $ Rates for use in North Carolina only This is a brief description of some of the provisions of policies individually underwritten by Reserve National Insurance Company. Only the actual policy provisions will control. SEE THE POLICY AND/OR OUTLINE OF COVERAGE FOR LIMITATIONS AND EXCLUSIONS. Policy Form Series HHC with PD-2 and Rider Form Series EBR-HHC Form numbers and availability may vary by state.

48

49 CANCER SCHEDULE OF BENEFITS BENEFIT OPTION A OPTION B OPTION C OPTION D Hospital & U.S. Govt. Hospital Confinement $100 per day $180 per day $250 per day $410 per day Hospital Confinement Inflation Fighter Not Available $10 per day $15 per day $20 per day Extended s (Begins with day 90 of consecutive hospital confinement, in lieu of all other benefits, except waiver of premium) Drugs & Diagnostic Testing Actual charges up to $350 per day Actual charges up to $10 per day Actual charges up to $600 per day Actual charges up to $25 per day Actual charges up to $600 per day Actual charges up to $40 per day Actual charges up to $600 per day Actual charges up to $50 per day Attending Physician Actual charges up to $10 per day Actual charges up to $30 per day Actual charges up to $35 per day Actual charges up to $40 per day Private Nurse Actual charges up to $50 per day Actual charges up to $125 per day Actual charges up to $125 per day Actual charges up to $125 per day Ambulance Surgical Procedure Radiation/Chemotherapy Breast Reconstruction Anesthesia Second and Third Surgical Opinion Actual charges up to $75 per trip Up to $2,500 Actual charges up to $100 per day Actual charges up to mastectomy amount up to $625 Not Available Actual charges up to $150 per trip Up to $4,500 Actual charges up to $175 per day plus $100 at time of 1st treatment Actual charges up to mastectomy amount up to $1,125 Actual charges up to $150 per opinion Actual charges up to $225 per trip Up to $7,500 Actual charges up to $250 per day plus $250 at time of 1st treatment Actual charges up to mastectomy amount up to $1,875 Actual charges up to $225 per opinion Actual charges up to $300 per trip Up to $9,000 Actual charges up to $300 per day plus $500 at time of 1st treatment Actual charges up to mastectomy amount up to $2,250 Actual charges up to $225 per opinion Blood and Plasma Skilled Nursing Facility $20 per unit Actual charges up to $50 per day $40 per unit Actual charges up to $100 per day $60 per unit Actual charges up to $125 per day $80 per unit Actual charges up to $150 per day Home Care and Recovery Not Available $15 per day $15 per day $25 per day Prosthesis Hospice Days 1-60 Days 61+ Waiver of Premium Transport (air) Actual charges up to $250 per device $50 per day $25 per day Yes Actual charges up to $500 per trip one-way Actual charges up to $1,000 per device $80 per day $40 per day Yes Actual charges up to $1,000 per trip one-way Actual charges up to $2,000 per device $100 per day $50 per day Yes Actual charges up to $1,500 per trip one-way Actual charges up to $2,500 per device $120 per day $60 per day Yes Actual charges up to $2,500 per trip one-way One Way trip $0.15 per mile $0.25 per mile $0.40 per mile $0.40 per mile Family Transport Actual charges up to $500 per trip one-way Actual charges up to $1,000 per trip one-way Actual charges up to $1,500 per trip one-way Actual charges up to $2,500 per trip one-way One Way trip Family Lodging $0.15 per mile Actual charges up to $20 per day $0.25 per mile Actual charges up to $40 per day $0.40 per mile Actual charges up to $50 per day $0.40 per mile Actual charges up to $60 per day Comfort (Outpatient Drugs) Not Available Not Available Actual charges up to $200 per year Actual charges up to $226 per year Bone Marrow Transplant Not Available $2,500 $5,000 $10,000 Daily Room (first 70 days of confinement) $100 $150 $200 $300 15B930

50 HEART ATTACK AND STROKE SCHEDULE OF BENEFITS BENEFIT OPTION A OPTION B OPTION C OPTION D Hospital & U.S. Govt. Hospital Confinement $100 per day $180 per day $250 per day $410 per day Hospital Confinement Inflation Fighter Extended s (Begins with day 90 of consecutive hospital confinement, in lieu of all other benefits, except waiver of premium) Not Available Actual charges up to $350 per day $10 per day Actual charges up to $600 per day $15 per day Actual charges up to $600 per day $20 per day Actual charges up to $600 per day Drugs & Diagnostic Testing Actual charges up to $10 per day Actual charges up to $25 per day Actual charges up to $40 per day Actual charges up to $50 per day Attending Physician Actual charges up to $10 per day Actual charges up to $30 per day Actual charges up to $35 per day Actual charges up to $40 per day Private Nurse Actual charges up to $50 per day Actual charges up to $125 per day Actual charges up to $125 per day Actual charges up to $125 per day Ambulance Actual charges up to $75 per trip Actual charges up to $150 per trip Actual charges up to $225 per trip Actual charges up to $300 per trip Surgical Procedure Anesthesia Second and Third Surgical Opinion Blood and Plasma Up to $2,500 Up to $625 Not Available $20 per unit Up to $4,500 Up to $1,125 Actual charges up to $150 per opinion $40 per unit Up to $7,500 Up to $1,875 Actual charges up to $225 per opinion $60 per unit Up to $9,000 Up to $2,250 Actual charges up to $225 per opinion $80 per unit Skilled Nursing Facility Transport (air) Actual charges up to $50 per day Actual charges up to $500 per trip one-way Actual charges up to $100 per day Actual charges up to $1,000 per trip one-way Actual charges up to $125 per day Actual charges up to $1,500 per trip one-way Actual charges up to $150 per day Actual charges up to $2,500 per trip one-way One Way trip $0.15 per mile $0.25 per mile $0.40 per mile $0.40 per mile Family Transport Actual charges up to $500 per trip one-way Actual charges up to $1,000 per trip one-way Actual charges up to $1,500 per trip one-way Actual charges up to $2,500 per trip one-way One Way trip $0.15 per mile $0.25 per mile $0.40 per mile $0.40 per mile Family Lodging Actual charges up to $20 per day Actual charges up to $40 per day Actual charges up to $50 per day Actual charges up to $60 per day Daily Room (first 70 days of confinement) $100 $150 $200 $300

51 SCHEDULE OF BENEFITS PLAN RATES SCHEDULE OF BENEFITS PLAN INDIVIDUAL Ages Option A Option B Option C Option D $ $ $ $ SCHEDULE OF BENEFITS PLAN FAMILY Ages Option A Option B Option C Option D $ $ $ $ HEART ATTACK AND STROKE RIDER INDIVIDUAL Ages Option A Option B Option C Option D $ $ $ $ , HEART ATTACK AND STROKE RIDER FAMILY Ages Option A Option B Option C Option D $ $ $ $ , , , , , , EXPRESS PAY RIDER INDIVIDUAL (CANCER ONLY) Ages Per $1, $ INDIVIDUAL (CANCER, HEART ATTACK & STROKE) Ages Per $1, $ FAMILY (CANCER ONLY) Ages Per $1, $ FAMILY (CANCER, HEART ATTACK & STROKE) Ages Per $1, $

52 PREMIUM CALCULATION WORKSHEET Calculate the Premium for your Supplemental Solutions plan in 5 Easy Steps! STEP 1: Select the annual premium rate for the desired schedule (e.g. At age 50, Schedule A for an individual costs $90.70 per year.) a) = $90.70 STEP 2:* Select the annual premium rate for the Heart Attack and Stroke Rider (e.g. At age 50, Schedule A for an individual costs $ per year.) b) = $ STEP 3:* Select the appropriate rate per thousand for the Express Pay Rider. (e.g. At age 50, the Express Pay rider rate is $34.03 per thousand. Multiply this by the desired number of units. For example, $34.03 x 10 = $ ) c) = $ STEP 4: Add a) $ b) $ c) $ = d) $ STEP 5: Multiply the annual premium $ x the appropriate modal factor. for Monthly Bank Draft, $ x.084 = $51.05) (e.g. This is the total modal premium. Don't forget to submit a $20 one-time fee with each application. ($6 in MS; $ 0 in AR & KY) * optional riders. MODAL FACTORS Monthly PAC:.084 Quarterly:.265 Semi:.52 Rates are: AL, AK, AZ,AR, DE, DC, HI, ID, IL, IN, IA, KY, LA, ME, MI, MS, MO, MT, NE, NV, NJ, NM, NC, OH, OK, OR, RI, SC, UT, VT, WV, WI 15B930

53 Lump Sum Plan Rates Cancer Plan with Heart Attack and Stroke Rider Age $5,000**-$24,999 $25,000-$49,999 $50,000 Individual Family* Individual Family* Individual Family* $ $ $ $ $ $ Premium Calculation This is based on a 40-year old individual who has selected a $50,000 lump sum benefit with the Heart Attack and Stroke. 1) Determine the correct rate per thousand, based on the proposed insured s age - in this example, it is $ ) Multiply the rate per thousand times the number of units of coverage desired. For example, $50,000 / $1,000 = 50 units. 50 x $12.40 = $620 this is the total annual premium. Cancer Plan Only Rates per $1,000 3) Please remember to submit the $20 application fee in addition to the modal premium. Age $5,000**-$24,999 $25,000-$49,999 $50,000 Individual Family* Individual Family* Individual Family* $ $ $ $ $ $ Rates per $1,000 *Family Plan is calculated based upon the age of the oldest insured. ** Minimum: $5,000 ages 50+; $10,000 under age 50 Modal Factors Monthly PAC:.084 Quarterly:.265 Semi:.5 Rev. 6/14 BASIC 15B929

54 Premium Calculation Worksheet Step 1 Multiply rate per thousand by the Number of Units = (a). Step 2 Multiply (a) by the desired modal factor = (b). This is the total modal premium. Don t forget to submit a $20 one-time fee with the application! Rates are for: ID, ME, NV, NJ, NC, RI, VT, WV Rev. 6/14 BASIC 15B929

55 For Producer Use Only US (07/12) Foresters PlanRight Whole Life Insurance Rate Book Product information and premium rates contained in this rate book are for reference purposes only and are subject to state restrictions, variations and eligibility requirements. If there is any discrepancy between premium rates contained in this rate book and the illustration software, the illustration software shall take precedence. Foresters is the trade name and a trademark of The Independent Order of Foresters, a fraternal benefit society, 789 Don Mills Road, Toronto, Ontario, Canada, M3C 1T9

56 Table of contents Page Monthly Quick Quotes (EFT/PAC) $20.00/Month... 3 Monthly Quick Quotes (EFT/PAC) $30.00/Month... 4 Monthly Quick Quotes (EFT/PAC) $40.00/Month... 5 Monthly Quick Quotes (EFT/PAC) $50.00/Month... 6 Monthly Quick Quotes (EFT/PAC) $60.00/Month... 7 Monthly Quick Quotes (EFT/PAC) $70.00/Month... 8 Monthly Quick Quotes (EFT/PAC) $80.00/Month... 9 Monthly Quick Quotes (EFT/PAC) $90.00/Month Monthly Quick Quotes (EFT/PAC) $100.00/Month Monthly Quick Quotes (EFT/PAC) $110.00/Month Monthly Quick Quotes (EFT/PAC) $120.00/Month Monthly Quick Quotes (EFT/PAC) $130.00/Month Monthly Quick Quotes (EFT/PAC) $140.00/Month Monthly Quick Quotes (EFT/PAC) $150.00/Month Monthly Quick Quotes (EFT/PAC) $5,000 Face Amount Monthly Quick Quotes (EFT/PAC) $10,000 Face Amount Monthly Quick Quotes (EFT/PAC) $15,000 Face Amount Monthly Quick Quotes (EFT/PAC) $20,000 Face Amount Monthly Quick Quotes (EFT/PAC) $25,000 Face Amount Monthly Quick Quotes (EFT/PAC) $30,000 Face Amount Monthly Quick Quotes (EFT/PAC) $35,000 Face Amount For Producer Use Only US (07/12)

57 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $20.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 6,256 $ 5,874 $ 4,021 $ 3,876 $ 8,446 $ 8,007 $ 4,968 $ 4, $ 4,373 $ 4,183 $ 2,930 $ 2,917 $ 5,220 $ 5,049 $ 3,982 $ 3,209 $ 5,986 $ 5,635 $ 3,795 $ 3,654 $ 8,020 $ 7,623 $ 4,827 $ 4, $ 4,174 $ 4,001 $ 2,751 $ 2,719 $ 5,024 $ 4,865 $ 3,828 $ 3,027 $ 5,738 $ 5,415 $ 3,593 $ 3,455 $ 7,635 $ 7,275 $ 4,694 $ 4, $ 3,992 $ 3,833 $ 2,592 $ 2,547 $ 4,842 $ 4,694 $ 3,685 $ 2,865 $ 5,508 $ 5,210 $ 3,411 $ 3,277 $ 7,283 $ 6,954 $ 4,569 $ 4, $ 3,826 $ 3,680 $ 2,451 $ 2,395 $ 4,674 $ 4,536 $ 3,553 $ 2,719 $ 5,297 $ 4,988 $ 3,247 $ 3,117 $ 6,964 $ 6,663 $ 4,450 $ 4, $ 3,673 $ 3,522 $ 2,324 $ 2,260 $ 4,516 $ 4,387 $ 3,430 $ 2,588 $ 5,102 $ 4,815 $ 3,097 $ 2,971 $ 6,672 $ 6,395 $ 4,337 $ 4, $ 3,532 $ 3,392 $ 2,210 $ 2,139 $ 4,368 $ 4,248 $ 3,315 $ 2,468 $ 4,866 $ 4,604 $ 2,943 $ 2,830 $ 6,359 $ 6,059 $ 4,188 $ 3, $ 3,360 $ 3,233 $ 2,097 $ 2,026 $ 4,167 $ 4,036 $ 3,207 $ 2,431 $ 4,652 $ 4,387 $ 2,803 $ 2,701 $ 6,074 $ 5,800 $ 4,048 $ 3, $ 3,205 $ 3,077 $ - $ - $ 3,983 $ 3,863 $ 3,106 $ 2,395 $ 4,455 $ 4,211 $ 2,676 $ 2,584 $ 5,812 $ 5,560 $ 3,918 $ 3, $ 3,063 $ 2,946 $ - $ - $ 3,816 $ 3,706 $ 3,012 $ 2,359 $ 4,275 $ 4,029 $ 2,560 $ 2,476 $ 5,573 $ 5,341 $ 3,795 $ 3, $ 2,934 $ 2,816 $ - $ - $ 3,661 $ 3,560 $ 2,923 $ 2,325 $ 4,108 $ 3,880 $ 2,453 $ 2,377 $ 5,353 $ 5,105 $ 3,680 $ 3, $ 2,815 $ 2,706 $ - $ - $ 3,519 $ 3,410 $ 2,839 $ 2,292 $ 3,943 $ 3,715 $ 2,340 $ 2,245 $ 5,117 $ 4,890 $ 3,487 $ 3, $ 2,656 $ 2,551 $ - $ - $ 3,372 $ 3,272 $ 2,687 $ 2,228 $ 3,792 $ 3,580 $ 2,236 $ 2,127 $ 4,900 $ 4,691 $ 3,314 $ 3, $ 2,515 $ 2,420 $ - $ - $ 3,238 $ 3,145 $ 2,550 $ 2,168 $ 3,651 $ 3,439 $ 2,142 $ 2,021 $ 4,701 $ 4,482 $ 3,156 $ 2, $ 2,388 $ 2,295 $ - $ - $ 3,113 $ 3,015 $ 2,427 $ 2,111 $ 3,521 $ 3,323 $ 2,054 $ - $ 4,517 $ 4,314 $ 3,014 $ 2, $ 2,273 $ 2,189 $ - $ - $ 2,998 $ 2,908 $ 2,315 $ 2,057 $ 3,399 $ 3,201 $ - $ - $ 4,347 $ 4,160 $ 2,883 $ 2, $ 2,168 $ 2,086 $ - $ - $ 2,891 $ 2,807 $ 2,213 $ 2,005 $ 3,182 $ 3,008 $ - $ - $ 4,127 $ 3,937 $ 2,716 $ 2, $ 2,059 $ - $ - $ - $ 2,803 $ 2,714 $ 2,082 $ - $ 2,992 $ 2,827 $ - $ - $ 3,926 $ 3,754 $ 2,567 $ 2, $ - $ - $ - $ - $ 2,720 $ 2,636 $ - $ - $ 2,823 $ 2,666 $ - $ - $ 3,745 $ 3,572 $ 2,433 $ 2, $ - $ - $ - $ - $ 2,643 $ 2,555 $ - $ - $ 2,672 $ 2,523 $ - $ - $ 3,580 $ 3,421 $ 2,313 $ 2, $ - $ - $ - $ - $ 2,569 $ 2,486 $ - $ - $ 2,536 $ 2,394 $ - $ - $ 3,428 $ 3,268 $ 2,204 $ 2, $ - $ - $ - $ - $ 2,499 $ 2,413 $ - $ - $ 2,343 $ 2,215 $ - $ - $ 3,170 $ 3,033 $ 2,021 $ - 71 $ - $ - $ - $ - $ 2,319 $ 2,244 $ - $ - $ 2,178 $ 2,061 $ - $ - $ 2,948 $ 2,819 $ - $ - 72 $ - $ - $ - $ - $ 2,163 $ 2,092 $ - $ - $ 2,034 $ - $ - $ - $ 2,755 $ 2,632 $ - $ - 73 $ - $ - $ - $ - $ 2,026 $ - $ - $ - $ - $ - $ - $ - $ 2,586 $ 2,470 $ - $ - 74 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,436 $ 2,326 $ - $ - 75 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,225 $ 2,127 $ - $ - 76 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,048 $ - $ - $ - 77 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 78 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 79 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 80 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 3 For Producer Use Only US (07/12)

