PROTECT YOUR LOVED ONES AND YOUR INCOME

X HELP PROTECT YOUR LOVED ONES AND YOUR INCOME Management Consulting & Research, LLC All Full Time Employees Optional Term Life Insurance with Matching OAD&D Optional Dependent Life Insurance with Matching OAD&D The Prudential Insurance Company of America 108309 Ed. 04.2015 ECEd.10.2016-23453 Exp. 04.2018 0181193-00008-00

Summary of Benefits Management Consulting & Research, LLC All Full Time Employees Optional Term Life, Optional Dependent Life and Optional Accidental Death & Dismemberment Issued by The Prudential Insurance Company of America Optional Term Life 100% Employee Paid n Purchase coverage in increments of $50,000 up to a maximum of $500,000, not to exceed 7.0 times your covered annual earnings. n n n New Hires: If you are newly eligible, you can elect a coverage amount up to the Guaranteed Issue amount of $150,000, without providing evidence of insurability to The Prudential Insurance Company of America. Current Participants: Your current coverage amount will be continued. During the annual enrollment period, you can increase your current coverage amount by $50,000, up to a total coverage amount of the plan maximum, without providing evidence of insurability to Prudential. Evidence of insurability satisfactory to The Prudential Company of America is required for all increases over $50,000 or if enrolling after the annual enrollment period. Current Employees who were denied coverage in the past, Current Employees who waived coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. n If terminally ill, you can get a partial payment of your group term life insurance benefit. You can use this payment as you see fit. In the event of your death, your beneficiary will receive a benefit payout which has been reduced by the amount you receive. n Payment of premium can be waived if you are totally disabled for 9 months, you are less than 60 years old when the disability begins, and you continue to be totally disabled. This waiver terminates at age 65. This provision may vary by state. Refer to the plan booklet for details. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. n Upon termination of employment, you (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts will be subject to maximum of five times your annual earnings or $1 million, whichever is less.

Spouse - Optional Dependent Life 100% Employee Paid n Purchase coverage for your spouse in increments of $10,000 up to a maximum of $250,000, not to exceed 100% of your Optional Term Life coverage amount. n n n New Hires: Get up to $30,000 for your spouse- no medical questions asked - when enrolling when first eligible in Optional Dependent Group Term Life. Current Spouse Participants: Your spouse's current coverage amount will be continued. Evidence of insurability satisfactory to the Prudential Insurance Company of America is required for all increases in coverage amounts. Current Employees whose spouse has been denied coverage in the past, Current Employees who waived spouse coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. n Upon termination of employment, your spouse (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts for you and your spouse will be subject to a maximum of five times your annual earnings or $1 million, whichever is less. 100% Employee Paid Child - Optional Dependent Life n Purchase coverage for $10,000, not to exceed 50% of your Optional Term Life coverage amount. There are no health requirements for this coverage. n Coverage begins from live birth, and continues to age 26. n Upon termination of employment, you (if eligible to port) may choose to continue a dependent child coverage amount equal to or lower than your current benefit amount. Employee - Optional Accidental Death & Dismemberment 100% Employee Paid n You are automatically enrolled for an equal amount of Optional AD&D Insurance coverage when you enroll for Optional Term Life Insurance. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70. Spouse - Optional Accidental Death & Dismemberment 100% Employee Paid n Your spouse is automatically enrolled for an equal amount of Optional AD&D Insurance coverage when you enroll your spouse for Optional Dependent Life Insurance coverage. n Coverage will be reduced as you age - by 35% at age 65 and 50% at age 70.

