Life and AD&D

Symetra

ABOUT LIFE AND AD&D

Group term life is the most inexpensive way to purchase life insurance. You have the freedom to select an amount of life insurance coverage you need to help protect the well-being of your family. Accidental Death & Dismemberment is life insurance coverage that pays a death benefit to the beneficiary, should death occur due to a covered accident. Dismemberment benefits are paid to you, according to the benefit level you select, if accidentally dismembered. For full plan details, please visit your benefit website: www.mybenefitshub.com/wylieisd

EMPLOYEE BENEFITS

Effective Date: September 1, 2021 Policy Number:01-020279-00 The information in this summary may be replaced by any subsequently issued summary or policy amendment.

Employee Amount Minimum Amount Employee Amount Minimum Amount

Employee Amount Minimum Amount Maximum Amount

Guaranteed Issue

Spouse Spouse Amount Minimum Amount Maximum Amount Guaranteed Issue

Child Child Amount Employee Amount Minimum Amount Maximum Amount Spouse Spouse Amount Minimum Amount Maximum Amount Child Child Amount

Basic Life Benefit $15,000 $15,000 Basic AD&D Benefit $15,000 $15,000

Life Benefit Increments of $10,000 $10,000 Lesser of $500,000 or 7 x Earnings Guaranteed Issue Amount: Age 70 and below: $350,000 Age 70 and up: $250,000 Life Benefit Increments of $5,000 $5,000 $500,000 not to exceed 100% of Supplemental Employee Coverage $50,000

Life Benefit Live Birth to age 26 year(s): $10,000 AD&D Benefit Increments of $10,000 $10,000 Lesser of $500,000 or 7 x Earnings AD&D Benefit Increments of $5,000 $5,000 $500,000 not to exceed 100% of Supplemental Employee Coverage AD&D Benefit Live Birth to age 26 year(s): $10,000 Voluntary Group Life - per $10,000 in coverage Age Employee 18-24 $0.48 25-29 $0.48 30-34 $0.57 35-39 $0.76 40-44 $1.05 45-49 $1.81 50-54 $3.04 55-59 $4.85 60-64 $7.41 65-69 $13.40 70-74 $24.13 75+ $24.13

Voluntary Group Life - Child(ren) Per $10,000 in coverage

0-26 Spouse rates based on Employee's age.

Employee Spouse Child Symetra AD&D- per $10,000 $0.20 $0.20 $0.20

Symetra

EMPLOYEE BENEFITS

Eligibility All Active Full Time Employees working a minimum of 20 hours per week and their eligible dependents. Evidence of Insurability

Evidence of Insurability is required for all amounts of insurance selected after the initial 31 day eligibility period and for any amount in excess of the Guarantee Issue amount.

Additional Benefit Details

Accelerated Death Benefit

If an employee has been diagnosed as terminally ill, Symetra Life Insurance Company may pay a portion of the death benefit in advance to the employee. Please refer to your employee certificate for additional information.

Conversion

Portability A conversion benefit is available that allows you to convert your group coverage to an individual policy if certain conditions apply. Please refer to your employee certificate for additional information.

This coverage may be continued at group rates upon termination of employment. Certain restrictions apply. Please refer to your employee certificate for additional information.

Waiver of Premium With proof of disability, Symetra Life Insurance Company will waive Life Insurance premiums for a employee that becomes disabled. Certain restrictions apply. Please refer to your employee certificate for additional information.

AD&D Riders Includes Seat Belt, Airbag, Repatriation, Child Education, Day Care, Rehabilitation, Spouse Education, Adaptive Home and Vehicle and Coma benefits. Please refer to your employee certificate for additional information.