WELLNESS BENEFIT We will pay the amount shown on the Schedule of Benefits for one health screening test performed during a 12 month period for each Insured, up to a maximum of four benefits per family, provided he/she: (1) supplies written proof satisfactory to us that such a health screening test has been performed; and (2) was covered under this Policy at the time the test was performed; and (3) has not already had one of the following health screening tests performed at any time during the same 12 month period. Health screening tests covered under this Policy are: (1) ALT/AST (liver function test); (2) Biopsy for cancer; (3) Blood test for triglycerides; (4) Bone density testing (DEXA scan); (5) Bone marrow testing; (6) CA 15-3 (blood test for breast cancer); (7) CA 125 (blood test for ovarian cancer); (8) CEA (blood test for colon cancer); (9) Chest X-ray; (10) Colonoscopy; (11) Echocardiogram; (12) Electrocardiogram; (13) Fasting blood glucose test; (14) Flexible sigmoidoscopy; (15) Genetic tests; (16) Hemoccult stool analysis; (17) Hepatitis screening; (18) Human Immunodeficiency Virus (HIV) screening; (19) Mammography; (20) Pap test; (21) PSA (blood test for prostate cancer); (22) Serum cholesterol test to determine level of HDL and LDL; (23) Serum Protein Electrophoresis (blood test for myeloma); (24) Skin cancer screening; (25) Stress test; (26) Ultrasound screening (of the breast, of the abdominal aorta for abdominal aortic aneurysms, of carotid arteries (carotid doppler), or for cancer detection); and (27) Any other preventative health screenings, including, but not limited to, tests, diagnostic procedures, routine examinations and immunizations. The Wellness Benefit is paid in addition to any other benefits the Insured may receive under this Policy. LRS-9537-10-0118 Page 10.0