Plan summary

Public Employees Benefits Board (PEBB) Program Term Life Insurance Overview Life insurance is a cost-effective way to protect your family and your finances. It helps ensure your short- and long-term financial obligations could be met if something unforeseen happens to you. Explore the coverage that makes it easy to give yourself and your loved ones more security today and in the future. Basic Term Life and Accidental Death and Dismemberment (AD&D) Insurance Your employer provides you with $35,000 in Basic Term Life insurance coverage and $5,000 in Basic AD&D insurance coverage at no cost to you. Supplemental Term Life Insurance Coverage Options Specific details regarding these provisions can be found in the Certificate of Coverage. You may enroll in supplemental life insurance, in addition to the basic life insurance provided by your employer. Use this document to: Learn more about the coverage options available to you, special plan features and services, and costs for coverage. Calculate your estimated monthly premium payment. Enroll by visiting the MetLife website at mybenefits.metlife.com/wapebb. For Your Spouse/State-Registered For You Domestic Partner For Your Dependent Children* $5,000 up to $500,000, in $5,000 $10,000 up to $1,000,000, in $10,000 increments, not to exceed 50% of $5,000 up to $20,000, in $5,000 increments Employee Supplemental Life increments coverage amount You must enroll in coverage for yourself to enroll your spouse or state-registered domestic partner and/or dependent child(ren). *Child(ren)’s Eligibility: Dependent children ages from 14 days to 26 years old are eligible for coverage. What is Supplemental Accidental Death and Dismemberment (AD&D) Insurance? Supplemental AD&D insurance complements your supplemental life insurance with coverage for severe accidents or loss of life on or off the job. AD&D insurance pays benefits if you suffer a covered accident that results in paralysis or the loss of a limb, speech, hearing or sight, or if you suffer a covered fatal accident. Covered Losses This AD&D insurance pays benefits for covered losses that are the result of an accidental injury or loss of life. The full amount of AD&D coverage you select is called the “Full Amount” and is equal to the benefit payable for the loss of life. Benefits for other losses are payable as a predetermined percentage of the Full Amount, and will be listed in your coverage in a table of Covered Losses. Such losses include loss of limbs, sight, speech and hearing, various forms of paralysis, brain damage and coma. The maximum amount payable for all Covered Losses sustained in any one accident is capped at 100% of the Full Amount. Supplemental AD&D Insurance Coverage Options This valuable coverage benefits beyond your disability or life insurance for losses due to covered accidents — including while commuting, traveling by public or private transportation and during business trips. MetLife’s AD&D insurance pays you benefits if you suffer a covered accident that results in paralysis or the loss of a limb, speech, hearing or sight; brain damage; or coma. If you suffer a covered fatal accident, benefits will be paid to your beneficiary. Supplemental AD&D Coverage Amounts for You • You can buy Supplemental AD&D in $10,000 increments up to a maximum of $250,000 Supplemental AD&D Coverage Amounts for Your Spouse/State-Registered Domestic Partner and Child(ren) • You can choose to cover your spouse/state-registered domestic partner and child(ren) with AD&D coverage. Your spouse/state- registered domestic partner will be eligible for coverage in $10,000 increments up to $250,000. Your child(ren) will be eligible for coverage amounts in $5,000 increments up to $25,000. *Child(ren)’s Eligibility: Dependent children ages from 14 days to 26 years are eligible for coverage.

