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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 1 STANDARD INSURANCE COMPANY CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE SI 621144 VA0012 OP OP F A 08/04/2006 741.79 PD A 423.48 03/07/2007 08/05/2056 F A 08/04/2006 741.79 SD A 701.00 01/01/2007 08/05/2056 VA0015 OP OP F A 05/27/2006 2,358.53 PS A 1,475.25 07/01/2004 11/27/2054 F A 05/27/2006 2,358.53 SD A 1,492.00 11/01/2006 11/27/2054 VA0068 OP OP M A 11/09/2005 2,437.92 PD A 2,062.74 10/05/2006 06/11/2050 M A 11/09/2005 2,437.92 SD A 1,622.00 01/01/2007 06/11/2050 M A 11/09/2005 2,437.92 WP A 779.16 08/18/2007 04/19/2027 VA0090 OP OP M A 05/23/2006 1,557.02 PD A 542.63 11/17/2006 06/12/2052 M A 05/23/2006 1,557.02 SD A 1,207.00 10/01/2007 06/12/2052 VA3003 OP OP M A 08/08/2006 1,050.35 PD A 546.35 10/21/2006 11/23/2056 M A 08/08/2006 1,050.35 SD A 1,016.00 02/01/2007 11/23/2056 VA3016 OP OP F A 02/04/2006 1,443.26 PD A 925.46 01/01/2007 12/11/2057 F A 02/04/2006 1,443.26 SD A 1,018.00 08/01/2006 12/11/2057 VA3038 OP OP M A 07/27/2006 1,578.69 BO A 116.03 02/01/2010 02/13/2031 M A 07/27/2006 1,578.69 PD A 771.99 12/14/2006 02/14/2066 M A 07/27/2006 1,578.69 SD A 308.00 01/01/2007 02/14/2066 M A 07/27/2006 1,578.69 WP A 321.95 01/13/2010 04/15/2041 VA3128 OP OP F A 04/27/2006 2,312.54 PD A 1,117.15 12/19/2006 02/08/2053 F A 04/27/2006 2,312.54 SD A 1,473.00 01/01/2007 02/08/2053 VA3164 OP OP M A 06/23/2006 1,619.59 PD A 688.64 07/13/2007 04/11/2051 M A 06/23/2006 1,619.59 SD A 1,336.00 10/01/2008 04/11/2051 M A 06/23/2006 1,619.59 WP A 721.52 09/29/2008 04/10/2021 VA5343 OP OP M A 09/28/2006 848.38 PD A 296.76 01/03/2007 02/11/2055 M A 09/28/2006 848.38 SD A 652.00 03/01/2007 02/11/2055 VA5344 OP OP F A 09/27/2006 1,560.60 PD A 774.63 12/13/2006 06/17/2068 F A 09/27/2006 1,560.60 PS A 1.21 12/12/2006 06/17/2068 F A 09/27/2006 1,560.60 SD A 1,000.00 03/01/2007 06/17/2068 VA5375 OP OP F A 09/12/2006 989.68 PD A 317.77 05/25/2007 08/06/2053 F A 09/12/2006 989.68 SD A 705.00 03/01/2007 08/06/2053 VA5393 OP OP M A 07/08/2006 1,730.45 PS A 1,056.13 03/03/2007 07/18/2051 M A 07/08/2006 1,730.45 SD A 1,147.00 01/01/2007 07/18/2051 VA6125 OP OP F A 08/03/2006 1,091.73 PD A 545.96 01/12/2007 07/28/2052 F A 08/03/2006 1,091.73 SD A 880.00 02/01/2007 07/28/2052 VA7506 OP OP F A 08/29/2006 2,694.38 PD A 2,800.00 08/17/2007 06/16/2058 F A 08/29/2006 2,694.38 SD A 1,701.00 02/01/2007 06/16/2058
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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 …procurement.sc.gov/files/Attachment_5_--_SLTD_Offset... · 2019. 10. 25. · claim offset information as of

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Page 1: CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 …procurement.sc.gov/files/Attachment_5_--_SLTD_Offset... · 2019. 10. 25. · claim offset information as of

CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 1 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VA0012 OP OP F A 08/04/2006 741.79 PD A 423.48 03/07/2007 08/05/2056 F A 08/04/2006 741.79 SD A 701.00 01/01/2007 08/05/2056

VA0015 OP OP F A 05/27/2006 2,358.53 PS A 1,475.25 07/01/2004 11/27/2054 F A 05/27/2006 2,358.53 SD A 1,492.00 11/01/2006 11/27/2054

VA0068 OP OP M A 11/09/2005 2,437.92 PD A 2,062.74 10/05/2006 06/11/2050 M A 11/09/2005 2,437.92 SD A 1,622.00 01/01/2007 06/11/2050 M A 11/09/2005 2,437.92 WP A 779.16 08/18/2007 04/19/2027

VA0090 OP OP M A 05/23/2006 1,557.02 PD A 542.63 11/17/2006 06/12/2052 M A 05/23/2006 1,557.02 SD A 1,207.00 10/01/2007 06/12/2052

VA3003 OP OP M A 08/08/2006 1,050.35 PD A 546.35 10/21/2006 11/23/2056 M A 08/08/2006 1,050.35 SD A 1,016.00 02/01/2007 11/23/2056

VA3016 OP OP F A 02/04/2006 1,443.26 PD A 925.46 01/01/2007 12/11/2057 F A 02/04/2006 1,443.26 SD A 1,018.00 08/01/2006 12/11/2057

VA3038 OP OP M A 07/27/2006 1,578.69 BO A 116.03 02/01/2010 02/13/2031 M A 07/27/2006 1,578.69 PD A 771.99 12/14/2006 02/14/2066 M A 07/27/2006 1,578.69 SD A 308.00 01/01/2007 02/14/2066 M A 07/27/2006 1,578.69 WP A 321.95 01/13/2010 04/15/2041

VA3128 OP OP F A 04/27/2006 2,312.54 PD A 1,117.15 12/19/2006 02/08/2053 F A 04/27/2006 2,312.54 SD A 1,473.00 01/01/2007 02/08/2053

VA3164 OP OP M A 06/23/2006 1,619.59 PD A 688.64 07/13/2007 04/11/2051 M A 06/23/2006 1,619.59 SD A 1,336.00 10/01/2008 04/11/2051 M A 06/23/2006 1,619.59 WP A 721.52 09/29/2008 04/10/2021

VA5343 OP OP M A 09/28/2006 848.38 PD A 296.76 01/03/2007 02/11/2055 M A 09/28/2006 848.38 SD A 652.00 03/01/2007 02/11/2055

VA5344 OP OP F A 09/27/2006 1,560.60 PD A 774.63 12/13/2006 06/17/2068 F A 09/27/2006 1,560.60 PS A 1.21 12/12/2006 06/17/2068 F A 09/27/2006 1,560.60 SD A 1,000.00 03/01/2007 06/17/2068

VA5375 OP OP F A 09/12/2006 989.68 PD A 317.77 05/25/2007 08/06/2053 F A 09/12/2006 989.68 SD A 705.00 03/01/2007 08/06/2053

VA5393 OP OP M A 07/08/2006 1,730.45 PS A 1,056.13 03/03/2007 07/18/2051 M A 07/08/2006 1,730.45 SD A 1,147.00 01/01/2007 07/18/2051

VA6125 OP OP F A 08/03/2006 1,091.73 PD A 545.96 01/12/2007 07/28/2052 F A 08/03/2006 1,091.73 SD A 880.00 02/01/2007 07/28/2052

VA7506 OP OP F A 08/29/2006 2,694.38 PD A 2,800.00 08/17/2007 06/16/2058 F A 08/29/2006 2,694.38 SD A 1,701.00 02/01/2007 06/16/2058

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 2 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VA7595 OP OP M A 12/13/2005 1,586.05 PD A 1,057.93 03/05/2007 09/24/2056 M A 12/13/2005 1,586.05 SD A 1,609.00 12/01/2008 09/24/2056 M A 12/13/2005 1,586.05 WP A 243.25 12/16/2008 04/05/2036

VA7717 OP OP M A 05/11/2006 1,300.06 PD A 342.83 02/02/2007 11/29/2051 M A 05/11/2006 1,300.06 SD A 260.00 12/01/2006 11/29/2051

VA7763 OP OP F A 11/02/2006 2,718.68 PD A 1,582.62 07/04/2007 10/20/2061 F A 11/02/2006 2,718.68 SD A 1,264.00 12/01/2007 10/19/2026

VA8100 OP OP F A 09/27/2006 2,183.08 PD A 1,053.70 01/10/2007 05/16/2057 F A 09/27/2006 2,183.08 SD A 1,180.00 03/01/2007 05/16/2057

VA8138 OP OP F A 10/31/2006 1,271.51 BO A 291.61 04/01/2008 02/05/2017 F A 10/31/2006 1,271.51 SD A 931.00 12/01/2007 02/06/2052

VA8143 OP OP F A 08/25/2006 1,791.26 BO A 15.48 02/01/2007 09/08/2018 F A 08/25/2006 1,791.26 PD A 682.57 01/01/2007 09/09/2053 F A 08/25/2006 1,791.26 PS A 85.32 01/01/2007 09/09/2053 F A 08/25/2006 1,791.26 SD A 939.00 02/01/2007 09/09/2053

VB2747 OP OP M A 05/02/2006 1,648.51 PD A 505.65 03/01/2007 05/26/2050 M A 05/02/2006 1,648.51 SD A 1,391.00 08/01/2007 05/26/2050

VB2817 OP OP F A 11/23/2006 1,372.48 PD A 714.44 09/27/2007 09/23/2052 F A 11/23/2006 1,372.48 SD A 1,041.00 05/01/2007 09/23/2052

VB2837 OP OP F A 01/18/2007 903.99 PD A 441.14 02/20/2008 10/11/2067 F A 01/18/2007 903.99 SD A 854.00 09/01/2007 10/11/2067

VB2897 OP OP M A 06/19/2007 1,787.66 PD A 543.32 09/01/2007 10/03/2051 M A 06/19/2007 1,787.66 SD A 1,380.00 01/01/2008 10/03/2051 M A 06/19/2007 1,787.66 WP A 334.16 01/03/2008 12/02/2031

VB3805 OP OP F A 05/19/2006 1,085.39 BO A 61.64 11/01/2006 05/08/2038 F A 05/19/2006 1,085.39 SD A 982.00 11/01/2006 05/09/2073

VB3808 OP OP M A 09/20/2006 980.41 PD A 338.47 07/01/2007 05/11/2055 M A 09/20/2006 980.41 SD A 951.00 01/01/2007 05/11/2055

VB5263 OP OP F A 02/10/2007 1,235.16 PD A 744.25 04/06/2007 07/08/2062 F A 02/10/2007 1,235.16 SD A 963.00 08/01/2007 07/08/2062

VB5314 OP OP F A 10/30/2006 692.35 SD A 746.00 06/01/2007 01/14/2052

VB5348 OP OP F A 10/24/2006 1,033.88 BO A 122.11 04/01/2007 10/31/2021 F A 10/24/2006 1,033.88 SD A 872.00 04/01/2007 11/01/2056

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VB5368 OP OP F A 02/27/2007 584.24 SD A 519.00 08/01/2007 03/15/2059

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 3 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VB7538 OP OP F A 02/01/2007 2,437.50 BO A 237.75 07/01/2007 11/09/2028 F A 02/01/2007 2,437.50 SD A 2,106.00 07/01/2007 11/10/2063

VB7556 OP OP F A 12/20/2006 592.90 PD A 283.33 10/19/2007 03/28/2062 F A 12/20/2006 592.90 SD A 677.00 06/01/2007 03/28/2062

VB7566 OP OP F A 02/17/2007 2,034.34 PD A 1,683.97 06/13/2007 09/15/2054 F A 02/17/2007 2,034.34 SD A 1,420.00 08/01/2007 09/15/2054

VB7570 OP OP M A 10/10/2006 1,616.34 PD A 971.48 02/02/2007 10/03/2057 M A 10/10/2006 1,616.34 SD A 1,082.00 10/01/2007 10/03/2057

VB7583 OP OP F A 02/08/2007 3,075.95 PD A 2,015.22 10/17/2007 05/28/2067 F A 02/08/2007 3,075.95 SD A 1,547.00 02/01/2008 05/28/2067

VB8053 OP OP F A 01/23/2007 2,933.61 PD A 1,843.22 07/07/2007 03/26/2053 F A 01/23/2007 2,933.61 SD A 1,689.00 07/01/2007 03/26/2053

VB8066 OP OP F A 02/24/2007 916.53 BO A 50.29 01/01/2008 06/14/2016 F A 02/24/2007 916.53 PD A 244.99 08/11/2007 06/15/2051 F A 02/24/2007 916.53 SD A 586.00 01/01/2008 06/15/2051

VB8068 OP OP M A 02/03/2007 948.46 SD A 1,195.00 12/01/2008 06/17/2055 M A 02/03/2007 948.46 WP A 149.40 10/22/2008 09/18/2038

VB9358 OP OP M A 03/30/2007 1,405.41 PD A 600.95 08/01/2007 10/27/2060 M A 03/30/2007 1,405.41 SD A 1,171.00 09/01/2007 10/27/2060

VB9373 OP OP F A 05/23/2007 2,482.08 PD A 1,491.54 11/26/2007 08/27/2068 F A 05/23/2007 2,482.08 SD A 1,287.00 12/01/2008 08/27/2068

VC2063 OP OP F A 06/25/2007 05/13/2015 1,146.81 PD A 528.09 12/22/2007 09/11/2059 F A 06/25/2007 05/13/2015 1,146.81 SD A 1,148.00 12/01/2007 09/11/2059

VC3515 OP OP M A 03/16/2007 1,623.43 PD A 724.23 07/13/2007 08/06/2056 M A 03/16/2007 1,623.43 SD A 1,165.00 01/01/2008 08/06/2056

VC3528 OP OP F A 04/14/2007 1,984.72 PD A 1,119.38 07/12/2007 08/17/2057 F A 04/14/2007 1,984.72 SD A 1,313.00 10/01/2008 08/17/2057

VC3822 OP OP M A 04/06/2007 2,571.24 PD A 1,693.69 10/17/2007 04/17/2057 M A 04/06/2007 2,571.24 SD A 1,375.00 10/01/2007 04/17/2057

VC3837 OP OP F A 02/28/2007 2,353.60 PD A 1,244.60 11/30/2007 10/25/2054 F A 02/28/2007 2,353.60 SD A 1,074.00 08/01/2008 10/25/2054

VC3860 OP OP F A 05/12/2007 2,271.36 BO A 71.11 08/01/2008 01/26/2022 F A 05/12/2007 2,271.36 PD A 789.89 07/19/2008 01/27/2057

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F A 05/12/2007 2,271.36 SD A 1,323.00 01/01/2008 01/27/2057

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 4 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VC4501 OP OP F A 04/29/2007 1,453.35 PD A 923.74 09/12/2007 12/19/2065 F A 04/29/2007 1,453.35 SD A 1,190.00 10/01/2007 12/19/2065

VC4503 OP OP F A 02/28/2007 2,657.19 BO A 800.00 03/01/2010 02/26/2024 F A 02/28/2007 2,657.19 SD A 1,426.00 03/01/2010 02/27/2059

VC4525 OP OP F A 02/17/2007 998.08 SD A 976.00 12/01/2006 10/14/2050

VC4581 OP OP M A 04/16/2007 1,401.35 PD A 985.69 05/17/2008 07/15/2069 M A 04/16/2007 1,401.35 SD A 1,026.00 10/01/2007 07/15/2069

VC4591 OP OP M A 05/25/2007 1,756.07 PD A 339.78 11/01/2007 06/17/2056 M A 05/25/2007 1,756.07 PS A 971.39 11/01/2007 06/17/2056 M A 05/25/2007 1,756.07 SD A 1,336.00 11/01/2007 06/17/2056

VC6738 OP OP M A 08/26/2007 1,429.14 PD A 647.66 09/26/2007 02/19/2070 M A 08/26/2007 1,429.14 SC A 527.00 03/01/2008 07/31/2025 M A 08/26/2007 1,429.14 SD A 1,054.00 03/01/2008 02/19/2070

VC6753 OP OP F A 08/23/2007 1,369.60 PD A 567.17 12/05/2007 06/23/2054 F A 08/23/2007 1,369.60 SD A 980.00 02/01/2008 06/23/2054

VC6763 OP OP F A 05/30/2007 1,868.66 BO A 718.79 01/01/2008 11/01/2023 F A 05/30/2007 1,868.66 SD A 1,078.00 01/01/2008 11/02/2058

VC6782 OP OP F A 08/23/2007 2,000.93 PD A 1,413.65 10/21/2007 01/04/2060 F A 08/23/2007 2,000.93 SD A 1,198.00 02/01/2008 01/04/2060

VC8401 OP OP M A 08/01/2007 3,932.71 PD A 3,288.96 11/10/2007 04/03/2057 M A 08/01/2007 3,932.71 SD A 1,848.00 01/01/2008 04/03/2057

VC8445 OP OP F A 10/10/2006 1,981.09 PD A 688.76 09/13/2007 03/17/2053 F A 10/10/2006 1,981.09 SD A 1,277.00 09/01/2007 03/17/2053 F A 10/10/2006 1,981.09 WP A 372.64 02/01/2009 04/04/2037

VD1208 OP OP F S 09/13/2007 1,337.91 BO A 6.89 04/01/2010 06/18/2015 F S 09/13/2007 1,337.91 PD A 339.57 06/04/2008 06/19/2050 F S 09/13/2007 1,337.91 SD A 940.00 04/01/2010 06/19/2050

VD1209 OP OP F A 09/07/2007 3,145.35 PD A 2,467.40 02/17/2008 07/26/2061 F A 09/07/2007 3,145.35 SD A 1,710.00 10/01/2007 07/26/2061

VD1250 OP OP F A 04/05/2007 2,031.95 BO A 800.00 11/01/2007 05/25/2023

VD1271 OP OP M A 12/01/2007 3,500.14 PD A 1,825.39 03/06/2008 08/06/2052 M A 12/01/2007 3,500.14 SD A 1,716.00 05/01/2008 08/06/2052

VD1279 OP OP F A 08/01/2007 1,295.72 PD A 785.67 02/23/2008 05/21/2065

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F A 08/01/2007 1,295.72 SD A 1,048.00 01/01/2008 05/21/2065

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 5 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VD1306 LT LS F A 01/29/2006 258.07 0.00

VD1310 OP OP F A 10/16/2007 1,085.39 PD A 787.51 05/21/2008 11/18/2056 F A 10/16/2007 1,085.39 SD A 884.00 03/01/2010 11/18/2056

VD1347 OP OP F A 11/28/2007 3,040.38 BO A 142.40 05/01/2008 09/15/2019 F A 11/28/2007 3,040.38 PD A 1,002.04 04/20/2008 09/16/2054 F A 11/28/2007 3,040.38 SD A 1,779.00 05/01/2008 09/16/2054

VD1391 OP OP F A 02/07/2008 2,259.61 PD A 1,207.21 02/07/2009 07/10/2063 F A 02/07/2008 2,259.61 SD A 1,349.00 01/01/2009 07/10/2063

VD2949 OP OP F A 08/16/2007 1,233.70 PD A 689.63 12/20/2007 09/04/2066 F A 08/16/2007 1,233.70 SD A 865.00 02/01/2008 09/04/2066

VD2965 OP OP M A 09/29/2007 1,497.28 PD A 1,204.66 02/12/2008 10/05/2057 M A 09/29/2007 1,497.28 SD A 1,243.00 03/01/2008 10/05/2057

VD4945 OP OP F A 07/21/2007 2,619.23 BO A 328.90 02/01/2008 10/10/2033 F A 07/21/2007 2,619.23 PD A 893.59 01/13/2008 10/11/2068 F A 07/21/2007 2,619.23 SD A 1,296.00 01/01/2008 10/11/2068

VD4950 OP OP M A 10/10/2007 3,099.96 PD A 1,354.72 01/12/2008 04/29/2063 M A 10/10/2007 3,099.96 PS A 1,058.77 01/12/2008 04/29/2063 M A 10/10/2007 3,099.96 SD A 1,669.00 03/01/2009 04/29/2063

VD6621 OP OP F A 09/14/2007 1,055.91 PD A 650.60 03/16/2008 06/05/2072 F A 09/14/2007 1,055.91 SD A 870.00 03/01/2008 06/05/2072

VD6622 OP OP F A 09/11/2007 1,841.66 PD A 895.02 03/27/2008 05/11/2072 F A 09/11/2007 1,841.66 SD A 1,044.00 04/01/2009 05/11/2072

VD6638 OP OP M A 01/16/2007 1,588.96 BO A 347.85 04/01/2008 06/26/2042 M A 01/16/2007 1,588.96 SD A 1,180.00 04/01/2008 06/27/2077

VD6649 OP OP M A 05/04/2007 1,087.94 SD A 1,431.00 11/01/2007 08/09/2054

VD6654 OP OP M A 12/05/2007 1,169.40 BO A 800.00 03/04/2008 11/30/2020

VD6717 OP OP F A 10/23/2007 875.11 BO A 309.46 01/01/2010 07/04/2024 F A 10/23/2007 875.11 SD A 532.00 01/01/2010 07/05/2059

VD6780 OP OP F A 09/08/2007 3,158.19 BO A 800.00 02/01/2008 08/31/2029 F A 09/08/2007 3,158.19 SD A 1,149.00 03/01/2008 09/01/2064

VD6796 OP OP F A 01/12/2008 1,164.98 SD A 1,434.00 07/01/2008 09/06/2051

VD7518 OP OP F A 01/01/2008 3,505.06 PD A 2,343.69 02/27/2010 11/14/2056

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F A 01/01/2008 3,505.06 SD A 1,432.00 04/01/2010 11/14/2056

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 6 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VD7537 OP OP F A 01/30/2008 3,178.39 PS A 2,139.72 01/01/2004 02/02/2052 F A 01/30/2008 3,178.39 SD A 1,800.00 07/01/2008 02/02/2052

VD7541 OP OP F A 02/20/2008 2,129.23 PD A 1,200.78 06/19/2008 12/30/2058 F A 02/20/2008 2,129.23 SD A 1,274.00 08/01/2008 12/30/2058

VE0925 OP OP F A 04/09/2008 1,119.74 PD A 428.16 06/03/2008 06/27/2054 F A 04/09/2008 1,119.74 SD A 1,389.00 10/01/2008 06/27/2054

VE0942 OP OP F A 01/01/2008 1,017.67 BO A 800.00 03/31/2008 07/01/2025

VE1543 OP OP F A 04/22/2008 1,096.39 SD A 1,088.00 10/01/2008 06/04/2056

VE1949 OP OP F A 02/11/2008 2,528.45 PD A 1,328.98 10/04/2008 10/06/2056 F A 02/11/2008 2,528.45 SD A 1,344.00 08/01/2008 10/06/2056

VE1996 OP OP M A 03/12/2008 3,096.81 PD A 1,719.65 07/27/2008 01/18/2062 M A 03/12/2008 3,096.81 SD A 1,766.00 12/01/2011 01/18/2062 M A 03/12/2008 3,096.81 WP A 328.31 03/01/2011 02/18/2041

VE2438 OP OP F A 12/31/2007 2,311.51 BO A 72.92 07/01/2008 08/06/2016 F A 12/31/2007 2,311.51 PD A 769.69 06/11/2008 08/07/2051 F A 12/31/2007 2,311.51 SD A 1,380.00 06/01/2008 08/07/2051

VE2439 OP OP F A 11/04/2007 685.37 SD A 657.00 04/01/2008 07/16/2066

VE2448 OP OP F A 12/13/2007 524.96 SD A 785.00 06/01/2008 03/05/2058

VE2487 OP OP M A 01/19/2008 4,213.19 BO A 22.57 07/01/2008 04/25/2029 M A 01/19/2008 4,213.19 PD A 2,215.57 03/28/2008 04/26/2064 M A 01/19/2008 4,213.19 SD A 1,813.00 07/01/2008 04/26/2064

VE2499 OP OP F A 12/04/2007 2,569.50 PD A 1,659.67 09/01/2007 12/01/2056 F A 12/04/2007 2,569.50 SD A 1,520.00 06/01/2008 12/01/2056

VE4307 OP OP F A 02/06/2008 2,485.39 PD A 1,591.42 04/16/2008 07/10/2070 F A 02/06/2008 2,485.39 SD A 1,408.00 08/01/2008 07/10/2070

VE4335 OP OP F A 03/14/2008 1,318.04 PD A 593.96 06/05/2008 01/04/2061 F A 03/14/2008 1,318.04 SD A 1,138.00 09/01/2008 01/04/2061

VE4361 OP OP M A 02/11/2008 1,439.05 SD A 427.00 08/01/2008 07/15/2050

VE4364 OP OP F A 11/29/2007 938.28 BO A 115.19 06/01/2008 12/08/2020 F A 11/29/2007 938.28 SD A 787.00 05/01/2008 12/09/2055

VE4366 OP OP F A 03/21/2008 1,039.46 BO A 308.48 09/01/2008 01/23/2021 F A 03/21/2008 1,039.46 SD A 691.00 09/01/2008 01/24/2056

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VE4380 OP OP M A 10/06/2007 2,281.55 PD A 2,530.83 11/10/2007 08/22/2063

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 7 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VE4380 OP OP M A 10/06/2007 2,281.55 SD A 1,574.00 04/01/2008 08/22/2063

VE4466 OP OP F A 11/16/2007 1,846.16 BO A 800.00 02/14/2008 02/09/2017 F A 11/16/2007 1,846.16 SD A 803.00 01/01/2009 02/10/2052

VE4827 OP OP M A 01/12/2008 3,070.71 PD A 1,760.02 01/12/2008 07/14/2052 M A 01/12/2008 3,070.71 SD A 1,674.00 07/01/2008 07/14/2052

VE5251 OP OP M A 03/15/2008 2,171.70 PD A 1,237.60 10/08/2008 08/03/2056 M A 03/15/2008 2,171.70 SD A 1,360.00 09/01/2008 08/03/2056

VE5817 OP OP F A 05/22/2008 1,954.82 PD A 2,077.04 06/01/2008 03/31/2043 F A 05/22/2008 1,954.82 SD A 1,343.00 11/01/2008 03/19/2078

VE5819 OP OP M A 01/22/2008 1,544.56 PD A 576.10 06/28/2008 08/06/2052 M A 01/22/2008 1,544.56 SD A 1,269.00 07/01/2008 08/06/2052

VE5840 OP OP F A 02/12/2008 1,137.24 PD A 547.33 08/06/2008 07/28/2054 F A 02/12/2008 1,137.24 SD A 780.00 01/01/2010 07/28/2054

VE6804 OP OP F A 02/13/2008 1,730.90 PS A 688.10 01/27/2009 09/28/2053 F A 02/13/2008 1,730.90 SD A 1,596.00 08/01/2008 09/28/2053

VE6831 OP OP F A 04/18/2008 672.01 PD A 417.29 08/01/2008 10/18/2060 F A 04/18/2008 672.01 SD A 736.00 10/01/2008 10/18/2060

VE6844 OP OP F A 11/30/2007 1,360.29 PD A 467.28 07/20/2008 07/28/2056 F A 11/30/2007 1,360.29 SD A 1,214.00 05/01/2008 07/28/2056

VE6851 OP OP M A 04/01/2008 4,807.60 PD A 4,099.44 04/01/2008 04/14/2051 M A 04/01/2008 4,807.60 SD A 2,107.00 09/01/2008 04/14/2051

VE6853 OP OP M A 05/30/2008 1,827.91 PD A 737.34 07/02/2008 11/25/2062 M A 05/30/2008 1,827.91 SD A 1,794.00 11/01/2008 11/25/2062

VE6884 OP OP M A 03/10/2008 1,172.44 PD A 666.00 07/09/2008 11/15/2061 M A 03/10/2008 1,172.44 SD A 1,070.00 09/01/2008 11/15/2061

VE7151 OP OP M A 04/20/2008 1,572.73 PD A 557.97 08/16/2008 09/22/2051 M A 04/20/2008 1,572.73 PS A 52.05 08/16/2008 09/22/2051 M A 04/20/2008 1,572.73 SD A 1,861.00 10/01/2008 09/22/2051

VE7163 OP OP M A 03/12/2008 1,376.49 PD A 584.29 09/06/2008 06/03/2053 M A 03/12/2008 1,376.49 SD A 1,193.00 06/01/2009 06/03/2053

VE7189 OP OP F A 06/04/2008 1,269.45 PS A 365.82 07/22/2008 05/08/2051 F A 06/04/2008 1,269.45 SD A 1,280.00 02/01/2009 05/08/2051

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VE7265 OP OP F A 04/09/2008 1,084.58 PD A 593.34 09/01/2008 03/21/2068 F A 04/09/2008 1,084.58 SD A 925.00 10/01/2009 03/21/2068

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 8 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VF0525 OP OP M A 04/15/2008 1,470.41 BO A 48.95 10/01/2008 09/29/2016 M A 04/15/2008 1,470.41 PD A 404.91 07/06/2008 09/30/2051 M A 04/15/2008 1,470.41 SD A 960.00 10/01/2008 09/30/2051

VF0609 OP OP F A 03/14/2008 2,638.95 PD A 1,768.29 08/09/2008 09/22/2069 F A 03/14/2008 2,638.95 SD A 1,445.00 09/01/2008 09/22/2069

VF0659 OP OP F A 07/10/2008 1,062.26 SD A 1,046.00 01/01/2009 01/13/2052

VF0670 OP OP F A 02/23/2008 1,740.75 PD A 748.04 09/19/2008 03/11/2055 F A 02/23/2008 1,740.75 SD A 80.60 08/01/2008 03/11/2055 F A 02/23/2008 1,740.75 WP A 212.92 05/01/2012 05/01/2038

VF3315 OP OP M A 06/09/2008 1,672.15 PD A 1,008.84 10/31/2008 07/02/2074 M A 06/09/2008 1,672.15 SD A 1,162.00 12/01/2009 07/02/2074

VF3316 OP OP F A 09/19/2008 1,000.24 BO A 77.77 03/01/2009 02/26/2022 F A 09/19/2008 1,000.24 SD A 884.00 03/01/2009 02/27/2057

VF3320 OP OP F A 06/04/2008 771.82 SD A 770.00 12/01/2008 05/14/2055

VF3335 OP OP F A 08/14/2008 2,400.94 PD A 1,260.39 12/03/2008 03/25/2072 F A 08/14/2008 2,400.94 SD A 1,303.00 02/01/2009 03/25/2072

VF3348 OP OP F A 06/29/2008 1,906.45 PD A 1,064.26 06/02/2009 06/22/2056 F A 06/29/2008 1,906.45 SD A 1,204.00 12/01/2008 06/22/2056

VF3377 OP OP F A 12/14/2007 3,084.69 PD A 1,918.20 02/07/2009 01/20/2059 F A 12/14/2007 3,084.69 SD A 1,696.00 06/01/2008 01/20/2059

VF3397 OP OP F A 09/25/2007 1,052.53 PD A 347.84 04/30/2009 04/14/2059 F A 09/25/2007 1,052.53 SD A 1,199.00 03/01/2010 04/14/2059 F A 09/25/2007 1,052.53 WP A 158.59 04/01/2009 09/24/2039

VF3505 OP OP F A 01/29/2007 1,936.30 BO A 40.83 07/01/2007 09/09/2042 F A 01/29/2007 1,936.30 PD A 709.00 03/29/2007 09/10/2077 F A 01/29/2007 1,936.30 SD A 1,112.00 07/01/2007 09/10/2077

VF3538 OP OP F A 07/24/2008 655.09 SD A 959.00 10/01/2008 06/20/2058

VF3539 OP OP F A 04/17/2008 2,126.43 BO A 127.93 01/01/2009 12/21/2023 F A 04/17/2008 2,126.43 PD A 912.71 10/05/2008 12/22/2058 F A 04/17/2008 2,126.43 SD A 1,004.00 01/01/2009 12/22/2058

VF5109 OP OP F A 07/04/2008 916.83 BO A 581.56 01/01/2009 08/27/2022 F A 07/04/2008 916.83 SD A 300.00 01/01/2009 08/28/2057

VF5162 OP OP F A 06/03/2008 2,708.34 PD A 1,971.56 02/10/2009 09/09/2059

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F A 06/03/2008 2,708.34 SD A 1,669.00 01/01/2009 09/09/2059

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 9 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VF5195 OP OP F A 09/17/2008 1,961.38 PD A 1,541.84 02/28/2009 06/20/2055 F A 09/17/2008 1,961.38 SD A 1,062.00 03/01/2009 06/20/2055

VF5210 OP OP F A 06/06/2008 728.33 SD A 424.00 11/01/2009 12/01/2080

VF5215 OP OP F A 07/04/2008 1,437.11 BO A 232.84 01/01/2009 08/27/2044 F A 07/04/2008 1,437.11 SC A 574.00 01/01/2009 09/30/2025 F A 07/04/2008 1,437.11 SD A 1,149.00 01/01/2009 08/28/2079

VF5217 OP OP M A 07/26/2008 3,155.70 PD A 1,399.37 10/18/2008 11/22/2054 M A 07/26/2008 3,155.70 SD A 1,654.00 03/01/2010 11/22/2054

VF5266 OP OP F A 06/05/2008 621.08 PD A 408.24 11/09/2008 09/07/2056 F A 06/05/2008 621.08 SD A 784.00 12/01/2008 09/07/2056

VF5268 OP OP F A 06/03/2008 2,405.76 PD A 988.76 02/08/2009 10/09/2050 F A 06/03/2008 2,405.76 SD A 1,510.00 01/01/2009 10/09/2050

VF6223 OP OP M A 10/18/2008 1,253.15 PD A 1,243.42 01/22/2009 10/29/2060 M A 10/18/2008 1,253.15 SD A 1,090.00 04/01/2009 10/29/2060

VF6248 OP OP F A 08/30/2008 1,539.15 BO A 364.95 02/01/2009 05/20/2038 F A 08/30/2008 1,539.15 SD A 1,115.00 02/01/2009 05/21/2073

VF6273 OP OP F A 07/29/2008 1,395.94 PD A 753.57 12/10/2008 12/02/2065 F A 07/29/2008 1,395.94 SD A 1,002.00 01/01/2009 12/02/2065

VF6284 OP OP M A 10/10/2008 1,171.73 PD A 442.64 12/05/2008 01/06/2052 M A 10/10/2008 1,171.73 SD A 812.00 04/01/2009 01/06/2052

VF6331 OP OP F A 08/01/2008 1,568.61 PD A 780.37 11/08/2008 02/25/2051 F A 08/01/2008 1,568.61 SD A 1,177.00 05/01/2009 02/25/2051

VF6334 OP OP F A 10/01/2008 1,843.84 BO A 800.00 12/30/2008 08/23/2044 F A 10/01/2008 1,843.84 SD A 728.00 03/01/2009 08/24/2079

VF6364 OP OP M A 10/11/2008 6,148.66 BO A 92.95 05/01/2009 01/05/2017 M A 10/11/2008 6,148.66 PS A 3,455.22 10/11/2008 01/06/2052 M A 10/11/2008 6,148.66 SD A 2,364.00 04/01/2009 01/06/2052

VF6384 OP OP F A 09/20/2008 3,512.87 PD A 884.95 06/05/2009 12/17/2050 F A 09/20/2008 3,512.87 SD A 1,932.00 03/01/2009 12/17/2050

VF9196 OP OP M A 01/27/2009 1,664.44 PD A 1,002.31 06/11/2009 11/27/2060 M A 01/27/2009 1,664.44 SD A 1,080.00 07/01/2009 11/27/2060

VF9309 OP OP F A 11/15/2008 2,382.46 PD A 1,478.07 01/17/2009 12/25/2050 F A 11/15/2008 2,382.46 SD A 1,368.00 05/01/2009 12/25/2050

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VF9312 OP OP F A 09/25/2008 2,693.49 PD A 1,599.32 02/16/2009 11/26/2074

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 10 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VF9312 OP OP F A 09/25/2008 2,693.49 SD A 1,547.00 03/01/2009 11/26/2074

VF9329 OP OP M A 08/20/2008 2,921.10 PD A 772.53 01/01/2009 12/27/2058 M A 08/20/2008 2,921.10 PS A 611.90 01/01/2009 12/27/2058 M A 08/20/2008 2,921.10 SD A 1,624.00 02/01/2009 12/27/2058

VF9339 OP OP M A 08/22/2008 1,294.30 PD A 747.19 03/27/2009 10/10/2050 M A 08/22/2008 1,294.30 SD A 978.00 02/01/2009 10/10/2050 M A 08/22/2008 1,294.30 WP A 415.21 09/23/2009 10/09/2020

VF9382 OP OP F A 12/10/2008 6,364.59 BO A 800.00 03/10/2009 11/07/2017 F A 12/10/2008 6,364.59 SD A 2,139.00 06/01/2009 11/08/2052

VF9387 OP OP M A 09/03/2008 1,511.33 BO A 115.20 03/01/2009 07/26/2023 M A 09/03/2008 1,511.33 SD A 1,338.00 03/01/2009 07/27/2058

VF9396 OP OP F A 08/07/2008 1,868.92 PS A 1,175.72 08/06/2008 06/15/2050 F A 08/07/2008 1,868.92 SD A 1,138.00 01/01/2009 06/15/2050

VF9401 OP OP F A 03/28/2008 2,032.11 PS A 1,249.21 01/09/2008 03/27/2056 F A 03/28/2008 2,032.11 SD A 1,307.00 04/01/2009 03/27/2056

VF9418 OP OP F A 09/18/2008 1,760.80 PD A 813.83 02/28/2009 03/16/2053 F A 09/18/2008 1,760.80 SD A 1,637.00 03/01/2009 03/16/2053

VF9469 OP OP F A 10/29/2008 5,916.84 PD A 4,423.78 03/06/2009 05/22/2058 F A 10/29/2008 5,916.84 SD A 2,258.00 04/01/2009 05/22/2058

VG1213 OP OP F A 10/01/2008 1,112.83 PD A 868.28 12/12/2008 05/23/2061 F A 10/01/2008 1,112.83 SD A 965.00 03/01/2009 05/23/2061

VG1214 OP OP F A 11/26/2008 1,034.42 PD A 728.92 04/28/2009 06/10/2054 F A 11/26/2008 1,034.42 SD A 976.00 10/01/2009 06/10/2054

VG1216 OP OP M A 01/02/2009 1,629.68 PD A 1,715.51 02/04/2009 11/09/2075 M A 01/02/2009 1,629.68 SD A 1,219.00 06/01/2009 11/09/2075

VG1279 OP OP F A 10/09/2008 1,158.25 BO A 800.00 01/07/2009 09/02/2036

VG1501 OP OP M A 11/27/2008 2,125.06 BO A 737.33 02/25/2009 04/17/2029 M A 11/27/2008 2,125.06 SC A 654.00 01/01/2009 02/28/2017 M A 11/27/2008 2,125.06 SD A 1,306.00 01/01/2009 04/18/2064

VG1504 OP OP F A 12/20/2008 2,991.29 PS A 1,893.76 07/01/2008 12/15/2055 F A 12/20/2008 2,991.29 SD A 1,715.00 06/01/2009 12/15/2055

VG2002 OP OP F A 02/24/2009 2,795.34 PD A 2,000.87 04/05/2009 02/21/2057 F A 02/24/2009 2,795.34 SD A 1,605.00 08/01/2009 02/21/2057

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VG2007 OP OP M A 07/19/2008 1,803.80 PD A 926.52 06/16/2009 01/28/2063

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 11 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VG2007 OP OP M A 07/19/2008 1,803.80 SC A 613.00 01/01/2009 06/30/2024 M A 07/19/2008 1,803.80 SD A 1,217.00 01/01/2009 01/28/2063

VG2019 OP OP M A 02/07/2009 949.54 BO A 28.02 08/01/2012 11/08/2017 M A 02/07/2009 949.54 SD A 885.00 08/01/2012 11/09/2052

VG2085 OP OP M A 12/24/2008 1,601.28 BO A 238.69 08/01/2010 02/19/2027 M A 12/24/2008 1,601.28 SD A 1,301.00 07/10/2010 02/20/2062

VG2095 OP OP F A 06/19/2008 1,171.09 SD A 1,162.00 02/01/2009 03/16/2069

VG4796 OP OP F A 12/26/2008 1,917.96 PD A 782.68 07/25/2009 05/14/2054 F A 12/26/2008 1,917.96 SD A 1,635.00 06/01/2009 05/14/2054

VG4827 OP OP M A 07/09/2008 1,400.21 PD A 743.83 06/25/2009 10/02/2078 M A 07/09/2008 1,400.21 SD A 705.00 01/01/2009 10/02/2078

VG4865 OP OP F A 01/06/2009 809.35 PD A 360.87 05/06/2009 07/22/2055 F A 01/06/2009 809.35 SD A 440.00 07/01/2009 07/22/2055

VG4881 OP OP M A 07/02/2008 2,278.52 BO A 800.00 09/30/2008 04/30/2016 M A 07/02/2008 2,278.52 SD A 865.00 01/01/2009 05/01/2051

VG4907 OP OP F A 03/09/2009 975.70 PD A 533.55 11/07/2009 03/19/2057 F A 03/09/2009 975.70 SD A 894.00 09/01/2009 03/19/2057

VG4914 OP OP F A 02/19/2009 1,107.70 BO A 316.10 08/01/2009 12/04/2024 F A 02/19/2009 1,107.70 SD A 749.00 08/01/2009 12/05/2059

VG4918 OP OP M A 03/05/2009 3,291.16 BO A 12.07 09/01/2009 08/15/2018 M A 03/05/2009 3,291.16 PD A 1,394.51 06/25/2009 08/16/2053 M A 03/05/2009 3,291.16 SD A 1,758.00 09/01/2009 08/16/2053

VG4965 OP OP M A 03/25/2009 1,483.18 PD A 698.30 07/30/2009 08/31/2052 M A 03/25/2009 1,483.18 SD A 1,233.00 09/01/2009 08/31/2052

VG4976 OP OP M A 12/23/2008 3,077.75 PD A 2,187.71 01/02/2009 11/13/2060 M A 12/23/2008 3,077.75 PS A 8.38 01/02/2009 11/13/2060 M A 12/23/2008 3,077.75 SD A 1,892.00 06/01/2009 11/13/2060

VG4983 OP OP M A 01/07/2009 1,388.36 PD A 1,086.69 05/30/2009 03/12/2071 M A 01/07/2009 1,388.36 SD A 1,293.00 07/01/2009 03/12/2071

VG6174 OP OP M A 01/05/2009 3,115.89 PS A 2,135.62 07/17/2009 06/29/2055 M A 01/05/2009 3,115.89 SD A 1,915.00 02/01/2009 06/29/2055

VG7945 OP OP M A 03/06/2009 1,640.33 PD A 1,034.26 04/25/2009 11/03/2050 M A 03/06/2009 1,640.33 SD A 1,345.00 09/01/2009 11/03/2050

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VG7997 OP OP M A 01/01/2009 3,156.35 PD A 1,486.94 08/18/2009 09/02/2067

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 12 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VG7997 OP OP M A 01/01/2009 3,156.35 SC A 878.00 06/01/2009 07/31/2015 M A 01/01/2009 3,156.35 SD A 1,756.00 06/01/2009 09/02/2067

VG8137 OP OP M A 06/11/2009 1,542.18 PD A 518.55 11/18/2009 06/24/2052 M A 06/11/2009 1,542.18 SD A 1,332.00 11/01/2009 06/24/2052

VG8477 OP OP F A 03/12/2009 2,195.31 SD A 965.00 09/01/2009 01/15/2062

VG8484 OP OP F A 01/30/2009 1,293.71 PD A 355.59 06/27/2009 02/19/2053 F A 01/30/2009 1,293.71 SD A 933.00 07/01/2009 02/19/2053

VG9243 OP OP F A 02/26/2009 1,364.78 PD A 1,616.20 08/02/2009 09/30/2062 F A 02/26/2009 1,364.78 SD A 827.00 05/01/2012 09/30/2062

VG9839 OP OP F A 09/08/2008 2,480.17 BO A 630.78 03/01/2009 12/07/2015 F A 09/08/2008 2,480.17 SD A 1,754.00 03/01/2009 12/08/2050

VG9840 OP OP F A 02/07/2009 3,629.17 BO A 719.17 01/01/2010 02/22/2018 F A 02/07/2009 3,629.17 PD A 1,039.42 08/16/2009 02/23/2053 F A 02/07/2009 3,629.17 SD A 1,731.00 01/01/2010 02/23/2053

VG9859 OP OP F A 01/13/2009 1,118.38 PD A 719.60 07/14/2009 01/25/2055 F A 01/13/2009 1,118.38 SD A 991.00 07/01/2009 01/25/2055

VG9873 OP OP M A 05/15/2009 1,659.76 PS A 1,084.06 12/19/2008 07/19/2055 M A 05/15/2009 1,659.76 SD A 1,039.00 11/01/2009 07/19/2055

VG9893 OP OP F A 01/07/2009 2,212.65 SC A 648.00 07/01/2009 01/31/2021 F A 01/07/2009 2,212.65 SD A 1,300.00 07/01/2009 05/10/2073

VH0439 OP OP F A 05/07/2009 1,935.70 PD A 1,251.80 01/02/2010 08/09/2056 F A 05/07/2009 1,935.70 SD A 1,314.00 01/01/2010 08/09/2056

VH0442 OP OP F A 02/20/2009 1,132.37 BO A 200.82 07/01/2009 01/22/2026 F A 02/20/2009 1,132.37 SD A 888.00 07/01/2009 01/23/2061

VH1475 OP OP M A 05/12/2009 1,845.30 PD A 1,929.95 08/18/2009 12/31/2054 M A 05/12/2009 1,845.30 SD A 1,352.00 02/01/2010 12/31/2054

VH1530 OP OP F A 01/29/2009 1,242.57 PD A 617.27 08/18/2009 03/12/2054 F A 01/29/2009 1,242.57 SD A 1,060.00 07/01/2009 03/12/2054

VH1535 OP OP M A 05/14/2009 1,392.57 PD A 430.00 10/29/2009 04/29/2056 M A 05/14/2009 1,392.57 SD A 1,204.00 11/01/2009 04/29/2056

VH1570 OP OP M A 04/16/2009 1,933.91 PD A 1,144.06 09/23/2009 12/27/2057 M A 04/16/2009 1,933.91 SD A 1,552.00 10/01/2009 12/27/2057

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VH1571 OP OP F A 05/30/2009 4,492.05 BO A 800.00 08/28/2009 12/27/2019 F A 05/30/2009 4,492.05 SD A 2,082.00 01/01/2010 12/28/2054

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 13 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VH1659 OP OP F A 06/11/2009 3,347.19 PD A 2,617.62 11/18/2009 08/14/2055 F A 06/11/2009 3,347.19 SD A 1,802.00 12/01/2009 08/14/2055

VH1669 OP OP M A 06/26/2009 1,567.93 SD A 1,381.00 05/01/2013 12/25/2061

VH1672 OP OP F A 06/09/2009 1,829.26 PD A 505.21 09/30/2009 06/03/2050 F A 06/09/2009 1,829.26 SD A 1,486.00 01/01/2010 06/03/2050

VH1674 OP OP F A 06/30/2009 2,072.69 BO A 800.00 09/28/2009 12/15/2018 F A 06/30/2009 2,072.69 SD A 830.00 01/01/2010 12/16/2053

