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SCHEDULE OF BENEFITS <br /> NAME OF SUBSIDIARIES, DIVISIONS OR AFFILIATES TO BE COVERED: None <br /> ELIGIBLE CLASSES: Each active, Full-time employee, except any person employed on a temporary or seasonal basis, <br /> according to the following classifications: <br /> CLASS 1: City Manager <br /> CLASS 2: City& Library Management Employee <br /> CLASS 3: Police Officer <br /> CLASS 4: Fire Fighter <br /> CLASS 5: General Service Employee <br /> CLASS 6: Library General Service Employee <br /> INDIVIDUAL EFFECTIVE DATE: The day the person becomes eligible. <br /> MINIMUM PARTICIPATION REQUIREMENTS: Percentage: 100% Number of Insureds: 10 <br /> AMOUNT OF INSURANCE: <br /> Basic Life and Accidental Death and Dismemberment: <br /> CLASS 1: Three (3) times Earnings, rounded to the next higher $1,000, plus $5,000, subject to a maximum of <br /> $425,000. <br /> CLASS 2: One (1) times Earnings, rounded to the next higher $1,000, plus $5,000, subject to a maximum of <br /> $110,000. <br /> CLASS 3&4: $25,000. <br /> CLASS 5: $10,000. <br /> CLASS 6: $5,000. <br /> CLASS 1: Amounts of basic insurance over$396,000 are subject to our approval of a person's proof of good health. <br /> However, any proof of good health required due to late application for this insurance (See EFFECTIVE DATE OF <br /> INDIVIDUAL INSURANCE)will be at no expense to us. <br /> � The Amount of Basic Life and Accidental Death and Dismemberment Insurance will be reduced by 50%of the pre-age 70 <br /> amount at age 70. <br /> DEPENDENT LIFE: Spouse Amount: $2,000 <br /> Child Amount: <br /> 14 days to 6 months: $100 <br /> 6 months and over: $1,000 <br /> The Spouse amount of insurance may not exceed 100%of the Insured's amount. <br /> The Spouse amount of insurance will reduce in the same manner as the Insured's amount of insurance upon Spouse's <br /> attainment of reducing ages. <br /> The Life amount will be reduced by any benefit paid under the Accelerated Benefit Rider. <br /> LRS-6422-2 Ed. 9/89 Page 1.0 <br />