MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan)

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Transcription:

MEDISECURE BOOSTER POLICY (Hospitalisation & Surgical Insurance) POLISI MEDISECURE BOOSTER (Insurans Hospital dan Pembedahan) FOR CONSUMER INSURANCE CONTRACTS (INSURANCE WHOLLY FOR PURPOSES UNRELATED TO YOUR TRADE, BUSINESS OR PROFESSION) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance) and any other disclosures made by you between the time of submission of your Proposal Form (or when you applied for this insurance) and the time this contract is entered into. The answers and any other disclosures given by you shall form part of this contract of insurance between you and us. However, in the event of any pre-contractual misrepresentation made in relation to your answers or in any disclosures given by you, only the remedies in Schedule 9 of the Financial Services Act 2013 will apply. This Policy reflects the terms and conditions of the contract of insurance as agreed between you and us. BAGI KONTRAK INSURANS PENGGUNA (INSURANS SEPENUHNYA YANG TIDAK BERKAITAN DENGAN PERDAGANGAN, PERNIAGAAN ATAU PROFESION) Polisi dikeluarkan sejajar dengan pembayaran dari premium yang ditentukan dalam Jadual Polisi dan menurut kepada kenyataan yang telah dikemukakan di dalam borang cadangan (atau semasa permohonan insurans ini) dan segala kenyataan yang telah dibuat oleh pihak anda pada atau semasa penyerahan borang cadangan (atau semasa permohonan insurans ini) dan pada masa perjanjian ini ditandatangani. Jawapan dan sebarang pernyataan lain yang anda berikan akan menjadi sebahagian daripada kontrak insurans antara anda dan pihak kami. Walau bagaimanapun, sekiranya terdapat sebarang salah nyata semasa pra-kontrak berhubung dengan jawapan anda atau di mana-mana pernyataan yang diberikan oleh anda, hanya remedi yang terdapat dalam Jadual 9 Akta Perkhidmatan Kewangan 2013 akan diguna pakai. Polisi ini bertindak atas terma-terma dan syarat-syarat kontrak insurans seperti yang telah dipersetujui antara anda dan pihak kami. FOR NON CONSUMER INSURANCE CONTRACTS (INSURANCE FOR PURPOSES RELATED TO YOUR TRADE, BUSINESS OR PROFESSION) This Policy is issued in consideration of the payment of premium as specified in the Policy Schedule and pursuant to the answers given in your Proposal Form (or when you applied for this insurance) and any other disclosures made by you between the time of submission of your Proposal Form (or when you applied for this insurance) and the time this contract is entered into. The answers and any other disclosures given by you shall form part of this contract of insurance between you and us. In the event of any pre-contractual misrepresentation made in relation to your answers or in any disclosures made by you, it may result in avoidance of your contract of insurance, refusal or reduction of your claim(s), change of terms or termination of your contract of insurance. This Policy reflects the terms and conditions of the contract of insurance as agreed between you and us. WHEREAS the Policyholder named in the Policy Schedule has applied to Lonpac Insurance Bhd (hereinafter called 'the Company') for the insurance herein described and has paid or agreed to pay the premium stated in the Policy Schedule as consideration for the insurance hereinafter contained. NOW THIS POLICY WITNESSES that if the Insured Person is confined to a hospital for treatment or is surgically treated as a day case during the Period of Insurance stated in the Policy Schedule, the Company will pay to the Policyholder or his legal personal representative the sum or sums stated in Policy Schedule. Payment is subject to reasonable and customary charges and will only be made upon receipt and approval of proofs of expenses incurred. THIS POLICY is an excess major medical insurance policy and will only pay after the Insured Person has exhausted all other avenues of compensation from other basic or major medical insurances and is subject to provisions, conditions and limitations as contained herein or as may be endorsed hereon. BAGI KONTRAK INSURANS KOMERSIAL (INSURANS BAGI TUJUAN PERDAGANGAN, PERNIAGAAN ATAU PROFESION) Polisi dikeluarkan sejajar dengan pembayaran dari premium yang ditentukan dalam Jadual Polisi dan menurut kepada kenyataan yang telah dikemukakan di dalam borang cadangan (atau semasa permohonan insurans ini) dan segala kenyataan yang telah dibuat oleh pihak anda pada atau semasa penyerahan borang cadangan (atau semasa permohonan insurans ini) dan pada masa perjanjian ini ditandatangani. Jawapan dan sebarang pernyataan lain yang anda berikan akan menjadi sebahagian daripada kontrak insurans antara anda dan pihak kami. Sekiranya terdapat sebarang salah nyata pada pra-kontrak berhubung dengan jawapan anda atau di mana-mana pernyataan yang diberikan oleh anda, ia mungkin mengakibatkan pembatalan kontrak insurans, keengganan atau pengurangan gantirugi, perubahan terma atau penamatan kontrak insurans anda. Polisi ini bertindak atas terma-terma dan syarat-syarat kontrak insurans seperti yang telah dipersetujui antara anda dan pihak kami. BAHAWASANYA Pemegang Polisi yang dinamakan di dalam Jadual Polisi telah memohon kepada Lonpac Insurance Bhd (selepas dari ini dirujuk sebagai 'Syarikat') untuk insurans yang dinyatakan dan telah membayar atau bersetuju untuk membayar premium yang dinyatakan di dalam Jadual Polisi sebagai pertimbangan untuk insurans yang terkandung. DENGAN INI POLISI INI MENYAKSIKAN jika sekiranya semasa Tempoh Insurans, Orang Yang Diinsuranskan dimasukkan ke hospital untuk rawatan atau menjalani pembedahan sebagai kes hari, Syarikat akan bayar kepada Pemegang Polisi atau kepada wakil diri sah di sisi undang-undang Pemegang Polisi jumlah atau sejumlah wang seperti yang dinyatakan di dalam Jadual Insurans. Pembayaran akan tertakluk kepada bayaran munasabah dan biasa diamalkan dan hanya akan dibayar selepas bukti perbelanjaan diterima dan diluluskan. POLISI INI adalah insurans perubatan major ekses dan hanya akan membayar selepas Orang Yang Diinsuranskan telah kehabisan semua kemudahan pampasan lain dari insurans perubatan asas atau insurans perubatan major lain dan tertakluk kepada peruntukan, syarat dan batasan seperti yang terkandung di sini atau sebagaimana yang diendorskan di sini. Page 1 of 30

