Life and Disability Insurance Coverages by jolinmilioncherie

VIEWS: 4 PAGES: 224

									                                 Request for Proposals

The Purchasing Division of Knoxville's Community Development Corporation (KCDC) will receive
sealed proposals for the services detailed herein

                        Life and Disability Insurance Coverages
Due Date:                        October 5, 2011

Due Time:                        By 11:00 a.m. (as shown by KCDC’s clock)

Pre-Proposal Meeting Location:   NA

Pre-Proposal Meeting Date:       NA

Pre-Proposal Meeting Time:       NA

Pre-Proposal is Mandatory        Yes      No

Proposal Number:                 C12006


Deliver Proposals to:            Knoxville's Community Development Corporation
                                 Purchasing Division
                                 901 Broadway N.E.
                                 Knoxville, Tennessee 37917

                                 Faxed/Emailed Responses are acceptable: Yes     No

Award Results:                   KCDC posts the award decision and the tabulation to its web page.
                                 Individual notices are normally not mailed or emailed. Please see
                                 http://www.kcdc.org/en/DoingBusiness/SolicitationStatus.aspx for
                                 the details.


MS Word Version:                 This document is available in MS WORD format. If you are
                                 interested in obtaining the Word document, please email
                                 purchasing@kcdc.org. Note that KCDC’s Adobe copy of the
                                 document will remain the “official” version of the document. The
                                 Word version will not have some forms which are only available in
                                 Adobe format.


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                                     Instructions to Proposers

1.   BACKGROUND AND INTENT

a.   Knoxville's Community Development Corporation (KCDC) is the public housing and
     redevelopment agency for the City of Knoxville and Knox County in Tennessee. KCDC’s public
     housing property portfolio includes 16 housing properties with approximately 3,900 dwelling
     units. KCDC also oversees approximately 3,600 Section 8 Vouchers and 21 redevelopment areas.

b.   The intent of this specification is to arrive at a contract with a firm to provide Basic Life and
     AD&D, Optional Life, Long Term Disability, and Short Term Disability insurance coverage for
     KCDC employees.

c.   KCDC will not be accepting proposals from insurance brokers. KCDC will only accept proposals
     from insurance companies who can provide the services as stated in this RFP. Cowan Benefit
     Services is KCDC’s broker and commissions are payable to Cowan (if included). Cowan will
     assist KCDC in the analysis of the proposals

2.   BACKGROUND
     KCDC currently employs approximately 155 employees. Rates shown in Exhibit J are net of
     commissions with the exception of Supplemental Life rates which include 10% commissions.

     Basic Life and AD&D coverage is 100% paid by KCDC. Supplemental life is 100% paid by the
     employee on an after tax basis. LTD and STD is 50% paid by KCDC and 50% paid by the
     employee on a post tax basis.

     Benefits terminate for employees who are no longer eligible on the last day of the month in which
     loss of eligibility occurs. See KCDC’s other leave provisions as highlighted in the eligibility
     section below.

3.   CANCELLATION
     The successful vendor and KCDC shall agree that the contract shall not be canceled by either party
     without sixty days written notice, unless mutually agreed to by both parties.

4.   CONTRACT LENGTH
     KCDC is requesting a three-year rate guarantee with the option to extend for an additional two
     years.

5.   ELIGIBILITY

a.   All regular, full-time employees working thirty or more hours per week are eligible.

b.   Dependents including:

     1.     Legal spouse, and

     2.     Dependent children to age 26

c.   Regular Full Time Employees are eligible as follows:

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     1. Basic Life/AD&D and Supplemental Life – 1st of the month following six months of
        employment.

     2. LTD and STD – 1st of the month following 90 days of employment.

d.   All employees must enroll during the above waiting periods. Employees are not extended an
     additional 31 days to enroll after the completion of the above waiting periods.

e.   KCDC allows employees to remain on the plan due to periods of leave or disability as follows:

      1. FMLA leave – first of the month following 12 weeks plus an additional 30 days if an
         additional leave is requested and granted.

      2. Leave of absence – an employee may request a non-FMLA leave of absence and remain on
         benefits until the end of the month following eight weeks of leave. This includes an
         employee who does not yet qualify for FMLA.

      3. Worker’s Compensation – an employee on worker’s compensation may continue on
         KCDC’s plan until the employee returns to work or a settlement is reached at which point
         the employee is no longer deemed eligible.

      4. Employees returning from a military leave will have their benefit reinstated on the first of the
         month following their return.

f.   Employees have the choice of using sick and or annual leave vs. receiving STD and LTD benefits.
     They may not use both.

6.   EXHIBITS

a.   Census

b.   KCDC Basic Life Certificate

c.   KCDC Optional Life Certificate

d.   KCDC LTD Certificate

e.   KCDC STD Certificate

f.   LTD and STD Claims Status Report 8.06 – 7.11

g.   Questionnaire – to be completed and submitted with your proposal that includes restatement of
     questions with your responses.

h.   Scope of Services – conditions that must be met when submitting your proposal.

i.   Summary of Current and Proposed Coverage – proposers are required to complete the Excel
     spreadsheet that details how your policy matches the current KCDC coverage provisions. Please
     pay particular attention to the details of the plan that follow and match or note why you cannot
     match in your proposal.

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j.    Rate History – to 2005

k.    Current sick and annual leave balances

7.    GENERAL INSTRUCTIONS
      KCDC no longer inserts “General Instructions to Vendors” in the solicitation document. Instead,
      these instructions may be found at www.kcdc.org. Please click on “Doing Business With KCDC”
      where you will find the instructions. By submitting a response to this solicitation, the proposer
      accepts the responsibility for downloading, reading and bidding by the terms and conditions set
      forth in KCDC’s “General Instructions to Vendors.” The proposer may wish to review certain
      applicable HUD instructions which can also be found on KCDC’s web site.

8.    METHOD OF EVALUATION

a.    KCDC's evaluation committee will evaluate each proposal based upon a weighted evaluation
      system. Each category listed on the proposal form will be evaluated and assigned a total score.
      KCDC may require an oral presentation of the proposal or for the clarification of the proposal.
      The categories and points assigned for each category on the proposal form are:

                                        Category                                         Maximum
                                                                                          Score
     Administration/Experience                                                              20
     Cost of Product                                                                        50
     Strength of contract provisions                                                        20
     Additional features added to the coverage (i.e., EAP services, additional benefits)    10
                                                                     Maximum Score         100

b.    Procedures

      1.     KCDC will convene an evaluation team to evaluate responsive proposals using the
             evaluation criteria listed herein. Evaluation team members will independently review and
             score each proposal. Those individual scores will be compiled in a master score.

      2.     The evaluation team will then meet to review and discuss the scores. Evaluation team
             members may adjust their scores if they choose to do so. If so, they will update their
             scoring sheets and turn those into the Purchasing Manager for changing the composite
             score.

      3.     The evaluation team will decide whether to award to the highest scoring proposer or to
             determine a “shortlist” of proposers for oral presentations. If the evaluation team elects to
             forego the oral presentation, the process is over and a recommendation will be made to the
             KCDC Board.

      4.     If oral presentations are required, the Purchasing Manager will arrange structured oral
             presentations by each proposer on the shortlist.

             At the conclusion of the oral presentations, the evaluation team members will rank (i.e.
             “1,” “2,” or “3”) the proposers that presented. The proposer receiving the most votes as “1”
             is the top scorer. KCDC will then commence negotiations with that proposer.


                                     Total Document Page 4 of 224
      5.     KCDC reserves the right to request additional information from any proposer after the
             submission deadline. KCDC also reserves the right to reject any and all, or part(s) of any
             and all proposals, to select one or more proposers, or to award no contract and re-advertise
             this RFP; postpone or cancel the RFP process at any time, and to waive any irregularities
             in this RFP or in proposals received as a result of this RFP.

9.    PLAN SUMMARY OF CURRENT AND PROPOSED COVERAGE
      Please see Exhibit I for a detailed Summary of Current and Proposed Coverage for the Basic Life
      and AD&D, Optional Life, LTD, and STD plans.

10.   PRICE STRUCTURE
      Bidders are to quote a specific price for each service listed herein. All quotes should contain
      commissions payable to Cowan Benefit Services as shown below:

            Basic Life/ AD&D and Supplemental Life – 10%

            LTD and STD – 15%

a.    At the end of the contract term, the successful bidder may request a price increase. Price increase
      requests must be accompanied by proof of increased cost to the successful bidder. KCDC may, at
      its option:

      1.     Accept the proposed price increase.
      2.     Reject the proposed price increase.
      3.     Suggest an alternative price increase.

b.    If KCDC rejects a proposed price the successful bidder may:

      1.     Continue with the existing pricing.
      2.     Suggest an alternative price increase.
      3.     End the contract.

c.    Price decreases are allowed at any time with or without notice.

11.   QUESTIONS
      Questions pertaining to this document should be submitted via email with “Questions about Life
      and Disability Insurance” in the subject line, no later than 4:00 p.m. one week prior to the proposal
      due date to purchasing@KCDC.org. The answers to substantial questions will be posted as
      addenda on KCDC’s web page for all interested parties to review.




                                     Total Document Page 5 of 224
                                    Proposal Structure Instructions

Proposers are to follow these steps/guidelines when preparing and submitting a response.

1.     Number all pages consecutively. Reference the section that you are responding to as shown on the
       following pages.

2.     Place your company’s name on each page.

3.     Be thorough yet succinct in responding to the above requirements. The use of tables in presenting
       information, where appropriate, will facilitate the evaluation team’s review.

4.     Submit one original document (with all pages marked “original”) and five copies of the original
       document. An electronic copy of each document must be included with each hard copy proposal.

5.     Fancy bindings, brochures, advertisements are not necessary.

6.     Do not use phrases such as “See the attached” or “Will be provided upon award.”

7.     If you have attachments, mark them (on the cover) with the proposer’s name. KCDC takes no
       responsibility for proposals or documents that are not clearly marked.

8.     Only one proposal will be accepted from each insurance carrier.

9.     Keep your response in this order and format.

Solicitation Document A       Proposer’s Table of Contents                  (Provided by proposer)

Solicitation Document B       Proposer General Response Section             (Form provided herein)

Solicitation Document C       Proposer’s Affidavits                         (Form provided herein)

Solicitation Document D       Proposer’s References                         (Form provided herein)

Solicitation Document E        Proposer’s Exceptions to Criteria Herein (Form provided herein)
Clearly relate the Section and item number of the criteria that is in question. Detail your exception.

Solicitation Document F        Proposer’s Additional Information              (Provided by proposer)
This is the place for any additional information that the proposer desires to supply.

Solicitation Document G       Required Documents supplied by the Proposer

1.     Provide a copy of an administration manual to be used by KCDC.

2.     Provide sample copies of your billing.

3.     Provide sample plan materials to be distributed to employees.

4.     Provide a sample of your employer contract.

                                       Total Document Page 6 of 224
5.    Provide a copy of your current contract.

6.    Provide a copy of benefit contract/booklet describing benefits and all limitations and/or
      restrictions.

7.    Provide a copy of the current audited financial statement.

8.    Provide a statement of current financial reserves.

9.    Include the completed Exhibit I Summary of Current and Proposed Coverage

10.   Include the completed Exhibit G Questionnaire.




 THIS AND THE PRECEDING PAGES NEED NOT BE RETURNED WITH YOUR RESPONSE




                                      Total Document Page 7 of 224
                 Basic Life and AD&D, Optional Life, LTD, and STD Coverages

Solicitation Document B      General Response Section

                               General Information about the Proposer
Sign Your Name to The Right of the Arrow

                          Printed Name and Title
                                Company Name
                                    Street Address
                                    City/State/Zip
          Contact Person (Please Print Clearly)
                              Telephone Number
                                     Fax Number
                                     Cell Number
Vendor’s e-mail address (Please Print Clearly)

         Please acknowledge addenda have been issued by checking below as appropriate:

None:     Addendum 1          Addendum 2         Addendum 3          Addendum 4     Addendum 5


Addenda are not mailed but posted at www.kcdc.org. Click on “Doing Business With KCDC” and
then on “Open Solicitations” to find addenda. Please check for addenda prior to submitting your
proposal.

                                         Statistical Information
   This business is owned & operated by persons at least 51% of the following ethnic background
 NA-This is a             White 1                Black 2             Native Americans 3
 corporation
  Hispanic 4        Asian/Pacific 5           Hasidic Jew 6
                 As defined on KCDC’s webpage, this business qualifies as being:
                  Small Business                Section 3              Woman Owned




                                      Total Document Page 8 of 224
Solicitation Document C      Affidavits

                The undersigned agrees that the following conditions are or will be met.

                                  NON COLLUSION AFFIDAVIT

1.    He/she is fully informed respecting the preparation, circumstances and contents of the attached bid
      or proposal;

2.    Such bid or proposal is genuine and not sham nor is it the result of collusion;

3.    Neither the said firm nor any of its officers, partners, owners, agents, representatives, employees
      or parties interest, including this affiant, has in any way colluded conspired, connived or agreed,
      directly or indirectly, with any other responder, firm, or person to submit a collusive or sham bid
      or proposal in connection with the contract or agreement for which the attached bid or proposal
      has been submitted. Bidders or proposers will refrain from making a bid or proposal in connection
      with such contract or agreement, or collusion or communication or conference with any other firm,
      or, to fix any overhead, profit, or cost element of the price or the proposal price of any other firm,
      or to secure through any collusion, conspiracy, connivance, or unlawful agreement any advantage
      against KCDC or any person interested in the proposed contract or agreement; and

4.    The price or prices quoted in the attached bid or proposal are fair and proper and are not tainted by
      any collusion, conspiracy, connivance, or unlawful agreement on the part of the firm or any of its
      agents, representatives, owners, employees, or parties in interest, including this affiant.

                                   AFFIDAVIT OF ELIGIBILITY

1.    The responder is not ineligible for employment on public contracts as a result of a conviction or
      guilty plea or a plea of nolo contender to violations of the Sherman Antitrust Act, mail fraud or
      state criminal violations with a contract let by the State of Tennessee or any political subdivision
      of the State of Tennessee.

2.    No commissioner or officer of KCDC or other person whose duty it is to vote for, let out, overlook
      or in any manner superintend any of the work for KCDC has a direct interest in the
      proposer/bidder.

                                      ILLEGAL IMMIGRANTS

1.    The State of Tennessee amended the Tennessee Code Annotated, Title 12, Chapter 4 to prohibit
      contracting with firms that knowingly utilize the services of illegal immigrants in the performance
      of a contract for goods or services in the performance of a contract with the state or a state entity.
      Additionally such firms may not knowingly contract with subcontractors who utilize the services
      of illegal immigrants.

2.    By signing below the proposer agrees that:

a.    The firm does not knowingly utilize the services of illegal immigrants in the performance of
      contracts.



                                      Total Document Page 9 of 224
Solicitation Document C       Affidavits Continued

b.     The firm agrees that the State may conduct random checks of personnel records as it pertains to
       this issue.

c.     Violation of this requirement shall be grounds for monetary and other penalties, up to and
       including termination of the contract. Additionally violation of this requirement may result in the
       firm being prohibited from submitting bids and/or proposals for a period of one year.



The undersigned proposer hereby acknowledges receipt of the above applicable law and verifies that the
bid or proposal he/she has submitted in response to this solicitation is in full compliance with the listed
requirements.




_________________________________________                   ___________________________________
                  (Name)                                                 (Signature)


_________________________________________                   ___________________________________
                  (Title)                                                 (Date)



Subscribed and sworn before me this _____ day of _____________________________ 20                .


___________________________________ My commission expires: ________________________
            Notary Public




                                      Total Document Page 10 of 224
Solicitation Document D       References

Provide five client references. Include references with employees in the Knoxville service area if possible.
                                                    One
Name of the business that was
serviced
Contact person
Contact person title
Contact person’s telephone
number
Description of the service
provided
Value of the service over its life
Contract began
Contract ended
Number of Employees Covered
Type of insurance provided
(Basic Life, AD&D, Optional
Life, LTD, STD):

                                                   Two

Name of the business that was
serviced
Contact person
Contact person title
Contact person’s telephone
number
Description of the service
provided
Value of the service over its life
Contract began
Contract ended
Number of Employees Covered
Type of insurance provided
(Basic Life, AD&D, Optional
Life, LTD, STD):




                                      Total Document Page 11 of 224
Solicitation Document D       References (continued)

                                                Three
Name of the business that was
serviced
Contact person
Contact person title
Contact person’s telephone
number
Description of the service
provided
Value of the service over its life
Contract began
Contract ended
Number of Employees Covered
Type of insurance provided
(Basic Life, AD&D, Optional
Life, LTD, STD):

                                                Four
Name of the business that was
serviced
Contact person
Contact person title
Contact person’s telephone
number
Description of the service
provided
Value of the service over its life
Contract began
Contract ended
Number of Employees Covered
Type of insurance provided
(Basic Life, AD&D, Optional
Life, LTD, STD):




                                     Total Document Page 12 of 224
Solicitation Document D       References (continued)

                                                 Five
Name of the business that was
serviced
Contact person
Contact person title
Contact person’s telephone
number
Description of the service
provided
Value of the service over its life
Contract began
Contract ended
Number of Employees Covered
Type of insurance provided
(Basic Life, AD&D, Optional
Life, LTD, STD):




                                     Total Document Page 13 of 224
Solicitation Document E       Proposer’s Exceptions to Criteria Herein

Specify the section and item number of the criteria that is in question. Detail your reasoning.




