Exhibit_B__Colonial_Life__Brevard_2025.pdf

2025 Employee Benefits Booklet

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Contents

Welcome

Colonial Life voluntary benefits

Accident insurance

Cancer insurance

Critical illness insurance

Hospital indemnity insurance

Colonial Life Services Guide

Contacts

Welcome

It’s time to enroll in your employee benefits.* This booklet has been provided to inform you of all the benefit options available to you. Please take the time to review the various plan designs and coverages and decide which options best fit your needs.

WHAT DO YOU NEED TO ENROLL?

When it’s time for you to enroll, you will need to have the following items:

to enroll in one or more of the plans

to medical or dental insurance plans

TAKING ADVANTAGE OF PRE-TAX BENEFITS

Brevard County Board of Commissioners has put into place a Section 125 pre-tax plan. Certain coverages you contribute to are deducted from your paycheck on a pre-tax basis. The IRS stipulates that when you elect to have your deductions taken out with pre-tax dollars, you also agree to remain in the benefit plan of your selection for one full year, unless you experience a change in family status. Examples of changes in family status include the following:

You must notify human resources in writing within 30 days of the family status change and provide appropriate documentation.

The information contained in this booklet is only a summary of coverage and is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Should there be differences between the information in the booklet and the contract, the contract will govern.

Core benefit list, product details and/or hyperlinks are provided by a third party and are being offered for informational purposes only and as a service to our customers. Colonial Life in no way controls, guarantees, endorses, sponsors, or promotes these products or their intellectual property, and is not responsible for the accuracy of the information.

Accident Insurance Basic Plan

If you are in an accident, your focus should be on recovery, not how you’re going to pay your bills. Colonial Life Accident Insurance can pay benefits directly to you to use however you like — from medical costs to everyday expenses — offering financial support when you need it.

Our coverage includes:

• Benefits payable directly to you

• No medical questions to qualify for coverage

• Coverage for simple and complex injuries

• Benefits payable regardless of other insurance

• Worldwide coverage

• Works alongside your Health Savings Account (HSA)

BENEFITS STORY

Jacob was running on the playground when he tripped and injured his hand.

With Colonial Life accident benefits, Jacob’s parents were able to pay the annual deductible and co-payments.

JACOB’S ACCIDENT BENEFITS

Jacob went to an urgent care facility and received immediate care.

Accident emergency treatment $125

The doctor ordered an X-ray and discovered Jacob had fractured his hand.

• X-ray

• Fracture (hand)

$40 $400

The doctor also found that Jacob had a cut on his hand.

Laceration (no stitches) $30

Jacob was discharged with a splint. Medical equipment (splint) $40

Over the next several weeks, Jacob had three follow-up appointments with his doctor.

Accident follow-up treatment (3 visits)

$135

Total $770For illustrative purposes only for covered accidents. Benefit amounts may vary and may not cover all expenses.

IAC4000 – BASIC PLAN

BENEFITS STORY

Olivia was driving to the store when she got into a car accident.

Olivia’s accident benefits helped cover her annual deductible and co-payments.

OLIVIA’S ACCIDENT BENEFITS

Olivia arrived by ambulance at the nearest emergency room and received immediate care.

• Ambulance

• Accident emergency treatment

• Injury due to auto accident

$200 $125

$250

The doctor ordered an X-ray and discovered Olivia had fractured her thigh (femur). He also ordered a CT scan of her head to check for a brain injury.

• X-ray

• Medical imaging (CT)

• Thigh fracture — femur (surgical)

$40 $200

$3,600

Olivia was admitted to the hospital for surgery on her leg. She was confined for three days.

• Hospital admission

• Surgery (exploratory/arthroscopic)

• Hospital confinement (3 days)

$1,250 $250 $750

Olivia had eight sessions of physical therapy to help regain the strength in her leg.

• Physical therapy (8 days)

• Medical equipment (crutches)

$240 $100

Over the next several weeks, she had six follow-up appointments with her doctor.

Accident follow-up treatment (6 visits) $270

Total $7,275For illustrative purposes only for covered accidents. Benefit amounts may vary and may not cover all expenses.

Summary of Benefits Benefits are per covered person per covered accident unless stated otherwise.

