1R2 1982 07080 SOUTH PLAINFIELD P1900600 Bett A Way Traffic Systems NJ 110 SYLVANIA PL Liazon Daryl walthew 199 SCOTT ST STE 800 BUFFALO NY 14204 James Kane 860-573-4882 jekane1@metlife.com) 199 SCOTT ST STE 800 BUFFALO NY 14204 12/19/2016 GBF data could not be retrieved for the structure creation. Structure review required: 12/19/2016 at 01:00 PM, EST 2016-12-19 13:00:19.478 L. Goncalves 12/19/2016 Case sold and approved: 12/19/2016 at 01:00 PM, EST 2016-12-19 13:00:19.438 L. Goncalves 12/14/2016 Liazon rate card case. Held rates from card. 2016-12-14 13:24:45.155 B. Banks 12/14/2016 Axis pointe is the underlying brokerage Liazon as TPA unable to select in sales radar address taken default 12/14/2016 at 12:32 PM, EST by Sarita Gupta 2016-12-14 12:32:36.582 12/14/2016 RFP Submitted from Intake on 12/14/2016 at 12:32 PM, EST 2016-12-14 12:32:36.581 James Kane Martine Lamartiniere 12/15/2016 4731 932572 Banks, Brad NJ 01/01/2017 Banks, Brad 12/14/2016 97 Boston 200 West Street 3rd Floor Waltham MA 02451 781-472-3600 800-624-4076 781-279-2813 888-638-6978 Addition SM 100- NJ 4731 N 4033916 SupplementalLife CostBenefit 4033916 SupplementalLife-ADD CostBenefit 4033916 SupplementalDependentLife CostBenefit 4033916 SupplementalDependentLife-DepADD CostBenefit 4033917 STD CostBenefit 4033918 LTD CostBenefit No Sold Exchange_Liazon_Supp Life Sold 4033916 1.0 15.00 24 Hour Yes 5 75.00 Yes No GCERT2000 No No No Yes 100.00 10.00 Yes Flat % 2017-01-01 Death & Dismemberment Yes 50.00 No 50.00 50.00 No No No No 75.00 Yes No 50.00 100.00 50.00 25.00 Yes No No Yes Separate No Yes 10 50.00 100.00 50.00 No No 25.00 No 0 0 10.00 0.035 1939952.00 4033916 SupplementalADD 2016-12-14 0.035 Increments 500000.00 25000.00 97 0.035 $25,000 0.035 Yes 500000.00 Yes No 80.0 Yes Yes None 5.00 Lesser of Flat or Mult Increments No All Active Full Time Employees Basic Monthly Earnings CP 60/65 All Active Full Time Employees (30 Hours) 0 Non-retro rated No 500000.00 Yes No NewPort 12 None No 12 Yes 1939952.00 No No 25 0 1939952.00 9 months 7425800 1 Less than 30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+ GCERT2000 10.0 10.00 Flat % 2017-01-01 1.0 0.290 0.231 1.03 Actuarial Adjustment NewPort 25.18 New - Replacement 12 1.0 1939953.00 Included None None Included 1939952.00 No 24 Not allowed No No 4033916 SupplementalLife 2016-12-14 80.0 None $25,000 500000.00 25000.00 Increments 10.00 No All Active Full Time Employees CP 60/65 Basic Monthly Earnings All Active Full Time Employees (30 Hours) 97 1st of the Month 90 Days 90 Days 0 34.74 0.290 1.0 1.1 1.1 0.00 100000.00 25 EE Supp 500000.00 1.0 None 4731 1.0 1.28 0.985 24 1939952.00 0.00 0.00 1.0 0.955 Yes No Tight 5.00 Lesser of Flat or Mult No Non-retro rated 500000.00 Flat Amount 100000.00 NewPort 12 No 12 9 months 7425799 1 1 0.066 0.066 0.080 1 91954.00 Less than 30 0.083 0.083 0.100 2 197875.00 30-34 0.093 0.093 0.130 4 341237.00 35-39 0.136 0.136 0.170 5 414762.00 40-44 0.215 0.215 0.250 5 371695.00 45-49 0.339 0.339 0.400 4 292933.00 50-54 0.529 0.529 0.710 2 152868.00 55-59 0.778 0.778 0.990 1 54125.00 60-64 1.324 1.324 1.790 0 16296.00 65-69 2.504 2.504 3.200 0 6208.00 70+ 24 Hour Yes 5 75.00 Yes No GCERT2000 No Yes 100.00 Yes 10.00 Flat % 2017-01-01 Death & Dismemberment Yes 50.00 No 50.00 50.00 No No 75.00 No 50.00 100.00 50.00 25.00 Yes No Yes Separate No Yes 10 50.00 100.00 50.00 No 25.00 432500.00 4033916 