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Tj ET q n 0 25.15 m 183.6 25.15 l 183.6 13.15 l 0 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 15.56 Tm (GL1102 FACE PAGE) Tj ET Q q n 183.6 25.15 m 367.2 25.15 l 367.2 13.15 l 183.6 13.15 l h W n Q q n 367.2 25.15 m 550.8 25.15 l 550.8 13.15 l 367.2 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 528 15.56 Tm (02) Tj ET Q q n 0 13.15 m 550.8 13.15 l 550.8 1.15 l 0 1.15 l h W n 0 0 0 rg BT /F2 10 Tf 1 0 0 1 504.44 3.56 Tm (07/01/21) Tj ET Q Q q Q q 1 0 0 1 36 58.25 cm q 1 0 0 1 0 651.25 cm q n 0 0 m 135 0 l 135 46.5 l 0 46.5 l h W n q 135 0 0 46.5 0 0 cm /img17847 Do Q Q Q q Q 0 0 0 rg BT /F2 14 Tf 1 0 0 1 179.4 685.28 Tm (The Lincoln National Life Insurance Company) Tj ET BT /F2 10 Tf 1 0 0 1 179.4 672.74 Tm (A Stock Company) Tj ET BT /F2 10 Tf 1 0 0 1 263.29 672.74 Tm (Home Office Location:) Tj ET BT /F2 10 Tf 1 0 0 1 361.58 672.74 Tm (Fort Wayne, Indiana) Tj ET BT /F2 10 Tf 1 0 0 1 179.4 661.24 Tm (Group Insurance Service Office:) Tj ET BT /F2 10 Tf 1 0 0 1 314.62 661.24 Tm (8801 Indian Hills Drive, Omaha, NE 68114-4066) Tj ET BT /F2 10 Tf 1 0 0 1 179.4 649.74 Tm (\(800\) 423-2765) Tj ET BT /F2 10 Tf 1 0 0 1 251.89 649.74 Tm (Online: www.LincolnFinancial.com) Tj ET q n 0 647.16 m 612 647.16 l 612 635.16 l 0 635.16 l h W n Q q n 0 635.16 m 612 635.16 l 612 623.16 l 0 623.16 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 625.56 Tm (CERTIFIES THAT Group Policy No.) Tj ET BT /F2 12 Tf 1 0 0 1 209.33 625.56 Tm (000010232170) Tj ET BT /F2 12 Tf 1 0 0 1 308.33 625.56 Tm (has been issued to) Tj ET Q q n 0 623.16 m 612 623.16 l 612 611.16 l 0 611.16 l h W n Q q n 0 611.16 m 612 611.16 l 612 599.16 l 0 599.16 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 219.84 601.56 Tm (ɫɫ University) Tj ET Q q n 0 599.15 m 612 599.15 l 612 587.15 l 0 587.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 207.68 589.56 Tm (\(The Group Policyholder\)) Tj ET Q q n 0 587.15 m 612 587.15 l 612 575.15 l 0 575.15 l h W n Q q n 0 575.15 m 612 575.15 l 612 563.15 l 0 563.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 565.56 Tm (The issue date of the Policy is August 1, 2017.) Tj ET Q q n 0 563.15 m 612 563.15 l 612 551.15 l 0 551.15 l h W n Q q n 0 551.15 m 612 551.15 l 612 539.15 l 0 539.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 541.56 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.32 541.56 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 71.97 541.56 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 83.64 541.56 Tm (effective) Tj ET BT /F2 12 Tf 1 0 0 1 129.27 541.56 Tm (only) Tj ET BT /F2 12 Tf 1 0 0 1 154.27 541.56 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 165.26 541.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 183.59 541.56 Tm (Employee) Tj ET BT /F2 12 Tf 1 0 0 1 235.9 541.56 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 247.57 541.56 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 287.23 541.56 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 304.88 541.56 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 354.53 541.56 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 375.52 541.56 Tm (becomes) Tj ET BT /F2 12 Tf 1 0 0 1 421.17 541.56 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 442.16 541.56 Tm (remains) Tj ET BT /F2 12 Tf 1 0 0 1 483.81 541.56 Tm (insured) Tj ET BT /F2 12 Tf 1 0 0 1 522.8 541.56 Tm (as) Tj ET Q q n 0 539.15 m 612 539.15 l 612 527.15 l 0 527.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 529.56 Tm (provided in the Group Policy.) Tj ET Q q n 0 527.15 m 612 527.15 l 612 515.15 l 0 515.15 l h W n Q q n 0 515.15 m 612 515.15 l 612 503.15 l 0 503.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 185.87 505.56 Tm (Certificate of Insurance for Class 1) Tj ET Q q n 0 503.15 m 612 503.15 l 612 497.15 l 0 497.15 l h W n Q q n 5.4 497.15 m 248.4 497.15 l 248.4 485.15 l 5.4 485.15 l h W n Q q n 0 485.15 m 612 485.15 l 612 479.15 l 0 479.15 l h W n Q q n 0 479.15 m 612 479.15 l 612 473.15 l 0 473.15 l h W n Q q n 0 473.15 m 228.05 473.15 l 228.05 461.15 l 0 461.15 l h W n Q q n 0 461.15 m 612 461.15 l 612 449.15 l 0 449.15 l h W n Q q n 0 449.15 m 612 449.15 l 612 437.15 l 0 437.15 l h W n Q q n 0 437.15 m 612 437.15 l 612 425.15 l 0 425.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 427.56 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 23.75 427.56 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 41.48 427.56 Tm (entitled) Tj ET BT /F2 12 Tf 1 0 0 1 80.55 427.56 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 92.97 427.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 110.72 427.56 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 151.79 427.56 Tm (described) Tj ET BT /F2 12 Tf 1 0 0 1 200.85 427.56 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 213.27 427.56 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 233.69 427.56 Tm (Certificate) Tj ET BT /F2 12 Tf 1 0 0 1 287.41 427.56 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 297.82 427.56 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 318.9 427.56 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 336.64 427.56 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 375.71 427.56 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 392.78 427.56 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 441.85 427.56 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 472.25 427.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 490 427.56 Tm (provisions) Tj ET Q q n 0 425.15 m 612 425.15 l 612 413.15 l 0 413.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 415.56 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 13.45 415.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 31.57 415.56 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 72.15 415.56 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 96.94 415.56 Tm (Certificate) Tj ET BT /F2 12 Tf 1 0 0 1 151.03 415.56 Tm (replaces) Tj ET BT /F2 12 Tf 1 0 0 1 193.79 415.56 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 214.57 415.56 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 242.69 415.56 Tm (certificates) Tj ET BT /F2 12 Tf 1 0 0 1 298.77 415.56 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 316.22 415.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 334.34 415.56 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 375.78 415.56 Tm (described) Tj ET BT /F2 12 Tf 1 0 0 1 425.21 415.56 Tm (inside.) Tj ET BT /F2 12 Tf 1 0 0 1 463.79 415.56 Tm (As) Tj ET BT /F2 12 Tf 1 0 0 1 480.58 415.56 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 489.36 415.56 Tm (Certificate) Tj ET Q q n 0 413.15 m 612 413.15 l 612 401.15 l 0 401.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 403.56 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 13.65 403.56 Tm (Insurance,) Tj ET BT /F2 12 Tf 1 0 0 1 66.95 403.56 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 77.27 403.56 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 88.93 403.56 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 107.92 403.56 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 116.9 403.56 Tm (contract) Tj ET BT /F2 12 Tf 1 0 0 1 159.2 403.56 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 172.86 403.56 Tm (insurance;) Tj ET BT /F2 12 Tf 1 0 0 1 225.82 403.56 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 236.15 403.56 Tm (only) Tj ET BT /F2 12 Tf 1 0 0 1 261.14 403.56 Tm (summarizes) Tj ET BT /F2 12 Tf 1 0 0 1 322.11 403.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 340.43 403.56 Tm (provisions) Tj ET BT /F2 12 Tf 1 0 0 1 394.09 403.56 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 407.74 403.56 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 426.05 403.56 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 460.38 403.56 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 481.36 403.56 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 493.02 403.56 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 403.56 Tm (to) Tj ET Q q n 0 401.15 m 612 401.15 l 612 389.15 l 0 389.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 391.56 Tm (the Policy's terms.) Tj ET Q q n 0 375.35 m 612 375.35 l 612 363.35 l 0 363.35 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 365.76 Tm (The) Tj ET BT /F4 12 Tf 1 0 0 1 23.1 365.76 Tm (Policy) Tj ET BT /F4 12 Tf 1 0 0 1 57.52 365.76 Tm (contains) Tj ET BT /F4 12 Tf 1 0 0 1 103.29 365.76 Tm (an) Tj ET BT /F4 12 Tf 1 0 0 1 119.06 365.76 Tm (Accelerated) Tj ET BT /F4 12 Tf 1 0 0 1 182.78 365.76 Tm (Death) Tj ET BT /F4 12 Tf 1 0 0 1 216.54 365.76 Tm (Benefit) Tj ET BT /F4 12 Tf 1 0 0 1 256.29 365.76 Tm (provision.) Tj ET BT /F4 12 Tf 1 0 0 1 313.49 365.76 Tm (Receipt) Tj ET BT /F4 12 Tf 1 0 0 1 355.24 365.76 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 368.33 365.76 Tm (an) Tj ET BT /F4 12 Tf 1 0 0 1 384.1 365.76 Tm (Accelerated) Tj ET BT /F4 12 Tf 1 0 0 1 447.82 365.76 Tm (Death) Tj ET BT /F4 12 Tf 1 0 0 1 481.58 365.76 Tm (Benefit) Tj ET BT /F4 12 Tf 1 0 0 1 521.33 365.76 Tm (will) Tj ET Q q n 0 363.35 m 612 363.35 l 612 351.35 l 0 351.35 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 353.76 Tm (reduce) Tj ET BT /F4 12 Tf 1 0 0 1 39.87 353.76 Tm (benefits) Tj ET BT /F4 12 Tf 1 0 0 1 85.09 353.76 Tm (specified) Tj ET BT /F4 12 Tf 1 0 0 1 134.97 353.76 Tm (in) Tj ET BT /F4 12 Tf 1 0 0 1 150.2 353.76 Tm (the) Tj ET BT /F4 12 Tf 1 0 0 1 171.42 353.76 Tm (Policy.) Tj ET BT /F4 12 Tf 1 0 0 1 216.18 353.76 Tm (Accelerated) Tj ET BT /F4 12 Tf 1 0 0 1 282.03 353.76 Tm (Death) Tj ET BT /F4 12 Tf 1 0 0 1 317.91 353.76 Tm (Benefits) Tj ET BT /F4 12 Tf 1 0 0 1 364.46 353.76 Tm (may) Tj ET BT /F4 12 Tf 1 0 0 1 391.68 353.76 Tm (be) Tj ET BT /F4 12 Tf 1 0 0 1 408.9 353.76 Tm (taxable.) Tj ET BT /F4 12 Tf 1 0 0 1 459.67 353.76 Tm (As) Tj ET BT /F4 12 Tf 1 0 0 1 478.23 353.76 Tm (with) Tj ET BT /F4 12 Tf 1 0 0 1 506.12 353.76 Tm (all) Tj ET BT /F4 12 Tf 1 0 0 1 524 353.76 Tm (tax) Tj ET Q q n 0 351.35 m 612 351.35 l 612 339.35 l 0 339.35 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 341.76 Tm (matters,) Tj ET BT /F4 12 Tf 1 0 0 1 46.88 341.76 Tm (the) Tj ET BT /F4 12 Tf 1 0 0 1 67.45 341.76 Tm (Insured) Tj ET BT /F4 12 Tf 1 0 0 1 112.03 341.76 Tm (Person) Tj ET BT /F4 12 Tf 1 0 0 1 151.93 341.76 Tm (should) Tj ET BT /F4 12 Tf 1 0 0 1 190.53 341.76 Tm (consult) Tj ET BT /F4 12 Tf 1 0 0 1 231.77 341.76 Tm (a) Tj ET BT /F4 12 Tf 1 0 0 1 242.34 341.76 Tm (professional) Tj ET BT /F4 12 Tf 1 0 0 1 308.92 341.76 Tm (tax) Tj ET BT /F4 12 Tf 1 0 0 1 329.48 341.76 Tm (advisor) Tj ET BT /F4 12 Tf 1 0 0 1 372.06 341.76 Tm (before) Tj ET BT /F4 12 Tf 1 0 0 1 409.28 341.76 Tm (applying) Tj ET BT /F4 12 Tf 1 0 0 1 458.54 341.76 Tm (for) Tj ET BT /F4 12 Tf 1 0 0 1 478.43 341.76 Tm (this) Tj ET BT /F4 12 Tf 1 0 0 1 501.67 341.76 Tm (benefit.) Tj ET Q q n 0 339.35 m 612 339.35 l 612 327.35 l 0 327.35 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 329.76 Tm (Please read the Limitations section of the Accelerated Death Benefit included in the Policy.) Tj ET Q q n 0 327.35 m 612 327.35 l 612 315.35 l 0 315.35 l h W n Q q 1 0 0 1 326.63 274.1 cm q n 0 0 m 162.75 0 l 162.75 41.25 l 0 41.25 l h W n q 162.75 0 0 41.25 0 0 cm /img17848 Do Q Q Q q Q q n 0 274.1 m 612 274.1 l 612 262.1 l 0 262.1 l h W n Q q n 0 262.1 m 612 262.1 l 612 250.1 l 0 250.1 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 158.16 252.51 Tm (CERTIFICATE OF GROUP INSURANCE) Tj ET Q Q q Q Q endstream endobj 2 0 obj <>>>>> endobj 39 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 729 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 216.51 30.7 Tm (ɫɫ University) Tj ET BT /F4 12 Tf 1 0 0 1 234 16.91 Tm (000010232170) Tj ET BT /F4 12 Tf 1 0 0 1 189.99 3.11 Tm (SCHEDULE OF INSURANCE) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-SB PA) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 219.81 646.11 Tm (ELIGIBLE CLASS) Tj ET q n 73.45 629.21 m 200.9 629.21 l 200.9 617.21 l 73.45 617.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 150.8 619.62 Tm (Class 1) Tj ET Q q n 200.9 629.21 m 474.5 629.21 l 474.5 617.21 l 200.9 617.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 200.9 619.62 Tm (All) Tj ET BT /F2 12 Tf 1 0 0 1 219.97 619.62 Tm (Full-Time) Tj ET BT /F2 12 Tf 1 0 0 1 272.37 619.62 Tm (Employees) Tj ET BT /F2 12 Tf 1 0 0 1 329.42 619.62 Tm (Working) Tj ET BT /F2 12 Tf 1 0 0 1 375.81 619.62 Tm (30) Tj ET BT /F2 12 Tf 1 0 0 1 391.55 619.62 Tm (Hours) Tj ET BT /F2 12 Tf 1 0 0 1 424.61 619.62 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 438.34 619.62 Tm (more) Tj ET Q q n 200.9 617.21 m 474.5 617.21 l 474.5 605.21 l 200.9 605.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 200.9 607.62 Tm (per week) Tj ET Q q n 0 605.21 m 612 605.21 l 612 593.21 l 0 593.21 l h W n Q q n 0 593.21 m 612 593.21 l 612 581.21 l 0 581.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 583.62 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.37 583.62 Tm (following) Tj ET BT /F2 12 Tf 1 0 0 1 72.75 583.62 Tm (chart) Tj ET BT /F2 12 Tf 1 0 0 1 100.45 583.62 Tm (applies) Tj ET BT /F2 12 Tf 1 0 0 1 138.16 583.62 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 151.21 583.62 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 169.59 583.62 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 221.3 583.62 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 235.01 583.62 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 267.38 583.62 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 306.42 583.62 Tm (provision) Tj ET BT /F2 12 Tf 1 0 0 1 355.47 583.62 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 385.18 583.62 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 426.88 583.62 Tm (end) Tj ET BT /F2 12 Tf 1 0 0 1 447.92 583.62 Tm (upon) Tj ET BT /F2 12 Tf 1 0 0 1 475.64 583.62 Tm (attainment) Tj ET BT /F2 12 Tf 1 0 0 1 530 583.62 Tm (of) Tj ET Q q n 0 581.21 m 612 581.21 l 612 569.21 l 0 569.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 571.62 Tm (the Social Security Normal Retirement Age:) Tj ET Q q n 0 569.21 m 612 569.21 l 612 557.21 l 0 557.21 l h W n Q q n 0 557.21 m 275.4 557.21 l 275.4 545.21 l 0 545.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 100.31 547.62 Tm (Year of Birth) Tj ET 2 J 0.586 w [] 0 d 0 0 0 RG 100.6 546.02 m 163.99 546.02 l S 1 w [] 0 d Q q n 275.4 557.21 m 550.8 557.21 l 550.8 545.21 l 275.4 545.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 349.72 547.62 Tm (Normal Retirement Age) Tj ET 2 J 0.586 w [] 0 d 0 0 0 RG 350.01 546.02 m 465.39 546.02 l S 1 w [] 0 d Q q n 0 545.21 m 275.4 545.21 l 275.4 533.21 l 0 533.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 96.97 535.62 Tm (1937 and prior) Tj ET Q q n 275.4 545.21 m 550.8 545.21 l 550.8 533.21 l 275.4 533.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 401.7 535.62 Tm (65) Tj ET Q q n 0 533.21 m 275.4 533.21 l 275.4 521.21 l 0 521.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 523.62 Tm (1938) Tj ET Q q n 275.4 533.21 m 550.8 533.21 l 550.8 521.21 l 275.4 521.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 523.62 Tm (65 and 2 months) Tj ET Q q n 0 521.21 m 275.4 521.21 l 275.4 509.21 l 0 509.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 511.62 Tm (1939) Tj ET Q q n 275.4 521.21 m 550.8 521.21 l 550.8 509.21 l 275.4 509.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 511.62 Tm (65 and 4 months) Tj ET Q q n 0 509.21 m 275.4 509.21 l 275.4 497.21 l 0 497.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 499.62 Tm (1940) Tj ET Q q n 275.4 509.21 m 550.8 509.21 l 550.8 497.21 l 275.4 497.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 499.62 Tm (65 and 6 months) Tj ET Q q n 0 497.21 m 275.4 497.21 l 275.4 485.21 l 0 485.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 487.62 Tm (1941) Tj ET Q q n 275.4 497.21 m 550.8 497.21 l 550.8 485.21 l 275.4 485.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 487.62 Tm (65 and 8 months) Tj ET Q q n 0 485.21 m 275.4 485.21 l 275.4 473.21 l 0 473.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 475.62 Tm (1942) Tj ET Q q n 275.4 485.21 m 550.8 485.21 l 550.8 473.21 l 275.4 473.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 364.87 475.62 Tm (65 and 10 months) Tj ET Q q n 0 473.21 m 275.4 473.21 l 275.4 461.21 l 0 461.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 109.3 463.62 Tm (1943 - 54) Tj ET Q q n 275.4 473.21 m 550.8 473.21 l 550.8 461.21 l 275.4 461.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 401.7 463.62 Tm (66) Tj ET Q q n 0 461.21 m 275.4 461.21 l 275.4 449.21 l 0 449.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 451.62 Tm (1955) Tj ET Q q n 275.4 461.21 m 550.8 461.21 l 550.8 449.21 l 275.4 449.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 451.62 Tm (66 and 2 months) Tj ET Q q n 0 449.21 m 275.4 449.21 l 275.4 437.21 l 0 437.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 439.62 Tm (1956) Tj ET Q q n 275.4 449.21 m 550.8 449.21 l 550.8 437.21 l 275.4 437.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 439.62 Tm (66 and 4 months) Tj ET Q q n 0 437.21 m 275.4 437.21 l 275.4 425.21 l 0 425.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 427.62 Tm (1957) Tj ET Q q n 275.4 437.21 m 550.8 437.21 l 550.8 425.21 l 275.4 425.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 427.62 Tm (66 and 6 months) Tj ET Q q n 0 425.21 m 275.4 425.21 l 275.4 413.21 l 0 413.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 415.62 Tm (1958) Tj ET Q q n 275.4 425.21 m 550.8 425.21 l 550.8 413.21 l 275.4 413.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 367.87 415.62 Tm (66 and 8 months) Tj ET Q q n 0 413.21 m 275.4 413.21 l 275.4 401.21 l 0 401.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 120.3 403.62 Tm (1959) Tj ET Q q n 275.4 413.21 m 550.8 413.21 l 550.8 401.21 l 275.4 401.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 364.87 403.62 Tm (66 and 10 months) Tj ET Q q n 0 401.21 m 275.4 401.21 l 275.4 389.21 l 0 389.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 97.98 391.62 Tm (1960 and later) Tj ET Q q n 275.4 401.21 m 550.8 401.21 l 550.8 389.21 l 275.4 389.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 401.7 391.62 Tm (67) Tj ET Q q n 0 389.21 m 275.4 389.21 l 275.4 377.21 l 0 377.21 l h W n Q q n 275.4 389.21 m 550.8 389.21 l 550.8 377.21 l 275.4 377.21 l h W n Q q n 0 377.21 m 550.8 377.21 l 550.8 365.21 l 0 365.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 367.62 Tm (Note:) Tj ET BT /F2 12 Tf 1 0 0 1 32.66 367.62 Tm (Persons born on January 1 of any year should refer to the Normal Retirement Age for the previous year.) Tj ET Q q n 0 365.21 m 612 365.21 l 612 353.21 l 0 353.21 l h W n Q Q q Q Q endstream endobj 3 0 obj <>>>>> endobj 40 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 746.4 cm q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 216.51 14.41 Tm (ɫɫ University) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 234 2.41 Tm (000010232170) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-SB PA) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 189.99 677.31 Tm (SCHEDULE OF INSURANCE) Tj ET BT /F4 12 Tf 1 0 0 1 260.67 663.51 Tm (For) Tj ET BT /F4 12 Tf 1 0 0 1 86.68 649.71 Tm (Class 1 - All Full-Time Employees Working 30 Hours or more per week) Tj ET BT /F2 12 Tf 1 0 0 1 0 622.11 Tm (MINIMUM HOURS:) Tj ET BT /F2 12 Tf 1 0 0 1 117.6 622.11 Tm (30 hours per week) Tj ET q n 0 605.21 m 117.6 605.21 l 117.6 593.21 l 0 593.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 595.62 Tm (WAITING PERIOD:) Tj ET Q q n 117.6 605.21 m 550.8 605.21 l 550.8 593.21 l 117.6 593.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 117.6 595.62 Tm (\(For date insurance begins, refer to Effective Dates of Coverages section\)) Tj ET Q q n 0 593.21 m 117.6 593.21 l 117.6 581.21 l 0 581.21 l h W n Q q n 117.6 593.21 m 550.8 593.21 l 550.8 581.21 l 117.6 581.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 117.6 583.62 Tm (None) Tj ET Q q n 0 581.21 m 612 581.21 l 612 569.21 l 0 569.21 l h W n Q q n 0 569.21 m 612 569.21 l 612 557.21 l 0 557.21 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 559.62 Tm (Basic) Tj ET BT /F4 12 Tf 1 0 0 1 31.79 559.62 Tm (Annual) Tj ET BT /F4 12 Tf 1 0 0 1 74.26 559.62 Tm (Earnings) Tj ET BT /F2 12 Tf 1 0 0 1 125.39 559.62 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 160.5 559.62 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 186.95 559.62 Tm (annual) Tj ET BT /F2 12 Tf 1 0 0 1 223.39 559.62 Tm (base) Tj ET BT /F2 12 Tf 1 0 0 1 249.16 559.62 Tm (salary) Tj ET BT /F2 12 Tf 1 0 0 1 282.26 559.62 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 296.71 559.62 Tm (annualized) Tj ET BT /F2 12 Tf 1 0 0 1 353.14 559.62 Tm (hourly) Tj ET BT /F2 12 Tf 1 0 0 1 388.92 559.62 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 410.69 559.62 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 438.47 559.62 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 457.58 559.62 Tm (Employer) Tj ET BT /F2 12 Tf 1 0 0 1 509.36 559.62 Tm (before) Tj ET Q q n 0 557.21 m 612 557.21 l 612 545.21 l 0 545.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 547.62 Tm (taxes on the Determination Date.) Tj ET BT /F2 12 Tf 1 0 0 1 164.28 547.62 Tm (The) Tj ET BT /F4 12 Tf 1 0 0 1 185.94 547.62 Tm ("Determination Date") Tj ET BT /F2 12 Tf 1 0 0 1 300.9 547.62 Tm ( is the last day worked just prior to the loss.) 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Tj ET Q q n 0 497.21 m 612 497.21 l 612 485.21 l 0 485.21 l h W n Q q n 0 485.21 m 612 485.21 l 612 473.21 l 0 473.21 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 184.83 475.62 Tm (LIFE AND AD&D) Tj ET BT /F4 12 Tf 1 0 0 1 280.83 475.62 Tm ( INSURANCE) Tj ET Q q n 0 473.21 m 612 473.21 l 612 461.21 l 0 461.21 l h W n Q q n 0 461.21 m 233.3 461.21 l 233.3 449.21 l 0 449.21 l h W n Q q n 233.3 461.21 m 470.9 461.21 l 470.9 449.21 l 233.3 449.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 307.87 451.62 Tm (Benefit Amount) Tj ET Q q n 0 449.21 m 612 449.21 l 612 448.21 l 0 448.21 l h W n Q q n 0 448.21 m 612 448.21 l 612 443.21 l 0 443.21 l h W n Q q n 0 443.21 m 190.8 443.21 l 190.8 431.21 l 0 431.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 433.62 Tm (Personal Life Insurance) Tj ET Q q n 190.8 443.21 m 514.8 443.21 l 514.8 431.21 l 190.8 431.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 190.8 433.62 Tm (One) Tj ET BT /F2 12 Tf 1 0 0 1 215.12 433.62 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 236.77 433.62 Tm (one-half) Tj ET BT /F2 12 Tf 1 0 0 1 281.08 433.62 Tm (times) Tj ET BT /F2 12 Tf 1 0 0 1 311.4 433.62 Tm (Basic) Tj ET BT /F2 12 Tf 1 0 0 1 342.39 433.62 Tm (Annual) Tj ET BT /F2 12 Tf 1 0 0 1 382.05 433.62 Tm (Earnings,) Tj ET BT /F2 12 Tf 1 0 0 1 432.03 433.62 Tm (rounded) Tj ET BT /F2 12 Tf 1 0 0 1 475.68 433.62 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 433.62 Tm (the) Tj ET Q q n 190.8 431.21 m 514.8 431.21 l 514.8 419.21 l 190.8 419.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 190.8 421.62 Tm (next higher $1,000; subject to a maximum of $600,000.) Tj ET Q q n 0 419.21 m 190.8 419.21 l 190.8 407.21 l 0 407.21 l h W n Q q n 190.8 419.21 m 514.8 419.21 l 514.8 407.21 l 190.8 407.21 l h W n Q q n 0 407.21 m 190.8 407.21 l 190.8 395.21 l 0 395.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 397.62 Tm (AD&D Insurance Principal Sum) Tj ET Q q n 190.8 407.21 m 514.8 407.21 l 514.8 395.21 l 190.8 395.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 190.8 397.62 Tm (One) Tj ET BT /F2 12 Tf 1 0 0 1 215.12 397.62 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 236.77 397.62 Tm (one-half) Tj ET BT /F2 12 Tf 1 0 0 1 281.08 397.62 Tm (times) Tj ET BT /F2 12 Tf 1 0 0 1 311.4 397.62 Tm (Basic) Tj ET BT /F2 12 Tf 1 0 0 1 342.39 397.62 Tm (Annual) Tj ET BT /F2 12 Tf 1 0 0 1 382.05 397.62 Tm (Earnings,) Tj ET BT /F2 12 Tf 1 0 0 1 432.03 397.62 Tm (rounded) Tj ET BT /F2 12 Tf 1 0 0 1 475.68 397.62 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 397.62 Tm (the) Tj ET Q q n 190.8 395.21 m 514.8 395.21 l 514.8 383.21 l 190.8 383.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 190.8 385.62 Tm (next higher $1,000; subject to a maximum of $600,000.) 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Tj ET Q q n 0 323.21 m 612 323.21 l 612 311.21 l 0 311.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 313.62 Tm (Benefits will terminate when you retire.) 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Tj ET BT /F2 12 Tf 1 0 0 1 534 642.91 Tm (3) Tj ET BT /F2 12 Tf 1 0 0 1 0 615.31 Tm (Definitions) Tj ET BT /F2 12 Tf 1 0 0 1 53.99 615.31 Tm (................................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 615.31 Tm (3) Tj ET BT /F2 12 Tf 1 0 0 1 0 587.72 Tm (Eligibility) Tj ET BT /F2 12 Tf 1 0 0 1 48.67 587.72 Tm (.................................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 587.72 Tm (4) Tj ET BT /F2 12 Tf 1 0 0 1 0 560.12 Tm (Effective Dates of Coverages) Tj ET BT /F2 12 Tf 1 0 0 1 140.94 560.12 Tm (...................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 560.12 Tm (4) Tj ET BT /F2 12 Tf 1 0 0 1 0 532.52 Tm (Termination of Coverage) Tj ET BT /F2 12 Tf 1 0 0 1 121.29 532.52 Tm (.........................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 532.52 Tm (5) Tj ET BT /F2 12 Tf 1 0 0 1 0 504.92 Tm (Death Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 66.97 504.92 Tm (...........................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 504.92 Tm (6) Tj ET BT /F2 12 Tf 1 0 0 1 0 477.33 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 55.97 477.33 Tm (...............................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 477.33 Tm (6) Tj ET BT /F2 12 Tf 1 0 0 1 0 449.73 Tm (Assignments) Tj ET BT /F2 12 Tf 1 0 0 1 62 449.73 Tm (.............................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 449.73 Tm (7) Tj ET BT /F2 12 Tf 1 0 0 1 0 422.13 Tm (Extension of Death Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 130.96 422.13 Tm (......................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 422.13 Tm (8) Tj ET BT /F2 12 Tf 1 0 0 1 0 394.53 Tm (Accelerated Death Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 127.26 394.53 Tm (.......................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 534 394.53 Tm (9) Tj ET BT /F2 12 Tf 1 0 0 1 0 366.93 Tm (Conversion Privilege) Tj ET BT /F2 12 Tf 1 0 0 1 101.65 366.93 Tm (..............................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 366.93 Tm (11) Tj ET BT /F2 12 Tf 1 0 0 1 0 339.34 Tm (Accidental Death and Dismemberment Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 236.57 339.34 Tm (.................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 339.34 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 0 311.74 Tm (Safe Driver Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 93.96 311.74 Tm (................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 311.74 Tm (18) Tj ET BT /F2 12 Tf 1 0 0 1 0 284.14 Tm (Claims Procedures for Life or Accidental Death and Dismemberment Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 376.21 284.14 Tm (..................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 284.14 Tm (19) Tj ET BT /F2 12 Tf 1 0 0 1 0 256.54 Tm (Notice) Tj ET BT /F2 12 Tf 1 0 0 1 31.99 256.54 Tm (.....................................................................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 256.54 Tm (22) Tj ET BT /F2 12 Tf 1 0 0 1 0 228.95 Tm (Prior Insurance Credit Provision) Tj ET BT /F2 12 Tf 1 0 0 1 155.64 228.95 Tm (............................................................................................................................) Tj ET BT /F2 12 Tf 1 0 0 1 528 228.95 Tm (24) Tj ET Q q Q Q endstream endobj 5 0 obj <>>>>> endobj 106 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-1 PA) Tj ET BT /F2 10 Tf 1 0 0 1 267.5 14.09 Tm (3) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 195.67 686.91 Tm (AMOUNT OF INSURANCE) Tj ET q n 0 683.8 m 612 683.8 l 612 671.8 l 0 671.8 l h W n Q q n 0 671.8 m 612 671.8 l 612 659.8 l 0 659.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 662.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.23 662.21 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 61.79 662.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 75.35 662.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 100.92 662.21 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 150.47 662.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 162.04 662.21 Tm (determined) Tj ET BT /F2 12 Tf 1 0 0 1 219.58 662.21 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 235.15 662.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 253.38 662.21 Tm (Schedule) Tj ET BT /F2 12 Tf 1 0 0 1 300.94 662.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 314.5 662.21 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 364.71 662.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 377.62 662.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 395.85 662.21 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 436.65 662.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 458.88 662.21 Tm (initial) Tj ET BT /F2 12 Tf 1 0 0 1 490.44 662.21 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 530 662.21 Tm (of) Tj ET Q q n 0 659.8 m 612 659.8 l 612 647.8 l 0 647.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 650.21 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 47.36 650.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 59.43 650.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 78.15 650.21 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 118.21 650.21 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 151.6 650.21 Tm (applies) Tj ET BT /F2 12 Tf 1 0 0 1 189.65 650.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 203.05 650.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 229.11 650.21 Tm (class) Tj ET BT /F2 12 Tf 1 0 0 1 256.49 650.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 272.56 650.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 291.28 650.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 312.67 650.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 338.73 650.21 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 386.09 650.21 Tm (takes) Tj ET BT /F2 12 Tf 1 0 0 1 414.81 650.21 Tm (effect.) Tj ET BT /F2 12 Tf 1 0 0 1 453.24 650.21 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 477.97 650.21 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 502.69 650.21 Tm (become) Tj ET Q q n 0 647.8 m 612 647.8 l 612 635.8 l 0 635.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 638.21 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 39.72 638.21 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 57.45 638.21 Tm (increases) Tj ET BT /F2 12 Tf 1 0 0 1 105.15 638.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 118.22 638.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 136.61 638.21 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 176.34 638.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 190.07 638.21 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 239.78 638.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 252.85 638.21 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 288.55 638.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 313.62 638.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 332.01 638.21 Tm (Schedule) Tj ET BT /F2 12 Tf 1 0 0 1 379.73 638.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 393.46 638.21 Tm (Insurance.) Tj ET BT /F2 12 Tf 1 0 0 1 450.57 638.21 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 474.97 638.21 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 500.7 638.21 Tm (increase) Tj ET Q q n 0 635.8 m 612 635.8 l 612 623.8 l 0 623.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 626.21 Tm (will take effect on the latest of:) Tj ET Q q n 18 623.8 m 630 623.8 l 630 611.8 l 18 611.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 614.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 614.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.27 614.21 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 87.85 614.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 109.43 614.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 123.68 614.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 142.6 614.21 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 193.5 614.21 Tm (Month) Tj ET BT /F2 12 Tf 1 0 0 1 229.76 614.21 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 263.34 614.21 Tm (coincides) Tj ET BT /F2 12 Tf 1 0 0 1 312.91 614.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 338.5 614.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 352.75 614.21 Tm (follows) Tj ET BT /F2 12 Tf 1 0 0 1 393.01 614.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 411.92 614.21 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 436.16 614.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 452.42 614.21 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 486 614.21 Tm (you) Tj ET Q q n 45.35 611.8 m 657.35 611.8 l 657.35 599.8 l 45.35 599.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 602.21 Tm (become eligible for the increase; provided you are Actively at Work on that day;) Tj ET Q q n 18 599.8 m 630 599.8 l 630 587.8 l 18 587.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 590.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 590.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.78 590.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 86.88 590.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 109.66 590.21 Tm (resume) Tj ET BT /F2 12 Tf 1 0 0 1 149.08 590.21 Tm (Active) Tj ET BT /F2 12 Tf 1 0 0 1 185.84 590.21 Tm (Work,) Tj ET BT /F2 12 Tf 1 0 0 1 220.93 590.21 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 233.04 590.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 255.81 590.21 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 275.23 590.21 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 295.34 590.21 Tm (Actively) Tj ET BT /F2 12 Tf 1 0 0 1 341.43 590.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 354.86 590.21 Tm (Work) Tj ET BT /F2 12 Tf 1 0 0 1 386.96 590.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 403.73 590.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 423.16 590.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 445.26 590.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 464.7 590.21 Tm (increase) Tj ET Q q n 45.35 587.8 m 657.35 587.8 l 657.35 575.8 l 45.35 575.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 578.21 Tm (would otherwise take effect; or) Tj ET Q q n 18 575.8 m 630 575.8 l 630 563.8 l 18 563.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 566.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 566.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 69.92 566.21 Tm (respect) Tj ET BT /F2 12 Tf 1 0 0 1 107.13 566.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 119.69 566.21 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 142.91 566.21 Tm (Insurance,) Tj ET BT /F2 12 Tf 1 0 0 1 195.78 566.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 213.67 566.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 234.23 566.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 254.79 566.21 Tm (required) Tj ET BT /F2 12 Tf 1 0 0 1 298 566.21 Tm (evidence) Tj ET BT /F2 12 Tf 1 0 0 1 343.87 566.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 357.1 566.21 Tm (insurability) Tj ET BT /F2 12 Tf 1 0 0 1 414.99 566.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 426.23 566.21 Tm (approved) Tj ET BT /F2 12 Tf 1 0 0 1 474.11 566.21 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 566.21 Tm (the) Tj ET Q q n 45.35 563.8 m 657.35 563.8 l 657.35 551.8 l 45.35 551.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 554.21 Tm (Company.) Tj ET Q q n 18 551.8 m 630 551.8 l 630 539.8 l 18 539.8 l h W n Q q n 0 539.8 m 612 539.8 l 612 527.8 l 0 527.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 530.21 Tm (Any decrease will take effect on the day of the change; whether or not you are Actively at Work.) Tj ET Q q n 0 527.8 m 612 527.8 l 612 515.8 l 0 515.8 l h W n Q q n 0 515.8 m 612 515.8 l 612 503.8 l 0 503.8 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 230.32 506.21 Tm (DEFINITIONS) Tj ET Q q n 0 503.8 m 612 503.8 l 612 491.8 l 0 491.8 l h W n Q q n 0 491.8 m 612 491.8 l 612 479.8 l 0 479.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 482.21 Tm (ACTIVE) Tj ET BT /F2 12 Tf 1 0 0 1 49.12 482.21 Tm (WORK) Tj ET BT /F2 12 Tf 1 0 0 1 90.91 482.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 106.03 482.21 Tm (ACTIVELY) Tj ET BT /F2 12 Tf 1 0 0 1 171.15 482.21 Tm (AT) Tj ET BT /F2 12 Tf 1 0 0 1 192.27 482.21 Tm (WORK) Tj ET BT /F2 12 Tf 1 0 0 1 234.06 482.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 269.84 482.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 286.3 482.21 Tm (employee's) Tj ET BT /F2 12 Tf 1 0 0 1 344.9 482.21 Tm (full-time) Tj ET BT /F2 12 Tf 1 0 0 1 392.02 482.21 Tm (performance) Tj ET BT /F2 12 Tf 1 0 0 1 457.77 482.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 472.89 482.21 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 490.01 482.21 Tm (customary) Tj ET Q q n 0 479.8 m 612 479.8 l 612 467.8 l 0 467.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 470.21 Tm (duties of his or her occupation at:) Tj ET Q q n 18 467.8 m 630 467.8 l 630 455.8 l 18 455.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 458.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 458.21 Tm (the EMPLOYERS place of business; or) Tj ET Q q n 18 455.8 m 630 455.8 l 630 443.8 l 18 443.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 446.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 446.21 Tm (any other business location where the employee is required to travel.) Tj ET Q q n 0 443.8 m 612 443.8 l 612 431.8 l 0 431.8 l h W n Q q n 0 431.8 m 612 431.8 l 612 419.8 l 0 419.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 422.21 Tm (Unless) Tj ET BT /F2 12 Tf 1 0 0 1 37.14 422.21 Tm (disabled) Tj ET BT /F2 12 Tf 1 0 0 1 81.6 422.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 98.07 422.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 117.2 422.21 Tm (prior) Tj ET BT /F2 12 Tf 1 0 0 1 145 422.21 Tm (workday) Tj ET BT /F2 12 Tf 1 0 0 1 191.46 422.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 205.93 422.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 222.4 422.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 241.53 422.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 263.33 422.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 277.8 422.21 Tm (absence,) Tj ET BT /F2 12 Tf 1 0 0 1 323.24 422.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 339.04 422.21 Tm (employee) Tj ET BT /F2 12 Tf 1 0 0 1 390.16 422.21 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 413.3 422.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 429.1 422.21 Tm (considered) Tj ET BT /F2 12 Tf 1 0 0 1 485.55 422.21 Tm (Actively) Tj ET BT /F2 12 Tf 1 0 0 1 531.34 422.21 Tm (at) Tj ET Q q n 0 419.8 m 612 419.8 l 612 407.8 l 0 407.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 410.21 Tm (Work on the following days:) Tj ET Q q n 18 407.8 m 630 407.8 l 630 395.8 l 18 395.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 398.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 398.21 Tm (a Saturday, Sunday or holiday which is not a scheduled workday;) Tj ET Q q n 18 395.8 m 630 395.8 l 630 383.8 l 18 383.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 386.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 386.21 Tm (a paid vacation day, or other scheduled or unscheduled non-workday; or) Tj ET Q q n 18 383.8 m 630 383.8 l 630 371.8 l 18 371.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 374.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 374.21 Tm (an excused or emergency leave of absence \(except a medical leave\).) Tj ET Q q n 0 371.8 m 612 371.8 l 612 359.8 l 0 359.8 l h W n Q q n 0 359.8 m 612 359.8 l 612 347.8 l 0 347.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 350.21 Tm (COMPANY) Tj ET BT /F2 12 Tf 1 0 0 1 65.75 350.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 102.13 350.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 126.52 350.21 Tm (Lincoln) Tj ET BT /F2 12 Tf 1 0 0 1 169.58 350.21 Tm (National) Tj ET BT /F2 12 Tf 1 0 0 1 216.63 350.21 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 242.35 350.21 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 294.73 350.21 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 341.39 350.21 Tm (,) Tj ET BT /F2 12 Tf 1 0 0 1 350.12 350.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 367.18 350.21 Tm (Indiana) Tj ET BT /F2 12 Tf 1 0 0 1 408.9 350.21 Tm (corporation,) Tj ET BT /F2 12 Tf 1 0 0 1 472.94 350.21 Tm (whose) Tj ET BT /F2 12 Tf 1 0 0 1 509.34 350.21 Tm (Group) Tj ET Q q n 0 347.8 m 612 347.8 l 612 335.8 l 0 335.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 338.21 Tm (Insurance Service Office address is) Tj ET BT /F2 12 Tf 1 0 0 1 172.26 338.21 Tm (8801 Indian Hills Drive) Tj ET BT /F2 12 Tf 1 0 0 1 286.58 338.21 Tm (,) Tj ET BT /F2 12 Tf 1 0 0 1 292.58 338.21 Tm (Omaha) Tj ET BT /F2 12 Tf 1 0 0 1 327.23 338.21 Tm (,) Tj ET BT /F2 12 Tf 1 0 0 1 333.23 338.21 Tm (Nebraska) Tj ET BT /F2 12 Tf 1 0 0 1 384.54 338.21 Tm (68114-4066) Tj ET BT /F2 12 Tf 1 0 0 1 442.54 338.21 Tm (.) Tj ET Q q n 0 335.8 m 612 335.8 l 612 323.8 l 0 323.8 l h W n Q q n 0 323.8 m 612 323.8 l 612 311.8 l 0 311.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 314.21 Tm (DAY) Tj ET BT /F2 12 Tf 1 0 0 1 29.33 314.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 42.65 314.21 Tm (DATE) Tj ET BT /F2 12 Tf 1 0 0 1 77.98 314.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 111.96 314.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 123.95 314.21 Tm (12:01) Tj ET BT /F2 12 Tf 1 0 0 1 154.62 314.21 Tm (A.M.,) Tj ET BT /F2 12 Tf 1 0 0 1 186.28 314.21 Tm (Standard) Tj ET BT /F2 12 Tf 1 0 0 1 232.27 314.21 Tm (Time,) Tj ET BT /F2 12 Tf 1 0 0 1 263.92 314.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 275.91 314.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 293.9 314.21 Tm (Group) Tj ET BT /F2 12 Tf 1 0 0 1 327.89 314.21 Tm (Policyholder's) Tj ET BT /F2 12 Tf 1 0 0 1 399.38 314.21 Tm (place) Tj ET BT /F2 12 Tf 1 0 0 1 428.02 314.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 441.35 314.21 Tm (business;) Tj ET BT /F2 12 Tf 1 0 0 1 488.68 314.21 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 518 314.21 Tm (used) Tj ET Q q n 0 311.8 m 612 311.8 l 612 299.8 l 0 299.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 302.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 24.73 302.21 Tm (regard) Tj ET BT /F2 12 Tf 1 0 0 1 58.77 302.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 71.51 302.21 Tm (eligibility) Tj ET BT /F2 12 Tf 1 0 0 1 121.57 302.21 Tm (dates) Tj ET BT /F2 12 Tf 1 0 0 1 149.62 302.21 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 170.35 302.21 Tm (effective) Tj ET BT /F2 12 Tf 1 0 0 1 215.71 302.21 Tm (dates.) Tj ET BT /F2 12 Tf 1 0 0 1 250.16 302.21 Tm (It) Tj ET BT /F2 12 Tf 1 0 0 1 260.89 302.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 294.94 302.21 Tm (12:00) Tj ET BT /F2 12 Tf 1 0 0 1 325.67 302.21 Tm (midnight,) Tj ET BT /F2 12 Tf 1 0 0 1 375.41 302.21 Tm (Standard) Tj ET BT /F2 12 Tf 1 0 0 1 421.46 302.21 Tm (Time,) Tj ET BT /F2 12 Tf 1 0 0 1 453.18 302.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 465.24 302.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 483.3 302.21 Tm (same) Tj ET BT /F2 12 Tf 1 0 0 1 511.35 302.21 Tm (place;) Tj ET Q q n 0 299.8 m 612 299.8 l 612 287.8 l 0 287.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 290.21 Tm (when used with regard to termination dates.) Tj ET Q q n 0 287.8 m 612 287.8 l 612 275.8 l 0 275.8 l h W n Q q n 0 275.8 m 612 275.8 l 612 263.8 l 0 263.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 266.21 Tm (EMPLOYER means the Group Policyholder or the Participating Employer named on the Face Page.) Tj ET Q q n 0 263.8 m 612 263.8 l 612 251.8 l 0 251.8 l h W n Q q n 0 251.8 m 612 251.8 l 612 239.8 l 0 239.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 242.21 Tm (FULL-TIME EMPLOYEE means an employee of the EMPLOYER:) Tj ET Q q n 18 239.8 m 630 239.8 l 630 227.8 l 18 227.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 230.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 230.21 Tm (whose employment with the EMPLOYER is the employee's principal occupation;) Tj ET Q q n 18 227.8 m 630 227.8 l 630 215.8 l 18 215.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 218.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 218.21 Tm (who is not a temporary or seasonal employee; and) Tj ET Q q n 18 215.8 m 630 215.8 l 630 203.8 l 18 203.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 206.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 206.21 Tm (who) Tj ET BT /F2 12 Tf 1 0 0 1 69.89 206.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 81.76 206.21 Tm (regularly) Tj ET BT /F2 12 Tf 1 0 0 1 128.95 206.21 Tm (scheduled) Tj ET BT /F2 12 Tf 1 0 0 1 180.8 206.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 194.01 206.21 Tm (work) Tj ET BT /F2 12 Tf 1 0 0 1 222.54 206.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 235.07 206.21 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 260.94 206.21 Tm (occupation) Tj ET BT /F2 12 Tf 1 0 0 1 317.45 206.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 329.99 206.21 Tm (least) Tj ET BT /F2 12 Tf 1 0 0 1 355.85 206.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 374.38 206.21 Tm (Minimum) Tj ET BT /F2 12 Tf 1 0 0 1 426.26 206.21 Tm (Hours) Tj ET BT /F2 12 Tf 1 0 0 1 459.46 206.21 Tm (shown) Tj ET BT /F2 12 Tf 1 0 0 1 494.67 206.21 Tm (in) Tj ET Q q n 45.35 203.8 m 657.35 203.8 l 657.35 191.8 l 45.35 191.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 194.21 Tm (the Schedule of Insurance.) Tj ET Q q n 0 191.8 m 612 191.8 l 612 179.8 l 0 179.8 l h W n Q q n 0 179.8 m 612 179.8 l 612 167.8 l 0 167.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 170.21 Tm (INSURANCE MONTH means:) Tj ET Q q n 18 167.8 m 630 167.8 l 630 155.8 l 18 155.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 158.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 158.21 Tm (that period of time beginning on the Issue Date of the Policy and extending for one month; and) Tj ET Q q n 18 155.8 m 630 155.8 l 630 143.8 l 18 143.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 146.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 146.21 Tm (each subsequent month beginning on the same day after that.) Tj ET Q q n 0 143.8 m 612 143.8 l 612 131.8 l 0 131.8 l h W n Q q n 0 131.8 m 612 131.8 l 612 119.8 l 0 119.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 122.21 Tm (PERSONAL INSURANCE means the insurance provided by the Policy on Insured Persons.) Tj ET Q q n 0 119.8 m 612 119.8 l 612 107.8 l 0 107.8 l h W n Q q n 0 107.8 m 612 107.8 l 612 95.8 l 0 95.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 98.21 Tm (PHYSICIAN) Tj ET BT /F2 12 Tf 1 0 0 1 67.53 98.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 101.72 98.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 110.57 98.21 Tm (licensed) Tj ET BT /F2 12 Tf 1 0 0 1 153.42 98.21 Tm (practitioner) Tj ET BT /F2 12 Tf 1 0 0 1 212.25 98.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 225.78 98.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 243.96 98.21 Tm (healing) Tj ET BT /F2 12 Tf 1 0 0 1 282.81 98.21 Tm (arts) Tj ET BT /F2 12 Tf 1 0 0 1 303.67 98.21 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 331.85 98.21 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 356.04 98.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 374.23 98.21 Tm (Insured) Tj ET BT /F2 12 Tf 1 0 0 1 413.74 98.21 Tm (Person) Tj ET BT /F2 12 Tf 1 0 0 1 449.93 98.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 463.46 98.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 472.31 98.21 Tm (relative) Tj ET BT /F2 12 Tf 1 0 0 1 511.82 98.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 98.21 Tm (the) Tj ET Q q n 0 95.8 m 612 95.8 l 612 83.8 l 0 83.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 86.21 Tm (Insured Person.) Tj ET Q q n 0 83.8 m 612 83.8 l 612 71.8 l 0 71.8 l h W n Q q n 0 71.8 m 612 71.8 l 612 59.8 l 0 59.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 62.21 Tm (POLICY) Tj ET BT /F2 12 Tf 1 0 0 1 46.92 62.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 81.15 62.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 99.39 62.21 Tm (Group) Tj ET BT /F2 12 Tf 1 0 0 1 133.63 62.21 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 183.85 62.21 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 218.1 62.21 Tm (issued) Tj ET BT /F2 12 Tf 1 0 0 1 251.68 62.21 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 267.26 62.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 285.5 62.21 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 335.74 62.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 348.65 62.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 366.89 62.21 Tm (Group) Tj ET BT /F2 12 Tf 1 0 0 1 401.13 62.21 Tm (Policyholder.) Tj ET BT /F2 12 Tf 1 0 0 1 472.61 62.21 Tm (A) Tj ET BT /F2 12 Tf 1 0 0 1 484.86 62.21 Tm (copy) Tj ET BT /F2 12 Tf 1 0 0 1 511.77 62.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 62.21 Tm (the) Tj ET Q q n 0 59.8 m 612 59.8 l 612 47.8 l 0 47.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 50.21 Tm (Policy may be examined upon request at the Group Insurance Service Office of the Group Policyholder.) Tj ET Q q n 0 47.8 m 612 47.8 l 612 35.8 l 0 35.8 l h W n Q Q q Q Q endstream endobj 6 0 obj <>>>>> endobj 107 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 744 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 231.65 2.41 Tm (ELIGIBILITY) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-2 93) Tj ET BT /F2 12 Tf 1 0 0 1 498.67 26.1 Tm (\(FMLA\)) Tj ET BT /F2 10 Tf 1 0 0 1 267.5 14.09 Tm (4) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 671.8 m 612 671.8 l 612 659.8 l 0 659.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 662.21 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 11.34 662.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 32.68 662.21 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 50.67 662.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 59.34 662.21 Tm (Full-Time) Tj ET BT /F2 12 Tf 1 0 0 1 111.34 662.21 Tm (Employee) Tj ET BT /F2 12 Tf 1 0 0 1 163.34 662.21 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 184 662.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 192.67 662.21 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 235.33 662.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 248.67 662.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 263.34 662.21 Tm (employee) Tj ET BT /F2 12 Tf 1 0 0 1 313.33 662.21 Tm (class) Tj ET BT /F2 12 Tf 1 0 0 1 340 662.21 Tm (shown) Tj ET BT /F2 12 Tf 1 0 0 1 374.68 662.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 387.35 662.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 405.36 662.21 Tm (Schedule) Tj ET BT /F2 12 Tf 1 0 0 1 452.68 662.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 466.02 662.21 Tm (Insurance;) Tj ET BT /F2 12 Tf 1 0 0 1 519.34 662.21 Tm (then) Tj ET Q q n 0 659.8 m 612 659.8 l 612 647.8 l 0 647.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 650.21 Tm (you will become eligible for the coverage provided by the Policy on the later of:) Tj ET Q q n 18 647.8 m 630 647.8 l 630 635.8 l 18 635.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 638.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 638.21 Tm (the Policy's date of issue; or) Tj ET Q q n 18 635.8 m 630 635.8 l 630 623.8 l 18 623.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 626.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 626.21 Tm (the day you complete the Waiting Period.) Tj ET Q q n 0 623.8 m 612 623.8 l 612 611.8 l 0 611.8 l h W n Q q n 0 611.8 m 612 611.8 l 612 599.8 l 0 599.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 602.21 Tm (WAITING PERIOD.) Tj ET BT /F2 12 Tf 1 0 0 1 107.98 602.21 Tm (\(See Schedule of Insurance\).) Tj ET Q q n 0 599.8 m 612 599.8 l 612 587.8 l 0 587.8 l h W n Q q n 0 587.8 m 612 587.8 l 612 575.8 l 0 575.8 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 164.82 578.21 Tm (EFFECTIVE DATES OF COVERAGES) Tj ET Q q n 0 575.8 m 612 575.8 l 612 563.8 l 0 563.8 l h W n Q q n 0 563.8 m 612 563.8 l 612 551.8 l 0 551.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 554.21 Tm (Your insurance is effective on the latest of:) Tj ET Q q n 18 551.8 m 630 551.8 l 630 539.8 l 18 539.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 542.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 542.21 Tm (the first day of the Insurance Month following the day you become eligible for the coverage;) Tj ET Q q n 18 539.8 m 630 539.8 l 630 527.8 l 18 527.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 530.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 530.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.7 530.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 86.72 530.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 109.42 530.21 Tm (resume) Tj ET BT /F2 12 Tf 1 0 0 1 148.76 530.21 Tm (Active) Tj ET BT /F2 12 Tf 1 0 0 1 185.44 530.21 Tm (Work,) Tj ET BT /F2 12 Tf 1 0 0 1 220.46 530.21 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 232.48 530.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 255.18 530.21 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 274.52 530.21 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 294.54 530.21 Tm (Actively) Tj ET BT /F2 12 Tf 1 0 0 1 340.56 530.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 353.91 530.21 Tm (Work) Tj ET BT /F2 12 Tf 1 0 0 1 385.93 530.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 402.62 530.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 421.97 530.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 443.99 530.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 466.69 530.21 Tm (become) Tj ET Q q n 45.35 527.8 m 657.35 527.8 l 657.35 515.8 l 45.35 515.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 518.21 Tm (eligible;) Tj ET Q q n 18 515.8 m 630 515.8 l 630 503.8 l 18 503.