58 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $30.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 9,969 $ 9,361 $ 6,408 $ 6,176 $ 13,458 $ 12,759 $ 7,916 $ 7, $ 6,969 $ 6,666 $ 4,669 $ 4,649 $ 8,318 $ 8,045 $ 6,345 $ 5,114 $ 9,538 $ 8,980 $ 6,047 $ 5,822 $ 12,780 $ 12,147 $ 7,692 $ 7, $ 6,652 $ 6,375 $ 4,383 $ 4,334 $ 8,005 $ 7,752 $ 6,100 $ 4,824 $ 9,143 $ 8,629 $ 5,726 $ 5,506 $ 12,167 $ 11,592 $ 7,480 $ 7, $ 6,362 $ 6,109 $ 4,131 $ 4,058 $ 7,715 $ 7,480 $ 5,872 $ 4,566 $ 8,777 $ 8,302 $ 5,435 $ 5,223 $ 11,605 $ 11,081 $ 7,281 $ 7, $ 6,098 $ 5,865 $ 3,906 $ 3,816 $ 7,447 $ 7,228 $ 5,662 $ 4,334 $ 8,441 $ 7,949 $ 5,174 $ 4,966 $ 11,097 $ 10,617 $ 7,091 $ 6, $ 5,853 $ 5,612 $ 3,704 $ 3,601 $ 7,196 $ 6,991 $ 5,465 $ 4,124 $ 8,130 $ 7,673 $ 4,936 $ 4,735 $ 10,632 $ 10,191 $ 6,911 $ 6, $ 5,628 $ 5,405 $ 3,522 $ 3,409 $ 6,961 $ 6,769 $ 5,283 $ 3,934 $ 7,754 $ 7,337 $ 4,690 $ 4,509 $ 10,133 $ 9,655 $ 6,673 $ 6, $ 5,355 $ 5,152 $ 3,341 $ 3,228 $ 6,640 $ 6,431 $ 5,111 $ 3,874 $ 7,413 $ 6,991 $ 4,467 $ 4,304 $ 9,680 $ 9,242 $ 6,450 $ 6, $ 5,108 $ 4,904 $ 3,178 $ 3,066 $ 6,347 $ 6,156 $ 4,950 $ 3,816 $ 7,099 $ 6,711 $ 4,264 $ 4,117 $ 9,262 $ 8,861 $ 6,243 $ 5, $ 4,882 $ 4,695 $ 3,030 $ 2,919 $ 6,081 $ 5,905 $ 4,799 $ 3,760 $ 6,812 $ 6,420 $ 4,079 $ 3,946 $ 8,881 $ 8,511 $ 6,047 $ 5, $ 4,676 $ 4,488 $ 2,895 $ 2,785 $ 5,834 $ 5,673 $ 4,657 $ 3,706 $ 6,546 $ 6,184 $ 3,910 $ 3,788 $ 8,530 $ 8,135 $ 5,865 $ 5, $ 4,486 $ 4,312 $ 2,772 $ 2,663 $ 5,607 $ 5,433 $ 4,523 $ 3,653 $ 6,284 $ 5,920 $ 3,728 $ 3,578 $ 8,154 $ 7,792 $ 5,557 $ 5, $ 4,233 $ 4,065 $ 2,652 $ 2,531 $ 5,374 $ 5,214 $ 4,282 $ 3,551 $ 6,042 $ 5,705 $ 3,563 $ 3,390 $ 7,808 $ 7,475 $ 5,281 $ 4, $ 4,008 $ 3,856 $ 2,542 $ 2,412 $ 5,159 $ 5,012 $ 4,064 $ 3,455 $ 5,818 $ 5,480 $ 3,413 $ 3,221 $ 7,491 $ 7,142 $ 5,030 $ 4, $ 3,805 $ 3,657 $ 2,441 $ 2,303 $ 4,961 $ 4,805 $ 3,868 $ 3,364 $ 5,610 $ 5,296 $ 3,274 $ 3,068 $ 7,198 $ 6,875 $ 4,802 $ 4, $ 3,622 $ 3,488 $ 2,347 $ 2,204 $ 4,778 $ 4,633 $ 3,689 $ 3,278 $ 5,416 $ 5,101 $ 3,146 $ 2,929 $ 6,928 $ 6,629 $ 4,595 $ 4, $ 3,455 $ 3,324 $ 2,260 $ 2,113 $ 4,607 $ 4,473 $ 3,527 $ 3,196 $ 5,072 $ 4,794 $ 3,016 $ 2,785 $ 6,576 $ 6,273 $ 4,328 $ 4, $ 3,281 $ 3,163 $ 2,175 $ - $ 4,467 $ 4,325 $ 3,319 $ 2,994 $ 4,767 $ 4,505 $ 2,896 $ 2,655 $ 6,257 $ 5,982 $ 4,090 $ 3, $ 3,124 $ 3,009 $ 2,096 $ - $ 4,335 $ 4,201 $ 3,134 $ 2,816 $ 4,498 $ 4,249 $ 2,786 $ 2,536 $ 5,968 $ 5,692 $ 3,877 $ 3, $ 2,981 $ 2,869 $ 2,022 $ - $ 4,211 $ 4,071 $ 2,969 $ 2,658 $ 4,257 $ 4,020 $ 2,683 $ 2,428 $ 5,704 $ 5,451 $ 3,686 $ 3, $ 2,850 $ 2,742 $ - $ - $ 4,094 $ 3,962 $ 2,820 $ 2,516 $ 4,041 $ 3,815 $ 2,588 $ 2,328 $ 5,463 $ 5,208 $ 3,512 $ 3, $ 2,731 $ 2,626 $ - $ - $ 3,983 $ 3,845 $ 2,686 $ 2,389 $ 3,734 $ 3,530 $ 2,375 $ 2,133 $ 5,051 $ 4,833 $ 3,221 $ 2, $ 2,493 $ 2,401 $ - $ - $ 3,695 $ 3,577 $ 2,490 $ 2,223 $ 3,471 $ 3,285 $ 2,195 $ - $ 4,698 $ 4,492 $ 2,974 $ 2, $ 2,294 $ 2,211 $ - $ - $ 3,447 $ 3,334 $ 2,321 $ 2,078 $ 3,242 $ 3,071 $ 2,040 $ - $ 4,390 $ 4,195 $ 2,762 $ 2, $ 2,124 $ 2,049 $ - $ - $ 3,229 $ 3,122 $ 2,174 $ - $ 3,041 $ 2,884 $ - $ - $ 4,121 $ 3,936 $ 2,579 $ 2, $ - $ - $ - $ - $ 3,037 $ 2,936 $ 2,044 $ - $ 2,864 $ 2,712 $ - $ - $ 3,882 $ 3,706 $ 2,418 $ 2, $ - $ - $ - $ - $ 2,867 $ 2,770 $ - $ - $ 2,629 $ 2,490 $ - $ - $ 3,546 $ 3,389 $ 2,208 $ - 76 $ - $ - $ - $ - $ 2,645 $ 2,557 $ - $ - $ 2,430 $ 2,302 $ - $ - $ 3,263 $ 3,122 $ 2,032 $ - 77 $ - $ - $ - $ - $ 2,455 $ 2,374 $ - $ - $ 2,259 $ 2,137 $ - $ - $ 3,023 $ 2,888 $ - $ - 78 $ - $ - $ - $ - $ 2,290 $ 2,212 $ - $ - $ 2,110 $ - $ - $ - $ 2,815 $ 2,680 $ - $ - 79 $ - $ - $ - $ - $ 2,146 $ 2,067 $ - $ - $ - $ - $ - $ - $ 2,634 $ 2,490 $ - $ - 80 $ - $ - $ - $ - $ 2,019 $ - $ - $ - $ - $ - $ - $ - $ 2,383 $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,175 $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,001 $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 4 For Producer Use Only US (07/12)

59 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $40.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 13,682 $ 12,847 $ 8,795 $ 8,477 $ 18,471 $ 17,511 $ 10,865 $ 10, $ 9,564 $ 9,149 $ 6,408 $ 6,380 $ 11,416 $ 11,042 $ 8,708 $ 7,019 $ 13,091 $ 12,324 $ 8,300 $ 7,991 $ 17,540 $ 16,672 $ 10,557 $ 10, $ 9,129 $ 8,750 $ 6,016 $ 5,948 $ 10,987 $ 10,640 $ 8,372 $ 6,621 $ 12,548 $ 11,843 $ 7,858 $ 7,556 $ 16,698 $ 15,910 $ 10,266 $ 10, $ 8,731 $ 8,384 $ 5,669 $ 5,570 $ 10,589 $ 10,266 $ 8,060 $ 6,267 $ 12,046 $ 11,394 $ 7,460 $ 7,168 $ 15,928 $ 15,209 $ 9,993 $ 9, $ 8,369 $ 8,049 $ 5,360 $ 5,238 $ 10,221 $ 9,920 $ 7,771 $ 5,948 $ 11,585 $ 10,910 $ 7,101 $ 6,816 $ 15,231 $ 14,572 $ 9,732 $ 9, $ 8,034 $ 7,703 $ 5,083 $ 4,942 $ 9,876 $ 9,595 $ 7,501 $ 5,660 $ 11,159 $ 10,531 $ 6,775 $ 6,499 $ 14,592 $ 13,986 $ 9,485 $ 9, $ 7,724 $ 7,418 $ 4,834 $ 4,679 $ 9,554 $ 9,290 $ 7,251 $ 5,399 $ 10,642 $ 10,070 $ 6,437 $ 6,189 $ 13,908 $ 13,251 $ 9,159 $ 8, $ 7,349 $ 7,072 $ 4,586 $ 4,431 $ 9,113 $ 8,827 $ 7,015 $ 5,317 $ 10,174 $ 9,595 $ 6,131 $ 5,908 $ 13,285 $ 12,685 $ 8,853 $ 8, $ 7,010 $ 6,730 $ 4,362 $ 4,208 $ 8,712 $ 8,449 $ 6,794 $ 5,238 $ 9,744 $ 9,211 $ 5,853 $ 5,651 $ 12,711 $ 12,161 $ 8,568 $ 8, $ 6,700 $ 6,444 $ 4,159 $ 4,006 $ 8,346 $ 8,105 $ 6,587 $ 5,161 $ 9,350 $ 8,812 $ 5,598 $ 5,415 $ 12,189 $ 11,682 $ 8,300 $ 7, $ 6,417 $ 6,159 $ 3,974 $ 3,823 $ 8,008 $ 7,785 $ 6,392 $ 5,086 $ 8,985 $ 8,487 $ 5,366 $ 5,199 $ 11,708 $ 11,164 $ 8,049 $ 7, $ 6,157 $ 5,919 $ 3,805 $ 3,655 $ 7,696 $ 7,457 $ 6,208 $ 5,013 $ 8,624 $ 8,125 $ 5,117 $ 4,911 $ 11,191 $ 10,694 $ 7,628 $ 7, $ 5,810 $ 5,579 $ 3,640 $ 3,474 $ 7,375 $ 7,156 $ 5,876 $ 4,874 $ 8,293 $ 7,830 $ 4,891 $ 4,653 $ 10,716 $ 10,259 $ 7,248 $ 6, $ 5,500 $ 5,293 $ 3,489 $ 3,310 $ 7,081 $ 6,879 $ 5,578 $ 4,742 $ 7,985 $ 7,521 $ 4,684 $ 4,420 $ 10,281 $ 9,803 $ 6,903 $ 6, $ 5,222 $ 5,020 $ 3,350 $ 3,161 $ 6,809 $ 6,595 $ 5,308 $ 4,617 $ 7,700 $ 7,268 $ 4,494 $ 4,211 $ 9,879 $ 9,436 $ 6,591 $ 6, $ 4,970 $ 4,787 $ 3,221 $ 3,025 $ 6,557 $ 6,359 $ 5,063 $ 4,499 $ 7,434 $ 7,001 $ 4,318 $ 4,020 $ 9,508 $ 9,097 $ 6,306 $ 5, $ 4,742 $ 4,562 $ 3,103 $ 2,900 $ 6,323 $ 6,139 $ 4,840 $ 4,386 $ 6,961 $ 6,580 $ 4,139 $ 3,823 $ 9,025 $ 8,610 $ 5,939 $ 5, $ 4,503 $ 4,341 $ 2,985 $ 2,733 $ 6,131 $ 5,936 $ 4,555 $ 4,109 $ 6,543 $ 6,183 $ 3,975 $ 3,644 $ 8,587 $ 8,211 $ 5,614 $ 5, $ 4,287 $ 4,130 $ 2,876 $ 2,584 $ 5,950 $ 5,766 $ 4,301 $ 3,865 $ 6,174 $ 5,832 $ 3,823 $ 3,481 $ 8,191 $ 7,811 $ 5,322 $ 4, $ 4,091 $ 3,938 $ 2,775 $ 2,450 $ 5,780 $ 5,588 $ 4,075 $ 3,648 $ 5,843 $ 5,518 $ 3,682 $ 3,332 $ 7,829 $ 7,481 $ 5,059 $ 4, $ 3,912 $ 3,763 $ 2,681 $ 2,330 $ 5,618 $ 5,437 $ 3,871 $ 3,454 $ 5,547 $ 5,236 $ 3,552 $ 3,196 $ 7,498 $ 7,148 $ 4,820 $ 4, $ 3,748 $ 3,604 $ 2,593 $ 2,221 $ 5,466 $ 5,278 $ 3,686 $ 3,279 $ 5,125 $ 4,845 $ 3,260 $ 2,927 $ 6,933 $ 6,633 $ 4,420 $ 3, $ 3,422 $ 3,295 $ 2,410 $ 2,069 $ 5,072 $ 4,909 $ 3,418 $ 3,051 $ 4,764 $ 4,509 $ 3,012 $ 2,700 $ 6,448 $ 6,165 $ 4,082 $ 3, $ 3,148 $ 3,035 $ 2,251 $ - $ 4,730 $ 4,576 $ 3,186 $ 2,853 $ 4,449 $ 4,216 $ 2,800 $ 2,506 $ 6,025 $ 5,758 $ 3,791 $ 3, $ 2,915 $ 2,813 $ 2,112 $ - $ 4,432 $ 4,285 $ 2,984 $ 2,679 $ 4,174 $ 3,958 $ 2,615 $ 2,337 $ 5,655 $ 5,402 $ 3,539 $ 3, $ 2,714 $ 2,621 $ - $ - $ 4,169 $ 4,029 $ 2,806 $ 2,524 $ 3,931 $ 3,722 $ 2,454 $ 2,190 $ 5,328 $ 5,086 $ 3,319 $ 2, $ 2,539 $ 2,450 $ - $ - $ 3,935 $ 3,802 $ 2,648 $ 2,387 $ 3,609 $ 3,418 $ 2,264 $ - $ 4,867 $ 4,651 $ 3,031 $ 2, $ 2,371 $ 2,287 $ - $ - $ 3,630 $ 3,509 $ 2,454 $ 2,193 $ 3,335 $ 3,160 $ 2,102 $ - $ 4,479 $ 4,285 $ 2,788 $ 2, $ 2,223 $ 2,144 $ - $ - $ 3,369 $ 3,258 $ 2,287 $ 2,028 $ 3,100 $ 2,933 $ - $ - $ 4,149 $ 3,963 $ 2,582 $ 2, $ 2,093 $ 2,015 $ - $ - $ 3,143 $ 3,036 $ 2,141 $ - $ 2,896 $ 2,727 $ - $ - $ 3,864 $ 3,678 $ 2,404 $ 2, $ - $ - $ - $ - $ 2,946 $ 2,836 $ 2,012 $ - $ 2,717 $ 2,537 $ - $ - $ 3,615 $ 3,417 $ 2,249 $ - 80 $ - $ - $ - $ - $ 2,771 $ 2,653 $ - $ - $ 2,521 $ - $ - $ - $ 3,271 $ - $ 2,034 $ - 81 $ - $ - $ - $ - $ 2,510 $ - $ - $ - $ 2,351 $ - $ - $ - $ 2,986 $ - $ - $ - 82 $ - $ - $ - $ - $ 2,293 $ - $ - $ - $ 2,203 $ - $ - $ - $ 2,747 $ - $ - $ - 83 $ - $ - $ - $ - $ 2,111 $ - $ - $ - $ 2,072 $ - $ - $ - $ 2,543 $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ 2,368 $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 5 For Producer Use Only US (07/12)

60 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $50.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 17,395 $ 16,334 $ 11,182 $ 10,777 $ 23,483 $ 22,263 $ 13,813 $ 13, $ 12,160 $ 11,632 $ 8,147 $ 8,112 $ 14,514 $ 14,038 $ 11,071 $ 8,923 $ 16,643 $ 15,669 $ 10,552 $ 10,159 $ 22,300 $ 21,196 $ 13,422 $ 13, $ 11,606 $ 11,124 $ 7,648 $ 7,562 $ 13,968 $ 13,527 $ 10,644 $ 8,418 $ 15,954 $ 15,057 $ 9,991 $ 9,607 $ 21,230 $ 20,227 $ 13,052 $ 12, $ 11,101 $ 10,659 $ 7,208 $ 7,082 $ 13,463 $ 13,052 $ 10,247 $ 7,967 $ 15,315 $ 14,486 $ 9,485 $ 9,113 $ 20,250 $ 19,336 $ 12,705 $ 12, $ 10,640 $ 10,233 $ 6,815 $ 6,659 $ 12,995 $ 12,613 $ 9,880 $ 7,562 $ 14,729 $ 13,871 $ 9,029 $ 8,666 $ 19,364 $ 18,526 $ 12,374 $ 11, $ 10,214 $ 9,793 $ 6,463 $ 6,284 $ 12,556 $ 12,199 $ 9,537 $ 7,196 $ 14,187 $ 13,389 $ 8,613 $ 8,262 $ 18,552 $ 17,782 $ 12,059 $ 11, $ 9,820 $ 9,431 $ 6,145 $ 5,949 $ 12,146 $ 11,811 $ 9,218 $ 6,864 $ 13,531 $ 12,803 $ 8,184 $ 7,869 $ 17,682 $ 16,847 $ 11,644 $ 11, $ 9,344 $ 8,991 $ 5,830 $ 5,633 $ 11,586 $ 11,222 $ 8,919 $ 6,760 $ 12,936 $ 12,199 $ 7,794 $ 7,511 $ 16,890 $ 16,127 $ 11,255 $ 10, $ 8,913 $ 8,557 $ 5,546 $ 5,350 $ 11,076 $ 10,742 $ 8,638 $ 6,659 $ 12,388 $ 11,711 $ 7,441 $ 7,185 $ 16,161 $ 15,461 $ 10,893 $ 10, $ 8,519 $ 8,193 $ 5,288 $ 5,093 $ 10,610 $ 10,304 $ 8,375 $ 6,561 $ 11,887 $ 11,203 $ 7,118 $ 6,885 $ 15,497 $ 14,852 $ 10,552 $ 9, $ 8,159 $ 7,831 $ 5,053 $ 4,860 $ 10,181 $ 9,898 $ 8,127 $ 6,466 $ 11,423 $ 10,790 $ 6,822 $ 6,610 $ 14,885 $ 14,194 $ 10,233 $ 9, $ 7,827 $ 7,525 $ 4,838 $ 4,647 $ 9,784 $ 9,481 $ 7,893 $ 6,374 $ 10,965 $ 10,330 $ 6,506 $ 6,244 $ 14,228 $ 13,596 $ 9,698 $ 9, $ 7,387 $ 7,093 $ 4,628 $ 4,417 $ 9,377 $ 9,098 $ 7,471 $ 6,197 $ 10,544 $ 9,955 $ 6,218 $ 5,916 $ 13,624 $ 13,043 $ 9,215 $ 8, $ 6,993 $ 6,729 $ 4,436 $ 4,209 $ 9,003 $ 8,745 $ 7,091 $ 6,029 $ 10,152 $ 9,562 $ 5,955 $ 5,620 $ 13,071 $ 12,463 $ 8,777 $ 8, $ 6,639 $ 6,382 $ 4,259 $ 4,019 $ 8,656 $ 8,385 $ 6,749 $ 5,870 $ 9,790 $ 9,241 $ 5,713 $ 5,353 $ 12,559 $ 11,997 $ 8,380 $ 7, $ 6,319 $ 6,086 $ 4,096 $ 3,846 $ 8,337 $ 8,085 $ 6,437 $ 5,720 $ 9,451 $ 8,901 $ 5,490 $ 5,111 $ 12,089 $ 11,566 $ 8,017 $ 7, $ 6,029 $ 5,800 $ 3,945 $ 3,687 $ 8,039 $ 7,805 $ 6,154 $ 5,577 $ 8,850 $ 8,366 $ 5,263 $ 4,860 $ 11,475 $ 10,947 $ 7,551 $ 7, $ 5,725 $ 5,519 $ 3,795 $ 3,475 $ 7,794 $ 7,547 $ 5,791 $ 5,224 $ 8,319 $ 7,861 $ 5,054 $ 4,633 $ 10,918 $ 10,439 $ 7,138 $ 6, $ 5,451 $ 5,250 $ 3,657 $ 3,285 $ 7,564 $ 7,331 $ 5,469 $ 4,913 $ 7,849 $ 7,414 $ 4,861 $ 4,426 $ 10,414 $ 9,931 $ 6,766 $ 6, $ 5,201 $ 5,007 $ 3,528 $ 3,115 $ 7,348 $ 7,104 $ 5,181 $ 4,638 $ 7,429 $ 7,015 $ 4,682 $ 4,237 $ 9,954 $ 9,511 $ 6,432 $ 5, $ 4,974 $ 4,785 $ 3,409 $ 2,962 $ 7,143 $ 6,913 $ 4,921 $ 4,391 $ 7,052 $ 6,657 $ 4,516 $ 4,063 $ 9,533 $ 9,088 $ 6,128 $ 5, $ 4,765 $ 4,582 $ 3,296 $ 2,823 $ 6,950 $ 6,710 $ 4,686 $ 4,170 $ 6,516 $ 6,160 $ 4,145 $ 3,721 $ 8,815 $ 8,433 $ 5,620 $ 5, $ 4,351 $ 4,189 $ 3,064 $ 2,630 $ 6,448 $ 6,241 $ 4,346 $ 3,879 $ 6,056 $ 5,732 $ 3,830 $ 3,433 $ 8,198 $ 7,838 $ 5,189 $ 4, $ 4,003 $ 3,858 $ 2,862 $ 2,462 $ 6,014 $ 5,818 $ 4,051 $ 3,627 $ 5,657 $ 5,360 $ 3,560 $ 3,186 $ 7,661 $ 7,320 $ 4,820 $ 4, $ 3,706 $ 3,576 $ 2,685 $ 2,314 $ 5,634 $ 5,448 $ 3,794 $ 3,406 $ 5,307 $ 5,033 $ 3,325 $ 2,972 $ 7,190 $ 6,867 $ 4,500 $ 3, $ 3,451 $ 3,332 $ 2,529 $ 2,182 $ 5,300 $ 5,123 $ 3,567 $ 3,210 $ 4,998 $ 4,733 $ 3,120 $ 2,785 $ 6,774 $ 6,467 $ 4,219 $ 3, $ 3,228 $ 3,115 $ 2,390 $ 2,065 $ 5,004 $ 4,834 $ 3,366 $ 3,035 $ 4,588 $ 4,346 $ 2,879 $ 2,521 $ 6,187 $ 5,914 $ 3,853 $ 3, $ 3,014 $ 2,908 $ 2,203 $ - $ 4,616 $ 4,462 $ 3,120 $ 2,788 $ 4,240 $ 4,017 $ 2,673 $ 2,303 $ 5,694 $ 5,448 $ 3,545 $ 3, $ 2,827 $ 2,726 $ 2,042 $ - $ 4,284 $ 4,143 $ 2,907 $ 2,579 $ 3,942 $ 3,729 $ 2,494 $ 2,120 $ 5,275 $ 5,039 $ 3,283 $ 2, $ 2,661 $ 2,562 $ - $ - $ 3,996 $ 3,860 $ 2,722 $ 2,398 $ 3,682 $ 3,468 $ 2,338 $ - $ 4,912 $ 4,676 $ 3,057 $ 2, $ 2,514 $ 2,412 $ - $ - $ 3,745 $ 3,606 $ 2,559 $ 2,242 $ 3,455 $ 3,226 $ 2,200 $ - $ 4,596 $ 4,344 $ 2,860 $ 2, $ 2,382 $ 2,271 $ - $ - $ 3,523 $ 3,374 $ 2,414 $ 2,104 $ 3,205 $ - $ 2,025 $ - $ 4,158 $ - $ 2,587 $ - 81 $ 2,231 $ - $ - $ - $ 3,191 $ - $ 2,194 $ - $ 2,989 $ - $ - $ - $ 3,796 $ - $ 2,361 $ - 82 $ 2,098 $ - $ - $ - $ 2,916 $ - $ 2,012 $ - $ 2,801 $ - $ - $ - $ 3,492 $ - $ 2,172 $ - 83 $ - $ - $ - $ - $ 2,684 $ - $ - $ - $ 2,634 $ - $ - $ - $ 3,233 $ - $ 2,011 $ - 84 $ - $ - $ - $ - $ 2,487 $ - $ - $ - $ 2,487 $ - $ - $ - $ 3,010 $ - $ - $ - 85 $ - $ - $ - $ - $ 2,316 $ - $ - $ - 6 For Producer Use Only US (07/12)

