Open Class Retirees 1 RD12995 ELIGIBLE CLASS(ES) Class 4: Retired Administrators under age 65 who are receiving retirement benefits under an eligible retirement plan sponsored by the Employer. Class 5: Retired Administrator Age 65 to Age 70 Option 1 who are receiving retirement benefits under an eligible retirement plan sponsored by the Employer. Class 6: Retired Administrator Age 65 to Age 75 Option 2 who are receiving retirement benefits under an eligible retirement plan sponsored by the Employer. You must be an Employee of the Employer and in an eligible class. BASIC LIFE INSURANCE Basic life insurance is Noncontributory by Employees. Eligible Class(es) Amount Class 4 Retirees Class 5 Retirees Class 6 Retirees 1 times your Basic Yearly Earnings, coverage terminates at age 75 0.5 times your Basic Yearly Earnings, coverage terminates at age 75 0.25 times your Basic Yearly Earnings, coverage terminates at age 75 RELIASTAR LIFE INSURANCE COMPANY Minneapolis, Minnesota CERTIFICATE ENDORSEMENT SCHEDULE OF BENEFITS The SCHEDULE OF BENEFITS in your Certificate D12995 includes this Schedule of Benefits. Please keep this Schedule of Benefits with your Certificate. This Schedule of Benefits is subject to all other terms of the Certificate. EMPLOYER(S): Noblesville Schools GROUP POLICY NUMBER: 73058-1GAT2 Applicable only to All Eligible Retirees in Class 4, Class 5 or Class 6 An insurance amount that does not equal an increment of $1,000 is rounded to the next higher $1,000.