                                       Total Document Page 14 of 224
Exhibit A      Census

     Gender    DOB          Job Title       Annual     Zip    Employee   Spouse     Basic      Child       STD            LTD
                                                      Code      Life      Life       Life       Life

1      M      01/16/63   Housing            $36,043   37803         $0        $0    $50,000       $0        Enrolled       Enrolled
                         Craftsman I
2      F      06/14/66   Senior             $58,500   37918         $0        $0        $0        $0    No Coverage    No Coverage
                         Accountant
3      F      02/16/71   Occupancy          $44,487   37914   $200,000   $100,000   $50,000   $10,000   No Coverage        Enrolled
                         Manager
4      F      02/20/49   Occupancy          $81,367   37922         $0        $0    $50,000       $0        Enrolled       Enrolled
                         Management
                         Admin
5      F      06/04/66   Occupancy          $55,731   37918    $90,000    $25,000   $50,000   $10,000   No Coverage        Enrolled
                         Manager
6      F      04/12/70   Training           $34,523   37917         $0        $0    $50,000       $0        Enrolled       Enrolled
                         Specialist
7      M      04/03/68   Information        $48,452   37938         $0        $0    $50,000       $0        Enrolled       Enrolled
                         Systems
                         Analyst I
8      M      10/23/59   Housing            $43,701   37912         $0        $0    $50,000       $0    No Coverage        Enrolled
                         Craftsman II
9      M      10/30/56   Housing            $41,939   37743         $0        $0    $50,000       $0    No Coverage        Enrolled
                         Craftsman II
10     M      11/12/59   Housing            $44,353   37914    $60,000        $0    $50,000   $10,000   No Coverage    No Coverage
                         Craftsman II
11     F      09/07/60   Housing            $31,038   37914         $0        $0    $47,000       $0        Enrolled       Enrolled
                         Craftsman II
12     M      09/07/70   Skilled Laborer    $30,959   37914   $100,000        $0    $47,000    $5,000       Enrolled       Enrolled
13     F      01/01/48   Receptionist       $21,637   37918         $0        $0    $33,000        $0       Enrolled       Enrolled
14     M      11/15/52   Plumber-Maint      $51,921   37938         $0        $0    $50,000        $0   No Coverage        Enrolled
                         Sup
15     F      08/21/51   Admissions         $28,956   37917         $0        $0    $44,000       $0        Enrolled       Enrolled
                         and Occupancy
                         Asst.
16     M      01/01/59   Housing            $43,701   37920   $110,000    $20,000   $50,000   $10,000       Enrolled       Enrolled
                         Craftsman II
17     F      08/07/55   Activity           $36,782   37912         $0        $0    $50,000       $0        Enrolled       Enrolled
                         Specialist
18     F      12/30/77   Admissions         $28,723   37917    $50,000    $25,000   $44,000   $10,000       Enrolled       Enrolled
                         Specialist
19     M      05/20/60   Housing            $42,738   37915    $50,000    $25,000   $50,000    $5,000   No Coverage        Enrolled
                         Craftsman II
20     F      06/16/51   Occupancy          $70,400   37919         $0        $0    $50,000       $0    No Coverage        Enrolled
                         Manager
21     F      08/02/71   Occupancy          $27,748   37912         $0        $0    $42,000       $0        Enrolled       Enrolled
                         Specialist
22     F      01/08/58   Custodian          $27,415   37921         $0         $0   $42,000        $0       Enrolled       Enrolled
23     F      01/20/65   Human              $89,173   37920   $200,000   $100,000   $50,000   $10,000       Enrolled       Enrolled
                         Resources
                         Director
24     M      10/21/56   Maintenance        $61,687   37865    $50,000    $25,000   $50,000   $10,000   No Coverage        Enrolled
                         Manager
25     M      05/27/74   Housing            $26,728   37914         $0        $0    $41,000       $0        Enrolled   No Coverage
                         Craftsman I
26     F      08/06/61   Quality            $40,680   37849   $100,000    $50,000   $50,000       $0        Enrolled       Enrolled


                                           Total Document Page 15 of 224
     Gender    DOB          Job Title       Annual     Zip    Employee   Spouse    Basic      Child       STD             LTD
                                                      Code      Life      Life      Life       Life

                         Assurance
                         Specialist
27     M      11/22/50   COO               $140,737   37918   $100,000   $40,000   $50,000        $0       Enrolled       Enrolled
28     M      06/18/62   Property          $77,325    37918   $120,000   $45,000   $50,000   $10,000   No Coverage        Enrolled
                         Management
                         Admin
29     M      11/26/64   Painter            $36,402   37917    $50,000   $20,000   $50,000   $10,000       Enrolled       Enrolled
30     M      02/21/60   Information        $65,000   49770         $0        $0   $50,000        $0       Enrolled       Enrolled
                         Systems
                         Analyst II
31     F      03/24/52   Accounting         $37,201   37807         $0       $0    $50,000       $0    No Coverage        Enrolled
                         Technician II
32     M      06/04/56   Property           $47,290   37807         $0       $0    $50,000       $0        Enrolled       Enrolled
                         Manager
33     M      06/06/57   Property           $56,346   37804    $50,000   $25,000   $50,000       $0    No Coverage        Enrolled
                         Manager
34     F      09/19/55   Receptionist       $21,616   37918         $0        $0   $33,000        $0   No Coverage    No Coverage
35     M      02/13/71   Housing            $43,701   37920    $20,000   $10,000   $50,000    $5,000   No Coverage        Enrolled
                         Craftsman II
36     M      09/08/53   Controller         $77,990   37705    $60,000   $25,000   $50,000   $10,000   No Coverage    No Coverage
37     M      10/02/67   Housing            $33,778   37912    $50,000   $25,000   $50,000   $10,000       Enrolled       Enrolled
                         Craftsman II
38     F      11/06/52   Purchasing &       $45,352   37779    $50,000   $25,000   $50,000       $0        Enrolled       Enrolled
                         Materials Asst.
                         Manager
39     M      07/28/62   Redevelopment      $64,626   37922   $110,000   $55,000   $50,000       $0    No Coverage        Enrolled
                         Administrator
40     M      07/14/72   Housing            $43,141   37921    $80,000   $30,000   $50,000   $10,000       Enrolled       Enrolled
                         Craftsman II
41     F      04/24/57   Accounting         $39,212   37921    $50,000   $20,000   $50,000       $0        Enrolled       Enrolled
                         Technician II
42     M      02/20/61   Maintenance        $42,976   37865   $100,000   $50,000   $50,000       $0    No Coverage    No Coverage
                         Supervisor
43     F      10/19/72   Customer           $80,815   37774   $130,000   $65,000   $50,000   $10,000       Enrolled       Enrolled
                         Relations
                         Administrator
44     M      11/03/54   Painter            $40,092   37914    $20,000   $10,000   $50,000   $10,000   No Coverage        Enrolled
45     M      02/11/54   Housing            $28,682   37915    $50,000        $0   $44,000        $0       Enrolled       Enrolled
                         Craftsman I
46     F      10/21/50   Resident           $33,745   37917         $0       $0    $50,000       $0        Enrolled       Enrolled
                         Services Aide
47     F      06/10/53   Occupancy          $28,721   37920         $0       $0    $44,000       $0        Enrolled       Enrolled
                         Specialist
48     M      04/09/52   Occupancy          $53,970   37909    $40,000   $20,000   $50,000       $0        Enrolled       Enrolled
                         Manager
49     F      11/04/60   Custodian          $27,309   37917   $100,000        $0   $41,000       $0        Enrolled       Enrolled
50     M      02/26/60   Housing            $38,957   37931   $100,000   $50,000   $50,000       $0        Enrolled       Enrolled
                         Craftsman I
51     F      06/10/59   Occupancy          $56,594   37921         $0       $0    $50,000       $0        Enrolled       Enrolled
                         Manager
52     M      08/11/70   Information        $77,881   37849    $30,000   $15,000   $50,000   $10,000   No Coverage    No Coverage
                         Systems
                         Analyst II
53     F      10/26/67   Occupancy          $40,462   37876   $100,000   $50,000   $50,000       $0        Enrolled       Enrolled
                         Manager

                                           Total Document Page 16 of 224
     Gender    DOB          Job Title       Annual     Zip    Employee   Spouse    Basic      Child       STD             LTD
                                                      Code      Life      Life      Life       Life

54     M      09/29/57   Housing            $28,751   37917         $0       $0    $44,000       $0    No Coverage        Enrolled
                         Craftsman I
55     F      11/17/57   Strategic Plan     $89,028   37583         $0       $0    $50,000       $0        Enrolled       Enrolled
                         Director
56     F      03/07/59   Occupancy          $34,701   37924    $50,000       $0    $50,000   $10,000       Enrolled       Enrolled
                         Specialist
57     F      10/25/61   Occupancy          $38,931   37915   $100,000       $0    $50,000       $0        Enrolled       Enrolled
                         Specialist
58     F      03/13/55   Housing            $31,086   37921    $30,000       $0    $47,000   $10,000       Enrolled       Enrolled
                         Craftsman II
59     M      06/06/66   Housing            $41,430   37920   $110,000       $0    $50,000   $10,000   No Coverage    No Coverage
                         Craftsman II
60     F      11/15/55   Accounting         $34,028   37931    $50,000       $0    $50,000       $0        Enrolled       Enrolled
                         Technician
61     M      10/26/65   Housing            $40,092   37924   $155,000   $75,000   $50,000   $10,000       Enrolled       Enrolled
                         Craftsman I
62     M      12/22/50   Housing            $37,153   37917    $20,000   $10,000   $50,000   $10,000   No Coverage        Enrolled
                         Craftsman II
63     F      04/23/69   Occupancy          $54,466   37924    $50,000       $0    $50,000   $10,000       Enrolled       Enrolled
                         Manager
64     F      01/16/51   Admissions         $34,133   37917         $0       $0    $50,000       $0        Enrolled       Enrolled
                         and Occupancy
                         Asst.
65     M      09/28/77   Housing            $40,092   37885   $100,000   $50,000   $50,000       $0        Enrolled       Enrolled
                         Craftsman I
66     M      07/16/47   Painting           $51,921   37914    $20,000   $10,000   $50,000   $10,000   No Coverage        Enrolled
                         Supervisor
67     M      11/02/67   Property           $53,394   37803   $100,000   $40,000   $50,000   $10,000       Enrolled       Enrolled
                         Manager
68     M      06/22/65   Plumber            $34,495   37828   $100,000        $0   $50,000   $10,000       Enrolled       Enrolled
69     F      01/18/49   Admissions         $28,586   37777    $50,000   $25,000   $43,000        $0       Enrolled       Enrolled
                         and Occupancy
                         Asst.
70     M      05/18/70   Inspections        $43,402   37825         $0       $0    $50,000       $0    No Coverage    No Coverage
                         Coordinator
71     M      10/27/57   Painter            $36,861   37721    $50,000       $0    $50,000       $0        Enrolled       Enrolled
72     F      02/16/55   Admissions         $40,092   37920         $0       $0    $50,000       $0    No Coverage        Enrolled
                         and Occupancy
                         Asst.
73     M      06/18/64   Housing            $40,092   37914   $100,000   $45,000   $50,000   $10,000       Enrolled       Enrolled
                         Craftsman I
74     M      06/12/52   Painter            $28,676   37940    $50,000   $25,000   $44,000   $10,000       Enrolled       Enrolled
75     F      02/16/82   Resident           $34,114   37921         $0        $0   $50,000        $0       Enrolled       Enrolled
                         Services
                         Liaison
76     F      08/15/58   Occupancy          $56,594   37934    $30,000       $0    $50,000   $10,000       Enrolled       Enrolled
                         Manager
77     F      03/02/51   Occupancy          $54,602   37914    $50,000   $20,000   $50,000       $0        Enrolled       Enrolled
                         Manager
78     M      10/10/70   Housing            $31,166   37918    $20,000       $0    $47,000       $0    No Coverage    No Coverage
                         Craftsman II
79     M      12/04/79   Housing            $31,690   37921    $50,000   $20,000   $48,000   $10,000   No Coverage        Enrolled
                         Craftsman I
80     M      10/24/46   Inventory Clerk    $33,238   37932         $0        $0   $50,000       $0        Enrolled       Enrolled
81     M      08/01/57   Housing            $28,749   37914   $100,000   $50,000   $44,000       $0    No Coverage    No Coverage


                                           Total Document Page 17 of 224
      Gender    DOB          Job Title      Annual     Zip    Employee   Spouse    Basic      Child       STD             LTD
                                                      Code      Life      Life      Life       Life

                          Craftsman I
82      F      01/10/54   Admissions        $36,500   37921    $40,000       $0    $50,000   $10,000       Enrolled       Enrolled
                          Specialist
83      F      01/29/65   Admissions        $31,107   37920         $0       $0    $47,000       $0        Enrolled       Enrolled
                          and Occupancy
                          Asst.
84      M      11/27/50   Housing           $43,701   37917    $50,000   $25,000   $50,000       $0    No Coverage        Enrolled
                          Craftsman II
85      F      11/09/66   Admissions        $28,987   37871    $50,000       $0    $44,000   $10,000       Enrolled       Enrolled
                          and Occupancy
                          Asst.
86      M      12/08/80   Custodian         $19,787   37912    $30,000   $15,000   $30,000   $10,000       Enrolled       Enrolled
87      F      12/01/60   Resident          $47,634   37849         $0        $0   $50,000        $0       Enrolled       Enrolled
                          Services
                          Liaison
88      M      12/30/57   Housing           $43,701   37921    $30,000       $0    $50,000   $10,000       Enrolled       Enrolled
                          Craftsman II
89      F      01/30/56   Admissions        $38,478   37920         $0       $0    $50,000       $0        Enrolled       Enrolled
                          and Occupancy
                          Asst.
90      F      12/03/57   Admissions        $28,400   37912    $20,000       $0    $43,000       $0    No Coverage    No Coverage
                          and Occupancy
                          Asst.
91      M      06/09/58   Property          $39,380   37804         $0       $0    $50,000       $0    No Coverage        Enrolled
                          Manager
92      M      03/17/72   Stock Clerk       $32,910   37917   $100,000   $15,000   $50,000    $5,000       Enrolled   No Coverage
93      M      09/19/69   Housing           $42,455   37914   $100,000   $25,000   $50,000   $10,000       Enrolled       Enrolled
                          Craftsman II
94      M      11/27/65   Housing           $26,728   37807         $0       $0    $41,000       $0        Enrolled       Enrolled
                          Craftsman I
95      F      09/26/62   Admissions        $36,791   37915    $40,000       $0    $50,000       $0    No Coverage        Enrolled
                          and Occupancy
                          Asst.
96      M      02/02/57   Housing           $42,244   37924   $100,000   $50,000   $50,000       $0        Enrolled       Enrolled
                          Craftsman I
97      M      06/17/55   Housing           $33,500   37914    $60,000       $0    $50,000       $0        Enrolled       Enrolled
                          Craftsman II
98      F      08/03/59   Contracts and     $68,494   37932         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Risk Manager
99      F      09/16/57   Admissions        $41,277   37915         $0       $0    $50,000       $0        Enrolled       Enrolled
                          and Occupancy
                          Asst.
100     F      01/28/57   Admissions        $36,520   37917   $140,000       $0    $50,000   $10,000   No Coverage        Enrolled
                          and Occupancy
                          Asst.
101     F      08/13/71   Human             $45,636   37716   $100,000       $0    $50,000   $10,000       Enrolled       Enrolled
                          Resources
                          Analyst
102     M      10/15/62   Purchasing and    $80,656   37853   $100,000   $50,000   $50,000   $10,000       Enrolled       Enrolled
                          Materials
                          Manager
103     M      09/28/82   Housing           $31,138   37914         $0       $0    $47,000       $0        Enrolled       Enrolled
                          Craftsman II
104     M      03/27/58   Housing           $31,391   37918    $50,000   $25,000   $48,000       $0        Enrolled       Enrolled
                          Craftsman I


                                           Total Document Page 18 of 224
      Gender    DOB          Job Title       Annual     Zip    Employee   Spouse    Basic      Child       STD             LTD
                                                       Code      Life      Life      Life       Life

105     M      10/09/72   Maintenance        $43,059   37912         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Supervisor
106     M      10/12/54   Maintenance        $50,936   37918    $50,000       $0    $50,000   $10,000   No Coverage        Enrolled
                          Supervisor
107     F      07/09/74   Accounting         $39,212   37806    $70,000       $0    $50,000       $0        Enrolled       Enrolled
                          Technician II
108     F      11/18/61   Public Housing     $30,477   37721   $100,000   $25,000   $46,000       $0        Enrolled       Enrolled
                          Technician
109     F      09/24/59   Resident           $47,634   37923    $30,000       $0    $50,000       $0    No Coverage        Enrolled
                          Services
                          Liaison
110     M      07/21/61   Housing            $43,701   37871   $120,000   $60,000   $50,000       $0    No Coverage        Enrolled
                          Craftsman II
111     F      08/17/61   Occupancy          $40,092   37927    $30,000       $0    $50,000       $0        Enrolled       Enrolled
                          Specialist
112     M      04/23/57   Executive         $150,966   37914         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Director/CEO
113     F      10/28/64   Senior             $64,631   37918         $0       $0    $50,000       $0    No Coverage    No Coverage
                          Accountant
114     F      02/29/80   General            $94,350   37919         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Counsel
115     M      08/11/69   Property           $53,109   37920    $65,000   $25,000   $50,000   $10,000   No Coverage        Enrolled
                          Manager
116     M      10/24/59   Plumber            $41,637   37938   $150,000   $50,000   $50,000   $10,000       Enrolled       Enrolled
117     F      02/03/66   Resident           $55,583   37923   $250,000        $0   $50,000        $0       Enrolled       Enrolled
                          Services
                          Coordinator
118     M      05/26/62   Painter            $39,941   37725   $100,000   $50,000   $50,000   $10,000       Enrolled       Enrolled
119     M      01/31/59   Housing            $35,319   37922    $50,000   $25,000   $50,000        $0   No Coverage    No Coverage
                          Craftsman II
120     M      04/09/50   Vice President    $84,020    37931   $100,000   $25,000   $50,000       $0        Enrolled       Enrolled
121     F      08/29/60   VP Finance        $107,434   37865   $110,000   $45,000   $50,000       $0        Enrolled       Enrolled
                          and
                          Administration
122     M      03/11/64   Property           $56,594   37820    $50,000   $25,000   $50,000   $10,000   No Coverage        Enrolled
                          Manager
123     M      07/02/73   Plumber            $39,959   37754   $100,000   $50,000   $50,000   $10,000       Enrolled       Enrolled
124     M      12/31/63   Housing            $43,701   37849         $0        $0   $50,000        $0       Enrolled       Enrolled
                          Craftsman II
125     M      08/11/57   Plumbing           $43,889   37917         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Supervisor
126     M      07/22/71   Painter            $28,721   37917    $30,000        $0   $44,000        $0       Enrolled       Enrolled
127     F      12/05/61   Executive Asst.    $51,996   37927    $80,000        $0   $50,000   $10,000       Enrolled       Enrolled
128     M      02/10/50   Housing            $40,656   37807    $70,000   $30,000   $50,000        $0   No Coverage        Enrolled
                          Craftsman II
129     M      11/15/80   Housing            $31,032   37917    $50,000       $0    $47,000    $5,000       Enrolled       Enrolled
                          Craftsman II
130     F      09/22/67   Occupancy          $34,695   37918         $0       $0    $50,000       $0    No Coverage    No Coverage
                          Specialist
131     F      09/11/58   Executive          $39,488   37922         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Secretary
132     M      04/09/65   Housing            $31,412   37721    $60,000   $10,000   $48,000   $10,000   No Coverage    No Coverage
                          Craftsman II
133     M      06/08/60   Housing            $31,636   37721         $0       $0    $48,000       $0        Enrolled       Enrolled
                          Craftsman II

                                            Total Document Page 19 of 224
      Gender    DOB          Job Title     Annual     Zip    Employee   Spouse    Basic      Child       STD             LTD
                                                     Code      Life      Life      Life       Life

134     F      12/26/61   Case Manager     $39,188   37914    $60,000   $25,000   $50,000   $10,000       Enrolled       Enrolled
135     F      01/03/75   Occupancy        $28,917   37920    $60,000   $25,000   $44,000   $10,000       Enrolled   No Coverage
                          Specialist
136     F      08/20/54   Admissions       $28,319   37914    $50,000       $0    $43,000       $0        Enrolled       Enrolled
                          and Occupancy
                          Asst.
137     F      08/21/53   Section 8        $84,420   37918         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Housing
                          Director
138     F      12/22/62   Senior           $71,088   37924   $120,000   $55,000   $50,000       $0    No Coverage        Enrolled
                          Accountant
139     M      02/26/68   Occupancy        $55,861   37914    $50,000       $0    $50,000       $0    No Coverage        Enrolled
                          Manager
140     F      12/28/72   Occupancy        $47,844   37914   $150,000       $0    $50,000   $10,000       Enrolled       Enrolled
                          Manager
141     F      05/02/75   Occupancy        $54,712   37804         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Manager
142     F      08/15/73   Occupancy        $29,263   37938    $50,000   $25,000   $44,000       $0    No Coverage    No Coverage
                          Specialist
143     M      07/21/73   Housing          $35,498   37920    $30,000       $0    $50,000   $10,000       Enrolled   No Coverage
                          Craftsman II
144     M      11/11/44   Housing          $34,998   37938    $70,000   $35,000   $32,500       $0    No Coverage        Enrolled
                          Inspector
145     M      08/29/59   Painter          $37,487   37920   $120,000        $0   $50,000   $10,000       Enrolled       Enrolled
146     F      07/18/79   Admissions       $28,724   37915    $30,000   $15,000   $44,000   $10,000       Enrolled       Enrolled
                          and Occupancy
                          Asst.
147     F      06/06/68   Occupancy        $45,005   37915    $40,000       $0    $50,000       $0    No Coverage        Enrolled
                          Manager
148     M      11/27/83   Housing          $28,572   37938         $0       $0    $43,000       $0    No Coverage    No Coverage
                          Craftsman I
149     F      12/09/55   Accounting       $48,340   37912   $110,000       $0    $50,000       $0        Enrolled       Enrolled
                          Technician II
150     F      07/21/46   Quality          $61,687   37865         $0       $0    $32,500       $0    No Coverage        Enrolled
                          Assurance
                          Coordinator
151     F      10/27/60   Secretary        $25,707   37921    $10,000        $0   $39,000   $10,000       Enrolled       Enrolled
152     F      07/16/50   Custodian        $27,415   37921         $0        $0   $42,000        $0       Enrolled       Enrolled
153     M      06/29/63   Housing          $43,701   37807    $70,000   $25,000   $50,000   $10,000   No Coverage        Enrolled
                          Craftsman II
154     F      04/02/57   Admissions       $29,139   37764    $80,000   $25,000   $44,000   $10,000       Enrolled       Enrolled
                          and Occupancy
                          Asst.
155     M      07/27/61   Maintenance      $36,957   37917         $0       $0    $50,000       $0        Enrolled       Enrolled
                          Supervisor




                                          Total Document Page 20 of 224
Exhibit B   KCDC’s Basic Life Certificate




                                Total Document Page 21 of 224
                                    Metropolitan Life Insurance Company
                            One Madison Avenue, New York, New York 10010-3690

                                      CERTIFICATE OF INSURANCE

Metropolitan Life Insurance Company (“MetLife”), a stock company, certifies that You are insured for the
benefits described in this certificate, subject to the provisions of this certificate. This certificate is issued to
You under the Group Policy and it includes the terms and provisions of the Group Policy that describe Your
insurance. PLEASE READ THIS CERTIFICATE CAREFULLY.