61 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $60.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADB w/ ADB w/o ADB w/ ADB w/o ADB w/ ADB w/o ADB w/ ADB $ 21,108 $ 19,820 $ 13,569 $ 13,077 $ 28,496 $ 27,015 $ 16,762 $ - 50 $ 14,756 $ 14,115 $ 9,886 $ 9,844 $ 17,612 $ 17,034 $ 13,434 $ 10,828 $ 20,196 $ 19,014 $ 12,804 $ 12,328 $ 27,060 $ 25,721 $ 16,287 $ - 51 $ 14,084 $ 13,499 $ 9,281 $ 9,176 $ 16,950 $ 16,415 $ 12,916 $ 10,215 $ 19,359 $ 18,270 $ 12,123 $ 11,658 $ 25,761 $ 24,545 $ 15,838 $ - 52 $ 13,471 $ 12,934 $ 8,746 $ 8,594 $ 16,336 $ 15,838 $ 12,434 $ 9,668 $ 18,584 $ 17,578 $ 11,509 $ 11,058 $ 24,573 $ 23,463 $ 15,417 $ 14, $ 12,911 $ 12,418 $ 8,270 $ 8,081 $ 15,769 $ 15,305 $ 11,989 $ 9,176 $ 17,873 $ 16,831 $ 10,956 $ 10,516 $ 23,497 $ 22,481 $ 15,015 $ 14, $ 12,394 $ 11,884 $ 7,843 $ 7,625 $ 15,237 $ 14,803 $ 11,573 $ 8,732 $ 17,215 $ 16,246 $ 10,452 $ 10,026 $ 22,512 $ 21,578 $ 14,633 $ 13, $ 11,916 $ 11,444 $ 7,457 $ 7,219 $ 14,739 $ 14,332 $ 11,186 $ 8,329 $ 16,419 $ 15,535 $ 9,931 $ 9,549 $ 21,456 $ 20,444 $ 14,130 $ 13, $ 11,338 $ 10,910 $ 7,075 $ 6,836 $ 14,060 $ 13,617 $ 10,823 $ 8,203 $ 15,697 $ 14,803 $ 9,458 $ 9,114 $ 20,495 $ 19,569 $ 13,658 $ 12, $ 10,815 $ 10,383 $ 6,730 $ 6,491 $ 13,440 $ 13,036 $ 10,482 $ 8,081 $ 15,032 $ 14,210 $ 9,030 $ 8,718 $ 19,611 $ 18,761 $ 13,219 $ 12, $ 10,337 $ 9,942 $ 6,416 $ 6,180 $ 12,875 $ 12,504 $ 10,162 $ 7,962 $ 14,425 $ 13,595 $ 8,637 $ 8,355 $ 18,805 $ 18,022 $ 12,804 $ 11, $ 9,901 $ 9,502 $ 6,131 $ 5,897 $ 12,354 $ 12,011 $ 9,862 $ 7,846 $ 13,862 $ 13,093 $ 8,278 $ 8,021 $ 18,062 $ 17,224 $ 12,418 $ 11, $ 9,498 $ 9,131 $ 5,870 $ 5,639 $ 11,873 $ 11,505 $ 9,578 $ 7,734 $ 13,305 $ 12,535 $ 7,895 $ 7,576 $ 17,265 $ 16,498 $ 11,768 $ 10, $ 8,964 $ 8,607 $ 5,616 $ 5,360 $ 11,378 $ 11,040 $ 9,066 $ 7,519 $ 12,794 $ 12,080 $ 7,546 $ 7,179 $ 16,532 $ 15,827 $ 11,182 $ 10, $ 8,486 $ 8,166 $ 5,383 $ 5,107 $ 10,925 $ 10,612 $ 8,605 $ 7,316 $ 12,319 $ 11,604 $ 7,227 $ 6,820 $ 15,862 $ 15,123 $ 10,651 $ 9, $ 8,056 $ 7,744 $ 5,168 $ 4,877 $ 10,504 $ 10,175 $ 8,190 $ 7,124 $ 11,879 $ 11,213 $ 6,933 $ 6,496 $ 15,240 $ 14,557 $ 10,169 $ 9, $ 7,668 $ 7,385 $ 4,970 $ 4,667 $ 10,117 $ 9,811 $ 7,811 $ 6,941 $ 11,468 $ 10,801 $ 6,662 $ 6,201 $ 14,669 $ 14,035 $ 9,729 $ 9, $ 7,316 $ 7,039 $ 4,787 $ 4,474 $ 9,755 $ 9,471 $ 7,467 $ 6,767 $ 10,739 $ 10,151 $ 6,386 $ 5,897 $ 13,924 $ 13,283 $ 9,163 $ 8, $ 6,948 $ 6,697 $ 4,605 $ 4,216 $ 9,458 $ 9,158 $ 7,027 $ 6,339 $ 10,095 $ 9,539 $ 6,132 $ 5,622 $ 13,248 $ 12,667 $ 8,661 $ 8, $ 6,614 $ 6,371 $ 4,438 $ 3,986 $ 9,179 $ 8,896 $ 6,636 $ 5,962 $ 9,525 $ 8,997 $ 5,898 $ 5,371 $ 12,637 $ 12,051 $ 8,210 $ 7, $ 6,312 $ 6,076 $ 4,282 $ 3,780 $ 8,917 $ 8,621 $ 6,287 $ 5,628 $ 9,015 $ 8,513 $ 5,681 $ 5,141 $ 12,078 $ 11,542 $ 7,805 $ 7, $ 6,035 $ 5,806 $ 4,136 $ 3,595 $ 8,668 $ 8,388 $ 5,972 $ 5,329 $ 8,557 $ 8,079 $ 5,480 $ 4,931 $ 11,568 $ 11,028 $ 7,437 $ 6, $ 5,782 $ 5,560 $ 4,000 $ 3,426 $ 8,433 $ 8,142 $ 5,687 $ 5,060 $ 7,907 $ 7,475 $ 5,029 $ 4,516 $ 10,696 $ 10,233 $ 6,820 $ 6, $ 5,280 $ 5,083 $ 3,718 $ 3,192 $ 7,825 $ 7,574 $ 5,273 $ 4,708 $ 7,349 $ 6,956 $ 4,648 $ 4,166 $ 9,948 $ 9,511 $ 6,297 $ 5, $ 4,857 $ 4,682 $ 3,473 $ 2,988 $ 7,298 $ 7,060 $ 4,916 $ 4,401 $ 6,865 $ 6,504 $ 4,320 $ 3,866 $ 9,296 $ 8,883 $ 5,849 $ 5, $ 4,497 $ 4,340 $ 3,259 $ 2,808 $ 6,837 $ 6,611 $ 4,603 $ 4,133 $ 6,440 $ 6,107 $ 4,035 $ 3,606 $ 8,725 $ 8,333 $ 5,460 $ 4, $ 4,187 $ 4,044 $ 3,069 $ 2,648 $ 6,432 $ 6,216 $ 4,329 $ 3,895 $ 6,065 $ 5,743 $ 3,786 $ 3,379 $ 8,220 $ 7,847 $ 5,120 $ 4, $ 3,917 $ 3,780 $ 2,900 $ 2,506 $ 6,072 $ 5,866 $ 4,085 $ 3,683 $ 5,567 $ 5,274 $ 3,494 $ 3,059 $ 7,508 $ 7,176 $ 4,676 $ 4, $ 3,657 $ 3,528 $ 2,673 $ 2,296 $ 5,601 $ 5,414 $ 3,786 $ 3,383 $ 5,145 $ 4,875 $ 3,243 $ 2,795 $ 6,910 $ 6,611 $ 4,302 $ 3, $ 3,430 $ 3,308 $ 2,479 $ 2,118 $ 5,198 $ 5,027 $ 3,528 $ 3,129 $ 4,783 $ 4,525 $ 3,026 $ 2,573 $ 6,401 $ 6,114 $ 3,984 $ 3, $ 3,229 $ 3,110 $ 2,311 $ - $ 4,850 $ 4,683 $ 3,303 $ 2,910 $ 4,468 $ 4,208 $ 2,837 $ 2,383 $ 5,961 $ 5,674 $ 3,709 $ 3, $ 3,051 $ 2,927 $ 2,164 $ - $ 4,545 $ 4,376 $ 3,105 $ 2,720 $ 4,192 $ 3,914 $ 2,669 $ 2,219 $ 5,577 $ 5,272 $ 3,470 $ 3, $ 2,891 $ 2,756 $ 2,035 $ - $ 4,276 $ 4,094 $ 2,929 $ 2,553 $ 3,890 $ - $ 2,457 $ - $ 5,046 $ - $ 3,139 $ - 81 $ 2,708 $ - $ - $ - $ 3,872 $ - $ 2,663 $ - $ 3,627 $ - $ 2,276 $ - $ 4,607 $ - $ 2,865 $ - 82 $ 2,547 $ - $ - $ - $ 3,538 $ - $ 2,441 $ - $ 3,398 $ - $ 2,120 $ - $ 4,238 $ - $ 2,635 $ - 83 $ 2,403 $ - $ - $ - $ 3,257 $ - $ 2,253 $ - $ 3,197 $ - $ - $ - $ 3,924 $ - $ 2,440 $ - 84 $ 2,275 $ - $ - $ - $ 3,017 $ - $ 2,092 $ - $ 3,017 $ - $ - $ - $ 3,653 $ - $ 2,271 $ - 85 $ 2,160 $ - $ - $ - $ 2,811 $ - $ - $ - 7 For Producer Use Only US (07/12)

62 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $70.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 24,821 $ 23,306 $ 15,956 $ - $ 33,508 $ 31,767 $ 19,711 $ - 50 $ 17,351 $ 16,597 $ 11,625 $ 11,575 $ 20,710 $ 20,031 $ 15,798 $ 12,733 $ 23,748 $ 22,358 $ 15,057 $ 14,497 $ 31,820 $ 30,245 $ 19,152 $ - 51 $ 16,561 $ 15,873 $ 10,914 $ 10,790 $ 19,932 $ 19,302 $ 15,188 $ 12,012 $ 22,765 $ 21,484 $ 14,256 $ 13,708 $ 30,293 $ 28,862 $ 18,625 $ - 52 $ 15,840 $ 15,210 $ 10,285 $ 10,105 $ 19,210 $ 18,625 $ 14,622 $ 11,369 $ 21,853 $ 20,670 $ 13,534 $ 13,004 $ 28,895 $ 27,591 $ 18,130 $ - 53 $ 15,182 $ 14,602 $ 9,725 $ 9,502 $ 18,543 $ 17,997 $ 14,098 $ 10,790 $ 21,017 $ 19,792 $ 12,883 $ 12,366 $ 27,631 $ 26,435 $ 17,656 $ - 54 $ 14,574 $ 13,974 $ 9,222 $ 8,967 $ 17,917 $ 17,407 $ 13,608 $ 10,268 $ 20,243 $ 19,104 $ 12,290 $ 11,790 $ 26,472 $ 25,373 $ 17,207 $ - 55 $ 14,013 $ 13,457 $ 8,769 $ 8,488 $ 17,332 $ 16,854 $ 13,154 $ 9,794 $ 19,307 $ 18,268 $ 11,678 $ 11,228 $ 25,231 $ 24,040 $ 16,615 $ - 56 $ 13,333 $ 12,829 $ 8,319 $ 8,038 $ 16,533 $ 16,013 $ 12,726 $ 9,646 $ 18,458 $ 17,407 $ 11,122 $ 10,718 $ 24,100 $ 23,012 $ 16,060 $ - 57 $ 12,718 $ 12,210 $ 7,913 $ 7,633 $ 15,804 $ 15,329 $ 12,326 $ 9,502 $ 17,677 $ 16,710 $ 10,618 $ 10,252 $ 23,060 $ 22,061 $ 15,544 $ 14, $ 12,155 $ 11,690 $ 7,545 $ 7,267 $ 15,140 $ 14,703 $ 11,950 $ 9,362 $ 16,962 $ 15,986 $ 10,156 $ 9,825 $ 22,112 $ 21,192 $ 15,057 $ 14, $ 11,642 $ 11,174 $ 7,210 $ 6,935 $ 14,527 $ 14,124 $ 11,596 $ 9,227 $ 16,300 $ 15,397 $ 9,734 $ 9,432 $ 21,239 $ 20,254 $ 14,602 $ 13, $ 11,169 $ 10,737 $ 6,903 $ 6,631 $ 13,961 $ 13,529 $ 11,263 $ 9,095 $ 15,646 $ 14,740 $ 9,284 $ 8,909 $ 20,302 $ 19,400 $ 13,838 $ 12, $ 10,540 $ 10,121 $ 6,604 $ 6,303 $ 13,380 $ 12,982 $ 10,661 $ 8,842 $ 15,045 $ 14,206 $ 8,873 $ 8,441 $ 19,440 $ 18,611 $ 13,149 $ 12, $ 9,979 $ 9,602 $ 6,330 $ 6,006 $ 12,846 $ 12,479 $ 10,119 $ 8,603 $ 14,486 $ 13,645 $ 8,498 $ 8,020 $ 18,652 $ 17,783 $ 12,524 $ 11, $ 9,474 $ 9,107 $ 6,077 $ 5,735 $ 12,352 $ 11,965 $ 9,630 $ 8,377 $ 13,969 $ 13,186 $ 8,152 $ 7,639 $ 17,921 $ 17,118 $ 11,958 $ 11, $ 9,017 $ 8,684 $ 5,845 $ 5,488 $ 11,896 $ 11,537 $ 9,186 $ 8,162 $ 13,486 $ 12,701 $ 7,834 $ 7,292 $ 17,249 $ 16,504 $ 11,440 $ 10, $ 8,603 $ 8,277 $ 5,629 $ 5,261 $ 11,471 $ 11,137 $ 8,781 $ 7,958 $ 12,628 $ 11,937 $ 7,510 $ 6,935 $ 16,373 $ 15,620 $ 10,775 $ 10, $ 8,170 $ 7,875 $ 5,416 $ 4,958 $ 11,122 $ 10,769 $ 8,263 $ 7,455 $ 11,870 $ 11,217 $ 7,211 $ 6,611 $ 15,579 $ 14,895 $ 10,185 $ 9, $ 7,778 $ 7,492 $ 5,218 $ 4,688 $ 10,794 $ 10,461 $ 7,803 $ 7,011 $ 11,200 $ 10,580 $ 6,936 $ 6,316 $ 14,860 $ 14,171 $ 9,654 $ 8, $ 7,422 $ 7,144 $ 5,035 $ 4,445 $ 10,485 $ 10,138 $ 7,393 $ 6,618 $ 10,600 $ 10,010 $ 6,681 $ 6,046 $ 14,203 $ 13,572 $ 9,178 $ 8, $ 7,097 $ 6,828 $ 4,864 $ 4,227 $ 10,193 $ 9,864 $ 7,022 $ 6,266 $ 10,063 $ 9,500 $ 6,443 $ 5,798 $ 13,603 $ 12,968 $ 8,745 $ 8, $ 6,800 $ 6,538 $ 4,704 $ 4,029 $ 9,916 $ 9,575 $ 6,687 $ 5,950 $ 9,298 $ 8,790 $ 5,914 $ 5,310 $ 12,578 $ 12,033 $ 8,020 $ 7, $ 6,208 $ 5,978 $ 4,372 $ 3,753 $ 9,201 $ 8,906 $ 6,201 $ 5,536 $ 8,642 $ 8,179 $ 5,465 $ 4,899 $ 11,698 $ 11,184 $ 7,405 $ 6, $ 5,712 $ 5,506 $ 4,084 $ 3,513 $ 8,582 $ 8,302 $ 5,780 $ 5,176 $ 8,072 $ 7,648 $ 5,080 $ 4,546 $ 10,931 $ 10,445 $ 6,878 $ 6, $ 5,289 $ 5,103 $ 3,832 $ 3,302 $ 8,040 $ 7,774 $ 5,413 $ 4,860 $ 7,573 $ 7,181 $ 4,745 $ 4,241 $ 10,260 $ 9,799 $ 6,421 $ 5, $ 4,924 $ 4,755 $ 3,609 $ 3,114 $ 7,563 $ 7,310 $ 5,090 $ 4,580 $ 7,132 $ 6,753 $ 4,452 $ 3,974 $ 9,665 $ 9,228 $ 6,021 $ 5, $ 4,606 $ 4,445 $ 3,410 $ 2,947 $ 7,140 $ 6,898 $ 4,803 $ 4,331 $ 6,547 $ 6,201 $ 4,108 $ 3,598 $ 8,829 $ 8,439 $ 5,498 $ 4, $ 4,301 $ 4,149 $ 3,143 $ 2,700 $ 6,586 $ 6,367 $ 4,452 $ 3,979 $ 6,051 $ 5,733 $ 3,814 $ 3,287 $ 8,125 $ 7,774 $ 5,059 $ 4, $ 4,034 $ 3,890 $ 2,915 $ 2,490 $ 6,112 $ 5,911 $ 4,149 $ 3,680 $ 5,625 $ 5,321 $ 3,559 $ 3,025 $ 7,527 $ 7,190 $ 4,685 $ 4, $ 3,797 $ 3,657 $ 2,717 $ 2,311 $ 5,703 $ 5,507 $ 3,884 $ 3,422 $ 5,254 $ 4,948 $ 3,336 $ 2,802 $ 7,009 $ 6,673 $ 4,362 $ 3, $ 3,588 $ 3,442 $ 2,545 $ 2,156 $ 5,344 $ 5,146 $ 3,651 $ 3,199 $ 4,930 $ 4,603 $ 3,139 $ 2,610 $ 6,559 $ 6,199 $ 4,081 $ 3, $ 3,400 $ 3,241 $ 2,393 $ 2,021 $ 5,028 $ 4,814 $ 3,445 $ 3,003 $ 4,574 $ - $ 2,889 $ - $ 5,933 $ - $ 3,691 $ - 81 $ 3,184 $ - $ 2,242 $ - $ 4,553 $ - $ 3,131 $ - $ 4,266 $ - $ 2,677 $ - $ 5,417 $ - $ 3,369 $ - 82 $ 2,995 $ - $ 2,109 $ - $ 4,160 $ - $ 2,870 $ - $ 3,996 $ - $ 2,493 $ - $ 4,983 $ - $ 3,099 $ - 83 $ 2,826 $ - $ - $ - $ 3,830 $ - $ 2,650 $ - $ 3,759 $ - $ 2,333 $ - $ 4,614 $ - $ 2,869 $ - 84 $ 2,676 $ - $ - $ - $ 3,548 $ - $ 2,460 $ - $ 3,548 $ - $ 2,192 $ - $ 4,295 $ - $ 2,671 $ - 85 $ 2,540 $ - $ - $ - $ 3,305 $ - $ 2,296 $ - 8 For Producer Use Only US (07/12)