SCHEDULE OF BENEFITS Section Description of Benefits (as at 01 January 2018) Plan 1 (RM) Plan 2 (RM) Plan 3 (RM) Plan 4 (RM) Plan 5 (RM) Plan 6 (RM) A HOSPITALISATION AND SURGICAL EXPENSES 1. Before the patient is admitted to hospital or surgically treated in a hospital a. Pre-Surgical Consultation & Diagnosis b. Pre-Hospital Specialist Consultation c. Pre-Hospital Diagnostic Tests 2. When the patient is being treated as a bed-paying patient in a hospital or is surgically treated a. Intensive Care Unit b. Hospital Supplies & Services c. Surgical Fees (including Anaesthetist & Operating Theatre Fees) d. In-Hospital Physician Visit not exceeding two visits a day 3. After the patient is discharged from hospital for a non-surgical treatment a. Post Hospitalisation Treatment 4. If the patient needs to be moved by road ambulance to an appropriate location for treatment or diagnosis a. Ambulance Fees As Charged, subject to reasonable, customary and necessary expenses which is incurred within 31 days prior to hospital admission or surgery As Charged, subject to reasonable, customary and necessary expenses which is incurred during the policy period As Charged, subject to reasonable, customary and necessary expenses which is incurred up to 60 days from the date of discharge from the hospital As Charged, subject to reasonable, customary and necessary expenses which is incurred during the policy period 5. Other Benefits As Charged, subject to reasonable, customary and necessary expenses which is a. Organ Transplant b. Goods and Services Tax c. Medical Report Fee d. Nursing at Home incurred during the policy period B SPECIFIC OUTPATIENT TREATMENTS (Sub-Limit included in the Per Disability Limit) 1. Outpatient Cancer Treatment, per annum (inclusive in the Per Disability Limit) 2. Outpatient Kidney Dialysis, per annum (inclusive in the Per Disability Limit) 300,000 300,000 225,000 225,000 150,000 150,000 300,000 300,000 225,000 225,000 150,000 150,000 LIMITS OF COVERAGE (Section A & B) a. Room & Board, per day limit (incurred during the policy period) 1,000 1,000 750 750 500 500 b. Deductible Per Disability (Top-Up Basis) 15,000 150,000 10,000 100,000 7,500 75,000 c. Per Disability Limit 1,000,000 1,000,000 750,000 750,000 500,000 500,000 d. Overall Annual Limit 2,000,000 2,000,000 1,500,000 1,500,000 1,000,000 1,000,000 Important Note: The Room and Board Limit, Per Disability Limit, Sub-Limit and Overall Annual Limit will increase every five years as stipulated in the Schedule of Limits, subject to the following but the Deductible Per Disability remains unchanged during the increase in limits:- a. The respective new limits will only apply to new policies issued or policies renewed on or after the effective date of the respective increase in limits. b. The limits applicable for the respective claims shall be the limits applicable to the policy during the first intimation of the respective claim and the increased limits will not be applicable to claims already reported. Page 2 of 30

JADUAL MANFAAT Seksyen Keterangan Manfaat (pada 01 Januari 2018) Pelan 1 (RM) Pelan 2 (RM) Pelan 3 (RM) Pelan 4 (RM) Pelan 5 (RM) Pelan 6 (RM) A PERBELANJAAN HOSPITAL DAN PEMBEDAHAN 1. Sebelum pesakit dimasukkan ke hospital atau menjalani pembedahan di hospital a. Rundingan Pakar dan Ujian Diagnostik Pra-pembedahan b. Rundingan Pakar Pra-hospital c. Ujian Diagnostik Pra-hospital 2. Apabila pesakit sedang dirawat sebagai pesakit dalam di hospital atau menjalani pembedahan a. Unit Rawatan Rapi b. Bekalan dan Khidmat Hospital c. Bayaran Pembedahan (termasuk Bayaran Pakar Bius dan Bayaran Bilik Bedah) d. Lawatan Pakar Perubatan Dalam Hospital, tidak melebihi dua lawatan sehari 3. Selepas pesakit keluar dari hospital untuk rawatan bukan pembedahan a. Rawatan selepas penghospitalan 4. Jika pesakit perlu dipindahkan oleh ambulans darat ke lokasi yang sesuai untuk rawatan atau diagnosis a. Bayaran Ambulans Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan dalam masa 31 hari sebelum kemasukan atau pembedahan hospital Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan semasa tempoh polisi Seperti yang Dicajkan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang ditanggung sehingga 60 hari dari tarikh selepas keluar dari hospital Seperti yang Dikenakan, tertakluk kepada perbelanjaan munasabah, biasa dan perlu yang dilakukan semasa tempoh polisi 5. Manfaat Lain Seperti yang Dikenakan, tertakluk kepada perbelanjaan munasabah, biasa dan a. Transplan Organ b. Cukai Barang dan Perkhidmatan c. Bayaran Laporan Perubatan d. Jagaan Jururawat Di Rumah perlu yang dilakukan semasa tempoh polisi B RAWATAN PESAKIT LUAR YANG TERTENTU (Had yang termasuk dalam Had Setiap Hilang Upaya) 1. Rawatan Kanser Pesakit Luar, setiap tahun (termasuk dalam Had Setiap Hilang Upaya) 2. Dialisis Buah Pinggang Pesakit Luar, setiap tahun (termasuk dalam Had Setiap Hilang Upaya) 300,000 300,000 225,000 225,000 150,000 150,000 300,000 300,000 225,000 225,000 150,000 150,000 HAD PERLINDUNGAN (Seksyen A & B) a. Bilik Hospital dan Makan, had harian yang dikenakan semasa tempoh polisi b. Deduktibel Setiap Hilang Upaya (berasaskan perlindungan tambahan) 1,000 1,000 750 750 500 500 15,000 150,000 10,000 100,000 7,500 75,000 c. Had Setiap Hilang Upaya 1,000,000 1,000,000 750,000 750,000 500,000 500,000 d. Had Tahunan Keseluruhan 2,000,000 2,000,000 1,500,000 1,500,000 1,000,000 1,000,000 Nota Penting: Had Harian Bilik Hospital dan Makan, Had Setiap Hilang Upaya dan Had Tahunan Keseluruhan akan meningkat setiap lima tahun seperti yang dinyatakan di dalam Jadual Had dan tertakluk kepada berikut tetapi Deduktibel Setiap Hilang Upaya