This certificate is part of the Group Policy. The Group Policy is a contract between MetLife and the Employer
and may be changed or ended without Your consent or notice to You.

Employer:                             Knoxville's Community Development
                                      Corporation

Group Policy Number:                  TM 05579023-G

Type of Insurance:                    Basic Term Life & Accidental Death and
                                      Dismemberment Insurance

MetLife Toll Free Number(s):
  For General Information             1-800-275-4638

THE GROUP INSURANCE POLICY PROVIDING COVERAGE UNDER THIS
CERTIFICATE WAS ISSUED IN A JURISDICTION OTHER THAN MARYLAND AND
MAY NOT PROVIDE ALL THE BENEFITS REQUIRED BY MARYLAND LAW.
THIS CERTIFICATE ONLY DESCRIBES LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT
INSURANCE.

THE BENEFITS OF THE POLICY PROVIDING YOUR COVERAGE ARE GOVERNED PRIMARILY BY THE
LAW OF A STATE OTHER THAN FLORIDA.

WE ARE REQUIRED BY STATE LAW TO INCLUDE THE NOTICE(S) SECTION WHICH FOLLOWS THIS
PAGE. PLEASE READ THE(SE) NOTICE(S) CAREFULLY.




GCERT2000
                                                                                     All Active Full Time Employees
fp                                                                                                     NB 02/08/2005
                                                                                                                   1
                                       Total Document Page 22 of 224
.

For Texas Residents:                                 Para Residentes de Texas:

            IMPORTANT NOTICE                                     AVISO IMPORTANTE
To obtain information or make a complaint:           Para obtener informacion o para someter una
                                                     queja:

You may call MetLife’s toll free telephone number    Usted puede llamar al numero de telefono gratis de
for information or to make a complaint at            MetLife para informacion o para someter una queja
                                                     al

                 1-800-275-4638                                       1-800-275-4638


You may contact the Texas Department of              Puede comunicarse con el Departmento de
Insurance to obtain information on companies,        Seguros de Texas para obtener informacion acerca
coverages, rights or complaints at                   de companias, coberturas, derechos o quejas al


                 1-800-252-3439                                       1-800-252-3439


You may write the Texas Department of Insurance      Puede escribir al Departmento de Seguros de
P.O. Box 149104                                      Texas
Austin, TX 78714-9104                                P.O. Box 149104
Fax # (512) 475-1771                                 Austin, TX 78714-9104
                                                     Fax # (512) 475-1771

PREMIUM OR CLAIM DISPUTES: Should You                DISPUTAS SOBRE PRIMAS O RECLAMOS: Si
have a dispute concerning Your premium or about      tiene una disputa concerniente a su prima o a un
a claim You should contact MetLife first. If the     reclamo, debe comunicarse con MetLife primero.
dispute is not resolved, You may contact the Texas   Si no se resuelve la disputa, puede entonces
Department of Insurance.                             comunicarse con el departamento (TDI).

ATTACH THIS NOTICE TO YOUR CERTIFICATE:              UNA ESTE AVISO A SU CERTIFICADO:
This notice is for information only and does not     Este aviso es solo para proposito de informacion y
become a part or condition of the attached           no se convierte en parte o condicion del
document.                                            documento adjunto.




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NOTICE FOR RESIDENTS OF ALL STATES

LIFE INSURANCE BENEFITS WILL BE REDUCED IF AN ACCELERATED BENEFIT IS
PAID

DISCLOSURE: The Life Insurance accelerated benefit offered under this certificate is intended to qualify for
favorable tax treatment under the Internal Revenue Code of 1986. If this benefit qualifies for such favorable
tax treatment, the benefit will be excludable from Your income and not subject to federal taxation. Tax laws
relating to accelerated benefits are complex. You are advised to consult with a qualified tax advisor about
circumstances under which You could receive an accelerated benefit excludable from income under federal
law.

DISCLOSURE: Receipt of an accelerated benefit may affect Your, Your Spouse’s or Your family’s eligibility
for public assistance programs such as Medical Assistance (Medicaid), Aid to Families with Dependent
Children (AFDC), Supplementary Social Security Income (SSI), and drug assistance programs. You are
advised to consult with a qualified tax advisor and with social service agencies concerning how receipt of
such payment will affect Your, Your Spouse’s and Your family’s eligibility for public assistance.




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NOTICE FOR RESIDENTS OF ARKANSAS
If You have a question concerning Your coverage or a claim, first contact the Policyholder or group account
administrator. If, after doing so, You still have a concern, You may call the toll free telephone number shown
on the Certificate Face Page.

If You are still concerned after contacting both the Policyholder and MetLife, You should feel free to contact:

                                       Arkansas Insurance Department
                                           Consumer Services Division
                                                1200 West Third
                                      Little Rock, Arkansas 722014-1904
                                                1-800-852-5494




GCERT2000
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NOTICE FOR RESIDENTS OF CALIFORNIA
IMPORTANT NOTICE

TO OBTAIN ADDITIONAL INFORMATION, OR TO MAKE A COMPLAINT, CONTACT:

                      METROPOLITAN LIFE INSURANCE COMPANY
                               1 MADISON AVENUE
                              NEW YORK, NY 10010
                ATTN: CORPORATE CONSUMER RELATIONS DEPARTMENT
                                  1-800-275-4638

IF, AFTER CONTACTING METLIFE REGARDING A COMPLAINT, YOU FEEL THAT A SATISFACTORY
RESOLUTION HAS NOT BEEN REACHED, YOU MAY FILE A COMPLAINT WITH THE CALIFORNIA
INSURANCE DEPARTMENT AT:

                             DEPARTMENT OF INSURANCE
                              300 SOUTH SPRING STREET
                               LOS ANGELES, CA 90013
                            1-800-927-4357 (within California)
                           1-213-897-8921 (outside California)




GCERT2000
notice/ca                  Total Document Page 26 of 224                      6
NOTICE FOR RESIDENTS OF GEORGIA

IMPORTANT NOTICE

The laws of the state of Georgia prohibit insurers from unfairly discriminating against any person based upon
his or her status as a victim of family violence.




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NOTICE FOR RESIDENTS OF ILLINOIS

                                         IMPORTANT NOTICE

     To make a complaint to Metropolitan Life Insurance Company you may write to:

                                 Metropolitan Life Insurance Company
                                          1 Madison Avenue
                                     New York, New York 10010

     The address of the Illinois Department of Insurance is:

                                    Illinois Department of Insurance
                                         Public Services Division
                                         Springfield, Illinois 62767




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NOTICE FOR RESIDENTS OF MASSACHUSETTS

CONTINUATION OF ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D)

1. If Your AD&D Insurance ends due to a Plant Closing or Covered Partial Closing, such insurance will be
    continued for 90 days after the date it ends.

2. If Your AD&D Insurance ends because:

    ·   You cease to be in an Eligible Class; or
    ·   Your employment terminates

for any reason other than a Plant Closing or Covered Partial Closing, such insurance will continue for 31 days
after the date it ends.

Continuation of Your AD&D Insurance under this subsection will end before the end of continuation periods
shown above if You become covered for similar benefits under another plan.

Plant Closing and Covered Partial Closing have the meaning set forth in Massachusetts Annotated Laws,
Chapter 151A, Section 71A.




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NOTICE FOR RESIDENTS OF UTAH

                                  NOTICE TO POLICYHOLDERS

Insurance companies licensed to sell life insurance, health insurance, or annuities in the State of Utah are
required by law to be members of an organization called the Utah Life and Health Insurance Guaranty
Association ("ULHIGA"). If an insurance company that is licensed to sell insurance in Utah becomes insolvent
(bankrupt), and is unable to pay claims to its policyholders, the law requires ULHIGA to pay some of the
insurance company's claims. The purpose of this notice is to briefly describe some of the benefits and
limitations provided to Utah insureds by ULHIGA.

                                   PEOPLE ENTITLED TO COVERAGE

      ·      You must be a Utah resident.

      ·      You must have insurance coverage under an individual or group policy.

                                            POLICIES COVERED

      ·      ULHIGA provides coverage for certain life, health and annuity insurance policies.

                                    EXCLUSIONS AND LIMITATIONS

Several kinds of insurance policies are specifically excluded from coverage. There are also a number of
limitations to coverage. The following are not covered by ULHIGA:

      ·      Coverage through an HMO.

      ·      Coverage by insurance companies not licensed in Utah.

      ·      Self-funded and self-insured coverage provided by an employer that is only administered by an
             insurance company.

      ·      Policies protected by another state's Guaranty Association.

      ·      Policies where the insurance company does not guarantee the benefits.

      ·      Policies where the policyholder bears the risk under the policy.

      ·      Re-insurance contracts.

      ·     Annuity policies that are not issued to and owned by an individual, unless the annuity policy is
            issued to a pension benefit plan that is covered.

      ·     Policies issued to pension benefit plans protected by the Federal Pension Benefit Guaranty
            Corporation.

      ·     Policies issued to entities that are not members of the ULHIGA, including health plans, fraternal
            benefit societies, state pooling plans and mutual assessment companies.




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NOTICE FOR RESIDENTS OF UTAH

                                 LIMITS ON AMOUNT OF COVERAGE

Caps are placed on the amount ULHIGA will pay. These caps apply even if you are insured by more than one
policy issued by the insolvent company. The maximum ULHIGA will pay is the amount of your coverage or
$500,000 — whichever is lower. Other caps also apply:

       ·       $100,000 in net cash surrender values.

       ·       $500,000 in life insurance death benefits (including cash surrender values).

       ·       $500,000 in health insurance benefits.

       ·       $200,000 in annuity benefits — if the annuity is issued to and owned by an individual or the
               annuity is issued to a pension plan covering government employees.

       ·       $5,000,000 in annuity benefits to the contract holder of annuities issued to pension plans
               covered by the law. (Other limitations apply).

       ·       Interest rates on some policies may be adjusted downward.

                                            DISCLAIMER

       PLEASE READ CAREFULLY:
      ·    COVERAGE FROM ULHIGA MAY BE UNAVAILABLE UNDER THIS
POLICY. OR, IF AVAILABLE, IT MAY BE SUBJECT TO SUBSTANTIAL LIMITATIONS OR
EXCLUSIONS. THE DESCRIPTION OF COVERAGES CONTAINED IN THIS DOCUMENT
IS AN OVERVIEW. IT IS NOT A COMPLETE DESCRIPTION. YOU CANNOT RELY ON
THIS DOCUMENT AS A DESCRIPTION OF COVERAGE. FOR A COMPLETE
DESCRIPTION OF COVERAGE, CONSULT THE UTAH CODE, TITLE 31A, CHAPTER 28.
     ·    COVERAGE IS CONDITIONED ON CONTINUED RESIDENCY IN THE
STATE OF UTAH.

     ·    THE PROTECTION THAT MAY BE PROVIDED BY ULHIGA IS NOT A
SUBSTITUTE FOR CONSUMERS' CARE IN SELECTING AN INSURANCE COMPANY
THAT IS WELL-MANAGED AND FINANCIALLY STABLE.

     ·     INSURANCE COMPANIES AND INSURANCE AGENTS ARE REQUIRED BY
LAW TO GIVE YOU THIS NOTICE. THE LAW DOES, HOWEVER, PROHIBIT THEM FROM
USING THE EXISTENCE OF ULHIGA AS AN INDUCEMENT TO SELL YOU INSURANCE.
     ·    THE ADDRESS OF ULHIGA, AND THE INSURANCE DEPARTMENT ARE
PROVIDED BELOW.
                                     Utah Life and Health Insurance
                                         Guaranty Association
                                          955 E. Pioneer Rd.
                                          Draper, Utah 84114
                                       Utah Insurance Department
                                    State Office Building, Room 3110
                                       Salt Lake City, Utah 84114


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NOTICE FOR RESIDENTS OF VIRGINIA
Virginia residents please be advised of the following:

                    IMPORTANT INFORMATION REGARDING YOUR INSURANCE


               In the event you need to contact someone about this insurance for any reason please contact
               your agent. If no agent was involved in the sale of this insurance, or if you have additional
               questions you my contact the insurance company issuing this insurance at the following
               address and telephone number:

                           METROPOLITAN LIFE INSURANCE COMPANY
                                    1 MADISON AVENUE
                                NEW YORK, NEW YORK 10010
                     ATTN: CORPORATE CUSTOMER RELATIONS DEPARTMENT
                                       1-800-275-4638


               If you have been unable to contact or obtain satisfaction from the company or the agent, you
               may contact the Virginia State Corporation Commission’s Bureau of Insurance at:


                            VIRGINIA STATE CORPORATION COMMISSION
                                      BUREAU OF INSURANCE
                                    LIFE AND HEALTH DIVISION
                                          P.O. BOX 1157
                                       RICHMOND, VA 23219

                                    1-800-552-7945 – (within Virginia)
                                   1-804-371-9691 – (outside Virginia)


               Written correspondence is preferable so that a record of your inquiry is maintained. When
               contacting your agent, company or the Bureau of Insurance, have your policy number
               available.




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CIVIL UNION NOTICE FOR RESIDENTS OF VERMONT
Vermont law provides that the following definitions apply to your certificate:

·   Terms that mean or refer to a marital relationship, or that may be construed to mean or refer to a marital
    relationship, such as "marriage," "spouse," "husband," "wife," "dependent," "next of kin," "relative,"
    "beneficiary," "survivor," "immediate family" and any other such terms include the relationship created by
    a Civil Union established according to Vermont law.

·   Terms that mean or refer to the inception or dissolution of a marriage, such as "date of marriage,"
    "divorce decree," "termination of marriage" and any other such terms include the inception or dissolution
    of a Civil Union established according to Vermont law.

·   Terms that mean or refer to family relationships arising from a marriage, such as "family," "immediate
    family," "dependent," "children," "next of kin," "relative," "beneficiary," "survivor" and any other such terms
    include family relationships created by a Civil Union established according to Vermont law.

·   "Dependent" includes a spouse, a party to a Civil Union established according to Vermont law, and a child
    or children (natural, step-child, legally adopted or a minor or disabled child who is dependent on the
    insured for support and maintenance) who is born to or brought to a marriage or to a Civil Union
    established according to Vermont law.

·   "Child" includes a child (natural, stepchild, legally adopted or a minor or disabled child who is dependent
    on the insured for support and maintenance) who is born to or brought to a marriage or to a Civil Union
    established according to Vermont law.

·   “Civil Union” means a civil union established pursuant to Act 91 of the 2000 Vermont Legislative Session,
    entitled “Act Relating to Civil Unions”.

All references in this notice to Civil Unions are limited to Civil Unions in which the parties are residents of
Vermont.

If dependent insurance for a spouse and/or child is not provided under your certificate, such insurance is not
added by virtue of this notice.

For purposes of dependent insurance, any person who meets the definition of “dependent” as set forth in this
notice is required to meet all other applicable requirements in order to qualify for such insurance.

This notice does not limit any definitions or terms included in your certificate. It broadens definitions and
terms only to the extent required by Vermont law.

DISCLOSURE:

Vermont law grants parties to a Civil Union the same benefits, protections and responsibilities that flow from
marriage under state law. However, some or all of the benefits, protections and responsibilities related to life
and health insurance that are available to married persons under federal law may not be available to parties
to a Civil Union. For example, a federal law, the Employee Retirement Income Security Act of 1974 known as
“ERISA”, controls the employer/employee relationship with regard to determining eligibility for enrollment in
private employer benefit plans. Because of ERISA, Act 91 does not state requirements pertaining to a private
employer’s enrollment of a party to a Civil Union in an ERISA employee benefit plan. However, governmental
employers (not federal government) are required to provide life and health benefits to the dependents of a
party to a Civil Union if the public employer provides such benefits to dependents of married persons.
Federal law also controls group health insurance continuation rights under “COBRA” for employers with 20 or
more employees as well as the Internal Revenue Code treatment of insurance premiums. As a result, parties
to a Civil Union and their families may or may not have access to certain benefits under this notice and the
certificate to which it is attached that derive from federal law. You are advised to seek expert advice to
determine your rights under this notice and the certificate to which it is attached.



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NOTICE FOR RESIDENTS OF WISCONSIN
Wisconsin residents please be advised of the following:


                        KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS




PROBLEMS WITH YOUR INSURANCE? - If you are having problems with your insurance company or
agent, do not hesitate to contact the insurance company or agent to resolve your problem.



                                  Metropolitan Life Insurance Company
                                            Customer Service
                                         4100 Boy Scout Blvd.
                                            Tampa, FL 33607
                                             1-800-811-8319



You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a state agency which
enforces Wisconsin’s insurance laws, and file a complaint. You can contact the OFFICE OF THE
COMMISSIONER OF INSURANCE by contacting:



                                Office of the Commissioner of Insurance
                                         Complaints Department
                                              P.O. Box 7873
                                        Madison, WI 53707-7873
                       1-800-236-8517 outside of Madison or 266-0103 in Madison.




