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Item C04 � C.4 � � �, BOARD OF COUNTY COMMISSIONERS County of Monroe � ��r�i �r � s�� Mayor Heather Carruthers,District 3 The Florida.Keys � � � ������]�j Mayor Pro Tem Michelle Coldiron,District 2 Craig Cates,District 1 ^_, David Rice,District 4 Sylvia J.Murphy,District 5 County Commission Meeting July 15, 2020 Agenda Item Number: C.4 Agenda Item Summary #6943 BULK ITEM: Yes DEPARTMENT: Employee Services TIME APPROXIMATE: STAFF CONTACT: Natalie Maddox (305) 292-4450 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, 2020 - September 30, 2023 with no increase in cost and no plan design changes; and approval for the Employee Services Director to sign all necessary documents. ITEM BACKGROUND: For the period of October 1, 2020 — September 30, 2023, Minnesota Life is offering a 3-year renewal with no increase in cost for coverage, and no plan design changes. With this contract, Monroe County will experience no cost increases for Life, Accidental Death and Dismemberment(AD&D), and Supplemental Life Insurance for a period of 3 years, ending 9/30/2023. The estimated annual cost per year for employee Life and Accidental Death & Dismemberment Insurance is $160,000.00. The current 3-year contract ends on September 30, 2020. Minnesota Life has been the County's provider since 10/1/2014. 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. Renewed with Minnesota Life in 2017 for 3 years. CONTRACT/AGREEMENT CHANGES: 3 Year Renewal with Minnesota Life for Basic Life/AD&D/Supplemental Life; No Increase in Cost STAFF RECOMMENDATION: Approval. DOCUMENTATION: Packet Pg. 127 C.4 Minnesota Life 3 Year Renewal AM BEST RATING 2020 MN Life Exp 2017 - 2019 MCBCC MN Life Term Policy 34395 10 01 14 FINANCIAL IMPACT: Effective Date: October 1, 2020 Expiration Date: September 30, 2023 Total Dollar Value of Contract: 3 years of life insurance for $480,000.00; includes AD&D Total Cost to County: 3 years of life insurance for $480,000.00; includes AD&D Current Year Portion: FY 19/20 Zero Cost; FY 20/21 $ 160,000.00 Budgeted: $162,000 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: Yes Additional Details: 06/21/17 502-08002 - GROUP INS OPERATIONS $41,598.00 3 year renewal, 10% increase on basic life only REVIEWED BY: Natalie Maddox Completed 06/11/2020 2:32 PM Bryan Cook Completed 06/11/2020 2:44 PM Assistant County Administrator Christine Hurley Completed 06/16/2020 9:52 AM Cynthia Hall Completed 06/16/2020 1:52 PM Budget and Finance Completed 06/22/2020 4:42 PM Maria Slavik Completed 06/23/2020 2:29 PM Kathy Peters Completed 06/24/2020 10:01 AM Board of County Commissioners Pending 07/15/2020 9:00 AM Packet Pg. 128 C.4.a oxo o securian FINANCIAL RATE CONFIRMATION 1. Policyholder: Monroe County BOCC E m 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 Life06 4. The insurance rates included in this rate confirmation are net of commissions. 5. Underwriting company: Minnesota Life Insurance Company .2 6. Rate Coverage Period: October 1, 2020-September 30,2023 Premium Rates: ns Current Rates Renewal Rates y Coverage Rate per$1,000 Rate per$1,000 per month per month 9 Basic Active Life $0.400 $0.400 Basic Retiree Life $0.400 $0.400 Basic Active AD&D $0.020 $0.020 76 Employee and Spouse Age Rate Age Rate Supplemental Life* Under 25 $0.05 Under 25 $0.05 25-29 $0.06 25-29 $0.06 30-34 $0.08 30-34 $0.08 35-39 $0.09 35-39 $0.09 40-44 $0.12 40-44 $0.12 45-49 $0.21 45-49 $0.21 50-54 $0.37 50-54 $0.37 0. 55-59 $0.61 55-59 $0.61 60-64 $0.75 60-64 $0.75 65-69 $1.31 65-69 $1.31 70-74 $2.06 70-74 $2.06 75** $2.38 75** $2.38 Employee and Spouse $0.020 $0.020 a Supplemental AD&D Child Life $0.130 $0.130 "9 *Please note,supplemental life rates do not include AD&D **Rates Increase beyond age 75 and will be provided upon request. ns 0 Securian Financial Group By Date March 27,2020 Susan Munson-Regala ns Title 2nd Vice President Packet;Pg. 129 C.4.a ACKNOWLEDGEMENT BY AUTHORIZED REPRESENTATIVE OF POLICYHOLDER This document confirms that the rates stated above are the agreed upon rates for the specified policy numbers. These rates will be charged for coverage amounts effective during the Rate Coverage Period listed above. This renewal offer is subject to the current terms and conditions of the policies covering employees and their dependents. Minnesota Life reserves the right to adjust the rates at any time in the event of plan design changes, modifications to the definition of eligible employees,or significant demographic changes in the group. We define significant changes to mean a change in the volume within a coverage or across coverages of more than 15%. Actives and retirees are considered 06 independent coverages. The baseline for calculating the total change in volume will be the volume provided in the 2020 renewal census. 0 0 76 r9 0 2 r9 0 Rate Confirmation Page 2 of 2 Packet,Pg. 130 C.4.b Minnesota Life Insurance Company AMB#:006724 NAIC#:66168 FEIN M 410417830 Domiciliary Address 400 Robert Street North St.Paul,Minnesota 55101-2098 United States m Web:www.securian.com Phone:651-665-3500 Fax:651-665-4488 06 AM Best Rating Unit:AMB#:069565-Securian Financial Insurance Group Assigned to insurance companies that have,in our opinion,a superior ability to meet their ongoing insurance obligations. %new Aai�� U y View additional news,reports and products for this company. 0 Based on AM Best's analysis,050746-Minnesota Mutual Companies, 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: A+(Superior) Financial Size Category: XV($2 Billion or greater) Outlook: Stable Action: Affirmed Effective Date: December 10,2019 Initial Rating Date: June 30, 1928 c4I Long-Term Issuer Credit Rating View Definition N Long-Tenn: as U) Outlook: Stable Action: Affirmed Effective Date: December 10,2019 Initial Rating Date: February 17,2004 u Denotes Under Review Best's Rating Best's Credit Rating Analyst Rating Office:A.M.Best Rating Services,Inc. Senior Financial Analyst:Keith Behrmann PaCket',Pg. 131 C.4.b Director:Edward Kohlberg Note:See the Disclosure information Form or Press Release below for the office and analyst at the time of the rating event. I Disclosure Information Disclosure Information Form i View AM Best's Rating Disclosure Form Press Release AM Best Affirms Credit Ratings of Securian Financial Group,Inc.and Its Subsidiaries December 10,2019 06 i j Rating History ra AM Best has provided ratings&analysis on this company since 1928. Financial Strength Rating I i ra Effective Date Rating 12/10/2019 A+ W 12/13/2018 A+ j 12/1/2017 A+ { 11/18/2016 A+ 2/3/2016 A+ i 1/8/2015 A+ W Long-Term Issuer Credit Rating Effective Date Rating 12/10/2019 as 12/13/2018 as G 12/1/2017 as 11/18/2016 aa- c44 2/3/2016 aa- 1/8/2015 aa- l.._. —. _...._................®......._ _.,...,_....__..,_ _. ..... F®_� _ _ Rated Issues Issue Credit Ratings Date Issued Amount Coupon Issue Type Rating Effective Date Outlook/Implication 09/21/1995 125,000,000 USD 8.25% Surplus Notes a+ 12/10/2019 Stable (i)Denotes Indicative Rating _.�. .a��m -_ _ _... __.._............ _....._.n.__.._ __. ._._.... ... __.._.. ..._....................... _._._..._ Packet;Pg. 132 C.4.b Related Financial and Analytical Data The following links provide access to related data records that AM Best utilizes to provide financial and analytical data on a consolidated or branch basis. AMB# Company Name Company Description I 069565 Securian Financial Insurance Represents the AM Best Consolidated financials for the Life,Annuity,and Accident business of Group(G) this legal entity. Rating Unit Best's Credit&Financial Reports _e. r ....._m.. ......m _ _.m_. . _... ..__m..mmmmmmm..__._ $ d Best's Credit Report-financial data included in Best's Credit Report reflects the data used in determining the current credit rating(s)for 'AM Best Rating Unit:AMB#:069565-Securian Financial Insurance Group. 4i Best's Credit Report-Archive-reports which were released prior to the current Best's Credit Report. .2 m (n Best's Financial Report-financial data included in Best's Financial Report reflects the most current data available to AM Best,including updated financial exhibits and additional company information,and is available to subscribers of Best's Insurance Reports. 0 View additional news,reports and products for this company. Press Releases ..__ .... _.— -- .- Date n& Dec 1Q 2019 AM Best Affirms Credit Ratings of Securian Financial Group,Inc.and Its Subsidiaries Dec 13,2018 AM Best Affirms Credit Ratings of Securian Financial Group,Inc.and Its Subsidiaries Dec 01,2017 A.M.Best Upgrades Issuer Credit Ratings of Securian Financial Group,Inc.and Its Key Insurance Subsidiaries Nov 18,2016 A.M.Best Affirms Credit Ratings of Securian Financial Group,Inc,and Its Subsidiaries j 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 Mar 24,2014 A.M.Best Affirms Ratings of Securian Financial Group,Inc.'s Subsidiaries Mar 29,2013 A.M.Best Affirms Ratings of Securian Financial Group,Inc.'s Subsidiaries Mar 3Q 2012 A.M.Best Affirms Ratings of Subsidiaries of Securian Financial Group,Inc. W Apr 19,2011 A.M.Best Affirms Ratings of Securian Financial Group,Inc's Key Life Members tV N 1 2 Page size: 10 19 items in 2 pages Find a Best's Credit Rating Inter a Company Name Go Advanced Search fig saiwiti,60it k efirigs App Packet iPg. 133 C.4.b 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.A.M. Best(EU)Rating Services B.V.(AMB-EU),a subsidiary of A.M.Best Rating Services,Inc.,is an External Credit Assessment(ECAI)in the EU.Therefore,credit ratings issued and endorsed by AMB-EU may be used for regulatory purposes in the EU as per Directive 2006/48/EC. 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J re O re M O O N CD re Packet iPg. 134 C.4.c Monroe County BOCC Policy Number: 34395 January 1,2017 through December 31,2019 1.Earned Premium 2017 2018 2019 Employee Basic Life $140,366 $154,401 $154,808 Employee Basic AD&D 6,034 5,927 6,187 0. 