63 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $80.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 28,534 $ 26,793 $ 18,343 $ - $ 38,521 $ 36,519 $ - $ - 50 $ 19,947 $ 19,080 $ 13,364 $ 13,307 $ 23,808 $ 23,027 $ 18,161 $ 14,638 $ 27,301 $ 25,703 $ 17,309 $ - $ 36,579 $ 34,769 $ - $ - 51 $ 19,039 $ 18,248 $ 12,546 $ 12,405 $ 22,913 $ 22,190 $ 17,460 $ 13,809 $ 26,170 $ 24,698 $ 16,388 $ - $ 34,824 $ 33,180 $ - $ - 52 $ 18,210 $ 17,485 $ 11,823 $ 11,617 $ 22,084 $ 21,411 $ 16,809 $ 13,069 $ 25,122 $ 23,763 $ 15,558 $ 14,949 $ 33,218 $ 31,718 $ - $ - 53 $ 17,454 $ 16,786 $ 11,179 $ 10,923 $ 21,317 $ 20,689 $ 16,207 $ 12,405 $ 24,161 $ 22,753 $ 14,810 $ 14,216 $ 31,764 $ 30,390 $ - $ - 54 $ 16,754 $ 16,065 $ 10,602 $ 10,308 $ 20,597 $ 20,011 $ 15,644 $ 11,804 $ 23,272 $ 21,962 $ 14,129 $ 13,553 $ 30,432 $ 29,169 $ 19,781 $ - 55 $ 16,109 $ 15,470 $ 10,081 $ 9,758 $ 19,924 $ 19,375 $ 15,121 $ 11,260 $ 22,195 $ 21,001 $ 13,425 $ 12,908 $ 29,005 $ 27,636 $ 19,101 $ - 56 $ 15,327 $ 14,748 $ 9,564 $ 9,241 $ 19,006 $ 18,408 $ 14,630 $ 11,089 $ 21,219 $ 20,011 $ 12,786 $ 12,321 $ 27,706 $ 26,454 $ 18,463 $ - 57 $ 14,621 $ 14,036 $ 9,097 $ 8,775 $ 18,168 $ 17,622 $ 14,170 $ 10,923 $ 20,321 $ 19,210 $ 12,206 $ 11,785 $ 26,510 $ 25,361 $ 17,869 $ - 58 $ 13,974 $ 13,439 $ 8,674 $ 8,355 $ 17,405 $ 16,903 $ 13,738 $ 10,763 $ 19,500 $ 18,378 $ 11,676 $ 11,294 $ 25,420 $ 24,362 $ 17,309 $ - 59 $ 13,384 $ 12,846 $ 8,288 $ 7,972 $ 16,700 $ 16,237 $ 13,331 $ 10,607 $ 18,738 $ 17,700 $ 11,191 $ 10,843 $ 24,417 $ 23,284 $ 16,786 $ - 60 $ 12,840 $ 12,344 $ 7,936 $ 7,624 $ 16,050 $ 15,553 $ 12,948 $ 10,455 $ 17,986 $ 16,945 $ 10,673 $ 10,242 $ 23,340 $ 22,302 $ 15,908 $ 14, $ 12,117 $ 11,636 $ 7,592 $ 7,246 $ 15,381 $ 14,924 $ 12,256 $ 10,165 $ 17,295 $ 16,331 $ 10,200 $ 9,704 $ 22,348 $ 21,395 $ 15,116 $ 14, $ 11,471 $ 11,039 $ 7,277 $ 6,904 $ 14,768 $ 14,346 $ 11,632 $ 9,890 $ 16,653 $ 15,686 $ 9,769 $ 9,219 $ 21,442 $ 20,444 $ 14,398 $ 13, $ 10,891 $ 10,469 $ 6,987 $ 6,593 $ 14,200 $ 13,755 $ 11,071 $ 9,630 $ 16,059 $ 15,158 $ 9,372 $ 8,781 $ 20,602 $ 19,679 $ 13,746 $ 12, $ 10,366 $ 9,983 $ 6,719 $ 6,309 $ 13,676 $ 13,263 $ 10,560 $ 9,383 $ 15,503 $ 14,601 $ 9,006 $ 8,383 $ 19,830 $ 18,973 $ 13,151 $ 12, $ 9,890 $ 9,515 $ 6,471 $ 6,048 $ 13,187 $ 12,802 $ 10,095 $ 9,148 $ 14,517 $ 13,723 $ 8,633 $ 7,972 $ 18,823 $ 17,957 $ 12,387 $ 11, $ 9,392 $ 9,053 $ 6,226 $ 5,700 $ 12,786 $ 12,380 $ 9,500 $ 8,570 $ 13,646 $ 12,895 $ 8,290 $ 7,600 $ 17,909 $ 17,123 $ 11,708 $ 10, $ 8,942 $ 8,613 $ 5,999 $ 5,389 $ 12,408 $ 12,026 $ 8,971 $ 8,060 $ 12,876 $ 12,162 $ 7,974 $ 7,260 $ 17,083 $ 16,291 $ 11,099 $ 10, $ 8,532 $ 8,213 $ 5,788 $ 5,111 $ 12,054 $ 11,654 $ 8,498 $ 7,608 $ 12,186 $ 11,507 $ 7,680 $ 6,950 $ 16,328 $ 15,602 $ 10,551 $ 9, $ 8,159 $ 7,849 $ 5,592 $ 4,859 $ 11,718 $ 11,340 $ 8,073 $ 7,203 $ 11,568 $ 10,921 $ 7,407 $ 6,665 $ 15,638 $ 14,908 $ 10,053 $ 9, $ 7,817 $ 7,516 $ 5,408 $ 4,632 $ 11,400 $ 11,007 $ 7,688 $ 6,840 $ 10,689 $ 10,105 $ 6,799 $ 6,105 $ 14,459 $ 13,833 $ 9,219 $ 8, $ 7,137 $ 6,872 $ 5,026 $ 4,315 $ 10,577 $ 10,238 $ 7,128 $ 6,364 $ 9,935 $ 9,403 $ 6,283 $ 5,631 $ 13,447 $ 12,857 $ 8,512 $ 7, $ 6,566 $ 6,329 $ 4,695 $ 4,039 $ 9,866 $ 9,544 $ 6,645 $ 5,950 $ 9,280 $ 8,792 $ 5,840 $ 5,226 $ 12,566 $ 12,008 $ 7,907 $ 6, $ 6,080 $ 5,866 $ 4,405 $ 3,796 $ 9,243 $ 8,937 $ 6,223 $ 5,587 $ 8,706 $ 8,256 $ 5,455 $ 4,875 $ 11,795 $ 11,265 $ 7,381 $ 6, $ 5,660 $ 5,467 $ 4,149 $ 3,580 $ 8,695 $ 8,403 $ 5,852 $ 5,265 $ 8,199 $ 7,764 $ 5,118 $ 4,568 $ 11,111 $ 10,608 $ 6,922 $ 5, $ 5,295 $ 5,110 $ 3,920 $ 3,388 $ 8,208 $ 7,930 $ 5,522 $ 4,978 $ 7,526 $ 7,129 $ 4,723 $ 4,136 $ 10,150 $ 9,701 $ 6,321 $ 5, $ 4,944 $ 4,770 $ 3,613 $ 3,103 $ 7,572 $ 7,319 $ 5,118 $ 4,574 $ 6,956 $ 6,590 $ 4,384 $ 3,778 $ 9,341 $ 8,937 $ 5,816 $ 5, $ 4,637 $ 4,472 $ 3,351 $ 2,863 $ 7,027 $ 6,796 $ 4,769 $ 4,230 $ 6,466 $ 6,117 $ 4,091 $ 3,478 $ 8,653 $ 8,266 $ 5,385 $ 4, $ 4,366 $ 4,204 $ 3,124 $ 2,657 $ 6,556 $ 6,331 $ 4,465 $ 3,934 $ 6,040 $ 5,688 $ 3,835 $ 3,222 $ 8,058 $ 7,671 $ 5,014 $ 4, $ 4,124 $ 3,957 $ 2,926 $ 2,479 $ 6,144 $ 5,916 $ 4,197 $ 3,677 $ 5,667 $ 5,292 $ 3,608 $ 3,000 $ 7,540 $ 7,127 $ 4,691 $ 4, $ 3,908 $ 3,726 $ 2,751 $ 2,323 $ 5,780 $ 5,534 $ 3,960 $ 3,452 $ 5,258 $ - $ 3,322 $ - $ 6,821 $ - $ 4,243 $ - 81 $ 3,661 $ - $ 2,577 $ - $ 5,234 $ - $ 3,600 $ - $ 4,904 $ - $ 3,077 $ - $ 6,228 $ - $ 3,873 $ - 82 $ 3,443 $ - $ 2,424 $ - $ 4,783 $ - $ 3,300 $ - $ 4,594 $ - $ 2,866 $ - $ 5,729 $ - $ 3,563 $ - 83 $ 3,249 $ - $ 2,288 $ - $ 4,403 $ - $ 3,046 $ - $ 4,321 $ - $ 2,682 $ - $ 5,304 $ - $ 3,298 $ - 84 $ 3,076 $ - $ 2,167 $ - $ 4,079 $ - $ 2,828 $ - $ 4,079 $ - $ 2,520 $ - $ 4,938 $ - $ 3,070 $ - 85 $ 2,921 $ - $ 2,058 $ - $ 3,800 $ - $ 2,640 $ - 9 For Producer Use Only US (07/12)

64 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $90.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ 32,247 $ 30,279 $ - $ - $ - $ - $ - $ - 50 $ 22,543 $ 21,563 $ 15,103 $ - $ 26,906 $ 26,024 $ - $ - $ 30,853 $ 29,048 $ 19,561 $ - $ - $ - $ - $ - 51 $ 21,516 $ 20,622 $ 14,179 $ 14,019 $ 25,895 $ 25,077 $ 19,733 $ - $ 29,576 $ 27,912 $ 18,521 $ - $ - $ - $ - $ - 52 $ 20,579 $ 19,760 $ 13,362 $ 13,129 $ 24,957 $ 24,197 $ 18,996 $ 14,770 $ 28,391 $ 26,855 $ 17,583 $ - $ - $ - $ - $ - 53 $ 19,725 $ 18,971 $ 12,634 $ 12,345 $ 24,091 $ 23,382 $ 18,316 $ 14,019 $ 27,305 $ 25,714 $ 16,738 $ - $ - $ 34,345 $ - $ - 54 $ 18,934 $ 18,155 $ 11,981 $ 11,649 $ 23,277 $ 22,614 $ 17,680 $ 13,341 $ 26,300 $ 24,820 $ 15,968 $ - $ 34,392 $ 32,964 $ - $ - 55 $ 18,205 $ 17,484 $ 11,393 $ 11,028 $ 22,517 $ 21,896 $ 17,089 $ 12,725 $ 25,083 $ 23,734 $ 15,172 $ 14,588 $ 32,779 $ 31,232 $ - $ - 56 $ 17,322 $ 16,667 $ 10,808 $ 10,443 $ 21,479 $ 20,804 $ 16,534 $ 12,532 $ 23,980 $ 22,614 $ 14,450 $ 13,924 $ 31,311 $ 29,896 $ - $ - 57 $ 16,523 $ 15,863 $ 10,281 $ 9,917 $ 20,533 $ 19,915 $ 16,014 $ 12,345 $ 22,965 $ 21,709 $ 13,795 $ 13,319 $ 29,959 $ 28,662 $ - $ - 58 $ 15,792 $ 15,188 $ 9,803 $ 9,442 $ 19,670 $ 19,102 $ 15,525 $ 12,163 $ 22,037 $ 20,769 $ 13,195 $ 12,764 $ 28,728 $ 27,533 $ 19,561 $ - 59 $ 15,126 $ 14,517 $ 9,367 $ 9,010 $ 18,873 $ 18,350 $ 15,066 $ 11,987 $ 21,177 $ 20,003 $ 12,647 $ 12,253 $ 27,594 $ 26,314 $ 18,971 $ - 60 $ 14,511 $ 13,950 $ 8,968 $ 8,616 $ 18,139 $ 17,576 $ 14,633 $ 11,816 $ 20,327 $ 19,150 $ 12,061 $ 11,575 $ 26,377 $ 25,204 $ 17,978 $ - 61 $ 13,694 $ 13,150 $ 8,580 $ 8,189 $ 17,383 $ 16,866 $ 13,851 $ 11,488 $ 19,546 $ 18,456 $ 11,528 $ 10,967 $ 25,256 $ 24,179 $ 17,083 $ - 62 $ 12,964 $ 12,475 $ 8,224 $ 7,803 $ 16,690 $ 16,213 $ 13,146 $ 11,177 $ 18,820 $ 17,727 $ 11,040 $ 10,419 $ 24,232 $ 23,104 $ 16,271 $ - 63 $ 12,308 $ 11,831 $ 7,896 $ 7,451 $ 16,048 $ 15,545 $ 12,511 $ 10,883 $ 18,149 $ 17,131 $ 10,591 $ 9,924 $ 23,283 $ 22,240 $ 15,535 $ 14, $ 11,715 $ 11,283 $ 7,593 $ 7,130 $ 15,455 $ 14,988 $ 11,934 $ 10,604 $ 17,521 $ 16,501 $ 10,178 $ 9,474 $ 22,410 $ 21,442 $ 14,863 $ 13, $ 11,177 $ 10,753 $ 7,313 $ 6,835 $ 14,903 $ 14,468 $ 11,408 $ 10,339 $ 16,406 $ 15,508 $ 9,756 $ 9,010 $ 21,272 $ 20,293 $ 13,999 $ 13, $ 10,614 $ 10,231 $ 7,036 $ 6,441 $ 14,450 $ 13,991 $ 10,736 $ 9,685 $ 15,422 $ 14,573 $ 9,369 $ 8,589 $ 20,240 $ 19,352 $ 13,232 $ 12, $ 10,105 $ 9,733 $ 6,780 $ 6,090 $ 14,023 $ 13,591 $ 10,138 $ 9,109 $ 14,551 $ 13,745 $ 9,011 $ 8,205 $ 19,306 $ 18,411 $ 12,543 $ 11, $ 9,643 $ 9,282 $ 6,541 $ 5,776 $ 13,622 $ 13,171 $ 9,604 $ 8,598 $ 13,772 $ 13,005 $ 8,680 $ 7,855 $ 18,452 $ 17,633 $ 11,924 $ 10, $ 9,221 $ 8,870 $ 6,319 $ 5,492 $ 13,243 $ 12,815 $ 9,123 $ 8,141 $ 13,073 $ 12,342 $ 8,371 $ 7,533 $ 17,673 $ 16,848 $ 11,361 $ 10, $ 8,834 $ 8,494 $ 6,111 $ 5,235 $ 12,883 $ 12,439 $ 8,688 $ 7,730 $ 12,080 $ 11,420 $ 7,684 $ 6,899 $ 16,341 $ 15,633 $ 10,419 $ 9, $ 8,066 $ 7,766 $ 5,680 $ 4,877 $ 11,954 $ 11,571 $ 8,056 $ 7,192 $ 11,228 $ 10,627 $ 7,100 $ 6,364 $ 15,197 $ 14,530 $ 9,620 $ 8, $ 7,421 $ 7,153 $ 5,306 $ 4,564 $ 11,149 $ 10,786 $ 7,510 $ 6,724 $ 10,487 $ 9,936 $ 6,600 $ 5,906 $ 14,201 $ 13,570 $ 8,936 $ 7, $ 6,871 $ 6,630 $ 4,978 $ 4,290 $ 10,445 $ 10,100 $ 7,033 $ 6,314 $ 9,839 $ 9,330 $ 6,165 $ 5,510 $ 13,330 $ 12,731 $ 8,342 $ 7, $ 6,397 $ 6,178 $ 4,689 $ 4,046 $ 9,826 $ 9,497 $ 6,613 $ 5,950 $ 9,265 $ 8,774 $ 5,784 $ 5,163 $ 12,557 $ 11,989 $ 7,822 $ 6, $ 5,984 $ 5,775 $ 4,431 $ 3,829 $ 9,276 $ 8,962 $ 6,241 $ 5,626 $ 8,506 $ 8,057 $ 5,337 $ 4,674 $ 11,470 $ 10,964 $ 7,143 $ 6, $ 5,588 $ 5,390 $ 4,083 $ 3,507 $ 8,557 $ 8,272 $ 5,784 $ 5,169 $ 7,861 $ 7,448 $ 4,955 $ 4,270 $ 10,557 $ 10,100 $ 6,572 $ 5, $ 5,240 $ 5,054 $ 3,787 $ 3,236 $ 7,941 $ 7,680 $ 5,390 $ 4,781 $ 7,307 $ 6,913 $ 4,623 $ 3,930 $ 9,779 $ 9,341 $ 6,086 $ 5, $ 4,934 $ 4,751 $ 3,530 $ 3,003 $ 7,409 $ 7,155 $ 5,046 $ 4,447 $ 6,826 $ 6,428 $ 4,334 $ 3,641 $ 9,106 $ 8,669 $ 5,667 $ 4, $ 4,661 $ 4,472 $ 3,306 $ 2,801 $ 6,943 $ 6,686 $ 4,744 $ 4,156 $ 6,405 $ 5,980 $ 4,078 $ 3,391 $ 8,521 $ 8,054 $ 5,302 $ 4, $ 4,417 $ 4,211 $ 3,109 $ 2,625 $ 6,532 $ 6,254 $ 4,475 $ 3,901 $ 5,942 $ - $ 3,754 $ - $ 7,709 $ - $ 4,795 $ - 81 $ 4,137 $ - $ 2,913 $ - $ 5,915 $ - $ 4,068 $ - $ 5,542 $ - $ 3,478 $ - $ 7,038 $ - $ 4,377 $ - 82 $ 3,891 $ - $ 2,740 $ - $ 5,405 $ - $ 3,729 $ - $ 5,192 $ - $ 3,239 $ - $ 6,474 $ - $ 4,026 $ - 83 $ 3,672 $ - $ 2,586 $ - $ 4,976 $ - $ 3,442 $ - $ 4,884 $ - $ 3,031 $ - $ 5,994 $ - $ 3,728 $ - 84 $ 3,476 $ - $ 2,449 $ - $ 4,610 $ - $ 3,197 $ - $ 4,610 $ - $ 2,848 $ - $ 5,581 $ - $ 3,470 $ - 85 $ 3,301 $ - $ 2,326 $ - $ 4,294 $ - $ 2,983 $ - 10 For Producer Use Only US (07/12)