VH1677 OP OP F A 05/09/2009 1,347.15 BO A 170.10 01/01/2010 02/05/2017 F A 05/09/2009 1,347.15 PD A 377.24 11/06/2009 02/06/2052 F A 05/09/2009 1,347.15 SD A 748.00 01/01/2010 02/06/2052

VH1681 OP OP M A 07/08/2009 1,207.80 PD A 584.44 08/23/2009 04/24/2065 M A 07/08/2009 1,207.80 SD A 1,012.00 01/01/2010 04/24/2065

VH2215 OP OP M A 06/06/2009 2,519.61 PD A 1,474.49 09/09/2009 10/21/2065 M A 06/06/2009 2,519.61 SD A 1,654.00 12/01/2009 10/21/2065

VH2292 OP OP F A 05/14/2009 2,088.39 PS A 1,244.57 05/13/2009 08/31/2051 F A 05/14/2009 2,088.39 SD A 1,223.00 10/01/2009 08/31/2051

VH2294 OP OP F A 03/18/2009 1,048.85 SD A 1,054.00 03/01/2010 01/01/2055

VH2299 OP OP M A 04/07/2009 1,724.46 BO A 733.13 09/01/2009 07/24/2031 M A 04/07/2009 1,724.46 SC A 387.00 09/01/2009 05/31/2019 M A 04/07/2009 1,724.46 SD A 925.00 09/01/2009 07/25/2066

VH2310 OP OP M A 04/03/2009 1,446.11 PD A 460.92 07/01/2009 12/06/2051 M A 04/03/2009 1,446.11 SD A 1,216.00 10/01/2009 12/06/2051

VH2312 OP OP F A 05/29/2009 1,510.43 PD A 916.57 09/02/2009 03/27/2063 F A 05/29/2009 1,510.43 SD A 846.00 01/01/2010 03/27/2063

VH3307 OP OP F A 02/24/2009 1,941.60 BO A 800.00 05/25/2009 07/05/2031 F A 02/24/2009 1,941.60 SD A 461.00 01/01/2010 07/06/2066

VH3832 OP OP F A 03/19/2009 1,172.37 PD A 1,020.95 09/01/2009 06/09/2053 F A 03/19/2009 1,172.37 SD A 1,306.00 09/01/2009 09/21/2055

VH3849 OP OP M A 04/04/2009 1,149.11 PD A 667.08 11/10/2009 09/02/2068 M A 04/04/2009 1,149.11 SD A 1,213.00 07/01/2010 09/02/2068

VH3947 OP OP F A 05/16/2009 1,074.40 SD A 1,204.00 11/01/2009 06/24/2021

VH3948 OP OP M A 05/02/2009 1,593.04 PS A 658.67 10/01/2009 02/01/2150

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M A 05/02/2009 1,593.04 SD A 1,369.00 10/01/2009 09/15/2050

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 14 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VH4920 OP OP M A 05/09/2009 1,093.95 PD A 343.98 12/09/2009 12/07/2053 M A 05/09/2009 1,093.95 SD A 1,171.00 11/01/2009 12/07/2053

VH4954 OP OP M A 06/29/2009 1,586.52 PD A 517.25 01/06/2010 03/30/2052 M A 06/29/2009 1,586.52 SD A 1,461.00 12/01/2009 03/30/2052

VH4969 OP OP F A 07/23/2009 2,051.73 PD A 1,578.07 10/16/2009 12/01/2056 F A 07/23/2009 2,051.73 SD A 1,370.00 01/01/2010 12/01/2056

VH4990 OP OP F A 06/27/2009 2,989.56 PD A 2,018.87 10/04/2009 11/27/2056 F A 06/27/2009 2,989.56 SD A 1,586.00 01/01/2010 11/27/2056

VH5452 LT LS M A 01/23/2008 1,600.14 PS A 469.02 05/06/2008 07/11/2040

VH5457 LT LS F A 10/15/2006 964.96 SR A 269.00 03/01/2007 10/12/2059

VH5935 OP OP F A 06/13/2009 1,787.38 PD A 1,679.84 09/17/2009 02/03/2158 F A 06/13/2009 1,787.38 SD A 1,227.00 01/01/2010 02/03/2058

VH6009 OP OP F A 10/16/2008 1,255.26 PD A 732.35 08/15/2009 01/28/2073 F A 10/16/2008 1,255.26 SD A 1,061.00 01/01/2010 01/28/2073

VH6020 OP OP M A 06/13/2009 813.85 SD A 1,127.00 12/01/2009 06/14/2062

VH6031 OP OP F A 08/15/2009 1,607.29 PD A 924.17 04/13/2010 02/25/2055 F A 08/15/2009 1,607.29 SD A 1,231.00 07/01/2010 02/25/2055

VH6051 OP OP F A 02/04/2009 2,886.42 BO A 396.41 02/01/2010 09/30/2029 F A 02/04/2009 2,886.42 PD A 1,124.01 01/01/2010 10/01/2064 F A 02/04/2009 2,886.42 SD A 1,037.00 02/01/2010 10/01/2064 F A 02/04/2009 2,886.42 WP A 217.99 01/22/2010 10/28/2043

VH6072 OP OP F A 06/13/2009 1,004.14 PD A 491.42 01/02/2010 08/12/2060 F A 06/13/2009 1,004.14 SD A 741.00 12/01/2009 08/12/2060

VH6080 OP OP F A 07/24/2009 1,530.80 PD A 482.74 09/11/2009 05/04/2082 F A 07/24/2009 1,530.80 SD A 1,078.00 01/01/2010 05/04/2082

VH6094 OP OP F A 07/28/2009 1,455.42 PD A 565.48 02/14/2010 07/10/2050 F A 07/28/2009 1,455.42 SD A 985.00 01/01/2010 07/10/2050

VH6098 OP OP M A 05/13/2009 05/01/2015 1,780.03 PD A 738.27 11/22/2009 02/08/2057 M A 05/13/2009 05/01/2015 1,780.03 SD A 1,356.00 11/01/2009 02/08/2057

VH9005 OP OP M A 07/22/2009 1,448.36 PD A 401.85 10/28/2009 07/21/2059 M A 07/22/2009 1,448.36 PS A 16.68 10/28/2009 07/21/2059 M A 07/22/2009 1,448.36 SD A 1,337.00 01/01/2010 07/21/2059

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VH9094 OP OP F A 07/29/2009 1,044.71 PD A 464.50 12/03/2009 07/17/2060 F A 07/29/2009 1,044.71 SD A 818.00 01/01/2010 07/17/2060

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 15 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VI0611 OP OP F A 07/28/2009 1,833.85 PD A 1,185.71 12/01/2009 06/14/2056 F A 07/28/2009 1,833.85 SD A 1,183.00 01/01/2010 06/14/2056

VI0616 OP OP F A 08/06/2009 938.86 PD A 416.31 12/02/2009 01/24/2062 F A 08/06/2009 938.86 SD A 756.00 01/01/2010 01/24/2062

VI0635 OP OP F A 08/02/2009 1,772.76 PD A 1,199.51 01/30/2010 06/28/2053 F A 08/02/2009 1,772.76 SD A 1,307.00 01/01/2010 06/28/2053

VI0797 OP OP M A 05/14/2009 2,206.54 PD A 1,387.98 04/02/2010 03/19/2052 M A 05/14/2009 2,206.54 SD A 1,413.00 10/01/2009 03/19/2052

VI1085 OP OP M A 05/20/2009 2,319.85 PD A 1,637.00 10/31/2009 02/08/2052 M A 05/20/2009 2,319.85 SD A 1,776.00 04/01/2010 02/08/2052

VI1159 OP OP M A 07/30/2009 3,582.75 PD A 2,297.74 06/01/2010 05/25/2061 M A 07/30/2009 3,582.75 SD A 1,950.00 01/01/2010 05/21/2061

VI1313 OP OP F A 10/28/2009 1,239.52 PD A 447.56 01/21/2010 01/10/2053 F A 10/28/2009 1,239.52 SD A 878.00 04/01/2010 01/10/2053

VI1429 OP OP F A 07/03/2009 1,010.10 PD A 1,106.55 08/05/2010 05/19/2055 F A 07/03/2009 1,010.10 SD A 11,330.00 11/01/2010 05/19/2055

VI1468 OP OP F A 03/31/2009 1,089.27 SD A 1,020.00 01/01/2010 09/06/2054

VI1470 OP OP F A 09/15/2009 2,780.53 BO A 800.00 12/14/2009 04/21/2028 F A 09/15/2009 2,780.53 SD A 1,562.00 10/01/2009 04/22/2063

VI1478 OP OP F A 05/12/2009 1,100.89 PD A 458.25 12/20/2009 09/17/2050 F A 05/12/2009 1,100.89 SD A 950.00 11/01/2009 09/17/2050

VI2431 OP OP F A 10/27/2009 1,081.77 PD A 480.72 03/11/2010 10/28/2050 F A 10/27/2009 1,081.77 SD A 840.00 04/01/2010 10/28/2050

VI2444 OP OP F A 08/18/2009 1,131.70 PD A 685.63 02/02/2010 05/15/2062 F A 08/18/2009 1,131.70 SD A 778.00 08/01/2010 05/15/2062

VI2661 OP OP F A 08/19/2009 984.86 PD A 682.47 04/14/2010 05/29/2060 F A 08/19/2009 984.86 SD A 930.00 03/01/2010 05/29/2060

VI2915 OP OP M A 10/13/2009 2,263.30 PD A 1,202.41 03/02/2010 02/27/2060 M A 10/13/2009 2,263.30 SD A 1,295.00 04/01/2010 02/27/2060

VI3067 OP OP F A 12/05/2009 2,339.19 PD A 1,013.61 01/09/2010 08/25/2078 F A 12/05/2009 2,339.19 SD A 1,527.00 01/01/2010 08/25/2078

VI4054 OP OP F A 12/02/2009 1,789.56 PD A 939.62 11/23/2010 10/29/2058

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F A 12/02/2009 1,789.56 SD A 838.00 05/01/2010 10/29/2058

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 16 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VI4073 OP OP F A 09/24/2009 667.79 PD A 348.27 01/16/2010 11/27/2053 F A 09/24/2009 667.79 SD A 650.00 03/01/2010 11/27/2053

VI4122 OP OP F A 08/27/2009 1,451.28 BO A 131.46 02/01/2010 01/04/2027 F A 08/27/2009 1,451.28 SD A 1,264.00 02/01/2010 01/05/2062

VI4130 OP OP F A 07/17/2009 1,655.63 BO A 528.96 01/01/2010 03/04/2039 F A 07/17/2009 1,655.63 SD A 1,063.00 01/01/2010 03/05/2074

VI4707 OP OP M A 12/01/2009 2,205.66 PD A 559.02 12/01/2009 01/26/2055 M A 12/01/2009 2,205.66 PS A 846.51 12/01/2009 01/26/2055 M A 12/01/2009 2,205.66 SD A 1,617.00 05/01/2010 01/26/2055

VI4764 OP OP M A 08/14/2009 1,699.20 PD A 1,135.51 04/03/2010 02/05/2056 M A 08/14/2009 1,699.20 SD A 1,139.00 01/01/2011 02/05/2056

VI4809 OP OP M A 06/24/2009 1,150.11 PD A 861.34 04/13/2010 02/13/2051 M A 06/24/2009 1,150.11 SD A 1,478.00 11/01/2009 02/13/2051

VI5711 OP OP F A 12/21/2009 1,810.46 PD A 710.11 04/17/2010 10/23/2050 F A 12/21/2009 1,810.46 SD A 1,741.00 06/01/2010 10/23/2050

VI5721 OP OP F A 01/05/2010 1,641.97 PD A 705.22 03/03/2010 01/01/2064 F A 01/05/2010 1,641.97 SD A 1,154.00 07/01/2010 01/01/2064

VI5749 OP OP M A 10/06/2009 1,567.48 PD A 680.56 03/26/2010 10/19/2050 M A 10/06/2009 1,567.48 SD A 1,030.00 03/01/2010 10/19/2050

VI6218 OP OP F A 09/16/2009 948.88 SD A 772.00 03/01/2010 05/24/2057

VI6602 OP OP M A 07/23/2009 1,746.39 PD A 623.68 03/16/2010 06/29/2054 M A 07/23/2009 1,746.39 SD A 1,350.00 01/01/2010 06/29/2054

VI6636 OP OP M A 11/11/2009 1,319.23 PD A 497.59 03/03/2010 12/27/2061 M A 11/11/2009 1,319.23 SD A 1,249.00 05/01/2010 12/27/2061

VI6654 OP OP F A 12/11/2009 1,593.04 BO A 80.77 05/01/2010 03/21/2027 F A 12/11/2009 1,593.04 SD A 1,451.00 05/01/2010 03/22/2062

VI6695 OP OP F A 10/17/2009 2,238.94 BO A 144.74 05/01/2010 12/09/2019 F A 10/17/2009 2,238.94 PD A 648.09 04/06/2010 12/10/2054 F A 10/17/2009 2,238.94 SD A 1,360.00 04/01/2010 12/10/2054

VI7059 OP OP F A 10/07/2009 933.88 PD A 257.54 01/20/2010 03/31/2053 F A 10/07/2009 933.88 SD A 935.00 04/01/2010 03/31/2053

VI7061 OP OP M A 08/27/2009 1,375.24 PD A 595.54 02/24/2010 10/02/2050 M A 08/27/2009 1,375.24 SD A 953.00 02/01/2010 10/02/2050

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VI7071 OP OP M A 11/13/2009 2,754.10 BO A 800.00 02/11/2010 10/12/2018

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 17 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VI7071 OP OP M A 11/13/2009 2,754.10 SD A 462.00 05/01/2010 10/13/2053

VI7807 OP OP M A 01/14/2010 1,477.13 SD A 1,802.00 08/01/2010 10/24/2050

VI7871 OP OP F A 01/15/2010 3,256.71 PD A 2,271.71 07/17/2010 12/03/2056 F A 01/15/2010 3,256.71 SD A 1,678.00 07/01/2010 12/03/2056

VI7889 OP OP F A 01/30/2010 2,637.10 BO A 358.48 07/01/2010 09/28/2019 F A 01/30/2010 2,637.10 PD A 781.20 03/12/2010 09/29/2054 F A 01/30/2010 2,637.10 SD A 1,396.00 07/01/2010 09/29/2054

VI7893 OP OP F A 01/16/2010 3,033.33 PD A 784.40 04/18/2010 08/11/2059 F A 01/16/2010 3,033.33 SD A 2,090.00 07/01/2010 08/11/2059 F A 01/16/2010 3,033.33 WP A 572.17 09/09/2010 06/23/2042

VI7895 OP OP M A 12/18/2009 1,728.36 PD A 1,347.60 02/28/2010 03/20/2064 M A 12/18/2009 1,728.36 PS A 329.35 02/28/2010 03/20/2064 M A 12/18/2009 1,728.36 SD A 1,582.00 06/01/2010 03/20/2064

VI7957 OP OP M A 07/12/2009 2,275.33 PD A 2,573.12 03/10/2010 06/21/2056 M A 07/12/2009 2,275.33 SD A 1,862.00 01/01/2010 06/21/2056

VJ0730 OP OP M A 12/23/2009 2,079.30 PD A 897.83 11/12/2010 07/12/2054 M A 12/23/2009 2,079.30 SD A 1,203.00 06/01/2010 07/12/2054

VJ0766 OP OP M A 12/21/2009 1,542.98 PD A 1,809.17 03/02/2010 11/18/2074 M A 12/21/2009 1,542.98 SD A 1,196.00 05/01/2010 11/18/2074

VJ0915 OP OP F A 02/11/2010 1,931.85 PS A 1,072.26 02/11/2010 11/30/2053 F A 02/11/2010 1,931.85 SD A 1,175.00 08/01/2010 11/30/2053

VJ0926 OP OP F A 12/12/2009 2,942.63 PD A 1,625.56 07/03/2010 09/11/2056 F A 12/12/2009 2,942.63 SD A 1,703.00 06/01/2010 09/11/2056

VJ0968 OP OP M A 02/18/2010 1,655.76 PD A 1,403.63 05/29/2010 10/31/2057 M A 02/18/2010 1,655.76 SD A 1,298.00 08/01/2010 10/31/2057

VJ0973 OP OP F A 01/27/2010 3,201.37 PS A 1,895.32 04/27/2010 02/01/2053 F A 01/27/2010 3,201.37 SD A 1,838.00 07/01/2010 02/01/2053

VJ1603 OP OP M A 12/10/2009 3,313.72 PD A 3,448.96 01/30/2010 03/13/2075 M A 12/10/2009 3,313.72 PS A 4.35 01/30/2010 03/13/2075

VJ2048 OP OP M A 01/04/2010 1,628.77 BO A 419.13 07/01/2010 12/17/2015 M A 01/04/2010 1,628.77 SD A 1,147.00 07/01/2010 12/18/2050

VJ2261 OP OP F A 02/22/2010 643.94 SD A 1,045.00 08/01/2010 11/22/2051

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VJ2301 OP OP F A 10/11/2009 1,351.74 PD A 792.32 03/10/2010 08/08/2053 F A 10/11/2009 1,351.74 SD A 1,100.00 04/01/2010 08/08/2053

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 18 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VJ2303 OP OP F A 02/20/2010 1,207.80 SD A 1,249.00 11/01/2011 05/27/2056

VJ2324 OP OP F A 12/19/2009 2,463.07 PD A 1,566.66 08/27/2010 12/17/2061 F A 12/19/2009 2,463.07 SD A 1,642.00 06/01/2010 12/17/2061

VJ2341 OP OP F A 11/25/2009 3,315.36 BO A 27.47 09/01/2010 08/15/2019 F A 11/25/2009 3,315.36 PD A 1,446.38 08/17/2010 08/16/2054 F A 11/25/2009 3,315.36 SD A 1,714.00 05/01/2010 08/16/2054

VJ4256 OP OP F A 04/17/2010 2,325.75 BO A 124.76 08/01/2012 01/18/2032 F A 04/17/2010 2,325.75 PD A 1,010.54 07/02/2010 01/19/2067 F A 04/17/2010 2,325.75 SC A 550.00 08/01/2010 09/30/2020 F A 04/17/2010 2,325.75 SD A 1,101.00 08/01/2012 01/19/2067

VJ4277 OP OP F A 03/05/2010 2,774.84 PD A 1,625.38 07/22/2010 04/28/2054 F A 03/05/2010 2,774.84 SD A 1,015.00 09/01/2010 04/28/2054 F A 03/05/2010 2,774.84 WP A 458.65 12/20/2010 05/03/2037

VJ4285 OP OP F A 01/23/2010 1,703.39 PD A 1,032.45 04/20/2010 07/05/2067 F A 01/23/2010 1,703.39 SD A 1,143.00 07/01/2010 07/02/2067

VJ4301 OP OP M A 01/27/2010 1,343.06 PD A 653.79 06/23/2010 03/10/2058 M A 01/27/2010 1,343.06 SD A 954.00 01/01/2011 03/10/2058

VJ4336 OP OP F A 09/26/2009 2,680.81 BO A 159.79 06/01/2010 04/22/2021 F A 09/26/2009 2,680.81 PD A 1,258.92 05/29/2010 04/23/2056 F A 09/26/2009 2,680.81 SD A 1,159.00 03/01/2010 04/23/2056

VJ5418 OP OP M A 03/27/2010 2,114.45 PD A 702.91 05/02/2011 10/29/2059 M A 03/27/2010 2,114.45 SD A 1,494.00 09/01/2010 10/29/2059

VJ5429 OP OP F A 11/03/2009 2,493.45 PD A 912.55 11/01/2010 08/09/2054 F A 11/03/2009 2,493.45 SD A 1,306.00 07/01/2012 08/09/2054 F A 11/03/2009 2,493.45 WP A 331.53 06/27/2012 12/26/2038

VJ8044 OP OP F A 06/05/2010 1,055.24 BO A 800.00 09/03/2010 06/03/2027 F A 06/05/2010 1,055.24 SD E 731.00 12/01/2010 06/04/2062

VJ8105 OP OP F A 06/04/2010 3,058.64 PD A 2,223.88 09/16/2010 03/07/2053 F A 06/04/2010 3,058.64 SD A 1,662.00 01/01/2011 03/07/2053

VJ8110 OP OP F A 04/01/2010 1,787.01 PD A 1,517.01 08/26/2010 07/15/2062 F A 04/01/2010 1,787.01 SD A 1,254.00 09/01/2010 07/15/2062

VJ8128 OP OP M A 03/04/2010 1,264.14 PD A 329.53 08/05/2010 12/19/2050 M A 03/04/2010 1,264.14 SD A 1,399.00 09/01/2010 12/19/2050

VJ8455 OP OP F A 03/12/2010 1,186.35 PD A 407.68 03/01/2011 10/01/2051

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F A 03/12/2010 1,186.35 SD A 1,117.00 09/01/2010 10/01/2051

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 19 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VJ8456 OP OP F A 02/02/2010 1,318.25 BO A 277.54 10/01/2012 03/19/2026 F A 02/02/2010 1,318.25 SD A 990.00 10/01/2012 03/20/2061

VJ8468 OP OP M A 03/26/2010 3,293.24 PD A 1,747.36 03/12/2011 08/01/2055 M A 03/26/2010 3,293.24 SD A 1,575.00 09/01/2010 08/01/2055

VJ8480 OP OP F A 06/08/2010 1,576.47 PD A 327.36 08/05/2010 07/16/2055 F A 06/08/2010 1,576.47 SD A 1,267.00 12/01/2010 07/16/2055

VJ8533 OP OP F A 05/10/2010 816.83 PD A 433.65 12/07/2010 02/10/2062 F A 05/10/2010 816.83 SD A 741.00 11/01/2010 02/10/2062

VK0007 OP OP F A 02/16/2010 1,003.08 SD A 1,055.00 01/01/2011 06/02/2062

VK0019 OP OP M A 03/26/2010 861.37 SD A 747.00 09/01/2010 09/15/2053

VK0025 OP OP M A 03/24/2010 1,497.38 PD A 654.94 09/08/2010 10/23/2057 M A 03/24/2010 1,497.38 SC A 582.00 09/01/2010 05/31/2017 M A 03/24/2010 1,497.38 SD A 1,164.00 09/01/2010 10/23/2057

VK0029 OP OP M A 04/22/2010 1,309.10 PD A 715.12 08/05/2010 08/07/2051 M A 04/22/2010 1,309.10 SD A 914.00 10/01/2010 08/07/2051

VK0038 OP OP F A 10/02/2009 4,784.70 PD A 3,655.48 07/10/2010 12/06/2053 F A 10/02/2009 4,784.70 SD A 2,099.00 04/01/2010 12/06/2053 F A 10/02/2009 4,784.70 WP A 66.86 07/09/2010 10/31/2037

VK0069 OP OP M A 04/20/2010 1,601.70 BO A 562.10 10/01/2010 12/02/2024 M A 04/20/2010 1,601.70 SD A 978.00 10/01/2010 12/03/2059

VK0080 OP OP M A 10/02/2009 1,170.51 SD A 796.00 07/01/2011 05/03/2056

VK0084 OP OP F A 09/10/2009 2,084.50 BO A 126.91 07/01/2010 12/16/2022 F A 09/10/2009 2,084.50 PD A 752.42 06/17/2010 12/17/2057 F A 09/10/2009 2,084.50 SD A 1,125.00 03/01/2010 12/17/2057

VK0092 OP OP M A 05/26/2010 1,696.17 PD A 658.51 12/05/2010 02/25/2082 M A 05/26/2010 1,696.17 SD A 1,173.00 01/01/2011 02/25/2082

VK0093 OP OP F A 02/25/2010 2,905.77 PD A 1,627.01 08/15/2010 09/25/2050 F A 02/25/2010 2,905.77 SD A 1,269.00 10/01/2010 09/25/2060

VK0100 OP OP F A 10/30/2009 893.75 PD A 427.24 08/19/2010 08/15/2052 F A 10/30/2009 893.75 SD A 189.00 04/01/2010 08/15/2052 F A 10/30/2009 893.75 WP A 113.52 09/09/2013 08/15/2052

VK0101 OP OP F A 07/22/2010 2,794.03 PD A 1,550.79 10/06/2010 10/18/2054 F A 07/22/2010 2,794.03 SD A 1,586.00 11/01/2010 10/18/2054

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VK0616 OP OP F A 03/25/2010 1,272.12 PD A 839.69 07/23/2010 03/31/2056

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 20 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VK0616 OP OP F A 03/25/2010 1,272.12 SD A 847.00 09/01/2010 03/31/2056

VK0649 OP OP F A 05/16/2010 3,462.34 PD A 2,926.36 06/03/2010 07/26/2059 F A 05/16/2010 3,462.34 SD A 1,977.00 12/01/2010 07/26/2059

VK1987 OP OP F A 06/05/2010 2,471.06 PD A 1,572.27 10/08/2010 01/12/2071 F A 06/05/2010 2,471.06 RO S 209.30 09/01/2014 05/31/2015 F A 06/05/2010 2,471.06 SD A 1,609.00 12/01/2010 01/12/2071

VK2694 OP OP M A 02/26/2010 1,547.21 PD A 615.80 10/23/2010 07/13/2065 M A 02/26/2010 1,547.21 SD A 1,437.00 02/01/2014 07/13/2065 M A 02/26/2010 1,547.21 WP A 374.11 01/30/2014 07/12/2035

VK3507 OP OP M A 06/17/2010 1,055.12 PD A 369.08 11/20/2010 02/22/2051 M A 06/17/2010 1,055.12 SD A 1,222.00 12/01/2010 02/22/2051

VK3547 OP OP F A 05/06/2010 1,978.50 SD A 1,567.00 01/01/2011 01/24/2071

VK6112 OP OP F A 09/04/2010 2,863.73 PD A 2,684.15 11/18/2010 05/12/2058 F A 09/04/2010 2,863.73 SD A 1,649.00 03/01/2011 05/12/2058

VK6122 OP OP F A 07/15/2010 2,295.04 PD A 1,041.21 04/25/2011 03/17/2060 F A 07/15/2010 2,295.04 SD A 1,299.00 09/01/2011 03/17/2060

VK6124 OP OP F A 06/01/2010 1,048.03 BO A 55.73 01/01/2011 11/28/2016 F A 06/01/2010 1,048.03 SD A 952.00 01/01/2011 11/29/2051

VK6154 OP OP F A 06/11/2010 1,720.49 SD A 1,929.00 12/01/2010 06/26/2052

VK6171 OP OP F A 03/19/2010 2,917.85 PD A 643.80 02/17/2011 09/01/2051 F A 03/19/2010 2,917.85 SD A 1,519.00 01/01/2011 09/01/2051 F A 03/19/2010 2,917.85 WP A 353.49 11/14/2012 12/06/2035

VK6173 OP OP M A 03/24/2010 1,543.90 PD A 913.51 06/30/2010 08/27/2028 M A 03/24/2010 1,543.90 SD A 1,283.00 11/01/2010 08/28/2063

VK6185 OP OP F A 09/30/2010 3,047.08 PD A 1,283.09 12/02/2010 09/09/2054 F A 09/30/2010 3,047.08 SD A 1,937.00 03/01/2011 09/09/2054

VK6276 OP OP F A 03/16/2010 1,061.79 PD A 318.10 09/05/2010 02/03/2052 F A 03/16/2010 1,061.79 SD A 1,126.00 09/01/2010 02/03/2052

VK6296 OP OP M A 07/12/2010 1,693.36 PS A 999.13 08/28/2010 06/21/2052 M A 07/12/2010 1,693.36 SC A 630.00 02/01/2011 12/31/2018 M A 07/12/2010 1,693.36 SD A 1,261.00 02/01/2011 06/21/2052

VK6407 OP OP F A 08/19/2010 1,562.38 PD A 539.23 10/06/2010 08/20/2052 F A 08/19/2010 1,562.38 SD A 1,209.00 02/01/2011 08/20/2052

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VK6409 OP OP M A 07/01/2010 6,750.25 BO A 800.00 09/29/2010 05/10/2036

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 21 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VK6409 OP OP M A 07/01/2010 6,750.25 SC A 1,200.00 12/01/2011 10/31/2022 M A 07/01/2010 6,750.25 SD A 2,400.00 12/01/2011 05/11/2071

VK6414 OP OP F A 07/08/2010 1,624.40 PD A 997.90 02/03/2011 04/09/2074 F A 07/08/2010 1,624.40 SD A 1,186.00 01/01/2011 04/09/2074

VK6428 OP OP M A 06/15/2010 1,924.98 PD A 1,128.97 06/15/2011 03/08/2074 M A 06/15/2010 1,924.98 SD A 1,235.00 09/01/2011 03/08/2074

VK6430 OP OP F A 05/16/2010 1,044.66 0.00

VK6442 OP OP F A 06/15/2010 1,684.48 PD A 320.20 01/01/2011 08/18/2051 F A 06/15/2010 1,684.48 SD A 1,322.00 12/01/2010 08/18/2051

VK6454 OP OP M A 07/28/2010 1,320.69 PD A 503.62 10/02/2010 12/29/2057 M A 07/28/2010 1,320.69 SD A 1,345.00 12/01/2010 12/29/2057

VK7715 OP OP M A 07/27/2010 1,482.49 SD A 1,437.00 01/01/2011 07/18/2053

VK7724 OP OP M A 07/24/2010 2,081.40 PD A 1,536.78 12/03/2010 03/24/2064 M A 07/24/2010 2,081.40 PS A 271.08 12/03/2010 03/24/2064 M A 07/24/2010 2,081.40 SD A 1,523.00 01/01/2011 03/24/2064

VK7727 OP OP F A 04/20/2010 887.52 PD A 582.63 10/13/2010 04/30/2060 F A 04/20/2010 887.52 SD A 856.00 10/01/2010 04/30/2060

VK7750 LT LS F A 06/28/2008 874.56 0.00

VK7788 OP OP F A 05/22/2010 1,795.82 PD A 805.60 10/24/2010 07/12/2050 F A 05/22/2010 1,795.82 SD A 1,118.00 01/01/2011 07/12/2050

VK7799 OP OP F A 06/06/2010 1,310.04 PD A 554.27 05/07/2011 09/13/2052 F A 06/06/2010 1,310.04 SD A 844.00 01/01/2011 09/13/2052

VK7864 OP OP F A 06/18/2010 2,854.42 PD A 1,658.21 01/27/2011 09/20/2069 F A 06/18/2010 2,854.42 SC A 857.00 01/01/2011 01/31/2023 F A 06/18/2010 2,854.42 SD A 1,714.00 01/01/2011 09/20/2069

VK9421 OP OP F A 09/16/2010 2,380.41 PD A 1,645.38 09/16/2010 07/13/2056 F A 09/16/2010 2,380.41 SD A 1,216.00 03/01/2011 07/13/2056

VK9425 OP OP F A 08/28/2010 2,407.38 PD A 1,752.29 11/05/2010 07/05/2070 F A 08/28/2010 2,407.38 SD A 1,311.00 03/01/2011 07/05/2070

VK9497 OP OP F A 05/29/2010 1,374.70 BO A 569.83 01/01/2011 11/20/2015 F A 05/29/2010 1,374.70 SD A 752.00 01/01/2011 11/21/2050

VL1400 OP OP F A 08/12/2010 1,663.51 PD A 674.18 12/08/2010 08/02/2070

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F A 08/12/2010 1,663.51 SD A 1,202.00 02/01/2011 08/02/2070

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 22 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VL1446 OP OP M A 06/19/2010 2,615.59 PS A 1,545.82 04/09/2008 08/15/2051 M A 06/19/2010 2,615.59 SD A 1,633.00 12/01/2010 08/15/2051

VL1449 LT LS F A 11/07/2010 1,056.85 0.00

VL1480 OP OP F A 09/30/2010 1,140.24 SD A 1,151.00 03/01/2011 04/08/2055

VL2715 OP OP F A 11/02/2010 1,120.17 PD A 508.39 01/01/2011 12/31/2050 F A 11/02/2010 1,120.17 SD A 777.00 12/01/2011 12/31/2050

VL2718 OP OP M A 07/20/2010 1,571.75 PD A 937.92 01/14/2011 11/15/2065 M A 07/20/2010 1,571.75 SD A 1,239.00 03/01/2012 11/15/2065 M A 07/20/2010 1,571.75 WP A 176.20 02/07/2011 11/14/2035

VL2774 OP OP M A 10/21/2010 2,178.80 PD A 1,071.25 12/15/2010 01/20/2054 M A 10/21/2010 2,178.80 SC A 921.00 04/01/2011 06/30/2015 M A 10/21/2010 2,178.80 SD A 1,843.00 04/01/2011 01/20/2054

VL3436 OP OP F A 10/01/2010 1,794.00 BO A 774.00 09/01/2012 09/13/2035 F A 10/01/2010 1,794.00 SD A 951.00 09/01/2012 09/14/2070

VL4708 OP OP M A 09/17/2010 3,698.72 SC A 1,092.00 01/01/2012 03/31/2018 M A 09/17/2010 3,698.72 SD A 2,148.00 12/01/2011 08/18/2065

VL4758 OP OP F A 05/04/2010 1,032.23 PD A 500.53 07/15/2010 01/17/2051 F A 05/04/2010 1,032.23 SD A 709.00 11/01/2010 01/17/2051

VL4767 OP OP F A 10/30/2010 1,019.20 PD A 340.90 12/02/2010 01/19/2059 F A 10/30/2010 1,019.20 SD A 1,051.00 05/01/2011 01/19/2059 F A 10/30/2010 1,019.20 WP A 134.84 04/29/2013 06/30/2041

VL4784 LT LS M A 03/28/2009 932.36 0.00

VL4787 OP OP M A 09/01/2010 943.96 BO A 155.66 02/01/2011 12/21/2028 M A 09/01/2010 943.96 SD A 752.00 02/01/2011 12/22/2063

VL6200 OP OP F A 10/08/2010 1,130.66 SD A 1,806.00 04/01/2011 08/11/2059

VL6201 OP OP M A 06/10/2010 899.60 SD A 1,214.00 07/01/2010 02/12/2061

VL6207 OP OP M A 08/18/2010 3,475.93 PD A 2,311.15 02/24/2011 04/04/2051 M A 08/18/2010 3,475.93 SD A 1,787.00 02/01/2011 04/04/2051

VL6240 OP OP F A 09/25/2010 2,588.82 BO A 800.00 12/24/2010 09/26/2049 F A 09/25/2010 2,588.82 SD A 900.00 03/01/2011 09/27/2084

VL6241 OP OP F A 11/16/2010 1,476.20 PD A 1,367.15 04/30/2011 11/20/2049 F A 11/16/2010 1,476.20 SC A 589.00 05/01/2011 05/31/2016

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F A 11/16/2010 1,476.20 SD A 1,178.00 05/01/2011 11/20/2069

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 23 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VL6242 OP OP M A 10/16/2010 1,940.13 PS A 1,385.22 01/01/2009 01/24/2057 M A 10/16/2010 1,940.13 SD A 1,412.00 04/01/2011 01/24/2057

VL6248 OP OP M A 12/15/2010 1,270.59 PD A 693.53 03/13/2011 06/11/2056 M A 12/15/2010 1,270.59 SD A 1,233.00 12/01/2011 06/11/2056

VL6310 OP OP M A 12/28/2010 1,520.82 PD A 400.11 04/02/2011 07/17/2051 M A 12/28/2010 1,520.82 SD A 1,263.00 06/01/2011 07/17/2051

VL6323 OP OP M A 11/19/2010 1,604.79 PD A 1,252.71 04/30/2011 05/29/2064 M A 11/19/2010 1,604.79 SD A 1,613.00 05/01/2011 05/29/2064

VL8365 OP OP F A 08/24/2010 1,482.43 BO A 380.41 09/01/2011 02/16/2030 F A 08/24/2010 1,482.43 SD A 1,045.00 09/01/2011 02/17/2065

VL8403 OP OP M A 01/13/2011 1,998.68 BO A 526.82 07/01/2011 12/16/2022 M A 01/13/2011 1,998.68 PD A 574.99 03/03/2011 12/17/2057 M A 01/13/2011 1,998.68 SC A 216.00 01/01/2012 12/31/2015 M A 01/13/2011 1,998.68 SD A 820.00 07/01/2011 12/17/2057

VL8442 OP OP F A 01/18/2011 1,067.63 PD A 226.02 03/26/2011 08/14/2057 F A 01/18/2011 1,067.63 SD A 1,395.00 01/01/2012 08/14/2057 F A 01/18/2011 1,067.63 WP A 79.38 02/01/2011 01/31/2041

VL8463 OP OP F A 11/19/2010 2,185.09 PD A 1,579.43 04/15/2011 03/09/2062 F A 11/19/2010 2,185.09 SD A 1,266.00 05/01/2011 03/09/2062

VL8467 OP OP F A 10/16/2010 1,228.25 PD A 790.05 04/16/2011 07/11/2052 F A 10/16/2010 1,228.25 SD A 959.00 10/01/2011 07/11/2052

VL8482 OP OP F A 10/14/2010 980.93 PD A 210.24 07/13/2011 05/07/2051 F A 10/14/2010 980.93 SD A 1,121.00 04/01/2011 05/07/2051

VL8488 OP OP M A 12/15/2010 2,041.81 PD A 1,572.54 04/02/2011 05/14/2070 M A 12/15/2010 2,041.81 SD A 1,499.00 06/01/2011 05/14/2070

VL8602 OP OP F A 12/15/2010 1,240.10 BO A 233.41 06/01/2011 08/31/2020 F A 12/15/2010 1,240.10 SD A 959.00 06/01/2011 09/01/2055

VM1600 OP OP F A 01/15/2011 985.62 PD A 702.23 03/16/2011 08/31/2059 F A 01/15/2011 985.62 SD A 1,180.00 09/01/2011 08/31/2059

VM1641 OP OP M A 07/05/2010 1,122.88 PD A 664.34 02/11/2011 08/20/2052 M A 07/05/2010 1,122.88 SD A 947.00 01/01/2011 08/20/2052

VM1657 OP OP M A 11/24/2010 1,856.56 PS A 1,154.55 11/24/2010 07/03/2059 M A 11/24/2010 1,856.56 SD A 1,290.00 05/01/2011 07/03/2059

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VM1668 OP OP M A 01/22/2011 1,917.83 PD A 651.58 07/23/2011 12/19/2051 M A 01/22/2011 1,917.83 SD A 1,612.00 07/01/2011 12/19/2051

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 24 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VM2502 OP OP F A 01/12/2011 1,068.28 PD A 295.44 03/09/2011 09/25/2054 F A 01/12/2011 1,068.28 SD A 1,170.00 06/01/2011 09/25/2054

VM2530 OP OP F A 02/11/2011 1,558.80 PD A 542.58 04/02/2011 04/26/2059 F A 02/11/2011 1,558.80 SD A 1,475.00 08/01/2011 04/26/2059

VM2540 OP OP M A 09/29/2010 1,369.82 PD A 1,178.04 04/16/2011 10/15/2057 M A 09/29/2010 1,369.82 SD A 1,228.00 03/01/2011 10/15/2057

VM2545 OP OP F A 02/19/2011 3,242.75 PD A 1,992.50 05/07/2011 01/14/2057 F A 02/19/2011 3,242.75 SC A 878.00 08/01/2011 10/31/2016 F A 02/19/2011 3,242.75 SD A 1,757.00 08/01/2011 01/14/2057

VM2705 OP OP F A 06/11/2010 978.46 SD A 1,005.00 12/01/2010 04/11/2066

VM2719 OP OP F A 12/31/2010 1,394.20 PD A 689.30 05/21/2011 09/24/2055 F A 12/31/2010 1,394.20 SD A 995.00 06/01/2011 09/24/2055

VM2756 OP OP M A 09/12/2007 2,113.48 PD A 843.07 09/11/2009 09/29/2059 M A 09/12/2007 2,113.48 SD A 1,476.00 05/01/2008 09/29/2059

VM2772 OP OP F A 12/18/2010 2,668.86 BO A 129.26 07/01/2011 12/03/2015 F A 12/18/2010 2,668.86 PD A 1,261.95 01/15/2011 12/04/2050 F A 12/18/2010 2,668.86 SD A 1,175.00 07/01/2011 12/04/2050

VM3554 OP OP F A 01/08/2011 1,030.16 PD A 533.88 06/09/2011 12/22/2054 F A 01/08/2011 1,030.16 SD A 804.00 07/01/2011 12/22/2054

VM3586 OP OP F A 01/05/2011 2,740.08 PD A 1,530.76 05/16/2011 02/14/2057 F A 01/05/2011 2,740.08 SD A 1,627.00 07/01/2011 02/14/2057

VM3963 OP OP M A 12/27/2010 2,316.14 0.00

VM4732 OP OP F A 12/08/2010 1,092.77 PD A 521.60 06/12/2011 10/02/2058 F A 12/08/2010 1,092.77 SD A 1,134.00 02/01/2011 10/02/2058

VM4742 OP OP M A 12/18/2010 1,386.30 SD A 1,031.00 09/01/2011 10/08/2064

VM4745 OP OP M A 01/09/2011 2,218.64 PD A 1,846.89 04/24/2011 12/22/2060 M A 01/09/2011 2,218.64 SD A 1,471.00 07/01/2011 12/22/2060

VM4751 OP OP M A 01/19/2011 2,743.27 PD A 1,624.23 06/04/2011 08/22/2050 M A 01/19/2011 2,743.27 SD A 1,533.00 07/01/2011 08/22/2050

VM4761 OP OP F A 03/22/2011 2,970.28 PD A 2,737.59 04/13/2011 11/02/2059 F A 03/22/2011 2,970.28 SD A 1,758.00 12/01/2011 11/02/2059

VM4775 OP OP F A 02/05/2011 1,124.50 BO A 179.25 08/01/2011 09/24/2024

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F A 02/05/2011 1,124.50 SD A 902.00 08/01/2011 09/25/2059

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 25 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VM5742 OP OP F A 01/15/2011 1,383.42 PD A 513.78 06/12/2011 05/09/2064 F A 01/15/2011 1,383.42 PS A 223.51 06/12/2011 05/09/2064 F A 01/15/2011 1,383.42 SD A 869.00 07/01/2011 05/09/2064

VM5750 OP OP M A 01/15/2011 1,231.00 PD A 630.29 05/21/2011 10/09/2050 M A 01/15/2011 1,231.00 SD A 997.00 07/01/2011 10/09/2050

VM5756 OP OP F A 10/08/2010 1,644.92 PD A 1,138.75 05/28/2011 04/06/2058 F A 10/08/2010 1,644.92 PS A 64.31 05/28/2011 04/06/2058 F A 10/08/2010 1,644.92 SD A 1,327.00 04/01/2011 04/06/2058

VM5796 OP OP F A 01/11/2011 1,108.30 SD A 1,186.00 07/01/2011 04/04/2063

VN0915 OP OP F A 03/05/2011 3,306.36 PD A 1,875.80 08/02/2011 10/02/2063 F A 03/05/2011 3,306.36 SD A 1,506.00 01/01/2012 10/02/2063

VN0990 OP OP F A 12/18/2010 3,472.63 PD A 3,088.75 07/01/2011 11/20/2061 F A 12/18/2010 3,472.63 SD A 1,805.00 01/01/2012 11/20/2061

VN1678 OP OP M A 03/17/2011 1,601.15 PL A 760.50 07/01/2011 11/18/2054 M A 03/17/2011 1,601.15 SD A 1,295.00 09/01/2011 11/18/2054

VN1740 OP OP M A 04/09/2011 2,115.75 PD A 1,642.83 07/20/2011 10/28/2059 M A 04/09/2011 2,115.75 SD A 1,239.00 10/01/2011 10/28/2059

VN1798 OP OP M A 02/01/2011 1,271.56 PD A 344.13 07/30/2011 04/11/2055 M A 02/01/2011 1,271.56 SD A 1,463.00 07/01/2011 04/11/2055

VN2008 OP OP F A 04/30/2011 3,167.13 PD A 2,406.94 06/04/2011 03/24/2053 F A 04/30/2011 3,167.13 SD A 1,676.00 11/01/2011 03/24/2053

VN2018 OP OP F A 03/14/2011 1,003.00 BO A 273.75 09/10/2011 06/11/2029 F A 03/14/2011 1,003.00 SD A 980.00 09/01/2011 06/12/2064

VN2063 OP OP M A 04/01/2011 3,111.23 BO A 255.47 09/01/2011 11/12/2015 M A 04/01/2011 3,111.23 PD A 675.09 05/03/2011 11/13/2050 M A 04/01/2011 3,111.23 SD A 2,061.00 09/01/2011 11/13/2050

VN2761 LT LS F A 10/23/2009 779.48 0.00

VN2939 OP OP M A 04/25/2011 973.10 PD A 467.09 09/01/2011 05/22/2057 M A 04/25/2011 973.10 SD A 920.00 10/01/2011 05/22/2057

VN2973 OP OP M A 07/19/2011 1,971.55 PD A 650.20 07/19/2011 05/14/2050 M A 07/19/2011 1,971.55 SD A 1,351.00 01/01/2012 05/14/2050

VN3900 OP OP F A 03/01/2011 2,740.78 PD A 1,519.68 07/25/2011 05/14/2055 F A 03/01/2011 2,740.78 SD A 1,228.00 08/01/2011 05/14/2055

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VN3962 OP OP F A 04/28/2011 2,880.35 PD A 2,707.51 04/28/2011 11/21/2062

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 26 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VN3962 OP OP F A 04/28/2011 2,880.35 SD A 1,773.00 10/01/2011 11/21/2062

VN3965 OP OP M A 04/19/2011 1,184.85 PD A 448.82 08/02/2011 08/24/2063 M A 04/19/2011 1,184.85 SD A 890.00 10/01/2011 08/24/2063

VN3967 OP OP M A 04/05/2011 1,251.90 PD A 370.27 11/29/2011 01/04/2053 M A 04/05/2011 1,251.90 SD A 1,102.00 10/01/2011 01/04/2053

VN3968 OP OP M A 11/10/2010 2,317.59 PD A 1,374.32 08/20/2011 09/22/2050 M A 11/10/2010 2,317.59 SA A 202.57 02/08/2011 09/21/2015 M A 11/10/2010 2,317.59 SD A 1,511.00 02/01/2012 09/22/2050

VN3977 OP OP F A 05/18/2011 2,413.71 PD A 1,561.35 07/02/2011 01/14/2047 F A 05/18/2011 2,413.71 SD A 1,739.00 11/01/2011 07/07/2051

VN3979 OP OP F A 05/21/2011 1,639.30 PD A 637.91 08/07/2011 07/02/2056 F A 05/21/2011 1,639.30 SD A 1,287.00 11/01/2011 07/02/2056

VN4765 OP OP M A 04/29/2011 2,637.61 PD A 1,815.16 07/16/2011 07/21/2057 M A 04/29/2011 2,637.61 SD A 1,662.00 01/01/2012 07/21/2057

VN4788 OP OP F A 06/09/2011 2,418.76 PD A 838.30 08/17/2011 10/17/2057 F A 06/09/2011 2,418.76 PS A 205.84 08/17/2011 10/17/2057 F A 06/09/2011 2,418.76 SD A 1,608.00 12/01/2011 10/17/2057

VN7568 OP OP F A 05/26/2011 1,211.41 PD A 874.07 06/12/2011 11/09/2051 F A 05/26/2011 1,211.41 SD A 1,107.00 11/01/2011 11/09/2051

VN7580 OP OP F A 04/08/2011 3,257.68 BO A 797.66 01/01/2012 10/23/2023 F A 04/08/2011 3,257.68 PD A 931.72 08/24/2011 10/24/2058 F A 04/08/2011 3,257.68 SD A 1,403.00 01/01/2012 10/24/2058

