Life Beneficiary Form

Group Term Life Insurance Beneficiary Designation Metropolitan Life Insurance Company Things to know before you begin • This form MUST be signed before you return it. You MUST return all See "SECTION 3 - Signature" on page 8. pages of this form. SECTION 1: Insured information Customer number Employer name/Group policyholder name First name Middle name Last name Address - Street City State ZIP code Date of birth (mm/dd/yyyy) Phone number SSN SECTION 2: Beneficiary and plan information • You MUST designate at least one primary beneficiary for each coverage in which you enroll. A person may only be listed once. Anyone listed in the primary section cannot be listed in the contingent section. • The sum of the Primary Beneficiary percentages MUST equal 100%. The sum of the Contingent Beneficiary percentages MUST equal 100%. Dollar amounts, fractions and decimals will not be accepted. • If you need more space for additional beneficiaries, attach a separate page. Include all beneficiary information, and sign/date the page. Please complete each coverage section and all sections that pertain to the type of beneficiary you are designating. Basic life - Beneficiary designation I elect that the beneficiary designation indicated below applies to the Basic Life plans insured by MetLife: A. Individual beneficiaries Primary beneficiary - Your first choice to receive your life insurance proceeds in the event of your death. If any primary beneficiaries predecease you, that person's share will be equally divided among any remaining primary beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Page 1 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Contingent beneficiary - Your second choice to receive your life insurance proceeds if ALL of your primary beneficiary(ies) are not living at the time of your death. If any contingent beneficiaries predecease you, that person’s share will be equally divided among any remaining contingent beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number B. Living trust - Primary Contingent If this form is executed by the insured, it is understood and agreed that if MetLife receives satisfactory proof that the aforesaid trust has been revoked or is not in effect at the insured's death, the beneficiary shall be the insured's Estate, unless otherwise indicated on this form. Trust name Trust date (mm/dd/yyyy) Trustee phone number Share % Trustee - First name Middle initial Last name Trustee address - Street City State ZIP code C. Testamentary trust created in the insured's will - Primary Contingent Share % The trust(ee) under any last Will and Testament of mine as shall be admitted to probate. Page 2 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

D. Insured's estate - Primary Contingent Share % If the Insured's Estate is selected as the Primary Beneficiary, no Contingent Beneficiary may be named. E. Charity/Organization - Primary Contingent Be sure to name the charity or organization and not the charity or organization director or an employee of that charity/organization. Charity/Organization name Phone number Share % Address - Street City State ZIP code Accidental Death & Dismemberment for basic life - Beneficiary designation I elect that the beneficiary designation indicated below applies to the Accidental Death & Dismemberment plans insured by MetLife: A. Individual beneficiaries Primary beneficiary - Your first choice to receive your life insurance proceeds in the event of your death. If any primary beneficiaries predecease you, that person's share will be equally divided among any remaining primary beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Page 3 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

Contingent beneficiary - Your second choice to receive your life insurance proceeds if ALL of your primary beneficiary(ies) are not living at the time of your death. If any contingent beneficiaries predecease you, that person’s share will be equally divided among any remaining contingent beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number B. Living trust - Primary Contingent If this form is executed by the insured, it is understood and agreed that if MetLife receives satisfactory proof that the aforesaid trust has been revoked or is not in effect at the insured's death, the beneficiary shall be the insured's Estate, unless otherwise indicated on this form. Trust name Trust date (mm/dd/yyyy) Trustee phone number Share % Trustee - First name Middle initial Last name Trustee address - Street City State ZIP code C. Testamentary trust created in the insured's will - Primary Contingent Share % The trust(ee) under any last Will and Testament of mine as shall be admitted to probate. D. Insured's estate - Primary Contingent Share % If the Insured's Estate is selected as the Primary Beneficiary, no Contingent Beneficiary may be named. E. Charity/Organization - Primary Contingent Be sure to name the charity or organization and not the charity or organization director or an employee of that charity/organization. Charity/Organization name Phone number Share % Address - Street City State ZIP code Page 4 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

Supplemental/Optional life - Beneficiary designation I elect that the beneficiary designation indicated below applies to the Supplemental/Optional Life plans insured by MetLife: A. Individual beneficiaries Primary beneficiary - Your first choice to receive your life insurance proceeds in the event of your death. If any primary beneficiaries predecease you, that person's share will be equally divided among any remaining primary beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Contingent beneficiary - Your second choice to receive your life insurance proceeds if ALL of your primary beneficiary(ies) are not living at the time of your death. If any contingent beneficiaries predecease you, that person’s share will be equally divided among any remaining contingent beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Page 5 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

B. Living trust - Primary Contingent If this form is executed by the insured, it is understood and agreed that if MetLife receives satisfactory proof that the aforesaid trust has been revoked or is not in effect at the insured's death, the beneficiary shall be the insured's Estate, unless otherwise indicated on this form. Trust name Trust date (mm/dd/yyyy) Trustee phone number Share % Trustee - First name Middle initial Last name Trustee address - Street City State ZIP code C. Testamentary trust created in the insured's will - Primary Contingent Share % The trust(ee) under any last Will and Testament of mine as shall be admitted to probate. D. Insured's estate - Primary Contingent Share % If the Insured's Estate is selected as the Primary Beneficiary, no Contingent Beneficiary may be named. E. Charity/Organization - Primary Contingent Be sure to name the charity or organization and not the charity or organization director or an employee of that charity/organization. Charity/Organization name Phone number Share % Address - Street City State ZIP code Accidental Death & Dismemberment for Supplemental/Optional life - Beneficiary designation I elect that the beneficiary designation indicated below applies to the Accidental Death & Dismemberment plans insured by MetLife: A. Individual beneficiaries Primary beneficiary - Your first choice to receive your life insurance proceeds in the event of your death. If any primary beneficiaries predecease you, that person's share will be equally divided among any remaining primary beneficiaries. First name Middle initial Last name Share % Address - Street City State ZIP code Relationship to employee Social security number Date of birth (mm/dd/yyyy) Phone number Page 6 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f

D. Insured's estate - Primary Contingent Share % If the Insured's Estate is selected as the Primary Beneficiary, no Contingent Beneficiary may be named. E. Charity/Organization - Primary Contingent Be sure to name the charity or organization and not the charity or organization director or an employee of that charity/organization. Charity/Organization name Phone number Share % Address - Street City State ZIP code SECTION 3: Signature Check if you are completing and signing this form as agent for the employee under a valid Power of Attorney. Return a copy of the Power of Attorney with this beneficiary form. The Power of Attorney paperwork is subject to review by MetLife. I hereby revoke any previous designations, and I designate the person, people, or entity named in Section 2 as Beneficiary(ies). I reserve the right to change or revoke this designation at any time. Insured/Owner name (Please print) First name Middle name Last name Signature of Insured/Owner Date (mm/dd/yyyy) (must be date form was completed) SECTION 4: How to submit this form The employee should provide the completed form to their Employer. Retain a copy for your records. Page 8 of 8 GR-TR-BENE-EMP-M (12/18) Fs/f