65 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $100.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ 33,766 $ - $ - $ - $ - $ - $ - 50 $ 25,138 $ 24,046 $ 16,842 $ - $ 30,004 $ 29,020 $ - $ - $ 34,406 $ 32,392 $ - $ - $ - $ - $ - $ - 51 $ 23,994 $ 22,997 $ 15,812 $ - $ 28,877 $ 27,965 $ - $ - $ 32,981 $ 31,126 $ - $ - $ - $ - $ - $ - 52 $ 22,949 $ 22,035 $ 14,901 $ 14,640 $ 27,831 $ 26,983 $ - $ - $ 31,660 $ 29,947 $ 19,607 $ - $ - $ - $ - $ - 53 $ 21,996 $ 21,155 $ 14,089 $ 13,766 $ 26,865 $ 26,074 $ - $ - $ 30,449 $ 28,675 $ 18,665 $ - $ - $ - $ - $ - 54 $ 21,115 $ 20,246 $ 13,361 $ 12,991 $ 25,958 $ 25,218 $ 19,716 $ 14,877 $ 29,328 $ 27,678 $ 17,806 $ - $ - $ - $ - $ - 55 $ 20,301 $ 19,497 $ 12,704 $ 12,298 $ 25,110 $ 24,417 $ 19,057 $ 14,190 $ 27,972 $ 26,467 $ 16,919 $ - $ - $ 34,828 $ - $ - 56 $ 19,316 $ 18,587 $ 12,053 $ 11,646 $ 23,952 $ 23,199 $ 18,438 $ 13,975 $ 26,742 $ 25,218 $ 16,113 $ - $ 34,916 $ 33,339 $ - $ - 57 $ 18,426 $ 17,689 $ 11,465 $ 11,059 $ 22,897 $ 22,208 $ 17,858 $ 13,766 $ 25,609 $ 24,209 $ 15,383 $ 14,853 $ 33,409 $ 31,962 $ - $ - 58 $ 17,611 $ 16,937 $ 10,931 $ 10,529 $ 21,935 $ 21,302 $ 17,313 $ 13,564 $ 24,574 $ 23,160 $ 14,714 $ 14,234 $ 32,036 $ 30,703 $ - $ - 59 $ 16,867 $ 16,189 $ 10,445 $ 10,047 $ 21,046 $ 20,463 $ 16,801 $ 13,367 $ 23,615 $ 22,306 $ 14,103 $ 13,664 $ 30,771 $ 29,344 $ - $ - 60 $ 16,182 $ 15,556 $ 10,001 $ 9,608 $ 20,227 $ 19,600 $ 16,318 $ 13,176 $ 22,667 $ 21,355 $ 13,450 $ 12,907 $ 29,414 $ 28,107 $ - $ - 61 $ 15,271 $ 14,664 $ 9,568 $ 9,132 $ 19,384 $ 18,808 $ 15,445 $ 12,810 $ 21,797 $ 20,581 $ 12,855 $ 12,230 $ 28,164 $ 26,963 $ 19,050 $ - 62 $ 14,457 $ 13,912 $ 9,171 $ 8,701 $ 18,612 $ 18,079 $ 14,660 $ 12,464 $ 20,987 $ 19,768 $ 12,312 $ 11,619 $ 27,022 $ 25,764 $ 18,145 $ - 63 $ 13,725 $ 13,194 $ 8,805 $ 8,309 $ 17,895 $ 17,335 $ 13,952 $ 12,136 $ 20,238 $ 19,103 $ 11,811 $ 11,067 $ 25,964 $ 24,800 $ 17,324 $ - 64 $ 13,064 $ 12,582 $ 8,468 $ 7,951 $ 17,235 $ 16,714 $ 13,308 $ 11,825 $ 19,538 $ 18,401 $ 11,350 $ 10,565 $ 24,991 $ 23,911 $ 16,574 $ - 65 $ 12,464 $ 11,991 $ 8,155 $ 7,622 $ 16,619 $ 16,134 $ 12,722 $ 11,529 $ 18,295 $ 17,294 $ 10,880 $ 10,047 $ 23,721 $ 22,630 $ 15,611 $ 14, $ 11,836 $ 11,409 $ 7,846 $ 7,183 $ 16,113 $ 15,602 $ 11,972 $ 10,800 $ 17,197 $ 16,251 $ 10,447 $ 9,578 $ 22,570 $ 21,580 $ 14,756 $ 13, $ 11,269 $ 10,854 $ 7,561 $ 6,792 $ 15,637 $ 15,156 $ 11,305 $ 10,158 $ 16,227 $ 15,328 $ 10,049 $ 9,150 $ 21,529 $ 20,531 $ 13,987 $ 12, $ 10,753 $ 10,351 $ 7,294 $ 6,441 $ 15,191 $ 14,687 $ 10,710 $ 9,588 $ 15,358 $ 14,502 $ 9,679 $ 8,759 $ 20,577 $ 19,663 $ 13,297 $ 12, $ 10,282 $ 9,892 $ 7,047 $ 6,124 $ 14,767 $ 14,291 $ 10,174 $ 9,078 $ 14,579 $ 13,763 $ 9,335 $ 8,400 $ 19,708 $ 18,788 $ 12,670 $ 11, $ 9,851 $ 9,472 $ 6,815 $ 5,837 $ 14,367 $ 13,872 $ 9,688 $ 8,620 $ 13,471 $ 12,735 $ 8,568 $ 7,693 $ 18,222 $ 17,433 $ 11,619 $ 10, $ 8,995 $ 8,660 $ 6,335 $ 5,438 $ 13,330 $ 12,903 $ 8,984 $ 8,020 $ 12,521 $ 11,850 $ 7,918 $ 7,097 $ 16,947 $ 16,203 $ 10,728 $ 9, $ 8,275 $ 7,977 $ 5,917 $ 5,090 $ 12,433 $ 12,028 $ 8,375 $ 7,499 $ 11,695 $ 11,080 $ 7,360 $ 6,586 $ 15,837 $ 15,133 $ 9,965 $ 8, $ 7,662 $ 7,393 $ 5,552 $ 4,784 $ 11,648 $ 11,263 $ 7,843 $ 7,041 $ 10,972 $ 10,404 $ 6,875 $ 6,144 $ 14,865 $ 14,197 $ 9,302 $ 8, $ 7,134 $ 6,889 $ 5,228 $ 4,512 $ 10,957 $ 10,590 $ 7,375 $ 6,635 $ 10,332 $ 9,784 $ 6,450 $ 5,757 $ 14,003 $ 13,369 $ 8,723 $ 7, $ 6,673 $ 6,440 $ 4,941 $ 4,270 $ 10,344 $ 9,994 $ 6,959 $ 6,274 $ 9,485 $ 8,984 $ 5,952 $ 5,212 $ 12,791 $ 12,226 $ 7,966 $ 6, $ 6,231 $ 6,011 $ 4,554 $ 3,911 $ 9,542 $ 9,224 $ 6,450 $ 5,764 $ 8,766 $ 8,305 $ 5,525 $ 4,762 $ 11,772 $ 11,263 $ 7,329 $ 6, $ 5,844 $ 5,636 $ 4,223 $ 3,608 $ 8,856 $ 8,565 $ 6,011 $ 5,331 $ 8,149 $ 7,709 $ 5,156 $ 4,383 $ 10,904 $ 10,417 $ 6,787 $ 5, $ 5,502 $ 5,298 $ 3,937 $ 3,349 $ 8,262 $ 7,979 $ 5,627 $ 4,959 $ 7,613 $ 7,169 $ 4,833 $ 4,060 $ 10,155 $ 9,667 $ 6,319 $ 5, $ 5,198 $ 4,987 $ 3,687 $ 3,124 $ 7,742 $ 7,456 $ 5,290 $ 4,635 $ 7,142 $ 6,669 $ 4,548 $ 3,781 $ 9,502 $ 8,982 $ 5,912 $ 5, $ 4,925 $ 4,696 $ 3,467 $ 2,928 $ 7,284 $ 6,974 $ 4,991 $ 4,350 $ 6,627 $ - $ 4,186 $ - $ 8,596 $ - $ 5,348 $ - 81 $ 4,614 $ - $ 3,248 $ - $ 6,597 $ - $ 4,537 $ - $ 6,180 $ - $ 3,878 $ - $ 7,848 $ - $ 4,882 $ - 82 $ 4,339 $ - $ 3,055 $ - $ 6,028 $ - $ 4,159 $ - $ 5,790 $ - $ 3,612 $ - $ 7,220 $ - $ 4,490 $ - 83 $ 4,095 $ - $ 2,884 $ - $ 5,549 $ - $ 3,839 $ - $ 5,446 $ - $ 3,380 $ - $ 6,685 $ - $ 4,157 $ - 84 $ 3,877 $ - $ 2,731 $ - $ 5,141 $ - $ 3,565 $ - $ 5,141 $ - $ 3,176 $ - $ 6,223 $ - $ 3,870 $ - 85 $ 3,681 $ - $ 2,593 $ - $ 4,789 $ - $ 3,327 $ - 11 For Producer Use Only US (07/12)

66 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $110.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ - $ - $ - $ - $ - $ - $ - 50 $ 27,734 $ 26,529 $ 18,580 $ - $ 33,102 $ 32,017 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 51 $ 26,471 $ 25,371 $ 17,444 $ - $ 31,858 $ 30,852 $ - $ - $ - $ 34,340 $ - $ - $ - $ - $ - $ - 52 $ 25,319 $ 24,311 $ 16,439 $ - $ 30,705 $ 29,769 $ - $ - $ 34,929 $ 33,039 $ - $ - $ - $ - $ - $ - 53 $ 24,267 $ 23,339 $ 15,544 $ - $ 29,639 $ 28,766 $ - $ - $ 33,594 $ 31,635 $ - $ - $ - $ - $ - $ - 54 $ 23,295 $ 22,336 $ 14,740 $ 14,332 $ 28,638 $ 27,822 $ - $ - $ 32,356 $ 30,536 $ 19,645 $ - $ - $ - $ - $ - 55 $ 22,398 $ 21,510 $ 14,016 $ 13,568 $ 27,702 $ 26,938 $ - $ - $ 30,860 $ 29,199 $ 18,666 $ - $ - $ - $ - $ - 56 $ 21,311 $ 20,506 $ 13,297 $ 12,848 $ 26,425 $ 25,595 $ - $ - $ 29,503 $ 27,822 $ 17,777 $ - $ - $ - $ - $ - 57 $ 20,328 $ 19,516 $ 12,649 $ 12,201 $ 25,261 $ 24,501 $ 19,702 $ - $ 28,254 $ 26,709 $ 16,972 $ - $ - $ - $ - $ - 58 $ 19,429 $ 18,686 $ 12,060 $ 11,616 $ 24,200 $ 23,501 $ 19,101 $ 14,964 $ 27,112 $ 25,552 $ 16,234 $ - $ - $ 33,873 $ - $ - 59 $ 18,609 $ 17,860 $ 11,524 $ 11,085 $ 23,220 $ 22,576 $ 18,535 $ 14,748 $ 26,053 $ 24,609 $ 15,559 $ - $ 33,948 $ 32,373 $ - $ - 60 $ 17,852 $ 17,162 $ 11,034 $ 10,600 $ 22,316 $ 21,624 $ 18,002 $ 14,537 $ 25,008 $ 23,560 $ 14,839 $ 14,240 $ 32,451 $ 31,009 $ - $ - 61 $ 16,847 $ 16,178 $ 10,556 $ 10,075 $ 21,386 $ 20,750 $ 17,040 $ 14,133 $ 24,047 $ 22,706 $ 14,182 $ 13,493 $ 31,072 $ 29,747 $ - $ - 62 $ 15,950 $ 15,348 $ 10,118 $ 9,600 $ 20,533 $ 19,946 $ 16,174 $ 13,751 $ 23,154 $ 21,810 $ 13,583 $ 12,819 $ 29,813 $ 28,425 $ - $ - 63 $ 15,143 $ 14,556 $ 9,714 $ 9,167 $ 19,743 $ 19,125 $ 15,393 $ 13,389 $ 22,328 $ 21,075 $ 13,031 $ 12,210 $ 28,645 $ 27,361 $ 19,113 $ - 64 $ 14,413 $ 13,881 $ 9,342 $ 8,772 $ 19,014 $ 18,440 $ 14,682 $ 13,046 $ 21,555 $ 20,301 $ 12,521 $ 11,656 $ 27,571 $ 26,380 $ 18,286 $ - 65 $ 13,751 $ 13,230 $ 8,997 $ 8,410 $ 18,335 $ 17,800 $ 14,036 $ 12,720 $ 20,184 $ 19,080 $ 12,003 $ 11,085 $ 26,171 $ 24,967 $ 17,223 $ - 66 $ 13,058 $ 12,587 $ 8,656 $ 7,925 $ 17,777 $ 17,213 $ 13,208 $ 11,915 $ 18,973 $ 17,928 $ 11,526 $ 10,567 $ 24,900 $ 23,808 $ 16,279 $ - 67 $ 12,432 $ 11,975 $ 8,341 $ 7,493 $ 17,252 $ 16,721 $ 12,473 $ 11,207 $ 17,902 $ 16,910 $ 11,087 $ 10,095 $ 23,753 $ 22,651 $ 15,432 $ 14, $ 11,863 $ 11,420 $ 8,048 $ 7,106 $ 16,760 $ 16,204 $ 11,816 $ 10,578 $ 16,943 $ 16,000 $ 10,678 $ 9,663 $ 22,702 $ 21,693 $ 14,670 $ 13, $ 11,344 $ 10,913 $ 7,775 $ 6,757 $ 16,292 $ 15,766 $ 11,224 $ 10,015 $ 16,084 $ 15,184 $ 10,299 $ 9,267 $ 21,743 $ 20,728 $ 13,978 $ 12, $ 10,869 $ 10,450 $ 7,519 $ 6,440 $ 15,850 $ 15,304 $ 10,689 $ 9,510 $ 14,862 $ 14,050 $ 9,453 $ 8,488 $ 20,104 $ 19,233 $ 12,819 $ 11, $ 9,923 $ 9,555 $ 6,989 $ 6,000 $ 14,707 $ 14,235 $ 9,911 $ 8,848 $ 13,813 $ 13,074 $ 8,736 $ 7,830 $ 18,697 $ 17,876 $ 11,836 $ 10, $ 9,130 $ 8,801 $ 6,528 $ 5,615 $ 13,717 $ 13,270 $ 9,239 $ 8,273 $ 12,903 $ 12,224 $ 8,120 $ 7,266 $ 17,472 $ 16,695 $ 10,994 $ 9, $ 8,453 $ 8,157 $ 6,125 $ 5,278 $ 12,851 $ 12,426 $ 8,653 $ 7,768 $ 12,104 $ 11,479 $ 7,585 $ 6,778 $ 16,399 $ 15,663 $ 10,263 $ 8, $ 7,870 $ 7,601 $ 5,768 $ 4,978 $ 12,089 $ 11,684 $ 8,136 $ 7,321 $ 11,399 $ 10,795 $ 7,116 $ 6,352 $ 15,449 $ 14,749 $ 9,624 $ 8, $ 7,362 $ 7,105 $ 5,451 $ 4,711 $ 11,412 $ 11,026 $ 7,678 $ 6,922 $ 10,464 $ 9,912 $ 6,567 $ 5,751 $ 14,112 $ 13,488 $ 8,788 $ 7, $ 6,875 $ 6,632 $ 5,024 $ 4,315 $ 10,528 $ 10,177 $ 7,117 $ 6,360 $ 9,671 $ 9,163 $ 6,096 $ 5,254 $ 12,988 $ 12,426 $ 8,086 $ 6, $ 6,447 $ 6,217 $ 4,659 $ 3,981 $ 9,770 $ 9,449 $ 6,631 $ 5,882 $ 8,990 $ 8,505 $ 5,688 $ 4,836 $ 12,030 $ 11,493 $ 7,488 $ 6, $ 6,070 $ 5,845 $ 4,343 $ 3,695 $ 9,115 $ 8,803 $ 6,209 $ 5,471 $ 8,399 $ 7,909 $ 5,332 $ 4,479 $ 11,204 $ 10,665 $ 6,972 $ 6, $ 5,734 $ 5,502 $ 4,068 $ 3,447 $ 8,542 $ 8,225 $ 5,836 $ 5,113 $ 7,880 $ 7,358 $ 5,017 $ 4,172 $ 10,483 $ 9,909 $ 6,523 $ 5, $ 5,434 $ 5,180 $ 3,825 $ 3,230 $ 8,037 $ 7,695 $ 5,506 $ 4,800 $ 7,311 $ - $ 4,619 $ - $ 9,484 $ - $ 5,900 $ - 81 $ 5,090 $ - $ 3,584 $ - $ 7,278 $ - $ 5,005 $ - $ 6,818 $ - $ 4,279 $ - $ 8,659 $ - $ 5,386 $ - 82 $ 4,787 $ - $ 3,371 $ - $ 6,650 $ - $ 4,588 $ - $ 6,388 $ - $ 3,985 $ - $ 7,965 $ - $ 4,954 $ - 83 $ 4,518 $ - $ 3,182 $ - $ 6,122 $ - $ 4,235 $ - $ 6,008 $ - $ 3,729 $ - $ 7,375 $ - $ 4,586 $ - 84 $ 4,277 $ - $ 3,013 $ - $ 5,672 $ - $ 3,933 $ - $ 5,672 $ - $ 3,505 $ - $ 6,866 $ - $ 4,269 $ - 85 $ 4,061 $ - $ 2,861 $ - $ 5,283 $ - $ 3,671 $ - 12 For Producer Use Only US (07/12)