SupplementalDependentADD 2016-12-14 0.048 100000.00 0.035 10000.00 Yes No 80.0 Yes Yes None $5,000 $10,000 Flat Amount Increments Flat Amount 0.00 No All Active Full Time Employees Basic Monthly Earnings Spouse & Child(ren) CP 60/65 All Active Full Time Employees (30 Hours) 97 0 Non-retro rated No 500000.00 50000.00 No None 12 None No 12 Yes No 190000.00 0.031 25 24 242500.00 No 5000.00 100.00 10000.00 9 months 7425809 1 0.035 0.048 0.031 0.035 0.041 10.00 Flat % 2017-01-01 12 New - Replacement None None 240000.00 Not allowed No 0 No 4033916 SupplementalDependentLife 2016-12-14 $5,000 $10,000 100000.00 5000.00 Increments All Active Full Time Employees 50000.00 26 Spouse & Child(ren) 97 0 50000.00 Dep Supp 100000.00 None 4731 26 100.00 10000.00 10000.00 Yes No 80.0 Tight Flat Amount Increments Flat Amount 0.00 CP 60/65 Basic Monthly Earnings Non-retro rated No 500000.00 Flat Amount 25000.00 10000.00 None 12 No 12 No 25 None None All Active Full Time Employees (30 Hours) 9 months 7425808 1 1 0.240 0.250 0.24 0.065 0.080 0 11376.00 Less than 30 0.080 0.100 0 24480.00 30-34 0.090 0.130 0 42216.00 35-39 0.132 0.170 0 51312.00 40-44 0.209 0.250 0 45984.00 45-49 0.330 0.400 0 36240.00 50-54 0.514 0.710 0 18912.00 55-59 0.756 0.990 0 6696.00 60-64 1.286 1.790 0 2016.00 65-69 2.430 3.200 0 768.00 70+ Sold Exchange_Liazon_Vol STD Sold 4033917 0.819 427.92 GCERT2000 - October 05 0.944 10.00 Flat % 2017-01-01 94.26 0.00 0.00 0.000 0.00 0.000 0.00 1.0 0.061 Non-retro rated Other 0.061 5.50 1 1.0 12 24.90 1.03 Actuarial Adjustment New - Replacement 10 No Separate 4033917 STD 2016-12-14 No 0.0 No 1.0 0.819 1.952 0.254 Benefit Percent 60% 2000.00 25 25.00 Flat Benefit Amount AAFT EEs Excluding CA, HI, RI Included 1.89 Earnings Test 80% None Not Included 0.0 0.0 Basic Weekly Earnings 97 All Active Full Time Employees (30 Hours) 1st of the Month 90 Days 90 Days 7 7 100 No 0.0 Included Excluded No 0.92 Yes No No Yes No No No 5.50 Included Included 10 30 60%-2k, 7/7/25 0.95 3/12 Included Voluntary 1.0 4731 Family 50 days 5769.20 No 100% predisability earnings Non-retro rated 12 0.061 Per $10 of covered benefit None Excluded 10 5769.20 N/A Yes Total Rate/Total Volume None 1.000 0.061 35.66 0.061 5769.20 No Yes Yes No 7425826 1 0.041 0.710 0.040 1153.84 Less than 30 0.041 0.710 0.040 576.92 30-34 0.041 0.710 0.040 576.92 35-39 0.052 0.710 0.050 576.92 40-44 0.052 0.790 0.050 576.92 45-49 0.072 0.990 0.070 576.92 50-54 0.082 1.390 0.080 576.92 55-59 0.093 1.670 0.090 576.92 60-64 0.103 1.780 0.100 576.92 65+ Sold Exchange_Liazon_Vol LTD Sold 4033918 5148.96 GCERT2000 - Oct '05 0.94 10.00 Flat % 2017-01-01 74.21 97 1.0 32.0 15625.01 0.0 0.0 0.0 0.0 2.294 Other 15 15 57.0 15625.01 0.0 0.0 40.0 40.0 0.672 14.50 70.01 1 12 1.0 10416.68 30 27.14 1.03 Actuarial Adjustment 2781.24 2694.96 0.00 No 1440.00 New - Replacement No No Separate 4033918 LTD 2016-12-14 10416.68 120.00 159.59 2.225 2.156 0.000 0.9700 0.9400 0.0000 231.77 224.58 0.00 0.692 Yes Excluded Benefit Percent 60.000 10000.00 RBD w/ SSNRA 100.00 Flat Benefit Amount Yes Excluded No No Unlimited Per Occurrence All Active Full Time Employees - 60% Excluded Included 1.0 Excluded 1.0 Earnings Test 60% 80% Local Date of Benefits (DOB) Yes Yes 24 months One Excluded Option 1, 3 sessions 0.04 Basic Monthly Earnings 97 All Active Full Time Employees (30 Hours) 1st of the Month 90 Days 90 Days 180 Yes Days 100 No 10 