solutions INSURANCE For CES Member Institutions Selected and Endorsed by:

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1 INSURANCE solutions Selected and Endorsed by: (505) For CES Member Institutions GROUP VOLUNTARY ACCIDENT, CANCER, CRITICAL ILLNESS, DISABILITY, LIFE, AND GAP INSURANCE Best in Benefits Series sm ABJ23676X Page 1 of 28

2 major medical complement think about your coverage Gaps in health insurance coverage may be caused by medical circumstances that are beyond your control and can wreak havoc on your finances. High deductible and coinsurance payments can lead to out-of-pocket expenses you are not prepared to pay. These expenses can be covered through the purchase of a GAP product, which can help alleviate the costs associated with major medical coinsurance and deductible. That s where Major Medical Complement coverage can help. i meeting your needs Major Medical Complement coverage helps meet the needs of you, your spouse, and your children. We know you will agree what we offer will help provide peace of mind for a secure future. Affordable plan designs Reduces out-of-pocket expenses when hospital confined Guaranteed Issue with no medical tests required* Employee, Employee and Spouse, Employee and Child(ren), or Family coverage Hospital Confinement benefits for: Inpatient hospital stays Inpatient surgery Inhospital physician charges Emergency Room treatment** *Enrollment in group coverage is based on the employer-determined major medical open enrollment period. To be eligible, you must be covered under your group Major Medical/Comprehensive plan that includes deductible and coinsurance. **If employee treatment is due to sickness, the benefit is payable only if a hospital confinement is required within 24 hours of hospital emergency room treatment. Your employer has made it easy to protect your family. your benefit coverage Benefits are paid for out-of-pocket expenses for deductible and coinsurance you or each covered family member incur for a hospital confinement due to injury or sickness. HOW TO GET STARTED 1. Review the benefits offered through your employer and the example of how benefits are paid. Your employer has chosen a calendar year benefit amount that will be provided to you and each covered family member. 2. Select coverage for you, you and your spouse, you and your child(ren), or your entire family. Hospital Confinement Insurance - A benefit will be paid each calendar year for you or each covered family member who incurs eligible out-ofpocket expenses for a hospital confinement due to an injury or sickness provided you or a covered family member are under the regular care and attendance of a physician, and such expenses are covered by your or your covered family member s major medical/comprehensive policy, and the injury or sickness begins after the effective date of coverage. The benefit amount cannot exceed your out-of-pocket responsibility under your major medical/comprehensive policy. Benefits are limited to the deductible and/or the coinsurance amount you or each covered family member is required to pay under the major medical/comprehensive policy, and include: Inpatient hospital stays Inpatient surgeries Physician s hospital charges Benefits will also be paid for hospital emergency room treatment if you or a covered family member incur an injury or sickness. The sickness must result in a hospital confinement within 24 hours of the hospital emergency room treatment. Page 2 of 28 ABJ23676X

3 Below is an example of how benefits will be paid under the Hospital Confinement Insurance policy. As you can see, if you did not have the Major Medical Complement Hospital Confinement benefit, you or a covered family member would have to pay $2,800 out of pocket for deductible and coinsurance. With the purchase of Major Medical Complement, the $2,500 Hospital Confinement Insurance policy would pick up the difference in what your major medical insurance would pay and what you or a covered family member would owe. In the example, you or a covered family member would only have to pay $300 in out-of-pocket expenses. Now that s a complement! EXAMPLE OF HOW BENEFITS ARE PAID Below is an example of how the Hospital Confinement Insurance would be paid if you or a covered family member were hospitalized for a covered injury or sickness and required surgery. Covered Hospital Stay + Surgery Example A Hospital Stay + Surgery = $16,000 Total Expenses Without HCB With $2,500 HCB Per Admission Copay $500 $500 Coinsurance 20% $2,300 $2,300 Total Expenses $2,800 $2,800 Major Medical Complement Hospital Confinement Benefit $0 $2,500 Total Out-of-Pocket $2,800 $300 This example is only for illustrative purposes. The example assumes a $2,800 out-of-pocket expense. You and your covered family member s experience under the coverage will vary based on the plan selected. The Hospital Confinement Insurance can be enhanced through the addition of the Outpatient Benefit. This benefit offers enhanced protection to help assure your deductible and coinsurance out-of-pocket expenses don t get out of control. Outpatient (OPB) - A benefit will be paid each calendar year when you or each covered family member receive outpatient treatment under the regular care and attendance of a physician at a hospital, an outpatient surgical or emergency facility, or a diagnostic testing facility or similar facility that is licensed to provide outpatient treatment. Benefits are paid per person, per calendar year up to a family maximum of 2x s the per person, per calendar year maximum. Does not include charges for physician office visit expense. EXAMPLE OF HOW BENEFITS ARE PAID Below is an example of how the Outpatient Benefit would be paid: Outpatient Benefit Example Example 1 Out-Of-Pocket Benefit Occurrence Cost Amount Individual (MRI) $1,750 $1,250 Child (Blood work) $1,000 $1,250 Child (Stitches) $500 $0 Spouse (X-ray) $250 $0 Total $3,500 $2,500 Example 2 Total Paid by Insured = $1,000 Out-Of-Pocket Benefit Occurrence Cost Amount Individual (X-ray) $750 $750 Individual (Blood work) $1,000 $500 Child (Stitches) $500 $500 Spouse (X-ray) $250 $250 Child (MRI) $450 $450 Total $2,950 $2,450 Total Paid by Insured = $500 These examples are only for illustrative purposes. You and your covered family member s experience under the coverage will vary based on the plan selected. ABJ23676X Page 3 of 28