0. Employee Supplemental Life 63,715 57,877 103,706 Employee Supplemental AD&D 4,656 4,047 7,246 06 Spouse Supplemental Life 9,362 9,405 20,057 Dependent Supplemental AD&D 551 520 1,142 Child Supplemental Life 926 802 1,413 U Total $225,610 $232,979 $294,559 0 2.Paid Claims 2017 2018 2019 Employee Basic Life $130,140 $340,632 $150,213 Employee Basic AD&D 0 0 0 Employee Supplemental Life 20,023 150,538 50,048 _ Employee Supplemental AD&D 0 0 0 Spouse Supplemental Life 0 0 0 Spouse Supplemental AD&D 0 0 0 Child Supplemental Life 0 0 0 Total $150,163 $491,170 $200,261 3.Incurred Claims` 2017 2018 2019 0 Employee Basic Life $159,167 $327,681 $168,897 Employee Basic AD&D 0 20,000 (20,000) Employee Supplemental Life 33,000 100,521 53,975 Employee Supplemental AD&D 0 150,000 (150,000) c, Spouse Supplemental Life 101 (80) 839 Spouse Supplemental AD&D (2) 0 0 r� Child Supplemental Life 0 (20) 47 cv Total $192,266 $598,102 $53,758 *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 2017 through 2019 29 1 Packet,Pg. 13!5 I =1 Group Term Life Insurance Policy MINNESOTA LIFE Minnesota Life Insurance Company-A Securian Company 400 Robert Street North St.Paul,Minnesota 55101-2098 06 J U Ito J Read Your Policy Carefully Right to Cancel y This policy was issued to the policyholder on the effective It is important to us that you are satisfied with this policy date shown on the specifications page attached to this after it is issued. If you are not satisfied with this policy, policy. We promise to pay the benefits provided by this you may cancel it by delivering or mailing a written notice policy, subject to its conditions, limitations, and or sending a telegram to Minnesota Life Insurance exceptions. We make this promise and issue this policy in Company(Minnesota Life), 400 Robert Street North, St. _ consideration of the application for this policy and the Paul, Minnesota 55101-2098 and returning the policy payment of the premiums. before midnight of the 30th day after you received this policy. Minnesota Life Insurance Company is a subsidiary of Minnesota Mutual Companies, Inc., a mutual insurance Notice given by mail and return of the policy by mail are holding company. The policyholder is a member of effective on being postmarked, properly addressed, and Minnesota Mutual Companies, Inc.,which holds its annual postage prepaid. If you return this policy, you will receive, r� meetings on the first Tuesday in March of each year at 3 within 10 days of the date we receive a notice of p.m. local time. The meetings are held at 400 Robert cancellation, a full refund of any premiums you paid. Street North, St. Paul, Minnesota 55101-2098. 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. LO Secretary President r9 Notice to Policyholders If you have any questions regarding this group policy, or if you need assistance in resolving a complaint, you can contact 2 us at: Minnesota Life Insurance Company, 400 Robert Street North, St. Paul, MN 55101-2098. Toll Free Telephone Number: 1-866-293-6047. CL E TABLE OF CONTENTS Definitions..........................................................................2 Termination........................................................................5 General Information ..........................................................2 Conversion Right...............................................................6 Premiums..........................................................................4 Additional Information........................................................6 Death Benefit.....................................................................4Ito CJ CJ GROUP TERM LIFE INSURANCE POLICY NONPARTICIPATING MHC-96-13180.9 Minnesota Life 1 EdF81772 10-2014 M I =1 GROUP POLICY SPECIFICATIONS PAGE GENERAL INFORMATION POLICYHOLDER: Monroe County Board of County Commissioners POLICY NO.: 34395-G E m ASSOCIATED COMPANIES: All subsidiaries and affiliates reported to Minnesota Life by the policyholder for inclusion in the policy. U) POLICY SITUS: The policy was issued and delivered in the state of Florida. 06 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. 4- 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 0 policyholder and its associated companies working in the United States classified as follows: Class 1: All active,full-time employees 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 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 for contributory insurance. WAITING PERIOD: Class 1: The period commencing with the employee's date of employment and ending 0 with the employee's completion of 60 days of continuous employment. 0 Classes 2 and 3: None MINIMUM HOURS Class 1: 25 hours per week PER WEEK REQUIRED: Classes 2 and 3: Not Applicable PLAN OF INSURANCE LO EMPLOYEE BENEFIT SCHEDULE r9 EMPLOYEE TERM LIFE INSURANCE: 2 Basic Life Insurance CL 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. U CJ L) F.MHC-50062 A I =1 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 06 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 0 which the employee is insured under the group policy. Classes 2 and 3 None 0 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: 76 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 70t11 and 75t11 birthdays. The reduced amount of insurance will be rounded to the next higher multiple of $1,000,if not a multiple thereof. 0 76 AGE REDUCTIONS FOR CLASS 2: The amount of basic life insurance on a retiree age 70 or older shall be reduced 2 (applies to basic life coverage only) to 50%of the amount otherwise provided by the plan of insurance applicable to such retiree. e( Age reductions will apply on the insured retiree's 70t11 birthday. AGE REDUCTIONS FOR CLASS 3: None LO CONTRIBUTORY/NONCONTRIBUTORY: Basic insurance is noncontributory insurance;supplemental insurance is contributory insurance. et GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an employee can receive 2 without evidence of insurability when first eligible under the plan provided enrollment is made within the enrollment period. The amounts are as follows: L E For basic insurance: All basic insurance is guaranteed issue. ,u For supplemental insurance: For employees who first become eligible after the effective date of this policy: $150,000. L) 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 I =1 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 Eli06 gible Class Amount of Spouse/Domestic Partner Life Insurance Class I 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. 2 Classes 2 and 3 None 0 Spouse/Domestic Partner AD&D Insurance Eligible Class Amount of Spouse/Domestic Partner AD&D Insurance 0 Class I An amount equal to the amount of supplemental life insurance for which the spouse/domestic partner is insured under the group policy. Classes 2 and 3 None Child Life Insurance Eligible Class Amount of Child Life Insurance Children of class 1 $10,000 Classes 2 and 3 None GENERAL PROVISIONS FOR DEPENDENTS INSURANCE CONTRIBUTORY/NONCONTRIBUTORY: Dependents insurance is contributory insurance. 0 GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an eligible dependent W 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 employees who first become eligible for dependents insurance after the y effective date of this policy,the guaranteed issue amount is as follows: �+ For spouse/domestic partner insurance: $25,000 For child insurance: $10,000 2 EVIDENCE OF INSURABILITY: Evidence of insurability is required as stated in the policy and for an amount of 0 insurance greater than the guaranteed issue amount. p. E EFFECT OF EMPLOYEE'S RETIREMENT: All dependents insurance terminates upon the employee's retirement except as provided under the portability provision. , CJ CJ L) F.MHC-50062 C I =1 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 U) WAIVER OF PREMIUM APPLICATION: Applies to contributory and noncontributory employee insurance. 06 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. '2�PREMIUM PAYMENT GRACE PERIOD: Notwithstanding anything in the policy to the contrary,the premium payment grace period is 60 days. 0 4T 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: y • 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 6 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. r9 ANNUAL ENROLLMENTS: During the policyholder's annual open enrollment,the following election change can be made without providing evidence of insurability,provided the 6 insured receiving the increase has not previously been declined any insurance > 0 amount under this policy due to failure to provide satisfactory evidence of insurability: • An employee may elect any child life amount er Coverage will be effective on January 1 following the annual enrollment, 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 '2 and the insured receiving the increase has not previously been declined any CL insurance amount under this policy due to failure to provide satisfactory E evidence of insurability: u • 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 U 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 C) dependents. F.MHC-50062 D I =1 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 m Accelerated Benefits Applies to all classes. Accidental Death and Dismemberment Applies to class 1 only. U) Dependents Term Life Applies to class 1 only. a Portability Applies to all classes. p Waiver of Premium Applies to class 1 only. C 0 0 r9 0 0 r r r LO w Cn r9 0 CL CJ CJ U F.MHC-50062 E I =1 Definitions Non-work day does not include time off for medical leave of absence, temporary layoff, employer suspension of age operations in total or in part, strike, and any time off due to sickness or injury including sick days, short-term disability, Attained age as of most recent birthday. or long-term disability. m associated company noncontributory insurance Any company which is a subsidiary or affiliate of the Insurance for which an employee is not required to make policyholder which is designated by the policyholder and premium contributions. 06 agreed to by us to participate under this policy. policy anniversary certificate effective date The policy anniversary date shown on the specifications U The date the insured's coverage under this policy page attached to this policy. becomes effective. policy effective date certificate holder The date this policy was issued as shown on the An employee who is eligible for and becomes insured specifications page attached to this policy. according to the terms of this policy. policyholder y contributory insurance W The owner of the group policy as shown on the Insurance for which an employee is required to make specifications page attached to the group policy. premium contributions. specifications page - earnings The outline which summarizes the policyholder's plan of An employee's basic rate of compensation not including insurance. W commissions, overtime or premium pay, bonuses, or any other additional compensation. waiting period employee The period, if any, of continuous employment with the W employer required prior to becoming eligible for coverage An individual who is employed by the policyholder or by an under this policy. The waiting period is shown on the associated company. A sole proprietor will be considered specifications page attached to this policy. the employee of the proprietorship. A partner in a > partnership will be considered an employee so long as the we, our, us partner's principal work is the conduct of the partnership's business. The term employee does not include temporary Minnesota Life Insurance Company. employees nor corporate directors who are not otherwise employees. you,your employer The policyholder named on the specifications page attached to this policy. The policyholder or any designated associated t companies. General Information evidence of insurability What is your agreement with us? 2 Evidence satisfactory to us of the good health of the This policy and your application contain the entire contract prospective insured and any other underwriting between you and us. Any statements you make will, in CL information we require. the absence of fraud, be considered representations