67 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $120.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ - $ - $ - $ - $ - $ - $ - 50 $ 30,329 $ 29,012 $ - $ - $ 36,200 $ 35,013 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 51 $ 28,949 $ 27,746 $ 19,077 $ - $ 34,840 $ 33,739 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 52 $ 27,688 $ 26,586 $ 17,978 $ - $ 33,578 $ 32,555 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 53 $ 26,538 $ 25,524 $ 16,998 $ - $ 32,413 $ 31,458 $ - $ - $ - $ 34,596 $ - $ - $ - $ - $ - $ - 54 $ 25,475 $ 24,427 $ 16,120 $ - $ 31,318 $ 30,426 $ - $ - $ - $ 33,394 $ - $ - $ - $ - $ - $ - 55 $ 24,494 $ 23,523 $ 15,328 $ 14,838 $ 30,295 $ 29,460 $ - $ - $ 33,748 $ 31,932 $ - $ - $ - $ - $ - $ - 56 $ 23,305 $ 22,425 $ 14,542 $ 14,051 $ 28,899 $ 27,990 $ - $ - $ 32,264 $ 30,426 $ 19,441 $ - $ - $ - $ - $ - 57 $ 22,231 $ 21,342 $ 13,832 $ 13,343 $ 27,625 $ 26,794 $ - $ - $ 30,898 $ 29,208 $ 18,560 $ - $ - $ - $ - $ - 58 $ 21,247 $ 20,435 $ 13,189 $ 12,703 $ 26,465 $ 25,701 $ - $ - $ 29,649 $ 27,943 $ 17,753 $ - $ - $ - $ - $ - 59 $ 20,350 $ 19,532 $ 12,603 $ 12,122 $ 25,393 $ 24,689 $ - $ - $ 28,492 $ 26,913 $ 17,016 $ - $ - $ - $ - $ - 60 $ 19,523 $ 18,769 $ 12,066 $ 11,592 $ 24,404 $ 23,648 $ 19,687 $ - $ 27,348 $ 25,765 $ 16,228 $ - $ - $ 33,911 $ - $ - 61 $ 18,424 $ 17,692 $ 11,544 $ 11,018 $ 23,387 $ 22,692 $ 18,635 $ - $ 26,298 $ 24,831 $ 15,510 $ 14,756 $ 33,980 $ 32,531 $ - $ - 62 $ 17,442 $ 16,785 $ 11,064 $ 10,498 $ 22,455 $ 21,813 $ 17,687 $ - $ 25,320 $ 23,851 $ 14,854 $ 14,018 $ 32,603 $ 31,085 $ - $ - 63 $ 16,560 $ 15,918 $ 10,623 $ 10,025 $ 21,591 $ 20,915 $ 16,833 $ 14,642 $ 24,418 $ 23,048 $ 14,250 $ 13,352 $ 31,326 $ 29,922 $ - $ - 64 $ 15,762 $ 15,180 $ 10,216 $ 9,593 $ 20,794 $ 20,166 $ 16,056 $ 14,267 $ 23,573 $ 22,201 $ 13,693 $ 12,747 $ 30,151 $ 28,849 $ 19,997 $ - 65 $ 15,038 $ 14,468 $ 9,839 $ 9,197 $ 20,051 $ 19,466 $ 15,349 $ 13,910 $ 22,073 $ 20,866 $ 13,127 $ 12,122 $ 28,620 $ 27,303 $ 18,835 $ - 66 $ 14,281 $ 13,765 $ 9,467 $ 8,667 $ 19,441 $ 18,824 $ 14,444 $ 13,031 $ 20,749 $ 19,606 $ 12,605 $ 11,556 $ 27,231 $ 26,036 $ 17,803 $ - 67 $ 13,596 $ 13,096 $ 9,122 $ 8,194 $ 18,867 $ 18,286 $ 13,640 $ 12,256 $ 19,578 $ 18,493 $ 12,124 $ 11,040 $ 25,976 $ 24,771 $ 16,876 $ - 68 $ 12,974 $ 12,488 $ 8,801 $ 7,771 $ 18,328 $ 17,720 $ 12,922 $ 11,568 $ 18,529 $ 17,497 $ 11,678 $ 10,568 $ 24,826 $ 23,724 $ 16,043 $ 14, $ 12,406 $ 11,935 $ 8,502 $ 7,389 $ 17,817 $ 17,242 $ 12,275 $ 10,953 $ 17,589 $ 16,605 $ 11,263 $ 10,135 $ 23,778 $ 22,668 $ 15,286 $ 14, $ 11,886 $ 11,428 $ 8,223 $ 7,043 $ 17,334 $ 16,736 $ 11,689 $ 10,400 $ 16,253 $ 15,365 $ 10,338 $ 9,282 $ 21,985 $ 21,033 $ 14,018 $ 12, $ 10,852 $ 10,449 $ 7,643 $ 6,561 $ 16,083 $ 15,568 $ 10,839 $ 9,677 $ 15,106 $ 14,297 $ 9,553 $ 8,563 $ 20,447 $ 19,549 $ 12,943 $ 11, $ 9,984 $ 9,624 $ 7,139 $ 6,141 $ 15,001 $ 14,512 $ 10,104 $ 9,047 $ 14,110 $ 13,368 $ 8,880 $ 7,946 $ 19,107 $ 18,258 $ 12,023 $ 10, $ 9,244 $ 8,920 $ 6,698 $ 5,772 $ 14,054 $ 13,589 $ 9,463 $ 8,495 $ 13,237 $ 12,553 $ 8,295 $ 7,413 $ 17,934 $ 17,129 $ 11,223 $ 9, $ 8,607 $ 8,312 $ 6,308 $ 5,444 $ 13,220 $ 12,777 $ 8,898 $ 8,006 $ 12,466 $ 11,805 $ 7,782 $ 6,946 $ 16,895 $ 16,130 $ 10,525 $ 9, $ 8,052 $ 7,770 $ 5,961 $ 5,152 $ 12,480 $ 12,058 $ 8,396 $ 7,570 $ 11,444 $ 10,840 $ 7,181 $ 6,289 $ 15,433 $ 14,751 $ 9,611 $ 8, $ 7,518 $ 7,253 $ 5,494 $ 4,719 $ 11,513 $ 11,129 $ 7,783 $ 6,955 $ 10,576 $ 10,021 $ 6,667 $ 5,745 $ 14,203 $ 13,589 $ 8,843 $ 7, $ 7,051 $ 6,799 $ 5,095 $ 4,353 $ 10,685 $ 10,333 $ 7,252 $ 6,432 $ 9,832 $ 9,301 $ 6,221 $ 5,288 $ 13,156 $ 12,568 $ 8,189 $ 7, $ 6,638 $ 6,392 $ 4,750 $ 4,040 $ 9,968 $ 9,627 $ 6,790 $ 5,983 $ 9,185 $ 8,649 $ 5,831 $ 4,899 $ 12,252 $ 11,664 $ 7,624 $ 6, $ 6,271 $ 6,017 $ 4,449 $ 3,769 $ 9,341 $ 8,995 $ 6,382 $ 5,592 $ 8,617 $ 8,046 $ 5,487 $ 4,562 $ 11,464 $ 10,836 $ 7,133 $ 6, $ 5,943 $ 5,665 $ 4,183 $ 3,532 $ 8,789 $ 8,415 $ 6,021 $ 5,249 $ 7,995 $ - $ 5,051 $ - $ 10,372 $ - $ 6,452 $ - 81 $ 5,566 $ - $ 3,919 $ - $ 7,959 $ - $ 5,474 $ - $ 7,456 $ - $ 4,679 $ - $ 9,469 $ - $ 5,890 $ - 82 $ 5,235 $ - $ 3,686 $ - $ 7,273 $ - $ 5,018 $ - $ 6,986 $ - $ 4,358 $ - $ 8,711 $ - $ 5,417 $ - 83 $ 4,940 $ - $ 3,480 $ - $ 6,695 $ - $ 4,632 $ - $ 6,571 $ - $ 4,079 $ - $ 8,065 $ - $ 5,015 $ - 84 $ 4,677 $ - $ 3,295 $ - $ 6,203 $ - $ 4,301 $ - $ 6,203 $ - $ 3,833 $ - $ 7,509 $ - $ 4,669 $ - 85 $ 4,441 $ - $ 3,129 $ - $ 5,778 $ - $ 4,014 $ - 13 For Producer Use Only US (07/12)

68 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $130.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ - $ - $ - $ - $ - $ - $ - 50 $ 32,925 $ 31,494 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 51 $ 31,426 $ 30,120 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 52 $ 30,058 $ 28,861 $ 19,516 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 53 $ 28,809 $ 27,708 $ 18,453 $ - $ - $ 34,151 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 54 $ 27,655 $ 26,517 $ 17,500 $ - $ 33,998 $ 33,030 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 55 $ 26,590 $ 25,536 $ 16,640 $ - $ 32,888 $ 31,981 $ - $ - $ - $ 34,665 $ - $ - $ - $ - $ - $ - 56 $ 25,300 $ 24,344 $ 15,786 $ - $ 31,372 $ 30,385 $ - $ - $ - $ 33,030 $ - $ - $ - $ - $ - $ - 57 $ 24,133 $ 23,169 $ 15,016 $ 14,485 $ 29,989 $ 29,087 $ - $ - $ 33,542 $ 31,708 $ - $ - $ - $ - $ - $ - 58 $ 23,066 $ 22,183 $ 14,318 $ 13,791 $ 28,729 $ 27,900 $ - $ - $ 32,187 $ 30,335 $ 19,272 $ - $ - $ - $ - $ - 59 $ 22,092 $ 21,203 $ 13,681 $ 13,160 $ 27,566 $ 26,801 $ - $ - $ 30,930 $ 29,216 $ 18,472 $ - $ - $ - $ - $ - 60 $ 21,194 $ 20,375 $ 13,099 $ 12,584 $ 26,493 $ 25,672 $ - $ - $ 29,689 $ 27,970 $ 17,617 $ - $ - $ - $ - $ - 61 $ 20,001 $ 19,206 $ 12,532 $ 11,961 $ 25,389 $ 24,634 $ - $ - $ 28,548 $ 26,956 $ 16,837 $ - $ - $ - $ - $ - 62 $ 18,935 $ 18,221 $ 12,011 $ 11,397 $ 24,377 $ 23,680 $ 19,201 $ - $ 27,487 $ 25,892 $ 16,125 $ - $ - $ 33,745 $ - $ - 63 $ 17,977 $ 17,281 $ 11,533 $ 10,883 $ 23,439 $ 22,705 $ 18,274 $ - $ 26,507 $ 25,020 $ 15,470 $ 14,495 $ 34,006 $ 32,482 $ - $ - 64 $ 17,111 $ 16,479 $ 11,091 $ 10,414 $ 22,574 $ 21,892 $ 17,430 $ - $ 25,590 $ 24,101 $ 14,865 $ 13,838 $ 32,732 $ 31,318 $ - $ - 65 $ 16,325 $ 15,706 $ 10,681 $ 9,984 $ 21,767 $ 21,132 $ 16,663 $ - $ 23,962 $ 22,651 $ 14,250 $ 13,160 $ 31,069 $ 29,640 $ - $ - 66 $ 15,503 $ 14,943 $ 10,277 $ 9,408 $ 21,105 $ 20,435 $ 15,681 $ 14,146 $ 22,525 $ 21,284 $ 13,684 $ 12,545 $ 29,561 $ 28,265 $ 19,326 $ - 67 $ 14,759 $ 14,217 $ 9,903 $ 8,896 $ 20,481 $ 19,850 $ 14,808 $ 13,305 $ 21,253 $ 20,076 $ 13,162 $ 11,985 $ 28,199 $ 26,891 $ 18,320 $ - 68 $ 14,084 $ 13,557 $ 9,554 $ 8,436 $ 19,897 $ 19,237 $ 14,028 $ 12,558 $ 20,115 $ 18,995 $ 12,677 $ 11,472 $ 26,951 $ 25,754 $ 17,416 $ - 69 $ 13,468 $ 12,956 $ 9,230 $ 8,021 $ 19,342 $ 18,718 $ 13,325 $ 11,890 $ 19,095 $ 18,026 $ 12,227 $ 11,002 $ 25,814 $ 24,608 $ 16,594 $ - 70 $ 12,903 $ 12,406 $ 8,926 $ 7,646 $ 18,817 $ 18,169 $ 12,690 $ 11,290 $ 17,645 $ 16,680 $ 11,223 $ 10,077 $ 23,867 $ 22,833 $ 15,218 $ 13, $ 11,781 $ 11,343 $ 8,297 $ 7,123 $ 17,460 $ 16,900 $ 11,767 $ 10,505 $ 16,399 $ 15,521 $ 10,371 $ 9,296 $ 22,197 $ 21,222 $ 14,051 $ 12, $ 10,838 $ 10,448 $ 7,750 $ 6,667 $ 16,285 $ 15,754 $ 10,969 $ 9,821 $ 15,318 $ 14,513 $ 9,640 $ 8,626 $ 20,742 $ 19,821 $ 13,052 $ 11, $ 10,036 $ 9,684 $ 7,271 $ 6,266 $ 15,256 $ 14,752 $ 10,272 $ 9,222 $ 14,370 $ 13,627 $ 9,004 $ 8,047 $ 19,469 $ 18,595 $ 12,184 $ 10, $ 9,343 $ 9,024 $ 6,848 $ 5,910 $ 14,352 $ 13,871 $ 9,659 $ 8,691 $ 13,533 $ 12,815 $ 8,448 $ 7,541 $ 18,341 $ 17,510 $ 11,425 $ 9, $ 8,741 $ 8,435 $ 6,471 $ 5,593 $ 13,548 $ 13,089 $ 9,115 $ 8,218 $ 12,423 $ 11,768 $ 7,796 $ 6,827 $ 16,753 $ 16,013 $ 10,434 $ 9, $ 8,161 $ 7,873 $ 5,964 $ 5,123 $ 12,498 $ 12,081 $ 8,449 $ 7,550 $ 11,481 $ 10,878 $ 7,237 $ 6,237 $ 15,419 $ 14,752 $ 9,600 $ 8, $ 7,654 $ 7,381 $ 5,531 $ 4,726 $ 11,599 $ 11,218 $ 7,873 $ 6,983 $ 10,673 $ 10,097 $ 6,753 $ 5,741 $ 14,282 $ 13,644 $ 8,890 $ 7, $ 7,206 $ 6,939 $ 5,156 $ 4,386 $ 10,821 $ 10,451 $ 7,371 $ 6,495 $ 9,971 $ 9,389 $ 6,330 $ 5,318 $ 13,301 $ 12,662 $ 8,277 $ 7, $ 6,808 $ 6,532 $ 4,829 $ 4,092 $ 10,141 $ 9,765 $ 6,929 $ 6,070 $ 9,355 $ 8,735 $ 5,957 $ 4,953 $ 12,446 $ 11,764 $ 7,744 $ 6, $ 6,451 $ 6,150 $ 4,541 $ 3,835 $ 9,541 $ 9,135 $ 6,537 $ 5,698 $ 8,679 $ - $ 5,483 $ - $ 11,259 $ - $ 7,004 $ - 81 $ 6,043 $ - $ 4,255 $ - $ 8,640 $ - $ 5,942 $ - $ 8,094 $ - $ 5,079 $ - $ 10,280 $ - $ 6,394 $ - 82 $ 5,683 $ - $ 4,002 $ - $ 7,895 $ - $ 5,447 $ - $ 7,584 $ - $ 4,731 $ - $ 9,456 $ - $ 5,881 $ - 83 $ 5,363 $ - $ 3,778 $ - $ 7,268 $ - $ 5,028 $ - $ 7,133 $ - $ 4,428 $ - $ 8,755 $ - $ 5,445 $ - 84 $ 5,078 $ - $ 3,577 $ - $ 6,734 $ - $ 4,669 $ - $ 6,734 $ - $ 4,161 $ - $ 8,151 $ - $ 5,068 $ - 85 $ 4,821 $ - $ 3,397 $ - $ 6,272 $ - $ 4,358 $ - 14 For Producer Use Only US (07/12)

69 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $140.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ - $ - $ - $ - $ - $ - $ - 50 $ - $ 33,977 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 51 $ 33,904 $ 32,495 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 52 $ 32,427 $ 31,136 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 53 $ 31,081 $ 29,892 $ 19,908 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 54 $ 29,835 $ 28,608 $ 18,879 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 55 $ 28,686 $ 27,549 $ 17,952 $ - $ - $ 34,502 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 56 $ 27,294 $ 26,263 $ 17,031 $ - $ 33,845 $ 32,781 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 57 $ 26,036 $ 24,996 $ 16,200 $ - $ 32,354 $ 31,380 $ - $ - $ - $ 34,208 $ - $ - $ - $ - $ - $ - 58 $ 24,884 $ 23,932 $ 15,446 $ 14,878 $ 30,994 $ 30,100 $ - $ - $ 34,724 $ 32,726 $ - $ - $ - $ - $ - $ - 59 $ 23,834 $ 22,875 $ 14,760 $ 14,197 $ 29,739 $ 28,914 $ - $ - $ 33,368 $ 31,519 $ 19,928 $ - $ - $ - $ - $ - 60 $ 22,865 $ 21,981 $ 14,132 $ 13,576 $ 28,581 $ 27,696 $ - $ - $ 32,029 $ 30,175 $ 19,005 $ - $ - $ - $ - $ - 61 $ 21,578 $ 20,720 $ 13,520 $ 12,904 $ 27,390 $ 26,576 $ - $ - $ 30,799 $ 29,081 $ 18,164 $ - $ - $ - $ - $ - 62 $ 20,428 $ 19,658 $ 12,958 $ 12,295 $ 26,298 $ 25,547 $ - $ - $ 29,654 $ 27,933 $ 17,397 $ - $ - $ - $ - $ - 63 $ 19,394 $ 18,643 $ 12,442 $ 11,741 $ 25,286 $ 24,494 $ 19,715 $ - $ 28,597 $ 26,993 $ 16,689 $ - $ - $ - $ - $ - 64 $ 18,460 $ 17,778 $ 11,965 $ 11,235 $ 24,353 $ 23,618 $ 18,804 $ - $ 27,608 $ 26,001 $ 16,037 $ 14,929 $ - $ 33,786 $ - $ - 65 $ 17,612 $ 16,944 $ 11,523 $ 10,771 $ 23,483 $ 22,798 $ 17,977 $ - $ 25,851 $ 24,437 $ 15,374 $ 14,197 $ 33,519 $ 31,977 $ - $ - 66 $ 16,725 $ 16,122 $ 11,087 $ 10,150 $ 22,768 $ 22,046 $ 16,917 $ - $ 24,300 $ 22,962 $ 14,763 $ 13,534 $ 31,892 $ 30,493 $ - $ - 67 $ 15,923 $ 15,337 $ 10,683 $ 9,597 $ 22,096 $ 21,415 $ 15,975 $ 14,353 $ 22,929 $ 21,659 $ 14,200 $ 12,929 $ 30,422 $ 29,011 $ 19,764 $ - 68 $ 15,194 $ 14,626 $ 10,307 $ 9,101 $ 21,465 $ 20,753 $ 15,134 $ 13,548 $ 21,701 $ 20,492 $ 13,677 $ 12,377 $ 29,076 $ 27,784 $ 18,789 $ - 69 $ 14,529 $ 13,978 $ 9,957 $ 8,654 $ 20,867 $ 20,193 $ 14,376 $ 12,828 $ 20,600 $ 19,447 $ 13,191 $ 11,870 $ 27,849 $ 26,548 $ 17,902 $ - 70 $ 13,920 $ 13,384 $ 9,630 $ 8,248 $ 20,301 $ 19,601 $ 13,690 $ 12,180 $ 19,036 $ 17,995 $ 12,108 $ 10,871 $ 25,749 $ 24,633 $ 16,418 $ 14, $ 12,710 $ 12,237 $ 8,951 $ 7,684 $ 18,836 $ 18,232 $ 12,694 $ 11,333 $ 17,692 $ 16,745 $ 11,189 $ 10,028 $ 23,947 $ 22,895 $ 15,159 $ 13, $ 11,693 $ 11,272 $ 8,361 $ 7,192 $ 17,569 $ 16,996 $ 11,834 $ 10,596 $ 16,525 $ 15,657 $ 10,400 $ 9,306 $ 22,378 $ 21,383 $ 14,081 $ 12, $ 10,827 $ 10,447 $ 7,845 $ 6,760 $ 16,459 $ 15,915 $ 11,082 $ 9,949 $ 15,503 $ 14,702 $ 9,714 $ 8,682 $ 21,004 $ 20,061 $ 13,145 $ 11, $ 10,080 $ 9,735 $ 7,388 $ 6,376 $ 15,483 $ 14,965 $ 10,421 $ 9,376 $ 14,600 $ 13,826 $ 9,114 $ 8,135 $ 19,787 $ 18,891 $ 12,326 $ 10, $ 9,430 $ 9,100 $ 6,982 $ 6,033 $ 14,616 $ 14,121 $ 9,834 $ 8,866 $ 13,403 $ 12,695 $ 8,410 $ 7,365 $ 18,074 $ 17,276 $ 11,256 $ 9, $ 8,805 $ 8,494 $ 6,435 $ 5,527 $ 13,483 $ 13,034 $ 9,115 $ 8,145 $ 12,387 $ 11,736 $ 7,808 $ 6,729 $ 16,634 $ 15,915 $ 10,356 $ 8, $ 8,258 $ 7,963 $ 5,967 $ 5,099 $ 12,514 $ 12,102 $ 8,493 $ 7,533 $ 11,515 $ 10,893 $ 7,285 $ 6,194 $ 15,408 $ 14,720 $ 9,590 $ 8, $ 7,774 $ 7,486 $ 5,563 $ 4,732 $ 11,675 $ 11,275 $ 7,952 $ 7,007 $ 10,757 $ 10,130 $ 6,829 $ 5,737 $ 14,349 $ 13,660 $ 8,929 $ 7, $ 7,345 $ 7,047 $ 5,210 $ 4,415 $ 10,940 $ 10,535 $ 7,475 $ 6,549 $ 10,092 $ 9,423 $ 6,426 $ 5,343 $ 13,427 $ 12,691 $ 8,354 $ 7, $ 6,960 $ 6,635 $ 4,899 $ 4,137 $ 10,293 $ 9,855 $ 7,052 $ 6,147 $ 9,364 $ - $ 5,915 $ - $ 12,147 $ - $ 7,557 $ - 81 $ 6,519 $ - $ 4,590 $ - $ 9,321 $ - $ 6,411 $ - $ 8,733 $ - $ 5,480 $ - $ 11,090 $ - $ 6,898 $ - 82 $ 6,131 $ - $ 4,317 $ - $ 8,518 $ - $ 5,877 $ - $ 8,182 $ - $ 5,104 $ - $ 10,202 $ - $ 6,345 $ - 83 $ 5,786 $ - $ 4,075 $ - $ 7,841 $ - $ 5,425 $ - $ 7,696 $ - $ 4,777 $ - $ 9,446 $ - $ 5,874 $ - 84 $ 5,478 $ - $ 3,859 $ - $ 7,264 $ - $ 5,037 $ - $ 7,264 $ - $ 4,489 $ - $ 8,794 $ - $ 5,468 $ - 85 $ 5,201 $ - $ 3,665 $ - $ 6,767 $ - $ 4,701 $ - 15 For Producer Use Only US (07/12)