4 DEFINITIONS To help with terminology, we have provided a brief listing of definitions. Hospital - Means a legally authorized and operated institution for the care and treatment of sick and injured persons. It must have graduate registered nurses (RNs) on 24-hour call and organized facilities for diagnosis and surgery either on its premises or in facilities available to it on a contractual prearranged basis. The following does not qualify as a hospital: an institution, or part of it, which is used mainly as a facility for rest, nursing care, convalescent care, care of the aged, or for remedial education or training. Sickness - A disease or illness, or more than one disease or illness, resulting from the same or related causes or conditions, including all complications thereof and all related conditions and recurrences resulting in medical expense insured under the policy or otherwise resulting in a claim for benefits while the policy is in force with respect to the insured for whom the claim is made. Hospital Confinement - Means the insured person is admitted to the facility as an overnight bed patient for a minimum of 15 consecutive hours. Insured Person - (a) Means either an insured or an insured dependent. An insured is an employee of the policyholder whose coverage under the policy has become effective and has not been terminated. Insured dependent means any of the following: (b) the lawful spouse of an insured whose coverage under the policy has become effective and has not terminated; or (c) unmarried dependent child or children of an Insured or of an Insured s spouse who are under 25 and whose coverage under the policy has become effective and has not been terminated. (d) Dependent children include: stepchildren, legally adopted, children who have been placed in the insured s home for adoption, and foster children. Injury - Means a bodily injury sustained by an insured person caused by an accident, directly and independently of all other causes, that occurs while the policy is in force. All injuries sustained by an insured person in any one accident are considered a single Injury. Major Medical/Comprehensive Policy - Means any one of the following types of policies or plans which provide benefits for hospital confinement for an insured person on his or her effective date of coverage, and such policy or plan requires the insured person to pay a deductible and/or portion of coinsurance: group or blanket insurance plans; group Blue Cross, Blue Shield or other group prepayment coverage plans; coverage under labor-management trusteed plans; union welfare plans; employer organizational plans; employee benefit organizational plans; or other arrangements of benefits for persons of a group. Major Medical/Comprehensive Policy does not include Medicare. Page 4 of 28 ABJ23676X

5 premiums detailed PLAN Semi-Monthly* Employee (24) Under Age 40 Employee Only $15.67 Employee plus Spouse $28.23 Employee plus Children $34.67 Employee plus Family $47.20 Ages Employee Only $21.30 Employee plus Spouse $38.34 Employee plus Children $39.24 Employee plus Family $56.27 Plan - Major Medical Hospital Confinement Outpatient Benefit Ages 50 & Above Employee Only $35.54 Employee plus Spouse $63.97 Employee plus Children $57.60 Employee plus Family $86.00 *12 monthly payroll deductions. The full monthly rate is payable regardless of the payroll deduction method listed by the employer. Premiums are not pro-rated for partial periods of coverage. Payroll deduction rates reflect the employee cost based on the employer contribution level and assumes employer is not contributing toward any dependent cost. policy benefits The listing below describes the benefit amounts associated with each benefit described in this brochure. Major Medical BENEFIT Hospital Confinement PLAN $2,500/year** Outpatient $1,250/year 16 ** Benefit pays for hospital confinement for injury or sickness, and must be covered by your Major Medical/ Comprehensive Policy. It cannot exceed the out-of-pocket responsibility under the Major Medical/ Comprehensive Policy. 16 Paid per person, per calendar year up to a family maximum of 2x s the per person, per calendar year maximum. ABJ23676X Page 5 of 28

6 group voluntary accident AB group voluntary accident coverage provides cash benefits for out-of-pocket expenses associated with an accidental injury and can help protect hard-earned savings should an on- or off-the-job accidental injury occur. No one plans to have an accident. But, it can happen at any moment throughout the day, whether at work or at play. Most major medical insurance plans only pay a portion of the bills. Our policy can help pick up where other insurance leaves off and provide cash to cover the expenses. Our accident coverage helps offer peace of mind when an accidental injury occurs. Below is an example of how benefits are paid.* } 1 of 4 Incremental benefits is Injury chosen } occurs 2 years later the employee is traveling to work, is in a car accident, and is air lifted to the hospital Employee incurred expenses for services in and out of the hospital. In addition to what their major medical insurance paid; our voluntary accident benefits paid for: Air Ambulance Service $ 300 Hospital Admission $ 500 Open Abdominal/Thoracic Surgery $ 1,000 Medicine $ 5 Medical Expenses (surgery) $ 250 Initial Hospital Confinement $ Day Hospital Stay $ 300 Outpatient Doctor Visit $ 50 With Accident Coverage Additional dollars to pay for copay, deductible and other out-of-pocket costs Benefits paid: $2,905 Without Accident Coverage No additional dollars to pay for copay, deductible or other out-of-pocket costs Benefits paid: $0 i meeting your needs your benefit coverage Our accident coverage helps offer peace of mind when an accidental injury occurs. Coverage that is guaranteed at initial enrollment, there are no medical exams or tests to take** Benefits that correspond with treatment for on- and off-the-job accidental injuries including hospitalization, emergency treatment, intensive care, fractures, plus more 24-hour accident coverage for yourself or your entire family Affordable premiums Benefits paid directly to you, unless you assign them to someone else An additional rider benefit has been added to the plan, and is designed to enhance your coverage Portable coverage **During open enrollment only. If you enroll after the open-enrollment period, evidence of insurability may be required. Accidental Death*** - Pays for accidental death. Common Carrier Accidental Death*** - Pays for death while riding as a fare-paying passenger on a scheduled common carrier. Dismemberment*** - Pays for dismemberment. Multiple dismemberments during the same injury are limited to the principal amount listed in the policy. Dislocation or Fracture*** - Pays for dislocation or fracture. Multiple dislocations or fractures during the same injury are limited to the principal amount listed in the policy. Initial Hospital Confinement - Pays when you are hospital confined for the first time after the effective date. Hospital Confinement - Pays when you are confined in a hospital up to 90 days for each continuous hospital confinement. Intensive Care - Pays when you are confined in a hospital intensivecare unit up to 90 days for each continuous hospital intensive-care confinement. Ambulance - Pays for you to be transferred by ambulance service to or from a hospital. Medical Expenses - Pays when you have medical expenses. Outpatient Physician s Treatment - Pays when you are treated by a physician outside of a hospital for any reason. Limited to 2 visits per person per year, and 4 visits per year if your dependents are covered. Page 6 of 28 ABJ23676X *The example shown may vary from the plan your employer is offering. Your individual experience may also vary. ***Pays 50% of the benefit amount for a covered spouse and 25% for each covered child. Benefit amounts are shown on page 8. See page 23 for limits and conditions.

