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Item C13
BOARD OF COUNTY COMMISSIONERS C ounty of M onroe A(I Mayor George Neugent, District 2 T he Fl orida Keys 4� �� m Mayor Pro Tem David Rice, District 4 l Danny L. Kolhage, District 1 „ Y „; ° W Heather Carruthers, District 3 Sylvia J. Murphy, District 5 County Commission Meeting June 21, 2017 Agenda Item Number: C.13 Agenda Item Summary #3031 BULK ITEM: Yes DEPARTMENT: Employee Services TIME APPROXIMATE: STAFF CONTACT: Maria Fernandez- Gonzalez (305) 292 -4448 N/A AGENDA ITEM WORDING: Approval of 3 (three) year renewal with Minnesota Life for Group Term Life /Accidental Death and Dismemberment (AD &D) and Supplemental Life effective October 1, 2017 - September 30, 2020 with a 10% increase in the premium for life insurance from $.365/$1000 to $.40/$1000 (estimated annual cost is $152,524) plus estimated AD &D of $6000, for a grand total per year of $158,524. No increase to AD &D or Supplemental Life premiums have been made in this renewal. ITEM BACKGROUND: From 2000 — 2014 the County's life insurance company was Hartford insurance. The last year (2014) with Hartford the County paid $213,919. The County bid life insurance and accidental death and dismemberment (AD &D) in 2014. Minnesota Life won the bid and for 2015, the County paid ($.365/$1,000 of insurance) $131,259 (basic life) and in 2016, the County paid $138,658 (less a refund later for accrual set up of $2,426) for basic life, for a total of $136,232. AD &D runs approximately $6000 per year. The total Life and AD &D premium runs approximately $144,658 per year. The RFP was developed with an initial term of 1 year, with the potential to renew for 3 additional one year terms, which puts the County at a total of 4 years under the RFP. This renewal beginning in 10/1/17 would be the 4 year of the bid. Staff is recommending a 3 year renewal given the favorable renewal rate being offered by Minnesota Life. The renewal quote with Minnesota Life includes a 10% increase from $ .365/$1,000 to $.40/$1,000, which will result in approximately $152,524 annually. The total annual Life and AD &D premium would then be $158,524. The AD &D premium is not changing from approximately $6,000 per year. Based on our experience in 2015 this increase is far less than we expected (premiums paid by county for basic life /ad &d was $145,414; claims paid by Minnesota Life for basic life /ad &d was $290,487). PREVIOUS RELEVANT BOCC ACTION: RFP's done 2001; 2007; 2010 & 2014. Hartford Life was carrier from 2000 through 2014. Minnesota Life became our carrier effective October 1, 2014, adding Supplemental Life Insurance for employee, and dependents. CONTRACT /AGREEMENT CHANGES: 3 year renewal with a 10% increase in premium for basic life only STAFF RECOMMENDATION: Approval DOCUMENTATION: MINNESOTA LIFE THREE YEAR RENEWAL MCBCC MN Life Experience 2014 - July 2016 AM Best MN Life 4 13 17 MCBCC MN Life Term Policy 34395 10 01 14 FINANCIAL IMPACT: Effective Date: October 1, 2017 Expiration Date: September 31, 2020 Total Dollar Value of Contract: 3 years of life insurance for $457,572 plus $18,000 for AD &D for three years = $475,572 Total Cost to County: 3 years of life insurance for $457,572 plus $18,000 for AD &D for three years = $475,572 Current Year Portion: $152,524 + $6000 = $158,524 annually beginning 10/1/17 Budgeted: $160,000 Source of Funds: Primarily Ad Valorem CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: No If yes, amount: Grant: County Match: Insurance Required: Additional Details: 06/21/17 502 -08002 - GROUP INS OPERATIONS $41,598.00 3 year renewal, 10% increase on basic life only h]X TA1 IH17." Christine Hurley Completed Budget and Finance Completed Cynthia Hall Completed Maria Slavik Completed 06/01/2017 2:04 PM 06/01/2017 2:07 PM 06/05/2017 3:54 PM 06/06/2017 7:31 AM Kathy Peters Completed 06/06/2017 11:49 AM Board of County Commissioners Pending 06/21/2017 9:00 AM Financial security for the long run. SEC:URIAN' RATE CONFIRMATION 1. Policyholder: Monroe County BOCC 2. Policy Number(s): 34395 3. Insurance Product(s): Basic Term Life and AD &D, Employee and Spouse Supplemental Term Life and AD &D and Child Life 4. The insurance rates included in this rate confirmation are net of commissions. 5. Rate Coverage Period: October 1, 2017 — September 30, 2020 Premium Rates: Basic Life (Active and Retiree): $0.400 / $1,000 / month Basic AD &D: $0.020 / $1,000 / month Employee and Spouse Supplemental Term Life: Age Rate / $1,000 / Month Under 25 $ 0.050 _ 25 -29 $ 0.060 30 -34 $ 0.080 35 -39 $ 0.090 40 -44 $ 0.120 45 -49 $ 0.210 CL CL 50 -54 $ 0.370 55 -59 $ 0.610 CD 60 -64 $ 0.750 m 65-69 $ 1.310 70 -74 $ 2.060 75* $ 2.380 *Please note, rates increase past 75 and will be provided upon request Employee and Spouse Supplemental AD &D: $0.020 / $1,000 / month Child Life: $0.130/$1,000 /month MINNESOTA LIFE INSURANCE COMPANY By Date April 13, 2017 Susan Munson - Regala Title 2nd Vice President and BY Date Tifie I MONROE - COUNTY ATTORNEY AP OD AS T FM: QYNTHIA L. HALL ASSISTANT OUNTY ATTORNEY Date— - 5 RO I ?- Rate Confirmafion Monroe County BOCC Page 2 of 2 Monroe County BOCC Policy Number: 34395 October 1, 2014 through June 30, 2016 Thru 1. Earned Premium 2014 2015 June 30, 2016 2 CL CL Employee Basic Life $34,531 $139,340 $69,202 Employee Basic AD &D 1,517 6,074 3,001 Employee Supplemental Life 0 60,734 34,507 Employee Supplemental AD &D 0 5,094 2,726 as J Spouse Supplemental Life 0 8,080 4,630 Spouse Supplemental AD &D 0 448 255 Child Supplemental Life 0 936 519 Total $36,048 $220,706 $114,840 as Thru 2. Paid Claims 2014 2015 June 30, 2016 as Employee Basic Life $0 $260,404 $66,877 Employee Basic AD &D 0 30,083 0 Employee Supplemental Life 0 120,213 0 Employee Supplemental AD &D 0 0 0 as Spouse Supplemental Life 0 25,016 0 Spouse Supplemental AD &D 0 0 0 4- Child Supplemental Life 0 0 0 0 L- Total $0 $435,716 $66,877 CL Thru 3. Incurred Claims * 2014 2015 June 30, 2016 Employee Basic Life $30,750 $262,850 $65,512 Employee Basic AD &D 0 30,083 0 Employee Supplemental Life 0 125,965 650 Employee Supplemental AD &D 0 0 0 Spouse Supplemental Life 0 25,781 94 Spouse Supplemental AD &D 0 0 0 Child Supplemental Life 0 89 7 Total $30,750 $444,768 $66,263 CL * Incurred Claims = Paid Claims + Interest + Current Pending Claims - Prior Pending Claims + Current Waiver Reserve - Prior Waiver Reserve + Current IBNR - Prior IBNR + Conversions 4. Number of Open Waiver Claims 1 5. Number of Paid Claims 2014 through June 30, 2016 26 1 Minnesota Life Insurance Company - Company Profile - Best's Credit Rating Center A.M. Best Rating Services Minnesota Life Insurance Company ( ?) A.M. Best #: 006724 NAIC M 66168 FEIN M 410417830 Domiciliary Address 400 Robert Street North St. Paul, MN 55101 -2098 United States Web: www.securian.com Phone: 651 - 665 -3500 Fax: 651-665-4488 Page I of 3 FinwwiW Stmgffi R " g` A+ Su ' Assigned to insurance companies that have, in our opinion, a superior ability to meet their ongoing insurance obligations. View additional news, reports and products for this company. Based on A.M. Best's analysis, 050751 - Securian Financial Group Inc is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Best's Credit Ratings Financial Strength Rating View Definition Rating: Financial Size Category: Outlook: Action: Effective Date: Initial Rating Date: A+ (Superior) XV ($2 Billion or greater) Stable Affirmed November 18, 2016 June 30, 1928 Long -Term Issuer Credit Rating View Definition Long -Term: Outlook: Action: Effective Date: Initial Rating Date: aa- Stable Affirmed November 18, 2016 February 17, 2004 u Denotes Under Review Best's Rating Best's Credit Rating Analyst Rating Issued by: A.M. Best Rating Services, Inc. Financial Analyst: Keith Behrmann Associate Director : Edward Kohlberg Disclosure Information 9M View A.M. Best's Rating Disclosure Form A.M. Best Affirms Credit Ratings of Securian Financial Group, Inc. and Its Subsidiaries November 18, 2016 Rating History A.M. Best has provided ratings & analysis on this company since 1928. Financial Strength Rating http: / /www3.ambest.com/ ratings / entities /CompanyProfile.aspx ?ambnum= 6724 &URATIN... 4/13/2017 Minnesota Life Insurance Company - Company Profile - Best's Credit Rating Center Effective Date Rating 11/18/2016 A+ 2/3/2016 A+ 1/8/2015 A+ 3/24/2014 A+ 3/29/2013 A+ 3/30/2012 A+ Long -Term Issuer Credit Rating Effective Date Rating 11/18/2016 aa- 2/3/2016 aa- 1 /8/2015 aa- 3/24/2014 aa- 3/29/2013 aa- 3/30/2012 aa- Rated Issues Issue Credit Ratings Page 2 of 3 Date Issued Amount Coupon Issue Type Rating Effective Date Outlook/ Implication )9/21/1995 125,000,000 LSD 8.25% Surplus Notes a 11/18/2016 Stable (i) Denotes Indicative Rating Related Financial and Analytical Data The following links provide access to related data records that A.M. Best utilizes to provide financial and analytical data on a consolidated or branch basis. AMB # Company Name Company Description 069565 Minnesota Life Insurance Represents the A.M. Best Consolidated financials for the Life, Annuity, and Accident business Group (G) of this legal entity. Rating Unit AMB Credit Reports AMB Credit Report - includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 3/10/2017 (represents the latest significant change). - Historical Reports are available in AMB Credit Report Archive. 9 A View additional news, reports and products for this company. Press Releases Date Title Nov 18, 2016 A.M. Best Affirms Credit Ratings of Securian Financial Group, Inc. and Its Subsidiaries Feb 03, 2016 A.M. Best Affirms Ratings of Securian Financial Group, Inc. and Its Subsidiaries Jan 08, 2015 A.M. Best Affirms Ratings of Securian Financial Group, Inc.'s Subsidiaries �r http: / /www3.ambest.com/ ratings / entities /CompanyProfile.aspx ?ambnum= 6724 &URATIN... 4/13/2017 Minnesota Life Insurance Company - Company Profile - Best's Credit Rating Center Page 3 of 3 Mar 24, 2014 Mar 29, 2013 Mar 30, 2012 Apr 19, 2011 Apr 06, 2010 Apr 10, 2009 Mar 25, 2008 1 2 A.M. Best Affirms Ratings of Securian Financial Group, Inc.'s Subsidiaries A.M. Best Affirms Ratings of Securian Financial Group, Inc.'s Subsidiaries A.M. Best Affirms Ratings of Subsidiaries of Securian Financial Group, Inc. A.M. Best Affirms Ratings of Securian Financial Group, Inc's Key Life Members A.M. Best Revises Outlook to Stable for Securian Financial Group, Inc.'s Key Life Companies A.M. Best Downgrades Issuer Credit Ratings of Securian Financial Group Members; Revises Outlook to Negative A.M. Best Affirms Ratings of Securian Financial Group Members Page size: 10 16 items in 2 pages European Union Disclosures A.M. Best - Europe Rating Services Limited (AMBERS), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit Assessment Institution (ECAI) in the European Union (EU). Therefore, Credit Ratings issued and endorsed by AMBERS may be used for regulatory purposes in the EU as per Directive 2006/48/EC. Australian Disclosures A.M. Best Asia - Pacific Limited ( AMBAP), Australian Registered Body Number (ARBN No.150375287), is a limited liability company incorporated and domiciled in Hong Kong. AMBAP is a wholesale Australian Financial Services (AFS) Licence holder (AFS No. 411055) under the Corporations Act 2001. Credit Ratings emanating from AMBAP are not intended for and must not be distributed to any person in Australia other than a wholesale client as defined in Chapter 7 of the Corporations Act. 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Best Company, Inc. and /or its affiliates ALL RIGHTS RESERVED. http: / /www3.ambest.com/ ratings / entities /CompanyProfile.aspx ?ambnum= 6724 &URATIN... 