Child - Optional Accidental Death & Dismemberment 100% Employee Paid n Your child(ren) will be automatically enrolled for an equal amount of Optional AD&D Insurance coverage when you enroll your child(ren) for Optional Dependent Life Insurance coverage. Benefits, exclusions and provisions may vary by state. Refer to the plan booklet for details. For your coverage to become effective, you must be actively at work on the effective date of the plan. If you apply for an amount that requires satisfactory evidence of insurability to The Prudential Insurance Company of America, you must be actively at work on the date of approval for the amount requiring satisfactory evidence of insurability. *Accelerated Death Benefit option is a feature that is made available to group life insurance participants. It is not a health, nursing home, or long-term care insurance benefit and is not designed to eliminate the need for those types of insurance coverage. The death benefit is reduced by the amount of the accelerated death benefit paid. There is no administrative fee to accelerate benefits. Receipt of accelerated death benefits may affect eligibility for public assistance and may be taxable. The federal income tax treatment of payments made under this rider depends upon whether the insured is the recipient of the benefits and is considered "terminally ill" or "chronically ill." You may wish to seek professional tax advice before exercising this option. This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. IMPORTANT NOTICE - THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS. North Carolina residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company. All benefit features may not be available in all states. Group Term Life and Disability coverages are issued by The Prudential Insurance Company of America, a New Jersey Company, 751 Broad Street, Newark, NJ 07102. Life Claims: 1-800-524-0542 and Disability Support: 1-800-842-1718. This brochure is intended to be a summary of your benefits and does not include all plan provisions, exclusions and limitations. Please refer to the Booklet-Certificate, which is made a part of the Group Contract, for all plan details, including any exclusions, limitations and restrictions which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the terms of the Group Contract will govern. Contract provisions may vary by state. Contract Series: 83500. California COA #1179 NAIC # 6824. 2014 Prudential Financial, Inc., and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide.

How much it will cost RateSheet Management Consulting & Research, LLC All Full Time Employees Issued by The Prudential Insurance Company of America Effective: 01/01/2017 Employee - Optional Term Life Monthly Cost per Coverage Amount with Matching OAD&D Coverage is available in increments of $50,000 to a maximum of $500,000, not to exceed 7.0 times your covered annual earnings. Refer to the Optional Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule. Age $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 0-24 $3.10 $6.20 $9.30 $12.40 $15.50 $18.60 $21.70 $24.80 $27.90 $31.00 25-29 $3.55 $7.10 $10.65 $14.20 $17.75 $21.30 $24.85 $28.40 $31.95 $35.50 30-34 $3.95 $7.90 $11.85 $15.80 $19.75 $23.70 $27.65 $31.60 $35.55 $39.50 35-39 $4.80 $9.60 $14.40 $19.20 $24.00 $28.80 $33.60 $38.40 $43.20 $48.00 40-44 $5.20 $10.40 $15.60 $20.80 $26.00 $31.20 $36.40 $41.60 $46.80 $52.00 45-49 $7.30 $14.60 $21.90 $29.20 $36.50 $43.80 $51.10 $58.40 $65.70 $73.00 50-54 $10.70 $21.40 $32.10 $42.80 $53.50 $64.20 $74.90 $85.60 $96.30 $107.00 55-59 $19.10 $38.20 $57.30 $76.40 $95.50 $114.60 $133.70 $152.80 $171.90 $191.00 60-64 $28.80 $57.60 $86.40 $115.20 $144.00 $172.80 $201.60 $230.40 $259.20 $288.00 65-69 $54.55 $109.10 $163.65 $218.20 $272.75 $327.30 $381.85 $436.40 $490.95 $545.50 70-100 $87.85 $175.70 $263.55 $351.40 $439.25 $527.10 $614.95 $702.80 $790.65 $878.50 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds. The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here. 0270257

