E M P LO Y E R B E N E F I T S O LU T I O N S F O R E D U C AT I O N AF™ Limited Benefit Individual Cancer Insurance Riders Enhance Your Plan+,++ SCHEDULE OF BENEFITS Cancer Benefit per unit - maximum $10,000 $2,500 Heart Attack/Stroke Benefit per unit - maximum $10,000 $2,500 +Availability of riders may vary by state and employer. Optional benefit riders are subject to our general underwriting guidelines and coverage is not guaranteed. ++The premium and amount of benefits provided vary based upon the plan selected. Summary of Critical Illness Rider Benefits: • Pays when diagnosed by a Physician after the covered persons effective date of coverage with Internal Cancer or Heart Attack/Stroke, depending upon the Critical Illness coverage elected at time of application. • Pays the specified Maximum Benefit Amount per Covered Critical Illness, as defined under this rider. • Each benefit is a one-time paid benefit. • All Critical Illness amounts reduce by 50% at age 70. Hospital Intensive Care Unit Rider SCHEDULE OF BENEFITS ICU Confinement Benefit per day up to 30 days per confinement $600 Ambulance Benefit per admission in an ICU $100 Summary of Hospital ICU Rider Benefits: • Confinement must be due to an accident or sickness and begin after the effective date of coverage under this rider. • A day is defined as a 24-hour period. • If confined to an ICU for a portion of a day, a pro rata share of the daily benefit will be paid. • For ambulance charges, $100 for transportation to a Hospital where the Covered Person is admitted to an ICU within 24 hours of arrival. • All ICU and Ambulance amounts reduce by 50% at age 70. CANCER ONLY $2,500 $5,000 $7,500 $10,000 Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Age 18-40 $1.50 $2.20 $2.90 $3.00 $4.40 $5.80 $4.50 $6.60 $8.70 $6.00 $8.80 $11.60 Age 41-50 $3.00 $4.50 $5.80 $6.00 $9.00 $11.60 $9.00 $13.50 $17.40 $12.00 $18.00 $23.20 Age 51-60 $4.90 $7.30 $9.40 $9.80 $14.60 $18.80 $14.70 $21.90 $28.20 $19.60 $29.20 $37.60 Age 61+ $7.10 $10.60 $13.80 $14.20 $21.20 $27.60 $21.30 $31.80 $41.40 $28.40 $42.40 $55.20 HEART ATTACK/ STROKE ONLY $2,500 $5,000 $7,500 $10,000 Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Ind 1 Parent Family 2 Parent Family Age 18-40 $0.80 $1.20 $1.50 $1.60 $2.40 $3.00 $2.40 $3.60 $4.50 $3.20 $4.80 $6.00 Age 41-50 $2.10 $3.10 $4.10 $4.20 $6.20 $8.20 $6.30 $9.30 $12.30 $8.40 $12.40 $16.40 Age 51-60 $3.10 $4.60 $6.00 $6.20 $9.20 $12.00 $9.30 $13.80 $18.00 $12.40 $18.40 $24.00 Age 61+ $4.60 $6.90 $8.90 $9.20 $13.80 $17.80 $13.80 $20.70 $26.70 $18.40 $27.60 $35.60 Critical Illness Rider Optional Benefit Rider Monthly Premiums++ HOSPITAL INTENSIVE CARE UNIT RIDER Age 18–40 Age 41–50 Age 51–60 Age 61+ Individual $3.40 $4.20 $5.50 $7.10 Single Parent Family $5.10 $6.30 $8.20 $10.60 Family $6.60 $8.20 $10.70 $13.80 Critical Illness Rider Monthly Premiums Hospital Intensive Care Unit Rider Monthly Premiums