Initial care Accident emergency treatment . . . . . . . . . . . . . . . . . . . . . . . . . $125 Hospital emergency room, urgent care facility or physician’s office

Accidental injury due to an automobile accident1 . . . . . . . . $250 Air ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,600 Ambulance — ground or water . . . . . . . . . . . . . . . . . . . . . . . . . $200 Observation room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$175 per day (up to two days per calendar year)

X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40

Common accidental injuries Burn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1,000–$12,000 (based on size and degree)

Burn — skin graft . . . . . . . . . . . . . .50% of applicable burn benefit Coma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12,500 (lasting for seven or more consecutive days)

Concussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$100

Dislocation — separated joint

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . $100–$2,250

Examples: elbow: $500 | ankle: $1,000 | hip: $2,250

• Incomplete dislocation — or dislocation without anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25% (payable as a % of the applicable dislocation benefit)

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . .$200–$4,500 Examples: elbow: $1,000 | ankle: $2,000 | hip: $4,500

Emergency dental work . . . . . . . . . . . . . . . . . . . . . . . . . . .$50–$200 Dental extraction or dental crown, denture or implant

Eye injury — with surgical repair or removal of a foreign object . . . . . . . . . . . . . . . . . . . . . . . . . . . . $200 Fracture — complete

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . $275–$3,000 Examples: hand/foot: $400 | collarbone: $625 | leg: $875

• Chip fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25% (payable as a % of the applicable fracture benefit )

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . $550–$6,000 Examples: hand/foot: $800 | collarbone: $1,250 | leg: $1,750

Hearing-loss injuries2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$140 Knee cartilage — torn — with surgical repair . . . . . . . . . . . . . $600 Laceration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $30–$625 (based on repair and length)

Ruptured disc — with surgical repair . . . . . . . . . . . . . . . . . . . $600 Tendon/ligament/rotator cuff — with surgical repair

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $600

• Two or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,200

Hospital care Hospital admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,250 Hospital confinement . . . . . . . . . . . . . . . . . . . . . . . . . $250 per day (up to 365 days)

Hospital sub-acute intensive care unit confinement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350 per day (up to 30 days)

Intensive care unit admission . . . . . . . . . . . . . . . . . . . . . . . . $1,750 Intensive care unit confinement . . . . . . . . . . . . . . . . $450 per day (up to 15 days)

Surgical care Blood/plasma/platelets — transfusion . . . . . . . . . . . . . . . . . $400 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $225–$1,200 (based on type of repair and surgery)

Transportation and lodging Transportation for hospital confinement . . $500 per round trip (up to three round trips, 50+ miles from home)

Lodging–companion . . . . . . . . . . . . . . . . . . . . . . . . . . $125 per day (up to 30 days)

Follow-up care Accident follow-up treatment, including transportation/telemedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . $45 (up to six benefits per covered person per covered accident and up to 12 benefits per covered person per calendar year)

Medical equipment

• Tier 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40

Arm sling, cane, medical ring cushion, neck brace or wrist/ankle splint

• Tier 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$100 Bedside commode, cold therapy system (cryotherapy), crutches, leg brace, shower chair, walker or walking boot

• Tier 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $200 Back brace, body jacket, continuous passive movement (CPM), halo, electric scooter, hospital bed (including rental), knee scooter, stair lift chair or wheelchair

Medical imaging study — CT, CAT scan, EEG, EMG, MR or MRI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $200 (one per calendar year)

Pain management for epidural anesthesia — non-surgical . . $125 Post-traumatic stress disorder (PTSD) . . . . . . . . . . . . . . . . . $250 Prosthetic device/artificial limb

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $600

• More than one . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,200

• Repair/replacement3 . . . . . . . . . . . . . . . . . . . . . . . . . .$300/$600

Rehabilitation unit confinement . . . . . . . . . . . . . . . . $125 per day (up to 15 days, not to exceed 30 days per calendar year)

Therapy — occupational, physical or speech . . . . . . $30 per day (up to 10 days)

Accidental dismemberment Accidental dismemberment . . . . . . . . . . . . . . . . . . .$300–$20,000

• Loss, loss of use or paralysis – hand, arm, foot, leg, sight of eye

• Loss, loss of use – finger, toe, partial dismemberment of finger or toe

Accidental dismemberment due to a catastrophic accident

• Named insured, spouse or child . . . . . . . . . . . . . . . . . . $12,5004

• Total and irrecoverable loss, loss of use or paralysis – 180-day elimination period

• Loss of both hands, arms, feet, legs or the sight of both eyes;

or any combination; or

• Loss of hearing in both ears, or loss of ability to speak

Accidental death Accidental death

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . . $25,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$5,000

Accidental death common carrier Examples of common carriers are mass transit trains, buses and planes

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . .$100,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15,000

For more information, contact your Colonial Life benefits counselor.

1 Requires transportation by a licensed professional air ambulance or ambulance (ground or water).

2 One benefit for each injured ear per covered person per lifetime.

3 One repair or replacement per prosthetic device/artificial limb per covered person per lifetime.

4 Payable once per lifetime per covered person.

HEALTH SAVINGS ACCOUNT (HSA) COMPATIBLE

This plan is compatible with HSA guidelines and any other HSA plan in which a covered family member may participate. It may also be offered to employees who do not have HSAs.

THIS POLICY PROVIDES LIMITED BENEFITS.

This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this coverage.