Included 24 months No Included Lesser CPI or % 7% IOS1 0.96 Yes Yes 24 months One 1.0 Included 24 months 0.96 25 Excluded No High Vol LTD 3/12 Included Voluntary 4731 Family No No Unlimited Per Occurrence None Excluded 50% reduction after 24 months 1.05 No No No Non-retro rated Per $100 of covered payroll None Excluded 10416.68 2.294 12 N/A Total Rate/Total Volume None 1.000 0.672 Yes No 0.0 Excluded Yes Yes No No Unlimited Per Occurrence No No Unlimited No Yes 7425837 1 0.260 11.88 0.380 0.252 3125.00 Less than 35 0.544 5.00 0.480 0.528 1041.67 35-39 0.751 8.02 0.770 0.729 1041.67 40-44 0.826 10.94 1.050 0.802 1041.67 45-49 1.085 17.71 1.700 1.053 1041.67 50-54 1.256 30.52 2.930 1.219 1041.67 55-59 1.158 40.21 3.860 1.124 1041.67 60-64 0.525 35.31 3.390 0.510 1041.67 65+ 10416.68 120.00 151.67 1.183 1.147 0.000 0.9700 0.9400 0.0000 123.23 119.48 0.00 0.368 Yes Excluded Benefit Percent 50.000 10000.00 RBD w/ SSNRA 100.00 Flat Benefit Amount Yes Excluded No No Unlimited Per Occurrence All Active Full Time Employees - 50% Excluded Included 1.0 Excluded 1.0 Earnings Test 60% 80% Local Date of Benefits (DOB) Yes Yes 24 months One Excluded Option 1, 3 sessions 0.04 Basic Monthly Earnings 97 All Active Full Time Employees (30 Hours) 1st of the Month 90 Days 90 Days 180 Yes Days 100 No 10 Included 24 months No Included Lesser CPI or % 7% IOS1 0.96 Yes Yes 24 months One 1.0 Included 24 months 0.96 25 Excluded No Med Vol LTD 3/12 Included Voluntary 4731 Family No No Unlimited Per Occurrence None Excluded 50% reduction after 24 months 1.05 No No No Non-retro rated Per $100 of covered payroll None Excluded 10416.68 1.220 12 N/A Total Rate/Total Volume None 1.000 0.357 Yes No 0.0 Excluded Yes Yes No No Unlimited Per Occurrence No No Unlimited No Yes 7425838 2 0.166 11.25 0.360 0.161 3125.00 Less than 35 0.319 4.79 0.460 0.310 1041.67 35-39 0.430 7.60 0.730 0.417 1041.67 40-44 0.422 10.42 1.000 0.410 1041.67 45-49 0.544 16.88 1.620 0.528 1041.67 50-54 0.639 28.96 2.780 0.620 1041.67 55-59 0.649 38.23 3.670 0.630 1041.67 60-64 0.176 33.54 3.220 0.171 1041.67 65+ 10416.68 120.00 117.82 0.585 0.567 0.000 0.9700 0.9400 0.0000 60.94 59.06 0.00 0.182 Yes Excluded Benefit Percent 40.000 10000.00 lesser of RBD or 5 yrs 100.00 Flat Benefit Amount Yes Excluded No No Unlimited Per Occurrence All Active Full Time Employees - 40% Excluded Included 1.0 Excluded 1.0 Earnings Test 60% 80% Local Date of Benefits (DOB) Yes Yes 24 months One Excluded Option 1, 3 sessions 0.04 Basic Monthly Earnings 97 All Active Full Time Employees (30 Hours) 1st of the Month 90 Days 90 Days 180 Yes Days 100 No 10 Included 24 months No Included Lesser CPI or % 7% IOS1 0.96 Yes Yes 24 months One 1.0 Included 24 months 0.96 25 Excluded No Low Vol LTD 3/12 Included Voluntary 4731 Family No No Unlimited Per Occurrence None Excluded 50% reduction after 24 months 1.05 No No No Non-retro rated Per $100 of covered payroll None Excluded 10416.68 0.603 12 N/A Total Rate/Total Volume None 1.000 0.177 Yes No 0.0 Excluded Yes Yes No No Unlimited Per Occurrence No No Unlimited No Yes 7425848 3 0.088 8.75 0.280 0.085 3125.00 Less than 35 0.129 3.75 0.360 0.125 1041.67 35-39 0.156 5.94 0.570 0.151 1041.67 40-44 0.183 8.02 0.770 0.178 1041.67 45-49 0.249 13.13 1.260 0.242 1041.67 50-54 0.344 22.50 2.160 0.334 1041.67 55-59 0.403 29.69 2.850 0.391 1041.67 60-64 0.096 26.04 2.500 0.093 1041.67 65+ CostBenefit