and E not warranties. Also, any statement that you make will not insured be used to void this policy, nor will it be used in our defense if we refuse to pay a claim, unless the statement A person who is eligible for and becomes insured is contained in your application. according to the terms of this policy. No change or waiver of any provisions of this policy, or non-work day any certificate issued under it,will be valid unless made in U writing by us and signed by our president, a vice- A day on which the employee is not regularly scheduled to president, our secretary, or an assistant secretary. No work, including scheduled time off for vacations, personal agent or other person has the authority to change or waive holidays,weekends and holidays, and approved leaves of absence for non-medical reasons. MHC-96-13180.9 Minnesota Life 2 EdF81772 10-2014 M I =1 any provisions of this policy, or of any certificate issued increase in his or her amount of insurance would under it. otherwise be effective, he or she will not be eligible for the coverage or increase until he or she returns to active Are employees of associated companies eligible for work. However, if the absence is on a non-work day, insurance under this policy? coverage will not be delayed provided the employee was m actively at work on the work day immediately preceding Yes. Employees of associated companies may be eligible the non-work day. for insurance under this policy. Associated companies are shown on the specifications page attached to this policy. Except as otherwise provided for in this policy, an You represent any associated company in all transactions 06 employee is eligible to continue to be insured only while pertaining to this policy. Your acts or omissions and every he or she remains actively at work. notice given by us to you shall be binding on every associated company. When an associated company When will we require evidence of insurability? ceases its participation under the policy, the policy shall U be considered to be terminated for all employees of the Evidence of insurability will be required if: associated company. All provisions related to the policy terminating will apply to such employees. (1) the specifications page attached to this policy states that evidence of insurability is required; or Can this policy be amended? (2) the insurance is contributory and the employee _ does not enroll within the enrollment period shown Yes. The insured's consent is not required to amend this on the specifications page attached to this policy; policy or any certificates issued under it. Any amendment or y will be without prejudice to any claim for benefits incurred (3) the insurance for which the employee previously prior to the effective date of the amendment. enrolled did not go into effect or was terminated _ because the employee failed to make a required Who is eligible for insurance? premium contribution; or (4) during a previous period of eligibility, the An employee is eligible if he or she: employee failed to submit required evidence of insurability or that which was submitted was not (1) is a member of the group and of an eligible class satisfactory to us; or as shown on the specifications page attached to (5) the employee is insured by an individual policy this policy; and issued under the terms of the conversion right (2) works for the employer for at least the number of section. hours per week shown as the minimum hours per week requirement on the specifications page When does insurance become effective? attached to this policy; and (3) has satisfied the waiting period as shown on the Insurance becomes effective on the date that all of the specifications page attached to this policy; and following conditions have been met: > (4) meets the actively at work requirement as shown in the section entitled "What is the actively at work (1) an employee meets all eligibility requirements; requirement?". and (2) if required, the employee applies for the insurance Are retired employees eligible for insurance? on forms which are approved by us; and r (3) we are satisfied with the employee's evidence of r If the policyholder's plan of insurance, as reflected in the insurability, if we require evidence; and specifications page attached to this policy, does not (4) we receive the required premium. LO specifically provide insurance for retired employees, a retired employee shall not be eligible to become insured, Can an insured employee's coverage be continued "9 nor have his or her insurance continued. If the during sickness, injury, leave of absence or temporary policyholder's plan of insurance specifically provides layoff? insurance for retired employees, the minimum hours per week and actively at work requirements will not apply to Yes. Insurance may be continued on an insured CL such persons. employee who is not actively at work due to sickness, injury, leave of absence or temporary layoff, subject to the W What is the actively at work requirement? employer's practices and procedures, including the employer's limits on the length of continuation allowed for To be eligible to become insured or to receive an increase the type of absence. Continuation is contingent upon in the amount of insurance, an employee must be actively continued premium payment and is subject to the at work fully performing his or her customary duties for his following maximum time frames: or her regularly scheduled number of hours at the employer's normal lace of business, or at other laces P P (1) for an employee on non-medical leave of absence the employer's business requires him or her to travel. or temporary layoff, insurance cannot be continued beyond 12 months from the last day the If the employee is not actively at work on the date insured employee was actively at work. coverage would otherwise begin, or on the date an m MHC-96-13180.9 Minnesota Life 3 EdF81772 10-2014 M I =1 (2) for an employee on a medical leave of absence, may be paid during the 31-day period following the due insurance cannot be continued beyond the later of date. The insurance under this policy will remain in effect 12 months from the last day the insured employee during the 31-day grace period. This grace period does was actively at work or the date the employee not apply to the first premium payment. attains age 65. m Can the premium be adjusted? Continuation of insurance must be in accordance with practices and procedures that preclude individual Yes. We will adjust the premium on each due date for selection. insurance which was effective or terminated before the most recent due date, but not reflected in prior premium 06 Coverage during a leave of absence and upon return from payments. We will charge you for any additional premium, a leave of absence shall meet all state and federal and will refund any overpayment, excluding any requirements. The above limits will be expanded if overpayment made more than 12 months before the necessary in order to meet such requirements. adjustment. U Premiums Death Benefit 0 When and how often are premiums due? What is the amount of the death benefit? Unless we have agreed to some other premium payment The amount of the death benefit is the amount of procedure, premiums for this policy are remitted to us insurance shown on the specifications page attached to monthly. Premiums are due on the premium due date as this group policy. shown on the specifications page attached to this policy. We apply premiums consecutively to keep the insurance Can an insured request a change in the amount of his in force. or her contributory insurance? You may pay premiums before they are due for any period An insured can request a change in his or her contributory up to the next policy anniversary. Premiums paid in insurance amount only during an annual open enrollment advance should be calculated at the rate of the monthly period, as determined by the employer, or within 31 days premium currently due. of a Qualified Status Change. Qualified Status Change shall be as determined by the employer. Premium contributions for contributory insurance are to be paid to you. The premium contributions by insureds for If an insured requests an increase in the amount of his or contributory insurance should be remitted to us as due her contributory insurance,we will require evidence of >- along with the premiums payable for noncontributory insurability, unless otherwise noted on the specifications insurance. page. How is the premium determined? When will changes in an insured's coverage amount be effective? The premium will be the premium rate multiplied by the number of$1,000 units of insurance in force on the date Requested increases in the amount of an insured's premiums are due. The premium may also be computed contributory insurance, if approved, are effective on the by any other method on which you and we agree. date we approve the increase. Requested decreases in the amount of an insured's contributory insurance are r We may change the premium rate: effective on the first day of the month following receipt of the insured's request for a decrease, or if different, LO r (1) on any premium due date following the expiration according to the administrative practices of the employer. of any rate guarantee period, or following the date that the amount of insurance in force for any one Requests for a change made during a special enrollment "9 coverage changes by more than 15%from that period offered by the employer will not become effective which was used to determine the current rates prior to the general effective date of elections made during (active employee coverage and retiree coverage that enrollment. CL are considered separate coverages, as are basic life, supplemental life, spouse/domestic partner Increases and decreases in insurance amounts which life, child life and AD&D); or result from a change in the insured's eligible class or (2) anytime, if the policy terms are amended or the earnings will be effective as shown on the specifications _ total amount of insurance in force changes by page attached to this policy. 15%from the volume that was used to determine the current rates or more. All increases in the amount of insurance are subject to the actively at work requirement. Can a premium be paid after the date it is due? When will the death benefit be payable? Yes. This policy has a 31-day grace period. If a premium We will pay the death benefit upon receipt at our home is not paid on or before the date it is due, that premium office of written proof satisfactory to us that an individual MHC-96-13180.9 Minnesota Life 4 EdF81772 10-2014 M I =1 died while insured under this policy. All payments by us change will take effect as of the date it is signed, but will are payable from our home office. not affect any payment we make or action we take before receiving an insured's notice. The death benefit will be paid in a single sum or by any other method agreeable to us and the beneficiary. We will Termination m pay interest on the death benefit from the date of the insured's death until the date of payment. Interest will be When does an insured's coverage terminate? at an annual rate determined by us, but never less than .