7 Most unintentional injuries occurred in or around the home (44.3%) followed by injuries at recreational and sport facilities (15.4%) and injuries on streets, highways, sidewalks, and parking lots (10.9%). 7 7 Injury Facts 2010 Edition, National Safety Council. BENEFIT ENHANCEMENT RIDER Hospital Admission - Pays for your first hospital confinement, after you have been continuously covered by this rider for 12 months. Must be confined within 3 days after the accident. Paid once per year. Lacerations - Pays when you receive treatment for 1 or more cuts within 3 days after an accident. Paid once per year. Burns - Pays when you receive treatment for burns, other than sun burns, within 3 days after an accident. Paid once per accident. Skin Graft** - Pays when you receive a skin graft for a covered burn. Paid once per accident. Brain Injury Diagnosis - Pays a one-time benefit when you are diagnosed with 1 of these traumatic brain injuries within 30 days after an accident: concussion, cerebral laceration, cerebral contusion, or intracranial hemorrhage. Must be first treated by a physician within 3 days after the accident. Computed Tomography (CT) Scan and Magnetic Resonance Imaging (MRI)* - Pays when you receive a CT scan or MRI. Must be first treated by a physician within 30 days after the accident. Paid once per year. Paralysis - Pays a one-time benefit when you are paralyzed from a spinal-cord injury for at least 90 days. Must be confirmed by a physician within 3 days after the accident. Coma With Respiratory Assistance - Pays a one-time benefit when you are in a coma. Open Abdominal or Thoracic Surgery - Pays when you have open abdominal or thoracic surgery for internal injuries within 3 days after the accident. Tendon, Ligament, Rotator Cuff or Knee Cartilage Surgery* - Pays when you have surgery to repair a tendon, ligament, rotator cuff or knee cartilage; or for exploratory arthroscopic surgery. Ruptured Disc Surgery* - Pays when you have a surgical procedure to repair a ruptured spinal disc. Eye Surgery** - Pays when you have surgery or a foreign object removed from the eye. Paid once per accident. General Anesthesia* - Pays for general anesthesia during a covered surgery. Blood and Plasma - Pays for a blood or plasma transfusion within 3 days after an accident. Paid once per accident. Appliance** - Pays for 1 of the following: wheelchair, crutches, or walker. Paid once per accident. Medical Supplies** - Pays for over-the-counter medical supplies. Paid once per accident. Medicine** - Pays for prescription or over-the-counter medicine. Paid once per accident. Prosthesis* - Pays for a physician-prescribed prosthetic arm, leg, hand, foot or eye. Paid once per accident. Physical Therapy** - Pays for physician-prescribed physical therapy (up to 6 treatments per accident). Must take place within 6 months after the accident. Rehabilitation Unit - Pays when you are confined in a rehabilitation unit after a hospital stay. Paid up to 30 days per confinement (maximum 60 days per year). Non-Local Transportation - Pays when you have physicianprescribed treatment at a hospital or treatment center more than 100 miles from your home. Paid up to 3 times per accident. Family Member Lodging - Pays when one adult family member accompanies you to receive treatment at a hospital or treatment center more than 100 miles from the family member s home. Post-Accident Transportation - Pays when you are hospital confined for at least 3 days in a row more than 250 miles from your home, and you are brought home by a common carrier. Accident Follow-Up Treatment - Pays when you receive follow-up treatment from a physician in their office or in a hospital as an outpatient (up to 2 treatments per accident). Must take place within 6 months after the accident. *must begin or be received within 180 days of the accident. **must begin, be received, or performed within 90 days of the accident. ABJ23676X Page 7 of 28

8 BASE ACCIDENT BENEFITS LOW MEDIAN HIGH Accidental Death Employee $20,000 $40,000 $60,000 Spouse $10,000 $20,000 $30,000 Child $5,000 $10,000 $15,000 Common Carrier Employee $100,000 $200,000 $300,000 Accidental Death Spouse $500,000 $100,000 $150,000 Child $250,000 $50,000 $75,000 Dismemberment Employee up to $20,000 8 up to $40,000 8 up to $60,000 8 Spouse up to $10,000 8 up to $20,000 8 up to $30,000 8 Child up to $5,000 8 up to $10,000 8 up to $15,000 8 Dislocation and Fracture Employee up to $2,000 8 up to $4,000 8 up to $6,000 8 Spouse up to $1,000 8 up to $2,000 8 up to $3,000 8 Child up to $500 8 up to $1,000 8 up to $1,500 8 Initial Hospital Confinement $500 $1,000 $1,500 Hospital Confinement (per day) $100 $200 $300 Intensive Care (per day) $200 $400 $600 Ambulance Regular Ambulance $100 $200 $300 Air Ambulance $300 $600 $900 Medical Expenses up to $250 up to $500 up to $750 Outpatient Physician s Treatment (per visit) $25 $50 $75 BENEFIT ENHANCEMENT RIDER BENEFITS LOW MEDIAN HIGH Hospital Admission $500 $1,000 $1,000 Lacerations $50 $100 $100 Burns < 15% of body surface $100 $200 $200 > 15% or more $500 $1,000 $1,000 Skin Graft (% of Burns) 50% 50% 50% Brain Injury Diagnosis $150 $300 $300 Computed Tomography (CT) Scan and $50 $100 $100 Magnetic Resonance Imaging (MRI) Paralysis Paraplegia $7,500 $15,000 $15,000 Quadriplegia $15,000 $30,000 $30,000 Coma with Respiratory Assistance $10,000 $20,000 $20,000 Open Abdominal or Thoracic Surgery $1,000 $2,000 $2,000 Tendon, Ligament, Rotator Cuff Surgery $500 $1,000 $1,000 or Knee Cartilage Surgery Exploratory $150 $300 $300 Ruptured Disc Surgery $500 $1,000 $1,000 Eye Surgery $100 $200 $200 General Anesthesia $100 $200 $200 Blood and Plasma $300 $600 $600 Appliance $125 $250 $250 Medical Supplies $5 $10 $10 Medicine $5 $10 $10 Prosthesis One Device $500 $1,000 $1,000 Two or More $1,000 $2,000 $2,000 Physical Therapy (per day) $30 $60 $60 Rehabilitation Unit (per day) $100 $200 $200 Non-Local Transportation (per trip) $400 $800 $800 Family Member Lodging (per day) $100 $200 $200 Post-Accident Transportation $200 $400 $400 Accident Follow-Up Treatment (per day) $50 $100 $100 8 Based on amounts shown in the Injury Benefit Schedule on page 9. Page 8 of 28 ABJ23676X