tidak akan berubah pada masa had perlindungan meningkat:- a. Had baru masing-masing hanya akan terpakai kepada polisi baru yang dikeluarkan atau polisi yang diperbaharui pada atau selepas tarikh berkuat kuasa peningkatan had tersebut. b. Had Perlindungan yang dikenakan untuk tuntutan masing-masing adalah had yang dikenakan terhadap polisi pada hari pertama tuntutan masing-masing dibuat dan peningkatan Had Perlindungan tidak akan terpakai kepada tuntutan yang telah dilaporkan. Page 3 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan SCHEDULE OF LIMITS JADUAL HAD Schedule of Limits Plan 1 (Ringgit Malaysia) Jadual Had Pelan 1 (Ringgit Malaysia) 1/1/2018 1,000 1,000,000 15,000 300,000 300,000 2,000,000 1/1/2068 2,000 2,000,000 15,000 600,000 600,000 4,000,000 1/1/2019 1,000 1,000,000 15,000 300,000 300,000 2,000,000 1/1/2069 2,000 2,000,000 15,000 600,000 600,000 4,000,000 1/1/2020 1,000 1,000,000 15,000 300,000 300,000 2,000,000 1/1/2070 2,000 2,000,000 15,000 600,000 600,000 4,000,000 1/1/2021 1,000 1,000,000 15,000 300,000 300,000 2,000,000 1/1/2071 2,000 2,000,000 15,000 600,000 600,000 4,000,000 1/1/2022 1,000 1,000,000 15,000 300,000 300,000 2,000,000 1/1/2072 2,000 2,000,000 15,000 600,000 600,000 4,000,000 1/1/2023 1,100 1,100,000 15,000 330,000 330,000 2,200,000 1/1/2073 2,100 2,100,000 15,000 630,000 630,000 4,200,000 1/1/2024 1,100 1,100,000 15,000 330,000 330,000 2,200,000 1/1/2074 2,100 2,100,000 15,000 630,000 630,000 4,200,000 1/1/2025 1,100 1,100,000 15,000 330,000 330,000 2,200,000 1/1/2075 2,100 2,100,000 15,000 630,000 630,000 4,200,000 1/1/2026 1,100 1,100,000 15,000 330,000 330,000 2,200,000 1/1/2076 2,100 2,100,000 15,000 630,000 630,000 4,200,000 1/1/2027 1,100 1,100,000 15,000 330,000 330,000 2,200,000 1/1/2077 2,100 2,100,000 15,000 630,000 630,000 4,200,000 1/1/2028 1,200 1,200,000 15,000 360,000 360,000 2,400,000 1/1/2078 2,200 2,200,000 15,000 660,000 660,000 4,400,000 1/1/2029 1,200 1,200,000 15,000 360,000 360,000 2,400,000 1/1/2079 2,200 2,200,000 15,000 660,000 660,000 4,400,000 1/1/2030 1,200 1,200,000 15,000 360,000 360,000 2,400,000 1/1/2080 2,200 2,200,000 15,000 660,000 660,000 4,400,000 1/1/2031 1,200 1,200,000 15,000 360,000 360,000 2,400,000 1/1/2081 2,200 2,200,000 15,000 660,000 660,000 4,400,000 1/1/2032 1,200 1,200,000 15,000 360,000 360,000 2,400,000 1/1/2082 2,200 2,200,000 15,000 660,000 660,000 4,400,000 1/1/2033 1,300 1,300,000 15,000 390,000 390,000 2,600,000 1/1/2083 2,300 2,300,000 15,000 690,000 690,000 4,600,000 1/1/2034 1,300 1,300,000 15,000 390,000 390,000 2,600,000 1/1/2084 2,300 2,300,000 15,000 690,000 690,000 4,600,000 1/1/2035 1,300 1,300,000 15,000 390,000 390,000 2,600,000 1/1/2085 2,300 2,300,000 15,000 690,000 690,000 4,600,000 1/1/2036 1,300 1,300,000 15,000 390,000 390,000 2,600,000 1/1/2086 2,300 2,300,000 15,000 690,000 690,000 4,600,000 1/1/2037 1,300 1,300,000 15,000 390,000 390,000 2,600,000 1/1/2087 2,300 2,300,000 15,000 690,000 690,000 4,600,000 1/1/2038 1,400 1,400,000 15,000 420,000 420,000 2,800,000 1/1/2088 2,400 2,400,000 15,000 720,000 720,000 4,800,000 1/1/2039 1,400 1,400,000 15,000 420,000 420,000 2,800,000 1/1/2089 2,400 2,400,000 15,000 720,000 720,000 4,800,000 1/1/2040 1,400 1,400,000 15,000 420,000 420,000 2,800,000 1/1/2090 2,400 2,400,000 15,000 720,000 720,000 4,800,000 1/1/2041 1,400 1,400,000 15,000 420,000 420,000 2,800,000 1/1/2091 2,400 2,400,000 15,000 720,000 720,000 4,800,000 1/1/2042 1,400 1,400,000 15,000 420,000 420,000 2,800,000 1/1/2092 2,400 2,400,000 15,000 720,000 720,000 4,800,000 1/1/2043 1,500 1,500,000 15,000 450,000 450,000 3,000,000 1/1/2093 2,500 2,500,000 15,000 750,000 750,000 5,000,000 1/1/2044 1,500 1,500,000 15,000 450,000 450,000 3,000,000 1/1/2094 2,500 2,500,000 15,000 750,000 750,000 5,000,000 1/1/2045 1,500 1,500,000 15,000 450,000 450,000 3,000,000 1/1/2095 2,500 2,500,000 15,000 750,000 750,000 5,000,000 1/1/2046 1,500 1,500,000 15,000 450,000 450,000 3,000,000 1/1/2096 2,500 2,500,000 15,000 750,000 750,000 5,000,000 1/1/2047 1,500 1,500,000 15,000 450,000 450,000 3,000,000 1/1/2097 2,500 2,500,000 15,000 750,000 750,000 5,000,000 1/1/2048 1,600 1,600,000 15,000 480,000 480,000 3,200,000 1/1/2098 2,600 2,600,000 15,000 780,000 780,000 5,200,000 1/1/2049 1,600 1,600,000 15,000 480,000 480,000 3,200,000 1/1/2099 2,600 2,600,000 15,000 780,000 780,000 5,200,000 1/1/2050 1,600 1,600,000 15,000 480,000 480,000 3,200,000 1/1/2100 2,600 2,600,000 15,000 780,000 780,000 5,200,000 1/1/2051 1,600 1,600,000 15,000 480,000 480,000 3,200,000 1/1/2101 2,600 2,600,000 15,000 780,000 780,000 5,200,000 1/1/2052 1,600 1,600,000 15,000 480,000 480,000 3,200,000 1/1/2102 2,600 2,600,000 15,000 780,000 780,000 5,200,000 1/1/2053 1,700 1,700,000 15,000 510,000 510,000 3,400,000 1/1/2103 2,700 2,700,000 15,000 810,000 810,000 5,400,000 1/1/2054 1,700 1,700,000 15,000 510,000 510,000 3,400,000 1/1/2104 2,700 2,700,000 15,000 810,000 810,000 5,400,000 1/1/2055 1,700 1,700,000 15,000 510,000 510,000 3,400,000 1/1/2105 2,700 2,700,000 15,000 810,000 810,000 5,400,000 1/1/2056 1,700 1,700,000 15,000 510,000 510,000 3,400,000 1/1/2106 2,700 2,700,000 15,000 810,000 810,000 5,400,000 1/1/2057 1,700 1,700,000 15,000 510,000 510,000 3,400,000 1/1/2107 2,700 2,700,000 15,000 810,000 810,000 5,400,000 1/1/2058 1,800 1,800,000 15,000 540,000 540,000 3,600,000 1/1/2108 2,800 2,800,000 15,000 840,000 840,000 5,600,000 1/1/2059 1,800 1,800,000 15,000 540,000 540,000 3,600,000 1/1/2109 2,800 2,800,000 15,000 840,000 840,000 5,600,000 1/1/2060 1,800 1,800,000 15,000 540,000 540,000 3,600,000 1/1/2110 2,800 2,800,000 15,000 840,000 840,000 5,600,000 1/1/2061 1,800 1,800,000 15,000 540,000 540,000 3,600,000 1/1/2111 2,800 2,800,000 15,000 840,000 840,000 5,600,000 1/1/2062 1,800 1,800,000 15,000 540,000 540,000 3,600,000 1/1/2112 2,800 2,800,000 15,000 840,000 840,000 5,600,000 1/1/2063 1,900 1,900,000 15,000 570,000 570,000 3,800,000 1/1/2113 2,900 2,900,000 15,000 870,000 870,000 5,800,000 1/1/2064 