` 0.1% per year compounded annually, or the minimum The insured's coverage ends on the earliest of the 06 required by state law, whichever is greater. following: Payment of the death benefit will extinguish our liability (1) the date this policy ends; or under the certificate for which the death benefit has been (2) the date the employee no longer meets the paid. eligibility requirements; or 2 (3) the date the policy is amended so the employee is To whom will we pay the death benefit? no longer eligible; or (4) 31 days(the grace period)after the due date of We will pay the death benefit to the beneficiary or any premium contribution which is not paid; or beneficiaries. A beneficiary is named by an insured to (5) the last day for which premium contributions have receive the death benefit to be paid at the insured's death. been paid following an employee's written request The insured may name one or more beneficiaries. The to cease participation under this policy. insured cannot name you or an associated company as a to beneficiary. If an insured's coverage under this policy terminates due to non-payment of premiums, his or her coverage may be The insured may also choose to name a beneficiary that reinstated if all premiums due are paid and received by us the insured cannot change without the beneficiary's within 31 days of the date of termination and during the _ consent. This is called an irrevocable beneficiary. insured's lifetime. If there is more than one beneficiary, each will receive an equal share, unless the insured has requested another Can insurance o'the life of an insured be reinstated method in writing. To receive the death benefit, a after termination. beneficiary must be living on the date of the insured's Yes. When an insured's coverage terminates because he death. In the event a beneficiary is not living on the date or she is no longer eligible, and the insured becomes of the insured's death, that beneficiary's portion of the eligible again within three months after the date his or her �- death benefit shall be equally distributed to the remaining coverage terminated, the insured's coverage under this "9 surviving beneficiaries. In the event of the simultaneous policy may be reinstated. deaths of the insured and a beneficiary, the death benefit will be paid as if the insured survived the beneficiary. Provided the insured is not then covered by an individual policy issued under the terms of the conversion right If there is no eligible beneficiary, or if the insured does not section, his or her coverage under this group policy shall name one,we will pay the death benefit to: be reinstated automatically,without evidence of �-- (1) the insured's lawful spouse(this does not apply to insurability or satisfaction of any waiting period. The a domestic partner) if living, otherwise; amount of insurance will be that which applies to the (2) the insured's natural or legally adopted child classification to which he or she then belongs, on the date he or she again becomes eligible. If the policyholder's r (children) in equal shares, if living, otherwise; plan of insurance provides for contributory insurance LO (3) the insured's parents in equal shares, if living, under this policy, an insured's amount of contributory otherwise; insurance will be limited to that for which he or she was (4) the personal representative of the insured's "9 insured immediately prior to the loss of coverage. estate. U Can an insured add or change beneficiaries? When does this group policy terminate? CL You may terminate this group policy by giving us 31 days E Yes. An insured can add or change beneficiaries if all of prior written notice. We reserve the right to terminate this the following are true: policy on the earliest of the following to occur: (1) the insured's coverage is in force; and (1) 31 days(the grace period)after the due date of (2) we have written consent of all irrevocable any premiums which are not paid; or beneficiaries; and (2) on any subsequent policy anniversary after the (3) the insured has not assigned the ownership of his date the number of employees insured is less or her insurance. than any minimum established by us or as required by applicable state law; or A request to add or change a beneficiary must be made in (3) 90 days after we provide you with notice of our writing. All requests are subject to our approval. A intent to terminate this policy. MHC-96-13180.9 Minnesota Life 5 EdF81772 10-2014 M I =1 Can this policy be reinstated? How is the premium for the individual policy determined? No. We will not reinstate this policy after it terminates. You must submit a new application for a new policy after We base the premium for the individual policy on the plan m this policy has terminated. of insurance, the insured's age, and the class of risk to m which the insured belongs on the date of the conversion. Conversion Right When is the individual policy effective? What is the conversion right? The individual policy takes effect 31 days after the group 06 An insured may be able to convert this insurance to a new insurance provided under this policy terminates. individual life insurance policy if all or part of the insured's life insurance under this policy terminates. What happens if the insured dies during the 31-day period allowed for conversion? U The insured may convert up to the full amount of terminated insurance if termination occurs because he or If the insured dies during the 31-day period allowed for she moves from one existing eligible class to another, or conversion,we will pay a death benefit regardless of he or she is no longer in an eligible class. whether or not an application for coverage under an individual policy has been submitted. The death benefit Limited conversion is available if, after the insured has will be the amount of insurance the insured would have been insured for at least five years, insurance is been eligible to convert under the terms of the conversion terminated because: right section. N (1) the policy is terminated; or We will return any premium the insured paid for an _ (2) the policy is changed to reduce or terminate the individual policy to the insured's beneficiary named under insurance for that individual. this group policy. In no event will we be liable under both this group policy and the individual policy. In such case, the insured may convert up to the full amount of terminated insurance, but not more than the Additional Information maximum. The maximum is the lesser of: What if an insured's age has been misstated? (a) $10,000; and (b) the amount of life insurance which terminated If an insured's age has been misstated, the death benefit minus any amount of group life insurance for payable will be that amount to which the insured is entitled >- which the insured becomes eligible under any based on his or her correct age. r9 group policy issued or reinstated by us or any other carrier within 31 days of the date the A premium adjustment will be made to the premium you pay for the insured's noncontributory insurance and to the > insurance terminated under this policy. premium an insured pays for contributory insurance, if Neither the conversion right nor the limited conversion any, so that the actual premium required at the insured's right is available if the insured's coverage under this policy correct age is paid. terminates due to failure to make,when due, required Is there a suicide exclusion? premium contributions. The specifications page attached to this policy indicates Under both the conversion right and the limited conversion what insurance, if any, is subject to the suicide exclusion r right, the insured may convert his or her insurance to any outlined below. LO type of individual policy of life insurance then customarily r9 issued by us for purposes of conversion, except term When applicable, this suicide exclusion limits our liability insurance. The individual policy will not include any to an amount equal to the premiums paid for an insured, if supplemental benefits, including, but not limited to, any that insured,whether sane or insane, dies by suicide disability benefits, accidental death and dismemberment within two years of the effective date of his or her CL benefits, or accelerated benefits. insurance. How does an insured convert his or her insurance? If there has been an increase in the insured's amount of h® insurance for which he or she was required to apply or for An insured converts his or her insurance by applying for which we required evidence of insurability, and if the an individual policy and paying the first premium within 31 insured dies by suicide within two years of the effective days after the group insurance terminates. No evidence date of the increase, our liability with respect to that of insurability will be required. increase will be limited to the premiums paid and attributable to such increase. C) MHC-96-13180.9 Minnesota Life 6 EdF81772 10-2014 M I =1 When does an insured's insurance become Are you required to maintain records? incontestable? Yes. You are required to maintain adequate records of Except for the non-payment of premiums, after the any information necessary for us to administer this policy. m insured's insurance has been in force during his or her We own the records relating to the insurance provided by m lifetime for two years from the effective date of his or her this policy, and can obtain them from you at any coverage,we cannot contest the insured's coverage. reasonable time. However, if there has been an increase in the amount of .` insurance for which the insured was required to apply or If a clerical error is made in keeping records on the 06 for which we required evidence of insurability, then, to the insurance under this policy, it will not affect otherwise valid extent of the increase, any loss which occurs within two insurance.A clerical error does not continue insurance years of the effective date of the increase will be which is otherwise stopped. If an error causes a change in contestable. premium payment,we will make a fair adjustment. Any statements the insured makes in his or her application Will a certificate of insurance be provided for each will, in the absence of fraud, be considered certificate holder? representations and not warranties. Also, any statement an insured makes will not be used to void his or her Yes. We will provide you with a certificate of insurance for insurance, nor defend against a claim, unless the delivery to each certificate holder. The certificate will statement is contained in the application and any evidence include information regarding the principal provisions of of insurability application attached to the insured's his or her coverage. certificate. cn Will this policy receive experience credits? Can an insured's insurance be assigned? Each year we will determine if this policy will receive an Yes. However, we will not be bound by an assignment of experience credit. the certificate or of any interest in it unless it is made as a written instrument, the insured files the original instrument Are you our agent? or a certified copy with us at our home office, and we send the insured an acknowledged copy. No. For all purposes of this policy, neither you, an associated company, nor any administrator you appoint is We are not responsible for the validity of any assignment. our agent. We will not be liable for any of your acts or An insured is responsible for ensuring that the assignment omissions or those of an associated company or is legal in his or her state and that it accomplishes his or administrator. her intended goals. If a claim is based on an assignment, r9 we may require proof of interest of the claimant. A valid Will the provisions of this policy conform with state assignment will take precedence over any claim of a law? beneficiary. 