R2007-197 AUTHORIZING GROUP TERM LIFE INSURANCE COVERAGE

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WAIVER OF PREMIUM IN EVENT OF TOTAL DISABILITY We will extend the Amount of Insurance during a period of Total Disability for one (1)year if: (1) the Insured becomes totally disabled prior to age 60; (2) the Total Disability begins while he/she is insured; (3) the Total Disability begins while this Policy is in force; (4) the Total Disability lasts for at least 9 months; (5) the premium continues to be paid; and (6) we receive proof of Total Disability within one (1)year from the date it began. . After proof of Total Disability is approved by us, neither you or the Insured is required to pay premiums. Also, any premiums paid from the start of the Total Disability will be returned. We will ask the Insured to submit annual proof of continued Total Disability. The Amount of Insurance may then be extended for additional one (1) year periods. The Insured may be required to be examined by a Physician approved by us as part of the proof. We will not require the Insured to be examined more than once a year after the insurance has been extended two(2)full years. The Amount of Insurance extended will be limited to the amount of basic group life coverage on the life of the Insured that was in force at the time that Total Disability began excluding any additional benefits. This amount will not increase. This amount will reduce or cease at any time it would reduce or cease if the Insured had not been totally disabled. If the ' Insured dies, we will be liable under this extension only if written proof of death is received by us. !, The Amount of Insurance extended for an Insured will cease on the earliest of: I (1) the date he/she no longer meets the definition of Total Disability; or (2) the date he/she refuses to be examined; or (3) the date he/she fails to furnish the required proof of Total Disability; or (4) the date he/she becomes age 70; or (5) the date he/she retires. The Insured may use the conversion privilege when this extension ceases. Please refer to the Conversion Privilege section for rules. An Insured is not entitled to conversion if he/she returns to work and is again eligible for the insurance under this Policy. If the Insured uses the conversion privilege, benefits will not be payable under the Waiver of Premium in Event of Total Disability provision unless the converted policy is surrendered to us. LRS-6422-38 Ed. 11/00 Page 9.0