EXCLUSIONS

We will not pay benefits for losses that are caused by, contributed to by or occur as the result of a covered personʼs felonies or illegal occupations, hazardous avocations, racing, semi-professional or professional sports, sickness, suicide or injuries which any covered person intentionally does to himself, war or armed conflict. In addition, we will not pay Accidental Dismemberment due to Catastrophic Accident benefits for injuries a child sustains during birth, or for injuries that are the result of intoxication or use of narcotics.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. Applicable to policy form IAC4000-FL. For cost and complete details of the coverage, call or write your Colonial Life benefits counselor or the company.

Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.

© 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

FOR EMPLOYEES 6-24 | 101775-5-FLColonialLife.com

Preferred Plan

If you are in an accident, your focus should be on recovery, not how you’re going to pay your bills. Colonial Life Accident Insurance can pay benefits directly to you to use however you like — from medical costs to everyday expenses — offering financial support when you need it.

Our coverage includes:

• Benefits payable directly to you

• No medical questions to qualify for coverage

• Coverage for simple and complex injuries

• Benefits payable regardless of other insurance

• Worldwide coverage

• Works alongside your Health Savings Account (HSA)

BENEFITS STORY

Jacob was running on the playground when he tripped and injured his hand.

With Colonial Life accident benefits, Jacob’s parents were able to pay the annual deductible and co-payments.

JACOB’S ACCIDENT BENEFITS

Jacob went to an urgent care facility and received immediate care.

Accident emergency treatment $150

The doctor ordered an X-ray and discovered Jacob had fractured his hand.

• X-ray

• Fracture (hand)

$40 $475

The doctor also found that Jacob had a cut on his hand.

Laceration (no stitches) $30

Jacob was discharged with a splint. Medical equipment (splint) $40

Over the next several weeks, Jacob had three follow-up appointments with his doctor.

Accident follow-up treatment (3 visits)

$165

Total $900For illustrative purposes only for covered accidents. Benefit amounts

IAC4000 – PREFERRED PLAN

Olivia was driving to the store when she got into a car accident.

Olivia’s accident benefits helped cover her annual deductible and co-payments.

OLIVIA’S ACCIDENT BENEFITS

Olivia arrived by ambulance at the nearest emergency room and received immediate care.

• Ambulance

• Accident emergency treatment

• Injury due to auto accident

$250 $150 $250

The doctor ordered an X-ray and discovered Olivia had fractured her thigh (femur). He also ordered a CT scan of her head to check for a brain injury.

• X-ray

• Medical imaging (CT)

• Thigh fracture — femur (surgical)

$40 $250

$5,600

Olivia was admitted to the hospital for surgery on her leg. She was confined for three days.

• Hospital admission

• Surgery (exploratory/arthroscopic)

• Hospital confinement (3 days)

$1,250 $350 $900

Olivia had eight sessions of physical therapy to help regain the strength in her leg.

• Physical therapy (8 days)

• Medical equipment (crutches)

$360 $125

Over the next several weeks, she had six follow-up appointments with her doctor.

Accident follow-up treatment (6 visits) $330

Total $9,855For illustrative purposes only for covered accidents. Benefit amounts may vary and may not cover all expenses.

Summary of Benefits Benefits are per covered person per covered accident unless stated otherwise.

Initial care Accident emergency treatment . . . . . . . . . . . . . . . . . . . . . . . . .$150 Hospital emergency room, urgent care facility or physician’s office

Accidental injury due to an automobile accident1 . . . . . . . . $250 Air ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,400 Ambulance — ground or water . . . . . . . . . . . . . . . . . . . . . . . . . $250 Observation room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$175 per day (up to two days per calendar year)

X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40

Common accidental injuries Burn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,000–$15,000 (based on size and degree)

Burn — skin graft . . . . . . . . . . . . . .50% of applicable burn benefit Coma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15,000 (lasting for seven or more consecutive days)

Concussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $200

Dislocation — separated joint

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . $125–$2,750

Examples: elbow: $600 | ankle: $1,250 | hip: $2,750

• Incomplete dislocation — or dislocation without anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25% (payable as a % of the applicable dislocation benefit)

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250–$5,500 Examples: elbow: $1,200 | ankle: $2,500 | hip: $5,500

Emergency dental work . . . . . . . . . . . . . . . . . . . . . . . . . . $125–$350 Dental extraction or dental crown, denture or implant

Eye injury — with surgical repair or removal of a foreign object . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350 Fracture — complete

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . $300–$3,750 Examples: hand/foot: $475 | collarbone: $775 | leg: $1,250

• Chip fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25% (payable as a % of the applicable fracture benefit )

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . $600–$7,500 Examples: hand/foot: $950 | collarbone: $1,550 | leg: $2,500

Knee cartilage — torn — with surgical repair . . . . . . . . . . . . . $800 Laceration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $30–$750 (based on repair and length)

