917800 Critical Illness (12) 01.01.2024

Critical Illness Insurance Y HELPS PROTECT YOUR FINANCES FROM AN ILLNESS. When you, your spouse or child is diagnosed with a covered condition, you can receive a cash benefit to help pay unexpected costs not covered by your health plan. HELPS COVER RELATED EXPENSES. While health plans may cover direct costs associated with a critical illness, you can use your benefit to help with related expenses like lost income, child care, travel to and from treatment, deductibles and co-pays. PAYS A CASH BENEFIT DIRECTLY TO YOU. Critical Illness insurance can be used however you want, and it pays in addition to any other coverage you may already have. What’s more, all family members on your plan are eligible for a wellness-screening benefit, also paid directly to you once each year per covered person. BENEFITS (You can purchase this coverage at a group rate.) Included: For you You can choose between $5,000 and $20,000 of coverage, in increments of $5,000. No medical questions asked. Health Navigator Help Your benefit amount is reduced to 50% at age 70. Line for expert guidance with health needs and For your If you elect coverage for yourself, you can choose medical billing questions. spouse between $2,500 and $10,000 of coverage, in increments of $2,500. No medical questions asked. Not to exceed 50% of your coverage amount. The benefit may be reduced when the employee benefit amount is reduced. For your If you elect coverage for yourself, you can choose $2,500 child(ren) or $5,000 of coverage. No medical questions asked. Not to exceed 50% of your coverage amount. The benefit may be reduced when the employee benefit amount is reduced. An eligible child is defined as your child from birth to age DEPAUW UNIVERSITY 26. All Eligible Employees POLICY #: 917800 Sun Life Assurance Company of Canada 2389889 SEQ2 CL1 03/19/2024 07:50:05 800-247-6875 • sunlife.com/us Critical Illness Insurance

What’s covered Once your coverage goes into effect, you can file a claim for covered conditions diagnosed after your insurance plan’s effective date. Below is the full list of conditions. COVERED CONDITIONS – The plan pays 100% of the benefit amount unless stated otherwise. R R Core Heart Attack Stroke Conditions R R End-Stage Kidney Disease Coronary Artery Bypass Graft (Pays 25%) R Occupational HIV/Hepatitis B, C, or D Angioplasty (Pays 5%) R Major Organ Failure Cancer Invasive Cancer Conditions Noninvasive Cancer (Pays 25%) Skin Cancer (Pays 5%) Other Complete Blindness Severe Burns Conditions Complete Loss of Hearing Advanced ALS/Lou Gehrig's Disease Loss of Speech Advanced Parkinson's Disease (Pays 25%) Benign Brain Tumor Advanced Alzheimer's Disease (Pays 25%) Coma Paralysis Childhood Conditions Down Syndrome Cerebral Palsy Applies to dependent Cystic Fibrosis Cleft Lip/Palate children only Type 1 Diabetes Mellitus Muscular Dystrophy Complex Congenital Heart Disease Spina Bifida Wellness Payable to any covered person on Employee $50 Screening Benefit your plan one time each year, once Spouse $50 you provide proof of an eligible Child $50 health screening. R = Recurrence Benefit available When would I need the Recurrence Benefit? Sometimes people are diagnosed with the same condition twice. If this happens to you, and 12 consecutive months have passed between the first and second diagnoses, we’ll pay you an additional benefit (the amount of which is noted in your Certificate). Only the conditions marked (R) in the table above are eligible for the Recurrence Benefit. Once a Recurrence Benefit has been paid, no additional benefit will be paid for that critical illness. 800-247-6875 • sunlife.com/us Critical Illness Insurance

Frequently asked questions Y Do I need to answer any health questions to enroll? Can I receive benefits for more than one critical If you contribute to the cost of your insurance, you may illness? need to complete health questions if you don’t elect Yes. In order to receive benefits for more than one coverage when it’s first available to you and you want critical illness, there must be at least 6 consecutive to elect at a later date, or if you want to increase months between each diagnosis date. You can only coverage. To answer health questions, please fill out claim benefits once for each covered condition unless a our Evidence of Insurability application. Health recurrence benefit is payable. questions must be approved by Sun Life before How is my benefit taxed? coverage takes effect. Please see your Certificate for If you or your employer pay for all or part of the cost of details. coverage on a pre-tax basis, some or all of your benefit What if I have a pre-existing condition? amount will be tax reported on a Form 1099 as taxable If you are diagnosed with a covered critical illness income. Please reach out to a tax advisor or your within 12 months of your insurance taking effect or 12 employer if you have any questions. months following any increase in your amount of Can I take my insurance with me if I leave my insurance, we will not pay any benefit for any pre- employer? existing condition. A pre-existing condition includes Depending upon state variations and your employer’s anything you have sought treatment for in the 6 plan, you may have an option to continue coverage months prior to your insurance becoming effective. when your employment terminates. Your employer can Treatment can include consultation, advice, care, advise you about your options. services or a prescription for drugs or medicine. How do I file a critical illness claim? If you have a diagnosis after the effective date of coverage, you can file a claim with us by downloading forms from our website. We’ll ask that you and your doctor provide information about your medical CRITICAL ILLNESS condition. FAST FACT How do I get the Wellness Screening Benefit? Most heart attack victims are You may be paid the benefit when you or a covered middle-aged or older; the risk of family member submit proof of a covered screening each year, like specific blood tests, cancer screenings, a heart attack climbs for men cardiac stress tests, immunizations, school sports exams after age 45 and for women and more (may vary by state). The claim form can also after age 55.** be downloaded from our website. **”What Are Your Odds of a Heart Attack?” health.com, June 2018. Critical Illness insurance is a limited benefit policy. The certificate has exclusions, limitations and benefit waiting periods for certain conditions that may affect any benefits payable. Benefits payable are subject to all terms and conditions of the certificate. Read the Important information section for more details including limitations and exclusions. 800-247-6875 • sunlife.com/us Critical Illness Insurance