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. LO r9 r9 0 CL CJ CJ C� MHC-96-13180.9 Minnesota Life 7 EdF81772 10-2014 M I =1 Accelerated Benefits Policy Rider MINNESOTA LIFE Minnesota Life Insurance Company-A Securian Company 400 Robert Street North • St.Paul,Minnesota 55101-2098 Benefits received under this Accelerated Benefits Policy Terminal Condition Rider may be taxable. Certificate holders should seek assistance from a personal tax advisor prior to requesting What is a terminal condition? 06 an accelerated payment of death benefits. A terminal condition is a condition caused by sickness or < General Information accident which directly results in a life expectancy of twelve months or less. This rider amends the group policy to which it is attached 'N and is subject to every term, condition, exclusion, What evidence do we require of the insured's terminal limitation, and provision of the group policy unless condition? otherwise expressly provided for herein. We must be given evidence that satisfies us that the What does this rider provide? insured's life expectancy, because of sickness or accident, is twelve months or less. That evidence must include This rider provides for the accelerated payment of either certification by a physician. the full or a partial amount of an insured's death benefit provided under the group policy. If the insured has a Do we have the right to obtain independent medical terminal condition as defined in this rider, an accelerated verification? payment of the death benefit may be requested. Yes. We retain the right to have the insured medically _ Definitions examined at our own expense to verify the insured's medical condition. We may do this as often as reasonably accelerated benefit required while accelerated benefits are being considered P The amount of the death benefit we will pay if the insured is eligible under this rider. Payment of Accelerated Benefit death benefit How do we calculate the accelerated benefit? The amount of the insured's life insurance as shown on We will multiply the death benefit by the accelerated 76 the specifications page attached to the certificate holder's benefit factor to determine the accelerated benefit > certificate. available. immediate family How do we calculate the accelerated benefit factor? The certificate holder's spouse/domestic partner, children, The accelerated benefit factor will be stated as a parents, grandparents, grandchildren, brothers and percentage of the insured's death benefit. When we r sisters, and their spouses. calculate this factor,we will consider the insured's age and gender. insured t We will also base our calculation on certain assumptions, For purposes of this rider, an insured employee, an which we may change from time to time, including but not r� insured spouse/domestic partner, or an insured dependent limited to assumptions about: child. 2 (1) expected future premiums; and physician (2) the insured's life expectancy. CL E An individual who is licensed to practice medicine or treat What are the conditions for the payment of an illness in the state in which treatment is received. This accelerated benefit? does not include the certificate holder, or a member of the certificate holder's immediate family. We will consider the payment of an accelerated benefit, CJ CJ U MHC-96-13184.9 Minnesota Life 1 EdF81773 10-2014 M I =1 subject to all of the following conditions: may ask for further satisfactory evidence that the insured meets all requirements for the accelerated benefit. (1) coverage must be in force and all premiums due must be fully paid; and What is the effect on an insured's coverage of the m (2) application must be made in writing and in a form receipt of an accelerated benefit? m which is satisfactory to us. We will tell a certificate holder what form is required; and If a certificate holder elects to accelerate the full amount of (3) the certificate holder must be the sole owner of an insured's death benefit, the insured's coverage and all the certificate; and other benefits under the certificate and any certificate 06 (4) the insured's insurance must not have an supplements which apply to that insured will end. If the irrevocable beneficiary. insured is a certificate holder, any other individual insured under his or her certificate will be allowed to convert any Who may request an accelerated payment of the death such insurance to a policy of individual life insurance benefit? according to the conversion right section of the group 2 policy to which this rider is attached. to A certificate holder may request an accelerated payment If a partial accelerated benefit is chosen, coverage will of the insurance on his or her life or on the life of a spouse/domestic partner or dependent child insured under remain in force and premiums will be reduced accordingly. his or her certificate. The remaining amount of insurance under the certificate _ will be the full amount of insurance minus the amount of Is the request for an accelerated benefit voluntary? insurance that was accelerated. Yes. An accelerated benefit will be made available on a How will we pay the accelerated benefit? voluntary basis only. An accelerated benefit under this rider is not intended to cause an involuntary reduction of We will pay the accelerated benefit in one lump sum or in the death benefit ultimately payable to the named any other mutually agreeable manner. beneficiary. Therefore, payment of the death benefit To whom will we pay accelerated benefits? cannot be accelerated under this rider if the insured: All accelerated benefits will be paid to the certificate (1) is required by law to use this option to meet the holder who requested the accelerated payment unless the C claims of creditors,whether in bankruptcy or certificate holder validly assigns them otherwise. If such otherwise; or certificate holder dies before all payments have been (2) is required by a government agency to use this made,we will pay the remainder to the insured's option in order to apply for, obtain, or keep a beneficiary named under the certificate. Payment will be government benefit or entitlement. made in one lump sum which will be the present value of 0 the payments that remain, using the interest rate we use Is there a minimum or maximum death benefit eligible to determine the payments. > for an accelerated benefit? Yes. The minimum death benefit to be eligible for an Termination accelerated benefit under this rider is$10,000. The When does an insured's coverage under this rider W maximum death benefit to be eligible for an accelerated terminate? r benefit is$1,000,000. CD Does a certificate holder have to take the entire An insured's coverage ends on the date the insured is no CD CD accelerated benefit? longer covered for life insurance under the group policy. LO When does this rider terminate? "9 No. The certificate holder may choose to receive a partial r� accelerated benefit. If he or she does so, the insured's This rider will terminate on the earlier of: remaining coverage will stay in force. 2 If a certificate holder elects to receive only a partial (1) the date we receive a written request to cancel CL this rider; or accelerated benefit amount available under this rider, the (2) the date the group policy is terminated. remaining death benefit under the certificate must be at least$25,000. Y reapply payment The certificate holder may rea I for the of the G' remaining amount of insurance at any time. However,we Secretary President CJ U MHC-96-13184.9 Minnesota Life 2 EdF81773 10-2014 M I =1 Accidental Death and Dismemberment Policy Rider MINNESOTA LIFE Minnesota Life Insurance Company,a Securian Financial Group affiliate 400 Robert Street North • St.Paul,Minnesota 55101-2098 Statement to Policyholders from, or where there is a contribution from, any of the following: If you have any questions regarding this policy rider, or if you need assistance in resolving a complaint, you can (1) self-inflicted injury or self destruction, whether sane contact us at: Minnesota Life Insurance Company, 400 or insane; or 06 Robert Street North, St. Paul, MN 55101-2098. Toll-Free (2) suicide or attempted suicide,whether sane or Telephone Number: 1-800-843-8358. insane; or (3) the insured's participation in or attempt to commit a General Information crime, assault,felony, or any illegal activity, 2 regardless of any legal proceedings, or the This rider is issued in consideration of the required absence of any legal proceedings, thereto; or premium and amends the group policy to which it is (4) bodily or mental infirmity, illness or disease; or attached. This rider is subject to every term, condition, (5) the use of alcohol, drugs, medications, poisons, W exclusion, limitation, and provision of the group policy gases,fumes or other substances taken, absorbed, unless otherwise expressly provided for herein. inhaled, ingested or injected, unless taken upon the advice of a licensed physician in the verifiable What does this rider provide? prescribed manner and dosage; or (6) motor vehicle collision or accident where the This rider provides accidental death and dismemberment insured is the operator of the motor vehicle and this coverage subject to all terms, conditions, and exclusions insured's blood alcohol level meets or exceeds the herein. level at which intoxication is defined in the state where the collision or accident occurred, _ Who is eligible for insurance under this rider? regardless of any legal proceedings, or the An employee or a spouse/domestic partner who is eligible absence of any legal proceedings, thereto; or under the provisions applicable to life insurance coverage (7) infection, other than infection occurring under the group policy is eligible for insurance under this simultaneously with, and as a direct result of, the rider. accidental injury; or (8) medical or surgical treatment or diagnostic >_ When does insurance under this rider become procedures or any resulting complications; or r9 effective? (9) travel