Ruptured disc — with surgical repair . . . . . . . . . . . . . . . . . . . $950 Tendon/ligament/rotator cuff — with surgical repair

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $800

• Two or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,600

Hospital care Hospital admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,250 Hospital confinement . . . . . . . . . . . . . . . . . . . . . . . . . $300 per day (up to 365 days)

Hospital sub-acute intensive care unit confinement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $400 per day (up to 30 days)

Intensive care unit admission . . . . . . . . . . . . . . . . . . . . . . . .$2,500 Intensive care unit confinement . . . . . . . . . . . . . . . . $550 per day (up to 15 days)

Surgical care Blood/plasma/platelets — transfusion . . . . . . . . . . . . . . . . . $400 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250–$1,900 (based on type of repair and surgery)

Transportation and lodging Transportation for hospital confinement . . $700 per round trip (up to three round trips, 50+ miles from home)

Lodging–companion . . . . . . . . . . . . . . . . . . . . . . . . . . $150 per day (up to 30 days)

Follow-up care Accident follow-up treatment, including transportation/telemedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . .$55 (up to six benefits per covered person per covered accident and up to 12 benefits per covered person per calendar year)

Medical equipment

• Tier 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40

Arm sling, cane, medical ring cushion, neck brace or wrist/ankle splint

• Tier 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $125 Bedside commode, cold therapy system (cryotherapy), crutches, leg brace, shower chair, walker or walking boot

• Tier 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250 Back brace, body jacket, continuous passive movement (CPM), halo, electric scooter, hospital bed (including rental), knee scooter, stair lift chair or wheelchair

Medical imaging study — CT, CAT scan, EEG, EMG, MR or MRI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250 (one per calendar year)

Pain management for epidural anesthesia — non-surgical . . $125 Post-traumatic stress disorder (PTSD) . . . . . . . . . . . . . . . . . $250 Prosthetic device/artificial limb

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $950

• More than one . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,900

• Repair/replacement3 . . . . . . . . . . . . . . . . . . . . . . . . . . $475/$950

Rehabilitation unit confinement . . . . . . . . . . . . . . . . .$175 per day (up to 15 days, not to exceed 30 days per calendar year)

Therapy — occupational, physical or speech . . . . . . $45 per day (up to 10 days)

Accidental dismemberment Accidental dismemberment . . . . . . . . . . . . . . . . . . .$600–$25,000

• Loss, loss of use or paralysis – hand, arm, foot, leg, sight of eye

• Loss, loss of use – finger, toe, partial dismemberment of finger or toe

Accidental dismemberment due to a catastrophic accident

• Named insured, spouse or child . . . . . . . . . . . . . . . . . .$30,0004

• Total and irrecoverable loss, loss of use or paralysis – 180-day elimination period

• Loss of both hands, arms, feet, legs or the sight of both eyes;

or any combination; or

• Loss of hearing in both ears, or loss of ability to speak

Accidental death Accidental death

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . . $40,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$10,000

Accidental death common carrier Examples of common carriers are mass transit trains, buses and planes

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . .$160,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $30,000

1 Requires transportation by a licensed professional air ambulance or ambulance (ground or water).

2 One benefit for each injured ear per covered person per lifetime.

3 One repair or replacement per prosthetic device/artificial limb per covered person per lifetime.

4 Payable once per lifetime per covered person.

HEALTH SAVINGS ACCOUNT (HSA) COMPATIBLE

This plan is compatible with HSA guidelines and any other HSA plan in which a covered family member may participate. It may also be offered to employees who do not have HSAs.

THIS POLICY PROVIDES LIMITED BENEFITS.

This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this coverage.

EXCLUSIONS

We will not pay benefits for losses that are caused by, contributed to by or occur as the result of a covered personʼs felonies or illegal occupations, hazardous avocations, racing, semi-professional or professional sports, sickness, suicide or injuries which any covered person intentionally does to himself, war or armed conflict. In addition, we will not pay Accidental Dismemberment due to Catastrophic Accident benefits for injuries a child sustains during birth, or for injuries that are the result of intoxication or use of narcotics.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. Applicable to policy form IAC4000-FL. For cost and complete details of the coverage, call or write your Colonial Life benefits counselor or the company.

Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.

© 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and

FOR EMPLOYEES 6-24 | 101776-4-FLColonialLife.com

Premier Plan

If you are in an accident, your focus should be on recovery, not how you’re going to pay your bills. Colonial Life Accident Insurance can pay benefits directly to you to use however you like — from medical costs to everyday expenses — offering financial support when you need it.

Our coverage includes:

• Benefits payable directly to you

• No medical questions to qualify for coverage

• Coverage for simple and complex injuries

• Benefits payable regardless of other insurance

• Worldwide coverage

• Works alongside your Health Savings Account (HSA)

BENEFITS STORY

Jacob was running on the playground when he tripped and injured his hand.

