ii. You were not eligible to continue Employee-Paid Insurance after losing eligibility for the Employer contribution. 8. When an employee who is called to active duty in the uniformed services under USERRA loses eligibility for the employer contribution toward PEBB benefits, they regain eligibility for the employer contribution toward PEBB benefits the day they return from active duty. Employer-Paid benefits will begin the first day of the month in which they return from active duty. LT.RE.01X DEFINITIONS Benefit Waiting Period means the period you must be continuously Disabled before LTD Benefits become payable. No LTD Benefits are payable for the Benefit Waiting Period. See Coverage Outline. CPI-W means the Consumer Price Index for Urban Wage Earners and Clerical Workers published by the United States Department of Labor. If the CPI-W is discontinued or changed, we may use a comparable index. Where required, we will obtain prior state approval of the new index. Eligibility Waiting Period means the period you must be a Member before you become eligible for insurance. See Coverage Outline. Employee-Paid means the level of insurance coverage for which you pay all of the premium. Employer means the State of Washington and any governmental subdivision obtaining employee benefits through a contractual agreement with the Policyholder. Employer-Paid means the level of insurance coverage for which the entire premium is paid by the Employer, except for approved educational or USERRA leave. Providing Evidence Of Insurability means you must: 1. Complete and sign our medical history statement; 2. Sign our form authorizing us to obtain information about your health; 3. Undergo a physical examination, if required by us, which may include blood testing; and 4. Provide any additional information about your insurability that we may reasonably require. Providing Evidence Of Insurability does not mean your application for coverage will be approved. Group Policy means the group LTD insurance policy issued by us to the Policyholder and identified by the Group Policy Number. Indexed Predisability Earnings means your Predisability Earnings adjusted by the rate of increase in the CPI-W. During your first year of Disability, your Indexed Predisability Earnings are the same as your Predisability Earnings. Thereafter, your Indexed Predisability Earnings are determined on each anniversary of your Disability by increasing the previous year's Indexed Predisability Earnings by the rate of increase in the CPI-W for the prior calendar year. The maximum adjustment in any year is 10%. Your Indexed Predisability Earnings will not decrease, even if the CPI-W decreases. Injury means harm, hurt or damage to your body. LTD Benefit means the monthly benefit payable to you under the terms of the Group Policy. Maximum Benefit Period means the longest period for which LTD Benefits are payable for any one period of continuous Disability, whether from one or more causes. It begins at the end of the Benefit Waiting Period. No LTD Benefits are payable after the end of the Maximum Benefit Period, even if you are still Disabled. See Coverage Outline. Physician means a licensed medical professional, other than yourself, acting within the scope of the license. 377661-B - 23 6/29/2022

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