9 injury benefit schedule Benefit amounts for coverage and one occurrence are shown below. Covered spouse gets 50% of the amounts shown and children 25%. LOSS OF LIFE OR LIMB LOW MEDIAN HIGH Life, or both eyes, hands, arms, feet, or legs, or one hand or arm and one foot or leg $20,000 $40,000 $60,000 One eye, hand, arm, foot, or leg $10,000 $20,000 $30,000 One or more entire toes or fingers $2,000 $4,000 $6,000 COMPLETE DISLOCATION LOW MEDIAN HIGH Hip joint $2,000 $4,000 $6,000 Knee or ankle joint*, bone or bones of the foot* $800 $1,600 $2,400 Wrist joint $700 $1,400 $2,100 Elbow joint $600 $1,200 $1,800 Shoulder joint $400 $800 $1,200 Bone or bones of the hand*, Collarbone $300 $600 $900 Two or more fingers or toes $140 $280 $420 One finger or toe $60 $120 $180 COMPLETE, SIMPLE OR CLOSED FRACTURE LOW MEDIAN HIGH Hip, thigh (femur), pelvis** $2,000 $4,000 $6,000 Skull** $1,900 $3,800 $5,700 Arm, between shoulder and elbow (shaft), shoulder blade (scapula), leg (tibia or fibula) $1,100 $2,200 $3,300 Ankle, knee cap (patella), forearm (radius or ulna), collarbone (clavicle) $800 $1,600 $2,400 Foot**, hand or wrist** $700 $1,400 $2,100 Lower jaw** $400 $800 $1,200 Two or more ribs, fingers or toes, bones of face or nose $300 $600 $900 One rib, finger or toe, Coccyx $140 $280 $420 *Knee joint (except patella). Bone or bones of the foot (except toes). Bone or bones of the hand (except fingers). **Pelvis (except coccyx). Skull (except bones of face or nose). Foot (except toes). Hand or wrist (except fingers). Lower jaw (except alveolar process). premiums MODE PLAN EE EE + SP EE + CH F LOW $5.66 $10.25 $11.00 $13.17 Semi-Monthly MEDIAN $10.23 $19.43 $20.92 $25.25 HIGH $13.57 $26.11 $28.34 $34.53 EE = Employee; EE + SP = Employee + Spouse; EE + CH = Employee + Child(ren); and F = Family Issue ages: 18 and over if Actively at Work ABJ23676X Page 9 of 28

10 group voluntary cancer Allstate Benefits (AB) group voluntary cancer coverage provides cash benefits for cancer and 29 specified diseases, and can help cover the costs of specific cancer and specified disease treatments and expenses as they happen. Being diagnosed with cancer or a specified disease can be difficult on anyone both emotionally and financially. Having the right coverage to help when sickness occurs or when undergoing treatments for cancer is important. Our cancer coverage can help provide added financial security when it is needed most. Cancer coverage can help offer peace of mind when a diagnosis of cancer or a specified disease occurs. Below is an example of how benefits might be paid.* Our cancer insurance policy paid John the following: Wellness Exam $0,100 Hospital Confinement $ 600 Cancer Initial Diagnosis $2,000 Non-Local Transportation $ 400 Surgery $ 1,500 Anesthesia $ 375 Radiation/Chemo $5,000 Medical Imaging $ 250 Inpatient Medicine $ 75 Physician Visits $ 150 Hair Prosthesis $ 25 Anti-Nausea $ 200 Total cash benefits $10,675 John chooses coverage from the plan benefits his employer is offering John has an annual wellness test, is diagnosed with cancer, travels 200 miles to the nearest cancer treatment hospital, undergoes pre-op testing (medical imaging) and is admitted to the hospital for surgery In Hospital Out of Hospital John has surgery with anesthesia, receives inpatient medication and is visited by a doctor during a 3-day hospital stay Every 2 weeks John has radiation/chemo, is given anti-nausea medication, and sees his doctor 3 times. He also purchases a hair prosthesis i meeting your needs Our cancer coverage can help offer you and your family financial support. Benefits paid directly to you unless otherwise assigned Coverage for you or your entire family No evidence of insurability required at initial enrollment Waiver of premium after 90 days of disability due to cancer for as long as your disability lasts** benefit coverage highlights Cancer and specified disease benefits can help cover the costs of specific treatments and expenses as they happen. Terms and conditions for each benefit will vary. Benefit amounts are shown on page 12. See pages 23 and 24 for limits and conditions. Specified Diseases - Amyotrophic Lateral Sclerosis (Lou Gehrig s Disease), Muscular Dystrophy, Poliomyelitis, Multiple Sclerosis, Encephalitis, Rabies, Tetanus, Tuberculosis, Osteomyelitis, Diphtheria, Scarlet Fever, Cerebrospinal Meningitis, Brucellosis, Sickle Cell Anemia, Thallasemia, Rocky Mountain Spotted Fever, Legionnaire s Disease, Addison s Disease, Hansen s Disease, Tularemia, Hepatitis (Chronic B or C), Typhoid Fever, Myasthenia Gravis, Reye s Syndrome, Primary Sclerosing Cholangitis (Walter Payton s Disease), Lyme Disease, Systemic Lupus Erythematosus, Cystic Fibrosis, and Primary Biliary Cirrhosis. Includes coverage for 29 other specified diseases Portable Enrolling after your initial enrollment period requires evidence of insurability HOSPITAL AND RELATED BENEFITS Continuous Hospital Confinement - Pays for each day of inpatient confinement. Government or Charity Hospital - Pays for each day of inpatient confinement to a U.S. government hospital or a hospital that does not charge for its services. In lieu of all other benefits. Private Duty Nursing Services - Pays daily when receiving physicianauthorized inpatient private nursing services. Extended Care Facility - Pays daily for physician-authorized inpatient confinement (within 14 days of a hospital stay). Page 10 of 28 ABJ23676X *The example shown may vary from the plan your employer is offering. Your individual experience may also vary. **Primary insured only.

