� � � � � !� � " � #� � � � $""� %&� '� � � ! � � (� � � � $""� � )� � � � � � !� !#'!� � � � "� � � � #� � '!� � )(� '� � "*#� � "� '!&� !� � (� � � !!� � � ! "!)� !� '� � !� +� � � )� ,� "!,#� ,� '!,#,'!,� � � � � "� -$� .%� *� +� /'� 0'!'� � !(!!� $%(� � "� � *� � � � � !(!� � )(� $(� '� )� )(� � '!� � '� (' 1(� � 2� � � )!� $(� � "� *� /'� � *#� � � � � ) +"!$� 3� 4 � "� */� !� !'� � � � !� !(� � � 1(� 5� 1(� � !� � � � $""� � '!#� � "� "'"� � � )(� � "� !#� !� $"� � "#� )� '#� %� � (� �!� � � "� !� !� � � '� 6&� 7� */ 8 � � !#� 7� */ 9 � � !#� � 6� 7� */ � � ! :;
Benefit Summary - Short Term Disability Page 2 Page 4