Standard Additional Benefits Include Some of the standard additional benefits included in your AD&D coverage that may increase the amounts payable to you and/or cover additional expenses that result from accidental injury or loss of life are: • Air Bag • Child Care Center • Hospitalization • Seat Belt • Child Education • Presumption of Death • Common Carrier • Spouse Education • Exposure What Is Not Covered by AD&D? AD&D insurance does not include payment for any loss which is caused by or contributed to by: physical or mental illness, diagnosis of or treatment of the illness; an infection, unless caused by an external wound accidentally sustained; suicide or attempted suicide; injuring oneself on purpose; the voluntary intake or use by any means of any drug, medication or sedative, unless taken as prescribed by a doctor or an over-the-counter drug taken as directed; voluntary intake of alcohol in combination with any drug, medication or sedative; war, whether declared or undeclared, or act of war, insurrection, rebellion or active participation in a riot; committing or trying to commit a felony; any poison, fumes or gas, voluntarily taken, administered or absorbed; service in the armed forces of any country or international authority, except the United States National Guard; operating, learning to operate, or serving as a member of a crew of an aircraft; while in any aircraft for the purpose of descent from such aircraft while in flight (except for self-preservation); or operating a vehicle or device while intoxicated as defined by the laws of the jurisdiction in which the accident occurs. Additional Coverage Information How to Enroll • You may enroll in supplemental life and AD&D insurance coverage quickly and securely online using the MyBenefits website. It’s easy to use. Just go to mybenefits.metlife.com/wapebb. For Employee Coverage Enrollment in this Supplemental Term Life insurance plan is available without providing medical information as long as: For New Hires • The enrollment takes place within 31 days from the date you become eligible for benefits, and • You are enrolling for coverage up to $500,000. If you do not meet all of the conditions stated above, you will need to provide additional medical information by completing a Statement of Health form provided by MetLife.* *All applications for coverage are subject to review and approval by MetLife. If you choose to apply for increased coverage, the increase may be subject to underwriting. MetLife will review your information and evaluate your request for coverage based upon your answers to the health questions, MetLife’s underwriting rules and other information you authorize us to review. In certain cases, MetLife may request additional information to evaluate your request for coverage. † For Dependent Coverage You must be covered or enrolling in coverage in order to cover your spouse/state-registered domestic partner and child(ren). Your spouse/state-registered domestic partner does not need to provide medical information as long as: For New Hires • The enrollment takes place within 31 days from the date you become eligible for benefits, and • You are enrolling for spouse/state-registered domestic partner coverage less than $100,000. If you do not meet all of the conditions stated above, you will need to provide additional medical information by completing a Statement of Health form provided by MetLife. * *All applications for coverage are subject to review and approval by MetLife. If you choose to apply for increased coverage, the increase may be subject to underwriting. MetLife will review your information and evaluate your request for coverage based upon your answers to the health questions, MetLife’s underwriting rules and other information you authorize us to review. In certain cases, MetLife may request additional information to evaluate your request for coverage.

About Your Coverage Effective Date You must be Actively at Work on the date your coverage becomes effective. Actively at Work means that You are performing the usual and customary duties of Your job at your Employer’s place of business, an alternate place approved by Your Employer, or a place which the Employer’s business requires you to travel. Your coverage must be in effect for your spouse/state-registered domestic partner’s and eligible children’s coverage to take effect. In addition, your spouse/state-registered domestic partner and eligible child(ren) must not be home or hospital confined or receiving or applying to receive disability benefits from any source when their coverage becomes effective. If Actively at Work requirements are met, coverage will become effective on the first of the month following the receipt of your completed application for all requests that do not require additional medical information. A request for your amount that requires additional medical information and is not approved by the date listed above will not be effective until the first of the month following the date MetLife approved the coverage or increase if you meet Actively at Work requirements on that date, or the date that Actively at Work requirements are met after MetLife has approved the coverage or increase. The coverage for your spouse/state-registered domestic partner and eligible child(ren) will take effect on the date they are no longer confined, receiving or applying for disability benefits from any source or hospitalized. Who Can Be a Designated Beneficiary? You can select any beneficiary other than your employer for your Basic and Supplemental coverages, and you may change your beneficiary at any time. You can also designate more than one beneficiary. You are the beneficiary for your Dependent coverage. You can name beneficiaries online using the MyBenefits website at mybenefits.metlife.com/wapebb or by calling 866-548-7139. Monthly Costs* for Supplemental Term Life Insurance Cost is based on the amount of coverage you elect, your age as of December 31 of the prior year, and your smoking status. Spouse or state- registered domestic partner coverage is based on your age as of December 31 of the prior year as well as your spouse’s or state-registered domestic partner’s smoking status. The rates shown are the monthly cost per $1,000 of coverage. The monthly cost for dependent children covers all eligible children. Monthly Cost Per $1,000 of Employee Monthly Cost Per $1,000 of Spouse/State- Age Coverage Registered Domestic Partner Coverage Tobacco User* Non-Tobacco User Tobacco User* Non-Tobacco User Under 25 $0.039 $0.030 $0.039 $0.030 25 – 29 $0.046 $0.033 $0.046 $0.033 30 – 34 $0.060 $0.036 $0.060 $0.036 35 – 39 $0.069 $0.045 $0.069 $0.045 40 – 44 $0.077 $0.067 $0.077 $0.067 45 – 49 $0.117 $0.097 $0.117 $0.097 50 – 54 $0.179 $0.151 $0.179 $0.151 55 – 59 $0.334 $0.282 $0.334 $0.282 60 – 64 $0.508 $0.432 $0.508 $0.432 65 – 69 $0.978 $0.798 $0.978 $0.798 70 + $1.589 $1.190 $1.589 $1.190 † $0.124 Cost for your Child(ren) † Covers all eligible children * A tobacco user is anyone who has smoked cigarettes, pipes, cigars or used any tobacco in any form in the past 2 months. **Note: rates are subject to the policy’s right to change premium rates, and the employer’s right to change employee contributions.