Spouse - Optional Dependent Life Monthly Cost per Coverage Amount with Matching OAD&D Coverage is available in increments of $10,000 to a maximum of $250,000, not to exceed 100% of your Optional Term Life coverage amount. Refer to the Optional Dependent Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule. Age $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 0-24 $0.62 $1.24 $1.86 $2.48 $3.10 $3.72 $4.34 $4.96 $5.58 $6.20 $6.82 $7.44 $8.06 25-29 $0.71 $1.42 $2.13 $2.84 $3.55 $4.26 $4.97 $5.68 $6.39 $7.10 $7.81 $8.52 $9.23 30-34 $0.79 $1.58 $2.37 $3.16 $3.95 $4.74 $5.53 $6.32 $7.11 $7.90 $8.69 $9.48 $10.27 35-39 $0.96 $1.92 $2.88 $3.84 $4.80 $5.76 $6.72 $7.68 $8.64 $9.60 $10.56 $11.52 $12.48 40-44 $1.04 $2.08 $3.12 $4.16 $5.20 $6.24 $7.28 $8.32 $9.36 $10.40 $11.44 $12.48 $13.52 45-49 $1.46 $2.92 $4.38 $5.84 $7.30 $8.76 $10.22 $11.68 $13.14 $14.60 $16.06 $17.52 $18.98 50-54 $2.14 $4.28 $6.42 $8.56 $10.70 $12.84 $14.98 $17.12 $19.26 $21.40 $23.54 $25.68 $27.82 55-59 $3.82 $7.64 $11.46 $15.28 $19.10 $22.92 $26.74 $30.56 $34.38 $38.20 $42.02 $45.84 $49.66 60-64 $5.76 $11.52 $17.28 $23.04 $28.80 $34.56 $40.32 $46.08 $51.84 $57.60 $63.36 $69.12 $74.88 65-69 $10.91 $21.82 $32.73 $43.64 $54.55 $65.46 $76.37 $87.28 $98.19 $109.10 $120.01 $130.92 $141.83 70-100 $17.57 $35.14 $52.71 $70.28 $87.85 $105.42 $122.99 $140.56 $158.13 $175.70 $193.27 $210.84 $228.41 Age $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 $210,000 $220,000 $230,000 $240,000 $250,000 0-24 $8.68 $9.30 $9.92 $10.54 $11.16 $11.78 $12.40 $13.02 $13.64 $14.26 $14.88 $15.50 25-29 $9.94 $10.65 $11.36 $12.07 $12.78 $13.49 $14.20 $14.91 $15.62 $16.33 $17.04 $17.75 30-34 $11.06 $11.85 $12.64 $13.43 $14.22 $15.01 $15.80 $16.59 $17.38 $18.17 $18.96 $19.75 35-39 $13.44 $14.40 $15.36 $16.32 $17.28 $18.24 $19.20 $20.16 $21.12 $22.08 $23.04 $24.00 40-44 $14.56 $15.60 $16.64 $17.68 $18.72 $19.76 $20.80 $21.84 $22.88 $23.92 $24.96 $26.00 45-49 $20.44 $21.90 $23.36 $24.82 $26.28 $27.74 $29.20 $30.66 $32.12 $33.58 $35.04 $36.50 50-54 $29.96 $32.10 $34.24 $36.38 $38.52 $40.66 $42.80 $44.94 $47.08 $49.22 $51.36 $53.50 55-59 $53.48 $57.30 $61.12 $64.94 $68.76 $72.58 $76.40 $80.22 $84.04 $87.86 $91.68 $95.50 60-64 $80.64 $86.40 $92.16 $97.92 $103.68 $109.44 $115.20 $120.96 $126.72 $132.48 $138.24 $144.00 65-69 $152.74 $163.65 $174.56 $185.47 $196.38 $207.29 $218.20 $229.11 $240.02 $250.93 $261.84 $272.75 70-100 $245.98 $263.55 $281.12 $298.69 $316.26 $333.83 $351.40 $368.97 $386.54 $404.11 $421.68 $439.25 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds. Spouse rate is based on employee's age. Children - Optional Dependent Life Monthly Cost per Coverage Amount with Matching OAD&D One premium rate covers all eligible children $10,000 $1.12 Rates may change if plan experience requires a change for all insureds.

The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here. This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York Department of Financial Services. IMPORTANT NOTICE THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS North Carolina Residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company. Optional Term Life, Dependent Term Life, Long Term Disability, Short Term Disability, Accidental Death & Dismemberment Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, 751 Broad Street, Newark, NJ 07102. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. Contract Series: 83500 2014 Prudential Financial, Inc. and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide. 0270257-00001-00

Enrollment Form Management Consulting & Research, LLC The Prudential Insurance Company of America 751 Broad Street, Newark, New Jersey 07102 1-877-232-3619 Employee General Information Effective Date of Coverage (for office use only) / / Last Name First Name Middle Initial Email Phone Address City State Zip Code Social Security Number Marital Status Date of Birth Single Married Month Day Year Divorced Widowed / / Date Employed Your Annual Earnings (For Prudential Use Only) Month Day Year Optional Term Life / / $ Control # 52265 Auto Approved Increase for Current Participants $50,000 ( No Evidence of Insurability needed ) Payroll Deduction: $ $50,000 $100,000 $150,000 $200,000 Payroll Deduction: $ $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 No coverage chosen Continue current coverage amount Optional Dependent Term Life You must be enrolled for Optional Term Life to elect coverage for your dependents. Spouse coverage cannot exceed 100% of your Optional Term Life coverage amount. Child(ren) coverage cannot exceed 50% of your Optional Term Life coverage amount. Spouse No coverage chosen Children No coverage chosen Coverage amount chosen: $ Coverage amount chosen: $ Continue current coverage amount Payroll Deduction: $ Continue current coverage amount Payroll Deduction: $ Optional Accidental Death & Dismemberment (Optional AD&D) Employee Only Automatically enrolled when you enroll for Optional Term Life Spouse, Child(ren) Automatically enrolled when you enroll for Optional Dependent Term Life GL.2014.192 Ed. 03/2016 Page 1 of 4