in or descent from any aircraft, except as a fare-paying passenger on a regularly scheduled Insurance becomes effective on the date that the commercial flight on a licensed passenger aircraft; > employee orspouse/domestic partner becomes insured or for life insurance under the group policy. (10) war or any act of war,whether declared or undeclared; or Accidental Death and Dismemberment (11) service in the military of any nation. (AD&D) Benefit What is the amount of the accidental death and What does accidental death or dismemberment by dismemberment benefit? accidental injury mean? to The amount of the benefit shall be a percentage of the Accidental death or dismemberment by accidental injury amount of insurance shown on the specifications page as used in this rider means that the insured's death or "9 attached to the group policy. The percentage is dismemberment results, directly and independently of all determined by the type of loss as shown in the following 2 other causes,from an accidental bodily injury which is table: unintended, unexpected, and unforeseen. The bodily CL injury must be evidenced by a visible contusion or wound, FOR LOSS OF AMOUNT OF BENEFIT E except in the case of accidental drowning. The bodily 0) injury must be the sole cause of death or dismemberment. Life....................................Full Amount of AD&D Insurance Both Hands or Both Feet..Full Amount of AD&D Insurance The injury must occur while the insured's coverage under Sight of Both Eyes............Full Amount of AD&D Insurance this rider is in force. The insured's death or Speech and Hearing.........Full Amount of AD&D Insurance dismemberment must occur within 180 days after the date One Hand and One Foot..Full Amount of AD&D Insurance of the injury. One Foot and Sight CJ of One Eye........................Full Amount of AD&D Insurance In no event will we pay the accidental death or One Hand and Sight dismemberment benefit where the insured's death or of One Eye........................Full Amount of AD&D Insurance dismemberment is caused directly or indirectly by, results Quadriplegia.....................Full Amount of AD&D Insurance Paraplegia ..................75%of Amount of AD&D Insurance 11-31358 Minnesota Life 1 EdF81774 10-2014 I =1 Sight of One Eye.........50%of Amount of AD&D Insurance to the person or persons entitled to receive a death benefit Speech or Hearing......50%of Amount of AD&D Insurance under the terms of the group policy. The benefit for other One Hand or losses sustained by a certificate holder will be paid to the One Foot.....................50%of Amount of AD&D Insurance certificate holder, if living, otherwise to his or her estate. m Hemiplegia ..................50%of Amount of AD&D Insurance m Thumb and Index Additional Benefits Finger of One Hand.....25%of Amount of AD&D Insurance Unless stated otherwise, additional benefits are payable to Loss of hands or feet means complete severance at or the same person or persons who receive the AD&D 06 above the wrist or ankle joints. Loss of sight, speech, or benefits. Additional benefits are paid in addition to any hearing means the entire and irrecoverable loss of sight, AD&D benefits described in the Accidental Death and speech, or hearing which cannot be corrected by medical Dismemberment section, unless otherwise stated. All or surgical treatment or by artificial means. Loss of thumb provisions of this rider, including but not limited to the or finger means complete severance at or above the exclusions listed under the"What does accidental death or 2 metacarpophalangeal joints(the joints closest to the palm dismemberment by accidental injury mean?"section, shall of the hand). apply to these additional benefits. 0 Quadriplegia means total and permanent paralysis of both Air Bag Benefit upper limbs(from the shoulder down including total paralysis of both hands)and both lower limbs(from the What is the air bag benefit? waist down including total paralysis of both feet). Paraplegia means total and permanent paralysis of both If an insured dies as a result of a covered accident which Cn lower limbs(from the waist down including total paralysis occurs while he or she is driving or riding in a private of both feet). Hemiplegia means total and permanent passenger car,we will pay an additional AD&D benefit paralysis of both the upper limb(from the shoulder down equal to the lesser of: including total paralysis of the hand)and lower limb(from the waist down including total paralysis of the foot)on one (1) $10,000; or side of the body. (2) 10%of the insured's amount of AD&D insurance. A benefit is not payable for both loss of one hand and the In order to be eligible for this benefit, the following must loss of thumb and index finger of one hand for injury to the apply: same hand as a result of any one accident. Under no circumstance will more than one payment be made for the (1) the seat in which the insured was seated was loss or paralysis of the same limb, eye,finger, thumb, equipped with a properly installed airbag at the >- hand,foot, sight, speech, or hearing if one payment has time of the accident; and already been made for that loss. (2) the private passenger car is equipped with seatbelts; and Benefits may be paid for more than one accidental loss (3) a seatbelt was in proper use by the insured at the but the total amount of AD&D insurance payable under time of the accident as certified in the official this rider for all of an insured's losses due to any one accident report or by the investigating officer; and accident, not including any amount paid according to the (4) at the time of the accident, the driver of the private terms of the Additional Benefits section of this rider,will passenger car was a licensed driver and was not r never exceed the full amount of AD&D insurance shown intoxicated, impaired, or under the influence of on the specifications page attached to the group policy. alcohol or drugs. When will the accidental death and dismemberment Airbag means a passive restraint device in a vehicle which LO benefit be payable? inflates upon collision to protect an individual from injury or We will pay the AD&D benefit upon receipt at our home death. r9 office of written proof satisfactory to us that the insured Seatbelt means a properly installed seatbelt(or child 2 died or suffered dismemberment as a result of an accidental injury. All payments by us are payable from our restraint if the insured is a child), lap and shoulder restraint, CL home office. or other restraint approved by the National Highway Traffic Safety Administration or any successor governmental The benefit will be paid in a single sum. We will pay agency. A private passenger car means a validly h® interest on the benefit from the date of the insured's death registered four-wheeled private passenger car or or dismemberment until the date of payment. Interest will policyholder-owned car,jeep, pickup truck or van, including be at an annual rate determined by us, but never less than a sport utility vehicle(SUV), that is not licensed 0.1% per year compounded annually or the minimum commercially or being used for racing, or acrobatic or stunt driving. required by state law, whichever is greater. CJ To whom do we pay the benefit? A certificate holder's accidental death benefit will be paid 11-31358 Minnesota Life 2 EdF81774 10-2014 M I =1 Seatbelt Benefit When does this rider terminate? What is the seatbelt benefit? This rider will terminate on the earlier of: m If an insured dies as a result of a covered accident which (1) the date we receive a written request from the m occurs while he or she is driving or riding in a private policyholder to cancel this rider; or passenger car,we will pay an additional AD&D benefit (2) the date the group policy is terminated. equal to the lesser of: (1) $20,000; or Additional Information 06 (2) 20%of the insured's amount of AD&D insurance. Do we have the right to obtain independent medical verification? In order to be eligible for this benefit, the following must apply: Yes. We retain the right to have an insured medically 2 examined at our expense whenever a claim is pending and, (1) the private passenger car was equipped with where not forbidden by law,we reserve the right to have an seatbelts; and autopsy performed in case of death. (2) a seatbelt was in proper use by the insured at the W time of the accident as certified in the official Can insurance under this rider be converted to a policy accident report or by the investigating officer; and of individual insurance upon termination? (3) at the time of the accident, the driver of the private passenger car was a licensed driver and was not No. Coverage under this rider will not be included in any intoxicated, impaired, or under the influence of insurance issued under the conversion right section of the alcohol or drugs. group policy. — Termination When does an insured's coverage under this rider 47 terminate? Secretary President 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 r9 (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 r (4) 31 days(the grace period)after the due date of any premium contribution which is not paid. r LO r9 r9 0 CL CJ CJ U 11-31358 Minnesota Life 3 EdF81774 10-2014 M I =1 Dependents Term Life Insurance Policy Rider MINNESOTA LIFE Minnesota Life Insurance Company-A Securian Company 400 Robert Street North • St.Paul,Minnesota 55101-2098 General Information dependent on the employee for more than one- half of their support and maintenance. 06 This rider is issued in consideration of the required premium and amends the group policy to which it is If both parents of a child qualify as eligible employees < attached. The rider is subject to every term, condition, under the group policy, the child shall be considered a exclusion, limitation, and provision of the group policy dependent of only one parent for purposes of this rider. If unless otherwise expressly provided for herein. any child qualifies as an eligible employee under the N group policy, he or she is not eligible to be insured as a What does this rider provide? dependent child. 