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 506.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 506.21 Tm (the day you make written application for coverage; and sign:) Tj ET Q q n 44.65 503.8 m 656.65 503.8 l 656.65 491.8 l 44.65 491.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 494.21 Tm (\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 494.21 Tm (a payroll deduction order, if you pay any part of the premium; or) Tj ET Q q n 44.65 491.8 m 656.65 491.8 l 656.65 479.8 l 44.65 479.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 482.21 Tm (\(b\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 482.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 89.08 482.21 Tm (order) Tj ET BT /F2 12 Tf 1 0 0 1 120.16 482.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 135.25 482.21 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 158.33 482.21 Tm (premiums) Tj ET BT /F2 12 Tf 1 0 0 1 212.09 482.21 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 241.17 482.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 268.92 482.21 Tm (Section) Tj ET BT /F2 12 Tf 1 0 0 1 310.67 482.21 Tm (125) Tj ET BT /F2 12 Tf 1 0 0 1 334.43 482.21 Tm (Plan) Tj ET BT /F2 12 Tf 1 0 0 1 361.52 482.21 Tm (account,) Tj ET BT /F2 12 Tf 1 0 0 1 407.59 482.21 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 420.68 482.21 Tm (Employer) Tj ET Q q n 72 479.8 m 684 479.8 l 684 467.8 l 72 467.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 72 470.21 Tm (contributions are paid through a Section 125 Plan; or) Tj ET Q q n 18 467.8 m 630 467.8 l 630 455.8 l 18 455.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 458.21 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 458.21 Tm (the day the Company approves your coverage, if evidence of insurability is required.) Tj ET Q q n 0 455.8 m 612 455.8 l 612 443.8 l 0 443.8 l h W n Q q n 0 443.8 m 612 443.8 l 612 431.8 l 0 431.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 434.21 Tm (Evidence of insurability is required if:) Tj ET Q q n 18 431.8 m 630 431.8 l 630 419.8 l 18 419.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 422.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 422.21 Tm (you apply for coverage more than 31 days after you become eligible; or) Tj ET Q q n 18 419.8 m 630 419.8 l 630 407.8 l 18 407.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 410.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 410.21 Tm (you make written application to re-enroll for coverage after you have requested:) Tj ET Q q n 44.65 407.8 m 656.65 407.8 l 656.65 395.8 l 44.65 395.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 398.21 Tm (\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 398.21 Tm (to cancel your coverage;) Tj ET Q q n 44.65 395.8 m 656.65 395.8 l 656.65 383.8 l 44.65 383.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 386.21 Tm (\(b\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 386.21 Tm (to stop payroll deductions for the coverage; or) Tj ET Q q n 44.65 383.8 m 656.65 383.8 l 656.65 371.8 l 44.65 371.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 374.21 Tm (\(c\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 374.21 Tm (to stop premium payments from your Section 125 Plan account.) Tj ET Q q n 0 371.8 m 612 371.8 l 612 359.8 l 0 359.8 l h W n Q q n 0 359.8 m 612 359.8 l 612 347.8 l 0 347.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 350.21 Tm (EXCEPTIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 86.4 350.21 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 99.42 350.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 126.45 350.21 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 174.78 350.21 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 229.79 350.21 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 252.15 350.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 266.51 350.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 282.87 350.21 Tm (approved) Tj ET BT /F2 12 Tf 1 0 0 1 332.55 350.21 Tm (leave) Tj ET BT /F2 12 Tf 1 0 0 1 362.89 350.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 377.92 350.21 Tm (absence) Tj ET BT /F2 12 Tf 1 0 0 1 420.92 350.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 435.95 350.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 446.31 350.21 Tm (military) Tj ET BT /F2 12 Tf 1 0 0 1 489.33 350.21 Tm (leave,) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 350.21 Tm (any) Tj ET Q q n 0 347.8 m 612 347.8 l 612 335.8 l 0 335.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 338.21 Tm (Waiting Period or evidence of insurability requirement will be waived upon your return; provided:) Tj ET Q q n 18 335.8 m 630 335.8 l 630 323.8 l 18 323.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 326.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 326.21 Tm (you return within six months after the leave begins;) Tj ET Q q n 18 323.8 m 630 323.8 l 630 311.8 l 18 311.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 314.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 314.21 Tm (you apply or are enrolled within 31 days after resuming Active Work; and) Tj ET Q q n 18 311.8 m 630 311.8 l 630 299.8 l 18 299.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 302.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 302.21 Tm (the reinstated amount of insurance does not exceed the amount which terminated.) Tj ET Q q n 18 299.8 m 630 299.8 l 630 287.8 l 18 287.8 l h W n Q q n 0 287.8 m 612 287.8 l 612 275.8 l 0 275.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 278.21 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 13.32 278.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 40.64 278.21 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 89.26 278.21 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 144.57 278.21 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 167.22 278.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 181.87 278.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 192.53 278.21 Tm (lay-off,) Tj ET BT /F2 12 Tf 1 0 0 1 233.5 278.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 253.48 278.21 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 305.47 278.21 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 329.46 278.21 Tm (waive) Tj ET BT /F2 12 Tf 1 0 0 1 363.44 278.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 386.09 278.21 Tm (Waiting) Tj ET BT /F2 12 Tf 1 0 0 1 430.07 278.21 Tm (Period) Tj ET BT /F2 12 Tf 1 0 0 1 466.72 278.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 482.04 278.21 Tm (evidence) Tj ET BT /F2 12 Tf 1 0 0 1 530 278.21 Tm (of) Tj ET Q q n 0 275.8 m 612 275.8 l 612 263.8 l 0 263.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 266.21 Tm (insurability requirement upon your return; provided:) Tj ET Q q n 18 263.8 m 630 263.8 l 630 251.8 l 18 251.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 254.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 254.21 Tm (you return within 12 months after the date the lay-off begins;) Tj ET Q q n 18 251.8 m 630 251.8 l 630 239.8 l 18 239.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 242.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 242.21 Tm (you apply or are reenrolled within 31 days after resuming Active Work; and) Tj ET Q q n 18 239.8 m 630 239.8 l 630 227.8 l 18 227.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 230.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 230.21 Tm (the reinstated amount of insurance does not exceed the amount which terminated.) Tj ET Q q n 0 227.8 m 612 227.8 l 612 215.8 l 0 215.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 218.21 Tm (Reinstatement will take effect on the date you return to Active Work.) Tj ET Q q n 0 215.8 m 612 215.8 l 612 203.8 l 0 203.8 l h W n Q q n 0 203.8 m 612 203.8 l 612 191.8 l 0 191.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 194.21 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 12.38 194.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 38.77 194.21 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 86.45 194.21 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 140.82 194.21 Tm (because) Tj ET BT /F2 12 Tf 1 0 0 1 183.19 194.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 209.57 194.21 Tm (employment) Tj ET BT /F2 12 Tf 1 0 0 1 273.95 194.21 Tm (ends,) Tj ET BT /F2 12 Tf 1 0 0 1 303.33 194.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 322.38 194.21 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 373.43 194.21 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 396.49 194.21 Tm (waive) Tj ET BT /F2 12 Tf 1 0 0 1 429.53 194.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 451.24 194.21 Tm (Waiting) Tj ET BT /F2 12 Tf 1 0 0 1 494.29 194.21 Tm (Period) Tj ET BT /F2 12 Tf 1 0 0 1 530 194.21 Tm (or) Tj ET Q q n 0 191.8 m 612 191.8 l 612 179.8 l 0 179.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 182.21 Tm (evidence of insurability requirement upon your return; provided:) Tj ET Q q n 18 179.8 m 630 179.8 l 630 167.8 l 18 167.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 170.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 170.21 Tm (you are rehired within 12 months after employment terminated;) Tj ET Q q n 18 167.8 m 630 167.8 l 630 155.8 l 18 155.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 158.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 158.21 Tm (you apply or are reenrolled within 31 days after resuming Active Work; and) Tj ET Q q n 18 155.8 m 630 155.8 l 630 143.8 l 18 143.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 146.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 146.21 Tm (the reinstated amount of insurance does not exceed the amount which terminated.) Tj ET Q q n 0 143.8 m 612 143.8 l 612 131.8 l 0 131.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 134.21 Tm (Reinstatement will take effect on the date you return to Active Work.) Tj ET Q q n 0 131.8 m 612 131.8 l 612 119.8 l 0 119.8 l h W n Q Q q Q Q endstream endobj 7 0 obj <>>>>> endobj 108 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 744 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 179.66 2.41 Tm (TERMINATION OF COVERAGE) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-2 93) Tj ET BT /F2 12 Tf 1 0 0 1 498.67 26.1 Tm (\(FMLA\)) Tj ET BT /F2 10 Tf 1 0 0 1 267.5 14.09 Tm (5) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 671.8 m 612 671.8 l 612 659.8 l 0 659.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 662.21 Tm (Your coverage terminates on the earliest of:) Tj ET Q q n 18 659.8 m 630 659.8 l 630 647.8 l 18 647.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 650.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 650.21 Tm (the day the Policy terminates;) Tj ET Q q n 18 647.8 m 630 647.8 l 630 635.8 l 18 635.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 638.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 638.21 Tm (the last day of the Insurance Month in which you request termination;) Tj ET Q q n 18 635.8 m 630 635.8 l 630 623.8 l 18 623.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 626.21 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 626.21 Tm (the last day of the period for which the premium for your insurance has been paid;) Tj ET Q q n 18 623.8 m 630 623.8 l 630 611.8 l 18 611.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 614.21 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 614.21 Tm (the day you cease to be a member of an employee class shown in the Schedule of Insurance;) Tj ET Q q n 18 611.8 m 630 611.8 l 630 599.8 l 18 599.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 602.21 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 602.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 70.89 602.21 Tm (respect) Tj ET BT /F2 12 Tf 1 0 0 1 109.08 602.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 122.62 602.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 144.16 602.21 Tm (particular) Tj ET BT /F2 12 Tf 1 0 0 1 194.34 602.21 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 244.52 602.21 Tm (benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 285.05 602.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 303.92 602.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 325.45 602.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 344.32 602.21 Tm (part) Tj ET BT /F2 12 Tf 1 0 0 1 367.18 602.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 381.39 602.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 400.26 602.21 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 435.13 602.21 Tm (providing) Tj ET BT /F2 12 Tf 1 0 0 1 486.01 602.21 Tm (that) Tj ET Q q n 45.35 599.8 m 657.35 599.8 l 657.35 587.8 l 45.35 587.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 590.21 Tm (benefit terminates;) Tj ET Q q n 18 587.8 m 630 587.8 l 630 575.8 l 18 575.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 578.21 Tm (\(6\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 578.21 Tm (the day your employment with the Employer terminates; or) Tj ET Q q n 18 575.8 m 630 575.8 l 630 563.8 l 18 563.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 566.21 Tm (\(7\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 566.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.54 566.21 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 84.39 566.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 105.92 566.21 Tm (enter) Tj ET BT /F2 12 Tf 1 0 0 1 133.43 566.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 151.61 566.21 Tm (armed) Tj ET BT /F2 12 Tf 1 0 0 1 185.12 566.21 Tm (services) Tj ET BT /F2 12 Tf 1 0 0 1 227.3 566.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 240.82 566.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 261.67 566.21 Tm (state) Tj ET BT /F2 12 Tf 1 0 0 1 287.19 566.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 300.71 566.21 Tm (country) Tj ET BT /F2 12 Tf 1 0 0 1 340.89 566.21 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 356.42 566.21 Tm (active) Tj ET BT /F2 12 Tf 1 0 0 1 388.59 566.21 Tm (duty;) Tj ET BT /F2 12 Tf 1 0 0 1 416.79 566.21 Tm (except) Tj ET BT /F2 12 Tf 1 0 0 1 451.63 566.21 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 469.14 566.21 Tm (duty) Tj ET BT /F2 12 Tf 1 0 0 1 494 566.21 Tm (of) Tj ET Q q n 45.35 563.8 m 657.35 563.8 l 657.35 551.8 l 45.35 551.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 554.21 Tm (30) Tj ET BT /F2 12 Tf 1 0 0 1 61.11 554.21 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 86.88 554.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 100.64 554.21 Tm (less) Tj ET BT /F2 12 Tf 1 0 0 1 122.4 554.21 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 140.16 554.21 Tm (training) Tj ET BT /F2 12 Tf 1 0 0 1 181.25 554.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 194.34 554.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 212.77 554.21 Tm (Reserves) Tj ET BT /F2 12 Tf 1 0 0 1 259.85 554.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 273.61 554.21 Tm (National) Tj ET BT /F2 12 Tf 1 0 0 1 318.7 554.21 Tm (Guard.) Tj ET BT /F2 12 Tf 1 0 0 1 359.21 554.21 Tm (\(If) Tj ET BT /F2 12 Tf 1 0 0 1 374.97 554.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 396.73 554.21 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 422.49 554.21 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 452.25 554.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 466.01 554.21 Tm (military) Tj ET Q q n 45.35 551.8 m 657.35 551.8 l 657.35 539.8 l 45.35 539.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 542.21 Tm (service, the Company will refund any unearned premium.\)) Tj ET Q q n 0 539.8 m 612 539.8 l 612 527.8 l 0 527.8 l h W n Q q n 0 527.8 m 612 527.8 l 612 515.8 l 0 515.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 518.21 Tm (Ceasing) Tj ET BT /F2 12 Tf 1 0 0 1 42.67 518.21 Tm (Active) Tj ET BT /F2 12 Tf 1 0 0 1 78.66 518.21 Tm (Work) Tj ET BT /F2 12 Tf 1 0 0 1 109.99 518.21 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 163.98 518.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 189.98 518.21 Tm (eligibility.) Tj ET BT /F2 12 Tf 1 0 0 1 247.66 518.21 Tm (However,) Tj ET BT /F2 12 Tf 1 0 0 1 298.65 518.21 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 309.32 518.21 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 333.99 518.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 349.32 518.21 Tm (possible) Tj ET BT /F2 12 Tf 1 0 0 1 392.66 518.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 406.01 518.21 Tm (continue) Tj ET BT /F2 12 Tf 1 0 0 1 451.33 518.21 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 467.33 518.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 481.34 518.21 Tm (part) Tj ET BT /F2 12 Tf 1 0 0 1 504 518.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 518 518.21 Tm (your) Tj ET Q q n 0 515.8 m 612 515.8 l 612 503.8 l 0 503.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 506.21 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 49.21 506.21 Tm (during) Tj ET BT /F2 12 Tf 1 0 0 1 83.76 506.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 92.32 506.21 Tm (temporary) Tj ET BT /F2 12 Tf 1 0 0 1 144.85 506.21 Tm (lay) Tj ET BT /F2 12 Tf 1 0 0 1 162.74 506.21 Tm (off,) Tj ET BT /F2 12 Tf 1 0 0 1 182.96 506.21 Tm (leave) Tj ET BT /F2 12 Tf 1 0 0 1 211.5 506.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 224.72 506.21 Tm (absence) Tj ET BT /F2 12 Tf 1 0 0 1 265.92 506.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 279.15 506.21 Tm (military) Tj ET BT /F2 12 Tf 1 0 0 1 320.37 506.21 Tm (leave;) Tj ET BT /F2 12 Tf 1 0 0 1 352.24 506.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 365.46 506.21 Tm (while) Tj ET BT /F2 12 Tf 1 0 0 1 395.35 506.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 416.58 506.21 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 434.45 506.21 Tm (unable) Tj ET BT /F2 12 Tf 1 0 0 1 469.66 506.21 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 482.22 506.21 Tm (work) Tj ET BT /F2 12 Tf 1 0 0 1 510.11 506.21 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 506.21 Tm (to) Tj ET Q q n 0 503.8 m 612 503.8 l 612 491.8 l 0 491.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 494.21 Tm (sickness) Tj ET BT /F2 12 Tf 1 0 0 1 45.23 494.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 60.45 494.21 Tm (injury.) Tj ET BT /F2 12 Tf 1 0 0 1 102.57 494.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 126.46 494.21 Tm (conditions) Tj ET BT /F2 12 Tf 1 0 0 1 181.68 494.21 Tm (concerning) Tj ET BT /F2 12 Tf 1 0 0 1 240.22 494.21 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 267.45 494.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 278 494.21 Tm (continuance) Tj ET BT /F2 12 Tf 1 0 0 1 341.2 494.21 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 367.09 494.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 383.65 494.21 Tm (found) Tj ET BT /F2 12 Tf 1 0 0 1 416.87 494.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 431.43 494.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 451.32 494.21 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 495.45 494.21 Tm (See) Tj ET BT /F2 12 Tf 1 0 0 1 518 494.21 Tm (your) Tj ET Q q n 0 491.8 m 612 491.8 l 612 479.8 l 0 479.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 482.21 Tm (Employer for this information.) Tj ET Q q n 0 479.8 m 612 479.8 l 612 467.8 l 0 467.8 l h W n Q Q q Q Q endstream endobj 8 0 obj <>>>>> endobj 109 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-3.0A 96 PA) Tj ET BT /F2 12 Tf 1 0 0 1 445.03 26.1 Tm (Pref. Bene.-No Ext.) Tj ET BT /F2 10 Tf 1 0 0 1 251.6 14.09 Tm (6) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 220.82 688.01 Tm (DEATH BENEFIT) Tj ET Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (Upon) Tj ET BT /F2 12 Tf 1 0 0 1 30.38 664.01 Tm (receipt) Tj ET BT /F2 12 Tf 1 0 0 1 66.73 664.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 80.44 664.01 Tm (satisfactory) Tj ET BT /F2 12 Tf 1 0 0 1 139.46 664.01 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 169.16 664.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 182.87 664.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 208.57 664.01 Tm (death,) Tj ET BT /F2 12 Tf 1 0 0 1 241.27 664.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 259.64 664.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 310.01 664.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 332.39 664.01 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 353.43 664.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 362.47 664.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 392.16 664.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 429.19 664.01 Tm (equal) Tj ET BT /F2 12 Tf 1 0 0 1 458.89 664.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 471.93 664.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 490.3 664.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 530 664.01 Tm (of) Tj ET Q q n 0 661.6 m 612 661.6 l 612 649.6 l 0 649.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 652.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 46.72 652.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 72.1 652.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 124.13 652.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 138.86 652.01 Tm (effect) Tj ET BT /F2 12 Tf 1 0 0 1 171.56 652.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 188.95 652.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 209 652.01 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 234.38 652.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 249.77 652.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 277.16 652.01 Tm (death.) Tj ET BT /F2 12 Tf 1 0 0 1 316.93 652.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 340.98 652.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 379.69 652.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 403.75 652.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 420.47 652.01 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 446.52 652.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 461.25 652.01 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 498.61 652.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 652.01 Tm (the) Tj ET Q q n 0 649.6 m 612 649.6 l 612 637.6 l 0 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.01 Tm (Beneficiary section.) Tj ET Q q n 0 637.6 m 612 637.6 l 612 625.6 l 0 625.6 l h W n Q q n 0 625.6 m 612 625.6 l 612 613.6 l 0 613.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 227.99 616.01 Tm (BENEFICIARY) Tj ET Q q n 0 613.6 m 612 613.6 l 612 601.6 l 0 601.6 l h W n Q q n 0 601.6 m 612 601.6 l 612 589.6 l 0 589.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 592.01 Tm (Your) Tj ET BT /F2 12 Tf 1 0 0 1 28.02 592.01 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 87.36 592.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 98.72 592.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 116.74 592.01 Tm (person) Tj ET BT /F2 12 Tf 1 0 0 1 152.1 592.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 165.46 592.01 Tm (persons) Tj ET BT /F2 12 Tf 1 0 0 1 205.48 592.01 Tm (named) Tj ET BT /F2 12 Tf 1 0 0 1 240.83 592.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 256.19 592.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 281.55 592.01 Tm (enrollment) Tj ET BT /F2 12 Tf 1 0 0 1 336.89 592.01 Tm (card.) Tj ET BT /F2 12 Tf 1 0 0 1 367.27 592.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 389.29 592.01 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 448.62 592.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 472.64 592.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 487.33 592.01 Tm (changed) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 592.01 Tm (in) Tj ET Q q n 0 589.6 m 612 589.6 l 612 577.6 l 0 577.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.01 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 35.48 580.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 60.31 580.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 78.47 580.01 Tm (terms) Tj ET BT /F2 12 Tf 1 0 0 1 108.63 580.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 122.13 580.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 140.29 580.01 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 180.95 580.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 192.45 580.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 213.95 580.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 240.1 580.01 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 258.93 580.01 Tm (named) Tj ET BT /F2 12 Tf 1 0 0 1 294.42 580.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 303.24 580.01 Tm (Beneficiary,) Tj ET BT /F2 12 Tf 1 0 0 1 365.71 580.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 379.21 580.01 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 390.04 580.01 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 405.54 580.01 Tm (named) Tj ET BT /F2 12 Tf 1 0 0 1 441.03 580.01 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 500.49 580.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 512 580.01 Tm (living) Tj ET Q q n 0 577.6 m 612 577.6 l 612 565.6 l 0 565.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.01 Tm (when you die; then the death benefit will be paid to your:) Tj ET Q q n 18 565.6 m 630 565.6 l 630 553.6 l 18 553.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 556.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 556.01 Tm (surviving spouse; or, if none) Tj ET Q q n 18 553.6 m 630 553.6 l 630 541.6 l 18 541.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 544.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 544.01 Tm (surviving child or children in equal shares; or, if none) Tj ET Q q n 18 541.6 m 630 541.6 l 630 529.6 l 18 529.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 532.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 532.01 Tm (surviving parent or parents in equal shares; or, if none) Tj ET Q q n 18 529.6 m 630 529.6 l 630 517.6 l 18 517.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 520.01 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 520.01 Tm (surviving brothers and sisters in equal shares; or, if none) Tj ET Q q n 18 517.6 m 630 517.6 l 630 505.6 l 18 505.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 508.01 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 508.01 Tm (estate, or in accord with the Facility of Payment section of the Policy.) Tj ET Q q n 0 505.6 m 612 505.6 l 612 493.6 l 0 493.6 l h W n Q Q q Q Q endstream endobj 9 0 obj <>>>>> endobj 110 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 758.4 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 226.32 2.41 Tm (ASSIGNMENTS) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-3.0C 01) Tj ET BT /F2 10 Tf 1 0 0 1 251.6 14.09 Tm (7) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 676.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 44.92 676.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 68.49 676.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 118.72 676.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 139.64 676.01 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 195.2 676.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 227.45 676.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 277.68 676.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 301.93 676.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 316.84 676.01 Tm (assigned.) Tj ET BT /F2 12 Tf 1 0 0 1 368.35 676.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 390.6 676.01 Tm (assignments) Tj ET BT /F2 12 Tf 1 0 0 1 452.85 676.01 Tm (allowed) Tj ET BT /F2 12 Tf 1 0 0 1 494.43 676.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 676.01 Tm (the) Tj ET Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (Policy are absolute assignments and funeral assignments as described below.) Tj ET Q q n 0 661.6 m 612 661.6 l 612 649.6 l 0 649.6 l h W n Q q n 0 649.6 m 612 649.6 l 612 637.6 l 0 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.01 Tm (No assignment will be binding on the Company unless and until:) Tj ET Q q n 18 637.6 m 630 637.6 l 630 625.6 l 18 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 628.01 Tm (it is made on a form furnished by the Company;) Tj ET Q q n 18 625.6 m 630 625.6 l 630 613.6 l 18 613.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 616.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 616.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.26 616.01 Tm (original) Tj ET BT /F2 12 Tf 1 0 0 1 105.83 616.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 118.08 616.01 Tm (completed) Tj ET BT /F2 12 Tf 1 0 0 1 172.3 616.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 193.88 616.01 Tm (filed) Tj ET BT /F2 12 Tf 1 0 0 1 220.11 616.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 245.69 616.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 264.6 616.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 315.51 616.01 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 328.41 616.01 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 344 616.01 Tm (Group) Tj ET BT /F2 12 Tf 1 0 0 1 378.91 616.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 429.79 616.01 Tm (Service) Tj ET BT /F2 12 Tf 1 0 0 1 470.02 616.01 Tm (Office;) Tj ET Q q n 45.35 613.6 m 657.35 613.6 l 657.35 601.6 l 45.35 601.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 604.01 Tm (and) Tj ET Q q n 18 601.6 m 630 601.6 l 630 589.6 l 18 589.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 592.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 592.01 Tm (it is approved by the Company.) Tj ET Q q n 0 589.6 m 612 589.6 l 612 577.6 l 0 577.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.01 Tm (The Company and the Employer do not assume responsibility for the validity or effect of an assignment.) Tj ET Q q n 0 577.6 m 612 577.6 l 612 565.6 l 0 565.6 l h W n Q q n 0 565.6 m 612 565.6 l 612 553.6 l 0 553.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 556.01 Tm (ABSOLUTE) Tj ET BT /F2 12 Tf 1 0 0 1 65.98 556.01 Tm (ASSIGNMENTS.) Tj ET BT /F2 12 Tf 1 0 0 1 159.63 556.01 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 183.62 556.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 207.59 556.01 Tm (make) Tj ET BT /F2 12 Tf 1 0 0 1 236.9 556.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 251.54 556.01 Tm (irrevocable) Tj ET BT /F2 12 Tf 1 0 0 1 308.83 556.01 Tm (assignment) Tj ET BT /F2 12 Tf 1 0 0 1 366.14 556.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 379.45 556.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 404.77 556.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 449.41 556.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 472.72 556.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 556.01 Tm (and) Tj ET Q q n 0 553.6 m 612 553.6 l 612 541.6 l 0 541.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 544.01 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 56.63 544.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 89.94 544.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 141.24 544.01 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 155.89 544.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 165.88 544.01 Tm (gift) Tj ET BT /F2 12 Tf 1 0 0 1 187.2 544.01 Tm (\(with) Tj ET BT /F2 12 Tf 1 0 0 1 217.18 544.01 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 233.84 544.01 Tm (consideration\),) Tj ET BT /F2 12 Tf 1 0 0 1 310.14 544.01 Tm (providing) Tj ET BT /F2 12 Tf 1 0 0 1 361.46 544.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 384.12 544.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 411.43 544.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 430.75 544.01 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 458.73 544.01 Tm (capacity) Tj ET BT /F2 12 Tf 1 0 0 1 503.36 544.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 544.01 Tm (the) Tj ET Q q n 0 541.6 m 612 541.6 l 612 529.6 l 0 529.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 532.01 Tm (mental) Tj ET BT /F2 12 Tf 1 0 0 1 36.75 532.01 Tm (capacity) Tj ET BT /F2 12 Tf 1 0 0 1 80.83 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 94.26 532.01 Tm (do) Tj ET BT /F2 12 Tf 1 0 0 1 110.36 532.01 Tm (so.) Tj ET BT /F2 12 Tf 1 0 0 1 132.23 532.01 Tm (It) Tj ET BT /F2 12 Tf 1 0 0 1 143.66 532.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 168.42 532.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 183.84 532.01 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 213.93 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 227.36 532.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 236.79 532.01 Tm (trust) Tj ET BT /F2 12 Tf 1 0 0 1 262.22 532.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 276.32 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 289.75 532.01 Tm (one) Tj ET BT /F2 12 Tf 1 0 0 1 311.18 532.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 325.27 532.01 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 354.03 532.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 368.13 532.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 394.22 532.01 Tm (relatives,) Tj ET BT /F2 12 Tf 1 0 0 1 441.97 532.01 Tm (their) Tj ET BT /F2 12 Tf 1 0 0 1 468.06 532.01 Tm (estates,) Tj ET BT /F2 12 Tf 1 0 0 1 507.14 532.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 521.24 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 534.67 532.01 Tm (a) Tj ET Q q n 0 529.6 m 612 529.6 l 612 517.6 l 0 517.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 520.01 Tm (trustee of a trust under which one of the relatives is a beneficiary.) Tj ET Q q n 0 517.6 m 612 517.6 l 612 505.6 l 0 505.6 l h W n Q q n 0 505.6 m 612 505.6 l 612 493.6 l 0 493.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.54 496.01 Tm (term) Tj ET BT /F2 12 Tf 1 0 0 1 48.42 496.01 Tm ("relatives") Tj ET BT /F2 12 Tf 1 0 0 1 102.75 496.01 Tm (includes,) Tj ET BT /F2 12 Tf 1 0 0 1 149.63 496.01 Tm (but) Tj ET BT /F2 12 Tf 1 0 0 1 168.85 496.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 180.74 496.01 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 199.96 496.01 Tm (limited) Tj ET BT /F2 12 Tf 1 0 0 1 237.84 496.01 Tm (to,) Tj ET BT /F2 12 Tf 1 0 0 1 254.06 496.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 279.95 496.01 Tm (spouse,) Tj ET BT /F2 12 Tf 1 0 0 1 319.5 496.01 Tm (parents,) Tj ET BT /F2 12 Tf 1 0 0 1 361.04 496.01 Tm (grandparents,) Tj ET BT /F2 12 Tf 1 0 0 1 429.9 496.01 Tm (aunts,) Tj ET BT /F2 12 Tf 1 0 0 1 462.12 496.01 Tm (uncles,) Tj ET BT /F2 12 Tf 1 0 0 1 499.66 496.01 Tm (siblings,) Tj ET Q q n 0 493.6 m 612 493.6 l 612 481.6 l 0 481.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.01 Tm (children, adopted children, stepchildren, and grandchildren.) Tj ET Q q n 0 481.6 m 612 481.6 l 612 469.6 l 0 469.6 l h W n Q q n 0 469.6 m 612 469.6 l 612 457.6 l 0 457.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 460.01 Tm (In) Tj ET BT /F2 12 Tf 1 0 0 1 13.67 460.01 Tm (some) Tj ET BT /F2 12 Tf 1 0 0 1 42.67 460.01 Tm (states,) Tj ET BT /F2 12 Tf 1 0 0 1 76.01 460.01 Tm (community) Tj ET BT /F2 12 Tf 1 0 0 1 134.34 460.01 Tm (property) Tj ET BT /F2 12 Tf 1 0 0 1 178.67 460.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 190.34 460.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 205.34 460.01 Tm (established) Tj ET BT /F2 12 Tf 1 0 0 1 262.34 460.01 Tm (form) Tj ET BT /F2 12 Tf 1 0 0 1 289.34 460.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 303.01 460.01 Tm (ownership) Tj ET BT /F2 12 Tf 1 0 0 1 356.67 460.01 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 378.34 460.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 405.35 460.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 420.35 460.01 Tm (considered) Tj ET BT /F2 12 Tf 1 0 0 1 476 460.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 489.01 460.01 Tm (making) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 460.01 Tm (an) Tj ET Q q n 0 457.6 m 612 457.6 l 612 445.6 l 0 445.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 448.01 Tm (assignment.) Tj ET BT /F2 12 Tf 1 0 0 1 63.82 448.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 75.23 448.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 96.64 448.01 Tm (make) Tj ET BT /F2 12 Tf 1 0 0 1 126.04 448.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 140.78 448.01 Tm (absolute) Tj ET BT /F2 12 Tf 1 0 0 1 184.18 448.01 Tm (assignment) Tj ET BT /F2 12 Tf 1 0 0 1 241.59 448.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 254.34 448.01 Tm (two) Tj ET BT /F2 12 Tf 1 0 0 1 275.75 448.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 289.16 448.01 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 317.23 448.01 Tm (assignees,) Tj ET BT /F2 12 Tf 1 0 0 1 368.96 448.01 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 394.37 448.01 Tm (assignees) Tj ET BT /F2 12 Tf 1 0 0 1 443.11 448.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 465.19 448.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 479.93 448.01 Tm (joint) Tj ET BT /F2 12 Tf 1 0 0 1 505.34 448.01 Tm (owners) Tj ET Q q n 0 445.6 m 612 445.6 l 612 433.6 l 0 433.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 24.47 436.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 42.26 436.01 Tm (right) Tj ET BT /F2 12 Tf 1 0 0 1 68.06 436.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 81.19 436.01 Tm (survivorship) Tj ET BT /F2 12 Tf 1 0 0 1 144.33 436.01 Tm (between) Tj ET BT /F2 12 Tf 1 0 0 1 187.44 436.01 Tm (them.) Tj ET BT /F2 12 Tf 1 0 0 1 220.71 436.01 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 244.51 436.01 Tm (should) Tj ET BT /F2 12 Tf 1 0 0 1 279.65 436.01 Tm (consult) Tj ET BT /F2 12 Tf 1 0 0 1 317.45 436.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 341.92 436.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 367.05 436.01 Tm (own) Tj ET BT /F2 12 Tf 1 0 0 1 390.85 436.01 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 417.3 436.01 Tm (advisor) Tj ET BT /F2 12 Tf 1 0 0 1 455.77 436.01 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 489.55 436.01 Tm (making) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 436.01 Tm (an) Tj ET Q q n 0 433.6 m 612 433.6 l 612 421.6 l 0 421.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 424.01 Tm (assignment.) Tj ET Q q n 0 421.6 m 612 421.6 l 612 409.6 l 0 409.6 l h W n Q q n 0 409.6 m 612 409.6 l 612 397.6 l 0 397.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 400.01 Tm (Once) Tj ET BT /F2 12 Tf 1 0 0 1 28.84 400.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 47.02 400.01 Tm (assignment) Tj ET BT /F2 12 Tf 1 0 0 1 104.54 400.01 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 124.05 400.01 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 150.23 400.01 Tm (recorded) Tj ET BT /F2 12 Tf 1 0 0 1 195.72 400.01 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 211.24 400.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 229.42 400.01 Tm (Company,) Tj ET BT /F2 12 Tf 1 0 0 1 282.61 400.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 304.13 400.01 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 324.3 400.01 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 339.82 400.01 Tm (longer) Tj ET BT /F2 12 Tf 1 0 0 1 374 400.01 Tm (change) Tj ET BT /F2 12 Tf 1 0 0 1 411.5 400.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 429.68 400.01 Tm (beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 487.17 400.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 508.01 400.01 Tm (cannot) Tj ET Q q n 0 397.6 m 612 397.6 l 612 385.6 l 0 385.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 388.01 Tm (apply) Tj ET BT /F2 12 Tf 1 0 0 1 30.61 388.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 48.55 388.01 Tm (conversion.) Tj ET BT /F2 12 Tf 1 0 0 1 112.09 388.01 Tm (Only) Tj ET BT /F2 12 Tf 1 0 0 1 140.04 388.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 158.65 388.01 Tm (assignee) Tj ET BT /F2 12 Tf 1 0 0 1 203.25 388.01 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 223.85 388.01 Tm (change) Tj ET BT /F2 12 Tf 1 0 0 1 261.77 388.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 280.38 388.01 Tm (beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 338.29 388.01 Tm (designation) Tj ET BT /F2 12 Tf 1 0 0 1 397.57 388.01 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 408.84 388.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 427.45 388.01 Tm (previous) Tj ET BT /F2 12 Tf 1 0 0 1 472.72 388.01 Tm (designation) Tj ET BT /F2 12 Tf 1 0 0 1 532 388.01 Tm (is) Tj ET Q q n 0 385.6 m 612 385.6 l 612 373.6 l 0 373.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 376.01 Tm (revocable.) Tj ET BT /F2 12 Tf 1 0 0 1 56.09 376.01 Tm (An) Tj ET BT /F2 12 Tf 1 0 0 1 73.98 376.01 Tm (assignment) Tj ET BT /F2 12 Tf 1 0 0 1 131.2 376.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 153.1 376.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 178.98 376.01 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 194.21 376.01 Tm (effect) Tj ET BT /F2 12 Tf 1 0 0 1 224.74 376.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 239.96 376.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 248.52 376.01 Tm (prior) Tj ET BT /F2 12 Tf 1 0 0 1 275.07 376.01 Tm (irrevocable) Tj ET BT /F2 12 Tf 1 0 0 1 332.26 376.01 Tm (beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 389.46 376.01 Tm (designation.) Tj ET BT /F2 12 Tf 1 0 0 1 454.23 376.01 Tm (Only) Tj ET BT /F2 12 Tf 1 0 0 1 481.46 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 499.35 376.01 Tm (assignee) Tj ET Q q n 0 373.6 m 612 373.6 l 612 361.6 l 0 361.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 364.01 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 19.8 364.01 Tm (apply) Tj ET BT /F2 12 Tf 1 0 0 1 49.6 364.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 66.74 364.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 122.54 364.01 Tm (but) Tj ET BT /F2 12 Tf 1 0 0 1 141.01 364.01 Tm (only) Tj ET BT /F2 12 Tf 1 0 0 1 165.49 364.01 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 194.63 364.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 212.43 364.01 Tm (Conversion) Tj ET BT /F2 12 Tf 1 0 0 1 270.91 364.01 Tm (Privilege) Tj ET BT /F2 12 Tf 1 0 0 1 317.38 364.01 Tm (provision) Tj ET BT /F2 12 Tf 1 0 0 1 365.85 364.01 Tm (would) Tj ET BT /F2 12 Tf 1 0 0 1 399 364.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 424.8 364.01 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 450.59 364.01 Tm (available) Tj ET BT /F2 12 Tf 1 0 0 1 497.04 364.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 509.52 364.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 364.01 Tm (in) Tj ET Q q n 0 361.6 m 612 361.6 l 612 349.6 l 0 349.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.01 Tm (the absence of the assignment under the Policy.) Tj ET Q q n 0 349.6 m 612 349.6 l 612 337.6 l 0 337.6 l h W n Q q n 0 337.6 m 612 337.6 l 612 325.6 l 0 325.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 328.01 Tm (An absolute assignment cannot be used as a collateral assignment.) Tj ET Q q n 0 325.6 m 612 325.6 l 612 313.6 l 0 313.6 l h W n Q q n 0 313.6 m 612 313.6 l 612 301.6 l 0 301.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 304.01 Tm (FUNERAL) Tj ET BT /F2 12 Tf 1 0 0 1 58.54 304.01 Tm (ASSIGNMENTS.) Tj ET BT /F2 12 Tf 1 0 0 1 151.94 304.01 Tm (Upon) Tj ET BT /F2 12 Tf 1 0 0 1 181.81 304.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 207.01 304.01 Tm (death,) Tj ET BT /F2 12 Tf 1 0 0 1 239.19 304.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 257.05 304.01 Tm (beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 314.21 304.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 338.07 304.01 Tm (assign) Tj ET BT /F2 12 Tf 1 0 0 1 371.27 304.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 389.13 304.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 433.66 304.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 456.84 304.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 506.68 304.01 Tm (benefit) Tj ET Q q n 0 301.6 m 612 301.6 l 612 289.6 l 0 289.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 292.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 21.12 292.01 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 76.89 292.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 109.34 292.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 159.78 292.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 196.89 292.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 210.02 292.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 219.14 292.01 Tm (funeral) Tj ET BT /F2 12 Tf 1 0 0 1 256.92 292.01 Tm (home) Tj ET BT /F2 12 Tf 1 0 0 1 287.38 292.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 305.17 292.01 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 350.28 292.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 364.07 292.01 Tm (burial) Tj ET BT /F2 12 Tf 1 0 0 1 395.86 292.01 Tm (expenses.) Tj ET BT /F2 12 Tf 1 0 0 1 449.77 292.01 Tm (After) Tj ET BT /F2 12 Tf 1 0 0 1 478.89 292.01 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 524 292.01 Tm (has) Tj ET Q q n 0 289.6 m 612 289.6 l 612 277.6 l 0 277.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 280.01 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 27.16 280.01 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 57.66 280.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 76.16 280.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 95.33 280.01 Tm (burial) Tj ET BT /F2 12 Tf 1 0 0 1 127.83 280.01 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 175.66 280.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 189.5 280.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 208.67 280.01 Tm (assigned) Tj ET BT /F2 12 Tf 1 0 0 1 254.51 280.01 Tm (funeral) Tj ET BT /F2 12 Tf 1 0 0 1 292.99 280.01 Tm (home,) Tj ET BT /F2 12 Tf 1 0 0 1 327.16 280.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 346.33 280.01 Tm (remaining) Tj ET BT /F2 12 Tf 1 0 0 1 399.49 280.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 429.99 280.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 467.81 280.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 480.33 280.01 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 505.5 280.01 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 280.01 Tm (in) Tj ET Q q n 0 277.6 m 612 277.6 l 612 265.6 l 0 265.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 268.01 Tm (accord with the Beneficiary and Settlement Options sections of the Policy.) Tj ET Q q n 0 265.6 m 612 265.6 l 612 253.6 l 0 253.6 l h W n Q Q q Q Q endstream endobj 10 0 obj <>>>>> endobj 111 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 758.4 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 60.63 2.41 Tm (EXTENSION OF DEATH BENEFIT IF YOU BECOME TOTALLY DISABLED) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-3.1 97) Tj ET BT /F2 12 Tf 1 0 0 1 466.32 26.1 Tm (Ext. to SSNRA) Tj ET BT /F2 10 Tf 1 0 0 1 251.6 14.09 Tm (8) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 676.01 Tm (Your life insurance will be continued,) Tj ET BT /F4 12 Tf 1 0 0 1 184.95 676.01 Tm (without payment of premiums) Tj ET BT /F2 12 Tf 1 0 0 1 339.94 676.01 Tm (, if:) Tj ET Q q n 18 673.6 m 630 673.6 l 630 661.6 l 18 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 664.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 664.01 Tm (you become Totally Disabled while insured and before reaching age 60;) Tj ET Q q n 18 661.6 m 630 661.6 l 630 649.6 l 18 649.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 652.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 652.01 Tm (you remain Totally Disabled for at least 6 months in a row; and) Tj ET Q q n 18 649.6 m 630 649.6 l 630 637.6 l 18 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 640.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 640.01 Tm (you submit satisfactory proof within the 7) Tj ET BT /F2 7.2 Tf 1 0 0 1 246.66 643.61 Tm (th) Tj ET BT /F2 12 Tf 1 0 0 1 252.26 640.01 Tm ( through 12) Tj ET BT /F2 7.2 Tf 1 0 0 1 307.58 643.61 Tm (th) Tj ET BT /F2 12 Tf 1 0 0 1 313.19 640.01 Tm ( months of disability; or:) Tj ET Q q n 44.65 637.6 m 656.65 637.6 l 656.65 625.6 l 44.65 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 628.01 Tm (\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 628.01 Tm (as soon as reasonably possible after that; but) Tj ET Q q n 44.65 625.6 m 656.65 625.6 l 656.65 613.6 l 44.65 613.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 616.01 Tm (\(b\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 616.01 Tm (not later than the 24) Tj ET BT /F2 7.2 Tf 1 0 0 1 167.97 619.61 Tm (th) Tj ET BT /F2 12 Tf 1 0 0 1 173.57 616.01 Tm ( month of disability, unless you were legally incapacitated.) Tj ET Q q n 0 613.6 m 612 613.6 l 612 601.6 l 0 601.6 l h W n Q q n 0 601.6 m 612 601.6 l 612 589.6 l 0 589.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 592.01 Tm (PREMIUM) Tj ET BT /F2 12 Tf 1 0 0 1 61.13 592.01 Tm (PAYMENT.) Tj ET BT /F2 12 Tf 1 0 0 1 132.36 592.01 Tm (Premium) Tj ET BT /F2 12 Tf 1 0 0 1 181.47 592.01 Tm (payments) Tj ET BT /F2 12 Tf 1 0 0 1 232.58 592.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 261.03 592.01 Tm (continue) Tj ET BT /F2 12 Tf 1 0 0 1 307.47 592.01 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 334.59 592.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 357.7 592.01 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 377.47 592.01 Tm (approved) Tj ET BT /F2 12 Tf 1 0 0 1 427.23 592.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 446.34 592.01 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 468.8 592.01 Tm (benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 510.23 592.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 592.01 Tm (the) Tj ET Q q n 0 589.6 m 612 589.6 l 612 577.6 l 0 577.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 35.35 580.01 Tm (terminates,) Tj ET BT /F2 12 Tf 1 0 0 1 93.02 580.01 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 105.03 580.01 Tm (earlier.) Tj ET BT /F2 12 Tf 1 0 0 1 148.04 580.01 Tm (Upon) Tj ET BT /F2 12 Tf 1 0 0 1 179.39 580.01 Tm (receipt) Tj ET BT /F2 12 Tf 1 0 0 1 216.71 580.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 231.39 580.01 Tm (satisfactory) Tj ET BT /F2 12 Tf 1 0 0 1 291.39 580.01 Tm (proof,) Tj ET BT /F2 12 Tf 1 0 0 1 325.07 580.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 344.41 580.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 395.76 580.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 419.11 580.01 Tm (refund) Tj ET BT /F2 12 Tf 1 0 0 1 455.11 580.01 Tm (up) Tj ET BT /F2 12 Tf 1 0 0 1 471.8 580.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 485.82 580.01 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 502.5 580.01 Tm (months') Tj ET Q q n 0 577.6 m 612 577.6 l 612 565.6 l 0 565.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.01 Tm (premium paid for your life insurance, from your 1) Tj ET BT /F2 7.2 Tf 1 0 0 1 240.26 571.61 Tm (st) Tj ET BT /F2 12 Tf 1 0 0 1 245.07 568.01 Tm ( day of Total Disability.) Tj ET Q q n 0 565.6 m 612 565.6 l 612 553.6 l 0 553.6 l h W n Q q n 0 553.6 m 612 553.6 l 612 541.6 l 0 541.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 544.01 Tm (DEFINITION.) Tj ET BT /F2 12 Tf 1 0 0 1 76.99 544.01 Tm (For this benefit, Total Disability or Totally Disabled means you:) Tj ET Q q n 18 541.6 m 630 541.6 l 630 529.6 l 18 529.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 532.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 532.01 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 64.32 532.01 Tm (unable,) Tj ET BT /F2 12 Tf 1 0 0 1 103.62 532.01 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 125.27 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 138.92 532.01 Tm (sickness) Tj ET BT /F2 12 Tf 1 0 0 1 183.23 532.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 197.55 532.01 Tm (injury,) Tj ET BT /F2 12 Tf 1 0 0 1 233.53 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 247.18 532.01 Tm (engage) Tj ET BT /F2 12 Tf 1 0 0 1 285.48 532.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 299.13 532.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 320.78 532.01 Tm (employment) Tj ET BT /F2 12 Tf 1 0 0 1 385.08 532.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 399.4 532.01 Tm (occupation) Tj ET BT /F2 12 Tf 1 0 0 1 456.36 532.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 474.67 532.01 Tm (which) Tj ET Q q n 45.35 529.6 m 657.35 529.6 l 657.35 517.6 l 45.35 517.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 520.01 Tm (you are or become qualified by reason of education, training, or experience; and) Tj ET Q q n 18 517.6 m 630 517.6 l 630 505.6 l 18 505.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 508.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 508.01 Tm (are not engaging in any gainful employment or occupation.) Tj ET Q q n 0 505.6 m 612 505.6 l 612 493.6 l 0 493.6 l h W n Q q n 0 493.6 m 612 493.6 l 612 481.6 l 0 481.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.01 Tm (AMOUNT) Tj ET BT /F2 12 Tf 1 0 0 1 59.47 484.01 Tm (CONTINUED.) Tj ET BT /F2 12 Tf 1 0 0 1 146.07 484.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 171.54 484.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 214.34 484.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 231.14 484.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 279.27 484.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 306.07 484.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 359.52 484.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 383.65 484.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 407.78 484.01 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 466.57 484.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 493.36 484.01 Tm (Insurance) Tj ET Q q n 0 481.6 m 612 481.6 l 612 469.6 l 0 469.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 472.01 Tm (continued) Tj ET BT /F2 12 Tf 1 0 0 1 51.59 472.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 74.52 472.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 90.11 472.01 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 128.37 472.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 141.97 472.