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NOTICE FOR RESIDENTS OF ALL STATES
FRAUD WARNING

If You have applied for insurance under a policy issued in one of the following states, or if You reside in one
of the following states, note the following applicable warning:


For Residents of New York - only applies to Accident and Health Insurance (AD&D)
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or statement of claim containing any materially false information, or conceals for the
purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,
which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated
value of the claim for each such violation.

For Residents of Florida
Any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of claim
or an application containing any false, incomplete or misleading information is guilty of a felony of the third
degree.

For Residents of Kansas and Massachusetts
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or a statement of claim containing any materially false information or conceals, for
the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance
act, and may subject such person to criminal and civil penalties.

For Residents of New Jersey
Any person who includes any false or misleading information on an application for an insurance policy or who
knowingly files a statement of claim containing any false or misleading information is subject to criminal and
civil penalties.

For Residents of Oklahoma
Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the
proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a
felony.

For Residents of Oregon
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance containing any materially false information or conceals, for the purpose of
misleading, information concerning any fact material thereto may be guilty of insurance fraud, and may be
subject to criminal and civil penalties.

For Residents of Virginia
Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, submits
an application or statement of claim containing a false or deceptive statement may have violated state law.

For Residents of All Other States
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or a statement of claim containing any materially false information or conceals, for
the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance
act, which is a crime and subjects such person to criminal and civil penalties.




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TABLE OF CONTENTS
The bottom left of each page of this certificate has a unique coding which describes the section of the
certificate that the page contains (fp = Certificate Face Page, sch = Schedule of Benefits).

Section                                                                                                                                                       Page
CERTIFICATE FACE PAGE ................................................................................................................................1
NOTICES .............................................................................................................................................................3
TABLE OF CONTENTS .....................................................................................................................................16
SCHEDULE OF BENEFITS ...............................................................................................................................18
DEFINITIONS.....................................................................................................................................................21
ELIGIBILITY PROVISIONS: INSURANCE FOR YOU.......................................................................................23
  Eligible Classes ..............................................................................................................................................23
  Date You Are Eligible For Insurance ..............................................................................................................23
  Enrollment Process ........................................................................................................................................23
  Date Your Insurance Takes Effect .................................................................................................................23
  Date Your Insurance Ends .............................................................................................................................25
CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT.....................................................................26
  For Family And Medical Leave .......................................................................................................................26
  At The Employer's Option...............................................................................................................................26
EVIDENCE OF INSURABILITY .........................................................................................................................27
LIFE INSURANCE: FOR YOU ...........................................................................................................................28
LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU .....................................................29
LIFE INSURANCE: CONVERSION OPTION FOR YOU...................................................................................31
LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS WHILE YOU ARE
TOTALLY DISABLED ........................................................................................................................................33
ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE .......................................................................36
  ADDITIONAL BENEFIT: AIR BAG USE.........................................................................................................38
  ADDITIONAL BENEFIT: SEAT BELT ............................................................................................................39
  ADDITIONAL BENEFIT: CHILD CARE..........................................................................................................40
  ADDITIONAL BENEFIT: COMMON CARRIER..............................................................................................41
FILING A CLAIM ................................................................................................................................................42
GENERAL PROVISIONS...................................................................................................................................43
  Assignment .....................................................................................................................................................43
  Beneficiary ......................................................................................................................................................43
  Entire Contract................................................................................................................................................43
  Incontestability: Statements Made By You.....................................................................................................44
  Mistatement of Age.........................................................................................................................................44
  Conformity With Law ......................................................................................................................................44
  Physical Exams ..............................................................................................................................................44
  Autopsy...........................................................................................................................................................44




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SCHEDULE OF BENEFITS
This schedule shows the benefits that are available under the Group Policy. You will only be insured for the
benefits:

·    for which You become and remain eligible, and
·    which You elect, if subject to election; and
·    which are in effect.

                                                                                                BENEFIT AMOUNT
BENEFIT                                                                                         AND HIGHLIGHTS

Life Insurance For You

Basic Life Insurance
                For All Active Full Time Employees..........................................    An amount equal to 1.5
                                                                                                times Your Basic Annual
                                                                                                Earnings, rounded to the
                                                                                                next higher $1,000.

                Maximum Life Benefit……………………………………………..                                         $50,000

                Non-Medical Issue Amount…………………..…………………..                                      $50,000

                Accelerated Benefit Option………………....……………………                                    Up to 50% of Your Basic
                                                                                                Life amount not to exceed
                                                                                                $250,000.

If You Are Age 65 Or Older

If You are over age 65 but under age 70 on Your effective date of insurance, the amount of Your Basic Life
                                                                        th
Insurance will be limited to 65% of such amount. On and after Your 70 birthday, the amount of such
insurance will be 50% of the amount of such insurance in effect on the effective date of Your insurance. If
You are age 70 or older on the effective date of Your insurance, the amounts of Your Basic Life Insurance on
Your effective date of insurance will be limited to 50% of such amount.

If You are under age 65 on the effective date of Your insurance, the amounts of Your Basic Life Insurance on
                                                                                  th
and after age 65 will be 65% of such insurance in effect on the day before Your 65 birthday. On and after
        th
Your 70 birthday, the amount of such insurance will be 50% of the amount of such insurance in effect on the
                   th
day before Your 65 birthday.

Accidental Death and Dismemberment Insurance (AD&D) for You

    Full Amount for AD&D
                For All Active Full Time Employees ..........................................   An amount equal to Your
                                                                                                Life Insurance

If You Are Age 65 Or Older

If You are over age 65 but under age 70 on Your effective date of insurance, the amount of Your Accidental
                                                                                                   th
Death and Dismemberment Insurance will be limited to 65% of such amount. On and after Your 70 birthday,
the amount of such insurance will be 50% of the amount of such insurance in effect on the effective date of
Your insurance. If You are age 70 or older on the effective date of Your insurance, the amounts of Your
Accidental Death and Dismemberment Insurance on Your effective date of insurance will be limited to 50% of
such amount.



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SCHEDULE OF BENEFITS
If You are under age 65 on the effective date of Your insurance, the amounts of Your Accidental Death and
Dismemberment Insurance on and after age 65 will be 65% of such insurance in effect on the day before
        th                               th
Your 65 birthday. On and after Your 70 birthday, the amount of such insurance will be 50% of the amount
                                                      th
of such insurance in effect on the day before Your 65 birthday.

                For All Active Full Time Employees

                Additional Benefits:

                Air Bag Benefit……..……………………………………...………                           Yes

                Seat Belt Benefit……..………………….………………...………                         Yes

                Child Care Benefit……..…..……………………………...………                        Yes

                Common Carrier Benefit……..…………………………………...                        Yes, an amount equal to
                                                                                  the Basic AD&D Full
                                                                                  Amount

Schedule of Covered Losses for Accidental Death and Dismemberment Insurance

               All amounts listed are stated as percentages of the Full Amount.

                Covered Losses

                Loss of life…………..……………………………………………..                             100%
                Loss of an arm permanently severed at or above the elbow…         75%
                Loss of a leg permanently severed at or above the knee…….         75%
                Loss of a hand permanently severed at or above the wrist but
                below the elbow……………………………………………………                               50%
                Loss of a foot permanently severed at or above the ankle but
                below the knee…………………………………………………….                               50%
                Loss of sight in one eye…………………………………………..                        50%

                       Loss of sight means permanent and uncorrectable loss of sight in the eye. Visual
                       acuity must be 20/200 or worse in the eye or the field of vision must be less than 20
                       degrees.

                Loss of any combination of hand, foot, or sight of one eye, as
                defined above……………………………………………………...                              100%
                Loss of the thumb and index finger of same hand….………….            25%

                       Loss of thumb and index finger of same hand means that the thumb and index
                       finger are permanently severed through or above the third joint from the tip of the
                       index finger and the second joint from the tip of the thumb.

                Loss of speech and loss of hearing……………………………..                   100%
                Loss of speech or loss of hearing…………………….…………                    50%

                       Loss of speech means the entire and irrecoverable loss of speech that continues for
                       6 consecutive months following the accidental injury.

                       Loss of hearing means the entire and irrecoverable loss of hearing in both ears that
                       continues for 6 consecutive months following the accidental injury.

                Paralysis of both arms and both legs……………………………                   100%
                Paralysis of both legs……………………………………………..                         50%
                Paralysis of the arm and leg on either side of the
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SCHEDULE OF BENEFITS
            body…………………………………………………………………                                   50%
            Paralysis of one arm or leg……………………………………….                     25%

                 Paralysis means loss of use of a limb, without severance. A Physician must
                 determine the paralysis to be permanent, complete and irreversible.

            Brain Damage……………………………………………………...                             100%

                 Brain Damage means permanent and irreversible physical damage to the brain
                 causing the complete inability to perform all the substantial and material functions
                 and activities normal to everyday life. Such damage must manifest itself within 30
                 days of the accidental injury, require a hospitalization of at least 5 days and persists
                 for 12 consecutive months after the date of the accidental injury.

            Coma……………………………………………………...……......                             1% monthly, beginning
                                                                                    th
                                                                            on the 7 day of the
                                                                            Coma and for the
                                                                            duration of the Coma to
                                                                            a maximum of 60
                                                                            months

                 Coma means a state of deep and total unconsciousness from which the comatose
                 person cannot be aroused. Such state must begin within 30 days of the accidental
                 injury and continue for 7 consecutive days.




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DEFINITIONS
As used in this certificate, the terms listed below will have the meanings set forth below. When defined terms
are used in this certificate, they will appear with initial capitalization. The plural use of a term defined in the
singular will share the same meaning.

Actively at Work or Active Work means that You are performing all of the usual and customary duties of
Your job on a Full-Time basis. This must be done at:

·   the Employer's place of business;
·   an alternate place approved by the Employer; or
·   a location to which the Employer's business requires You to travel.

You will be deemed to be Actively at Work during weekends or Employer-approved vacations, holidays or
business closures if You were Actively at Work on the last scheduled work day preceding such time off.

Basic Annual Earnings means Your gross annual rate of pay as determined by Your Employer, excluding
overtime and other extra pay.

Beneficiary means the person(s) to whom We will pay insurance as determined in accordance with the
General Provisions section.

Common Carrier means a government regulated entity that is in the business of transporting fare paying
passengers. The term does not include:

·   chartered or other privately arranged transportation;
·   taxis; or
·   limousines.

Contributory Insurance means insurance for which the Employer requires You to pay any part of the
premium.

Contributory Insurance includes: None.

Full-Time means Active Work on the Employer's regular work schedule for the class of employees to which
You belong. The work schedule must be at least 30 hours a week.

Noncontributory Insurance means insurance for which the Employer does not require You to pay any part
of the premium.

Physician means:

·   a person licensed to practice medicine in the jurisdiction where such services are performed; or

·   any other person whose services, according to applicable law, must be treated as Physician’s services for
    purposes of the Group Policy. Each such person must be licensed in the jurisdiction where the service is
    performed and must act within the scope of that license. He must also be certified and/or registered if
    required by such jurisdiction.

    The term does not include:

    ·   You, or
    ·   Your Spouse, or
    ·   any member of Your immediate family including Your and/or Your spouse’s parents; children (natural,
        step or adopted); siblings; grandparents; or grandchildren.

Proof means Written evidence satisfactory to Us that a person has satisfied the conditions and requirements
for any benefit described in this certificate. When a claim is made for any benefit described in this certificate,
Proof must establish:

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DEFINITIONS

·   the nature and extent of the loss or condition;
·   Our obligation to pay the claim; and
·   the claimant’s right to receive payment.

Proof must be provided at the claimant’s expense.

Sickness means illness, disease or pregnancy, including complications of pregnancy

Signed means any symbol or method executed or adopted by a person with the present intention to
authenticate a record, which is on or transmitted by paper or electronic media which is acceptable to Us and
consistent with applicable law.

Spouse means Your lawful Spouse.

The term does not include any person who:

·   is in the military of any country or subdivision of any country;
·   lives outside of the United States or Canada; or
·   is insured under the Group Policy as an employee.

We, Us and Our mean MetLife.

Written or Writing means a record which is on or transmitted by paper or electronic media which is
acceptable to Us and consistent with applicable law.

You and Your mean an employee who is insured under the Group Policy for the insurance described in this
certificate.




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU
ELIGIBLE CLASS(ES)
All Active Full Time Employees

DATE YOU ARE ELIGIBLE FOR INSURANCE

You may only become eligible for the insurance available for Your class as shown in the SCHEDULE OF
BENEFITS.

All Active Full Time Employees

Basic Life Insurance

You will be eligible for insurance on the later of:

1. January 01, 2005; and
2. the first day of the month coincident with or next following the date You complete the Waiting Period of 6
    months.

If You enter an eligible class after January 01, 2005, You will be eligible for insurance on the first day of the
month coincident with or next following the date You complete the Waiting Period of 6 months.

Basic Accidental Death and Dismemberment Insurance

You will be eligible for insurance on the later of:

1. January 01, 2005; and
2. the first day of the month coincident with or next following the date You complete the Waiting Period of 6
    months.

If You enter an eligible class after January 01, 2005, You will be eligible for insurance on the first day of the
month coincident with or next following the date You complete the Waiting Period of 6 months.

Waiting Period means the period of continuous membership in an eligible class that You must wait before
You become eligible for insurance. This period begins on the date You enter an eligible class and ends on
the date You complete the period(s) specified.

ENROLLMENT PROCESS

If You are eligible for insurance, You may enroll for such insurance by completing the required form. In
addition, You must give evidence of Your insurability satisfactory to Us at Your expense if You are required to
do so under the section entitled EVIDENCE OF INSURABILITY. If you enroll for Contributory Insurance, You
must also give the Employer written permission to deduct premiums from Your pay for such insurance. You
will be notified by the Employer how much You will be required to contribute.

DATE YOUR INSURANCE TAKES EFFECT

Rules for Noncontributory Insurance

When You complete the enrollment process for Noncontributory Insurance, such insurance will take effect as
follows:

·   if You are not required to give evidence of Your insurability, such insurance will take effect on the date
    You become eligible, provided You are Actively at Work on that date; or

·   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.



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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU
If You are not Actively at Work on the date the Noncontributory Insurance benefit would otherwise take effect,
the insurance will take effect on the day You resume Active Work.

Rules for Contributory Insurance

If You request Contributory Insurance before the date You become eligible for such insurance, such
insurance will take effect as follows:

·   if You are not required to give evidence of Your insurability, such insurance will take effect on the date
    You become eligible, provided You are Actively at Work on that date.

·   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.
    Accidental Death and Dismemberment Insurance does not require evidence of Your insurability but such
    insurance will not take effect until the day Your Life Insurance takes effect.

If You request Contributory Insurance within 31 days of the date You become eligible for such insurance,
such insurance will take effect as follows:

·   if You are not required to give evidence of Your insurability, such insurance will take effect on the later
    of:
    · the date You become eligible for such insurance; and
    · the date You enroll
    provided You are Actively at Work on that date.

·   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.

If You request Contributory Life Insurance more than 31 days after the date You become eligible for such
insurance, You must give evidence of Your insurability satisfactory to us. You must give such evidence at
Your expense. If We determine that You are insurable, such insurance will take effect on the date We state in
Writing, if You are Actively at Work on that date.

If You complete the enrollment process for Contributory Accidental Death and Dismemberment Insurance
more than 31 days after the date You become eligible for such insurance, Accidental Death and
Dismemberment Insurance does not require evidence of Your insurability, but will not take effect until the day
Your Life Insurance takes effect.

If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on
the day You resume Active Work.

See the DEFINITIONS section of this certificate for a complete list of Contributory Insurance benefits.

Increase in Insurance

An increase in insurance due to a change in class of employee, an increase in Your earnings, or a requested
increase in insurance will take effect as follows:

·   if You are required to give evidence of insurability for the entire increase and We approve Your evidence
    of insurability, the increase will take effect on the date We state in Writing. If We do not approve Your
    evidence of insurability, or You do not submit evidence of insurability, the increase in insurance will not
    take effect.

·   if You are required to give evidence of insurability for a portion of the increase:

    ·   the portion of the increase that is not subject to evidence of insurability will take effect on the first day
        of the month coincident with or next following the date of Your request or the date of the increase in Your
        earnings.
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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU

    ·   if We approve Your evidence of insurability, the portion of the increase that is subject to evidence of
        insurability will take effect on the date We state in Writing. If We do not approve Your evidence of
        insurability or You do not submit evidence of insurability, the increase in insurance will not take effect.

·   if You are not required to give evidence of insurability, the increase will take effect on the first day of the
    month coincident with or next following the date of Your request or the date of the increase in Your
    earnings.

You must be Actively at Work on that date. If You are not Actively at Work on the date the increase would
otherwise take effect, the increase will take effect on the day You resume Active Work.

Decrease in Insurance

A decrease in insurance due to a change in class of employee or a decrease in Your earnings will take effect
on the first day of the month coincident with or next following the date of change.

If You make a Written application to decrease Your insurance, that decrease will take effect as of the date of
Your application.

DATE YOUR INSURANCE ENDS

Your insurance will end on the earliest of:

1. the date the Group Policy ends;

2. the date insurance ends for Your class;

3. the end of the period for which the last premium has been paid for You; or

4. for Basic Life Insurance, the last day of the month in which Your employment ends; Your employment will
    end if You cease to be Actively at Work in any eligible class, except as stated in the section entitled
    CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT; or

5. for Basic Life Insurance, the date You retire in accordance with the Employer’s retirement plan.

6. for Basic Accidental Death and Dismemberment Insurance, the last day of the month in which Your
    employment ends; Your employment will end if You cease to be Actively at Work in any eligible class,
    except as stated in the section entitled CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT;
    or

7. for Basic Accidental Death and Dismemberment Insurance, the date You retire in accordance with the
    Employer’s retirement plan.

Please refer to the section entitled LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE
INSURANCE ENDS WHILE YOU ARE TOTALLY DISABLED for information concerning continuation of Your
Life Insurance if insurance ends while You are Totally Disabled. Please refer to the section entitled LIFE
INSURANCE: CONVERSION OPTION FOR YOU for information concerning the option to convert to an
individual policy of life insurance if Your Life Insurance ends.

Please refer to the section entitled CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT for
information concerning Continuation For Family and Medical Leave or Continuation of the Insurance at the
Employer’s Option.




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CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT


FOR FAMILY AND MEDICAL LEAVE

Certain leaves of absence may qualify under the Family and Medical Leave Act of 1993 (FMLA) for
continuation of insurance. Please contact the Employer for information regarding the FMLA.

AT THE EMPLOYER’S OPTION

The Employer has elected to continue insurance by paying premiums for employees who cease Active Work
in an eligible class for any of the reasons specified below.

Insurance will continue for the following periods:

1. for the period You cease Active Work in an eligible class due to injury or Sickness, up to 9 months;

2. for the period You cease Active Work in an eligible class due to part-time work, layoff or strike, up to 2
    months;

3. for the period You cease Active Work in an eligible class due to any other Employer approved leave of
    absence, up to 2 months.

4. for the period You cease Active Work in an eligible class due to any Employer approved leave of absence
    because of a call-up to active military service, up to 24 months.

At the end of any of the continuation periods listed above, Your insurance will be affected as follows:

·   if You resume Active Work in an eligible class at this time, You will continue to be insured under the
    Group Policy;

·   if You do not resume Active Work in an eligible class at this time, Your employment will be considered to
    end and Your insurance will end in accordance with the DATE YOUR INSURANCE ENDS subsection of
    the section entitled ELIGIBILITY PROVISIONS: INSURANCE FOR YOU.