With Colonial Life accident benefits, Jacob’s parents were able to pay the annual deductible and co-payments.

JACOB’S ACCIDENT BENEFITS

Jacob went to an urgent care facility and received immediate care.

Accident emergency treatment $175

The doctor ordered an X-ray and discovered Jacob had fractured his hand.

• X-ray

• Fracture (hand)

$50 $525

The doctor also found that Jacob had a cut on his hand.

Laceration (no stitches) $30

Jacob was discharged with a splint. Medical equipment (splint) $40

Over the next several weeks, Jacob had three follow-up appointments with his doctor.

Accident follow-up treatment (3 visits)

$225

Total $1,045For illustrative purposes only for covered accidents. Benefit amounts

IAC4000 – PREMIER PLAN

Olivia was driving to the store when she got into a car accident.

Olivia’s accident benefits helped cover her annual deductible and co-payments.

OLIVIA’S ACCIDENT BENEFITS

Olivia arrived by ambulance at the nearest emergency room and received immediate care.

• Ambulance

• Accident emergency treatment

• Injury due to auto accident

$350 $175

$250

The doctor ordered an X-ray and discovered Olivia had fractured her thigh (femur). He also ordered a CT scan of her head to check for a brain injury.

• X-ray

• Medical imaging (CT)

• Thigh fracture — femur (surgical)

$50 $300

$7,600

Olivia was admitted to the hospital for surgery on her leg. She was confined for three days.

• Hospital admission

• Surgery (exploratory/arthroscopic)

• Hospital confinement (3 days)

$1,750 $400

$1,050

Olivia had eight sessions of physical therapy to help regain the strength in her leg.

• Physical therapy (8 days)

• Medical equipment (crutches)

$480 $175

Over the next several weeks, she had six follow-up appointments with her doctor.

Accident follow-up treatment (6 visits) $450

Total $13,030For illustrative purposes only for covered accidents. Benefit amounts may vary and may not cover all expenses.

Summary of benefits Benefits are per covered person per covered accident unless stated otherwise.

Initial care Accident emergency treatment . . . . . . . . . . . . . . . . . . . . . . . . . $175 Hospital emergency room, urgent care facility or physician’s office

Accidental injury due to an automobile accident1 . . . . . . . . $250 Air ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,800 Ambulance — ground or water . . . . . . . . . . . . . . . . . . . . . . . . . $350 Observation room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$175 per day (up to two days per calendar year)

X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50

Common accidental injuries Burn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,500–$21,000 (based on size and degree)

Burn — skin graft . . . . . . . . . . . . . .50% of applicable burn benefit Coma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $17,500 (lasting for seven or more consecutive days)

Concussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250

Dislocation — separated joint

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . $150–$3,000

Examples: elbow: $750 | ankle: $1,500 | hip: $3,000

• Incomplete dislocation — or dislocation without anesthesia . . . . . . . . . . . . . . . . . . . . . . . . 25% of benefit (payable as a % of the applicable dislocation benefit)

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . $300–$6,000 Examples: elbow: $1,500 | ankle: $3,000 | hip: $6,000

Emergency dental work . . . . . . . . . . . . . . . . . . . . . . . . . . $250–$750 Dental extraction or dental crown, denture or implant

Eye injury — with surgical repair or removal of a foreign object . . . . . . . . . . . . . . . . . . . . . . . . . . . . $500 Fracture — complete

• Non-surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . $350–$4,750 Examples: hand/foot: $525 | collarbone: $925 | leg: $1,500

• Chip fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25% of benefit (payable as a % of the applicable fracture benefit)

• Surgical — repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . $700–$9,500 Examples: hand/foot: $1,050 | collarbone: $1,850 | leg: $3,000

Knee cartilage — torn — with surgical repair . . . . . . . . . . . . . $950 Laceration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $30–$750 (based on repair and length)

Ruptured disc — with surgical repair . . . . . . . . . . . . . . . . . . $1,550 Tendon/ligament/rotator cuff — with surgical repair

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $950

• Two or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,900

Hospital care Hospital admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,750 Hospital confinement . . . . . . . . . . . . . . . . . . . . . . . . . $350 per day (up to 365 days)

Hospital sub-acute intensive care unit confinement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $500 per day (up to 30 days)

Intensive care unit admission . . . . . . . . . . . . . . . . . . . . . . . .$3,000 Intensive care unit confinement . . . . . . . . . . . . . . . . $600 per day (up to 15 days)

Surgical care Blood/plasma/platelets — transfusion . . . . . . . . . . . . . . . . . $600 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $300–$2,000 (based on type of repair and surgery)

Transportation and lodging Transportation for hospital confinement . . $900 per round trip (up to three round trips, 50+ miles from home)

Lodging — companion . . . . . . . . . . . . . . . . . . . . . . . . . .$175 per day (up to 30 days)