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 160.9 472.01 Tm (reductions) Tj ET BT /F2 12 Tf 1 0 0 1 215.15 472.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 236.75 472.01 Tm (terminations) Tj ET BT /F2 12 Tf 1 0 0 1 301 472.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 314.6 472.01 Tm (effect) Tj ET BT /F2 12 Tf 1 0 0 1 346.17 472.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 377.76 472.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 396.69 472.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 431.63 472.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 447.89 472.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 466.82 472.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 488.41 472.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 514.68 472.01 Tm (Total) Tj ET Q q n 0 469.6 m 612 469.6 l 612 457.6 l 0 457.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 460.01 Tm (Disability begins.) Tj ET BT /F2 12 Tf 1 0 0 1 90.66 460.01 Tm (Any Accidental Death and Dismemberment Benefit will not be continued.) Tj ET Q q n 0 457.6 m 612 457.6 l 612 445.6 l 0 445.6 l h W n Q q n 0 445.6 m 612 445.6 l 612 433.6 l 0 433.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.01 Tm (ADDITIONAL) Tj ET BT /F2 12 Tf 1 0 0 1 78.88 436.01 Tm (PROOF.) Tj ET BT /F2 12 Tf 1 0 0 1 129.03 436.01 Tm (From) Tj ET BT /F2 12 Tf 1 0 0 1 159.26 436.01 Tm (time) Tj ET BT /F2 12 Tf 1 0 0 1 184.82 436.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 198.38 436.01 Tm (time,) Tj ET BT /F2 12 Tf 1 0 0 1 226.94 436.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 249.17 436.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 276.74 436.01 Tm (submit) Tj ET BT /F2 12 Tf 1 0 0 1 313.64 436.01 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 343.87 436.01 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 366.09 436.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 392.32 436.01 Tm (Total) Tj ET BT /F2 12 Tf 1 0 0 1 421.87 436.01 Tm (Disability) Tj ET BT /F2 12 Tf 1 0 0 1 473.44 436.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 485.67 436.01 Tm (continuing.) Tj ET Q q n 0 433.6 m 612 433.6 l 612 421.6 l 0 421.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 424.01 Tm (Proof) Tj ET BT /F2 12 Tf 1 0 0 1 30.02 424.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 52.05 424.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 66.73 424.01 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 78.75 424.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 104.1 424.01 Tm (expense;) Tj ET BT /F2 12 Tf 1 0 0 1 149.44 424.01 Tm (unless) Tj ET BT /F2 12 Tf 1 0 0 1 182.8 424.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 200.82 424.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 250.84 424.01 Tm (requests) Tj ET BT /F2 12 Tf 1 0 0 1 293.52 424.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 306.21 424.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 332.22 424.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 353.57 424.01 Tm (examined) Tj ET BT /F2 12 Tf 1 0 0 1 403.58 424.01 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 418.94 424.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 427.62 424.01 Tm (Physician) Tj ET BT /F2 12 Tf 1 0 0 1 477.64 424.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 490.99 424.01 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 505.69 424.01 Tm (choice.) Tj ET Q q n 0 421.6 m 612 421.6 l 612 409.6 l 0 409.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 412.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 11.78 412.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 33.57 412.01 Tm (die) Tj ET BT /F2 12 Tf 1 0 0 1 52.02 412.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 77.79 412.01 Tm (submitting) Tj ET BT /F2 12 Tf 1 0 0 1 132.92 412.01 Tm (proof,) Tj ET BT /F2 12 Tf 1 0 0 1 165.71 412.01 Tm (further) Tj ET BT /F2 12 Tf 1 0 0 1 202.14 412.01 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 231.93 412.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 259.05 412.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 274.17 412.01 Tm (submitted) Tj ET BT /F2 12 Tf 1 0 0 1 325.29 412.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 338.42 412.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 356.87 412.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 407.32 412.01 Tm (showing) Tj ET BT /F2 12 Tf 1 0 0 1 451.78 412.01 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 473.57 412.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 495.36 412.01 Tm (remained) Tj ET Q q n 0 409.6 m 612 409.6 l 612 397.6 l 0 397.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 400.01 Tm (continuously) Tj ET BT /F2 12 Tf 1 0 0 1 66.08 400.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 87.49 400.01 Tm (Totally) Tj ET BT /F2 12 Tf 1 0 0 1 126.23 400.01 Tm (Disabled) Tj ET BT /F2 12 Tf 1 0 0 1 172.97 400.01 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 199.06 400.01 Tm (death.) Tj ET BT /F2 12 Tf 1 0 0 1 236.21 400.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 248.29 400.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 270.37 400.01 Tm (die) Tj ET BT /F2 12 Tf 1 0 0 1 289.11 400.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 323.86 400.01 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 339.95 400.01 Tm (months) Tj ET BT /F2 12 Tf 1 0 0 1 379.37 400.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 405.43 400.01 Tm (Total) Tj ET BT /F2 12 Tf 1 0 0 1 434.84 400.01 Tm (Disability) Tj ET BT /F2 12 Tf 1 0 0 1 486.25 400.01 Tm (begins,) Tj ET BT /F2 12 Tf 1 0 0 1 524.67 400.01 Tm (but) Tj ET Q q n 0 397.6 m 612 397.6 l 612 385.6 l 0 385.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 388.01 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 35.86 388.01 Tm (submitting) Tj ET BT /F2 12 Tf 1 0 0 1 92.42 388.01 Tm (proof;) Tj ET BT /F2 12 Tf 1 0 0 1 126.96 388.01 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 152.84 388.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 180.05 388.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 211.25 388.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 249.78 388.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 273.67 388.01 Tm (still) Tj ET BT /F2 12 Tf 1 0 0 1 296.89 388.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 313.43 388.01 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 339.31 388.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 371.85 388.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 391.72 388.01 Tm (terms) Tj ET BT /F2 12 Tf 1 0 0 1 423.6 388.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 438.81 388.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 458.69 388.01 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 502.79 388.01 Tm (But) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 388.01 Tm (the) Tj ET Q q n 0 385.6 m 612 385.6 l 612 373.6 l 0 373.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 376.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 49.98 376.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 76.64 376.01 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 99.29 376.01 Tm (receive) Tj ET BT /F2 12 Tf 1 0 0 1 137.25 376.01 Tm (satisfactory) Tj ET BT /F2 12 Tf 1 0 0 1 195.88 376.01 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 225.19 376.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 238.51 376.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 263.82 376.01 Tm (continuous) Tj ET BT /F2 12 Tf 1 0 0 1 319.81 376.01 Tm (Total) Tj ET BT /F2 12 Tf 1 0 0 1 348.45 376.01 Tm (Disability,) Tj ET BT /F2 12 Tf 1 0 0 1 402.11 376.01 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 428.75 376.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 454.07 376.01 Tm (last) Tj ET BT /F2 12 Tf 1 0 0 1 474.05 376.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 494.7 376.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 508.01 376.01 Tm (Active) Tj ET Q q n 0 373.6 m 612 373.6 l 612 361.6 l 0 361.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 364.01 Tm (Work until your date of death.) Tj ET Q q n 0 361.6 m 612 361.6 l 612 349.6 l 0 349.6 l h W n Q q n 0 349.6 m 612 349.6 l 612 337.6 l 0 337.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 340.01 Tm (TERMINATION.) Tj ET BT /F2 12 Tf 1 0 0 1 92.32 340.01 Tm (Any life insurance continued under this section will terminate automatically on:) Tj ET Q q n 18 337.6 m 630 337.6 l 630 325.6 l 18 325.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 328.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 328.01 Tm (the day you cease to be Totally Disabled;) Tj ET Q q n 18 325.6 m 630 325.6 l 630 313.6 l 18 313.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 316.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 316.01 Tm (the day you fail to take a required medical examination;) Tj ET Q q n 18 313.6 m 630 313.6 l 630 301.6 l 18 301.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 304.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 304.01 Tm (the 60) Tj ET BT /F2 7.2 Tf 1 0 0 1 75.01 307.61 Tm (th) Tj ET BT /F2 12 Tf 1 0 0 1 80.61 304.01 Tm ( day after the Company mails a request for additional proof, if it is not given;) Tj ET Q q n 18 301.6 m 630 301.6 l 630 289.6 l 18 289.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 292.01 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 292.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 65.14 292.01 Tm (effective) Tj ET BT /F2 12 Tf 1 0 0 1 112.23 292.01 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 137.34 292.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 152.47 292.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 179.59 292.01 Tm (individual) Tj ET BT /F2 12 Tf 1 0 0 1 233.38 292.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 291.16 292.01 Tm (policy,) Tj ET BT /F2 12 Tf 1 0 0 1 329.28 292.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 355.74 292.01 Tm (respect) Tj ET BT /F2 12 Tf 1 0 0 1 394.85 292.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 409.31 292.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 431.77 292.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 472.89 292.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 488.01 292.01 Tm (life) Tj ET Q q n 45.35 289.6 m 657.35 289.6 l 657.35 277.6 l 45.35 277.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 280.01 Tm (insurance converted in accord with the Conversion Privilege section; or) Tj ET Q q n 18 277.6 m 630 277.6 l 630 265.6 l 18 265.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 268.01 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 268.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 62.81 268.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 83.29 268.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 104.44 268.01 Tm (reach) Tj ET BT /F2 12 Tf 1 0 0 1 133.56 268.01 Tm (Social) Tj ET BT /F2 12 Tf 1 0 0 1 166.71 268.01 Tm (Security) Tj ET BT /F2 12 Tf 1 0 0 1 209.85 268.01 Tm (Normal) Tj ET BT /F2 12 Tf 1 0 0 1 249.65 268.01 Tm (Retirement) Tj ET BT /F2 12 Tf 1 0 0 1 306.12 268.01 Tm (Age) Tj ET BT /F2 12 Tf 1 0 0 1 329.26 268.01 Tm (\(SSNRA\),) Tj ET BT /F2 12 Tf 1 0 0 1 382.09 268.01 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 395.23 268.01 Tm (shown) Tj ET BT /F2 12 Tf 1 0 0 1 429.72 268.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 442.2 268.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 460.01 268.01 Tm (Schedule) Tj ET Q q n 45.35 265.6 m 657.35 265.6 l 657.35 253.6 l 45.35 253.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 256.01 Tm (of Insurance \(whichever occurs first\).) Tj ET Q q n 0 253.6 m 612 253.6 l 612 241.6 l 0 241.6 l h W n Q q n 0 241.6 m 612 241.6 l 612 229.6 l 0 229.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 232.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 12.72 232.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 39.44 232.01 Tm (Total) Tj ET BT /F2 12 Tf 1 0 0 1 69.49 232.01 Tm (Disability) Tj ET BT /F2 12 Tf 1 0 0 1 121.55 232.01 Tm (ends,) Tj ET BT /F2 12 Tf 1 0 0 1 151.27 232.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 173.32 232.01 Tm (you) Tj ET BT /F4 12 Tf 1 0 0 1 196.04 232.01 Tm (do) Tj ET BT /F4 12 Tf 1 0 0 1 213.44 232.01 Tm (not) Tj ET BT /F4 12 Tf 1 0 0 1 234.84 232.01 Tm (return) Tj ET BT /F2 12 Tf 1 0 0 1 272.88 232.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 286.94 232.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 296.99 232.01 Tm (class) Tj ET BT /F2 12 Tf 1 0 0 1 325.05 232.01 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 365.76 232.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 384.48 232.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 419.87 232.01 Tm (coverage;) Tj ET BT /F2 12 Tf 1 0 0 1 471.23 232.01 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 496.62 232.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 519.34 232.01 Tm (may) Tj ET Q q n 0 229.6 m 612 229.6 l 612 217.6 l 0 217.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 220.01 Tm (exercise) Tj ET BT /F2 12 Tf 1 0 0 1 43.27 220.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 61.9 220.01 Tm (Conversion) Tj ET BT /F2 12 Tf 1 0 0 1 121.2 220.01 Tm (Privilege.) Tj ET BT /F2 12 Tf 1 0 0 1 175.47 220.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 187.43 220.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 213.39 220.01 Tm (Total) Tj ET BT /F2 12 Tf 1 0 0 1 242.69 220.01 Tm (Disability) Tj ET BT /F2 12 Tf 1 0 0 1 293.99 220.01 Tm (ends,) Tj ET BT /F2 12 Tf 1 0 0 1 322.95 220.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 344.25 220.01 Tm (you) Tj ET BT /F4 12 Tf 1 0 0 1 366.22 220.01 Tm (do) Tj ET BT /F4 12 Tf 1 0 0 1 382.86 220.01 Tm (return) Tj ET BT /F2 12 Tf 1 0 0 1 420.15 220.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 433.46 220.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 448.75 220.01 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 488.71 220.01 Tm (class;) Tj ET BT /F2 12 Tf 1 0 0 1 519.34 220.01 Tm (then) Tj ET Q q n 0 217.6 m 612 217.6 l 612 205.6 l 0 205.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 208.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 28.55 208.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 65.78 208.01 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 115.64 208.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 140.86 208.01 Tm (resume) Tj ET BT /F2 12 Tf 1 0 0 1 182.07 208.01 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 214.62 208.01 Tm (premium) Tj ET BT /F2 12 Tf 1 0 0 1 264.5 208.01 Tm (payments) Tj ET BT /F2 12 Tf 1 0 0 1 317.05 208.01 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 338.26 208.01 Tm (resumed,) Tj ET BT /F2 12 Tf 1 0 0 1 388.47 208.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 412.35 208.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 436.24 208.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 495.44 208.01 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 532 208.01 Tm (is) Tj ET Q q n 0 205.6 m 612 205.6 l 612 193.6 l 0 193.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 196.01 Tm (surrendered as provided in the Policy.) Tj ET Q Q q Q Q endstream endobj 11 0 obj <>>>>> endobj 113 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 758.4 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 173.31 2.41 Tm (ACCELERATED DEATH BENEFIT) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-3.8 01) Tj ET BT /F2 12 Tf 1 0 0 1 514.66 26.1 Tm (ADB) Tj ET BT /F2 10 Tf 1 0 0 1 251.6 14.09 Tm (9) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 676.01 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 59.98 676.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 82.47 676.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 143.58 676.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 176.06 676.01 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 215.2 676.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 227.03 676.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 242.19 676.01 Tm (advance) Tj ET BT /F2 12 Tf 1 0 0 1 285.32 676.01 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 330.46 676.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 344.29 676.01 Tm (part) Tj ET BT /F2 12 Tf 1 0 0 1 366.77 676.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 380.59 676.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 406.41 676.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 451.56 676.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 475.38 676.01 Tm (Insurance.) Tj ET BT /F2 12 Tf 1 0 0 1 532.67 676.01 Tm (It) Tj ET Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (may be paid to you, in a lump sum, once during your lifetime.) Tj ET Q q n 0 661.6 m 612 661.6 l 612 649.6 l 0 649.6 l h W n Q q n 0 649.6 m 612 649.6 l 612 637.6 l 0 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.01 Tm (To qualify, you must:) Tj ET Q q n 18 637.6 m 630 637.6 l 630 625.6 l 18 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 628.01 Tm (have satisfied the Active Work requirement under the Policy;) Tj ET Q q n 18 625.6 m 630 625.6 l 630 613.6 l 18 613.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 616.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 616.01 Tm (have been insured under the Policy for at least 12 months; and) Tj ET Q q n 18 613.6 m 630 613.6 l 630 601.6 l 18 601.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 604.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 604.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 74.17 604.01 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 88.99 604.01 Tm (least) Tj ET BT /F2 12 Tf 1 0 0 1 117.14 604.01 Tm ($2,000) Tj ET BT /F2 12 Tf 1 0 0 1 156.31 604.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 172.47 604.01 Tm (Personal) Tj ET BT /F2 12 Tf 1 0 0 1 219.96 604.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 246.11 604.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 298.91 604.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 332.4 604.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 353.22 604.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 390.05 604.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 408.22 604.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 429.04 604.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 452.53 604.01 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 604.01 Tm (the) Tj ET Q q n 45.35 601.6 m 657.35 601.6 l 657.35 589.6 l 45.35 589.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 592.01 Tm (Accelerated Death Benefit is paid.) Tj ET Q q n 0 589.6 m 612 589.6 l 612 577.6 l 0 577.6 l h W n Q q n 0 577.6 m 612 577.6 l 612 565.6 l 0 565.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.01 Tm (Receiving) Tj ET BT /F2 12 Tf 1 0 0 1 54 568.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 74.01 568.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 136.64 568.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 170.65 568.01 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 211.31 568.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 235.33 568.01 Tm (reduce) Tj ET BT /F2 12 Tf 1 0 0 1 272.65 568.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 292.66 568.01 Tm (Remaining) Tj ET BT /F2 12 Tf 1 0 0 1 350.67 568.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 376.01 568.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 428 568.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 450.67 568.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 470.68 568.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 504.68 568.01 Tm (Benefit) Tj ET Q q n 0 565.6 m 612 565.6 l 612 553.6 l 0 553.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 556.01 Tm (payable at death, as shown on the next page.) Tj ET Q q n 0 553.6 m 612 553.6 l 612 541.6 l 0 541.6 l h W n Q q n 0 541.6 m 612 541.6 l 612 529.6 l 0 529.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 532.01 Tm ("Claimant,") Tj ET BT /F2 12 Tf 1 0 0 1 59.9 532.01 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 73 532.01 Tm (used) Tj ET BT /F2 12 Tf 1 0 0 1 98.1 532.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 110.54 532.01 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 130.98 532.01 Tm (section,) Tj ET BT /F2 12 Tf 1 0 0 1 171.08 532.01 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 204.84 532.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 222.61 532.01 Tm (Terminal) Tj ET BT /F2 12 Tf 1 0 0 1 269.69 532.01 Tm (Insured) Tj ET BT /F2 12 Tf 1 0 0 1 308.79 532.01 Tm (Person) Tj ET BT /F2 12 Tf 1 0 0 1 344.56 532.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 361.66 532.01 Tm (whom) Tj ET BT /F2 12 Tf 1 0 0 1 394.76 532.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 412.53 532.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 472.92 532.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 504.68 532.01 Tm (Benefit) Tj ET Q q n 0 529.6 m 612 529.6 l 612 517.6 l 0 517.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 520.01 Tm (is requested.) Tj ET Q q n 0 517.6 m 612 517.6 l 612 505.6 l 0 505.6 l h W n Q q n 0 505.6 m 612 505.6 l 612 493.6 l 0 493.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.01 Tm ("Terminal") Tj ET BT /F2 12 Tf 1 0 0 1 57.31 496.01 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 91.49 496.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 113.02 496.01 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 139.2 496.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 148.06 496.01 Tm (medical) Tj ET BT /F2 12 Tf 1 0 0 1 189.57 496.01 Tm (condition) Tj ET BT /F2 12 Tf 1 0 0 1 238.43 496.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 271.28 496.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 282.82 496.01 Tm (expected) Tj ET BT /F2 12 Tf 1 0 0 1 328.98 496.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 341.85 496.01 Tm (result) Tj ET BT /F2 12 Tf 1 0 0 1 372.04 496.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 384.9 496.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 414.42 496.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 448.61 496.01 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 464.14 496.01 Tm (months,) Tj ET BT /F2 12 Tf 1 0 0 1 506.01 496.01 Tm (despite) Tj ET Q q n 0 493.6 m 612 493.6 l 612 481.6 l 0 481.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.01 Tm (appropriate medical treatment.) Tj ET Q q n 0 481.6 m 612 481.6 l 612 469.6 l 0 469.6 l h W n Q q n 0 469.6 m 612 469.6 l 612 457.6 l 0 457.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 460.01 Tm (APPLYING) Tj ET BT /F2 12 Tf 1 0 0 1 66.97 460.01 Tm (FOR) Tj ET BT /F2 12 Tf 1 0 0 1 97.94 460.01 Tm (THE) Tj ET BT /F2 12 Tf 1 0 0 1 128.89 460.01 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 196.47 460.01 Tm (To) Tj ET BT /F2 12 Tf 1 0 0 1 217.43 460.01 Tm (withdraw) Tj ET BT /F2 12 Tf 1 0 0 1 270.38 460.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 292.67 460.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 357.58 460.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 393.86 460.01 Tm (Benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 439.81 460.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 465.44 460.01 Tm (\(or) Tj ET BT /F2 12 Tf 1 0 0 1 487.06 460.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 516.68 460.01 Tm (legal) Tj ET Q q n 0 457.6 m 612 457.6 l 612 445.6 l 0 445.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 448.01 Tm (representative\) must send the Company:) Tj ET Q q n 18 445.6 m 630 445.6 l 630 433.6 l 18 433.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 436.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 436.01 Tm (written election of the Accelerated Death Benefit, on forms supplied by the Company; and) Tj ET Q q n 18 433.6 m 630 433.6 l 630 421.6 l 18 421.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 424.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 424.01 Tm (satisfactory proof that the Claimant is Terminal, including a Physician's written statement.) Tj ET Q q n 0 421.6 m 612 421.6 l 612 409.6 l 0 409.6 l h W n Q q n 0 409.6 m 612 409.6 l 612 397.6 l 0 397.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 400.01 Tm (The Company reserves the right to decide whether such proof is satisfactory.) Tj ET Q q n 0 397.6 m 612 397.6 l 612 385.6 l 0 385.6 l h W n Q q n 0 385.6 m 612 385.6 l 612 373.6 l 0 373.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 376.01 Tm (Before) Tj ET BT /F2 12 Tf 1 0 0 1 38.51 376.01 Tm (paying) Tj ET BT /F2 12 Tf 1 0 0 1 77.02 376.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 94.21 376.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 157.35 376.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 191.86 376.01 Tm (Benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 236.03 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 256.55 376.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 309.07 376.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 338.27 376.01 Tm (also) Tj ET BT /F2 12 Tf 1 0 0 1 363.45 376.01 Tm (receive) Tj ET BT /F2 12 Tf 1 0 0 1 403.95 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 424.46 376.01 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 464.31 376.01 Tm (consent) Tj ET BT /F2 12 Tf 1 0 0 1 506.82 376.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 376.01 Tm (any) Tj ET Q q n 0 373.6 m 612 373.6 l 612 361.6 l 0 361.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 364.01 Tm (irrevocable) Tj ET BT /F2 12 Tf 1 0 0 1 57.68 364.01 Tm (beneficiary,) Tj ET BT /F2 12 Tf 1 0 0 1 118.37 364.01 Tm (assignee) Tj ET BT /F2 12 Tf 1 0 0 1 162.74 364.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 176.46 364.01 Tm (bankruptcy) Tj ET BT /F2 12 Tf 1 0 0 1 234.16 364.01 Tm (court) Tj ET BT /F2 12 Tf 1 0 0 1 262.53 364.01 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 287.59 364.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 302.63 364.01 Tm (interest) Tj ET BT /F2 12 Tf 1 0 0 1 341.67 364.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 354.73 364.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 373.11 364.01 Tm (benefit.) Tj ET BT /F2 12 Tf 1 0 0 1 413.14 364.01 Tm (\(See) Tj ET BT /F2 12 Tf 1 0 0 1 438.19 364.01 Tm (Limitations) Tj ET BT /F2 12 Tf 1 0 0 1 497.24 364.01 Tm (3,) Tj ET BT /F2 12 Tf 1 0 0 1 509.95 364.01 Tm (4,) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 364.01 Tm (and) Tj ET Q q n 0 361.6 m 612 361.6 l 612 349.6 l 0 349.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.01 Tm (5.\)) Tj ET Q q n 0 349.6 m 612 349.6 l 612 337.6 l 0 337.6 l h W n Q q n 0 337.6 m 612 337.6 l 612 325.6 l 0 325.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 328.01 Tm (NOTE:) Tj ET BT /F4 12 Tf 1 0 0 1 51.05 328.01 Tm (THIS) Tj ET BT /F4 12 Tf 1 0 0 1 86.25 328.01 Tm (IS) Tj ET BT /F4 12 Tf 1 0 0 1 104.11 328.01 Tm (NOT) Tj ET BT /F4 12 Tf 1 0 0 1 136.64 328.01 Tm (A) Tj ET BT /F4 12 Tf 1 0 0 1 151.82 328.01 Tm (LONG-TERM) Tj ET BT /F4 12 Tf 1 0 0 1 233.68 328.01 Tm (CARE) Tj ET BT /F4 12 Tf 1 0 0 1 274.2 328.01 Tm (POLICY.) Tj ET BT /F4 12 Tf 1 0 0 1 336.92 328.01 Tm (RECEIVING) Tj ET BT /F4 12 Tf 1 0 0 1 412.78 328.01 Tm (THIS) Tj ET BT /F4 12 Tf 1 0 0 1 447.98 328.01 Tm (ACCELERATED) Tj ET Q q n 0 325.6 m 612 325.6 l 612 313.6 l 0 313.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 316.01 Tm (DEATH) Tj ET BT /F4 12 Tf 1 0 0 1 50.21 316.01 Tm (BENEFIT) Tj ET BT /F4 12 Tf 1 0 0 1 110.43 316.01 Tm (WILL) Tj ET BT /F4 12 Tf 1 0 0 1 150.65 316.01 Tm (REDUCE) Tj ET BT /F4 12 Tf 1 0 0 1 208.86 316.01 Tm (THE) Tj ET BT /F4 12 Tf 1 0 0 1 241.74 316.01 Tm (BENEFIT) Tj ET BT /F4 12 Tf 1 0 0 1 301.96 316.01 Tm (PAYABLE) Tj ET BT /F4 12 Tf 1 0 0 1 366.84 316.01 Tm (AT) Tj ET BT /F4 12 Tf 1 0 0 1 391.05 316.01 Tm (DEATH.) Tj ET BT /F4 12 Tf 1 0 0 1 451.8 316.01 Tm (ANY) Tj ET BT /F4 12 Tf 1 0 0 1 485.34 316.01 Tm (AMOUNT) Tj ET Q q n 0 313.6 m 612 313.6 l 612 301.6 l 0 301.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 304.01 Tm (WITHDRAWN) Tj ET BT /F4 12 Tf 1 0 0 1 86.33 304.01 Tm (MAY) Tj ET BT /F4 12 Tf 1 0 0 1 120.65 304.01 Tm (BE) Tj ET BT /F4 12 Tf 1 0 0 1 142.32 304.01 Tm (TAXABLE) Tj ET BT /F4 12 Tf 1 0 0 1 206 304.01 Tm (INCOME,) Tj ET BT /F4 12 Tf 1 0 0 1 265.32 304.01 Tm (SO) Tj ET BT /F4 12 Tf 1 0 0 1 286.99 304.01 Tm (YOU) Tj ET BT /F4 12 Tf 1 0 0 1 319.32 304.01 Tm (SHOULD) Tj ET BT /F4 12 Tf 1 0 0 1 375.66 304.01 Tm (CONSULT) Tj ET BT /F4 12 Tf 1 0 0 1 439.33 304.01 Tm (A) Tj ET BT /F4 12 Tf 1 0 0 1 453.66 304.01 Tm (TAX) Tj ET BT /F4 12 Tf 1 0 0 1 484.66 304.01 Tm (ADVISOR) Tj ET Q q n 0 301.6 m 612 301.6 l 612 289.6 l 0 289.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 292.01 Tm (BEFORE APPLYING FOR THIS BENEFIT.) Tj ET Q q n 0 289.6 m 612 289.6 l 612 277.6 l 0 277.6 l h W n Q q n 0 277.6 m 612 277.6 l 612 265.6 l 0 265.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 268.01 Tm (AMOUNT) Tj ET BT /F2 12 Tf 1 0 0 1 58.01 268.01 Tm (OF) Tj ET BT /F2 12 Tf 1 0 0 1 78.69 268.01 Tm (THE) Tj ET BT /F2 12 Tf 1 0 0 1 107.36 268.01 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 170.37 268.01 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 196.38 268.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 222.38 268.01 Tm (elect) Tj ET BT /F2 12 Tf 1 0 0 1 250.37 268.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 265.04 268.01 Tm (withdraw) Tj ET BT /F2 12 Tf 1 0 0 1 315.7 268.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 332.37 268.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 395 268.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 429 268.01 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 469.66 268.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 484.33 268.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 507 268.01 Tm ($1,000) Tj ET Q q n 0 265.6 m 612 265.6 l 612 253.6 l 0 253.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 256.01 Tm (increment; subject to:) Tj ET Q q n 18 253.6 m 630 253.6 l 630 241.6 l 18 241.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 244.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 244.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 56.5 244.01 Tm (minimum) Tj ET BT /F2 12 Tf 1 0 0 1 109 244.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 124.83 244.01 Tm ($1,000) Tj ET BT /F2 12 Tf 1 0 0 1 163.66 244.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 179.48 244.01 Tm (10%) Tj ET BT /F2 12 Tf 1 0 0 1 207.3 244.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 223.13 244.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 243.62 244.01 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 300.27 244.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 342.09 244.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 357.91 244.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 383.73 244.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 436.2 244.01 Tm (\(whichever) Tj ET BT /F2 12 Tf 1 0 0 1 496 244.01 Tm (is) Tj ET Q q n 45.35 241.6 m 657.35 241.6 l 657.35 229.6 l 45.35 229.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 232.01 Tm (greater\); and) Tj ET Q q n 18 229.6 m 630 229.6 l 630 217.6 l 18 217.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 220.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 220.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 55.51 220.01 Tm (maximum) Tj ET BT /F2 12 Tf 1 0 0 1 109 220.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 123.82 220.01 Tm ($250,000) Tj ET BT /F2 12 Tf 1 0 0 1 173.65 220.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 188.47 220.01 Tm (75%) Tj ET BT /F2 12 Tf 1 0 0 1 215.3 220.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 230.12 220.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 249.61 220.01 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 305.27 220.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 346.09 220.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 360.91 220.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 385.73 220.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 437.2 220.01 Tm (\(whichever) Tj ET BT /F2 12 Tf 1 0 0 1 496 220.01 Tm (is) Tj ET Q q n 45.35 217.6 m 657.35 217.6 l 657.35 205.6 l 45.35 205.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 208.01 Tm (less\).) Tj ET Q q n 0 205.6 m 612 205.6 l 612 193.6 l 0 193.6 l h W n Q q n 0 193.6 m 612 193.6 l 612 181.6 l 0 181.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 184.01 Tm (To determine the Accelerated Death Benefit, the Company will use the lesser of A or B below:) Tj ET Q q n 18 181.6 m 630 181.6 l 630 169.6 l 18 169.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 172.01 Tm (A.) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 172.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.19 172.01 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 119.19 172.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 159.36 172.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 173.53 172.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 197.7 172.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 248.52 172.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 282.02 172.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 294.2 172.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 307.71 172.01 Tm (force) Tj ET BT /F2 12 Tf 1 0 0 1 336.54 172.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 352.71 172.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 371.55 172.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 393.05 172.01 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 427.88 172.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 446.71 172.01 Tm (Accelerated) Tj ET Q q n 45.35 169.6 m 657.35 169.6 l 657.35 157.6 l 45.35 157.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 160.01 Tm (Death Benefit is paid; or) Tj ET Q q n 18 157.6 m 630 157.6 l 630 145.6 l 18 145.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 148.01 Tm (B.) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 148.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.63 148.01 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 118.08 148.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 157.69 148.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 171.31 148.01 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 194.92 148.01 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 245.19 148.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 278.13 148.01 Tm (would) Tj ET BT /F2 12 Tf 1 0 0 1 311.76 148.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 326.7 148.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 339.66 148.01 Tm (force) Tj ET BT /F2 12 Tf 1 0 0 1 367.93 148.01 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 383.55 148.01 Tm (months) Tj ET BT /F2 12 Tf 1 0 0 1 422.51 148.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 448.11 148.01 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 469.73 148.01 Tm (date;) Tj ET BT /F2 12 Tf 1 0 0 1 496.67 148.01 Tm (if) Tj ET Q q n 45.35 145.6 m 657.35 145.6 l 657.35 133.6 l 45.35 133.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 136.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.58 136.01 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 110.44 136.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 122.01 136.01 Tm (scheduled) Tj ET BT /F2 12 Tf 1 0 0 1 173.56 136.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 186.46 136.01 Tm (reduce,) Tj ET BT /F2 12 Tf 1 0 0 1 225.01 136.01 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 245.9 136.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 258.8 136.01 Tm (age,) Tj ET BT /F2 12 Tf 1 0 0 1 282.02 136.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 316.25 136.01 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 331.82 136.01 Tm (months) Tj ET BT /F2 12 Tf 1 0 0 1 370.72 136.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 396.27 136.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 414.49 136.01 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 475.35 136.01 Tm (Death) Tj ET Q q n 45.35 133.6 m 657.35 133.6 l 657.35 121.6 l 45.35 121.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 124.01 Tm (Benefit is paid.) Tj ET Q q n 0 121.6 m 612 121.6 l 612 109.6 l 0 109.6 l h W n Q q n 0 109.6 m 612 109.6 l 612 97.6 l 0 97.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 100.01 Tm (ADMINISTRATIVE CHARGE:) Tj ET BT /F2 12 Tf 1 0 0 1 164.33 100.01 Tm (NONE) Tj ET Q q n 0 97.6 m 612 97.6 l 612 85.6 l 0 85.6 l h W n Q q n 0 85.6 m 612 85.6 l 612 73.6 l 0 73.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 76.01 Tm (WITHDRAWAL FEE:) Tj ET BT /F2 12 Tf 1 0 0 1 117.65 76.01 Tm (NONE) Tj ET Q q n 0 73.6 m 612 73.6 l 612 61.6 l 0 61.6 l h W n Q Q q Q Q endstream endobj 12 0 obj <>>>>> endobj 114 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 734.4 cm q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 173.31 26.41 Tm (ACCELERATED DEATH BENEFIT) Tj ET Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 239 14.41 Tm (\(Continued\)) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-3.8 01) Tj ET BT /F2 12 Tf 1 0 0 1 514.66 26.1 Tm (ADB) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (10) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 676 m 612 676 l 612 664 l 0 664 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 666.41 Tm (EFFECT) Tj ET BT /F2 12 Tf 1 0 0 1 48.62 666.41 Tm (ON) Tj ET BT /F2 12 Tf 1 0 0 1 71.24 666.41 Tm (AMOUNT) Tj ET BT /F2 12 Tf 1 0 0 1 129.18 666.41 Tm (OF) Tj ET BT /F2 12 Tf 1 0 0 1 149.81 666.41 Tm (LIFE) Tj ET BT /F2 12 Tf 1 0 0 1 180.42 666.41 Tm (INSURANCE.) Tj ET BT /F2 12 Tf 1 0 0 1 262.65 666.41 Tm ("Remaining) Tj ET BT /F2 12 Tf 1 0 0 1 325.49 666.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 350.76 666.41 Tm (Insurance") Tj ET BT /F2 12 Tf 1 0 0 1 407.58 666.41 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 443.52 666.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 463.46 666.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 504.74 666.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 520.01 666.41 Tm (Life) Tj ET Q q n 0 664 m 612 664 l 612 652 l 0 652 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 654.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 52.15 654.41 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 86.99 654.41 Tm (remains) Tj ET BT /F2 12 Tf 1 0 0 1 130.49 654.41 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 145.34 654.41 Tm (force) Tj ET BT /F2 12 Tf 1 0 0 1 175.49 654.41 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 193.01 654.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 213.18 654.41 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 269.51 654.41 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 291.02 654.41 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 318.51 654.41 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 335.35 654.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 398.15 654.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 432.31 654.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 473.14 654.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 486.66 654.41 Tm (paid.) Tj ET BT /F2 12 Tf 1 0 0 1 521.34 654.41 Tm (The) Tj ET Q q n 0 652 m 612 652 l 612 640 l 0 640 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 642.41 Tm (Remaining Life Insurance will equal:) Tj ET Q q n 18 640 m 630 640 l 630 628 l 18 628 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 630.41 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 630.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 64.06 630.41 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 118.94 630.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 158.98 630.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 173.03 630.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 197.06 630.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 247.75 630.41 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 281.13 630.41 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 303.84 630.41 Tm (used) Tj ET BT /F2 12 Tf 1 0 0 1 329.89 630.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 343.27 630.41 Tm (determine) Tj ET BT /F2 12 Tf 1 0 0 1 395.3 630.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 414.01 630.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 475.35 630.41 Tm (Death) Tj ET Q q n 45.35 628 m 657.35 628 l 657.35 616 l 45.35 616 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 618.41 Tm (Benefit \(A or B above\); minus) Tj ET Q q n 18 616 m 630 616 l 630 604 l 18 604 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 606.41 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 606.41 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 67.36 606.41 Tm (percentage) Tj ET BT /F2 12 Tf 1 0 0 1 124.01 606.41 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 140.7 606.41 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 174.72 606.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 194.06 606.41 Tm (Claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 249.58 606.41 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 297.56 606.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 310.26 606.41 Tm (scheduled) Tj ET BT /F2 12 Tf 1 0 0 1 362.93 606.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 376.95 606.41 Tm (reduce,) Tj ET BT /F2 12 Tf 1 0 0 1 416.61 606.41 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 438.63 606.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 452.65 606.41 Tm (age;) Tj ET BT /F2 12 Tf 1 0 0 1 477.32 606.41 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 606.41 Tm (the) Tj ET Q q n 45.35 604 m 657.35 604 l 657.35 592 l 45.35 592 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 594.41 Tm (reduction) Tj ET BT /F2 12 Tf 1 0 0 1 94.65 594.41 Tm (occurs) Tj ET BT /F2 12 Tf 1 0 0 1 129.96 594.41 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 158.6 594.41 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 183.25 594.41 Tm (12) Tj ET BT /F2 12 Tf 1 0 0 1 199.23 594.41 Tm (months) Tj ET BT /F2 12 Tf 1 0 0 1 238.56 594.41 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 264.52 594.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 283.17 594.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 344.44 594.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 377.08 594.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 416.39 594.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 428.38 594.41 Tm (paid,) Tj ET BT /F2 12 Tf 1 0 0 1 456.03 594.41 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 477.34 594.41 Tm (while) Tj ET Q q n 45.35 592 m 657.35 592 l 657.35 580 l 45.35 580 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 582.41 Tm (he or she is still living; minus) Tj ET Q q n 18 580 m 630 580 l 630 568 l 18 568 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 570.41 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 570.41 Tm (the amount of the Accelerated Death Benefit withdrawn.) Tj ET Q q n 0 568 m 612 568 l 612 556 l 0 556 l h W n Q q n 0 556 m 612 556 l 612 544 l 0 544 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 546.41 Tm (PREMIUM:) Tj ET BT /F2 12 Tf 1 0 0 1 66.82 546.41 Tm (There) Tj ET BT /F2 12 Tf 1 0 0 1 98.53 546.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 110.27 546.41 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 126.01 546.41 Tm (additional) Tj ET BT /F2 12 Tf 1 0 0 1 177.74 546.41 Tm (charge) Tj ET BT /F2 12 Tf 1 0 0 1 213.45 546.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 231.18 546.41 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 252.25 546.41 Tm (benefit.) Tj ET BT /F2 12 Tf 1 0 0 1 292.3 546.41 Tm (Continuation) Tj ET BT /F2 12 Tf 1 0 0 1 358.71 546.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 372.44 546.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 390.84 546.41 Tm (Remaining) Tj ET BT /F2 12 Tf 1 0 0 1 447.23 546.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 470.96 546.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 521.33 546.41 Tm (will) Tj ET Q q n 0 544 m 612 544 l 612 532 l 0 532 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 534.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 14.52 534.41 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 51.7 534.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 64.23 534.41 Tm (timely) Tj ET BT /F2 12 Tf 1 0 0 1 98.09 534.41 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 142.6 534.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 155.79 534.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 173.64 534.41 Tm (premium) Tj ET BT /F2 12 Tf 1 0 0 1 220.16 534.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 237.35 534.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 255.2 534.41 Tm (reduced) Tj ET BT /F2 12 Tf 1 0 0 1 296.37 534.41 Tm (amount;) Tj ET BT /F2 12 Tf 1 0 0 1 338.89 534.41 Tm (unless) Tj ET BT /F2 12 Tf 1 0 0 1 372.08 534.41 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 393.28 534.41 Tm (qualify) Tj ET BT /F2 12 Tf 1 0 0 1 430.46 534.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 447.65 534.41 Tm (waiver) Tj ET BT /F2 12 Tf 1 0 0 1 483.49 534.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 496.68 534.41 Tm (premium) Tj ET Q q n 0 532 m 612 532 l 612 520 l 0 520 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 522.41 Tm (under the Policy's Extension of Death Benefit provision, if included.) Tj ET Q q n 0 520 m 612 520 l 612 508 l 0 508 l h W n Q q n 0 508 m 612 508 l 612 496 l 0 496 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 498.41 Tm (CONDITIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 83.46 498.41 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 95.02 498.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 113.25 498.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 160.81 498.41 Tm (exercises) Tj ET BT /F2 12 Tf 1 0 0 1 208.35 498.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 226.58 498.41 Tm (Conversion) Tj ET BT /F2 12 Tf 1 0 0 1 285.48 498.41 Tm (Privilege) Tj ET BT /F2 12 Tf 1 0 0 1 332.37 498.41 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 357.91 498.41 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 372.81 498.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 433.66 498.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 465.88 498.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 504.77 498.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 516.34 498.41 Tm (paid,) Tj ET Q q n 0 496 m 612 496 l 612 484 l 0 484 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 486.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 18.15 486.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 57.64 486.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 71.12 486.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 89.28 486.41 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 145.42 486.41 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 178.91 486.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 201.06 486.41 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 219.89 486.41 Tm (exceed) Tj ET BT /F2 12 Tf 1 0 0 1 256.69 486.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 274.84 486.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 314.32 486.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 327.81 486.41 Tm (his) Tj ET BT /F2 12 Tf 1 0 0 1 345.31 486.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 358.79 486.41 Tm (her) Tj ET BT /F2 12 Tf 1 0 0 1 377.61 486.41 Tm (Remaining) Tj ET BT /F2 12 Tf 1 0 0 1 433.76 486.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 457.23 486.41 Tm (Insurance.) Tj ET BT /F2 12 Tf 1 0 0 1 513.86 486.41 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 486.41 Tm (the) Tj ET Q q n 0 484 m 612 484 l 612 472 l 0 472 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 474.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 48.2 474.41 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 68.41 474.41 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 124.59 474.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 157.45 474.41 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 178.98 474.41 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 263.17 474.41 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 305.36 474.41 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 336.89 474.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 355.76 474.41 Tm (Policy,) Tj ET BT /F2 12 Tf 1 0 0 1 393.64 474.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 412.51 474.41 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 460.04 474.41 Tm (Sum) Tj ET BT /F2 12 Tf 1 0 0 1 486.26 474.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 509.13 474.41 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 474.41 Tm (be) Tj ET Q q n 0 472 m 612 472 l 612 460 l 0 460 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 462.41 Tm (affected by the payment of an Accelerated Death Benefit.) Tj ET Q q n 0 460 m 612 460 l 612 448 l 0 448 l h W n Q q n 0 448 m 612 448 l 612 436 l 0 436 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 438.41 Tm (EFFECT) Tj ET BT /F2 12 Tf 1 0 0 1 48.27 438.41 Tm (ON) Tj ET BT /F2 12 Tf 1 0 0 1 70.53 438.41 Tm (DEATH) Tj ET BT /F2 12 Tf 1 0 0 1 116.11 438.41 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 178.29 438.41 Tm (When) Tj ET BT /F2 12 Tf 1 0 0 1 211.87 438.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 231.46 438.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 280.37 438.41 Tm (dies) Tj ET BT /F2 12 Tf 1 0 0 1 304.63 438.41 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 331.53 438.41 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 347.79 438.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 410 438.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 443.58 438.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 483.82 438.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 496.75 438.41 Tm (paid,) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 438.41 Tm (the) Tj ET Q q n 0 436 m 612 436 l 612 424 l 0 424 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 426.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 39.42 426.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 52.83 426.41 Tm (Remaining) Tj ET BT /F2 12 Tf 1 0 0 1 108.91 426.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 132.32 426.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 182.38 426.41 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 195.14 426.41 Tm (force) Tj ET BT /F2 12 Tf 1 0 0 1 223.21 426.41 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 238.63 426.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 256.71 426.41 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 280.12 426.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 293.53 426.41 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 322.94 426.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 345.03 426.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 359.78 426.41 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 383.86 426.41 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 397.28 426.41 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 406.03 426.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 438.1 426.41 Tm (Benefit.) Tj ET BT /F2 12 Tf 1 0 0 1 483.26 426.41 Tm (Your) Tj ET BT /F2 12 Tf 1 0 0 1 511.35 426.41 Tm (Death) Tj ET Q q n 0 424 m 612 424 l 612 412 l 0 412 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 414.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 38.86 414.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 61.06 414.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 75.92 414.41 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 100.12 414.41 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 112.99 414.41 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 148.5 414.41 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 173.37 414.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 191.56 414.41 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 251.06 414.41 Tm (section) Tj ET BT /F2 12 Tf 1 0 0 1 288.59 414.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 302.12 414.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 320.32 414.41 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 361.06 414.41 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 372.58 414.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 390.78 414.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 438.31 414.41 Tm (dies) Tj ET BT /F2 12 Tf 1 0 0 1 461.17 414.41 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 486.69 414.41 Tm (application) Tj ET Q q n 0 412 m 612 412 l 612 400 l 0 400 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 402.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 17.63 402.41 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 32.6 402.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 93.53 402.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 125.82 402.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 164.78 402.41 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 184.41 402.41 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 210.71 402.41 Tm (made,) Tj ET BT /F2 12 Tf 1 0 0 1 243.33 402.41 Tm (but) Tj ET BT /F2 12 Tf 1 0 0 1 262.3 402.41 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 296.59 402.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 314.89 402.41 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 365.19 402.41 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 384.83 402.41 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 414.45 402.41 Tm (payment;) Tj ET BT /F2 12 Tf 1 0 0 1 462.75 402.41 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 487.05 402.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 505.35 402.41 Tm (request) Tj ET Q q n 0 400 m 612 400 l 612 388 l 0 388 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 390.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 22.12 390.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 36.9 390.41 Tm (void) Tj ET BT /F2 12 Tf 1 0 0 1 61.69 390.41 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 82.47 390.41 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 97.92 390.