4/13/2017 Group Term Life Insurance Policy Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE Read Your Policy Carefully This policy was issued to the policyholder on the effective date shown on the specifications page attached to this policy. We promise to pay the benefits provided by this policy, subject to its conditions, limitations, and exceptions. We make this promise and issue this policy in consideration of the application for this policy and the payment of the premiums. Minnesota Life Insurance Company is a subsidiary of Minnesota Mutual Companies, Inc., a mutual insurance holding company. The policyholder is a member of Minnesota Mutual Companies, Inc., which holds its annual meetings on the first Tuesday in March of each year at 3 p.m. local time. The meetings are held at 400 Robert Street North, St. Paul, Minnesota 55101 -2098. Right to Cancel It is important to us that you are satisfied with this policy after it is issued. If you are not satisfied with this policy, you may cancel it by delivering or mailing a written notice or sending a telegram to Minnesota Life Insurance Company (Minnesota Life), 400 Robert Street North, St. Paul, Minnesota 55101 -2098 and returning the policy before midnight of the 30th day after you received this policy. Notice given by mail and return of the policy by mail are effective on being postmarked, properly addressed, and postage prepaid. If you return this policy, you will receive, within 10 days of the date we receive a notice of cancellation, a full refund of any premiums you paid. Upon cancellation of this policy, it will be void as if it had never been issued. Signed for Minnesota Life Insurance Company at St. Paul, Minnesota on the effective date. Secretary President Notice to Policyholders If you have any questions regarding this group policy, or if you need assistance in resolving a complaint, you can contact us at: Minnesota Life Insurance Company, 400 Robert Street North, St. Paul, MN 55101 -2098. Toll Free Telephone Number: 1- 866 - 293 -6047. TABLE OF CONTENTS Definitions ............................................ ..............................2 Termination................ General Information ........................... ............................... 2 Conversion Right....... Premiums ........................................... ............................... 4 Additional Information DeathBenefit ...................................... ............................... 4 GROUP TERM LIFE INSURANCE POLICY • NONPARTICIPATING MHC -96- 13180.9 Minnesota Life 1 EdF81772 10 -2014 GROUP POLICY SPECIFICATIONS PAGE GENERAL INFORMATION POLICYHOLDER: Monroe County Board of County Commissioners POLICY NO.: 34395 -G ASSOCIATED COMPANIES: All subsidiaries and affiliates reported to Minnesota Life by the policyholder for inclusion in the policy. POLICY SITUS: The policy was issued and delivered in the state of Florida. POLICY EFFECTIVE DATE: Basic Coverage - October 1, 2014 Supplemental Coverage for the Monroe County Sheriffs Dept — October 1, 2014 Supplemental Coverage for all other employees except the Monroe County Sheriffs Dept — January 1, 2015 POLICY ANNIVERSARY DATE: October 1 of each year beginning October 1, 2015. PREMIUM DUE DATE(S): The first day of each month. GROUP: The group is composed of all active full -time employees and retirees of the policyholder and its associated companies working in the United States classified as follows: c Class 1: All active, full -time employees e_ Class 2: Retired employees insured on October 1, 1987 or later who have worked at Monroe County Board of County Commissioners for at least 10 years 3 W Class 3: A closed class of retired employees insured prior to October 1, 1987 ENROLLMENT PERIOD: Not applicable for noncontributory insurance; 31 days from the first day of eligibility 0 for contributory insurance. 0 WAITING PERIOD: Class 1: The period commencing with the employee's date of employment and ending C CL with the employee's completion of 60 days of continuous employment. CL Classes 2 and 3: None CD MINIMUM HOURS Class 1: 25 hours per week PER WEEK REQUIRED: Classes 2 and 3: Not Applicable PLAN OF INSURANCE CD LO EMPLOYEE BENEFIT SCHEDULE EMPLOYEE TERM LIFE INSURANCE: Basic Life Insurance Eligible Class Amount of Basic Life Insurance Class 1 $20,000 Class 2 $20,000 Class 3 The lesser of 50% of the amount of life insurance in force prior to October 1, 1987 or $5,000. F. MHC -50062 A Supplemental Life Insurance Eligible Class Amount of Supplemental Life Insurance Class 1 An amount elected by the employee in increments of $10,000, subject to a maximum of the lesser of five times annual salary or $500,000. Classes 2 and 3 None EMPLOYEE ACCIDENTAL DEATH AND DISMEMBERMENT (AD &D) INSURANCE: Basic and Supplemental Insurance Eligible Class Amount of Basic and Supplemental AD &D Insurance Class 1 An amount equal to the amount of basic and supplemental life insurance for which the employee is insured under the group policy. Classes 2 and 3 None GENERAL PROVISIONS FOR EMPLOYEE INSURANCE AGE REDUCTIONS FOR CLASS 1: The amount of basic life and basic AD &D insurance on an employee age 70 or (applies to basic coverage only) older shall be a percentage of the amount otherwise provided by the plan of insurance applicable to such employee in accordance with the following table: Age of Employee Amount of Insurance will decrease by: 70-74 33% 75 and over 50% Age reductions will apply on the insured employee's 70 and 75 birthdays. The reduced amount of insurance will be rounded to the next higher multiple of $1,000, if not a multiple thereof. AGE REDUCTIONS FOR CLASS 2: The amount of basic life insurance on a retiree age 70 or older shall be reduced (applies to basic life coverage only) to 50% of the amount otherwise provided by the plan of insurance applicable to such retiree. Age reductions will apply on the insured retiree's 70 birthday. AGE REDUCTIONS FOR CLASS 3: None CONTRIBUTORY /NONCONTRIBUTORY: Basic insurance is noncontributory insurance; supplemental insurance is contributory insurance. GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an employee can receive without evidence of insurability when first eligible under the plan provided enrollment is made within the enrollment period. The amounts are as follows: For basic insurance: All basic insurance is guaranteed issue. For supplemental insurance: For employees who first become eligible after the effective date of this policy: $150,000. EVIDENCE OF INSURABILITY: Evidence of insurability is required as stated in the policy and for an amount of insurance greater than the guaranteed issue amount. F. MHC -50062 B EFFECTIVE DATE OF INCREASES Increases and decreases due to a change in eligible class will become effective AND DECREASES DUE TO CHANGE the date of the change in eligible class. IN ELIGIBLE CLASS: DEPENDENTS BENEFIT SCHEDULE DEPENDENTS TERM LIFE INSURANCE: Spouse /Domestic Partner Life Insurance Eligible Class Class 1 Classes 2 and 3 Spouse /Domestic Partner AD &D Insurance Eligible Class Class 1 Classes 2 and 3 Child Life Insurance Eligible Class Children of class 1 Classes 2 and 3 Amount of Spouse /Domestic Partner Life Insurance An amount elected by the employee, in increments of $5,000, subject to a maximum of $250,000, not to exceed the employees amount of basic and supplemental coverage combined. None Amount of Spouse /Domestic Partner AD &D Insurance An amount equal to the amount of supplemental life insurance for which the spouse /domestic partner is insured under the group policy. None Amount of Child Life Insurance $10,000 None GENERAL PROVISIONS FOR DEPENDENTS INSURANCE CONTRIBUTORY /NONCONTRIBUTORY: Dependents insurance is contributory insurance. CD GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an eligible dependent can receive without evidence of insurability when first eligible under the plan provided enrollment is made within the enrollment period. The amounts are as follows: Ca For employees who first become eligible for dependents insurance after the effective date of this policy, the guaranteed issue amount is as follows: For spouse /domestic partner insurance: $25,000 For child insurance: $10,000 EVIDENCE OF INSURABILITY: Evidence of insurability is required as stated in the policy and for an amount of insurance greater than the guaranteed issue amount. EFFECT OF EMPLOYEE'S RETIREMENT: All dependents insurance terminates upon the employee's retirement except as provided under the portability provision. F. MHC -50062 C ADDITIONAL INFORMATION SUICIDE EXCLUSION FOR LIFE Applies only to employee supplemental life and spouse /domestic partner life INSURANCE: insurance under this policy. Exclusions for AD &D insurance, including a suicide exclusion, are listed on the applicable policy rider WAIVER OF PREMIUM APPLICATION: Applies to contributory and noncontributory employee insurance. ACCELERATED DEATH BENEFIT RIDER: Notwithstanding anything in the policy to the contrary, the sections entitled "How do we calculate the accelerated benefit ?" and "How do we calculate the accelerated benefit factor" do not apply under this policy. PREMIUM PAYMENT GRACE PERIOD: Notwithstanding anything in the policy to the contrary, the premium payment grace period is 60 days. ONE TIME OPEN ENROLLMENT: The policyholder will hold a one -time open enrollment prior to January 1, 2015 During this enrollment, the following elections will not require evidence of insurability: • Employee supplemental life elections that do not exceed $150,000* • Spouse /domestic partner life elections that do not exceed $25,000 • Any child life election Coverage will be effective on January 1, 2015, subject to the actively at work requirement for employees and the hospitalization /confinement clause for dependents. *This one -time open enrollment does not apply to the Sheriffs of Class 1 who were employed on or before October 1, 2014. ANNUAL ENROLLMENTS: During the policyholder's annual open enrollment, the following election ZL change can be made without providing evidence of insurability, provided the CL insured receiving the increase has not previously been declined any insurance amount under this policy due to failure to provide satisfactory evidence of insurability: CD • An employee may elect any child life amount CD Coverage will be effective on January 1 following the annual enrollment, CD subject to the actively at work requirement for employees and the hospitalization/confinement clause for dependents. LO QUALIFIED STATUS CHANGES: An employee who experiences one of the Qualified Status Changes listed below may make the following election changes without providing evidence of insurability, provided enrollment is made within 31 days of the status change and the insured receiving the increase has not previously been declined any insurance amount under this policy due to failure to provide satisfactory evidence of insurability: • An employee may enroll in spouse /domestic partner life insurance for the first time provided the insurance amount does not exceed $25,000. • An employee may elect any child life amount Coverage will be effective on the date of the election, subject to the actively at work requirement for employees and the hospitalization /confinement clause for dependents. F. MHC -50062 D Qualified Status Change for this purpose means: • Birth or adoption or otherwise acquiring a newly eligible child • Marriage or creation of a domestic partnership RIDER(S) TO THE GROUP