In addition to the Continuation of Insurance options described above, You may have the right to convert to a
policy of individual life insurance. We urge You to read the section entitled LIFE INSURANCE: CONVERSION
OPTION FOR YOU.




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coi-eport                                                                                                       26
EVIDENCE OF INSURABILITY
We require evidence of insurability satisfactory to Us as follows:

1. In the case of transferred business, if You did not elect coverage under the prior plan for which You were
   eligible.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, You will not be covered for Life Insurance.

The evidence of insurability is to be given at Your expense.




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LIFE INSURANCE: FOR YOU
If You die, Proof of Your death must be sent to Us. When we receive such Proof with the claim, We will review
the claim and if We approve it, will pay the Beneficiary the Life Insurance in effect on the date of Your death.

PAYMENT OPTIONS

We will pay the Life Insurance in one sum. Other modes of payment may be available upon request. For
details, call Our toll free number shown on the Certificate Face Page.




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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU
For purposes of this section, the term “ABO Eligible Life Insurance” refers to each of Your Life Insurance
benefits for which the Accelerated Benefit Option is shown as available in the Schedule of Benefits.

If You become Terminally Ill, You or Your legal representative have the option to request Us to pay ABO
Eligible Life Insurance before Your death. This is called an accelerated benefit. The request must be made
while ABO Eligible Life Insurance is in effect.

Terminally Ill or Terminal Illness means that due to injury or sickness, You are expected to die within 6
months.

Requirements For Payment of an Accelerated Benefit

Subject to the conditions and requirements of this section, We will pay an accelerated benefit to You or Your
legal representative if:

·   the amount of each ABO Eligible Life Insurance benefit to be accelerated equals or exceeds $20,000; and
·   the ABO Eligible Life Insurance to be accelerated has not been assigned; and
·   We have received Proof that You are Terminally Ill.

We will only pay an accelerated benefit for each ABO Eligible Life Insurance benefit once.

Proof of Your Terminal Illness

We will require the following Proof of Your Terminal Illness:

·   a completed accelerated benefit claim form;
·   a signed Physician’s certification that You are Terminally Ill; and
·   an examination by a Physician of Our choice, at Our expense, if We request it.

You or Your legal representative should contact the Employer to obtain a claim form and information
regarding the accelerated benefit.

Upon Our receipt of Your request to accelerate benefits, We will send You a letter with information about the
accelerated benefit payment You requested. Our letter will describe the amount of the accelerated benefits
We will pay and the amount of Life Insurance remaining after the accelerated benefit is paid.

Accelerated Benefit Amount

We will pay an accelerated benefit up to the percentage shown in the SCHEDULE OF BENEFITS for each
ABO Eligible Life Insurance benefit in effect for You, subject to the following:

    Maximum accelerated benefit amount. The maximum amount We will pay for each ABO Eligible Life
    Insurance benefit is shown in the SCHEDULE OF BENEFITS.

    Scheduled reduction of an ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance
    benefit is scheduled to reduce within the 6 month period after the date You or Your legal representative
    request an accelerated benefit, We will calculate the accelerated benefit using the amount of such ABO
    Eligible Life Insurance that will be in effect immediately after the reduction(s) scheduled for such period.

    Scheduled end of ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance benefit is
    scheduled to end within 6 months after the date You or Your legal representative request an accelerated
    benefit, We will not pay an accelerated benefit for such ABO Eligible Life Insurance benefit.

    Previous conversion of an ABO Eligible Life Insurance Benefit. We will not pay an accelerated
    benefit for any amount of ABO Eligible Life Insurance which You previously converted under the section
    entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU.



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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU
We will pay the accelerated benefit in one sum unless You or Your legal representative select another
payment mode.

Effect of Payment of an Accelerated Benefit

    On premium for Your Life Insurance. After We pay the accelerated benefit, any premium You are
    required to pay will be based upon the amount of Your Life Insurance remaining after the accelerated
    benefit is paid.

    On Your Life Insurance at Your death. The amount of Life Insurance that We will pay at Your death will
    be decreased by:

    ·   the amount of the accelerated benefit paid by Us.

    On Your Life Insurance at conversion. The amount to which You are entitled to convert under the
    section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU, will be decreased by:

    ·   the amount of the accelerated benefit paid by Us.

    On Your Accidental Death and Dismemberment Insurance. Payment of an accelerated benefit will
    not affect Your Accidental Death and Dismemberment Insurance.

Date Your Option to Accelerate Benefits Ends

The accelerated benefit option will end on the earliest of:

·   the date ABO Eligible Life Insurance ends;
·   the date You or Your legal representative assign all ABO Eligible Life Insurance; or
·   the date You or Your legal representative have accelerated all ABO Eligible Life Insurance benefits.




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LIFE INSURANCE: CONVERSION OPTION FOR YOU
If Your Life Insurance ends for any of the reasons stated below, You have the option to buy an individual
policy of life insurance (“new policy”) from Us during the Application Period in accordance with the conditions
and requirements of this section. This is referred to as the “option to convert”. Evidence of Your insurability
will not be required.

When You Will Have the Option to Convert

You will have the option to convert when:

·   Your Life Insurance ends because:

    ·   You cease to be in an eligible class; or
    ·   Your employment ends; or
    ·   the Group Policy ends provided You have been insured for Life Insurance for at least 5 years; or
    ·   the Group Policy is amended to end Life Insurance for an eligible class of which You are a member,
        provided You have been insured for Life Insurance for at least 5 years.

A reduction in the amount of Your Life Insurance as a result of the payment of an accelerated benefit will not
give rise to a right to convert under this section.

Application Period

If You opt to convert Your Life Insurance for any of the reasons stated above, We must receive a completed
conversion application form from You within the Application Period described below.

If You are given Written notice of the option to convert within 15 days before or after the date Your Life
Insurance ends, the Application Period begins on the date that such Life Insurance ends and expires 31 days
after such date.

If You are given Written notice of the option to convert more than 15 days after the date Your Life Insurance
ends, the Application Period begins on the date such Life Insurance ends and expires 15 days from the date
of such notice. In no event will the Application Period exceed 91 days from the date Your Life Insurance ends.

Option Conditions

The option to convert is subject to these conditions:

1. Our receipt within the Application Period of:

    ·   Your Written application for the new policy; and
    ·   the premium due for such new policy;

2. The premium rates for the new policy will be based on:

    ·   Our rates then in use;
    ·   the form and amount of insurance;
    ·   Your class of risk; and
    ·   Your attained age when Your Life Insurance ends;

3. the new policy may be on any form then customarily offered by Us excluding term insurance;

4. the new policy will be issued without an accidental death and dismemberment benefit, a continuation
    benefit, an accelerated benefit option, a waiver of premium benefit or any other rider or additional benefit;
    and
                                            nd
5. the new policy will take effect on the 32 day after the date Your Life Insurance ends; this will be the case
    regardless of the duration of the Application Period.


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LIFE INSURANCE: CONVERSION OPTION FOR YOU
Maximum Amount of the New Policy

If Your Life Insurance ends due to the end of the Group Policy or the amendment of the Group Policy to end
Life Insurance for an eligible class of which You are a member, the maximum amount of insurance that You
may elect for the new policy is the lesser of:

·   the amount of Your Life Insurance that ends under the Group Policy less the amount of life insurance for
    which You become eligible under any group policy within 31 days after the date insurance ends under the
    Group Policy; or

·   $2,000

If Your Life Insurance ends for any other reason, the maximum amount of insurance that You may elect for
the new policy is the amount of Your Life Insurance that ends under the Group Policy.

If You Die Within 31 Days After Your Life Insurance Ends

If You die within 31 days after Your Life Insurance ends, Proof of Your death must be sent to Us. When We
receive such Proof with the claim, We will review the claim and if We approve it will pay the Beneficiary the
amount of Life Insurance You were entitled to convert.

Effect of Previous Conversion

If You obtained a new policy through this conversion option and Your Life Insurance is later continued under
the section entitled LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED, We will only pay Your Life Insurance under such section if the new
policy is returned to Us. If the new policy is returned to us, We will refund to Your estate the premium paid for
such policy without interest, less any debt incurred under such policy. If the new policy is not returned to Us,
We will only pay the life insurance in effect under such new policy.

We will not pay insurance under both the Group Policy and the new policy.




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LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED

For All Active Full Time Employees:

If Your Life Insurance ends while You are Totally Disabled, You may at a later date become eligible to
continue certain Life Insurance under this section during the period You are Totally Disabled. Premium
payment will not be required. We will determine Your eligibility for this continuation after We receive Proof
that You have satisfied the conditions and requirements of this section.

For the purpose of this section, the Life Insurance that You may become eligible to continue (“Continuation
Eligible Life Insurance”) refers to Your:

·   Life Insurance;

to the extent that such insurance was in effect for You on the date Your Continuation Eligible Life Insurance
ended.

Continuation Eligible Life Insurance does not include Life Insurance amounts accelerated under the section
entitled LIFE INSURANCE: ACCELERATED BENEFIT OPTION FOR YOU.

Total Disability must begin before You attain age 60 and while You are insured for Continuation Eligible Life
Insurance.

Total Disability or Totally Disabled means, for purposes of this section, that due to an injury or sickness:

·   You are unable to perform the material duties of Your regular job; and
·   You are unable to perform any other job for which You are fit by education, training or experience.

TOTAL DISABILITY AND PROOF REQUIREMENTS

You will become eligible for this continuation if Your Total Disability continues without interruption from the
date You become Totally Disabled through the end of the Continuation Waiting Period.

Continuation Waiting Period means the period which begins on the date You become Totally Disabled and
which expires 9 consecutive months after such date.

Please refer to the Important Notice that appears at the end of this section for information on insurance during
the Continuation Waiting Period.

If You were disabled when Your insurance ended, You should contact Us as soon as reasonably possible to
advise Us that You were disabled on the date such insurance ended. After the Continuation Waiting Period
expires, You must send Us Proof that You were Totally Disabled when Your Continuation Eligible Life
Insurance ended and that such Total Disability has continued without interruption through the expiration of the
Continuation Waiting Period. You must do this within 3 months following the expiration of the Continuation
Waiting Period.

As part of such Proof, We may choose a Physician to examine You to verify that You are eligible for this
continuation. If We do so, We will pay for such exam. After We receive and review Your Proof, We will
determine if You are approved for this continuation. We will send You Written notice advising whether You
are approved.

To verify that You continue to be Totally Disabled without interruption after Our initial approval, We may
periodically request that You send Us Proof that You continue to be Totally Disabled. We will not ask for such
Proof more than once each year.




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LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED
DATE CONTINUATION ENDS

The Continuation Eligible Life Insurance continued under this section may be reduced on account of Your age
or as otherwise described in this certificate and will end at the earliest of:

1. the date You die;
2. the date Your Total Disability ends;
3. the date You do not give Us Proof of Totally Disability, as required;
4. the date You refuse to be examined by Our Physician, as required; or
5. the date You attain age 65.

OPTION TO CONVERT YOUR CONTINUATION ELIGIBLE LIFE INSURANCE

When a continuation under this section ends, You may buy an individual policy of life insurance from Us. The
details of this option are described in the section entitled LIFE INSURANCE: CONVERSION OPTION FOR
YOU. For the purpose of that section, the end of this continuation will be considered the end of Your
employment. You may not use the conversion option described in such section if:

·   before the end of the Application Period for conversion You return to Active Work in an eligible class and
    become insured under the Group Policy; or

·   You have already converted all of Your Continuation Eligible Life Insurance under such section.

IF YOU DIE DURING CONTINUATION

If You die while Your Continuation Eligible Life Insurance is being continued under this section, Proof of Your
death must be sent to Us within one year of Your death. Proof includes supporting documentation that Total
Disability continued with no interruption from the date Your Life Insurance ended until the date of Your death.

When We receive such Proof with the claim, We will review the claim and if We approve it, will pay the
Beneficiary the Continuation Eligible Life Insurance continued under this section.

Effect of Previous Conversion

If You converted Your Continuation Eligible Life Insurance to an individual policy, We will only pay the
Continuation Eligible Life Insurance under this section if such individual policy is returned to Us. If it is
returned to Us, We will refund to Your estate the premiums paid for such policy without interest, less any debt
incurred under such policy.

If You do not return such individual policy to Us, We will pay the life insurance in effect under the individual
policy.

We will not pay insurance under both the Group Policy and the individual policy.

IMPORTANT NOTICE

On the date Your insurance ends, We will not know whether You will be able to satisfy the Total Disability and
Proof Requirements specified above. For this reason, We urge You to consider taking the following steps:

Step 1. When Your Continuation Eligible Life Insurance ends, ask the Employer if such insurance will be
continued with premium payment. If the answer is yes, ask if such continuation will be for at least 12 months.
If the answer is yes, file a claim for continuation of insurance under this section at the end of the Continuation
Waiting Period.



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LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED
If the Employer will not continue Your Continuation Eligible Life Insurance as described in Step 1, proceed to
Step 2.

Step 2. Read the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU. You have the
option to convert Your Continuation Eligible Life Insurance to an individual policy of insurance with premium
payment.

If the Employer will not continue Your Continuation Eligible Life Insurance as described in Step 1 and You do
not convert to an individual policy as described in Step 2:

·   You will not be insured should You die during the Continuation Waiting Period; and

·   You may not be eligible to convert Your Continuation Eligible Life Insurance at the end of the
    Continuation Waiting Period if We do not approve You for the continuation under this section.




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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE

Applicable to Basic Accidental Death and Dismemberment Insurance

If You sustain an accidental injury that is the Direct and Sole Cause of a Covered Loss described in the
SCHEDULE OF BENEFITS, Proof of the accidental injury and Covered Loss must be sent to Us. When We
receive such Proof We will review the claim and, if We approve it, We will pay the insurance in effect on the
date of the injury.

Direct and Sole Cause means that the Covered Loss occurs within 3 months of the date of the accidental
injury and was a direct result of the accidental injury, independent of other causes.

We will deem a loss to be the direct result of an accidental injury if it results from unavoidable exposure to the
elements and such exposure was a direct result of an accident.

EXCLUSIONS

We will not pay benefits under this section for any loss caused or contributed to by:

1. physical or mental illness or infirmity, or the diagnosis or treatment of such illness or infirmity;

2. infection, other than infection occurring in an external accidental wound;

3. suicide or attempted suicide;

4. intentionally self-inflicted injury;

5. committing or attempting to commit a felony;

6. the voluntary intake or use by any means of:

    ·    any drug, medication or sedative, unless it is:
         · taken or used as prescribed by a Physician, or
         · an “over the counter” drug, medication or sedative taken as directed; or

    ·    alcohol in combination with any drug, medication, or sedative; or

    ·    poison, gas, or fumes; or

7. war, whether declared or undeclared; or act of war, insurrection, rebellion, or riot.

Exclusion for Intoxication

We will not pay benefits under this section for any loss if the injured party is intoxicated at the time of the
incident and is the operator of a vehicle or other device involved in the incident.

Intoxicated means that the injured person’s blood alcohol level met or exceeded the level that creates a legal
presumption of intoxication under the laws of the jurisdiction in which the incident occurred.

BENEFIT PAYMENT

For loss of Your life, We will pay benefits to Your Beneficiary.

For any other loss sustained by You We will pay benefits to You.

If You sustain more than one Covered Loss due to an accidental injury, the amount We will pay, on behalf of
any such injured person, will not exceed the Full Amount.

We will pay benefits in one sum. Other modes of payment may be available upon request. For details call
Our toll free number on the Certificate Face Page.
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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE

APPLICABILITY OF PROVISIONS

The provisions set forth in this ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE section apply to
all Accidental Death and Dismemberment Insurance – Additional Benefit sections included in this certificate
except as may otherwise be provided in such Additional Benefit sections.




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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE -

ADDITIONAL BENEFIT: AIR BAG USE

If You die as a result of an accidental injury, We will pay this additional benefit if:

1. We pay a benefit for loss of life under the ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
   section;

2. this benefit is in effect on the date of the injury; and

3. We receive Proof that the deceased person:

    ·   was in an accident while driving or riding as a passenger in a Passenger Car equipped with an Air
        Bag(s);

    ·   was riding in a seat protected by an Air Bag;

    ·   was wearing a Seat Belt which was properly fastened at the time of the accident; and

    ·   died as a result of injuries sustained in the accident.

A police officer investigating the accident must certify that the Seat Belt was properly fastened and that the
Passenger Car in which the deceased was traveling was equipped with Air Bags. A copy of such certification
must be submitted to Us with the claim for benefits.

Passenger Car means any validly registered four-wheel private passenger car. It does not include any
commercially licensed car or any private car being used for commercial purposes.

Seat Belt means any restraint device that:

·   meets published United States government safety standards;
·   is properly installed by the car manufacturer; and
·   is not altered after the installation.

Air Bag means an inflatable restraint device that:

·   meets published United States government safety standards;
·   is properly installed by the car manufacturer; and
·   is not altered after the installation.

BENEFIT AMOUNT

The Air Bag Use Benefit is an additional benefit equal to 5% of the Full Amount shown in the SCHEDULE OF
BENEFITS. However, the amount We will pay for this benefit will not be less than $100 or more than $10,000.

BENEFIT PAYMENT

For loss of Your life We will pay benefits to Your Beneficiary.




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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE -

ADDITIONAL BENEFIT: SEAT BELT USE

If You die as a result of an accidental injury, We will pay this additional Seat Belt Use benefit if:

1. We pay a benefit for loss of life under the ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
   section;

2. this benefit is in effect on the date of the injury; and

3. We receive Proof that the deceased person:

    ·   was in an accident while driving or riding as a passenger in a Passenger Car;
    ·   was wearing a Seat Belt which was properly fastened at the time of the accident; and
    ·   died as a result of injuries sustained in the accident.

A police officer investigating the accident must certify that the Seat Belt was properly fastened. A copy of
such certification must be submitted to Us with the claim for benefits.

Passenger Car means any validly registered four-wheel private passenger car. It does not include any
commercially licensed car or any private car being used for commercial purposes.

Seat Belt means any restraint device that:

·   meets published United States Government safety standards;
·   is properly installed by the car manufacturer; and
·   is not altered after the installation.

BENEFIT AMOUNT

The Seat Belt Use benefit is an additional benefit equal to 10% of the Full Amount shown in the SCHEDULE
OF BENEFITS. However, the amount We will pay for this benefit will not be less than $1,000 or more than
$10,000.

BENEFIT PAYMENT

For loss of Your life, We will pay benefits to Your Beneficiary.




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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE -

ADDITIONAL BENEFIT: CHILD CARE
If You die as a result of an accidental injury, We will pay this additional Child Care benefit if:

1. We pay a benefit for loss of life under the ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
   section;

2. This benefit is in effect on the date of the injury; and

3. We receive Proof that:

    ·   on the date of Your death a Child was enrolled in a Child Care Center; or

    ·   within 12 months after the date of Your death a Child was enrolled in a Child Care Center.

Child Care Center means a facility that:

·   is operated and licensed according to the law of the jurisdiction where it is located; and

·   provides care and supervision for children in a group setting on a regularly scheduled and daily basis.

BENEFIT AMOUNT

For each Child who qualifies for this benefit, We will pay an amount equal to the Child Care Center charges
incurred for a period of up to 4 consecutive years, not to exceed:

·   an annual maximum of $5,000; and

·   an overall maximum of 10% of the Full Amount shown in the SCHEDULE OF BENEFITS.