Calculate Your Premium How to calculate your Employee supplemental life and AD&D insurance monthly cost: Example: 40-year-old non-tobacco users applying for $200,000 of coverage. Steps Example Calculate for yourself A. Find your *age-based rate in the chart above: $ 0.067 $ $ B. Choose how much coverage you are applying for: $200,000 200 C. Divide that coverage amount by 1,000 ($200,000 ÷ 1,000) $ D. Multiply A x C for estimated Monthly Cost: $13.40 ($0.067 x 200) $ Repeat steps B-D above to determine the cost for supplemental AD&D coverage. *based on your age of December 31 of the prior year Monthly Cost for Supplemental AD&D Insurance Supplemental Coverage Monthly Cost Per $1,000 of Coverage Employee $0.019 Dependent Spouse/State-Registered Domestic Partner $0.019 Dependent Child $0.016 SM MetLife Advantages Your plan(s) includes access to MetLife AdvantagesSM—a comprehensive suite of valuable services for support, planning and protection when you need it most at no cost to you. Services include: 1 Will Preparation Services Offers you and your spouse or state-registered domestic partner unlimited face-to-face or telephone meetings with an attorney from MetLife Legal Plans’ network of over 18,500 participating attorneys, to prepare or update a will, living will, and Power of Attorney. Call 1-800-821- 6400 and a Client Service Representative will assist you. 1 Estate Resolution Services Estate representatives and beneficiaries may receive unlimited face-to-face legal assistance with probating your and your spouse’s or state- registered domestic partner’s estates. Beneficiaries can also consult an attorney, from MetLife Legal Plans’ network of more than 18,500 participating attorneys, for general questions about the probate process. 2 WillsCenter.com Employees and spouses or state-registered domestic partners have access to WillsCenter.com, an online document service to prepare and update a will, living will, power of attorney, funeral directive, memorandum of wishes or HIPAA authorization form in a secure 24/7 environment at no additional cost. This service is available with all life coverages. Log on to the willscenter.com website to register as a new user. 3 Funeral Discounts and Planning Services As a MetLife group life policyholder, you and your family may have access to funeral discounts, planning and support to help honor a loved one’s life — at no additional cost to you. Dignity Memorial provides you and your loved ones access to discounts of up to 10% off of funeral, cremation and cemetery services through the largest network of funeral homes and cemeteries in the United States. When using a Dignity Memorial Network you have access to convenient planning services — either online at the finalwishesplanning.com website, or by calling 1- 866-853-0954 to help make final wishes easier to manage. You also have access to assistance from compassionate funeral planning experts to help guide you. 4 Grief Counseling Provides you and your dependents up to five private counseling sessions, in-person or by phone, with a professional grief counselor— per event—to help cope with a loss, no matter the circumstances, whether it’s a death, an illness or divorce. You can access these services by calling 1-888-319-7819 or log on to www.metlife.gc.lifeworks.com (Username: metlifeassist; Password: support).