VN7734 OP OP F A 07/07/2011 1,953.58 PS A 1,264.80 07/07/2011 01/17/2054 F A 07/07/2011 1,953.58 SD A 1,165.00 01/01/2012 01/17/2054

VN8101 OP OP F A 07/30/2011 3,585.28 BO A 800.00 10/28/2011 04/07/2017 F A 07/30/2011 3,585.28 PD A 754.47 10/01/2011 04/08/2052 F A 07/30/2011 3,585.28 SD A 1,204.00 01/01/2012 04/08/2052 F A 07/30/2011 3,585.28 WP A 297.12 07/30/2011 04/07/2022

VN8105 OP OP M A 04/29/2011 1,952.98 PD A 719.30 09/01/2011 02/04/2060 M A 04/29/2011 1,952.98 SD A 1,946.00 10/01/2011 02/04/2060

VN8128 OP OP F A 03/16/2011 1,192.75 PD A 792.60 08/01/2011 12/02/2057 F A 03/16/2011 1,192.75 SD A 1,012.00 11/01/2011 12/02/2057

VN8151 OP OP F A 06/21/2011 1,124.40 PD A 312.01 08/16/2011 05/01/2052 F A 06/21/2011 1,124.40 SD A 1,181.00 01/01/2012 05/01/2052

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VN8159 OP OP F A 05/14/2011 1,403.68 BO A 142.47 11/01/2011 09/13/2026

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 27 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VN8159 OP OP F A 05/14/2011 1,403.68 PD A 1,207.22 10/05/2011 09/14/2061

VN8177 OP OP M A 04/06/2011 1,543.83 SD A 2,035.00 10/01/2012 09/18/2066

VN8190 OP OP M A 08/01/2011 1,670.02 PD A 622.70 10/08/2011 06/21/2059 M A 08/01/2011 1,670.02 SD A 1,432.00 11/01/2012 06/21/2059

VN8817 OP OP F A 05/05/2011 1,246.97 PD A 531.82 10/30/2011 12/19/2051 F A 05/05/2011 1,246.97 SD A 936.00 11/01/2011 12/19/2051

VN8856 OP OP M A 07/14/2011 1,062.65 SD A 1,441.00 01/01/2012 03/10/2054

VN8857 OP OP M A 06/02/2011 1,497.43 BO A 69.84 12/01/2011 06/23/2016 M A 06/02/2011 1,497.43 SD A 1,370.00 12/01/2011 06/24/2051

VN8876 OP OP F A 08/16/2011 2,081.03 PD A 1,666.27 10/04/2011 01/08/2060 F A 08/16/2011 2,081.03 SD A 1,433.00 02/01/2012 01/08/2060

VN9916 OP OP F A 07/11/2011 2,356.25 BO A 800.00 12/01/2011 10/16/2032 F A 07/11/2011 2,356.25 SD A 967.00 07/11/2011 10/17/2067

VN9968 OP OP M A 04/02/2011 1,909.40 PD A 1,498.69 07/13/2011 07/08/2055 M A 04/02/2011 1,909.40 SD A 1,403.00 09/01/2011 07/08/2055

VN9995 OP OP F A 06/20/2011 2,067.40 BO A 488.89 12/01/2011 03/02/2018 F A 06/20/2011 2,067.40 SD A 1,499.00 12/01/2011 03/03/2053

VO3800 OP OP F A 07/20/2011 1,600.22 PD A 704.24 11/25/2011 06/24/2052 F A 07/20/2011 1,600.22 SD A 1,086.00 03/01/2012 06/24/2052

VO4244 OP OP F A 03/07/2011 2,529.09 PD A 1,322.95 10/22/2011 05/08/2063 F A 03/07/2011 2,529.09 SD A 1,385.00 08/01/2013 05/08/2063

VO4403 OP OP M A 08/12/2011 1,199.58 SD A 1,687.00 02/01/2012 12/19/2051

VO4471 OP OP F A 08/15/2011 1,740.73 PD A 1,108.41 11/26/2011 12/27/2048 F A 08/15/2011 1,740.73 SD A 1,119.00 02/01/2012 12/27/2048

VO4530 OP OP M A 09/13/2011 1,231.15 PD A 600.54 02/08/2012 07/17/2054 M A 09/13/2011 1,231.15 SD A 1,629.00 03/01/2012 07/17/2054

VO4633 OP OP F A 09/07/2011 2,440.76 PD A 1,487.15 05/20/2012 04/29/2074 F A 09/07/2011 2,440.76 SD A 1,491.00 03/01/2012 04/29/2074

VO4695 OP OP F A 10/14/2011 1,190.32 PD A 517.99 01/11/2012 08/24/2053 F A 10/14/2011 1,190.32 SD A 969.00 04/01/2012 08/24/2053

VO4696 OP OP F A 09/02/2011 1,809.32 BO A 800.00 12/01/2011 08/09/2030

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F A 09/02/2011 1,809.32 P1 A 804.66 03/30/2012 08/10/2065 F A 09/02/2011 1,809.32 SC E 502.00 02/01/2012 02/28/2021

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 28 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VO4696 OP OP F A 09/02/2011 1,809.32 SD E 1,004.00 02/01/2012 08/10/2065

VO5408 OP OP M A 05/07/2011 2,373.31 BO A 800.00 08/05/2011 03/31/2016 M A 05/07/2011 2,373.31 SD A 1,433.00 02/01/2012 04/01/2051

VO6109 OP OP F A 06/13/2011 1,056.22 SD A 1,160.00 12/01/2011 02/24/2056

VO6134 OP OP F A 06/12/2011 1,487.60 PD A 1,807.94 12/14/2011 07/12/2063

VO6151 OP OP M A 03/19/2011 1,254.89 PD A 414.10 11/01/2011 07/02/2054 M A 03/19/2011 1,254.89 SD A 1,308.00 09/01/2011 07/02/2054

VO6153 OP OP M A 05/20/2011 2,291.33 BO A 800.00 08/18/2011 12/18/2015 M A 05/20/2011 2,291.33 PD A 1,043.03 10/14/2011 12/19/2050 M A 05/20/2011 2,291.33 SD A 168.00 01/01/2012 12/19/2050

VO6162 OP OP M A 08/20/2011 1,092.25 PD A 471.21 10/18/2011 07/28/2056 M A 08/20/2011 1,092.25 SD A 770.00 02/01/2012 07/28/2056

VO6944 OP OP F A 07/13/2011 910.33 SD A 1,147.00 01/01/2012 01/01/2059

VO7611 OP OP M A 07/01/2011 1,540.33 BO A 359.09 01/01/2012 06/12/2047 M A 07/01/2011 1,540.33 SD A 1,122.00 01/01/2012 06/12/2082

VO7630 OP OP F A 08/18/2011 2,582.10 BO A 103.44 03/01/2012 10/17/2032 F A 08/18/2011 2,582.10 PD A 1,384.35 02/26/2012 10/18/2067 F A 08/18/2011 2,582.10 SD A 995.00 02/01/2012 10/18/2067

VO7651 OP OP M A 01/11/2011 1,445.17 PD A 1,107.30 02/01/2012 12/12/2052 M A 01/11/2011 1,445.17 SD A 1,178.00 07/01/2012 12/12/2052

VO7669 OP OP F A 09/20/2011 1,742.98 PD A 907.94 12/07/2011 05/03/2061 F A 09/20/2011 1,742.98 SD A 1,066.00 03/01/2012 05/03/2061

VO7673 OP OP F A 12/16/2010 1,671.49 PD A 1,065.83 10/22/2011 06/30/2054 F A 12/16/2010 1,671.49 SD A 1,217.00 02/01/2012 06/30/2054

VO8708 OP OP F A 09/17/2011 824.27 PD A 787.01 01/18/2012 05/07/2055 F A 09/17/2011 824.27 SD A 1,073.00 03/01/2012 05/07/2055

VO8748 OP OP F A 11/13/2011 1,693.62 BO A 512.91 05/01/2012 04/22/2016 F A 11/13/2011 1,693.62 PD A 894.20 01/12/2012 04/23/2051 F A 11/13/2011 1,693.62 SD A 217.00 05/01/2012 04/23/2051

VO8754 OP OP F A 03/17/2011 3,047.10 PD A 1,753.62 01/28/2012 01/06/2058 F A 03/17/2011 3,047.10 SD A 1,880.00 01/01/2012 01/06/2058

VO8755 OP OP M A 10/16/2011 1,583.30 BO A 800.00 01/14/2012 01/22/2019

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M A 10/16/2011 1,583.30 P1 A 372.07 03/03/2012 01/23/2054 M A 10/16/2011 1,583.30 SD E 919.00 04/01/2012 01/23/2054

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 29 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VO8774 OP OP M A 05/06/2011 1,316.35 PD A 853.40 12/21/2011 02/07/2054 M A 05/06/2011 1,316.35 SD A 1,009.00 11/01/2011 02/07/2054

VO8785 OP OP M A 10/05/2011 4,305.71 PD A 2,586.37 01/18/2012 06/27/2053 M A 10/05/2011 4,305.71 SD A 2,057.00 03/01/2012 06/27/2053

VO8791 OP OP F A 11/12/2011 701.52 PD A 521.23 04/21/2012 12/12/2057 F A 11/12/2011 701.52 SD A 772.00 05/01/2012 12/12/2057

VO9436 OP OP M A 07/27/2011 1,142.54 PD A 301.34 11/05/2011 06/12/2051 M A 07/27/2011 1,142.54 SD A 1,058.00 01/01/2012 06/12/2051

VO9752 OP OP M A 06/13/2011 1,241.62 SD A 1,596.00 12/01/2011 04/24/2058

VO9922 OP OP M A 09/04/2011 1,408.77 PL A 551.70 10/31/2011 09/07/2061 M A 09/04/2011 1,408.77 SD A 1,822.00 03/01/2012 09/07/2061

VO9978 OP OP F A 09/26/2011 1,071.38 PD A 323.93 04/19/2012 11/09/2051 F A 09/26/2011 1,071.38 SD A 1,149.00 03/01/2012 11/09/2051

VO9989 OP OP F A 06/16/2011 1,776.71 BO A 591.38 12/01/2011 09/05/2015 F A 06/16/2011 1,776.71 SD A 1,117.00 12/01/2011 09/06/2050

VP0809 OP OP F A 10/22/2011 1,400.36 BO A 86.96 05/01/2012 07/19/2015 F A 10/22/2011 1,400.36 PD A 226.54 04/05/2012 03/18/2049 F A 10/22/2011 1,400.36 SD A 1,033.00 04/01/2012 03/18/2049

VP0883 OP OP M A 09/15/2011 2,346.49 PL A 1,288.14 04/04/2012 04/22/2054 M A 09/15/2011 2,346.49 SD A 1,662.00 03/01/2012 04/22/2054

VP2136 OP OP F A 12/01/2011 4,243.95 PS A 356.00 03/12/2012 03/11/2052 F A 12/01/2011 4,243.95 SD A 2,075.00 05/01/2012 03/11/2052

VP2153 OP OP F A 09/24/2011 1,250.73 BO A 166.63 03/01/2012 08/13/2018 F A 09/24/2011 1,250.73 SD A 1,036.00 03/01/2012 08/14/2053

VP2157 OP OP F A 11/30/2011 1,131.70 BO A 654.96 06/01/2012 02/07/2026 F A 11/30/2011 1,131.70 PD A 433.22 05/30/2012 02/08/2061 F A 11/30/2011 1,131.70 SD E 779.00 05/01/2012 02/08/2061

VP2196 OP OP F A 01/07/2012 2,035.80 BO A 771.62 04/06/2012 10/30/2038 F A 01/07/2012 2,035.80 PD A 1,185.88 03/04/2012 10/31/2073 F A 01/07/2012 2,035.80 SC E 542.00 07/01/2012 01/31/2028 F A 01/07/2012 2,035.80 SD E 1,084.00 07/01/2012 10/31/2073

VP2906 OP OP F A 01/11/2012 1,462.89 PD A 996.63 04/25/2012 01/26/2050 F A 01/11/2012 1,462.89 SD A 1,075.00 07/01/2012 01/26/2050

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VP2928 OP OP M A 10/11/2011 1,059.99 SD A 1,114.00 09/01/2012 11/16/2053

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 30 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VP2941 OP OP M A 08/14/2011 3,488.61 BO A 800.00 06/01/2012 05/14/2021 M A 08/14/2011 3,488.61 SD A 1,649.00 08/01/2012 05/15/2056

VP2974 OP OP F A 12/01/2011 950.20 PD A 362.16 03/22/2012 09/14/2060 F A 12/01/2011 950.20 SD A 838.00 06/01/2012 09/14/2060

VP2991 OP OP F A 12/03/2011 1,237.93 PD A 787.69 05/16/2012 12/24/2055 F A 12/03/2011 1,237.93 SD A 1,171.00 06/01/2012 12/24/2055

VP3387 OP OP F A 05/01/2012 2,264.98 PD A 1,578.57 06/16/2012 05/20/2064 F A 05/01/2012 2,264.98 SD A 1,497.00 10/01/2012 05/20/2064

VP4440 OP OP F A 12/17/2011 1,721.33 SD A 1,749.00 06/01/2012 03/04/2071

VP4459 OP OP F A 11/08/2011 1,491.09 BO A 311.74 05/01/2012 07/16/2024 F A 11/08/2011 1,491.09 SD A 1,122.00 05/01/2012 07/17/2059

VP4480 OP OP F A 01/12/2012 2,506.73 PD A 1,481.45 04/28/2012 08/26/2067 F A 01/12/2012 2,506.73 SC A 611.00 07/01/2012 01/31/2018 F A 01/12/2012 2,506.73 SD A 1,222.00 07/01/2012 08/26/2067

VP5138 OP OP F A 10/11/2011 1,234.68 PD A 794.71 03/29/2012 02/28/2056 F A 10/11/2011 1,234.68 SD A 1,034.00 04/01/2012 02/28/2056

VP5161 OP OP M A 02/16/2012 1,451.60 BO A 329.77 08/01/2012 05/02/2016 M A 02/16/2012 1,451.60 SD A 1,066.00 08/01/2012 05/03/2051

VP6674 OP OP F A 01/07/2012 2,811.09 SC E 644.00 07/01/2012 08/31/2022 F A 01/07/2012 2,811.09 SD E 1,288.00 07/01/2012 04/01/2068

VP6934 OP OP F A 11/19/2011 994.50 PD A 795.50 06/02/2012 01/09/2055 F A 11/19/2011 994.50 SD A 829.00 05/01/2012 01/09/2055

VP6985 OP OP M A 07/30/2011 2,064.50 BO A 206.85 03/01/2012 01/14/2019 M A 07/30/2011 2,064.50 PS A 455.25 03/01/2012 01/15/2054 M A 07/30/2011 2,064.50 SD A 1,323.00 01/01/2012 01/15/2054

VP6990 OP OP F A 01/25/2012 741.81 PD A 295.52 04/28/2013 01/08/2070 F A 01/25/2012 741.81 SD A 556.00 01/01/2013 01/08/2070

VP7562 OP OP F A 02/28/2011 1,115.50 PD A 973.30 01/28/2012 08/16/2063 F A 02/28/2011 1,115.50 WP A 144.77 10/25/2013 05/17/2046

VP7604 OP OP F A 11/16/2011 1,706.20 PD A 661.57 05/16/2012 01/08/2050 F A 11/16/2011 1,706.20 SD A 1,178.00 05/01/2012 01/08/2050

VP8304 OP OP F A 01/19/2012 1,091.26 PD A 782.08 05/13/2012 12/30/2072 F A 01/19/2012 1,091.26 SD A 1,350.00 07/01/2012 12/30/2072

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VP8361 OP OP F A 12/18/2011 1,015.95 PD A 514.85 06/01/2012 04/07/2051

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 31 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VP8361 OP OP F A 12/18/2011 1,015.95 SD A 854.00 06/01/2012 04/07/2051

VP8364 OP OP F A 02/25/2012 1,085.84 PD A 562.28 09/18/2012 08/16/2067 F A 02/25/2012 1,085.84 SD A 964.00 08/01/2012 08/16/2067

VP8369 OP OP F A 03/08/2012 2,320.50 PL A 1,154.78 08/02/2012 03/12/2063 F A 03/08/2012 2,320.50 SD A 1,379.00 09/01/2012 03/12/2063

VP8522 OP OP F A 01/09/2012 1,157.82 SD A 1,835.00 02/01/2013 12/19/2057

VP8529 OP OP F A 03/20/2012 2,790.13 PD A 1,355.33 05/31/2012 05/22/2077 F A 03/20/2012 2,790.13 SD A 1,522.00 09/01/2012 05/22/2077

VP8576 OP OP F A 03/01/2012 1,129.86 PD A 900.60 08/15/2012 05/24/2065 F A 03/01/2012 1,129.86 SD A 1,139.00 08/01/2012 05/24/2065

VP8606 OP OP F A 05/03/2012 2,989.56 PD A 1,910.39 05/03/2012 05/24/2054 F A 05/03/2012 2,989.56 SD A 1,613.00 10/01/2012 05/24/2054

VQ0236 OP OP F A 01/17/2012 2,051.18 BO A 800.00 04/16/2012 07/10/2033 F A 01/17/2012 2,051.18 SC E 542.00 07/01/2012 01/31/2019 F A 01/17/2012 2,051.18 SD E 1,084.00 07/01/2012 07/11/2068

VQ4402 OP OP M A 03/19/2012 1,487.71 BO A 343.49 11/01/2012 10/31/2020 M A 03/19/2012 1,487.71 SD A 1,087.00 11/01/2012 11/01/2055

VQ4436 OP OP M A 04/30/2012 1,646.01 BO A 236.11 07/29/2012 05/07/2024 M A 04/30/2012 1,646.01 PD A 1,346.59 07/21/2012 05/08/2059 M A 04/30/2012 1,646.01 SD E 962.00 10/01/2012 05/08/2059

VQ4474 OP OP M A 05/26/2012 1,817.56 PD A 1,034.42 09/05/2012 07/20/2063 M A 05/26/2012 1,817.56 SD A 1,328.00 11/01/2012 07/20/2063

VQ5210 OP OP F A 03/31/2012 4,315.03 PD A 1,424.97 07/25/2012 09/11/2053 F A 03/31/2012 4,315.03 SD A 2,183.00 09/01/2012 09/11/2053

VQ5227 OP OP F A 06/21/2012 4,187.30 PS A 3,039.64 06/30/2012 01/03/2057 F A 06/21/2012 4,187.30 SD A 2,112.00 12/01/2012 01/03/2057

VQ5246 OP OP M A 05/08/2012 1,498.35 PD A 350.32 08/26/2012 02/22/2052 M A 05/08/2012 1,498.35 SD A 1,364.00 11/01/2012 02/22/2052

VQ5359 OP OP F A 06/11/2012 1,676.73 BO A 460.67 10/01/2012 10/07/2032 F A 06/11/2012 1,676.73 PD A 1,151.57 09/24/2012 10/08/2067

VQ5382 OP OP F A 06/21/2012 1,449.71 PD A 720.64 08/29/2012 11/12/2059 F A 06/21/2012 1,449.71 SD A 1,032.00 12/01/2012 11/12/2059

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VQ6622 OP OP F A 03/27/2012 1,828.72 BO A 491.29 02/01/2013 12/26/2041 F A 03/27/2012 1,828.72 PD A 1,267.10 01/13/2013 12/26/2041

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 32 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VQ6622 OP OP F A 03/27/2012 1,828.72 SC E 502.00 09/01/2012 09/30/2024 F A 03/27/2012 1,828.72 SD E 1,004.00 09/01/2012 12/27/2076

VQ6718 OP OP F A 06/14/2012 3,780.08 BO A 800.00 09/12/2012 01/05/2018 F A 06/14/2012 3,780.08 PS A 928.74 05/02/2013 01/06/2053 F A 06/14/2012 3,780.08 SD E 1,388.00 12/01/2012 01/06/2053

VQ6739 OP OP F A 01/05/2012 2,926.74 PD A 1,664.43 11/01/2012 11/08/2061 F A 01/05/2012 2,926.74 SD A 1,791.00 07/01/2012 11/08/2061

VQ6743 LT LS F A 10/31/2008 100.00 0.00

VQ6770 OP OP F A 06/12/2012 1,194.91 PS A 514.76 02/01/2012 12/23/2049 F A 06/12/2012 1,194.91 SR A 680.00 06/12/2012 12/23/2049

VQ6796 OP OP F A 03/31/2012 871.49 SD A 904.00 09/01/2012 08/16/2078

VQ7979 OP OP F A 09/27/2012 3,828.50 BO A 800.00 12/26/2012 12/25/2015 F A 09/27/2012 3,828.50 SD A 1,852.00 03/01/2013 05/29/2049

VQ8215 OP OP F A 07/14/2012 2,636.67 PD A 2,667.27 12/02/2012 03/05/2059 F A 07/14/2012 2,636.67 SD A 1,495.00 01/01/2013 03/05/2059

VQ8216 OP OP M A 06/02/2012 1,000.51 PD A 440.70 07/25/2012 02/13/2054 M A 06/02/2012 1,000.51 SD A 777.00 01/01/2013 02/13/2054

VQ8246 OP OP M A 04/01/2012 1,613.66 PD A 1,022.94 09/06/2012 05/26/2061 M A 04/01/2012 1,613.66 SD A 1,544.00 09/01/2012 05/26/2061

VQ8247 OP OP F A 07/01/2012 1,046.91 PL A 485.16 10/31/2012 09/24/2063 F A 07/01/2012 1,046.91 SD A 752.00 01/01/2013 09/24/2063

VQ8284 OP OP F A 07/03/2012 2,142.61 BO A 514.79 12/01/2012 03/11/2026 F A 07/03/2012 2,142.61 PD A 704.42 11/17/2012 03/12/2061 F A 07/03/2012 2,142.61 SC A 215.00 11/01/2012 10/31/2015 F A 07/03/2012 2,142.61 SD A 841.00 11/01/2012 03/12/2061

VQ8298 OP OP F A 06/06/2012 2,862.39 PD A 2,013.42 09/15/2012 03/23/2056 F A 06/06/2012 2,862.39 SD A 1,582.00 03/01/2013 03/23/2056

VQ8380 OP OP F A 07/01/2012 2,525.46 BO A 151.85 05/01/2013 11/15/2018 F A 07/01/2012 2,525.46 PD A 1,023.48 12/01/2012 11/16/2053 F A 07/01/2012 2,525.46 SD A 1,253.00 05/01/2013 11/16/2053

VQ8381 OP OP F A 04/17/2012 1,355.61 PD A 456.93 04/12/2013 11/07/2061 F A 04/17/2012 1,355.61 SD A 1,696.00 10/01/2013 11/07/2061

VQ8393 OP OP F A 06/20/2012 2,378.62 BO A 800.00 09/18/2012 05/15/2016

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F A 06/20/2012 2,378.62 SD E 1,158.00 12/01/2012 10/10/2062

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 33 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VQ8428 OP OP M A 06/12/2012 1,846.82 BO A 800.00 09/10/2012 04/11/2029 M A 06/12/2012 1,846.82 PD A 786.00 01/26/2013 11/01/2057 M A 06/12/2012 1,846.82 SD E 1,004.00 12/01/2012 11/01/2057

VQ9261 OP OP F A 05/05/2012 1,046.91 PD A 397.27 09/06/2012 04/15/2058 F A 05/05/2012 1,046.91 SD A 693.00 11/01/2012 04/15/2058

VQ9937 OP OP M A 06/03/2012 1,856.23 BO A 254.48 08/01/2014 08/29/2047 M A 06/03/2012 1,856.23 PD A 1,304.39 06/02/2013 08/20/2082 M A 06/03/2012 1,856.23 WP A 225.97 08/01/2014 08/30/2082

VQ9961 OP OP M A 07/20/2012 1,260.01 PD A 429.89 10/18/2012 02/01/2059 M A 07/20/2012 1,260.01 SD A 1,388.00 01/01/2013 02/01/2059

VQ9984 OP OP F A 06/06/2012 802.70 PD A 287.07 10/03/2012 03/30/2059 F A 06/06/2012 802.70 SD A 1,181.00 12/01/2012 03/30/2059

VQ9989 OP OP M A 07/19/2012 1,700.83 PD A 544.11 03/11/2013 05/21/2063 M A 07/19/2012 1,700.83 SD A 1,355.00 01/01/2013 05/21/2063

VR0922 OP OP M A 06/27/2012 1,166.11 PS A 139.93 07/13/2013 09/25/2051 M A 06/27/2012 1,166.11 SD A 2,013.00 12/01/2012 09/25/2051

VR0991 OP OP M A 08/17/2012 1,660.89 PD A 732.92 12/01/2012 03/12/2068 M A 08/17/2012 1,660.89 SD A 1,461.00 02/01/2013 03/12/2068

VR0993 OP OP F A 05/22/2012 2,158.60 PD A 1,851.66 02/20/2013 07/20/2069 F A 05/22/2012 2,158.60 SC A 699.00 02/01/2013 08/31/2020 F A 05/22/2012 2,158.60 SD A 1,399.00 02/01/2013 07/20/2069

VR1443 OP OP F A 06/05/2012 2,940.60 PD A 1,636.06 11/10/2012 06/17/2048 F A 06/05/2012 2,940.60 SD A 1,422.00 01/01/2013 06/17/2048

VR1470 OP OP M A 08/13/2012 1,278.56 SD A 1,671.00 03/01/2013 02/27/2064

VR2059 OP OP M A 08/12/2012 2,261.73 BO A 800.00 11/10/2012 08/30/2016 M A 08/12/2012 2,261.73 PD A 480.35 03/17/2013 08/31/2051 M A 08/12/2012 2,261.73 SD A 433.00 02/01/2013 08/31/2051

VR2703 OP OP F A 07/19/2012 4,631.37 PS A 3,783.99 12/30/2012 05/23/2057 F A 07/19/2012 4,631.37 SD A 1,753.00 01/01/2013 05/23/2057

VR2723 OP OP F A 03/06/2012 5,346.85 BO A 800.00 06/04/2012 12/16/2022 F A 03/06/2012 5,346.85 PS A 3,717.29 06/30/2013 12/17/2057 F A 03/06/2012 5,346.85 SD E 1,394.00 09/01/2012 12/17/2057

VR2741 OP OP M A 10/13/2012 3,003.27 BO A 9.36 04/01/2013 04/01/2017 M A 10/13/2012 3,003.27 PD A 1,147.40 12/02/2012 04/02/2052

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M A 10/13/2012 3,003.27 SD A 1,731.00 04/01/2013 04/02/2052

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 34 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VR2747 OP OP F A 10/17/2012 1,398.88 PL A 707.71 02/22/2013 02/02/2065 F A 10/17/2012 1,398.88 SD A 1,152.00 01/01/2014 02/02/2065

VR2762 OP OP M A 08/11/2012 3,547.80 PD A 2,116.58 12/09/2012 11/20/2053 M A 08/11/2012 3,547.80 SD A 1,744.00 01/01/2014 11/20/2053

VR2775 OP OP F A 09/12/2012 2,918.99 PD A 2,014.85 07/11/2013 08/16/2065 F A 09/12/2012 2,918.99 SD A 1,554.00 03/01/2013 08/16/2065

VR2776 OP OP F A 09/11/2012 3,097.52 PD A 1,966.21 12/15/2012 07/10/2058 F A 09/11/2012 3,097.52 SD A 1,795.00 11/01/2012 07/10/2058 F A 09/11/2012 3,097.52 WP A 349.71 11/19/2012 07/10/2028

VR4648 OP OP M A 07/05/2012 2,561.92 BO A 740.77 02/01/2013 05/25/2028 M A 07/05/2012 2,561.92 PD A 1,722.61 01/17/2013 05/26/2063 M A 07/05/2012 2,561.92 SD E 1,226.00 12/01/2012 05/26/2063

VR4663 OP OP F A 12/22/2012 3,081.49 BO A 800.00 03/22/2013 08/23/2026 F A 12/22/2012 3,081.49 PD A 1,158.81 02/06/2013 08/24/2061 F A 12/22/2012 3,081.49 SD E 1,323.00 06/01/2013 08/24/2061

VR4666 OP OP M A 10/10/2012 1,885.11 PD A 860.14 01/24/2013 11/29/2050 M A 10/10/2012 1,885.11 SD A 658.00 04/01/2013 11/29/2050

VR4668 OP OP F A 07/30/2012 1,602.30 BO A 439.68 02/01/2013 08/20/2049 F A 07/30/2012 1,602.30 SD A 1,101.00 02/01/2013 06/21/2084

VR4669 OP OP F A 05/12/2012 2,985.80 PD A 2,469.17 02/01/2013 01/17/2058 F A 05/12/2012 2,985.80 SD A 1,684.00 01/01/2013 01/17/2058

VR4673 OP OP M A 08/15/2012 1,274.38 PD A 375.08 02/19/2013 09/10/2051 M A 08/15/2012 1,274.38 SD A 1,156.00 02/01/2013 09/10/2051

VR4692 LT LS F A 10/20/2007 1,296.44 0.00

VR4694 LT LS M A 05/20/2010 1,286.49 0.00

VR4696 LT LS F A 11/07/2006 100.00 0.00

VR4698 LT LS F A 10/26/2007 100.00 0.00

VR4701 LT LS M A 01/01/2009 1,758.20 0.00

VR4703 LT LS F A 12/21/2009 100.00 0.00

VR4704 LT LS M A 07/05/2007 100.00 0.00

VR4706 LT LS F A 11/12/2005 100.00 0.00

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VR4724 OP OP F A 02/02/2013 2,438.42 PD A 1,906.39 05/25/2013 09/30/2058

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 35 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VR4724 OP OP F A 02/02/2013 2,438.42 SD A 1,594.00 11/01/2013 09/30/2058

VR5027 OP OP M A 06/22/2012 1,603.23 BO A 3.56 02/01/2013 09/18/2022 M A 06/22/2012 1,603.23 SC A 769.00 02/01/2013 03/31/2017 M A 06/22/2012 1,603.23 SD A 1,538.00 02/01/2013 09/19/2057

VR5610 OP OP M A 11/01/2012 1,665.79 BO A 149.10 04/01/2013 07/29/2016 M A 11/01/2012 1,665.79 PS A 546.62 11/01/2012 05/25/2051 M A 11/01/2012 1,665.79 SD A 906.00 04/01/2013 05/25/2051

VR5633 OP OP M A 09/01/2012 2,062.83 PD A 790.90 10/16/2012 10/21/2058 M A 09/01/2012 2,062.83 SD A 1,480.00 02/01/2013 10/21/2058

VR5648 OP OP M A 07/17/2012 2,283.02 PD A 824.04 02/10/2013 05/16/2050 M A 07/17/2012 2,283.02 PS A 614.34 02/10/2013 05/16/2050 M A 07/17/2012 2,283.02 SD A 1,486.00 01/01/2013 05/16/2050

VR5649 OP OP M A 10/18/2012 1,218.43 PD A 306.32 02/23/2013 11/15/2057 M A 10/18/2012 1,218.43 SD A 2,066.00 04/01/2013 11/15/2057

VR5650 OP OP F A 08/24/2012 428.84 SD A 1,118.00 02/01/2013 08/15/2068

VR5659 OP OP F A 11/15/2012 2,119.60 BO A 556.16 05/01/2013 12/17/2029 F A 11/15/2012 2,119.60 PD A 646.92 04/25/2013 12/18/2064 F A 11/15/2012 2,119.60 SD A 835.00 05/01/2013 12/18/2064

VR6208 OP OP F A 01/03/2012 2,427.59 PD A 1,688.82 02/01/2013 11/21/2052 F A 01/03/2012 2,427.59 SD A 1,457.00 07/01/2013 11/21/2052

VR6266 OP OP F A 08/07/2012 3,040.50 BO A 800.00 11/05/2012 10/12/2035 F A 08/07/2012 3,040.50 PD A 1,592.94 12/27/2012 10/13/2070 F A 08/07/2012 3,040.50 SD E 1,310.00 02/01/2013 10/13/2070

VR6299 OP OP F A 09/29/2012 788.27 PD A 222.14 03/29/2013 06/13/2057 F A 09/29/2012 788.27 SD A 668.00 12/01/2012 06/13/2057

VR6933 OP OP M A 10/02/2012 937.63 PD A 500.23 03/21/2013 10/10/2066 M A 10/02/2012 937.63 SC A 185.00 04/01/2013 05/31/2017 M A 10/02/2012 937.63 SD A 949.00 04/01/2013 10/10/2066

VR7134 OP OP F A 08/23/2012 599.01 SD A 889.00 02/01/2013 09/13/2051

VR7138 OP OP M A 11/17/2012 4,419.18 PD A 2,443.98 03/10/2013 01/18/2059 M A 11/17/2012 4,419.18 SD A 1,998.00 05/01/2013 02/18/2059

VR7142 OP OP M A 10/13/2012 2,100.57 BO A 429.85 04/01/2013 10/01/2016 M A 10/13/2012 2,100.57 PD A 440.93 01/17/2013 10/02/2051 M A 10/13/2012 2,100.57 SD A 1,149.00 04/01/2013 10/02/2051

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VR7174 OP OP F A 10/16/2012 2,296.89 BO A 37.33 01/14/2013 10/31/2028

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VR7174 OP OP F A 10/16/2012 2,296.89 PD A 2,171.22 01/09/2013 11/01/2063 F A 10/16/2012 2,296.89 SD E 1,158.00 04/01/2013 11/01/2063

VR7549 OP OP M A 10/09/2012 2,734.60 PD S 1,136.53 08/02/2014 04/10/2062 M A 10/09/2012 2,734.60 SC E 629.00 04/01/2013 08/31/2016 M A 10/09/2012 2,734.60 SD S 2,092.00 09/01/2014 04/10/2062 M A 10/09/2012 2,734.60 WT E 971.00 10/09/2012 10/08/2015

VR7705 OP OP M A 01/15/2013 2,632.11 PD A 1,253.30 06/02/2013 11/13/2059 M A 01/15/2013 2,632.11 SD A 1,511.00 07/01/2013 11/13/2059

VR7724 OP OP F A 10/07/2012 1,749.57 BO A 10.80 01/05/2013 07/04/2015 F A 10/07/2012 1,749.57 PS A 381.48 12/15/2012 12/14/2047 F A 10/07/2012 1,749.57 SR A 1,290.00 11/01/2012 12/14/2047

VR7764 OP OP F A 11/09/2012 2,028.38 BO A 800.00 02/07/2013 09/12/2041

VR7841 OP OP F A 11/14/2012 3,379.40 BO A 800.00 02/12/2013 12/09/2027 F A 11/14/2012 3,379.40 PD A 1,289.19 07/11/2013 12/10/2062 F A 11/14/2012 3,379.40 SD E 1,347.00 05/01/2013 12/10/2062

VR8014 OP OP F A 12/20/2012 1,638.21 PD A 774.97 03/15/2013 03/11/2055 F A 12/20/2012 1,638.21 SD A 1,085.00 06/01/2013 03/11/2055

VR8022 OP OP F A 01/05/2013 2,284.80 PD A 1,876.87 01/05/2013 08/29/2060 F A 01/05/2013 2,284.80 SD A 1,347.00 07/01/2013 08/29/2060

VR8038 OP OP M A 01/12/2013 3,529.55 BO A 651.06 07/01/2013 08/22/2017 M A 01/12/2013 3,529.55 PD A 1,214.74 01/13/2013 08/23/2052 M A 01/12/2013 3,529.55 SD A 1,528.00 07/01/2013 08/23/2052

VR8039 OP OP F A 09/25/2012 2,702.00 PD A 1,485.26 03/16/2013 08/28/2053 F A 09/25/2012 2,702.00 SD A 327.00 12/01/2012 08/28/2053 F A 09/25/2012 2,702.00 WT S 2,743.35 09/25/2012 09/24/2015

VR8067 OP OP F A 08/08/2012 2,947.80 PD A 1,881.02 03/07/2013 03/04/2061 F A 08/08/2012 2,947.80 SD A 1,605.00 01/01/2013 03/04/2061

VR8068 OP OP F A 11/01/2012 1,354.16 BO A 610.80 07/01/2013 01/10/2044 F A 11/01/2012 1,354.16 PD A 691.28 06/06/2013 01/11/2079 F A 11/01/2012 1,354.16 SC E 413.50 04/01/2013 08/31/2022 F A 11/01/2012 1,354.16 SD E 827.00 04/01/2013 01/11/2079

VR8089 OP OP M A 12/02/2012 1,999.73 BO A 556.89 05/01/2013 12/16/2031 M A 12/02/2012 1,999.73 PD A 1,365.92 04/03/2013 12/17/2066 M A 12/02/2012 1,999.73 SD E 1,045.00 05/01/2013 12/17/2066

VS0650 OP OP F A 01/19/2013 3,119.51 PS A 1,916.86 06/30/2012 09/18/2057

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F A 01/19/2013 3,119.51 SD A 1,712.00 07/01/2013 09/18/2057

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS0663 OP OP F A 08/15/2012 2,439.56 PL A 999.54 02/19/2013 06/03/2072 F A 08/15/2012 2,439.56 SC E 596.50 03/01/2013 06/30/2023 F A 08/15/2012 2,439.56 SD E 1,193.00 03/01/2013 06/03/2072

VS0667 OP OP M A 01/15/2013 1,472.39 PD A 572.14 03/22/2013 09/21/2078 M A 01/15/2013 1,472.39 SD A 925.00 07/01/2013 09/21/2078

VS0712 OP OP F A 01/03/2013 2,579.04 BO A 719.84 08/01/2013 07/01/2029 F A 01/03/2013 2,579.04 SD A 1,760.00 08/01/2013 07/02/2064

VS1143 OP OP F A 01/17/2013 1,209.98 PD A 731.95 06/08/2013 01/28/2057 F A 01/17/2013 1,209.98 SD A 1,066.00 07/01/2013 01/28/2057

VS1205 OP OP F A 01/29/2013 2,221.81 BO A 800.00 06/11/2013 09/25/2032 F A 01/29/2013 2,221.81 P1 E 410.18 01/29/2014 09/26/2067 F A 01/29/2013 2,221.81 SC E 561.00 07/01/2013 01/31/2019 F A 01/29/2013 2,221.81 SD E 1,122.00 07/01/2013 09/26/2067

VS1555 OP OP F A 11/17/2012 2,650.54 PD A 1,215.50 09/03/2013 05/29/2057 F A 11/17/2012 2,650.54 SD A 1,360.00 05/01/2013 05/29/2057

VS1564 OP OP F A 09/08/2012 2,604.50 PD A 1,427.00 03/20/2013 10/13/2071 F A 09/08/2012 2,604.50 SD A 1,431.00 03/01/2013 10/13/2071

VS1596 OP OP F A 11/06/2012 2,418.98 PD A 1,885.93 06/02/2013 08/05/2063 F A 11/06/2012 2,418.98 SD A 1,987.00 05/01/2013 08/05/2063

VS1606 OP OP F A 10/05/2012 1,850.03 BO A 800.00 01/03/2013 09/04/2037 F A 10/05/2012 1,850.03 P1 A 821.73 09/19/2013 09/05/2072 F A 10/05/2012 1,850.03 SD E 1,004.00 04/01/2013 09/05/2072

VS1988 OP OP F A 02/05/2013 05/05/2015 2,930.74 BO A 797.30 05/06/2013 05/05/2015 F A 02/05/2013 05/05/2015 2,930.74 PD A 2,020.72 04/21/2013 09/12/2070 F A 02/05/2013 05/05/2015 2,930.74 SC E 655.00 08/01/2013 02/28/2022 F A 02/05/2013 05/05/2015 2,930.74 SD E 1,310.00 08/01/2013 09/12/2070

VS2483 OP OP F A 12/02/2012 1,862.04 PD A 1,546.11 06/01/2013 10/20/2062 F A 12/02/2012 1,862.04 SD A 1,285.00 05/01/2013 10/20/2062

VS2576 OP OP M A 01/15/2013 2,524.98 PD A 1,125.38 03/31/2013 03/26/2052 M A 01/15/2013 2,524.98 SD A 1,560.00 07/01/2013 03/26/2052

VS3112 OP OP F A 11/10/2012 983.22 PD A 181.48 05/17/2013 05/16/2051 F A 11/10/2012 983.22 SD A 1,088.00 05/01/2013 05/16/2051

VS3133 OP OP M A 03/07/2013 2,102.80 PD A 703.55 06/15/2013 02/07/2058 M A 03/07/2013 2,102.80 SD A 1,637.00 09/01/2013 02/07/2058

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VS3135 OP OP F A 11/29/2012 1,509.54 BO A 800.00 03/03/2013 10/02/2038 F A 11/29/2012 1,509.54 SC E 459.50 05/01/2013 06/30/2021

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS3135 OP OP F A 11/29/2012 1,509.54 SD E 919.00 05/01/2013 10/03/2073

VS3136 OP OP F A 02/06/2013 1,691.19 BO A 800.00 05/07/2013 05/06/2015 F A 02/06/2013 1,691.19 PD S 680.75 10/01/2013 09/12/2062 F A 02/06/2013 1,691.19 SD E 962.00 08/01/2013 09/12/2062

VS3181 OP OP M A 04/20/2013 4,185.29 BO A 800.00 08/01/2013 02/26/2023 M A 04/20/2013 4,185.29 PD A 2,232.89 09/05/2013 02/27/2058 M A 04/20/2013 4,185.29 SC E 697.00 10/01/2013 01/31/2018 M A 04/20/2013 4,185.29 SD E 1,394.00 10/01/2013 02/27/2058

VS3345 OP OP F A 12/20/2012 775.01 PD A 919.05 04/18/2013 06/21/2063 F A 12/20/2012 775.01 SC A 324.00 06/01/2013 04/30/2022 F A 12/20/2012 775.01 SD A 932.00 06/01/2013 06/21/2063

VS3409 OP OP F A 03/23/2013 1,102.89 BO A 83.61 06/21/2013 06/20/2015 F A 03/23/2013 1,102.89 PD A 976.86 05/01/2013 07/31/2060 F A 03/23/2013 1,102.89 RO S 901.70 02/09/2015 07/30/2025

VS3561 OP OP F A 03/09/2013 1,656.41 BO A 649.67 07/01/2013 06/06/2015 F A 03/09/2013 1,656.41 PD A 617.44 06/12/2013 01/05/2060 F A 03/09/2013 1,656.41 PS A 325.59 06/12/2013 01/05/2060 F A 03/09/2013 1,656.41 SD E 962.00 09/01/2013 01/05/2060

VS3605 OP OP F A 02/23/2013 636.46 PD A 177.33 06/02/2013 02/26/2054 F A 02/23/2013 636.46 SD A 511.00 08/01/2013 02/26/2054

VS4455 OP OP M A 03/22/2013 3,119.51 PS A 2,700.47 03/22/2013 07/01/2054 M A 03/22/2013 3,119.51 SD A 2,155.00 09/01/2013 07/01/2054

VS4818 OP OP M A 03/16/2013 2,720.51 BO A 800.00 06/14/2013 10/11/2031 M A 03/16/2013 2,720.51 PD A 1,588.88 07/25/2013 10/12/2066 M A 03/16/2013 2,720.51 SD E 1,258.00 09/01/2013 10/12/2066

VS4839 OP OP F A 01/16/2013 2,888.78 PD A 1,686.24 06/15/2013 10/28/2057 F A 01/16/2013 2,888.78 SD A 1,695.00 08/01/2013 10/28/2057

VS4840 OP OP F A 02/11/2013 1,767.18 BO A 548.85 07/01/2013 05/11/2015 F A 02/11/2013 1,767.18 PD A 1,150.36 06/19/2013 12/26/2066 F A 02/11/2013 1,767.18 SD E 1,004.00 08/01/2013 12/26/2066

VS4961 OP OP F A 02/07/2013 993.86 BO A 407.46 12/01/2013 05/07/2015 F A 02/07/2013 993.86 PD A 548.18 11/08/2013 12/24/2061 F A 02/07/2013 993.86 SC E 365.50 08/01/2013 06/30/2015 F A 02/07/2013 993.86 SD E 731.00 08/01/2013 12/24/2061

VS5123 OP OP F A 03/14/2013 1,124.39 BO A 620.17 09/01/2013 09/15/2037 F A 03/14/2013 1,124.39 PD A 460.97 08/31/2013 09/16/2072

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F A 03/14/2013 1,124.39 SD E 779.00 09/01/2013 09/16/2072

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS5140 OP OP F S 12/06/2012 0.00 PD A 1,305.79 02/21/2014 01/30/2068 F S 12/06/2012 0.00 SD E 1,362.00 06/01/2013 01/30/2068

VS5147 OP OP F A 04/13/2013 1,728.83 BO A 655.00 10/01/2013 08/13/2036 F A 04/13/2013 1,728.83 PD A 1,007.34 10/01/2013 08/14/2071 F A 04/13/2013 1,728.83 SC E 481.00 10/01/2013 06/30/2019 F A 04/13/2013 1,728.83 SD E 962.00 10/01/2013 08/14/2071

VS5150 OP OP F A 02/02/2013 1,988.62 BO A 112.96 06/01/2013 11/02/2015 F A 02/02/2013 1,988.62 PD A 511.18 05/31/2013 09/12/2048 F A 02/02/2013 1,988.62 SR A 1,288.00 04/01/2013 09/12/2048

VS5153 OP OP F A 02/23/2013 1,515.85 BO A 241.55 09/01/2014 05/23/2015 F A 02/23/2013 1,515.85 SD A 1,216.00 09/01/2014 11/19/2064

VS5177 OP OP F A 04/19/2013 2,535.70 PD A 1,175.69 07/03/2013 05/27/2052 F A 04/19/2013 2,535.70 SD A 1,539.00 10/01/2013 05/27/2052

VS5181 OP OP F A 06/01/2013 2,719.49 PD A 1,818.79 06/01/2013 04/10/2074 F A 06/01/2013 2,719.49 SD A 1,509.00 11/01/2013 04/10/2074

VS5188 OP OP M A 01/26/2013 1,714.81 PD A 442.99 06/05/2013 05/20/2055 M A 01/26/2013 1,714.81 SD A 1,807.00 07/01/2013 05/20/2055

VS5195 OP OP F A 04/30/2013 3,552.79 PD A 1,615.66 10/03/2013 04/27/2056 F A 04/30/2013 3,552.79 SD A 2,207.00 10/01/2013 04/27/2056

VS5541 OP OP M A 03/15/2013 1,976.21 PD S 518.35 12/07/2013 05/06/2061 M A 03/15/2013 1,976.21 SD E 1,045.00 09/01/2013 05/06/2061 M A 03/15/2013 1,976.21 WT S 1,899.50 03/15/2013 03/14/2016

VS5546 OP OP M A 03/05/2013 1,568.66 PD A 626.71 12/03/2013 01/02/2058 M A 03/05/2013 1,568.66 SD A 1,383.00 09/01/2013 01/02/2058

VS6330 OP OP F A 03/27/2013 659.59 PD A 238.06 06/08/2013 03/05/2055 F A 03/27/2013 659.59 SD E 574.00 09/01/2013 03/05/2055

VS6333 OP OP M A 02/03/2013 978.32 BO A 433.54 02/01/2016 02/29/2016 M A 02/03/2013 978.32 BO A 601.90 03/01/2016 10/04/2026 M A 02/03/2013 978.32 PD A 338.79 08/01/2013 10/05/2061 M A 02/03/2013 978.32 SD E 731.00 08/01/2013 10/05/2061 M A 02/03/2013 978.32 WT S 2,441.26 02/03/2013 02/02/2016

