SCHEDULE OF BENEFITS This schedule shows the benefits that are available under the Group Policy. You will only be insured for the benefits:  for which You become and remain eligible;  which You elect, if subject to election; and  which are in effect. The amount of Insurance that We will pay for any insurance to which You make premiums will be decreased by the amount of Your premiums due and unpaid to Us for that insurance. How We Will Pay Benefits Unless the Beneficiary requests payment by check, when the Certificate states that We will pay benefits in "one sum", “lump sum” or a "single sum", We may pay the full benefit amount:  by check;  by establishing an account that earns interest and provides the Beneficiary with immediate access to the full benefit amount; or  by any other method that provides the Beneficiary with immediate access to the full benefit amount. Other modes of payment may be available upon request. For details, call Our toll free number shown on the Certificate Face Page. BENEFIT BENEFIT AMOUNTS AND HIGHLIGHTS Life Insurance For You Class 1 Retiree Term Life Plan: WA State Health Care Authority PEBB and WA State Health Care Authority SEBB employees enrolled in Basic Life Insurance who meet qualifications for enrollment in PEBB retiree insurance coverage on or after January 1, 2017; and Retirees who elected to move from the Policyholder’s $3,000 benefit plan to this Class 1 Retiree Term Life Plan during the 2016 open enrollment period. ........................................................ An amount, elected by You on the . date You retire, which is a multiple of $5,000 Minimum Life Benefit ................................................... $5,000 Maximum Life Benefit .................................................. $20,000 GCERT2024-WSHCA-WA-LIFE-RETIREE1 19