POLICY Accelerated Benefits Applies to all classes. Accidental Death and Dismemberment Applies to class 1 only. Dependents Term Life Applies to class 1 only. Portability Applies to all classes. Waiver of Premium Applies to class 1 only. F. MHC -50062 E Definitions age Attained age as of most recent birthday. associated company Any company which is a subsidiary or affiliate of the policyholder which is designated by the policyholder and agreed to by us to participate under this policy. certificate effective date The date the insured's coverage under this policy becomes effective. certificate holder An employee who is eligible for and becomes insured according to the terms of this policy. contributory insurance Insurance for which an employee is required to make premium contributions. earnings An employee's basic rate of compensation not including commissions, overtime or premium pay, bonuses, or any other additional compensation. employee An individual who is employed by the policyholder or by an associated company. A sole proprietor will be considered the employee of the proprietorship. A partner in a partnership will be considered an employee so long as the partner's principal work is the conduct of the partnership's business. The term employee does not include temporary employees nor corporate directors who are not otherwise employees. employer The policyholder or any designated associated companies. evidence of insurability Evidence satisfactory to us of the good health of the prospective insured and any other underwriting information we require. insured A person who is eligible for and becomes insured according to the terms of this policy. non -work day A day on which the employee is not regularly scheduled to work, including scheduled time off for vacations, personal holidays, weekends and holidays, and approved leaves of absence for non - medical reasons. MH C -96- 13180.9 Non -work day does not include time off for medical leave of absence, temporary layoff, employer suspension of operations in total or in part, strike, and any time off due to sickness or injury including sick days, short -term disability, or long -term disability. noncontributory insurance Insurance for which an employee is not required to make premium contributions. policy anniversary The policy anniversary date shown on the specifications page attached to this policy. policy effective date The date this policy was issued as shown on the specifications page attached to this policy. policyholder The owner of the group policy as shown on the specifications page attached to the group policy. specifications page The outline which summarizes the policyholder's plan of insurance. waiting period The period, if any, of continuous employment with the employer required prior to becoming eligible for coverage under this policy. The waiting period is shown on the specifications page attached to this policy. we, our, us Minnesota Life Insurance Company. you, your The policyholder named on the specifications page attached to this policy. General Information What is your agreement with us? This policy and your application contain the entire contract between you and us. Any statements you make will, in the absence of fraud, be considered representations and not warranties. Also, any statement that you make will not be used to void this policy, nor will it be used in our defense if we refuse to pay a claim, unless the statement is contained in your application. No change or waiver of any provisions of this policy, or any certificate issued under it, will be valid unless made in writing by us and signed by our president, a vice - president, our secretary, or an assistant secretary. No agent or other person has the authority to change or waive Minnesota Life 2 EdF81772 10 -2014 any provisions of this policy, or of any certificate issued under it. Are employees of associated companies eligible for insurance under this policy? Yes. Employees of associated companies may be eligible for insurance under this policy. Associated companies are shown on the specifications page attached to this policy. You represent any associated company in all transactions pertaining to this policy. Your acts or omissions and every notice given by us to you shall be binding on every associated company. When an associated company ceases its participation under the policy, the policy shall be considered to be terminated for all employees of the associated company. All provisions related to the policy terminating will apply to such employees. Can this policy be amended? Yes. The insured's consent is not required to amend this policy or any certificates issued under it. Any amendment will be without prejudice to any claim for benefits incurred prior to the effective date of the amendment. Who is eligible for insurance? An employee is eligible if he or she: (1) is a member of the group and of an eligible class as shown on the specifications page attached to this policy; and (2) works for the employer for at least the number of hours per week shown as the minimum hours per week requirement on the specifications page attached to this policy; and (3) has satisfied the waiting period as shown on the specifications page attached to this policy; and (4) meets the actively at work requirement as shown in the section entitled "What is the actively at work requirement ? ". Are retired employees eligible for insurance? If the policyholder's plan of insurance, as reflected in the specifications page attached to this policy, does not specifically provide insurance for retired employees, a retired employee shall not be eligible to become insured, nor have his or her insurance continued. If the policyholder's plan of insurance specifically provides insurance for retired employees, the minimum hours per week and actively at work requirements will not apply to such persons. What is the actively at work requirement? To be eligible to become insured or to receive an increase in the amount of insurance, an employee must be actively at work fully performing his or her customary duties for his or her regularly scheduled number of hours at the employer's normal place of business, or at other places the employer's business requires him or her to travel. If the employee is not actively at work on the date coverage would otherwise begin, or on the date an MH C -96- 13180.9 increase in his or her amount of insurance would otherwise be effective, he or she will not be eligible for the coverage or increase until he or she returns to active work. However, if the absence is on a non -work day, coverage will not be delayed provided the employee was actively at work on the work day immediately preceding the non -work day. Except as otherwise provided for in this policy, an employee is eligible to continue to be insured only while he or she remains actively at work. When will we require evidence of insurability? Evidence of insurability will be required if: (1) the specifications page attached to this policy states that evidence of insurability is required; or (2) the insurance is contributory and the employee does not enroll within the enrollment period shown on the specifications page attached to this policy; or (3) the insurance for which the employee previously enrolled did not go into effect or was terminated because the employee failed to make a required premium contribution; or (4) during a previous period of eligibility, the employee failed to submit required evidence of insurability or that which was submitted was not satisfactory to us; or (5) the employee is insured by an individual policy issued under the terms of the conversion right section. When does insurance become effective? Insurance becomes effective on the date that all of the following conditions have been met: (1) an employee meets all eligibility requirements; and (2) if required, the employee applies for the insurance on forms which are approved by us; and (3) we are satisfied with the employee's evidence of insurability, if we require evidence; and (4) we receive the required premium. Can an insured employee's coverage be continued during sickness, injury, leave of absence or temporary layoff? Yes. Insurance may be continued on an insured employee who is not actively at work due to sickness, injury, leave of absence or temporary layoff, subject to the employer's practices and procedures, including the employer's limits on the length of continuation allowed for the type of absence. Continuation is contingent upon continued premium payment and is subject to the following maximum time frames: (1) for an employee on non - medical leave of absence or temporary layoff, insurance cannot be continued beyond 12 months from the last day the insured employee was actively at work. Minnesota Life 3 EdF81772 10 -2014 (2) for an employee on a medical leave of absence, insurance cannot be continued beyond the later of 12 months from the last day the insured employee was actively at work or the date the employee attains age 65. Continuation of insurance must be in accordance with practices and procedures that preclude individual selection. Coverage during a leave of absence and upon return from a leave of absence shall meet all state and federal requirements. The above limits will be expanded if necessary in order to meet such requirements. Premiums When and how often are premiums due? Unless we have agreed to some other premium payment procedure, premiums for this policy are remitted to us monthly. Premiums are due on the premium due date as shown on the specifications page attached to this policy. We apply premiums consecutively to keep the insurance in force. You may pay premiums before they are due for any period up to the next policy anniversary. Premiums paid in advance should be calculated at the rate of the monthly premium currently due. Premium contributions for contributory insurance are to be paid to you. The premium contributions by insureds for contributory insurance should be remitted to us as due along with the premiums payable for noncontributory insurance. How is the premium determined? The premium will be the premium rate multiplied by the number of $1,000 units of insurance in force on the date premiums are due. The premium may also be computed by any other method on which you and we agree. We may change the premium rate: (1) on any premium due date following the expiration of any rate guarantee period, or following the date that the amount of insurance in force for any one coverage changes by more than 15% from that which was used to determine the current rates (active employee coverage and retiree coverage are considered separate coverages, as are basic life, supplemental life, spouse /domestic partner life, child life and AD &D); or (2) anytime, if the policy terms are amended or the total amount of insurance in force changes by 15% from the volume that was used to determine the current rates or more. Can a premium be paid after the date it is due? Yes. This policy has a 31 -day grace period. If a premium is not paid on or before the date it is due, that premium MH C -96- 13180.9 may be paid during the 31 -day period following the due date. The insurance under this policy will remain in effect during the 31 -day grace period. This grace period does not apply to the first premium payment. Can the premium be adjusted? Yes. We will adjust the premium on each due date for insurance which was effective or terminated before the most recent due date, but not reflected in prior premium payments. We will charge