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Compensation Disclosure <br />6 <br />Compensation Disclosure — Attachment Sheet 3 of S Sheet(s) <br />Lockton believes it is or may be entitled to receive the compensation listed below, from the insurance companies and/or other entities <br />listed below, attributable to the insurance and/or administrative service contracts placed with those insurers and/or other entities on <br />your behalf. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Mutual of Omaha Insurance Company <br />Policy or Benefit Type: <br />Life and AD&D <br />Plan Name: <br />Basic Life and AD/D <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2024 <br />Base Commissions: <br />Basic Life and AD/D Rate - 5.0% <br />Additional <br />This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />Compensation: <br />description of the manner in which the Additional Compensation that Lockton may receive under such program would be <br />calculated. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Mutual of Omaha Insurance Company <br />Policy or Benefit Type: <br />Voluntary Life <br />Plan Name: <br />Vol. Life/Dep. Life <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2024 <br />Base Commissions: <br />Vol. Life/Dep Life Rate - 5.0% <br />Additional <br />This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />Compensation: <br />description of the manner in which the Additional Compensation that Lock -ton may receive under such program would be <br />calculated. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Mutual of Omaha Insurance Company <br />Policy or Benefit Type: <br />Short Term Disability (STD) <br />Plan Name: <br />Vol. STD <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2024 <br />Base Commissions: <br />Vol. STD Rate - 5.0% <br />Additional This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />description of the manner in which the Additional Compensation that Lockton may receive under such program would be <br />calculated. <br />Client Name: <br />INDIAN RIVER COUNTY <br />Insurer or TPA: <br />Mutual of Omaha Insurance Company <br />Policy or Benefit Type: <br />Long Term Disability (LTD) <br />Plan Name: <br />Vol. LTD <br />Policy / Contract Year: <br />Effective Date 10/1/2022 to Expiration Date 9/30/2024 <br />Base Commissions: <br />Vol. LTD Rate - 180 day EP - 5.0% <br />Vol. LTD Rate - 90 day EP - 5.0% <br />Additional <br />This insurer/TPA does have an Additional Compensation program in place that might apply to the placement of your <br />Compensation: <br />policy(ies) or administrative -services -only contract(s). Upon request, Lockton can provide you with a more detailed <br />description of the manner in which the Additional Compensation that Lockton may receive under such program would be <br />calculated. <br />L Copyright 2022 Lockton Companies, LLC. All rights reserved. The contents of this document are proprietary and confidential. <br />Unauthorized duplication of this document is prohibited. <br />LOCKTOW Page 13 of 15 <br />