11 In the U.S., men have slightly less than a 1 in 2 lifetime risk of developing cancer; for women, the risk is a little more than 1 in Cancer Facts & Figures, American Cancer Society, At Home Nursing - Pays daily for physician-authorized private nursing care (up to the number of days of the previous hospital stay). Hospice Care - Pays when a physician determines terminal illness and approves hospice care at home (1 visit per day) or in a freestanding hospice care center. RADIATION, CHEMOTHERAPY AND RELATED BENEFITS Radiation/Chemotherapy for Cancer - Pays for covered treatment to destroy or modify cancerous tissue. Blood, Plasma, and Platelets - Pays for blood, plasma, and platelets. Includes charges for transfusions, administration, processing, procurement and cross-matching. Does not include donor replaced blood or immunoglobulins. Medical Imaging - Pays for an initial diagnosis or follow-up evaluation. Hematological Drugs - Pays for drugs to boost cell lines when Radiation and Chemotherapy benefit is paid. SURGERY AND RELATED BENEFITS Surgery* - Pays for an inpatient or outpatient operation listed in the Schedule of Surgical Procedures. Anesthesia - Pays 25% of surgery benefit. Ambulatory Surgical Center - Pays for surgery at an ambulatory surgical center. Second Opinion - Pays for a second surgical opinion. Bone Marrow or Stem Cell Transplant - Pays for transplants. MISCELLANEOUS BENEFITS Inpatient Drugs and Medicine - Pays daily for inpatient drugs and medicine. Physician s Attendance - Pays daily for one inpatient visit. Ambulance - Pays for transfer by ambulance service to or from a hospital. Non-Local Transportation - Pays transportation for treatment not available locally (up to 700 miles). Outpatient Lodging - Pays daily for lodging when receiving radiation or chemotherapy on an outpatient basis non-locally (more than 100 miles from home). Family Member Lodging and Transportation - Pays daily for one adult family member when confined at a non-local hospital for specialized treatment (more than 100 miles from family member s home). Physical or Speech Therapy - Pays daily for physical or speech therapy to restore normal body function. New or Experimental Treatment - Pays for physicianapproved new or experimental treatments not paid under other benefits. Prosthesis - Pays for a prosthetic device that requires surgical implanting. Hair Prosthesis - Pays for a wig or hairpiece when hair loss is experienced. Nonsurgical External Breast Prosthesis - Pays for the initial nonsurgical breast prosthesis after a covered mastectomy. Anti-Nausea Benefit - Pays for prescribed anti-nausea medication administered on an outpatient basis. Waiver of Premium (primary insured only) - Pays premiums after disabled 90 days in a row due to cancer, for as long as disability lasts. ADDITIONAL BENEFITS Cancer Initial Diagnosis - Pays a one-time benefit if diagnosed for the first time with cancer (except skin cancer). Wellness - Pays each calendar year for one of the following: Biopsy for skin cancer; Blood tests for triglycerides, CA15-3 (breast cancer), CA125 (ovarian cancer), CEA (colon cancer) and PSA (prostate cancer); Bone Marrow Testing, Chest X-ray; Colonoscopy; Doppler screenings for carotids and peripheral vascular disease; Echocardiogram; EKG; Flexible sigmoidoscopy; Hemocult stool analysis; HPV Vaccination; Lipid panel (total cholesterol count); Mammography, including Breast Ultrasound; Pap Smear, including ThinPrep Pap; Serum Protein Electrophoresis (test for myeloma); Stress test on bike or treadmill; Thermography; and Ultrasound screening for abdominal aortic aneurysms. Intensive Care - Pays daily for Intensive Care Unit Confinements (up to 45 days for each stay), Step-down Intensive Care Unit Confinements (up to 45 days for each stay) and air or surface ambulance to a hospital intensive-care unit. *Two or more surgeries done at the same time are considered one operation. The operation with the largest benefit will be paid. Outpatient is paid at 150% of the amount listed in the Schedule of Surgical Procedures. ABJ23676X Page 11 of 28

12 HOSPITAL AND RELATED BENEFITS LOW MEDIAN HIGH Continuous Hospital Confinement (daily) $200 $300 $400 Government or Charity Hospital (daily) $200 $300 $400 Private Duty Nursing Services (daily) $200 $300 $400 Extended Care Facility (daily) $200 $300 $400 At Home Nursing (daily) $200 $300 $400 Hospice Care Center (daily) 1. $ $ $400 Hospice Care Team (per visit) 2. $ $ $400 RADIATION, CHEMOTHERAPY & RELATED BENEFITS Radiation/Chemotherapy for Cancer (every 12 mos.) $5,000* $10,000* $15,000* Blood, Plasma, and Platelets (every 12 mos.) $5,000* $10,000* $15,000* Medical Imaging (yearly) $250* 5 $500* 5 $750* 5 Hematological Drugs (yearly) $100* $200* $300* SURGERY AND RELATED BENEFITS Surgery $1,500* 3 $3,000* 3 $4,500* 3 Anesthesia (% of surgery) 25% 25% 25% Ambulatory Surgical Center (daily) $250 $500 $750 Second Opinion $200 $400 $600 Bone Marrow or Stem Cell Transplant 1. Autologous 1. $ $1, $1, Non-autologous 2. $1, $2, $3, Non-autologous for leukemia 3. $2, $5, $7,500 5 MISCELLANEOUS BENEFITS Inpatient Drugs and Medicine (daily) $25 $25 $25 Physician s Attendance (daily) $50 $50 $50 Ambulance (per confinement) $100 $100 $100 Non-Local Transportation (per trip or mile) Coach Fare Coach Fare Coach Fare or $0.40 or $0.40 or $0.40 Outpatient Lodging (daily) $50* 2 $50* 2 $50* 2 Family Member Lodging (daily) $50* $50* $50* and Transportation (per trip or mile) Coach Fare Coach Fare Coach Fare or $0.40 or $0.40 or $0.40 Physical or Speech Therapy (daily) $50 $50 $50 New or Experimental Treatment (every 12 mos.) $5,000* $5,000* $5,000* Prosthesis $2,000* 4 $2,000* 4 $2,000* 4 Hair Prosthesis (every 2 years) $25 $25 $25 Nonsurgical External Breast Prosthesis $50* $50* $50* Anti-Nausea Benefit (yearly) $200* $200* $200* Waiver of Premium (primary insured only) Yes Yes Yes ADDITIONAL BENEFITS Cancer Initial Diagnosis $2,000 6 $4,000 6 $6,000 6 Wellness (yearly) $100 5 $100 5 $100 5 Intensive Care 1. Intensive Care Confinement (daily) 1. $ $ $ Step-down Confinement (daily) 2. $ $ $ Air/Surface Ambulance 3. Charges 3. Charges 3. Charges * Benefit pays for charges/costs up to amount listed 2 Limit $2,000/12 mo. period 3 Based on procedure up to maximum shown 4 Per amputation 5 Payable once/covered person/calendar year 6 One time benefit Page 12 of 28 ABJ23676X

