RL-CI4-WELL2-20-IN 1 WELL-12969 (11/25) SCHEDULE OF BENEFITS WHO PAYS FOR THE COVERAGE The cost of coverage under this rider is automatically included in the cost of your coverage and the cost of your Spouse's coverage and the cost of your Children's coverage. WELLNESS BENEFIT DEFINITIONS General terms are defined in the DEFINITIONS section of the Certificate and riders. Covered Person means:  You, if you are covered for Critical Illness insurance under the Policy.  Your Spouse if covered under the Spouse Critical Illness Rider.  Your Children if covered under the Children’s Critical Illness Rider. WELLNESS BENEFIT RIDER RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CCI2 This rider is made a part of the Group Critical Illness Insurance Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate, unless changed by this rider. Unless expressly changed by this rider, the terms used in this rider have the same meaning as in the Certificate. CONTENTS Section Page Schedule of Benefits............................................................................................... 1 Definitions............................................................................................................... 1 General Provisions................................................................................................. 2 Benefits.................................................................................................................. 2 Claims.................................................................................................................... 3 You: $50 Your Spouse: $50 Your Children: 100% of your wellness benefit amount per Child A wellness benefit is payable up to a maximum of one time per Covered Person per calendar year.