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 158.66 390.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 190.77 390.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 229.55 390.41 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 251.67 390.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 266.45 390.41 Tm (paid.) Tj ET BT /F2 12 Tf 1 0 0 1 297.02 390.41 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 319.13 390.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 358.57 390.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 372.02 390.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 395.47 390.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 445.56 390.41 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 458.35 390.41 Tm (force) Tj ET BT /F2 12 Tf 1 0 0 1 486.45 390.41 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 501.9 390.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 520.01 390.41 Tm (date) Tj ET Q q n 0 388 m 612 388 l 612 376 l 0 376 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 378.41 Tm (of death will be paid in accord with Policy provisions.) Tj ET Q q n 0 376 m 612 376 l 612 364 l 0 364 l h W n Q q n 0 364 m 612 364 l 612 352 l 0 352 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 354.41 Tm (EFFECT) Tj ET BT /F2 12 Tf 1 0 0 1 46.88 354.41 Tm (ON) Tj ET BT /F2 12 Tf 1 0 0 1 67.74 354.41 Tm (TAXES) Tj ET BT /F2 12 Tf 1 0 0 1 109.94 354.41 Tm (AND) Tj ET BT /F2 12 Tf 1 0 0 1 139.48 354.41 Tm (GOVERNMENT) Tj ET BT /F2 12 Tf 1 0 0 1 227.01 354.41 Tm (BENEFITS.) Tj ET BT /F2 12 Tf 1 0 0 1 293.08 354.41 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 317.28 354.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 378.11 354.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 410.29 354.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 449.15 354.41 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 488.68 354.41 Tm (withdrawn) Tj ET Q q n 0 352 m 612 352 l 612 340 l 0 340 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 342.41 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 26.09 342.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 42.85 342.41 Tm (taxable) Tj ET BT /F2 12 Tf 1 0 0 1 82.93 342.41 Tm (income) Tj ET BT /F2 12 Tf 1 0 0 1 123.69 342.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 138.45 342.41 Tm (you.) Tj ET BT /F2 12 Tf 1 0 0 1 170.32 342.41 Tm (Receipt) Tj ET BT /F2 12 Tf 1 0 0 1 212.4 342.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 227.83 342.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 247.93 342.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 310.65 342.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 344.73 342.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 385.49 342.41 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 411.58 342.41 Tm (also) Tj ET BT /F2 12 Tf 1 0 0 1 436.34 342.41 Tm (affect) Tj ET BT /F2 12 Tf 1 0 0 1 469.08 342.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 489.18 342.41 Tm (Claimant's) Tj ET Q q n 0 340 m 612 340 l 612 328 l 0 328 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 330.41 Tm (eligibility) Tj ET BT /F2 12 Tf 1 0 0 1 50.83 330.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 68.98 330.41 Tm (Medicaid,) Tj ET BT /F2 12 Tf 1 0 0 1 121.46 330.41 Tm (Supplemental) Tj ET BT /F2 12 Tf 1 0 0 1 191.62 330.41 Tm (Security) Tj ET BT /F2 12 Tf 1 0 0 1 235.77 330.41 Tm (Income) Tj ET BT /F2 12 Tf 1 0 0 1 275.92 330.41 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 297.41 330.41 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 326.23 330.41 Tm (government) Tj ET BT /F2 12 Tf 1 0 0 1 387.71 330.41 Tm (benefits.) Tj ET BT /F2 12 Tf 1 0 0 1 437.02 330.41 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 459.84 330.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 508 330.41 Tm (should) Tj ET Q q n 0 328 m 612 328 l 612 316 l 0 316 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 318.41 Tm (consult) Tj ET BT /F2 12 Tf 1 0 0 1 37.78 318.41 Tm (his) Tj ET BT /F2 12 Tf 1 0 0 1 54.9 318.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 68.01 318.41 Tm (her) Tj ET BT /F2 12 Tf 1 0 0 1 86.44 318.41 Tm (own) Tj ET BT /F2 12 Tf 1 0 0 1 110.22 318.41 Tm (tax) Tj ET BT /F2 12 Tf 1 0 0 1 128 318.41 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 148.44 318.41 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 174.87 318.41 Tm (advisor) Tj ET BT /F2 12 Tf 1 0 0 1 213.32 318.41 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 247.07 318.41 Tm (applying) Tj ET BT /F2 12 Tf 1 0 0 1 292.18 318.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 309.29 318.41 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 323.73 318.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 384.13 318.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 415.9 318.41 Tm (Benefit.) Tj ET BT /F2 12 Tf 1 0 0 1 460.45 318.41 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 482.22 318.41 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 532 318.41 Tm (is) Tj ET Q q n 0 316 m 612 316 l 612 304 l 0 304 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 306.41 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 19.72 306.41 Tm (responsible) Tj ET BT /F2 12 Tf 1 0 0 1 78.76 306.41 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 97.13 306.41 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 118.84 306.41 Tm (tax) Tj ET BT /F2 12 Tf 1 0 0 1 137.89 306.41 Tm (owed) Tj ET BT /F2 12 Tf 1 0 0 1 168.26 306.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 182.64 306.41 Tm (government) Tj ET BT /F2 12 Tf 1 0 0 1 244.34 306.41 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 282.04 306.41 Tm (denied,) Tj ET BT /F2 12 Tf 1 0 0 1 321.42 306.41 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 335.8 306.41 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 345.51 306.41 Tm (result) Tj ET BT /F2 12 Tf 1 0 0 1 376.55 306.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 390.93 306.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 409.97 306.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 471.64 306.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 504.68 306.41 Tm (Benefit) Tj ET Q q n 0 304 m 612 304 l 612 292 l 0 292 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 294.41 Tm (payment.) Tj ET Q q n 0 292 m 612 292 l 612 280 l 0 280 l h W n Q q n 0 280 m 612 280 l 612 268 l 0 268 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 270.41 Tm (LIMITATIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 86.32 270.41 Tm (No Accelerated Death Benefit will be paid:) Tj ET Q q n 18 268 m 630 268 l 630 256 l 18 256 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 258.41 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 258.41 Tm (if any required premium is due and unpaid;) Tj ET Q q n 18 256 m 630 256 l 630 244 l 18 244 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 246.41 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 246.41 Tm (on any conversion policy purchased in accord with the Conversion Privilege;) Tj ET Q q n 18 244 m 630 244 l 630 232 l 18 232 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 234.41 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 234.41 Tm (without the written approval of the bankruptcy court, if you have filed for bankruptcy;) Tj ET Q q n 18 232 m 630 232 l 630 220 l 18 220 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 222.41 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 222.41 Tm (without the written consent of the beneficiary, if you have named an irrevocable beneficiary;) Tj ET Q q n 18 220 m 630 220 l 630 208 l 18 208 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 210.41 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 210.41 Tm (without the written consent of the assignee, if you have assigned your rights under the Policy;) Tj ET Q q n 18 208 m 630 208 l 630 196 l 18 196 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 198.41 Tm (\(6\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 198.41 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 56.08 198.41 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 76.8 198.41 Tm (part) Tj ET BT /F2 12 Tf 1 0 0 1 98.86 198.41 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 112.25 198.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 130.31 198.41 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 153.69 198.41 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 203.73 198.41 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 230.47 198.41 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 245.19 198.41 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 269.25 198.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 281.98 198.41 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 307.38 198.41 Tm (child,) Tj ET BT /F2 12 Tf 1 0 0 1 337.77 198.41 Tm (spouse) Tj ET BT /F2 12 Tf 1 0 0 1 373.84 198.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 387.23 198.41 Tm (former) Tj ET BT /F2 12 Tf 1 0 0 1 423.28 198.41 Tm (spouse;) Tj ET BT /F2 12 Tf 1 0 0 1 462.67 198.41 Tm (pursuant) Tj ET Q q n 45.35 196 m 657.35 196 l 657.35 184 l 45.35 184 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 186.41 Tm (to a legal separation agreement, divorce decree, child support order or other court order;) Tj ET Q q n 18 184 m 630 184 l 630 172 l 18 172 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 174.41 Tm (\(7\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 174.41 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 58.31 174.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 78.61 174.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 128.23 174.41 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 141.87 174.41 Tm (Terminal) Tj ET BT /F2 12 Tf 1 0 0 1 191.48 174.41 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 214.44 174.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 229.41 174.41 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 240.37 174.41 Tm (suicide) Tj ET BT /F2 12 Tf 1 0 0 1 279.99 174.41 Tm (attempt,) Tj ET BT /F2 12 Tf 1 0 0 1 324.62 174.41 Tm (while) Tj ET BT /F2 12 Tf 1 0 0 1 356.91 174.41 Tm (sane) Tj ET BT /F2 12 Tf 1 0 0 1 383.86 174.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 399.49 174.41 Tm (insane;) Tj ET BT /F2 12 Tf 1 0 0 1 439.12 174.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 454.75 174.41 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 477.71 174.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 492.67 174.41 Tm (an) Tj ET Q q n 45.35 172 m 657.35 172 l 657.35 160 l 45.35 160 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 162.41 Tm (intentionally self-inflicted injury;) Tj ET Q q n 18 160 m 630 160 l 630 148 l 18 148 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 150.41 Tm (\(8\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 150.41 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 56.6 150.41 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 65.85 150.41 Tm (government) Tj ET BT /F2 12 Tf 1 0 0 1 127.09 150.41 Tm (agency) Tj ET BT /F2 12 Tf 1 0 0 1 164.99 150.41 Tm (requires) Tj ET BT /F2 12 Tf 1 0 0 1 207.56 150.41 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 229.48 150.41 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 243.39 150.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 261.98 150.41 Tm (Claimant) Tj ET BT /F2 12 Tf 1 0 0 1 309.89 150.41 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 323.14 150.41 Tm (use) Tj ET BT /F2 12 Tf 1 0 0 1 343.06 150.41 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 361.64 150.41 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 422.85 150.41 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 455.43 150.41 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 494.67 150.41 Tm (to) Tj ET Q q n 45.35 148 m 657.35 148 l 657.35 136 l 45.35 136 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 138.41 Tm (apply for, receive or continue a government benefit or entitlement; or) Tj ET Q q n 18 136 m 630 136 l 630 124 l 18 124 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 126.41 Tm (\(9\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 126.41 Tm (if an Accelerated Death Benefit has been previously paid for the Claimant under the Policy.) Tj ET Q q n 18 124 m 630 124 l 630 112 l 18 112 l h W n Q Q q Q Q endstream endobj 13 0 obj <>>>>> endobj 115 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 756.6 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 194.15 3.11 Tm (CONVERSION PRIVILEGE) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-4 PA) Tj ET BT /F2 12 Tf 1 0 0 1 514.33 26.1 Tm (DEP.) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (11) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 676.01 Tm (GENERAL) Tj ET BT /F2 12 Tf 1 0 0 1 60.22 676.01 Tm (CONVERSION) Tj ET BT /F2 12 Tf 1 0 0 1 141.78 676.01 Tm (PRIVILEGE.) Tj ET BT /F2 12 Tf 1 0 0 1 215.22 676.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 227.43 676.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 253.65 676.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 303.86 676.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 318.08 676.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 368.28 676.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 384.5 676.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 394.05 676.01 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 450.25 676.01 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 504.46 676.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 676.01 Tm (any) Tj ET Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (reason except:) Tj ET Q q n 18 661.6 m 630 661.6 l 630 649.6 l 18 649.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 652.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 652.01 Tm (termination or amendment of the Policy; or) Tj ET Q q n 18 649.6 m 630 649.6 l 630 637.6 l 18 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 640.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 640.01 Tm (your request for:) Tj ET Q q n 44.65 637.6 m 656.65 637.6 l 656.65 625.6 l 44.65 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 628.01 Tm (\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 628.01 Tm (termination of insurance; or) Tj ET Q q n 44.65 625.6 m 656.65 625.6 l 656.65 613.6 l 44.65 613.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 44.65 616.01 Tm (\(b\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 616.01 Tm (cancellation of your payroll deduction,) Tj ET Q q n 0 613.6 m 612 613.6 l 612 601.6 l 0 601.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 604.01 Tm (an individual life policy, known as a conversion policy, may be purchased without evidence of insurability.) Tj ET Q q n 0 601.6 m 612 601.6 l 612 589.6 l 0 589.6 l h W n Q q n 0 589.6 m 612 589.6 l 612 577.6 l 0 577.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.01 Tm (To) Tj ET BT /F2 12 Tf 1 0 0 1 17.36 580.01 Tm (purchase) Tj ET BT /F2 12 Tf 1 0 0 1 64.03 580.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 73.38 580.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 130.06 580.01 Tm (policy,) Tj ET BT /F2 12 Tf 1 0 0 1 167.09 580.01 Tm (application) Tj ET BT /F2 12 Tf 1 0 0 1 224.43 580.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 245.78 580.01 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 291.13 580.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 305.15 580.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 323.84 580.01 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 347.2 580.01 Tm (premium) Tj ET BT /F2 12 Tf 1 0 0 1 394.55 580.01 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 421.91 580.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 437.27 580.01 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 467.28 580.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 501.98 580.01 Tm (31) Tj ET BT /F2 12 Tf 1 0 0 1 518 580.01 Tm (days) Tj ET Q q n 0 577.6 m 612 577.6 l 612 565.6 l 0 565.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.01 Tm (after the life insurance is terminated.) Tj ET Q q n 0 565.6 m 612 565.6 l 612 553.6 l 0 553.6 l h W n Q q n 0 553.6 m 612 553.6 l 612 541.6 l 0 541.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 544.01 Tm (The conversion policy will:) Tj ET Q q n 18 541.6 m 630 541.6 l 630 529.6 l 18 529.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 532.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 532.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 61.35 532.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 75.36 532.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 91.36 532.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 132.03 532.01 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 152.04 532.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 166.04 532.01 Tm (exceed) Tj ET BT /F2 12 Tf 1 0 0 1 204.02 532.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 223.36 532.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 264.02 532.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 278.69 532.01 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 299.36 532.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 350.01 532.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 384.01 532.01 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 407.35 532.01 Tm (terminated;) Tj ET BT /F2 12 Tf 1 0 0 1 466.67 532.01 Tm (less) Tj ET BT /F2 12 Tf 1 0 0 1 489.34 532.01 Tm (the) Tj ET Q q n 45.35 529.6 m 657.35 529.6 l 657.35 517.6 l 45.35 517.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 520.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 84.73 520.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 98.11 520.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 118.82 520.01 Tm (group) Tj ET BT /F2 12 Tf 1 0 0 1 150.21 520.01 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 169.58 520.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 218.95 520.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 236.32 520.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 269.04 520.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 287.08 520.01 Tm (person) Tj ET BT /F2 12 Tf 1 0 0 1 322.46 520.01 Tm (becomes) Tj ET BT /F2 12 Tf 1 0 0 1 367.83 520.01 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 407.2 520.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 441.25 520.01 Tm (31) Tj ET BT /F2 12 Tf 1 0 0 1 456.64 520.01 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 482.02 520.01 Tm (after) Tj ET Q q n 45.35 517.6 m 657.35 517.6 l 657.35 505.6 l 45.35 505.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 508.01 Tm (insurance terminates;) Tj ET Q q n 18 505.6 m 630 505.6 l 630 493.6 l 18 493.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 496.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 496.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 60.96 496.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 77.24 496.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 98.85 496.01 Tm (form) Tj ET BT /F2 12 Tf 1 0 0 1 126.45 496.01 Tm (\(except) Tj ET BT /F2 12 Tf 1 0 0 1 166.04 496.01 Tm (term\)) Tj ET BT /F2 12 Tf 1 0 0 1 196.31 496.01 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 221.25 496.01 Tm (issued) Tj ET BT /F2 12 Tf 1 0 0 1 255.53 496.01 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 271.82 496.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 290.76 496.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 341.7 496.01 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 354.64 496.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 373.58 496.01 Tm (age) Tj ET BT /F2 12 Tf 1 0 0 1 394.52 496.01 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 416.13 496.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 456.4 496.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 474.67 496.01 Tm (which) Tj ET Q q n 45.35 493.6 m 657.35 493.6 l 657.35 481.6 l 45.35 481.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 484.01 Tm (application is made;) Tj ET Q q n 18 481.6 m 630 481.6 l 630 469.6 l 18 469.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 472.01 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 472.01 Tm (be issued at the person's age at nearest birthday;) Tj ET Q q n 18 469.6 m 630 469.6 l 630 457.6 l 18 457.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 460.01 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 460.01 Tm (be issued without disability or other supplemental benefits; and) Tj ET Q q n 18 457.6 m 630 457.6 l 630 445.6 l 18 445.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 448.01 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 448.01 Tm (require premiums based on the class of risk to which the person then belongs.) Tj ET Q q n 0 445.6 m 612 445.6 l 612 433.6 l 0 433.6 l h W n Q q n 0 433.6 m 612 433.6 l 612 421.6 l 0 421.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 424.01 Tm (CONVERSION) Tj ET BT /F2 12 Tf 1 0 0 1 82.59 424.01 Tm (UPON) Tj ET BT /F2 12 Tf 1 0 0 1 120.52 424.01 Tm (POLICY) Tj ET BT /F2 12 Tf 1 0 0 1 169.11 424.01 Tm (TERMINATION) Tj ET BT /F2 12 Tf 1 0 0 1 257.68 424.01 Tm (OR) Tj ET BT /F2 12 Tf 1 0 0 1 279.6 424.01 Tm (AMENDMENT.) Tj ET BT /F2 12 Tf 1 0 0 1 371.1 424.01 Tm (A) Tj ET BT /F2 12 Tf 1 0 0 1 385.02 424.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 442.93 424.01 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 478.18 424.01 Tm (also) Tj ET BT /F2 12 Tf 1 0 0 1 502.76 424.01 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 424.01 Tm (be) Tj ET Q q n 0 421.6 m 612 421.6 l 612 409.6 l 0 409.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 412.01 Tm (purchased if:) Tj ET Q q n 18 409.6 m 630 409.6 l 630 397.6 l 18 397.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 400.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 400.01 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 62.15 400.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 76.96 400.01 Tm (part) Tj ET BT /F2 12 Tf 1 0 0 1 100.42 400.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 115.23 400.01 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 142.03 400.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 192.82 400.01 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 207.63 400.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 258.42 400.01 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 275.22 400.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 285.36 400.01 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 342.15 400.01 Tm (terminates) Tj ET BT /F2 12 Tf 1 0 0 1 396.94 400.01 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 419.07 400.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 433.21 400.01 Tm (amendment) Tj ET BT /F2 12 Tf 1 0 0 1 494 400.01 Tm (or) Tj ET Q q n 45.35 397.6 m 657.35 397.6 l 657.35 385.6 l 45.35 385.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 388.01 Tm (termination of the Policy; and) Tj ET Q q n 18 385.6 m 630 385.6 l 630 373.6 l 18 373.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 376.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.66 376.01 Tm (person) Tj ET BT /F2 12 Tf 1 0 0 1 99.3 376.01 Tm (applying) Tj ET BT /F2 12 Tf 1 0 0 1 144.94 376.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 162.58 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 180.89 376.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 237.19 376.01 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 270.84 376.01 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 290.48 376.01 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 316.78 376.01 Tm (covered) Tj ET BT /F2 12 Tf 1 0 0 1 358.41 376.01 Tm (continuously) Tj ET BT /F2 12 Tf 1 0 0 1 424.05 376.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 455.02 376.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 473.33 376.01 Tm (Policy) Tj ET Q q n 45.35 373.6 m 657.35 373.6 l 657.35 361.6 l 45.35 361.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 364.01 Tm (for at least 5 years.) Tj ET Q q n 0 361.6 m 612 361.6 l 612 349.6 l 0 349.6 l h W n Q q n 0 349.6 m 612 349.6 l 612 337.6 l 0 337.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 340.01 Tm (The amount of a conversion policy issued due to Policy termination or amendment may not exceed the lesser of:) Tj ET Q q n 18 337.6 m 630 337.6 l 630 325.6 l 18 325.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 328.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 328.01 Tm ($2,000; or) Tj ET Q q n 18 325.6 m 630 325.6 l 630 313.6 l 18 313.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 316.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 316.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.6 316.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 103.18 316.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 116.76 316.01 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 136.34 316.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 185.9 316.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 218.81 316.01 Tm (terminates,) Tj ET BT /F2 12 Tf 1 0 0 1 275.38 316.01 Tm (less) Tj ET BT /F2 12 Tf 1 0 0 1 296.96 316.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 315.21 316.01 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 354.79 316.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 368.37 316.01 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 389.29 316.01 Tm (group) Tj ET BT /F2 12 Tf 1 0 0 1 420.87 316.01 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 440.44 316.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 490.01 316.01 Tm (for) Tj ET Q q n 45.35 313.6 m 657.35 313.6 l 657.35 301.6 l 45.35 301.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 304.01 Tm (which the person becomes eligible within 31 days after the termination.) Tj ET Q q n 18 301.6 m 630 301.6 l 630 289.6 l 18 289.6 l h W n Q q n 0 289.6 m 612 289.6 l 612 277.6 l 0 277.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 280.01 Tm (The conversion policy will take effect on the later of:) Tj ET Q q n 18 277.6 m 630 277.6 l 630 265.6 l 18 265.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 268.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 268.01 Tm (its date of issue; or) Tj ET Q q n 18 265.6 m 630 265.6 l 630 253.6 l 18 253.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 256.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 256.01 Tm (31 days after the date the insurance terminated.) Tj ET Q q n 0 253.6 m 612 253.6 l 612 241.6 l 0 241.6 l h W n Q q n 0 241.6 m 612 241.6 l 612 229.6 l 0 229.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 232.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 11.35 232.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 40.7 232.01 Tm (occurs) Tj ET BT /F2 12 Tf 1 0 0 1 75.38 232.01 Tm (during) Tj ET BT /F2 12 Tf 1 0 0 1 110.07 232.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 128.09 232.01 Tm (31) Tj ET BT /F2 12 Tf 1 0 0 1 143.45 232.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 164.14 232.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 220.15 232.01 Tm (period,) Tj ET BT /F2 12 Tf 1 0 0 1 257.17 232.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 275.19 232.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 325.21 232.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 347.24 232.01 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 367.93 232.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 385.95 232.01 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 405.3 232.01 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 454.64 232.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 487.33 232.01 Tm (could) Tj ET BT /F2 12 Tf 1 0 0 1 517.35 232.01 Tm (have) Tj ET Q q n 0 229.6 m 612 229.6 l 612 217.6 l 0 217.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 220.01 Tm (been converted even if no one applied for the conversion policy.) Tj ET Q q n 0 217.6 m 612 217.6 l 612 205.6 l 0 205.6 l h W n Q q n 0 205.6 m 612 205.6 l 612 193.6 l 0 193.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 196.01 Tm (When your insurance terminates, written notice of your right to convert will be given to you.) Tj ET Q q n 0 193.6 m 612 193.6 l 612 181.6 l 0 181.6 l h W n Q q n 0 181.6 m 612 181.6 l 612 169.6 l 0 169.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 172.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 13.35 172.01 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 52.69 172.01 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 87.37 172.01 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 100.73 172.01 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 121.42 172.01 Tm (given) Tj ET BT /F2 12 Tf 1 0 0 1 153.44 172.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 168.13 172.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 191.48 172.01 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 205.5 172.01 Tm (least) Tj ET BT /F2 12 Tf 1 0 0 1 232.84 172.01 Tm (15) Tj ET BT /F2 12 Tf 1 0 0 1 250.2 172.01 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 277.55 172.01 Tm (before) Tj ET BT /F2 12 Tf 1 0 0 1 313.55 172.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 333.57 172.01 Tm (end) Tj ET BT /F2 12 Tf 1 0 0 1 356.25 172.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 371.6 172.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 391.62 172.01 Tm (31) Tj ET BT /F2 12 Tf 1 0 0 1 408.97 172.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 431.65 172.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 489.66 172.01 Tm (period,) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 172.01 Tm (an) Tj ET Q q n 0 169.6 m 612 169.6 l 612 157.6 l 0 157.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 160.01 Tm (additional) Tj ET BT /F2 12 Tf 1 0 0 1 51.5 160.01 Tm (period) Tj ET BT /F2 12 Tf 1 0 0 1 85.66 160.01 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 98.5 160.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 131.34 160.01 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 144.18 160.01 Tm (convert) Tj ET BT /F2 12 Tf 1 0 0 1 183.67 160.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 205.84 160.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 220.68 160.01 Tm (granted.) Tj ET BT /F2 12 Tf 1 0 0 1 266.67 160.01 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 290.85 160.01 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 316.35 160.01 Tm (extension) Tj ET BT /F2 12 Tf 1 0 0 1 365.85 160.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 379.35 160.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 397.52 160.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 453.68 160.01 Tm (period) Tj ET BT /F2 12 Tf 1 0 0 1 487.84 160.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 510.02 160.01 Tm (expire) Tj ET Q q n 0 157.6 m 612 157.6 l 612 145.6 l 0 145.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 148.01 Tm (on the earliest of:) Tj ET Q q n 18 145.6 m 630 145.6 l 630 133.6 l 18 133.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 136.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 136.01 Tm (15 days after you are given the written notice; or) Tj ET Q q n 18 133.6 m 630 133.6 l 630 121.6 l 18 121.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 124.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 124.01 Tm (60 days after the end of the 31 day conversion period, even if you are never given such notice.) Tj ET Q q n 0 121.6 m 612 121.6 l 612 109.6 l 0 109.6 l h W n Q q n 0 109.6 m 612 109.6 l 612 97.6 l 0 97.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 100.01 Tm (No) Tj ET BT /F2 12 Tf 1 0 0 1 18.49 100.01 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 48.3 100.01 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 85.44 100.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 107.93 100.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 123.08 100.01 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 164.22 100.01 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 195.37 100.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 213.85 100.01 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 248.34 100.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 274.15 100.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 292.63 100.01 Tm (31) Tj ET BT /F2 12 Tf 1 0 0 1 308.45 100.01 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 329.61 100.01 Tm (conversion) Tj ET BT /F2 12 Tf 1 0 0 1 386.08 100.01 Tm (period) Tj ET BT /F2 12 Tf 1 0 0 1 420.56 100.01 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 440.38 100.01 Tm (expired) Tj ET BT /F2 12 Tf 1 0 0 1 480.19 100.01 Tm (even) Tj ET BT /F2 12 Tf 1 0 0 1 506.67 100.01 Tm (though) Tj ET Q q n 0 97.6 m 612 97.6 l 612 85.6 l 0 85.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 88.01 Tm (the right to convert may be extended.) Tj ET Q q n 0 85.6 m 612 85.6 l 612 73.6 l 0 73.6 l h W n Q Q q Q Q endstream endobj 14 0 obj <>>>>> endobj 116 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 756.6 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 3.11 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-6.3A 01 PA) Tj ET BT /F2 12 Tf 1 0 0 1 352.31 26.1 Tm (COMMON CARRIER - PAR, REPAT) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (12) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 676.01 Tm (DEATH) Tj ET BT /F4 12 Tf 1 0 0 1 46.6 676.01 Tm (OR) Tj ET BT /F4 12 Tf 1 0 0 1 68.52 676.01 Tm (DISMEMBERMENT) Tj ET BT /F4 12 Tf 1 0 0 1 183.78 676.01 Tm (BENEFIT) Tj ET BT /F4 12 Tf 1 0 0 1 240.38 676.01 Tm (FOR) Tj ET BT /F4 12 Tf 1 0 0 1 269.63 676.01 Tm (AN) Tj ET BT /F4 12 Tf 1 0 0 1 290.89 676.01 Tm (INSURED) Tj ET BT /F4 12 Tf 1 0 0 1 348.82 676.01 Tm (PERSON.) Tj ET BT /F2 12 Tf 1 0 0 1 408.34 676.01 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 430.92 676.01 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 481.5 676.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 504.09 676.01 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 676.01 Tm (the) Tj ET Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (benefit listed below, if:) Tj ET Q q n 18 661.6 m 630 661.6 l 630 649.6 l 18 649.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 652.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 652.01 Tm (you sustain an accidental bodily injury while insured under this provision; and) Tj ET Q q n 18 649.6 m 630 649.6 l 630 637.6 l 18 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 640.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 640.01 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 66.48 640.01 Tm (injury) Tj ET BT /F2 12 Tf 1 0 0 1 98.27 640.01 Tm (directly) Tj ET BT /F2 12 Tf 1 0 0 1 138.05 640.01 Tm (causes) Tj ET BT /F2 12 Tf 1 0 0 1 172.5 640.01 Tm (one) Tj ET BT /F2 12 Tf 1 0 0 1 192.96 640.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 206.09 640.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 223.88 640.01 Tm (following) Tj ET BT /F2 12 Tf 1 0 0 1 273.68 640.01 Tm (nonfatal) Tj ET BT /F2 12 Tf 1 0 0 1 316.12 640.01 Tm (losses) Tj ET BT /F2 12 Tf 1 0 0 1 347.93 640.01 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 381.73 640.01 Tm (365) Tj ET BT /F2 12 Tf 1 0 0 1 402.86 640.01 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 427.98 640.01 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 453.09 640.01 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 470.89 640.01 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 494 640.01 Tm (of) Tj ET Q q n 45.35 637.6 m 657.35 637.6 l 657.35 625.6 l 45.35 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 628.01 Tm (the accident or directly causes your death \(regardless of the time elapsed\).) Tj ET Q q n 0 625.6 m 612 625.6 l 612 613.6 l 0 613.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 616.01 Tm (The loss must result directly from the injury and from no other causes.) Tj ET Q q n 0 613.6 m 612 613.6 l 612 601.6 l 0 601.6 l h W n Q 0 0 0 rg BT /F4 12 Tf 1 0 0 1 113.96 577.11 Tm (LOSS) Tj ET BT /F4 12 Tf 1 0 0 1 265.45 590.91 Tm (BENEFIT FOR COMMON) Tj ET BT /F4 12 Tf 1 0 0 1 265.45 577.11 Tm (CARRIER ACCIDENT) Tj ET BT /F4 12 Tf 1 0 0 1 414 590.91 Tm (BENEFIT FOR OTHER) Tj ET BT /F4 12 Tf 1 0 0 1 414 577.11 Tm (COVERED ACCIDENT) Tj ET q n 0.35 560.21 m 269.75 560.21 l 269.75 548.21 l 0.35 548.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 550.62 Tm (Loss of Life) Tj ET Q q n 268.3 560.21 m 418.3 560.21 l 418.3 548.21 l 268.3 548.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 550.62 Tm (2 Times Principal Sum) Tj ET Q q n 414 560.21 m 552 560.21 l 552 548.21 l 414 548.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 550.62 Tm (Principal Sum) Tj ET Q q n 0.35 548.21 m 269.75 548.21 l 269.75 536.21 l 0.35 536.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 538.62 Tm (Loss of One Member \(Hand, Foot or Eye\)) Tj ET Q q n 268.3 548.21 m 418.3 548.21 l 418.3 536.21 l 268.3 536.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 538.62 Tm (Principal Sum) Tj ET Q q n 414 548.21 m 552 548.21 l 552 536.21 l 414 536.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 538.62 Tm ( Principal Sum) Tj ET Q q n 0.35 536.21 m 269.75 536.21 l 269.75 524.21 l 0.35 524.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 526.62 Tm (Loss of Two or More Members) Tj ET Q q n 268.3 536.21 m 418.3 536.21 l 418.3 524.21 l 268.3 524.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 526.62 Tm (2 Times Principal Sum) Tj ET Q q n 414 536.21 m 552 536.21 l 552 524.21 l 414 524.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 526.62 Tm (Principal Sum) Tj ET Q q n 0 524.21 m 269.4 524.21 l 269.4 512.21 l 0 512.21 l h W n Q q n 268.3 524.21 m 418.3 524.21 l 418.3 512.21 l 268.3 512.21 l h W n Q q n 414 524.21 m 552 524.21 l 552 512.21 l 414 512.21 l h W n Q q n 0.35 512.21 m 269.75 512.21 l 269.75 500.21 l 0.35 500.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 502.61 Tm (Quadriplegia \(Paralysis of Both Arms and Both Legs\)) Tj ET Q q n 268.3 512.21 m 418.3 512.21 l 418.3 500.21 l 268.3 500.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 502.61 Tm (2 Times Principal Sum) Tj ET Q q n 414 512.21 m 552 512.21 l 552 500.21 l 414 500.21 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 502.61 Tm (Principal Sum) Tj ET Q q n 0.35 500.2 m 269.75 500.2 l 269.75 488.2 l 0.35 488.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 490.61 Tm (Paraplegia \(Paralysis of Both Legs\)) Tj ET Q q n 268.3 500.2 m 418.3 500.2 l 418.3 488.2 l 268.3 488.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 490.61 Tm (Principal Sum) Tj ET Q q n 414 500.2 m 552 500.2 l 552 488.2 l 414 488.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 490.61 Tm ( Principal Sum) Tj ET Q q n 0.35 488.2 m 269.75 488.2 l 269.75 476.2 l 0.35 476.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0.35 478.61 Tm (Hemiplegia \(Paralysis of Arm and Leg of Same Side\)) Tj ET Q q n 268.3 488.2 m 418.3 488.2 l 418.3 476.2 l 268.3 476.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 268.3 478.61 Tm (Principal Sum) Tj ET Q q n 414 488.2 m 552 488.2 l 552 476.2 l 414 476.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 414 478.61 Tm ( Principal Sum) Tj ET Q q n 0 476.2 m 269.4 476.2 l 269.4 464.2 l 0 464.2 l h W n Q q n 268.3 476.2 m 418.3 476.2 l 418.3 464.2 l 268.3 464.2 l h W n Q q n 414 476.2 m 552 476.2 l 552 464.2 l 414 464.2 l h W n Q q n 0 464.2 m 612 464.2 l 612 452.2 l 0 452.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 454.61 Tm (The Principal Sum for your class is shown in the Schedule of Insurance.) Tj ET Q q n 0 452.2 m 612 452.2 l 612 440.2 l 0 440.2 l h W n Q q n 0 440.2 m 612 440.2 l 612 428.2 l 0 428.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 430.61 Tm (MAXIMUM PER PERSON.) Tj ET BT /F2 12 Tf 1 0 0 1 152.32 430.61 Tm (If you sustain more than one loss resulting from the same accident, the benefit:) Tj ET Q q n 18 428.2 m 630 428.2 l 630 416.2 l 18 416.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 418.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 418.61 Tm (will be the one largest amount listed;) Tj ET Q q n 18 416.2 m 630 416.2 l 630 404.2 l 18 404.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 406.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 406.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 67.94 406.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 87.19 406.61 Tm (exceed) Tj ET BT /F2 12 Tf 1 0 0 1 124.42 406.61 Tm (two) Tj ET BT /F2 12 Tf 1 0 0 1 146.34 406.61 Tm (times) Tj ET BT /F2 12 Tf 1 0 0 1 176.26 406.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 194.84 406.61 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 242.09 406.61 Tm (Sum) Tj ET BT /F2 12 Tf 1 0 0 1 268.02 406.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 285.93 406.61 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 301.84 406.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 315.76 406.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 341.68 406.61 Tm (combined) Tj ET BT /F2 12 Tf 1 0 0 1 392.92 406.61 Tm (losses) Tj ET BT /F2 12 Tf 1 0 0 1 425.51 406.61 Tm (resulting) Tj ET BT /F2 12 Tf 1 0 0 1 471.43 406.61 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 498.67 406.61 Tm (a) Tj ET Q q n 45.35 404.2 m 657.35 404.2 l 657.35 392.2 l 45.35 392.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 394.61 Tm (Common Carrier Accident; and) Tj ET Q q n 18 392.2 m 630 392.2 l 630 380.2 l 18 380.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 382.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 382.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 68.69 382.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 88.7 382.61 Tm (exceed) Tj ET BT /F2 12 Tf 1 0 0 1 126.67 382.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 146.01 382.61 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 194 382.61 Tm (Sum) Tj ET BT /F2 12 Tf 1 0 0 1 220.68 382.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 239.35 382.61 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 256.01 382.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 270.68 382.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 297.35 382.61 Tm (combined) Tj ET BT /F2 12 Tf 1 0 0 1 349.34 382.61 Tm (losses) Tj ET BT /F2 12 Tf 1 0 0 1 382.68 382.61 Tm (resulting) Tj ET BT /F2 12 Tf 1 0 0 1 429.35 382.61 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 457.35 382.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 479.34 382.61 Tm (other) Tj ET Q q n 45.35 380.2 m 657.35 380.2 l 657.35 368.2 l 45.35 368.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 370.61 Tm (covered accident.) Tj ET Q q n 18 368.2 m 630 368.2 l 630 356.2 l 18 356.2 l h W n Q q n 0 356.2 m 612 356.2 l 612 344.2 l 0 344.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 346.61 Tm (TO) Tj ET BT /F4 12 Tf 1 0 0 1 20.51 346.61 Tm (WHOM) Tj ET BT /F4 12 Tf 1 0 0 1 65.68 346.61 Tm (PAYABLE.) Tj ET BT /F2 12 Tf 1 0 0 1 132.36 346.61 Tm (Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 175.52 346.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 192.69 346.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 217.85 346.61 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 239.7 346.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 252.87 346.61 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 272.03 346.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 293.87 346.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 308.37 346.61 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 332.2 346.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 344.71 346.61 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 379.85 346.61 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 404.36 346.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 422.19 346.61 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 481.33 346.61 Tm (section.) Tj ET BT /F2 12 Tf 1 0 0 1 524.67 346.61 Tm (All) Tj ET Q q n 0 344.2 m 612 344.2 l 612 332.2 l 0 332.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 334.61 Tm (other benefits will be paid to you.) Tj ET Q q n 0 332.2 m 612 332.2 l 612 320.2 l 0 320.2 l h W n Q q n 0 320.2 m 612 320.2 l 612 308.2 l 0 308.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 310.61 Tm (LIMITATIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 91.69 310.61 Tm (Benefits are not payable for any loss to which a contributing cause is:) Tj ET Q q n 18 308.2 m 630 308.2 l 630 296.2 l 18 296.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 298.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 298.61 Tm (intentional self-inflicted injury or self-destruction;) Tj ET Q q n 18 296.2 m 630 296.2 l 630 284.2 l 18 284.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 286.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 286.61 Tm (disease, bodily or mental infirmity, or medical or surgical treatment of these;) Tj ET Q q n 18 284.2 m 630 284.2 l 630 272.2 l 18 272.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 274.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 274.61 Tm (participation in a riot;) Tj ET Q q n 18 272.2 m 630 272.2 l 630 260.2 l 18 260.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 262.61 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 262.61 Tm (duty as a member of any military, naval or air force;) Tj ET Q q n 18 260.2 m 630 260.2 l 630 248.2 l 18 248.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 250.61 Tm (\(5\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 250.61 Tm (war or any act of war, declared or undeclared;) Tj ET Q q n 18 248.2 m 630 248.2 l 630 236.2 l 18 236.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 238.61 Tm (\(6\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 238.61 Tm (participation in the commission of a felony;) Tj ET Q q n 18 236.2 m 630 236.2 l 630 224.2 l 18 224.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 226.61 Tm (\(7\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 226.61 Tm (voluntary use of drugs; except when prescribed by a Physician;) Tj ET Q q n 18 224.2 m 630 224.2 l 630 212.2 l 18 212.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 214.61 Tm (\(8\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 214.61 Tm (voluntary) Tj ET BT /F2 12 Tf 1 0 0 1 94.71 214.61 Tm (inhalation) Tj ET BT /F2 12 Tf 1 0 0 1 146.07 214.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 159.43 214.61 Tm (gas,) Tj ET BT /F2 12 Tf 1 0 0 1 181.8 214.61 Tm (including) Tj ET BT /F2 12 Tf 1 0 0 1 230.5 214.61 Tm (carbon) Tj ET BT /F2 12 Tf 1 0 0 1 266.52 214.61 Tm (monoxide;) Tj ET BT /F2 12 Tf 1 0 0 1 321.21 214.61 Tm (except) Tj ET BT /F2 12 Tf 1 0 0 1 355.9 214.61 Tm (while) Tj ET BT /F2 12 Tf 1 0 0 1 385.93 214.61 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 407.3 214.61 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 425.31 214.61 Tm (conducting) Tj ET BT /F2 12 Tf 1 0 0 1 482 214.61 Tm (your) Tj ET Q q n 45.35 212.2 m 657.35 212.2 l 657.35 200.2 l 45.35 200.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 202.61 Tm (duties in the course of employment;) Tj ET Q q n 18 200.2 m 630 200.2 l 630 188.2 l 18 188.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 190.61 Tm (\(9\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 190.61 Tm (travel) Tj ET BT /F2 12 Tf 1 0 0 1 75.77 190.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 88.86 190.61 Tm (flight) Tj ET BT /F2 12 Tf 1 0 0 1 117.96 190.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 130.39 190.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 150.81 190.61 Tm (aircraft,) Tj ET BT /F2 12 Tf 1 0 0 1 191.55 190.61 Tm (including) Tj ET BT /F2 12 Tf 1 0 0 1 239.97 190.61 Tm (balloons) Tj ET BT /F2 12 Tf 1 0 0 1 283.74 190.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 304.16 190.61 Tm (gliders;) Tj ET BT /F2 12 Tf 1 0 0 1 343.25 190.61 Tm (except) Tj ET BT /F2 12 Tf 1 0 0 1 377.66 190.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 390.76 190.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 399.18 190.61 Tm (fare) Tj ET BT /F2 12 Tf 1 0 0 1 420.93 190.61 Tm (paying) Tj ET BT /F2 12 Tf 1 0 0 1 456.69 190.61 Tm (passenger) Tj ET Q q n 45.35 188.2 m 657.35 188.2 l 657.35 176.2 l 45.35 176.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 178.61 Tm (on a regularly scheduled flight; or) Tj ET Q q n 18 176.2 m 630 176.2 l 630 164.2 l 18 164.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 166.61 Tm (\(10\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 166.61 Tm (driving a vehicle while intoxicated.) Tj ET Q q n 0 164.2 m 612 164.2 l 612 152.2 l 0 152.2 l h W n Q Q q Q Q endstream endobj 15 0 obj <>>>>> endobj 117 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 734.4 cm q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 26.41 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 233.33 14.41 Tm (CONTINUED) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 28.4 Tm (GL1102-6.3A 01 PA) Tj ET BT /F2 12 Tf 1 0 0 1 352.31 28.4 Tm (COMMON CARRIER - PAR, REPAT) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 16.39 Tm (13) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 16.39 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 60.7 cm q n 0 673.7 m 612 673.7 l 612 661.7 l 0 661.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 664.11 Tm (DEFINITIONS.) Tj ET Q q n 0 661.7 m 612 661.7 l 612 649.7 l 0 649.7 l h W n Q q n 0 649.7 m 612 649.7 l 612 637.7 l 0 637.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.11 Tm ("Beneficiary") Tj ET BT /F2 12 Tf 1 0 0 1 69.27 640.11 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 103.43 640.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 121.59 640.11 Tm (person\(s\)) Tj ET BT /F2 12 Tf 1 0 0 1 169.75 640.11 Tm (named) Tj ET BT /F2 12 Tf 1 0 0 1 205.24 640.11 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 220.74 640.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 246.24 640.11 Tm (enrollment) Tj ET BT /F2 12 Tf 1 0 0 1 301.72 640.11 Tm (form.) Tj ET BT /F2 12 Tf 1 0 0 1 335.05 640.11 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 359.22 640.11 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 383.39 640.11 Tm (change) Tj ET BT /F2 12 Tf 1 0 0 1 420.87 640.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 439.03 640.11 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 498.5 640.11 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 514 640.11 Tm (filing) Tj ET Q q n 0 637.7 m 612 637.7 l 612 625.7 l 0 625.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 628.11 Tm (a written notice of the change with the Company at its Group Insurance Service Office.) Tj ET Q q n 0 625.7 m 612 625.7 l 612 613.7 l 0 613.7 l h W n Q q n 0 613.7 m 612 613.7 l 612 601.7 l 0 601.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 604.11 Tm ("Common) Tj ET BT /F2 12 Tf 1 0 0 1 53.01 604.11 Tm (Carrier) Tj ET BT /F2 12 Tf 1 0 0 1 90.43 604.11 Tm (Accident") Tj ET BT /F2 12 Tf 1 0 0 1 142.08 604.11 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 176.18 604.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 184.94 604.11 Tm (covered) Tj ET BT /F2 12 Tf 1 0 0 1 226.36 604.11 Tm (accidental) Tj ET BT /F2 12 Tf 1 0 0 1 278.43 604.11 Tm (bodily) Tj ET BT /F2 12 Tf 1 0 0 1 312.54 604.11 Tm (injury) Tj ET BT /F2 12 Tf 1 0 0 1 344.64 604.11 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 377.41 604.11 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 388.85 604.11 Tm (sustained) Tj ET BT /F2 12 Tf 1 0 0 1 436.95 604.11 Tm (while) Tj ET BT /F2 12 Tf 1 0 0 1 467.05 604.11 Tm (riding) Tj ET BT /F2 12 Tf 1 0 0 1 499.15 604.11 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 512.59 604.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 521.36 604.11 Tm (fare) Tj ET Q q n 0 601.7 m 612 601.7 l 612 589.7 l 0 589.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 592.11 Tm (paying) Tj ET BT /F2 12 Tf 1 0 0 1 37.45 592.11 Tm (passenger) Tj ET BT /F2 12 Tf 1 0 0 1 89.55 592.11 Tm (\(not) Tj ET BT /F2 12 Tf 1 0 0 1 113.66 592.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 123.77 592.11 Tm (pilot,) Tj ET BT /F2 12 Tf 1 0 0 1 153.56 592.11 Tm (operator) Tj ET BT /F2 12 Tf 1 0 0 1 198.32 592.11 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 213.11 592.11 Tm (crew) Tj ET BT /F2 12 Tf 1 0 0 1 241.21 592.11 Tm (member\)) Tj ET BT /F2 12 Tf 1 0 0 1 289.3 592.11 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 303.42 592.11 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 318.2 592.11 Tm (on,) Tj ET BT /F2 12 Tf 1 0 0 1 337.99 592.11 Tm (boarding) Tj ET BT /F2 12 Tf 1 0 0 1 385.43 592.11 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 400.21 592.11 Tm (getting) Tj ET BT /F2 12 Tf 1 0 0 1 438.33 592.11 Tm (off) Tj ET BT /F2 12 Tf 1 0 0 1 457.11 592.11 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 485.22 592.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 495.33 592.11 Tm (Common) Tj ET Q q n 0 589.7 m 612 589.7 l 612 577.7 l 0 577.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.11 Tm (Carrier.) Tj ET Q q n 0 577.7 m 612 577.7 l 612 565.7 l 0 565.7 l h W n Q q n 0 565.7 m 612 565.7 l 612 553.7 l 0 553.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 556.11 Tm ("Common) Tj ET BT /F2 12 Tf 1 0 0 1 52.62 556.11 Tm (Carrier") Tj ET BT /F2 12 Tf 1 0 0 1 94.54 556.11 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 128.24 556.11 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 148.61 556.11 Tm (land,) Tj ET BT /F2 12 Tf 1 0 0 1 175.32 556.11 Tm (air) Tj ET BT /F2 12 Tf 1 0 0 1 191.02 556.11 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 204.07 556.11 Tm (water) Tj ET BT /F2 12 Tf 1 0 0 1 233.76 556.11 Tm (conveyance) Tj ET BT /F2 12 Tf 1 0 0 1 293.44 556.11 Tm (operated) Tj ET BT /F2 12 Tf 1 0 0 1 337.79 556.11 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 368.16 556.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 376.53 556.11 Tm (license) Tj ET BT /F2 12 Tf 1 0 0 1 412.9 556.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 425.28 556.11 Tm (transport) Tj ET BT /F2 12 Tf 1 0 0 1 470.98 556.11 Tm (passengers) Tj ET BT /F2 12 Tf 1 0 0 1 526.01 556.11 Tm (for) Tj ET Q q n 0 553.7 m 612 553.7 l 612 541.7 l 0 541.