you for any additional premium, and will refund any overpayment, excluding any overpayment made more than 12 months before the adjustment. Death Benefit What is the amount of the death benefit? The amount of the death benefit is the amount of insurance shown on the specifications page attached to this group policy. Can an insured request a change in the amount of his or her contributory insurance? An insured can request a change in his or her contributory insurance amount only during an annual open enrollment period, as determined by the employer, or within 31 days of a Qualified Status Change. Qualified Status Change shall be as determined by the employer. If an insured requests an increase in the amount of his or her contributory insurance, we will require evidence of insurability, unless otherwise noted on the specifications page. When will changes in an insured's coverage amount be effective? Requested increases in the amount of an insured's contributory insurance, if approved, are effective on the date we approve the increase. Requested decreases in the amount of an insured's contributory insurance are effective on the first day of the month following receipt of the insured's request for a decrease, or if different, according to the administrative practices of the employer Requests for a change made during a special enrollment period offered by the employer will not become effective prior to the general effective date of elections made during that enrollment. Increases and decreases in insurance amounts which result from a change in the insured's eligible class or earnings will be effective as shown on the specifications page attached to this policy. All increases in the amount of insurance are subject to the actively at work requirement. When will the death benefit be payable? We will pay the death benefit upon receipt at our home office of written proof satisfactory to us that an individual Minnesota Life 4 EdF81772 10 -2014 died while insured under this policy. All payments by us are payable from our home office. The death benefit will be paid in a single sum or by any other method agreeable to us and the beneficiary. We will pay interest on the death benefit from the date of the insured's death until the date of payment. Interest will be at an annual rate determined by us, but never less than 0.1 % per year compounded annually, or the minimum required by state law, whichever is greater. Payment of the death benefit will extinguish our liability under the certificate for which the death benefit has been paid. To whom will we pay the death benefit? We will pay the death benefit to the beneficiary or beneficiaries. A beneficiary is named by an insured to receive the death benefit to be paid at the insured's death The insured may name one or more beneficiaries. The insured cannot name you or an associated company as a beneficiary. The insured may also choose to name a beneficiary that the insured cannot change without the beneficiary's consent. This is called an irrevocable beneficiary. If there is more than one beneficiary, each will receive an equal share, unless the insured has requested another method in writing. To receive the death benefit, a beneficiary must be living on the date of the insured's death. In the event a beneficiary is not living on the date of the insured's death, that beneficiary's portion of the death benefit shall be equally distributed to the remaining surviving beneficiaries. In the event of the simultaneous deaths of the insured and a beneficiary, the death benefit will be paid as if the insured survived the beneficiary. If there is no eligible beneficiary, or if the insured does not name one, we will pay the death benefit to: (1) the insured's lawful spouse (this does not apply to a domestic partner) if living, otherwise; (2) the insured's natural or legally adopted child (children) in equal shares, if living, otherwise; (3) the insured's parents in equal shares, if living, otherwise; (4) the personal representative of the insured's estate. Can an insured add or change beneficiaries? Yes. An insured can add or change beneficiaries if all of the following are true: (1) the insured's coverage is in force; and (2) we have written consent of all irrevocable beneficiaries; and (3) the insured has not assigned the ownership of his or her insurance. A request to add or change a beneficiary must be made in writing. All requests are subject to our approval. A MH C -96- 13180.9 change will take effect as of the date it is signed, but will not affect any payment we make or action we take before receiving an insured's notice. Termination When does an insured's coverage terminate? The insured's coverage ends on the earliest of the following: (1) the date this policy ends; or (2) the date the employee no longer meets the eligibility requirements; or (3) the date the policy is amended so the employee is no longer eligible; or (4) 31 days (the grace period) after the due date of any premium contribution which is not paid; or (5) the last day for which premium contributions have been paid following an employee's written request to cease participation under this policy. If an insured's coverage under this policy terminates due to non - payment of premiums, his or her coverage may be reinstated if all premiums due are paid and received by us within 31 days of the date of termination and during the insured's lifetime. Can insurance on the life of an insured be reinstated after termination? Yes. When an insured's coverage terminates because he or she is no longer eligible, and the insured becomes eligible again within three months after the date his or her coverage terminated, the insured's coverage under this policy may be reinstated. Provided the insured is not then covered by an individual policy issued under the terms of the conversion right section, his or her coverage under this group policy shall be reinstated automatically, without evidence of insurability or satisfaction of any waiting period. The amount of insurance will be that which applies to the classification to which he or she then belongs, on the date he or she again becomes eligible. If the policyholder's plan of insurance provides for contributory insurance under this policy, an insured's amount of contributory insurance will be limited to that for which he or she was insured immediately prior to the loss of coverage. When does this group policy terminate? You may terminate this group policy by giving us 31 days prior written notice. We reserve the right to terminate this policy on the earliest of the following to occur: (1) 31 days (the grace period) after the due date of any premiums which are not paid; or (2) on any subsequent policy anniversary after the date the number of employees insured is less than any minimum established by us or as required by applicable state law; or (3) 90 days after we provide you with notice of our intent to terminate this policy. Minnesota Life 5 EdF81772 10 -2014 Can this policy be reinstated? No. We will not reinstate this policy after it terminates. You must submit a new application for a new policy after this policy has terminated. Conversion Right What is the conversion right? An insured may be able to convert this insurance to a new individual life insurance policy if all or part of the insured's life insurance under this policy terminates. The insured may convert up to the full amount of terminated insurance if termination occurs because he or she moves from one existing eligible class to another, or he or she is no longer in an eligible class. Limited conversion is available if, after the insured has been insured for at least five years, insurance is terminated because: (1) the policy is terminated; or (2) the policy is changed to reduce or terminate the insurance for that individual. In such case, the insured may convert up to the full amount of terminated insurance, but not more than the maximum. The maximum is the lesser of: (a) $10,000; and (b) the amount of life insurance which terminated minus any amount of group life insurance for which the insured becomes eligible under any group policy issued or reinstated by us or any other carrier within 31 days of the date the insurance terminated under this policy. Neither the conversion right nor the limited conversion right is available if the insured's coverage under this policy terminates due to failure to make, when due, required premium contributions. Under both the conversion right and the limited conversion right, the insured may convert his or her insurance to any type of individual policy of life insurance then customarily issued by us for purposes of conversion, except term insurance. The individual policy will not include any supplemental benefits, including, but not limited to, any disability benefits, accidental death and dismemberment benefits, or accelerated benefits. How does an insured convert his or her insurance? An insured converts his or her insurance by applying for an individual policy and paying the first premium within 31 days after the group insurance terminates. No evidence of insurability will be required. MH C -96- 13180.9 How is the premium for the individual policy determined? We base the premium for the individual policy on the plan of insurance, the insured's age, and the class of risk to which the insured belongs on the date of the conversion. When is the individual policy effective? The individual policy takes effect 31 days after the group insurance provided under this policy terminates. What happens if the insured dies during the 31 -day period allowed for conversion? If the insured dies during the 31 -day period allowed for conversion, we will pay a death benefit regardless of whether or not an application for coverage under an individual policy has been submitted. The death benefit will be the amount of insurance the insured would have been eligible to convert under the terms of the conversion right section. We will return any premium the insured paid for an individual policy to the insured's beneficiary named under this group policy. In no event will we be liable under both this group policy and the individual policy. Additional Information What if an insured's age has been misstated? If an insured's age has been misstated, the death benefit payable will be that amount to which the insured is entitled based on his or her correct age. A premium adjustment will be made to the premium you pay for the insured's noncontributory insurance and to the premium an insured pays for contributory insurance, if any, so that the actual premium required at the insured's correct age is paid. Is there a suicide exclusion? The specifications page attached to this policy indicates what insurance, if any, is subject to the suicide exclusion outlined below. When applicable, this suicide exclusion limits our liability to an amount equal to the premiums paid for an insured, if that insured, whether sane or insane, dies by suicide within two years of the effective date of his or her insurance. If there has been an increase in the insured's amount of insurance for which he or she was required to apply or for which we required evidence of insurability, and if the insured dies by suicide within two years of the effective date of the increase, our liability with respect to that increase will be limited to the premiums paid and attributable to such increase. Minnesota Life 6 EdF81772 10 -2014 When does an insured's insurance become incontestable? Except for the non - payment of premiums, after