LONG TERM DISABILITY BENEFIT INFORMATION HC13GPIN 16 B-21114 (11/25) • The amount that you receive as retirement payments or the amount your spouse and your children receive as retirement payments because you are receiving retirement payments under: – The United States Social Security Act. – The Canada Pension Plan. – The Quebec Pension Plan. – Any similar Plan or Act. • The amount you receive from any form of employment. • The amount you receive from any unemployment compensation law. • The amount that you receive, or are eligible to receive, under: – A workers' compensation law. – An occupational disease law. – Any other act or law with similar intent. With the exception of retirement payments, we will only subtract deductible sources of income which are payable as a result of the same disability. We will not reduce your payment by your Social Security retirement income if your disability begins after age 65 and you were already receiving Social Security retirement payments. COST OF LIVING INCREASES FOR DEDUCTIBLE SOURCES OF INCOME Other than for increases in any income you earn from any form of employment, once we have subtracted any deductible sources of income from your gross monthly payment, we will not further reduce your payment due to a cost of living increase from that source. IF YOU QUALIFY FOR DEDUCTIBLE SOURCES OF INCOME When we determine that you may qualify for benefits for which you are eligible in the deductible sources of income provision, we will estimate your entitlement to these benefits. We can reduce your benefit under the policy by the estimated amounts if such benefits have either: • Not been awarded or denied. • Been denied and the denial is being appealed. Your gross monthly payment will NOT be reduced by the estimated amount if both of the following are true: • You apply for the disability payments for which you are eligible in the deductible sources of income provision and appeal your denial to all administrative levels we determine are necessary. • You sign our form. This form states that you promise to pay us any overpayment caused by an award and we shall be entitled to impose a constructive trust on any such award. If your gross monthly payment has been reduced by an estimated amount, your gross monthly payment will be adjusted when we receive either of the following: • Proof of the amount awarded. • Proof that benefits have been denied and all appeals we determine necessary have been completed. In this case, a lump sum refund of the estimated amount will be made to you. If you receive a lump sum payment from any deductible source of income, the lump sum will be pro-rated on a monthly basis over the time period for which the sum was given. If no time period is stated, the sum will be pro-rated on a monthly basis from the date of the award over your expected lifetime as determined by us.