70 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Face Amounts are based on $150.00/month premium (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ - $ - $ - $ - $ - $ - $ - $ - 50 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 51 $ - $ 34,869 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 52 $ 34,797 $ 33,412 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 53 $ 33,352 $ 32,077 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 54 $ 32,016 $ 30,698 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 55 $ 30,782 $ 29,562 $ 19,264 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 56 $ 29,289 $ 28,182 $ 18,276 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 57 $ 27,938 $ 26,822 $ 17,384 $ - $ 34,718 $ 33,673 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 58 $ 26,703 $ 25,681 $ 16,575 $ - $ 33,259 $ 32,299 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 59 $ 25,575 $ 24,547 $ 15,838 $ - $ 31,912 $ 31,027 $ - $ - $ - $ 33,822 $ - $ - $ - $ - $ - $ - 60 $ 24,536 $ 23,587 $ 15,164 $ 14,568 $ 30,670 $ 29,719 $ - $ - $ 34,369 $ 32,380 $ - $ - $ - $ - $ - $ - 61 $ 23,155 $ 22,234 $ 14,508 $ 13,847 $ 29,392 $ 28,518 $ - $ - $ 33,050 $ 31,206 $ 19,492 $ - $ - $ - $ - $ - 62 $ 21,921 $ 21,094 $ 13,905 $ 13,194 $ 28,220 $ 27,414 $ - $ - $ 31,821 $ 29,974 $ 18,668 $ - $ - $ - $ - $ - 63 $ 20,812 $ 20,005 $ 13,351 $ 12,599 $ 27,134 $ 26,284 $ - $ - $ 30,687 $ 28,965 $ 17,909 $ - $ - $ - $ - $ - 64 $ 19,809 $ 19,077 $ 12,839 $ 12,056 $ 26,133 $ 25,344 $ - $ - $ 29,625 $ 27,901 $ 17,209 $ - $ - $ - $ - $ - 65 $ 18,899 $ 18,182 $ 12,365 $ 11,558 $ 25,199 $ 24,464 $ 19,290 $ - $ 27,740 $ 26,223 $ 16,497 $ - $ - $ 34,313 $ - $ - 66 $ 17,947 $ 17,300 $ 11,897 $ 10,892 $ 24,432 $ 23,657 $ 18,153 $ - $ 26,076 $ 24,640 $ 15,841 $ 14,523 $ 34,222 $ 32,721 $ - $ - 67 $ 17,087 $ 16,458 $ 11,464 $ 10,298 $ 23,711 $ 22,980 $ 17,142 $ - $ 24,604 $ 23,241 $ 15,237 $ 13,874 $ 32,645 $ 31,131 $ - $ - 68 $ 16,305 $ 15,695 $ 11,061 $ 9,766 $ 23,034 $ 22,270 $ 16,240 $ 14,538 $ 23,286 $ 21,990 $ 14,676 $ 13,281 $ 31,200 $ 29,814 $ - $ - 69 $ 15,591 $ 14,999 $ 10,685 $ 9,286 $ 22,392 $ 21,669 $ 15,426 $ 13,765 $ 22,105 $ 20,869 $ 14,155 $ 12,737 $ 29,884 $ 28,488 $ 19,211 $ - 70 $ 14,938 $ 14,362 $ 10,334 $ 8,851 $ 21,784 $ 21,033 $ 14,690 $ 13,070 $ 20,427 $ 19,310 $ 12,992 $ 11,666 $ 27,630 $ 26,433 $ 17,617 $ - 71 $ 13,639 $ 13,132 $ 9,605 $ 8,246 $ 20,213 $ 19,565 $ 13,622 $ 12,161 $ 18,985 $ 17,968 $ 12,006 $ 10,761 $ 25,697 $ 24,568 $ 16,267 $ 14, $ 12,547 $ 12,095 $ 8,972 $ 7,718 $ 18,852 $ 18,238 $ 12,698 $ 11,370 $ 17,733 $ 16,801 $ 11,160 $ 9,986 $ 24,013 $ 22,946 $ 15,110 $ 13, $ 11,618 $ 11,210 $ 8,418 $ 7,254 $ 17,662 $ 17,078 $ 11,892 $ 10,676 $ 16,636 $ 15,776 $ 10,424 $ 9,316 $ 22,539 $ 21,527 $ 14,105 $ 12, $ 10,817 $ 10,446 $ 7,928 $ 6,842 $ 16,615 $ 16,058 $ 11,182 $ 10,061 $ 15,667 $ 14,836 $ 9,780 $ 8,730 $ 21,233 $ 20,271 $ 13,227 $ 11, $ 10,119 $ 9,765 $ 7,492 $ 6,474 $ 15,684 $ 15,153 $ 10,552 $ 9,514 $ 14,382 $ 13,623 $ 9,025 $ 7,904 $ 19,395 $ 18,538 $ 12,079 $ 10, $ 9,448 $ 9,115 $ 6,905 $ 5,931 $ 14,469 $ 13,986 $ 9,781 $ 8,741 $ 13,292 $ 12,594 $ 8,378 $ 7,220 $ 17,850 $ 17,078 $ 11,113 $ 9, $ 8,861 $ 8,545 $ 6,403 $ 5,471 $ 13,428 $ 12,986 $ 9,114 $ 8,084 $ 12,356 $ 11,689 $ 7,818 $ 6,646 $ 16,534 $ 15,795 $ 10,291 $ 8, $ 8,343 $ 8,033 $ 5,969 $ 5,078 $ 12,528 $ 12,099 $ 8,533 $ 7,519 $ 11,543 $ 10,870 $ 7,328 $ 6,156 $ 15,398 $ 14,658 $ 9,582 $ 8, $ 7,881 $ 7,562 $ 5,591 $ 4,737 $ 11,740 $ 11,305 $ 8,021 $ 7,027 $ 10,830 $ 10,112 $ 6,896 $ 5,734 $ 14,408 $ 13,619 $ 8,965 $ 7, $ 7,469 $ 7,120 $ 5,257 $ 4,439 $ 11,045 $ 10,575 $ 7,568 $ 6,597 $ 10,048 $ - $ 6,348 $ - $ 13,035 $ - $ 8,109 $ - 81 $ 6,996 $ - $ 4,925 $ - $ 10,002 $ - $ 6,879 $ - $ 9,371 $ - $ 5,880 $ - $ 11,901 $ - $ 7,402 $ - 82 $ 6,579 $ - $ 4,633 $ - $ 9,140 $ - $ 6,306 $ - $ 8,779 $ - $ 5,477 $ - $ 10,947 $ - $ 6,809 $ - 83 $ 6,209 $ - $ 4,373 $ - $ 8,414 $ - $ 5,821 $ - $ 8,258 $ - $ 5,126 $ - $ 10,136 $ - $ 6,303 $ - 84 $ 5,878 $ - $ 4,141 $ - $ 7,795 $ - $ 5,405 $ - $ 7,795 $ - $ 4,817 $ - $ 9,437 $ - $ 5,868 $ - 85 $ 5,581 $ - $ 3,932 $ - $ 7,261 $ - $ 5,045 $ - 16 For Producer Use Only US (07/12)

71 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $5,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ - $ $ - $ $ - $ $ - 81 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 82 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 83 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 84 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 85 $ $ - $ $ - $ $ - $ $ - 17 For Producer Use Only US (07/12)

72 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $10,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ - $ $ - $ $ - $ $ - 81 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 82 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 83 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 84 $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - $ $ - 85 $ $ - $ $ - $ $ - $ $ - 18 For Producer Use Only US (07/12)

73 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $15,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ - $ - $ - $ $ - $ - $ - 81 $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - 82 $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - 83 $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - 84 $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - $ $ - $ - $ - 85 $ $ - $ - $ - $ $ - $ - $ - 19 For Producer Use Only US (07/12)

74 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $20,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ $ - $ $ $ $ - 50 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 51 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 52 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 53 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 54 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 55 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 56 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 57 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 58 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 59 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 60 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 61 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 62 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 63 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 64 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 65 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 66 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 67 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 68 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 69 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 70 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 71 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 72 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 73 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 74 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 75 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 76 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 77 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 78 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 79 $ $ $ $ - $ $ $ $ - $ $ $ $ - $ $ $ $ - 80 $ $ $ $ - $ $ $ $ - $ - $ - $ - $ - $ - $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 20 For Producer Use Only US (07/12)

75 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $25,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ - $ - $ $ $ - $ - 50 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 51 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 52 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 53 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 54 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 55 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 56 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 57 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 58 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 59 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 60 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 61 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 62 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 63 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 64 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 65 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 66 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 67 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 68 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 69 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 70 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 71 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 72 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 73 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 74 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 75 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 76 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 77 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 78 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 79 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 80 $ $ $ - $ - $ $ $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 21 For Producer Use Only US (07/12)

76 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $30,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ - $ - $ $ $ - $ - 50 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 51 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 52 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 53 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 54 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 55 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 56 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 57 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 58 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 59 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 60 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 61 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 62 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 63 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 64 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 65 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 66 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 67 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 68 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 69 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 70 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 71 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 72 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 73 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 74 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 75 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 76 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 77 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 78 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 79 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 80 $ $ $ - $ - $ $ $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 22 For Producer Use Only US (07/12)

77 Foresters PlanRight Monthly Quick Quotes (EFT/PAC) Monthly Premium Amounts are based on $35,000 Face Amounts (monthly premium including annual certificate fee) Non-Tobacco Tobacco Male Female Male Female Level Graded Modified Level Graded Modified Issue Age Level Graded Modified Level Graded Modified w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR w/o ADR w/ ADR $ $ $ - $ - $ $ $ - $ - 50 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 51 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 52 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 53 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 54 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 55 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 56 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 57 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 58 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 59 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 60 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 61 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 62 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 63 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 64 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 65 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 66 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 67 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 68 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 69 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 70 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 71 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 72 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 73 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 74 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 75 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 76 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 77 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 78 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 79 $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - $ $ $ - $ - 80 $ $ $ - $ - $ $ $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 81 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 82 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 83 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 84 $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - 85 $ - $ - $ - $ - $ - $ - $ - $ - 23 For Producer Use Only US (07/12)

78

79 SIMPLIFIED ISSUE WHOLE LIFE Annual Premiums per $1,000* of Face Amount Annual Premiums Per $1000* of Face Amount Issue Age NON-TOBACCO TOBACCO Male Female Male Female Monthly EFT Modal Factors: Modal Certificate Fee: $2.61 Quarterly $7.95 Semi- Annual 0.52 $15.60 Annual 1.0 $30.00 [ (Rate Modal Factor) rounded to 2 places (Units) ] rounded to 2 places + Modal Certificate Fee = Modal Premium [ ( ) = ] = Monthly EFT Premium * Additional $30 Annual Certificate Fee Product not available in all states. Please confirm product availability. Note: Premiums quoted for Montana applications must use male rates for both male and female applicants 8

80 How Much Will It Cost? (per month) Issue Age $5,000 $6,000 $7,500 $10,000 $15,000 $20,000 $25,000 M F M F M F M F M F M F M F SIMPLIFIED ISSUE WHOLE LIFE - NON-TOBACCO MONTHLY EFT PREMIUMS

81 10 How Much Will It Cost? (per month) Issue Age $5,000 $6,000 $7,500 $10,000 $15,000 $20,000 $25,000 M F M F M F M F M F M F M F SIMPLIFIED ISSUE WHOLE LIFE - TOBACCO MONTHLY EFT PREMIUMS

82 GRADED DEATH BENEFIT WHOLE LIFE Annual Premiums per $1,000* of Face Amount Annual Premiums Per $1000* of Face Amount Issue Age NON-TOBACCO TOBACCO Male Female Male Female Monthly EFT Modal Factors: Modal Certificate Fee: $2.61 Quarterly $7.95 Semi- Annual 0.52 $15.60 Annual 1.0 $30.00 [ (Rate Modal Factor) rounded to 2 places (Units) ] rounded to 2 places + Modal Certificate Fee = Modal Premium [ ( ) = ] = Monthly EFT Premium * Additional $30 Annual Certificate Fee Accidental Death Provision not approved in Arkansas. Product not available in all states. Please confirm product availability. 11

83 12 How Much Will It Cost? (per month) Issue Age $5,000 $6,000 $7,000 $8,000 $9,000 $10,000 M F M F M F M F M F M F GRADED DEATH BENEFIT WHOLE LIFE - NON-TOBACCO MONTHLY EFT PREMIUMS

84 13 How Much Will It Cost? (per month) Issue Age $5,000 $6,000 $7,000 $8,000 $9,000 $10,000 M F M F M F M F M F M F GRADED DEATH BENEFIT WHOLE LIFE - TOBACCO MONTHLY EFT PREMIUMS

85 Annual Standard Premium Rates Per $1,000 Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Add $60 Annual Policy Fee $5,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 50 $19.22 $16.99 $ $ Standard Rates

86 x $10,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Standard Rates $20,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Standard Rates

87 $30,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Standard Rates $50,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Standard Rates

88 Annual Substandard Premium Rates Per $1,000 Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Add $60 Annual Policy Fee $5,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 50 $ $22.21 $ $ Substandard Rates

89 $10,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Substandard Rates $20,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Substandard Rates

90 $30,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ Substandard Rates $50,000 Face Amount Monthly Bank Draft Premiums Age Male NNU Female NNU Male NU Female NU 18 $ $ $ $ , , , , , , , Substandard Rates

91 AdvantageGuard Annual Graded $5,000 Face Amount Monthly Premium Rates Per $1,000 Bank Draft Premiums Age Male Female Male Female AdvantageGuard $10,000 Face Amount Monthly $25,000 Face Amount Monthly Bank Draft Premiums Bank Draft Premiums Age Male Female Male Female 50 $ $ $33.67 $ Add $60 Annual Policy Fee Graded Rates 50 $ $ $ $ Graded Rates

92

93 Simplified Issue Level-Pay for Life MALE, Level-Pay For Life $3,000 minimum (see page 14 for rates) Monthly Calculator $ 5,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 50,000 Age NT T NT T NT T NT T NT T NT T , $30.00 Policy fee included. Ages = $50,000 maximum; Ages = $10,000 maximum face amounts. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of For financial professional use only. 12

94 (see page 15 for rates) FEMALE, Level-Pay For Life $3,000 minimum Monthly Calculator $ 5,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 50,000 Age NT T NT T NT T NT T NT T NT T $30.00 Policy fee included. Ages = $50,000 maximum; Ages = $10,000 maximum face amounts. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of

95 Simplified Issue Level-Pay for Life MALE, Level-Pay for Life Annual Rates per Thousand and Cash Values Age NT T For financial professional use only. 14 Cash Values at Age Age Age $30.00 Policy fee not included. Ages = $50,000 maximum; Ages = $10,000 maximum face amounts. Premium Factors: monthly (preauthorized withdrawal).085, Quarterly.26, Semiannually.51 MT Please use male rates to comply with your unisex state requirements. All rates are effective as of 2015.

96 FEMALE, Level-Pay for Life Annual Rates per Thousand and Cash Values Age NT T Cash Values at Age Age Age $30.00 Policy fee not included. Ages = $50,000 maximum; Ages = $10,000 maximum face amounts. Premium Factors: monthly (preauthorized withdrawal).085, Quarterly.26, Semiannually.51 MT Please use male rates to comply with your unisex state requirements. All rates are effective as of 2015.

97 Simplified Issue Single Premium Single Premium Rates per 1,000 of Face Amount/Death Male Female Age NT T NT T Male Female Age NT T NT T Use this table if you know the Face Amount /Death and want to calculate the Premium. For example: Female, age 51, No-Tobacco, desires a $100,000 Policy. The premium for this coverage would be: ( x 100) + $50 policy fee = $42,538 Policy Limitation: Policy may only be issued at the lessor of: Maximum Premium of $100,000 or Maximum Face Amount of $250,000 For example: Female, age 65, No-Tobacco Face Amount: $250,000 The Premium for $250,000 Face Amount is: $153,595. (250 x ) + $50 policy fee = $153,595, which exceeds the Maximum Premium of $100,000. A $100,000 Premium would purchase ($100,000 - $50 policy fee) x = $162,739 in Death. The Face Amount would be adjusted to $162,739 to comply with policy limitations. Formula: (Single Premium - $50.00*) x Factor = Face Amount (Face Amount / Factor) + $50.00* = Single Premium * denotes policy fee. Face amounts purchased by Single Premium: Ages = $25,000 maximum premium. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of For financial professional use only. 16

98 Single Premium Face Amount of Insurance Per Dollar Male Female Age NT T NT T Male Female Age NT T NT T Use this table if you know the Dollar Amount the client wishes to spend and want to determine the Face Amount to be applied for. For example: Male, age 67, No-Tobacco, has $100,000 to spend. The face amount would be ($100,000 - $50 policy fee) x = $143, Policy Limitation: Policy may only be issued at the lessor of: Maximum Premium of $100,000 or Maximum Face Amount of $250,000 For example: Male, age 40, No-Tobacco Premium: $100,000 A $100,000 Premium will purchase $326,676 of Face Amount. ($100,000 - $50 policy fee) x = $273,982.94, which exceeds the Maximum Face Amount $250,000. The Face Amount of $250,000 (250 x ) + $50 policy fee = $91,253 Premium. The policy premium would be adjusted to $91,253 to comply with policy limitations. Formula: (Single Premium - $50.00*) x Factor = Face Amount (Face Amount / Factor) + $50.00* = Single Premium * denotes policy fee. Face amounts purchased by Single Premium: Ages = $25,000 maximum premium. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of

99 Simplified Issue Single Premium MALE, Single Premium Annual Rates per Thousand and Cash Values Age NT T Cash Values at Age Age Age $50.00 Policy fee not included. Ages = $100,000 maximum or maximum face of $250,000 (see page 15); Ages = $25,000 maximum premium. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of For financial professional use only. 18

100 FEMALE, Single Premium Annual Rates per Thousand and Cash Values Age NT T Cash Values at Age Age Age $50.00 Policy fee not included. Ages = $100,000 maximum or maximum face of $250,000 (see page 15); Ages = $25,000 maximum premium. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of

101 Graded Death Level-Pay for Life See page for Rates MALE, Level-Pay for Life Monthly PAW Age $3,000 $5,000 $10,000 $15,000 $20,000 $25, FEMALE, Level-Pay for Life Monthly PAW Age $3,000 $5,000 $10,000 $15,000 $20,000 $25, $30.00 Policy fee included. Ages = $25,000 maximum; Ages = $10,000 maximum face amounts. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of For financial professional use only. 20

102 MALE, Level-Pay for Life Annual Rates per Thousand and Cash Values 21 Cash Values at Age Age Male Age $30.00 Policy fee included. Ages = $25,000 maximum; Ages = $10,000 maximum face amounts. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of 2015.