13 premiums MODE PLAN EE EE + SP EE + CH F Semi-Monthly Low $8.47 $13.44 $11.69 $16.65 Median $14.32 $22.58 $20.24 $28.50 High $20.17 $31.72 $28.81 $40.34 EE = Employee; EE + SP = Employee + Spouse; EE + CH = Employee + Children; F = Family. Issue Ages: 18 and over if Actively at Work ABJ23676X Page 13 of 28

14 group voluntary critical illness AB group voluntary critical illness coverage provides a lump-sum cash benefit to help you cover the out-of-pocket expenses associated with a critical illness. No one knows what lies ahead on the road through life. Will you be diagnosed with Alzheimer s or Parkinson s? Will you suffer a stroke, heart attack or the complete loss of hearing? The signs pointing to a critical illness are not always clear and may not be preventable, but our coverage can help offer financial protection in the event you are diagnosed. Critical illness coverage can offer peace of mind when a critical illness diagnosis occurs. Below is an example of how benefits might be paid.* John chooses coverage from the plan benefits his employer is offering Three months after his annual wellness exam he has a heart attack. 3 yrs. later - John suffers another heart attack. Four months later he has Coronary Artery By-Pass Surgery. Our critical illness insurance policy would provide the following: Wellness Benefit $100 Heart Attack Benefit $10,000 Second Event Benefit $10,000 By-Pass Surgery Benefit $ 2,500 Total cash benefits $22,600 John s prognosis is good and he is expected to make a full recovery i meeting your needs Our coverage can help meet the needs of you and your family by offering financial support when it is needed most: Benefits and coverage amounts have been selected by your employer to make it easy to choose a plan that meets your needs** Covered dependents receive 50% of your basic-benefit amount Benefits paid directly to you Coverage supplements any existing medical benefits Premiums are affordable Portable your benefit coverage A percentage of the basic-benefit amount is payable for each covered person in the Initial Critical Illness benefits, Cancer Critical Illness benefits, Supplemental Critical Illness benefits, Second Event Initial Illness Benefit, and Additional benefits. Benefit amounts are shown on page 16. See pages 24 and 25 for conditions and requirements. INITIAL CRITICAL ILLNESS BENEFITS Heart Attack (100%) - Pays when you have a heart attack. Stroke (100%) - Pays when you have a stroke. Coronary Artery By-Pass Surgery (25%) - Pays when you have coronary artery bypass surgery. Major Organ Transplant (100%) - Pays when you have a heart, lung, liver, pancreas or kidney transplant (must be a human donor). End Stage Renal Failure (100%) - Pays when you have peritoneal dialysis or hemodialysis. Waiver of Premium (Employee only) - Pays your premium if you are disabled for 90 days in a row, due to a critical illness, as long as the disability lasts, up to 2 years. Page 14 of 28 ABJ23676X *The example shown may vary from the plan your employer is offering. Your individual experience may also vary. Please see page 16 for your plan details. **Amounts over the guaranteed issue amount or enrolling after your initial enrollment period requires evidence of insurability.

15 Stroke is the leading cause of serious, long-term disability in the United States Heart Disease and Stroke Statistics update, American Heart Association. CANCER CRITICAL ILLNESS BENEFITS Invasive Cancer (100%) - Pays when you are diagnosed with invasive cancer (includes Leukemia and Lymphoma). Carcinoma in Situ (25%) - Pays when you are diagnosed with cancer in situ. CRITICAL ILLNESS ADDITIONAL BENEFIT Second Event Initial Critical Illness Benefit - Pays when you are diagnosed for the second time with a previously paid Initial Critical Illness Benefit. SUPPLEMENTAL CRITICAL ILLNESS BENEFITS II Advanced Alzheimer s Disease (25%) - Pays when you are diagnosed with Advanced Alzheimer s. Advanced Parkinson s Disease (25%) - Pays when you are diagnosed with Advanced Parkinson s. Benign Brain Tumor (100%) - Pays when you are diagnosed with a brain tumor. Coma (100%) - Pays when you are unconscious more than 14 consecutive days, due to sickness or brain injury (a medically induced coma is not covered). Complete Blindness (100%) - Pays when you are diagnosed with irreversible loss of sight in both eyes. Complete Loss of Hearing (100%) - Pays when you are diagnosed with total and irreversible loss of hearing in both ears. Paralysis (100%) - Pays when you suffer a complete and permanent loss of use of two or more limbs. ADDITIONAL BENEFITS Increasing Critical Illness Benefit - Increases the basicbenefit amount you have chosen on the first 5 coverage year anniversaries. Return of Premium Layoff Rider - Returns the total premiums paid if you lose your job due to layoff during the first 6 months while coverage is in force provided here has been no claim incurred. Wellness Benefit - Pays annually when you receive one of the following: Biopsy for skin cancer Blood test for triglycerides Bone Marrow Testing CA15-3, CA125 and CEA (blood tests for breast, ovarian and colon cancer) Chest X-ray Colonoscopy Doppler screenings for carotids and peripheral vascular disease Echocardiogram EKG (Electrocardiogram) Flexible sigmoidoscopy Hemocult stool analysis HPV Vaccination (Human Papillomavirus) Lipid panel (total cholesterol count) Mammography, including Breast Ultrasound Pap Smear, including ThinPrep Pap Test PSA (prostate specific antigen blood test for prostate cancer) Serum Protein Electrophoresis (test for myeloma) Stress test on bike or treadmill Thermography Ultrasound (screening for abdominal aortic aneurysms) ABJ23676X Page 15 of 28