5 Travel Assistance Travel Assistance services are offered and administered by AXA Assistance USA, Inc. Certain benefits provided under the Travel Assistance program are underwritten by Certain Underwriters at Lloyd’s London (not incorporated) through Lloyd’s Illinois, Inc. Neither AXA Assistance USA Inc. nor the Lloyd’s entities are affiliated with MetLife, and the services and benefits they provide are separate and apart from the insurance provided by MetLife. ®6 Delivering the Promise This service is designed to help beneficiaries sort through the details and serious questions about claims and financial needs during a difficult time. MetLife has arranged for specially trained third-party financial professionals to be available for assistance in person or by telephone to help with filing life insurance claims, government benefits, and help with financial questions. 6 Transition Solutions Focuses on guidance and services around insurance and other financial products to help you and your family better prepare for your future in response to benefit changing events. Portability7 Gives you an opportunity to continue your Group Life insurance coverage with MetLife should you become ineligible for PEBB Program benefits for any reason. Competitive rates apply but will likely be higher than your current rates. MetLife will bill you directly. To take advantage of this feature, you must have coverage of at least $10,000 up to a maximum of $2,000,000. Generally, there is no minimum time for you to be covered by the plan before you can take advantage of the portability feature. Portability is also available on coverage you’ve selected for your spouse or state-registered domestic partner and dependent child(ren). Dependents’ amounts are contingent on the employee’s amount. Increases, decreases and maximums are subject to state availability. Please see your plan certificate for specific details. Please note that if you experience an event that makes you eligible for portable coverage, please call a MetLife representative at 1-866-548- 7139 for more information. 8 Total Control Account ® The Total Control Account (TCA) settlement option provides your loved ones with a safe and convenient way to manage the proceeds of a life or accidental death and dismemberment claim payments of $5,000 or more, backed by the financial strength and claims paying ability of Metropolitan Life Insurance Company. TCA death claim payments relieve beneficiaries of the need to make immediate decisions about what to do with a lump-sum check and enable them to have the flexibility to access funds as needed while earning a guaranteed minimum interest rate on the proceeds as they assess their financial situations. Call 1-800-638-7283 for more information about options available to you. Empathy9 Gives beneficiaries complimentary access to 24/7 support for challenges that the loss of a loved one brings, helping them save time, money, and stress. From settling the estate to dealing with grief, Empathy can offer guidance on a variety of topics to assist beneficiaries in navigating through the challenges that loss brings. Call 201-720-1584 to register via phone or visit join.empathy.com/metlife. Additional Features This insurance offering from your employer and MetLife comes with additional features that can provide assistance to you and your family. Accelerated Benefits Option10 For access to funds during a difficult time If you become terminally ill and are diagnosed with 24 months or less to live, you have the option to receive up to 80% of your life insurance proceeds. This can go a long way towards helping your family meet medical and other expenses at a difficult time. Amounts not accelerated will continue under your employer’s plan for as long as you remain eligible per the certificate requirements and the group policy remains in effect. The accelerated life insurance benefits offered under your certificate are intended to qualify for favorable tax treatment under Section 101(g) of the Internal Revenue Code (26 U.S.C.Sec 101(g)).11 Accelerated Benefits Option is not the same as long term care insurance (LTC). LTC provides nursing home care, home-health care, personal or adult day care for individuals above age 65 or with chronic or disabling conditions that require constant supervision. The Accelerated Benefits Option is also available to spouses/state-registered domestic partners insured under Dependent Life insurance plans. This option is not available for dependent child coverage.