Follow-up care Accident follow-up treatment, including transportation/telemedicine . . . . . . . . . . . . . . . . . . . . . . . . . . . .$75 (up to six benefits per covered person per covered accident and up to 12 benefits per covered person per calendar year)

Medical equipment

• Tier 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40

Arm sling, cane, medical ring cushion, neck brace or wrist/ankle splint

• Tier 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $175 Bedside commode, cold therapy system (cryotherapy), crutches, leg brace, shower chair, walker or walking boot

• Tier 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $350 Back brace, body jacket, continuous passive movement (CPM), halo, electric scooter, hospital bed (including rental), knee scooter, stair lift chair or wheelchair

Medical imaging study — CT, CAT scan, EEG, EMG, MR or MRI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $300 (one per calendar year)

Pain management for epidural anesthesia — non-surgical . . $175 Post-traumatic stress disorder (PTSD) . . . . . . . . . . . . . . . . . $250 Prosthetic device/artificial limb

• One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,250

• More than one . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$2,500

• Repair/replacement3 . . . . . . . . . . . . . . . . . . . . . . . . $625/$1,250

Rehabilitation unit confinement . . . . . . . . . . . . . . . . $250 per day (up to 15 days, not to exceed 30 days per calendar year)

Therapy — occupational, physical or speech . . . . . . $60 per day (up to 10 days)

Accidental dismemberment Accidental dismemberment . . . . . . . . . . . . . . . . . . . $750–$35,000

• Loss, loss of use or paralysis – hand, arm, foot, leg, sight of eye

• Loss, loss of use – finger, toe, partial dismemberment of finger or toe

Accidental dismemberment due to a catastrophic accident

• Named insured, spouse or child . . . . . . . . . . . . . . . . . .$30,0004

• Total and irrecoverable loss, loss of use or paralysis – 180-day elimination period

• Loss of both hands, arms, feet, legs or the sight of both eyes;

or any combination; or

• Loss of hearing in both ears, or loss of ability to speak

Accidental death Accidental death

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . . $50,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $15,000

Accidental death common carrier Examples of common carriers are mass transit trains, buses and planes.

• Named insured, spouse . . . . . . . . . . . . . . . . . . . . . . . . . $200,000

• Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45,000

1 Requires transportation by a licensed professional air ambulance or ambulance (ground or water).

2 One benefit for each injured ear per covered person per lifetime.

3 One repair or replacement per prosthetic device/artificial limb per covered person per lifetime.

4 Payable once per lifetime per covered person.

HEALTH SAVINGS ACCOUNT (HSA) COMPATIBLE

This plan is compatible with HSA guidelines and any other HSA plan in which a covered family member may participate. It may also be offered to employees who do not have HSAs.

THIS POLICY PROVIDES LIMITED BENEFITS.

This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this coverage.

EXCLUSIONS

We will not pay benefits for losses that are caused by, contributed to by or occur as the result of a covered personʼs felonies or illegal occupations, hazardous avocations, racing, semi-professional or professional sports, sickness, suicide or injuries which any covered person intentionally does to himself, war or armed conflict. In addition, we will not pay Accidental Dismemberment due to Catastrophic Accident benefits for injuries a child sustains during birth, or for injuries that are the result of intoxication or use of narcotics.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable. Applicable to policy form IAC4000-FL. For cost and complete details of the coverage, call or write your Colonial Life benefits counselor or the company.

Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.

© 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and

FOR EMPLOYEES 6-24 | 101777-4-FLColonialLife.com

Cancer Insurance Level 1 benefits

Cancer insurance helps provide financial protection through a variety of benefits.

These benefits are not only for you, but also for your covered family members.

BENEFIT DESCRIPTION BENEFIT AMOUNT

Air ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,000 per trip Transportation to or from a hospital or medical facility (max. of two trips per confinement)

Ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250 per trip Transportation to or from a hospital or medical facility (max. of two trips per confinement)

Anesthesia Administered during a surgical procedure for cancer treatment

• General anesthesia . . . . 25% of surgical procedures benefit

• Local anesthesia . . . . . . . . . . . . . . . . . . . . . .$25 per procedure

Anti-nausea medication . . . . . . . . . . .$25 per day administered or per prescription filled Doctor-prescribed medication for radiation or chemotherapy ($100 monthly max.)

Blood/plasma/platelets/immunoglobulins . . . . . . .$150 per day A transfusion required during cancer treatment ($10,000 calendar year max.)

