Your Employee Benefits Guide - PDF Free Download

Your Employee Benefits Guide Enroll Now To Help Secure Your Financial Future Standard Insurance Company Benefit Communicators Inc. Mary Maddox 502.499.2501

Welcome To Your Employee Benefits Guide Protect What Matters Most Building a financial safety net is important. It can also be easy if you take advantage of the benefits your employer offers. Take a few minutes now to explore your options and help protect your future and your loved ones. By enrolling in valuable insurance coverage from Standard Insurance Company at affordable group rates you can close key gaps in your financial safety net. You Can Count On The Standard trusts The Standard, and you can too. Founded in 1906, The Standard has been keeping promises for more than 100 years. We specialize in employee benefits and offer plans designed to help give you peace of mind. Doing the right thing for our customers is in our DNA. Whether you have a question or need to file a claim, we re easy to reach and ready to help online or on the phone. Valuable Benefits You Can Enroll In Now You may choose to enroll in any or all of the following plans at affordable group rates, with easy payroll deductions: Voluntary Life and Accidental Death & Dismemberment insurance (AD&D) Dependents Life and Accidental Death & Dismemberment insurance (AD&D) Long Term Disability (LTD) Act Now To Protect Yourself And Those You Love As you explore your benefit options, think about what and who is important to you, now and in the future. You may also want to plan ahead to take care of financial responsibilities. Read on to learn more reasons to enroll. Then refer to the Coverage Highlights included in this guide for the details of each plan. Life Insurance Plan Ahead For Peace Of Mind It s not easy to think about, but what would happen to your loved ones if something happened to you? Or, how would you cope if a family member died? An unexpected death could leave your family with significant extra expenses, including final medical and funeral costs, on top of ongoing bills and possible loss of income. How much Life insurance is enough? Refer to the Coverage Highlights to learn more about the Life insurance coverage available through your employer. To help determine your needs, use our simple Life Insurance Calculator, available at http://www.standard.com/calculators/life.html Accidental Death & Dismemberment Insurance Few people are prepared for the sudden financial loss brought on by an accidental death. Even fewer are financially prepared for the high cost of living after an accident results in a severe physical loss. Your employer offers additional financial support by including Accidental Death and Dismemberment (AD&D) insurance as part of a Group Life insurance policy or as a separate policy from The Standard. AD&D insurance is designed to pay a benefit if you or, if applicable, any other covered family member have an accident that results in a covered loss. Refer to the Coverage Highlights for more details on your Group Life and AD&D coverage. Benefits Guide Letter SI 16919-754575 1

Disability Insurance Protects A Key Asset Your Income You insure assets like your car, home or other possessions. But your most valuable asset is your income. That s why disability insurance is an important tool for securing your financial future. Disability insurance provides income replacement if you experience a covered illness, injury, pregnancy or mental disorder. The weekly or monthly benefit payments can help with bills that continue even when you can t work, like your mortgage or rent expenses health insurance won t cover. To help determine how much coverage you may need, use our easy online calculator at http://www.standard.com/calculators/dineeds.html. Long Term Disability Insurance How long would your savings last if you couldn t work for several months or years? After a Benefit Waiting Period, Long Term Disability (LTD) insurance replaces a portion of your income by paying monthly benefits if you experience a covered long-term illness, injury, pregnancy or mental disorder. Refer to the Coverage Highlights for more details. Ready To Enroll? Now that you ve reviewed your options and seen how important your benefits can be, the next step is to enroll. If you have any questions, please contact Mary Maddox at Benefit Communicators Inc. at 502.499.2501. Remember, you have a limited time to enroll, so start securing your financial future today. Do You Know Your Odds Of Disability? 1 in 4 of today s 20-year-olds will become disabled before they retire 1 Every 90 seconds someone files for bankruptcy due to a serious illness 2 The two leading causes of longterm disabilities are diseases of the musculoskeletal system and connective tissue and cancer. 3 1 Social Security Basic Facts, July 26, 2013 2 The American Journal of Medicine, Vol. 122, No. 8, August 2009 3 2012 Council for Disability Awareness Long-Term Disability Claims Review Benefits Guide Letter SI 16919-754575 2

Voluntary Life and AD&D Coverage Highlights Voluntary Life and Accidental Death and Dismemberment (AD&D) Insurance Life insurance coverage can help your family meet daily expenses, maintain their standard of living, pay off debt, secure your children s education, and more in the event of your passing. AD&D insurance can provide you and your family with extra protection in the event of death or dismemberment as a result of a covered accident. Standard Insurance Company (The Standard) has developed this document to provide you with information about the elective coverage you may select through. Eligibility Requirements Policy A minimum number of eligible employees must apply and qualify for the proposed plan before Voluntary Life coverage can become effective Employee Dependent Premium You must be an active employee of working at least 20 hours each week Temporary and seasonal employees, full-time members of the armed forces, leased employees and independent contractors are not eligible You must elect Voluntary Life insurance for yourself in order to elect Dependents Life insurance You must elect Voluntary AD&D insurance for yourself in order to elect AD&D insurance for your dependents Spouse means a person to whom you are legally married or your domestic partner as recognized by law Child means your child from live birth through age 20 (through age 24 if a registered student in full-time attendance at an accredited educational institution) Your spouse or children must not be full-time member(s) of the armed forces You pay 100 percent of the premium for this coverage through easy payroll deduction Coverage Amount Guidelines Within the coverage amount guidelines shown below, you select the amount of Voluntary Life and Dependents Life insurance for which you are interested in applying. Minimum Incremental Unit Guarantee Issue Amount Maximum Employee $10,000 $10,000 $200,000 $300,000 Spouse $5,000 $5,000 $50,000 $100,000 Child $10,000 Note: Amounts of coverage elected above the Guarantee Issue amount are subject to medical underwriting approval. To submit a medical history statement online, visit: www.standard.com/mhs. All late applications (applying 31 days after becoming eligible), requests for coverage increases and reinstatements are subject to medical underwriting approval. Employees eligible but not insured under the prior life insurance plan are also subject to medical underwriting approval. The coverage amount for your spouse cannot exceed 50 percent of your Voluntary Life coverage. The coverage amount for your child(ren) cannot exceed 100 percent of your Voluntary Life coverage. Coverage Amount Needed Your family has a unique set of circumstances and financial demands. To help you figure out the amount of Voluntary Life insurance you may need to protect your loved ones; the Standard has created a Life Insurance Needs Calculator found at: http://www.standard.com/lifeneeds. SI 12505-VLVA-754575 1 of 53