103 Graded Death Level-Pay for Life FEMALE, Level-Pay for Life For financial professional use only. 22 Annual Rates per Thousand and Cash Values Cash Values at Age Age Female Age $30.00 Policy fee included. Ages = $25,000 maximum; Ages = $10,000 maximum face amounts. MT Please use male rates to comply with your unisex state requirements. All rates are effective as of 2015.

104

105 Guaranteed Life is issued in all states except MT. State requirements may vary somewhat. Maximum face amount is $15,000 in South Dakota. Please refer to the policy for limitations and exclusions that may apply. Policy form series ICC12-GWLP and GWLP-12. Gerber Life's guarantee to accept all applicants age 50 to 80 is made possible by a two year graded death benefit limitation. If death occurs within the first two policy years for any reason other than an accident, all premiums shall be paid to the beneficiary, plus 10% interest on earned premiums. If death is due to accidental causes, the full death benefit will be paid. After the two-year Graded Death period, if the insured dies for any reason the full face amount of the policy shall be paid to the beneficiary. If the insured dies by suicide within two years from the Issue Date (one year in ND), the only amount payable will be the premiums paid for the policy plus 10% interest on earned premiums. $55.37 $57.93 $60.68 $63.62 $66.92 $70.77 $74.43 $78.47 $82.68 $87.27 $92.03 $95.52 $99.18 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ *Additional premium rates are available on the Gerber Life Agent Portal quote tool located at: $68.98 $72.19 $75.63 $79.29 $83.42 $88.23 $92.81 $97.85 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Gerber Life Guaranteed Life Male and Female Rates Guaranteed Life Monthly ACH Premiums* *Premiums deducted directly from a Checking or Savings Account. Male Female Issue Age $5,000 $10,000 $15,000 $20,000 $25,000 Issue Age $5,000 $10,000 $15,000 $20,000 $25, $19.66 $20.21 $20.90 $21.77 $22.64 $23.51 $24.34 $25.25 $26.40 $27.59 $28.78 $29.79 $30.85 $31.95 $33.23 $34.60 $35.84 $37.58 $39.78 $42.17 $44.41 $47.21 $50.42 $54.08 $58.21 $62.79 $69.67 $77.92 $88.00 $99.00 $ $38.41 $39.51 $40.88 $42.63 $44.37 $46.11 $47.76 $49.59 $51.88 $54.27 $56.65 $58.67 $60.78 $62.98 $65.54 $68.29 $70.77 $74.25 $78.65 $83.42 $87.91 $93.50 $99.92 $ $ $ $ $ $ $ $ $57.15 $58.80 $60.87 $63.48 $66.09 $68.70 $71.18 $73.93 $77.37 $80.94 $84.52 $87.54 $90.70 $94.00 $97.85 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $75.90 $78.10 $80.85 $84.33 $87.82 $91.30 $94.60 $98.27 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $94.65 $97.40 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $14.53 $15.17 $15.86 $16.59 $17.42 $18.38 $19.30 $20.30 $21.36 $22.50 $23.70 $24.57 $25.48 $26.35 $27.27 $28.19 $29.24 $30.48 $31.81 $33.28 $34.83 $36.67 $38.59 $40.65 $42.99 $45.60 $50.78 $56.65 $62.98 $69.58 $76.54 $28.14 $29.43 $30.80 $32.27 $33.92 $35.84 $37.68 $39.69 $41.80 $44.09 $46.48 $48.22 $50.05 $51.79 $53.63 $55.46 $57.57 $60.04 $62.70 $65.63 $68.75 $72.42 $76.27 $80.39 $85.07 $90.29 $ $ $ $ $ $41.75 $43.68 $45.74 $47.94 $50.42 $53.30 $56.05 $59.08 $62.24 $65.68 $69.25 $71.87 $74.62 $77.23 $79.98 $82.73 $85.89 $89.60 $93.59 $97.99 $ $ $ $ $ $ $ $ $ $ $ Copyright 2015 Gerber Life Insurance Company, White Plains, NY All rights reserved. For Financial Professional Internal Use Only. Not to Be Used With or Distributed to the General Public. Not FDIC Insured Not Bank Guaranteed Not a Deposit or Other Bank Obligation GL-RC (0815)

106 *Additional premium rates are available on the Gerber Life Agent Portal quote tool located at: Guaranteed Life is issued in all states except MT. State requirements may vary somewhat. Maximum face amount is $15,000 in South Dakota. Please refer to the policy for limitations and exclusions that may apply. Policy form series ICC12-GWLP and GWLP-12. Gerber Life's guarantee to accept all applicants age 50 to 80 is made possible by a two year graded death benefit limitation. If death occurs within the first two policy years for any reason other than an accident, all premiums shall be paid to the beneficiary, plus 10% interest on earned premiums. If death is due to accidental causes, the full death benefit will be paid. After the two-year Graded Death period, if the insured dies for any reason the full face amount of the policy shall be paid to the beneficiary. If the insured dies by suicide within two years from the Issue Date (one year in ND), the only amount payable will be the premiums paid for the policy plus 10% interest on earned premiums. Gerber Life Guaranteed Life Male and Female Rates Guaranteed Life Monthly Premiums for Direct Bill, Debit or Credit Card Payments* Male Female Issue Age $5,000 $10,000 $15,000 $20,000 $25,000 Issue Age $5,000 $10,000 $15,000 $20,000 $25, $21.45 $22.05 $22.80 $23.75 $24.70 $25.65 $26.55 $27.55 $28.80 $30.10 $31.40 $32.50 $33.65 $34.85 $36.25 $37.75 $39.10 $41.00 $43.40 $46.00 $48.45 $51.50 $55.00 $59.00 $63.50 $68.50 $76.00 $85.00 $96.00 $ $ $41.90 $43.10 $44.60 $46.50 $48.40 $50.30 $52.10 $54.10 $56.60 $59.20 $61.80 $64.00 $66.30 $68.70 $71.50 $74.50 $77.20 $81.00 $85.80 $91.00 $95.90 $ $ $ $ $ $ $ $ $ $ $62.35 $64.15 $66.40 $69.25 $72.10 $74.95 $77.65 $80.65 $84.40 $88.30 $92.20 $95.50 $98.95 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $82.80 $85.20 $88.20 $92.00 $95.80 $99.60 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $15.85 $16.55 $17.30 $18.10 $19.00 $20.05 $21.05 $22.15 $23.30 $24.55 $25.85 $26.80 $27.80 $28.75 $29.75 $30.75 $31.90 $33.25 $34.70 $36.30 $38.00 $40.00 $42.10 $44.35 $46.90 $49.75 $55.40 $61.80 $68.70 $75.90 $83.50 $30.70 $32.10 $33.60 $35.20 $37.00 $39.10 $41.10 $43.30 $45.60 $48.10 $50.70 $52.60 $54.60 $56.50 $58.50 $60.50 $62.80 $65.50 $68.40 $71.60 $75.00 $79.00 $83.20 $87.70 $92.80 $98.50 $ $ $ $ $ $45.55 $47.65 $49.90 $52.30 $55.00 $58.15 $61.15 $64.45 $67.90 $71.65 $75.55 $78.40 $81.40 $84.25 $87.25 $90.25 $93.70 $97.75 $ $ $ $ $ $ $ $ $ $ $ $ $ $60.40 $63.20 $66.20 $69.40 $73.00 $77.20 $81.20 $85.60 $90.20 $95.20 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $75.25 $78.75 $82.50 $86.50 $91.00 $96.25 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ GL-RC (0815)

107 Whole Life Monthly Premiums Male Issue Age BANK DRAFT MONTHLY PREMIUMS $2,000 $3,000 $4,000 $5,000 $7,500 $10,000 $15,000 $20,000 $25, $13.44 $18.07 $ $ $ $ $ $ $ $13.61 $18.33 $ $ $ $ $ $ $ $13.79 $18.60 $ $ $ $ $ $ $ $13.97 $18.87 $ $ $ $ $ $ $ $14.15 $19.14 $ $ $ $ $ $ $ $14.32 $19.40 $ $ $ $ $ $ $ $14.47 $19.62 $ $ $ $ $ $ $ $14.60 $19.82 $ $ $ $ $ $ $ $14.88 $20.24 $ $ $ $ $ $ $ $14.99 $20.40 $ $ $ $ $ $ $ $15.08 $20.54 $ $ $ $ $ $ $ $15.43 $21.06 $ $ $ $ $ $ $ $15.76 $21.56 $ $ $ $ $ $ $ $16.06 $22.01 $ $ $ $ $ $ $ $16.34 $22.43 $ $ $ $ $ $ $ $16.74 $23.02 $ $ $ $ $ $ $ $17.30 $23.87 $ $ $ $ $ $ $ $17.85 $24.69 $ $ $ $ $ $ $ $18.37 $25.47 $ $ $ $ $ $ $ $18.97 $26.37 $ $ $ $ $ $ $ $19.57 $27.27 $ $ $ $ $ $ $ $20.28 $28.34 $ $ $ $ $ $ $ $21.27 $29.82 $ $ $ $ $ $ $ $22.31 $31.38 $ $ $ $ $ $ $ $23.36 $32.95 $ $ $ $ $ $ $ $24.42 $34.54 $ $ $ $ $ $ $ $25.83 $36.66 $ $ $ $ $ $ $ $27.20 $38.72 $ $ $ $ $ $ $ $28.58 $40.79 $ $ $ $ $ $ $ $29.95 $42.84 $ $ $ $ $ $ $ $31.33 $44.91 $ $ $ $ $ $ $ $32.83 $47.16 $ $ $ $ $ $ $ $34.30 $49.37 $ $ $ $ $ $ $ $35.80 $51.61 $ $ $ $ $ $ $ $37.27 $53.82 $ $ $ $ $ $ $ $39.00 $56.42 $ $ $ $ $ $ $ * $42.18 $61.18 $ $ $ $ $ $ $ * $45.34 $65.93 $ $ $ $ $ $ $ * $48.55 $70.74 $ $ $ $ $ $ $ * $51.74 $75.53 $ $ $ $ $ $ $ * $54.97 $80.37 $ $ $ $ $ $ $ These rates may not be applicable in all states. Please refer to required forms list for appropriate brochure for each state. Multiply monthly rate for age by 12 to determine annual rate. * Ages are not available in Missouri.

108 Whole Life Monthly Premiums Female Issue Age BANK DRAFT MONTHLY PREMIUMS $2,000 $3,000 $4,000 $5,000 $7,500 $10,000 $15,000 $20,000 $25, $12.02 $15.95 $19.87 $ $ $ $ $ $ $12.16 $16.16 $20.16 $ $ $ $ $ $ $12.31 $16.38 $20.45 $ $ $ $ $ $ $12.45 $16.59 $20.73 $ $ $ $ $ $ $12.59 $16.80 $21.02 $ $ $ $ $ $ $12.74 $17.02 $21.31 $ $ $ $ $ $ $12.93 $17.31 $21.70 $ $ $ $ $ $ $13.11 $17.58 $22.06 $ $ $ $ $ $ $13.45 $18.09 $22.73 $ $ $ $ $ $ $13.61 $18.33 $23.05 $ $ $ $ $ $ $13.75 $18.54 $23.34 $ $ $ $ $ $ $14.01 $18.93 $23.86 $ $ $ $ $ $ $14.26 $19.30 $24.35 $ $ $ $ $ $ $14.63 $19.86 $25.09 $ $ $ $ $ $ $14.84 $20.17 $25.51 $ $ $ $ $ $ $15.02 $20.45 $25.88 $ $ $ $ $ $ $15.40 $21.01 $26.63 $ $ $ $ $ $ $15.74 $21.53 $27.31 $ $ $ $ $ $ $16.06 $22.01 $27.95 $ $ $ $ $ $ $16.44 $22.58 $28.72 $ $ $ $ $ $ $16.96 $23.35 $29.75 $ $ $ $ $ $ $17.58 $24.29 $31.00 $ $ $ $ $ $ $18.30 $25.37 $32.44 $ $ $ $ $ $ $19.05 $26.49 $33.93 $ $ $ $ $ $ $19.66 $27.41 $35.16 $ $ $ $ $ $ $20.41 $28.53 $36.66 $ $ $ $ $ $ $21.72 $30.50 $39.27 $ $ $ $ $ $ $23.06 $32.50 $41.95 $ $ $ $ $ $ $24.40 $34.52 $44.63 $ $ $ $ $ $ $25.63 $36.36 $47.09 $ $ $ $ $ $ $26.88 $38.24 $49.60 $ $ $ $ $ $ $28.28 $40.34 $52.40 $ $ $ $ $ $ $29.69 $42.45 $55.21 $ $ $ $ $ $ $31.26 $44.81 $58.36 $ $ $ $ $ $ $32.84 $47.18 $61.52 $ $ $ $ $ $ $34.15 $49.14 $64.14 $ $ $ $ $ $ * $36.82 $53.14 $69.47 $ $ $ $ $ $ * $39.16 $56.66 $74.16 $ $ $ $ $ $ * $41.74 $60.53 $79.32 $ $ $ $ $ $ * $44.20 $64.21 $84.23 $ $ $ $ $ $ * $47.00 $68.41 $89.83 $ $ $ $ $ $ These rates may not be applicable in all states. Please refer to required forms list for appropriate brochure for each state. Multiply monthly rate for age by 12 to determine annual rate. * Ages are not available in Missouri.

109 Living Promise Whole Life Insurance PREMIUM CALCULATOR UNITED OF OMAHA LIFE INSURANCE COMPANY A MuTUAL of OMAHA CoMPANY Level Plan Annual Premiums per $1,000 of Coverage Age Male Female Male Age Non Tobacco Tobacco Non Tobacco Tobacco Non Tobacco Tobacco 45 $24.99 $31.50 $21.80 $ $63.08 $ $25.81 $32.58 $22.27 $ $67.11 $ $26.76 $33.91 $22.86 $ $71.15 $ $27.82 $35.35 $23.57 $ $75.18 $ $28.45 $36.37 $23.91 $ $79.21 $ $29.16 $37.85 $24.12 $ $84.44 $ $30.45 $40.09 $25.00 $ $89.57 $ $31.37 $41.91 $25.48 $ $95.29 $ $32.58 $44.25 $26.31 $ $ $ $34.16 $46.70 $27.26 $ $ $ $35.83 $49.51 $28.31 $ $ $ $37.36 $51.96 $29.29 $ $ $ $38.99 $54.30 $30.17 $ $ $ $40.52 $56.64 $31.04 $ $ $ $42.26 $59.44 $32.02 $ $ $ $44.44 $62.71 $33.33 $ $ $ $47.39 $67.15 $35.18 $ $ $ $50.22 $71.71 $36.92 $ $ $ $53.16 $76.15 $38.78 $ $ $ $56.11 $80.71 $40.63 $ $ $ $59.05 $85.15 $42.48 $59.32 Follow these steps to calculate premium. 1. Divide the desired death benefit amount by 1,000. (Minimum $2,000; maximum $40,000) Example (Male, age 60, Nontobacco,needs $10,000 of coverage) Locate the rate chart for the plan you chose. Look for your 2.$44.44 age group and tobacco user status. Identify the premium rate per thousand. 3. Multiply #1 by #2 above. 3.$ Add policy fee of $ $ Annual Premium 5. Payment Options: 5. Monthly $42.76 Multiply annual premium by: Quarterly $ for monthly bank draft Semiannual $ for quarterly 0.52 for semiannual Female Non Tobacco Tobacco $45.21 $63.30 $47.93 $67.27 $50.66 $71.24 $53.49 $75.22 $56.22 $79.19 $60.03 $84.92 $63.95 $90.52 $68.23 $96.25 $72.56 $ $77.76 $ $84.32 $ $90.23 $ $95.77 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ My Living Promise $ $ $ $ $ $ $ Whole Life Insurance is underwritten by United of Omaha Life Insurance Company, Mutual of Omaha Plaza, Omaha, NE United of Omaha is licensed in all states except NY. Product base plans, provisions, features, and riders may not be available in all states and may vary by state. UC8167 For producer use only. Not for use with the general public.

110 Accidental Death Rider Annual Unisex Premiums per $1,000 of Coverage (Level Plan only) Age Premium Age Premium 45 $ $ $ $ $ $ $ $ $ $5.11 Follow these steps to calculate Example (Male, age My Living Promise premium with the AD rider. 60,Nontobacco,needs with AD Rider $10,000 of coverage) $ 1. Carry the Annual Premium (#4) 1. $ from front page. 50 $ $ Locate the rate for the rider. 2.$3.25 $ 51 $ $5.82 Identify the premium rate per thousand. 52 $ $ $ $ $ $ $ $ $ $9.00 3a. Carry the desired death 3a.10 $ benefit from #1 on front page. Multiply #2 by #3a. 3b. $ $ $ Add #3b to #1. 4. $ = $ 58 $ $10.59 $ Annual 59 $ $11.46 Premium 60 $ $ $ $ $ $ $ $ $ $ $3.93 Graded Plan 5. Payment Options: 5. Multiply annual premium by: for monthly bank draft Monthly $45.65 $ for quarterly Quarterly $ $ 0.52 for semiannual Semiannual $ $ Annual Premiums per $1,000 of Coverage Age Male Female Age Male Female Age Male Female Age Male Female 45 $43.61 $ $60.50 $ $93.75 $ $ $ $44.50 $ $63.75 $ $98.75 $ $ $ $45.42 $ $67.00 $ $ $ $ $ $46.34 $ $70.25 $ $ $ $ $ $47.29 $ $73.75 $ $ $ $ $ $48.25 $ $77.00 $ $ $ $ $ $51.50 $ $80.25 $ $ $ $ $ $54.75 $ $84.50 $ $ $ $ $ $57.25 $ $89.50 $ $ $ $ $ Follow these steps to calculate premium. Example (Male, age 60, needs $10,000 of coverage) 1. Divide the desired death benefit amount by 1, (Minimum $2,000; maximum $20,000) 2. Locate the rate chart for the plan you chose. Look for your age 2.$80.25 $ group and tobacco user status. Identify the premium rate per thousand. 3. Multiply #1 by #2 above. 3.$ $ 4. Add policy fee of $36. 4.$ $ Annual Premium 5. Payment Options: 5. Multiply annual premium by: for monthly bank draft Monthly $74.63 $ for quarterly Quarterly $ $ 0.52 for semiannual Semiannual $ $ My Living Promise $