Union Assurance PLC (PQ12), No. 20, St. Michael's Road, Colombo 03, Sri Lanka Telephone: Hotline (+94) 112 990 990 | Shortcode: 1330 | General (+94) 112 990 000 | Fax: Life Insurance: (+94) 112 438 165 Human Resources (+94) 112 320 595 | Email: info@unionassurance.com | Website: www.unionassurance.com Page 1 of 4 Union Life Pension Advantage Quotation Date of Issue : 29/11/2023 Quote No. : 0000004140370 FNA No. : 0000004498258 1. Personal Details Date of Birth Age Gender Main Life MR. UDAYANGA 07/08/1987 36 Male 2. About Your Plan Primary Need : Retirement Basic Sum Assured : Rs. 1,000,000 Term of the policy : 19 Years Basic Annual Premium : Rs. 71,429 Retirement Age : 55 Benefit Paying Term : 20 Deductible Option : 1 ( 0 ) 3. Illustrated Maturity Benefit ( Investment Account Value ) based on Premium Paying Frequency Premium Paying Frequency Assumed Annual Dividend Rate of 8% (Rs.) Assumed Annual Dividend Rate of 10% (Rs.) Assumed Annual Dividend Rate of 12% (Rs.) Yearly 2,412,820 2,998,364 3,740,630 Half Yearly 2,370,854 2,932,462 3,641,813 Quarterly 2,349,782 2,899,458 3,592,445 Monthly 2,335,907 2,877,750 3,560,011 4. Illustrated Monthly Retirement Income Benefit Paying Term Assumed Annual Dividend Rate of 8% (Rs.) Assumed Annual Dividend Rate of 10% (Rs.) Assumed Annual Dividend Rate of 12% (Rs.) 10 Years 28,735 38,604 51,857 15 Years 22,527 31,186 43,021 20 Years 19,639 27,862 39,227 Page 2 of 4 5. Protection Benefits Benefits for MR. UDAYANGA Rider Sum Assured (Rs.) Term Mode Premium (Rs.) Additional Life Protection Benefits Waiver of Premium Benefit on Death N/A 19 3,569 Total for Life Protection Benefits 3,569 Disability Benefits Waiver of Premium Benefit N/A 19 4,244 Total for Disability Benefits 4,244 Health Benefits Suwamaga Benefit (Critical Illness Cover) 1,000,000 19 13,392 Union Health 360 ( - Sri Lanka) 1,000,000 19 45,335 Total for Health Benefits 58,727 Total Premium for additional benefits of Main Life 66,540 Death Benefits Amount payable on Death : Basic Sum Assured of Rs. 1,000,000 6. Premium details of your Plan Category Yearly (Rs.) Half Yearly (Rs.) Quarterly (Rs.) Monthly (Rs.) Basic Sum Assured 71,429 37,143 18,929 6,429 Additional Life Protection Benefits 3,569 1,857 947 322 Disability Benefits & Waiver of Premium 4,244 2,194 1,116 378 Health Benefits 58,727 30,271 15,363 5,197 Policy Fee 50 32 19 7 Total Premium 138,019 71,497 36,374 12,333 Page 3 of 4 7. Illustration of Investment Account Values Assumed Annual Dividend Rate of 8% (Rs.) Assumed Annual Dividend Rate of 10% (Rs.) Assumed Annual Dividend Rate of 12%(Rs.) Year Annual Premium Amount payable on death Investment Account Value Amount payable on death Investment Account Value Amount payable on death Investment Account Value 1 71,429 1,000,000 25,285 1,000,000 25,767 1,000,000 26,250 2 71,429 1,000,000 82,689 1,000,000 84,761 1,000,000 86,852 3 71,429 1,000,000 161,435 1,000,000 166,699 1,000,000 172,067 4 71,429 1,000,000 245,405 1,000,000 255,704 1,000,000 266,327 5 71,429 1,000,000 335,001 1,000,000 352,468 1,000,000 370,704 6 71,429 1,000,000 430,436 1,000,000 457,460 1,000,000 486,030 7 71,429 1,000,000 532,149 1,000,000 571,471 1,000,000 613,578 8 71,429 1,000,000 640,532 1,000,000 695,260 1,000,000 754,637 9 71,429 1,000,000 756,163 1,000,000 829,872 1,000,000 910,916 10 71,429 1,000,000 879,173 1,000,000 975,787 1,000,000 1,083,455 11 71,429 1,000,000 1,010,182 1,000,000 1,134,173 1,000,000 1,274,255 12 71,429 1,000,000 1,149,681 1,000,000 1,306,084 1,000,000 1,485,245 13 71,429 1,000,000 1,298,472 1,000,000 1,493,050 1,000,000 1,719,094 14 71,429 1,000,000 1,456,575 1,000,000 1,695,558 1,000,000 1,977,150 15 71,429 1,000,000 1,624,834 1,000,000 1,915,307 1,000,000 2,262,507 16 71,429 1,000,000 1,803,868 1,000,000 2,153,748 1,000,000 2,578,053 17 71,429 1,000,000 1,994,752 1,000,000 2,413,085 1,000,000 2,927,894 18 71,429 1,000,000 2,197,361 1,000,000 2,693,815 1,000,000 3,313,842 19 71,429 1,000,000 2,412,820 1,000,000 2,998,364 1,000,000 3,740,630 Note : Fund accumulations are based on Yearly Premium Paying Frequency (Actual maturity value will depend on the actual dividends declared and date of premium payment) The fund accumulations shown are after deducting the applicable allocations charges, Fund Management Fees and Cover charges 8. Union Assurance Dividend Declaration Year 2016 2017 2018 2019 2020 2021 2022 Average Life Fund Yield 11.65% 12.48% 11.57% 11.24% 10.62% 10.92% 12.73% Distributable Dividend Rate 10.50% 10.25% 10.00% 10.00% 09.00% 08.00% 10.00% Guaranteed interim dividend rate for 2023 - 9% Stated premium is subject to revision based on the declarations made in the Insurance Proposal Form and the reports of the medical examination / laboratory tests where applicable. This quotation is valid only for 15 days and any alterations made on this quotation are invalid. The selected deductible option will be applicable on individual/floater basis to all the members covered under Union Health 360. The selected deductible option will be applicable on individual/floater basis to all the members covered under Union Health 360. The opted deductible amount cannot be removed during the term of the benefit. This Maternity Benefit can only be availed at the time of commencement of the policy and the age of the assured must be less than Forty (40) years and the benefit is ceased upon attaining age Forty Five (45). Special Features of Union Health 360 * Wellbeing, Outpatient and Ayurvedic Hospitalization Benefit, Routine Dental Benefit, Critical Illness Reimbursement covers are inbuild to UH360 Benefits. Maternity & Routine Optical Benefits are optional benefits (For Life Assured & Spouse) * Routine Dental Benefit, Critical Illness Reimbursement covers are inbuild to UH360 Benefit (For Children) 5 countries - Sri Lanka, India, Singapore , Thailand and Malaysia Worldwide cover - Worldwide Excluding USA and Canada Authorized Signature : Date : Adviser's Name : ANDRDI W.M.D.H. Adviser's Code : AG000230 Quotation No : 0000004140370 Page 4 of 4 For Office Use: Main Life SAR Medical 1,500,000 SAR Financial 1,000,000 Medical Requirements Financial Requirements N/A Occupation Category ADMINISTRATION OFFICER / Non Smoker Main Life BSA LTB SMB FEB WPD WP HEALTH360 OPD OPTICAL MATERNITY USHP 0 - 0 - 0 0 0 0 - - -