Voluntary Life and AD&D Coverage Highlights Employee Coverage Effective Date To become insured, you must satisfy the eligibility requirements listed above, serve an eligibility waiting period, receive medical underwriting approval (if applicable), agree to pay premium, and be actively at work (able to perform all normal duties of your job) on the day before the scheduled effective date of insurance. If you are not actively at work on the day before the scheduled effective date of insurance including Dependents Life insurance, your insurance will not become effective until the day after you complete one full day of active work as an eligible employee. Please contact your human resources representative for more information regarding these requirements that must be satisfied for your insurance to become effective. Life and AD&D Age Reductions Under this plan, your coverage amount reduces by your age as follows: by 35 percent at age 70, by 55 percent at age 75, by 70 percent at age 80, and by 80 percent at age 85. Your spouse s coverage amount reduces by your age as follows: by 35 percent at age 70, by 55 percent at age 75, by 70 percent at age 80 and by 80 percent at age 85. If you are age 70 or over, ask your human resources representative for the amount of coverage available. Life Insurance Exclusions This plan contains an exclusion for death resulting from suicide or other intentionally self-inflicted injury. The amount payable will exclude amounts that have not been continuously in effect for at least two years on the date of death. This is subject to state variations. Life Insurance Features and Benefits Please see your human resources representative for additional information about the features and benefits below. Waiver of Premium Accelerated Benefit Portability Conversion Travel Assistance 1 If you become totally disabled while insured under this plan and under age 60, and complete a waiting period of 180 days, your Voluntary Life insurance may continue without premium payment until Social Security Normal Retirement Age (SSNRA) provided you give us satisfactory proof that you remain totally disabled. Waiver of Premium does not apply to AD&D insurance. If you become terminally ill, you may be eligible to receive up to 75 percent of your Voluntary Life benefit to a maximum of $500,000 If your insurance ends because your employment terminates, you may be eligible to buy portable group insurance coverage. If your insurance ends or reduces, you may be eligible to convert your Voluntary Life insurance to an individual life insurance policy without submitting proof of good health. This service provides you and your dependents with access to appropriate medical care and other emergency services when traveling at least 100 miles from home or in foreign countries for up to 180 days. Travel Assistance also offers a range of professional, 24-hour medical, legal and trip assistance information and coordination services to help your travel go smoothly. 1 Travel Assistance is provided through an arrangement with a service provider, which is not affiliated with The Standard. Travel Assistance is not an insurance product in all states, except in the state of Oregon. For more information, visit www.standard.com/individual/insurance/groupservices/travel-assistance SI 12505-VLVA-754575 2 of 54

Voluntary Life and AD&D Coverage Highlights Voluntary AD&D Insurance Benefit Schedule The amount of the Voluntary AD&D benefit for loss of your, or your dependents, life is equal to the amount payable for your Voluntary Life or your Dependents Life benefit on the date of the accident. The amount of the Voluntary AD&D benefit for other covered losses is a percentage of the amount payable for the Voluntary AD&D benefit on the date of the accident as shown below. Loss: Percentage Payable: Loss of Life 100% One hand or one foot 50% Sight in one eye 50% Two or more of the losses listed above 100% The loss must be caused solely and directly by an accident and occurs independently of all other causes, within 365 days after the accident. Loss of life must be evidenced by a certified copy of the death certificate. All other losses must be certified by a physician in the appropriate specialty as determined by The Standard. No more than 100 percent of the AD&D benefit will be paid for all losses resulting from one accident. Voluntary AD&D Insurance Exclusions Subject to state variations, Voluntary AD&D benefits are not payable for death or dismemberment caused or contributed to by: War or act of war, declared or undeclared, whether civil or international, and any substantial armed conflict between organized forces of a military nature Suicide or other intentionally self-inflicted injury Committing or attempting to commit an assault or felony, or actively participating in a violent disorder or riot Voluntary use or consumption of any poison, chemical compound, alcohol or drug, unless used or consumed according to the directions of a physician Sickness or pregnancy existing at the time of the accident Heart attack or stroke Medical or surgical treatment for any of the above Voluntary AD&D Insurance Features The following are brief descriptions of features included in this plan. These features offer additional benefits when an AD&D benefit is payable. Seat Belt Air Bag Family Benefits Package This provides an additional benefit if you or your dependent die as a result of a covered automobile accident while properly using a seat belt system This provides an additional benefit if you or your dependent die as a result of a covered automobile accident where an eligible air bag system deployed at the time of the accident and for which a seat belt benefit is payable. This provides extra AD&D benefits to your family to help them transition as a result of your accidental death. Through this provision, your eligible family members may be entitled to receive additional financial help for child care, college or career training. Included are Child Care Benefit, Higher Education Benefit and Career Adjustment Benefit. SI 12505-VLVA-754575 3 of 55