1,900 1,900,000 15,000 570,000 570,000 3,800,000 1/1/2114 2,900 2,900,000 15,000 870,000 870,000 5,800,000 1/1/2065 1,900 1,900,000 15,000 570,000 570,000 3,800,000 1/1/2115 2,900 2,900,000 15,000 870,000 870,000 5,800,000 1/1/2066 1,900 1,900,000 15,000 570,000 570,000 3,800,000 1/1/2116 2,900 2,900,000 15,000 870,000 870,000 5,800,000 1/1/2067 1,900 1,900,000 15,000 570,000 570,000 3,800,000 1/1/2117 2,900 2,900,000 15,000 870,000 870,000 5,800,000 Page 4 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 2 (Ringgit Malaysia) Jadual Had Pelan 2 (Ringgit Malaysia) 1/1/2018 1,000 1,000,000 150,000 300,000 300,000 2,000,000 1/1/2068 2,000 2,000,000 150,000 600,000 600,000 4,000,000 1/1/2019 1,000 1,000,000 150,000 300,000 300,000 2,000,000 1/1/2069 2,000 2,000,000 150,000 600,000 600,000 4,000,000 1/1/2020 1,000 1,000,000 150,000 300,000 300,000 2,000,000 1/1/2070 2,000 2,000,000 150,000 600,000 600,000 4,000,000 1/1/2021 1,000 1,000,000 150,000 300,000 300,000 2,000,000 1/1/2071 2,000 2,000,000 150,000 600,000 600,000 4,000,000 1/1/2022 1,000 1,000,000 150,000 300,000 300,000 2,000,000 1/1/2072 2,000 2,000,000 150,000 600,000 600,000 4,000,000 1/1/2023 1,100 1,100,000 150,000 330,000 330,000 2,200,000 1/1/2073 2,100 2,100,000 150,000 630,000 630,000 4,200,000 1/1/2024 1,100 1,100,000 150,000 330,000 330,000 2,200,000 1/1/2074 2,100 2,100,000 150,000 630,000 630,000 4,200,000 1/1/2025 1,100 1,100,000 150,000 330,000 330,000 2,200,000 1/1/2075 2,100 2,100,000 150,000 630,000 630,000 4,200,000 1/1/2026 1,100 1,100,000 150,000 330,000 330,000 2,200,000 1/1/2076 2,100 2,100,000 150,000 630,000 630,000 4,200,000 1/1/2027 1,100 1,100,000 150,000 330,000 330,000 2,200,000 1/1/2077 2,100 2,100,000 150,000 630,000 630,000 4,200,000 1/1/2028 1,200 1,200,000 150,000 360,000 360,000 2,400,000 1/1/2078 2,200 2,200,000 150,000 660,000 660,000 4,400,000 1/1/2029 1,200 1,200,000 150,000 360,000 360,000 2,400,000 1/1/2079 2,200 2,200,000 150,000 660,000 660,000 4,400,000 1/1/2030 1,200 1,200,000 150,000 360,000 360,000 2,400,000 1/1/2080 2,200 2,200,000 150,000 660,000 660,000 4,400,000 1/1/2031 1,200 1,200,000 150,000 360,000 360,000 2,400,000 1/1/2081 2,200 2,200,000 150,000 660,000 660,000 4,400,000 1/1/2032 1,200 1,200,000 150,000 360,000 360,000 2,400,000 1/1/2082 2,200 2,200,000 150,000 660,000 660,000 4,400,000 1/1/2033 1,300 1,300,000 150,000 390,000 390,000 2,600,000 1/1/2083 2,300 2,300,000 150,000 690,000 690,000 4,600,000 1/1/2034 1,300 1,300,000 150,000 390,000 390,000 2,600,000 1/1/2084 2,300 2,300,000 150,000 690,000 690,000 4,600,000 1/1/2035 1,300 1,300,000 150,000 390,000 390,000 2,600,000 1/1/2085 2,300 2,300,000 150,000 690,000 690,000 4,600,000 1/1/2036 1,300 1,300,000 150,000 390,000 390,000 2,600,000 1/1/2086 2,300 2,300,000 150,000 690,000 690,000 4,600,000 1/1/2037 1,300 1,300,000 150,000 390,000 390,000 2,600,000 1/1/2087 2,300 2,300,000 150,000 690,000 690,000 4,600,000 1/1/2038 1,400 1,400,000 150,000 420,000 420,000 2,800,000 1/1/2088 2,400 2,400,000 150,000 720,000 720,000 4,800,000 1/1/2039 1,400 1,400,000 150,000 420,000 420,000 2,800,000 1/1/2089 2,400 2,400,000 150,000 720,000 720,000 4,800,000 1/1/2040 1,400 1,400,000 150,000 420,000 420,000 2,800,000 1/1/2090 2,400 2,400,000 150,000 720,000 720,000 4,800,000 1/1/2041 1,400 1,400,000 150,000 420,000 420,000 2,800,000 1/1/2091 2,400 2,400,000 150,000 720,000 720,000 4,800,000 1/1/2042 1,400 1,400,000 150,000 420,000 420,000 2,800,000 1/1/2092 2,400 2,400,000 150,000 720,000 720,000 4,800,000 1/1/2043 1,500 1,500,000 150,000 450,000 450,000 3,000,000 1/1/2093 2,500 2,500,000 150,000 750,000 750,000 5,000,000 1/1/2044 1,500 1,500,000 150,000 450,000 450,000 3,000,000 1/1/2094 2,500 2,500,000 150,000 750,000 750,000 5,000,000 1/1/2045 1,500 1,500,000 150,000 450,000 450,000 3,000,000 1/1/2095 2,500 2,500,000 150,000 750,000 750,000 5,000,000 1/1/2046 1,500 1,500,000 150,000 450,000 450,000 3,000,000 1/1/2096 2,500 2,500,000 150,000 750,000 750,000 5,000,000 1/1/2047 1,500 1,500,000 150,000 450,000 450,000 3,000,000 1/1/2097 2,500 2,500,000 150,000 750,000 750,000 5,000,000 1/1/2048 1,600 1,600,000 150,000 480,000 480,000 3,200,000 1/1/2098 2,600 2,600,000 150,000 780,000 780,000 5,200,000 1/1/2049 1,600 1,600,000 150,000 480,000 480,000 3,200,000 1/1/2099 2,600 2,600,000 150,000 780,000 780,000 5,200,000 1/1/2050 1,600 1,600,000 150,000 480,000 480,000 3,200,000 1/1/2100 2,600 2,600,000 150,000 780,000 780,000 5,200,000 1/1/2051 1,600 1,600,000 150,000 480,000 480,000 3,200,000 1/1/2101 2,600 2,600,000 150,000 780,000 780,000 5,200,000 1/1/2052 1,600 1,600,000 150,000 480,000 480,000 3,200,000 1/1/2102 2,600 2,600,000 150,000 780,000 780,000 5,200,000 1/1/2053 1,700 1,700,000 150,000 510,000 510,000 3,400,000 1/1/2103 2,700 2,700,000 150,000 810,000 810,000 5,400,000 1/1/2054 1,700 1,700,000 150,000 510,000 510,000 3,400,000 1/1/2104 2,700 2,700,000 150,000 810,000 810,000 5,400,000 1/1/2055 1,700 1,700,000 150,000 510,000 510,000 3,400,000 1/1/2105 2,700 2,700,000 150,000 810,000 810,000 5,400,000 1/1/2056 1,700 1,700,000 150,000 510,000 510,000 3,400,000 1/1/2106 2,700 2,700,000 150,000 810,000 810,000 5,400,000 1/1/2057 1,700 1,700,000 150,000 510,000 510,000 3,400,000 1/1/2107 2,700 2,700,000 150,000 810,000 810,000 5,400,000 1/1/2058 1,800 1,800,000 150,000 540,000 540,000 3,600,000 1/1/2108 2,800 2,800,000 150,000 840,000 840,000 5,600,000 1/1/2059 1,800 1,800,000 150,000 540,000 540,000 3,600,000 1/1/2109 2,800 2,800,000 150,000 840,000 840,000 5,600,000 1/1/2060 1,800 1,800,000 150,000 540,000 540,000 3,600,000 1/1/2110 2,800 2,800,000 150,000 840,000 840,000 5,600,000 1/1/2061 1,800 1,800,000 150,000 540,000 540,000 3,600,000 1/1/2111 2,800 2,800,000 150,000 840,000 840,000 5,600,000 1/1/2062 1,800 1,800,000 150,000 540,000 540,000 3,600,000 1/1/2112 2,800 2,800,000 150,000 840,000 840,000 5,600,000 1/1/2063 1,900 1,900,000 150,000 570,000 570,000 3,800,000 1/1/2113 2,900 2,900,000 150,000 870,000 870,000 