Allstate Benefits Group Whole Life Insurance (GWL) for Employee/Member with riders (when available for the issue age): Accelerated Death Benefit for Long Term Care with Extension of Benefits (GWCLTCE, GWCLTCE1)†, and Accelerated Death Benefit for Terminal Illness or Condition T O B A C C O P R E M I U M R A T E S A N D V A L U E S (These are GI quotes, unless otherwise noted) Face $20,000 $40,000 $60,000 $80,000 $100,000 Face Amount Amount Issue Biweekly CV @ age 65 Biweekly CV @ age 65 Biweekly CV @ age 65 Biweekly CV @ age 65 Biweekly CV @ age 65 This section intentionally This section intentionally Issue Age Premium or 10 years¹ Premium or 10 years¹ Premium or 10 years¹ Premium or 10 years¹ Premium or 10 years¹ left blank. left blank. Age 51 $38.62 $4,803 $77.26 $9,606 $115.88 $14,408 $154.50 $19,211 $193.12 $24,014 51 52 38.62 4,524 77.26 9,048 115.88 13,573 154.50 18,097 193.12 22,621 52 53 38.62 4,227 77.26 8,455 115.88 12,682 154.50 16,910 193.12 21,137 53 54 38.62 3,912 77.26 7,823 115.88 11,735 154.50 15,646 193.12 19,558 54 55 38.62 3,575 77.26 7,150 115.88 10,725 154.50 14,300 193.12 17,875 55 56 52.24 3,686 104.46 7,371 156.70 11,057 208.94 14,742 261.16 18,428 56 57 52.24 3,795 104.46 7,590 156.70 11,386 208.94 15,181 261.16 18,976 57 58 52.24 3,905 104.46 7,811 156.70 11,716 208.94 15,622 261.16 19,527 58 59 52.24 4,017 104.46 8,034 156.70 12,050 208.94 16,067 261.16 20,084 59 60 52.24 4,130 104.46 8,261 156.70 12,391 208.94 16,522 261.16 20,652 60 61 69.90 4,245 139.80 8,491 209.70 12,736 279.60 16,982 349.50 21,227 61 62 69.90 4,364 139.80 8,728 209.70 13,092 279.60 17,456 349.50 21,820 62 63 69.90 4,488 139.80 8,976 209.70 13,464 279.60 17,952 349.50 22,440 63 64 69.90 4,631 139.80 9,261 209.70 13,892 279.60 18,522 349.50 23,153 64 65 69.90 4,811 139.80 9,621 209.70 14,432 279.60 19,242 349.50 24,053 65 66 82.22 5,002 164.44 10,003 246.66 15,005 328.86 20,006 411.08 25,008 66 67 87.52 5,206 175.04 10,412 262.56 15,618 350.06 20,824 437.58 26,030 67 68 93.88 5,425 187.74 10,851 281.62 16,276 375.48 21,702 469.36 27,127 68 69 100.30 5,662 200.58 11,324 300.86 16,987 401.14 22,649 501.44 28,311 69 70 106.80 5,914 213.60 11,828 320.38 17,742 427.18 23,656 533.98 29,570 70 w/EOI Quote Requires EOI Quote Requires EOI Quote Requires EOI Quote Requires EOI Quote Requires EOI w/EOI 71 106.54 6,175 213.08 12,350 319.62 18,526 426.16 24,701 532.70 30,876 71 72 114.62 6,442 229.22 12,884 343.84 19,326 458.44 25,768 573.04 32,210 72 73 123.48 6,710 246.94 13,420 370.42 20,130 493.88 26,840 617.36 33,550 73 74 133.36 6,979 266.70 13,958 400.04 20,937 533.40 27,916 666.74 34,895 74 75 144.40 7,263 288.80 14,526 433.18 21,789 577.58 29,052 721.96 36,315 75 76 156.76 7,557 313.52 15,113 470.26 22,670 627.02 30,226 783.78 37,783 76 77 170.54 7,856 341.08 15,712 511.62 23,567 682.16 31,423 852.70 39,279 77 78 185.86 8,183 371.72 16,365 557.56 24,548 743.42 32,730 929.28 40,913 78 79 202.86 8,557 405.70 17,114 608.54 25,672 811.40 34,229 1,014.24 42,786 79 80 221.68 9,021 443.32 18,043 665.00 27,064 886.66 36,086 1,108.32 45,107 80 This rate insert is for use with materials for accounts sitused in Indiana, and is not to be used on its own. ¹ CV @ age 65 or 10 years - Value shown is at attained age 65 or the end of year 10 if later, and assumes all premiums have been paid, no changes have been made to the certificate, and there is no certificate debt. EXCLUSIONS AND LIMITATIONS: Suicide Exclusion - If a covered person commits suicide, the death benefit may be limited to the premiums paid for that covered person. Pre-existing Condition Limitation - The Accelerated Death Benefit for Long Term Care with Extension of Benefits (GWCLTCE, GWCLTCE1) rider may contain a pre-existing condition limitation. Other Exclusions and Limitations - The policy and riders (if included) have other elimination periods, exclusions and limitations that may affect coverage. Please refer to the certificate for details. Rates shown are based on Tobacco/Non-tobacco, Issue Age Banded rating structure. BIWEEKLY means 26 times per year. Age bands for rates are 0-17, 18-25, 26-30, 31-35, and so on in 5 year brackets up to 61-65, then separate rates for each individual age for ages 66, 67, 68, …, 80. This information is valid as long as information remains current, but in no event later than 12/31/2023. Group Whole Life Insurance benefits are provided under form GWLC, or state variations thereof. Rider benefits are provided under the following forms, or state variations thereof: Accelerated Death Benefit for Terminal Illness or Condition (GWPTI) and Accelerated Death Benefit for Long Term Care with Extension of Benefits (GWCLTCE, GWCLTCE1). Allstate Benefits is the marketing name used by This is a brief overview of the benefits available under the group voluntary policy underwritten by American Heritage Life Insurance Company (Home Office, Jacksonville, FL). American Heritage Life Insurance Company (Home Details of the insurance, including exclusions, restrictions, and other provisions are included in the certificates issued. Office, Jacksonville, FL), a subsidiary of The Allstate For additional information, you may contact your Allstate Benefits Representative. Corporation. ©2022 Allstate Insurance Company. www.allstate.com or allstatebenefits.com HO Use Only: lhumm-20221011-8211-IN-TNTB- † Issue Ages 18-70 Only for Accelerated Death Benefit for Long Term Care with Extension of Benefits (GWCLTCE, GWCLTCE1). B_STD_-FALSE-1033-FA-20000-100000-20000- PI:E-26x-TI:T-PWP:F-ADB:F-TYT:0-GWCLTCE:T- CT:F-ST:F-UWR Ratecard generated October 11, 2022 - 4:05 PM by ABQuote 09.28.2022. ABJ20743-14815 page 4 of 4 FOR AGENT USE ONLY GWLBIN 7 POD126436