When Insurance Ends Coverage ends automatically on the earliest of the following: Voluntary Life and AD&D Coverage Highlights The last date the last period ends for which a premium was paid The date your employment terminates The date you cease to meet the eligibility requirements (coverage may continue for limited periods under certain circumstances) The date the group policy, or your employer s coverage under the group policy, terminates For each elective insurance coverage, the date that coverage terminates under the group policy For Voluntary AD&D insurance for you, the date your Voluntary Life insurance ends In addition to the above requirements, your Dependents Life with AD&D coverage ends automatically on the date your dependent ceases to meet the eligibility requirements for a dependent. For more details on when insurance ends, contact your human resources representative. Group Insurance Certificate If coverage becomes effective, and you become insured, you will receive a group insurance certificate containing a detailed description of the insurance coverage including the definitions, exclusions, limitations, reductions and terminating events. The controlling provisions will be in the group policy. Neither the information presented in this summary nor the certificate modifies the group policy or the insurance coverage in any way. Employee Life with AD&D Monthly Premiums Coverage Employee s Age as of January 1 Amount < 35 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74* 75-79* 80-84* 85+* $10,000 0.60 0.80 1.00 1.50 2.50 4.10 6.80 11.80 6.13 9.63 12.25 14.00 $20,000 1.20 1.60 2.00 3.00 5.00 8.20 13.60 23.60 12.25 19.25 24.50 28.00 $30,000 1.80 2.40 3.00 4.50 7.50 12.30 20.40 35.40 18.38 28.88 36.75 42.00 $40,000 2.40 3.20 4.00 6.00 10.00 16.40 27.20 47.20 24.50 38.50 49.00 56.00 $50,000 3.00 4.00 5.00 7.50 12.50 20.50 34.00 59.00 30.63 48.13 61.25 70.00 $60,000 3.60 4.80 6.00 9.00 15.00 24.60 40.80 70.80 36.75 57.75 73.50 84.00 $70,000 4.20 5.60 7.00 10.50 17.50 28.70 47.60 82.60 42.88 67.38 85.75 98.00 $80,000 4.80 6.40 8.00 12.00 20.00 32.80 54.40 94.40 49.00 77.00 98.00 112.00 $90,000 5.40 7.20 9.00 13.50 22.50 36.90 61.20 106.20 55.13 86.63 110.25 126.00 $100,000 6.00 8.00 10.00 15.00 25.00 41.00 68.00 118.00 61.25 96.25 122.50 140.00 $110,000 6.60 8.80 11.00 16.50 27.50 45.10 74.80 129.80 67.38 105.88 134.75 154.00 $120,000 7.20 9.60 12.00 18.00 30.00 49.20 81.60 141.60 73.50 115.50 147.00 168.00 $130,000 7.80 10.40 13.00 19.50 32.50 53.30 88.40 153.40 79.63 125.13 159.25 182.00 $140,000 8.40 11.20 14.00 21.00 35.00 57.40 95.20 165.20 85.75 134.75 171.50 196.00 $150,000 9.00 12.00 15.00 22.50 37.50 61.50 102.00 177.00 91.88 144.38 183.75 210.00 $160,000 9.60 12.80 16.00 24.00 40.00 65.60 108.80 188.80 98.00 154.00 196.00 224.00 $170,000 10.20 13.60 17.00 25.50 42.50 69.70 115.60 200.60 104.13 163.63 208.25 238.00 $180,000 10.80 14.40 18.00 27.00 45.00 73.80 122.40 212.40 110.25 173.25 220.50 252.00 $190,000 11.40 15.20 19.00 28.50 47.50 77.90 129.20 224.20 116.38 182.88 232.75 266.00 $200,000 12.00 16.00 20.00 30.00 50.00 82.00 136.00 236.00 122.50 192.50 245.00 280.00 $210,000 12.60 16.80 21.00 31.50 52.50 86.10 142.80 247.80 128.63 202.13 257.25 294.00 $220,000 13.20 17.60 22.00 33.00 55.00 90.20 149.60 259.60 134.75 211.75 269.50 308.00 $230,000 13.80 18.40 23.00 34.50 57.50 94.30 156.40 271.40 140.88 221.38 281.75 322.00 $240,000 14.40 19.20 24.00 36.00 60.00 98.40 163.20 283.20 147.00 231.00 294.00 336.00 $250,000 15.00 20.00 25.00 37.50 62.50 102.50 170.00 295.00 153.13 240.63 306.25 350.00 $260,000 15.60 20.80 26.00 39.00 65.00 106.60 176.80 306.80 159.25 250.25 318.50 364.00 $270,000 16.20 21.60 27.00 40.50 67.50 110.70 183.60 318.60 165.38 259.88 330.75 378.00 $280,000 16.80 22.40 28.00 42.00 70.00 114.80 190.40 330.40 171.50 269.50 343.00 392.00 $290,000 17.40 23.20 29.00 43.50 72.50 118.90 197.20 342.20 177.63 279.13 355.25 406.00 $300,000 18.00 24.00 30.00 45.00 75.00 123.00 204.00 354.00 183.75 288.75 367.50 420.00 Coverage amounts for ages 70 and over reduce due to age reduction (see Life Insurance Age Reductions section). SI 12505-VLVA-754575 4 of 56

Spouse Life with AD&D Monthly Premiums Voluntary Life and AD&D Coverage Highlights Coverage Employee s Age as of January 1 Amount < 35 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74* 75-79* 80-84* 85+* $5,000 0.30 0.40 0.50 0.75 1.25 2.05 3.40 5.90 3.06 4.81 6.13 7.00 $10,000 0.60 0.80 1.00 1.50 2.50 4.10 6.80 11.80 6.13 9.63 12.25 14.00 $15,000 0.90 1.20 1.50 2.25 3.75 6.15 10.20 17.70 9.19 14.44 18.38 21.00 $20,000 1.20 1.60 2.00 3.00 5.00 8.20 13.60 23.60 12.25 19.25 24.50 28.00 $25,000 1.50 2.00 2.50 3.75 6.25 10.25 17.00 29.50 15.31 24.06 30.63 35.00 $30,000 1.80 2.40 3.00 4.50 7.50 12.30 20.40 35.40 18.38 28.88 36.75 42.00 $35,000 2.10 2.80 3.50 5.25 8.75 14.35 23.80 41.30 21.44 33.69 42.88 49.00 $40,000 2.40 3.20 4.00 6.00 10.00 16.40 27.20 47.20 24.50 38.50 49.00 56.00 $45,000 2.70 3.60 4.50 6.75 11.25 18.45 30.60 53.10 27.56 43.31 55.13 63.00 $50,000 3.00 4.00 5.00 7.50 12.50 20.50 34.00 59.00 30.63 48.13 61.25 70.00 $55,000 3.30 4.40 5.50 8.25 13.75 22.55 37.40 64.90 33.69 52.94 67.38 77.00 $60,000 3.60 4.80 6.00 9.00 15.00 24.60 40.80 70.80 36.75 57.75 73.50 84.00 $65,000 3.90 5.20 6.50 9.75 16.25 26.65 44.20 76.70 39.81 62.56 79.63 91.00 $70,000 4.20 5.60 7.00 10.50 17.50 28.70 47.60 82.60 42.88 67.38 85.75 98.00 $75,000 4.50 6.00 7.50 11.25 18.75 30.75 51.00 88.50 45.94 72.19 91.88 105.00 $80,000 4.80 6.40 8.00 12.00 20.00 32.80 54.40 94.40 49.00 77.00 98.00 112.00 $85,000 5.10 6.80 8.50 12.75 21.25 34.85 57.80 100.30 52.06 81.81 104.13 119.00 $90,000 5.40 7.20 9.00 13.50 22.50 36.90 61.20 106.20 55.13 86.63 110.25 126.00 $95,000 5.70 7.60 9.50 14.25 23.75 38.95 64.60 112.10 58.19 91.44 116.38 133.00 $100,000 6.00 8.00 10.00 15.00 25.00 41.00 68.00 118.00 61.25 96.25 122.50 140.00 Coverage amounts for ages 70 and over reduce due to age reduction (see Life Insurance Age Reductions section). Child Life with AD&D Monthly Premiums* Coverage Amount Premium $10,000 2.00 * Regardless of the number of eligible children covered. GP190-LIFE/S399, GP399-LIFE/TRUST, GP899-LIFE, GP190-LIFE/A997/S399 SI 12505-VLVA-754575 5 of 57