We will not pay for Child Care Center charges incurred after the date a Child attains age 12.

We may require Proof of the Child’s continued enrollment in a Child Care Center during the period for which a
benefit is claimed.

BENEFIT PAYMENT

We will pay this benefit quarterly when We receive Proof that Child Care Center charges have been paid.
Payment will be made to the person who pays such charges on behalf of the Child.

If this benefit is in effect on the date You die and there is no Child who could qualify for it, We will pay
$1,000 to Your Beneficiary in one sum.




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ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE -

ADDITIONAL BENEFIT: COMMON CARRIER

If You die as a result of an accidental injury, We will pay this additional benefit if:

1. We pay a benefit for loss of life under the ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE
   section;

2. this benefit is in effect on the date of the injury; and

3. We receive Proof that the injury resulting in the deceased’s death occurred while traveling in a Common
   Carrier.

BENEFIT AMOUNT

The Common Carrier Benefit is shown in the SCHEDULE OF BENEFITS.

BENEFIT PAYMENT

For loss of Your life We will pay benefits to Your Beneficiary.




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FILING A CLAIM
The Employer should have a supply of claim forms. Obtain a claim form from the Employer and fill it out
carefully. Return the completed claim form with the required Proof to the Employer. The Employer will certify
Your insurance under the Group Policy and send the certified claim form and Proof to Us.

When we receive the claim form and Proof We will review the claim and, if We approve it, We will pay benefits
subject to the terms and provisions of this certificate and the Group Policy.

CLAIMS FOR LIFE INSURANCE BENEFITS

    When a claimant files a claim for Life Insurance benefits, Proof should be sent to Us as soon as is
    reasonably possible after the death of an insured. If we approve the claim, we will pay benefits subject to
    the terms and provisions of this certificate and the Group Policy.

CLAIMS FOR OTHER INSURANCE BENEFITS

    When a claimant files a claim for any other insurance benefits described in this certificate, both the
    notice of claim and the required Proof should be sent to us within 90 days of the date of a loss.

    Notice of claim and Proof may also be given to Us by following the steps set forth below:

        Step 1
        A claimant may give Us notice by calling Us at the toll free number shown in the Certificate Face
        Page within 20 days of the date of a loss.

        Step 2
        We will send a claim form to the claimant and explain how to complete it. The claimant should receive
        the claim form within 15 days of giving Us notice of claim.

        Step 3
        When the claimant receives the claim form the claimant should fill it out as instructed and return it
        with the required Proof described in the claim form. If the claimant does not receive a claim form
        within 15 days after giving Us notice of claim, Proof may be sent using any form sufficient to provide
        Us with the required Proof.

        Step 4
        The claimant must give Us Proof not later than 90 days after the date of the loss.

If notice of claim or Proof is not given within the time limits described in this section, the delay will not cause a
claim to be denied or reduced if such notice and Proof are given as soon as is reasonably possible.

Time Limit on Legal Actions. A legal action on a claim may only be brought against Us during a certain
period. This period begins 60 days after the date Proof is filed and ends 5 years after the date such Proof is
required.




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GENERAL PROVISIONS
Assignment

You may assign Your Life Insurance rights and benefits under the Group Policy as a gift or as a viatical
assignment. You may also assign Your Accidental Death and Dismemberment Insurance rights and benefits
under the Group Policy as a gift.

We will recognize the assignee(s) under such assignment as owner(s) of Your right, title and interest in the
Group Policy if:

1. a Written form satisfactory to Us, affirming this assignment, has been completed;
2. the Written form has been Signed by You and the assignee(s);
3. the Employer acknowledges that the Life Insurance and Accidental Death and Dismemberment Insurance
    being assigned is in force on the life of the assignor; and
4. the Written form is delivered to Us for recording.

Viatical assignments may only be made after Your Life Insurance has been in effect under this certificate for 2
years. However, you may make a viatical assignment before the end of the 2 year period if you are Terminally
Ill.

Terminally Ill means that You are expected to die within 6 months. As Proof of Your Terminal Illness You or
Your legal representative must send Us a signed Physician’s certification that You are Terminally Ill. We may
also request an exam by a Physician of Our choice, at Our expense.

Beneficiary

You may designate a Beneficiary in Your application or enrollment form. You may change Your Beneficiary at
any time. To do so, You must send a Signed and dated, Written request to the Employer using a form
satisfactory to Us. Your Written request to change the Beneficiary must be sent to the Employer within 30
days of the date You Sign such request.

You do not need the Beneficiary’s consent to make a change. When We receive the change, it will take effect
as of the date You Signed it. The change will not apply to any payment made in good faith by Us before the
change request was recorded.

If two or more Beneficiaries are designated and their shares are not specified, they will share the insurance
equally.

If there is no Beneficiary designated or no surviving designated Beneficiary at Your death, We may determine
the Beneficiary to be one or more of the following who survive You:

1.   Your Spouse;
2.   Your Child(ren);
3.   Your parent(s); or
4.   Your siblings(s)

Instead of making payment to any of the above, we may pay Your estate. Any payment made in good faith
will discharge our liability to the extent of such payment.

If a Beneficiary or payee is a minor or incompetent to receive payment, We will pay that person’s guardian.

Entire Contract

Your insurance is provided under a contract of group insurance with the Employer. The entire contract with
the Employer is made up of the following:

1. the Group Policy and its Exhibits, which include the certificate(s);
2. the Employer's application; and
3. any amendments and/or endorsements to the Group Policy.

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GENERAL PROVISIONS
Incontestability: Statements Made by You

Any statement made by You will be considered a representation and not a warranty. We will not use such
statement to avoid insurance, reduce benefits or defend a claim unless the following requirements are met:

1. the statement is in a Written application or enrollment form;
2. You have Signed the application or enrollment form; and
3. a copy of the application or enrollment form has been given to You or Your Beneficiary.

We will not use Your statements which relate to insurability to contest life insurance after it has been in force
for 2 years during Your life, unless the statement is fraudulent. In addition, We will not use such statements
to contest an increase or benefit addition to such insurance after the increase or benefit has been in force for
2 years during Your life, unless the statement is fraudulent.

Misstatement of Age

If Your age is misstated, the correct age will be used to determine if insurance is in effect and, as appropriate,
We will adjust the benefits and/or premiums.

Conformity with Law

If the terms and provisions of this certificate do not conform to any applicable law, this certificate shall be
interpreted to so conform.

Physical Exams

If a claim is submitted for insurance benefits other than Life Insurance benefits, We have the right to ask the
insured to be examined by a Physician(s) of Our choice as often as is reasonably necessary to process the
claim. We will pay the cost of such exam.

Autopsy

We have the right to make a reasonable request for an autopsy where permitted by law. Any such request
will set forth the reasons We are requesting the autopsy.




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                          Privacy Notice To Our Customers

THIS PRIVACY NOTICE IS GIVEN TO YOU ON BEHALF OF METROPOLITAN LIFE
INSURANCE COMPANY.

TO PLAN SPONSORS AND GROUP INSURANCE CERTIFICATE
HOLDERS: This notice explains how we treat information we receive about
anyone who applies for or obtains our products and services under employee
benefit plans that we insure or group insurance contracts that we issue.
Please note that we refer to these individuals in this notice by using the term
"you", as if this notice were being addressed to these individuals.
Why We Need to Know About You: We need to know about you so that we can provide you with
the insurance and other products and services you’ve asked for. We may also need information from
you and others to help us verify your identity in order to prevent money laundering and terrorism.

What we need to know about you includes your address, age and other basic information. But we
may have to know more about you, including your finances, employment, health, hobbies or
business you conduct with us, with other MetLife companies (our “affiliates”) or with other
companies.

How We Learn about You: What we know about you we get mostly from you. But we may also
have to find out more about you from other sources in order to make sure that what we know about
you is correct and complete. Those sources may include your adult relatives, employers, consumer
reporting agencies, health care providers and others. Some of our sources may give us reports, and
they may disclose what they know about you to others.

How We Protect What We Know About You: We treat what we know about you confidentially.
Our employees are told to take care in handling your information. They may get information about
you only when there is a good reason to do so. We take steps to make our computer data bases
secure and to safeguard the information we have about you.

How We Use and Disclose What We Know About You: We may use anything we know about you
to help us serve you better. We may use it, and disclose it to our affiliates and others, for any
purpose allowed by law. For instance, we may use your information, and disclose it to others, in
order to:

· Help us evaluate your request for a MetLife          · Help us run our business
  product or service
                                                       · Process data for us
· Help us process claims and other transactions
                                                       · Perform research for us
· Confirm or correct what we know about you
                                                       · Audit our business
· Help us prevent fraud, money laundering,
  terrorism and other crimes by verifying what we      · Help us comply with the law
  know about you




                                 Total Document Page 64 of 224
Other reasons we may disclose what we know about you include:

·   Doing what a court or government agency requires us to do; for example, complying with a
    search warrant or subpoena
·   Telling another company what we know about you, if we are or may be selling all or any part of
    our business or merging with another company
·   Telling a group customer about its members’ claims or cooperating in a group customer’s audit of
    our service
·   Giving information to the government so that it can decide whether you may get benefits that it
    will have to pay for
·   Telling your health care provider about a medical problem that you have but may not be aware of
·   Giving your information to a peer review organization if you have health insurance with us
·   Giving your information to someone who has a legal interest in your insurance, such as someone
    who lent you money and holds a lien on your insurance or benefits

Generally, we will disclose only the information we consider reasonably necessary to disclose.

We may use what we know about you in order to offer you our other products and services. We
may disclose this information (other than consumer reports and health information) to our affiliates
so that they can offer their products and services, or ours, to you. By law, we don’t have to let you
prevent these disclosures. Our affiliates include life, car and home insurers, securities firms,
broker-dealers, a bank, a legal plans company and financial advisors. In the future, we may have
affiliates in other businesses.

We may also provide information to others outside of the MetLife companies, such as marketing
companies, to help us offer our products and services to you. If we have joint marketing
agreements with other financial services companies, we may give them information about you so
that they can offer their products and services to you; however, we cannot do this if the state law
that applies to you does not allow it. Except for joint marketing arrangements, we do not make any
other disclosures of your information to other companies who want to sell their products or services
to you. For example, we will not sell your name to a catalog company. And we will not disclose
any consumer report or health information to other companies so that they can offer their products
and services, or ours, to you.

How You Can See and Correct Your Information: Generally, we will let you review what we know
about you if you ask us in writing. Medical information will generally be disclosed through the
licensed physician you choose or as otherwise required by law. (Because of its legal sensitivity, we
will not show you anything that we learned in connection with a claim or lawsuit.) If you tell us that
what we know about you is incorrect, we will review it. If we agree with you, we will correct our
records. If we do not agree with you, you may tell us in writing, and we will include your statement
when we give your information to anyone outside MetLife.

How You Can Get Other Material from Us: In addition to any other privacy notice we may give you,
we must give you a summary of our privacy policy once each year. You may have other rights under
the law. If you want to know more about our privacy policy, please contact us at our website,
www.metlife.com, or write to your MetLife insurance company, c/o MetLife Privacy Office, P.O. Box
2006, Aurora, Illinois 60507-2006.

                                                                                       CPN-GLB-2003




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Exhibit C   KCDC’s Optional Life Certificate




                                Total Document Page 66 of 224
                                   Metropolitan Life Insurance Company
                           One Madison Avenue, New York, New York 10010-3690

                                    CERTIFICATE OF INSURANCE

Metropolitan Life Insurance Company (“MetLife”), a stock company, certifies that You and Your Dependents
are insured for the benefits described in this certificate, subject to the provisions of this certificate. This
certificate is issued to You under the Group Policy and it includes the terms and provisions of the Group
Policy that describe Your insurance. PLEASE READ THIS CERTIFICATE CAREFULLY.

This certificate is part of the Group Policy. The Group Policy is a contract between MetLife and the Employer
and may be changed or ended without Your consent or notice to You.

Employer:                           Knoxville's Community Development
                                    Corporation

Group Policy Number:                TM 05579023-G

{TC "CERTIFICATE FACE               Optional Term Life Insurance
PAGE"\l 1}Type of Insurance:
MetLife Toll Free Number(s):
   For General Information          1-800-275-4638

THE GROUP INSURANCE POLICY PROVIDING COVERAGE UNDER THIS
CERTIFICATE WAS ISSUED IN A JURISDICTION OTHER THAN MARYLAND AND
MAY NOT PROVIDE ALL THE BENEFITS REQUIRED BY MARYLAND LAW.
THIS CERTIFICATE ONLY DESCRIBES LIFE INSURANCE.

THE BENEFITS OF THE POLICY PROVIDING YOUR COVERAGE ARE GOVERNED PRIMARILY BY THE
LAW OF A STATE OTHER THAN FLORIDA.

WE ARE REQUIRED BY STATE LAW TO INCLUDE THE NOTICE(S) SECTION WHICH FOLLOWS THIS
PAGE. PLEASE READ THE(SE) NOTICE(S) CAREFULLY.




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                                     Total Document Page 67 of 224
.

For Texas Residents:                                 Para Residentes de Texas:

            IMPORTANT NOTICE                                     AVISO IMPORTANTE
{ TC "NOTICES"\l 1}To obtain information or make     Para obtener informacion o para someter una
a complaint:                                         queja:

                                                     Usted puede llamar al numero de telefono gratis de
You may call MetLife’s toll free telephone number    MetLife para informacion o para someter una queja
for information or to make a complaint at            al

                                                                      1-800-275-4638
                 1-800-275-4638

                                                     Puede comunicarse con el Departmento de
You may contact the Texas Department of              Seguros de Texas para obtener informacion acerca
Insurance to obtain information on companies,        de companias, coberturas, derechos o quejas al
coverages, rights or complaints at

                                                                      1-800-252-3439
                 1-800-252-3439

                                                     Puede escribir al Departmento de Seguros de
You may write the Texas Department of Insurance      Texas
P.O. Box 149104                                      P.O. Box 149104
Austin, TX 78714-9104                                Austin, TX 78714-9104
Fax # (512) 475-1771                                 Fax # (512) 475-1771

                                                     DISPUTAS SOBRE PRIMAS O RECLAMOS: Si
PREMIUM OR CLAIM DISPUTES: Should You                tiene una disputa concerniente a su prima o a un
have a dispute concerning Your premium or about      reclamo, debe comunicarse con MetLife primero.
a claim You should contact MetLife first. If the     Si no se resuelve la disputa, puede entonces
dispute is not resolved, You may contact the Texas   comunicarse con el departamento (TDI).
Department of Insurance.
                                                     UNA ESTE AVISO A SU CERTIFICADO:
ATTACH THIS NOTICE TO YOUR CERTIFICATE:              Este aviso es solo para proposito de informacion y
This notice is for information only and does not     no se convierte en parte o condicion del
become a part or condition of the attached           documento adjunto.
document.




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NOTICE FOR RESIDENTS OF ALL STATES

LIFE INSURANCE BENEFITS WILL BE REDUCED IF AN ACCELERATED BENEFIT IS
PAID
DISCLOSURE: The Life Insurance accelerated benefit offered under this certificate is intended to qualify for
favorable tax treatment under the Internal Revenue Code of 1986. If this benefit qualifies for such favorable
tax treatment, the benefit will be excludable from Your income and not subject to federal taxation. Tax laws
relating to accelerated benefits are complex. You are advised to consult with a qualified tax advisor about
circumstances under which You could receive an accelerated benefit excludable from income under federal
law.

DISCLOSURE: Receipt of an accelerated benefit may affect Your, Your Spouse’s or Your family’s eligibility
for public assistance programs such as Medical Assistance (Medicaid), Aid to Families with Dependent
Children (AFDC), Supplementary Social Security Income (SSI), and drug assistance programs. You are
advised to consult with a qualified tax advisor and with social service agencies concerning how receipt of
such payment will affect Your, Your Spouse’s and Your family’s eligibility for public assistance.




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NOTICE FOR RESIDENTS OF ARKANSAS
If You have a question concerning Your coverage or a claim, first contact the Policyholder or group account
administrator. If, after doing so, You still have a concern, You may call the toll free telephone number shown
on the Certificate Face Page.

If You are still concerned after contacting both the Policyholder and MetLife, You should feel free to contact:

                                       Arkansas Insurance Department
                                           Consumer Services Division
                                                1200 West Third
                                      Little Rock, Arkansas 722014-1904
                                                1-800-852-5494




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NOTICE FOR RESIDENTS OF CALIFORNIA
IMPORTANT NOTICE

TO OBTAIN ADDITIONAL INFORMATION, OR TO MAKE A COMPLAINT, CONTACT:

                      METROPOLITAN LIFE INSURANCE COMPANY
                               1 MADISON AVENUE
                              NEW YORK, NY 10010
                ATTN: CORPORATE CONSUMER RELATIONS DEPARTMENT
                                  1-800-275-4638

IF, AFTER CONTACTING METLIFE REGARDING A COMPLAINT, YOU FEEL THAT A SATISFACTORY
RESOLUTION HAS NOT BEEN REACHED, YOU MAY FILE A COMPLAINT WITH THE CALIFORNIA
INSURANCE DEPARTMENT AT:

                             DEPARTMENT OF INSURANCE
                              300 SOUTH SPRING STREET
                               LOS ANGELES, CA 90013
                            1-800-927-4357 (within California)
                           1-213-897-8921 (outside California)




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NOTICE FOR RESIDENTS OF GEORGIA

IMPORTANT NOTICE

The laws of the state of Georgia prohibit insurers from unfairly discriminating against any person based upon
his or her status as a victim of family violence.




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NOTICE FOR RESIDENTS OF ILLINOIS

                                         IMPORTANT NOTICE

     To make a complaint to Metropolitan Life Insurance Company you may write to:

                                 Metropolitan Life Insurance Company
                                          1 Madison Avenue
                                     New York, New York 10010

     The address of the Illinois Department of Insurance is:

                                    Illinois Department of Insurance
                                         Public Services Division
                                         Springfield, Illinois 62767




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NOTICE FOR RESIDENTS OF UTAH

                                  NOTICE TO POLICYHOLDERS

Insurance companies licensed to sell life insurance, health insurance, or annuities in the State of Utah are
required by law to be members of an organization called the Utah Life and Health Insurance Guaranty
Association ("ULHIGA"). If an insurance company that is licensed to sell insurance in Utah becomes insolvent
(bankrupt), and is unable to pay claims to its policyholders, the law requires ULHIGA to pay some of the
insurance company's claims. The purpose of this notice is to briefly describe some of the benefits and
limitations provided to Utah insureds by ULHIGA.

                                   PEOPLE ENTITLED TO COVERAGE

      ·      You must be a Utah resident.

      ·      You must have insurance coverage under an individual or group policy.

                                            POLICIES COVERED

      ·      ULHIGA provides coverage for certain life, health and annuity insurance policies.

                                    EXCLUSIONS AND LIMITATIONS

Several kinds of insurance policies are specifically excluded from coverage. There are also a number of
limitations to coverage. The following are not covered by ULHIGA:

      ·      Coverage through an HMO.

      ·      Coverage by insurance companies not licensed in Utah.

      ·      Self-funded and self-insured coverage provided by an employer that is only administered by an
             insurance company.

      ·      Policies protected by another state's Guaranty Association.

      ·      Policies where the insurance company does not guarantee the benefits.

      ·      Policies where the policyholder bears the risk under the policy.

      ·      Re-insurance contracts.

      ·     Annuity policies that are not issued to and owned by an individual, unless the annuity policy is
            issued to a pension benefit plan that is covered.