0 4- This rider provides insurance on the lives of the insured Any dependent child who, subsequent to the effective date employee's eligible dependents. of the insured employee's child life insurance, meets the requirements of this provision will become insured on the What members of the insured employee's family are date he or she so qualifies. eligible for insurance under this rider? When will we require evidence of insurability? The following members of the insured employee's family are eligible for insurance under this rider: Evidence of insurability will be required if: (1) the insured employee's lawful spouse who is not (1) the specifications page attached to the group legally separated from the insured and who is not policy states that evidence of insurability is eligible for insurance as an employee under the required; or policy to which this rider is attached; and (2) the insurance is contributory and the employee (2) the insured employee's domestic partner who is does not enroll for coverage under this rider within not eligible for insurance as an employee under the enrollment period shown on the specifications the policy to which this rider is attached. page attached to the group policy; or Domestic partners are two adults who have (3) dependents insurance for which the employee r� chosen to share one another's lives in a previously enrolled did not go into effect or was committed family relationship of mutual caring. terminated because the employee failed to make Two individuals are considered to be domestic a required premium contribution; or > partners if: (4) during a previous period of eligibility, the (a) they consider themselves to be members of employee failed to submit evidence of insurability 0. each other's immediate family; and that was required for a dependent or that which W (b) they agree to be jointly responsible for each was submitted was not satisfactory to us; or other's basic living expenses; and (5) the dependent is insured by an individual policy (c) neither of them is married or a member of issued under the terms of the conversion right of r another domestic partnership; and this rider. (d) they are not blood related in a way that would LO prevent them from being married to each When does insurance on a dependent become other under the laws of Florida; and effective? (e) each is at least of the legal age and competency required by Florida law to enter Insurance on a dependent becomes effective on the date U into a marriage or other binding contract; and when all of the following conditions have been met: (f) they must each sign a Declaration of CL Domestic Partnership as provided for in (1) the dependent meets all eligibility requirements; E and Section 14.03; and if required, the insured employee applies for (g) they both reside at the same residence; and (2) (3) the insured employee's and domestic partner's dependents coverage on forms which are children, stepchildren and legally adopted approved us; and children. Children are eligible from live birth (3) we are satisfied with the dependent's evidence of (stillborn and unborn children are not eligible)to insurability, if we require evidence; and the attainment of age 26. Children age 26 or (4) we receive the required premium. U older are also eligible if they are physically or mentally incapable of self-support,were incapable If a dependent is hospitalized or confined because of of self-support prior to age 26 and are financially illness or disease on the date his or her insurance would otherwise become effective, his or her effective date shall MHC-96-13186 Minnesota Life 1 EdF81775 10-2014 M I =1 be delayed until he or she is released from such Additional Information hospitalization or confinement. This does not apply to a newborn child. However, in no event will insurance on a What is the conversion right under this rider? dependent be effective before the insured employee's insurance under the group policy is effective. If an insured dependent's coverage under this rider terminates because he or she is no longer eligible, or Death Benefit because of the death of the insured employee, or because of termination or amendment of this rider, the insurance What is the amount of life insurance on each insured may be converted to a policy of individual insurance with 06 dependent? Minnesota Life. The amount of life insurance on each insured dependent Conversion may be requested by the insured employee, is shown on the specifications page attached to the group an insured dependent of legal capacity, or the insured policy. dependent's guardian, if applicable. All other conditions 2 and provisions of the conversion right section of the group To whom will we pay the death benefit? policy to which this rider is attached will apply. The death benefit payable under this rider will be paid to Does the Waiver of Premium rider to the group policy the insured employee if living, otherwise to his or her apply to insured dependents? estate. The Waiver of Premium rider to the group policy will not Termination apply to disabilities for dependents covered under this rider. When does an insured dependent's coverage under this rider terminate? However, if, due to the insured employee's disability, his or her insurance is continued in force without further An insured dependent's coverage ends on the earliest of payment of premiums due to the Waiver of Premium rider the following: to the group policy, any dependents insurance provided by this rider shall also continue in force without further (1) the date the dependent no longer meets the payment of premiums until the dependent's eligibility eligibility requirements; or terminates or until the insured employee's insurance is no (2) 31 days(the grace period)after the due date of longer continued in force due to the Waiver of Premium any premium contribution which is not paid; or rider to the group policy. (3) the last day for which premium contributions have been made following an employee's written This provision is not applicable if the dependent's request that insurance on his or her eligible insurance has been converted under the conversion right dependents be terminated; or section of this rider, unless the converted policy is (4) the date the employee is no longer covered under surrendered without claim except for refund of premiums. 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 Secretary President r premiums paid for dependents who are no longer eligible for coverage under this rider will be refunded without anyLO r payment of claim. r9 When does this rider terminate? r9 This rider will terminate on the earlier of: 2 0 CL (1) the date we receive a written request to cancel this rider; or (2) the date the group policy is terminated. h® U U MHC-96-13186 Minnesota Life 2 EdF81775 10-2014 M I =1 Term Life Insurance Portability Policy Rider MINNESOTA LIFE Minnesota Life Insurance Company-A Securian Company 400 Robert Street North • St.Paul,Minnesota 55101-2098 General Information What insurance can be continued under this rider? This rider is issued in consideration of the required Contributory life and AD&D insurance and noncontributory 06 premium and amends the group policy to which it is life and AD&D insurance may be continued under this attached. This rider is subject to every term, condition, rider. If the certificate holder elects to continue his or her exclusion, limitation and provision of the group policy own coverage according to the provisions of this rider, he unless otherwise expressly provided for herein. or she may also elect to continue contributory insurance p y for any other individual insured under his or her certificate. .N What does this rider provide? The certificate holder may also continue coverage under all supplements to such certificate which apply to This rider provides for continuation of group life insurance contributory insurance and by which he or she was for insureds who no longer meet the eligibility insured immediately preceding his or her portability date, requirements of the group policy except as provided for except the Waiver of Premium Certificate Supplement, herein. which shall terminate upon porting. 0 To continue coverage under the provisions of this rider, an The amount of insurance continued under this rider for eligible insured must make a written request and make the any individual will be subject to any applicable state law or first premium contribution within 31 days after insurance regulation relating to allowable amounts of insurance. — provided by the group policy would otherwise terminate. Evidence of insurability will not be required. Coverage What is the minimum amount of insurance that can be _ provided by this rider will then be deemed effective continued under this rider? retroactive to the beginning of the 31-day period. This date is considered to be the insured's portability date and The minimum amount of insurance that can be continued the insured is then considered to have portability status. 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 Who is eligible to continue insurance under this rider? dependents. A certificate holder is eligible to continue insurance under What is the maximum amount of insurance that can �- this rider if he or she, except as provided by this rider, no be continued under this rider? longer meets the eligibility requirements of the group policy due to any of the following: The maximum amount of insurance that can be continued under this rider is the amount of insurance that was in > 0 (1) the employee terminates employment, including force on the insured's portability date, but not more than 0. retirement; or $1,000,000 for an employee or$150,000 for a s. (2) the employee is no longer in a class eligible for spouse/domestic partner. However, for an insured who is �-- insurance or is on a leave or layoff; or age 65 or older on his or her portability date, the amount (3) a class or group of employees insured under the will not be more than 65%of the amount in force on the policy is no longer considered eligible and there is insured's portability date, to a maximum of$650,000 for no successor plan for that class or group. an employee or$97,500 for a spouse/domestic partner. r Successor plan means an insurance policy or LO policies provided by us or another insurer that The amount of ported AD&D insurance cannot exceed the replaces insurance provided under this policy. amount of ported life insurance. Will the amount of insurance continued under this 2 The certificate holder will not be eligible to request rider change? coverage under this rider if he or she: CL Yes. On the first day of the month following the date an (1) has attained the age of 70; or insured attains age 65, the amount of insurance on his or (2) has converted his or her insurance to an individual her life continued under this rider will reduce to 65%of the life policy under the terms of the group policy's amount of insurance in force on the day prior to his or her conversion right section; or attainment of age 65. Insurance terminates at age 70. (3) was not actively at work due to sickness or injury on the day immediately preceding his or her Can a certificate holder request a change in his or her portability date; or amount of insurance continued under this rider? (4) loses eligibility due to termination of the group policy. Yes. The certificate holder may elect to reduce the amount of insurance provided under his or her certificate. MHC-96-13214 Minnesota Life 1 EdF81776 10-2014 M I =1 The remaining amount of insurance on the life of a What happens to insurance provided under this rider certificate holder must be at least$10,000. when the group policy terminates? The amount of insurance continued under this rider will Anything in the group policy notwithstanding, termination never increase. of the group policy by the policyholder or us will not terminate life insurance then in force for any person under How will premium contributions be paid? the terms of this rider. The group policy will be deemed to remain in force solely for the purpose of continuing such .