Your Choice Voluntary Long Term Disability Coverage Highlights Voluntary Long Term Disability (LTD) Insurance Long Term Disability insurance is designed to pay a monthly benefit to you in the event you cannot work because of a covered illness or injury. This benefit replaces a portion of your income, thus helping you to meet your financial commitments in a time of need. Standard Insurance Company (The Standard) has developed this document to provide you with information about the optional coverage you may select through. Eligibility Requirements Policy A minimum number of eligible employees must apply and qualify for the proposed plan before Your Choice Voluntary LTD coverage can become effective Employee Premium A regular employee of Actively working at least 20 hours each week A citizen or resident of the United States or Canada Temporary and seasonal employees, full-time members of the armed forces, leased employees and independent contractors are not eligible You pay 100 percent of the premium for this coverage through easy payroll deduction Benefit Amount Benefit Amount Plan Maximum Monthly Benefit Plan Minimum Monthly Benefit You may select a monthly benefit amount in $100 increments, based on the tables and guidelines presented in the Rates section of these Coverage Highlights. The monthly benefit amount must not exceed 66 2/3 percent of your monthly predisability earnings. The minimum monthly amount you may elect is $200. The lesser of $8,000 or 66 2/3 percent of your predisability earnings $100 Note: If you do not apply for this coverage within 31 days after becoming eligible, and later decide to do so, you must wait until your employer holds an annual enrollment. Reinstatements are subject to medical underwriting approval. To submit a medical history statement online, visit: http://www.standard.com/mybenefits/mhs_ho.html. Disability Needs Calculator Your family has a unique set of circumstances and financial demands. To help you figure out the amount of Disability insurance you may need if you become unable to work, The Standard has created a Disability Needs Calculator found at: http://www.standard.com/calculators/dineeds.html Employee Coverage Effective Date To become insured, you must satisfy the eligibility requirements listed above, serve an eligibility waiting period, receive medical underwriting approval (if applicable), and be actively at work (able to perform all normal duties of your job) on the day before the scheduled effective date of insurance. If you are not actively at work on the day before the scheduled effective date of insurance, your insurance will not become effective until the day after you complete one full day of active work as an eligible employee. Please contact your human resources representative for more information regarding the requirements that must be satisfied for your insurance to become effective. SI 14493-754575 1 of 99

Your Choice Voluntary Long Term Disability Coverage Highlights Understanding Your Plan Design Benefit Waiting The benefit waiting period is the period of time that you must be continuously disabled Period before benefits become payable. Benefits are not payable during the benefit waiting period. The benefit waiting period options associated with your plan include: Accidental Injury Other Disabilities 7 days 7 days 14 days 14 days 30 days 30 days 60 days 60 days 90 days 90 days 180 days 180 days Own Occupation Definition of Disability Any Occupation Definition of Disability Deductible Income For the benefit waiting period and the first 24 months for which LTD benefits are paid, you are considered disabled when you are unable as a result of physical disease, injury, pregnancy or mental disorder to perform with reasonable continuity the material duties of your own occupation AND are suffering a loss of at least 20 percent of your indexed predisability earnings when working in your own occupation. You are not disabled merely because your right to perform your own occupation is restricted, including a restriction or loss of license. After the own occupation period of disability, you will be considered disabled if you are unable as a result of physical disease, injury, pregnancy or mental disorder to perform with reasonable continuity the material duties of any occupation. Deductible income is income you receive or are eligible to receive while LTD benefits are payable. Deductible income includes, but is not limited to: Benefits under any workers compensation law or similar law Amounts under unemployment compensation law Social Security disability or retirement benefits, including benefits for your spouse and children Disability benefits from any other group insurance Disability or retirement benefits under your employer s retirement plan Benefits under any state disability income benefit law or similar law Earnings or compensation included in predisability earnings which you receive or are eligible to receive while LTD benefits are payable Earnings from work activity while you are disabled, plus the earnings you could receive if you worked as much as your disability allows Amounts due from or on behalf of a third party because of your disability, whether by judgment, settlement or other method Any amount you receive by compromise, settlement or other method as a result of a claim for any of the above SI 14493-754575 2 of 910

