The Standard Long Term Disability Plans and Rates Plan Year (no change from )

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1 Plans and Rates Page 1 of 5 Voluntary Enrollment / Employee Paid plans allow each employee to choose whether or not they wish to enroll, and premiums must be paid by the employee. Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6 VOLUNTARY ENROLLMENT - EMPLOYEE PAID

2 Plans and Rates Page 2 of 5 Mandatory Enrollment / Employer Paid plans require all employees to enroll, and premiums must be paid by the employer. Plan 7 Plan 8 Plan 9 Plan 10 Plan 11 Plan 12 MANDATORY ENROLLMENT - EMPLOYER PAID

3 Plans and Rates Page 3 of 5 Mandatory Enrollment / Employee Paid plans require all employees to enroll, and premiums must be paid by the employee. Plan 13 Plan 14 Plan 15 Plan 16 Plan 17 Plan 18 MANDATORY ENROLLMENT - EMPLOYEE PAID

4 Plans and Rates Page 4 of 5 Mandatory Enrollment / Employer Paid plans require all employees to enroll, and premiums must be paid by the employer. Plan 19 Plan 20 Plan 21 Plan 22 Benefit Waiting Period (days) Maximum Monthly Benefit $2,000 $3,000 $4,000 $6,000 Benefit Percentage 66 ⅔% 66 ⅔% 66 ⅔% 66 ⅔% For $2,000 plan: The first $3,000 of employee's monthly predisability earnings For $3,000 plan: The first $4,500 of employee's monthly predisability earnings For $4,000 plan: The first $6,000 of employee's monthly predisability earnings For $6,000 plan: The first $9,000 of employee's monthly predisability earnings MANDATORY ENROLLMENT - EMPLOYER PAID

5 Plans and Rates Page 5 of 5 Mandatory Enrollment / Employee Paid plans require all employees to enroll, and premiums must be paid by the employee. Plan 23 Plan 24 Benefit Waiting Period (days) Maximum Monthly Benefit $2,000 $3,000 Benefit Percentage 66 ⅔% 66 ⅔% For $2,000 plan: The first $3,000 of employee's monthly predisability earnings For $3,000 plan: The first $4,500 of employee's monthly predisability earnings For $4,000 plan: The first $6,000 of employee's monthly predisability earnings For $6,000 plan: The first $9,000 of employee's monthly predisability earnings MANDATORY ENROLLMENT - EMPLOYEE PAID

(F) ESTIMATED ADDITIONAL SB1265 Added AMOUNT (E) X.01 ROUNDED TO THE NEAREST $ (E) Difference in Value (B - C) X.10. (C) Total Restricted Values

(F) ESTIMATED ADDITIONAL SB1265 Added AMOUNT (E) X.01 ROUNDED TO THE NEAREST $ (E) Difference in Value (B - C) X.10. (C) Total Restricted Values 002-010-002-000 97,497 141,975 Enrolled No Added Value 0 002-010-006-000 196,033 151,668 151,668 4,437 44 002-010-012-000 292,555 247,075 247,075 4,548 45 002-010-017-000 207,045 102,378 102,378 10,467

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