R2007-197 AUTHORIZING GROUP TERM LIFE INSURANCE COVERAGE

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CONVERSION OF DEPENDENT LIFE INSURANCE If the insurance of an Insured Dependent terminates because: (1) the Insured terminates employment or membership in the classes eligible for this insurance; or (2) the Insured dies; or (3) the dependent ceases to be eligible for this insurance; then the dependent may convert his/her insurance to an individual policy. The conversion is subject to the following ru les: (1) a written application for the conversion policy must be received by us within thirty-one (31) days after the dependenYs insurance terminates. The first premium must be sent in with the application; and (2) the premium due for the policy will be at our usual rates. This rate will be based on the amount of insurance, class of risk and the age of the dependent on the date the policy is issued; and (3) the policy may be any life plan we currently issue, except term insurance; and (4) proof of good health is not required; and (5) the policy issued will be for an amount not over what the dependent had before termination under this Policy; and ' (6) the policy issued will not have disability or supplemental benefits. If the dependent's insurance ceases due to termination or amendment of this Policy, an individual policy can be issued. The dependent must have been insured for at least five (5)years under this Policy. The same rules as shown above will be used, except that the face amount will be the lesser of: (1) the amount of dependent life insurance under this Policy. This amount will be less any amount of group life insurance the dependent receives or becomes eligible for within thirty-one (31) days after this Policy terminates; or (2) $10,000. If an Insured Dependent should die during the time in which he/she is entitled to apply for an individual policy, we will pay the benefit under the Group Policy that he/she was entitled to convert. This will be done whether or not the dependent applied for the individual policy, or the first premium was paid. Any individual policy issued with respect to this section will be effective at the end of the thirty-one (31) day period in which application must be made. If an Insured Dependent is entitled to have an individual policy issued to him/her without proof of health, then he/she must be given notice of this right at least fifteen (15) days before the end of the period specified above. Such notice must be: � (1) in writing; and (2) presented or mailed to the Insured Dependent by you. If not, the Insured Dependent will have an additional period in order to do so. This additional period will end fifteen (15) days after the Insured Dependent is given notice. This period will not extend beyond sixty (60) days after the expiration date of the period provided above. This insurance will not be continued beyond the period provided above. LRS-6422-36 Ed. 05/02 Page 13.1