Your Choice Voluntary Long Term Disability Coverage Highlights Maximum Benefit The maximum periods for which benefits are payable are shown in the tables below: Period If you become disabled before age 66, LTD benefits may continue during disability for 2 years. If you become disabled at age 66 or older, the benefit duration is determined by your age when disability begins: Age Maximum Benefit Period 66 1 year 9 months 67 1 year 6 months 68 1 year 3 months 69+ 1 year If you become disabled before age 62, LTD benefits may continue during disability until age 65 or to the Social Security Normal Retirement Age (SSNRA) or 3 years 6 months, whichever is longer. If you become disabled at age 62 or older, the benefit duration is determined by the age when disability begins: Age Maximum Benefit Period 62 To SSNRA, or 3 years 6 months, whichever is longer 63 To SSNRA, or 3 years, whichever is longer 64 To SSNRA, or 2 years 6 months, whichever is longer 65 2 years 66 1 year 9 months 67 1 year 6 months 68 1 year 3 months 69+ 1 year Benefit Calculation Example You select the amount of your LTD benefit when you enroll for coverage in the plan. The dollar amount selected must be a multiple of $100, from a minimum of $200 to a maximum of the lesser of $8,000 or 66 2/3 percent of your predisability earnings. This amount is then reduced by deductible income you receive, or are eligible to receive, while LTD benefits are payable. As an example, if your monthly predisability earnings are $4,500, you may select any dollar amount (in $100 increments) between $200 and $2,700 (66 2/3 percent of predisability earnings). In the example below, assume you elected the maximum benefit amount of $2,700, and you now receive a monthly Social Security disability benefit of $1,200 and a monthly retirement benefit of $900. Your monthly LTD benefit would be calculated as follows: Insured predisability earnings $4,500 Maximum benefit percentage X 66 2/3% Maximum benefit amount $3,001.50 Less Social Security disability benefit -$1,200 Less retirement benefit -$900 Amount of LTD benefit $901.50 SI 14493-754575 3 of 911

Your Choice Voluntary Long Term Disability Coverage Highlights Additional Features Please see your human resources representative for additional information about the features and benefits below. 24 Hour Coverage 24-hour LTD plans provide coverage for disabilities occurring on or off the job. Rehabilitation Plan Reasonable Accommodation Expense Benefit Rehabilitation Incentive Benefit Employee Assistance Program Survivors Benefit First Day Hospital Benefit If you are participating in an approved Rehabilitation Plan, The Standard may include payment of some of the expenses you incur in connection with the plan including but not limited to: training and education expenses, family (child and elder) care expenses, job related expenses and job search expenses. If your employer makes an approved work-site modification that enables you to return to work while disabled, The Standard will reimburse your employer up to a preapproved amount for some or all of the cost of the modification. If you agree to participate in a rehabilitation plan that prepares you to return to work (plan must be approved by The Standard), you may be eligible to receive an additional benefit equal to 10 percent of your predisability earnings. When added to any other amount you receive from The Standard, your total benefit cannot exceed the maximum benefit allowed by the policy. Includes an Employee Assistance Program and WorkLife Services to offer support, guidance and resources to help you and your household members resolve personal issues. If you die while LTD benefits are payable, and on the date you die you have been continuously disabled for at least 180 days, a survivors benefit equal to three time your unreduced LTD benefit may be payable (any survivors benefit payable will first be applied to any overpayment of your claim due to The Standard). If you are hospital confined for at least 4 hours during the benefit waiting period, the following will apply; the remainder of your benefit waiting period will be waived, LTD benefits will become payable on the first day you are hospital confined, and your maximum benefit period will begin on the date your LTD benefits are payable. You are eligible for this benefit only if your elected benefit waiting period is less than 45 days. Exclusions Subject to state variations, you are not covered for a disability caused or contributed to by any of the following: Your committing or attempting to commit an assault or felony, or your active participation in a violent disorder or riot An intentionally self-inflicted injury War or any act of war (declared or undeclared, and any substantial armed conflict between organized forces of a military nature) The loss of your professional or occupational license or certification If applicable, with respect to insurance increases, you are not covered for the insurance increase if your disability is caused or contributed by a preexisting condition or the medical or surgical treatment of a preexisting condition unless on the date you become disabled, you have been continuously insured under the group policy for the specified exclusion and limitation period, and you have been actively at work for at least one full day after the end of the specified exclusion and limitation period SI 14493-754575 4 of 912

Your Choice Voluntary Long Term Disability Coverage Highlights Preexisting Condition Provision Preexisting Condition For the first 90 days of disability, we will pay benefits even if you have a condition subject to the preexisting condition limitation. After 90 days, we will continue benefits only for conditions for which the preexisting condition exclusion or limitation does not apply. Benefit amounts subject to the preexisting condition exclusion will be excluded from payment. A preexisting condition is a mental or physical condition: For which you or a reasonably prudent person would have consulted a physician or other licensed medical professional; received medical treatment, services or advice; undergone diagnostic procedures, including selfadministered procedures; or taken prescribed drugs or medications Which, as a result of any medical examination, including routine examination, was discovered or suspected Preexisting Condition Period Specified Exclusion and Limitation Period The 180-day period just before your insurance becomes effective or any insurance increases become effective 12 months Limitations LTD benefits are not payable for any period when you are: Not under the ongoing care of a physician in the appropriate specialty as determined by The Standard Not participating in good faith in a plan, program or course of medical treatment or vocational training or education approved by The Standard, unless your disability prevents you from participating Confined for any reason in a penal or correctional institution Able to work and earn at least 20 percent of your indexed predisability earnings, but you elect not to work; during the first 24 months after the end of the benefit waiting period the responsibility to work is limited to work in your own occupation; thereafter, the responsibility to work includes work in any occupation In addition, payment of LTD benefits is limited in duration: If you reside outside the United States or Canada If applicable, if your disability is caused or contributed by a preexisting condition or the medical or surgical treatment of a preexisting condition unless on the date you become disabled, you have been continuously insured under the group policy for the specified exclusion and limitation period, and you have been actively at work for at least one full day after the end of the specified exclusion and limitation period If your disability is caused or contributed to by mental disorders, substance abuse or the environment, chronic fatigue conditions, chronic pain conditions, carpal tunnel or repetitive motion syndrome or temporomandibular joint disorder or craniomandibular joint disorder When Benefits End LTD benefits end automatically on the earliest of: The date you are no longer disabled The date your maximum benefit period ends The date you die The date benefits become payable under any other LTD disability insurance plan under which you become insured through employment during a period of temporary recovery The date you fail to provide proof of continued disability and entitlement to benefits SI 14493-754575 5 of 913