the insured's insurance has been in force during his or her lifetime for two years from the effective date of his or her coverage, we cannot contest the insured's coverage. However, if there has been an increase in the amount of insurance for which the insured was required to apply or for which we required evidence of insurability, then, to the extent of the increase, any loss which occurs within two years of the effective date of the increase will be contestable. Any statements the insured makes in his or her application will, in the absence of fraud, be considered representations and not warranties. Also, any statement an insured makes will not be used to void his or her insurance, nor defend against a claim, unless the statement is contained in the application and any evidence of insurability application attached to the insured's certificate. Can an insured's insurance be assigned? Yes. However, we will not be bound by an assignment of the certificate or of any interest in it unless it is made as a written instrument, the insured files the original instrument or a certified copy with us at our home office, and we send the insured an acknowledged copy. We are not responsible for the validity of any assignment. An insured is responsible for ensuring that the assignment is legal in his or her state and that it accomplishes his or her intended goals. If a claim is based on an assignment, we may require proof of interest of the claimant. A valid assignment will take precedence over any claim of a beneficiary. MH C -96- 13180.9 Are you required to maintain records? Yes. You are required to maintain adequate records of any information necessary for us to administer this policy. We own the records relating to the insurance provided by this policy, and can obtain them from you at any reasonable time. If a clerical error is made in keeping records on the insurance under this policy, it will not affect otherwise valid insurance. A clerical error does not continue insurance which is otherwise stopped. If an error causes a change in premium payment, we will make a fair adjustment. Will a certificate of insurance be provided for each certificate holder? Yes. We will provide you with a certificate of insurance for delivery to each certificate holder. The certificate will include information regarding the principal provisions of his or her coverage. Will this policy receive experience credits? Each year we will determine if this policy will receive an experience credit. Are you our agent? No. For all purposes of this policy, neither you, an associated company, nor any administrator you appoint is our agent. We will not be liable for any of your acts or omissions or those of an associated company or administrator. Will the provisions of this policy conform with state law? Yes. If any provision in this policy, or in the certificates issued under this policy, is in conflict with the laws of the state governing the policy or the certificates, the provision will be deemed to be amended to conform to such laws. Minnesota Life 7 EdF81772 10 -2014 Accelerated Benefits Policy Rider Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE Benefits received under this Accelerated Benefits Policy Rider may be taxable. Certificate holders should seek assistance from a personal tax advisor prior to requesting an accelerated payment of death benefits. General Information This rider amends the group policy to which it is attached and is subject to every term, condition, exclusion, limitation, and provision of the group policy unless otherwise expressly provided for herein. What does this rider provide? This rider provides for the accelerated payment of either the full or a partial amount of an insured's death benefit provided under the group policy. If the insured has a terminal condition as defined in this rider, an accelerated payment of the death benefit may be requested. Definitions accelerated benefit The amount of the death benefit we will pay if the insured is eligible under this rider. death benefit The amount of the insured's life insurance as shown on the specifications page attached to the certificate holder's certificate. immediate family The certificate holder's spouse /domestic partner, children, parents, grandparents, grandchildren, brothers and sisters, and their spouses. insured For purposes of this rider, an insured employee, an insured spouse /domestic partner, or an insured dependent child. physician An individual who is licensed to practice medicine or treat illness in the state in which treatment is received. This does not include the certificate holder, or a member of the certificate holder's immediate family. MH C -96- 13184.9 Terminal Condition What is a terminal condition? A terminal condition is a condition caused by sickness or accident which directly results in a life expectancy of twelve months or less. What evidence do we require of the insured's terminal condition? We must be given evidence that satisfies us that the insured's life expectancy, because of sickness or accident, is twelve months or less. That evidence must include certification by a physician. Do we have the right to obtain independent medical verification? Yes. We retain the right to have the insured medically examined at our own expense to verify the insured's medical condition. We may do this as often as reasonably required while accelerated benefits are being considered or paid. Payment of Accelerated Benefit How do we calculate the accelerated benefit? We will multiply the death benefit by the accelerated benefit factor to determine the accelerated benefit available. How do we calculate the accelerated benefit factor? The accelerated benefit factor will be stated as a percentage of the insured's death benefit. When we calculate this factor, we will consider the insured's age and gender. We will also base our calculation on certain assumptions, which we may change from time to time, including but not limited to assumptions about: (1) expected future premiums; and (2) the insured's life expectancy. What are the conditions for the payment of an accelerated benefit? We will consider the payment of an accelerated benefit, Minnesota Life 1 EdF81773 10 -2014 subject to all of the following conditions: (1) coverage must be in force and all premiums due must be fully paid; and (2) application must be made in writing and in a form which is satisfactory to us. We will tell a certificate holder what form is required; and (3) the certificate holder must be the sole owner of the certificate; and (4) the insured's insurance must not have an irrevocable beneficiary. Who may request an accelerated payment of the death benefit? A certificate holder may request an accelerated payment of the insurance on his or her life or on the life of a spouse /domestic partner or dependent child insured under his or her certificate. Is the request for an accelerated benefit voluntary? Yes. An accelerated benefit will be made available on a voluntary basis only. An accelerated benefit under this rider is not intended to cause an involuntary reduction of the death benefit ultimately payable to the named beneficiary. Therefore, payment of the death benefit cannot be accelerated under this rider if the insured: (1) is required by law to use this option to meet the claims of creditors, whether in bankruptcy or otherwise; or (2) is required by a government agency to use this option in order to apply for, obtain, or keep a government benefit or entitlement. Is there a minimum or maximum death benefit eligible for an accelerated benefit? Yes. The minimum death benefit to be eligible for an accelerated benefit under this rider is $10,000. The maximum death benefit to be eligible for an accelerated benefit is $1,000,000. Does a certificate holder have to take the entire accelerated benefit? No. The certificate holder may choose to receive a partial accelerated benefit. If he or she does so, the insured's remaining coverage will stay in force. If a certificate holder elects to receive only a partial accelerated benefit amount available under this rider, the remaining death benefit under the certificate must be at least $25,000. The certificate holder may reapply for the payment of the remaining amount of insurance at any time. However, we MH C -96- 13184.9 may ask for further satisfactory evidence that the insured meets all requirements for the accelerated benefit. What is the effect on an insured's coverage of the receipt of an accelerated benefit? If a certificate holder elects to accelerate the full amount of an insured's death benefit, the insured's coverage and all other benefits under the certificate and any certificate supplements which apply to that insured will end. If the insured is a certificate holder, any other individual insured under his or her certificate will be allowed to convert any such insurance to a policy of individual life insurance according to the conversion right section of the group policy to which this rider is attached. If a partial accelerated benefit is chosen, coverage will remain in force and premiums will be reduced accordingly The remaining amount of insurance under the certificate will be the full amount of insurance minus the amount of insurance that was accelerated. How will we pay the accelerated benefit? We will pay the accelerated benefit in one lump sum or in any other mutually agreeable manner. To whom will we pay accelerated benefits? All accelerated benefits will be paid to the certificate holder who requested the accelerated payment unless the certificate holder validly assigns them otherwise. If such certificate holder dies before all payments have been made, we will pay the remainder to the insured's beneficiary named under the certificate. Payment will be made in one lump sum which will be the present value of the payments that remain, using the interest rate we use to determine the payments. Termination When does an insured's coverage under this rider terminate? An insured's coverage ends on the date the insured is no longer covered for life insurance under the group policy. When does this rider terminate? This rider will terminate on the earlier of: (1) the date we receive a written request to cancel this rider; or (2) the date the group policy is terminated. Secretary President Minnesota Life 2 EdF81773 10 -2014 Accidental Death and Dismemberment Policy Rider Minnesota Life Insurance Company, a Securian Financial Group affiliate 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE Statement to Policyholders If you have any questions regarding this policy rider, or if you need assistance in resolving a complaint, you can contact us at: Minnesota Life Insurance Company, 400 Robert Street North, St. Paul, MN 55101 -2098. Toll -Free Telephone Number: 1- 800 - 843 -8358. General Information This rider is issued in consideration of the required premium and amends the group policy to which it is attached. This rider is subject to every term, condition, exclusion, limitation, and provision of the group policy unless otherwise expressly provided for herein. What does this rider provide? This rider provides accidental death and dismemberment coverage subject to all terms, conditions, and exclusions herein. Who is eligible for insurance under this rider? An employee or a spouse /domestic partner who is eligible under the provisions applicable to life insurance coverage under the group policy is eligible for insurance under this rider. When does insurance under this rider become effective? Insurance becomes