VS6363 OP OP F A 02/13/2013 562.79 BO A 325.75 11/01/2013 05/13/2015 F A 02/13/2013 562.79 PD A 215.39 10/09/2013 02/02/2065 F A 02/13/2013 562.79 SC E 259.50 08/01/2013 10/31/2024 F A 02/13/2013 562.79 SD E 519.00 08/01/2013 02/02/2065

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VS6364 OP OP F A 06/04/2013 2,107.57 SD A 1,277.00 12/01/2013 04/02/2061

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS6374 OP OP F A 04/12/2013 1,352.57 BO A 109.01 10/01/2013 07/10/2015 F A 04/12/2013 1,352.57 PL A 452.53 05/18/2013 02/03/2058 F A 04/12/2013 1,352.57 SD A 739.00 10/01/2013 02/03/2058

VS6388 OP OP M A 12/12/2012 1,477.55 PD A 848.97 07/07/2013 03/12/2062 M A 12/12/2012 1,477.55 SD A 1,378.00 06/01/2013 03/12/2062

VS6393 OP OP M A 02/26/2013 3,520.84 BO A 800.00 08/01/2013 10/25/2027 M A 02/26/2013 3,520.84 PD A 2,412.45 07/27/2013 10/26/2062 M A 02/26/2013 3,520.84 SD E 1,362.00 08/01/2013 10/26/2062

VS6396 OP OP F A 03/07/2013 1,167.04 BO A 800.00 06/05/2013 06/04/2015 F A 03/07/2013 1,167.04 SC E 389.50 09/01/2013 01/31/2030 F A 03/07/2013 1,167.04 SD E 779.00 09/01/2013 07/25/2077

VS7120 OP OP F A 05/13/2013 1,167.94 PD S 295.05 02/16/2014 03/25/2063 F A 05/13/2013 1,167.94 SD A 935.00 11/01/2013 03/25/2063

VS7499 OP OP M A 03/28/2013 2,304.10 BO A 800.00 06/26/2013 06/25/2015 M A 03/28/2013 2,304.10 P1 E 425.37 03/28/2014 09/19/2061 M A 03/28/2013 2,304.10 SD E 1,158.00 09/01/2013 09/19/2061

VS7608 OP OP F A 03/29/2013 1,482.78 PD A 930.46 09/27/2013 06/26/2057 F A 03/29/2013 1,482.78 SD A 1,061.00 09/01/2013 06/26/2057

VS7616 OP OP M A 03/30/2013 1,335.05 BO A 787.75 10/01/2013 06/27/2015 M A 03/30/2013 1,335.05 PD A 495.95 09/18/2013 06/09/2057 M A 03/30/2013 1,335.05 SD E 827.00 09/01/2013 06/09/2057

VS7696 OP OP M A 03/05/2013 2,853.31 BO A 800.00 07/01/2013 06/02/2015 M A 03/05/2013 2,853.31 P1 E 2,000.00 01/01/2014 11/24/2063 M A 03/05/2013 2,853.31 SD E 1,288.00 09/01/2013 11/24/2063

VS7697 OP OP F A 02/26/2013 1,067.63 PD A 329.12 12/10/2013 12/03/2053 F A 02/26/2013 1,067.63 SD A 819.00 01/01/2014 12/03/2053

VS7698 OP OP M A 01/16/2013 1,202.89 SR A 1,338.00 09/01/2014 01/27/2052

VS7812 OP OP F A 04/16/2013 1,017.58 PD A 504.27 07/14/2013 09/08/2061 F A 04/16/2013 1,017.58 SD A 1,260.00 10/01/2013 09/08/2061 F A 04/16/2013 1,017.58 WP A 93.02 10/01/2013 09/07/2031

VS7813 OP OP F A 02/12/2013 3,840.08 BO A 800.00 07/01/2013 05/12/2016 F A 02/12/2013 3,840.08 PD A 812.22 01/01/2013 04/11/2049 F A 02/12/2013 3,840.08 SD A 1,061.00 06/01/2013 04/11/2049

VS7822 OP OP F A 06/01/2013 997.05 BO A 800.00 08/30/2013 08/29/2015 F A 06/01/2013 997.05 SC E 365.50 11/01/2013 05/31/2020

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F A 06/01/2013 997.05 SD E 731.00 11/01/2013 04/08/2083

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS7841 OP OP F A 03/07/2013 2,977.81 BO A 800.00 02/08/2014 11/30/2015 F A 03/07/2013 2,977.81 SC E 655.00 08/01/2014 04/30/2017 F A 03/07/2013 2,977.81 SD E 1,310.00 08/01/2014 10/26/2065

VS7858 OP OP F A 05/10/2013 2,259.84 PD A 1,034.06 07/07/2013 10/06/2081 F A 05/10/2013 2,259.84 SD A 1,478.00 11/01/2013 10/06/2081

VS7870 OP OP M A 05/10/2013 1,665.73 PD A 846.34 09/26/2013 01/10/2052 M A 05/10/2013 1,665.73 SD A 1,303.00 11/01/2013 01/10/2052

VS7899 OP OP F A 02/09/2013 1,038.78 BO A 203.83 06/01/2013 02/18/2029 F A 02/09/2013 1,038.78 PD A 795.00 06/01/2013 02/19/2064 F A 02/09/2013 1,038.78 SD E 731.00 08/01/2013 02/19/2064

VS8059 OP OP F A 04/22/2013 1,129.00 PD A 244.42 10/04/2013 05/17/2052 F A 04/22/2013 1,129.00 SD A 1,164.00 10/01/2013 05/17/2052

VS8064 OP OP F A 04/09/2013 1,247.79 BO A 795.60 08/01/2013 07/07/2015 F A 04/09/2013 1,247.79 PD A 404.19 07/31/2013 01/31/2083 F A 04/09/2013 1,247.79 SC E 413.50 10/01/2013 07/31/2023 F A 04/09/2013 1,247.79 SD E 827.00 10/01/2013 01/31/2083

VS8087 OP OP M A 06/15/2013 2,834.75 SC E 644.00 12/01/2013 05/31/2020 M A 06/15/2013 2,834.75 SD E 1,288.00 12/01/2013 01/23/2061

VS8194 OP OP M A 02/14/2013 1,381.25 P1 E 255.00 02/14/2014 11/03/2058 M A 02/14/2013 1,381.25 SD E 874.00 08/01/2013 11/03/2058 M A 02/14/2013 1,381.25 WT S 1,659.84 02/14/2013 02/13/2016

VS8304 OP OP F A 04/24/2013 913.89 SD A 1,145.00 10/01/2013 06/29/2052

VS8315 OP OP F A 01/30/2013 2,351.97 BO A 800.00 08/01/2013 08/16/2035 F A 01/30/2013 2,351.97 SC S 647.00 01/01/2014 07/31/2015 F A 01/30/2013 2,351.97 SD A 1,295.00 01/01/2014 08/17/2070

VS8345 OP OP F A 04/09/2013 1,578.69 BO A 800.00 08/01/2013 07/07/2015 F A 04/09/2013 1,578.69 PL A 269.34 05/06/2014 07/25/2071 F A 04/09/2013 1,578.69 SD E 919.00 10/01/2013 07/25/2071

VS8409 OP OP F A 06/01/2013 3,402.21 PD A 1,909.33 07/27/2013 08/14/2052 F A 06/01/2013 3,402.21 SD A 1,999.00 12/01/2013 08/14/2052

VS8456 OP OP M A 03/14/2013 1,808.41 BO A 800.00 06/12/2013 04/27/2019 M A 03/14/2013 1,808.41 PD A 728.20 07/23/2013 04/28/2054 M A 03/14/2013 1,808.41 SC E 502.00 09/01/2013 12/31/2027 M A 03/14/2013 1,808.41 SD E 1,004.00 09/01/2013 04/28/2054

VS8849 OP OP F A 06/15/2013 2,859.32 PD A 2,222.05 07/12/2013 02/06/2058

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F A 06/15/2013 2,859.32 SD A 1,944.00 01/01/2014 02/06/2058

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VS8868 OP OP F A 05/10/2013 866.66 BO A 800.00 08/08/2013 08/07/2015 F A 05/10/2013 866.66 SD E 679.00 11/01/2013 04/02/2060

VS8878 OP OP M A 03/27/2013 1,681.13 BO A 800.00 06/25/2013 06/24/2015 M A 03/27/2013 1,681.13 PD A 801.43 07/27/2013 09/02/2062

VS9443 OP OP F A 12/31/2012 1,141.78 PD A 822.12 08/04/2013 07/20/2056 F A 12/31/2012 1,141.78 SD A 1,061.00 06/01/2013 07/20/2056

VS9459 OP OP M A 04/17/2013 1,954.44 PD A 1,157.63 10/01/2013 05/24/2053 M A 04/17/2013 1,954.44 SD A 1,535.00 10/01/2013 05/24/2053

VS9626 OP OP M A 05/08/2013 2,338.85 BO A 800.00 08/06/2013 05/04/2025 M A 05/08/2013 2,338.85 PD A 1,015.49 12/22/2013 05/05/2060 M A 05/08/2013 2,338.85 SD E 1,158.00 11/01/2013 05/05/2060

VS9640 OP OP F A 04/01/2013 1,472.46 PS A 615.65 10/02/2013 05/25/2055 F A 04/01/2013 1,472.46 SD A 1,187.00 01/01/2014 05/25/2055

VS9677 OP OP F A 03/31/2013 2,141.80 PD A 1,375.26 11/29/2013 10/03/2056 F A 03/31/2013 2,141.80 SD S 1,300.00 09/01/2013 10/03/2056

VS9695 OP OP F A 05/16/2013 4,102.80 BO A 800.00 08/14/2013 08/13/2015 F A 05/16/2013 4,102.80 SD A 1,512.00 01/01/2014 07/08/2052

VS9807 OP OP F A 03/29/2013 1,225.71 BO A 34.56 09/01/2013 05/08/2045 F A 03/29/2013 1,225.71 SD A 1,144.00 09/01/2013 05/09/2080

VS9824 OP OP M A 06/25/2013 2,012.50 BO A 712.53 12/01/2013 07/21/2039 M A 06/25/2013 2,012.50 PD A 1,222.57 11/02/2013 07/22/2074 M A 06/25/2013 2,012.50 SC E 522.50 12/01/2013 10/31/2020 M A 06/25/2013 2,012.50 SD E 1,045.00 12/01/2013 07/22/2074

VS9840 OP OP F A 06/08/2013 1,171.66 PD A 271.31 08/24/2013 10/31/2053 F A 06/08/2013 1,171.66 SD A 1,115.00 01/01/2014 10/31/2053

VS9879 OP OP M A 06/04/2013 1,612.21 P1 E 666.22 03/02/2013 11/08/2057 M A 06/04/2013 1,612.21 SD A 1,629.00 05/01/2013 11/08/2057

VS9896 OP OP F A 08/30/2013 3,216.41 PD A 2,235.28 08/30/2013 12/29/2056 F A 08/30/2013 3,216.41 SD A 1,970.00 02/01/2014 12/29/2056

VS9898 OP OP M A 06/26/2013 2,238.38 BO A 201.82 12/01/2013 09/23/2015 M A 06/26/2013 2,238.38 PD A 1,947.66 11/26/2013 10/31/2065 M A 06/26/2013 2,238.38 PS A 2.81 11/26/2013 10/31/2065 M A 06/26/2013 2,238.38 SC E 579.00 12/01/2013 08/31/2025 M A 06/26/2013 2,238.38 SD E 1,158.00 12/01/2013 10/31/2065

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VT0000 OP OP F A 04/26/2013 1,520.61 BO A 246.13 10/01/2013 07/28/2029 F A 04/26/2013 1,520.61 SD A 1,216.00 10/01/2013 07/29/2064

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT0242 OP OP M A 05/16/2013 2,596.85 PD S 1,206.79 10/02/2013 11/15/2056 M A 05/16/2013 2,596.85 SD A 2,033.00 11/01/2013 11/15/2056

VT0244 OP OP M A 06/06/2013 1,594.89 BO A 800.00 09/04/2013 07/21/2019 M A 06/06/2013 1,594.89 PS A 238.30 11/20/2013 07/22/2054 M A 06/06/2013 1,594.89 SD E 919.00 12/01/2013 07/22/2054

VT0253 OP OP M A 07/13/2013 2,329.16 BO A 516.99 11/01/2016 09/06/2018 M A 07/13/2013 2,329.16 PS S 505.59 10/10/2014 09/07/2053 M A 07/13/2013 2,329.16 SD A 1,217.00 01/01/2014 09/07/2053 M A 07/13/2013 2,329.16 WT S 2,352.86 10/08/2013 10/07/2016

VT0262 OP OP F A 06/18/2013 1,598.83 BO A 800.00 09/16/2013 09/15/2015 F A 06/18/2013 1,598.83 PS A 434.76 08/17/2013 10/09/2053 F A 06/18/2013 1,598.83 SD E 919.00 12/01/2013 10/09/2053

VT0274 OP OP M A 07/09/2013 1,788.31 BO A 638.07 01/01/2014 10/06/2015 M A 07/09/2013 1,788.31 PD A 1,081.46 12/19/2013 02/28/2064 M A 07/09/2013 1,788.31 SC E 502.00 01/01/2014 01/31/2016 M A 07/09/2013 1,788.31 SD E 1,004.00 01/01/2014 02/28/2064

VT0289 OP OP F A 05/18/2013 3,134.51 PD A 2,315.90 07/16/2013 01/21/2066 F A 05/18/2013 3,134.51 PS A 744.23 07/16/2013 01/21/2066 F A 05/18/2013 3,134.51 SC E 661.50 11/01/2013 02/28/2022 F A 05/18/2013 3,134.51 SD E 1,323.00 11/01/2013 01/21/2066

VT0316 OP OP F A 05/08/2013 1,129.00 PD A 471.88 10/29/2013 01/31/2059 F A 05/08/2013 1,129.00 SD E 779.00 11/01/2013 01/31/2059

VT0345 OP OP F A 04/09/2013 3,885.70 BO A 800.00 07/08/2013 07/07/2015 F A 04/09/2013 3,885.70 PD A 933.44 11/02/2013 11/14/2053 F A 04/09/2013 3,885.70 SD E 1,394.00 10/01/2013 11/14/2053

VT0351 OP OP F A 08/01/2013 1,735.18 PD A 1,145.68 08/14/2013 05/04/2061 F A 08/01/2013 1,735.18 SD A 1,348.00 01/01/2014 05/04/2061

VT0362 OP OP F A 05/25/2013 882.86 PD A 212.38 07/03/2013 10/16/2052 F A 05/25/2013 882.86 SD A 910.00 11/01/2013 10/16/2052

VT0371 OP OP F A 04/15/2013 990.08 SD A 1,513.00 10/01/2013 04/09/2052

VT0378 OP OP M A 08/13/2013 1,705.22 PD A 738.03 09/05/2013 12/04/2066 M A 08/13/2013 1,705.22 SD A 1,505.00 12/01/2013 12/04/2066

VT3291 OP OP M A 10/15/2013 2,805.40 PD A 2,198.64 01/22/2014 08/18/2059 M A 10/15/2013 2,805.40 SD A 1,750.00 07/01/2014 08/18/2059

VT3364 OP OP F A 06/11/2013 2,111.15 BO A 800.00 09/09/2013 07/28/2021

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F A 06/11/2013 2,111.15 PD A 943.00 01/01/2014 07/29/2056 F A 06/11/2013 2,111.15 SD E 1,084.00 12/01/2013 07/29/2056

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT4251 OP OP M A 07/05/2013 1,779.52 PD A 1,976.68 10/05/2013 10/01/2071

VT4261 OP OP F A 07/23/2013 1,877.74 PD A 1,279.43 12/14/2013 09/17/2057 F A 07/23/2013 1,877.74 SD A 1,199.00 01/01/2014 09/17/2057

VT4271 OP OP M A 05/21/2013 2,955.50 BO A 167.15 11/01/2013 08/18/2015 M A 05/21/2013 2,955.50 PS A 762.68 05/31/2013 11/06/2047 M A 05/21/2013 2,955.50 SR A 1,912.00 07/01/2013 11/06/2047

VT4277 OP OP F A 06/20/2013 3,649.63 BO A 800.00 09/18/2013 09/17/2015 F A 06/20/2013 3,649.63 SR A 1,423.00 10/01/2013 10/09/2047

VT4313 OP OP F A 06/24/2013 2,263.90 BO A 800.00 02/01/2014 02/07/2022 F A 06/24/2013 2,263.90 PD A 1,033.78 11/26/2013 02/08/2057 F A 06/24/2013 2,263.90 SD E 1,122.00 12/01/2013 02/08/2057

VT4341 OP OP F A 03/30/2013 1,124.42 BO A 688.08 08/01/2013 06/27/2015 F A 03/30/2013 1,124.42 PS A 393.09 08/01/2013 12/02/2046 F A 03/30/2013 1,124.42 SR E 779.00 04/01/2013 12/02/2046

VT4366 OP OP F A 04/22/2013 960.32 PS A 118.19 04/21/2013 12/22/2049 F A 04/22/2013 960.32 SR A 924.00 10/01/2013 12/22/2049

VT4373 OP OP F A 06/22/2013 3,168.31 PD A 1,332.90 01/15/2014 09/04/2055 F A 06/22/2013 3,168.31 PS A 439.28 03/29/2014 09/04/2055 F A 06/22/2013 3,168.31 SD A 2,041.00 01/01/2014 09/04/2055

VT4384 OP OP F A 07/12/2013 2,920.72 PD A 2,090.64 02/22/2014 10/29/2053 F A 07/12/2013 2,920.72 SD A 1,775.00 01/01/2014 10/29/2053

VT4527 OP OP F A 05/05/2013 3,879.32 BO A 800.00 08/03/2013 08/02/2015 F A 05/05/2013 3,879.32 PD A 2,149.40 10/10/2013 03/03/2067 F A 05/05/2013 3,879.32 SC E 697.00 11/01/2013 12/31/2023 F A 05/05/2013 3,879.32 SD E 1,394.00 11/01/2013 03/03/2067

VT4548 OP OP F A 03/28/2013 1,300.00 SD A 943.00 09/01/2013 03/15/2064

VT5248 OP OP F A 09/24/2013 2,676.70 PD S 1,786.23 11/19/2013 05/29/2056 F A 09/24/2013 2,676.70 SD A 1,551.00 03/01/2014 05/29/2056

VT5288 OP OP F A 06/01/2013 974.32 PD A 658.67 09/21/2013 01/15/2063 F A 06/01/2013 974.32 SD A 970.00 11/01/2013 01/15/2063

VT5493 OP OP F A 05/21/2013 1,731.90 PD A 723.37 09/07/2013 10/25/2055 F A 05/21/2013 1,731.90 SD A 1,129.00 11/01/2013 10/25/2055

VT5506 OP OP F A 06/01/2013 1,413.21 PD S 1,016.94 11/09/2013 04/18/2053 F A 06/01/2013 1,413.21 SD A 1,531.00 02/01/2014 04/18/2053

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VT5525 OP OP M A 07/18/2013 1,099.47 BO A 672.84 11/01/2013 02/24/2025

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT5525 OP OP M A 07/18/2013 1,099.47 PD A 384.34 10/31/2013 02/25/2060 M A 07/18/2013 1,099.47 SD E 731.00 01/01/2014 02/25/2060

VT5539 OP OP F A 06/12/2013 2,006.28 BO A 800.00 09/10/2013 12/01/2037 F A 06/12/2013 2,006.28 PD A 713.87 12/30/2013 12/02/2072 F A 06/12/2013 2,006.28 SC E 522.50 12/01/2013 10/31/2021 F A 06/12/2013 2,006.28 SD E 1,045.00 12/01/2013 12/02/2072

VT5569 OP OP F A 03/09/2013 1,636.58 PS A 613.88 07/26/2013 12/26/2057 F A 03/09/2013 1,636.58 SD A 1,147.00 12/01/2014 12/26/2057

VT5570 OP OP M A 09/06/2012 1,426.15 BO A 800.00 09/01/2015 06/04/2016 M A 09/06/2012 1,426.15 P1 E 576.57 12/21/2014 12/21/2049 M A 09/06/2012 1,426.15 SD S 195.00 05/20/2013 12/21/2049 M A 09/06/2012 1,426.15 WT S 2,007.31 08/20/2014 08/19/2015

VT5571 OP OP F A 03/27/2013 1,295.89 BO A 660.38 11/01/2013 06/24/2015 F A 03/27/2013 1,295.89 PD S 585.67 10/09/2013 10/05/2079 F A 03/27/2013 1,295.89 SC E 413.50 09/01/2013 02/29/2024 F A 03/27/2013 1,295.89 SD E 827.00 09/01/2013 10/05/2079

VT5597 OP OP F A 02/11/2013 2,291.73 PD A 1,852.43 10/29/2013 04/09/2063 F A 02/11/2013 2,291.73 SD A 1,440.00 01/01/2014 04/09/2063

VT5598 OP OP F A 07/16/2013 1,808.79 PS A 353.49 01/14/2014 11/21/2048 F A 07/16/2013 1,808.79 SD A 1,602.00 01/01/2014 11/21/2048

VT5610 OP OP M A 05/03/2013 1,235.53 PD A 211.21 12/14/2013 05/09/2049 M A 05/03/2013 1,235.53 SD A 1,004.00 11/01/2013 05/09/2049

VT5642 OP OP F A 05/08/2013 962.65 PD A 590.66 12/06/2013 06/27/2059 F A 05/08/2013 962.65 SC E 339.50 11/01/2013 01/31/2025 F A 05/08/2013 962.65 SD A 795.00 02/01/2015 06/27/2059 F A 05/08/2013 962.65 WP A 74.85 02/09/2015 06/26/2029

VT5643 OP OP F A 07/19/2013 2,940.37 PS A 1,966.49 07/19/2013 02/13/2055 F A 07/19/2013 2,940.37 SD A 1,720.00 12/01/2013 02/13/2055

VT5670 OP OP F A 07/02/2013 686.83 SD S 627.00 11/01/2013 03/06/2054

VT5889 OP OP M A 06/01/2013 1,631.88 BO A 800.00 12/01/2013 08/29/2015 M A 06/01/2013 1,631.88 RO S 1,280.37 11/18/2014 02/02/2018

VT6026 OP OP M A 05/10/2013 2,703.79 BO A 800.00 08/08/2013 04/22/2025 M A 05/10/2013 2,703.79 PD A 1,283.87 07/15/2013 04/23/2060 M A 05/10/2013 2,703.79 SD E 1,258.00 11/01/2013 04/23/2060

VT6065 OP OP M A 06/13/2013 1,978.28 BO A 662.72 02/01/2014 02/28/2018

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M A 06/13/2013 1,978.28 PD A 827.47 10/03/2013 03/01/2053 M A 06/13/2013 1,978.28 SD S 412.00 02/01/2014 03/01/2053

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT6313 OP OP M A 01/02/2013 2,798.43 PD A 2,140.91 09/11/2013 05/19/2057 M A 01/02/2013 2,798.43 SD A 1,541.00 06/01/2013 05/19/2057

VT6366 OP OP F A 07/26/2013 1,952.70 BO A 800.00 10/24/2013 08/26/2033 F A 07/26/2013 1,952.70 PD A 732.49 09/15/2013 08/27/2068 F A 07/26/2013 1,952.70 SD E 1,045.00 01/01/2014 08/27/2068

VT6394 OP OP F A 08/27/2013 2,386.64 PD S 1,256.64 10/30/2013 01/27/2075 F A 08/27/2013 2,386.64 SC S 736.00 02/01/2014 12/31/2025 F A 08/27/2013 2,386.64 SD A 1,473.00 02/01/2014 01/27/2075

VT6659 OP OP M A 01/10/2013 1,342.20 PD A 720.85 05/01/2013 11/14/2050 M A 01/10/2013 1,342.20 SR A 880.00 04/01/2013 11/14/2050 M A 01/10/2013 1,342.20 WT E 3,054.42 01/10/2013 01/09/2016

VT6684 OP OP F A 10/02/2013 3,203.36 BO A 800.00 02/01/2014 10/18/2022 F A 10/02/2013 3,203.36 PS A 1,566.61 06/06/2014 10/19/2057 F A 10/02/2013 3,203.36 SD E 1,336.00 03/01/2014 10/19/2057

VT6909 OP OP F A 05/31/2013 999.44 BO A 800.00 08/29/2013 08/28/2015 F A 05/31/2013 999.44 P1 E 184.51 05/31/2014 12/21/2064 F A 05/31/2013 999.44 SD E 731.00 11/01/2013 12/21/2064

VT6934 OP OP F A 07/23/2013 1,165.61 PD A 440.30 12/07/2013 12/13/2066 F A 07/23/2013 1,165.61 SD A 1,135.00 01/01/2014 12/13/2066

VT6948 OP OP F A 09/13/2013 3,020.66 PD A 2,119.79 12/01/2013 08/02/2071 F A 09/13/2013 3,020.66 SC A 845.00 03/01/2014 02/14/2022 F A 09/13/2013 3,020.66 SD A 1,691.00 03/01/2014 08/02/2071

VT6949 OP OP F A 08/01/2013 1,584.48 BO A 800.00 10/30/2013 10/29/2015 F A 08/01/2013 1,584.48 PD A 560.32 12/24/2013 07/12/2069 F A 08/01/2013 1,584.48 SC E 459.50 01/01/2014 11/30/2019 F A 08/01/2013 1,584.48 SD E 919.00 01/01/2014 07/12/2069

VT6978 OP OP F A 07/30/2013 1,487.62 PS A 303.04 05/01/2014 01/17/2053 F A 07/30/2013 1,487.62 SD A 931.00 01/01/2014 01/17/2053 F A 07/30/2013 1,487.62 WP A 237.34 02/17/2014 04/26/2037

VT7133 OP OP M A 04/09/2013 2,354.61 PD A 573.59 10/19/2013 07/15/2050 M A 04/09/2013 2,354.61 SD A 2,025.00 10/01/2013 07/15/2050

VT7163 OP OP M A 03/22/2013 4,109.63 BO A 75.18 01/01/2014 04/17/2027 M A 03/22/2013 4,109.63 PD A 1,802.38 08/04/2013 04/18/2062 M A 03/22/2013 4,109.63 SD A 2,074.00 01/01/2014 04/18/2062

VT7165 OP OP M A 09/01/2013 1,886.14 PD A 699.78 10/30/2013 11/29/2016 M A 09/01/2013 1,886.14 SD A 1,632.00 02/01/2014 04/08/2050

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VT7166 OP OP M A 09/16/2013 2,288.81 PD A 901.24 11/01/2013 08/02/2060

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT7166 OP OP M A 09/16/2013 2,288.81 SD E 1,158.00 03/01/2014 08/02/2060

VT7203 OP OP M A 06/20/2013 1,457.47 BO A 800.00 09/18/2013 04/11/2020 M A 06/20/2013 1,457.47 PD A 313.27 12/17/2013 04/12/2055 M A 06/20/2013 1,457.47 SD E 874.00 12/01/2013 04/12/2055

VT7206 OP OP M A 08/20/2013 1,822.00 BO A 498.11 11/18/2013 10/31/2028 M A 08/20/2013 1,822.00 PD S 1,253.82 11/11/2013 11/01/2063 M A 08/20/2013 1,822.00 SC E 502.00 02/01/2014 08/31/2015 M A 08/20/2013 1,822.00 SD E 1,004.00 02/01/2014 11/01/2063

VT7207 OP OP M A 09/28/2013 1,248.98 PD A 497.11 01/01/2014 08/22/2053 M A 09/28/2013 1,248.98 SD A 1,222.00 03/01/2014 08/22/2053

VT7219 OP OP F S 08/13/2013 3,399.43 PD A 1,263.24 11/22/2013 09/18/2067 F S 08/13/2013 3,399.43 SD A 2,032.00 01/01/2014 09/18/2067

VT7259 OP OP F A 07/29/2013 1,192.54 P1 A 152.15 03/27/2014 06/18/2078 F A 07/29/2013 1,192.54 WP A 18.47 09/19/2014 06/17/2048

VT7261 OP OP F A 06/05/2013 1,329.83 BO A 776.00 09/01/2014 05/16/2021 F A 06/05/2013 1,329.83 P1 A 502.68 08/08/2014 05/17/2056 F A 06/05/2013 1,329.83 SD E 827.00 12/01/2013 05/17/2056

VT7532 OP OP M A 06/04/2013 1,639.79 BO A 627.82 02/01/2014 09/01/2015 M A 06/04/2013 1,639.79 PD A 948.90 01/07/2014 12/04/2056 M A 06/04/2013 1,639.79 SD E 962.00 11/01/2013 12/04/2056

VT7554 OP OP M A 08/19/2013 2,043.48 PD A 668.96 02/09/2014 06/12/2055 M A 08/19/2013 2,043.48 SD A 1,548.00 02/01/2014 06/12/2055

VT7562 OP OP M A 06/03/2013 2,537.72 BO A 800.00 09/15/2013 09/22/2029 M A 06/03/2013 2,537.72 PD A 1,493.13 01/21/2014 09/23/2064 M A 06/03/2013 2,537.72 SD E 1,226.00 11/01/2013 09/23/2064

VT7563 OP OP F A 04/17/2013 1,837.43 BO A 800.00 07/16/2013 01/02/2049 F A 04/17/2013 1,837.43 SD E 1,004.00 10/01/2013 01/03/2084

VT7564 OP OP F A 07/31/2013 1,180.04 BO A 183.62 03/01/2014 10/10/2018 F A 07/31/2013 1,180.04 PD S 951.04 02/25/2014 10/11/2053 F A 07/31/2013 1,180.04 SD E 779.00 01/01/2014 10/11/2053

VT7576 OP OP F A 05/24/2013 3,221.08 PD A 2,457.13 12/14/2013 04/04/2069 F A 05/24/2013 3,221.08 SD A 1,794.00 11/01/2013 04/04/2069

VT7588 OP OP F A 08/12/2013 1,584.97 PD A 966.07 11/02/2013 08/09/2058 F A 08/12/2013 1,584.97 SD A 1,020.00 11/01/2013 08/09/2058

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VT7612 OP OP M A 07/31/2013 1,167.73 BO A 496.38 12/01/2013 06/30/2032 M A 07/31/2013 1,167.73 PD A 626.43 11/02/2013 07/01/2067

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT7612 OP OP M A 07/31/2013 1,167.73 SC E 389.50 01/01/2014 06/30/2017 M A 07/31/2013 1,167.73 SD E 779.00 01/01/2014 07/01/2067

VT7641 OP OP M A 06/14/2013 2,693.18 PD A 1,490.78 11/27/2013 08/14/2052 M A 06/14/2013 2,693.18 SD A 1,707.00 04/01/2014 08/14/2052

VT7699 OP OP F A 07/17/2013 1,570.84 BO A 314.42 01/01/2014 06/07/2020 F A 07/17/2013 1,570.84 SD A 1,196.00 01/01/2014 06/08/2055

VT8444 OP OP F A 08/13/2013 2,420.22 BO A 800.00 11/11/2013 09/02/2031 F A 08/13/2013 2,420.22 SC A 711.00 01/01/2014 03/31/2019 F A 08/13/2013 2,420.22 SD A 1,422.00 01/01/2014 09/03/2066

VT8480 OP OP F A 05/01/2013 1,376.65 BO A 701.93 03/01/2014 07/29/2015 F A 05/01/2013 1,376.65 PD A 621.77 02/25/2014 05/15/2064 F A 05/01/2013 1,376.65 SD E 874.00 10/01/2013 05/15/2064

VT8521 OP OP F A 09/08/2013 1,500.49 BO A 557.55 02/01/2014 12/16/2031 F A 09/08/2013 1,500.49 PL A 693.44 01/30/2014 12/17/2066 F A 09/08/2013 1,500.49 SD E 919.00 03/01/2014 12/17/2066

VT8546 OP OP M A 08/13/2013 05/13/2015 1,627.15 BO A 800.00 11/11/2013 05/13/2015 M A 08/13/2013 05/13/2015 1,627.15 SC E 481.00 02/01/2014 03/31/2029 M A 08/13/2013 05/13/2015 1,627.15 SD E 962.00 02/01/2014 01/04/2082

VT8547 OP OP F A 09/07/2013 904.42 BO A 613.63 02/01/2014 12/05/2015 F A 09/07/2013 904.42 PD A 256.00 01/22/2014 09/23/2059 F A 09/07/2013 904.42 SD E 679.00 03/01/2014 09/23/2059

VT8563 OP OP F A 08/09/2013 1,416.87 BO A 749.40 01/01/2014 07/06/2038 F A 08/09/2013 1,416.87 PD A 612.98 12/11/2013 07/07/2073 F A 08/09/2013 1,416.87 SC E 437.00 02/01/2014 08/31/2025 F A 08/09/2013 1,416.87 SD E 874.00 02/01/2014 07/07/2073

VT8564 OP OP M A 10/24/2013 05/14/2015 3,650.35 PD A 1,673.58 07/01/2014 10/01/2064 M A 10/24/2013 05/14/2015 3,650.35 SD A 2,006.00 04/01/2014 10/01/2064

VT8574 OP OP F A 07/11/2013 1,261.21 PD S 278.48 08/26/2014 11/29/2055 F A 07/11/2013 1,261.21 SD A 1,466.00 01/01/2014 11/29/2055 F A 07/11/2013 1,261.21 WT S 1,418.36 08/02/2013 07/10/2016

VT8579 OP OP F A 06/25/2013 05/03/2015 738.58 PS A 188.05 01/16/2014 09/27/2051 F A 06/25/2013 05/03/2015 738.58 SD A 781.00 01/01/2014 09/27/2051

VT8717 OP OP M A 08/19/2013 1,165.61 SD A 1,303.00 03/01/2014 06/25/2062

VT8719 OP OP F A 08/07/2013 1,933.75 BO A 800.00 11/05/2013 06/29/2032 F A 08/07/2013 1,933.75 SD E 1,045.00 02/01/2014 06/30/2067

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VT8720 OP OP F A 08/20/2013 1,605.50 BO A 800.00 11/18/2013 02/19/2035

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT8720 OP OP F A 08/20/2013 1,605.50 SC E 459.50 02/01/2014 01/31/2022 F A 08/20/2013 1,605.50 SD E 919.00 02/01/2014 02/20/2070

VT8737 OP OP F A 07/22/2013 1,104.18 PD S 224.97 12/12/2013 08/27/2050 F A 07/22/2013 1,104.18 SD A 1,245.00 01/01/2014 08/27/2050

VT8749 OP OP F A 10/01/2013 3,041.19 BO A 16.96 12/30/2013 12/29/2015 F A 10/01/2013 3,041.19 PD A 2,907.26 07/01/2013 01/25/2064 F A 10/01/2013 3,041.19 RO S 400.00 01/01/2015 01/24/2029 F A 10/01/2013 3,041.19 SD E 1,310.00 03/01/2014 01/25/2064

VT8773 OP OP F A 08/24/2013 623.44 PD A 664.51 12/14/2013 05/23/2066 F A 08/24/2013 623.44 SC E 287.00 02/01/2014 08/31/2018 F A 08/24/2013 623.44 SD E 574.00 02/01/2014 05/23/2066

VT9060 OP OP M A 11/05/2013 2,345.58 PD A 1,183.19 04/01/2014 05/28/2052 M A 11/05/2013 2,345.58 SD A 1,513.00 05/01/2014 05/28/2052

VT9074 OP OP F A 11/09/2013 809.69 PD A 478.36 12/24/2013 07/19/2063 F A 11/09/2013 809.69 SD A 754.00 05/01/2014 07/19/2063

VT9085 OP OP F A 06/04/2013 1,686.75 BO A 800.00 09/02/2013 03/02/2019 F A 06/04/2013 1,686.75 SD E 962.00 12/01/2013 03/03/2054

VT9129 LT LS F A 10/04/2009 333.39 0.00

VT9131 LT LS M A 10/15/2010 941.62 0.00

VT9133 LT LS F A 01/28/2010 169.30 0.00

VT9135 LT LS M A 12/15/2011 100.00 0.00

VT9672 OP OP F A 10/12/2013 5,157.30 BO A 800.00 01/10/2014 08/13/2018 F A 10/12/2013 5,157.30 SD E 1,394.00 12/01/2014 08/14/2053

VT9678 OP OP F A 07/18/2013 1,582.20 BO A 800.00 10/16/2013 09/19/2023 F A 07/18/2013 1,582.20 PD A 439.50 01/13/2014 09/20/2058 F A 07/18/2013 1,582.20 SD E 919.00 01/01/2014 09/20/2058

VT9684 OP OP F A 08/31/2013 1,191.01 P1 A 587.77 08/31/2013 11/25/2021 F A 08/31/2013 1,191.01 SD A 986.00 02/01/2014 03/14/2056

VT9686 OP OP F A 07/02/2013 2,299.70 BO A 724.90 07/01/2016 07/31/2016 F A 07/02/2013 2,299.70 BO A 796.80 08/01/2016 10/05/2019 F A 07/02/2013 2,299.70 PD A 1,414.45 03/22/2014 10/06/2054 F A 07/02/2013 2,299.70 SD E 1,158.00 12/01/2013 10/06/2054 F A 07/02/2013 2,299.70 WT S 2,228.85 07/02/2013 07/01/2016

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VT9697 OP OP F A 08/19/2013 1,874.11 BO A 800.00 12/01/2013 04/23/2021 F A 08/19/2013 1,874.11 PD A 828.72 01/14/2014 04/24/2056

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VT9697 OP OP F A 08/19/2013 1,874.11 SD E 1,004.00 02/01/2014 04/24/2056

VU0115 OP OP F A 06/01/2013 845.00 PD S 358.54 03/22/2014 08/02/2057 F A 06/01/2013 845.00 SD A 833.00 11/01/2013 08/02/2057

VU0150 OP OP F A 12/21/2013 2,638.89 BO A 800.00 03/21/2014 08/30/2032 F A 12/21/2013 2,638.89 P1 S 1,400.00 03/21/2014 08/31/2067 F A 12/21/2013 2,638.89 SD E 1,226.00 06/01/2014 08/31/2067

VU0152 OP OP F A 09/24/2013 1,063.08 BO A 800.00 12/23/2013 04/23/2024 F A 09/24/2013 1,063.08 SC E 365.50 03/01/2014 04/30/2017 F A 09/24/2013 1,063.08 SD E 731.00 03/01/2014 04/24/2059

VU0181 OP OP F A 07/22/2013 975.76 PD A 429.27 12/04/2013 06/05/2053 F A 07/22/2013 975.76 SD A 715.00 01/01/2014 06/05/2053

VU0192 OP OP M A 09/30/2013 1,621.95 BO A 800.00 12/29/2013 12/28/2015 M A 09/30/2013 1,621.95 SD E 919.00 03/01/2014 09/09/2065

VU0360 OP OP F A 06/08/2013 1,202.01 PD S 799.95 10/30/2013 06/21/2054 F A 06/08/2013 1,202.01 SD A 830.00 01/01/2014 06/21/2054

VU0361 OP OP F A 07/18/2013 1,066.21 BO A 191.04 01/01/2016 01/31/2016 F A 07/18/2013 1,066.21 BO A 749.87 02/01/2016 01/21/2047 F A 07/18/2013 1,066.21 P1 A 275.34 08/13/2014 01/22/2082 F A 07/18/2013 1,066.21 SD E 731.00 12/01/2013 01/22/2082 F A 07/18/2013 1,066.21 WT S 1,082.73 08/13/2013 01/16/2016

VU0371 OP OP M A 08/09/2013 2,042.20 PD A 1,332.08 11/23/2013 01/15/2060 M A 08/09/2013 2,042.20 SD A 1,403.00 01/01/2014 01/15/2060

VU0372 OP OP F A 09/03/2013 1,097.51 PD A 603.02 01/08/2014 01/16/2064 F A 09/03/2013 1,097.51 SD A 1,024.00 07/01/2014 01/16/2064

VU0373 OP OP F A 10/19/2013 2,210.81 PD A 731.26 04/07/2014 07/09/2080 F A 10/19/2013 2,210.81 SC E 561.00 04/01/2014 11/30/2028 F A 10/19/2013 2,210.81 SD E 1,122.00 04/01/2014 07/09/2080

VU0374 OP OP F A 04/16/2013 1,677.75 PD A 324.15 01/11/2014 01/16/2060 F A 04/16/2013 1,677.75 SD E 962.00 10/01/2013 01/16/2060 F A 04/16/2013 1,677.75 WT S 1,891.09 04/16/2013 04/15/2016

VU0403 OP OP M A 10/26/2013 2,040.62 BO A 800.00 01/24/2014 10/03/2043 M A 10/26/2013 2,040.62 P1 E 376.73 10/24/2014 10/04/2078 M A 10/26/2013 2,040.62 SC E 542.00 04/01/2014 06/30/2030 M A 10/26/2013 2,040.62 SD E 1,084.00 04/01/2014 10/04/2078

VU0417 OP OP F A 09/28/2013 2,626.69 BO A 800.00 02/01/2014 05/13/2025

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F A 09/28/2013 2,626.69 PD A 1,369.52 01/08/2014 05/14/2060 F A 09/28/2013 2,626.69 SD E 1,226.00 03/01/2014 05/14/2060

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU0419 OP OP F A 04/12/2013 1,456.23 PS A 373.33 12/27/2013 03/18/2052 F A 04/12/2013 1,456.23 SD E 874.00 10/01/2013 03/18/2052 F A 04/12/2013 1,456.23 SR A 221.00 05/01/2014 03/18/2052 F A 04/12/2013 1,456.23 WT S 1,551.99 07/11/2013 07/10/2016

VU0432 OP OP M A 09/25/2013 2,375.93 BO A 800.00 12/24/2013 03/27/2026 M A 09/25/2013 2,375.93 SD E 1,158.00 03/01/2014 03/28/2061

VU0433 OP OP F A 09/25/2013 1,128.80 PS A 348.18 09/23/2013 09/23/2053 F A 09/25/2013 1,128.80 SD A 1,010.00 03/01/2014 09/23/2053

VU0454 OP OP F A 09/20/2013 2,686.89 PD A 1,479.93 05/19/2014 05/19/2054 F A 09/20/2013 2,686.89 SD A 1,409.00 03/01/2014 05/19/2054

VU0466 OP OP M A 05/25/2013 2,676.59 BO A 800.00 05/01/2014 11/27/2025 M A 05/25/2013 2,676.59 P1 E 494.14 05/25/2014 11/28/2060 M A 05/25/2013 2,676.59 SD E 1,258.00 11/01/2013 11/28/2060 M A 05/25/2013 2,676.59 WP A 27.82 05/02/2014 11/01/2040

VU0476 OP OP M A 08/19/2013 2,631.82 PD A 2,930.86 03/26/2014 06/02/2060

VU0736 OP OP F A 10/03/2013 996.94 PD A 709.74 12/04/2013 10/08/2061 F A 10/03/2013 996.94 SD A 908.00 04/01/2014 10/08/2061

VU0786 OP OP M A 08/26/2013 1,684.59 PD A 584.00 02/22/2014 02/14/2054 M A 08/26/2013 1,684.59 SD A 1,462.00 02/01/2014 02/14/2054

VU0924 OP OP F A 12/12/2013 1,786.47 BO A 800.00 03/12/2014 04/06/2032 F A 12/12/2013 1,786.47 PD A 610.54 01/04/2014 04/07/2067 F A 12/12/2013 1,786.47 SC E 502.00 06/01/2014 06/30/2018 F A 12/12/2013 1,786.47 SD E 1,004.00 06/01/2014 04/07/2067

VU0939 OP OP F A 06/21/2013 1,378.21 BO A 647.53 03/01/2014 05/25/2030 F A 06/21/2013 1,378.21 PD A 572.20 02/25/2014 05/26/2065 F A 06/21/2013 1,378.21 PS A 105.48 02/25/2014 05/26/2065 F A 06/21/2013 1,378.21 SC E 437.00 12/01/2013 11/30/2024 F A 06/21/2013 1,378.21 SD E 874.00 12/01/2013 05/26/2065 F A 06/21/2013 1,378.21 WT E 3,222.54 06/21/2013 06/20/2016

VU0977 OP OP M A 08/21/2013 2,416.55 BO A 800.00 12/01/2013 11/18/2015 M A 08/21/2013 2,416.55 PD S 1,179.67 01/24/2014 05/17/2056 M A 08/21/2013 2,416.55 SD E 1,193.00 02/01/2014 05/17/2056

VU1221 OP OP F A 10/17/2013 1,696.83 BO A 800.00 01/15/2014 01/14/2016 F A 10/17/2013 1,696.83 PD A 663.93 01/17/2014 07/15/2066 F A 10/17/2013 1,696.83 SC E 481.00 04/01/2014 04/30/2017 F A 10/17/2013 1,696.83 SD E 962.00 04/01/2014 07/15/2066

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VU1233 OP OP M A 09/18/2013 1,165.61 PD A 332.20 03/05/2014 04/29/2059 M A 09/18/2013 1,165.61 SD A 1,550.00 03/01/2014 04/29/2059

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU1235 OP OP F A 06/29/2013 1,173.85 PD S 431.16 11/02/2014 04/01/2056 F A 06/29/2013 1,173.85 SD A 1,050.00 12/01/2013 04/01/2056

VU1248 OP OP F A 12/06/2013 3,070.22 BO A 800.00 03/06/2014 03/05/2016 F A 12/06/2013 3,070.22 PD S 1,807.65 04/26/2014 10/18/2062 F A 12/06/2013 3,070.22 SD E 1,323.00 06/01/2014 10/18/2062

VU1249 OP OP M A 10/02/2013 2,136.28 PD A 909.23 11/30/2013 04/15/2053 M A 10/02/2013 2,136.28 SD A 1,151.00 03/01/2014 04/15/2053

VU1273 OP OP M A 10/22/2013 1,799.20 BO A 800.00 01/20/2014 12/18/2036 M A 10/22/2013 1,799.20 SC E 502.00 04/01/2014 11/30/2020 M A 10/22/2013 1,799.20 SD E 1,004.00 04/01/2014 12/19/2071

VU1280 OP OP M A 08/06/2013 2,152.96 PD A 1,952.48 01/25/2014 12/06/2078 M A 08/06/2013 2,152.96 SD A 1,274.00 06/01/2014 12/06/2078

VU1288 OP OP F A 08/22/2013 1,708.46 P1 E 315.41 08/22/2014 08/20/2066 F A 08/22/2013 1,708.46 SD E 962.00 02/01/2014 08/20/2066

VU1914 OP OP M A 11/22/2013 2,336.05 BO A 109.76 05/01/2014 02/19/2016 M A 11/22/2013 2,336.05 PD A 707.44 01/12/2014 07/06/2050 M A 11/22/2013 2,336.05 SD A 1,429.00 05/01/2014 07/06/2050

VU1989 OP OP M A 07/01/2013 1,039.16 BO A 683.63 02/01/2014 09/28/2015 M A 07/01/2013 1,039.16 PS A 315.56 02/01/2014 02/19/2048

VU2171 OP OP M A 08/30/2013 2,744.83 BO A 800.00 11/28/2013 09/05/2035 M A 08/30/2013 2,744.83 SC A 792.00 02/01/2014 11/30/2022 M A 08/30/2013 2,744.83 SD A 1,584.00 02/01/2014 09/06/2070

VU2206 OP OP F A 01/21/2014 07/30/2015 1,332.06 PD A 706.77 02/02/2014 09/07/2062 F A 01/21/2014 07/30/2015 1,332.06 SD S 996.00 03/01/2014 09/07/2062

