Underwriting Breast Cancer [Presenter Name, Title] The Prudential Insurance Company of America, Newark, NJ NOT FOR CONSUMER USE. 0251209-00002-00 Ed. 3/2015 Exp. 03/5/2017

Description Breast Cancer Breast cancer is the most common cancer in women in the United States and second only to lung cancer as a cause of cancer deaths. Some cancers are discovered when a woman finds a palpable mass in her breast. Most cases are diagnosed by screening mammography (breast X-ray). The diagnosis of breast cancer is made by biopsy. Staging is done to determine the prognosis, to direct therapies, and to report results in treatment research studies. The staging system of the American Joint Committee on Cancer Staging uses TNM (tumor, node, metastasis) classification. The primary tumor is evaluated by size, involvement of other tissues, status node, and presence or absence of distant metastasis. Non-invasive cancer (aka in-situ) has a better prognosis than invasive tumors. Tumor size is an independent prognostic factor. Each involved node worsens the prognosis. For breast cancer, the mortality risk varies with the stage of the cancer. NOT FOR CONSUMER USE.

Underwriting Criteria Breast Cancer Reports Needed and Critical Information for Risk Assessment Pathology report/age at diagnosis. Stage, nodal involvement, and size of tumor Best Case Scenario (Non-Smokers) Stage 1A (T1 N0) and Stage 0 in-situ (T1 N0) – Standard rates if greater than or equal to 40 years old (at diagnosis) with small (less than or equal to 1 mm), low grade, estrogen receptor (ER) positive tumors and normal annual mammograms. Unable to Offer Greater than 3 nodes positive or nodes other than axillary or intramammary ( a 15 year postponement period, then individual consideration) Stages 3 and 4 (a 15 year postponement period, then individual consideration) NOT FOR CONSUMER USE.

Case Studies Susan Susan is a 60-year-old female with the following breast cancer history: • Diagnosis at age 58. • Low grade, estrogen receptor (ER) positive. • Tumor size is 1.1mm and node negative (T1a N0) Classification Under our guidelines, the final classification is Non-Smoker Plus with no postponement. NOT FOR CONSUMER USE.

Case Studies Sally Sally is a 47-year-old female with the following breast cancer history: • Diagnosed at age 40. • Treatment ended at age 42. • Tumor size is 1.5 cm and 1 node positive (T1 N1). Classification Table B with Temporary Extra of $10.00 per thousand for 6 years, after postponement of 5 years from end of treatment. NOT FOR CONSUMER USE.

Questions? NOT FOR CONSUMER USE.

Important Information Case studies are for example purposes only. This material is intended for insurance informational purposes only and is not personal medical advice for clients. Rates and availability will vary based on the satisfaction of our underwriting criteria. Underwriting rules are subject to change at the company’s discretion. Insurance is issued by The Prudential Insurance Company of America and its affiliates, Newark, NJ. . NOT FOR CONSUMER USE.