Mark Holand
June 30, 2026
Page 2

You will receive an explanation of benefits statement for your first payment. After that, we will only send
you an explanation of benefits statement to let you know if there is a change to your benefit amount.
We calculate your semi-monthly LTD payment as follows:

Your monthly earnings $8,205.60
Benefit formula according to your group =X 50%
benefits plan

Monthly LTD payment $4,102.80
Semi-Monthly LTD payment $2,051.40

Tax information
Your disability benefits aren’t taxable so you don’t need to report your LTD income on your annual income
tax return.

What we deduct

You may be entitled to benefits from other sources during the same period as your LTD payments. These
other benefits may be deducted from your LTD payments. We'll ask you to apply, reapply, or appeal
decisions for other benefits that you may be entitled to. It’s important to act on these requests otherwise
we may deduct estimated amounts.

f you are entitled to receive any of the benefits listed below, deduction from your LTD payment will occur.

Types of deductions: Examples:

Disability or retirement income e Canada or Quebec Pension Plan

e Benefits paid from a government plan in another country
e Provincial automobile insurance benefits

e Workers’ Compensation Benefits

The maximum income you can receive from all sources

There’s an all source maximum provision in your plan which limits the monthly amount of income you can
receive from all sources while you're disabled. This means if other sources of income plus your LTD
payment add up to more than 85% of your monthly pay before you became disabled, we'll reduce your
LTD payment with the excess amount.

How to report other income
We will let you know in a separate letter if you should apply for other disability benefits.

In the meantime, it is your responsibility to let us know if you receive other income. For this reason, we’ve
included a Reportable Income and Income Declaration Form with this letter for you to sign and return in 15
days. The Reportable Income and Income Declaration Form acknowledges that you will let Canada Life
know about any other income and repay Canada Life if that income results in an overpayment of LTD
benefits.

How your plan defines disability
In order to receive disability benefits, you must be disabled and unable to work according to your plan’s
initial and subsequent definitions of disability.

For LTD benefits, we assess your entitlement to benefit payments using two definitions of disability. First is
the initial assessment period and, if you're still disabled after that, a different definition of disability is used.
Here’s how this works.