Conversion For protection after your coverage terminates You can generally convert your group term life insurance benefits to an individual whole life insurance policy if your coverage terminates in whole or in part due to your retirement, termination of employment, or change in employee class. Conversion is available on all group life insurance coverages. Please note that conversion is not available on AD&D coverage. If you experience an event that makes you eligible to convert your coverage, please call 1-877-275-6387 to begin the conversion process. Please contact MetLife for more information. Waiver of Premiums for Total Disability (Continued Protection) Offering continued coverage when you need it most If you become Totally Disabled, you may qualify to continue certain insurance. You may also be eligible for waiver of your basic, supplemental, and dependent term life insurance premium until die, or recover from your disability, whichever is sooner. Total Disability or Totally Disabled means you are unable to do your job and any other job for which you are fit by education, training or experience due to injury or sickness. The Total Disability must begin before age 60, and your waiver will begin after you have satisfied a 6-month waiting period of continuous disability. The waiver of premium will end when you die or recover. Continuation for Surviving Dependents Continued coverage for your dependents This feature allows coverage for your surviving dependents, who were insured at the time of your death, to continue with premium payment. Surviving children must continue to meet the plan’s child definition in order to be eligible and coverage will end upon your spouse’s remarriage. Premium payments may be made directly to MetLife for up to 5 months. If you have questions, call 1-866-548-7139. Visit metlife.com/wshca to find plan information, documents, a life insurance calculator, and more!

1 Will Preparation Services and Estate Resolution Services are offered by MetLife Legal Plans, Inc., Cleveland, Ohio. In certain states, Will Preparation Services and Estate Resolution Services are provided through insurance coverage underwritten by Metropolitan General Insurance Company, Warwick, RI. These services are provided at no additional cost to those who purchase Supplemental Life Insurance only. Tax Planning and preparation of Living Trusts are not covered by the Will Preparation Service. Certain services are not covered by Estate Resolution Services, including matters in which there is a conflict of interest between the executor and any beneficiary or heir and the estate; any disputes with the group policyholder, MetLife and/or any of its affiliates; any disputes involving statutory benefits; will contests or litigation outside probate court; appeals; court costs, filing fees, recording fees, transcripts, witness fees, expenses to a third party, judgments or fines; and frivolous or unethical matters. 2 WillsCenter.com is a document service provided by SmartLegalForms, Inc., an affiliate of Epoq Group, Ltd. SmartLegalForms, Inc. is not affiliated with MetLife and the WillsCenter.com service is separate and apart from any insurance or service provided by MetLife. The WillsCenter.com service does not provide access to an attorney, does not provide legal advice, and may not be suitable for your specific needs. Please consult with your financial, legal, and tax advisors for advice with respect to such matters. WillsCenter.com is available to anyone with internet access regardless of affiliation with MetLife. 3 Services and discounts are provided through a member of the Dignity Memorial® Network, a brand name used to identify a network of licensed funeral, cremation and cemetery providers that are affiliates of Service Corporation International (together with its affiliates, “SCI”), 1929 Allen Parkway, Houston, Texas. The online planning site is provided by SCI Shared Resources, LLC. SCI is not affiliated with MetLife, and the services provided by Dignity Memorial members are separate and apart from the insurance provided by MetLife. Not available in some states. Planning services, expert assistance, and bereavement travel services are available to anyone regardless of affiliation with MetLife. Discounts through Dignity Memorial’s network of funeral providers are pre-negotiated. Not available where prohibited by law. The discount is available for services offered in any state except KY and NY, or where there is no Dignity Memorial presence (AK, MT, ND, SD, and WY). For MI and TN, the discount is available for “At Need” services only. 4 Grief Counseling and Funeral Assistance services are provided through an agreement with LifeWorks. LifeWorks is not an affiliate of MetLife, and the services LifeWorks provides are separate and apart from the insurance provided by MetLife. LifeWorks has a nationwide network of over 30,000 counselors. Counselors have master’s or doctoral degrees and are licensed professionals. The Grief Counseling program does not provide support for issues such as: domestic issues, parenting issues, or marital/relationship issues (other than a finalized divorce). For such issues, members should inquire with their human resources department about available company resources. This program is available to insureds, their dependents and beneficiaries who have received a serious medical diagnosis or suffered a loss. Events that may result in a loss are not covered under this program unless and until such loss has occurred. Services are not available in all jurisdictions and are subject to regulatory approval. Not available on all policy forms. 