effective on the date that the employee or spouse /domestic partner becomes insured for life insurance under the group policy. Accidental Death and Dismemberment (AD &D) Benefit What does accidental death or dismemberment by accidental injury mean? Accidental death or dismemberment by accidental injury as used in this rider means that the insured's death or dismemberment results, directly and independently of all other causes, from an accidental bodily injury which is unintended, unexpected, and unforeseen. The bodily injury must be evidenced by a visible contusion or wound, except in the case of accidental drowning. The bodily injury must be the sole cause of death or dismemberment The injury must occur while the insured's coverage under this rider is in force. The insured's death or dismemberment must occur within 180 days after the date of the injury. In no event will we pay the accidental death or dismemberment benefit where the insured's death or dismemberment is caused directly or indirectly by, results 11 -31358 from, or where there is a contribution from, any of the following: (1) self- inflicted injury or self destruction, whether sane or insane; or (2) suicide or attempted suicide, whether sane or insane (3) the insured's participation in or attempt to commit a crime, assault, felony, or any illegal activity, regardless of any legal proceedings, or the absence of any legal proceedings, thereto; or (4) bodily or mental infirmity, illness or disease; or (5) the use of alcohol, drugs, medications, poisons, gases, fumes or other substances taken, absorbed, inhaled, ingested or injected, unless taken upon the advice of a licensed physician in the verifiable prescribed manner and dosage; or (6) motor vehicle collision or accident where the insured is the operator of the motor vehicle and this insured's blood alcohol level meets or exceeds the level at which intoxication is defined in the state where the collision or accident occurred, regardless of any legal proceedings, or the absence of any legal proceedings, thereto; or (7) infection, other than infection occurring simultaneously with, and as a direct result of, the accidental injury; or (8) medical or surgical treatment or diagnostic procedures or any resulting complications; or (9) travel in or descent from any aircraft, except as a fare - paying passenger on a regularly scheduled commercial flight on a licensed passenger aircraft; or (10) war or any act of war, whether declared or undeclared; or (11) service in the military of any nation. What is the amount of the accidental death and dismemberment benefit? The amount of the benefit shall be a percentage of the amount of insurance shown on the specifications page attached to the group policy. The percentage is determined by the type of loss as shown in the following table: FOR LOSS OF Life... ............................... Both Hands or Both Feet Sight of Both Eyes.......... Speech and Hearing....... One Hand and One Foot One Foot and Sight of One Eye ...................... One Hand and Sight AMOUNT OF BENEFIT Full Amount of AD &D Insurance Full Amount of AD &D Insurance Full Amount of AD &D Insurance Full Amount of AD &D Insurance Full Amount of AD &D Insurance Full Amount ofAD &D Insurance of One Eye ........................ Full Amount of AD &D Insurance Quadriplegia .....................Full Amount of AD &D Insurance Paraplegia .................. 75% of Amount of AD &D Insurance Minnesota Life 1 EdF81774 10 -2014 Sight of One Eye .... Speech or Hearing . One Hand or One Foot ............... Hemiplegia ............ Thumb and Index Finger of One Hand 50% of Amount of AD &D Insurance 50% of Amount of AD &D Insurance 50% of Amount of AD &D Insurance 50% of Amount of AD &D Insurance 25% of Amount of AD &D Insurance Loss of hands or feet means complete severance at or above the wrist or ankle joints. Loss of sight, speech, or hearing means the entire and irrecoverable loss of sight, speech, or hearing which cannot be corrected by medical or surgical treatment or by artificial means. Loss of thumb or finger means complete severance at or above the metacarpophalangeal joints (the joints closest to the palm of the hand). Quadriplegia means total and permanent paralysis of both upper limbs (from the shoulder down including total paralysis of both hands) and both lower limbs (from the waist down including total paralysis of both feet). Paraplegia means total and permanent paralysis of both lower limbs (from the waist down including total paralysis of both feet). Hemiplegia means total and permanent paralysis of both the upper limb (from the shoulder down including total paralysis of the hand) and lower limb (from the waist down including total paralysis of the foot) on one side of the body. A benefit is not payable for both loss of one hand and the loss of thumb and index finger of one hand for injury to the same hand as a result of any one accident. Under no circumstance will more than one payment be made for the loss or paralysis of the same limb, eye, finger, thumb, hand, foot, sight, speech, or hearing if one payment has already been made for that loss. Benefits may be paid for more than one accidental loss but the total amount of AD &D insurance payable under this rider for all of an insured's losses due to any one accident, not including any amount paid according to the terms of the Additional Benefits section of this rider, will never exceed the full amount of AD &D insurance shown on the specifications page attached to the group policy. When will the accidental death and dismemberment benefit be payable? We will pay the AD &D benefit upon receipt at our home office of written proof satisfactory to us that the insured died or suffered dismemberment as a result of an accidental injury. All payments by us are payable from our home office. The benefit will be paid in a single sum. We will pay interest on the benefit from the date of the insured's death or dismemberment until the date of payment. Interest will be at an annual rate determined by us, but never less than 0.1% per year compounded annually or the minimum required by state law, whichever is greater. To whom do we pay the benefit? A certificate holder's accidental death benefit will be paid 11 -31358 to the person or persons entitled to receive a death benefit under the terms of the group policy. The benefit for other losses sustained by a certificate holder will be paid to the certificate holder, if living, otherwise to his or her estate. Additional Benefits Unless stated otherwise, additional benefits are payable to the same person or persons who receive the AD &D benefits. Additional benefits are paid in addition to any AD &D benefits described in the Accidental Death and Dismemberment section, unless otherwise stated. All provisions of this rider, including but not limited to the exclusions listed under the "What does accidental death or dismemberment by accidental injury mean ?" section, shall apply to these additional benefits. Air Bag Benefit What is the air bag benefit? If an insured dies as a result of a covered accident which occurs while he or she is driving or riding in a private passenger car, we will pay an additional AD &D benefit equal to the lesser of: (1) $10,000; or (2) 10% of the insured's amount of AD &D insurance In order to be eligible for this benefit, the following must apply: (1) the seat in which the insured was seated was equipped with a properly installed airbag at the time of the accident; and (2) the private passenger car is equipped with seatbelts; and (3) a seatbelt was in proper use by the insured at the time of the accident as certified in the official accident report or by the investigating officer; and (4) at the time of the accident, the driver of the private passenger car was a licensed driver and was not intoxicated, impaired, or under the influence of alcohol or drugs. Airbag means a passive restraint device in a vehicle which inflates upon collision to protect an individual from injury or death. Seatbelt means a properly installed seatbelt (or child restraint if the insured is a child), lap and shoulder restraint, or other restraint approved by the National Highway Traffic Safety Administration or any successor governmental agency. A private passenger car means a validly registered four - wheeled private passenger car or policyholder -owned car, jeep, pickup truck or van, including a sport utility vehicle (SUV), that is not licensed commercially or being used for racing, or acrobatic or stunt driving. Minnesota Life 2 EdF81774 10 -2014 Seatbelt Benefit What is the seatbelt benefit? If an insured dies as a result of a covered accident which occurs while he or she is driving or riding in a private passenger car, we will pay an additional AD &D benefit equal to the lesser of: (1) $20,000; or (2) 20% of the insured's amount of AD &D insurance In order to be eligible for this benefit, the following must apply: (1) the private passenger car was equipped with seatbelts; and (2) a seatbelt was in proper use by the insured at the time of the accident as certified in the official accident report or by the investigating officer; and (3) at the time of the accident, the driver of the private passenger car was a licensed driver and was not intoxicated, impaired, or under the influence of alcohol or drugs. Termination When does an insured's coverage under this rider terminate? An insured's coverage ends on the earlier of: (1) the date the certificate holder is no longer covered for life insurance under the group policy; or (2) for an insured dependent spouse /domestic partner, the date the dependent spouse /domestic partner no longer meets the eligibility requirements; or (3) for an insured dependent spouse /domestic partner, the date the dependent is no longer covered for life insurance under the group policy; or (4) 31 days (the grace period) after the due date of any premium contribution which is not paid. When does this rider terminate? This rider will terminate on the earlier of: (1) the date we receive a written request from the policyholder to cancel this rider; or (2) the date the group policy is terminated. Additional Information Do we have the right to obtain independent medical verification? Yes. We retain the right to have an insured medically examined at our expense whenever a claim is pending and, where not forbidden by law, we reserve the right to have an autopsy performed in case of death. Can insurance under this rider be converted to a policy of individual insurance upon termination? No. Coverage under this rider will not be included in any insurance issued under the conversion right section of the group policy. E ��� Secretary President 11 -31358 Minnesota Life 3 EdF81774 10 -2014 Dependents Term Life Insurance Policy Rider Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE General Information This rider is issued in consideration of the required premium and amends the group policy to which it is attached. The rider is subject to every term, condition, exclusion, limitation, and provision of the group policy unless otherwise expressly provided for herein. What does this rider provide? This rider provides insurance on the lives of the insured employee's eligible dependents. What members of the insured employee's family are eligible for insurance under this rider? The following members of the insured employee's family are eligible for insurance under this rider: (1) the insured employee's lawful spouse who is not legally separated from the insured and who is not