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 544.11 Tm (hire.) Tj ET Q q n 0 541.7 m 612 541.7 l 612 529.7 l 0 529.7 l h W n Q q n 0 529.7 m 612 529.7 l 612 517.7 l 0 517.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 520.11 Tm ("Intoxicated") Tj ET BT /F2 12 Tf 1 0 0 1 67.4 520.11 Tm (shall) Tj ET BT /F2 12 Tf 1 0 0 1 93.69 520.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 108.65 520.11 Tm (defined) Tj ET BT /F2 12 Tf 1 0 0 1 148.26 520.11 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 163.89 520.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 182.17 520.11 Tm (jurisdiction) Tj ET BT /F2 12 Tf 1 0 0 1 240.46 520.11 Tm (where) Tj ET BT /F2 12 Tf 1 0 0 1 273.4 520.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 291.69 520.11 Tm (accident) Tj ET BT /F2 12 Tf 1 0 0 1 335.29 520.11 Tm (occurs.) Tj ET BT /F2 12 Tf 1 0 0 1 376.87 520.11 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 399.15 520.11 Tm (exclusion) Tj ET BT /F2 12 Tf 1 0 0 1 448.77 520.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 471.06 520.11 Tm (apply) Tj ET BT /F2 12 Tf 1 0 0 1 501.35 520.11 Tm (whether) Tj ET Q q n 0 517.7 m 612 517.7 l 612 505.7 l 0 505.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 508.11 Tm (or not the driver is convicted.) Tj ET Q q n 0 505.7 m 612 505.7 l 612 493.7 l 0 493.7 l h W n Q q n 0 493.7 m 612 493.7 l 612 481.7 l 0 481.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.11 Tm ("Loss of a Member" includes the following:) Tj ET Q q n 18 481.7 m 630 481.7 l 630 469.7 l 18 469.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 472.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 472.11 Tm ("Loss of Hand or Foot," means complete severance through or above the wrist or ankle joint.) Tj ET Q q n 18 469.7 m 630 469.7 l 630 457.7 l 18 457.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 460.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 460.11 Tm ("Loss of an Eye," means total and irrevocable loss of sight in that eye.) Tj ET Q q n 0 457.7 m 612 457.7 l 612 445.7 l 0 445.7 l h W n Q q n 0 445.7 m 612 445.7 l 612 433.7 l 0 433.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.11 Tm ("Paralysis" means complete and irreversible loss or use of an arm or leg \(without severance\).) Tj ET Q q n 0 433.7 m 612 433.7 l 612 421.7 l 0 421.7 l h W n Q q n 0 421.7 m 612 421.7 l 612 409.7 l 0 409.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 412.11 Tm (REPATRIATION BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 158.03 412.11 Tm (The Company will pay a Repatriation Benefit, if:) Tj ET Q q n 18 409.7 m 630 409.7 l 630 397.7 l 18 397.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 400.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 400.11 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 68.81 400.11 Tm (die) Tj ET BT /F2 12 Tf 1 0 0 1 88.93 400.11 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 104.38 400.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 115.17 400.11 Tm (result) Tj ET BT /F2 12 Tf 1 0 0 1 147.29 400.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 162.75 400.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 173.53 400.11 Tm (covered) Tj ET BT /F2 12 Tf 1 0 0 1 216.96 400.11 Tm (accident) Tj ET BT /F2 12 Tf 1 0 0 1 262.4 400.11 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 276.52 400.11 Tm (least) Tj ET BT /F2 12 Tf 1 0 0 1 303.96 400.11 Tm (150) Tj ET BT /F2 12 Tf 1 0 0 1 327.42 400.11 Tm (miles) Tj ET BT /F2 12 Tf 1 0 0 1 358.88 400.11 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 387.67 400.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 415.12 400.11 Tm (principal) Tj ET BT /F2 12 Tf 1 0 0 1 463.23 400.11 Tm (place) Tj ET BT /F2 12 Tf 1 0 0 1 494 400.11 Tm (of) Tj ET Q q n 45.35 397.7 m 657.35 397.7 l 657.35 385.7 l 45.35 385.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 388.11 Tm (residence; and) Tj ET Q q n 18 385.7 m 630 385.7 l 630 373.7 l 18 373.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 376.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 376.11 Tm (expense is incurred for the preparation and transportation of your body to a mortuary.) Tj ET Q q n 0 373.7 m 612 373.7 l 612 361.7 l 0 361.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 364.11 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 25.09 364.11 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 62.16 364.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 84.59 364.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 99.67 364.11 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 124.09 364.11 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 137.18 364.11 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 180.26 364.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 193.36 364.11 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 209.11 364.11 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 237.52 364.11 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 279.26 364.11 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 320.33 364.11 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 351.41 364.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 369.83 364.11 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 411.01 364.11 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 436.1 364.11 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 473.17 364.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 495.6 364.11 Tm (equal) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 364.11 Tm (the) Tj ET Q q n 0 361.7 m 612 361.7 l 612 349.7 l 0 349.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.11 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 47.29 352.11 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 91.24 352.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 109.2 352.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 127.83 352.11 Tm (preparation) Tj ET BT /F2 12 Tf 1 0 0 1 186.44 352.11 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 207.73 352.11 Tm (transportation) Tj ET BT /F2 12 Tf 1 0 0 1 278.35 352.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 292.32 352.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 318.29 352.11 Tm (body) Tj ET BT /F2 12 Tf 1 0 0 1 346.26 352.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 359.56 352.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 368.86 352.11 Tm (mortuary) Tj ET BT /F2 12 Tf 1 0 0 1 416.81 352.11 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 454.77 352.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 468.08 352.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 477.37 352.11 Tm (maximum) Tj ET BT /F2 12 Tf 1 0 0 1 530 352.11 Tm (of) Tj ET Q q n 0 349.7 m 612 349.7 l 612 337.7 l 0 337.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 340.11 Tm ($5,000.) Tj ET BT /F2 12 Tf 1 0 0 1 42 340.11 Tm (This benefit will be paid:) Tj ET Q q n 18 337.7 m 630 337.7 l 630 325.7 l 18 325.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 328.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 328.11 Tm (when the benefit for accidental loss of life is paid; or) Tj ET Q q n 18 325.7 m 630 325.7 l 630 313.7 l 18 313.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 316.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 316.11 Tm (when the Company receives proof of expense incurred, if later.) Tj ET Q q n 18 313.7 m 630 313.7 l 630 301.7 l 18 301.7 l h W n Q q n 0 301.7 m 612 301.7 l 612 289.7 l 0 289.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 292.11 Tm (PROOF.) Tj ET BT /F2 12 Tf 1 0 0 1 52.64 292.11 Tm (In) Tj ET BT /F2 12 Tf 1 0 0 1 66.46 292.11 Tm (order) Tj ET BT /F2 12 Tf 1 0 0 1 95.61 292.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 113.42 292.11 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 134.59 292.11 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 171.73 292.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 184.89 292.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 200.04 292.11 Tm (payable,) Tj ET BT /F2 12 Tf 1 0 0 1 244.17 292.11 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 273.99 292.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 287.81 292.11 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 332.96 292.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 350.77 292.11 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 371.92 292.11 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 419.07 292.11 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 462.87 292.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 480.69 292.11 Tm (Repatriation) Tj ET Q q n 0 289.7 m 612 289.7 l 612 277.7 l 0 277.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 280.11 Tm (must be provided to the Company.) Tj ET Q q n 0 277.7 m 612 277.7 l 612 265.7 l 0 265.7 l h W n Q q n 0 265.7 m 612 265.7 l 612 253.7 l 0 253.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 256.11 Tm (TO) Tj ET BT /F4 12 Tf 1 0 0 1 20.83 256.11 Tm (WHOM) Tj ET BT /F4 12 Tf 1 0 0 1 66.31 256.11 Tm (PAYABLE.) Tj ET BT /F2 12 Tf 1 0 0 1 133.62 256.11 Tm (Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 177.1 256.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 194.57 256.11 Tm (Repatriation) Tj ET BT /F2 12 Tf 1 0 0 1 257.38 256.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 279.53 256.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 294.34 256.11 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 318.49 256.11 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 331.31 256.11 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 366.77 256.11 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 391.59 256.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 409.74 256.11 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 469.2 256.11 Tm (and/or) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 256.11 Tm (Facility) Tj ET Q q n 0 253.7 m 612 253.7 l 612 241.7 l 0 241.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 244.11 Tm (of Payment sections of the Policy.) Tj ET Q q n 0 241.7 m 612 241.7 l 612 229.7 l 0 229.7 l h W n Q q n 0 229.7 m 612 229.7 l 612 217.7 l 0 217.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 220.11 Tm (Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 43.82 220.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 66.33 220.11 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 85.49 220.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 100.65 220.11 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 141.8 220.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 159.63 220.11 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 180.79 220.11 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 203.3 220.11 Tm (excluded) Tj ET BT /F2 12 Tf 1 0 0 1 250.44 220.11 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 281.6 220.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 300.09 220.11 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 355.9 220.11 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 388.39 220.11 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 409.55 220.11 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 493.36 220.11 Tm (Insurance) Tj ET Q q n 0 217.7 m 612 217.7 l 612 205.7 l 0 205.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 208.11 Tm (Limitations section.) Tj ET Q Q q Q Q endstream endobj 16 0 obj <>>>>> endobj 118 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 742.8 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 16.91 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET BT /F4 12 Tf 1 0 0 1 233.33 3.11 Tm (CONTINUED) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-6.7 01 PA) Tj ET BT /F2 12 Tf 1 0 0 1 463.65 26.1 Tm (EDUC, SP. TR.) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (14) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 684.41 m 612 684.41 l 612 672.41 l 0 672.41 l h W n Q q n 0 672.41 m 612 672.41 l 612 660.41 l 0 660.41 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 662.81 Tm (EDUCATION) Tj ET BT /F4 12 Tf 1 0 0 1 77.24 662.81 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 140.71 662.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 163.26 662.81 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 213.82 662.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 236.39 662.81 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 257.61 662.81 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 272.83 662.81 Tm (Education) Tj ET BT /F2 12 Tf 1 0 0 1 325.38 662.81 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 364.59 662.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 382.48 662.81 Tm (each) Tj ET BT /F2 12 Tf 1 0 0 1 408.35 662.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 422.25 662.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 448.14 662.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 488.02 662.81 Tm (Dependent) Tj ET Q q n 0 660.41 m 612 660.41 l 612 648.41 l 0 648.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 650.81 Tm (Children, if you:) Tj ET Q q n 18 648.41 m 630 648.41 l 630 636.41 l 18 636.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 638.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 638.81 Tm (are injured in a covered accident while insured under the Policy;) Tj ET Q q n 18 636.41 m 630 636.41 l 630 624.41 l 18 624.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 626.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 626.81 Tm (die as a direct result of such injuries; and) Tj ET Q q n 18 624.41 m 630 624.41 l 630 612.41 l 18 612.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 614.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 614.81 Tm (are survived by one or more Dependent Children who are eligible for the benefit.) Tj ET Q q n 18 612.41 m 630 612.41 l 630 600.41 l 18 600.41 l h W n Q q n 0 600.4 m 612 600.4 l 612 588.4 l 0 588.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 590.81 Tm (To be eligible for the Education Benefit, a Dependent Child:) Tj ET Q q n 18 588.4 m 630 588.4 l 630 576.4 l 18 576.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 578.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 578.81 Tm (must be dependent on you for principal support;) Tj ET Q q n 18 576.4 m 630 576.4 l 630 564.4 l 18 564.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 566.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 566.81 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 71.95 566.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 86.54 566.81 Tm (enrolled) Tj ET BT /F2 12 Tf 1 0 0 1 129.12 566.81 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 142.38 566.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 150.97 566.81 Tm (Full-Time) Tj ET BT /F2 12 Tf 1 0 0 1 202.9 566.81 Tm (Student) Tj ET BT /F2 12 Tf 1 0 0 1 242.83 566.81 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 258.1 566.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 276.02 566.81 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 299.27 566.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 312.53 566.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 337.79 566.81 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 367.05 566.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 380.31 566.81 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 414.24 566.81 Tm (365) Tj ET BT /F2 12 Tf 1 0 0 1 435.5 566.81 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 460.76 566.81 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 486.01 566.81 Tm (that) Tj ET Q q n 45.35 564.4 m 657.35 564.4 l 657.35 552.4 l 45.35 552.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 554.81 Tm (date; and) Tj ET Q q n 18 552.4 m 630 552.4 l 630 540.4 l 18 540.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 542.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 542.81 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 72.9 542.81 Tm (incur) Tj ET BT /F2 12 Tf 1 0 0 1 101.78 542.81 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 149.31 542.81 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 175.5 542.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 194.38 542.81 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 218.58 542.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 232.79 542.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 259 542.81 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 289.2 542.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 307.41 542.81 Tm (tuition,) Tj ET BT /F2 12 Tf 1 0 0 1 345.96 542.81 Tm (fees,) Tj ET BT /F2 12 Tf 1 0 0 1 372.5 542.81 Tm (books,) Tj ET BT /F2 12 Tf 1 0 0 1 408.38 542.81 Tm (room) Tj ET BT /F2 12 Tf 1 0 0 1 437.93 542.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 459.47 542.81 Tm (board,) Tj ET BT /F2 12 Tf 1 0 0 1 494 542.81 Tm (or) Tj ET Q q n 45.35 540.4 m 657.35 540.4 l 657.35 528.4 l 45.35 528.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 530.81 Tm (any other costs payable directly to \(or approved and certified by\) that school.) Tj ET Q q n 0 528.4 m 612 528.4 l 612 516.4 l 0 516.4 l h W n Q q n 0 516.4 m 612 516.4 l 612 504.4 l 0 504.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 506.81 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 25.23 506.81 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 62.43 506.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 84.99 506.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 100.21 506.81 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 124.76 506.81 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 137.98 506.81 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 181.2 506.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 194.43 506.81 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 210.31 506.81 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 238.86 506.81 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 280.73 506.81 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 321.94 506.81 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 353.15 506.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 371.7 506.81 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 413.15 506.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 435.7 506.81 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 472.9 506.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 495.46 506.81 Tm (equal) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 506.81 Tm (the) Tj ET Q q n 0 504.4 m 612 504.4 l 612 492.4 l 0 492.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 494.81 Tm (actual) Tj ET BT /F2 12 Tf 1 0 0 1 32.3 494.81 Tm (expense) Tj ET BT /F2 12 Tf 1 0 0 1 74.61 494.81 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 118.25 494.81 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 143.88 494.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 162.2 494.81 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 185.85 494.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 199.5 494.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 225.16 494.81 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 254.8 494.81 Tm (up) Tj ET BT /F2 12 Tf 1 0 0 1 270.46 494.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 283.45 494.81 Tm (5%) Tj ET BT /F2 12 Tf 1 0 0 1 303.1 494.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 316.76 494.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 342.41 494.81 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 389.39 494.81 Tm (Sum,) Tj ET BT /F2 12 Tf 1 0 0 1 418.06 494.81 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 455.71 494.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 468.7 494.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 477.68 494.81 Tm (maximum) Tj ET BT /F2 12 Tf 1 0 0 1 530 494.81 Tm (of) Tj ET Q q n 0 492.4 m 612 492.4 l 612 480.4 l 0 480.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 482.81 Tm ($5,000) Tj ET BT /F2 12 Tf 1 0 0 1 36.93 482.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 54.84 482.81 Tm (each) Tj ET BT /F2 12 Tf 1 0 0 1 80.75 482.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 120.66 482.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 176.57 482.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 207.16 482.81 Tm (per) Tj ET BT /F2 12 Tf 1 0 0 1 226.41 482.81 Tm (year,) Tj ET BT /F2 12 Tf 1 0 0 1 253.98 482.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 271.9 482.81 Tm (up) Tj ET BT /F2 12 Tf 1 0 0 1 287.83 482.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 301.09 482.81 Tm (4) Tj ET BT /F2 12 Tf 1 0 0 1 311.01 482.81 Tm (consecutive) Tj ET BT /F2 12 Tf 1 0 0 1 371.58 482.81 Tm (years) Tj ET BT /F2 12 Tf 1 0 0 1 400.82 482.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 414.75 482.81 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 440.67 482.81 Tm (age) Tj ET BT /F2 12 Tf 1 0 0 1 461.25 482.81 Tm (25.) Tj ET BT /F2 12 Tf 1 0 0 1 484.1 482.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 506.68 482.81 Tm (benefit) Tj ET Q q n 0 480.4 m 612 480.4 l 612 468.4 l 0 468.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 470.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 22.26 470.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 37.18 470.81 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 61.43 470.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 74.35 470.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 99.94 470.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 155.51 470.81 Tm (Child,) Tj ET BT /F2 12 Tf 1 0 0 1 188.77 470.81 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 199.69 470.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 217.94 470.81 Tm (child) Tj ET BT /F2 12 Tf 1 0 0 1 245.53 470.81 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 265.12 470.81 Tm (reached) Tj ET BT /F2 12 Tf 1 0 0 1 306.01 470.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 324.26 470.81 Tm (age) Tj ET BT /F2 12 Tf 1 0 0 1 344.5 470.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 358.09 470.81 Tm (majority.) Tj ET BT /F2 12 Tf 1 0 0 1 408.93 470.81 Tm (Otherwise,) Tj ET BT /F2 12 Tf 1 0 0 1 464.84 470.81 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 506.42 470.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 470.81 Tm (be) Tj ET Q q n 0 468.4 m 612 468.4 l 612 456.4 l 0 456.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 458.81 Tm (paid to the child's legal guardian.) Tj ET BT /F2 12 Tf 1 0 0 1 164.78 458.81 Tm (The first payment will be made:) Tj ET Q q n 18 456.4 m 630 456.4 l 630 444.4 l 18 444.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 446.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 446.81 Tm (when the benefit for your accidental loss of life is paid; or) Tj ET Q q n 18 444.4 m 630 444.4 l 630 432.4 l 18 432.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 434.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 434.81 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 74.48 434.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 92.28 434.81 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 142.08 434.81 Tm (receives) Tj ET BT /F2 12 Tf 1 0 0 1 184.52 434.81 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 213.65 434.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 226.79 434.81 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 273.24 434.81 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 316.36 434.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 336.82 434.81 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 357.95 434.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 383.09 434.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 422.21 434.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 477.33 434.81 Tm (Child) Tj ET Q q n 45.35 432.4 m 657.35 432.4 l 657.35 420.4 l 45.35 420.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 422.81 Tm (meets the above requirements, if later.) Tj ET Q q n 0 420.4 m 612 420.4 l 612 408.4 l 0 408.4 l h W n Q q n 0 408.4 m 612 408.4 l 612 396.4 l 0 396.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 398.81 Tm (Subsequent payments will be made when the Company receives:) Tj ET Q q n 18 396.4 m 630 396.4 l 630 384.4 l 18 384.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 386.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 386.81 Tm (verification) Tj ET BT /F2 12 Tf 1 0 0 1 105.66 386.81 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 128.66 386.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 155.67 386.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 196.66 386.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 253.65 386.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 285.32 386.81 Tm (continues) Tj ET BT /F2 12 Tf 1 0 0 1 336.32 386.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 350.66 386.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 366.99 386.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 377.33 386.81 Tm (Full-Time) Tj ET BT /F2 12 Tf 1 0 0 1 431 386.81 Tm (Student) Tj ET BT /F2 12 Tf 1 0 0 1 472.67 386.81 Tm (during) Tj ET Q q n 45.35 384.4 m 657.35 384.4 l 657.35 372.4 l 45.35 372.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 374.81 Tm (each additional semester/year; and) Tj ET Q q n 18 372.4 m 630 372.4 l 630 360.4 l 18 360.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 362.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 362.81 Tm (proof of payment for the expenses incurred.) Tj ET Q q n 0 360.4 m 612 360.4 l 612 348.4 l 0 348.4 l h W n Q q n 0 348.4 m 612 348.4 l 612 336.4 l 0 336.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 338.81 Tm ("Full-Time Student" means your Dependent Child who:) Tj ET Q q n 18 336.4 m 630 336.4 l 630 324.4 l 18 324.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 326.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 326.81 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 57.18 326.81 Tm (attending) Tj ET BT /F2 12 Tf 1 0 0 1 105.67 326.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 114.83 326.81 Tm (licensed) Tj ET BT /F2 12 Tf 1 0 0 1 157.97 326.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 171.8 326.81 Tm (accredited) Tj ET BT /F2 12 Tf 1 0 0 1 224.92 326.81 Tm (college,) Tj ET BT /F2 12 Tf 1 0 0 1 266.4 326.81 Tm (university) Tj ET BT /F2 12 Tf 1 0 0 1 318.23 326.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 332.05 326.81 Tm (vocational) Tj ET BT /F2 12 Tf 1 0 0 1 385.86 326.81 Tm (school) Tj ET BT /F2 12 Tf 1 0 0 1 421.02 326.81 Tm (\(beyond) Tj ET BT /F2 12 Tf 1 0 0 1 464.18 326.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 482.67 326.81 Tm (12th) Tj ET Q q n 45.35 324.4 m 657.35 324.4 l 657.35 312.4 l 45.35 312.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 314.81 Tm (grade\);) Tj ET Q q n 18 312.4 m 630 312.4 l 630 300.4 l 18 300.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 302.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 302.81 Tm (is considered a full-time student based upon that school's standards; and) Tj ET Q q n 18 300.4 m 630 300.4 l 630 288.4 l 18 288.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 290.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 290.81 Tm (incurs) Tj ET BT /F2 12 Tf 1 0 0 1 78.11 290.81 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 124.85 290.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 142.27 290.81 Tm (tuition,) Tj ET BT /F2 12 Tf 1 0 0 1 180.04 290.81 Tm (fees,) Tj ET BT /F2 12 Tf 1 0 0 1 205.79 290.81 Tm (books,) Tj ET BT /F2 12 Tf 1 0 0 1 240.89 290.81 Tm (room) Tj ET BT /F2 12 Tf 1 0 0 1 269.64 290.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 290.4 290.81 Tm (board,) Tj ET BT /F2 12 Tf 1 0 0 1 324.15 290.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 337.58 290.81 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 358.33 290.81 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 386.42 290.81 Tm (costs) Tj ET BT /F2 12 Tf 1 0 0 1 413.85 290.81 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 454.59 290.81 Tm (directly) Tj ET BT /F2 12 Tf 1 0 0 1 494.67 290.81 Tm (to) Tj ET Q q n 45.35 288.4 m 657.35 288.4 l 657.35 276.4 l 45.35 276.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 278.81 Tm (\(or approved or certified by\) that school.) Tj ET Q q n 0 276.4 m 612 276.4 l 612 264.4 l 0 264.4 l h W n Q q n 0 264.4 m 612 264.4 l 612 252.4 l 0 252.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 254.81 Tm ("Child" includes your naturally born child, legally adopted child, stepchild, and foster child.) Tj ET Q Q q Q Q endstream endobj 17 0 obj <>>>>> endobj 119 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 734.4 cm q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 26.41 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 233.33 14.41 Tm (CONTINUED) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 28.4 Tm (GL1102-6.7 01 PA) Tj ET BT /F2 12 Tf 1 0 0 1 463.65 28.4 Tm (EDUC, SP. TR.) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 16.39 Tm (15) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 16.39 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 60.7 cm q n 0 673.7 m 612 673.7 l 612 661.7 l 0 661.7 l h W n Q q n 0 661.7 m 612 661.7 l 612 649.7 l 0 649.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 652.11 Tm (SPOUSE) Tj ET BT /F4 12 Tf 1 0 0 1 52.52 652.11 Tm (TRAINING) Tj ET BT /F4 12 Tf 1 0 0 1 119.69 652.11 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 187.04 652.11 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 211.53 652.11 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 264.03 652.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 288.53 652.11 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 311.69 652.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 322.85 652.11 Tm (Spouse) Tj ET BT /F2 12 Tf 1 0 0 1 363.36 652.11 Tm (Training) Tj ET BT /F2 12 Tf 1 0 0 1 410.51 652.11 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 451.67 652.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 466.84 652.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 494.67 652.11 Tm (surviving) Tj ET Q q n 0 649.7 m 612 649.7 l 612 637.7 l 0 637.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.11 Tm (Spouse, if you:) Tj ET Q q n 18 637.7 m 630 637.7 l 630 625.7 l 18 625.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 628.11 Tm (are injured in a covered accident while insured under the Policy;) Tj ET Q q n 18 625.7 m 630 625.7 l 630 613.7 l 18 613.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 616.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 616.11 Tm (die as a direct result of such injuries; and) Tj ET Q q n 18 613.7 m 630 613.7 l 630 601.7 l 18 601.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 604.11 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 604.11 Tm (are survived by a Spouse who is eligible for the benefit.) Tj ET Q q n 0 601.7 m 612 601.7 l 612 589.7 l 0 589.7 l h W n Q q n 0 589.7 m 612 589.7 l 612 577.7 l 0 577.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.11 Tm (To be eligible for the Spouse Training Benefit, your Spouse:) Tj ET Q q n 18 577.7 m 630 577.7 l 630 565.7 l 18 565.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 568.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 568.11 Tm (must not be legally separated from you on the date of the accident;) Tj ET Q q n 18 565.7 m 630 565.7 l 630 553.7 l 18 553.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 556.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 556.11 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 71.83 556.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 86.29 556.11 Tm (enrolled) Tj ET BT /F2 12 Tf 1 0 0 1 128.75 556.11 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 141.88 556.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 150.35 556.11 Tm (student) Tj ET BT /F2 12 Tf 1 0 0 1 188.15 556.11 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 203.29 556.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 221.09 556.11 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 244.21 556.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 257.35 556.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 282.48 556.11 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 311.61 556.11 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 324.74 556.11 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 358.55 556.11 Tm (365) Tj ET BT /F2 12 Tf 1 0 0 1 379.69 556.11 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 404.83 556.11 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 429.94 556.11 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 451.08 556.11 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 474.2 556.11 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 486.67 556.11 Tm (any) Tj ET Q q n 45.35 553.7 m 657.35 553.7 l 657.35 541.7 l 45.35 541.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 544.11 Tm (school to retrain or refresh skills needed for employment; and) Tj ET Q q n 18 541.7 m 630 541.7 l 630 529.7 l 18 529.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 532.11 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 532.11 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 72.63 532.11 Tm (incur) Tj ET BT /F2 12 Tf 1 0 0 1 101.23 532.11 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 148.5 532.11 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 174.42 532.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 193.02 532.11 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 216.96 532.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 230.9 532.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 256.84 532.11 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 286.77 532.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 304.7 532.11 Tm (tuition,) Tj ET BT /F2 12 Tf 1 0 0 1 342.98 532.11 Tm (fees,) Tj ET BT /F2 12 Tf 1 0 0 1 369.25 532.11 Tm (books,) Tj ET BT /F2 12 Tf 1 0 0 1 404.86 532.11 Tm (room) Tj ET BT /F2 12 Tf 1 0 0 1 434.14 532.11 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 455.41 532.11 Tm (board) Tj ET BT /F2 12 Tf 1 0 0 1 486.67 532.11 Tm (and) Tj ET Q q n 45.35 529.7 m 657.35 529.7 l 657.35 517.7 l 45.35 517.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 520.11 Tm (other costs payable directly to \(or approved or certified by\) that school.) Tj ET Q q n 0 517.7 m 612 517.7 l 612 505.7 l 0 505.7 l h W n Q q n 0 505.7 m 612 505.7 l 612 493.7 l 0 493.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.11 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 25.23 496.11 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 62.43 496.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 84.99 496.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 100.21 496.11 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 124.76 496.11 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 137.98 496.11 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 181.2 496.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 194.43 496.11 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 210.31 496.11 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 238.86 496.11 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 280.73 496.11 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 321.94 496.11 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 353.15 496.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 371.7 496.11 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 413.15 496.11 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 435.7 496.11 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 472.9 496.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 495.46 496.11 Tm (equal) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 496.11 Tm (the) Tj ET Q q n 0 493.7 m 612 493.7 l 612 481.7 l 0 481.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.11 Tm (actual) Tj ET BT /F2 12 Tf 1 0 0 1 32.29 484.11 Tm (expense) Tj ET BT /F2 12 Tf 1 0 0 1 74.58 484.11 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 118.2 484.11 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 143.82 484.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 162.12 484.11 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 185.75 484.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 199.38 484.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 225.02 484.11 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 254.65 484.11 Tm (up) Tj ET BT /F2 12 Tf 1 0 0 1 270.29 484.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 283.27 484.11 Tm (5%) Tj ET BT /F2 12 Tf 1 0 0 1 302.9 484.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 316.54 484.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 342.18 484.11 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 389.14 484.11 Tm (Sum;) Tj ET BT /F2 12 Tf 1 0 0 1 418.13 484.11 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 455.76 484.11 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 468.73 484.11 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 477.7 484.11 Tm (maximum) Tj ET BT /F2 12 Tf 1 0 0 1 530 484.11 Tm (of) Tj ET Q q n 0 481.7 m 612 481.7 l 612 469.7 l 0 469.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 472.11 Tm ($5,000. The benefit will be paid for one year.) Tj ET BT /F2 12 Tf 1 0 0 1 223.59 472.11 Tm (Payment will be made:) Tj ET Q q n 18 469.7 m 630 469.7 l 630 457.7 l 18 457.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 460.11 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 460.11 Tm (when the benefit for your accidental loss of life is paid; or) Tj ET Q q n 18 457.7 m 630 457.7 l 630 445.7 l 18 445.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 448.11 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 448.11 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 74.97 448.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 93.26 448.11 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 143.55 448.11 Tm (receives) Tj ET BT /F2 12 Tf 1 0 0 1 186.48 448.11 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 216.1 448.11 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 229.72 448.11 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 274.67 448.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 292.29 448.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 310.58 448.11 Tm (expenses) Tj ET BT /F2 12 Tf 1 0 0 1 357.53 448.11 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 401.13 448.11 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 422.09 448.11 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 443.71 448.11 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 469.33 448.11 Tm (Spouse) Tj ET Q q n 45.35 445.7 m 657.35 445.7 l 657.35 433.7 l 45.35 433.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 436.11 Tm (meets the above requirements, if later.) Tj ET Q q n 0 433.7 m 612 433.7 l 612 421.7 l 0 421.7 l h W n Q q n 0 421.7 m 612 421.7 l 612 409.7 l 0 409.7 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 412.11 Tm (EXCLUSIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 94.77 412.11 Tm (Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 141.63 412.11 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 167.18 412.11 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 189.39 412.11 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 207.59 412.11 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 251.77 412.11 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 272.64 412.11 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 296.84 412.11 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 322.39 412.11 Tm (excluded) Tj ET BT /F2 12 Tf 1 0 0 1 372.57 412.11 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 406.77 412.11 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 428.3 412.11 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 487.15 412.11 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 412.11 Tm (and) Tj ET Q q n 0 409.7 m 612 409.7 l 612 397.7 l 0 397.7 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 400.11 Tm (Dismemberment Insurance Limitations section.) Tj ET Q Q q Q Q endstream endobj 18 0 obj <>>>>> endobj 120 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 742.8 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 16.91 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET BT /F4 12 Tf 1 0 0 1 233.33 3.11 Tm (CONTINUED) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-6.13 01 PA) Tj ET BT /F2 12 Tf 1 0 0 1 485.33 26.1 Tm (CH. CARE) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (16) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 684.41 m 612 684.41 l 612 672.41 l 0 672.41 l h W n Q q n 0 672.41 m 612 672.41 l 612 660.41 l 0 660.41 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 662.81 Tm (CHILD) Tj ET BT /F4 12 Tf 1 0 0 1 43.09 662.81 Tm (CARE) Tj ET BT /F4 12 Tf 1 0 0 1 80.84 662.81 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 144.03 662.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 166.43 662.81 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 216.85 662.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 239.27 662.81 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 260.34 662.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 269.42 662.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 299.84 662.81 Tm (Care) Tj ET BT /F2 12 Tf 1 0 0 1 326.25 662.81 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 365.32 662.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 383.06 662.81 Tm (each) Tj ET BT /F2 12 Tf 1 0 0 1 408.79 662.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 422.54 662.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 448.28 662.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 488.02 662.81 Tm (Dependent) Tj ET Q q n 0 660.41 m 612 660.41 l 612 648.41 l 0 648.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 650.81 Tm (Children, if you:) Tj ET Q q n 18 648.41 m 630 648.41 l 630 636.41 l 18 636.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 638.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 638.81 Tm (are injured in a covered accident while insured under the Policy;) Tj ET Q q n 18 636.41 m 630 636.41 l 630 624.41 l 18 624.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 626.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 626.81 Tm (die as a direct result of such injuries; and) Tj ET Q q n 18 624.41 m 630 624.41 l 630 612.41 l 18 612.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 614.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 614.81 Tm (are survived by one or more Dependent Children who are eligible for the benefit.) Tj ET Q q n 0 612.41 m 612 612.41 l 612 600.41 l 0 600.41 l h W n Q q n 0 600.4 m 612 600.4 l 612 588.4 l 0 588.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 590.81 Tm (To be eligible for the Child Care Benefit, your Dependent Child must:) Tj ET Q q n 18 588.4 m 630 588.4 l 630 576.4 l 18 576.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 578.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 578.81 Tm (be dependent on you for principal support;) Tj ET Q q n 18 576.4 m 630 576.4 l 630 564.4 l 18 564.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 566.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 566.81 Tm (be under age 13 on the date of the accident; and) Tj ET Q q n 18 564.4 m 630 564.4 l 630 552.4 l 18 552.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 554.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 554.81 Tm (attend) Tj ET BT /F2 12 Tf 1 0 0 1 78.27 554.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 87.19 554.81 Tm (licensed) Tj ET BT /F2 12 Tf 1 0 0 1 130.11 554.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 160.38 554.81 Tm (Care) Tj ET BT /F2 12 Tf 1 0 0 1 186.63 554.81 Tm (Center) Tj ET BT /F2 12 Tf 1 0 0 1 222.22 554.81 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 237.82 554.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 246.74 554.81 Tm (regular) Tj ET BT /F2 12 Tf 1 0 0 1 284.32 554.81 Tm (basis) Tj ET BT /F2 12 Tf 1 0 0 1 311.92 554.81 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 327.52 554.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 345.78 554.81 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 369.36 554.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 382.96 554.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 408.55 554.81 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 438.14 554.81 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 451.73 554.81 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 486 554.81 Tm (365) Tj ET Q q n 45.35 552.4 m 657.35 552.4 l 657.35 540.4 l 45.35 540.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 542.81 Tm (days after that date.) Tj ET Q q n 0 540.4 m 612 540.4 l 612 528.4 l 0 528.4 l h W n Q q n 0 528.4 m 612 528.4 l 612 516.4 l 0 516.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 518.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 21.81 518.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 51.64 518.81 Tm (Care) Tj ET BT /F2 12 Tf 1 0 0 1 77.45 518.81 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 115.93 518.81 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 127.09 518.81 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 150.91 518.81 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 163.4 518.81 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 205.89 518.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 218.38 518.81 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 233.53 518.81 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 261.35 518.81 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 295.17 518.81 Tm (benefits.) Tj ET BT /F2 12 Tf 1 0 0 1 342.47 518.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 364.29 518.81 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 400.76 518.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 422.59 518.81 Tm (equal) Tj ET BT /F2 12 Tf 1 0 0 1 451.73 518.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 469.55 518.81 Tm (actual) Tj ET BT /F2 12 Tf 1 0 0 1 501.35 518.81 Tm (expense) Tj ET Q q n 0 516.4 m 612 516.4 l 612 504.4 l 0 504.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 506.81 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 43.22 506.81 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 68.45 506.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 86.35 506.81 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 109.58 506.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 122.83 506.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 148.07 506.81 Tm (death,) Tj ET BT /F2 12 Tf 1 0 0 1 180.3 506.81 Tm (up) Tj ET BT /F2 12 Tf 1 0 0 1 195.54 506.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 208.12 506.81 Tm (5%) Tj ET BT /F2 12 Tf 1 0 0 1 227.37 506.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 240.61 506.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 265.85 506.81 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 312.42 506.81 Tm (Sum;) Tj ET BT /F2 12 Tf 1 0 0 1 341 506.81 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 378.24 506.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 390.82 506.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 399.39 506.81 Tm (maximum) Tj ET BT /F2 12 Tf 1 0 0 1 451.3 506.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 464.54 506.81 Tm ($5,000) Tj ET BT /F2 12 Tf 1 0 0 1 500.78 506.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 518.02 506.81 Tm (each) Tj ET Q q n 0 504.4 m 612 504.4 l 612 492.4 l 0 492.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 494.81 Tm (eligible Dependent Child per year.) Tj ET BT /F2 12 Tf 1 0 0 1 171.61 494.81 Tm (The benefit will be paid to the legal guardian of the Dependent Child:) Tj ET Q q n 18 492.4 m 630 492.4 l 630 480.4 l 18 480.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 482.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 482.81 Tm (for up to 4 consecutive years; or) Tj ET Q q n 18 480.4 m 630 480.4 l 630 468.4 l 18 468.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 470.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 470.81 Tm (until your Dependent Child's 13th birthday \(whichever occurs first\).) Tj ET Q q n 0 468.4 m 612 468.4 l 612 456.4 l 0 456.4 l h W n Q q n 0 456.4 m 612 456.4 l 612 444.4 l 0 444.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 446.81 Tm (The first payment will be made:) Tj ET Q q n 18 444.4 m 630 444.4 l 630 432.4 l 18 432.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 434.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 434.81 Tm (when the benefit for your accidental loss of life is paid; or) Tj ET Q q n 18 432.4 m 630 432.4 l 630 420.4 l 18 420.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 422.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 422.81 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 74.84 422.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 93 422.81 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 143.16 422.81 Tm (receives) Tj ET BT /F2 12 Tf 1 0 0 1 185.96 422.81 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 215.45 422.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 228.94 422.81 Tm (expense) Tj ET BT /F2 12 Tf 1 0 0 1 271.09 422.81 Tm (incurred) Tj ET BT /F2 12 Tf 1 0 0 1 314.56 422.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 335.38 422.81 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 356.88 422.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 382.37 422.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 421.85 422.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 477.33 422.81 Tm (Child) Tj ET Q q n 45.35 420.4 m 657.35 420.4 l 657.35 408.4 l 45.35 408.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 410.81 Tm (meets the above requirements; if later.) Tj ET Q q n 18 408.4 m 630 408.4 l 630 396.4 l 18 396.4 l h W n Q q n 0 396.4 m 612 396.4 l 612 384.4 l 0 384.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 386.81 Tm (Subsequent payments will be made quarterly on a reimbursement basis when the Company receives:) Tj ET Q q n 18 384.4 m 630 384.4 l 630 372.4 l 18 372.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 374.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 374.81 Tm (verification) Tj ET BT /F2 12 Tf 1 0 0 1 106.5 374.81 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 130.34 374.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 158.17 374.81 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 200 374.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 257.82 374.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 290.34 374.81 Tm (continues) Tj ET BT /F2 12 Tf 1 0 0 1 342.17 374.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 357.35 374.81 Tm (attend) Tj ET BT /F2 12 Tf 1 0 0 1 392.51 374.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 403.68 374.81 Tm (licensed) Tj ET BT /F2 12 Tf 1 0 0 1 448.83 374.81 Tm (Child) Tj ET BT /F2 12 Tf 1 0 0 1 481.35 374.81 Tm (Care) Tj ET Q q n 45.35 372.4 m 657.35 372.4 l 657.35 360.4 l 45.35 360.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 362.81 Tm (Center on a regular basis; and) Tj ET Q q n 18 360.4 m 630 360.4 l 630 348.4 l 18 348.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 350.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 350.81 Tm (satisfactory proof of payment for the child care expense incurred.) Tj ET Q q n 0 348.4 m 612 348.4 l 612 336.4 l 0 336.4 l h W n Q q n 0 336.4 m 612 336.4 l 612 324.4 l 0 324.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 326.81 Tm (DEFINITIONS.) Tj ET BT /F4 12 Tf 1 0 0 1 88.35 326.81 Tm ("Child Care Center") Tj ET BT /F2 12 Tf 1 0 0 1 196.99 326.81 Tm ( means any facility \(other than a family day care home\) which:) Tj ET Q q n 18 324.4 m 630 324.4 l 630 312.4 l 18 312.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 314.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 314.81 Tm (is licensed as such by the state; and) Tj ET Q q n 18 312.4 m 630 312.4 l 630 300.4 l 18 300.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 302.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 302.81 Tm (provides non-medical care and supervision for children in a group setting; and) Tj ET Q q n 18 300.4 m 630 300.4 l 630 288.4 l 18 288.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 290.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 290.81 Tm (cares for children at least 6 but less than 24 hours per day.) Tj ET Q q n 0 288.4 m 612 288.4 l 612 276.4 l 0 276.4 l h W n Q q n 0 276.4 m 612 276.4 l 612 264.4 l 0 264.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 266.81 Tm ("Child") Tj ET BT /F2 12 Tf 1 0 0 1 42.01 266.81 Tm ( includes your naturally born child, legally adopted child, stepchild, and foster child.) Tj ET Q q n 0 264.4 m 612 264.4 l 612 252.4 l 0 252.4 l h W n Q q n 0 252.4 m 612 252.4 l 612 240.4 l 0 240.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 242.81 Tm ("Expense) Tj ET BT /F4 12 Tf 1 0 0 1 52.74 242.81 Tm (Incurred") Tj ET BT /F2 12 Tf 1 0 0 1 108.8 242.81 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 142.86 242.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 160.93 242.81 Tm (cost) Tj ET BT /F2 12 Tf 1 0 0 1 183.66 242.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 201.06 242.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 219.12 242.81 Tm (supervision) Tj ET BT /F2 12 Tf 1 0 0 1 277.86 242.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 298.59 242.81 Tm (care) Tj ET BT /F2 12 Tf 1 0 0 1 321.97 242.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 335.37 242.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 360.77 242.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 416.15 242.81 Tm (Child,) Tj ET BT /F2 12 Tf 1 0 0 1 449.23 242.81 Tm (excluding) Tj ET BT /F2 12 Tf 1 0 0 1 499.95 242.81 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 520.68 242.81 Tm (fees) Tj ET Q q n 0 240.4 m 612 240.4 l 612 228.4 l 0 228.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 230.81 Tm (for extra activities, which are directly payable to a Child Care Center.) Tj ET Q q n 0 228.4 m 612 228.4 l 612 216.4 l 0 216.4 l h W n Q q n 0 216.4 m 612 216.4 l 612 204.4 l 0 204.