When Insurance Ends Insurance ends automatically on the earliest of the following: Your Choice Voluntary Long Term Disability Coverage Highlights The last day of the last period for which you make a premium contribution (except if premiums are waived while disabled) The date your employment terminates The date the group policy terminates The date you cease to meet the eligibility requirements (coverage may continue for limited periods under certain circumstances) If applicable, the date your employer ceases to participate under the group policy Group Insurance Certificate If coverage becomes effective, and you become insured, you will receive a group insurance certificate containing a detailed description of the insurance coverage including the definitions, exclusions, limitations, reductions and terminating events. The controlling provisions will be in the group policy. Neither the information presented in this summary nor the certificate modifies the group policy or the insurance coverage in any way. Rates Employees can select a monthly LTD benefit ranging from a minimum of $200 to a maximum amount based on how much they earn. Referencing the appropriate attached charts, follow these steps to find the monthly cost for your desired level of monthly LTD benefit and benefit waiting period: Find the maximum LTD benefit by locating the amount of your earnings in either the annual earnings or Monthly Earnings column. The LTD benefit amount shown associated with these earnings is the maximum amount you can receive. If your earnings fall between two amounts, you must select the lower amount. Select the desired monthly LTD benefit between the minimum of $200 and the determined maximum amount, making sure not to exceed the maximum for your earnings. In the same row, select the desired benefit waiting period to see the monthly cost for that selection. If you have questions regarding how to determine your monthly LTD benefit, the benefit waiting period, or the premium payment of your desired benefit, please contact your human resources representative. Note: Rates begin on Page 7. SI 14493-754575 6 of 914

Your Choice Voluntary Long Term Disability Coverage Highlights Plan A: Maximum Benefit to age 65 Plan B: Maximum Benefit 2 Years Monthly Rates per $100 3.46 2.99 2.43 1.61 1.40 1.07 2.72 2.41 1.81 1.03 Accident/Sickness Benefit Waiting Period Accident/Sickness Benefit Waiting Period Monthly Cost Per Month Cost Per Month Annual Earnings Disability Benefit 7-7 14-14 30-30 60-60 90-90 180-180 7-7 14-14 30-30 60-60 First Day Hospital First Day Hospital 5,400 300 10.38 8.97 7.29 4.83 4.20 3.21 8.16 7.23 5.43 3.09 7,200 400 13.84 11.96 9.72 6.44 5.60 4.28 10.88 9.64 7.24 4.12 9,000 500 17.30 14.95 12.15 8.05 7.00 5.35 13.60 12.05 9.05 5.15 10,800 600 20.76 17.94 14.58 9.66 8.40 6.42 16.32 14.46 10.86 6.18 12,600 700 24.22 20.93 17.01 11.27 9.80 7.49 19.04 16.87 12.67 7.21 14,400 800 27.68 23.92 19.44 12.88 11.20 8.56 21.76 19.28 14.48 8.24 16,200 900 31.14 26.91 21.87 14.49 12.60 9.63 24.48 21.69 16.29 9.27 18,000 1,000 34.60 29.90 24.30 16.10 14.00 10.70 27.20 24.10 18.10 10.30 19,800 1,100 38.06 32.89 26.73 17.71 15.40 11.77 29.92 26.51 19.91 11.33 21,600 1,200 41.52 35.88 29.16 19.32 16.80 12.84 32.64 28.92 21.72 12.36 23,400 1,300 44.98 38.87 31.59 20.93 18.20 13.91 35.36 31.33 23.53 13.39 25,200 1,400 48.44 41.86 34.02 22.54 19.60 14.98 38.08 33.74 25.34 14.42 27,000 1,500 51.90 44.85 36.45 24.15 21.00 16.05 40.80 36.15 27.15 15.45 28,800 1,600 55.36 47.84 38.88 25.76 22.40 17.12 43.52 38.56 28.96 16.48 30,600 1,700 58.82 50.83 41.31 27.37 23.80 18.19 46.24 40.97 30.77 17.51 32,400 1,800 62.28 53.82 43.74 28.98 25.20 19.26 48.96 43.38 32.58 18.54 34,200 1,900 65.74 56.81 46.17 30.59 26.60 20.33 51.68 45.79 34.39 19.57 36,000 2,000 69.20 59.80 48.60 32.20 28.00 21.40 54.40 48.20 36.20 20.60 37,800 2,100 72.66 62.79 51.03 33.81 29.40 22.47 57.12 50.61 38.01 21.63 39,600 2,200 76.12 65.78 53.46 35.42 30.80 23.54 59.84 53.02 39.82 22.66 41,400 2,300 79.58 68.77 55.89 37.03 32.20 24.61 62.56 55.43 41.63 23.69 43,200 2,400 83.04 71.76 58.32 38.64 33.60 25.68 65.28 57.84 43.44 24.72 45,000 2,500 86.50 74.75 60.75 40.25 35.00 26.75 68.00 60.25 45.25 25.75 46,800 2,600 89.96 77.74 63.18 41.86 36.40 27.82 70.72 62.66 47.06 26.78 48,600 2,700 93.42 80.73 65.61 43.47 37.80 28.89 73.44 65.07 48.87 27.81 50,400 2,800 96.88 83.72 68.04 45.08 39.20 29.96 76.16 67.48 50.68 28.84 52,200 2,900 100.34 86.71 70.47 46.69 40.60 31.03 78.88 69.89 52.49 29.87 54,000 3,000 103.80 89.70 72.90 48.30 42.00 32.10 81.60 72.30 54.30 30.90 55,800 3,100 107.26 92.69 75.33 49.91 43.40 33.17 84.32 74.71 56.11 31.93 57,600 3,200 110.72 95.68 77.76 51.52 44.80 34.24 87.04 77.12 57.92 32.96 SI 14493-754575 7 of 915