eligible for insurance as an employee under the policy to which this rider is attached; and (2) the insured employee's domestic partner who is not eligible for insurance as an employee under the policy to which this rider is attached. Domestic partners are two adults who have chosen to share one another's lives in a committed family relationship of mutual caring. Two individuals are considered to be domestic partners if: (a) they consider themselves to be members of each other's immediate family; and (b) they agree to be jointly responsible for each other's basic living expenses; and (c) neither of them is married or a member of another domestic partnership; and (d) they are not blood related in a way that would prevent them from being married to each other under the laws of Florida; and (e) each is at least of the legal age and competency required by Florida law to enter into a marriage or other binding contract; and (f) they must each sign a Declaration of Domestic Partnership as provided for in Section 14.03; and (g) they both reside at the same residence; and (3) the insured employee's and domestic partner's children, stepchildren and legally adopted children. Children are eligible from live birth (stillborn and unborn children are not eligible) to the attainment of age 26. Children age 26 or older are also eligible if they are physically or mentally incapable of self- support, were incapable of self- support prior to age 26 and are financially MH C -96 -13186 dependent on the employee for more than one - half of their support and maintenance. If both parents of a child qualify as eligible employees under the group policy, the child shall be considered a dependent of only one parent for purposes of this rider. If any child qualifies as an eligible employee under the group policy, he or she is not eligible to be insured as a dependent child. Any dependent child who, subsequent to the effective date of the insured employee's child life insurance, meets the requirements of this provision will become insured on the date he or she so qualifies. When will we require evidence of insurability? Evidence of insurability will be required if: (1) the specifications page attached to the group policy states that evidence of insurability is required; or (2) the insurance is contributory and the employee does not enroll for coverage under this rider within the enrollment period shown on the specifications page attached to the group policy; or (3) dependents insurance for which the employee previously enrolled did not go into effect or was terminated because the employee failed to make a required premium contribution; or (4) during a previous period of eligibility, the employee failed to submit evidence of insurability that was required for a dependent or that which was submitted was not satisfactory to us; or (5) the dependent is insured by an individual policy issued under the terms of the conversion right of this rider. When does insurance on a dependent become effective? Insurance on a dependent becomes effective on the date when all of the following conditions have been met: (1) the dependent meets all eligibility requirements; and (2) if required, the insured employee applies for dependents coverage on forms which are approved by us; and (3) we are satisfied with the dependent's evidence of insurability, if we require evidence; and (4) we receive the required premium. If a dependent is hospitalized or confined because of illness or disease on the date his or her insurance would otherwise become effective, his or her effective date shall Minnesota Life 1 EdF81775 10 -2014 be delayed until he or she is released from such hospitalization or confinement. This does not apply to a newborn child. However, in no event will insurance on a dependent be effective before the insured employee's insurance under the group policy is effective. Death Benefit What is the amount of life insurance on each insured dependent? The amount of life insurance on each insured dependent is shown on the specifications page attached to the group policy. To whom will we pay the death benefit? The death benefit payable under this rider will be paid to the insured employee if living, otherwise to his or her estate. Termination When does an insured dependent's coverage under this rider terminate? An insured dependent's coverage ends on the earliest of the following: (1) the date the dependent no longer meets the eligibility requirements; or (2) 31 days (the grace period) after the due date of any premium contribution which is not paid; or (3) the last day for which premium contributions have been made following an employee's written request that insurance on his or her eligible dependents be terminated; or (4) the date the employee is no longer covered under the group policy. The employee must notify us or the employer when a dependent is no longer eligible for coverage under this rider so that premiums may be discontinued. All premiums paid for dependents who are no longer eligible for coverage under this rider will be refunded without any payment of claim. When does this rider terminate? This rider will terminate on the earlier of: (1) the date we receive a written request to cancel this rider; or (2) the date the group policy is terminated. Additional Information What is the conversion right under this rider? If an insured dependent's coverage under this rider terminates because he or she is no longer eligible, or because of the death of the insured employee, or because of termination or amendment of this rider, the insurance may be converted to a policy of individual insurance with Minnesota Life. Conversion may be requested by the insured employee, an insured dependent of legal capacity, or the insured dependent's guardian, if applicable. All other conditions and provisions of the conversion right section of the group policy to which this rider is attached will apply. Does the Waiver of Premium rider to the group policy apply to insured dependents? The Waiver of Premium rider to the group policy will not apply to disabilities for dependents covered under this rider. However, if, due to the insured employee's disability, his or her insurance is continued in force without further payment of premiums due to the Waiver of Premium rider to the group policy, any dependents insurance provided by this rider shall also continue in force without further payment of premiums until the dependent's eligibility terminates or until the insured employee's insurance is no longer continued in force due to the Waiver of Premium rider to the group policy. This provision is not applicable if the dependent's insurance has been converted under the conversion right section of this rider, unless the converted policy is surrendered without claim except for refund of premiums. �..- Secretary President MHC -96 -13186 Minnesota Life 2 EdF81775 10 -2014 Term Life Insurance Portability Policy Rider Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE General Information This rider is issued in consideration of the required premium and amends the group policy to which it is attached. This rider is subject to every term, condition, exclusion, limitation and provision of the group policy unless otherwise expressly provided for herein. What does this rider provide? This rider provides for continuation of group life insurance for insureds who no longer meet the eligibility requirements of the group policy except as provided for herein. To continue coverage under the provisions of this rider, an eligible insured must make a written request and make the first premium contribution within 31 days after insurance provided by the group policy would otherwise terminate. Evidence of insurability will not be required. Coverage provided by this rider will then be deemed effective retroactive to the beginning of the 31 -day period. This date is considered to be the insured's portability date and the insured is then considered to have portability status. Who is eligible to continue insurance under this rider? A certificate holder is eligible to continue insurance under this rider if he or she, except as provided by this rider, no longer meets the eligibility requirements of the group policy due to any of the following: (1) the employee terminates employment, including retirement; or (2) the employee is no longer in a class eligible for insurance or is on a leave or layoff; or (3) a class or group of employees insured under the policy is no longer considered eligible and there is no successor plan for that class or group. Successor plan means an insurance policy or policies provided by us or another insurer that replaces insurance provided under this policy. The certificate holder will not be eligible to request coverage under this rider if he or she: (1) has attained the age of 70; or (2) has converted his or her insurance to an individual life policy under the terms of the group policy's conversion right section; or (3) was not actively at work due to sickness or injury on the day immediately preceding his or her portability date; or (4) loses eligibility due to termination of the group policy. MH C -96 -13214 What insurance can be continued under this rider? Contributory life and AD &D insurance and noncontributory life and AD &D insurance may be continued under this rider. If the certificate holder elects to continue his or her own coverage according to the provisions of this rider, he or she may also elect to continue contributory insurance for any other individual insured under his or her certificate. The certificate holder may also continue coverage under all supplements to such certificate which apply to contributory insurance and by which he or she was insured immediately preceding his or her portability date, except the Waiver of Premium Certificate Supplement, which shall terminate upon porting. The amount of insurance continued under this rider for any individual will be subject to any applicable state law or regulation relating to allowable amounts of insurance. What is the minimum amount of insurance that can be continued under this rider? The minimum amount of insurance that can be continued on the life of an insured under this rider is $10,000 for an employee and $1,000 for each of his or her insured dependents. What is the maximum amount of insurance that can be continued under this rider? The maximum amount of insurance that can be continued under this rider is the amount of insurance that was in force on the insured's portability date, but not more than $1,000,000 for an employee or $150,000 for a spouse /domestic partner. However, for an insured who is age 65 or older on his or her portability date, the amount will not be more than 65% of the amount in force on the insured's portability date, to a maximum of $650,000 for an employee or $97,500 for a spouse /domestic partner. The amount of ported AD &D insurance cannot exceed the amount of ported life insurance. Will the amount of insurance continued under this rider change? Yes. On the first day of the month following the date an insured attains age 65, the amount of insurance on his or her life continued under this rider will reduce to 65% of the amount of insurance in force on the day prior to his or her attainment of age 65. Insurance terminates at age 70. Can a certificate holder request a change in his or her amount of insurance continued under this rider? Yes. The certificate holder may elect to reduce the amount of insurance provided under his or her certificate Minnesota Life 1 EdF81776 