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 206.81 Tm (EXCLUSIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 87.02 206.81 Tm (Benefits will not be paid:) Tj ET Q q n 18 204.4 m 630 204.4 l 630 192.4 l 18 192.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 194.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 194.81 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 76.04 194.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 102.73 194.81 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 159.41 194.81 Tm (Child's) Tj ET BT /F2 12 Tf 1 0 0 1 197.61 194.81 Tm (care) Tj ET BT /F2 12 Tf 1 0 0 1 222.28 194.81 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 234.98 194.81 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 282.33 194.81 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 299.03 194.81 Tm (\(or) Tj ET BT /F2 12 Tf 1 0 0 1 317.72 194.81 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 331.08 194.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 341.1 194.81 Tm (facility) Tj ET BT /F2 12 Tf 1 0 0 1 379.78 194.81 Tm (operated) Tj ET BT /F2 12 Tf 1 0 0 1 425.79 194.81 Tm (by\)) Tj ET BT /F2 12 Tf 1 0 0 1 446.48 194.81 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 473.17 194.81 Tm (child's) Tj ET Q q n 45.35 192.4 m 657.35 192.4 l 657.35 180.4 l 45.35 180.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 182.81 Tm (grandparent, parent, aunt, uncle or sibling; or) Tj ET Q q n 18 180.4 m 630 180.4 l 630 168.4 l 18 168.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 170.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 170.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 63.29 170.81 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 84.57 170.81 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 107.19 170.81 Tm (excluded) Tj ET BT /F2 12 Tf 1 0 0 1 154.46 170.81 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 185.73 170.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 204.34 170.81 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 260.27 170.81 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 292.87 170.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 314.15 170.81 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 398.08 170.81 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 448.67 170.81 Tm (Limitations) Tj ET Q q n 45.35 168.4 m 657.35 168.4 l 657.35 156.4 l 45.35 156.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 158.81 Tm (section of the Policy.) Tj ET Q Q q Q Q endstream endobj 19 0 obj <>>>>> endobj 121 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 742.8 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 97.98 16.91 Tm (ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE) Tj ET BT /F4 12 Tf 1 0 0 1 233.33 3.11 Tm (CONTINUED) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-6.14 01) Tj ET BT /F2 12 Tf 1 0 0 1 503.99 26.1 Tm (COMA) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (17) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 684.41 m 612 684.41 l 612 672.41 l 0 672.41 l h W n Q q n 0 672.41 m 612 672.41 l 612 660.41 l 0 660.41 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 662.81 Tm (COMA BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 102.67 662.81 Tm (The Company will pay a Coma Benefit, while you remain in a coma; provided:) Tj ET Q q n 18 660.41 m 630 660.41 l 630 648.41 l 18 648.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 650.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 650.81 Tm (the coma is caused by an Injury sustained while you are insured under the Policy;) Tj ET Q q n 18 648.41 m 630 648.41 l 630 636.41 l 18 636.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 638.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 638.81 Tm (the coma begins within 365 days after the date of the accident; and) Tj ET Q q n 18 636.41 m 630 636.41 l 630 624.41 l 18 624.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 626.81 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 626.81 Tm (you remain in a continuous coma for at least 31 days in a row.) Tj ET Q q n 0 624.41 m 612 624.41 l 612 612.41 l 0 612.41 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 614.81 Tm (The coma must result directly from the Injury and from no other causes.) Tj ET Q q n 0 612.4 m 612 612.4 l 612 600.4 l 0 600.4 l h W n Q q n 0 600.4 m 612 600.4 l 612 588.4 l 0 588.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 590.81 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 24.42 590.81 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 60.83 590.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 82.59 590.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 97.01 590.81 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 120.76 590.81 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 133.18 590.81 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 175.6 590.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 188.02 590.81 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 203.11 590.81 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 230.85 590.81 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 271.93 590.81 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 312.33 590.81 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 342.75 590.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 360.5 590.81 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 400.34 590.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 422.09 590.81 Tm (Coma) Tj ET BT /F2 12 Tf 1 0 0 1 453.85 590.81 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 492.26 590.81 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 514.01 590.81 Tm (equal) Tj ET Q q n 0 588.4 m 612 588.4 l 612 576.4 l 0 576.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 578.81 Tm (a one-time payment of 5% of the Insured Person's Principal Sum; subject to a maximum of $5,000.) Tj ET Q q n 0 576.4 m 612 576.4 l 612 564.4 l 0 564.4 l h W n Q q n 0 564.4 m 612 564.4 l 612 552.4 l 0 552.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 554.81 Tm (PROOF.) Tj ET BT /F2 12 Tf 1 0 0 1 52.44 554.81 Tm (Proof) Tj ET BT /F2 12 Tf 1 0 0 1 82.83 554.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 96.56 554.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 114.94 554.81 Tm (coma) Tj ET BT /F2 12 Tf 1 0 0 1 144.65 554.81 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 171.71 554.81 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 186.76 554.81 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 233.15 554.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 246.2 554.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 264.59 554.81 Tm (Company.) Tj ET BT /F2 12 Tf 1 0 0 1 321.7 554.81 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 344.08 554.81 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 394.47 554.81 Tm (retains) Tj ET BT /F2 12 Tf 1 0 0 1 430.18 554.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 448.57 554.81 Tm (right) Tj ET BT /F2 12 Tf 1 0 0 1 474.96 554.81 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 488.02 554.81 Tm (investigate) Tj ET Q q n 0 552.4 m 612 552.4 l 612 540.4 l 0 540.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 542.81 Tm (and to determine whether the coma exists.) Tj ET Q q n 0 540.4 m 612 540.4 l 612 528.4 l 0 528.4 l h W n Q q n 0 528.4 m 612 528.4 l 612 516.4 l 0 516.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 518.81 Tm (TO WHOM PAYABLE.) Tj ET BT /F2 12 Tf 1 0 0 1 131.67 518.81 Tm (Upon receipt of satisfactory proof, the Coma Benefit will be paid to you.) Tj ET Q q n 0 516.4 m 612 516.4 l 612 504.4 l 0 504.4 l h W n Q q n 0 504.4 m 612 504.4 l 612 492.4 l 0 492.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 494.81 Tm ("Coma") Tj ET BT /F2 12 Tf 1 0 0 1 50.26 494.81 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 87.19 494.81 Tm (being) Tj ET BT /F2 12 Tf 1 0 0 1 120.12 494.81 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 135.73 494.81 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 147.33 494.81 Tm (state) Tj ET BT /F2 12 Tf 1 0 0 1 175.59 494.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 191.86 494.81 Tm (complete) Tj ET BT /F2 12 Tf 1 0 0 1 242.11 494.81 Tm (mental) Tj ET BT /F2 12 Tf 1 0 0 1 281.04 494.81 Tm (unresponsiveness,) Tj ET BT /F2 12 Tf 1 0 0 1 374.3 494.81 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 401.91 494.81 Tm (no) Tj ET BT /F2 12 Tf 1 0 0 1 420.18 494.81 Tm (evidence) Tj ET BT /F2 12 Tf 1 0 0 1 469.09 494.81 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 485.36 494.81 Tm (appropriate) Tj ET Q q n 0 492.4 m 612 492.4 l 612 480.4 l 0 480.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 482.81 Tm (responses to stimulation.) Tj ET Q q n 0 480.4 m 612 480.4 l 612 468.4 l 0 468.4 l h W n Q q n 0 468.4 m 612 468.4 l 612 456.4 l 0 456.4 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 458.81 Tm (EXCLUSIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 87.02 458.81 Tm (Benefits will not be paid:) Tj ET Q q n 18 456.4 m 630 456.4 l 630 444.4 l 18 444.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 446.81 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 446.81 Tm (when you remain in a coma for less than 31 days in a row; or) Tj ET Q q n 18 444.4 m 630 444.4 l 630 432.4 l 18 432.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 434.81 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 434.81 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 63.29 434.81 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 84.57 434.81 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 107.19 434.81 Tm (excluded) Tj ET BT /F2 12 Tf 1 0 0 1 154.46 434.81 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 185.73 434.81 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 204.34 434.81 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 260.27 434.81 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 292.87 434.81 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 314.15 434.81 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 398.08 434.81 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 448.67 434.81 Tm (Limitations) Tj ET Q q n 45.35 432.4 m 657.35 432.4 l 657.35 420.4 l 45.35 420.4 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 422.81 Tm (section of the Policy.) Tj ET Q Q q Q Q endstream endobj 20 0 obj <>>>>> endobj 122 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 756.6 cm 0 0 0 rg BT /F4 12 Tf 1 0 0 1 201.65 3.11 Tm (SAFE DRIVER BENEFIT) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-6.15A) Tj ET BT /F2 12 Tf 1 0 0 1 442.68 26.1 Tm (Seat Belt & Air Bag) Tj ET BT /F2 10 Tf 1 0 0 1 265 14.09 Tm (18) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 58.4 cm q n 0 697.6 m 612 697.6 l 612 685.6 l 0 685.6 l h W n Q q n 0 685.6 m 612 685.6 l 612 673.6 l 0 673.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 676.01 Tm (BENEFIT.) Tj ET BT /F2 12 Tf 1 0 0 1 65.61 676.01 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 80.24 676.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 104.88 676.01 Tm (die) Tj ET BT /F2 12 Tf 1 0 0 1 126.18 676.01 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 142.82 676.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 154.79 676.01 Tm (direct) Tj ET BT /F2 12 Tf 1 0 0 1 188.74 676.01 Tm (result) Tj ET BT /F2 12 Tf 1 0 0 1 222.04 676.01 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 238.68 676.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 250.64 676.01 Tm (covered) Tj ET BT /F2 12 Tf 1 0 0 1 295.26 676.01 Tm (auto) Tj ET BT /F2 12 Tf 1 0 0 1 322.56 676.01 Tm (accident,) Tj ET BT /F2 12 Tf 1 0 0 1 372.17 676.01 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 392.8 676.01 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 428.77 676.01 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 487.38 676.01 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 676.01 Tm (and) Tj ET Q q n 0 673.6 m 612 673.6 l 612 661.6 l 0 661.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 664.01 Tm (Dismemberment Benefits are payable; then:) Tj ET Q q n 18 661.6 m 630 661.6 l 630 649.6 l 18 649.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 652.01 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 652.01 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 60.43 652.01 Tm (additional) Tj ET BT /F2 12 Tf 1 0 0 1 112.51 652.01 Tm (Seat) Tj ET BT /F2 12 Tf 1 0 0 1 137.27 652.01 Tm (Belt) Tj ET BT /F2 12 Tf 1 0 0 1 161.37 652.01 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 200.79 652.01 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 223.56 652.01 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 238.98 652.01 Tm (payable,) Tj ET BT /F2 12 Tf 1 0 0 1 283.4 652.01 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 294.83 652.01 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 316.93 652.01 Tm (were) Tj ET BT /F2 12 Tf 1 0 0 1 344.34 652.01 Tm (wearing) Tj ET BT /F2 12 Tf 1 0 0 1 387.09 652.01 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 396.51 652.01 Tm (properly) Tj ET BT /F2 12 Tf 1 0 0 1 441.27 652.01 Tm (fastened) Tj ET BT /F2 12 Tf 1 0 0 1 485.34 652.01 Tm (seat) Tj ET Q q n 45 649.6 m 657 649.6 l 657 637.6 l 45 637.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 640.01 Tm (belt at the time of the accident; and) Tj ET Q q n 18 637.6 m 630 637.6 l 630 625.6 l 18 625.6 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.01 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 628.01 Tm (an additional Air Bag Benefit will be payable, if the auto was equipped with air bag\(s\).) Tj ET Q q n 0 611.8 m 612 611.8 l 612 599.8 l 0 599.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 602.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.28 602.21 Tm (Seat) Tj ET BT /F2 12 Tf 1 0 0 1 46.56 602.21 Tm (Belt) Tj ET BT /F2 12 Tf 1 0 0 1 70.17 602.21 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 109.11 602.21 Tm (equals) Tj ET BT /F2 12 Tf 1 0 0 1 143.39 602.21 Tm ($10,000) Tj ET BT /F2 12 Tf 1 0 0 1 186.01 602.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 199.63 602.21 Tm (10%) Tj ET BT /F2 12 Tf 1 0 0 1 225.25 602.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 238.86 602.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 257.14 602.21 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 304.09 602.21 Tm (Sum,) Tj ET BT /F2 12 Tf 1 0 0 1 332.71 602.21 Tm (whichever) Tj ET BT /F2 12 Tf 1 0 0 1 386.31 602.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 397.93 602.21 Tm (less;) Tj ET BT /F2 12 Tf 1 0 0 1 422.89 602.21 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 443.83 602.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 462.11 602.21 Tm (Air) Tj ET BT /F2 12 Tf 1 0 0 1 481.73 602.21 Tm (Bag) Tj ET BT /F2 12 Tf 1 0 0 1 504.68 602.21 Tm (Benefit) Tj ET Q q n 0 599.8 m 612 599.8 l 612 587.8 l 0 587.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 590.21 Tm (equals) Tj ET BT /F2 12 Tf 1 0 0 1 34.11 590.21 Tm ($10,000) Tj ET BT /F2 12 Tf 1 0 0 1 76.57 590.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 90.02 590.21 Tm (10%) Tj ET BT /F2 12 Tf 1 0 0 1 115.47 590.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 128.92 590.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 147.04 590.21 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 193.82 590.21 Tm (Sum,) Tj ET BT /F2 12 Tf 1 0 0 1 222.28 590.21 Tm (whichever) Tj ET BT /F2 12 Tf 1 0 0 1 275.71 590.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 287.17 590.21 Tm (less.) Tj ET BT /F2 12 Tf 1 0 0 1 315.09 590.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 337.2 590.21 Tm (Seat) Tj ET BT /F2 12 Tf 1 0 0 1 361.31 590.21 Tm (Belt) Tj ET BT /F2 12 Tf 1 0 0 1 384.77 590.21 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 423.54 590.21 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 444.33 590.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 462.44 590.21 Tm (Air) Tj ET BT /F2 12 Tf 1 0 0 1 481.89 590.21 Tm (Bag) Tj ET BT /F2 12 Tf 1 0 0 1 504.68 590.21 Tm (Benefit) Tj ET Q q n 0 587.8 m 612 587.8 l 612 575.8 l 0 575.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 578.21 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 24.33 578.21 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 45.33 578.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 62.32 578.21 Tm (less) Tj ET BT /F2 12 Tf 1 0 0 1 85.98 578.21 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 112.3 578.21 Tm ($1,000.) Tj ET BT /F2 12 Tf 1 0 0 1 159.63 578.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 183.95 578.21 Tm (Principal) Tj ET BT /F2 12 Tf 1 0 0 1 232.94 578.21 Tm (Sum) Tj ET BT /F2 12 Tf 1 0 0 1 260.61 578.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 274.27 578.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 294.6 578.21 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 336.26 578.21 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 379.23 578.21 Tm (because) Tj ET BT /F2 12 Tf 1 0 0 1 422.87 578.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 438.53 578.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 458.85 578.21 Tm (Insured) Tj ET BT /F2 12 Tf 1 0 0 1 500.5 578.21 Tm (Person's) Tj ET Q q n 0 575.8 m 612 575.8 l 612 563.8 l 0 563.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 566.21 Tm (accidental death.) Tj ET Q q n 0 563.8 m 612 563.8 l 612 551.8 l 0 551.8 l h W n Q q n 0 551.8 m 612 551.8 l 612 539.8 l 0 539.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 542.21 Tm (A) Tj ET BT /F2 12 Tf 1 0 0 1 11.85 542.21 Tm (copy) Tj ET BT /F2 12 Tf 1 0 0 1 38.35 542.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 51.53 542.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 69.37 542.21 Tm (police) Tj ET BT /F2 12 Tf 1 0 0 1 101.87 542.21 Tm (report) Tj ET BT /F2 12 Tf 1 0 0 1 133.71 542.21 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 160.22 542.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 174.73 542.21 Tm (submitted) Tj ET BT /F2 12 Tf 1 0 0 1 225.24 542.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 249.76 542.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 267.6 542.21 Tm (claim.) Tj ET BT /F2 12 Tf 1 0 0 1 303.61 542.21 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 325.45 542.21 Tm (position) Tj ET BT /F2 12 Tf 1 0 0 1 367.3 542.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 380.48 542.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 398.32 542.21 Tm (seat) Tj ET BT /F2 12 Tf 1 0 0 1 420.16 542.21 Tm (belt) Tj ET BT /F2 12 Tf 1 0 0 1 441.33 542.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 454.51 542.21 Tm (presence) Tj ET BT /F2 12 Tf 1 0 0 1 499.66 542.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 512.84 542.21 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 527.34 542.21 Tm (air) Tj ET Q q n 0 539.8 m 612 539.8 l 612 527.8 l 0 527.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 530.21 Tm (bag must be certified by:) Tj ET Q q n 18 527.8 m 630 527.8 l 630 515.8 l 18 515.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 518.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 518.21 Tm (the official accident report; or) Tj ET Q q n 18 515.8 m 630 515.8 l 630 503.8 l 18 503.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 506.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 506.21 Tm (the coroner, traffic officer or other investigating officer.) Tj ET Q q n 0 503.8 m 612 503.8 l 612 491.8 l 0 491.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 494.21 Tm (Upon) Tj ET BT /F2 12 Tf 1 0 0 1 31.2 494.21 Tm (receipt) Tj ET BT /F2 12 Tf 1 0 0 1 68.37 494.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 82.9 494.21 Tm (satisfactory) Tj ET BT /F2 12 Tf 1 0 0 1 142.75 494.21 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 181.27 494.21 Tm (proof,) Tj ET BT /F2 12 Tf 1 0 0 1 214.79 494.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 233.98 494.21 Tm (additional) Tj ET BT /F2 12 Tf 1 0 0 1 286.5 494.21 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 324.35 494.21 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 347.55 494.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 363.41 494.21 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 388.6 494.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 402.47 494.21 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 438.97 494.21 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 464.84 494.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 484.03 494.21 Tm (Beneficiary) Tj ET Q q n 0 491.8 m 612 491.8 l 612 479.8 l 0 479.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 482.21 Tm (section.) Tj ET Q q n 0 479.8 m 612 479.8 l 612 467.8 l 0 467.8 l h W n Q q n 0 467.8 m 612 467.8 l 612 455.8 l 0 455.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 458.21 Tm (DEFINITIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 83.66 458.21 Tm (As used in this provision:) Tj ET Q q n 0 455.8 m 612 455.8 l 612 443.8 l 0 443.8 l h W n Q q n 0 443.8 m 612 443.8 l 612 431.8 l 0 431.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 434.21 Tm ("Auto") Tj ET BT /F2 12 Tf 1 0 0 1 37.37 434.21 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 71.61 434.21 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 80.51 434.21 Tm (4-wheel) Tj ET BT /F2 12 Tf 1 0 0 1 122.74 434.21 Tm (passenger) Tj ET BT /F2 12 Tf 1 0 0 1 173.63 434.21 Tm (car,) Tj ET BT /F2 12 Tf 1 0 0 1 194.85 434.21 Tm (station) Tj ET BT /F2 12 Tf 1 0 0 1 230.43 434.21 Tm (wagon,) Tj ET BT /F2 12 Tf 1 0 0 1 269 434.21 Tm (jeep,) Tj ET BT /F2 12 Tf 1 0 0 1 295.56 434.21 Tm (pick-up) Tj ET BT /F2 12 Tf 1 0 0 1 335.79 434.21 Tm (truck) Tj ET BT /F2 12 Tf 1 0 0 1 364.03 434.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 377.6 434.21 Tm (van-type) Tj ET BT /F2 12 Tf 1 0 0 1 423.16 434.21 Tm (car.) Tj ET BT /F2 12 Tf 1 0 0 1 447.96 434.21 Tm (It) Tj ET BT /F2 12 Tf 1 0 0 1 458.87 434.21 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 485.78 434.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 500.68 434.21 Tm (licensed) Tj ET Q q n 0 431.8 m 612 431.8 l 612 419.8 l 0 419.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 422.21 Tm (for use on public highways.) Tj ET BT /F2 12 Tf 1 0 0 1 138.98 422.21 Tm (It includes a car owned or leased by the Employer.) Tj ET Q q n 0 419.8 m 612 419.8 l 612 407.8 l 0 407.8 l h W n Q q n 0 407.8 m 612 407.8 l 612 395.8 l 0 395.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 398.21 Tm ("Intoxicated,") Tj ET BT /F2 12 Tf 1 0 0 1 70.7 398.21 Tm ("Impaired,") Tj ET BT /F2 12 Tf 1 0 0 1 130.73 398.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 144.65 398.21 Tm ("Under) Tj ET BT /F2 12 Tf 1 0 0 1 183.46 398.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 202.04 398.21 Tm (Influence) Tj ET BT /F2 12 Tf 1 0 0 1 251.27 398.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 265.19 398.21 Tm (Drugs") Tj ET BT /F2 12 Tf 1 0 0 1 303.35 398.21 Tm (shall) Tj ET BT /F2 12 Tf 1 0 0 1 329.93 398.21 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 345.18 398.21 Tm (defined) Tj ET BT /F2 12 Tf 1 0 0 1 385.09 398.21 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 399.01 398.21 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 414.93 398.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 433.52 398.21 Tm (jurisdiction) Tj ET BT /F2 12 Tf 1 0 0 1 492.1 398.21 Tm (where) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 398.21 Tm (the) Tj ET Q q n 0 395.8 m 612 395.8 l 612 383.8 l 0 383.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 386.21 Tm (accident occurs.) Tj ET Q q n 0 383.8 m 612 383.8 l 612 371.8 l 0 371.8 l h W n Q q n 0 371.8 m 612 371.8 l 612 359.8 l 0 359.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 362.21 Tm ("Seat Belt" means a properly installed:) Tj ET Q q n 18 359.8 m 630 359.8 l 630 347.8 l 18 347.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 350.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 350.21 Tm (seat belt or lap and shoulder restraint; or) Tj ET Q q n 18 347.8 m 630 347.8 l 630 335.8 l 18 335.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 338.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 338.21 Tm (other restraint approved by the National Highway Traffic Safety Administration.) Tj ET Q q n 0 335.8 m 612 335.8 l 612 323.8 l 0 323.8 l h W n Q q n 0 323.8 m 612 323.8 l 612 311.8 l 0 311.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 314.21 Tm (LIMITATIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 86.32 314.21 Tm (Safe Driver Benefits will not be paid if:) Tj ET Q q n 18 311.8 m 630 311.8 l 630 299.8 l 18 299.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 302.21 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 302.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 62.84 302.21 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 117.98 302.21 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 149.81 302.21 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 170.31 302.21 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 253.47 302.21 Tm (Benefits) Tj ET BT /F2 12 Tf 1 0 0 1 296.64 302.21 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 307.82 302.21 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 326.33 302.21 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 350.16 302.21 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 380.66 302.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 398.5 302.21 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 432.34 302.21 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 449.51 302.21 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 474.68 302.21 Tm (death;) Tj ET Q q n 45 299.8 m 657 299.8 l 657 287.8 l 45 287.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 290.21 Tm (or) Tj ET Q q n 18 287.8 m 630 287.8 l 630 275.8 l 18 275.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 278.21 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 278.21 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 58.04 278.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 77.07 278.21 Tm (time) Tj ET BT /F2 12 Tf 1 0 0 1 102.78 278.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 117.15 278.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 136.19 278.21 Tm (accident,) Tj ET BT /F2 12 Tf 1 0 0 1 183.54 278.21 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 205.91 278.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 220.29 278.21 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 241.99 278.21 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 271.02 278.21 Tm (person) Tj ET BT /F2 12 Tf 1 0 0 1 307.39 278.21 Tm (who) Tj ET BT /F2 12 Tf 1 0 0 1 332.43 278.21 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 355.47 278.21 Tm (driving) Tj ET BT /F2 12 Tf 1 0 0 1 394.51 278.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 413.55 278.21 Tm (auto) Tj ET BT /F2 12 Tf 1 0 0 1 438.59 278.21 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 452.3 278.21 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 486 278.21 Tm (you) Tj ET Q q n 45 275.8 m 657 275.8 l 657 263.8 l 45 263.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 266.21 Tm (were traveling:) Tj ET Q q n 45 263.8 m 657 263.8 l 657 251.8 l 45 251.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 254.21 Tm (\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 254.21 Tm (was driving without a valid drivers' license;) Tj ET Q q n 45 251.8 m 657 251.8 l 657 239.8 l 45 239.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 242.21 Tm (\(b\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 242.21 Tm (was driving in excess of the legal speed limit; or) Tj ET Q q n 45 239.8 m 657 239.8 l 657 227.8 l 45 227.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 230.21 Tm (\(c\)) Tj ET BT /F2 12 Tf 1 0 0 1 72 230.21 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 94.8 230.21 Tm (driving) Tj ET BT /F2 12 Tf 1 0 0 1 133.59 230.21 Tm (while) Tj ET BT /F2 12 Tf 1 0 0 1 164.38 230.21 Tm (intoxicated,) Tj ET BT /F2 12 Tf 1 0 0 1 224.83 230.21 Tm (impaired,) Tj ET BT /F2 12 Tf 1 0 0 1 274.61 230.21 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 288.74 230.21 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 320.2 230.21 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 338.99 230.21 Tm (influence) Tj ET BT /F2 12 Tf 1 0 0 1 387.76 230.21 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 401.89 230.21 Tm (drugs) Tj ET BT /F2 12 Tf 1 0 0 1 432.69 230.21 Tm (\(except) Tj ET Q q n 72 227.8 m 684 227.8 l 684 215.8 l 72 215.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 72 218.21 Tm (for drugs taken as prescribed by a Physician for the driver's use\).) Tj ET Q q n 45 215.8 m 657 215.8 l 657 203.8 l 45 203.8 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 206.21 Tm (The above limitations will apply, whether or not the driver is convicted.) Tj ET Q q n 0 203.8 m 612 203.8 l 612 191.8 l 0 191.8 l h W n Q Q q Q Q endstream endobj 21 0 obj <>>>>> endobj 124 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 746.4 cm q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 203.16 14.41 Tm (CLAIMS PROCEDURES) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 63.81 2.41 Tm (FOR LIFE OR ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS) Tj ET Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-8A 02 PA) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 26.1 Tm (L/ADD) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (19) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 72.2 cm q n 0 674.2 m 612 674.2 l 612 662.2 l 0 662.2 l h W n Q q n 0 662.2 m 612 662.2 l 612 650.2 l 0 650.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 652.61 Tm (NOTE:) Tj ET BT /F4 12 Tf 1 0 0 1 44.64 652.61 Tm (The) Tj ET BT /F4 12 Tf 1 0 0 1 67.96 652.61 Tm (Policy) Tj ET BT /F4 12 Tf 1 0 0 1 102.6 652.61 Tm (may) Tj ET BT /F4 12 Tf 1 0 0 1 127.91 652.61 Tm (include) Tj ET BT /F4 12 Tf 1 0 0 1 168.57 652.61 Tm (an) Tj ET BT /F4 12 Tf 1 0 0 1 184.56 652.61 Tm (Extension) Tj ET BT /F4 12 Tf 1 0 0 1 238.55 652.61 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 251.86 652.61 Tm (Death) Tj ET BT /F4 12 Tf 1 0 0 1 285.84 652.61 Tm (Benefit,) Tj ET BT /F4 12 Tf 1 0 0 1 328.81 652.61 Tm (an) Tj ET BT /F4 12 Tf 1 0 0 1 344.8 652.61 Tm (Accelerated) Tj ET BT /F4 12 Tf 1 0 0 1 408.75 652.61 Tm (Death) Tj ET BT /F4 12 Tf 1 0 0 1 442.72 652.61 Tm (Benefit) Tj ET BT /F4 12 Tf 1 0 0 1 482.7 652.61 Tm (or) Tj ET BT /F4 12 Tf 1 0 0 1 497.34 652.61 Tm (a) Tj ET BT /F4 12 Tf 1 0 0 1 506.65 652.61 Tm (Living) Tj ET Q q n 0 650.2 m 612 650.2 l 612 638.2 l 0 638.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 640.61 Tm (Benefit.) Tj ET BT /F4 12 Tf 1 0 0 1 45.66 640.61 Tm (If so, please refer to that section for special claim procedures.) Tj ET Q q n 0 638.2 m 612 638.2 l 612 626.2 l 0 626.2 l h W n Q q n 0 626.2 m 612 626.2 l 612 614.2 l 0 614.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 616.61 Tm (NOTICE AND PROOF OF CLAIM) Tj ET Q q n 0 614.2 m 612 614.2 l 612 602.2 l 0 602.2 l h W n Q q n 0 602.2 m 612 602.2 l 612 590.2 l 0 590.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 592.61 Tm (Notice) Tj ET BT /F4 12 Tf 1 0 0 1 36.05 592.61 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 49.44 592.61 Tm (Claim.) Tj ET BT /F2 12 Tf 1 0 0 1 90.57 592.61 Tm (Written) Tj ET BT /F2 12 Tf 1 0 0 1 130.61 592.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 163.33 592.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 176.73 592.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 191.45 592.61 Tm (accidental) Tj ET BT /F2 12 Tf 1 0 0 1 243.48 592.61 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 272.87 592.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 286.26 592.61 Tm (dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 366.97 592.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 397.02 592.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 423.76 592.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 438.48 592.61 Tm (given) Tj ET BT /F2 12 Tf 1 0 0 1 468.54 592.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 502.61 592.61 Tm (20) Tj ET BT /F2 12 Tf 1 0 0 1 518 592.61 Tm (days) Tj ET Q q n 0 590.2 m 612 590.2 l 612 578.2 l 0 578.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 25.86 580.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 44.4 580.61 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 66.96 580.61 Tm (occurs;) Tj ET BT /F2 12 Tf 1 0 0 1 105.49 580.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 119.37 580.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 133.25 580.61 Tm (soon) Tj ET BT /F2 12 Tf 1 0 0 1 159.8 580.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 173.68 580.61 Tm (reasonably) Tj ET BT /F2 12 Tf 1 0 0 1 229.54 580.61 Tm (possible) Tj ET BT /F2 12 Tf 1 0 0 1 272.75 580.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 298.61 580.61 Tm (that.) Tj ET BT /F4 12 Tf 1 0 0 1 319.61 580.61 Tm (*) Tj ET BT /F2 12 Tf 1 0 0 1 333.37 580.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 355.91 580.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 389.11 580.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 416.33 580.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 431.54 580.61 Tm (sent) Tj ET BT /F2 12 Tf 1 0 0 1 454.75 580.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 467.96 580.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 486.5 580.61 Tm (Company's) Tj ET Q q n 0 578.2 m 612 578.2 l 612 566.2 l 0 566.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.61 Tm (Group Insurance Service Office.) Tj ET BT /F2 12 Tf 1 0 0 1 161.93 568.61 Tm (It should include:) Tj ET Q q n 18 566.2 m 630 566.2 l 630 554.2 l 18 554.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 556.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 556.61 Tm (your name and address; and) Tj ET Q q n 18 554.2 m 630 554.2 l 630 542.2 l 18 542.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 544.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 544.61 Tm (the number of the Policy.) Tj ET Q q n 0 542.2 m 612 542.2 l 612 530.2 l 0 530.2 l h W n Q q n 0 530.2 m 612 530.2 l 612 518.2 l 0 518.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 520.61 Tm (Claim) Tj ET BT /F4 12 Tf 1 0 0 1 35.49 520.61 Tm (Forms.) Tj ET BT /F2 12 Tf 1 0 0 1 80.12 520.61 Tm (When) Tj ET BT /F2 12 Tf 1 0 0 1 112.93 520.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 146.41 520.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 160.56 520.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 191.37 520.61 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 203.53 520.61 Tm (received,) Tj ET BT /F2 12 Tf 1 0 0 1 251.32 520.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 270.14 520.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 320.96 520.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 343.79 520.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 369.94 520.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 400.75 520.61 Tm (forms) Tj ET BT /F2 12 Tf 1 0 0 1 432.9 520.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 451.05 520.61 Tm (filing) Tj ET BT /F2 12 Tf 1 0 0 1 481.21 520.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 500.02 520.61 Tm (required) Tj ET Q q n 0 518.2 m 612 518.2 l 612 506.2 l 0 506.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 508.61 Tm (proof.) Tj ET BT /F2 12 Tf 1 0 0 1 35.04 508.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 46.05 508.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 63.74 508.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 113.42 508.61 Tm (does) Tj ET BT /F2 12 Tf 1 0 0 1 138.44 508.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 156.8 508.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 181.82 508.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 199.5 508.61 Tm (forms) Tj ET BT /F2 12 Tf 1 0 0 1 230.52 508.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 264.21 508.61 Tm (15) Tj ET BT /F2 12 Tf 1 0 0 1 279.24 508.61 Tm (days;) Tj ET BT /F2 12 Tf 1 0 0 1 307.59 508.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 331.27 508.61 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 352.3 508.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 365.32 508.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 390.34 508.61 Tm (Beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 449.33 508.61 Tm (\(the) Tj ET BT /F2 12 Tf 1 0 0 1 471.01 508.61 Tm (claimant\)) Tj ET BT /F2 12 Tf 1 0 0 1 519.34 508.61 Tm (may) Tj ET Q q n 0 506.2 m 612 506.2 l 612 494.2 l 0 494.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.61 Tm (send the Company written proof of claim in a letter. It should state the nature, date and cause of the loss.) Tj ET Q q n 0 494.2 m 612 494.2 l 612 482.2 l 0 482.2 l h W n Q q n 0 482.2 m 612 482.2 l 612 470.2 l 0 470.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 472.61 Tm (Proof) Tj ET BT /F4 12 Tf 1 0 0 1 32.26 472.61 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 45.87 472.61 Tm (Claim.) Tj ET BT /F2 12 Tf 1 0 0 1 87.42 472.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 109.68 472.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 159.95 472.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 186.9 472.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 201.84 472.61 Tm (given) Tj ET BT /F2 12 Tf 1 0 0 1 232.11 472.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 269.7 472.61 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 299.31 472.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 312.91 472.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 343.17 472.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 377.45 472.61 Tm (90) Tj ET BT /F2 12 Tf 1 0 0 1 393.06 472.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 418.67 472.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 444.25 472.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 462.52 472.61 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 486.12 472.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 499.72 472.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 517.99 472.61 Tm (loss;) Tj ET Q q n 0 470.2 m 612 470.2 l 612 458.2 l 0 458.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 460.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 13.11 460.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 26.21 460.61 Tm (soon) Tj ET BT /F2 12 Tf 1 0 0 1 51.99 460.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 65.1 460.61 Tm (reasonably) Tj ET BT /F2 12 Tf 1 0 0 1 120.19 460.61 Tm (possible) Tj ET BT /F2 12 Tf 1 0 0 1 162.63 460.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 187.72 460.61 Tm (that.) Tj ET BT /F4 12 Tf 1 0 0 1 208.71 460.61 Tm (*) Tj ET BT /F2 12 Tf 1 0 0 1 220.93 460.61 Tm (Proof) Tj ET BT /F2 12 Tf 1 0 0 1 250.71 460.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 263.82 460.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 293.58 460.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 320.03 460.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 334.46 460.61 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 380.23 460.61 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 392 460.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 409.77 460.61 Tm (claimant's) Tj ET BT /F2 12 Tf 1 0 0 1 461.03 460.61 Tm (own) Tj ET BT /F2 12 Tf 1 0 0 1 484.8 460.61 Tm (expense.) Tj ET BT /F2 12 Tf 1 0 0 1 532.67 460.61 Tm (It) Tj ET Q q n 0 458.2 m 612 458.2 l 612 446.2 l 0 446.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 448.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 27.23 448.61 Tm (show) Tj ET BT /F2 12 Tf 1 0 0 1 56.45 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 75 448.61 Tm (nature,) Tj ET BT /F2 12 Tf 1 0 0 1 111.88 448.61 Tm (date) Tj ET BT /F2 12 Tf 1 0 0 1 135.75 448.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 156.97 448.61 Tm (cause) Tj ET BT /F2 12 Tf 1 0 0 1 187.51 448.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 201.39 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 219.94 448.61 Tm (loss.) Tj ET BT /F2 12 Tf 1 0 0 1 249.4 448.61 Tm (In) Tj ET BT /F2 12 Tf 1 0 0 1 263.28 448.61 Tm (addition) Tj ET BT /F2 12 Tf 1 0 0 1 306.5 448.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 319.73 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 338.28 448.61 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 398.82 448.61 Tm (requested) Tj ET BT /F2 12 Tf 1 0 0 1 448.69 448.61 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 464.58 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 483.13 448.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 513.67 448.61 Tm (form,) Tj ET Q q n 0 446.2 m 612 446.2 l 612 434.2 l 0 434.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.61 Tm (documentation must include:) Tj ET Q q n 18 434.2 m 630 434.2 l 630 422.2 l 18 422.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 424.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 424.61 Tm (A certified copy of the death certificate, for proof of death.) Tj ET Q q n 18 422.2 m 630 422.2 l 630 410.2 l 18 410.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 412.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 412.61 Tm (A copy of any police report, for proof of accidental death or dismemberment.) Tj ET Q q n 18 410.2 m 630 410.2 l 630 398.2 l 18 398.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 400.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 400.61 Tm (A signed authorization for the Company to obtain more information.) Tj ET Q q n 18 398.2 m 630 398.2 l 630 386.2 l 18 386.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 388.61 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 388.61 Tm (Any other items the Company may reasonably require in support of the claim.) Tj ET Q q n 18 386.2 m 630 386.2 l 630 374.2 l 18 374.2 l h W n Q q n 0 374.2 m 612 374.2 l 612 362.2 l 0 362.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 364.61 Tm (*) Tj ET BT /F4 12 Tf 1 0 0 1 9.16 364.61 Tm (Exception:) Tj ET BT /F2 12 Tf 1 0 0 1 70.82 364.61 Tm (Failure) Tj ET BT /F2 12 Tf 1 0 0 1 107.98 364.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 120.48 364.61 Tm (give) Tj ET BT /F2 12 Tf 1 0 0 1 144.3 364.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 176.79 364.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 189.95 364.61 Tm (furnish) Tj ET BT /F2 12 Tf 1 0 0 1 227.11 364.61 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 256.26 364.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 269.42 364.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 299.24 364.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 333.07 364.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 350.9 364.61 Tm (required) Tj ET BT /F2 12 Tf 1 0 0 1 394.04 364.61 Tm (time) Tj ET BT /F2 12 Tf 1 0 0 1 418.53 364.61 Tm (period) Tj ET BT /F2 12 Tf 1 0 0 1 452.36 364.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 474.19 364.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 492.69 364.61 Tm (invalidate) Tj ET Q q n 0 362.2 m 612 362.2 l 612 350.2 l 0 350.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.61 Tm (or reduce the claim; if it is shown that it was done:) Tj ET Q q n 18 350.2 m 630 350.2 l 630 338.2 l 18 338.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 340.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 340.61 Tm (as soon as reasonably possible; and) Tj ET Q q n 18 338.2 m 630 338.2 l 630 326.2 l 18 326.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 328.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 328.61 Tm (in no event more than one year after it was required.) Tj ET Q q n 0 326.2 m 612 326.2 l 612 314.2 l 0 314.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 316.61 Tm (These time limits will not apply while the claimant lacks legal capacity.) Tj ET Q q n 0 314.2 m 612 314.2 l 612 302.2 l 0 302.2 l h W n Q q n 0 302.2 m 612 302.2 l 612 290.2 l 0 290.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 292.61 Tm (EXAM OR AUTOPSY.) Tj ET BT /F2 12 Tf 1 0 0 1 127 292.61 Tm (At anytime while a claim is pending, the Company may have you examined:) Tj ET Q q n 18 290.2 m 630 290.2 l 630 278.2 l 18 278.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 280.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 280.61 Tm (by a Physician of the Company's choice;) Tj ET Q q n 18 278.2 m 630 278.2 l 630 266.2 l 18 266.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 268.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 268.61 Tm (as often as reasonably required.) Tj ET Q q n 0 266.2 m 612 266.2 l 612 254.2 l 0 254.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 256.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 11.78 256.61 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 33.58 256.61 Tm (fail) Tj ET BT /F2 12 Tf 1 0 0 1 53.36 256.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 66.48 256.61 Tm (cooperate) Tj ET BT /F2 12 Tf 1 0 0 1 116.91 256.61 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 142.04 256.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 157.15 256.61 Tm (examiner) Tj ET BT /F2 12 Tf 1 0 0 1 205.59 256.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 219.37 256.61 Tm (fail) Tj ET BT /F2 12 Tf 1 0 0 1 239.16 256.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 252.28 256.61 Tm (take) Tj ET BT /F2 12 Tf 1 0 0 1 276.06 256.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 291.18 256.61 Tm (exam,) Tj ET BT /F2 12 Tf 1 0 0 1 323.95 256.61 Tm (without) Tj ET BT /F2 12 Tf 1 0 0 1 364.42 256.61 Tm (good) Tj ET BT /F2 12 Tf 1 0 0 1 392.21 256.61 Tm (cause;) Tj ET BT /F2 12 Tf 1 0 0 1 425.98 256.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 450.43 256.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 468.88 256.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 519.34 256.61 Tm (may) Tj ET Q q n 0 254.2 m 612 254.2 l 612 242.2 l 0 242.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 244.61 Tm (deny) Tj ET BT /F2 12 Tf 1 0 0 1 27.72 244.61 Tm (benefits,) Tj ET BT /F2 12 Tf 1 0 0 1 73.1 244.61 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 99.5 244.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 118.55 244.61 Tm (exam) Tj ET BT /F2 12 Tf 1 0 0 1 148.93 244.61 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 161.33 244.61 Tm (completed.) Tj ET BT /F2 12 Tf 1 0 0 1 223.09 244.61 Tm (In) Tj ET BT /F2 12 Tf 1 0 0 1 237.48 244.61 Tm (case) Tj ET BT /F2 12 Tf 1 0 0 1 262.53 244.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 276.92 244.61 Tm (death,) Tj ET BT /F2 12 Tf 1 0 0 1 310.3 244.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 329.35 244.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 380.41 244.61 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 405.46 244.61 Tm (also) Tj ET BT /F2 12 Tf 1 0 0 1 429.18 244.61 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 456.23 244.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 471.95 244.61 Tm (autopsy) Tj ET BT /F2 12 Tf 1 0 0 1 513.67 244.61 Tm (done,) Tj ET Q q n 0 242.2 m 612 242.2 l 612 230.2 l 0 230.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 232.61 Tm (where it is not forbidden by law.) Tj ET BT /F2 12 Tf 1 0 0 1 162.3 232.61 Tm (Any such exam or autopsy will be at the Company's expense.) Tj ET Q q n 0 230.2 m 612 230.2 l 612 218.2 l 0 218.2 l h W n Q q n 0 218.2 m 612 218.2 l 612 206.2 l 0 206.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 208.61 Tm (TIME) Tj ET BT /F4 12 Tf 1 0 0 1 35.87 208.61 Tm (OF) Tj ET BT /F4 12 Tf 1 0 0 1 56.39 208.61 Tm (PAYMENT) Tj ET BT /F4 12 Tf 1 0 0 1 120.91 208.61 Tm (OF) Tj ET BT /F4 12 Tf 1 0 0 1 141.44 208.61 Tm (CLAIMS.) Tj ET BT /F2 12 Tf 1 0 0 1 200.16 208.61 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 224.69 208.61 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 266.54 208.61 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 307.71 208.61 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 338.89 208.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 357.41 208.61 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 391.94 208.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 414.47 208.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 429.66 208.61 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 454.18 208.61 Tm (immediately) Tj ET BT /F2 12 Tf 1 0 0 1 518.02 208.61 Tm (after) Tj ET Q q n 0 206.2 m 612 206.2 l 612 194.2 l 0 194.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 196.61 Tm (the Company receives complete proof of claim and confirms liability.) Tj ET Q q n 0 194.2 m 612 194.2 l 612 182.2 l 0 182.2 l h W n Q q n 0 182.2 m 612 182.2 l 612 170.2 l 0 170.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 172.61 Tm (TO WHOM PAYABLE) Tj ET Q q n 0 170.2 m 612 170.2 l 612 158.2 l 0 158.2 l h W n Q q n 0 158.2 m 612 158.2 l 612 146.2 l 0 146.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 148.61 Tm (Death.) Tj ET BT /F2 12 Tf 1 0 0 1 41.75 148.61 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 66.47 148.61 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 108.5 148.61 Tm (payable) Tj ET BT /F2 12 Tf 1 0 0 1 149.85 148.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 167.89 148.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 193.93 148.61 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 223.97 148.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 246.68 148.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 262.05 148.61 Tm (paid) Tj ET BT /F2 12 Tf 1 0 0 1 286.76 148.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 300.14 148.61 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 336.16 148.61 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 361.54 148.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 380.24 148.61 Tm (Beneficiary,) Tj ET BT /F2 12 Tf 1 0 0 1 443.26 148.61 Tm (Facility) Tj ET BT /F2 12 Tf 1 0 0 1 483.96 148.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 498.01 148.61 Tm (Payment) Tj ET Q q n 0 146.2 m 612 146.2 l 612 134.2 l 0 134.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 136.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 22.52 136.61 Tm (Settlement) Tj ET BT /F2 12 Tf 1 0 0 1 79.04 136.61 Tm (Options) Tj ET BT /F2 12 Tf 1 0 0 1 122.24 136.61 Tm (sections) Tj ET BT /F2 12 Tf 1 0 0 1 166.09 136.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 181.29 136.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 201.14 136.61 Tm (Policy.) Tj ET BT /F2 12 Tf 1 0 0 1 245.2 136.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 258.39 136.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 278.24 136.61 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 314.11 136.61 Tm (includes) Tj ET BT /F2 12 Tf 1 0 0 1 359.29 136.61 Tm (Dependent) Tj ET BT /F2 12 Tf 1 0 0 1 416.47 136.61 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 441.65 136.61 Tm (Insurance;) Tj ET BT /F2 12 Tf 1 0 0 1 496.82 136.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 136.61 Tm (any) Tj ET Q q n 0 134.2 m 612 134.2 l 612 122.2 l 0 122.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 124.61 Tm (benefits payable for an insured Dependent's death will be paid to:) Tj ET Q q n 18 122.2 m 630 122.2 l 630 110.2 l 18 110.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 112.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 112.61 Tm (you, if you survive that Dependent; or) Tj ET Q q n 18 110.2 m 630 110.2 l 630 98.2 l 18 98.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 100.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 100.61 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 70.67 100.61 Tm (Beneficiary,) Tj ET BT /F2 12 Tf 1 0 0 1 133.31 100.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 146.98 100.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 159.99 100.61 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 195.64 100.61 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 220.64 100.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 238.98 100.61 Tm (Facility) Tj ET BT /F2 12 Tf 1 0 0 1 279.31 100.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 292.98 100.61 Tm (Payment) Tj ET BT /F2 12 Tf 1 0 0 1 338.65 100.61 Tm (section;) Tj ET BT /F2 12 Tf 1 0 0 1 379.65 100.61 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 390.65 100.61 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 412.33 100.61 Tm (do) Tj ET BT /F2 12 Tf 1 0 0 1 428 100.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 447.01 100.61 Tm (survive) Tj ET BT /F2 12 Tf 1 0 0 1 486.01 100.61 Tm (that) Tj ET Q q n 45 98.2 m 657 98.2 l 657 86.2 l 45 86.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45 88.61 Tm (Dependent.) Tj ET Q q n 0 86.2 m 612 86.2 l 612 74.2 l 0 74.2 l h W n Q q n 0 74.2 m 612 74.2 l 612 62.2 l 0 62.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 64.61 Tm (Dismemberment.) Tj ET BT /F2 12 Tf 1 0 0 1 97.97 64.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 110.8 64.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 130.29 64.61 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 165.79 64.61 Tm (includes) Tj ET BT /F2 12 Tf 1 0 0 1 210.61 64.61 Tm (Accidental) Tj ET BT /F2 12 Tf 1 0 0 1 267.42 64.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 300.9 64.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 323.06 64.61 Tm (Dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 407.88 64.61 Tm (Benefits;) Tj ET BT /F2 12 Tf 1 0 0 1 456.03 64.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 481.53 64.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 503.68 64.61 Tm (benefit,) Tj ET Q q n 0 62.2 m 612 62.2 l 612 50.2 l 0 50.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 52.61 Tm (other than your death benefit, will be paid to you.) Tj ET Q q n 0 50.2 m 612 50.2 l 612 38.2 l 0 38.2 l h W n Q Q q Q Q endstream endobj 22 0 obj <>>>>> endobj 125 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 734.4 cm q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 203.16 26.41 Tm (CLAIMS PROCEDURES) Tj ET Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 239 14.41 Tm (\(Continued\)) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-8A 02 PA) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 26.1 Tm (L/ADD) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (20) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 72.2 cm q n 0 662.2 m 612 662.2 l 612 650.2 l 0 650.