5 Travel Assistance services are offered and administered by AXA Assistance USA, Inc. Certain benefits provided under the Travel Assistance program are underwritten by Certain Underwriters at Lloyd’s London (not incorporated) through Lloyd’s Illinois, Inc. Neither AXA Assistance USA, Inc. nor the Lloyd’s entities are affiliated with MetLife, and the services and benefits they provide are separate and apart from the insurance provided by MetLife. 6 MetLife administers the Transition Solutions and Delivering the Promise programs and has arranged to have specially trained third-party financial professionals offer financial education. The financial professionals providing financial education are not affiliated with MetLife but are providing the program under a service provider contract. 7 All coverage amounts are subject to applicable state laws. To take advantage of this benefit, coverage of at least $10,000 must be elected. 8 Subject to state law, and/or group policyholder direction, the Total Control Account is provided for all Life and AD&D benefits of $5,000 or more. The assets backing the Total Control Account (TCA) are maintained in the general account of MetLife or the Issuing Insurance Company. These general accounts are subject to the creditors of MetLife or the respective Issuing Insurance Company. MetLife or the Issuing Insurance Company bears the investment experience of such assets and expects to earn income sufficient to pay interest to TCA Accountholders and to make a profit on the operation of the TCAs. Regardless of the investment experience of such assets, the effective annual rate on the Account will not be less than the rate guaranteed on the welcome guide. The TCA and other available settlement options are not bank products and are not insured by the FDIC or any other governmental agency. In addition, while the funds in your account are not insured by the FDIC, they are guaranteed by each state’s insurance guarantee association. The coverage limits vary by state. Please contact the National Organization of Life and Health Insurance Guaranty Associations (www.NOLHGA.com or 703-481-5206) to learn more. FOR FURTHER INFORMATION, PLEASE CONTACT YOUR STATE DEPARTMENT OF INSURANCE. 9 Empathy’s bereavement services and platform are provided through an agreement with The Empathy Project, Inc., (doing business as Empathy). Empathy is not an affiliate of MetLife, and the services Empathy provides are separate and apart from the insurance provided by MetLife. This program is available to beneficiaries, and insureds who are terminally ill and eligible to accelerate life proceeds under MetLife's Accelerated Benefit Option. Not available on all policy forms or in all jurisdictions. Empathy is only available to insureds and beneficiaries who are US residents. Information disclosed directly to Empathy is not disclosed to MetLife, and therefore is not subject to MetLife’s privacy policy. 10 The Accelerated Benefits Option is subject to state regulation and is intended to qualify for favorable federal income tax treatment, in which case the benefits will not be subject to federal income taxation. This information was written as a supplement to the marketing of life insurance products. Tax laws relating to accelerated benefits are complex and limitations may apply. You are advised to consult with and rely on an independent tax advisor about your own particular circumstances. Receipt of accelerated benefits may affect your eligibility, or that of your spouse or your family, for public assistance programs such as medical assistance (Medicaid), Temporary Assistance to Needy Families (TANF), Supplementary Social Security Income (SSI) and drug assistance programs. You are advised to consult with social service agencies concerning the effect that receipt of accelerated benefits will have on public assistance eligibility for you, your spouse or your family.

This summary provides an overview of your plan’s benefits. These benefits are subject to the terms and conditions of the contract between MetLife and WA State Health Care Authority PEBB and are subject to each state’s laws and availability. Specific details regarding these provisions can be found in the certificate. If you have additional questions regarding the life Insurance program underwritten by MetLife, please contact your benefits administrator or MetLife. Nothing in these materials is intended to be advice for a particular situation or individual. Like most group life insurance policies, MetLife group policies contain exclusions, limitations, terms and conditions for keeping them in force. Please see your certificate for complete details. Life and AD&D coverages are provided under a group insurance policy (Policy Form GPNP16-WSHCA) issued to your employer by MetLife. Life and AD&D coverages under your employer’s plan terminates, when your employment ceases, when your Life and AD&D contributions cease, or upon termination of the group contract. Should your life insurance coverage terminate for reasons other than non-payment of premium, you may convert it to a MetLife individual permanent policy without providing medical evidence of insurability. Metropolitan Life Insurance Company | 200 Park Avenue | New York, NY 10166 L0823034629[exp0825][All States][DC,GU,MP,PR,VI]© 2023 MetLife Services and Solutions, LLC