5,800,000 1/1/2064 1,900 1,900,000 150,000 570,000 570,000 3,800,000 1/1/2114 2,900 2,900,000 150,000 870,000 870,000 5,800,000 1/1/2065 1,900 1,900,000 150,000 570,000 570,000 3,800,000 1/1/2115 2,900 2,900,000 150,000 870,000 870,000 5,800,000 1/1/2066 1,900 1,900,000 150,000 570,000 570,000 3,800,000 1/1/2116 2,900 2,900,000 150,000 870,000 870,000 5,800,000 1/1/2067 1,900 1,900,000 150,000 570,000 570,000 3,800,000 1/1/2117 2,900 2,900,000 150,000 870,000 870,000 5,800,000 Page 5 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 3 (Ringgit Malaysia) Jadual Had Pelan 3 (Ringgit Malaysia) 1/1/2018 750 750,000 10,000 225,000 225,000 1,500,000 1/1/2068 1,500 1,500,000 10,000 450,000 450,000 3,000,000 1/1/2019 750 750,000 10,000 225,000 225,000 1,500,000 1/1/2069 1,500 1,500,000 10,000 450,000 450,000 3,000,000 1/1/2020 750 750,000 10,000 225,000 225,000 1,500,000 1/1/2070 1,500 1,500,000 10,000 450,000 450,000 3,000,000 1/1/2021 750 750,000 10,000 225,000 225,000 1,500,000 1/1/2071 1,500 1,500,000 10,000 450,000 450,000 3,000,000 1/1/2022 750 750,000 10,000 225,000 225,000 1,500,000 1/1/2072 1,500 1,500,000 10,000 450,000 450,000 3,000,000 1/1/2023 825 825,000 10,000 247,500 247,500 1,650,000 1/1/2073 1,575 1,575,000 10,000 472,500 472,500 3,150,000 1/1/2024 825 825,000 10,000 247,500 247,500 1,650,000 1/1/2074 1,575 1,575,000 10,000 472,500 472,500 3,150,000 1/1/2025 825 825,000 10,000 247,500 247,500 1,650,000 1/1/2075 1,575 1,575,000 10,000 472,500 472,500 3,150,000 1/1/2026 825 825,000 10,000 247,500 247,500 1,650,000 1/1/2076 1,575 1,575,000 10,000 472,500 472,500 3,150,000 1/1/2027 825 825,000 10,000 247,500 247,500 1,650,000 1/1/2077 1,575 1,575,000 10,000 472,500 472,500 3,150,000 1/1/2028 900 900,000 10,000 270,000 270,000 1,800,000 1/1/2078 1,650 1,650,000 10,000 495,000 495,000 3,300,000 1/1/2029 900 900,000 10,000 270,000 270,000 1,800,000 1/1/2079 1,650 1,650,000 10,000 495,000 495,000 3,300,000 1/1/2030 900 900,000 10,000 270,000 270,000 1,800,000 1/1/2080 1,650 1,650,000 10,000 495,000 495,000 3,300,000 1/1/2031 900 900,000 10,000 270,000 270,000 1,800,000 1/1/2081 1,650 1,650,000 10,000 495,000 495,000 3,300,000 1/1/2032 900 900,000 10,000 270,000 270,000 1,800,000 1/1/2082 1,650 1,650,000 10,000 495,000 495,000 3,300,000 1/1/2033 975 975,000 10,000 292,500 292,500 1,950,000 1/1/2083 1,725 1,725,000 10,000 517,500 517,500 3,450,000 1/1/2034 975 975,000 10,000 292,500 292,500 1,950,000 1/1/2084 1,725 1,725,000 10,000 517,500 517,500 3,450,000 1/1/2035 975 975,000 10,000 292,500 292,500 1,950,000 1/1/2085 1,725 1,725,000 10,000 517,500 517,500 3,450,000 1/1/2036 975 975,000 10,000 292,500 292,500 1,950,000 1/1/2086 1,725 1,725,000 10,000 517,500 517,500 3,450,000 1/1/2037 975 975,000 10,000 292,500 292,500 1,950,000 1/1/2087 1,725 1,725,000 10,000 517,500 517,500 3,450,000 1/1/2038 1,050 1,050,000 10,000 315,000 315,000 2,100,000 1/1/2088 1,800 1,800,000 10,000 540,000 540,000 3,600,000 1/1/2039 1,050 1,050,000 10,000 315,000 315,000 2,100,000 1/1/2089 1,800 1,800,000 10,000 540,000 540,000 3,600,000 1/1/2040 1,050 1,050,000 10,000 315,000 315,000 2,100,000 1/1/2090 1,800 1,800,000 10,000 540,000 540,000 3,600,000 1/1/2041 1,050 1,050,000 10,000 315,000 315,000 2,100,000 1/1/2091 1,800 1,800,000 10,000 540,000 540,000 3,600,000 1/1/2042 1,050 1,050,000 10,000 315,000 315,000 2,100,000 1/1/2092 1,800 1,800,000 10,000 540,000 540,000 3,600,000 1/1/2043 1,125 1,125,000 10,000 337,500 337,500 2,250,000 1/1/2093 1,875 1,875,000 10,000 562,500 562,500 3,750,000 1/1/2044 1,125 1,125,000 10,000 337,500 337,500 2,250,000 1/1/2094 1,875 1,875,000 10,000 562,500 562,500 3,750,000 1/1/2045 1,125 1,125,000 10,000 337,500 337,500 2,250,000 1/1/2095 1,875 1,875,000 10,000 562,500 562,500 3,750,000 1/1/2046 1,125 1,125,000 10,000 337,500 337,500 2,250,000 1/1/2096 1,875 1,875,000 10,000 562,500 562,500 3,750,000 1/1/2047 1,125 1,125,000 10,000 337,500 337,500 2,250,000 1/1/2097 1,875 1,875,000 10,000 562,500 562,500 3,750,000 1/1/2048 1,200 1,200,000 10,000 360,000 360,000 2,400,000 1/1/2098 1,950 1,950,000 10,000 585,000 585,000 3,900,000 1/1/2049 1,200 1,200,000 10,000 360,000 360,000 2,400,000 1/1/2099 1,950 1,950,000 10,000 585,000 585,000 3,900,000 1/1/2050 1,200 1,200,000 10,000 360,000 360,000 2,400,000 1/1/2100 1,950 1,950,000 10,000 585,000 585,000 3,900,000 1/1/2051 1,200 1,200,000 10,000 360,000 360,000 2,400,000 1/1/2101 1,950 1,950,000 10,000 585,000 585,000 3,900,000 1/1/2052 1,200 1,200,000 10,000 360,000 360,000 2,400,000 1/1/2102 1,950 1,950,000 10,000 585,000 585,000 3,900,000 1/1/2053 1,275 1,275,000 10,000 382,500 382,500 2,550,000 1/1/2103 2,025 2,025,000 10,000 607,500 607,500 4,050,000 1/1/2054 1,275 1,275,000 10,000 382,500 382,500 2,550,000 1/1/2104 2,025 2,025,000 10,000 607,500 607,500 4,050,000 1/1/2055 1,275 1,275,000 10,000 382,500 382,500 2,550,000 1/1/2105 2,025 2,025,000 10,000 607,500 607,500 4,050,000 1/1/2056 1,275 1,275,000 10,000 382,500 382,500 2,550,000 1/1/2106 2,025 2,025,000 10,000 607,500 607,500 4,050,000 1/1/2057 1,275 1,275,000 10,000 382,500 382,500 2,550,000 1/1/2107 2,025 2,025,000 10,000 607,500 607,500 4,050,000 1/1/2058 1,350 1,350,000 10,000 405,000 405,000 2,700,000 1/1/2108 2,100 2,100,000 10,000 630,000 630,000 4,200,000 1/1/2059 1,350 1,350,000 10,000 405,000 405,000 2,700,000 1/1/2109 2,100 2,100,000 10,000 630,000 630,000 4,200,000 1/1/2060 1,350 1,350,000 10,000 405,000 405,000 2,700,000 1/1/2110 2,100 2,100,000 10,000 630,000 630,000 4,200,000 1/1/2061 1,350 1,350,000 10,000 405,000 405,000 2,700,000 1/1/2111 2,100 2,100,000 10,000 630,000 630,000 4,200,000 1/1/2062 1,350 1,350,000 10,000 405,000 405,000 2,700,000 1/1/2112 2,100 2,100,000 10,000 630,000 630,000 4,200,000 1/1/2063 1,425 1,425,000 10,000 427,500 427,500 2,850,000 1/1/2113 2,175 2,175,000 10,000 652,500 652,500 4,350,000 1/1/2064 1,425 1,425,000 10,000 427,500 427,500 2,850,000 1/1/2114 2,175 2,175,000 10,000 652,500 652,500 4,350,000 1/1/2065 1,425 1,425,000 