VU2221 OP OP F A 09/25/2013 1,073.10 BO A 786.11 04/01/2014 12/23/2015 F A 09/25/2013 1,073.10 P1 A 245.72 03/07/2014 09/07/2062 F A 09/25/2013 1,073.10 SD E 731.00 03/01/2014 09/07/2062

VU2227 OP OP M A 01/03/2014 2,843.52 BO A 303.38 09/01/2014 04/02/2017 M A 01/03/2014 2,843.52 PD A 747.77 06/08/2014 11/04/2050 M A 01/03/2014 2,843.52 SD A 1,683.00 07/01/2014 11/04/2050

VU2273 OP OP F A 04/19/2013 1,297.58 PS A 723.26 04/19/2013 01/11/2054 F A 04/19/2013 1,297.58 SD A 1,044.00 10/01/2013 01/11/2054

VU2274 OP OP F A 05/14/2013 3,450.20 BO A 94.96 08/01/2014 08/11/2015 F A 05/14/2013 3,450.20 WT S 3,222.54 07/07/2014 10/01/2016

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VU2297 OP OP F A 08/21/2013 1,177.35 BO A 800.00 11/01/2014 11/18/2015 F A 08/21/2013 1,177.35 P1 E 217.36 12/16/2014 08/06/2066

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU2297 OP OP F A 08/21/2013 1,177.35 SD E 779.00 06/01/2014 08/06/2066 F A 08/21/2013 1,177.35 WP A 31.59 10/23/2014 08/05/2036

VU2503 OP OP F A 12/16/2013 3,063.18 PD A 1,660.75 03/15/2014 01/24/2067 F A 12/16/2013 3,063.18 SD A 1,639.00 06/01/2014 06/01/2050

VU2512 OP OP F A 10/03/2013 2,558.61 PD A 685.45 01/15/2014 02/12/2059 F A 10/03/2013 2,558.61 SD A 1,987.00 04/01/2014 02/12/2059

VU2513 OP OP F A 09/27/2013 1,470.30 BO A 800.00 12/26/2013 12/25/2015 F A 09/27/2013 1,470.30 SD E 874.00 03/01/2014 01/09/2067

VU2537 OP OP F A 10/12/2013 2,835.19 BO A 679.34 01/10/2014 04/11/2035 F A 10/12/2013 2,835.19 PD A 2,046.80 12/18/2013 04/12/2070 F A 10/12/2013 2,835.19 SD E 1,288.00 04/01/2014 04/12/2070

VU2548 OP OP F A 01/11/2014 1,767.83 BO A 332.31 10/01/2014 10/10/2016 F A 01/11/2014 1,767.83 PD S 299.53 01/22/2014 05/18/2049 F A 01/11/2014 1,767.83 SD A 1,068.00 10/01/2014 05/18/2049

VU2550 OP OP F A 09/02/2013 1,078.40 SD E 731.00 03/01/2014 01/11/2066

VU2574 OP OP F A 06/18/2013 1,026.67 BO A 731.83 08/01/2016 08/31/2016 F A 06/18/2013 1,026.67 BO A 797.53 09/01/2016 10/15/2024 F A 06/18/2013 1,026.67 P1 A 189.65 03/22/2014 10/16/2059 F A 06/18/2013 1,026.67 SD E 731.00 12/01/2013 10/16/2059 F A 06/18/2013 1,026.67 WT A 1,018.30 08/02/2013 08/02/2016

VU2583 OP OP F A 11/06/2013 818.95 BO A 787.45 02/04/2014 09/09/2029 F A 11/06/2013 818.95 SD E 627.00 05/01/2014 09/10/2064

VU2824 OP OP F A 11/11/2013 3,119.92 BO A 800.00 05/01/2014 08/08/2016 F A 11/11/2013 3,119.92 PD A 966.14 05/02/2014 05/02/2049 F A 11/11/2013 3,119.92 SD E 1,323.00 05/01/2014 05/02/2049 F A 11/11/2013 3,119.92 SR A 1,037.00 04/01/2014 05/02/2049

VU2856 OP OP M A 01/14/2014 1,464.66 PD S 325.07 04/03/2014 09/01/2066 M A 01/14/2014 1,464.66 SD A 1,160.00 08/01/2014 09/01/2066

VU3315 OP OP F A 10/24/2013 2,782.33 BO A 800.00 01/22/2014 04/27/2028 F A 10/24/2013 2,782.33 P1 E 513.66 10/24/2014 04/28/2063 F A 10/24/2013 2,782.33 SD E 1,258.00 04/01/2014 04/28/2063

VU3317 OP OP M A 11/16/2013 1,672.78 BO A 330.44 05/01/2014 07/02/2019 M A 11/16/2013 1,672.78 SD A 1,278.00 05/01/2014 07/03/2054

VU3319 OP OP F A 07/30/2013 1,301.03 P1 E 240.19 07/31/2014 09/18/2063 F A 07/30/2013 1,301.03 SD E 827.00 01/01/2014 09/18/2063

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F A 07/30/2013 1,301.03 WT S 1,401.12 08/02/2013 08/01/2016

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU3384 OP OP F A 12/07/2013 2,887.72 BO A 800.00 03/07/2014 03/06/2016 F A 12/07/2013 2,887.72 P1 E 200.00 12/07/2014 01/01/2080

VU3391 OP OP M A 10/21/2013 2,173.66 PD A 1,286.00 01/11/2014 12/10/2053 M A 10/21/2013 2,173.66 SD A 1,501.00 04/01/2014 12/10/2053

VU3473 OP OP F A 11/02/2013 2,750.53 BO A 800.00 01/31/2014 08/28/2037 F A 11/02/2013 2,750.53 P1 E 507.79 11/02/2014 08/29/2072 F A 11/02/2013 2,750.53 SC E 629.00 04/01/2014 02/28/2029 F A 11/02/2013 2,750.53 SD E 1,258.00 04/01/2014 08/29/2072

VU3487 OP OP M A 12/02/2013 1,652.35 BO A 535.32 12/01/2016 12/31/2016 M A 12/02/2013 1,652.35 BO A 598.42 01/01/2017 12/19/2033 M A 12/02/2013 1,652.35 PD A 990.38 04/18/2014 12/20/2068 M A 12/02/2013 1,652.35 SD E 962.00 05/01/2014 12/20/2068 M A 12/02/2013 1,652.35 WT S 1,956.09 12/01/2013 12/01/2016

VU3832 OP OP F S 11/04/2013 1,838.61 BO A 399.28 02/02/2014 02/26/2023 F S 11/04/2013 1,838.61 PD A 1,368.61 10/01/2013 02/27/2058 F S 11/04/2013 1,838.61 SD E 1,004.00 04/01/2014 02/27/2058

VU3833 OP OP F A 10/17/2013 2,069.11 BO A 800.00 01/15/2014 01/14/2016 F A 10/17/2013 2,069.11 P1 E 381.99 10/17/2014 08/31/2085 F A 10/17/2013 2,069.11 SD E 1,084.00 04/01/2014 08/31/2085

VU3882 OP OP F A 12/06/2013 2,666.30 P1 E 796.33 12/06/2014 11/26/2047 F A 12/06/2013 2,666.30 WT S 2,780.44 02/14/2014 02/13/2017

VU3884 OP OP F A 08/10/2013 871.08 SD A 861.00 03/01/2014 12/09/2078

VU3897 OP OP F A 01/24/2014 3,219.13 BO A 800.00 04/24/2014 02/12/2019 F A 01/24/2014 3,219.13 SD E 1,336.00 07/01/2014 02/13/2054

VU4612 OP OP F A 12/05/2013 1,559.68 BO A 800.00 03/05/2014 03/31/2039 F A 12/05/2013 1,559.68 P1 E 200.00 12/05/2014 04/01/2074 F A 12/05/2013 1,559.68 SD E 919.00 06/01/2014 04/01/2074

VU4613 OP OP F S 11/15/2013 1,401.08 BO A 800.00 03/01/2014 08/10/2046 F S 11/15/2013 1,401.08 P1 E 258.66 11/12/2014 08/11/2081 F S 11/15/2013 1,401.08 SD E 874.00 05/01/2014 08/11/2081

VU4616 OP OP M A 07/16/2013 1,602.13 BO A 463.07 11/01/2016 11/30/2016 M A 07/16/2013 1,602.13 BO A 797.69 12/01/2016 07/24/2033 M A 07/16/2013 1,602.13 PD A 742.82 05/01/2014 07/25/2068 M A 07/16/2013 1,602.13 WT S 1,673.10 11/07/2013 11/06/2016

VU4637 OP OP M A 01/23/2014 05/06/2015 1,062.98 BO A 800.00 04/23/2014 05/06/2015 M A 01/23/2014 05/06/2015 1,062.98 P1 E 200.00 01/23/2015 10/08/2058

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M A 01/23/2014 05/06/2015 1,062.98 SD E 731.00 07/01/2014 10/08/2058

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 55 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU6800 OP OP F A 12/06/2013 893.33 SD A 862.00 06/01/2014 06/28/2056

VU6806 OP OP F A 08/26/2013 4,517.97 BO A 800.00 01/01/2014 11/12/2029 F A 08/26/2013 4,517.97 SD E 1,394.00 02/01/2014 11/13/2064

VU6810 OP OP F A 09/13/2013 8,000.00 BO A 800.00 06/01/2014 06/11/2015 F A 09/13/2013 8,000.00 SR A 2,592.00 06/01/2014 07/12/2046

VU6817 OP OP F A 12/14/2013 1,391.80 PD A 837.59 01/04/2014 02/12/2052 F A 12/14/2013 1,391.80 SD A 1,085.00 06/01/2014 02/12/2052

VU6823 OP OP M A 11/20/2013 1,873.35 PD A 1,494.95 04/17/2014 03/11/2061 M A 11/20/2013 1,873.35 PS A 93.09 04/17/2014 03/11/2061 M A 11/20/2013 1,873.35 SD A 1,830.00 10/01/2014 03/11/2061

VU6846 OP OP M A 10/25/2013 3,334.14 P1 S 2,000.00 03/01/2014 05/16/2055 M A 10/25/2013 3,334.14 SD A 2,147.00 07/01/2014 05/16/2055

VU6848 OP OP F A 09/05/2013 1,109.01 BO A 800.00 10/02/2014 03/04/2019 F A 09/05/2013 1,109.01 P1 E 200.00 09/04/2014 03/05/2054 F A 09/05/2013 1,109.01 SD E 779.00 03/01/2014 03/05/2054 F A 09/05/2013 1,109.01 WP A 60.62 01/26/2015 10/22/2037

VU6850 OP OP M A 11/29/2013 1,625.00 BO A 800.00 04/01/2014 07/14/2038 M A 11/29/2013 1,625.00 SC E 481.00 05/01/2014 03/31/2026 M A 11/29/2013 1,625.00 SD E 962.00 05/01/2014 07/15/2073

VU6857 OP OP M A 08/16/2013 1,102.89 BO A 800.00 11/14/2013 09/09/2047 M A 08/16/2013 1,102.89 P1 E 214.44 03/20/2014 09/10/2082 M A 08/16/2013 1,102.89 SC E 365.50 02/01/2014 09/30/2026 M A 08/16/2013 1,102.89 SD E 731.00 02/01/2014 09/10/2082 M A 08/16/2013 1,102.89 WT E 971.00 08/16/2013 08/15/2016

VU6876 OP OP F A 11/13/2013 4,492.73 BO A 800.00 02/11/2014 05/08/2032 F A 11/13/2013 4,492.73 RO S 3,738.31 03/01/2015 05/08/2032

VU6885 OP OP F A 02/10/2014 2,321.59 BO A 572.98 05/11/2014 11/26/2029 F A 02/10/2014 2,321.59 PD A 1,659.31 05/01/2014 11/27/2064 F A 02/10/2014 2,321.59 SD E 1,158.00 08/01/2014 11/27/2064

VU6887 OP OP F A 01/02/2014 1,873.09 BO A 307.52 04/12/2014 07/01/2048 F A 01/02/2014 1,873.09 P1 A 362.52 03/12/2014 07/02/2083 F A 01/02/2014 1,873.09 SD A 1,131.00 01/01/2014 07/02/2083

VU6890 OP OP F A 02/07/2014 730.72 BO A 702.61 05/08/2014 08/27/2030 F A 02/07/2014 730.72 SD E 627.00 08/01/2014 08/28/2065

VU6899 OP OP F A 11/01/2013 05/02/2015 1,643.87 BO A 223.81 09/01/2014 05/02/2015

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F A 11/01/2013 05/02/2015 1,643.87 PD S 1,332.91 08/31/2014 12/09/2076 F A 11/01/2013 05/02/2015 1,643.87 SD E 962.00 04/01/2014 12/09/2076

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU6899 OP OP F A 11/01/2013 05/02/2015 1,643.87 WP A 23.92 10/07/2013 12/08/2046

VU7427 OP OP F A 03/29/2014 3,063.76 BO A 800.00 06/27/2014 06/26/2016 F A 03/29/2014 3,063.76 PD A 1,621.97 03/29/2014 04/21/2056 F A 03/29/2014 3,063.76 SD E 1,323.00 09/01/2014 04/21/2056

VU7441 OP OP F A 10/24/2013 3,589.06 PD A 2,316.42 11/27/2013 11/13/2054 F A 10/24/2013 3,589.06 SD A 2,090.00 04/01/2014 11/13/2054

VU7448 OP OP F A 02/04/2014 2,351.97 P1 E 434.21 01/31/2015 03/04/2059 F A 02/04/2014 2,351.97 SD E 1,158.00 07/01/2014 03/04/2059

VU7463 OP OP F A 10/29/2013 830.26 P1 E 160.19 10/28/2014 04/29/2060 F A 10/29/2013 830.26 SD E 627.00 04/01/2014 04/29/2060

VU7465 OP OP F A 12/11/2013 1,403.77 PD S 313.62 11/01/2014 10/21/2064 F A 12/11/2013 1,403.77 SC E 437.00 06/01/2014 09/30/2015 F A 12/11/2013 1,403.77 SD A 1,498.00 04/01/2015 10/21/2064

VU7466 OP OP M A 03/21/2014 1,350.53 BO A 180.51 09/01/2014 06/18/2016 M A 03/21/2014 1,350.53 PD A 319.08 04/12/2014 11/10/2050 M A 03/21/2014 1,350.53 SD A 799.00 09/01/2014 11/10/2050

VU7467 OP OP F A 02/20/2014 655.09 BO A 629.89 05/21/2014 01/22/2026 F A 02/20/2014 655.09 SD E 574.00 08/01/2014 01/23/2061

VU7490 OP OP F A 01/17/2014 3,397.64 BO A 800.00 04/17/2014 02/23/2019 F A 01/17/2014 3,397.64 P1 E 652.36 01/17/2015 02/24/2054 F A 01/17/2014 3,397.64 SD E 1,347.00 07/01/2014 02/24/2054

VU7495 OP OP F A 04/02/2014 2,253.99 BO A 10.66 09/01/2014 06/30/2017 F A 04/02/2014 2,253.99 PD A 457.63 04/03/2014 06/02/2050 F A 04/02/2014 2,253.99 SD A 1,699.00 09/01/2014 06/02/2050

VU7506 OP OP F A 10/04/2013 1,169.81 BO A 800.00 10/01/2014 01/01/2016 F A 10/04/2013 1,169.81 P1 E 215.96 10/04/2014 06/22/2062 F A 10/04/2013 1,169.81 SD E 779.00 04/01/2014 06/22/2062 F A 10/04/2013 1,169.81 WP A 140.82 09/18/2014 02/07/2037

VU7508 OP OP F A 09/04/2013 1,561.46 BO A 384.81 05/01/2014 04/12/2034 F A 09/04/2013 1,561.46 PD A 1,116.59 04/29/2014 04/13/2069 F A 09/04/2013 1,561.46 SC E 459.50 03/01/2014 10/31/2019 F A 09/04/2013 1,561.46 SD E 919.00 03/01/2014 04/13/2069

VU7512 OP OP F A 11/08/2013 2,358.51 PD A 1,035.15 05/01/2014 01/13/2055 F A 11/08/2013 2,358.51 SD A 1,269.00 04/01/2014 01/13/2055

VU7513 OP OP M A 10/13/2013 2,941.69 PD A 1,546.31 03/08/2014 09/15/2063

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M A 10/13/2013 2,941.69 SD A 1,612.00 04/01/2014 09/15/2063

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 57 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU7524 OP OP M A 04/05/2013 1,411.25 BO A 800.00 06/01/2014 01/01/2037 M A 04/05/2013 1,411.25 P1 A 365.10 01/26/2014 01/02/2072 M A 04/05/2013 1,411.25 SD E 874.00 10/01/2013 01/02/2072

VU7534 OP OP M A 01/17/2014 1,807.16 BO A 800.00 04/17/2014 04/14/2025 M A 01/17/2014 1,807.16 P1 E 200.00 01/17/2015 04/15/2060 M A 01/17/2014 1,807.16 SD E 1,004.00 07/01/2014 04/15/2060

VU7548 OP OP F A 11/23/2013 2,113.96 BO A 800.00 02/21/2014 02/20/2016 F A 11/23/2013 2,113.96 P1 E 390.27 11/23/2014 02/07/2071 F A 11/23/2013 2,113.96 SD E 1,084.00 05/01/2014 02/07/2071

VU7554 OP OP M A 01/25/2014 2,096.85 P1 E 200.00 01/25/2015 07/11/2064 M A 01/25/2014 2,096.85 SD S 1,527.00 07/01/2014 07/11/2064

VU7564 OP OP F A 08/08/2013 1,553.89 BO A 133.13 12/01/2013 11/05/2015 F A 08/08/2013 1,553.89 P1 E 540.02 08/08/2014 01/22/2054 F A 08/08/2013 1,553.89 SD A 1,361.00 12/01/2013 01/22/2054

VU7583 OP OP F A 03/15/2014 1,494.62 BO A 175.14 09/01/2014 12/12/2017 F A 03/15/2014 1,494.62 P1 E 1,132.72 03/14/2015 11/29/2052 F A 03/15/2014 1,494.62 SD A 1,262.00 09/01/2014 11/29/2052

VU7584 OP OP F A 10/07/2013 4,879.24 BO A 800.00 03/01/2015 11/16/2036 F A 10/07/2013 4,879.24 RO S 0.00 02/07/2015 01/25/2016 F A 10/07/2013 4,879.24 SD E 1,394.00 04/01/2014 11/17/2071

VU7585 OP OP F A 11/20/2013 835.97 BO A 800.00 02/25/2014 04/22/2034 F A 11/20/2013 835.97 P1 E 154.33 11/19/2014 04/23/2069 F A 11/20/2013 835.97 SD E 627.00 05/01/2014 04/23/2069

VU7613 OP OP F A 12/21/2013 858.76 SD A 877.00 06/01/2014 12/04/2071

VU7624 OP OP M A 11/12/2013 1,885.79 BO A 580.34 12/01/2014 10/09/2031 M A 11/12/2013 1,885.79 PD S 1,232.92 11/06/2014 10/10/2066 M A 11/12/2013 1,885.79 SD E 1,045.00 05/01/2014 10/10/2066

VU7633 OP OP F A 02/08/2014 1,349.88 BO A 772.98 05/09/2014 05/08/2016 F A 02/08/2014 1,349.88 PD A 524.98 02/08/2014 04/04/2060 F A 02/08/2014 1,349.88 SD E 827.00 08/01/2014 04/04/2060

VU7662 OP OP F A 11/14/2013 1,089.63 BO A 800.00 02/01/2015 04/19/2032 F A 11/14/2013 1,089.63 P1 E 201.16 11/13/2013 04/20/2067 F A 11/14/2013 1,089.63 SD E 731.00 05/01/2014 04/20/2067 F A 11/14/2013 1,089.63 WP A 162.96 02/02/2015 05/24/2050

VU7676 OP OP F A 10/25/2013 3,088.49 BO A 800.00 05/01/2014 01/22/2016 F A 10/25/2013 3,088.49 P1 E 200.00 10/25/2014 05/03/2054

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F A 10/25/2013 3,088.49 SD E 1,323.00 04/01/2014 05/03/2054

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 58 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU7678 OP OP F A 12/12/2013 1,345.55 PD S 555.54 11/05/2014 09/28/2059 F A 12/12/2013 1,345.55 SD A 1,071.00 06/01/2014 09/28/2059

VU7692 OP OP M A 02/20/2014 1,634.23 PD S 371.83 05/03/2014 12/15/2075 M A 02/20/2014 1,634.23 SC E 481.00 08/01/2014 07/31/2030 M A 02/20/2014 1,634.23 SD S 1,573.00 08/01/2014 12/15/2075

VU7705 OP OP F A 02/17/2014 2,153.23 BO A 800.00 05/18/2014 07/18/2021 F A 02/17/2014 2,153.23 PS S 889.96 08/23/2014 07/19/2056 F A 02/17/2014 2,153.23 SD E 1,122.00 08/01/2014 07/19/2056

VU7728 OP OP F A 12/19/2013 940.00 BO A 653.14 02/01/2015 06/26/2020 F A 12/19/2013 940.00 P1 E 157.54 12/19/2014 06/27/2055 F A 12/19/2013 940.00 SC E 339.50 06/01/2014 06/30/2017 F A 12/19/2013 940.00 SD E 679.00 06/01/2014 06/27/2055 F A 12/19/2013 940.00 WP A 250.71 02/01/2015 01/27/2037

VU7771 OP OP M A 06/20/2013 3,880.50 BO A 800.00 10/01/2014 05/24/2022 M A 06/20/2013 3,880.50 SD A 1,728.00 01/01/2014 05/25/2057

VU7775 OP OP M A 03/01/2014 1,562.06 PS A 705.98 02/15/2014 01/12/2052 M A 03/01/2014 1,562.06 SD A 1,081.00 08/01/2014 01/12/2052

VU7785 OP OP M A 11/22/2013 3,080.79 P1 S 1,400.00 06/04/2014 06/29/2059 M A 11/22/2013 3,080.79 SD A 1,759.00 05/01/2014 06/29/2059

VU7786 OP OP F A 11/09/2013 446.43 SR E 476.00 12/01/2013 02/25/2046

VU7963 OP OP F A 10/29/2013 815.05 BO A 631.76 08/01/2014 01/26/2016 F A 10/29/2013 815.05 PL A 151.94 07/06/2014 10/03/2074 F A 10/29/2013 815.05 SD E 627.00 04/01/2014 10/03/2074

VU8600 OP OP M A 04/13/2013 1,828.83 BO A 800.00 09/01/2013 07/11/2015 M A 04/13/2013 1,828.83 P1 E 200.00 04/13/2014 02/12/2079 M A 04/13/2013 1,828.83 SC E 502.00 10/01/2013 12/31/2025 M A 04/13/2013 1,828.83 SD E 1,004.00 10/01/2013 02/12/2079 M A 04/13/2013 1,828.83 WT E 971.00 04/13/2013 04/12/2016

VU8606 OP OP F A 02/04/2014 1,523.93 PS A 1,005.58 05/05/2014 07/07/2061 F A 02/04/2014 1,523.93 SD A 1,203.00 08/01/2014 07/07/2061

VU8610 OP OP M A 04/26/2013 1,068.28 P1 E 197.22 04/26/2014 01/18/2065 M A 04/26/2013 1,068.28 SD E 731.00 10/01/2013 01/18/2065 M A 04/26/2013 1,068.28 WT A 1,517.72 10/14/2013 01/17/2030

VU8616 OP OP F A 11/30/2013 1,254.99 BO A 800.00 02/28/2014 01/03/2028 F A 11/30/2013 1,254.99 P1 E 200.00 11/30/2014 01/04/2063 F A 11/30/2013 1,254.99 SD E 827.00 05/01/2014 01/04/2063

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VU8621 OP OP F A 12/17/2013 2,405.98 BO A 800.00 04/01/2014 03/16/2016

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU8621 OP OP F A 12/17/2013 2,405.98 SC E 596.50 06/01/2014 09/30/2016 F A 12/17/2013 2,405.98 SD E 1,193.00 06/01/2014 02/01/2076

VU8635 OP OP M A 12/21/2013 825.50 P1 E 200.00 12/21/2014 02/10/2057 M A 12/21/2013 825.50 SD S 2,099.00 06/01/2014 02/10/2057

VU8637 OP OP M A 03/15/2014 3,288.63 BO A 717.51 06/13/2014 07/12/2027 M A 03/15/2014 3,288.63 PD A 2,444.63 04/26/2014 07/13/2062 M A 03/15/2014 3,288.63 SD E 1,336.00 09/01/2014 07/13/2062

VU8651 OP OP F A 10/15/2013 2,438.10 BO A 272.55 12/01/2014 01/12/2016 F A 10/15/2013 2,438.10 SD A 1,269.00 12/01/2014 01/15/2049 F A 10/15/2013 2,438.10 WP A 802.78 11/10/2014 01/15/2049

VU8695 OP OP F A 02/02/2014 1,609.13 PS A 1,240.28 03/22/2014 11/10/2050 F A 02/02/2014 1,609.13 SD A 1,242.00 07/01/2014 11/10/2050

VU8707 OP OP M A 12/28/2013 3,772.70 BO A 800.00 03/28/2014 02/14/2031 M A 12/28/2013 3,772.70 PD A 2,483.79 12/28/2013 02/15/2066 M A 12/28/2013 3,772.70 SD E 1,388.00 06/01/2014 02/15/2066

VU8728 OP OP M S 12/17/2013 936.07 PD S 202.33 09/06/2014 07/20/2058 M S 12/17/2013 936.07 SC E 339.50 06/01/2014 12/31/2017 M S 12/17/2013 936.07 SD E 1,400.00 11/01/2014 07/20/2058

VU8745 OP OP M A 01/04/2014 1,403.85 PD S 274.30 05/31/2014 12/09/2081 M A 01/04/2014 1,403.85 SD A 1,094.00 07/01/2014 12/09/2081

VU9306 OP OP M A 03/14/2014 1,173.52 PD S 485.18 07/01/2014 05/13/2056 M A 03/14/2014 1,173.52 SD A 1,056.00 07/01/2014 05/13/2056

VU9307 OP OP M A 12/04/2013 1,565.19 BO A 44.94 04/01/2014 03/03/2016 M A 12/04/2013 1,565.19 P1 E 288.96 12/04/2014 11/25/2079 M A 12/04/2013 1,565.19 SD E 919.00 05/01/2014 11/25/2079 M A 12/04/2013 1,565.19 WT A 1,460.05 03/21/2014 11/24/2044

VU9318 OP OP F A 12/28/2013 1,500.64 BO A 800.00 03/28/2014 04/29/2034 F A 12/28/2013 1,500.64 P1 E 277.04 12/27/2014 04/30/2069 F A 12/28/2013 1,500.64 SD E 919.00 06/01/2014 04/30/2069

VU9319 OP OP F A 03/06/2014 3,336.76 BO A 800.00 06/04/2014 06/03/2016 F A 03/06/2014 3,336.76 SR A 1,692.00 04/01/2014 07/26/2048

VU9341 OP OP M A 12/30/2013 2,332.55 PD A 1,865.00 04/22/2014 03/18/2060 M A 12/30/2013 2,332.55 SD A 1,805.00 03/01/2015 03/18/2060

VU9349 OP OP F A 03/12/2014 922.67 P1 E 170.34 03/11/2015 07/15/2035 F A 03/12/2014 922.67 SC E 339.50 09/01/2014 07/31/2018

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F A 03/12/2014 922.67 SD E 679.00 09/01/2014 07/16/2070

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 60 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU9359 OP OP F A 10/11/2013 1,007.51 PD A 589.42 01/22/2014 06/17/2054 F A 10/11/2013 1,007.51 SD A 837.00 04/01/2014 06/17/2054

VU9371 OP OP F A 01/21/2014 608.19 BO A 584.80 04/21/2014 01/22/2031 F A 01/21/2014 608.19 SD E 574.00 08/01/2014 01/23/2066

VU9372 OP OP M A 10/31/2013 2,084.16 BO A 800.00 01/01/2018 10/05/2039 M A 10/31/2013 2,084.16 PD A 1,175.75 02/28/2014 10/06/2074 M A 10/31/2013 2,084.16 SC E 542.00 04/01/2014 09/30/2018 M A 10/31/2013 2,084.16 SD E 1,084.00 04/01/2014 10/06/2074 M A 10/31/2013 2,084.16 WT S 2,309.14 01/01/2014 12/31/2017

VU9373 OP OP M A 01/17/2014 3,174.39 BO A 98.64 08/01/2014 09/27/2019 M A 01/17/2014 3,174.39 PD S 961.65 06/03/2014 09/28/2054 M A 01/17/2014 3,174.39 SD A 1,992.00 07/01/2014 09/28/2054

VU9391 OP OP F A 12/27/2013 1,105.18 BO A 800.00 03/27/2014 03/26/2016 F A 12/27/2013 1,105.18 P1 E 204.03 12/24/2014 03/08/2058 F A 12/27/2013 1,105.18 SD E 779.00 06/01/2014 03/08/2058

VU9462 OP OP M A 01/18/2014 649.61 SD A 1,196.00 07/01/2014 01/18/2057

VU9518 OP OP M A 04/19/2014 3,304.93 BO A 800.00 07/18/2014 07/17/2016 M A 04/19/2014 3,304.93 PD A 1,414.52 04/19/2014 07/29/2051 M A 04/19/2014 3,304.93 SD E 1,336.00 10/01/2014 07/29/2051

VU9535 OP OP F A 08/17/2013 1,089.30 SD A 1,101.00 02/01/2014 07/11/2066

VU9540 OP OP M A 03/28/2014 2,223.36 PS A 1,282.13 03/28/2014 11/05/2055 M A 03/28/2014 2,223.36 SD A 1,514.00 09/01/2014 11/05/2055

VU9541 OP OP F A 08/22/2013 3,976.65 SD E 1,394.00 02/01/2014 07/29/2051

VU9562 OP OP F A 03/08/2014 2,091.27 BO A 800.00 06/06/2014 11/16/2026 F A 03/08/2014 2,091.27 P1 E 386.08 03/08/2015 11/17/2061 F A 03/08/2014 2,091.27 SD E 1,084.00 09/01/2014 11/17/2061

VU9564 OP OP F A 11/07/2013 2,465.34 PD S 1,005.09 05/06/2014 02/21/2059 F A 11/07/2013 2,465.34 SD A 1,747.00 10/01/2014 02/21/2059

VU9574 OP OP F A 04/10/2014 2,962.43 PD S 1,128.23 07/15/2014 05/29/2059 F A 04/10/2014 2,962.43 SD A 1,927.00 10/01/2014 05/29/2059

VU9591 OP OP M A 12/20/2013 1,200.60 PD S 222.32 08/01/2014 03/21/2063 M A 12/20/2013 1,200.60 SD A 1,040.00 06/01/2014 03/21/2063

VU9621 OP OP F A 01/11/2014 3,502.59 BO A 800.00 04/11/2014 10/10/2017 F A 01/11/2014 3,502.59 P1 E 660.42 01/11/2015 10/02/2052

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F A 01/11/2014 3,502.59 SD E 1,362.00 07/01/2014 10/02/2052

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU9645 OP OP M A 01/06/2014 1,928.99 PD S 1,071.96 07/03/2014 07/14/2066 M A 01/06/2014 1,928.99 SD A 1,423.00 07/01/2014 07/14/2066

VU9658 OP OP F A 01/30/2014 1,777.83 BO A 800.00 04/30/2014 06/22/2042 F A 01/30/2014 1,777.83 SC E 502.00 07/01/2014 07/31/2025 F A 01/30/2014 1,777.83 SD E 1,004.00 07/01/2014 06/23/2077

VU9667 OP OP F A 03/12/2014 921.09 PD S 173.76 07/31/2014 10/15/2064 F A 03/12/2014 921.09 SD A 840.00 11/01/2014 10/15/2064

VU9672 OP OP M A 03/11/2014 2,451.91 BO A 371.59 08/01/2014 03/13/2032 M A 03/11/2014 2,451.91 PD A 1,986.02 07/02/2014 03/14/2067 M A 03/11/2014 2,451.91 SD E 1,193.00 09/01/2014 03/14/2067

VU9763 OP OP F A 02/24/2014 2,907.73 BO A 800.00 05/25/2014 03/22/2047 F A 02/24/2014 2,907.73 SD E 1,288.00 08/01/2014 03/23/2082

VU9772 OP OP M A 11/07/2013 1,320.15 BO A 800.00 01/01/2015 10/21/2022 M A 11/07/2013 1,320.15 P1 E 362.27 03/06/2015 10/22/2057 M A 11/07/2013 1,320.15 SD E 827.00 08/01/2014 10/22/2057

VU9775 OP OP F A 01/02/2014 2,714.56 BO A 800.00 08/01/2014 04/01/2016 F A 01/02/2014 2,714.56 P1 E 501.15 01/02/2015 05/03/2060 F A 01/02/2014 2,714.56 SD E 1,258.00 06/01/2014 05/03/2060

VU9830 OP OP M A 01/31/2014 1,154.29 BO A 800.00 06/01/2014 07/26/2023 M A 01/31/2014 1,154.29 P1 A 249.76 07/12/2014 07/27/2058 M A 01/31/2014 1,154.29 SD E 779.00 07/01/2014 07/27/2058

VU9834 OP OP F A 01/25/2014 805.29 PD A 285.12 07/08/2014 05/25/2062 F A 01/25/2014 805.29 SD A 796.00 07/01/2014 05/25/2062

VU9838 OP OP M A 05/16/2014 2,803.78 PD S 906.13 06/03/2014 04/04/2060 M A 05/16/2014 2,803.78 SD A 2,112.00 10/01/2014 04/04/2060

VU9840 OP OP M A 03/31/2014 686.21 BO A 659.81 06/29/2014 12/09/2030 M A 03/31/2014 686.21 SC E 287.00 09/01/2014 09/30/2018 M A 03/31/2014 686.21 SD E 574.00 09/01/2014 12/10/2065

VU9852 OP OP F A 04/15/2014 1,339.28 PS A 290.94 06/25/2014 06/25/2054 F A 04/15/2014 1,339.28 SD A 1,080.00 11/01/2014 06/25/2054

VU9864 OP OP F A 01/10/2014 1,374.59 BO A 800.00 04/10/2014 10/09/2017 F A 01/10/2014 1,374.59 WT E 971.00 01/10/2014 01/09/2017

VU9874 OP OP F A 01/02/2014 1,573.79 BO A 800.00 04/02/2014 09/04/2044 F A 01/02/2014 1,573.79 P1 E 200.00 01/02/2015 09/05/2079 F A 01/02/2014 1,573.79 SC E 459.50 06/01/2014 11/30/2029

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F A 01/02/2014 1,573.79 SD E 919.00 06/01/2014 09/05/2079

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VU9877 OP OP F A 02/20/2014 2,050.37 BO A 800.00 06/01/2014 03/16/2024 F A 02/20/2014 2,050.37 P1 E 455.23 02/20/2015 03/17/2059 F A 02/20/2014 2,050.37 SD E 1,084.00 08/01/2014 03/17/2059

VU9899 OP OP M A 03/25/2014 1,758.25 BO A 524.36 07/01/2014 12/05/2036 M A 03/25/2014 1,758.25 PD A 1,166.27 06/24/2014 12/06/2071 M A 03/25/2014 1,758.25 SC E 502.00 09/01/2014 10/31/2024 M A 03/25/2014 1,758.25 SD E 1,004.00 09/01/2014 12/06/2071

VU9900 OP OP F A 01/08/2014 3,765.46 BO A 800.00 04/11/2014 04/10/2016 F A 01/08/2014 3,765.46 SD A 1,867.00 07/01/2014 04/19/2059

VU9937 OP OP F A 02/04/2014 1,690.00 BO A 800.00 05/05/2014 10/04/2039 F A 02/04/2014 1,690.00 SD E 962.00 08/01/2014 10/05/2074

VU9961 OP OP M A 04/08/2014 5,629.75 BO A 800.00 07/07/2014 03/10/2024 M A 04/08/2014 5,629.75 PD A 3,908.20 04/22/2014 03/11/2059 M A 04/08/2014 5,629.75 RO S 0.00 07/07/2014 07/06/2015 M A 04/08/2014 5,629.75 RO S 250.00 07/07/2015 03/10/2024 M A 04/08/2014 5,629.75 SC E 697.00 10/01/2014 01/31/2023 M A 04/08/2014 5,629.75 SD E 1,394.00 10/01/2014 03/11/2059

VU9974 OP OP F A 09/06/2013 3,246.50 BO A 800.00 03/01/2014 06/04/2017 F A 09/06/2013 3,246.50 PS A 236.97 08/05/2014 08/24/2051 F A 09/06/2013 3,246.50 SD A 1,235.00 08/01/2014 08/24/2051

VU9975 OP OP F A 02/08/2014 1,296.59 BO A 800.00 05/09/2014 03/05/2020 F A 02/08/2014 1,296.59 P1 E 510.00 02/08/2015 03/06/2055 F A 02/08/2014 1,296.59 SD E 827.00 08/01/2014 03/06/2055

VU9992 OP OP M A 02/11/2014 1,254.99 BO A 800.00 05/12/2014 05/11/2016 M A 02/11/2014 1,254.99 P1 E 200.00 02/11/2015 08/18/2057

VU9994 OP OP M A 01/17/2014 4,289.79 BO A 800.00 04/17/2014 10/16/2016 M A 01/17/2014 4,289.79 SR A 2,127.00 07/01/2014 05/21/2049

VV0706 OP OP F A 12/16/2013 1,524.30 BO A 564.68 07/01/2014 02/21/2026 F A 12/16/2013 1,524.30 P1 E 283.28 12/13/2013 02/22/2061 F A 12/16/2013 1,524.30 SD A 901.00 06/01/2014 02/22/2061

VV0740 OP OP F A 02/11/2014 1,296.15 PS A 693.82 08/01/2009 04/29/2050 F A 02/11/2014 1,296.15 SD A 987.00 08/01/2014 04/29/2050

VV0747 OP OP F A 03/07/2014 1,478.64 P1 A 271.16 06/30/2014 06/06/2063 F A 03/07/2014 1,478.64 SD A 1,196.00 09/01/2014 06/06/2063

VV0752 OP OP F A 03/06/2013 1,912.24 BO A 573.75 04/01/2016 06/24/2033 F A 03/06/2013 1,912.24 PS A 1,264.94 06/30/2010 06/25/2068

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F A 03/06/2013 1,912.24 SD E 1,045.00 03/01/2014 06/25/2068 F A 03/06/2013 1,912.24 WT S 1,810.50 09/17/2013 03/12/2016

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV0753 OP OP M A 12/04/2013 2,827.70 BO A 800.00 05/01/2014 12/03/2015 M A 12/04/2013 2,827.70 PS A 735.06 12/04/2013 10/24/2047

VV0781 OP OP M A 12/18/2013 1,581.13 P1 E 200.00 12/18/2014 09/05/2065 M A 12/18/2013 1,581.13 SD E 919.00 06/01/2014 09/05/2065

VV0782 OP OP F A 02/12/2013 1,361.75 BO A 800.00 05/01/2014 05/12/2015 F A 02/12/2013 1,361.75 P1 A 270.32 09/29/2013 12/14/2065 F A 02/12/2013 1,361.75 SC E 413.50 08/01/2013 06/30/2017 F A 02/12/2013 1,361.75 SD E 827.00 08/01/2013 12/14/2065 F A 02/12/2013 1,361.75 WP A 96.15 04/30/2014 12/13/2035

VV0792 OP OP F A 09/20/2013 2,235.51 BO A 286.36 07/01/2014 12/18/2015 F A 09/20/2013 2,235.51 PD A 1,863.17 06/13/2014 03/11/2077 F A 09/20/2013 2,235.51 SC E 561.00 03/01/2014 05/31/2031 F A 09/20/2013 2,235.51 SD E 1,122.00 03/01/2014 03/11/2077

VV0799 OP OP M A 02/21/2014 736.72 BO A 708.39 05/22/2014 12/01/2020 M A 02/21/2014 736.72 P1 E 200.00 02/21/2015 12/02/2055 M A 02/21/2014 736.72 SD E 627.00 08/01/2014 12/02/2055

VV1523 OP OP F A 09/19/2013 1,340.79 BO A 800.00 07/01/2014 01/11/2031 F A 09/19/2013 1,340.79 P1 E 247.53 03/31/2015 01/12/2066 F A 09/19/2013 1,340.79 SD E 827.00 03/01/2014 01/12/2066 F A 09/19/2013 1,340.79 WP A 64.00 07/01/2014 09/30/2045

VV1533 OP OP F A 05/30/2014 1,476.22 BO A 800.00 08/28/2014 08/27/2016 F A 05/30/2014 1,476.22 P1 E 352.99 05/30/2015 11/20/2057 F A 05/30/2014 1,476.22 SD E 874.00 11/01/2014 11/20/2057

VV1564 OP OP F A 07/25/2013 1,181.65 BO A 800.00 08/01/2016 06/07/2022 F A 07/25/2013 1,181.65 P1 E 218.15 07/25/2014 06/08/2057 F A 07/25/2013 1,181.65 SD E 779.00 01/01/2014 06/08/2057 F A 07/25/2013 1,181.65 WT S 1,481.89 07/29/2013 07/28/2016

VV1578 OP OP F A 03/17/2014 1,099.76 BO A 800.00 06/15/2014 01/08/2018 F A 03/17/2014 1,099.76 P1 E 227.91 03/14/2015 01/09/2053 F A 03/17/2014 1,099.76 SD E 731.00 09/01/2014 01/09/2053

VV1590 OP OP M A 03/20/2014 1,632.48 BO A 800.00 04/01/2017 08/18/2019 M A 03/20/2014 1,632.48 P1 E 301.38 03/20/2015 08/19/2054 M A 03/20/2014 1,632.48 SD E 962.00 09/01/2014 08/19/2054 M A 03/20/2014 1,632.48 WT S 1,621.02 04/02/2014 04/01/2017

VV1604 OP OP F A 01/01/2014 06/30/2015 1,538.23 BO A 800.00 04/01/2014 06/30/2015 F A 01/01/2014 06/30/2015 1,538.23 P1 E 200.00 05/28/2015 09/24/2060 F A 01/01/2014 06/30/2015 1,538.23 SD E 919.00 11/01/2014 09/24/2060

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VV1691 OP OP F A 01/31/2014 2,812.12 PS A 1,656.89 01/01/2013 11/15/2052 F A 01/31/2014 2,812.12 SD A 1,226.00 12/01/2014 11/15/2052

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV1752 OP OP M A 06/24/2014 1,936.36 BO A 800.00 11/01/2014 03/19/2020 M A 06/24/2014 1,936.36 PD S 729.54 11/05/2014 03/20/2055 M A 06/24/2014 1,936.36 SC E 522.50 12/01/2014 04/30/2016 M A 06/24/2014 1,936.36 SD E 1,045.00 12/01/2014 03/20/2055

VV1754 OP OP F A 04/25/2014 1,373.60 BO A 800.00 07/24/2014 12/11/2023 F A 04/25/2014 1,373.60 PD S 309.36 11/02/2014 12/12/2058 F A 04/25/2014 1,373.60 SD A 207.00 10/01/2014 12/12/2058

VV1781 OP OP F A 07/01/2014 3,598.53 BO A 623.82 12/01/2014 02/09/2043 F A 07/01/2014 3,598.53 P1 A 811.31 07/01/2014 02/10/2078 F A 07/01/2014 3,598.53 RO S 0.00 02/11/2015 02/10/2016 F A 07/01/2014 3,598.53 RO S 833.34 02/11/2016 02/09/2043 F A 07/01/2014 3,598.53 SD A 2,025.00 12/01/2014 02/10/2078

VV1815 OP OP M A 12/21/2013 1,031.98 SD A 1,807.00 06/01/2014 09/24/2052

VV1842 OP OP F A 02/28/2014 1,227.72 PD S 532.24 07/01/2014 07/24/2063 F A 02/28/2014 1,227.72 SD A 863.00 07/01/2014 07/24/2063

VV1883 OP OP F A 03/03/2014 1,574.39 BO A 243.76 01/01/2015 05/31/2016 F A 03/03/2014 1,574.39 PS A 228.08 11/02/2012 06/13/2054 F A 03/03/2014 1,574.39 SD A 1,042.00 01/01/2015 06/13/2054

VV1897 OP OP F A 04/12/2014 1,058.80 SR A 1,102.00 05/01/2014 09/05/2050

VV1898 OP OP F A 05/02/2014 2,905.61 BO A 81.87 10/01/2014 12/08/2025 F A 05/02/2014 2,905.61 PD S 980.09 09/13/2014 12/09/2060 F A 05/02/2014 2,905.61 PS S 180.90 09/13/2014 12/09/2060 F A 05/02/2014 2,905.61 SD A 1,551.00 07/01/2014 12/09/2060

VV2003 OP OP M A 03/18/2014 1,165.61 BO A 100.78 09/01/2014 12/15/2017 M A 03/18/2014 1,165.61 P1 E 215.19 03/17/2015 07/09/2051 M A 03/18/2014 1,165.61 SD A 1,020.00 09/01/2014 07/09/2051

VV2920 OP OP F A 04/08/2014 2,656.55 BO A 689.26 07/07/2014 07/06/2017 F A 04/08/2014 2,656.55 PS A 1,865.12 08/01/2012 11/01/2050 F A 04/08/2014 2,656.55 SD E 1,226.00 10/01/2014 11/01/2050

VV2924 OP OP M A 04/22/2014 1,415.26 BO A 800.00 07/21/2014 02/04/2036 M A 04/22/2014 1,415.26 SD E 874.00 10/01/2014 02/05/2071

VV2927 OP OP F A 03/05/2014 1,125.49 BO A 800.00 11/01/2014 06/02/2016

VV2936 OP OP F A 06/19/2014 1,500.58 BO A 800.00 09/17/2014 09/11/2033 F A 06/19/2014 1,500.58 P1 E 277.03 05/07/2015 09/12/2068 F A 06/19/2014 1,500.58 SC E 459.50 11/01/2014 01/31/2020 F A 06/19/2014 1,500.58 SD E 919.00 11/01/2014 09/12/2068

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VV2939 OP OP F A 03/25/2013 1,627.15 BO A 124.69 12/01/2014 06/03/2043

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV2939 OP OP F A 03/25/2013 1,627.15 PD S 1,439.88 11/01/2014 06/04/2078 F A 03/25/2013 1,627.15 SD E 962.00 09/01/2013 06/04/2078

VV2947 OP OP M A 09/07/2013 1,297.58 PD A 673.11 05/01/2014 12/12/2059 M A 09/07/2013 1,297.58 SD A 1,051.00 03/01/2014 12/12/2059

VV2954 OP OP M A 07/12/2013 2,998.92 BO A 499.59 10/10/2013 06/22/2027 M A 07/12/2013 2,998.92 PD A 2,383.99 10/10/2013 06/23/2062 M A 07/12/2013 2,998.92 SC E 655.00 01/01/2014 03/31/2029 M A 07/12/2013 2,998.92 SD E 1,310.00 01/01/2014 06/23/2062

VV2962 OP OP F A 05/15/2014 782.10 BO A 752.02 08/13/2014 08/12/2016 F A 05/15/2014 782.10 SD E 627.00 11/01/2014 04/21/2065

VV2964 OP OP F A 01/24/2014 1,030.62 BO A 800.00 04/24/2014 04/23/2016 F A 01/24/2014 1,030.62 P1 E 190.27 01/23/2015 04/15/2067 F A 01/24/2014 1,030.62 SC E 365.50 07/01/2014 07/31/2024 F A 01/24/2014 1,030.62 SD E 731.00 07/01/2014 04/15/2067