Important information Y The following coverage(s) do not constitute Information about services offered comprehensive health insurance (often referred to as Value-added services are not insurance, are offered only on “major medical coverage”). They do NOT provide basic specific lines of coverage, and carry a separate charge, which hospital, basic medical, or major medical insurance. is added to the cost of the insurance. The cost is included in To become insured, you must meet the eligibility the total amount billed. requirements set forth by your employer. Your coverage Health Navigator Help Line is provided by PinnacleCare. effective date will be determined by the Policy and may be PinnacleCare is a member of the Sun Life Financial Inc. (“Sun delayed if you are not actively at work on the date your Life”) family of companies. PinnacleCare and its employees coverage would otherwise go into effect. Similarly, do not diagnose medical conditions, recommend treatment dependent coverage, if offered, may be delayed if your options or provide medical care, and any information or dependents are in the hospital (except for newborns) on services provided should not be considered medical advice. the date coverage would otherwise become effective. Refer Any medical decisions should be made only after to your Certificate for details. consultation with and at the direction of the medical Limitations and exclusions provider. Any person or entity who provides health care The below exclusions and limitations may vary by state law services following a referral or other service provided does so and regulations. This list may not be comprehensive. Please independently and not as an agent or representative of see your Certificate or ask your benefits administrator for PinnacleCare. details. Sun Life reserves the right to discontinue any of the Services Critical Illness at any time. Employers who provide group insurance We will not pay a benefit that is due to or results from coverage and make available value-added services within an services, treatment or complications not included in the I.R.C. Section 125 cafeteria plan should consult a tax Benefit Highlights; provided by an immediate family professional to determine whether those services are member; or unrelated to a Critical Illness/Specified Disease. Qualified Benefits for Section 125 plans. Value-added These include an autologous bone marrow transplant, services are not available in New York and may not be suicide, attempted suicide or intentionally self inflicted available in all other states. injuries, elective plastic or cosmetic surgery, active military This Overview is preliminary to the issuance of the duty, war, any act of war, or your active duty in any armed Policy. Refer to your Certificate for details. Receipt of service during a time of war (excluding during acts of this Overview does not constitute approval of coverage terrorism); your active participation in a riot, rebellion or under the Policy. In the event of a discrepancy between insurrection; committing or attempting to commit an this Overview, the Certificate and the Policy, the terms assault, felony or other criminal act; engaging in dangerous of the Policy will govern. Product offerings may not be conduct or hazardous activity where there is a likelihood of available in all states and may vary depending on state death or serious injury; being incarcerated in a penal laws and regulations. institution of any kind; being legally intoxicated or under the influence of any narcotic, unless taken on the advice of a physician and taken as prescribed. Covered conditions have specific diagnostic criteria that must be met (along with supporting documentation) for a benefit to be paid. For additional information regarding covered conditions, please request an outline of coverage. This product is inappropriate for individuals who are eligible for Medicaid coverage. Sun Life companies include Sun Life and Health Insurance Company (U.S.) and Sun Life Assurance Company of Canada (collectively, “Sun Life”). Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 12-GP-01, 15-GP-01, 12-SD-C-01, and 16-SD-C-01. © 2019 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. All rights reserved. Sun Life and the globe symbol are trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us. GVBH-EE-8384 SLPC 29579 800-247-6875 • sunlife.com/us Critical Illness Insurance

Rates Rates are effective as of January 1, 2024. Thechartbelowshowspossible coverage amountsand their monthly costs. Find your age bracket (as of the effective date of coverage) to see the cost for the coverage amount you choose. EmployeeCriticalIllness - Choice 1 Non-tobacco rates ! Age and cost- pay period(monthly) premium Coverage amounts

Rates Rates are effective as of January 1, 2024. Thechartbelowshowspossible coverage amountsand their monthly costs. Find your age bracket (as of the effective date of coverage) to see the cost for the coverage amount you choose. Spouse rates are based on the employee's age. SpouseCriticalIllness - Choice 1 Non-tobacco rates ! Age and cost- pay period(monthly) premium Coverage amounts