      ·     Policies issued to pension benefit plans protected by the Federal Pension Benefit Guaranty
            Corporation.

      ·     Policies issued to entities that are not members of the ULHIGA, including health plans, fraternal
            benefit societies, state pooling plans and mutual assessment companies.




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NOTICE FOR RESIDENTS OF UTAH

                                 LIMITS ON AMOUNT OF COVERAGE

Caps are placed on the amount ULHIGA will pay. These caps apply even if you are insured by more than one
policy issued by the insolvent company. The maximum ULHIGA will pay is the amount of your coverage or
$500,000 — whichever is lower. Other caps also apply:

       ·       $100,000 in net cash surrender values.

       ·       $500,000 in life insurance death benefits (including cash surrender values).

       ·       $500,000 in health insurance benefits.

       ·       $200,000 in annuity benefits — if the annuity is issued to and owned by an individual or the
               annuity is issued to a pension plan covering government employees.

       ·       $5,000,000 in annuity benefits to the contract holder of annuities issued to pension plans
               covered by the law. (Other limitations apply).

       ·       Interest rates on some policies may be adjusted downward.

                                            DISCLAIMER

       PLEASE READ CAREFULLY:
      ·    COVERAGE FROM ULHIGA MAY BE UNAVAILABLE UNDER THIS
POLICY. OR, IF AVAILABLE, IT MAY BE SUBJECT TO SUBSTANTIAL LIMITATIONS OR
EXCLUSIONS. THE DESCRIPTION OF COVERAGES CONTAINED IN THIS DOCUMENT
IS AN OVERVIEW. IT IS NOT A COMPLETE DESCRIPTION. YOU CANNOT RELY ON
THIS DOCUMENT AS A DESCRIPTION OF COVERAGE. FOR A COMPLETE
DESCRIPTION OF COVERAGE, CONSULT THE UTAH CODE, TITLE 31A, CHAPTER 28.
     ·    COVERAGE IS CONDITIONED ON CONTINUED RESIDENCY IN THE
STATE OF UTAH.

     ·    THE PROTECTION THAT MAY BE PROVIDED BY ULHIGA IS NOT A
SUBSTITUTE FOR CONSUMERS' CARE IN SELECTING AN INSURANCE COMPANY
THAT IS WELL-MANAGED AND FINANCIALLY STABLE.

     ·     INSURANCE COMPANIES AND INSURANCE AGENTS ARE REQUIRED BY
LAW TO GIVE YOU THIS NOTICE. THE LAW DOES, HOWEVER, PROHIBIT THEM FROM
USING THE EXISTENCE OF ULHIGA AS AN INDUCEMENT TO SELL YOU INSURANCE.
     ·    THE ADDRESS OF ULHIGA, AND THE INSURANCE DEPARTMENT ARE
PROVIDED BELOW.
                                     Utah Life and Health Insurance
                                         Guaranty Association
                                          955 E. Pioneer Rd.
                                          Draper, Utah 84114
                                       Utah Insurance Department
                                    State Office Building, Room 3110
                                       Salt Lake City, Utah 84114


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NOTICE FOR RESIDENTS OF VIRGINIA
Virginia residents please be advised of the following:

                    IMPORTANT INFORMATION REGARDING YOUR INSURANCE


               In the event you need to contact someone about this insurance for any reason please contact
               your agent. If no agent was involved in the sale of this insurance, or if you have additional
               questions you my contact the insurance company issuing this insurance at the following
               address and telephone number:

                           METROPOLITAN LIFE INSURANCE COMPANY
                                    1 MADISON AVENUE
                                NEW YORK, NEW YORK 10010
                     ATTN: CORPORATE CUSTOMER RELATIONS DEPARTMENT
                                       1-800-275-4638


               If you have been unable to contact or obtain satisfaction from the company or the agent, you
               may contact the Virginia State Corporation Commission’s Bureau of Insurance at:


                            VIRGINIA STATE CORPORATION COMMISSION
                                      BUREAU OF INSURANCE
                                    LIFE AND HEALTH DIVISION
                                          P.O. BOX 1157
                                       RICHMOND, VA 23219

                                    1-800-552-7945 – (within Virginia)
                                   1-804-371-9691 – (outside Virginia)


               Written correspondence is preferable so that a record of your inquiry is maintained. When
               contacting your agent, company or the Bureau of Insurance, have your policy number
               available.




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CIVIL UNION NOTICE FOR RESIDENTS OF VERMONT
Vermont law provides that the following definitions apply to your certificate:

•   Terms that mean or refer to a marital relationship, or that may be construed to mean or refer to a marital
    relationship, such as "marriage," "spouse," "husband," "wife," "dependent," "next of kin," "relative,"
    "beneficiary," "survivor," "immediate family" and any other such terms include the relationship created by
    a Civil Union established according to Vermont law.

•   Terms that mean or refer to the inception or dissolution of a marriage, such as "date of marriage,"
    "divorce decree," "termination of marriage" and any other such terms include the inception or dissolution
    of a Civil Union established according to Vermont law.

•   Terms that mean or refer to family relationships arising from a marriage, such as "family," "immediate
    family," "dependent," "children," "next of kin," "relative," "beneficiary," "survivor" and any other such terms
    include family relationships created by a Civil Union established according to Vermont law.

•   "Dependent" includes a spouse, a party to a Civil Union established according to Vermont law, and a child
    or children (natural, step-child, legally adopted or a minor or disabled child who is dependent on the
    insured for support and maintenance) who is born to or brought to a marriage or to a Civil Union
    established according to Vermont law.

•   "Child" includes a child (natural, stepchild, legally adopted or a minor or disabled child who is dependent
    on the insured for support and maintenance) who is born to or brought to a marriage or to a Civil Union
    established according to Vermont law.

•   “Civil Union” means a civil union established pursuant to Act 91 of the 2000 Vermont Legislative Session,
    entitled “Act Relating to Civil Unions”.

All references in this notice to Civil Unions are limited to Civil Unions in which the parties are residents of
Vermont.

If dependent insurance for a spouse and/or child is not provided under your certificate, such insurance is not
added by virtue of this notice.

For purposes of dependent insurance, any person who meets the definition of “dependent” as set forth in this
notice is required to meet all other applicable requirements in order to qualify for such insurance.

This notice does not limit any definitions or terms included in your certificate. It broadens definitions and
terms only to the extent required by Vermont law.

DISCLOSURE:

Vermont law grants parties to a Civil Union the same benefits, protections and responsibilities that flow from
marriage under state law. However, some or all of the benefits, protections and responsibilities related to life
and health insurance that are available to married persons under federal law may not be available to parties
to a Civil Union. For example, a federal law, the Employee Retirement Income Security Act of 1974 known as
“ERISA”, controls the employer/employee relationship with regard to determining eligibility for enrollment in
private employer benefit plans. Because of ERISA, Act 91 does not state requirements pertaining to a private
employer’s enrollment of a party to a Civil Union in an ERISA employee benefit plan. However, governmental
employers (not federal government) are required to provide life and health benefits to the dependents of a
party to a Civil Union if the public employer provides such benefits to dependents of married persons.
Federal law also controls group health insurance continuation rights under “COBRA” for employers with 20 or
more employees as well as the Internal Revenue Code treatment of insurance premiums. As a result, parties
to a Civil Union and their families may or may not have access to certain benefits under this notice and the
certificate to which it is attached that derive from federal law. You are advised to seek expert advice to
determine your rights under this notice and the certificate to which it is attached.



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NOTICE FOR RESIDENTS OF WISCONSIN
Wisconsin residents please be advised of the following:


                        KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS




PROBLEMS WITH YOUR INSURANCE? - If you are having problems with your insurance company or
agent, do not hesitate to contact the insurance company or agent to resolve your problem.



                                  Metropolitan Life Insurance Company
                                            Customer Service
                                         4100 Boy Scout Blvd.
                                            Tampa, FL 33607
                                             1-800-811-8319



You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a state agency which
enforces Wisconsin’s insurance laws, and file a complaint. You can contact the OFFICE OF THE
COMMISSIONER OF INSURANCE by contacting:



                                Office of the Commissioner of Insurance
                                         Complaints Department
                                              P.O. Box 7873
                                        Madison, WI 53707-7873
                       1-800-236-8517 outside of Madison or 266-0103 in Madison.




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NOTICE FOR RESIDENTS OF ALL STATES
FRAUD WARNING

If You have applied for insurance under a policy issued in one of the following states, or if You reside in one
of the following states, note the following applicable warning:


For Residents of New York - only applies to Accident and Health Insurance (AD&D)
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or statement of claim containing any materially false information, or conceals for the
purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act,
which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated
value of the claim for each such violation.

For Residents of Florida
Any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of claim
or an application containing any false, incomplete or misleading information is guilty of a felony of the third
degree.

For Residents of Kansas and Massachusetts
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or a statement of claim containing any materially false information or conceals, for
the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance
act, and may subject such person to criminal and civil penalties.

For Residents of New Jersey
Any person who includes any false or misleading information on an application for an insurance policy or who
knowingly files a statement of claim containing any false or misleading information is subject to criminal and
civil penalties.

For Residents of Oklahoma
Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the
proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a
felony.

For Residents of Oregon
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance containing any materially false information or conceals, for the purpose of
misleading, information concerning any fact material thereto may be guilty of insurance fraud, and may be
subject to criminal and civil penalties.

For Residents of Virginia
Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, submits
an application or statement of claim containing a false or deceptive statement may have violated state law.

For Residents of All Other States
Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or a statement of claim containing any materially false information or conceals, for
the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance
act, which is a crime and subjects such person to criminal and civil penalties.




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TABLE OF CONTENTS
{tc "TABLE OF CONTENTS" \l 1}The bottom left of each page of this certificate has a unique coding which
describes the section of the certificate that the page contains (fp = Certificate Face Page, sch = Schedule of
Benefits).
Section                                                                                                  Page
CERTIFICATE FACE PAGE ............................................................................................................................... 1
NOTICES ............................................................................................................................................................ 3
TABLE OF CONTENTS .................................................................................................................................... 16
SCHEDULE OF BENEFITS .............................................................................................................................. 18
DEFINITIONS ................................................................................................................................................... 20
ELIGIBILITY PROVISIONS: INSURANCE FOR YOU...................................................................................... 23
  Eligible Classes ............................................................................................................................................. 23
  Date You Are Eligible For Insurance ............................................................................................................. 23
  Enrollment Process ....................................................................................................................................... 23
  Date Your Insurance Takes Effect ................................................................................................................ 23
  Date Your Insurance Ends ............................................................................................................................ 25
ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS ......................................................... 27
  Eligible Classes For Dependent Insurance ................................................................................................... 27
  Date You Are Eligible For Dependent Insurance .......................................................................................... 27
  Enrollment Process ....................................................................................................................................... 27
  Date Insurance For Your Dependents Take Effect ....................................................................................... 27
  Date Your Insurance For Your Dependents Ends......................................................................................... 30
CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT.................................................................... 32
 For Mentally Or Physically Handicapped Children........................................................................................ 32
 For Family And Medical Leave...................................................................................................................... 32
 At Your Option: Portability ............................................................................................................................. 32
 At The Employer's Option.............................................................................................................................. 34
EVIDENCE OF INSURABILITY ........................................................................................................................ 35
LIFE INSURANCE: FOR YOU .......................................................................................................................... 38
LIFE INSURANCE: FOR YOUR DEPENDENTS.............................................................................................. 39
LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU.................................................... 40
LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOUR DEPENDENT SPOUSE.......... 42
LIFE INSURANCE: CONVERSION OPTION FOR YOU.................................................................................. 44
LIFE INSURANCE: CONVERSION OPTION FOR YOUR DEPENDENTS ..................................................... 46
LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS WHILE YOU ARE
TOTALLY DISABLED ....................................................................................................................................... 48
FILING A CLAIM ............................................................................................................................................... 51
GENERAL PROVISIONS.................................................................................................................................. 52
 Assignment.................................................................................................................................................... 52
 Beneficiary..................................................................................................................................................... 52
 Suicide ........................................................................................................................................................... 53
 Entire Contract............................................................................................................................................... 53
 Incontestability: Statements Made By You.................................................................................................... 53
 Mistatement of Age........................................................................................................................................ 53
 Conformity With Law ..................................................................................................................................... 54
 Autopsy.......................................................................................................................................................... 54




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SCHEDULE OF BENEFITS
{ TC "SCHEDULE OF BENEFITS"\l 1}This schedule shows the benefits that are available under the Group
Policy. You and Your Dependents will only be insured for the benefits:

•   for which You and Your Dependents become and remain eligible, and
•   which You elect, if subject to election; and
•   which are in effect.

                                                                                               BENEFIT AMOUNT
BENEFIT                                                                                        AND HIGHLIGHTS

Life Insurance For You

Optional Life Insurance (if elected by You)
                For All Active Full Time Employees..........................................   An amount, elected by
                                                                                               You, which is a multiple
                                                                                               of $10,000.

                Maximum Optional Life Benefit………..………………….……..                                 The lesser of 5 times
                                                                                               Your Basic Annual
                                                                                               Earnings or $500,000.

                Non-Medical Issue Amount……………..………………………..                                     $100,000

                Accelerated Benefit Option ........................................................ Up to 50% of Your
                                                                                                    Optional Life amount not
                                                                                                    to exceed $250,000.

If You Are Age 65 Or Older

If You are over age 65 but under age 70 on Your effective date of insurance, the amount of Your Optional Life
Insurance will be limited to 65% of such amount. On and after Your 70th birthday, the amount of such
insurance will be 50% of the amount of such insurance in effect on the effective date of Your insurance. If
You are age 70 or older on the effective date of Your insurance, the amounts of Your Optional Life Insurance
on Your effective date of insurance will be limited to 50% of such amount.

If You are under age 65 on the effective date of Your insurance, the amounts of Your Optional Life Insurance
on and after age 65 will be 65% of such insurance in effect on the day before Your 65th birthday. On and after
Your 70th birthday, the amount of such insurance will be 50% of the amount of such insurance in effect on the
day before Your 65th birthday.

Life Insurance For Your Dependents
                For All Active Full Time Employees who elect:

                For Your Spouse…………………………………………………..                                           Multiples of $5,000, up
                                                                                               to a Maximum Benefit of
                                                                                               $100,000 or 50% of the
                                                                                               Employee’s Optional Life
                                                                                               Insurance amount,
                                                                                               whichever is less.

                Non-Medical Issue Amount………………………………………                                        $25,000

                Accelerated Benefit Option……………………………………….                                     Up to 50% of Your
                                                                                               Dependent Life amount
                                                                                               not to exceed $250,000

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SCHEDULE OF BENEFITS
If the Spouse is age 70 or older on his effective date of insurance, Life Insurance is not available. If the
Spouse is under age 70 on his effective date of insurance, the Spouse's Life Insurance will end on the date
he attains age 70.

                For All Active Full Time Employees who elect:

                For Your Child from age 15 days but less than 6 months….…        $100

                For Your Child 6 months and over
                Option 1…………………………………………………………….                                 $5,000
                Option 2…………………………………………………………….                                 $10,000

                Non-Medical Issue Amount………………………………………                          $10,000




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DEFINITIONS
{ TC "DEFINITIONS"\l 1}As used in this certificate, the terms listed below will have the meanings set forth
below. When defined terms are used in this certificate, they will appear with initial capitalization. The plural
use of a term defined in the singular will share the same meaning.

Actively at Work or Active Work means that You are performing all of the usual and customary duties of
Your job on a Full-Time basis. This must be done at:

•   the Employer's place of business;
•   an alternate place approved by the Employer; or
•   a location to which the Employer's business requires You to travel.

You will be deemed to be Actively at Work during weekends or Employer-approved vacations, holidays or
business closures if You were Actively at Work on the last scheduled work day preceding such time off.

Basic Annual Earnings means Your gross annual rate of pay as determined by Your Employer, excluding
overtime and other extra pay.

Beneficiary means the person(s) to whom We will pay insurance as determined in accordance with the
General Provisions section.

Child means the following:

For Life Insurance, Your natural child, adopted child, or stepchild who is:

•   at least 15 days, under age 19; or

•   under age 25 and who is:

    •   a full-time student at an accredited school, college or university that is licensed in the jurisdiction
        where it is located; and

    •   not employed on a full-time basis.

In all cases the child must be unmarried and supported by You.

The term does not include any person who:

•   is in the military of any country or subdivision of any country;
•   lives outside of the United States or Canada; or
•   a person who is insured under the Group Policy as an employee.

Contributory Insurance means insurance for which the Employer requires You to pay any part of the
premium.

Contributory Insurance includes: Optional Life Insurance and Optional Dependent Life Insurance.

Dependent(s) means Your Spouse and/or Child.

Full-Time means Active Work on the Employer's regular work schedule for the class of employees to which
You belong. The work schedule must be at least 30 hours a week.

Hospital means a facility which is licensed as such in the jurisdiction in which it is located and:

•   provides a broad range of medical and surgical services on a 24 hour a day basis for injured and sick
    persons by or under the supervision of a staff of Physicians; and

•   provides a broad range of nursing care on a 24 hour a day basis by or under the direction of a registered
    professional nurse.
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DEFINITIONS

Hospitalized means:

•   admission for inpatient care in a Hospital;

•   receipt of care in the following:

    •   a hospice facility; or
    •   an intermediate care facility; or
    •   a long term care facility; or

•   receipt of the following treatment, wherever performed:

    •   chemotherapy; or
    •   radiation therapy; or
    •   dialysis.

Noncontributory Insurance means insurance for which the Employer does not require You to pay any part
of the premium.

Physician means:

•   a person licensed to practice medicine in the jurisdiction where such services are performed; or

•   any other person whose services, according to applicable law, must be treated as Physician’s services for
    purposes of the Group Policy. Each such person must be licensed in the jurisdiction where the service is
    performed and must act within the scope of that license. He must also be certified and/or registered if
    required by such jurisdiction.

    The term does not include:

    •   You, or
    •   Your Spouse, or
    •   any member of Your immediate family including Your and/or Your spouse’s parents; children (natural,
        step or adopted); siblings; grandparents; or grandchildren.

Proof means Written evidence satisfactory to Us that a person has satisfied the conditions and requirements
for any benefit described in this certificate. When a claim is made for any benefit described in this certificate,
Proof must establish:

•   the nature and extent of the loss or condition;
•   Our obligation to pay the claim; and
•   the claimant’s right to receive payment.

Proof must be provided at the claimant’s expense.

Sickness means illness, disease or pregnancy, including complications of pregnancy

Signed means any symbol or method executed or adopted by a person with the present intention to
authenticate a record, which is on or transmitted by paper or electronic media which is acceptable to Us and
consistent with applicable law.

Spouse means Your lawful Spouse.

The term does not include any person who:

•   is in the military of any country or subdivision of any country;

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DEFINITIONS

•   lives outside of the United States or Canada; or
•   is insured under the Group Policy as an employee.

We, Us and Our mean MetLife.

Written or Writing means a record which is on or transmitted by paper or electronic media which is
acceptable to Us and consistent with applicable law.

You and Your mean an employee who is insured under the Group Policy for the insurance described in this
certificate.




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU
{ TC "ELIGIBILITY PROVISIONS: INSURANCE FOR YOU"\l 1}ELIGIBLE CLASS(ES){ TC "Eligible
Classes"\l 2}
All Active Full Time Employees

DATE YOU ARE ELIGIBLE FOR INSURANCE{ TC "Date You Are Eligible For Insurance"\l 2}

You may only become eligible for the insurance available for Your class as shown in the SCHEDULE OF
BENEFITS.

