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Reliance Standard Voluntary

            Benefits – Critical Illness Plan



            Coverage                                               Benefit Amount

            Voluntary Critical Illness insurance provides a fixed,    Employee: Choose from a benefit of $5,000 to a
            lump-sum benefit upon diagnosis of a critical illness,    maximum of $30,000 in $1,000 increments.
            which can include heart attack, stroke, paralysis and
                                                                   Spouse: Choose from a benefit of $5,000 to a maximum
            more. These benefits are paid directly to you and
                                                                   of $30,000 in $1,000 increments, not to exceed 100% of
            may be used for any reason, from deductibles and
                                                                   approved employee amount.
            prescriptions to transportation and child care.
                                                                   Dependent child(ren): 50% of approved employee
            Eligibility                                            amount up to a maximum of $15,000.

            Employees: All eligible employees.                     Guaranteed Issue
            Dependents: The employee must be enrolled in Critical   Employee: $30,000
            Illness coverage in order for dependents to be covered.  Spouse: $30,000

            Dependents are:                                        Child: All child amounts are Guaranteed Issue
            O   Your legal spouse or your domestic partner. Spouse
               must be under age 70 at date of application.
               Coverage terminates at age 75.                      Plan Features Also Include:
            O   Your dependent children from birth to 26 years.    O   Lifetime Maximum Benefit – 1,000% of
                                                                       insurance amount
            Dependent children are an eligible employee’s child(ren)
                                                                   O   Recurrence Benefit (Same Illness) – 50% of
            from birth to 26 years, including natural children, legally
                                                                       benefit if diagnosed six months or later
            adopted children, children who are dependent on the
                                                                   O   FMLA / MSLA Continuation
            eligible employee during the waiting period before
                                                                   O   Portability to employee age 70
            adoption, stepchildren and foster children. Foster children
                                                                   O   Wellness (Health Screening) Benefit – $100
            must be in the custody of the eligible employee to be
            considered a dependent; and an eligible employee’s           –  To submit for your wellness credit, visit
            child(ren) beyond the limiting age who is incapable of self-  www.rslclaims.com and enter Policy
            sustaining employment by reason of intellectual disability    Number 802980
            or physical handicap and who is chiefly dependent on the
            eligible employee for support and maintenance.
            A person may not have coverage as both an employee                  Important Information
            and dependent.
                                                                                O   You may not have coverage as
            Exclusions: For a comprehensive list of exclusions and
                                                                                   both an employee and as a dependent.
            limitations, please refer to the plan documents, which
                                                                                O   Employee must have coverage
            also provides all requirements necessary to be eligible
                                                                                   in order for spouse and dependent
            for benefits.
     38                                                                            child(ren) to be covered.
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