10,000 427,500 427,500 2,850,000 1/1/2115 2,175 2,175,000 10,000 652,500 652,500 4,350,000 1/1/2066 1,425 1,425,000 10,000 427,500 427,500 2,850,000 1/1/2116 2,175 2,175,000 10,000 652,500 652,500 4,350,000 1/1/2067 1,425 1,425,000 10,000 427,500 427,500 2,850,000 1/1/2117 2,175 2,175,000 10,000 652,500 652,500 4,350,000 Page 6 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 4 (Ringgit Malaysia) Jadual Had Pelan 4 (Ringgit Malaysia) 1/1/2018 750 750,000 100,000 225,000 225,000 1,500,000 1/1/2068 1,500 1,500,000 100,000 450,000 450,000 3,000,000 1/1/2019 750 750,000 100,000 225,000 225,000 1,500,000 1/1/2069 1,500 1,500,000 100,000 450,000 450,000 3,000,000 1/1/2020 750 750,000 100,000 225,000 225,000 1,500,000 1/1/2070 1,500 1,500,000 100,000 450,000 450,000 3,000,000 1/1/2021 750 750,000 100,000 225,000 225,000 1,500,000 1/1/2071 1,500 1,500,000 100,000 450,000 450,000 3,000,000 1/1/2022 750 750,000 100,000 225,000 225,000 1,500,000 1/1/2072 1,500 1,500,000 100,000 450,000 450,000 3,000,000 1/1/2023 825 825,000 100,000 247,500 247,500 1,650,000 1/1/2073 1,575 1,575,000 100,000 472,500 472,500 3,150,000 1/1/2024 825 825,000 100,000 247,500 247,500 1,650,000 1/1/2074 1,575 1,575,000 100,000 472,500 472,500 3,150,000 1/1/2025 825 825,000 100,000 247,500 247,500 1,650,000 1/1/2075 1,575 1,575,000 100,000 472,500 472,500 3,150,000 1/1/2026 825 825,000 100,000 247,500 247,500 1,650,000 1/1/2076 1,575 1,575,000 100,000 472,500 472,500 3,150,000 1/1/2027 825 825,000 100,000 247,500 247,500 1,650,000 1/1/2077 1,575 1,575,000 100,000 472,500 472,500 3,150,000 1/1/2028 900 900,000 100,000 270,000 270,000 1,800,000 1/1/2078 1,650 1,650,000 100,000 495,000 495,000 3,300,000 1/1/2029 900 900,000 100,000 270,000 270,000 1,800,000 1/1/2079 1,650 1,650,000 100,000 495,000 495,000 3,300,000 1/1/2030 900 900,000 100,000 270,000 270,000 1,800,000 1/1/2080 1,650 1,650,000 100,000 495,000 495,000 3,300,000 1/1/2031 900 900,000 100,000 270,000 270,000 1,800,000 1/1/2081 1,650 1,650,000 100,000 495,000 495,000 3,300,000 1/1/2032 900 900,000 100,000 270,000 270,000 1,800,000 1/1/2082 1,650 1,650,000 100,000 495,000 495,000 3,300,000 1/1/2033 975 975,000 100,000 292,500 292,500 1,950,000 1/1/2083 1,725 1,725,000 100,000 517,500 517,500 3,450,000 1/1/2034 975 975,000 100,000 292,500 292,500 1,950,000 1/1/2084 1,725 1,725,000 100,000 517,500 517,500 3,450,000 1/1/2035 975 975,000 100,000 292,500 292,500 1,950,000 1/1/2085 1,725 1,725,000 100,000 517,500 517,500 3,450,000 1/1/2036 975 975,000 100,000 292,500 292,500 1,950,000 1/1/2086 1,725 1,725,000 100,000 517,500 517,500 3,450,000 1/1/2037 975 975,000 100,000 292,500 292,500 1,950,000 1/1/2087 1,725 1,725,000 100,000 517,500 517,500 3,450,000 1/1/2038 1,050 1,050,000 100,000 315,000 315,000 2,100,000 1/1/2088 1,800 1,800,000 100,000 540,000 540,000 3,600,000 1/1/2039 1,050 1,050,000 100,000 315,000 315,000 2,100,000 1/1/2089 1,800 1,800,000 100,000 540,000 540,000 3,600,000 1/1/2040 1,050 1,050,000 100,000 315,000 315,000 2,100,000 1/1/2090 1,800 1,800,000 100,000 540,000 540,000 3,600,000 1/1/2041 1,050 1,050,000 100,000 315,000 315,000 2,100,000 1/1/2091 1,800 1,800,000 100,000 540,000 540,000 3,600,000 1/1/2042 1,050 1,050,000 100,000 315,000 315,000 2,100,000 1/1/2092 1,800 1,800,000 100,000 540,000 540,000 3,600,000 1/1/2043 1,125 1,125,000 100,000 337,500 337,500 2,250,000 1/1/2093 1,875 1,875,000 100,000 562,500 562,500 3,750,000 1/1/2044 1,125 1,125,000 100,000 337,500 337,500 2,250,000 1/1/2094 1,875 1,875,000 100,000 562,500 562,500 3,750,000 1/1/2045 1,125 1,125,000 100,000 337,500 337,500 2,250,000 1/1/2095 1,875 1,875,000 100,000 562,500 562,500 3,750,000 1/1/2046 1,125 1,125,000 100,000 337,500 337,500 2,250,000 1/1/2096 1,875 1,875,000 100,000 562,500 562,500 3,750,000 1/1/2047 1,125 1,125,000 100,000 337,500 337,500 2,250,000 1/1/2097 1,875 1,875,000 100,000 562,500 562,500 3,750,000 1/1/2048 1,200 1,200,000 100,000 360,000 360,000 2,400,000 1/1/2098 1,950 1,950,000 100,000 585,000 585,000 3,900,000 1/1/2049 1,200 1,200,000 100,000 360,000 360,000 2,400,000 1/1/2099 1,950 1,950,000 100,000 585,000 585,000 3,900,000 1/1/2050 1,200 1,200,000 100,000 360,000 360,000 2,400,000 1/1/2100 1,950 1,950,000 100,000 585,000 585,000 3,900,000 1/1/2051 1,200 1,200,000 100,000 360,000 360,000 2,400,000 1/1/2101 1,950 1,950,000 100,000 585,000 585,000 3,900,000 1/1/2052 1,200 1,200,000 100,000 360,000 360,000 2,400,000 1/1/2102 1,950 1,950,000 100,000 585,000 585,000 3,900,000 1/1/2053 1,275 1,275,000 100,000 382,500 382,500 2,550,000 1/1/2103 2,025 2,025,000 100,000 607,500 607,500 4,050,000 1/1/2054 1,275 1,275,000 100,000 382,500 382,500 2,550,000 1/1/2104 2,025 2,025,000 100,000 607,500 607,500 4,050,000 1/1/2055 1,275 1,275,000 100,000 382,500 382,500 2,550,000 1/1/2105 2,025 2,025,000 100,000 607,500 607,500 4,050,000 1/1/2056 1,275 1,275,000 100,000 382,500 382,500 2,550,000 1/1/2106 2,025 2,025,000 100,000 607,500 607,500 4,050,000 1/1/2057 1,275 1,275,000 100,000 382,500 382,500 2,550,000 1/1/2107 2,025 2,025,000 100,000 607,500 607,500 4,050,000 1/1/2058 1,350 1,350,000 100,000 405,000 405,000 2,700,000 1/1/2108 2,100 2,100,000 100,000 630,000 630,000 4,200,000 1/1/2059 1,350 1,350,000 100,000 405,000 405,000 2,700,000 1/1/2109 2,100 2,100,000 100,000 630,000 630,000 4,200,000 1/1/2060 1,350 1,350,000 100,000 405,000 405,000 2,700,000 1/1/2110 2,100 2,100,000 100,000 630,000 630,000 4,200,000 1/1/2061 1,350 1,350,000 100,000 405,000 405,000 2,700,000 1/1/2111 2,100 2,100,000 100,000 630,000 630,000 4,200,000 1/1/2062 1,350 1,350,000 100,000 405,000 405,000 2,700,000 1/1/2112 2,100 2,100,000 100,000 630,000 630,000 4,200,000 1/1/2063 1,425 1,425,000 100,000 427,500 427,500 2,850,000 1/1/2113 2,175 2,175,000 100,000 652,500 652,500 4,350,000 1/1/2064 1,425 1,425,000 100,000 427,500 427,500 2,850,000 1/1/2114 2,175 2,175,000 100,000 652,500 652,500 4,350,000 1/1/2065 1,425 1,425,000 100,000 427,500 427,500 2,850,000 1/1/2115 2,175 2,175,000 