` Premium contributions will be paid directly to us on a insurance, but without further obligation of the 06 monthly, quarterly, semi-annual, or annual basis and will policyholder. be subject to an administrative charge per billing period. We may adjust the amount of the charge, but not more Any insurance continued under the terms of this rider will often than once per year. remain in force until terminated by the provisions of the section entitled "When will insurance continued under this U Can the premium rate change? rider terminate?". Yes. The premium rate may increase on the portability No individual may elect coverage under this rider on or date. The premium rate may also increase in the future after the date of termination of the group policy. but will not change more often than once per year. _ When will insurance continued under this rider Can insurance continued under this rider be terminate? converted to a policy of individual insurance? y Insurance continued under this rider will terminate on the Yes. At any time after insurance has been continued earliest of the following: under the provisions of this rider, it may be converted to a policy of individual insurance with Minnesota Life. All (1) the insured's 70th birthday; or other conditions and provisions of the conversion right (2) the date the certificate holder again meets the section of the group policy to which this rider is attached eligibility requirements of the group policy, not will apply. including the terms of this rider; or (3) in the case of a dependent child or a What happens if a certificate holder again becomes spouse/domestic partner who is insured by a rider eligible under the group policy? to the certificate holder's coverage, the date the certificate holder's coverage is no longer being If a certificate holder who is continuing coverage under the continued under this rider, or the date the provisions of this rider again meets the eligibility certificate holder's spouse/domestic partner or requirements of the group policy, not including the terms child ceases to be eligible as defined under the of this rider, he or she shall no longer be considered to terms of the group policy; or have portability status. Insurance for that certificate holder (4) 31 days after the due date of any premium may be provided only under the terms of the group policy, 2 not including this rider, unless and until he or she no contribution which is not made. longer meets the eligibility requirements of the group policy and again returns to portability status as provided for herein. A&'Afe Secretary President LO r9 r9 0 CL CJ CJ U MHC-96-13214 Minnesota Life 2 EdF81776 10-2014 M I =1 Term Life Waiver of Premium Policy Rider MINNESOTA LIFE Minnesota Life Insurance Company-A Securian Company 400 Robert Street North • St.Paul,Minnesota 55101-2098 General Information Do premiums have to be paid for a certificate holder after he or she becomes disabled? 06 This rider is issued in consideration of the required premium and amends the group policy to which it is Yes. Premiums have to be paid after a certificate holder < attached. The specifications page attached to the group becomes disabled, but only until we approve his or her policyp Y Indicates whether this rider applies to contributor total and permanent disability claim. Continued payment insurance su ance or noncontributory insurance. This rider is prevents the possible loss of the certificate holder's .N subject to every term, condition, exclusion, limitation, and coverage and eligibility if the claim is not approved. provision of the group policy unless otherwise expressly provided for herein. Coverage under this rider will not be What if a certificate holder converts his or her group included in any insurance issued under the conversion life insurance to a policy of individual insurance prior right section of the group policy. to the approval of his or her disability claim? What does this rider provide? If a certificate holder's coverage has been converted in accordance with the conversion right section of the group This rider provides for waiver of premium for certificate policy, benefits under this rider will apply only if the holders who become totally and permanently disabled, as converted policy is surrendered without claim, except for defined herein,while under age 60. Upon approval of refund of premiums. proof of such disability, a certificate holder's insurance, What will be considered due proof of total and including all riders applicable to such certificate holder which were in force on the date of the onset of the permanent disability? certificate holder's disability,will be continued in force without payment of premiums during the uninterrupted A certificate holder must furnish evidence satisfactory to continuance of the total and permanent disability. us that his or her disability: (1) commenced while his or her insurance under the What is total disability? group policy was in force; and (2) meets the definition of total disability; and r9 Total disability is a disability which occurs while a (3) commenced before his or her 60th birthday; and certificate holder's insurance and the coverage under this (4) was continuous for six months or more. rider is in force and which results from an accidental injury > or an illness that continuously prevents the certificate We will,from time to time, also require additional proof holder from engaging in any occupation for which he or 0. satisfactory to us that the certificate holder continues to be 0. she is reasonably suited by education, training, or totally and permanently disabled. We may also require experience. The certificate holder must be under the care that the certificate holder submit to one or more medical W of a licensed physician. The licensed physician cannot be examinations at our expense. r the certificate holder or a member of the certificate holder's immediate family. For purposes of this rider, the If a certificate holder dies within one year of the date of certificate holder's immediate family consists of his or her onset of his or her disability, the certificate holder's LO spouse/domestic partner, children, parents, grandparents, beneficiary may claim benefits under this rider even if the grandchildren, brothers and sisters and their spouses. certificate holder's premium payments were discontinued "9 and he or she had not submitted due proof satisfactory to What is permanent disability? us of his or her total disability or was continuously Permanent disability is a total disabilitywhich has existed disabled for less than six months. The certificate holder's CL continuously for at least six months. beneficiary must submit due proof satisfactory to us that the certificate holder's total disability, which began before E the certificate holder's premium payments were Are there any limitations? discontinued and before his or her 60th birthday, Yes. Insurance will not be continued if a certificate continued without interruption until his or her death. holder's disability results from intentionally self-inflicted injury, participation in or any attempt to commit a felony, or When must we be notified of a certificate holder's war or any act of war,whether declared or undeclared. disability or death? CJ 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 M I =1 date of onset of such disability. However, failure to give What happens to a certificate holder's insurance when notice within the time provided will not invalidate the claim the waiver of premium benefit ends? if it is shown that notice was given as soon as reasonably possible. When the benefits under this rider end according to the provisions of the section entitled "How long will insurance m We must receive written notice at our home office within be continued without payment of premium?,"the following one year of death that a certificate holder died during a will apply: period of continuance provided by this rider. Proof must .` be furnished that he or she continued to be totally disabled (1) If the certificate holder is then eligible for coverage during the entire period of continuance until death. If such under the group policy, his or her insurance may 06 notice and proof are not provided within the required time be continued under the group policy provided that frame, there shall be no liability for any payment under this premiums are paid. The first such premium payment must be made within 31 days of the date rider. the waiver of premium benefit ends. What is the amount of insurance to be continued (2) If the certificate holder is no longer eligible forCh without payment of premium under this rider? 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 amount of insurance continued without payment of the group policy. premium shall be the amount of insurance that was in _ force on the date of onset of total disability. Insurance will end for a certificate holder unless,within 31 days of the date benefits under this rider end, premium If the group policy provides for reductions in amounts of payment is resumed or the insured applies to convert his insurance based on age or retirement, such reductions or her coverage. shall apply to the insurance of the disabled certificate holder. When does this rider terminate? How long will insurance be continued without This rider will terminate on the earlier of: payment of premium? (1) the date we receive a written request to terminate If a certificate holder becomes totally and permanently this rider; or C disabled, insurance will be continued,without payment of (2) the date the group policy is terminated. premium, until the earliest of: Insurance being continued without further payment of M (1) the date the certificate holder recovers so that he premiums in accordance with the provisions of this rider >- or she is no longer totally and permanently will not end due solely to the termination of this rider or of r9 disabled; or the group policy. (2) the date the certificate holder fails to furnish proof _ of continued disability when requested or refuses to submit to a required medical examination. � � � � � 07 However, if the group policy provides for termination of insurance at retirement, insurance provided under this Secretary President `✓ 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 CD CD the terms of this rider shall be the earlier of: T. LO (1) the date he or she actually retires; or (2) his or her presumed normal retirement date as r� established by the employer's applicable retirement plan. If no such date has been 2 established, the insured employee's presumed retirement date shall be age 65. CL E CJ CJ U MHC-96-13208 Minnesota Life 2 EdF81777 10-2014 M I =1 06 2 LO a) cn m 0 CL MINNESQTA LIFE 400 Robert Street North St. Paul, Minnesota 55101-2098 GROUP TERM LIFE INSURANCE POLICY NONPARTICIPATING