16 benefit amounts INITIAL CRITICAL ILLNESS BENEFITS LOW A MEDIAN A HIGH A Heart Attack (100%) $10,000 $15,000 $20,000 Stroke (100%) $10,000 $15,000 $20,000 Coronary Artery By-Pass Surgery (25%) $2,500 $3,750 $5,000 Major Organ Transplant (100%) $10,000 $15,000 $20,000 End Stage Renal Failure (100%) $10,000 $15,000 $20,000 Waiver of Premium (Employee only) Yes Yes Yes CANCER CRITICAL ILLNESS BENEFITS Invasive Cancer (100%) $10,000 $15,000 $20,000 Carcinoma in-situ (25%) $2,500 $3,750 $5,000 CRITICAL ILLNESS ADDITIONAL BENEFIT Second Event Initial Critical Illness Benefit 14 Yes Yes Yes SUPPLEMENTAL CRITICAL ILLNESS BENEFITS II Advanced Alzheimer s Disease (25%) $2,500 $3,750 $5,000 Advanced Parkinson s Disease (25%) $2,500 $3,750 $5,000 Benign Brain Tumor (100%) $10,000 $15,000 $20,000 Coma (100%) $10,000 $15,000 $20,000 Complete Blindness (100%) $10,000 $15,000 $20,000 Complete Loss of Hearing (100%) $10,000 $15,000 $20,000 Paralysis (100%) $10,000 $15,000 $20,000 ADDITIONAL BENEFITS Wellness Benefit (per year) $75 $100 $100 Return of Premium Layoff Rider Yes Yes Yes Increasing Critical Illness Benefit 15 (per year) $1,000 $1,000 $1,000 OPTIONAL BENEFIT* LOW B MEDIAN B HIGH B Increasing Critical Illness Benefit 15 (per year) $1,000 $1,000 $1, Pays same amount as Initial Critical Illness Benefit 15 For years 2-5 * Pays in addition to Plan A semi-monthly premiums LOW A PLAN - $10,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $5.53 $8.57 $5.53 $ $12.88 $19.60 $12.88 $ $26.75 $40.39 $26.75 $ $42.01 $63.29 $42.01 $ $62.59 $94.16 $62.59 $94.16 EE = Employee; EE + SP = Employee + Spouse; EE + CH = Employee + Children; F = Family $8.57 $13.14 $8.57 $ $21.31 $32.24 $21.31 $ $44.47 $66.97 $44.47 $ $64.64 $97.24 $64.64 $ $96.65 $ $96.65 $ Issue Ages: 18 and over if Actively at Work Additional premiums on page 17. Page 16 of 28 ABJ23676X

17 semi-monthly premiums LOW B PLAN - $10,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $6.50 $10.03 $6.50 $ $15.67 $23.78 $15.67 $ $32.94 $49.68 $32.94 $ $51.96 $78.22 $51.96 $ $77.63 $ $77.63 $ $10.30 $15.72 $10.30 $ $26.17 $39.53 $26.17 $ $55.02 $82.81 $55.02 $ $80.18 $ $80.18 $ $ $ $ $ MEDIAN A PLAN - $15,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $8.74 $14.24 $8.74 $ $18.87 $29.44 $18.87 $ $37.96 $58.07 $37.96 $ $58.97 $89.58 $58.97 $ $87.30 $ $87.30 $ $12.93 $20.52 $12.93 $ $30.47 $46.84 $30.47 $ $62.35 $94.65 $62.35 $ $90.13 $ $90.13 $ $ $ $ $ MEDIAN B PLAN - $15,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $9.71 $15.70 $9.71 $ $21.66 $33.62 $21.66 $ $44.15 $67.36 $44.15 $ $68.92 $ $68.92 $ $ $ $ $ $14.66 $23.11 $14.66 $ $35.33 $54.13 $35.33 $ $72.91 $ $72.91 $ $ $ $ $ $ $ $ $ HIGH A PLAN - $20,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $10.24 $16.49 $10.24 $ $23.14 $35.85 $23.14 $ $47.47 $72.32 $47.47 $ $74.22 $ $74.22 $ $ $ $ $ $15.57 $24.50 $15.57 $ $37.92 $58.01 $37.92 $ $78.53 $ $78.53 $ $ $ $ $ $ $ $ $ HIGH B PLAN - $20,000 BASIC BENEFIT AMOUNT non-tobacco tobacco AGES EE EE + SP EE + CH F AGES EE EE + SP EE + CH F $11.21 $17.95 $11.21 $ $25.93 $40.02 $25.93 $ $53.66 $81.61 $53.66 $ $84.18 $ $84.18 $ $ $ $ $ EE = Employee; EE + SP = Employee + Spouse; EE + CH = Employee + Children; F = Family $17.30 $27.08 $17.30 $ $42.78 $65.30 $42.78 $ $89.09 $ $89.09 $ $ $ $ $ $ $ $ $ Issue Ages: 18 and over if Actively at Work ABJ23676X Page 17 of 28

18 group voluntary disability AB group voluntary disability coverage provides a monthly cash benefit when you suffer a sickness or off-the-job injury that leaves you totally disabled or partially disabled. You can t predict if or when you will become disabled in your lifetime. But you can plan for a disability by having coverage in place to help provide an income should you become disabled due to a sickness or injury and are unable to work. Our coverage can help provide a monthly income when it is needed most. Disability benefits can offer peace of mind when a disability occurs. Below is an example of how benefits might be paid. * Jane and John are offered group disability coverage by their employer Jane chooses $3,000 in disability coverage, plus the On-the-Job Accident Disability and Survivor and Accident riders. 8 months later, she suffers a disabling injury due to a work related auto injury, is taken to the emergency room, hospitalized (2 days), is disabled for 6 months, but is expected to make a full recovery. 10 John declines coverage. 6 months later he suffers a disabling back injury, is rushed to the hospital by ambulance, treated, hospitalized (2 days), and is disabled for 4 months. 10 In addition to her medical coverage our disability insurance provided Jane the following: On-the-Job Accident Disability Rider Monthly Benefit - $3,000. Because she had Allstate Auto Insurance her Survivor and Accident Rider Benefit paid a one-time benefit of $3,000. John does not have disability coverage. His medical coverage will pay for a portion of his hospital expenses, but his monthly expenses while out of work will be paid out of his own pocket. i meeting your needs Our coverage offers support during a period of unexpected sickness or an off-the-job injury. Choose a guaranteed issue maximum ** monthly benefit ranging from $400 - $5,000, up to 60%*** of income A benefits representative may help you determine the following: Maximum Monthly Benefit: Maximum Benefit Period: Elimination Periods: Accident: Sickness: Premium: Benefits start the first day after the elimination (waiting) period, when you are totally disabled and cannot work your benefit coverage Terms and conditions for each benefit vary. 11 Please review your coverage carefully. Total Disability - Pays for total disability that begins while actively at work. Monthly benefit starts after the waiting period. Benefits continue while totally disabled up to the maximum benefit period. Partial Disability - Pays 50% of the monthly benefit when partially disabled immediately after at least one month of total disability. Payments continue while partially disabled for up to 3 months, but not beyond the maximum benefit period. Pregnancy - Pays for pregnancy if total disability first begins after your coverage has been in force for at least 9 months. Organ Donor - Pays when disabled from donating an organ to another. Waiver of Premium - Pays your premium after monthly disability benefits are payable for 30 days in a row, for as long as monthly benefits are payable. **You must apply during your initial enrollment period to be eligible. If enrolling after your enrollment period evidence of insurability will be required. ***May be less depending on state. Page 18 of 28 ABJ23676X *The example shown may vary from the plan your employer is offering. Your individual experience may also vary. 10 This example assumes that Jane and John have medical insurance and did not receive disability income from other sources during the same time period. 11 See page 25 for conditions and limits.