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 652.61 Tm (NOTICE) Tj ET BT /F4 12 Tf 1 0 0 1 53.2 652.61 Tm (OF) Tj ET BT /F4 12 Tf 1 0 0 1 75.72 652.61 Tm (CLAIM) Tj ET BT /F4 12 Tf 1 0 0 1 122.91 652.61 Tm (DECISION.) Tj ET BT /F2 12 Tf 1 0 0 1 196.98 652.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 221.49 652.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 274.02 652.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 298.54 652.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 326.39 652.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 346.91 652.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 394.09 652.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 405.27 652.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 445.12 652.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 480.3 652.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 496.15 652.61 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 513.35 652.61 Tm (claim) Tj ET Q q n 0 650.2 m 612 650.2 l 612 638.2 l 0 638.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.61 Tm (decision.) Tj ET BT /F2 12 Tf 1 0 0 1 48.99 640.61 Tm (If the Company denies any part of the claim; then the written notice will explain:) Tj ET Q q n 18 638.2 m 630 638.2 l 630 626.2 l 18 626.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 628.61 Tm (the reason for the denial, under the terms of the Policy and any internal guidelines;) Tj ET Q q n 18 626.2 m 630 626.2 l 630 614.2 l 18 614.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 616.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 616.61 Tm (how the claimant may request a review of the Company's decision; and) Tj ET Q q n 18 614.2 m 630 614.2 l 630 602.2 l 18 602.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 604.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 604.61 Tm (whether more information is needed to support the claim.) Tj ET Q q n 0 602.2 m 612 602.2 l 612 590.2 l 0 590.2 l h W n Q q n 0 590.2 m 612 590.2 l 612 578.2 l 0 578.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 24.23 580.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 76.47 580.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 100.71 580.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 128.28 580.61 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 151.2 580.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 186.09 580.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 222.34 580.61 Tm (15) Tj ET BT /F2 12 Tf 1 0 0 1 239.91 580.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 267.48 580.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 295.04 580.61 Tm (resolving) Tj ET BT /F2 12 Tf 1 0 0 1 345.27 580.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 365.51 580.61 Tm (claim.) Tj ET BT /F2 12 Tf 1 0 0 1 406.31 580.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 419.88 580.61 Tm (reasonably) Tj ET BT /F2 12 Tf 1 0 0 1 477.43 580.61 Tm (possible,) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 580.61 Tm (the) Tj ET Q q n 0 578.2 m 612 578.2 l 612 566.2 l 0 566.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.61 Tm (Company will send it within:) Tj ET Q q n 18 566.2 m 630 566.2 l 630 554.2 l 18 554.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 556.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 556.61 Tm (90 days after receiving the first proof of a death or dismemberment claim; or) Tj ET Q q n 18 554.2 m 630 554.2 l 630 542.2 l 18 542.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 544.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 544.61 Tm (45) Tj ET BT /F2 12 Tf 1 0 0 1 61.59 544.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 87.82 544.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 114.04 544.61 Tm (receiving) Tj ET BT /F2 12 Tf 1 0 0 1 162.92 544.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 181.81 544.61 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 205.38 544.61 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 235.61 544.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 249.84 544.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 259.41 544.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 290.3 544.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 308.53 544.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 330.09 544.61 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 382.32 544.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 396.56 544.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 429.44 544.61 Tm (Benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 472 544.61 Tm (Living) Tj ET Q q n 45.35 542.2 m 657.35 542.2 l 657.35 530.2 l 45.35 530.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 532.61 Tm (Benefit or Accelerated Death Benefit available under the Policy.) Tj ET Q q n 0 530.2 m 612 530.2 l 612 518.2 l 0 518.2 l h W n Q q n 0 518.2 m 612 518.2 l 612 506.2 l 0 506.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 508.61 Tm (Delay) Tj ET BT /F4 12 Tf 1 0 0 1 32.6 508.61 Tm (Notice.) Tj ET BT /F2 12 Tf 1 0 0 1 74.81 508.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 86.08 508.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 104.02 508.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 153.96 508.61 Tm (needs) Tj ET BT /F2 12 Tf 1 0 0 1 184.56 508.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 212.49 508.61 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 236.43 508.61 Tm (15) Tj ET BT /F2 12 Tf 1 0 0 1 251.71 508.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 276.98 508.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 289.6 508.61 Tm (process) Tj ET BT /F2 12 Tf 1 0 0 1 328.86 508.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 337.47 508.61 Tm (claim,) Tj ET BT /F2 12 Tf 1 0 0 1 370.4 508.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 383.01 508.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 391.61 508.61 Tm (special) Tj ET BT /F2 12 Tf 1 0 0 1 428.21 508.61 Tm (case;) Tj ET BT /F2 12 Tf 1 0 0 1 455.47 508.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 479.41 508.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 494.01 508.61 Tm (extension) Tj ET Q q n 0 506.2 m 612 506.2 l 612 494.2 l 0 494.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.61 Tm (will be permitted.) Tj ET BT /F2 12 Tf 1 0 0 1 90.98 496.61 Tm (If needed, the Company will send the claimant a written delay notice:) Tj ET Q q n 18 494.2 m 630 494.2 l 630 482.2 l 18 482.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 484.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 484.61 Tm (by the 15) Tj ET BT /F2 7.2 Tf 1 0 0 1 90.01 488.21 Tm (th) Tj ET BT /F2 12 Tf 1 0 0 1 95.61 484.61 Tm ( day after receiving the first proof of claim; and) Tj ET Q q n 18 482.2 m 630 482.2 l 630 470.2 l 18 470.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 472.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 472.61 Tm (every 30 days after that, until the claim is resolved.) Tj ET Q q n 18 470.2 m 630 470.2 l 630 458.2 l 18 458.2 l h W n Q q n 0 458.2 m 612 458.2 l 612 446.2 l 0 446.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 448.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 21.77 448.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 54.2 448.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 75.98 448.61 Tm (explain) Tj ET BT /F2 12 Tf 1 0 0 1 114.41 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 132.18 448.61 Tm (special) Tj ET BT /F2 12 Tf 1 0 0 1 168.61 448.61 Tm (circumstances) Tj ET BT /F2 12 Tf 1 0 0 1 239.69 448.61 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 272.12 448.61 Tm (require) Tj ET BT /F2 12 Tf 1 0 0 1 309.21 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 326.99 448.61 Tm (delay,) Tj ET BT /F2 12 Tf 1 0 0 1 359.08 448.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 379.52 448.61 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 408.62 448.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 417.06 448.61 Tm (decision) Tj ET BT /F2 12 Tf 1 0 0 1 460.16 448.61 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 479.92 448.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 494.36 448.61 Tm (expected.) Tj ET Q q n 0 446.2 m 612 446.2 l 612 434.2 l 0 434.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.61 Tm (In any event, the Company must send written notice of its decision within:) Tj ET Q q n 18 434.2 m 630 434.2 l 630 422.2 l 18 422.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 424.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 424.61 Tm (180 days after receiving the first proof of a death or dismemberment claim; or) Tj ET Q q n 18 422.2 m 630 422.2 l 630 410.2 l 18 410.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 412.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 412.61 Tm (105) Tj ET BT /F2 12 Tf 1 0 0 1 67.21 412.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 93.07 412.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 118.91 412.61 Tm (receiving) Tj ET BT /F2 12 Tf 1 0 0 1 167.42 412.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 185.94 412.61 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 209.13 412.61 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 238.99 412.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 252.84 412.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 262.03 412.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 292.55 412.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 310.4 412.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 331.59 412.61 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 383.45 412.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 397.31 412.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 429.82 412.61 Tm (Benefit,) Tj ET BT /F2 12 Tf 1 0 0 1 472 412.61 Tm (Living) Tj ET Q q n 45.35 410.2 m 657.35 410.2 l 657.35 398.2 l 45.35 398.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 400.61 Tm (Benefit or Accelerated Death Benefit available under the Policy.) Tj ET Q q n 0 398.2 m 612 398.2 l 612 386.2 l 0 386.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 388.61 Tm (If the Company fails to do so; then there is a right to an immediate review, as if the claim was denied.) Tj ET Q q n 0 386.2 m 612 386.2 l 612 374.2 l 0 374.2 l h W n Q q n 0 374.2 m 612 374.2 l 612 362.2 l 0 362.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 364.61 Tm (Exception:) Tj ET BT /F2 12 Tf 1 0 0 1 64.75 364.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 77.45 364.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 96.83 364.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 148.2 364.61 Tm (needs) Tj ET BT /F2 12 Tf 1 0 0 1 180.23 364.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 209.6 364.61 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 270.96 364.61 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 299 364.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 318.37 364.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 364.4 364.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 378.44 364.61 Tm (process) Tj ET BT /F2 12 Tf 1 0 0 1 419.14 364.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 429.18 364.61 Tm (claim;) Tj ET BT /F2 12 Tf 1 0 0 1 463.88 364.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 489.25 364.61 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 500.63 364.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 364.61 Tm (be) Tj ET Q q n 0 362.2 m 612 362.2 l 612 350.2 l 0 350.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.61 Tm (supplied) Tj ET BT /F2 12 Tf 1 0 0 1 44.76 352.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 79.53 352.61 Tm (45) Tj ET BT /F2 12 Tf 1 0 0 1 95.63 352.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 121.72 352.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 147.8 352.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 166.56 352.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 217.32 352.61 Tm (requests) Tj ET BT /F2 12 Tf 1 0 0 1 260.74 352.61 Tm (it.) Tj ET BT /F2 12 Tf 1 0 0 1 278.61 352.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 301.36 352.61 Tm (resulting) Tj ET BT /F2 12 Tf 1 0 0 1 347.46 352.61 Tm (delay) Tj ET BT /F2 12 Tf 1 0 0 1 377.54 352.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 400.31 352.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 419.74 352.61 Tm (count) Tj ET BT /F2 12 Tf 1 0 0 1 450.5 352.61 Tm (towards) Tj ET BT /F2 12 Tf 1 0 0 1 492.59 352.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 511.35 352.61 Tm (above) Tj ET Q q n 0 350.2 m 612 350.2 l 612 338.2 l 0 338.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 340.61 Tm (time limits for claim processing.) Tj ET Q q n 0 338.2 m 612 338.2 l 612 326.2 l 0 326.2 l h W n Q q n 0 326.2 m 612 326.2 l 612 314.2 l 0 314.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 316.61 Tm (REVIEW PROCEDURE.) Tj ET BT /F2 12 Tf 1 0 0 1 138.01 316.61 Tm (The claimant may request a claim review, within:) Tj ET Q q n 18 314.2 m 630 314.2 l 630 302.2 l 18 302.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 304.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 304.61 Tm (60 days after receiving a denial notice of a death or dismemberment claim; or) Tj ET Q q n 18 302.2 m 630 302.2 l 630 290.2 l 18 290.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 292.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 292.61 Tm (180) Tj ET BT /F2 12 Tf 1 0 0 1 66.96 292.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 92.57 292.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 118.16 292.61 Tm (receiving) Tj ET BT /F2 12 Tf 1 0 0 1 166.42 292.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 175.36 292.61 Tm (denial) Tj ET BT /F2 12 Tf 1 0 0 1 208.29 292.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 241.23 292.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 254.84 292.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 263.77 292.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 294.04 292.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 311.65 292.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 332.59 292.61 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 384.19 292.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 397.8 292.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 430.07 292.61 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 465.39 292.61 Tm (,) Tj ET BT /F2 12 Tf 1 0 0 1 472 292.61 Tm (Living) Tj ET Q q n 45.35 290.2 m 657.35 290.2 l 657.35 278.2 l 45.35 278.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 280.61 Tm (Benefit or Accelerated Death Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 223.93 280.61 Tm ( available under the Policy.) Tj ET Q q n 0 278.2 m 612 278.2 l 612 266.2 l 0 266.2 l h W n Q q n 0 266.2 m 612 266.2 l 612 254.2 l 0 254.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 256.61 Tm (To) Tj ET BT /F2 12 Tf 1 0 0 1 16.6 256.61 Tm (request) Tj ET BT /F2 12 Tf 1 0 0 1 54.52 256.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 63.11 256.61 Tm (review,) Tj ET BT /F2 12 Tf 1 0 0 1 102.03 256.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 119.96 256.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 164.54 256.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 191.15 256.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 216.41 256.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 234.34 256.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 284.27 256.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 292.86 256.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 330.12 256.61 Tm (request,) Tj ET BT /F2 12 Tf 1 0 0 1 371.04 256.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 391.64 256.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 412.23 256.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 449.49 256.61 Tm (comments) Tj ET BT /F2 12 Tf 1 0 0 1 502.08 256.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 515.34 256.61 Tm (other) Tj ET Q q n 0 254.2 m 612 254.2 l 612 242.2 l 0 242.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 244.61 Tm (items) Tj ET BT /F2 12 Tf 1 0 0 1 29.49 244.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 42.31 244.61 Tm (support) Tj ET BT /F2 12 Tf 1 0 0 1 81.8 244.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 99.95 244.61 Tm (claim.) Tj ET BT /F2 12 Tf 1 0 0 1 136.58 244.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 158.73 244.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 203.53 244.61 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 227.68 244.61 Tm (review) Tj ET BT /F2 12 Tf 1 0 0 1 263.82 244.61 Tm (certain) Tj ET BT /F2 12 Tf 1 0 0 1 299.95 244.61 Tm (non-privileged) Tj ET BT /F2 12 Tf 1 0 0 1 374.09 244.61 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 434.23 244.61 Tm (relating) Tj ET BT /F2 12 Tf 1 0 0 1 474.37 244.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 487.2 244.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 505.35 244.61 Tm (request) Tj ET Q q n 0 242.2 m 612 242.2 l 612 230.2 l 0 230.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 232.61 Tm (for review.) Tj ET Q q n 0 230.2 m 612 230.2 l 612 218.2 l 0 218.2 l h W n Q q n 0 218.2 m 612 218.2 l 612 206.2 l 0 206.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 208.61 Tm (Notice) Tj ET BT /F4 12 Tf 1 0 0 1 36.06 208.61 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 49.47 208.61 Tm (Decision.) Tj ET BT /F2 12 Tf 1 0 0 1 102.62 208.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 124.69 208.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 174.76 208.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 196.84 208.61 Tm (review) Tj ET BT /F2 12 Tf 1 0 0 1 232.9 208.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 250.97 208.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 281.04 208.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 301.78 208.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 327.19 208.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 345.26 208.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 389.98 208.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 398.72 208.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 436.12 208.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 468.85 208.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 482.26 208.61 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 497.01 208.61 Tm (decision.) Tj ET Q q n 0 206.2 m 612 206.2 l 612 194.2 l 0 194.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 196.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.38 196.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 55.42 196.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 77.81 196.61 Tm (explain) Tj ET BT /F2 12 Tf 1 0 0 1 116.85 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 135.23 196.61 Tm (reasons) Tj ET BT /F2 12 Tf 1 0 0 1 174.94 196.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 192.65 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 211.03 196.61 Tm (Company's) Tj ET BT /F2 12 Tf 1 0 0 1 268.25 196.61 Tm (decision,) Tj ET BT /F2 12 Tf 1 0 0 1 314.96 196.61 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 346.01 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 364.39 196.61 Tm (terms) Tj ET BT /F2 12 Tf 1 0 0 1 394.77 196.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 408.49 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 426.87 196.61 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 461.26 196.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 482.3 196.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 503.35 196.61 Tm (internal) Tj ET Q q n 0 194.2 m 612 194.2 l 612 182.2 l 0 182.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 184.61 Tm (guidelines.) Tj ET BT /F2 12 Tf 1 0 0 1 58.32 184.61 Tm (If the Company upholds the denial of all or part of the claim; then the notice will also describe:) Tj ET Q q n 18 182.2 m 630 182.2 l 630 170.2 l 18 170.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 172.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 172.61 Tm (any further appeal procedures available under the Policy;) Tj ET Q q n 18 170.2 m 630 170.2 l 630 158.2 l 18 158.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 160.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 160.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 66.01 160.61 Tm (right to access relevant claim information; and) Tj ET Q q n 18 158.2 m 630 158.2 l 630 146.2 l 18 146.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 148.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 148.61 Tm (the right to request a state insurance department review, or to bring legal action.) Tj ET Q q n 0 146.2 m 612 146.2 l 612 134.2 l 0 134.2 l h W n Q q n 0 134.2 m 612 134.2 l 612 122.2 l 0 122.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 124.61 Tm (For) Tj ET BT /F2 12 Tf 1 0 0 1 21.1 124.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 30.86 124.61 Tm (death) Tj ET BT /F2 12 Tf 1 0 0 1 61.29 124.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 75.72 124.61 Tm (dismemberment) Tj ET BT /F2 12 Tf 1 0 0 1 157.46 124.61 Tm (claim,) Tj ET BT /F2 12 Tf 1 0 0 1 191.55 124.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 210.65 124.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 244.4 124.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 267.5 124.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 283.26 124.61 Tm (sent) Tj ET BT /F2 12 Tf 1 0 0 1 307.03 124.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 342.13 124.61 Tm (60) Tj ET BT /F2 12 Tf 1 0 0 1 358.57 124.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 385 124.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 411.41 124.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 430.5 124.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 481.6 124.61 Tm (receives) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 124.61 Tm (the) Tj ET Q q n 0 122.2 m 612 122.2 l 612 110.2 l 0 110.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 112.61 Tm (request) Tj ET BT /F2 12 Tf 1 0 0 1 38.44 112.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 56.22 112.61 Tm (review;) Tj ET BT /F2 12 Tf 1 0 0 1 95.98 112.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 109.77 112.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 144.22 112.61 Tm (120) Tj ET BT /F2 12 Tf 1 0 0 1 166.01 112.61 Tm (days,) Tj ET BT /F2 12 Tf 1 0 0 1 194.79 112.61 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 205.9 112.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 215.02 112.61 Tm (special) Tj ET BT /F2 12 Tf 1 0 0 1 252.12 112.61 Tm (case) Tj ET BT /F2 12 Tf 1 0 0 1 276.55 112.61 Tm (requires) Tj ET BT /F2 12 Tf 1 0 0 1 318.99 112.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 347.43 112.61 Tm (time.) Tj ET BT /F2 12 Tf 1 0 0 1 379.33 112.61 Tm (For) Tj ET BT /F2 12 Tf 1 0 0 1 399.78 112.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 408.89 112.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 439.33 112.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 457.11 112.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 478.22 112.61 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 530 112.61 Tm (of) Tj ET Q q n 0 110.2 m 612 110.2 l 612 98.2 l 0 98.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 100.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 32.54 100.61 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 67.86 100.61 Tm (,) Tj ET BT /F2 12 Tf 1 0 0 1 74.75 100.61 Tm (Living) Tj ET BT /F2 12 Tf 1 0 0 1 110.63 100.61 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 149.84 100.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 163.72 100.61 Tm (Accelerated) Tj ET BT /F2 12 Tf 1 0 0 1 224.9 100.61 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 257.44 100.61 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 296.64 100.61 Tm (available) Tj ET BT /F2 12 Tf 1 0 0 1 343.84 100.61 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 375.05 100.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 393.59 100.61 Tm (Policy,) Tj ET BT /F2 12 Tf 1 0 0 1 431.15 100.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 449.7 100.61 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 482.9 100.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 505.46 100.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 520.67 100.61 Tm (sent) Tj ET Q q n 0 98.2 m 612 98.2 l 612 86.2 l 0 86.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 88.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 34.38 88.61 Tm (45) Tj ET BT /F2 12 Tf 1 0 0 1 50.09 88.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 75.8 88.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 101.49 88.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 119.86 88.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 170.23 88.61 Tm (receives) Tj ET BT /F2 12 Tf 1 0 0 1 213.25 88.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 231.62 88.61 Tm (request) Tj ET BT /F2 12 Tf 1 0 0 1 269.98 88.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 287.69 88.61 Tm (review;) Tj ET BT /F2 12 Tf 1 0 0 1 327.38 88.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 341.09 88.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 375.47 88.61 Tm (90) Tj ET BT /F2 12 Tf 1 0 0 1 391.18 88.61 Tm (days,) Tj ET BT /F2 12 Tf 1 0 0 1 419.89 88.61 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 430.93 88.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 439.96 88.61 Tm (special) Tj ET BT /F2 12 Tf 1 0 0 1 476.99 88.61 Tm (case) Tj ET BT /F2 12 Tf 1 0 0 1 501.35 88.61 Tm (requires) Tj ET Q q n 0 86.2 m 612 86.2 l 612 74.2 l 0 74.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 76.61 Tm (more time.) Tj ET Q q n 0 74.2 m 612 74.2 l 612 62.2 l 0 62.2 l h W n Q Q q Q Q endstream endobj 23 0 obj <>>>>> endobj 126 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 734.4 cm q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 203.16 26.41 Tm (CLAIMS PROCEDURES) Tj ET Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 239 14.41 Tm (\(Continued\)) Tj ET Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 26.1 Tm (GL1102-8A 02 PA) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 26.1 Tm (L/ADD) Tj ET BT /F2 10 Tf 1 0 0 1 249.1 14.09 Tm (21) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 14.09 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 72.2 cm q n 0 662.2 m 612 662.2 l 612 650.2 l 0 650.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 652.61 Tm (Delay) Tj ET BT /F4 12 Tf 1 0 0 1 33.46 652.61 Tm (Notice.) Tj ET BT /F2 12 Tf 1 0 0 1 77.38 652.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 89.51 652.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 108.3 652.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 159.1 652.61 Tm (needs) Tj ET BT /F2 12 Tf 1 0 0 1 190.56 652.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 219.35 652.61 Tm (time) Tj ET BT /F2 12 Tf 1 0 0 1 244.81 652.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 258.28 652.61 Tm (process) Tj ET BT /F2 12 Tf 1 0 0 1 298.4 652.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 313.86 652.61 Tm (appeal,) Tj ET BT /F2 12 Tf 1 0 0 1 352.31 652.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 365.78 652.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 375.24 652.61 Tm (special) Tj ET BT /F2 12 Tf 1 0 0 1 412.69 652.61 Tm (case;) Tj ET BT /F2 12 Tf 1 0 0 1 440.81 652.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 465.6 652.61 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 476.41 652.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 499.21 652.61 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 652.61 Tm (the) Tj ET Q q n 0 650.2 m 612 650.2 l 612 638.2 l 0 638.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.61 Tm (claimant a written delay notice, by the 30th day after receiving the request for review.) Tj ET BT /F2 12 Tf 1 0 0 1 417.83 640.61 Tm (The notice will explain:) Tj ET Q q n 18 638.2 m 630 638.2 l 630 626.2 l 18 626.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 628.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 628.61 Tm (the special circumstances which require the delay;) Tj ET Q q n 18 626.2 m 630 626.2 l 630 614.2 l 18 614.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 616.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 616.61 Tm (whether more information is needed to review the claim; and) Tj ET Q q n 18 614.2 m 630 614.2 l 630 602.2 l 18 602.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 604.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 604.61 Tm (when a decision can be expected.) Tj ET Q q n 0 602.2 m 612 602.2 l 612 590.2 l 0 590.2 l h W n Q q n 0 590.2 m 612 590.2 l 612 578.2 l 0 578.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 580.61 Tm (Exception:) Tj ET BT /F2 12 Tf 1 0 0 1 63.57 580.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 75.68 580.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 94.46 580.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 145.24 580.61 Tm (needs) Tj ET BT /F2 12 Tf 1 0 0 1 176.68 580.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 205.45 580.61 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 266.23 580.61 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 293.67 580.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 312.45 580.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 357.88 580.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 371.34 580.61 Tm (process) Tj ET BT /F2 12 Tf 1 0 0 1 411.44 580.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 426.89 580.61 Tm (appeal;) Tj ET BT /F2 12 Tf 1 0 0 1 465.65 580.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 490.43 580.61 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 501.22 580.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 528.67 580.61 Tm (be) Tj ET Q q n 0 578.2 m 612 578.2 l 612 566.2 l 0 566.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.61 Tm (supplied) Tj ET BT /F2 12 Tf 1 0 0 1 44.76 568.61 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 79.53 568.61 Tm (45) Tj ET BT /F2 12 Tf 1 0 0 1 95.63 568.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 121.72 568.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 147.8 568.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 166.56 568.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 217.32 568.61 Tm (requests) Tj ET BT /F2 12 Tf 1 0 0 1 260.74 568.61 Tm (it.) Tj ET BT /F2 12 Tf 1 0 0 1 278.61 568.61 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 301.36 568.61 Tm (resulting) Tj ET BT /F2 12 Tf 1 0 0 1 347.46 568.61 Tm (delay) Tj ET BT /F2 12 Tf 1 0 0 1 377.54 568.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 400.31 568.61 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 419.74 568.61 Tm (count) Tj ET BT /F2 12 Tf 1 0 0 1 450.5 568.61 Tm (towards) Tj ET BT /F2 12 Tf 1 0 0 1 492.59 568.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 511.35 568.61 Tm (above) Tj ET Q q n 0 566.2 m 612 566.2 l 612 554.2 l 0 554.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 556.61 Tm (time limits for appeal processing.) Tj ET Q q n 0 554.2 m 612 554.2 l 612 542.2 l 0 542.2 l h W n Q q n 0 542.2 m 612 542.2 l 612 530.2 l 0 530.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 532.61 Tm (Claims) Tj ET BT /F4 12 Tf 1 0 0 1 39.45 532.61 Tm (Subject) Tj ET BT /F4 12 Tf 1 0 0 1 81.56 532.61 Tm (to) Tj ET BT /F4 12 Tf 1 0 0 1 95 532.61 Tm (ERISA) Tj ET BT /F4 12 Tf 1 0 0 1 135.12 532.61 Tm (\() Tj ET BT /F2 12 Tf 1 0 0 1 139.12 532.61 Tm (Employee) Tj ET BT /F2 12 Tf 1 0 0 1 191.21 532.61 Tm (Retirement) Tj ET BT /F2 12 Tf 1 0 0 1 247.97 532.61 Tm (Income) Tj ET BT /F2 12 Tf 1 0 0 1 287.4 532.61 Tm (Security) Tj ET BT /F2 12 Tf 1 0 0 1 330.84 532.61 Tm (Act) Tj ET BT /F2 12 Tf 1 0 0 1 351.61 532.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 365.05 532.61 Tm (1974) Tj ET BT /F4 12 Tf 1 0 0 1 389.05 532.61 Tm (\).) Tj ET BT /F2 12 Tf 1 0 0 1 402.93 532.61 Tm (Before) Tj ET BT /F2 12 Tf 1 0 0 1 439.03 532.61 Tm (bringing) Tj ET BT /F2 12 Tf 1 0 0 1 483.14 532.61 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 491.91 532.61 Tm (civil) Tj ET BT /F2 12 Tf 1 0 0 1 516.68 532.61 Tm (legal) Tj ET Q q n 0 530.2 m 612 530.2 l 612 518.2 l 0 518.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 520.61 Tm (action) Tj ET BT /F2 12 Tf 1 0 0 1 33.23 520.61 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 64.46 520.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 83.03 520.61 Tm (federal) Tj ET BT /F2 12 Tf 1 0 0 1 120.24 520.61 Tm (labor) Tj ET BT /F2 12 Tf 1 0 0 1 148.8 520.61 Tm (law) Tj ET BT /F2 12 Tf 1 0 0 1 170.04 520.61 Tm (known) Tj ET BT /F2 12 Tf 1 0 0 1 206.61 520.61 Tm (as) Tj ET BT /F2 12 Tf 1 0 0 1 220.51 520.61 Tm (ERISA,) Tj ET BT /F2 12 Tf 1 0 0 1 262.09 520.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 277.32 520.61 Tm (employee) Tj ET BT /F2 12 Tf 1 0 0 1 327.88 520.61 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 365.1 520.61 Tm (plan) Tj ET BT /F2 12 Tf 1 0 0 1 389.67 520.61 Tm (participant) Tj ET BT /F2 12 Tf 1 0 0 1 444.89 520.61 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 458.79 520.61 Tm (beneficiary) Tj ET BT /F2 12 Tf 1 0 0 1 516.66 520.61 Tm (must) Tj ET Q q n 0 518.2 m 612 518.2 l 612 506.2 l 0 506.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 508.61 Tm (exhaust) Tj ET BT /F2 12 Tf 1 0 0 1 40.95 508.61 Tm (available) Tj ET BT /F2 12 Tf 1 0 0 1 88.56 508.61 Tm (administrative) Tj ET BT /F2 12 Tf 1 0 0 1 161.5 508.61 Tm (remedies.) Tj ET BT /F2 12 Tf 1 0 0 1 216.41 508.61 Tm (Under) Tj ET BT /F2 12 Tf 1 0 0 1 250.69 508.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 269.65 508.61 Tm (Policy,) Tj ET BT /F2 12 Tf 1 0 0 1 307.61 508.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 326.57 508.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 372.18 508.61 Tm (must) Tj ET BT /F2 12 Tf 1 0 0 1 399.81 508.61 Tm (first) Tj ET BT /F2 12 Tf 1 0 0 1 423.44 508.61 Tm (seek) Tj ET BT /F2 12 Tf 1 0 0 1 449.06 508.61 Tm (two) Tj ET BT /F2 12 Tf 1 0 0 1 471.35 508.61 Tm (administrative) Tj ET Q q n 0 506.2 m 612 506.2 l 612 494.2 l 0 494.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.61 Tm (reviews) Tj ET BT /F2 12 Tf 1 0 0 1 41.59 496.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 55.85 496.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 74.78 496.61 Tm (adverse) Tj ET BT /F2 12 Tf 1 0 0 1 115.69 496.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 146.61 496.61 Tm (decision,) Tj ET BT /F2 12 Tf 1 0 0 1 193.87 496.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 207.47 496.61 Tm (accord) Tj ET BT /F2 12 Tf 1 0 0 1 243.72 496.61 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 269.32 496.61 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 290.92 496.61 Tm (section.) Tj ET BT /F2 12 Tf 1 0 0 1 336.45 496.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 348.71 496.61 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 364.3 496.61 Tm (ERISA) Tj ET BT /F2 12 Tf 1 0 0 1 403.24 496.61 Tm (claimant) Tj ET BT /F2 12 Tf 1 0 0 1 448.82 496.61 Tm (brings) Tj ET BT /F2 12 Tf 1 0 0 1 483.09 496.61 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 510.68 496.61 Tm (action) Tj ET Q q n 0 494.2 m 612 494.2 l 612 482.2 l 0 482.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.61 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 30.63 484.61 Tm (Section) Tj ET BT /F2 12 Tf 1 0 0 1 69.93 484.61 Tm (502\(a\)) Tj ET BT /F2 12 Tf 1 0 0 1 104.55 484.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 117.85 484.61 Tm (ERISA) Tj ET BT /F2 12 Tf 1 0 0 1 155.82 484.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 181.11 484.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 199.07 484.61 Tm (required) Tj ET BT /F2 12 Tf 1 0 0 1 242.36 484.61 Tm (reviews;) Tj ET BT /F2 12 Tf 1 0 0 1 286.31 484.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 310.28 484.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 328.24 484.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 378.21 484.61 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 400.18 484.61 Tm (waive) Tj ET BT /F2 12 Tf 1 0 0 1 432.14 484.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 452.77 484.61 Tm (right) Tj ET BT /F2 12 Tf 1 0 0 1 478.74 484.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 491.38 484.61 Tm (assert) Tj ET BT /F2 12 Tf 1 0 0 1 522.01 484.61 Tm (that) Tj ET Q q n 0 482.2 m 612 482.2 l 612 470.2 l 0 470.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 472.61 Tm (he or she failed to exhaust administrative remedies.) Tj ET Q q n 0 470.2 m 612 470.2 l 612 458.2 l 0 458.2 l h W n Q q n 0 458.2 m 612 458.2 l 612 446.2 l 0 446.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 448.61 Tm (RIGHT) Tj ET BT /F4 12 Tf 1 0 0 1 44.14 448.61 Tm (OF) Tj ET BT /F4 12 Tf 1 0 0 1 64.94 448.61 Tm (RECOVERY.) Tj ET BT /F2 12 Tf 1 0 0 1 144.88 448.61 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 157.01 448.61 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 199.14 448.61 Tm (have) Tj ET BT /F2 12 Tf 1 0 0 1 225.92 448.61 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 252.71 448.61 Tm (overpaid) Tj ET BT /F2 12 Tf 1 0 0 1 298.83 448.61 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 314.96 448.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 336.43 448.61 Tm (claim;) Tj ET BT /F2 12 Tf 1 0 0 1 370.55 448.61 Tm (then) Tj ET BT /F2 12 Tf 1 0 0 1 395.34 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 414.14 448.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 464.94 448.61 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 485.07 448.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 503.87 448.61 Tm (right) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 448.61 Tm (to) Tj ET Q q n 0 446.2 m 612 446.2 l 612 434.2 l 0 434.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 436.61 Tm (recover the excess, from one or more of:) Tj ET Q q n 18 434.2 m 630 434.2 l 630 422.2 l 18 422.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 424.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 424.61 Tm (you or your estate;) Tj ET Q q n 18 422.2 m 630 422.2 l 630 410.2 l 18 410.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 412.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 412.61 Tm (your Beneficiary, or his or her estate; or) Tj ET Q q n 18 410.2 m 630 410.2 l 630 398.2 l 18 398.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 400.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 400.61 Tm (an insurance company or other organization which has been overpaid.) Tj ET Q q n 0 398.2 m 612 398.2 l 612 386.2 l 0 386.2 l h W n Q q n 0 386.2 m 612 386.2 l 612 374.2 l 0 374.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 376.61 Tm (LEGAL) Tj ET BT /F4 12 Tf 1 0 0 1 45.93 376.61 Tm (ACTIONS.) Tj ET BT /F2 12 Tf 1 0 0 1 111.43 376.61 Tm (No) Tj ET BT /F2 12 Tf 1 0 0 1 130.01 376.61 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 157.25 376.61 Tm (action) Tj ET BT /F2 12 Tf 1 0 0 1 190.48 376.61 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 203.73 376.61 Tm (recover) Tj ET BT /F2 12 Tf 1 0 0 1 243.62 376.61 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 264.86 376.61 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 306.76 376.61 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 331.33 376.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 346.57 376.61 Tm (brought) Tj ET BT /F2 12 Tf 1 0 0 1 387.81 376.61 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 413.73 376.61 Tm (60) Tj ET BT /F2 12 Tf 1 0 0 1 429.65 376.61 Tm (days) Tj ET BT /F2 12 Tf 1 0 0 1 455.56 376.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 481.45 376.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 500.02 376.61 Tm (required) Tj ET Q q n 0 374.2 m 612 374.2 l 612 362.2 l 0 362.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 364.61 Tm (written) Tj ET BT /F2 12 Tf 1 0 0 1 37.1 364.61 Tm (proof) Tj ET BT /F2 12 Tf 1 0 0 1 66.19 364.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 79.29 364.61 Tm (claim) Tj ET BT /F2 12 Tf 1 0 0 1 109.05 364.61 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 128.15 364.61 Tm (been) Tj ET BT /F2 12 Tf 1 0 0 1 153.91 364.61 Tm (given.) Tj ET BT /F2 12 Tf 1 0 0 1 189.78 364.61 Tm (No) Tj ET BT /F2 12 Tf 1 0 0 1 207.55 364.61 Tm (such) Tj ET BT /F2 12 Tf 1 0 0 1 232.65 364.61 Tm (legal) Tj ET BT /F2 12 Tf 1 0 0 1 259.08 364.61 Tm (action) Tj ET BT /F2 12 Tf 1 0 0 1 291.5 364.61 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 315.27 364.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 329.7 364.61 Tm (brought) Tj ET BT /F2 12 Tf 1 0 0 1 370.13 364.61 Tm (more) Tj ET BT /F2 12 Tf 1 0 0 1 397.89 364.61 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 421.66 364.61 Tm (three) Tj ET BT /F2 12 Tf 1 0 0 1 448.74 364.61 Tm (years) Tj ET BT /F2 12 Tf 1 0 0 1 477.17 364.61 Tm (after) Tj ET BT /F2 12 Tf 1 0 0 1 502.25 364.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 520.01 364.61 Tm (date) Tj ET Q q n 0 362.2 m 612 362.2 l 612 350.2 l 0 350.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 352.61 Tm (written proof of claim is required.) Tj ET Q q n 0 350.2 m 612 350.2 l 612 338.2 l 0 338.2 l h W n Q q n 0 338.2 m 612 338.2 l 612 326.2 l 0 326.2 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 328.61 Tm (COMPANY'S) Tj ET BT /F4 12 Tf 1 0 0 1 76.53 328.61 Tm (DISCRETIONARY) Tj ET BT /F4 12 Tf 1 0 0 1 182.41 328.61 Tm (AUTHORITY.) Tj ET BT /F2 12 Tf 1 0 0 1 267.16 328.61 Tm (Except) Tj ET BT /F2 12 Tf 1 0 0 1 304.34 328.61 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 322.2 328.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 340.73 328.61 Tm (functions) Tj ET BT /F2 12 Tf 1 0 0 1 389.26 328.61 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 411.12 328.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 429.65 328.61 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 464.18 328.61 Tm (clearly) Tj ET BT /F2 12 Tf 1 0 0 1 500.69 328.61 Tm (reserves) Tj ET Q q n 0 326.2 m 612 326.2 l 612 314.2 l 0 314.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 316.61 Tm (to the Group Policyholder or Employer, the Company has the authority to:) Tj ET Q q n 18 314.2 m 630 314.2 l 630 302.2 l 18 302.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 304.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 304.61 Tm (manage the Policy and administer claims under it; and) Tj ET Q q n 18 302.2 m 630 302.2 l 630 290.2 l 18 290.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 292.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 292.61 Tm (interpret the provisions and resolve questions arising under the Policy.) Tj ET Q q n 0 290.2 m 612 290.2 l 612 278.2 l 0 278.2 l h W n Q q n 0 278.2 m 612 278.2 l 612 266.2 l 0 266.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 268.61 Tm (The Company's authority includes \(but is not limited to\) the right to:) Tj ET Q q n 18 266.2 m 630 266.2 l 630 254.2 l 18 254.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 256.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 256.61 Tm (establish and enforce procedures for administering the Policy and claims under it;) Tj ET Q q n 18 254.2 m 630 254.2 l 630 242.2 l 18 242.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 244.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 244.61 Tm (determine your eligibility for insurance and entitlement to benefits;) Tj ET Q q n 18 242.2 m 630 242.2 l 630 230.2 l 18 230.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 232.61 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 232.61 Tm (determine what information the Company reasonably requires to make such decisions; and) Tj ET Q q n 18 230.2 m 630 230.2 l 630 218.2 l 18 218.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 220.61 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 220.61 Tm (resolve all matters when a claim review is requested.) Tj ET Q q n 18 218.2 m 630 218.2 l 630 206.2 l 18 206.2 l h W n Q q n 0 206.2 m 612 206.2 l 612 194.2 l 0 194.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 196.61 Tm (Any) Tj ET BT /F2 12 Tf 1 0 0 1 24.63 196.61 Tm (decision) Tj ET BT /F2 12 Tf 1 0 0 1 68.59 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 87.22 196.61 Tm (Company) Tj ET BT /F2 12 Tf 1 0 0 1 137.85 196.61 Tm (makes,) Tj ET BT /F2 12 Tf 1 0 0 1 175.47 196.61 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 188.78 196.61 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 207.4 196.61 Tm (exercise) Tj ET BT /F2 12 Tf 1 0 0 1 250.68 196.61 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 264.64 196.61 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 279.94 196.61 Tm (authority,) Tj ET BT /F2 12 Tf 1 0 0 1 330.24 196.61 Tm (shall) Tj ET BT /F2 12 Tf 1 0 0 1 356.87 196.61 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 372.16 196.61 Tm (conclusive) Tj ET BT /F2 12 Tf 1 0 0 1 427.45 196.61 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 448.74 196.61 Tm (binding;) Tj ET BT /F2 12 Tf 1 0 0 1 492.71 196.61 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 196.61 Tm (to) Tj ET Q q n 0 194.2 m 612 194.2 l 612 182.2 l 0 182.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 184.61 Tm (your or your Beneficiary's rights to:) Tj ET Q q n 18 182.2 m 630 182.2 l 630 170.2 l 18 170.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 172.61 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45 172.61 Tm (request a state insurance department review; or) Tj ET Q q n 18 170.2 m 630 170.2 l 630 158.2 l 18 158.2 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 160.61 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 160.61 Tm (bring legal action.) Tj ET Q Q q Q Q endstream endobj 24 0 obj <>>>>> endobj 128 0 obj <> endobj 127 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 722.4 cm q n 0 48 m 612 48 l 612 36 l 0 36 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 151.32 38.41 Tm (NOTICE OF PROTECTION PROVIDED BY) Tj ET Q q n 0 36 m 612 36 l 612 24 l 0 24 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 48.3 26.41 Tm (PENNSYLVANIA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 48.87 24.53 m 491.13 24.53 l S 1 w [] 0 d Q q n 0 24 m 612 24 l 612 12 l 0 12 l h W n Q q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm q n 0 37.15 m 183.6 37.15 l 183.6 25.15 l 0 25.15 l h W n Q q n 183.6 37.15 m 367.2 37.15 l 367.2 25.15 l 183.6 25.15 l h W n Q q n 367.2 37.15 m 550.8 37.15 l 550.8 25.15 l 367.2 25.15 l h W n Q q n 0 25.15 m 183.6 25.15 l 183.6 13.15 l 0 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 15.56 Tm (GAN-GRP-PA NOTICE-P/C) Tj ET Q q n 183.6 25.15 m 367.2 25.15 l 367.2 13.15 l 183.6 13.15 l h W n Q q n 367.2 25.15 m 550.8 25.15 l 550.8 13.15 l 367.2 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 512.67 15.56 Tm (11/20) Tj ET Q q n 0 13.15 m 183.6 13.15 l 183.6 1.15 l 0 1.15 l h W n Q q n 183.6 13.15 m 367.2 13.15 l 367.2 1.15 l 183.6 1.15 l h W n 0 0 0 rg BT /F2 10 Tf 1 0 0 1 265 3.56 Tm (22) Tj ET Q q n 367.2 13.15 m 550.8 13.15 l 550.8 1.15 l 367.2 1.15 l h W n 0 0 0 rg BT /F2 10 Tf 1 0 0 1 504.44 3.56 Tm (07/01/21) Tj ET Q Q q Q q 1 0 0 1 36 58.75 cm q n 0 649.85 m 612 649.85 l 612 637.85 l 0 637.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 640.26 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 24.72 640.26 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 57.43 640.26 Tm (provides) Tj ET BT /F2 12 Tf 1 0 0 1 102.15 640.26 Tm (a) Tj ET BT /F4 12 Tf 1 0 0 1 110.86 640.26 Tm (brief) Tj ET BT /F4 12 Tf 1 0 0 1 138.91 640.26 Tm (summary) Tj ET BT /F2 12 Tf 1 0 0 1 190.96 640.26 Tm (regarding) Tj ET BT /F2 12 Tf 1 0 0 1 240.33 640.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 258.38 640.26 Tm (protections) Tj ET BT /F2 12 Tf 1 0 0 1 315.09 640.26 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 361.14 640.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 373.86 640.26 Tm (policyholders) Tj ET BT /F2 12 Tf 1 0 0 1 442.57 640.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 457.96 640.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 476.01 640.26 Tm (Pennsylvania) Tj ET Q q n 0 637.85 m 612 637.85 l 612 625.85 l 0 625.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 628.26 Tm (Life) Tj ET BT /F2 12 Tf 1 0 0 1 26.59 628.26 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 50.51 628.26 Tm (Health) Tj ET BT /F2 12 Tf 1 0 0 1 89.1 628.26 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 142.33 628.26 Tm (Guaranty) Tj ET BT /F2 12 Tf 1 0 0 1 193.58 628.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 256.84 628.26 Tm (\(the) Tj ET BT /F2 12 Tf 1 0 0 1 287.42 628.26 Tm (Association\).) Tj ET BT /F2 12 Tf 1 0 0 1 363 628.26 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 390.94 628.26 Tm (protection) Tj ET BT /F2 12 Tf 1 0 0 1 446.18 628.26 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 471.44 628.26 Tm (created) Tj ET BT /F2 12 Tf 1 0 0 1 512.68 628.26 Tm (under) Tj ET Q q n 0 625.85 m 612 625.85 l 612 613.85 l 0 613.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 616.26 Tm (Pennsylvania law, which determines who and what is covered and the amounts of coverage.) Tj ET Q q n 0 613.85 m 612 613.85 l 612 601.85 l 0 601.85 l h W n Q q n 0 601.85 m 612 601.85 l 612 589.85 l 0 589.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 592.26 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.5 592.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 83 592.26 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 105.5 592.26 Tm (established) Tj ET BT /F2 12 Tf 1 0 0 1 162.66 592.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 175.84 592.26 Tm (provide) Tj ET BT /F2 12 Tf 1 0 0 1 216.34 592.26 Tm (protection) Tj ET BT /F2 12 Tf 1 0 0 1 268.83 592.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 282.01 592.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 300.51 592.26 Tm (unlikely) Tj ET BT /F2 12 Tf 1 0 0 1 343.68 592.26 Tm (event) Tj ET BT /F2 12 Tf 1 0 0 1 373.51 592.26 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 395.34 592.26 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 421.18 592.26 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 464.34 592.26 Tm (life,) Tj ET BT /F2 12 Tf 1 0 0 1 487.17 592.26 Tm (annuity,) Tj ET BT /F2 12 Tf 1 0 0 1 530 592.26 Tm (or) Tj ET Q q n 0 589.85 m 612 589.85 l 612 577.85 l 0 577.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 580.26 Tm (health) Tj ET BT /F2 12 Tf 1 0 0 1 32.36 580.26 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 81.38 580.26 Tm (company,) Tj ET BT /F2 12 Tf 1 0 0 1 131.4 580.26 Tm (RANLI) Tj ET BT /F2 12 Tf 1 0 0 1 171.11 580.26 Tm (PPO,) Tj ET BT /F2 12 Tf 1 0 0 1 199.16 580.26 Tm (hospital) Tj ET BT /F2 12 Tf 1 0 0 1 240.2 580.26 Tm (plan) Tj ET BT /F2 12 Tf 1 0 0 1 263.9 580.26 Tm (corporation,) Tj ET BT /F2 12 Tf 1 0 0 1 325.25 580.26 Tm (professional) Tj ET BT /F2 12 Tf 1 0 0 1 386.94 580.26 Tm (health) Tj ET BT /F2 12 Tf 1 0 0 1 419.3 580.26 Tm (services) Tj ET BT /F2 12 Tf 1 0 0 1 460.99 580.26 Tm (plan) Tj ET BT /F2 12 Tf 1 0 0 1 484.69 580.26 Tm (corporation) Tj ET Q q n 0 577.85 m 612 577.85 l 612 565.85 l 0 565.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 568.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 13.46 568.26 Tm (health) Tj ET BT /F2 12 Tf 1 0 0 1 46.25 568.26 Tm (maintenance) Tj ET BT /F2 12 Tf 1 0 0 1 110.34 568.26 Tm (organization) Tj ET BT /F2 12 Tf 1 0 0 1 173.79 568.26 Tm (\(member) Tj ET BT /F2 12 Tf 1 0 0 1 220.56 568.26 Tm (insurer\)) Tj ET BT /F2 12 Tf 1 0 0 1 261.35 568.26 Tm (becomes) Tj ET BT /F2 12 Tf 1 0 0 1 306.79 568.26 Tm (financially) Tj ET BT /F2 12 Tf 1 0 0 1 361.57 568.26 Tm (unable) Tj ET BT /F2 12 Tf 1 0 0 1 397.02 568.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 409.82 568.26 Tm (meet) Tj ET BT /F2 12 Tf 1 0 0 1 436.61 568.26 Tm (its) Tj ET BT /F2 12 Tf 1 0 0 1 451.41 568.26 Tm (obligations.) Tj ET BT /F2 12 Tf 1 0 0 1 511.21 568.26 Tm (If) Tj ET BT /F2 12 Tf 1 0 0 1 522.66 568.26 Tm (this) Tj ET Q q n 0 565.85 m 612 565.85 l 612 553.85 l 0 553.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 556.26 Tm (should) Tj ET BT /F2 12 Tf 1 0 0 1 36.66 556.26 Tm (happen,) Tj ET BT /F2 12 Tf 1 0 0 1 78.96 556.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 98.28 556.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 159.59 556.26 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 182.91 556.26 Tm (typically) Tj ET BT /F2 12 Tf 1 0 0 1 229.55 556.26 Tm (arrange) Tj ET BT /F2 12 Tf 1 0 0 1 270.18 556.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 284.17 556.26 Tm (provide) Tj ET BT /F2 12 Tf 1 0 0 1 325.48 556.26 Tm (coverage,) Tj ET BT /F2 12 Tf 1 0 0 1 376.43 556.26 Tm (pay) Tj ET BT /F2 12 Tf 1 0 0 1 398.41 556.26 Tm (claims,) Tj ET BT /F2 12 Tf 1 0 0 1 437.39 556.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 452.04 556.26 Tm (otherwise) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 556.26 Tm (provide) Tj ET Q q n 0 553.85 m 612 553.85 l 612 541.85 l 0 541.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 544.26 Tm (protection) Tj ET BT /F2 12 Tf 1 0 0 1 52.92 544.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 66.53 544.26 Tm (accordance) Tj ET BT /F2 12 Tf 1 0 0 1 124.75 544.26 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 150.36 544.26 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 218.62 544.26 Tm (law.) Tj ET BT /F2 12 Tf 1 0 0 1 243.21 544.26 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 266.14 544.26 Tm (protection) Tj ET BT /F2 12 Tf 1 0 0 1 319.06 544.26 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 365.99 544.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 382.26 544.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 401.19 544.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 462.12 544.26 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 474.4 544.26 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 494 544.26 Tm (unlimited) Tj ET Q q n 0 541.85 m 612 541.85 l 612 529.85 l 0 529.