Bone marrow donor screening . . . . . . . . . . . . . . . . . . . . . . . . . .$50 Testing in connection with being a potential donor (once per lifetime)

Bone marrow or peripheral stem cell donation . . . . . . . . . $500 Receiving another person’s bone marrow or stem cells for a transplant (once per lifetime)

Bone marrow or peripheral stem cell transplant . . . . . . . . . . . . . . . . . . . . . . . $3,500 per transplant Transplant you receive in connection with cancer treatment (max. of two bone marrow transplant benefits per lifetime)

Cancer vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$50 An FDA-approved vaccine for the prevention of cancer (once per lifetime)

BENEFIT DESCRIPTION BENEFIT AMOUNT

Companion transportation . . . . . . . . . . . . . . . . . . . $0 .50 per mile Companion travels by plane, train or bus to accompany a covered cancer patient more than 50 miles one way for treatment (up to $1,000 per round trip)

Egg(s) extraction or harvesting/sperm collection and storage Extracted/harvested or collected before chemotherapy or radiation (once per lifetime)

• Egg(s) extraction or harvesting/sperm collection . . . . . . $500

• Egg(s) or sperm storage (cryopreservation) . . . . . . . . . . . $175

Experimental treatment . . . . . . . . . . . . . . . . . . . . . . $200 per day Hospital, medical or surgical care for cancer ($10,000 lifetime max.)

Family care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $30 per day Inpatient or outpatient treatment for a covered dependent child ($1,500 calendar year max.)

Hair/external breast/ voice box prosthesis . . . . . . . . . . . . . . . . $200 per calendar year Prosthesis needed as a direct result of cancer

Home health care services1 . . . . . . . . . . . . . . . . . . . . . $50 per day Examples include physical therapy, occupational therapy, speech therapy and audiology; prosthesis and orthopedic appliances; rental or purchase of durable medical equipment (up to 30 days per calendar year or twice the number of days hospital confined, whichever is greater)

Hospice (initial or daily care)2 An initial, one-time benefit and a daily benefit for treatment ($15,000 lifetime max. for both)

• Initial hospice care (once per lifetime) . . . . . . . . . . . . . . $1,000

• Daily hospice care . . . . . . . . . . . . . . . . . . . . . . . . . . . $50 per day

CANCER ASSIST - LEVEL 1

BENEFIT DESCRIPTION BENEFIT AMOUNT

Hospital confinement Hospital stay (including intensive care) required for cancer treatment

• 30 days or less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $100 per day

• 31 days or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$200 per day

Lodging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50 per day Hotel/motel expenses when being treated for cancer more than 50 miles from home (70-day calendar year max.)

Medical imaging studies . . . . . . . . . . . . . . . . . . . . . .$75 per study Specific studies for cancer treatment ($150 calendar year max.)

Outpatient surgical center . . . . . . . . . . . . . . . . . . . . $100 per day Surgery at an outpatient center for cancer treatment ($300 calendar year max.)

Private full-time nursing services . . . . . . . . . . . . . . . $50 per day Services while hospital confined other than those regularly furnished by the hospital

Prosthetic device/artificial limb . . . . $1,000 per device or limb A surgical implant needed because of cancer surgery (payable one per site, $2,000 lifetime max.)

Radiation/chemotherapy Weekly benefit (max. once per week)

• Injected chemotherapy by medical personnel . . . . . . . . . $250

• Radiation delivered by medical personnel . . . . . . . . . . . . $250

Monthly chemotherapy benefit (max. once per month)

• Self-injected . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150

• Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150

• Topical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150

• Oral hormonal (1-24 months) . . . . . . . . . . . . . . . . . . . . . . . . $150

• Oral hormonal (25+ months) . . . . . . . . . . . . . . . . . . . . . . . . . . $75

• Oral non-hormonal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150

BENEFIT DESCRIPTION BENEFIT AMOUNT

Reconstructive surgery3 . . . . . . . . . . . . . . . $40 per surgical unit A surgery to reconstruct anatomic defects that result from cancer treatment (up to $2,500 per procedure, including 25% for general anesthesia)

Second medical opinion4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150 A second physician’s opinion on cancer surgery or treatment (once per lifetime)

Skilled nursing care facility . . . . . . . . . . . . . . . . . . . . . $75 per day Confinement to a covered facility after hospital release (up to the number of days paid for hospital confinement)

Skin cancer initial diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . $300 A skin cancer diagnosis while the policy is in force (once per lifetime)

Supportive or protective care drugs and colony stimulating factors . . . . . . . . . . . . . . . . . $50 per day Doctor-prescribed drugs to enhance or modify radiation/chemotherapy treatments ($400 calendar year max.)

Surgical procedures . . . . . . . . . . . . . . . . . . . $40 per surgical unit Inpatient or outpatient surgery for cancer treatment ($2,500 max. per procedure)

Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0 .50 per mile Travel expenses when being treated for cancer more than 50 miles from home (up to $1,000 per round trip)

Waiver of premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Is available No premiums due if the named insured is disabled longer than 90 consecutive days

For more information, talk with your Colonial Life benefits counselor.

1 In CO, home health care services maximum is up to 60 days per calendar year or twice the number of days hospital confined, whichever is greater. In WI, Home health care services maximum is up to 40 days per calendar year or twice the number of days hospital confined, whichever is greater.