Your Choice Voluntary Long Term Disability Coverage Highlights Plan A: Maximum Benefit to age 65 Plan B: Maximum Benefit 2 Years Monthly Rates per $100 3.46 2.99 2.43 1.61 1.40 1.07 2.72 2.41 1.81 1.03 Accident/Sickness Benefit Waiting Period Accident/Sickness Benefit Waiting Period Monthly Cost Per Month Cost Per Month Annual Earnings Disability Benefit 7-7 14-14 30-30 60-60 90-90 180-180 7-7 14-14 30-30 60-60 First Day Hospital First Day Hospital 59,400 3,300 114.18 98.67 80.19 53.13 46.20 35.31 89.76 79.53 59.73 33.99 61,200 3,400 117.64 101.66 82.62 54.74 47.60 36.38 92.48 81.94 61.54 35.02 63,000 3,500 121.10 104.65 85.05 56.35 49.00 37.45 95.20 84.35 63.35 36.05 64,800 3,600 124.56 107.64 87.48 57.96 50.40 38.52 97.92 86.76 65.16 37.08 66,600 3,700 128.02 110.63 89.91 59.57 51.80 39.59 100.64 89.17 66.97 38.11 68,400 3,800 131.48 113.62 92.34 61.18 53.20 40.66 103.36 91.58 68.78 39.14 70,200 3,900 134.94 116.61 94.77 62.79 54.60 41.73 106.08 93.99 70.59 40.17 72,000 4,000 138.40 119.60 97.20 64.40 56.00 42.80 108.80 96.40 72.40 41.20 73,800 4,100 141.86 122.59 99.63 66.01 57.40 43.87 111.52 98.81 74.21 42.23 75,600 4,200 145.32 125.58 102.06 67.62 58.80 44.94 114.24 101.22 76.02 43.26 77,400 4,300 148.78 128.57 104.49 69.23 60.20 46.01 116.96 103.63 77.83 44.29 79,200 4,400 152.24 131.56 106.92 70.84 61.60 47.08 119.68 106.04 79.64 45.32 81,000 4,500 155.70 134.55 109.35 72.45 63.00 48.15 122.40 108.45 81.45 46.35 82,800 4,600 159.16 137.54 111.78 74.06 64.40 49.22 125.12 110.86 83.26 47.38 84,600 4,700 162.62 140.53 114.21 75.67 65.80 50.29 127.84 113.27 85.07 48.41 86,400 4,800 166.08 143.52 116.64 77.28 67.20 51.36 130.56 115.68 86.88 49.44 88,200 4,900 169.54 146.51 119.07 78.89 68.60 52.43 133.28 118.09 88.69 50.47 90,000 5,000 173.00 149.50 121.50 80.50 70.00 53.50 136.00 120.50 90.50 51.50 91,800 5,100 176.46 152.49 123.93 82.11 71.40 54.57 138.72 122.91 92.31 52.53 93,600 5,200 179.92 155.48 126.36 83.72 72.80 55.64 141.44 125.32 94.12 53.56 95,400 5,300 183.38 158.47 128.79 85.33 74.20 56.71 144.16 127.73 95.93 54.59 97,200 5,400 186.84 161.46 131.22 86.94 75.60 57.78 146.88 130.14 97.74 55.62 99,000 5,500 190.30 164.45 133.65 88.55 77.00 58.85 149.60 132.55 99.55 56.65 100,800 5,600 193.76 167.44 136.08 90.16 78.40 59.92 152.32 134.96 101.36 57.68 102,600 5,700 197.22 170.43 138.51 91.77 79.80 60.99 155.04 137.37 103.17 58.71 104,400 5,800 200.68 173.42 140.94 93.38 81.20 62.06 157.76 139.78 104.98 59.74 106,200 5,900 204.14 176.41 143.37 94.99 82.60 63.13 160.48 142.19 106.79 60.77 108,000 6,000 207.60 179.40 145.80 96.60 84.00 64.20 163.20 144.60 108.60 61.80 109,800 6,100 211.06 182.39 148.23 98.21 85.40 65.27 165.92 147.01 110.41 62.83 111,600 6,200 214.52 185.38 150.66 99.82 86.80 66.34 168.64 149.42 112.22 63.86 113,400 6,300 217.98 188.37 153.09 101.43 88.20 67.41 171.36 151.83 114.03 64.89 SI 14493-754575 8 of 916

Life Insurance Life Services Toolkit Resources and tools to help you and your beneficiary meet life s challenges Group Life insurance through your employer gives you assurance that your family will receive some financial assistance in the event of a death. But coverage under a Group Life policy from The Standard does more than help protect your family from financial hardship after a loss. We have partnered with Bensinger, DuPont & Associates (BDA) to offer a lineup of additional services that can make a difference now and in the future. Online tools and services can help you create a will, make advance funeral plans and put your finances in order. After a loss, beneficiaries can consult experts by phone or in person, and obtain other helpful information online. The Life Services Toolkit is automatically available to those insured under a Group Life insurance policy from The Standard. Recipients of an Accelerated Benefit can access services for 12 months after the date of payment. Life insurance beneficiaries 1 can access services for 12 months after the date of death. Services to Help You Now Visit the Life Services Toolkit website for information and tools to help you make important life decisions. www.standard.com/mytoolkit with the username assurance Estate-Planning Assistance: Online tools, found in the Legal Forms section, walk you through the steps to prepare a will and create other documents, such as living wills, powers of attorney and health care agent forms. Financial Planning: Consult online services to help you manage debt, calculate mortgage and loan payments, and take care of other financial matters with confidence. Health and Wellness: Timely articles about nutrition, stress management and wellness help employees and their families lead healthy lives. Identity Theft Prevention: Check the website for ways to thwart identity thieves and resolve issues if identity theft occurs. Funeral Arrangements: Use the website to calculate funeral costs, find funeral-related services and make decisions about funeral arrangements in advance. If you are a recipient of an Accelerated Benefit, you may access the services for beneficiaries outlined on the next page. Standard Insurance Company The Standard Life Insurance Company of New York www.standard.com The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company of Portland, Oregon, in all states except New York, where insurance products are offered by The Standard Life Insurance Company of New York of White Plains, New York. 1 The Life Services Toolkit is not available to Life insurance beneficiaries who are minors or to non-individual entities such as trusts, estates or charities. 19 Life Services Toolkit 17526 (10/15) SI/SNY EE FLYER