Enrollment Form Management Consulting & Research, LLC Employee General Information Last Name First Name Middle Initial Last 4 digits of Social Security No. XXX XX Accelerated Death Benefit Option is a feature that is made available to group life insurance participants. It is not a health, nursing home, or long-term care insurance benefit and is not designed to eliminate the need for those types of insurance coverage. The death benefit is reduced by the amount of the accelerated death benefit paid. There is no administrative fee to accelerate benefits. Receipt of accelerated death benefits may affect eligibility for public assistance and may be taxable. The federal income tax treatment of payments made under this rider depends upon whether the insured is the recipient of the benefits and is considered terminally ill or chronically ill. You may wish to seek professional tax advice before exercising this option. NOTICE TO CONSUMER: THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMAL ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES. ALSO, THE BENEFITS PROVIDED BY THIS POLICY CANNOT BE COORDINATED WITH THE BENEFITS PROVIDED BY OTHER COVERAGE. PLEASE REVIEW THE BENEFITS PROVIDED BY THIS POLICY CAREFULLY TO AVOID A DUPLICATION OF COVERAGE. Basic Life, Accidental Death & Dismemberment, Optional Term Life, Dependent Term Life, Long-Term Disability, Short-Term Disability Insurance coverages are issued by The Prudential Insurance Company of America, 751 Broad Street, Newark, NJ 07102. Life Claims: 1-800-524-0542 and Disability Support 1-800-842-1718. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. If there is a discrepancy between this document and the Booklet- Certificate/Group Contract issued by Prudential, the terms of the Group Contract will govern. Contract provisions may vary by state. California COA #1179, NAIC#68241. Contract Series: 83500. 2016 Prudential Financial, Inc. and its related entities. Prudential, the Prudential logo and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide. GL.2014.192 Ed. 03/2016 Page 2 of 4

Enrollment Form Management Consulting & Research, LLC Employee General Information Last Name First Name Middle Initial Last 4 digits of Social Security No. Acceptance or Waiver of Coverage XXX XX I am enrolling for coverage and I authorize my employer to deduct from my earnings until further notice my contributions for insurance under a contract issued by The Prudential Insurance Company of America. I understand that if I desire to increase the amount of my insurance or add dependent coverage hereafter, I may be required to furnish evidence of insurability for myself and/or my dependents. To the best of my knowledge and belief, I declare the statement above is true and understand it is the basis for determining the contribution for coverage. I also understand that for coverage to become effective, I must be actively at work during the enrollment period and on the effective date of the plan. If I apply for an amount that requires evidence of insurability satisfactory to The Prudential Insurance Company of America, I must be actively at work on the date of approval for the amount requiring satisfactory evidence of insurability. I do not wish to enroll for any of the above optional coverages. I certify that I have been given the opportunity by my above named employer to enroll for coverage. I understand that if I desire to enroll hereafter, I may be required to furnish satisfactory evidence of insurability to The Prudential Insurance Company of America for myself and/or my dependents. FLORIDA RESIDENTS Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing false, incomplete, or misleading information is guilty of a felony of the third degree. NEW YORK RESIDENTS Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. This warning ONLY applies to accident and disability coverage. I have read and understand the terms and requirements of the fraud warnings included as part of this form. Employee Signature: Date (Month/Day/Year) / / FOR INSUREDS WHO RESIDE IN MICHIGAN OR MINNESOTA ONLY If you wish to enroll your Spouse or Domestic Partner, and/or eligible child 18 years of age or older for Dependent Life and/or Accidental Death and Dismemberment Insurance coverage, your Spouse or Domestic Partner, and/or each of your eligible children age 18 years or older must consent to such coverage by signing and dating this consent in the appropriate space(s) below. Coverage on your Spouse or Domestic Partner and child(ren) age 18 or older will not become effective unless and until the requisite consent is provided. Spouse Signature: Date (Month, Day, Year) / / _ Child Signature: Date (Month, Day, Year) / / Child Signature: Date (Month, Day, Year) / / Child Signature: Date (Month, Day, Year) / / Child Signature: Date (Month, Day, Year) / / GL.2014.192 Ed. 03/2016 Page 3 of 4