100,000 652,500 652,500 4,350,000 1/1/2066 1,425 1,425,000 100,000 427,500 427,500 2,850,000 1/1/2116 2,175 2,175,000 100,000 652,500 652,500 4,350,000 1/1/2067 1,425 1,425,000 100,000 427,500 427,500 2,850,000 1/1/2117 2,175 2,175,000 100,000 652,500 652,500 4,350,000 Page 7 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 5 (Ringgit Malaysia) Jadual Had Pelan 5 (Ringgit Malaysia) 1/1/2018 500 500,000 7,500 150,000 150,000 1,000,000 1/1/2068 1,000 1,000,000 7,500 300,000 300,000 2,000,000 1/1/2019 500 500,000 7,500 150,000 150,000 1,000,000 1/1/2069 1,000 1,000,000 7,500 300,000 300,000 2,000,000 1/1/2020 500 500,000 7,500 150,000 150,000 1,000,000 1/1/2070 1,000 1,000,000 7,500 300,000 300,000 2,000,000 1/1/2021 500 500,000 7,500 150,000 150,000 1,000,000 1/1/2071 1,000 1,000,000 7,500 300,000 300,000 2,000,000 1/1/2022 500 500,000 7,500 150,000 150,000 1,000,000 1/1/2072 1,000 1,000,000 7,500 300,000 300,000 2,000,000 1/1/2023 550 550,000 7,500 165,000 165,000 1,100,000 1/1/2073 1,050 1,050,000 7,500 315,000 315,000 2,100,000 1/1/2024 550 550,000 7,500 165,000 165,000 1,100,000 1/1/2074 1,050 1,050,000 7,500 315,000 315,000 2,100,000 1/1/2025 550 550,000 7,500 165,000 165,000 1,100,000 1/1/2075 1,050 1,050,000 7,500 315,000 315,000 2,100,000 1/1/2026 550 550,000 7,500 165,000 165,000 1,100,000 1/1/2076 1,050 1,050,000 7,500 315,000 315,000 2,100,000 1/1/2027 550 550,000 7,500 165,000 165,000 1,100,000 1/1/2077 1,050 1,050,000 7,500 315,000 315,000 2,100,000 1/1/2028 600 600,000 7,500 180,000 180,000 1,200,000 1/1/2078 1,100 1,100,000 7,500 330,000 330,000 2,200,000 1/1/2029 600 600,000 7,500 180,000 180,000 1,200,000 1/1/2079 1,100 1,100,000 7,500 330,000 330,000 2,200,000 1/1/2030 600 600,000 7,500 180,000 180,000 1,200,000 1/1/2080 1,100 1,100,000 7,500 330,000 330,000 2,200,000 1/1/2031 600 600,000 7,500 180,000 180,000 1,200,000 1/1/2081 1,100 1,100,000 7,500 330,000 330,000 2,200,000 1/1/2032 600 600,000 7,500 180,000 180,000 1,200,000 1/1/2082 1,100 1,100,000 7,500 330,000 330,000 2,200,000 1/1/2033 650 650,000 7,500 195,000 195,000 1,300,000 1/1/2083 1,150 1,150,000 7,500 345,000 345,000 2,300,000 1/1/2034 650 650,000 7,500 195,000 195,000 1,300,000 1/1/2084 1,150 1,150,000 7,500 345,000 345,000 2,300,000 1/1/2035 650 650,000 7,500 195,000 195,000 1,300,000 1/1/2085 1,150 1,150,000 7,500 345,000 345,000 2,300,000 1/1/2036 650 650,000 7,500 195,000 195,000 1,300,000 1/1/2086 1,150 1,150,000 7,500 345,000 345,000 2,300,000 1/1/2037 650 650,000 7,500 195,000 195,000 1,300,000 1/1/2087 1,150 1,150,000 7,500 345,000 345,000 2,300,000 1/1/2038 700 700,000 7,500 210,000 210,000 1,400,000 1/1/2088 1,200 1,200,000 7,500 360,000 360,000 2,400,000 1/1/2039 700 700,000 7,500 210,000 210,000 1,400,000 1/1/2089 1,200 1,200,000 7,500 360,000 360,000 2,400,000 1/1/2040 700 700,000 7,500 210,000 210,000 1,400,000 1/1/2090 1,200 1,200,000 7,500 360,000 360,000 2,400,000 1/1/2041 700 700,000 7,500 210,000 210,000 1,400,000 1/1/2091 1,200 1,200,000 7,500 360,000 360,000 2,400,000 1/1/2042 700 700,000 7,500 210,000 210,000 1,400,000 1/1/2092 1,200 1,200,000 7,500 360,000 360,000 2,400,000 1/1/2043 750 750,000 7,500 225,000 225,000 1,500,000 1/1/2093 1,250 1,250,000 7,500 375,000 375,000 2,500,000 1/1/2044 750 750,000 7,500 225,000 225,000 1,500,000 1/1/2094 1,250 1,250,000 7,500 375,000 375,000 2,500,000 1/1/2045 750 750,000 7,500 225,000 225,000 1,500,000 1/1/2095 1,250 1,250,000 7,500 375,000 375,000 2,500,000 1/1/2046 750 750,000 7,500 225,000 225,000 1,500,000 1/1/2096 1,250 1,250,000 7,500 375,000 375,000 2,500,000 1/1/2047 750 750,000 7,500 225,000 225,000 1,500,000 1/1/2097 1,250 1,250,000 7,500 375,000 375,000 2,500,000 1/1/2048 800 800,000 7,500 240,000 240,000 1,600,000 1/1/2098 1,300 1,300,000 7,500 390,000 390,000 2,600,000 1/1/2049 800 800,000 7,500 240,000 240,000 1,600,000 1/1/2099 1,300 1,300,000 7,500 390,000 390,000 2,600,000 1/1/2050 800 800,000 7,500 240,000 240,000 1,600,000 1/1/2100 1,300 1,300,000 7,500 390,000 390,000 2,600,000 1/1/2051 800 800,000 7,500 240,000 240,000 1,600,000 1/1/2101 1,300 1,300,000 7,500 390,000 390,000 2,600,000 1/1/2052 800 800,000 7,500 240,000 240,000 1,600,000 1/1/2102 1,300 1,300,000 7,500 390,000 390,000 2,600,000 1/1/2053 850 850,000 7,500 255,000 255,000 1,700,000 1/1/2103 1,350 1,350,000 7,500 405,000 405,000 2,700,000 1/1/2054 850 850,000 7,500 255,000 255,000 1,700,000 1/1/2104 1,350 1,350,000 7,500 405,000 405,000 2,700,000 1/1/2055 850 850,000 7,500 255,000 255,000 1,700,000 1/1/2105 1,350 1,350,000 7,500 405,000 405,000 2,700,000 1/1/2056 850 850,000 7,500 255,000 255,000 1,700,000 1/1/2106 1,350 1,350,000 7,500 405,000 405,000 2,700,000 1/1/2057 850 850,000 7,500 255,000 255,000 1,700,000 1/1/2107 1,350 1,350,000 7,500 405,000 405,000 2,700,000 1/1/2058 900 900,000 7,500 270,000 270,000 1,800,000 1/1/2108 1,400 1,400,000 7,500 420,000 420,000 2,800,000 1/1/2059 900 900,000 7,500 270,000 270,000 1,800,000 1/1/2109 1,400 1,400,000 7,500 420,000 420,000 2,800,000 1/1/2060 900 900,000 7,500 270,000 270,000 1,800,000 1/1/2110 1,400 1,400,000 7,500 420,000 420,000 2,800,000 1/1/2061 900 900,000 7,500 270,000 270,000 1,800,000 1/1/2111 1,400 1,400,000 7,500 420,000 420,000 2,800,000 1/1/2062 900 900,000 7,500 270,000 270,000 1,800,000 1/1/2112 1,400 1,400,000 7,500 420,000 420,000 2,800,000 1/1/2063 950 950,000 7,500 285,000 285,000 1,900,000 1/1/2113 1,450 1,450,000 7,500 435,000 435,000 2,900,000 1/1/2064 950 950,000 7,500 285,000 285,000 1,900,000 1/1/2114 1,450 1,450,000 7,500 435,000 435,000 2,900,000 1/1/2065 950 950,000 7,500 285,000 285,000 1,900,000 1/1/2115 1,450 1,450,000 7,500 435,000 435,000 2,900,000 1/1/2066 950 950,000 7,500 285,000 285,000 1,900,000 1/1/2116 1,450 1,450,000 7,500 435,000 435,000 2,900,000 1/1/2067 950 950,000 7,500 285,000 285,000 1,900,000 1/1/2117 1,450 1,450,000 7,500 435,000 435,000 2,900,000 Page 8 of 30

Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Effective Revision Date Tarikh Semakan Berkuat kuasa Room & Board Bilik & Makan Per Disability Limit Had Setiap Hilang Upaya Deductible Per Disability Deduktibel Setiap Hilang Upaya OutPatient Cancer Treatment Rawatan Kanser Pesakit Luar OutPatient Kidney Dialysis Dialisis Buah Pinggang Pesakit Luar Overall Annual Limit Had Tahunan Keseluruhan Schedule of Limits Plan 6 (Ringgit Malaysia) Jadual Had Pelan 6 (Ringgit Malaysia) 1/1/2018 500 500,000 75,000 150,000 150,000 1,000,000 1/1/2068 1,000 1,000,000 75,000 300,000 300,000 2,000,000 1/1/2019 500 500,000 75,000 150,000 150,000 1,000,000 1/1/2069 1,000 1,000,000 75,000 300,000 300,000 2,000,000 1/1/2020 500 500,000 75,000 150,000 150,000 1,000,000 1/1/2070 1,000 1,000,000 75,000 300,000 300,000 2,000,000 1/1/2021 500 500,000 75,000 150,000 150,000 1,000,000 1/1/2071 1,000 1,000,000 75,000 300,000 300,000 2,000,000 1/1/2022 500 500,000 75,000 150,000 150,000 1,000,000 1/1/2072 1,000 1,000,000 75,000 300,000 300,000 2,000,000 1/1/2023 550 550,000 75,000 165,000 165,000 1,100,000 1/1/2073 1,050 1,050,000 75,000 315,000 315,000 2,100,000 1/1/2024 550 550,000 75,000 165,000 165,000 1,100,000 1/1/2074 1,050 1,050,000 75,000 315,000 315,000 2,100,000 1/1/2025 550 550,000 75,000 165,000 165,000 1,100,000 1/1/2075 1,050 1,050,000 75,000 315,000 315,000 2,100,000 1/1/2026 550 550,000 75,000 165,000 165,000 1,100,000 1/1/2076 1,050 1,050,000 75,000 315,000 315,000 2,100,000 1/1/2027 550 550,000 75,000 165,000 165,000 1,100,000 1/1/2077 1,050 1,050,000 75,000 315,000 315,000 2,100,000 1/1/2028 600 600,000 75,000 180,000 180,000 1,200,000 1/1/2078 1,100 1,100,000 75,000 330,000 330,000 2,200,000 1/1/2029 600 600,000 75,000 180,000 180,000 1,200,000 1/1/2079 1,100 1,100,000 75,000 330,000 330,000 2,200,000 1/1/2030 600 600,000 75,000 180,000 180,000 1,200,000 1/1/2080 1,100 1,100,000 75,000 330,000 330,000 2,200,000 1/1/2031 600 600,000 75,000 180,000 180,000 1,200,000 1/1/2081 1,100 1,100,000 75,000 330,000 330,000 2,200,000 1/1/2032 600 600,000 75,000 180,000 180,000 1,200,000 1/1/2082 1,100 1,100,000 75,000 330,000 330,000 2,200,000 1/1/2033 650 650,000 75,000 195,000 195,000 1,300,000 1/1/2083 1,150 1,150,000 75,000 345,000 345,000 2,300,000 1/1/2034 650 650,000 75,000 195,000 195,000 1,300,000 1/1/2084 1,150 1,150,000 75,000 345,000 345,000 2,300,000 1/1/2035 650 650,000 75,000 195,000 195,000 1,300,000 1/1/2085 1,150 1,150,000 75,000 345,000 345,000 2,300,000 1/1/2036 650 650,000 75,000 195,000 195,000 1,300,000 1/1/2086 1,150 1,150,000 75,000 345,000 345,000 2,300,000 1/1/2037 650 650,000 75,000 195,000 195,000 1,300,000 1/1/2087 1,150 1,150,000 75,000 345,000 345,000 2,300,000 1/1/2038 700 700,000 75,000 210,000 210,000 1,400,000 1/1/2088 1,200 1,200,000 75,000 360,000 360,000 2,400,000 1/1/2039 700 700,000 75,000 210,000 210,000 1,400,000 1/1/2089 1,200 1,200,000 75,000 360,000 360,000 2,400,000 1/1/2040 700 700,000 75,000 210,000 210,000 1,400,000 1/1/2090 1,200 1,200,000 75,000 360,000 360,000 2,400,000 1/1/2041 700 700,000 75,000 210,000 210,000 1,400,000 1/1/2091 1,200 1,200,000 75,000 360,000 360,000 2,400,000 1/1/2042 700 700,000 75,000 210,000 210,000 1,400,000 1/1/2092 1,200 1,200,000 75,000 360,000 360,000 2,400,000 1/1/2043 750 750,000 75,000 225,000 225,000 1,500,000 1/1/2093 1,250 1,250,000 75,000 375,000 375,000 2,500,000 1/1/2044 750 750,000 75,000 225,000 225,000 1,500,000 1/1/2094 1,250 1,250,000 75,000 375,000 375,000 2,500,000 1/1/2045 750 750,000 75,000 225,000 225,000 1,500,000 1/1/2095 1,250 1,250,000 75,000 375,000 375,000 2,500,000 1/1/2046 750 750,000 75,000 225,000 225,000 1,500,000 1/1/2096 1,250 1,250,000 75,000 375,000 375,000 2,500,000 1/1/2047 750 750,000 75,000 225,000 225,000 1,500,000 1/1/2097 1,250 1,250,000 75,000 375,000 375,000 2,500,000 1/1/2048 800 800,000 75,000 240,000 240,000 1,600,000 1/1/2098 1,300 1,300,000 75,000 390,000 390,000 2,600,000 1/1/2049 800 800,000 75,000 240,000 240,000 1,600,000 1/1/2099 1,300 1,300,000 75,000 390,000 390,000 2,600,000 1/1/2050 800 800,000 75,000 240,000 240,000 1,600,000 1/1/2100 1,300 1,300,000 75,000 390,000 390,000 2,600,000 1/1/2051 800 800,000 75,000 240,000 240,000 1,600,000 1/1/2101 1,300 1,300,000 75,000 390,000 390,000 2,600,000 1/1/2052 800 800,000 75,000 240,000 240,000 1,600,000 1/1/2102 1,300 1,300,000 75,000 390,000 390,000 2,600,000 1/1/2053 850 850,000 75,000 255,000 255,000 1,700,000 1/1/2103 1,350 1,350,000 75,000 405,000 405,000 2,700,000 1/1/2054 850 850,000 75,000 255,000 255,000 1,700,000 1/1/2104 1,350 1,350,000 75,000 405,000 405,000 2,700,000 1/1/2055 850 850,000 75,000 255,000 255,000 1,700,000 1/1/2105 1,350 1,350,000 75,000 405,000 405,000 2,700,000 1/1/2056 850 850,000 75,000 255,000 255,000 1,700,000 1/1/2106 1,350 1,350,000 75,000 405,000 405,000 2,700,000 1/1/2057 850 850,000 75,000 255,000 255,000 1,700,000 1/1/2107 1,350 1,350,000 75,000 405,000 405,000 2,700,000 1/1/2058 900 900,000 75,000 270,000 270,000 1,800,000 1/1/2108 1,400 1,400,000 75,000 420,000 420,000 2,800,000 1/1/2059 900 900,000 75,000 270,000 270,000 1,800,000 1/1/2109 1,400 1,400,000 75,000 420,000 420,000 2,800,000 1/1/2060 900 900,000 75,000 270,000 270,000 1,800,000 1/1/2110 1,400 1,400,000 75,000 420,000 420,000 2,800,000 1/1/2061 900 900,000 75,000 270,000 270,000 1,800,000 1/1/2111 1,400 1,400,000 75,000 420,000 420,000 2,800,000 1/1/2062 900 900,000 75,000 270,000 270,000 1,800,000 1/1/2112 1,400 1,400,000 75,000 420,000 420,000 2,800,000 1/1/2063 950 950,000 75,000 285,000 285,000 1,900,000 1/1/2113 1,450 1,450,000 75,000 435,000 435,000 2,900,000 1/1/2064 950 950,000 75,000 285,000 285,000 1,900,000 1/1/2114 1,450 1,450,000 75,000 435,000 435,000 2,900,000 1/1/2065 950 950,000 75,000 285,000 285,000 1,900,000 1/1/2115 1,450 1,450,000 75,000 435,000 435,000 2,900,000 1/1/2066 950 950,000 75,000 285,000 285,000 1,900,000 1/1/2116 1,450 1,450,000 75,000 435,000 435,000 2,900,000 1/1/2067 950 950,000 75,000 285,000 285,000 1,900,000 1/1/2117 1,450 1,450,000 75,000 435,000 435,000 2,900,000 Page 9 of 30