Services for Your Beneficiary These supportive services can help your beneficiary cope after a loss: Grief Support: Clinicians with master s degrees are on call to provide confidential grief sessions by phone or in person. Beneficiaries are eligible for up to six face-to-face sessions and unlimited phone contact. Beneficiaries can participate in phone consultations or in-person meetings with trained grief counselors. Legal Services: Beneficiaries can obtain legal assistance from experienced attorneys. - They can schedule an initial 30-minute office and a telephone consultation with a network attorney. Beneficiaries who wish to retain a participating attorney after the initial consultation receive a 25 percent rate reduction from the attorney s normal hourly or fixed fee rates. - They can obtain an estate-planning package that consists of a simple will, a living will, a health care agent form and a durable power of attorney. Financial Assistance: Beneficiaries have unlimited phone access to financial counselors who can help with issues such as budgeting strategies, and credit and debt management, including hour-long sessions on topics requiring more in-depth discussion. Support Services: During an emotional time, beneficiaries can receive help planning a funeral or memorial service. Work-life advisors can guide them to resources to help manage household repairs and chores; find child care and elder care providers; or organize a move or relocation. Online Resources: Beneficiaries can easily access additional services and features on the Life Services Toolkit website for beneficiaries, including online resources to calculate funeral costs, find funeral-related services and make decisions about funeral arrangements. For beneficiary services, visit www.standard.com/mytoolkit (User name = support) or call the phone assistance line at 800.378.5742. The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company, 1100 SW Sixth Avenue, Portland, Oregon, in all states except New York, where insurance products are offered by The Standard Life Insurance Company of New York, 360 Hamilton Avenue, Suite 210, White Plains, New York. Product features and availability vary by state and company, and are solely the responsibility of each subsidiary. Each company is solely responsible for its own financial condition. Standard Insurance Company is licensed to solicit insurance business in all states except New York. The Standard Life Insurance Company of New York is licensed to solicit insurance business in only the state of New York. The Life Services Toolkit is provided through an arrangement with Bensinger, DuPont & Associates (BDA) and is not affiliated with The Standard. BDA is solely responsible for providing and administering the included service. This service is not an insurance product. 20

Employee Benefits Employee Assistance Program Pointing You In The Right Direction We all experience times when we need a little help managing our personal lives. Your employer understands this and is providing the Employee Assistance Program (EAP) to covered employees in connection with your group insurance from The Standard, to offer support, guidance and resources to help you and your family find the right balance between your work and home life. What Can The EAP Do For Me? Experienced master s-degreed clinicians will confidentially consult with you over the telephone and direct you to the solutions and resources you need. You may also receive referrals to support groups, community resources, a network counselor or your health plan. These services are available for covered employees, their dependents, including children to age 26, and all household members. The EAP Services Can Help With: Child care and elder care Alcohol and drug abuse Life improvement Difficulties in relationships Stress and anxiety with work or family Depression Goal-setting Emotional well-being Financial and legal concerns Grief and loss Identity theft and fraud resolution Online will preparation How Do I Access EAP Services? Follow the directions on the wallet card on this page. Is It Confidential? Your calls and all counseling services are confidential. Information will be released only with your permission or as required by law. continued on reverse The EAP service is provided through an arrangement with Bensinger, DuPont & Associates, which is not affiliated with The Standard. EAP is not an insurance product, and is provided to groups of 10-2,499 lives The Standard is a marketing name for StanCorp Financial Group, Inc. and subsidiaries. Insurance products are offered by Standard Insurance Company of 1100 SW Sixth Avenue, Portland, Ore., in all states except New York, where insurance products are offered by The Standard Life Insurance Company of New York of 360 Hamilton Avenue, Suite 210, White Plains, NY. Product features and availability vary by state and company, and are solely the responsibility of each subsidiary. Each company is solely responsible for its own financial condition. Standard Insurance Company is licensed to solicit insurance business in all states except New York. The Standard Life Insurance Company of New York is licensed to solicit insurance business in only the state of New York. Call 888.293.6948 or visit www.eapbda.com. The EAP is always ready to assist you. We ve also provided a handy reference card for your wallet. How To Access EAP Online 1. Enter this address in your Web browser: www.eapbda.com 2. Enter standard as the login ID (in all lowercase letters) when prompted. 3. Enter eap4u as the password (in all lowercase letters) when prompted. Note: It is a violation of your company s contract to share this information with individuals who are not eligible for this service. Fold EAP For Policyholders of The Standard Call this toll-free number for access to EAP services. 888.293.6948 TDD 800.327.1833 Available 24 hours a day, 365 days a year. Standard Insurance Company The Standard Life Insurance Company of New York www.standard.com Employee Assistance Program-3 17201 (4/15) SI/SNY EE 21

When Is The EAP Available? Over-the-phone consultation and online access to EAP services are always available. Simply call the toll-free number or log on to www.eapbda.com. In emergency situations, you may call the toll-free number to speak with a master s-degreed clinician who can also connect you to emergency services. Your program also includes up to three face-to-face assessment and consultative sessions per issue. A clinician will work with you to schedule appointments according to your needs. What Can WorkLife Services Do For Me? WorkLife services can save you countless hours by researching and providing referrals for important needs like: Child care and elder care Education Adoption Pet care Daily living Travel A broad range of educational materials and guide books on dependent care topics are also available. How Much Does It Cost? The EAP and WorkLife services are provided to you in connection with your employer-sponsored group insurance from The Standard. If you accept a referral to services that are not a part of your EAP program, you may be responsible for the costs associated with those services. All The Help You Need Online The EAP provides the following online services: Informative guides and articles Monthly webinars and bulletins Ability to search on your own for: Child care or elder care services Pet care Adoption resources Detailed maps for every search Self-assessments Healthy lifestyle guidance, from tools for diet and fitness to smoking cessation Videos and articles on topics like understanding depression, nutrition advice and preparing for childbirth Financial and legal information, including a program for completing a simple will and identity theft consultation recovery and prevention services Detailed calculators used to help solve common financial concerns, such as computing college finances 22