R2007-197 AUTHORIZING GROUP TERM LIFE INSURANCE COVERAGE

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9. EFFECTIVE DATE OF INDIVIDUAL INSURANCE: With respect to employees and spouses who were approved for coverage on or after November 1, 2007 and were insured with the prior carrier on October 31, 2007, individual insurance will be effective on November 1, 2007. The Amount of Insurance will be the amount the employee/spouse had with the prior carrier. With respect to persons who were not insured with the prior carrier on October 31,2007,the following applies: GUARANTEED ISSUE AMOUNT: An Eligible Person must apply in writing for this insurance. Those employees eligible before or upon the Effective Date of this Policy must complete, sign and return the application during the initial enrollment period. All other employees must apply within thirty-one (31) days of becoming eligible. If insurance is applied for beyond the enrollment period or beyond thirty-one (31) days of becoming eligible, medical evidence of insurability will always be required; the only exceptions are life event changes (see CHANGES section) and any annual enrollment approved by us. EMPLOYEE: If an eligible employee is under the age of 70 and applies for coverage within 31 days of becoming eligible, up to $100,000 of insurance will be issued. The employee's Effective Date of coverage will be the first day of the month following the date the application is signed, provided any premium has been paid. DEPENDENT SPOUSE: A Dependent spouse under age 60 may be eligible for guaranteed issue coverage, provided the eligible employee applies for coverage within 31 days of becoming eligible. Spouse guaranteed issue coverage is limited to$50,000 of coverage. The spouse must not be confined at home or in a hospital. AMOUNTS OVER THE GUARANTEED ISSUE AMOUNT AND AMOUNTS APPLIED FOR AFTER THE INITIAL ELIGIBILITY PERIOD: An Eligible Person's Effective Date of coverage will be the first day of the month following the date the application is signed, provided the Insurance Company agrees to insure such person and any additional premium is received. Amounts of Insurance on Dependent children are effective on the first day of the month following the date the application is signed(provided the employee or spouse has insurance coverage). Under all circumstances, premiums must be paid as required. The Individual Effective Date cannot predate either: (a) the Participating Unit Effective Date; or (b) the date the employee first becomes eligible for this insurance. Any application dated prior to the date the employee first becomes eligible will be considered to be dated on the first day of eligibility. Insurance applied for during a Reliance Standard-approved annual enrollment that takes place beyond the eligible employee's initial enrollment period or beyond the employee's initial eligibility period will become effective according to the specific rules for such enrollment. 10. PREMIUMS: Employee and spouse premiums are based on the person's age as of his last birthday. Premiums are payable monthly, in advance. Premium increases, resulting from an Insured or an insured Dependent spouse entering into a higher age bracket, occur on the anniversary date (shown in the Insured's Certificate of Insurance) coinciding with or next following such Insured's or insured Dependent spouse's last birthday. 11. MINIMUM PARTICIPATION REQUIREMENTS: The greater of: 10 continuously approved employees; or 10% of eligible employees. Such employees must be approved within 60 days of our receipt of this Application. LRS-8348-01-0592