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WHAT TYPE OF LIFE PLAN DO YOU OFFER? WHAT TYPE OF LIFE PLAN DO YOU OFFER? Basic Life Supp Life Exec Life Base + Supp Base + Supp + Exec None (OTHER)

Select Life Carrier Select Life CarrierAetnaAflacAnthemBCBSB. ShieldCignaColonialGuardianHartfordHealth NetHumanaLincolnMet LifePrincipalStandardSun LifeUnitedUnumNone (OTHER)

Select Additional Carrier Select Additional CarrierAetnaAflacAnthemBCBSB. ShieldCignaColonialGuardianHartfordHealth NetHumanaLincolnMet LifePrincipalStandardSun LifeUnitedUnumNone (OTHER)

HOW MANY EMPLOYEES ARE LIFE ENROLLED (%)? HOW MANY EMPLOYEES ARE LIFE ENROLLED (%)? less than 33% 33% - 66% 66% - 99% 100% Basic Only N/A

WHAT TYPE OF DISABILITY PLAN DO YOU OFFER? WHAT TYPE OF DISABILITY PLAN DO YOU OFFER? Short-Term Only Long-Term Only Executive Only STD + LTD STD + LTD + EXEC None (OTHER)

Select Disability Carrier Select Disability CarrierAetnaAflacAnthemBCBSB. ShieldCignaColonialGuardianHartfordHealth NetHumanaLincolnMet LifePrincipalStandardSun LifeUnitedUnumNone (OTHER)

Select Additional Carrier Select Additional CarrierAetnaAflacAnthemBCBSB. ShieldCignaColonialGuardianHartfordHealth NetHumanaLincolnMet LifePrincipalStandardSun LifeUnitedUnumNone (OTHER)

HOW MANY EMPLOYEES ARE DISABILITY ENROLLED (%)? HOW MANY EMPLOYEES ARE DISABILITY ENROLLED (%)? less than 33% 33% - 66% 66% - 99% 100% Basic Only N/A

FREE VALUE-ADDS INCLUDED FREE VALUE-ADDS INCLUDED Will Prep Discounts Certificates