VV2981 OP OP F A 03/02/2014 672.67 P1 E 124.18 03/02/2015 08/23/2066 F A 03/02/2014 672.67 SD E 574.00 08/01/2014 08/23/2066

VV2984 OP OP M A 02/22/2014 4,736.66 BO A 800.00 08/01/2014 08/24/2036 M A 02/22/2014 4,736.66 P1 E 734.18 02/22/2015 08/25/2071 M A 02/22/2014 4,736.66 SC E 697.00 08/01/2014 09/30/2025 M A 02/22/2014 4,736.66 SD E 1,394.00 08/01/2014 08/25/2071

VV3247 OP OP M A 04/06/2014 1,462.50 BO A 800.00 07/05/2014 12/30/2026 M A 04/06/2014 1,462.50 P1 E 200.00 04/06/2015 12/31/2061 M A 04/06/2014 1,462.50 SD E 874.00 10/01/2014 12/31/2061 M A 04/06/2014 1,462.50 WT E 971.00 04/06/2014 04/05/2017

VV3250 OP OP F A 03/07/2014 8,000.00 BO A 800.00 10/01/2014 05/27/2018 F A 03/07/2014 8,000.00 P1 E 200.00 03/07/2015 05/28/2053 F A 03/07/2014 8,000.00 SD A 2,331.00 09/01/2014 05/28/2053

VV3508 OP OP M A 05/17/2014 1,096.06 BO A 800.00 08/15/2014 05/12/2033 M A 05/17/2014 1,096.06 SD E 731.00 11/01/2014 05/13/2068

VV3551 OP OP F A 06/17/2014 1,261.07 BO A 800.00 09/15/2014 04/28/2021 F A 06/17/2014 1,261.07 P1 E 287.19 06/07/2015 04/29/2056 F A 06/17/2014 1,261.07 SD E 827.00 12/01/2014 04/29/2056

VV3552 OP OP F A 01/14/2014 2,354.56 BO A 800.00 08/01/2014 04/13/2016 F A 01/14/2014 2,354.56 RO S 2,343.69 08/19/2014 08/18/2015 F A 01/14/2014 2,354.56 RO S 1,850.00 08/19/2015 02/15/2021

VV3558 OP OP F A 05/04/2013 2,244.44 PL A 644.43 07/01/2014 01/01/2070

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F A 05/04/2013 2,244.44 SD E 1,122.00 11/01/2013 01/01/2070 F A 05/04/2013 2,244.44 WT S 3,222.54 12/14/2013 12/13/2016

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV3563 OP OP M A 09/20/2013 914.73 P1 E 200.00 09/20/2014 06/04/2053 M A 09/20/2013 914.73 SD E 679.00 03/01/2014 06/04/2053

VV3566 OP OP F A 08/16/2013 1,096.50 BO A 800.00 11/14/2013 12/09/2032 F A 08/16/2013 1,096.50 P1 E 200.00 08/16/2014 12/10/2067 F A 08/16/2013 1,096.50 SC E 365.50 02/01/2014 02/28/2017 F A 08/16/2013 1,096.50 SD E 731.00 02/01/2014 12/10/2067

VV3578 OP OP M A 04/05/2014 1,916.36 PS S 1,252.93 08/01/2014 02/21/2054 M A 04/05/2014 1,916.36 SD A 1,208.00 10/01/2014 02/21/2054

VV3618 OP OP F A 07/10/2014 2,868.99 BO A 800.00 10/08/2014 08/27/2050 F A 07/10/2014 2,868.99 SD E 1,288.00 11/01/2014 08/28/2085

VV3669 OP OP M A 06/10/2014 1,942.79 BO A 800.00 09/08/2014 06/25/2025 M A 06/10/2014 1,942.79 P1 E 542.96 06/11/2014 06/26/2060 M A 06/10/2014 1,942.79 SD E 1,045.00 12/01/2014 06/26/2060

VV3903 OP OP M A 04/02/2014 1,650.77 BO A 800.00 07/01/2014 03/03/2029 M A 04/02/2014 1,650.77 P1 E 304.76 04/02/2015 03/04/2064 M A 04/02/2014 1,650.77 SD E 962.00 09/01/2014 03/04/2064

VV3931 OP OP M A 06/22/2013 2,307.47 BO A 173.44 11/01/2014 09/19/2015 M A 06/22/2013 2,307.47 PD S 1,929.06 10/17/2014 09/25/2069 M A 06/22/2013 2,307.47 RO A 1,565.65 11/28/2014 09/19/2015 M A 06/22/2013 2,307.47 WP A 116.23 08/22/2014 09/24/2039

VV3995 OP OP F A 03/29/2014 05/13/2015 871.92 BO A 531.39 10/01/2014 05/13/2015 F A 03/29/2014 05/13/2015 871.92 P1 E 160.97 03/29/2015 05/02/2066 F A 03/29/2014 05/13/2015 871.92 SD A 307.00 09/01/2014 05/02/2066

VV4006 OP OP F A 07/15/2014 2,549.27 SC E 613.00 12/01/2014 10/31/2021 F A 07/15/2014 2,549.27 SD E 1,226.00 12/01/2014 01/31/2065

VV4009 OP OP F A 02/03/2014 1,665.46 PD S 347.48 06/06/2014 06/20/2070 F A 02/03/2014 1,665.46 SD A 1,018.00 06/01/2014 06/20/2070

VV4019 OP OP F A 02/28/2014 1,054.57 SD A 1,501.00 08/01/2014 01/11/2057

VV4022 OP OP F A 04/15/2014 1,345.60 BO A 800.00 07/14/2014 05/03/2028 F A 04/15/2014 1,345.60 SD E 827.00 10/01/2014 05/04/2063

VV4038 OP OP F A 04/24/2013 2,112.94 PS A 2,578.71 04/24/2013 05/21/2060

VV4606 OP OP F A 03/14/2014 866.99 SD A 1,004.00 09/01/2014 06/23/2052

VV4612 OP OP F A 04/05/2014 3,439.36 P1 S 3,000.00 02/01/2015 12/28/2063 F A 04/05/2014 3,439.36 SD A 1,963.00 12/01/2014 12/28/2063

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VV4615 OP OP F A 06/04/2014 937.63 PD S 169.16 09/03/2014 03/24/2057

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV4615 OP OP F A 06/04/2014 937.63 SD A 1,025.00 01/01/2015 03/24/2057

VV4628 OP OP F A 02/21/2014 1,802.71 BO A 800.00 05/22/2014 05/22/2041 F A 02/21/2014 1,802.71 P1 E 200.00 02/21/2015 05/23/2076 F A 02/21/2014 1,802.71 SC E 502.00 08/01/2014 07/31/2020 F A 02/21/2014 1,802.71 SD E 1,004.00 08/01/2014 05/23/2076

VV4629 OP OP F A 01/17/2014 1,665.68 BO A 282.61 07/01/2014 09/22/2026 F A 01/17/2014 1,665.68 P1 E 307.51 01/17/2015 09/23/2061 F A 01/17/2014 1,665.68 SD A 1,319.00 07/01/2014 09/23/2061

VV4649 OP OP F A 06/07/2014 1,091.98 PS A 424.60 07/01/2014 08/07/2052 F A 06/07/2014 1,091.98 SR A 689.00 09/01/2014 08/07/2052

VV4651 OP OP F A 08/02/2014 2,170.29 PS A 845.81 08/02/2014 07/16/2054 F A 08/02/2014 2,170.29 SD A 1,731.00 01/01/2015 07/16/2054

VV4654 OP OP F A 03/28/2014 1,097.74 BO A 582.13 11/01/2014 10/30/2031 F A 03/28/2014 1,097.74 P1 A 473.39 10/12/2014 10/31/2066 F A 03/28/2014 1,097.74 SD E 731.00 09/01/2014 10/31/2066 F A 03/28/2014 1,097.74 WT E 971.00 03/28/2014 03/27/2017

VV4657 OP OP F A 04/19/2014 1,084.09 PD S 357.34 11/07/2014 10/14/2056 F A 04/19/2014 1,084.09 SD A 744.00 10/01/2014 10/14/2056

VV4660 OP OP F A 04/25/2014 1,436.92 BO A 800.00 07/24/2014 05/04/2028 F A 04/25/2014 1,436.92 P1 E 265.28 04/25/2015 05/05/2063 F A 04/25/2014 1,436.92 SC E 437.00 10/01/2014 08/31/2017 F A 04/25/2014 1,436.92 SD E 874.00 10/01/2014 05/05/2063

VV4906 OP OP F A 08/02/2014 2,392.33 PD S 1,540.39 02/24/2015 04/25/2062 F A 08/02/2014 2,392.33 SD A 1,543.00 02/01/2015 04/25/2062

VV4911 OP OP F A 02/22/2014 1,813.81 BO A 457.04 08/01/2014 08/01/2029 F A 02/22/2014 1,813.81 P1 E 334.86 02/22/2015 08/02/2064 F A 02/22/2014 1,813.81 SD A 1,287.00 08/01/2014 08/02/2064

VV4979 OP OP F A 07/09/2014 1,409.58 BO A 800.00 10/07/2014 07/08/2022 F A 07/09/2014 1,409.58 P1 E 463.86 07/09/2015 07/09/2057 F A 07/09/2014 1,409.58 SD E 874.00 01/01/2015 07/09/2057

VV5503 OP OP M A 07/09/2014 1,670.18 PD S 352.99 11/29/2014 01/06/2055 M A 07/09/2014 1,670.18 SC E 481.00 01/01/2015 09/30/2016 M A 07/09/2014 1,670.18 SD A 1,819.00 01/01/2015 01/06/2055

VV5506 OP OP F A 02/02/2014 3,385.20 PS S 878.74 07/04/2014 06/01/2050 F A 02/02/2014 3,385.20 SD E 1,347.00 07/01/2014 06/01/2050 F A 02/02/2014 3,385.20 WT S 3,222.54 02/13/2014 02/12/2017

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VV5517 OP OP M A 07/26/2014 1,506.83 BO A 800.00 10/24/2014 10/29/2038

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV5517 OP OP M A 07/26/2014 1,506.83 SC E 459.50 01/01/2015 12/31/2024 M A 07/26/2014 1,506.83 SD E 919.00 01/01/2015 10/30/2073

VV5531 OP OP M A 03/08/2014 1,608.52 BO A 800.00 03/01/2017 04/12/2027 M A 03/08/2014 1,608.52 P1 E 296.96 03/08/2015 04/13/2062 M A 03/08/2014 1,608.52 SD E 919.00 09/01/2014 04/13/2062 M A 03/08/2014 1,608.52 WT S 1,952.36 03/08/2014 03/07/2017

VV5554 OP OP F A 12/05/2013 703.20 BO A 676.15 04/01/2014 09/07/2020 F A 12/05/2013 703.20 P1 E 129.82 12/05/2014 09/08/2055 F A 12/05/2013 703.20 SC E 287.00 06/01/2014 08/31/2028 F A 12/05/2013 703.20 SD E 574.00 06/01/2014 09/08/2055 F A 12/05/2013 703.20 WT E 721.26 12/05/2013 12/04/2016

VV5573 OP OP F A 08/16/2014 843.05 BO A 800.00 11/14/2014 04/22/2035 F A 08/16/2014 843.05 P1 E 155.64 08/15/2015 04/23/2070 F A 08/16/2014 843.05 SC E 313.50 02/01/2015 05/31/2015 F A 08/16/2014 843.05 SD E 627.00 02/01/2015 04/23/2070

VV5581 OP OP F A 03/12/2014 3,194.37 BO A 800.00 09/01/2014 03/29/2028 F A 03/12/2014 3,194.37 P1 E 589.73 03/12/2015 03/30/2063 F A 03/12/2014 3,194.37 SD E 1,336.00 09/01/2014 03/30/2063

VV5592 OP OP M A 06/04/2014 4,267.13 BO A 181.84 10/01/2014 09/01/2016 M A 06/04/2014 4,267.13 PS A 1,917.17 08/23/2014 04/19/2050 M A 06/04/2014 4,267.13 SR A 2,004.00 10/01/2014 04/19/2050

VV5599 OP OP F A 06/19/2014 1,078.40 P1 E 200.00 06/19/2015 06/05/2065 F A 06/19/2014 1,078.40 SC E 365.50 12/01/2014 05/31/2023 F A 06/19/2014 1,078.40 SD E 731.00 12/01/2014 06/05/2065

VV5881 OP OP M A 06/25/2014 1,532.75 BO A 800.00 10/01/2014 04/13/2034 M A 06/25/2014 1,532.75 P1 E 282.97 06/24/2015 04/14/2069 M A 06/25/2014 1,532.75 SC E 459.50 12/01/2014 01/31/2025 M A 06/25/2014 1,532.75 SD E 919.00 12/01/2014 04/14/2069

VV5907 OP OP F A 06/27/2014 1,888.38 BO A 800.00 09/25/2014 09/24/2016 F A 06/27/2014 1,888.38 P1 E 200.00 06/28/2015 01/02/2068 F A 06/27/2014 1,888.38 SC E 522.50 12/01/2014 05/31/2024 F A 06/27/2014 1,888.38 SD E 1,045.00 12/01/2014 01/02/2068

VV5945 OP OP F A 06/10/2014 663.14 BO A 637.64 09/08/2014 05/02/2019 F A 06/10/2014 663.14 P1 E 122.43 06/10/2015 05/03/2054 F A 06/10/2014 663.14 SD E 574.00 11/01/2014 05/03/2054

VV6402 OP OP F A 05/09/2014 1,637.50 BO A 800.00 09/01/2014 08/06/2016 F A 05/09/2014 1,637.50 P1 E 302.31 05/09/2015 11/02/2063 F A 05/09/2014 1,637.50 SD E 962.00 11/01/2014 11/02/2063

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VV6425 OP OP F A 06/11/2014 2,820.40 BO A 375.73 12/01/2014 07/06/2023

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 69 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV6425 OP OP F A 06/11/2014 2,820.40 PD S 1,041.20 06/27/2014 07/07/2058 F A 06/11/2014 2,820.40 SD A 1,295.00 12/01/2014 07/07/2058

VV8909 OP OP F A 05/07/2014 930.43 P1 A 431.50 09/01/2014 02/10/2057 F A 05/07/2014 930.43 SD A 1,011.00 08/01/2014 02/10/2057

VV8921 OP OP F A 08/15/2013 711.26 P1 E 131.31 08/14/2014 05/21/2066 F A 08/15/2013 711.26 SC E 287.00 02/01/2014 12/31/2016 F A 08/15/2013 711.26 SD E 574.00 02/01/2014 05/21/2066 F A 08/15/2013 711.26 WT A 924.88 04/24/2014 05/20/2031

VV8939 OP OP M A 08/02/2014 1,352.00 BO A 800.00 10/31/2014 06/19/2029 M A 08/02/2014 1,352.00 P1 E 200.00 08/02/2015 06/20/2064 M A 08/02/2014 1,352.00 SD E 827.00 01/01/2015 06/20/2064

VV8955 OP OP F A 06/27/2014 05/29/2015 1,276.31 BO A 800.00 09/25/2014 05/29/2015 F A 06/27/2014 05/29/2015 1,276.31 P1 E 235.63 06/27/2015 10/26/2061 F A 06/27/2014 05/29/2015 1,276.31 SD E 827.00 12/01/2014 10/26/2061

VV8963 OP OP F A 06/24/2014 1,081.28 P1 E 199.62 06/24/2015 11/23/2053 F A 06/24/2014 1,081.28 SD A 1,340.00 01/01/2015 11/23/2053

VV8964 OP OP F A 06/05/2014 1,637.51 P1 S 800.00 04/01/2015 11/17/2045

VV8996 OP OP F A 06/28/2014 2,364.08 P1 E 200.00 06/28/2015 01/08/2057 F A 06/28/2014 2,364.08 SC E 579.00 12/01/2014 10/31/2020 F A 06/28/2014 2,364.08 SD E 1,158.00 12/01/2014 01/08/2057 F A 06/28/2014 2,364.08 WT S 3,637.05 06/28/2014 06/27/2017

VV9006 OP OP F A 09/11/2014 1,884.24 BO A 800.00 12/10/2014 12/30/2021 F A 09/11/2014 1,884.24 SD E 1,004.00 03/01/2015 12/31/2056

VV9035 OP OP F A 06/14/2014 1,530.59 BO A 800.00 09/12/2014 04/29/2044 F A 06/14/2014 1,530.59 SD E 919.00 12/01/2014 04/30/2079

VV9039 OP OP M A 06/27/2014 2,289.25 BO A 221.67 11/01/2014 09/24/2016 M A 06/27/2014 2,289.25 PD S 1,979.53 11/01/2014 12/26/2078 M A 06/27/2014 2,289.25 SC E 579.00 12/01/2014 01/31/2018 M A 06/27/2014 2,289.25 SD E 1,158.00 12/01/2014 12/26/2078

VV9055 OP OP M A 05/28/2014 804.39 BO A 773.46 08/26/2014 10/23/2026 M A 05/28/2014 804.39 SD E 627.00 11/01/2014 10/24/2061

VV9056 OP OP F A 09/13/2014 3,368.57 BO A 800.00 12/12/2014 11/15/2022 F A 09/13/2014 3,368.57 P1 E 200.00 09/13/2015 11/16/2057 F A 09/13/2014 3,368.57 SD E 1,347.00 03/01/2015 11/16/2057

VV9057 OP OP M A 12/27/2013 1,602.63 BO A 800.00 03/27/2014 01/01/2028

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M A 12/27/2013 1,602.63 P1 E 295.87 07/10/2015 01/02/2063

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV9083 OP OP F A 06/16/2014 1,465.54 BO A 800.00 09/14/2014 09/13/2016 F A 06/16/2014 1,465.54 P1 E 200.00 06/16/2015 06/07/2055 F A 06/16/2014 1,465.54 SD E 874.00 12/01/2014 06/07/2055

VV9622 OP OP F A 09/05/2014 1,883.32 BO A 800.00 12/04/2014 12/03/2016 F A 09/05/2014 1,883.32 PD S 775.70 12/29/2014 07/12/2061 F A 09/05/2014 1,883.32 SD E 1,004.00 03/01/2015 07/12/2061

VV9633 OP OP M A 06/26/2014 2,390.58 PS A 1,552.46 10/18/2014 08/12/2052 M A 06/26/2014 2,390.58 SD A 1,678.00 12/01/2014 08/12/2052 M A 06/26/2014 2,390.58 SR A 1,258.00 01/01/2015 08/12/2052

VV9635 OP OP M A 05/13/2014 2,847.23 BO A 579.73 11/01/2014 04/18/2019 M A 05/13/2014 2,847.23 SD A 2,158.00 11/01/2014 04/19/2054

VV9654 OP OP F A 06/06/2014 1,263.90 BO A 800.00 12/01/2014 04/20/2030 F A 06/06/2014 1,263.90 P1 E 243.41 06/05/2015 04/21/2065 F A 06/06/2014 1,263.90 RO S 1,319.44 03/22/2015 09/04/2015 F A 06/06/2014 1,263.90 SD E 827.00 12/01/2014 04/21/2065

VV9657 OP OP F A 04/14/2014 1,162.53 BO A 601.14 04/01/2017 04/30/2017 F A 04/14/2014 1,162.53 BO A 800.00 05/01/2017 08/25/2036 F A 04/14/2014 1,162.53 P1 E 214.62 04/13/2015 08/26/2071 F A 04/14/2014 1,162.53 SD E 779.00 10/01/2014 08/26/2071 F A 04/14/2014 1,162.53 WT S 1,192.31 04/15/2014 04/13/2017

VV9670 OP OP F A 07/08/2014 1,548.76 BO A 800.00 10/06/2014 10/05/2016 F A 07/08/2014 1,548.76 P1 E 285.92 07/08/2015 01/25/2067 F A 07/08/2014 1,548.76 SD E 919.00 01/01/2015 01/25/2067

VV9676 OP OP M A 06/10/2014 1,371.89 BO A 800.00 09/01/2017 07/16/2018 M A 06/10/2014 1,371.89 P1 E 253.85 06/09/2015 07/17/2053 M A 06/10/2014 1,371.89 SC E 437.00 12/01/2014 04/30/2018 M A 06/10/2014 1,371.89 SD E 874.00 12/01/2014 07/17/2053 M A 06/10/2014 1,371.89 WT S 1,464.55 09/08/2014 09/07/2017

VV9680 OP OP F A 07/01/2014 5,083.00 BO A 800.00 11/01/2014 11/18/2018 F A 07/01/2014 5,083.00 PS S 1,243.64 12/01/2014 11/19/2053 F A 07/01/2014 5,083.00 SD E 1,394.00 12/01/2014 11/19/2053

VV9689 OP OP F A 08/25/2014 3,143.13 BO A 800.00 11/23/2014 11/22/2017 F A 08/25/2014 3,143.13 P1 E 200.00 08/25/2015 02/06/2051 F A 08/25/2014 3,143.13 SD E 1,323.00 12/01/2014 02/06/2051

VV9690 OP OP F A 08/19/2014 580.94 BO A 558.59 11/17/2014 11/16/2016 F A 08/19/2014 580.94 P1 E 200.00 08/19/2015 10/24/2051 F A 08/19/2014 580.94 SD E 519.00 02/01/2015 10/24/2051

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VV9691 OP OP F A 06/06/2014 977.33 BO A 800.00 10/01/2014 10/09/2022 F A 06/06/2014 977.33 P1 E 200.00 06/06/2015 10/10/2057

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VV9691 OP OP F A 06/06/2014 977.33 SD E 731.00 12/01/2014 10/10/2057

VV9693 OP OP M A 10/02/2014 1,324.32 BO A 800.00 12/31/2014 06/30/2018 M A 10/02/2014 1,324.32 P1 S 2,037.42 11/16/2014 12/14/2052 M A 10/02/2014 1,324.32 SD E 827.00 03/01/2015 12/14/2052

VV9802 OP OP F A 05/12/2014 1,927.46 BO A 800.00 11/01/2014 08/09/2016 F A 05/12/2014 1,927.46 P1 E 200.00 05/12/2015 07/25/2053 F A 05/12/2014 1,927.46 SD E 1,045.00 11/01/2014 07/25/2053

VV9902 OP OP F A 07/03/2014 1,306.74 BO A 23.16 01/01/2015 04/11/2021 F A 07/03/2014 1,306.74 SD A 1,188.00 01/01/2015 04/12/2056

VV9905 OP OP F A 05/25/2014 908.70 BO A 800.00 02/01/2015 09/27/2024 F A 05/25/2014 908.70 P1 E 170.81 05/23/2015 09/28/2059 F A 05/25/2014 908.70 SD E 679.00 11/01/2014 09/28/2059

VV9906 OP OP F A 06/10/2014 1,239.34 BO A 800.00 01/01/2015 09/07/2016 F A 06/10/2014 1,239.34 SD E 827.00 12/01/2014 04/19/2064

VV9944 OP OP F A 07/16/2014 1,657.03 PD S 651.72 12/20/2014 01/17/2066 F A 07/16/2014 1,657.03 SC E 481.00 01/01/2015 08/31/2019 F A 07/16/2014 1,657.03 SD A 1,336.00 01/01/2015 01/17/2066

VV9968 OP OP M A 06/03/2014 1,997.18 BO A 800.00 11/01/2014 06/20/2032 M A 06/03/2014 1,997.18 P1 E 200.00 06/03/2015 06/21/2067 M A 06/03/2014 1,997.18 SD E 1,045.00 12/01/2014 06/21/2067

VV9973 OP OP M A 07/25/2014 1,777.83 BO A 800.00 11/01/2014 06/21/2038 M A 07/25/2014 1,777.83 P1 E 200.00 07/25/2015 06/14/2075 M A 07/25/2014 1,777.83 SD E 1,004.00 01/01/2015 06/14/2075

VV9983 OP OP F A 10/01/2014 3,986.39 BO A 800.00 12/30/2014 10/24/2028 F A 10/01/2014 3,986.39 P1 S 1,239.04 04/01/2015 10/25/2063 F A 10/01/2014 3,986.39 SC E 697.00 03/01/2015 08/31/2024 F A 10/01/2014 3,986.39 SD A 1,659.00 03/01/2015 10/25/2063

VW0000 OP OP F A 05/09/2014 1,285.26 PS A 782.51 07/20/2013 10/25/2059 F A 05/09/2014 1,285.26 SD A 1,168.00 11/01/2014 10/25/2059

VW0017 OP OP F A 03/15/2014 1,157.60 BO A 800.00 06/13/2014 06/12/2016 F A 03/15/2014 1,157.60 P1 E 213.71 03/15/2015 07/05/2065 F A 03/15/2014 1,157.60 SD E 779.00 09/01/2014 07/05/2065

VW0019 OP OP F A 06/07/2014 2,051.17 BO A 340.07 02/01/2015 02/11/2037 F A 06/07/2014 2,051.17 PD S 1,632.21 01/29/2015 02/12/2072 F A 06/07/2014 2,051.17 SD E 1,084.00 12/01/2014 02/12/2072

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VW0030 OP OP F A 07/14/2014 2,612.68 BO A 800.00 12/01/2014 01/22/2021 F A 07/14/2014 2,612.68 PS S 1,627.77 10/08/2014 01/23/2056

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW0030 OP OP F A 07/14/2014 2,612.68 SD E 1,226.00 12/01/2014 01/23/2056

VW0038 OP OP M A 07/29/2014 1,394.64 SD A 1,598.00 01/01/2015 06/22/2053

VW0059 OP OP M A 07/23/2014 2,351.33 BO A 53.10 07/01/2017 07/31/2017 M A 07/23/2014 2,351.33 BO A 800.00 08/01/2017 12/08/2031 M A 07/23/2014 2,351.33 P1 E 200.00 07/23/2015 12/09/2066 M A 07/23/2014 2,351.33 SD E 1,158.00 01/01/2015 12/09/2066 M A 07/23/2014 2,351.33 WT S 3,259.12 07/22/2014 07/21/2017

VW0067 OP OP M A 08/06/2014 2,260.91 BO A 800.00 11/04/2014 05/08/2020 M A 08/06/2014 2,260.91 PD S 757.71 11/01/2014 05/08/2055 M A 08/06/2014 2,260.91 SD E 1,122.00 02/01/2015 05/09/2055 M A 08/06/2014 2,260.91 WT E 971.00 08/06/2014 08/05/2017

VW0087 OP OP F A 07/24/2014 2,715.74 BO A 800.00 10/22/2014 02/25/2040 F A 07/24/2014 2,715.74 SC E 629.00 01/01/2015 01/31/2027 F A 07/24/2014 2,715.74 SD E 1,258.00 01/01/2015 02/26/2075

VW0097 OP OP M A 10/09/2014 2,292.66 BO A 800.00 04/01/2015 04/02/2027 M A 10/09/2014 2,292.66 P1 E 423.26 10/09/2015 04/03/2062 M A 10/09/2014 2,292.66 SD E 1,158.00 04/01/2015 04/03/2062

VW0098 OP OP F A 08/07/2014 1,659.58 BO A 695.54 11/05/2014 05/04/2018 F A 08/07/2014 1,659.58 PS S 900.21 11/01/2014 05/04/2018 F A 08/07/2014 1,659.58 SD E 962.00 02/01/2015 10/21/2052

VW0803 OP OP F A 05/13/2014 2,785.58 BO A 800.00 11/01/2014 06/22/2040 F A 05/13/2014 2,785.58 P1 E 514.26 02/01/2015 06/23/2075 F A 05/13/2014 2,785.58 SD E 1,258.00 02/01/2015 06/23/2075

VW1116 OP OP F A 09/23/2014 4,303.00 BO A 800.00 01/01/2015 12/28/2027 F A 09/23/2014 4,303.00 PS S 3,219.16 01/01/2015 12/29/2062 F A 09/23/2014 4,303.00 SD E 1,394.00 03/01/2015 12/29/2062

VW1121 OP OP F A 03/02/2014 1,093.16 BO A 800.00 01/01/2017 04/02/2018 F A 03/02/2014 1,093.16 P1 E 201.81 03/02/2015 04/03/2053 F A 03/02/2014 1,093.16 SD E 731.00 08/01/2014 04/03/2053 F A 03/02/2014 1,093.16 WT S 1,122.81 01/03/2014 01/02/2017

VW1128 OP OP F A 10/14/2014 1,158.24 P1 E 213.83 10/14/2015 10/02/2069 F A 10/14/2014 1,158.24 SC E 389.50 04/01/2015 11/30/2017 F A 10/14/2014 1,158.24 SD A 1,123.00 04/01/2015 10/02/2069

VW1131 OP OP M A 10/06/2014 1,831.81 BO A 800.00 01/04/2015 01/16/2051 M A 10/06/2014 1,831.81 P1 E 338.18 10/05/2015 01/17/2086 M A 10/06/2014 1,831.81 SC E 502.00 04/01/2015 02/29/2032 M A 10/06/2014 1,831.81 SD E 1,004.00 04/01/2015 01/17/2086

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VW1148 OP OP F A 09/11/2014 1,111.50 PD S 277.36 01/17/2015 01/28/2068

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW1148 OP OP F A 09/11/2014 1,111.50 SD A 866.00 03/01/2015 01/28/2068

VW1154 OP OP M A 04/26/2014 2,104.05 P1 E 391.03 04/25/2015 02/11/2061 M A 04/26/2014 2,104.05 SD E 1,084.00 10/01/2014 02/11/2061 M A 04/26/2014 2,104.05 WT S 2,206.15 04/28/2014 04/26/2017

VW1158 OP OP F A 08/12/2014 1,260.79 BO A 800.00 11/10/2014 12/14/2019 F A 08/12/2014 1,260.79 PS S 317.93 12/15/2014 12/15/2054 F A 08/12/2014 1,260.79 SD E 827.00 02/01/2015 12/15/2054

VW1190 OP OP F A 09/20/2014 3,421.00 BO A 800.00 12/19/2014 07/03/2037 F A 09/20/2014 3,421.00 SC A 419.00 05/01/2014 07/31/2018 F A 09/20/2014 3,421.00 SD A 1,676.00 05/01/2014 07/04/2072

VW1192 OP OP M A 09/02/2014 1,595.41 BO A 800.00 12/01/2014 11/30/2016 M A 09/02/2014 1,595.41 P1 E 294.54 09/02/2015 07/30/2049 M A 09/02/2014 1,595.41 SR E 919.00 08/01/2014 07/30/2049

VW1197 OP OP M A 08/05/2014 788.00 BO A 757.69 11/03/2014 01/17/2026 M A 08/05/2014 788.00 SD E 627.00 02/01/2015 01/18/2061

VW1215 OP OP F A 04/07/2014 2,302.79 P1 E 425.13 07/15/2015 09/05/2082 F A 04/07/2014 2,302.79 SC E 579.00 01/01/2015 08/31/2025 F A 04/07/2014 2,302.79 SD E 1,158.00 01/01/2015 09/05/2082 F A 04/07/2014 2,302.79 WT S 2,790.89 08/22/2014 08/21/2017

VW1249 OP OP F A 08/05/2014 1,092.49 BO A 800.00 11/03/2014 09/10/2029 F A 08/05/2014 1,092.49 P1 E 201.69 06/05/2015 09/11/2064 F A 08/05/2014 1,092.49 SD E 731.00 12/01/2014 09/11/2064

VW1257 OP OP M A 08/29/2014 1,231.11 PD S 239.50 12/01/2014 06/16/2043

VW1661 OP OP F A 11/04/2014 2,778.37 P1 S 1,223.45 03/01/2015 09/03/2058 F A 11/04/2014 2,778.37 SD A 1,486.00 05/01/2015 09/03/2058

VW1921 OP OP M A 08/22/2014 1,487.20 BO A 800.00 11/20/2014 04/18/2038 M A 08/22/2014 1,487.20 SC E 437.00 02/01/2015 02/28/2026 M A 08/22/2014 1,487.20 SD E 874.00 02/01/2015 04/19/2073

VW1926 OP OP F A 10/15/2014 997.05 BO A 800.00 01/13/2015 09/06/2044 F A 10/15/2014 997.05 P1 E 200.00 10/15/2015 09/07/2079 F A 10/15/2014 997.05 SC E 365.50 04/01/2015 10/31/2020 F A 10/15/2014 997.05 SD E 731.00 04/01/2015 09/07/2079

VW1933 OP OP F A 07/03/2014 1,369.02 PS S 334.16 10/01/2014 03/06/2051 F A 07/03/2014 1,369.02 RO S 0.00 10/01/2014 09/30/2015 F A 07/03/2014 1,369.02 SD A 1,232.00 12/01/2014 03/06/2051

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VW1936 OP OP F A 08/21/2014 2,991.17 BO A 800.00 11/19/2014 05/18/2018 F A 08/21/2014 2,991.17 PS A 1,798.15 08/21/2014 05/18/2018

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW1936 OP OP F A 08/21/2014 2,991.17 P1 E 200.00 08/21/2015 06/15/2052 F A 08/21/2014 2,991.17 SD E 1,310.00 02/01/2015 06/15/2052

VW1937 OP OP F A 10/16/2014 3,347.50 BO A 800.00 01/14/2015 06/16/2042 F A 10/16/2014 3,347.50 P1 E 618.00 02/18/2015 06/17/2077 F A 10/16/2014 3,347.50 SD E 1,347.00 08/01/2014 06/17/2077

VW1947 OP OP F A 10/27/2014 1,076.82 BO A 800.00 01/25/2015 10/03/2031 F A 10/27/2014 1,076.82 P1 E 200.00 10/25/2015 10/04/2066 F A 10/27/2014 1,076.82 SD E 731.00 04/01/2015 10/04/2066

VW2210 OP OP F A 08/01/2014 2,681.36 P1 S 2,000.00 08/01/2014 10/16/2059 F A 08/01/2014 2,681.36 SD S 1,669.00 02/01/2015 10/16/2059

VW2223 OP OP M A 06/19/2014 1,667.97 BO A 800.00 09/17/2014 09/16/2016 M A 06/19/2014 1,667.97 P1 E 200.00 06/19/2015 11/15/2061 M A 06/19/2014 1,667.97 SD E 962.00 12/01/2014 11/15/2061

VW2228 OP OP F A 10/22/2014 2,705.09 BO A 800.00 01/20/2015 08/10/2036 F A 10/22/2014 2,705.09 P1 E 200.00 10/22/2015 08/11/2071 F A 10/22/2014 2,705.09 SD E 1,258.00 04/01/2015 08/11/2071

VW2229 OP OP M A 06/18/2014 1,677.75 BO A 526.79 07/01/2017 08/07/2023 M A 06/18/2014 1,677.75 PD S 1,086.44 11/15/2014 08/08/2058 M A 06/18/2014 1,677.75 SD E 962.00 12/01/2014 08/08/2058 M A 06/18/2014 1,677.75 WT S 2,722.42 06/19/2014 06/18/2017

VW2252 OP OP F A 07/11/2014 1,271.45 BO A 800.00 10/09/2014 10/23/2022 F A 07/11/2014 1,271.45 P1 E 522.64 07/09/2015 10/24/2057 F A 07/11/2014 1,271.45 SD E 827.00 01/01/2015 10/24/2057

VW2286 OP OP F A 12/03/2014 1,792.59 BO A 800.00 03/03/2015 03/27/2021 F A 12/03/2014 1,792.59 P1 E 200.00 12/03/2015 03/28/2056 F A 12/03/2014 1,792.59 SD E 1,004.00 06/01/2015 03/28/2056

VW2413 OP OP M A 09/12/2014 585.00 BO A 562.50 12/11/2014 06/02/2033 M A 09/12/2014 585.00 SC E 287.00 03/01/2015 12/31/2017 M A 09/12/2014 585.00 SD E 574.00 03/01/2015 06/03/2068

VW2421 OP OP F A 07/12/2014 1,984.13 BO A 800.00 10/10/2014 12/29/2036 F A 07/12/2014 1,984.13 P1 E 366.30 07/12/2015 12/30/2071 F A 07/12/2014 1,984.13 SC E 522.50 01/01/2015 07/31/2016 F A 07/12/2014 1,984.13 SD E 1,045.00 01/01/2015 12/30/2071

VW2704 OP OP M A 07/11/2014 1,885.79 BO A 800.00 11/01/2014 09/13/2029 M A 07/11/2014 1,885.79 P1 E 348.15 07/01/2015 09/14/2064 M A 07/11/2014 1,885.79 SD E 1,045.00 12/01/2014 09/14/2064

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VW2705 OP OP F A 09/24/2014 1,125.48 BO A 800.00 12/23/2014 04/26/2021 F A 09/24/2014 1,125.48 P1 E 200.00 09/24/2015 04/27/2056

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW2705 OP OP F A 09/24/2014 1,125.48 SD E 779.00 03/01/2015 04/27/2056

VW2763 OP OP F A 11/07/2013 1,019.92 BO A 800.00 12/01/2014 05/03/2021 F A 11/07/2013 1,019.92 P1 E 200.00 11/07/2014 05/04/2056 F A 11/07/2013 1,019.92 SD E 731.00 05/01/2014 05/04/2056

VW2769 OP OP F A 08/13/2014 1,472.46 BO A 708.74 08/01/2017 08/31/2017 F A 08/13/2014 1,472.46 BO A 800.00 09/01/2017 05/31/2034 F A 08/13/2014 1,472.46 P1 E 200.00 08/13/2015 06/01/2069 F A 08/13/2014 1,472.46 SD E 874.00 02/01/2015 06/01/2069 F A 08/13/2014 1,472.46 WT S 1,826.66 08/13/2014 08/12/2017

VW2784 OP OP F A 09/27/2014 1,857.88 BO A 800.00 12/26/2014 11/14/2033 F A 09/27/2014 1,857.88 SD E 1,004.00 03/01/2015 11/15/2068

VW2787 OP OP F A 10/14/2014 2,085.41 BO A 800.00 01/12/2015 06/10/2023 F A 10/14/2014 2,085.41 P1 E 200.00 10/14/2015 06/11/2058 F A 10/14/2014 2,085.41 SD E 1,084.00 04/01/2015 06/11/2058

VW2795 OP OP F A 10/28/2014 1,064.49 BO A 800.00 01/26/2015 12/26/2033 F A 10/28/2014 1,064.49 P1 E 200.00 10/28/2015 12/27/2068 F A 10/28/2014 1,064.49 SC E 365.50 04/01/2015 06/30/2025 F A 10/28/2014 1,064.49 SD E 731.00 04/01/2015 12/27/2068

VW2798 OP OP F A 08/23/2014 694.90 BO A 668.18 01/01/2015 06/03/2021 F A 08/23/2014 694.90 P1 E 157.46 08/21/2015 06/04/2056 F A 08/23/2014 694.90 SD E 574.00 02/01/2015 06/04/2056

VW2814 OP OP M A 09/23/2014 1,812.60 BO A 424.91 12/22/2014 02/26/2039 M A 09/23/2014 1,812.60 PD S 1,317.97 12/13/2014 02/27/2074 M A 09/23/2014 1,812.60 SD E 1,004.00 03/01/2015 02/27/2074

VW2857 OP OP M A 10/16/2014 3,207.63 PD S 2,151.21 05/09/2015 12/10/2055 M A 10/16/2014 3,207.63 SD A 1,983.00 04/01/2015 12/10/2055

VW2885 OP OP F A 11/13/2014 942.92 BO A 800.00 02/11/2015 01/04/2021 F A 11/13/2014 942.92 P1 E 365.05 11/12/2015 01/05/2056 F A 11/13/2014 942.92 SD E 679.00 05/01/2015 01/05/2056

VW2893 OP OP M A 08/21/2014 1,626.24 P1 E 200.00 08/21/2015 08/03/2056 M A 08/21/2014 1,626.24 SD E 962.00 02/01/2015 08/03/2056

VW2933 OP OP F A 10/30/2014 1,083.77 BO A 800.00 01/28/2015 02/18/2029 F A 10/30/2014 1,083.77 SD E 731.00 04/01/2015 02/19/2064

VW2936 OP OP F A 08/06/2014 1,988.35 BO A 800.00 01/01/2015 12/20/2020 F A 08/06/2014 1,988.35 P1 E 545.64 08/06/2015 12/21/2055 F A 08/06/2014 1,988.35 SD E 1,045.00 02/01/2015 12/21/2055

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VW2941 OP OP M A 10/06/2014 816.45 BO A 785.05 01/04/2015 07/03/2017

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW2941 OP OP M A 10/06/2014 816.45 P1 E 200.00 10/06/2015 01/01/2050

VW2958 OP OP F A 08/12/2014 2,512.41 PD S 457.65 02/01/2015 10/05/2058 F A 08/12/2014 2,512.41 SD A 1,562.00 12/01/2014 10/05/2058

VW2970 OP OP F A 10/11/2014 2,110.63 BO A 800.00 01/09/2015 12/08/2027 F A 10/11/2014 2,110.63 P1 E 200.00 10/11/2015 12/09/2062 F A 10/11/2014 2,110.63 SD E 1,084.00 04/01/2015 12/09/2062

VW2983 OP OP F A 09/27/2014 1,191.07 BO A 800.00 12/26/2014 05/22/2019 F A 09/27/2014 1,191.07 P1 E 200.00 09/27/2015 05/23/2054 F A 09/27/2014 1,191.07 SD E 779.00 03/01/2015 05/23/2054

VW3028 OP OP F A 09/05/2014 1,093.95 BO A 48.94 09/01/2017 09/30/2017 F A 09/05/2014 1,093.95 BO A 198.88 10/01/2017 06/03/2018 F A 09/05/2014 1,093.95 P1 E 200.00 09/05/2015 03/27/2052 F A 09/05/2014 1,093.95 SD E 731.00 03/01/2015 03/27/2052 F A 09/05/2014 1,093.95 SR S 853.00 09/24/2014 03/27/2052 F A 09/05/2014 1,093.95 WT S 1,124.54 09/18/2014 09/04/2017

VW3116 OP OP F A 09/27/2014 2,637.75 PD S 1,648.06 03/06/2015 04/12/2056 F A 09/27/2014 2,637.75 SD A 1,715.00 03/01/2015 04/12/2056

VW3161 OP OP F A 12/05/2014 1,320.42 BO A 800.00 03/05/2015 11/30/2031 F A 12/05/2014 1,320.42 P1 E 200.00 12/05/2015 12/01/2066 F A 12/05/2014 1,320.42 SD E 827.00 06/01/2015 12/01/2066

VW3172 OP OP F A 08/12/2014 1,486.60 BO A 800.00 11/10/2014 03/27/2023 F A 08/12/2014 1,486.60 P1 E 301.31 08/12/2015 03/28/2058 F A 08/12/2014 1,486.60 SD E 874.00 02/01/2015 03/28/2058

VW3174 OP OP F A 08/25/2014 1,157.11 BO A 800.00 12/01/2014 06/14/2025 F A 08/25/2014 1,157.11 SD A 944.00 02/01/2015 06/14/2025

VW3177 OP OP M A 09/29/2014 2,252.30 BO A 417.90 03/28/2015 03/25/2043 M A 09/29/2014 2,252.30 PD S 1,747.78 03/03/2015 03/26/2078 M A 09/29/2014 2,252.30 SC E 561.00 03/01/2015 07/31/2024 M A 09/29/2014 2,252.30 SD E 1,122.00 03/01/2015 03/26/2078

VW3314 OP OP F A 04/30/2014 1,313.27 P1 E 200.00 04/30/2015 02/22/2060 F A 04/30/2014 1,313.27 SD E 827.00 10/01/2014 02/22/2060 F A 04/30/2014 1,313.27 WT S 3,222.54 04/30/2014 04/29/2017

VW3325 OP OP F A 09/07/2014 1,949.88 BO A 800.00 01/01/2015 02/03/2023 F A 09/07/2014 1,949.88 P1 E 477.36 09/03/2015 02/04/2058 F A 09/07/2014 1,949.88 SD E 1,045.00 03/01/2015 02/04/2058

VW3331 OP OP F A 08/23/2014 1,017.95 BO A 800.00 03/01/2015 11/20/2016

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F A 08/23/2014 1,017.95 P1 E 187.93 08/23/2015 04/02/2065 F A 08/23/2014 1,017.95 SD E 731.00 02/01/2015 04/02/2065

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 77 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW3335 OP OP F A 09/10/2014 05/10/2015 961.66 BO A 96.52 12/09/2014 05/10/2015 F A 09/10/2014 05/10/2015 961.66 P1 E 200.00 09/10/2015 07/05/2055 F A 09/10/2014 05/10/2015 961.66 SD E 679.00 03/01/2015 07/05/2055 F A 09/10/2014 05/10/2015 961.66 WT S 828.17 09/13/2014 09/12/2017

VW3366 OP OP F A 07/20/2014 1,499.39 PD S 401.10 01/15/2015 03/19/2055 F A 07/20/2014 1,499.39 SD S 1,245.00 01/01/2015 03/19/2055

VW3368 OP OP F A 10/01/2014 1,357.58 BO A 800.00 12/30/2014 07/08/2021 F A 10/01/2014 1,357.58 P1 E 200.00 10/01/2015 07/09/2056 F A 10/01/2014 1,357.58 SD E 827.00 03/01/2015 07/09/2056

VW3379 OP OP F A 07/15/2014 1,734.82 BO A 800.00 12/01/2014 07/30/2022 F A 07/15/2014 1,734.82 P1 E 200.00 07/15/2015 07/31/2057 F A 07/15/2014 1,734.82 SD E 962.00 01/01/2015 07/31/2057

VW3380 OP OP M A 02/13/2014 4,626.75 BO A 800.00 04/01/2015 05/13/2016 M A 02/13/2014 4,626.75 PS A 3,039.58 02/13/2014 09/28/2054 M A 02/13/2014 4,626.75 SD E 1,394.00 05/01/2015 09/28/2054

VW3384 OP OP M A 04/08/2014 5,732.04 BO A 800.00 09/01/2014 10/18/2033 M A 04/08/2014 5,732.04 P1 E 1,058.22 04/08/2015 10/19/2068 M A 04/08/2014 5,732.04 SD E 1,394.00 04/01/2015 10/19/2068

VW3440 OP OP F A 08/16/2014 2,859.79 BO A 800.00 11/14/2014 12/27/2036 F A 08/16/2014 2,859.79 P1 E 527.96 08/15/2015 12/28/2071 F A 08/16/2014 2,859.79 SC E 644.00 02/01/2015 06/30/2031 F A 08/16/2014 2,859.79 SD E 1,288.00 02/01/2015 12/28/2071

VW3468 OP OP M A 09/12/2014 1,490.38 BO A 139.12 01/01/2015 11/19/2022 M A 09/12/2014 1,490.38 PS A 1,293.94 09/12/2014 11/20/2057 M A 09/12/2014 1,490.38 SD E 874.00 03/01/2015 11/20/2057

VW3477 OP OP F A 08/12/2014 1,184.36 BO A 800.00 11/10/2014 01/15/2030 F A 08/12/2014 1,184.36 P1 E 200.00 08/12/2015 01/16/2065 F A 08/12/2014 1,184.36 SD E 779.00 02/01/2015 01/16/2065

VW3489 OP OP M A 10/29/2014 4,776.80 BO A 800.00 01/27/2015 07/21/2030 M A 10/29/2014 4,776.80 P1 E 881.87 01/30/2016 07/22/2065 M A 10/29/2014 4,776.80 SD A 2,367.00 07/01/2015 07/22/2065