10 -2014 The remaining amount of insurance on the life of a certificate holder must be at least $10,000. The amount of insurance continued under this rider will never increase. How will premium contributions be paid? Premium contributions will be paid directly to us on a monthly, quarterly, semi - annual, or annual basis and will be subject to an administrative charge per billing period. We may adjust the amount of the charge, but not more often than once per year. Can the premium rate change? Yes. The premium rate may increase on the portability date. The premium rate may also increase in the future but will not change more often than once per year. Can insurance continued under this rider be converted to a policy of individual insurance? Yes. At any time after insurance has been continued under the provisions of this rider, it may be converted to a policy of individual insurance with Minnesota Life. All other conditions and provisions of the conversion right section of the group policy to which this rider is attached will apply. What happens if a certificate holder again becomes eligible under the group policy? If a certificate holder who is continuing coverage under the provisions of this rider again meets the eligibility requirements of the group policy, not including the terms of this rider, he or she shall no longer be considered to have portability status. Insurance for that certificate holder may be provided only under the terms of the group policy, not including this rider, unless and until he or she no longer meets the eligibility requirements of the group policy and again returns to portability status as provided for herein. What happens to insurance provided under this rider when the group policy terminates? Anything in the group policy notwithstanding, termination of the group policy by the policyholder or us will not terminate life insurance then in force for any person under the terms of this rider. The group policy will be deemed to remain in force solely for the purpose of continuing such insurance, but without further obligation of the policyholder. Any insurance continued under the terms of this rider will remain in force until terminated by the provisions of the section entitled "When will insurance continued under this rider terminate ? ". No individual may elect coverage under this rider on or after the date of termination of the group policy. When will insurance continued under this rider terminate? Insurance continued under this rider will terminate on the earliest of the following: (1) the insured's 70th birthday; or (2) the date the certificate holder again meets the eligibility requirements of the group policy, not including the terms of this rider; or (3) in the case of a dependent child or a spouse /domestic partner who is insured by a rider to the certificate holder's coverage, the date the certificate holder's coverage is no longer being continued under this rider, or the date the certificate holder's spouse /domestic partner or child ceases to be eligible as defined under the terms of the group policy; or (4) 31 days after the due date of any premium contribution which is not made. t Secretary President MHC -96 -13214 Minnesota Life 2 EdF81776 10 -2014 Term Life Waiver of Premium Policy Rider Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101 -2098 MINNESOTA LIFE General Information This rider is issued in consideration of the required premium and amends the group policy to which it is attached. The specifications page attached to the group policy indicates whether this rider applies to contributory insurance or noncontributory insurance. This rider is subject to every term, condition, exclusion, limitation, and provision of the group policy unless otherwise expressly provided for herein. Coverage under this rider will not be included in any insurance issued under the conversion right section of the group policy. What does this rider provide? This rider provides for waiver of premium for certificate holders who become totally and permanently disabled, as defined herein, while under age 60. Upon approval of proof of such disability, a certificate holder's insurance, including all riders applicable to such certificate holder which were in force on the date of the onset of the certificate holder's disability, will be continued in force without payment of premiums during the uninterrupted continuance of the total and permanent disability. What is total disability? Total disability is a disability which occurs while a certificate holder's insurance and the coverage under this rider is in force and which results from an accidental injury or an illness that continuously prevents the certificate holder from engaging in any occupation for which he or she is reasonably suited by education, training, or experience. The certificate holder must be under the care of a licensed physician. The licensed physician cannot be the certificate holder or a member of the certificate holder's immediate family. For purposes of this rider, the certificate holder's immediate family consists of his or her spouse /domestic partner, children, parents, grandparents, grandchildren, brothers and sisters and their spouses. What is permanent disability? Permanent disability is a total disability which has existed continuously for at least six months. Are there any limitations? Yes. Insurance will not be continued if a certificate holder's disability results from intentionally self - inflicted injury, participation in or any attempt to commit a felony, or war or any act of war, whether declared or undeclared. Do premiums have to be paid for a certificate holder after he or she becomes disabled? Yes. Premiums have to be paid after a certificate holder becomes disabled, but only until we approve his or her total and permanent disability claim. Continued payment prevents the possible loss of the certificate holder's coverage and eligibility if the claim is not approved. What if a certificate holder converts his or her group life insurance to a policy of individual insurance prior to the approval of his or her disability claim? If a certificate holder's coverage has been converted in accordance with the conversion right section of the group policy, benefits under this rider will apply only if the converted policy is surrendered without claim, except for refund of premiums. What will be considered due proof of total and permanent disability? A certificate holder must furnish evidence satisfactory to us that his or her disability: (1) commenced while his or her insurance under the group policy was in force; and (2) meets the definition of total disability; and (3) commenced before his or her 60th birthday; and (4) was continuous for six months or more. We will, from time to time, also require additional proof satisfactory to us that the certificate holder continues to be totally and permanently disabled. We may also require that the certificate holder submit to one or more medical examinations at our expense. If a certificate holder dies within one year of the date of onset of his or her disability, the certificate holder's beneficiary may claim benefits under this rider even if the certificate holder's premium payments were discontinued and he or she had not submitted due proof satisfactory to us of his or her total disability or was continuously disabled for less than six months. The certificate holder's beneficiary must submit due proof satisfactory to us that the certificate holder's total disability, which began before the certificate holder's premium payments were discontinued and before his or her 60th birthday, continued without interruption until his or her death. When must we be notified of a certificate holder's disability or death? We must receive written notice at our home office of a certificate holder's total disability within one year of the MHC -96 -13208 Minnesota Life 1 EdF81777 10 -2014 date of onset of such disability. However, failure to give notice within the time provided will not invalidate the claim if it is shown that notice was given as soon as reasonably possible. We must receive written notice at our home office within one year of death that a certificate holder died during a period of continuance provided by this rider. Proof must be furnished that he or she continued to be totally disabled during the entire period of continuance until death. If such notice and proof are not provided within the required time frame, there shall be no liability for any payment under this rider. What is the amount of insurance to be continued without payment of premium under this rider? The amount of insurance continued without payment of premium shall be the amount of insurance that was in force on the date of onset of total disability. If the group policy provides for reductions in amounts of insurance based on age or retirement, such reductions shall apply to the insurance of the disabled certificate holder. How long will insurance be continued without payment of premium? If a certificate holder becomes totally and permanently disabled, insurance will be continued, without payment of premium, until the earliest of: (1) the date the certificate holder recovers so that he or she is no longer totally and permanently disabled; or (2) the date the certificate holder fails to furnish proof of continued disability when requested or refuses to submit to a required medical examination. However, if the group policy provides for termination of insurance at retirement, insurance provided under this rider will terminate when the insured employee retires, including normal or early retirement. The retirement date for an employee whose insurance is being continued by the terms of this rider shall be the earlier of: (1) the date he or she actually retires; or (2) his or her presumed normal retirement date as established by the employer's applicable retirement plan. If no such date has been established, the insured employee's presumed retirement date shall be age 65. MH C -96 -13208 What happens to a certificate holder's insurance when the waiver of premium benefit ends? When the benefits under this rider end according to the provisions of the section entitled "How long will insurance be continued without payment of premium ?," the following will apply: (1) If the certificate holder is then eligible for coverage under the group policy, his or her insurance may be continued under the group policy provided that premiums are paid. The first such premium payment must be made within 31 days of the date the waiver of premium benefit ends. (2) If the certificate holder is no longer eligible for coverage under the group policy, he or she may convert coverage to an individual policy, as provided for under the conversion right section of the group policy. Insurance will end for a certificate holder unless, within 31 days of the date benefits under this rider end, premium payment is resumed or the insured applies to convert his or her coverage. When does this rider terminate? This rider will terminate on the earlier of: (1) the date we receive a written request to terminate this rider; or (2) the date the group policy is terminated. Insurance being continued without further payment of premiums in accordance with the provisions of this rider will not end due solely to the termination of this rider or of the group policy. Secretary President Minnesota Life 2 EdF81777 10 -2014 MINNESQTA LIFE 400 Robert Street North • St. Paul, Minnesota 55101 -2098 GROUP TERM LIFE INSURANCE POLICY • NONPARTICIPATING