19 Nine out of 10 deaths and nearly three-fourths of the disabling injuries suffered by workers occurred off the job Injury Facts 2010 Edition, National Safety Council. RIDER BENEFITS Return of Premium Due to Layoff - Provides a refund of premiums if laid off during the first six months of coverage. Must surrender coverage. On-the-Job Accident Disability* - Pays for total disability from an on-the-job injury that begins while actively at work. Monthly benefit starts after the waiting period and continue while totally disabled up to the length of the benefit period. Pays 50% of the monthly benefit if you receive workers compensation or other state disability benefit. Family Medical Leave and Doula Services Family Medical Leave Benefit - Pays if you take leave to give full-time care for a family member or for your own health condition. Leave must be for at least 7 days in a row and up to 12 weeks a year. Doula Services Benefit - Pays for one of the following: Antepartum, Childbirth, or Postpartum up to 1 time per year. Increasing Benefit Period - Increases the maximum benefit period by 1 month each year you keep your coverage, for up to 6 increases. Survivor and Accident Survivor Death Benefit - Pays a benefit equal to 3 times your monthly disability benefit if you die while receiving disability benefits for a sickness disability or die due to an accident within 180 days of the accident. Allstate Auto Benefit - Pays a benefit equal to one monthly disability benefit if you receive a disability benefit for an accident in a vehicle insured by an Allstate auto policy. The disability must start within 180 days of the accident. *Benefits for disabilities covered by Workers Compensation reduced 50%. ABJ23676X Page 19 of 28

20 group universal life Best in Benefits Series AB group universal life provides a lump-sum cash benefit upon death. Plus, life-event riders can be added to provide coverage for terminal illness, premium waiver for disability, long-term care, and more. Life insurance coverage is for the living; those left behind must deal with final expenses, bills, mortgage, and expenses associated with day-to-day life. It can also help provide financial security during life-changing events that occur as you age and your needs change. Plus, fund value accumulation allows for loans and withdrawals when needed. Life coverage helps offer peace of mind during life s changing events. Below is an example of how life insurance benefits might be paid. John and Jane choose coverage from the plan benefits their employer is offering Married Single John chooses a $150,000 face amount, plus riders. His goal is to protect his family and help pay debts should he die unexpectedly Jane chooses an $80,000 face amount, plus riders. Her goal is to build fund value, prepare for longterm care and provide for final expenses }While John is out of town } visiting friends he is in an automobile accident, suffers extensive injuries, and dies on the way to the hospital. } }Jane is in an auto accident resulting in extensive injuries and requiring the need for long-term care Our life insurance coverage provided the following for John s family Life Insurance $150,000 Accidental Death Benefit $150,000 Term Insurance $015,000 Total Cash Benefits $215,000 Our life insurance coverage provided the following for Jane s long-term care Long-Term Care $3,200 Total Monthly Benefit $3,200 See Accelerated Death Benefit for Long- Term Care conditions on next page. i meeting your needs prepare for the future today Our coverage can help provide security for you and your family s financial future. Up to $150,000 of coverage guaranteed issue*, or $250,000 with health questions to answer Family coverage** Optional rider coverage Affordable premiums Tax benefits*** Withdrawals and loans*** Portable coverage *For guaranteed issue, there are no health questions asked during initial enrollment period. After enrollment period, health questions are required. **Coverage for spouse and child(ren) is limited to a percentage of the insured s face amount in some states. Where do you see yourself 5 or 10 years from now getting married, having children, paying for your child s college education? What if your or a loved one s life was cut short by an unexpected death? How would you, your spouse or your children survive financially? Losing a loved one can be devastating. Final expenses and daily bills shouldn t add to the stress. Our coverage may be used to: pay off a mortgage or debts, provide for child care or educational expenses, or replace income to continue the same standard of living. how it works - You decide what benefit amount is right for you and your family. Your premium payments are deducted from your paycheck and added to the fund value which earns interest at a rate of no less than 4.0% annually. Each month, AB will deduct expenses and cost of insurance charges from the fund, leaving any excess money to earn interest. The interest is not taxed as income until it is withdrawn.*** fund value and premium payments - Over time, as you continue to pay your premium, your fund value may grow. Monthly premiums are flexible, meaning you can choose to pay as much or as little as you can afford, subject to policy minimums and maximums. Page 20 of 28 ABJ23676X The example shown may vary from the plan your employer is offering. Your individual experience may also vary. ***Partial withdrawals, surrenders and loans from life insurance policies may be subject to ordinary income taxes and possibly an additional 10% federal tax penalty. Outstanding loan balances and withdrawals generally reduce the death benefit and cash value. With proper planning, the death benefit can pass to your beneficiaries free from state or federal estate taxes. Please consult with your tax advisor for specific information. It is possible that coverage will expire when either: no premiums are paid following the initial premium, or subsequent premiums are insufficient to continue coverage.