VW4302 OP OP F A 10/12/2014 1,088.52 BO A 800.00 01/10/2015 11/16/2033 F A 10/12/2014 1,088.52 P1 E 200.96 10/12/2015 11/17/2068 F A 10/12/2014 1,088.52 SD E 731.00 04/01/2015 11/17/2068

VW4303 OP OP F A 11/11/2014 1,272.32 BO A 800.00 02/09/2015 02/06/2019 F A 11/11/2014 1,272.32 P1 E 200.00 11/11/2015 02/07/2054 F A 11/11/2014 1,272.32 SD E 827.00 05/01/2015 02/07/2054

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VW4362 OP OP F A 09/13/2014 1,970.54 P1 A 441.03 12/11/2014 11/17/2060

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 78 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW4362 OP OP F A 09/13/2014 1,970.54 SD A 1,477.00 03/01/2015 11/17/2060

VW4368 OP OP M A 06/25/2014 1,112.90 BO A 800.00 09/23/2014 12/05/2034 M A 06/25/2014 1,112.90 SC E 389.50 12/01/2014 07/31/2023 M A 06/25/2014 1,112.90 SD E 779.00 12/01/2014 12/06/2069

VW4430 OP OP F A 08/13/2014 3,035.08 BO A 800.00 11/11/2014 12/18/2044 F A 08/13/2014 3,035.08 P1 E 200.00 08/13/2015 12/19/2079 F A 08/13/2014 3,035.08 SD E 1,310.00 02/01/2015 12/19/2079

VW4443 OP OP F A 10/01/2014 2,652.00 BO A 800.00 12/30/2014 04/17/2041 F A 10/01/2014 2,652.00 P1 E 489.60 10/01/2015 04/18/2076 F A 10/01/2014 2,652.00 SC E 613.00 03/01/2015 10/31/2026 F A 10/01/2014 2,652.00 SD E 1,226.00 03/01/2015 04/18/2076

VW4489 OP OP M A 11/03/2014 2,467.35 BO A 303.26 03/01/2015 11/14/2031 M A 11/03/2014 2,467.35 PD S 2,069.19 02/04/2015 11/15/2066 M A 11/03/2014 2,467.35 SC E 596.50 05/01/2015 08/31/2024 M A 11/03/2014 2,467.35 SD E 1,193.00 05/01/2015 11/15/2066

VW4491 OP OP M A 12/09/2014 1,405.90 BO A 800.00 03/09/2015 02/14/2025 M A 12/09/2014 1,405.90 P1 E 259.55 12/09/2015 02/15/2060 M A 12/09/2014 1,405.90 SD E 874.00 06/01/2015 02/15/2060

VW4613 OP OP F A 09/10/2014 1,388.13 BO A 800.00 12/09/2014 12/06/2047 F A 09/10/2014 1,388.13 P1 E 256.27 09/10/2015 12/07/2082 F A 09/10/2014 1,388.13 SD E 874.00 03/01/2015 12/07/2082

VW4615 OP OP F A 11/18/2014 1,797.30 BO A 373.18 05/01/2015 09/23/2020 F A 11/18/2014 1,797.30 SD A 1,355.00 05/01/2015 09/24/2055

VW4620 OP OP F A 10/07/2014 2,945.05 BO A 800.00 01/05/2015 09/23/2033 F A 10/07/2014 2,945.05 SC E 655.00 04/01/2015 11/30/2016 F A 10/07/2014 2,945.05 SD E 1,310.00 04/01/2015 09/24/2068

VW4621 OP OP M A 07/11/2014 2,082.44 PL A 445.53 02/20/2015 07/31/2067 M A 07/11/2014 2,082.44 SD S 1,601.00 01/01/2015 07/31/2067

VW4645 OP OP M A 09/03/2014 1,673.75 BO A 773.53 10/01/2017 10/31/2017 M A 09/03/2014 1,673.75 BO A 800.00 11/01/2017 09/06/2035 M A 09/03/2014 1,673.75 P1 E 200.00 09/04/2015 09/07/2070 M A 09/03/2014 1,673.75 SC E 481.00 03/01/2015 08/31/2021 M A 09/03/2014 1,673.75 SD E 962.00 03/01/2015 09/07/2070 M A 09/03/2014 1,673.75 WT S 1,619.46 10/17/2014 10/16/2017

VW4666 OP OP F A 10/24/2014 983.17 BO A 800.00 07/01/2015 06/27/2029 F A 10/24/2014 983.17 P1 E 664.36 10/24/2015 06/28/2064 F A 10/24/2014 983.17 SD E 731.00 04/01/2015 06/28/2064

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F A 10/24/2014 983.17 SL S 1,718.83 10/24/2014 06/30/2015

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 79 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW4669 OP OP M A 11/15/2014 1,194.43 BO A 800.00 02/13/2015 03/11/2033 M A 11/15/2014 1,194.43 P1 E 200.00 11/15/2015 03/12/2068 M A 11/15/2014 1,194.43 SD E 827.00 05/01/2015 03/12/2068 M A 11/15/2014 1,194.43 WT E 971.00 11/15/2014 11/14/2017

VW4696 OP OP F A 12/06/2014 1,574.74 BO A 800.00 03/06/2015 05/31/2015 F A 12/06/2014 1,574.74 BO A 522.17 06/01/2015 07/26/2023 F A 12/06/2014 1,574.74 P1 E 200.00 12/06/2015 07/27/2058 F A 12/06/2014 1,574.74 SD E 919.00 06/01/2015 07/27/2058

VW4737 OP OP F A 09/17/2014 1,308.50 BO A 800.00 12/16/2014 10/06/2019 F A 09/17/2014 1,308.50 P1 E 200.00 09/17/2015 10/07/2054 F A 09/17/2014 1,308.50 SD E 827.00 03/01/2015 10/07/2054

VW4787 OP OP F A 08/30/2014 963.82 PS S 300.00 07/01/2014 11/30/2043 F A 08/30/2014 963.82 SR S 1,256.00 01/01/2015 11/30/2043

VW4809 OP OP M A 11/15/2014 1,670.18 SD A 2,129.00 05/01/2015 10/31/2060

VW4826 OP OP M A 12/03/2014 4,271.03 BO A 800.00 03/03/2015 11/19/2020 M A 12/03/2014 4,271.03 P1 E 200.00 12/03/2015 11/20/2055 M A 12/03/2014 4,271.03 SD E 1,394.00 06/01/2015 11/20/2055

VW4836 OP OP F A 10/31/2014 1,614.76 BO A 800.00 01/29/2015 03/26/2035 F A 10/31/2014 1,614.76 P1 E 200.00 11/01/2015 03/27/2070 F A 10/31/2014 1,614.76 SD E 919.00 04/01/2015 03/27/2070

VW4859 OP OP F A 08/10/2014 769.60 BO A 740.00 03/01/2015 08/08/2022 F A 08/10/2014 769.60 P1 E 200.00 08/10/2015 08/09/2057 F A 08/10/2014 769.60 SC E 313.50 12/01/2014 04/30/2016 F A 08/10/2014 769.60 SD E 627.00 12/01/2014 08/09/2057

VW4876 OP OP F A 10/31/2014 05/10/2015 702.19 BO A 675.18 01/29/2015 05/10/2015 F A 10/31/2014 05/10/2015 702.19 P1 E 129.63 10/30/2015 04/05/2067 F A 10/31/2014 05/10/2015 702.19 SD E 574.00 04/01/2015 04/05/2067

VW4898 OP OP M A 07/19/2014 993.58 BO A 786.61 10/17/2014 03/28/2024 M A 07/19/2014 993.58 P1 E 200.00 07/19/2015 03/29/2059 M A 07/19/2014 993.58 SD E 731.00 01/01/2015 03/29/2059

VW4912 OP OP F A 11/18/2014 1,752.29 BO A 800.00 02/16/2015 10/31/2029 F A 11/18/2014 1,752.29 P1 E 200.00 10/01/2015 11/01/2064 F A 11/18/2014 1,752.29 RO S 1,806.21 02/16/2015 02/15/2016

VW4920 OP OP F A 10/31/2014 935.86 BO A 800.00 01/29/2015 10/26/2020 F A 10/31/2014 935.86 P1 E 172.77 10/30/2015 10/27/2055 F A 10/31/2014 935.86 SD E 679.00 04/01/2015 10/27/2055

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VW4952 OP OP F A 12/20/2014 3,570.03 BO A 800.00 05/01/2015 11/12/2030 F A 12/20/2014 3,570.03 P1 E 200.00 12/20/2015 11/13/2065

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 80 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW4952 OP OP F A 12/20/2014 3,570.03 SD E 1,388.00 06/01/2015 11/13/2065

VW4982 OP OP F A 04/28/2014 2,424.64 BO A 800.00 07/01/2015 08/03/2038 F A 04/28/2014 2,424.64 P1 E 447.63 09/12/2015 08/14/2073 F A 04/28/2014 2,424.64 SD E 1,193.00 03/01/2015 08/14/2073 F A 04/28/2014 2,424.64 SL A 3,882.33 09/13/2014 06/30/2015

VW4989 OP OP F A 09/09/2014 2,491.66 BO A 558.83 03/01/2015 11/11/2023 F A 09/09/2014 2,491.66 P1 E 200.00 09/09/2015 11/12/2058 F A 09/09/2014 2,491.66 SD A 1,837.00 03/01/2015 11/12/2058

VW4996 OP OP F A 12/17/2014 06/06/2015 1,631.34 SD E 962.00 06/01/2015 03/10/2085 F A 12/17/2014 06/06/2015 1,631.34 WT S 1,683.94 01/08/2015 12/16/2017

VW4998 OP OP F A 10/02/2014 2,685.69 P1 S 979.74 12/02/2014 01/10/2051 F A 10/02/2014 2,685.69 SR A 1,395.00 03/01/2015 01/10/2051

VW5030 OP OP M A 08/06/2014 2,369.32 BO A 800.00 11/04/2014 03/01/2041 M A 08/06/2014 2,369.32 P1 E 200.00 08/06/2015 03/02/2076 M A 08/06/2014 2,369.32 RO S 1,224.21 03/24/2015 03/23/2016 M A 08/06/2014 2,369.32 RO S 1,250.00 03/24/2016 03/23/2017 M A 08/06/2014 2,369.32 SC E 596.50 02/01/2015 01/31/2027 M A 08/06/2014 2,369.32 SD E 1,193.00 02/01/2015 03/02/2076

VW5077 OP OP M A 12/15/2014 2,413.18 P1 E 684.20 12/15/2015 02/16/2058 M A 12/15/2014 2,413.18 SD E 1,193.00 06/01/2015 02/16/2058

VW5310 OP OP F A 01/07/2015 768.36 BO A 738.81 04/07/2015 10/20/2024 F A 01/07/2015 768.36 SC E 313.50 07/01/2015 03/31/2019 F A 01/07/2015 768.36 SD E 627.00 07/01/2015 10/21/2059

VW5315 OP OP M A 12/30/2014 2,638.95 BO A 800.00 04/01/2015 03/29/2016 M A 12/30/2014 2,638.95 PD S 487.48 04/04/2015 06/11/2045

VW5330 OP OP M A 12/04/2014 1,627.00 BO A 800.00 03/04/2015 07/27/2024 M A 12/04/2014 1,627.00 P1 E 200.00 12/04/2015 07/28/2059 M A 12/04/2014 1,627.00 SD E 962.00 06/01/2015 07/28/2059

VW5377 OP OP F A 12/20/2014 1,102.89 BO A 800.00 04/01/2015 11/16/2018 F A 12/20/2014 1,102.89 P1 E 203.61 12/20/2015 11/17/2053 F A 12/20/2014 1,102.89 SD E 731.00 06/01/2015 11/17/2053

VW5716 OP OP F A 12/19/2014 05/03/2015 2,627.03 BO A 800.00 03/19/2015 05/03/2015 F A 12/19/2014 05/03/2015 2,627.03 P1 E 200.00 12/19/2015 05/24/2077 F A 12/19/2014 05/03/2015 2,627.03 SD E 1,226.00 06/01/2015 05/24/2077

VW5727 OP OP F A 10/21/2014 1,191.66 BO A 800.00 01/19/2015 07/03/2027 F A 10/21/2014 1,191.66 P1 E 200.00 10/21/2015 07/04/2062

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F A 10/21/2014 1,191.66 SD E 779.00 04/01/2015 07/04/2062

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW5731 OP OP F A 11/22/2014 1,704.95 BO A 800.00 02/20/2015 08/28/2029 F A 11/22/2014 1,704.95 SD E 962.00 05/01/2015 08/29/2064

VW5741 OP OP M A 09/30/2014 1,893.34 BO A 800.00 10/01/2017 05/16/2031 M A 09/30/2014 1,893.34 P1 E 200.00 09/30/2015 05/17/2066 M A 09/30/2014 1,893.34 SD E 1,045.00 03/01/2015 05/17/2066 M A 09/30/2014 1,893.34 WT S 1,900.00 10/01/2014 09/29/2017

VW5758 OP OP F A 01/05/2015 621.73 BO A 597.81 04/05/2015 02/10/2025 F A 01/05/2015 621.73 P1 E 200.00 01/05/2016 02/11/2060 F A 01/05/2015 621.73 SD E 574.00 06/01/2015 02/11/2060

VW5760 OP OP F A 08/29/2014 1,162.04 BO A 800.00 11/27/2014 12/10/2026 F A 08/29/2014 1,162.04 P1 E 328.06 08/28/2015 12/11/2061 F A 08/29/2014 1,162.04 SC E 389.50 02/01/2015 08/31/2021 F A 08/29/2014 1,162.04 SD E 779.00 02/01/2015 12/11/2061

VW5807 OP OP F A 11/15/2014 2,884.05 BO A 583.29 05/01/2015 05/31/2015 F A 11/15/2014 2,884.05 BO A 800.00 06/01/2015 02/12/2017 F A 11/15/2014 2,884.05 P1 E 600.97 11/15/2015 11/17/2058 F A 11/15/2014 2,884.05 SD E 1,288.00 05/01/2015 11/17/2058 F A 11/15/2014 2,884.05 SL A 4,525.67 11/15/2014 05/15/2015

VW5825 OP OP M A 11/13/2014 05/24/2015 1,539.44 BO A 800.00 02/11/2015 05/24/2015 M A 11/13/2014 05/24/2015 1,539.44 P1 E 284.20 11/12/2015 09/03/2072 M A 11/13/2014 05/24/2015 1,539.44 SC E 459.50 05/01/2015 02/28/2030 M A 11/13/2014 05/24/2015 1,539.44 SD E 919.00 05/01/2015 09/03/2072

VW5924 OP OP M A 08/01/2014 1,216.91 BO A 800.00 08/01/2017 10/12/2031 M A 08/01/2014 1,216.91 P1 E 200.00 08/01/2015 10/13/2066 M A 08/01/2014 1,216.91 SD E 827.00 01/01/2015 10/13/2066 M A 08/01/2014 1,216.91 WT S 1,651.61 08/01/2014 07/31/2017

VW5925 OP OP M A 11/01/2014 1,683.38 BO A 800.00 01/30/2015 06/05/2021 M A 11/01/2014 1,683.38 P1 E 200.00 11/01/2015 06/06/2056 M A 11/01/2014 1,683.38 SD E 962.00 04/01/2015 06/06/2056

VW5929 OP OP M A 10/09/2014 2,176.31 BO A 800.00 01/07/2015 10/01/2031 M A 10/09/2014 2,176.31 PD E 401.78 10/08/2014 10/02/2036 M A 10/09/2014 2,176.31 P1 E 200.00 10/09/2015 10/02/2066 M A 10/09/2014 2,176.31 SD E 1,122.00 04/01/2015 10/02/2066

VW5938 OP OP F A 11/04/2014 1,915.50 BO A 800.00 05/01/2015 04/30/2034 F A 11/04/2014 1,915.50 P1 E 200.00 11/04/2015 05/01/2069 F A 11/04/2014 1,915.50 SD E 1,045.00 04/01/2015 05/01/2069

VW5963 OP OP F A 01/01/2015 3,157.71 P1 E 582.96 12/19/2015 09/19/2049 F A 01/01/2015 3,157.71 SR E 1,323.00 01/01/2015 09/19/2049

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VW5984 OP OP M A 02/22/2015 2,020.80 BO A 800.00 05/23/2015 09/09/2028

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CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW5984 OP OP M A 02/22/2015 2,020.80 P1 E 288.21 02/22/2016 09/10/2063 M A 02/22/2015 2,020.80 SD E 1,084.00 08/01/2015 09/10/2063

VW5989 OP OP F A 01/10/2015 1,216.36 BO A 800.00 04/10/2015 12/11/2042 F A 01/10/2015 1,216.36 SC E 389.50 07/01/2015 12/31/2017 F A 01/10/2015 1,216.36 SD E 779.00 07/01/2015 12/12/2077

VW5992 OP OP M A 04/18/2014 2,210.11 BO A 800.00 11/01/2017 08/25/2020 M A 04/18/2014 2,210.11 P1 E 717.22 04/17/2015 08/26/2055 M A 04/18/2014 2,210.11 SD E 1,122.00 10/01/2014 08/26/2055 M A 04/18/2014 2,210.11 WT S 2,760.99 10/25/2014 10/24/2017

VW5995 OP OP M A 01/16/2015 1,964.50 BO A 800.00 05/01/2015 03/12/2022 M A 01/16/2015 1,964.50 P1 E 200.00 01/16/2016 03/13/2057 M A 01/16/2015 1,964.50 SD E 1,045.00 07/01/2015 03/13/2057

VW6202 OP OP F A 11/13/2014 2,010.75 BO A 800.00 02/11/2015 02/10/2016 F A 11/13/2014 2,010.75 PS A 270.00 02/06/2015 04/26/2044

VW6250 OP OP F A 07/09/2014 1,330.22 BO A 10.06 10/07/2014 10/06/2016 F A 07/09/2014 1,330.22 P1 E 200.00 07/09/2015 12/08/2064 F A 07/09/2014 1,330.22 SD E 827.00 01/01/2015 12/08/2064 F A 07/09/2014 1,330.22 WT S 1,269.00 10/01/2014 09/30/2017

VW6261 OP OP M A 07/22/2014 1,171.95 BO A 776.88 02/01/2015 10/19/2017 M A 07/22/2014 1,171.95 P1 S 350.00 08/01/2014 08/05/2050 M A 07/22/2014 1,171.95 SD E 779.00 01/01/2015 08/05/2050 M A 07/22/2014 1,171.95 WT E 971.00 07/22/2014 07/21/2017

VW6268 OP OP F A 06/24/2014 1,661.40 BO A 800.00 09/22/2014 01/27/2036 F A 06/24/2014 1,661.40 SC E 481.00 12/01/2014 01/31/2024 F A 06/24/2014 1,661.40 SD E 962.00 12/01/2014 01/28/2071

VW6274 OP OP F A 10/24/2014 1,102.89 BO A 800.00 01/22/2015 04/06/2028 F A 10/24/2014 1,102.89 P1 E 203.61 10/24/2015 04/07/2063 F A 10/24/2014 1,102.89 SD E 731.00 04/01/2015 04/07/2063

VW6430 OP OP F A 01/08/2015 1,220.05 BO A 800.00 05/01/2015 09/12/2030 F A 01/08/2015 1,220.05 P1 E 225.24 01/08/2016 09/13/2065 F A 01/08/2015 1,220.05 SD E 779.00 07/01/2015 09/13/2065

VW6473 OP OP F A 01/14/2015 1,507.62 BO A 800.00 04/14/2015 03/04/2025 F A 01/14/2015 1,507.62 P1 E 378.57 01/14/2016 03/05/2060 F A 01/14/2015 1,507.62 SD E 919.00 07/01/2015 03/05/2060

VW6598 OP OP F A 01/24/2015 1,121.85 BO A 800.00 04/24/2015 04/09/2021 F A 01/24/2015 1,121.85 P1 E 207.11 01/24/2016 04/10/2056 F A 01/24/2015 1,121.85 SD E 779.00 07/01/2015 04/10/2056

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VW6629 OP OP F A 12/02/2014 1,622.94 BO A 800.00 03/02/2015 01/27/2030

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 83 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW6629 OP OP F A 12/02/2014 1,622.94 P1 E 299.62 11/27/2015 01/28/2065 F A 12/02/2014 1,622.94 SC E 459.50 05/01/2015 05/31/2017 F A 12/02/2014 1,622.94 SD E 919.00 05/01/2015 01/28/2065

VW6636 OP OP F A 11/15/2014 2,348.94 BO A 800.00 04/01/2015 10/30/2026 F A 11/15/2014 2,348.94 P1 E 200.00 11/15/2015 10/31/2061 F A 11/15/2014 2,348.94 SD E 1,158.00 05/01/2015 10/31/2061

VW6643 OP OP M A 11/04/2014 1,245.43 BO A 800.00 02/02/2015 08/01/2017 M A 11/04/2014 1,245.43 P1 E 229.92 11/01/2015 03/27/2050 M A 11/04/2014 1,245.43 SD E 827.00 04/01/2015 03/27/2050

VW6693 OP OP F A 12/07/2014 05/02/2015 1,960.84 BO A 800.00 05/01/2015 05/02/2015 F A 12/07/2014 05/02/2015 1,960.84 P1 E 1,204.22 12/07/2015 01/04/2048

VW6721 OP OP M A 09/22/2014 1,853.93 BO A 800.00 03/01/2015 01/18/2032 M A 09/22/2014 1,853.93 PD S 861.51 02/06/2015 01/19/2067 M A 09/22/2014 1,853.93 SD E 1,004.00 03/01/2015 01/19/2067

VW6743 OP OP F A 06/06/2014 2,909.61 PS S 631.02 11/01/2014 08/23/2052 F A 06/06/2014 2,909.61 SD A 2,029.00 11/01/2014 08/23/2052

VW6760 OP OP F A 12/30/2014 05/03/2015 3,208.13 BO A 800.00 05/01/2015 05/03/2015 F A 12/30/2014 05/03/2015 3,208.13 PS S 1,335.63 07/01/2014 07/18/2056 F A 12/30/2014 05/03/2015 3,208.13 SD E 1,336.00 06/01/2015 07/18/2056

VW6762 OP OP F A 12/12/2014 1,511.08 BO A 800.00 03/12/2015 10/19/2029 F A 12/12/2014 1,511.08 P1 E 200.00 12/12/2015 10/20/2064 F A 12/12/2014 1,511.08 SD E 919.00 06/01/2015 10/20/2064

VW6764 OP OP F A 01/02/2015 1,651.49 P1 E 200.00 01/02/2016 07/18/2057 F A 01/02/2015 1,651.49 SD E 962.00 06/01/2015 07/18/2057

VW7417 OP OP M A 11/08/2014 1,359.75 BO A 800.00 02/06/2015 12/29/2031 M A 11/08/2014 1,359.75 P1 E 200.00 11/08/2015 12/30/2066 M A 11/08/2014 1,359.75 SD E 827.00 05/01/2015 12/30/2066

VW7434 OP OP F A 03/01/2015 3,360.18 P1 E 200.00 03/01/2016 03/05/2050 F A 03/01/2015 3,360.18 SD E 1,347.00 08/01/2015 03/05/2050

VW7485 OP OP M A 02/12/2015 2,994.54 BO A 800.00 05/13/2015 06/22/2032 M A 02/12/2015 2,994.54 P1 E 200.00 02/12/2016 06/23/2067 M A 02/12/2015 2,994.54 SD E 1,310.00 08/01/2015 06/23/2067

VW7498 OP OP F A 01/15/2015 1,442.49 BO A 800.00 04/15/2015 09/19/2034 F A 01/15/2015 1,442.49 P1 E 266.31 01/14/2016 09/20/2069 F A 01/15/2015 1,442.49 SD E 874.00 07/01/2015 09/20/2069

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VW7502 OP OP F A 11/22/2014 2,576.44 BO A 800.00 02/20/2015 07/28/2022 F A 11/22/2014 2,576.44 P1 E 200.00 11/22/2015 07/29/2057

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 84 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW7502 OP OP F A 11/22/2014 2,576.44 SD E 1,226.00 05/01/2015 07/29/2057

VW7503 OP OP M A 01/01/2015 2,280.09 BO A 800.00 04/01/2015 06/20/2033 M A 01/01/2015 2,280.09 P1 E 200.00 01/01/2016 06/21/2068 M A 01/01/2015 2,280.09 SD E 1,158.00 06/01/2015 06/21/2068

VW7507 OP OP M A 10/01/2014 1,581.05 BO A 800.00 04/01/2015 12/29/2016 M A 10/01/2014 1,581.05 P1 E 291.89 10/01/2015 01/19/2060 M A 10/01/2014 1,581.05 SD E 919.00 03/01/2015 01/19/2060

VW7508 OP OP F S 02/10/2015 1,002.79 BO A 800.00 05/11/2015 11/08/2025 F S 02/10/2015 1,002.79 P1 E 185.13 02/10/2016 11/09/2060 F S 02/10/2015 1,002.79 SD E 731.00 08/01/2015 11/09/2060

VW7536 OP OP F A 01/06/2015 05/21/2015 843.65 PD S 294.20 01/30/2015 09/16/2067 F A 01/06/2015 05/21/2015 843.65 SD S 822.00 02/01/2015 09/16/2067

VW7813 OP OP F A 11/18/2014 965.90 BO A 800.00 02/16/2015 05/21/2036 F A 11/18/2014 965.90 P1 E 200.00 11/18/2015 05/22/2071 F A 11/18/2014 965.90 SD E 731.00 05/01/2015 05/22/2071

VW7844 OP OP F A 01/22/2015 06/07/2015 2,038.40 BO A 800.00 04/22/2015 06/07/2015 F A 01/22/2015 06/07/2015 2,038.40 P1 E 400.52 01/22/2016 08/01/2060 F A 01/22/2015 06/07/2015 2,038.40 SD E 1,084.00 07/01/2015 08/01/2060

VW7880 OP OP M A 03/13/2015 2,845.65 BO A 800.00 06/11/2015 04/20/2032 M A 03/13/2015 2,845.65 P1 E 200.00 03/13/2016 04/21/2067 M A 03/13/2015 2,845.65 SC E 644.00 09/01/2015 08/31/2017 M A 03/13/2015 2,845.65 SD E 1,288.00 09/01/2015 04/21/2067

VW8024 OP OP M A 02/26/2015 2,121.49 BO A 800.00 05/27/2015 05/26/2017 M A 02/26/2015 2,121.49 P1 E 1,544.45 02/26/2016 05/28/2060 M A 02/26/2015 2,121.49 SD E 1,084.00 08/01/2015 05/28/2060 M A 02/26/2015 2,121.49 WT E 3,259.11 02/26/2015 02/25/2018

VW8109 OP OP F A 12/23/2014 2,868.34 BO A 800.00 03/30/2015 05/08/2019 F A 12/23/2014 2,868.34 P1 E 992.89 12/20/2015 05/09/2054 F A 12/23/2014 2,868.34 SD E 1,288.00 06/01/2015 05/09/2054

VW8126 OP OP F A 01/05/2015 1,601.60 BO A 800.00 04/05/2015 05/23/2021 F A 01/05/2015 1,601.60 P1 E 497.87 01/05/2016 05/24/2056 F A 01/05/2015 1,601.60 SD E 919.00 06/01/2015 05/24/2056

VW8149 OP OP M A 12/17/2014 1,927.52 BO A 800.00 05/01/2015 03/16/2017 M A 12/17/2014 1,927.52 P1 E 355.85 12/17/2015 06/30/2075 M A 12/17/2014 1,927.52 SC E 522.50 06/01/2015 08/31/2021 M A 12/17/2014 1,927.52 SD E 1,045.00 06/01/2015 06/30/2075

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VW8153 OP OP F A 11/25/2014 1,946.88 BO A 800.00 03/01/2015 08/22/2018 F A 11/25/2014 1,946.88 P1 E 605.20 11/25/2015 09/23/2052

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 85 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 VW8153 OP OP F A 11/25/2014 1,946.88 SD E 1,045.00 05/01/2015 09/23/2052

VW8177 OP OP F A 01/05/2015 809.82 BO A 778.68 04/05/2015 01/08/2041 F A 01/05/2015 809.82 P1 E 149.41 01/05/2016 01/09/2076 F A 01/05/2015 809.82 SC E 313.50 06/01/2015 11/30/2018 F A 01/05/2015 809.82 SD E 627.00 06/01/2015 01/09/2076

VW8179 OP OP F A 02/27/2015 1,017.14 BO A 800.00 05/28/2015 05/27/2017 F A 02/27/2015 1,017.14 SD E 731.00 08/01/2015 02/10/2056

VW8424 OP OP F A 12/22/2014 1,422.69 BO A 800.00 03/22/2015 10/06/2019 F A 12/22/2014 1,422.69 SD E 874.00 06/01/2015 10/07/2054

VW8456 OP OP M A 12/22/2014 1,551.55 SD E 919.00 06/01/2015 03/11/2058

VW8686 OP OP M A 10/14/2014 1,972.43 BO A 800.00 04/01/2015 06/25/2036 M A 10/14/2014 1,972.43 P1 E 364.14 10/14/2015 06/26/2071 M A 10/14/2014 1,972.43 SC E 522.50 04/01/2015 11/30/2024 M A 10/14/2014 1,972.43 SD E 1,045.00 04/01/2015 06/26/2071

VW8687 OP OP F A 12/22/2014 1,707.51 BO A 800.00 05/01/2015 06/29/2027 F A 12/22/2014 1,707.51 P1 E 315.23 12/22/2015 06/30/2062 F A 12/22/2014 1,707.51 SD E 962.00 06/01/2015 06/30/2062

VX0808 OP OP F A 12/10/2014 693.39 BO A 666.72 03/10/2015 09/12/2039 F A 12/10/2014 693.39 P1 E 128.01 03/10/2016 09/13/2074 F A 12/10/2014 693.39 SC E 287.00 06/01/2015 10/31/2031 F A 12/10/2014 693.39 SD E 574.00 06/01/2015 09/13/2074

VX1023 OP OP F A 12/20/2014 2,038.78 P1 E 200.00 12/20/2015 02/19/2065 F A 12/20/2014 2,038.78 SC E 542.00 06/01/2015 06/30/2017 F A 12/20/2014 2,038.78 SD E 1,084.00 06/01/2015 02/19/2065

VX1056 OP OP M A 03/24/2015 07/03/2015 1,709.77 BO A 800.00 06/22/2015 07/03/2015 M A 03/24/2015 07/03/2015 1,709.77 SC E 481.00 09/01/2015 08/31/2023 M A 03/24/2015 07/03/2015 1,709.77 SD E 962.00 09/01/2015 01/21/2070

VX1058 OP OP F A 11/04/2014 2,548.76 BO A 800.00 02/02/2015 09/25/2042 F A 11/04/2014 2,548.76 P1 E 470.54 11/04/2015 09/26/2077 F A 11/04/2014 2,548.76 SD E 1,226.00 05/01/2015 09/26/2077

040831 OP OP F A 02/08/2003 1,578.00 PD A 788.92 03/01/2003 05/01/2067 F A 02/08/2003 1,578.00 SD A 975.00 08/01/2003 05/01/2067

040849 OP OP F A 09/27/2002 956.54 BO A 219.75 03/01/2003 06/26/2018 F A 09/27/2002 956.54 SD A 700.00 03/01/2003 06/27/2053

046614 OP OP F A 01/04/2003 869.23 SD A 1,127.00 07/01/2003 09/30/2050

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046637 OP OP F A 02/04/2003 2,168.44 BO A 666.04 08/01/2003 12/19/2018

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 86 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 046637 OP OP F A 02/04/2003 2,168.44 SD A 1,419.00 08/01/2003 12/20/2053

046643 OP OP F A 03/12/2003 1,541.28 PD A 1,260.18 05/09/2003 10/25/2057 F A 03/12/2003 1,541.28 SD A 1,006.00 09/01/2003 10/25/2057

046673 OP OP F A 05/30/2003 2,507.70 PD A 1,796.22 09/02/2003 06/15/2062 F A 05/30/2003 2,507.70 SD A 1,457.00 11/01/2003 06/15/2062

046688 OP OP F A 01/12/2003 651.34 PD A 294.12 07/13/2003 03/28/2056 F A 01/12/2003 651.34 SD A 675.00 07/01/2003 03/27/2056

049430 OP OP F A 05/23/2003 515.39 PD A 626.80 09/11/2003 11/26/2052 F A 05/23/2003 515.39 SD A 811.00 12/01/2003 11/26/2055

050332 OP OP F A 05/19/2003 786.39 PD A 239.00 11/19/2003 06/25/2050 F A 05/19/2003 786.39 SD A 684.00 11/01/2003 06/26/2050

051240 OP OP M A 10/27/2002 2,316.47 PD A 2,239.27 06/07/2003 10/24/2055 M A 10/27/2002 2,316.47 SD A 1,535.00 07/01/2003 10/24/2055

051270 OP OP F A 04/12/2003 911.48 PD A 282.43 09/04/2003 05/11/2052 F A 04/12/2003 911.48 SD A 1,144.00 10/01/2003 05/11/2052

051273 OP OP M A 04/02/2003 1,297.67 PD A 829.43 05/31/2003 12/27/2060 M A 04/02/2003 1,297.67 SD A 916.00 11/01/2003 12/27/2060

051882 OP OP F A 03/19/2003 2,471.79 PD A 912.05 04/14/2004 05/23/2056 F A 03/19/2003 2,471.79 SD A 1,538.00 07/01/2004 05/23/2056

052222 OP OP M A 03/26/2003 908.32 PD A 661.33 05/10/2003 10/09/2050 M A 03/26/2003 908.32 SD A 897.00 01/01/2005 10/09/2050

052634 OP OP F A 03/15/2003 1,728.36 BO A 487.88 09/01/2003 12/02/2017 F A 03/15/2003 1,728.36 SD A 1,174.00 09/01/2003 12/03/2052

052744 OP OP F A 05/31/2003 1,513.36 BO A 800.00 08/29/2003 08/03/2020 F A 05/31/2003 1,513.36 SD A 363.00 11/01/2003 08/04/2055

055731 OP OP F A 06/20/2003 3,314.73 BO A 316.13 12/01/2003 08/20/2015 F A 06/20/2003 3,314.73 PD A 1,297.11 09/02/2003 08/21/2050 F A 06/20/2003 3,314.73 SD A 1,574.00 12/01/2003 08/21/2050

055953 OP OP F A 05/30/2003 1,817.94 PD A 777.16 08/20/2004 10/16/2055 F A 05/30/2003 1,817.94 SD A 842.00 01/01/2004 10/16/2055 F A 05/30/2003 1,817.94 WP A 185.28 11/10/2005 06/08/2038

058400 OP OP F A 06/17/2003 1,289.16 PD A 976.46 02/04/2004 11/15/2057 F A 06/17/2003 1,289.16 SD A 878.00 12/01/2003 11/15/2057

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059048 OP OP M A 05/27/2003 792.68 BO A 269.19 05/01/2004 11/09/2018

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 87 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 059048 OP OP M A 05/27/2003 792.68 SD A 493.00 05/01/2004 11/10/2053

059077 OP OP M A 10/21/2003 1,753.81 PD A 774.37 02/14/2004 05/30/2061 M A 10/21/2003 1,753.81 SD A 1,240.00 04/01/2004 05/30/2061

060458 OP OP F A 09/30/2003 1,895.84 BO A 251.92 05/01/2004 03/02/2023 F A 09/30/2003 1,895.84 SD A 1,571.00 03/01/2004 03/03/2058

060745 OP OP M A 09/12/2003 2,003.45 PD A 1,410.33 01/29/2004 01/10/2052 M A 09/12/2003 2,003.45 SD A 1,602.00 03/01/2004 01/10/2052

062136 OP OP F A 11/25/2003 1,515.59 BO A 582.29 09/01/2008 02/24/2029 F A 11/25/2003 1,515.59 RO S 400.00 08/01/2014 02/25/2064 F A 11/25/2003 1,515.59 SD A 875.00 09/01/2008 02/25/2064

062149 OP OP M A 04/08/2004 1,451.89 PD A 579.14 06/17/2004 09/11/2052 M A 04/08/2004 1,451.89 SD A 1,282.00 12/01/2004 09/11/2052

063307 OP OP F A 03/05/2004 1,888.30 PD A 1,572.64 08/07/2004 07/26/2056 F A 03/05/2004 1,888.30 SD A 1,260.00 09/01/2004 07/26/2056

063352 OP OP F A 09/23/2003 1,234.70 BO A 383.21 03/01/2004 11/09/2023 F A 09/23/2003 1,234.70 SD A 804.00 03/01/2004 11/10/2058

063370 OP OP F A 08/03/2004 6,179.66 PD A 5,308.64 02/26/2005 12/07/2051 F A 08/03/2004 6,179.66 SD A 1,917.00 08/01/2005 12/07/2051

063382 OP OP M A 05/04/2004 1,068.16 PD A 391.99 03/16/2005 06/15/2051 M A 05/04/2004 1,068.16 SD A 1,420.00 12/01/2004 06/15/2051

063584 OP OP F A 06/17/2004 922.09 BO A 139.63 12/01/2004 09/28/2029 F A 06/17/2004 922.09 SD A 747.00 12/01/2004 09/29/2064

066348 OP OP M A 02/04/2004 793.00 PD A 393.24 02/04/2004 11/20/2054 M A 02/04/2004 793.00 SD A 996.00 06/01/2004 11/20/2054

066380 OP OP M A 01/20/2004 2,906.83 PD A 4,212.26 08/25/2004 09/28/2055 M A 01/20/2004 2,906.83 SD A 1,804.00 08/01/2004 09/28/2055

067905 OP OP F A 01/21/2004 2,170.29 PD A 903.73 06/13/2004 08/10/2053 F A 01/21/2004 2,170.29 SD A 1,354.00 07/01/2004 08/10/2057

067922 OP OP M A 01/01/2004 2,179.83 PD A 1,561.04 07/01/2004 08/02/2094 M A 01/01/2004 2,179.83 SD A 1,369.00 06/01/2004 02/12/2052

067934 OP OP F A 01/18/2004 1,085.71 SD A 656.00 11/01/2004 09/26/2077

067964 OP OP M A 01/17/2004 2,123.01 PD A 1,852.15 06/30/2004 01/18/2052

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M A 01/17/2004 2,123.01 SD A 1,153.00 07/01/2004 01/18/2052

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 88 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 067986 OP OP M A 04/13/2004 1,573.86 PD A 631.53 07/10/2004 06/26/2053 M A 04/13/2004 1,573.86 SD A 1,270.00 01/01/2005 06/26/2053

067991 OP OP M A 01/06/2004 1,824.55 PD A 825.34 10/13/2004 02/15/2066 M A 01/06/2004 1,824.55 SD A 1,233.00 06/01/2004 06/18/2044 M A 01/06/2004 1,824.55 WP A 269.12 05/01/2005 06/18/2044

067998 OP OP F A 10/30/2003 1,024.19 PD A 628.02 06/19/2004 07/19/2057 F A 10/30/2003 1,024.19 SD A 878.00 04/01/2004 07/19/2057

068742 OP OP F A 11/14/2003 1,079.76 PD A 381.49 04/14/2004 07/01/2054 F A 11/14/2003 1,079.76 SD A 822.00 05/01/2004 07/01/2054

070220 OP OP F A 02/06/2004 1,548.25 PD A 1,045.10 12/22/2004 12/13/2057 F A 02/06/2004 1,548.25 PS A 4.44 12/22/2004 12/13/2057 F A 02/06/2004 1,548.25 SD A 1,089.00 01/01/2005 12/13/2057

070254 OP OP F A 05/28/2004 2,384.58 PD A 1,882.65 11/13/2004 12/30/2057 F A 05/28/2004 2,384.58 SD A 1,342.00 11/01/2004 12/30/2057

070467 OP OP M A 08/19/2004 2,185.46 PD A 1,955.86 03/10/2005 12/06/2054 M A 08/19/2004 2,185.46 SD A 1,303.00 02/01/2005 12/06/2054

070802 OP OP F A 02/07/2004 2,313.84 PD A 2,012.53 07/01/2004 10/02/2050 F A 02/07/2004 2,313.84 SD A 1,310.00 08/01/2004 10/02/2050

070817 OP OP F A 02/28/2004 3,123.41 BO A 734.88 01/01/2005 08/09/2022 F A 02/28/2004 3,123.41 PD A 1,033.40 04/11/2004 08/10/2057 F A 02/28/2004 3,123.41 SD A 1,235.00 01/01/2005 08/10/2057

070844 OP OP F A 03/05/2004 2,843.91 PD A 2,257.17 04/17/2004 08/07/2050 F A 03/05/2004 2,843.91 SD A 1,489.00 09/01/2004 08/07/2050

072212 OP OP M A 10/11/2003 1,287.86 PD A 1,029.22 06/17/2004 10/08/2054 M A 10/11/2003 1,287.86 SD A 1,086.00 04/01/2004 10/08/2054

074640 OP OP F A 05/26/2004 1,006.74 PD A 832.43 09/03/2004 03/07/2057 F A 05/26/2004 1,006.74 SD A 788.00 11/01/2004 03/07/2057

074664 OP OP F A 05/19/2004 1,023.54 PD A 462.67 12/03/2004 04/03/2065 F A 05/19/2004 1,023.54 SD A 986.00 11/01/2004 04/03/2065

076717 OP OP F A 05/26/2004 743.87 PD A 330.74 08/16/2004 09/05/2059 F A 05/26/2004 743.87 SD A 717.00 11/01/2004 09/05/2059

076757 OP OP M A 01/27/2002 1,912.68 BO A 800.00 04/27/2002 07/15/2030 M A 01/27/2002 1,912.68 SD A 971.00 12/01/2002 07/16/2065

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077311 OP OP F A 05/25/2004 2,267.96 PD A 1,215.70 08/15/2004 08/14/2051 F A 05/25/2004 2,267.96 SD A 1,131.00 01/01/2005 08/14/2051

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 89 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 077369 OP OP M A 07/23/2004 4,463.34 BO A 800.00 10/21/2004 08/04/2015 M A 07/23/2004 4,463.34 SD A 1,780.00 01/01/2005 08/05/2050

080059 OP OP F A 12/17/2004 950.05 BO A 252.51 06/01/2005 06/19/2017 F A 12/17/2004 950.05 SD A 661.00 06/01/2005 06/20/2052

083431 OP OP F A 09/24/2004 2,507.54 PD A 1,496.08 04/17/2005 02/28/2055 F A 09/24/2004 2,507.54 SD A 1,433.00 11/01/2004 02/28/2055

083433 OP OP F A 09/01/2004 1,476.91 PD A 1,252.45 09/01/2004 06/13/2062 F A 09/01/2004 1,476.91 SD A 1,105.00 02/01/2005 06/13/2062

083440 OP OP M A 09/30/2004 1,594.91 PD A 727.88 03/19/2005 08/26/2067 M A 09/30/2004 1,594.91 SC A 202.00 03/01/2005 10/31/2019 M A 09/30/2004 1,594.91 SD A 404.00 01/01/2008 08/25/2032

083591 OP OP F A 04/01/2005 3,129.59 PD A 1,417.15 04/08/2005 03/26/2055 F A 04/01/2005 3,129.59 SD A 1,615.00 09/01/2005 03/26/2055

083951 OP OP M A 09/13/2004 2,025.67 PD A 1,158.04 04/30/2005 10/28/2064 M A 09/13/2004 2,025.67 SD A 1,331.00 03/01/2005 10/28/2064

084026 OP OP F A 04/17/2004 1,391.21 PD A 776.00 10/15/2004 01/30/2054 F A 04/17/2004 1,391.21 SD A 1,098.00 10/01/2004 01/30/2054

084049 OP OP F A 07/21/2004 1,174.28 PD A 567.04 01/17/2005 08/19/2064 F A 07/21/2004 1,174.28 SD A 873.00 01/01/2005 08/19/2064

084059 OP OP F A 07/07/2004 998.56 PD A 411.64 05/11/2005 03/11/2053 F A 07/07/2004 998.56 SD A 816.00 03/01/2006 03/11/2053

085254 OP OP M A 03/27/2004 1,422.58 PD A 1,349.52 12/17/2004 07/19/2052 M A 03/27/2004 1,422.58 SD A 1,132.00 09/01/2004 07/19/2052

085268 OP OP F A 09/29/2004 820.19 PD A 711.12 02/02/2005 03/17/2056 F A 09/29/2004 820.19 SC A 312.00 03/01/2005 05/31/2015 F A 09/29/2004 820.19 SD A 773.00 03/01/2005 03/17/2056

086856 OP OP M A 10/15/2004 1,416.87 BO A 188.38 04/01/2005 09/28/2018 M A 10/15/2004 1,416.87 SD A 1,174.00 04/01/2005 09/29/2053

087942 OP OP F A 01/26/2005 1,695.80 PD A 1,520.51 03/25/2005 08/12/2059 F A 01/26/2005 1,695.80 SD A 1,093.00 09/01/2005 11/12/2059

088558 OP OP M A 12/10/2004 1,784.98 PD A 1,242.77 03/02/2005 05/16/2068 M A 12/10/2004 1,784.98 SD A 1,188.00 04/01/2006 05/16/2068 M A 12/10/2004 1,784.98 WP A 185.32 04/01/2006 04/07/2047

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092053 OP OP F A 01/09/2005 2,516.48 PD A 1,203.43 04/14/2005 10/21/2066 F A 01/09/2005 2,516.48 SD A 1,319.00 07/01/2005 10/21/2066

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 90 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 093629 OP OP F A 02/02/2005 634.02 SD A 739.00 08/01/2005 03/07/2053

093663 OP OP F A 03/09/2005 2,176.25 PD A 1,716.12 06/15/2005 11/23/2053 F A 03/09/2005 2,176.25 SD A 1,200.00 09/01/2005 11/23/2053

095124 OP OP M A 03/05/2005 1,083.53 PD A 492.55 07/01/2005 03/29/2052 M A 03/05/2005 1,083.53 SD A 1,028.00 02/01/2007 03/29/2052

095127 OP OP M A 03/22/2005 1,206.71 BO A 187.30 06/01/2013 06/19/2039 M A 03/22/2005 1,206.71 SD A 973.00 06/01/2013 06/20/2074

095260 OP OP F A 04/26/2005 2,014.51 PD A 1,004.39 06/25/2005 01/19/2073 F A 04/26/2005 2,014.51 SD A 1,062.00 10/01/2005 01/19/2073

095268 OP OP M A 08/10/2004 1,540.33 BO A 332.34 08/01/2010 02/07/2029 M A 08/10/2004 1,540.33 SD S 1,148.75 08/01/2010 02/08/2064

097506 OP OP M A 03/05/2005 1,086.80 PD A 390.44 08/13/2005 05/14/2055 M A 03/05/2005 1,086.80 SD A 918.00 09/01/2005 05/14/2055

097572 OP OP M A 10/27/2004 1,674.38 PD A 2,258.71 07/13/2005 02/21/2053 M A 10/27/2004 1,674.38 SD A 1,657.00 06/01/2005 02/21/2053

097655 OP OP M A 07/27/2004 1,826.75 BO A 27.23 06/01/2006 07/09/2015 M A 07/27/2004 1,826.75 P1 A 472.66 05/10/2006 07/10/2050 M A 07/27/2004 1,826.75 SD A 1,088.00 06/01/2006 07/10/2050 M A 07/27/2004 1,826.75 WP A 168.60 03/28/2006 02/03/2030

097706 OP OP F A 05/27/2005 2,409.34 PD A 1,610.32 12/16/2005 01/29/2066 F A 05/27/2005 2,409.34 SD A 1,251.00 11/01/2005 01/29/2066