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 532.26 Tm (and is not a substitute for consumers' care in selecting companies that are well managed and financially stable.) Tj ET Q q n 0 529.85 m 612 529.85 l 612 517.85 l 0 517.85 l h W n Q q n 0 517.85 m 612 517.85 l 612 505.85 l 0 505.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 508.26 Tm (Below) Tj ET BT /F2 12 Tf 1 0 0 1 35.21 508.26 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 47.1 508.26 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 56.31 508.26 Tm (brief) Tj ET BT /F2 12 Tf 1 0 0 1 82.84 508.26 Tm (summary) Tj ET BT /F2 12 Tf 1 0 0 1 131.38 508.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 145.26 508.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 163.8 508.26 Tm (coverages,) Tj ET BT /F2 12 Tf 1 0 0 1 218.65 508.26 Tm (exclusions) Tj ET BT /F2 12 Tf 1 0 0 1 273.19 508.26 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 294.4 508.26 Tm (limits) Tj ET BT /F2 12 Tf 1 0 0 1 325.62 508.26 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 372.16 508.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 388.04 508.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 406.58 508.26 Tm (Association.) Tj ET BT /F2 12 Tf 1 0 0 1 470.12 508.26 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 495.34 508.26 Tm (summary) Tj ET Q q n 0 505.85 m 612 505.85 l 612 493.85 l 0 493.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 496.26 Tm (does) Tj ET BT /F2 12 Tf 1 0 0 1 26.33 496.26 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 45.99 496.26 Tm (cover) Tj ET BT /F2 12 Tf 1 0 0 1 76.97 496.26 Tm (all) Tj ET BT /F2 12 Tf 1 0 0 1 93.3 496.26 Tm (provisions) Tj ET BT /F2 12 Tf 1 0 0 1 147.63 496.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 161.96 496.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 180.95 496.26 Tm (law;) Tj ET BT /F2 12 Tf 1 0 0 1 205.94 496.26 Tm (nor) Tj ET BT /F2 12 Tf 1 0 0 1 226.27 496.26 Tm (does) Tj ET BT /F2 12 Tf 1 0 0 1 252.59 496.26 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 263.59 496.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 277.26 496.26 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 298.91 496.26 Tm (way) Tj ET BT /F2 12 Tf 1 0 0 1 323.24 496.26 Tm (change) Tj ET BT /F2 12 Tf 1 0 0 1 361.54 496.26 Tm (anyone's) Tj ET BT /F2 12 Tf 1 0 0 1 407.36 496.26 Tm (rights) Tj ET BT /F2 12 Tf 1 0 0 1 439.02 496.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 453.35 496.26 Tm (obligations) Tj ET BT /F2 12 Tf 1 0 0 1 511.01 496.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 496.26 Tm (the) Tj ET Q q n 0 493.85 m 612 493.85 l 612 481.85 l 0 481.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 484.26 Tm (rights or obligations of the Association.) Tj ET Q q n 0 481.85 m 612 481.85 l 612 469.85 l 0 469.85 l h W n Q q n 0 469.85 m 612 469.85 l 612 457.85 l 0 457.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 235.33 460.26 Tm (COVERAGE) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 235.9 458.38 m 304.1 458.38 l S 1 w [] 0 d Q q n 0 457.85 m 612 457.85 l 612 445.85 l 0 445.85 l h W n Q q n 0 445.85 m 612 445.85 l 612 433.85 l 0 433.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 436.26 Tm (Persons Covered) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 0.57 434.38 m 85.74 434.38 l S 1 w [] 0 d Q q n 0 433.85 m 612 433.85 l 612 421.85 l 0 421.85 l h W n Q q n 0 421.85 m 612 421.85 l 612 409.85 l 0 409.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 412.26 Tm (Generally,) Tj ET BT /F2 12 Tf 1 0 0 1 56.3 412.26 Tm (individuals) Tj ET BT /F2 12 Tf 1 0 0 1 115.62 412.26 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 140.27 412.26 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 157.59 412.26 Tm (protected) Tj ET BT /F2 12 Tf 1 0 0 1 208.22 412.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 226.21 412.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 246.86 412.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 309.5 412.26 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 322.82 412.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 343.47 412.26 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 388.78 412.26 Tm (insurer) Tj ET BT /F2 12 Tf 1 0 0 1 428.09 412.26 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 452.74 412.26 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 464.05 412.26 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 509.36 412.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 412.26 Tm (the) Tj ET Q q n 0 409.85 m 612 409.85 l 612 397.85 l 0 397.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 400.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 60.08 400.26 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 80.81 400.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 98.89 400.26 Tm (individual) Tj ET BT /F2 12 Tf 1 0 0 1 150.97 400.26 Tm (lives) Tj ET BT /F2 12 Tf 1 0 0 1 177.05 400.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 189.79 400.26 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 257.2 400.26 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 269.27 400.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 287.35 400.26 Tm (time) Tj ET BT /F2 12 Tf 1 0 0 1 312.09 400.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 330.16 400.26 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 372.9 400.26 Tm (insurer) Tj ET BT /F2 12 Tf 1 0 0 1 409.63 400.26 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 421.05 400.26 Tm (determined) Tj ET BT /F2 12 Tf 1 0 0 1 478.44 400.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 493.86 400.26 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 502.6 400.26 Tm (court) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 400.26 Tm (to) Tj ET Q q n 0 397.85 m 612 397.85 l 612 385.85 l 0 385.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 388.26 Tm (be insolvent. Coverage is also provided to policy beneficiaries, payees or assignees of such individuals.) Tj ET Q q n 0 385.85 m 612 385.85 l 612 373.85 l 0 373.85 l h W n Q q n 0 373.85 m 612 373.85 l 612 361.85 l 0 361.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 364.26 Tm (Amounts of Coverage) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 0.57 362.38 m 110.74 362.38 l S 1 w [] 0 d Q q n 0 361.85 m 612 361.85 l 612 349.85 l 0 349.85 l h W n Q q n 0 349.85 m 612 349.85 l 612 337.85 l 0 337.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 340.26 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.88 340.26 Tm (basic) Tj ET BT /F2 12 Tf 1 0 0 1 51.75 340.26 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 99.27 340.26 Tm (protections) Tj ET BT /F2 12 Tf 1 0 0 1 156.81 340.26 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 203.68 340.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 219.9 340.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 238.78 340.26 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 299.66 340.26 Tm (per) Tj ET BT /F2 12 Tf 1 0 0 1 319.2 340.26 Tm (insured) Tj ET BT /F2 12 Tf 1 0 0 1 358.75 340.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 372.3 340.26 Tm (each) Tj ET BT /F2 12 Tf 1 0 0 1 398.5 340.26 Tm (insolvency) Tj ET BT /F2 12 Tf 1 0 0 1 454.71 340.26 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 473.57 340.26 Tm (limited) Tj ET BT /F2 12 Tf 1 0 0 1 511.79 340.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 340.26 Tm (the) Tj ET Q q n 0 337.85 m 612 337.85 l 612 325.85 l 0 325.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 328.26 Tm (aggregate) Tj ET BT /F2 12 Tf 1 0 0 1 52.37 328.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 67.44 328.26 Tm ($300,000) Tj ET BT /F2 12 Tf 1 0 0 1 118.18 328.26 Tm (\(or) Tj ET BT /F2 12 Tf 1 0 0 1 137.91 328.26 Tm ($500,000) Tj ET BT /F2 12 Tf 1 0 0 1 188.65 328.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 203.72 328.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 224.12 328.26 Tm (case) Tj ET BT /F2 12 Tf 1 0 0 1 250.51 328.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 266.24 328.26 Tm (health) Tj ET BT /F2 12 Tf 1 0 0 1 301.3 328.26 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 340.35 328.26 Tm (plans\),) Tj ET BT /F2 12 Tf 1 0 0 1 378.42 328.26 Tm (including) Tj ET BT /F2 12 Tf 1 0 0 1 429.48 328.26 Tm (specific) Tj ET BT /F2 12 Tf 1 0 0 1 472.53 328.26 Tm (limits) Tj ET BT /F2 12 Tf 1 0 0 1 505.61 328.26 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 328.26 Tm (the) Tj ET Q q n 0 325.85 m 612 325.85 l 612 313.85 l 0 313.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 316.26 Tm (following types of coverage but not in excess of the contractual obligations of the member insurer;) Tj ET Q q n 0 313.85 m 612 313.85 l 612 301.85 l 0 301.85 l h W n Q q n 0 301.85 m 612 301.85 l 612 289.85 l 0 289.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 292.26 Tm (Life insurance:) Tj ET Q q n 0 289.85 m 612 289.85 l 612 277.85 l 0 277.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 280.26 Tm (o Up to $300,000 in death benefits including up to $100,000 in net cash surrender or withdrawal value.) Tj ET Q q n 0 277.85 m 612 277.85 l 612 265.85 l 0 265.85 l h W n Q q n 0 265.85 m 612 265.85 l 612 253.85 l 0 253.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 256.26 Tm (Accident, accident and health, or health insurance \(including HMOs\):) Tj ET Q q n 18 253.85 m 630 253.85 l 630 241.85 l 18 241.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 244.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 244.26 Tm (Up to $500,000 for health benefit plans, with some exceptions.) Tj ET Q q n 18 241.85 m 630 241.85 l 630 229.85 l 18 229.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 232.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 232.26 Tm (Up to $300,000 for disability income benefits.) Tj ET Q q n 18 229.85 m 630 229.85 l 630 217.85 l 18 217.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 220.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 220.26 Tm (Up to $300,000 for long-term care insurance benefits.) Tj ET Q q n 18 217.85 m 630 217.85 l 630 205.85 l 18 205.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 208.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 208.26 Tm (Up to $100,000 for all other types of health insurance.) Tj ET Q q n 0 205.85 m 612 205.85 l 612 193.85 l 0 193.85 l h W n Q q n 0 193.85 m 612 193.85 l 612 181.85 l 0 181.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 184.26 Tm (Individual annuities) Tj ET Q q n 18 181.85 m 630 181.85 l 630 169.85 l 18 169.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 172.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 172.26 Tm (Up) Tj ET BT /F2 12 Tf 1 0 0 1 56.01 172.26 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 70.68 172.26 Tm ($250,000) Tj ET BT /F2 12 Tf 1 0 0 1 121.03 172.26 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 135.7 172.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 155.71 172.26 Tm (present) Tj ET BT /F2 12 Tf 1 0 0 1 195.7 172.26 Tm (value) Tj ET BT /F2 12 Tf 1 0 0 1 227.03 172.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 242.37 172.26 Tm (benefits,) Tj ET BT /F2 12 Tf 1 0 0 1 288.7 172.26 Tm (including) Tj ET BT /F2 12 Tf 1 0 0 1 339.37 172.26 Tm (cash) Tj ET BT /F2 12 Tf 1 0 0 1 366.03 172.26 Tm (surrender) Tj ET BT /F2 12 Tf 1 0 0 1 416.68 172.26 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 439.35 172.26 Tm (net) Tj ET BT /F2 12 Tf 1 0 0 1 459.35 172.26 Tm (cash) Tj ET BT /F2 12 Tf 1 0 0 1 486.02 172.26 Tm (withdrawal) Tj ET Q q n 36 169.85 m 648 169.85 l 648 157.85 l 36 157.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 160.26 Tm (values.) Tj ET Q q n 0 157.85 m 612 157.85 l 612 145.85 l 0 145.85 l h W n Q q n 0 145.85 m 612 145.85 l 612 133.85 l 0 133.85 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 117.65 136.26 Tm (LIMITATIONS AND EXCLUSIONS FROM COVERAGE) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 118.22 134.38 m 421.78 134.38 l S 1 w [] 0 d Q q n 0 133.85 m 612 133.85 l 612 121.85 l 0 121.85 l h W n Q q n 0 121.85 m 612 121.85 l 612 109.85 l 0 109.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 112.26 Tm (The Association also does not provide coverage for:) Tj ET Q q n 0 109.85 m 612 109.85 l 612 97.85 l 0 97.85 l h W n Q q n 18 97.85 m 630 97.85 l 630 85.85 l 18 85.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 88.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 88.26 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 56.93 88.26 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 90.52 88.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 104.12 88.26 Tm (contract) Tj ET BT /F2 12 Tf 1 0 0 1 146.37 88.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 159.96 88.26 Tm (portion) Tj ET BT /F2 12 Tf 1 0 0 1 198.23 88.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 211.83 88.26 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 220.75 88.26 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 254.35 88.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 267.95 88.26 Tm (contract) Tj ET BT /F2 12 Tf 1 0 0 1 310.19 88.26 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 343.12 88.26 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 354.73 88.26 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 373.66 88.26 Tm (guaranteed) Tj ET BT /F2 12 Tf 1 0 0 1 429.9 88.26 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 445.5 88.26 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 463.76 88.26 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 506.68 88.26 Tm (insurer) Tj ET Q q n 36 85.85 m 648 85.85 l 648 73.85 l 36 73.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 76.26 Tm (or for which the individual has assumed the risk, such as a variable contract sold by prospectus;) Tj ET Q q n 18 73.85 m 630 73.85 l 630 61.85 l 18 61.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 64.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 64.26 Tm (claims) Tj ET BT /F2 12 Tf 1 0 0 1 72.43 64.26 Tm (based) Tj ET BT /F2 12 Tf 1 0 0 1 104.86 64.26 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 121.97 64.26 Tm (marketing) Tj ET BT /F2 12 Tf 1 0 0 1 175.72 64.26 Tm (materials) Tj ET BT /F2 12 Tf 1 0 0 1 224.81 64.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 239.91 64.26 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 269.68 64.26 Tm (documents) Tj ET BT /F2 12 Tf 1 0 0 1 326.77 64.26 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 361.2 64.26 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 380.96 64.26 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 401.4 64.26 Tm (approved) Tj ET BT /F2 12 Tf 1 0 0 1 451.15 64.26 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 486.26 64.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 501.36 64.26 Tm (contract) Tj ET Q q n 36 61.85 m 648 61.85 l 648 49.85 l 36 49.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 52.26 Tm (forms,) Tj ET BT /F2 12 Tf 1 0 0 1 71.95 52.26 Tm (claims) Tj ET BT /F2 12 Tf 1 0 0 1 108.24 52.26 Tm (based) Tj ET BT /F2 12 Tf 1 0 0 1 140.52 52.26 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 157.48 52.26 Tm (misrepresentations) Tj ET BT /F2 12 Tf 1 0 0 1 252.41 52.26 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 267.37 52.26 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 302.32 52.26 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 317.27 52.26 Tm (contract) Tj ET BT /F2 12 Tf 1 0 0 1 360.88 52.26 Tm (benefits,) Tj ET BT /F2 12 Tf 1 0 0 1 406.82 52.26 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 429.1 52.26 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 458.72 52.26 Tm (extra-contractual) Tj ET Q q n 36 49.85 m 648 49.85 l 648 37.85 l 36 37.85 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 40.26 Tm (claims;) Tj ET Q q n 18 37.85 m 630 37.85 l 630 25.85 l 18 25.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 28.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 28.26 Tm (any policy of reinsurance \(unless an assumption certificate was issued\);) Tj ET Q q n 18 25.85 m 630 25.85 l 630 13.85 l 18 13.85 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 16.26 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 16.26 Tm (interest rate yields or increases based on an index that exceed an average rate specified by statute;) Tj ET Q Q q Q Q endstream endobj 25 0 obj <>>>>> endobj 134 0 obj <>/Border[0 0 0]/Rect[439.79 444 526.43 456]/Subtype/Link>> endobj 135 0 obj <>/Border[0 0 0]/Rect[252 324 362.3 336]/Subtype/Link>> endobj 136 0 obj <>stream q 0 0 612 792 re W n q 1 0 0 1 36 758.4 cm q n 0 12 m 612 12 l 612 0 l 0 0 l h W n Q Q q Q q 1 0 0 1 36 21.6 cm q n 0 37.15 m 183.6 37.15 l 183.6 25.15 l 0 25.15 l h W n Q q n 183.6 37.15 m 367.2 37.15 l 367.2 25.15 l 183.6 25.15 l h W n Q q n 367.2 37.15 m 550.8 37.15 l 550.8 25.15 l 367.2 25.15 l h W n Q q n 0 25.15 m 183.6 25.15 l 183.6 13.15 l 0 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 15.56 Tm (GAN-GRP-PA NOTICE-P/C) Tj ET Q q n 183.6 25.15 m 367.2 25.15 l 367.2 13.15 l 183.6 13.15 l h W n Q q n 367.2 25.15 m 550.8 25.15 l 550.8 13.15 l 367.2 13.15 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 512.67 15.56 Tm (11/20) Tj ET Q q n 0 13.15 m 183.6 13.15 l 183.6 1.15 l 0 1.15 l h W n Q q n 183.6 13.15 m 367.2 13.15 l 367.2 1.15 l 183.6 1.15 l h W n 0 0 0 rg BT /F2 10 Tf 1 0 0 1 265 3.56 Tm (23) Tj ET Q q n 367.2 13.15 m 550.8 13.15 l 550.8 1.15 l 367.2 1.15 l h W n 0 0 0 rg BT /F2 10 Tf 1 0 0 1 504.44 3.56 Tm (07/01/21) Tj ET Q Q q Q q 1 0 0 1 36 58.75 cm q n 18 697.25 m 630 697.25 l 630 685.25 l 18 685.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 687.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 687.66 Tm (dividends,) Tj ET BT /F2 12 Tf 1 0 0 1 88.87 687.66 Tm (experience) Tj ET BT /F2 12 Tf 1 0 0 1 144.04 687.66 Tm (rating) Tj ET BT /F2 12 Tf 1 0 0 1 175.25 687.66 Tm (credits,) Tj ET BT /F2 12 Tf 1 0 0 1 213.44 687.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 226.65 687.66 Tm (credits) Tj ET BT /F2 12 Tf 1 0 0 1 261.84 687.66 Tm (given) Tj ET BT /F2 12 Tf 1 0 0 1 291.71 687.66 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 304.26 687.66 Tm (connection) Tj ET BT /F2 12 Tf 1 0 0 1 360.11 687.66 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 384.66 687.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 402.53 687.66 Tm (administration) Tj ET BT /F2 12 Tf 1 0 0 1 475.06 687.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 488.26 687.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 496.8 687.66 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 530 687.66 Tm (or) Tj ET Q q n 36 685.25 m 648 685.25 l 648 673.25 l 36 673.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 675.66 Tm (contract by a group contractholder;) Tj ET Q q n 18 673.25 m 630 673.25 l 630 661.25 l 18 661.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 663.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 663.66 Tm (employers') Tj ET BT /F2 12 Tf 1 0 0 1 92.5 663.66 Tm (plans) Tj ET BT /F2 12 Tf 1 0 0 1 122.19 663.66 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 144.54 663.66 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 163.54 663.66 Tm (self-funded) Tj ET BT /F2 12 Tf 1 0 0 1 222.54 663.66 Tm (\(that) Tj ET BT /F2 12 Tf 1 0 0 1 248.88 663.66 Tm (is,) Tj ET BT /F2 12 Tf 1 0 0 1 264.24 663.66 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 283.93 663.66 Tm (insured) Tj ET BT /F2 12 Tf 1 0 0 1 323.61 663.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 339.97 663.66 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 383.64 663.66 Tm (insurer,) Tj ET BT /F2 12 Tf 1 0 0 1 424.32 663.66 Tm (even) Tj ET BT /F2 12 Tf 1 0 0 1 451.32 663.66 Tm (if) Tj ET BT /F2 12 Tf 1 0 0 1 463.01 663.66 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 506.68 663.66 Tm (insurer) Tj ET Q q n 36 661.25 m 648 661.25 l 648 649.25 l 36 649.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 651.66 Tm (administers them\);) Tj ET Q q n 18 649.25 m 630 649.25 l 630 637.25 l 18 637.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 639.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 639.66 Tm (unallocated) Tj ET BT /F2 12 Tf 1 0 0 1 94.88 639.66 Tm (annuity) Tj ET BT /F2 12 Tf 1 0 0 1 134.45 639.66 Tm (contracts) Tj ET BT /F2 12 Tf 1 0 0 1 181.34 639.66 Tm (\(which) Tj ET BT /F2 12 Tf 1 0 0 1 218.23 639.66 Tm (give) Tj ET BT /F2 12 Tf 1 0 0 1 242.47 639.66 Tm (rights) Tj ET BT /F2 12 Tf 1 0 0 1 273.37 639.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 286.28 639.66 Tm (group) Tj ET BT /F2 12 Tf 1 0 0 1 317.85 639.66 Tm (contractholders,) Tj ET BT /F2 12 Tf 1 0 0 1 398.39 639.66 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 417.3 639.66 Tm (individuals\)) Tj ET BT /F2 12 Tf 1 0 0 1 478.2 639.66 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 506.43 639.66 Tm (than) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 639.66 Tm (in) Tj ET Q q n 36 637.25 m 648 637.25 l 648 625.25 l 36 625.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 627.66 Tm (limited circumstances and amounts;) Tj ET Q q n 18 625.25 m 630 625.25 l 630 613.25 l 18 613.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 615.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 615.66 Tm (certain) Tj ET BT /F2 12 Tf 1 0 0 1 72.03 615.66 Tm (contracts) Tj ET BT /F2 12 Tf 1 0 0 1 118.73 615.66 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 151.44 615.66 Tm (establish) Tj ET BT /F2 12 Tf 1 0 0 1 196.82 615.66 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 238.19 615.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 253.58 615.66 Tm (reference) Tj ET BT /F2 12 Tf 1 0 0 1 301.58 615.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 314.3 615.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 323.01 615.66 Tm (portfolio) Tj ET BT /F2 12 Tf 1 0 0 1 368.39 615.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 381.77 615.66 Tm (assets) Tj ET BT /F2 12 Tf 1 0 0 1 413.16 615.66 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 431.87 615.66 Tm (owned) Tj ET BT /F2 12 Tf 1 0 0 1 467.25 615.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 482.64 615.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 500.68 615.66 Tm (member) Tj ET Q q n 36 613.25 m 648 613.25 l 648 601.25 l 36 601.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 603.66 Tm (insurer; or) Tj ET Q q n 18 601.25 m 630 601.25 l 630 589.25 l 18 589.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 591.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 591.66 Tm (policies) Tj ET BT /F2 12 Tf 1 0 0 1 77.4 591.66 Tm (providing) Tj ET BT /F2 12 Tf 1 0 0 1 128.14 591.66 Tm (health) Tj ET BT /F2 12 Tf 1 0 0 1 161.53 591.66 Tm (care) Tj ET BT /F2 12 Tf 1 0 0 1 185.58 591.66 Tm (benefits) Tj ET BT /F2 12 Tf 1 0 0 1 227.64 591.66 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 245.7 591.66 Tm (Medicare) Tj ET BT /F2 12 Tf 1 0 0 1 295.08 591.66 Tm (Parts) Tj ET BT /F2 12 Tf 1 0 0 1 323.16 591.66 Tm (C) Tj ET BT /F2 12 Tf 1 0 0 1 335.23 591.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 349.3 591.66 Tm (D) Tj ET BT /F2 12 Tf 1 0 0 1 362.04 591.66 Tm (coverage,) Tj ET BT /F2 12 Tf 1 0 0 1 412.42 591.66 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 430.48 591.66 Tm (Medicaid) Tj ET BT /F2 12 Tf 1 0 0 1 479.87 591.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 493.94 591.66 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 591.66 Tm (the) Tj ET Q q n 36 589.25 m 648 589.25 l 648 577.25 l 36 577.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 579.66 Tm (Pennsylvania program for Comprehensive Health Care for Uninsured Children.) Tj ET Q q n 0 577.25 m 612 577.25 l 612 565.25 l 0 565.25 l h W n Q q n 0 565.25 m 612 565.25 l 612 553.25 l 0 553.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 555.66 Tm (The following policies and persons are among those that are excluded from Association coverage:) Tj ET Q q n 36 553.25 m 648 553.25 l 648 541.25 l 36 541.25 l h W n Q q n 18 541.25 m 630 541.25 l 630 529.25 l 18 529.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 531.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 531.66 Tm (A) Tj ET BT /F2 12 Tf 1 0 0 1 47.97 531.66 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 81.26 531.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 94.56 531.66 Tm (contract) Tj ET BT /F2 12 Tf 1 0 0 1 136.51 531.66 Tm (issued) Tj ET BT /F2 12 Tf 1 0 0 1 169.81 531.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 185.11 531.66 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 199.74 531.66 Tm (insurer) Tj ET BT /F2 12 Tf 1 0 0 1 236.36 531.66 Tm (that) Tj ET BT /F2 12 Tf 1 0 0 1 257.66 531.66 Tm (was) Tj ET BT /F2 12 Tf 1 0 0 1 279.62 531.66 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 298.26 531.66 Tm (authorized) Tj ET BT /F2 12 Tf 1 0 0 1 352.2 531.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 364.84 531.66 Tm (do) Tj ET BT /F2 12 Tf 1 0 0 1 380.14 531.66 Tm (business) Tj ET BT /F2 12 Tf 1 0 0 1 424.11 531.66 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 436.75 531.66 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 504.04 531.66 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 533.33 531.66 Tm (it) Tj ET Q q n 36 529.25 m 648 529.25 l 648 517.25 l 36 517.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 519.66 Tm (issued the policy or contract) Tj ET Q q n 18 517.25 m 630 517.25 l 630 505.25 l 18 505.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 507.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 507.66 Tm (If the person is provided coverage by the guaranty association of another state) Tj ET Q q n 18 505.25 m 630 505.25 l 630 493.25 l 18 493.25 l h W n 0 0 0 rg BT /F122 12 Tf 1 0 0 1 18 495.66 Tm (x) Tj ET BT /F2 12 Tf 1 0 0 1 36 495.66 Tm (A) Tj ET BT /F2 12 Tf 1 0 0 1 49.74 495.66 Tm (policy) Tj ET BT /F2 12 Tf 1 0 0 1 84.81 495.66 Tm (issued) Tj ET BT /F2 12 Tf 1 0 0 1 119.89 495.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 136.96 495.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 147.36 495.66 Tm (fraternal) Tj ET BT /F2 12 Tf 1 0 0 1 193.07 495.66 Tm (benefit) Tj ET BT /F2 12 Tf 1 0 0 1 231.47 495.66 Tm (society,) Tj ET BT /F2 12 Tf 1 0 0 1 273.53 495.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 283.93 495.66 Tm (mandatory) Tj ET BT /F2 12 Tf 1 0 0 1 340.32 495.66 Tm (state) Tj ET BT /F2 12 Tf 1 0 0 1 367.39 495.66 Tm (pooling) Tj ET BT /F2 12 Tf 1 0 0 1 409.13 495.66 Tm (plan,) Tj ET BT /F2 12 Tf 1 0 0 1 437.87 495.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 448.27 495.66 Tm (mutual) Tj ET BT /F2 12 Tf 1 0 0 1 486.67 495.66 Tm (assessment) Tj ET Q q n 36 493.25 m 648 493.25 l 648 481.25 l 36 481.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 483.66 Tm (company) Tj ET BT /F2 12 Tf 1 0 0 1 83.85 483.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 97.71 483.66 Tm (similar) Tj ET BT /F2 12 Tf 1 0 0 1 134.9 483.66 Tm (plan) Tj ET BT /F2 12 Tf 1 0 0 1 159.42 483.66 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 172.61 483.66 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 205.8 483.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 224.32 483.66 Tm (policyholder) Tj ET BT /F2 12 Tf 1 0 0 1 288.83 483.66 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 300.7 483.66 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 338.55 483.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 351.74 483.66 Tm (future) Tj ET BT /F2 12 Tf 1 0 0 1 384.26 483.66 Tm (assessments,) Tj ET BT /F2 12 Tf 1 0 0 1 449.12 483.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 462.97 483.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 478.83 483.66 Tm (an) Tj ET BT /F2 12 Tf 1 0 0 1 494.02 483.66 Tm (insurance) Tj ET Q q n 36 481.25 m 648 481.25 l 648 469.25 l 36 469.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 36 471.66 Tm (exchange) Tj ET Q q n 0 469.25 m 612 469.25 l 612 457.25 l 0 457.25 l h W n Q q n 0 457.25 m 612 457.25 l 612 445.25 l 0 445.25 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 242.99 447.66 Tm (NOTICES) Tj ET 2 J 1.14 w [] 0 d 0 0 0 RG 243.56 445.78 m 296.44 445.78 l S 1 w [] 0 d Q q n 0 445.25 m 612 445.25 l 612 433.25 l 0 433.25 l h W n Q q n 0 433.25 m 612 433.25 l 612 421.25 l 0 421.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 423.66 Tm (Member) Tj ET BT /F2 12 Tf 1 0 0 1 44.38 423.66 Tm (insurers) Tj ET BT /F2 12 Tf 1 0 0 1 86.09 423.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 99.81 423.66 Tm (their) Tj ET BT /F2 12 Tf 1 0 0 1 125.53 423.66 Tm (agents) Tj ET BT /F2 12 Tf 1 0 0 1 159.91 423.66 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 178.28 423.66 Tm (required) Tj ET BT /F2 12 Tf 1 0 0 1 221.99 423.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 237.71 423.66 Tm (law) Tj ET BT /F2 12 Tf 1 0 0 1 258.76 423.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 271.82 423.66 Tm (give) Tj ET BT /F2 12 Tf 1 0 0 1 296.2 423.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 309.93 423.66 Tm (send) Tj ET BT /F2 12 Tf 1 0 0 1 335.65 423.66 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 357.37 423.66 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 378.43 423.66 Tm (notice,) Tj ET BT /F2 12 Tf 1 0 0 1 414.48 423.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 435.53 423.66 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 453.9 423.66 Tm (prohibited) Tj ET BT /F2 12 Tf 1 0 0 1 506.95 423.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 423.66 Tm (law) Tj ET Q q n 0 421.25 m 612 421.25 l 612 409.25 l 0 409.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 411.66 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 26.84 411.66 Tm (using) Tj ET BT /F2 12 Tf 1 0 0 1 56.35 411.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 74.52 411.66 Tm (existence) Tj ET BT /F2 12 Tf 1 0 0 1 122.67 411.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 136.17 411.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 154.34 411.66 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 214.51 411.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 227.36 411.66 Tm (induce) Tj ET BT /F2 12 Tf 1 0 0 1 262.85 411.66 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 284.36 411.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 297.2 411.66 Tm (purchase) Tj ET BT /F2 12 Tf 1 0 0 1 343.36 411.66 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 364.19 411.66 Tm (kind) Tj ET BT /F2 12 Tf 1 0 0 1 389.04 411.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 402.54 411.66 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 452.03 411.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 465.53 411.66 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 493.7 411.66 Tm (coverage.) 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Tj ET BT /F2 12 Tf 1 0 0 1 498.06 387.66 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 523.35 387.66 Tm (can) Tj ET Q q n 0 385.25 m 612 385.25 l 612 373.25 l 0 373.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 375.66 Tm (obtain) Tj ET BT /F2 12 Tf 1 0 0 1 33.44 375.66 Tm (additional) Tj ET BT /F2 12 Tf 1 0 0 1 84.87 375.66 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 144.97 375.66 Tm (from) Tj ET BT /F2 12 Tf 1 0 0 1 171.75 375.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 189.85 375.66 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 249.96 375.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 265.4 375.66 Tm (contacting) Tj ET BT /F2 12 Tf 1 0 0 1 318.83 375.66 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 328.94 375.66 Tm (at) Tj ET BT /F2 12 Tf 1 0 0 1 341.05 375.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 359.15 375.66 Tm (address) Tj ET BT /F2 12 Tf 1 0 0 1 398.59 375.66 Tm (below.) Tj ET BT /F2 12 Tf 1 0 0 1 434.36 375.66 Tm (You) Tj ET BT /F2 12 Tf 1 0 0 1 458.47 375.66 Tm (may) Tj ET BT /F2 12 Tf 1 0 0 1 482.58 375.66 Tm (also) Tj ET BT /F2 12 Tf 1 0 0 1 505.35 375.66 Tm (contact) Tj ET Q q n 0 373.25 m 612 373.25 l 612 361.25 l 0 361.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 363.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 18.77 363.66 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 86.88 363.66 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 137.63 363.66 Tm (Department) Tj ET BT /F2 12 Tf 1 0 0 1 198.39 363.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 211.83 363.66 Tm (file) Tj ET BT /F2 12 Tf 1 0 0 1 231.94 363.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 241.37 363.66 Tm (complaint) Tj ET BT /F2 12 Tf 1 0 0 1 293.48 363.66 Tm (with) Tj ET BT /F2 12 Tf 1 0 0 1 318.92 363.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 337.7 363.66 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 405.8 363.66 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 456.55 363.66 Tm (Commissioner) Tj ET BT /F2 12 Tf 1 0 0 1 530.67 363.66 Tm (to) Tj ET Q q n 0 361.25 m 612 361.25 l 612 349.25 l 0 349.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 351.66 Tm (allege) Tj ET BT /F2 12 Tf 1 0 0 1 31.78 351.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 40.24 351.66 Tm (violation) Tj ET BT /F2 12 Tf 1 0 0 1 86.04 351.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 99.16 351.66 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 119.62 351.66 Tm (provisions) Tj ET BT /F2 12 Tf 1 0 0 1 172.76 351.66 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 185.89 351.66 Tm (Pennsylvania) Tj ET BT /F2 12 Tf 1 0 0 1 253.01 351.66 Tm (laws) Tj ET BT /F2 12 Tf 1 0 0 1 278.14 351.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 298.6 351.66 Tm (regulations) Tj ET BT /F2 12 Tf 1 0 0 1 355.06 351.66 Tm (relating) Tj ET BT /F2 12 Tf 1 0 0 1 394.84 351.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 407.31 351.66 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 456.42 351.66 Tm (including) Tj ET BT /F2 12 Tf 1 0 0 1 504.88 351.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 522.67 351.66 Tm (law) Tj ET Q q n 0 349.25 m 612 349.25 l 612 337.25 l 0 337.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 339.66 Tm (establishing the Association:) Tj ET Q q n 0 337.25 m 612 337.25 l 612 325.25 l 0 325.25 l h W n Q q n 0 325.25 m 612 325.25 l 612 313.25 l 0 313.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 315.66 Tm (Pennsylvania Life and Health Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 216 315.66 Tm (Pennsylvania Insurance Department) Tj ET Q q n 0 313.25 m 612 313.25 l 612 301.25 l 0 301.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 303.66 Tm (Guaranty Association) Tj ET BT /F2 12 Tf 1 0 0 1 216 303.66 Tm (1209 Strawberry Square) Tj ET Q q n 0 301.25 m 612 301.25 l 612 289.25 l 0 289.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 291.66 Tm (290 King of Prussia Road) Tj ET BT /F2 12 Tf 1 0 0 1 216 291.66 Tm (Harrisburg, PA 17120) Tj ET Q q n 0 289.25 m 612 289.25 l 612 277.25 l 0 277.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 279.66 Tm (Radnor Station Building 2, Suite 218) Tj ET BT /F2 12 Tf 1 0 0 1 216 279.66 Tm (1-877-881-6388) Tj ET Q q n 0 277.25 m 612 277.25 l 612 265.25 l 0 265.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 267.66 Tm (Radnor, PA 19087) Tj ET BT /F2 12 Tf 1 0 0 1 216 267.66 Tm (www.insurance.pa.gov) Tj ET Q q n 0 265.25 m 612 265.25 l 612 253.25 l 0 253.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 255.66 Tm (\(610\) 975-0572) Tj ET Q q n 0 253.25 m 612 253.25 l 612 241.25 l 0 241.25 l h W n Q q n 0 241.25 m 612 241.25 l 612 229.25 l 0 229.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 231.66 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 22.92 231.66 Tm (summary) Tj ET BT /F2 12 Tf 1 0 0 1 71.85 231.66 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 132.77 231.66 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 179.69 231.66 Tm (by) Tj ET BT /F2 12 Tf 1 0 0 1 195.95 231.66 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 217.56 231.66 Tm (notice) Tj ET BT /F2 12 Tf 1 0 0 1 251.14 231.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 272.73 231.66 Tm (on) Tj ET BT /F2 12 Tf 1 0 0 1 289 231.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 307.92 231.66 Tm 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ET BT /F2 12 Tf 1 0 0 1 342.22 219.66 Tm (subject) Tj ET BT /F2 12 Tf 1 0 0 1 382.78 219.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 398.68 219.66 Tm (change) Tj ET BT /F2 12 Tf 1 0 0 1 439.22 219.66 Tm (without) Tj ET BT /F2 12 Tf 1 0 0 1 482.46 219.66 Tm (notice.) Tj ET BT /F2 12 Tf 1 0 0 1 521.34 219.66 Tm (The) Tj ET Q q n 0 217.25 m 612 217.25 l 612 205.25 l 0 205.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 207.66 Tm (statements) Tj ET BT /F2 12 Tf 1 0 0 1 56.07 207.66 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 87.47 207.66 Tm (herein) Tj ET BT /F2 12 Tf 1 0 0 1 122.87 207.66 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 142.94 207.66 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 162.34 207.66 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 224.42 207.66 Tm (purposes) Tj ET BT /F2 12 Tf 1 0 0 1 272.49 207.66 Tm (only.) Tj ET BT /F2 12 Tf 1 0 0 1 302.24 207.66 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 326.32 207.66 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 388.39 207.66 Tm (has) Tj ET BT /F2 12 Tf 1 0 0 1 409.8 207.66 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 430.55 207.66 Tm (reviewed) Tj ET BT /F2 12 Tf 1 0 0 1 479.95 207.66 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 502.69 207.66 Tm (specific) Tj ET Q q n 0 205.25 m 612 205.25 l 612 193.25 l 0 193.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 195.66 Tm (policy,) Tj ET BT /F2 12 Tf 1 0 0 1 37.29 195.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 51.59 195.66 Tm (verified) Tj ET BT /F2 12 Tf 1 0 0 1 93.19 195.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 112.15 195.66 Tm (information) Tj ET BT /F2 12 Tf 1 0 0 1 173.1 195.66 Tm (provided) Tj ET BT /F2 12 Tf 1 0 0 1 220.06 195.66 Tm (regarding) Tj ET BT /F2 12 Tf 1 0 0 1 270.33 195.66 Tm (residency) Tj ET BT /F2 12 Tf 1 0 0 1 320.61 195.66 Tm (or) Tj ET BT /F2 12 Tf 1 0 0 1 334.9 195.66 Tm (other) Tj ET BT /F2 12 Tf 1 0 0 1 363.86 195.66 Tm (relevant) Tj ET BT /F2 12 Tf 1 0 0 1 406.79 195.66 Tm (factors.) 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Tj ET BT /F2 12 Tf 1 0 0 1 410.85 171.66 Tm (No) Tj ET BT /F2 12 Tf 1 0 0 1 430.8 171.66 Tm (final) Tj ET BT /F2 12 Tf 1 0 0 1 458.07 171.66 Tm (determination) Tj ET BT /F2 12 Tf 1 0 0 1 530 171.66 Tm (of) Tj ET Q q n 0 169.25 m 612 169.25 l 612 157.25 l 0 157.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 159.66 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 50.02 159.66 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 73.4 159.66 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 91.44 159.66 Tm (made) Tj ET BT /F2 12 Tf 1 0 0 1 124.15 159.66 Tm (until) Tj ET BT /F2 12 Tf 1 0 0 1 152.88 159.66 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 164.92 159.66 Tm (member) Tj ET BT /F2 12 Tf 1 0 0 1 210.96 159.66 Tm (insurer) Tj ET BT /F2 12 Tf 1 0 0 1 251 159.66 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 265.73 159.66 Tm (declared) Tj ET BT /F2 12 Tf 1 0 0 1 313.08 159.66 Tm (insolvent) Tj ET BT /F2 12 Tf 1 0 0 1 363.81 159.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 387.85 159.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 409.23 159.66 Tm (specific) Tj ET BT /F2 12 Tf 1 0 0 1 453.27 159.66 Tm (factual) Tj ET BT /F2 12 Tf 1 0 0 1 492.63 159.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 516.68 159.66 Tm (legal) Tj ET Q q n 0 157.25 m 612 157.25 l 612 145.25 l 0 145.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 147.66 Tm (circumstances) Tj ET BT /F2 12 Tf 1 0 0 1 71.49 147.66 Tm (can) Tj ET BT /F2 12 Tf 1 0 0 1 91.67 147.66 Tm (be) Tj ET BT /F2 12 Tf 1 0 0 1 106.52 147.66 Tm (reviewed.) Tj ET BT /F2 12 Tf 1 0 0 1 157.02 147.66 Tm (Nothing) Tj ET BT /F2 12 Tf 1 0 0 1 199.88 147.66 Tm (contained) Tj ET BT /F2 12 Tf 1 0 0 1 250.06 147.66 Tm (herein) Tj ET BT /F2 12 Tf 1 0 0 1 283.56 147.66 Tm (is) Tj ET BT /F2 12 Tf 1 0 0 1 295.09 147.66 Tm (intended) Tj ET BT /F2 12 Tf 1 0 0 1 339.94 147.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 352.8 147.66 Tm (guarantee) Tj ET BT /F2 12 Tf 1 0 0 1 402.96 147.66 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 449.78 147.66 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 467.3 147.66 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 488.15 147.66 Tm (insured,) Tj ET BT /F2 12 Tf 1 0 0 1 530 147.66 Tm (or) Tj ET Q q n 0 145.25 m 612 145.25 l 612 133.25 l 0 133.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 135.66 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 14.71 135.66 Tm (bind) Tj ET BT /F2 12 Tf 1 0 0 1 41.43 135.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 61.47 135.66 Tm (Association) Tj ET BT /F2 12 Tf 1 0 0 1 123.5 135.66 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 138.22 135.66 Tm (any) Tj ET BT /F2 12 Tf 1 0 0 1 160.92 135.66 Tm (way.) Tj ET BT /F2 12 Tf 1 0 0 1 189.29 135.66 Tm (Finally,) Tj ET BT /F2 12 Tf 1 0 0 1 231.67 135.66 Tm (this) Tj ET BT /F2 12 Tf 1 0 0 1 254.39 135.66 Tm (summary) Tj ET BT /F2 12 Tf 1 0 0 1 304.43 135.66 Tm (and) Tj ET BT /F2 12 Tf 1 0 0 1 327.14 135.66 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 347.17 135.66 Tm (Associations) Tj ET BT /F2 12 Tf 1 0 0 1 417.88 135.66 Tm (web) Tj ET BT /F2 12 Tf 1 0 0 1 443.25 135.66 Tm (site) Tj ET BT /F2 12 Tf 1 0 0 1 465.29 135.66 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 485.32 135.66 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 504.69 135.66 Tm (general) Tj ET Q q n 0 133.25 m 612 133.25 l 612 121.25 l 0 121.25 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 123.66 Tm (information purposes and should not be relied upon as legal advice.) 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Tj ET Q q n 0 39.6 m 612 39.6 l 612 27.6 l 0 27.6 l h W n Q 0 0 0 rg BT /F4 12 Tf 1 0 0 1 126.49 16.91 Tm (PRIOR INSURANCE CREDIT UPON TRANSFER OF) Tj ET BT /F4 12 Tf 1 0 0 1 185.99 3.11 Tm (LIFE INSURANCE CARRIERS) Tj ET Q q Q q 1 0 0 1 36 21.6 cm 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 28.4 Tm (GL1102-AMEND. PC1) Tj ET BT /F2 12 Tf 1 0 0 1 436.03 28.4 Tm (Prior Ins. Cred. - Life) Tj ET BT /F2 10 Tf 1 0 0 1 265 16.39 Tm (24) Tj ET BT /F2 10 Tf 1 0 0 1 504.44 16.39 Tm (07/01/21) Tj ET Q q Q q 1 0 0 1 36 60.7 cm q n 0 590.91 m 612 590.91 l 612 578.91 l 0 578.91 l h W n Q q n 0 578.91 m 612 578.91 l 612 566.91 l 0 566.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 569.32 Tm (This) Tj ET BT /F2 12 Tf 1 0 0 1 24.42 569.32 Tm (provision) Tj ET BT /F2 12 Tf 1 0 0 1 72.84 569.32 Tm (prevents) Tj ET BT /F2 12 Tf 1 0 0 1 116.58 569.32 Tm (loss) Tj ET BT /F2 12 Tf 1 0 0 1 138.35 569.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 151.43 569.32 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 170.51 569.32 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 219.58 569.32 Tm (coverage) Tj ET BT /F2 12 Tf 1 0 0 1 265.97 569.32 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 283.05 569.32 Tm (you,) Tj ET BT /F2 12 Tf 1 0 0 1 307.13 569.32 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 339.55 569.32 Tm (could) Tj ET BT /F2 12 Tf 1 0 0 1 369.3 569.32 Tm (otherwise) Tj ET BT /F2 12 Tf 1 0 0 1 419.04 569.32 Tm (occur) Tj ET BT /F2 12 Tf 1 0 0 1 448.77 569.32 Tm (solely) Tj ET BT /F2 12 Tf 1 0 0 1 480.53 569.32 Tm (because) Tj ET BT /F2 12 Tf 1 0 0 1 521.59 569.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 534.67 569.32 Tm (a) Tj ET Q q n 0 566.91 m 612 566.91 l 612 554.91 l 0 554.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 557.32 Tm (transfer) Tj ET BT /F2 12 Tf 1 0 0 1 40.26 557.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 53.88 557.32 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 103.47 557.32 Tm (carriers.) Tj ET BT /F2 12 Tf 1 0 0 1 149.68 557.32 Tm (The) Tj ET BT /F2 12 Tf 1 0 0 1 171.96 557.32 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 206.24 557.32 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 228.53 557.32 Tm (provide) Tj ET BT /F2 12 Tf 1 0 0 1 268.8 557.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 287.08 557.32 Tm (following) Tj ET BT /F2 12 Tf 1 0 0 1 337.36 557.32 Tm (Prior) Tj ET BT /F2 12 Tf 1 0 0 1 364.98 557.32 Tm (Insurance) Tj ET BT /F2 12 Tf 1 0 0 1 415.24 557.32 Tm (Credit,) Tj ET BT /F2 12 Tf 1 0 0 1 451.85 557.32 Tm (when) Tj ET BT /F2 12 Tf 1 0 0 1 481.46 557.32 Tm (it) Tj ET BT /F2 12 Tf 1 0 0 1 491.75 557.32 Tm (replaces) Tj ET BT /F2 12 Tf 1 0 0 1 534.67 557.32 Tm (a) Tj ET Q q n 0 554.91 m 612 554.91 l 612 542.91 l 0 542.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 545.32 Tm (prior plan.) Tj ET Q q n 0 542.91 m 612 542.91 l 612 530.91 l 0 530.91 l h W n Q q n 0 530.91 m 612 530.91 l 612 518.91 l 0 518.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 521.32 Tm (") Tj ET BT /F4 12 Tf 1 0 0 1 4.9 521.32 Tm (Prior) Tj ET BT /F4 12 Tf 1 0 0 1 35.64 521.32 Tm (Plan") Tj ET BT /F2 12 Tf 1 0 0 1 69.06 521.32 Tm (means) Tj ET BT /F2 12 Tf 1 0 0 1 103.14 521.32 Tm (a) Tj ET BT /F2 12 Tf 1 0 0 1 111.89 521.32 Tm (prior) Tj ET BT /F2 12 Tf 1 0 0 1 138.64 521.32 Tm (carriers) Tj ET BT /F2 12 Tf 1 0 0 1 182.03 521.32 Tm (group) Tj ET BT /F2 12 Tf 1 0 0 1 213.45 521.32 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 232.86 521.32 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 282.26 521.32 Tm (policy,) Tj ET BT /F2 12 Tf 1 0 0 1 318.68 521.32 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 351.43 521.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 369.51 521.32 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 403.6 521.32 Tm (replaced) Tj ET BT /F2 12 Tf 1 0 0 1 447.66 521.32 Tm (within) Tj ET BT /F2 12 Tf 1 0 0 1 481.75 521.32 Tm (1) Tj ET BT /F2 12 Tf 1 0 0 1 491.17 521.32 Tm (day) Tj ET BT /F2 12 Tf 1 0 0 1 511.92 521.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 525.34 521.32 Tm (the) Tj ET Q q n 0 518.91 m 612 518.91 l 612 506.91 l 0 506.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 509.32 Tm (prior plans termination date.) Tj ET Q q n 0 506.91 m 612 506.91 l 612 494.91 l 0 494.91 l h W n Q q n 0 494.91 m 612 494.91 l 612 482.91 l 0 482.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 485.32 Tm (FAILURE) Tj ET BT /F2 12 Tf 1 0 0 1 54.76 485.32 Tm (TO) Tj ET BT /F2 12 Tf 1 0 0 1 74.85 485.32 Tm (SATISFY) Tj ET BT /F2 12 Tf 1 0 0 1 127.62 485.32 Tm (ACTIVE) Tj ET BT /F2 12 Tf 1 0 0 1 175.7 485.32 Tm (WORK) Tj ET BT /F2 12 Tf 1 0 0 1 216.46 485.32 Tm (RULE.) Tj ET BT /F2 12 Tf 1 0 0 1 258.97 485.32 Tm (Subject) Tj ET BT /F2 12 Tf 1 0 0 1 299.06 485.32 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 312.48 485.32 Tm (payment) Tj ET BT /F2 12 Tf 1 0 0 1 357.9 485.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 371.99 485.32 Tm (premiums,) Tj ET BT /F2 12 Tf 1 0 0 1 427.07 485.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 445.82 485.32 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 480.58 485.32 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 503.34 485.32 Tm (provide) Tj ET Q q n 0 482.91 m 612 482.91 l 612 470.91 l 0 470.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 473.32 Tm (life coverage if you:) Tj ET Q q n 18 470.91 m 630 470.91 l 630 458.91 l 18 458.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 461.32 Tm (\(1\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 461.32 Tm (were insured under the prior plan on its termination date;) Tj ET Q q n 18 458.91 m 630 458.91 l 630 446.91 l 18 446.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 449.32 Tm (\(2\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 449.32 Tm (were) Tj ET BT /F2 12 Tf 1 0 0 1 73.9 449.32 Tm (otherwise) Tj ET BT /F2 12 Tf 1 0 0 1 125.8 449.32 Tm (eligible) Tj ET BT /F2 12 Tf 1 0 0 1 167.02 449.32 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 199.59 449.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 219.48 449.32 Tm (Policy;) Tj ET BT /F2 12 Tf 1 0 0 1 258.73 449.32 Tm (but) Tj ET BT /F2 12 Tf 1 0 0 1 279.3 449.32 Tm (were) Tj ET BT /F2 12 Tf 1 0 0 1 307.85 449.32 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 328.43 449.32 Tm (Actively-At-Work) Tj ET BT /F2 12 Tf 1 0 0 1 422.3 449.32 Tm (due) Tj ET BT /F2 12 Tf 1 0 0 1 444.87 449.32 Tm (to) Tj ET BT /F2 12 Tf 1 0 0 1 459.44 449.32 Tm (Injury) Tj ET BT /F2 12 Tf 1 0 0 1 494 449.32 Tm (or) Tj ET Q q n 45.35 446.91 m 657.35 446.91 l 657.35 434.91 l 45.35 434.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 437.32 Tm (Sickness on its Effective Date;) Tj ET Q q n 18 434.91 m 630 434.91 l 630 422.91 l 18 422.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 425.32 Tm (\(3\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 425.32 Tm (are not entitled to any extension of life insurance under the prior plan; and) Tj ET Q q n 18 422.91 m 630 422.91 l 630 410.91 l 18 410.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 18 413.32 Tm (\(4\)) Tj ET BT /F2 12 Tf 1 0 0 1 45.35 413.32 Tm (are) Tj ET BT /F2 12 Tf 1 0 0 1 63.13 413.32 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 81.6 413.32 Tm (Totally) Tj ET BT /F2 12 Tf 1 0 0 1 119.39 413.32 Tm (Disabled) Tj ET BT /F2 12 Tf 1 0 0 1 165.18 413.32 Tm (\(as) Tj ET BT /F2 12 Tf 1 0 0 1 182.3 413.32 Tm (defined) Tj ET BT /F2 12 Tf 1 0 0 1 221.41 413.32 Tm (in) Tj ET BT /F2 12 Tf 1 0 0 1 233.88 413.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 251.67 413.32 Tm (Extension) Tj ET BT /F2 12 Tf 1 0 0 1 302.8 413.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 315.93 413.32 Tm (Death) Tj ET BT /F2 12 Tf 1 0 0 1 347.71 413.32 Tm (Benefit) Tj ET BT /F2 12 Tf 1 0 0 1 386.16 413.32 Tm (section) Tj ET BT /F2 12 Tf 1 0 0 1 423.28 413.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 436.41 413.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 454.2 413.32 Tm (Policy\)) Tj ET BT /F2 12 Tf 1 0 0 1 492 413.32 Tm (on) Tj ET Q q n 45.35 410.91 m 657.35 410.91 l 657.35 398.91 l 45.35 398.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 45.35 401.32 Tm (the date the Policy takes effect.) Tj ET Q q n 0 398.91 m 612 398.91 l 612 386.91 l 0 386.91 l h W n Q q n 0 386.91 m 612 386.91 l 612 374.91 l 0 374.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 377.32 Tm (AMOUNT) Tj ET BT /F2 12 Tf 1 0 0 1 55.92 377.32 Tm (OF) Tj ET BT /F2 12 Tf 1 0 0 1 74.52 377.32 Tm (LIFE) Tj ET BT /F2 12 Tf 1 0 0 1 103.11 377.32 Tm (INSURANCE.) Tj ET BT /F2 12 Tf 1 0 0 1 181.3 377.32 Tm (Until) Tj ET BT /F2 12 Tf 1 0 0 1 209.23 377.32 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 230.48 377.32 Tm (satisfy) Tj ET BT /F2 12 Tf 1 0 0 1 265.07 377.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 282.99 377.32 Tm (Policys) Tj ET BT /F2 12 Tf 1 0 0 1 325.58 377.32 Tm (Active) Tj ET BT /F2 12 Tf 1 0 0 1 360.83 377.32 Tm (Work) Tj ET BT /F2 12 Tf 1 0 0 1 391.41 377.32 Tm (rule,) Tj ET BT /F2 12 Tf 1 0 0 1 416.32 377.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 434.24 377.32 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 473.5 377.32 Tm (of) Tj ET BT /F2 12 Tf 1 0 0 1 486.75 377.32 Tm (your) Tj ET BT /F2 12 Tf 1 0 0 1 512 377.32 Tm (group) Tj ET Q q n 0 374.91 m 612 374.91 l 612 362.91 l 0 362.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 365.32 Tm (life) Tj ET BT /F2 12 Tf 1 0 0 1 19.65 365.32 Tm (insurance) Tj ET BT /F2 12 Tf 1 0 0 1 69.28 365.32 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 100.26 365.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 118.58 365.32 Tm (Policy) Tj ET BT /F2 12 Tf 1 0 0 1 152.91 365.32 Tm (will) Tj ET BT /F2 12 Tf 1 0 0 1 175.23 365.32 Tm (not) Tj ET BT /F2 12 Tf 1 0 0 1 194.22 365.32 Tm (exceed) Tj ET BT /F2 12 Tf 1 0 0 1 231.19 365.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 249.5 365.32 Tm (amount) Tj ET BT /F2 12 Tf 1 0 0 1 289.15 365.32 Tm (for) Tj ET BT /F2 12 Tf 1 0 0 1 306.81 365.32 Tm (which) Tj ET BT /F2 12 Tf 1 0 0 1 339.79 365.32 Tm (you) Tj ET BT /F2 12 Tf 1 0 0 1 361.45 365.32 Tm (were) Tj ET BT /F2 12 Tf 1 0 0 1 388.42 365.32 Tm (insured) Tj ET BT /F2 12 Tf 1 0 0 1 427.4 365.32 Tm (under) Tj ET BT /F2 12 Tf 1 0 0 1 458.38 365.32 Tm (the) Tj ET BT /F2 12 Tf 1 0 0 1 476.7 365.32 Tm (prior) Tj ET BT /F2 12 Tf 1 0 0 1 503.68 365.32 Tm (plan) Tj ET BT /F2 12 Tf 1 0 0 1 528 365.32 Tm (on) Tj ET Q q n 0 362.91 m 612 362.91 l 612 350.91 l 0 350.91 l h W n 0 0 0 rg BT /F2 12 Tf 1 0 0 1 0 353.32 Tm (its termination date.) Tj ET Q q n 0 350.91 m 612 350.91 l 612 338.91 l 0 338.91 l h W n Q q n 0 338.91 m 612 338.91 l 612 326.91 l 0 326.91 l h W n Q q n 0 326.91 m 612 326.91 l 612 314.91 l 0 314.91 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 317.32 Tm (This) Tj ET BT /F4 12 Tf 1 0 0 1 26.57 317.32 Tm (Amendment) Tj ET BT /F4 12 Tf 1 0 0 1 93.79 317.32 Tm (takes) Tj ET BT /F4 12 Tf 1 0 0 1 124.34 317.32 Tm (effect) Tj ET BT /F4 12 Tf 1 0 0 1 156.2 317.32 Tm (on) Tj ET BT /F4 12 Tf 1 0 0 1 172.76 317.32 Tm (your) Tj ET BT /F4 12 Tf 1 0 0 1 200.65 317.32 Tm (effective) Tj ET BT /F4 12 Tf 1 0 0 1 247.17 317.32 Tm (date) Tj ET BT /F4 12 Tf 1 0 0 1 273.05 317.32 Tm (of) Tj ET BT /F4 12 Tf 1 0 0 1 286.94 317.32 Tm (coverage) Tj ET BT /F4 12 Tf 1 0 0 1 336.13 317.32 Tm (under) Tj ET BT /F4 12 Tf 1 0 0 1 370.7 317.32 Tm (the) Tj ET BT /F4 12 Tf 1 0 0 1 390.58 317.32 Tm (Policy.) Tj ET BT /F4 12 Tf 1 0 0 1 432.68 317.32 Tm (In) Tj ET BT /F4 12 Tf 1 0 0 1 447.92 317.32 Tm (all) Tj ET BT /F4 12 Tf 1 0 0 1 464.47 317.32 Tm (other) Tj ET BT /F4 12 Tf 1 0 0 1 495.69 317.32 Tm (respects,) Tj ET Q q n 0 314.91 m 612 314.91 l 612 302.91 l 0 302.91 l h W n 0 0 0 rg BT /F4 12 Tf 1 0 0 1 0 305.32 Tm (your Certificate remains unchanged.) Tj ET Q q n 0 302.91 m 612 302.91 l 612 290.91 l 0 290.91 l h W n Q 0 0 0 rg BT /F4 12 Tf 1 0 0 1 216 266.42 Tm (THE LINCOLN NATIONAL LIFE INSURANCE COMPANY) Tj ET q 1 0 0 1 293.75 204.51 cm q n 0 0 m 172.5 0 l 172.5 45 l 0 45 l h W n q 172.5 0 0 45 0 0 cm /img17850 Do Q Q Q q Q Q q Q Q endstream endobj 35 0 obj <>stream   cmap郞">cvt 0"fpgmæ*1glyf&90|head9kx6hheaxذ$hmtx/5Rloca(5\maxp*C prep9 CE66~ Y#Oou~ O:^mjkEMWY[]}  " & 0 4 : < > D ^ o  !!!!"!&!.!N!T!^!!!"""""""")"+"H"a"e###!%%% %%%%%$%,%4%<%l%%%%%%%%%%%%%%%&<&@&B&`&c&f&k&o,m,w.!6<>ADb?# !Z$PtzP !@`Pkl HPY[]_  & * 2 9 < > D ^ j  !!!!"!&!.!M!S![!!!"""""""")"+"H"`"d### %%% %%%%%$%,%4%<%P%%%%%%%%%%%%%%%&:&@&B&`&c&e&j&o,`,q.8>@CF^> =)i*(6L wi8W}ujy,ߨߖޖޢދަq_0@3$FE<9630)"ۿ۾۷ۥۯEBA$"!޺> c4^F8"46h    H 6 T r ~ x ~ ^ ` \ J d n ^bcdefghjikmlnoqprsutvwxzy{}|~      !"#$%&'()*$jklm     !"     #$%&'()*+%           ! 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