- XXX Enrollment Form Management Consulting & Research, LLC Employee General Information Last Name First Name Middle Initial Last 4 digits of Social Security No. XX For residents of all states except Alabama, Arkansas, the District of Columbia, Florida, Kentucky, Louisiana, Maine, Maryland, New Jersey, New York, North Carolina, Pennsylvania, Puerto Rico, Rhode Island, Utah, Vermont, Virginia and Washington; WARNING: Any person who knowingly and with intent to injure, defraud, or deceive any insurance company or other person, or knowing that he is facilitating commission of a fraud, submits incomplete, false, fraudulent, deceptive or misleading facts or information when filing an insurance application or a statement of claim for payment of a loss or benefit commits a fraudulent insurance act, is/may be guilty of a crime and may be prosecuted and punished under state law. Penalties may include fines, civil damages and criminal penalties, including confinement in prison. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant or if the applicant conceals, for the purpose of misleading, information concerning any fact material thereto ALABAMA RESIDENTS - Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or who knowingly presents false information in an application for insurance is guilty of a crime and may be subject to restitution fines or confinement in prison, or any combination thereof. ARKANSAS, DISTRICT OF COLUMBIA, LOUISIANA and RHODE ISLAND RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. KENTUCKY RESIDENTS - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime. MAINE AND WASHINGTON RESIDENTS - Any person who knowingly provides false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company commits a crime. Penalties include imprisonment, fines, and denial of insurance benefits. MARYLAND RESIDENTS - Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. NEW JERSEY RESIDENTS - Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. NORTH CAROLINA RESIDENTS Any person who, with the intent to injure, defraud, or deceive an insurer or insurance claimant, knowing that the statement contains false or misleading information concerning a fact or matter material to the claim may be guilty of a Class H felony. PENNSYLVANIA and UTAH RESIDENTS - Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any material fact thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties. PUERTO RICO RESIDENTS: Any person who knowingly and with the intention of defrauding presents false information in an insurance application, or presents, helps, or causes the presentation of a fraudulent claim for the payment of a loss or any other benefit, or presents more than one claim for the same damage or loss, shall incur a felony and, upon conviction, shall be sanctioned for each violation by a fine of not less than five thousand dollars ($5,000) and not more than ten thousand dollars ($10,000), or a fixed term of imprisonment for three (3) years, or both penalties. Should aggravating circumstances be present, the penalty thus established may be increased to a maximum of five (5) years, if extenuating circumstances are present, it may be reduced to a minimum of two (2) years. VERMONT RESIDENTS Any person who knowingly presents a false or fraudulent claim for payment of a loss or knowingly makes a false statement in an application for insurance may be guilty of a criminal offense under state law. VIRGINIA RESIDENTS - Any person who, with the intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement may have violated state law. You must also complete a separate beneficiary designation form. If you have any questions, please see Human Resources for details. GL.2014.192 Ed. 03/2016 Page 4 of 4

1 Page 1 of 2 Beneficiary Designation - Management Consulting & Research, LLC Control # 52265 Last Name First Name Middle Initial Social Security No. Optional Term Life, Optional AD&D- Primary Beneficiary Designation 2 Optional Term Life, Optional AD&D- Contingent Beneficiary Designation 1 2

Page 2 of 2 The above beneficiary designation only applies to: Optional Term Life, Optional AD&D Employee Signature Date (mm/dd/yyyy) If you have any questions, please see Human Resources for details. Group Term Life and Disability coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, 751 Broad Street, Newark, NJ 07102. Life Claims: 800-524-0542, Disability Support: 800-842-1718. This brochure is intended to be a summary of your benefits and does not include all plan provisions, exclusions and limitations. Please refer to the Booklet-Certificate, which is made a part of the Group Contract, for all plan details, including any exclusions, limitations and restrictions which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the Group Contract will govern. Contract provisions may vary by state. Contract Series:83500. California COA # 1179 NAIC #68241 2013 Prudential Financial, Inc., and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide. GL.2005.289 Ed. 04.2015 ECEd.10.2016-23453 Exp. 04.2018