097708 OP OP M A 06/10/2005 1,848.44 PD A 960.69 09/08/2005 11/04/2054 M A 06/10/2005 1,848.44 SD A 1,155.00 12/01/2005 11/04/2054

098011 OP OP F A 08/08/2005 772.98 PL A 362.64 10/01/2007 11/29/2053 F A 08/08/2005 772.98 SD A 435.00 01/01/2007 11/29/2053

098049 OP OP M A 07/30/2005 1,756.03 PD A 393.25 09/02/2005 02/23/2052 M A 07/30/2005 1,756.03 PS A 531.18 09/02/2005 02/23/2052 M A 07/30/2005 1,756.03 SD A 1,154.00 01/01/2006 02/23/2052

098569 OP OP F A 03/15/2005 2,060.88 PD A 1,047.60 11/19/2005 01/09/2069 F A 03/15/2005 2,060.88 SD A 1,195.00 01/01/2008 01/09/2069

098599 OP OP F A 07/27/2005 1,115.84 PD A 716.95 11/19/2005 12/13/2058 F A 07/27/2005 1,115.84 SD A 1,048.00 01/01/2006 12/13/2058

098636 OP OP F A 04/18/2005 2,032.66 BO A 152.20 07/01/2006 12/05/2034

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F A 04/18/2005 2,032.66 PD A 724.28 07/01/2006 12/06/2069 F A 04/18/2005 2,032.66 SD A 1,078.00 03/01/2006 12/06/2069

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 91 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 098909 OP OP F A 04/17/2005 1,866.53 PD A 1,674.82 12/17/2005 11/05/2069 F A 04/17/2005 1,866.53 SD A 1,054.00 06/01/2006 11/05/2069

098923 OP OP F A 07/29/2005 883.24 BO A 165.85 12/01/2007 05/06/2019 F A 07/29/2005 883.24 SD A 665.00 12/01/2007 05/07/2054 F A 07/29/2005 883.24 WP A 18.42 10/02/2005 05/06/2024

098945 OP OP M A 09/16/2005 1,631.99 PD A 1,526.03 03/08/2006 08/09/2053 M A 09/16/2005 1,631.99 SD A 1,174.00 05/01/2007 08/09/2053

261355 OP OP F A 01/21/1996 862.39 BO A 232.22 07/01/1996 09/30/2021 F A 01/21/1996 862.39 SD A 597.00 07/01/1996 09/03/2056

261943 OP OP F A 02/17/1996 1,047.04 PD A 538.66 06/11/1996 12/06/2050 F A 02/17/1996 1,047.04 SD A 557.00 08/01/1996 12/06/2050

263802 OP OP F A 03/19/1996 1,613.46 BO A 29.86 11/01/1996 07/31/2019 F A 03/19/1996 1,613.46 PD A 657.55 06/13/1996 07/03/2054 F A 03/19/1996 1,613.46 SD A 864.00 11/01/1996 07/03/2054

264657 OP OP F A 03/14/1996 1,218.75 PD A 890.46 07/06/1996 08/21/2051 F A 03/14/1996 1,218.75 SD A 897.00 03/01/2001 08/21/2051 F A 03/14/1996 1,218.75 WP A 231.95 08/15/1998 08/20/2021

264663 OP OP M A 04/08/1996 1,198.17 PD A 760.28 03/05/1997 12/07/2052 M A 04/08/1996 1,198.17 SD A 674.00 10/01/1996 12/07/2052

266835 OP OP F A 07/29/1996 972.32 PD A 411.89 09/25/1997 01/01/2069 F A 07/29/1996 972.32 SD A 698.00 01/01/1997 01/01/2069

266838 OP OP F A 09/13/1996 1,663.74 BO A 114.20 03/01/1997 11/30/2019 F A 09/13/1996 1,663.74 PD A 823.33 12/03/1996 12/01/2054 F A 09/13/1996 1,663.74 SD A 777.00 03/01/1997 12/01/2054

266850 OP OP M A 07/14/1996 1,706.47 PD A 1,069.50 09/10/1996 04/01/2051 M A 07/14/1996 1,706.47 SD A 905.00 01/01/1997 03/31/2016

266851 OP OP F A 05/14/1996 4,225.00 BO A 800.00 08/12/1996 02/29/2020 F A 05/14/1996 4,225.00 SD A 1,272.00 01/01/1997 02/04/2055 F A 05/14/1996 4,225.00 WP A 238.09 05/24/1999 05/23/2033

267795 OP OP F A 04/22/1996 403.33 PD A 227.25 10/22/1996 02/03/2054 F A 04/22/1996 403.33 SD A 434.00 10/01/1996 02/03/2054

267797 OP OP F A 07/25/1996 1,231.25 BO A 671.42 02/01/1997 01/30/2018 F A 07/25/1996 1,231.25 SD A 548.00 01/01/1997 01/01/2053

267869 OP OP F A 10/23/1996 1,038.81 BO A 218.51 05/01/1997 01/31/2024

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F A 10/23/1996 1,038.81 SD A 813.00 05/01/1997 01/08/2059

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 92 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 270808 OP OP F A 10/29/1996 1,715.41 PD A 1,345.22 01/16/1997 02/28/2055 F A 10/29/1996 1,715.41 SD A 1,022.00 04/01/1997 02/28/2055

270833 OP OP F A 12/19/1996 1,260.74 PD A 955.69 03/14/1997 06/24/2054 F A 12/19/1996 1,260.74 SD A 781.00 06/01/1997 06/24/2054

272200 OP OP M A 09/25/1996 1,008.91 BO A 31.58 07/01/1998 06/04/2021 M A 09/25/1996 1,008.91 PL A 233.91 07/26/1997 06/05/2056 M A 09/25/1996 1,008.91 SD A 682.00 10/01/1997 06/05/2056 M A 09/25/1996 1,008.91 WP A 55.59 06/15/1998 10/31/2030

272607 OP OP F A 12/07/1996 1,319.18 PD A 580.32 03/05/1997 02/05/2063 F A 12/07/1996 1,319.18 SD A 903.00 06/01/1997 02/05/2063

274145 OP OP F A 12/20/1996 1,539.31 BO A 329.53 08/01/1997 04/30/2017 F A 12/20/1996 1,539.31 PD A 597.89 03/25/1997 04/23/2052 F A 12/20/1996 1,539.31 SD A 603.00 08/01/1997 04/23/2052

274155 OP OP M A 11/15/1996 1,067.30 PD A 611.79 05/14/1997 08/08/2052 M A 11/15/1996 1,067.30 SD A 767.00 05/01/1997 08/08/2052

274160 OP OP M A 09/25/1996 1,501.36 PD A 1,486.81 02/27/1997 09/28/2050 M A 09/25/1996 1,501.36 SD A 827.00 06/01/1997 09/28/2050

274991 OP OP M A 09/13/1996 817.13 PD A 577.35 07/11/1997 06/15/2053 M A 09/13/1996 817.13 SD A 631.00 03/01/1997 06/15/2053

275176 OP OP M A 09/27/1996 1,311.44 PD A 788.14 06/06/1997 07/24/2062 M A 09/27/1996 1,311.44 SD A 869.00 11/01/1997 07/24/2062

275975 OP OP F A 01/31/1997 914.71 PD A 643.85 03/13/1997 11/26/2062 F A 01/31/1997 914.71 SD A 790.00 07/01/1997 11/26/2062

275978 OP OP F A 03/06/1997 1,478.85 BO A 607.98 09/01/1997 07/19/2025 F A 03/06/1997 1,478.85 SD A 814.00 09/01/1997 07/20/2060

277166 OP OP F A 01/17/1997 1,680.25 BO A 800.00 04/17/1997 08/14/2036 F A 01/17/1997 1,680.25 SC A 381.00 10/01/1999 08/31/2019 F A 01/17/1997 1,680.25 SD A 738.00 07/01/1997 08/14/2036

277178 OP OP F A 03/25/1997 1,525.58 PD A 1,149.81 07/26/1997 09/28/2054 F A 03/25/1997 1,525.58 SD A 865.00 09/01/1997 09/28/2054

277830 OP OP F A 06/13/1997 1,746.35 PD A 823.36 06/13/1997 08/31/2057 F A 06/13/1997 1,746.35 SD A 900.00 12/01/1997 08/31/2057

277849 OP OP F A 03/08/1997 1,724.45 PD A 859.03 05/24/1997 07/24/2064 F A 03/08/1997 1,724.45 SD A 993.00 01/01/1998 07/24/2064

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277863 OP OP F A 04/18/1997 526.34 BO A 36.09 04/01/1998 05/11/2026

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 93 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 277863 OP OP F A 04/18/1997 526.34 SD A 470.00 04/01/1998 05/12/2061

279434 OP OP F A 03/08/1997 1,260.74 BO A 354.25 09/01/1997 12/07/2019 F A 03/08/1997 1,260.74 SD A 858.00 09/01/1997 12/08/2054

279437 OP OP M A 06/04/1997 677.90 PD A 267.11 07/30/1997 05/23/2063 M A 06/04/1997 677.90 SD A 501.00 12/01/1997 05/23/2063

279459 OP OP F A 04/15/1997 960.43 PD A 356.70 05/31/1997 08/30/2057 F A 04/15/1997 960.43 SD A 694.00 10/01/1997 08/30/2057

279461 OP OP M A 07/04/1997 2,301.33 PD A 1,805.43 08/20/1997 06/25/2059 M A 07/04/1997 2,301.33 SD A 1,206.00 01/01/1998 06/25/2059

279936 OP OP F A 02/28/1997 2,072.20 BO A 800.00 05/29/1997 12/12/2024 F A 02/28/1997 2,072.20 SD A 1,187.00 10/01/1997 12/13/2059

280889 OP OP F A 05/01/1997 1,544.51 PD A 1,092.33 09/18/1997 09/18/2061 F A 05/01/1997 1,544.51 SD A 795.00 01/01/1998 09/18/2061

280891 OP OP F A 04/12/1997 984.26 BO A 134.07 10/01/1997 07/04/2016 F A 04/12/1997 984.26 PD A 367.34 08/01/1997 07/05/2051 F A 04/12/1997 984.26 SD A 445.00 10/01/1997 07/05/2051

281120 OP OP M A 07/01/1997 2,631.96 PD A 1,901.46 10/01/1997 03/03/2054 M A 07/01/1997 2,631.96 SD A 1,291.00 01/01/1999 03/03/2054

281154 OP OP M A 02/14/1997 1,736.26 PD A 523.87 09/09/1997 08/16/2053 M A 02/14/1997 1,736.26 SD A 1,161.00 08/01/1997 08/16/2053

281161 OP OP F A 05/31/1997 2,052.48 PD A 1,251.22 10/08/1997 05/23/2050 F A 05/31/1997 2,052.48 SD A 1,075.00 11/01/1997 05/23/2050

281207 OP OP F A 01/09/1997 1,436.85 PD A 566.78 10/15/1998 09/06/2066 F A 01/09/1997 1,436.85 SD A 818.00 02/01/1998 09/06/2066

283524 OP OP F A 03/29/1997 488.10 PD A 1,205.27 04/29/1997 11/06/2051 F A 03/29/1997 488.10 SD A 952.00 09/01/1997 11/06/2051

283581 OP OP F A 05/09/1997 1,922.91 PD A 1,467.63 10/14/1997 09/11/2052 F A 05/09/1997 1,922.91 SD A 966.00 04/01/1998 09/11/2052

284261 OP OP F A 02/28/1997 2,549.90 PD A 1,076.82 12/02/1997 08/19/2053 F A 02/28/1997 2,549.90 SD A 1,231.00 01/01/1998 08/19/2053 F A 02/28/1997 2,549.90 WP A 334.73 01/17/1999 08/19/2023

284269 OP OP M A 10/09/1997 1,074.56 PD A 493.78 04/01/1998 03/24/2068 M A 10/09/1997 1,074.56 SD A 781.00 06/01/1993 03/24/2068

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284345 OP OP F A 08/19/1997 971.80 PD A 374.76 11/19/1997 06/07/2060

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 94 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 284345 OP OP F A 08/19/1997 971.80 SD A 856.00 06/01/2000 06/07/2060

284368 OP OP M A 10/02/1997 1,424.10 PD A 1,067.39 11/25/1997 08/20/2056 M A 10/02/1997 1,424.10 SD A 972.00 03/01/1997 08/20/2056

284415 OP OP F A 09/01/1997 946.83 BO A 403.41 02/01/1998 06/24/2025 F A 09/01/1997 946.83 SD A 507.00 02/01/1998 06/25/2060

288485 OP OP M A 07/15/1999 1,680.04 PD A 639.69 09/05/2002 02/02/2051 M A 07/15/1999 1,680.04 SD A 1,183.00 06/01/2003 02/02/2051 M A 07/15/1999 1,680.04 WP A 315.34 06/04/2003 01/03/2027

289079 OP OP F A 06/03/2002 1,292.05 PD A 930.62 09/19/2002 01/08/2063 F A 06/03/2002 1,292.05 SD A 949.00 09/01/2007 01/08/2063

290365 OP OP M A 06/04/2002 1,257.96 PD A 554.75 12/27/2002 11/19/2056 M A 06/04/2002 1,257.96 SD A 1,085.00 04/01/2003 11/19/2056

290802 OP OP F A 09/16/2002 4,160.65 BO A 626.60 04/01/2003 06/26/2015 F A 09/16/2002 4,160.65 PD A 1,723.03 03/02/2003 06/27/2050 F A 09/16/2002 4,160.65 SD A 1,651.00 03/01/2003 06/27/2050

291055 OP OP M A 12/14/2000 2,091.57 BO A 24.45 01/01/2006 10/05/2022 M A 12/14/2000 2,091.57 PL A 323.44 06/29/2002 10/06/2057 M A 12/14/2000 2,091.57 SD A 1,429.00 01/01/2006 10/06/2057 M A 12/14/2000 2,091.57 WP A 234.24 12/31/2005 10/03/2027

295911 OP OP F A 08/12/2002 1,112.13 PD A 778.95 07/24/2003 03/12/2054 F A 08/12/2002 1,112.13 SD A 839.00 02/01/2003 03/12/2054 F A 08/12/2002 1,112.13 WP A 31.72 08/01/2003 10/31/2033

295918 OP OP M A 07/02/2002 1,178.13 BO A 364.44 12/01/2002 07/26/2028 M A 07/02/2002 1,178.13 SD A 774.00 12/01/2002 07/27/2063

296905 OP OP F A 10/30/2002 1,435.69 BO A 117.47 04/01/2003 05/12/2029 F A 10/30/2002 1,435.69 SD A 1,263.00 04/01/2003 05/13/2064

296951 OP OP F A 12/02/2002 1,011.13 BO A 580.24 11/01/2005 07/29/2027 F A 12/02/2002 1,011.13 SD A 392.00 11/01/2005 07/30/2062

299452 OP OP F A 09/28/2002 1,673.75 BO A 384.12 12/01/2006 01/15/2030 F A 09/28/2002 1,673.75 PD A 727.49 08/21/2003 01/16/2065 F A 09/28/2002 1,673.75 SD A 277.00 01/01/2006 01/15/2030 F A 09/28/2002 1,673.75 WP A 220.77 11/30/2006 03/29/2044

300022 OP OP F A 09/20/2002 793.60 PD A 470.09 01/14/2003 09/03/2056 F A 09/20/2002 793.60 SD A 684.00 04/01/2003 09/03/2056

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300039 OP OP F A 11/09/2002 1,150.61 BO A 408.36 05/01/2003 04/01/2031 F A 11/09/2002 1,150.61 SD A 698.00 05/01/2003 04/02/2066

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 95 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 300194 OP OP M A 07/24/2002 2,024.10 PD A 1,343.55 02/23/2003 08/05/2054 M A 07/24/2002 2,024.10 SD A 1,442.00 07/01/2003 08/05/2054

375167 OP OP M A 11/07/2005 2,987.13 PD A 2,303.42 07/01/2006 05/17/2063 M A 11/07/2005 2,987.13 SD A 1,608.00 05/01/2006 05/17/2063

377430 OP OP F A 05/13/2005 1,390.89 BO A 86.93 01/01/2006 07/28/2019 F A 05/13/2005 1,390.89 PD A 468.46 12/10/2005 07/29/2054 F A 05/13/2005 1,390.89 SD A 782.00 12/01/2005 07/29/2054

377553 OP OP F A 06/01/2005 2,115.75 PD A 1,143.90 08/19/2005 05/26/2050 F A 06/01/2005 2,115.75 SD A 1,063.00 11/01/2005 05/26/2050

377561 OP OP F A 06/18/2005 670.80 BO A 14.00 01/01/2006 07/15/2030 F A 06/18/2005 670.80 SD A 631.00 01/01/2006 07/16/2065

377582 OP OP M A 04/24/2005 1,270.91 BO A 575.03 11/01/2006 07/01/2015 M A 04/24/2005 1,270.91 SD A 647.00 11/01/2006 07/02/2050

378288 OP OP F A 05/07/2005 1,150.29 PD A 578.65 08/27/2005 09/18/2064 F A 05/07/2005 1,150.29 SD A 860.00 11/01/2005 09/18/2064

379506 OP OP F A 07/20/2005 2,489.29 PD A 1,941.95 09/10/2005 01/19/2073 F A 07/20/2005 2,489.29 PS A 445.45 09/10/2005 01/19/2073 F A 07/20/2005 2,489.29 SD A 1,408.00 05/01/2006 01/19/2073

379536 OP OP F A 12/20/2004 964.82 PD A 448.24 11/06/2005 07/20/2056 F A 12/20/2004 964.82 SD A 980.00 01/01/2006 07/20/2056

379590 OP OP F A 07/29/2005 2,035.96 PD A 1,198.59 03/01/2006 12/26/2068 F A 07/29/2005 2,035.96 SD A 1,242.00 01/01/2006 12/26/2068

381525 OP OP F A 09/03/2005 1,500.00 SD A 1,153.00 09/01/2006 01/11/2065

381596 OP OP M A 09/17/2005 1,321.50 BO A 701.44 04/01/2006 11/14/2028 M A 09/17/2005 1,321.50 PD A 569.24 03/15/2006 11/15/2063

381607 OP OP F A 09/08/2005 2,541.60 BO A 237.45 04/01/2006 07/22/2020 F A 09/08/2005 2,541.60 PD A 874.39 03/02/2006 07/23/2055 F A 09/08/2005 2,541.60 SD A 1,332.00 03/01/2006 07/23/2055

381785 OP OP M A 07/12/2005 1,512.01 BO A 247.86 01/01/2006 07/13/2033 M A 07/12/2005 1,512.01 SC A 634.00 01/01/2006 10/31/2023 M A 07/12/2005 1,512.01 SD A 1,206.00 01/01/2006 07/14/2068

384255 OP OP F A 01/31/2006 1,784.30 PD A 679.50 03/03/2007 05/17/2075 F A 01/31/2006 1,784.30 SD A 1,136.00 01/01/2007 05/17/2075

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384262 OP OP F A 04/08/2006 431.71 SD A 1,000.00 10/01/2006 10/27/2054

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 96 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 384274 OP OP F A 05/13/2006 885.51 BO A 126.46 01/01/2007 01/27/2025 F A 05/13/2006 885.51 SD A 725.00 01/01/2007 01/28/2060

386642 OP OP F A 10/01/2004 1,874.22 PD A 1,179.98 10/01/2005 06/25/2058 F A 10/01/2004 1,874.22 SD A 1,201.00 03/01/2006 06/25/2058

386644 OP OP M A 05/28/2005 2,553.25 PD A 1,545.49 04/06/2006 08/17/2053 M A 05/28/2005 2,553.25 SD A 1,323.00 11/01/2005 08/17/2053 M A 05/28/2005 2,553.25 WP A 947.80 11/01/2006 01/18/2033

389125 OP OP M A 11/25/2005 1,192.91 PD A 460.89 08/03/2006 02/26/2051 M A 11/25/2005 1,192.91 SD A 734.00 05/01/2006 02/26/2051

389733 OP OP F A 10/03/2005 2,642.36 PD A 1,574.18 08/09/2006 12/01/2054 F A 10/03/2005 2,642.36 SD A 1,477.00 05/01/2006 12/01/2054

389735 OP OP F A 11/08/2005 3,068.05 PD A 1,860.26 04/05/2006 07/08/2053 F A 11/08/2005 3,068.05 SD A 1,442.00 05/01/2006 07/08/2053

389736 OP OP F A 12/03/2005 2,012.02 BO A 779.64 06/01/2006 08/17/2043 F A 12/03/2005 2,012.02 SC A 577.00 06/01/2006 10/31/2022 F A 12/03/2005 2,012.02 SD A 1,155.00 06/01/2006 08/18/2078

390415 OP OP F A 11/10/2005 2,011.86 PD A 1,809.52 06/23/2006 06/29/2059 F A 11/10/2005 2,011.86 SD A 1,003.00 01/01/2007 06/29/2059

394857 OP OP M A 07/12/2005 2,153.29 PD A 1,545.25 07/21/2006 05/30/2055 M A 07/12/2005 2,153.29 SD A 1,395.00 01/01/2006 05/30/2055

394890 OP OP M A 05/26/2006 2,313.14 PD A 1,153.85 09/06/2006 05/11/2064 M A 05/26/2006 2,313.14 SC A 636.00 11/01/2006 05/31/2020 M A 05/26/2006 2,313.14 SD A 1,272.00 11/01/2006 05/11/2064

394892 OP OP M A 04/15/2006 1,115.40 BO A 91.50 01/01/2007 10/18/2023 M A 04/15/2006 1,115.40 SD A 981.00 01/01/2007 10/19/2058

394975 OP OP F A 06/02/2005 1,095.14 PD A 577.45 06/29/2006 08/23/2058 F A 06/02/2005 1,095.14 SD A 1,082.00 11/01/2005 08/23/2058

394989 OP OP M A 01/18/2006 1,192.25 PD A 709.71 09/01/2006 02/17/2053 M A 01/18/2006 1,192.25 SD A 821.00 07/01/2006 02/17/2053

395158 OP OP F A 10/11/2005 1,358.40 PD A 985.65 05/11/2006 08/13/2051 F A 10/11/2005 1,358.40 SD A 1,215.00 04/01/2006 08/13/2051

395194 OP OP F A 04/18/2006 1,793.66 PD A 1,240.35 07/07/2006 08/03/2063 F A 04/18/2006 1,793.66 SD A 1,438.00 10/01/2006 08/03/2063

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395583 OP OP F A 03/31/2006 1,148.06 PD A 623.67 11/15/2006 10/10/2071 F A 03/31/2006 1,148.06 SC A 351.00 09/01/2006 07/31/2023

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 97 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 395583 OP OP F A 03/31/2006 1,148.06 SD A 842.00 09/01/2006 10/10/2071

395586 OP OP M A 04/21/2006 1,414.62 PD A 665.12 09/03/2006 08/11/2065 M A 04/21/2006 1,414.62 SD A 1,047.00 10/01/2006 08/11/2065

397530 OP OP F A 05/25/2006 786.32 PD A 545.02 12/29/2006 09/04/2065

397552 OP OP F A 08/05/2006 2,095.00 PD A 1,009.82 10/07/2006 02/12/2073 F A 08/05/2006 2,095.00 SC A 574.00 02/01/2007 04/30/2016 F A 08/05/2006 2,095.00 SD A 1,148.00 02/01/2007 02/12/2073

398806 OP OP F A 04/20/2006 998.11 RR A 1,815.00 10/01/2006 10/19/2061

917167 OP OP F A 10/23/1997 1,789.40 BO A 84.12 08/01/1998 12/20/2019 F A 10/23/1997 1,789.40 PD A 832.46 03/04/1998 12/21/2054 F A 10/23/1997 1,789.40 SD A 804.00 08/01/1998 12/21/2054

917192 OP OP F A 11/06/1997 2,045.28 PD A 1,495.11 12/24/1997 07/21/2052 F A 11/06/1997 2,045.28 SD A 1,082.00 04/01/1998 07/21/2052

917265 OP OP M A 12/04/1997 930.48 BO A 800.00 03/01/2003 09/10/2030

917270 OP OP F A 09/20/1997 802.15 PD A 299.87 06/25/1998 02/24/2051 F A 09/20/1997 802.15 SD A 666.00 03/01/1998 02/24/2051

917292 OP OP F A 11/01/1997 930.42 PD A 398.23 02/04/1998 01/15/2052 F A 11/01/1997 930.42 SD A 701.00 04/01/1998 01/15/2052

917333 OP OP F A 12/02/1997 1,971.66 PD A 1,143.02 06/27/1998 05/05/2054 F A 12/02/1997 1,971.66 SD A 1,217.00 01/01/1999 05/05/2054

918906 OP OP M A 01/03/1998 1,732.04 PD A 762.31 03/06/1998 10/26/2063 M A 01/03/1998 1,732.04 SD A 946.00 07/01/1998 10/26/2063

918935 OP OP F A 11/26/1997 1,564.06 PD A 814.10 03/04/1998 03/23/2061 F A 11/26/1997 1,564.06 SD A 796.00 05/01/1998 03/23/2061

919173 OP OP F A 07/15/1997 782.11 BO A 138.03 01/01/1998 06/14/2031 F A 07/15/1997 782.11 SD A 614.00 01/01/1998 06/15/2066

919207 OP OP F A 10/24/1997 1,085.12 BO A 505.39 04/01/1998 07/24/2038 F A 10/24/1997 1,085.12 SD A 538.00 04/01/1998 07/25/2073

919283 OP OP M A 10/11/1997 3,167.56 BO A 224.29 08/01/1998 06/15/2015 M A 10/11/1997 3,167.56 PD A 1,562.44 07/01/1998 06/16/2050 M A 10/11/1997 3,167.56 SD A 1,259.00 08/01/1998 06/16/2050

919348 OP OP F A 01/17/1998 1,438.40 BO A 104.64 02/01/2000 03/26/2035

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F A 01/17/1998 1,438.40 PD A 451.44 03/07/1998 03/27/2070 F A 01/17/1998 1,438.40 SD A 827.00 02/01/2000 03/27/2070

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 98 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 922112 OP OP F A 02/07/1998 2,013.16 PD A 1,239.94 05/20/1998 10/20/2051 F A 02/07/1998 2,013.16 SD A 1,105.00 01/01/1999 10/20/2051

922133 OP OP F A 01/09/1998 940.99 PD A 334.89 04/09/1998 07/19/2066 F A 01/09/1998 940.99 SD A 727.00 07/01/1998 07/19/2066

922950 OP OP F A 02/14/1998 598.01 PD A 279.07 05/27/1998 05/24/2056 F A 02/14/1998 598.01 SD A 507.00 01/01/2000 05/24/2056

923278 OP OP M A 02/07/1998 1,515.36 BO A 59.23 11/01/1998 06/29/2017 M A 02/07/1998 1,515.36 PD A 553.85 10/16/1998 06/30/2052 M A 02/07/1998 1,515.36 SD A 844.00 08/01/1998 06/30/2052

924600 OP OP F A 07/03/1998 1,088.70 PD A 529.60 10/09/1998 07/20/2057 F A 07/03/1998 1,088.70 SD A 728.00 01/01/1999 07/20/2057

924823 OP OP F A 06/20/1998 1,335.21 PD A 1,087.16 11/05/1998 06/08/2059 F A 06/20/1998 1,335.21 SD A 899.00 12/01/1998 06/08/2059

926388 OP OP M A 10/07/1997 1,361.77 PD A 1,378.99 09/16/1998 11/17/2055 M A 10/07/1997 1,361.77 SD A 897.00 04/01/1998 11/17/2055 M A 10/07/1997 1,361.77 WP A 217.30 03/13/1999 11/11/2024

926427 OP OP M A 09/03/1998 1,966.95 PD A 1,537.31 10/17/1998 02/26/2053 M A 09/03/1998 1,966.95 SD A 1,162.00 03/01/1999 02/26/2053

927712 OP OP M A 07/24/1998 967.07 BO A 144.94 10/01/2002 12/23/2021 M A 07/24/1998 967.07 SD A 742.00 10/01/2002 12/24/2056 M A 07/24/1998 967.07 WP A 42.94 03/01/2000 07/31/2031

928520 OP OP F A 04/14/1998 1,882.47 BO A 800.00 01/04/2003 05/16/2020 F A 04/14/1998 1,882.47 PD A 932.23 07/01/1999 05/17/2025

929674 OP OP F A 07/15/1998 2,079.56 PD A 1,487.78 08/28/1999 09/22/2057 F A 07/15/1998 2,079.56 SD A 1,093.00 01/01/1999 09/22/2057

929830 OP OP M A 06/26/1998 1,743.19 PD A 1,823.49 10/09/1998 10/02/2058 M A 06/26/1998 1,743.19 SD A 1,012.00 03/01/1999 10/02/2058 M A 06/26/1998 1,743.19 WP A 83.76 09/01/1999 11/01/2032

929884 OP OP F A 08/29/1998 1,441.59 PD A 1,262.69 11/10/1998 11/25/2050 F A 08/29/1998 1,441.59 SD A 930.00 04/01/1999 11/25/2050

931287 OP OP F A 07/03/1998 988.54 BO A 5.18 06/01/1999 06/26/2017 F A 07/03/1998 988.54 PD A 290.07 05/21/1999 06/27/2052 F A 07/03/1998 988.54 PS A 94.27 05/21/1999 06/27/2052 F A 07/03/1998 988.54 SD A 561.00 01/01/1999 06/27/2052

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931879 OP OP F A 08/15/1998 1,182.84 PD A 685.75 11/08/1998 12/09/2056 F A 08/15/1998 1,182.84 SD A 800.00 06/01/1999 12/09/2056

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 99 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 932008 OP OP F A 02/02/1998 1,250.93 BO A 420.81 08/01/1998 11/10/2021 F A 02/02/1998 1,250.93 SD A 782.00 08/01/1998 11/11/2056

932233 OP OP F A 09/11/1998 1,912.95 PD A 1,151.26 02/23/1999 05/31/2060 F A 09/11/1998 1,912.95 SD A 1,115.00 05/01/1999 05/31/2060

933931 OP OP F A 12/01/1998 1,662.75 PD A 963.14 05/07/1999 01/11/2057 F A 12/01/1998 1,662.75 SD A 1,100.00 05/01/1999 01/11/2057

934288 OP OP F A 11/24/1998 481.76 PD A 210.79 02/20/1999 04/18/2056 F A 11/24/1998 481.76 SD A 459.00 05/01/1999 04/18/2056

934290 OP OP F A 01/16/1999 2,070.25 BO A 169.23 06/01/2001 11/06/2019 F A 01/16/1999 2,070.25 PD A 928.40 09/24/2000 11/07/2054 F A 01/16/1999 2,070.25 SD A 893.00 06/01/2001 11/07/2054

934875 OP OP F A 12/17/1997 2,648.54 PD A 1,606.45 08/15/1999 02/29/2052 F A 12/17/1997 2,648.54 SD A 1,207.00 01/01/1999 02/29/2052 F A 12/17/1997 2,648.54 WP A 648.37 02/03/2000 04/30/2032

936147 OP OP F A 04/23/1999 846.46 PD A 348.81 05/04/1999 07/10/2058 F A 04/23/1999 846.46 SD A 691.00 06/01/1999 07/10/2058

937312 OP OP F A 08/22/1998 652.60 PD A 341.21 05/21/1999 08/03/2052 F A 08/22/1998 652.60 SD A 580.00 11/01/1999 08/03/2052

941925 OP OP F A 07/29/1999 1,279.09 PD A 1,113.91 10/15/1999 02/17/2054 F A 07/29/1999 1,279.09 SD A 893.00 01/01/2000 02/17/2054

943770 OP OP F A 08/31/1999 602.01 PD A 250.63 11/16/1999 08/14/2056 F A 08/31/1999 602.01 SD A 853.00 01/01/2001 08/14/2056

943856 OP OP F A 06/05/1999 1,910.46 PD A 1,579.50 09/08/1999 12/19/2051 F A 06/05/1999 1,910.46 SD A 1,163.00 12/01/1999 12/19/2051

947151 OP OP F A 05/30/1999 1,543.26 BO A 662.91 01/01/2000 02/27/2029 F A 05/30/1999 1,543.26 SD A 821.00 01/01/2000 02/28/2064

947450 OP OP M A 05/09/1998 1,005.30 PD A 710.28 09/01/2000 09/07/2054 M A 05/09/1998 1,005.30 SD A 890.00 12/01/2000 09/07/2054

949293 OP OP F A 10/02/1999 2,697.45 PD A 2,013.02 02/09/2000 07/19/2053 F A 10/02/1999 2,697.45 SD A 1,387.00 04/01/2000 07/19/2053

950006 OP OP M A 08/24/1999 1,658.70 PD A 1,550.81 02/15/2000 12/05/2051 M A 08/24/1999 1,658.70 SD A 1,150.00 02/01/2000 12/05/2051

950954 OP OP F A 10/28/1999 1,898.60 PD A 1,099.18 03/29/2000 01/20/2064

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F A 10/28/1999 1,898.60 SD A 1,147.00 04/01/2000 01/20/2064

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 100 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 951225 OP OP M A 12/04/1999 731.25 SD A 781.00 06/01/2000 08/05/2054

953648 OP OP M A 06/08/2000 1,797.69 BO A 150.54 12/01/2000 10/29/2017 M A 06/08/2000 1,797.69 SD A 1,578.00 12/01/2000 10/30/2052

953692 OP OP F A 02/24/2000 1,286.63 BO A 487.14 01/01/2001 04/06/2037 F A 02/24/2000 1,286.63 SD A 750.00 01/01/2001 04/07/2072

953696 OP OP M A 03/25/2000 1,118.11 PD A 435.80 09/28/2000 09/15/2052 M A 03/25/2000 1,118.11 SD A 1,099.00 09/01/2000 09/15/2052

955414 OP OP F A 04/13/2000 2,368.44 PD A 1,792.64 09/12/2000 05/06/2050 F A 04/13/2000 2,368.44 SD A 1,317.00 10/01/2000 05/06/2050

955452 OP OP F A 04/08/2000 1,592.29 BO A 749.04 10/01/2000 02/19/2036 F A 04/08/2000 1,592.29 SD A 782.00 10/01/2000 02/20/2071

956594 OP OP F A 04/15/2000 1,570.13 PD A 848.58 07/08/2000 07/24/2052 F A 04/15/2000 1,570.13 SD A 757.00 10/01/2000 07/24/2052

957511 OP OP F A 06/04/2000 663.49 PD A 356.52 06/09/2000 01/07/2056 F A 06/04/2000 663.49 SD A 576.00 12/01/2000 01/07/2056

957580 OP OP F A 02/18/2000 527.09 SD A 837.00 05/01/2000 07/23/2067

957638 OP OP F A 06/26/2000 892.18 PD A 434.42 10/24/2000 01/11/2056 F A 06/26/2000 892.18 SD A 611.00 01/01/2001 01/11/2056

957653 OP OP F A 01/03/2000 1,910.51 PD A 1,104.13 09/06/2000 09/07/2054 F A 01/03/2000 1,910.51 SD A 998.00 03/01/2001 09/07/2054

957657 OP OP F A 02/07/2000 609.64 BO A 164.19 09/01/2000 03/01/2028 F A 02/07/2000 609.64 SD A 422.00 07/01/2000 03/02/2063

957667 OP OP M A 04/28/2000 1,313.44 PD A 696.06 06/21/2000 04/11/2057 M A 04/28/2000 1,313.44 SD A 889.00 12/01/2000 04/11/2057

957704 OP OP F A 12/16/2000 1,398.36 PD A 975.93 03/23/2001 04/03/2061 F A 12/16/2000 1,398.36 SD A 924.00 06/01/2001 04/03/2061

957783 OP OP F A 06/02/2000 3,097.58 PD A 1,929.25 09/02/2000 01/25/2053 F A 06/02/2000 3,097.58 SD A 1,470.00 02/01/2001 01/25/2053

960295 OP OP M A 06/10/2000 2,744.74 BO A 800.00 10/01/2000 08/25/2019 M A 06/10/2000 2,744.74 SD A 1,666.00 12/01/2000 08/26/2054

960353 OP OP F A 05/29/2000 610.89 SD A 441.00 07/01/2003 05/11/2057

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960367 OP OP M A 06/05/1999 1,932.94 PD A 1,993.38 08/16/2000 04/21/2051 M A 06/05/1999 1,932.94 SD A 1,287.00 01/01/2000 04/21/2051

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 101 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 960367 OP OP M A 06/05/1999 1,932.94 WP A 1,638.39 06/09/2000 02/06/2027

961948 OP OP F A 09/30/2000 1,790.48 PD A 755.15 11/03/2000 05/07/2050 F A 09/30/2000 1,790.48 SD A 1,061.00 03/01/2001 05/07/2050

963359 OP OP M A 05/01/2000 2,313.04 PD A 1,498.56 12/15/2000 09/08/2051 M A 05/01/2000 2,313.04 SD A 999.00 05/01/2001 09/08/2051

963389 OP OP F A 09/15/2000 1,146.11 PD A 615.36 12/13/2000 10/27/2056 F A 09/15/2000 1,146.11 SD A 901.00 03/01/2001 10/27/2056

964201 OP OP M A 08/12/2000 1,012.97 PD A 578.58 01/27/2001 09/03/2068 M A 08/12/2000 1,012.97 SD A 876.00 02/01/2001 09/03/2068

964436 OP OP M A 08/20/2000 919.48 PD A 491.37 01/13/2001 06/15/2068 M A 08/20/2000 919.48 SD A 752.00 02/01/2001 06/15/2068

965638 OP OP F A 11/15/2000 1,767.74 BO A 800.00 02/13/2001 10/26/2018 F A 11/15/2000 1,767.74 SD A 856.00 05/01/2001 10/27/2053

966161 OP OP F A 12/16/2000 1,408.77 PD A 647.33 12/16/2000 01/01/2053 F A 12/16/2000 1,408.77 SD A 831.00 06/01/2001 01/01/2053

966181 OP OP M A 10/11/2000 1,389.70 BO A 411.25 04/01/2001 03/03/2023 M A 10/11/2000 1,389.70 SD A 925.00 04/01/2001 03/14/2058

966206 OP OP F A 10/28/2000 1,765.84 PD A 1,590.78 03/01/2001 02/22/2051 F A 10/28/2000 1,765.84 SD A 1,209.00 04/01/2001 02/22/2051

966788 OP OP M A 01/12/2001 1,420.46 BO A 469.83 07/01/2001 06/07/2019 M A 01/12/2001 1,420.46 SD A 896.00 07/01/2001 06/08/2054

967769 OP OP F A 10/25/2000 1,302.11 PD A 978.99 03/23/2001 07/07/2054 F A 10/25/2000 1,302.11 SD A 903.00 04/01/2001 07/07/2054

967994 OP OP F A 06/09/2000 2,358.74 PD A 2,509.42 05/16/2001 10/13/2051 F A 06/09/2000 2,358.74 SD A 1,473.00 08/01/2001 10/13/2051

968822 OP OP M A 01/09/2001 1,308.56 PD A 461.00 05/17/2001 11/14/2050 M A 01/09/2001 1,308.56 SD A 1,074.00 07/01/2001 11/14/2050

969055 OP OP M A 02/07/2001 731.51 PD A 421.36 06/05/2001 07/31/2055 M A 02/07/2001 731.51 SD A 733.00 07/01/2001 07/31/2055

972049 OP OP F A 10/03/2000 628.93 BO A 604.74 01/01/2001 04/27/2016

972268 OP OP F A 02/27/2001 1,528.69 PD A 1,092.72 08/12/2001 12/07/2058 F A 02/27/2001 1,528.69 SC A 408.00 08/01/2001 10/31/2016

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F A 02/27/2001 1,528.69 SD A 817.00 08/01/2001 12/07/2058

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 102 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 972826 OP OP F A 03/29/2001 1,181.65 PD A 970.45 08/17/2001 06/16/2057 F A 03/29/2001 1,181.65 SD A 870.00 06/01/2001 06/16/2057

973458 OP OP F A 03/30/2001 838.88 BO A 301.61 01/01/2002 05/08/2016 F A 03/30/2001 838.88 SD A 505.00 01/01/2002 05/09/2051

974762 OP OP M A 05/04/2001 1,009.34 PD A 796.93 07/19/2001 06/19/2059 M A 05/04/2001 1,009.34 SD A 854.00 11/01/2001 06/19/2059

976264 OP OP M A 09/26/2000 1,094.18 PS S 795.14 04/18/2001 03/12/2059 M A 09/26/2000 1,094.18 SD A 868.00 06/01/2002 03/12/2059 M A 09/26/2000 1,094.18 WP A 61.90 05/24/2002 03/11/2029

980791 OP OP F A 04/18/2001 451.37 SD A 648.00 10/01/2001 09/08/2059

983465 OP OP F A 10/17/2001 1,205.59 BO A 374.22 04/01/2002 05/25/2016 F A 10/17/2001 1,205.59 SD A 785.00 04/01/2002 05/26/2051

983874 OP OP F A 09/25/2001 1,518.13 BO A 574.74 03/01/2002 02/10/2036 F A 09/25/2001 1,518.13 SD A 885.00 03/01/2002 02/11/2071

984550 OP OP M A 09/26/2001 962.33 BO A 257.31 03/01/2002 02/08/2025 M A 09/26/2001 962.33 SD A 668.00 03/01/2002 02/09/2060

985339 OP OP M A 08/24/2001 2,236.16 PD A 1,555.85 03/30/2002 08/25/2054 M A 08/24/2001 2,236.16 SD A 1,516.00 06/01/2002 08/25/2054

985359 OP OP F A 05/25/2001 720.09 PD A 837.06 07/15/2001 06/19/2060 F A 05/25/2001 720.09 SD A 775.00 11/01/2001 06/19/2060

986037 OP OP M A 07/25/2001 1,380.76 SD A 1,370.00 01/01/2002 10/06/2052

986908 OP OP F A 08/04/2001 1,083.66 BO A 261.98 01/01/2002 11/26/2019 F A 08/04/2001 1,083.66 SD A 780.00 01/01/2002 11/27/2054

986944 OP OP F A 08/14/2001 1,440.24 PD A 923.14 01/10/2002 10/14/2051 F A 08/14/2001 1,440.24 SD A 880.00 08/01/2003 10/14/2051

986947 OP OP F A 08/13/2001 682.18 BO A 71.94 02/01/2002 03/10/2023 F A 08/13/2001 682.18 SD A 584.00 02/01/2002 03/11/2058

986985 OP OP F A 10/12/2001 1,382.01 PD A 619.60 02/21/2002 10/26/2061 F A 10/12/2001 1,382.01 SD A 977.00 04/01/2003 10/26/2061

986988 OP OP M A 08/08/2001 1,401.61 PD A 1,042.32 07/19/2002 11/20/2056 M A 08/08/2001 1,401.61 SD A 943.00 02/01/2002 11/20/2056

987235 OP OP M A 10/20/2001 739.10 SD A 775.00 04/01/2002 05/19/2064

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987707 OP OP F A 01/08/2002 1,082.95 PD A 426.51 08/09/2002 06/14/2063

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 103 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 987707 OP OP F A 01/08/2002 1,082.95 SD A 727.00 12/01/2002 06/14/2063

988274 OP OP M A 10/18/2001 1,493.59 PD A 513.01 01/17/2002 12/07/2051 M A 10/18/2001 1,493.59 PS A 10.41 01/17/2002 12/07/2051 M A 10/18/2001 1,493.59 SR A 1,457.00 04/01/2002 12/07/2051

988282 OP OP F A 09/29/2001 3,010.64 PD A 2,151.83 05/15/2002 07/07/2055 F A 09/29/2001 3,010.64 SD A 1,514.00 03/01/2002 07/07/2055

988764 OP OP F A 09/18/2001 2,489.12 PD A 2,183.70 04/30/2002 11/21/2052 F A 09/18/2001 2,489.12 SD A 1,405.00 05/01/2003 11/21/2052

989102 OP OP F A 07/12/2001 1,961.70 PD A 691.52 05/30/2002 01/03/2053 F A 07/12/2001 1,961.70 SD A 1,240.00 01/01/2002 01/03/2053 F A 07/12/2001 1,961.70 WP A 267.86 05/01/2004 01/02/2023

991740 OP OP F A 11/10/2001 2,342.22 BO A 762.14 05/01/2002 06/28/2021 F A 11/10/2001 2,342.22 SD A 1,490.00 05/01/2002 06/29/2056

993009 OP OP M A 03/26/2002 2,077.58 PD A 1,369.33 07/02/2002 12/22/2053 M A 03/26/2002 2,077.58 SD A 1,112.00 09/01/2002 12/22/2053

993017 OP OP F A 01/16/2002 1,818.91 BO A 61.77 07/01/2002 11/06/2015 F A 01/16/2002 1,818.91 PD A 789.19 04/05/2002 11/07/2050 F A 01/16/2002 1,818.91 SD A 898.00 07/01/2002 11/07/2050

993041 OP OP M A 03/14/2002 1,783.46 PD A 1,337.22 09/07/2002 05/17/2059 M A 03/14/2002 1,783.46 PS A 238.13 03/20/2003 05/17/2059 M A 03/14/2002 1,783.46 SD A 1,334.00 06/01/2005 05/17/2059 M A 03/14/2002 1,783.46 WP A 50.18 10/01/2002 12/31/2033

994123 OP OP F A 02/19/2002 1,357.47 PD A 914.27 06/12/2002 12/16/2055 F A 02/19/2002 1,357.47 SD A 917.00 08/01/2002 12/16/2055

994133 OP OP F A 10/09/2001 1,744.49 BO A 800.00 01/07/2002 04/28/2018 F A 10/09/2001 1,744.49 SD A 693.00 03/01/2003 04/29/2053

994453 OP OP F A 02/06/2002 1,498.30 PD A 765.52 05/22/2002 04/11/2063 F A 02/06/2002 1,498.30 SD A 977.00 08/01/2002 04/11/2063

995999 OP OP F A 01/03/2002 1,534.44 BO A 800.00 04/03/2002 07/20/2036 F A 01/03/2002 1,534.44 SD A 657.00 03/01/2003 07/21/2071

996924 OP OP M A 03/19/2002 981.66 BO A 18.91 09/01/2002 03/12/2026 M A 03/19/2002 981.66 SD A 925.00 09/01/2002 03/13/2061

996967 OP OP F A 06/01/2002 2,087.04 BO A 215.88 01/01/2003 10/19/2015 F A 06/01/2002 2,087.04 PD A 1,014.89 08/24/2002 10/20/2050

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F A 06/01/2002 2,087.04 SD A 776.00 01/01/2003 10/20/2050

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CLAIM OFFSET INFORMATION AS OF 04/30/2015 13:17 Tuesday, May 5, 2015 104 STANDARD INSURANCE COMPANY

CLM CLM INCURRAL CLOSE GROSS OFFSET OFFSET OFFSET OFFSET OFFSET CO POLICY CLAIM PROD TYPE GENDER STS DATE DATE BENEFIT ID STATUS AMOUNT EFF DATE LIM DATE

SI 621144 998008 OP OP M A 01/17/1999 2,035.35 PD A 988.08 07/14/2002 12/25/2062 M A 01/17/1999 2,035.35 SD A 1,431.00 05/01/2000 12/25/2062 M A 01/17/1999 2,035.35 WP A 135.42 07/02/1904 07/19/2037

998014 OP OP M A 11/26/2001 1,366.68 PD A 979.07 09/01/2002 07/05/2064 M A 11/26/2001 1,366.68 SD A 208.00 05/01/2002 07/05/2064 M A 11/26/2001 1,366.68 WP A 1,427.81 07/11/2005 07/05/2064