2 In CO, no hospice benefit available.

3 In OK, reconstructive surgery is $20 per surgical unit.

4 In MD, second medical opinion is $25 maximum of one per covered person per hospital confinement.

In MD,tobacco cessation benefit available. $20 per prescription filled, maximum of two 90-day prescriptions per covered person.

In MT, mammography benefit available. $70 for one baseline mammogram for ages 35-39; one mammogram every two years for ages 40-49; one mammogram each year for ages 50+.

THIS POLICY PROVIDES LIMITED BENEFITS .

This coverage is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for cancer insurance.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benefits payable.

Applicable to policy form CanAssist (including state abbreviations where used, for example: CanAssist-TX). This chart is not complete without form number 1170702 (Exclusions & Limitations) in applicable states. For cost and complete details of coverage, call or write your Colonial Life benefits counselor or the company.

Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.

© 2025 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. FOR EMPLOYEES 3-25 | 101482-5

ColonialLife .com

Cancer insurance helps provide financial protection through a variety of benefits.

These benefits are not only for you but also for your covered family members.

BENEFIT DESCRIPTION BENEFIT AMOUNT

Air ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $2,000 per trip Transportation to or from a hospital or medical facility (max. of two trips per confinement)

Ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $250 per trip Transportation to or from a hospital or medical facility (max. of two trips per confinement)

Anesthesia Administered during a surgical procedure for cancer treatment

• General anesthesia . . . . 25% of surgical procedures benefit

• Local anesthesia . . . . . . . . . . . . . . . . . . . . . $30 per procedure

Anti-nausea medication . . . . . . . . . . $40 per day administered or per prescription filled Doctor-prescribed medication for radiation or chemotherapy ($160 monthly max.)

Blood/plasma/platelets/immunoglobulins . . . . . . .$150 per day A transfusion required during cancer treatment ($10,000 calendar year max.)

Bone marrow donor screening . . . . . . . . . . . . . . . . . . . . . . . . . .$50 Testing in connection with being a potential donor (once per lifetime)

Bone marrow or peripheral stem cell donation . . . . . . . . . $500 Receiving another person’s bone marrow or stem cells for a transplant (once per lifetime)

Bone marrow or peripheral stem cell transplant . . . . . . . . . . . . . . . . . . . . . . . $4,000 per transplant Transplant you receive in connection with cancer treatment (max. of two bone marrow transplant benefits per lifetime)

Cancer vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$50 An FDA-approved vaccine for the prevention of cancer (once per lifetime)

BENEFIT DESCRIPTION BENEFIT AMOUNT

Companion transportation . . . . . . . . . . . . . . . . . . . $0 .50 per mile Companion travels by plane, train or bus to accompany a covered cancer patient more than 50 miles one way for treatment (up to $1,000 per round trip)

Egg(s) extraction or harvesting/sperm collection and storage Extracted/harvested or collected before chemotherapy or radiation (once per lifetime)

• Egg(s) extraction or harvesting/sperm collection . . . . . . $700

• Egg(s) or sperm storage (cryopreservation) . . . . . . . . . . .$200

Experimental treatment . . . . . . . . . . . . . . . . . . . . . . $250 per day Hospital, medical or surgical care for cancer ($12,500 lifetime max.)

Family care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $40 per day Inpatient or outpatient treatment for a covered dependent child ($2,000 calendar year max.)

Hair/external breast/ voice box prosthesis . . . . . . . . . . . . . . . . $200 per calendar year Prosthesis needed as a direct result of cancer

Home health care services1 . . . . . . . . . . . . . . . . . . . . . $75 per day Examples include physical therapy, occupational therapy, speech therapy and audiology; prosthesis and orthopedic appliances; rental or purchase of durable medical equipment (up to 30 days per calendar year or twice the number of days hospital confined, whichever is greater)

Hospice (initial or daily care)2 An initial, one-time benefit and a daily benefit for treatment ($15,000 lifetime max. for both)

• Initial hospice care (once per lifetime) . . . . . . . . . . . . . . $1,000

• Daily hospice care . . . . . . . . . . . . . . . . . . . . . . . . . . . $50 per day

CANCER ASSIST — LEVEL 2

Level 2 benefits

Hospital confinement Hospital stay (including intensive care) required for cancer treatment

• 30 days or less . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $150 per day

• 31 days or more . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$300 per day

Lodging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $50 per day Hotel/motel expenses when being treated for cancer more than 50 miles from home (70-day calendar year max.)

Medical imaging studies . . . . . . . . . . . . . . . . . . . . .$125 per study Specific studies for cancer treatment ($250 calendar year max.)

Outpatient surgical center . . . . . . . . . . . . . . . . . . . . $200 per day Surgery at an outpatient center for cancer treatment ($600 calendar year max.)

Private full-time nursing services . . . . . . . . . . . . . . .