All Active Full Time Employees

Optional Life Insurance

You will be eligible for insurance on the later of:

1. January 01, 2005; and
2. the first day of the month coincident with or next following the date You complete the Waiting Period of 6
    months.

If You enter an eligible class after January 01, 2005, You will be eligible for insurance on the first day of the
month coincident with or next following the date You complete the Waiting Period of 6 months.

Waiting Period means the period of continuous membership in an eligible class that You must wait before
You become eligible for insurance. This period begins on the date You enter an eligible class and ends on
the date You complete the period(s) specified.

ENROLLMENT PROCESS{ TC "Enrollment Process"\l 2}

If You are eligible for insurance, You may enroll for such insurance by completing the required form. In
addition, You must give evidence of Your insurability satisfactory to Us at Your expense if You are required to
do so under the section entitled EVIDENCE OF INSURABILITY. If you enroll for Contributory Insurance, You
must also give the Employer written permission to deduct premiums from Your pay for such insurance. You
will be notified by the Employer how much You will be required to contribute.

DATE YOUR INSURANCE TAKES EFFECT{ TC "Date Your Insurance Takes Effect"\l 2}

Rules for Noncontributory Insurance

When You complete the enrollment process for Noncontributory Insurance, such insurance will take effect as
follows:

•   if You are not required to give evidence of Your insurability, such insurance will take effect on the date
    You become eligible, provided You are Actively at Work on that date; or

•   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.

If You are not Actively at Work on the date the Noncontributory Insurance benefit would otherwise take effect,
the insurance will take effect on the day You resume Active Work.

Rules for Contributory Insurance

If You request Contributory Insurance before the date You become eligible for such insurance, such
insurance will take effect as follows:

•   if You are not required to give evidence of Your insurability, such insurance will take effect on the date
    You become eligible, provided You are Actively at Work on that date.


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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU

•   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.

If You request Contributory Insurance within 31 days of the date You become eligible for such insurance,
such insurance will take effect as follows:

•   if You are not required to give evidence of Your insurability, such insurance will take effect on the later
    of:
    • the date You become eligible for such insurance; and
    • the date You enroll
    provided You are Actively at Work on that date.

•   if You are required to give evidence of Your insurability and We determine that You are insurable, such
    insurance will take effect on the date We state in Writing, provided You are Actively at Work on that date.

If You request Contributory Optional Life Insurance more than 31 days after the date You become eligible
for such insurance, You must give evidence of Your insurability satisfactory to us. You must give such
evidence at Your expense. If We determine that You are insurable, such insurance will take effect on the
date We state in Writing, if You are Actively at Work on that date.

If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on
the day You resume Active Work.

See the DEFINITIONS section of this certificate for a complete list of Contributory Insurance benefits.

For Optional Life Insurance

When You become eligible under the plan, You may choose an option for Optional Life Insurance.

Each year You can choose the amount and types of benefits for Optional Life Insurance subject to the
following rules.

A request to increase the amount by $10,000 may be made each year 31 days before January 01.

You will be able to enroll by completing the required form in Writing. You must also give the Employer written
permission to deduct the contribution from Your pay. The Employer will notify You of the amount You will be
required to contribute.

Enrollment During Annual Enrollment Periods For Optional Life Insurance Only

If You choose an option which does not require You to give evidence of Your insurability, the insurance will
take effect on the first day of the month following the annual enrollment period, provided You are Actively at
Work on that day.

If You choose an option which requires You to give evidence of Your insurability under the section entitled
EVIDENCE OF INSURABILITY and We determine that You are insurable, the insurance will take effect on the
date We state in Writing, provided You are Actively at Work on that date.

•   if We do not approve Your evidence of insurability, or You do not submit evidence of insurability, the
    insurance will not take effect.

•   if You are required to give evidence of insurability under the section entitled EVIDENCE OF
    INSURABILITY for a portion of the insurance:

    •   the portion of the insurance that is not subject to evidence of insurability will take effect on the first day
        of the month coincident with or next following the date of Your request.



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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU

    •   if We approve Your evidence of insurability, the portion of the insurance that is subject to evidence of
        insurability will take effect on the date We state in Writing. If We do not approve Your evidence of
        insurability or You do not submit evidence of insurability, the portion of the insurance that is subject to
        evidence of insurability will not take effect.

If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on
the day You resume Active Work.

Increase in Insurance

An increase in insurance due to a change in class of employee, an increase in Your earnings, or a requested
increase in insurance will take effect as follows:

•   if You are required to give evidence of insurability for the entire increase and We approve Your evidence
    of insurability, the increase will take effect on the date We state in Writing. If We do not approve Your
    evidence of insurability, or You do not submit evidence of insurability, the increase in insurance will not
    take effect.

•   if You are required to give evidence of insurability for a portion of the increase:

    •   the portion of the increase that is not subject to evidence of insurability will take effect on the first day
        of the month coincident with or next following the date of Your request or the date of the increase in Your
        earnings.

    •   if We approve Your evidence of insurability, the portion of the increase that is subject to evidence of
        insurability will take effect on the date We state in Writing. If We do not approve Your evidence of
        insurability or You do not submit evidence of insurability, the increase in insurance will not take effect.

•   if You are not required to give evidence of insurability, the increase will take effect on the first day of the
    month coincident with or next following the date of Your request or the date of the increase in Your
    earnings.

You must be Actively at Work on that date. If You are not Actively at Work on the date the increase would
otherwise take effect, the increase will take effect on the day You resume Active Work. For Contributory
Insurance to take effect, in addition to having been Actively at Work on the date the insurance is to take
effect, You must also have been Actively at Work for at least 20 hours during the 7 calendar days preceding
that date.

Decrease in Insurance

A decrease in insurance due to a change in class of employee or a decrease in Your earnings will take effect
on the first day of the month coincident with or next following the date of change.

If You make a Written application to decrease Your insurance, that decrease will take effect as of the date of
Your application.

DATE YOUR INSURANCE ENDS{ TC "Date Your Insurance Ends"\l 2}

Your insurance will end on the earliest of:

1. the date the Group Policy ends;

2. the date insurance ends for Your class;

3. the end of the period for which the last premium has been paid for You; or




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOU
4. for Optional Life Insurance, the last day of the month in which Your employment ends; Your employment
   will end if You cease to be Actively at Work in any eligible class, except as stated in the section entitled
   CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT; or

5. for Optional Life Insurance, the date You retire in accordance with the Employer’s retirement plan.

Please refer to the section entitled LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE
INSURANCE ENDS WHILE YOU ARE TOTALLY DISABLED for information concerning continuation of Your
Life Insurance if insurance ends while You are Totally Disabled. Please refer to the section entitled LIFE
INSURANCE: CONVERSION OPTION FOR YOU for information concerning the option to convert to an
individual policy of life insurance if Your Life Insurance ends.

Please refer to the section entitled CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT for
information concerning Continuation For Family and Medical Leave, continuation for employees who choose
portability, or Continuation of the Insurance at the Employer’s Option.




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS
{ TC "ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS"\l 1}ELIGIBLE CLASS(ES)
FOR DEPENDENT INSURANCE{ TC "Eligible Classes For Dependent Insurance"\l 2}
All Active Full Time Employees

DATE YOU ARE ELIGIBLE FOR DEPENDENT INSURANCE{ TC "Date You Are Eligible For Dependent
Insurance"\l 2}

You may only become eligible for the Dependent insurance available for Your eligible class as shown in the
SCHEDULE OF BENEFITS.

Optional Life Insurance for Your Dependents

You will be eligible for Dependent insurance on the latest of:

1. January 01, 2005;
2. the first day of the month coincident with or next following the date You complete the Waiting Period of 6
    months; and
3. the date You obtain a Dependent.

If You enter an eligible class after January 01, 2005, You will be eligible for Dependent insurance on the first
day of the month coincident with or next following the date You complete the Waiting Period of 6 months.

No person may be insured as a Dependent of more than one employee.

Waiting Period means the period of continuous membership in an eligible class that You must wait before
You become eligible for Dependent Insurance. This period begins on the later of:

•   the date You enter an eligible class; and
•   the date You obtain a Dependent.

This period ends on the date You complete the period(s) specified.

ENROLLMENT PROCESS { TC "Enrollment Process"\l 2}

If You are eligible for Dependent insurance, You may enroll for such insurance by completing the required
form for each Dependent to be insured. In addition, each of Your Dependents must give evidence of his
insurability satisfactory to Us at Your expense if required to do so under the section entitled EVIDENCE OF
INSURABILITY. If You enroll for a Contributory Insurance, You must also give the Employer Written
permission to deduct premiums from Your pay for such insurance. You will be notified by the Employer how
much You will be required to contribute.

DATE INSURANCE FOR YOUR DEPENDENTS TAKES EFFECT{ TC "Date Insurance For Your
Dependents Take Effect"\l 2}

Rules for Noncontributory Dependent Insurance

For Dependents You Have When You Become Eligible For Dependent Insurance

If You complete the enrollment process for Noncontributory Dependent Insurance, the insurance will take
effect for each enrolled Dependent as follows:

•   if the Dependent is not required to give evidence of his insurability, the insurance for each enrolled
    Dependent will take effect on the date You become eligible for such insurance, if You are Actively at Work
    on that day and the Dependent satisfies the Additional Requirement stated below; or




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS

•   if the Dependent is required to give evidence of his insurability and We determine that the Dependent is
    insurable, the insurance will take effect on the date We state in Writing, if You are Actively at Work on that
    day and the dependent satisfies the Additional Requirement stated below.

If You are not Actively at Work on the date the Noncontributory Dependent Insurance benefit would otherwise
take effect, the insurance will take effect on the day You resume Active Work and the Additional Requirement
stated below is satisfied.

Rules for Contributory Dependent Insurance

For Dependents You Have When You Become Eligible For Dependent Insurance

If You complete the enrollment process for Contributory Dependent Insurance before the date You become
eligible for such insurance, such insurance will take effect for each enrolled Dependent as follows:

•   if the Dependent is not required to give evidence of his insurability, such insurance will take effect on the
    date You become eligible, provided You are Actively at Work on that date and the Dependent satisfies the
    Additional Requirement stated below.

•   if the Dependent is required to give evidence of insurability and We determine that the Dependent is
    insurable, such insurance will take effect on the date We state in Writing, if You are Actively at Work on
    that date.

If You complete the enrollment process for Contributory Dependent Insurance within 31 days of the date You
become eligible for such insurance, such insurance will take effect for each enrolled Dependent as follows:

•   If the Dependent is not required to give evidence of his insurability, such insurance will take effect on the
    later of:

    •   the date You become eligible for such insurance; and
    •   the date You enroll;

•   if You are Actively at Work on that date and the Dependent satisfies the Additional Requirement stated
    below.

•   if the Dependent is required to give evidence of his insurability and We determine that the Dependent is
    insurable, such insurance will take effect on the date We state in Writing, if You are Actively at Work on
    that date the Dependent satisfies the Additional Requirement stated below.

If You complete the enrollment process for Contributory Dependent Life Insurance more than 31 days after
the date You become eligible for such insurance, each Dependent must give evidence of his insurability
satisfactory to us. You must give such evidence at Your expense. If We determine that the Dependent is
insurable, such insurance will take effect on the date We state in Writing, if You are Actively at Work on that
date and the Dependent satisfies the Additional Requirement stated below.

If You are not Actively at Work on the date benefits would otherwise take effect, benefits will take effect on the
day You resume Active Work.




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS
For Dependents You Obtain After You Become Eligible For Dependent Insurance

If You obtain a Dependent after You become eligible for Dependent insurance, You may enroll the Dependent
for such insurance within 31 days after the date he qualifies as a Dependent as defined in this certificate.
The Dependent must give evidence of his insurability satisfactory to Us at Your expense if required to do so
under the section entitled EVIDENCE OF INSURABILITY. The Dependent insurance for the Dependent will
take effect as follows:

•   if Dependents were not required to give evidence of insurability, the benefit for those Dependents will take
    effect on the later of:

    •   the date You become eligible for such insurance; and
    •   the date You enroll;

    provided You are Actively at Work on that day and the Additional Requirement stated below is satisfied;
    or

•   if Dependents were required to give evidence of insurability and We determine that all Dependents are
    insurable, the insurance will take effect on the date We state in Writing, provided You are Actively at Work
    on that day and the Additional Requirement stated below is satisfied.

If You complete the enrollment process for any Dependent more than 31 days after the date he qualifies as a
Dependent, the Dependent must give evidence of his insurability satisfactory to Us at Your expense. If We
determine that the Dependent is insurable, the insurance will take effect on the date We state in Writing, if the
Dependent satisfies the Additional Requirement stated below.

Once You have enrolled one Child for Dependent insurance, each succeeding Child will automatically be
insured for such insurance on the date he qualifies as a Dependent.

If You are not Actively at Work on the date the Noncontributory Dependent Insurance would otherwise take
effect, the insurance will take effect on the day You resume Active Work and the Additional Requirement
stated below is satisfied.

If You choose an option during Annual Enrollment Periods, the insurance will take effect for Your
Dependents as follows:

•   if Dependents are not required to give evidence of insurability, the insurance for those Dependents will
    take effect on the first day of the month following the annual enrollment period, provided You are Actively
    at Work on that day and the Additional Requirement stated below is satisfied; or

•   if Dependents are required to give evidence of insurability under the section entitled EVIDENCE OF
    INSURABILITY:

    •   the portion of the insurance that is not subject to evidence of insurability will take effect on the first day
        of the month coincident with or next following the date of Your request.

    •   if We approve the evidence of insurability, the portion of the insurance that is subject to evidence of
        insurability will take effect on the date We state in Writing. If We do not approve the evidence of
        insurability or You do not submit evidence of insurability, the portion of the insurance for Your
        Dependents that is subject to evidence of insurability will not take effect.

If You are not Actively at Work on the date insurance would otherwise take effect, insurance will take effect on
the day You resume Active Work provided the Additional Requirement stated below is satisfied.




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ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS
Additional Requirement

On the date a Dependent insurance is scheduled to take effect, the Dependent must not be:

•   confined at home under a Physician's care;
•   receiving or applying to receive disability insurance from any source; or
•   Hospitalized.

If the Dependent does not meet this requirement on such date, insurance for the Dependent will take effect on
the date he is no longer:

•   confined;
•   receiving or applying to receive disability insurance from any source; or
•   Hospitalized.

Increase in Insurance for Your Dependents

An increase in insurance for Your Dependents due to a change in Your employee class, an increase in Your
earnings, or a requested increase in insurance for Your Dependents will take effect as follows:

•   if Your Dependents are required to give evidence of insurability for the entire increase and We approve
    the evidence of insurability, the increase will take effect on the date We state in Writing. If We do not
    approve the evidence of insurability, or You do not submit evidence of insurability for Your Dependent, the
    increase in insurance for Your Dependents will not take effect.

•   if Your Dependents are required to give evidence of insurability for a portion of the increase in insurance:

    •   the portion of the increase in insurance that is not subject to evidence of insurability will take effect on
        the first day of the month coincident with or next following the date of Your request or the date of the
        increase in Your earnings.

    •   if We approve the evidence of insurability, the portion of the increase in insurance that is subject to
        evidence of insurability will take effect on the date We state in Writing. If We do not approve the
        evidence of insurability or You do not submit evidence of insurability for Your Dependent, the increase in
        insurance for Your Dependents will not take effect.

•   If Your Dependents are not required to give evidence of insurability, the increase will take effect on the
    first day of the month coincident with or next following the date of Your request or the date of the increase
    in Your earnings.

You must be Actively at Work on that date. If You are not Actively at Work on the date the increase would
otherwise take effect, the increase will take effect on the day You resume Active Work.

Decrease in Insurance for Your Dependents

A decrease in insurance for Your Dependents due to a change in Your employee class or a decrease in Your
earnings will take effect on the first day of the month coincident with or next following the date of change.

If You make a Written application to decrease insurance for Your Dependents, that decrease will take effect
as of the date of Your application.

DATE YOUR INSURANCE FOR YOUR DEPENDENTS ENDS{ TC "Date Your Insurance For Your
Dependents Ends"\l 2}

A Dependent's insurance will end on the earliest of:

1. for Dependent Life Insurance, the date all Your Life Insurance under the Group Policy ends;
2. the date You die;
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ELIGIBILITY PROVISIONS: INSURANCE FOR YOUR DEPENDENTS
3.   the date the Group Policy ends;
4.   the date insurance for Your Dependents ends under the Group Policy;
5.   the date insurance for Your Dependents ends for Your class;
6.   for a Spouse, the date he attains age 70;
7.   the date the person ceases to be a Dependent;
8.   the last day of the month in which Your employment ends; Your employment will end if You cease to be
     Actively at Work in any eligible class, except as stated in the section entitled CONTINUATION WITH
     PREMIUM PAYMENT;
9. the date You retire in accordance with the Employer’s retirement plan; or
10. the end of the period for which the last premium has been paid for the Dependent.
Please refer to the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOUR DEPENDENTS
for information concerning the option to convert to an individual policy of life insurance if Life Insurance for a
Dependent ends.

Please refer to the section entitled CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT for
information concerning Continuation For Family and Medical Leave.




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CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT
{ TC "CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT"\l 1}
FOR MENTALLY OR PHYSICALLY HANDICAPPED CHILDREN{ TC "For Mentally Or Physically
Handicapped Children"\l 2}

Insurance for a Dependent Child may be continued past the age limit if that child is incapable of self-
sustaining employment because of a mental or physical handicap as defined by applicable law. Proof of such
handicap must be sent to Us within 31 days after the date the Child attains the age limit and at reasonable
intervals after such date.

Subject to the Date Insurance For Your Dependents Ends subsection of the section entitled ELIGIBILITY
PROVISIONS: INSURANCE FOR YOUR DEPENDENTS, insurance will continue while such Child:

•   remains incapable of self-sustaining employment because of a mental or physical handicap; and
•   continues to qualify as a Child, except for the age limit.

FOR FAMILY AND MEDICAL LEAVE { TC "For Family And Medical Leave"\l 2}

Certain leaves of absence may qualify under the Family and Medical Leave Act of 1993 (FMLA) for
continuation of insurance. Please contact the Employer for information regarding the FMLA.

AT YOUR OPTION: PORTABILITY{ TC "At Your Option: Portability"\l 2}

For Life Insurance

For purposes of this subsection the term “Portability Eligible Insurance” refers to Your Optional Life Insurance.

Evidence of insurability will not be required to exercise this Portability Option. If You choose not to exercise
this Portability Option, Life Insurance benefits may be converted in accordance with the section entitled LIFE
INSURANCE: CONVERSION OPTION FOR YOU.

You may request in Writing during the Request Period specified below to continue Portability Eligible
Insurance under another group policy if such insurance ends because:

•   Your employment ends; or
•   You cease to be in a class that is eligible for such insurance.

If a request is made under this subsection, We will issue a new certificate of insurance which will explain the
new insurance benefits. The insurance benefits under the new certificate may not be the same as those that
ended under the Group Policy.

A request under this subsection may be made, if on the date of the request, the following requirements are
met:

•   the Group Policy is in effect;

•   We have not received notice from the Employer of its intent to end the Group Policy;

•   no application has been made to convert the insurance that is to be continued to an individual policy of
    life insurance as provided in the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU;
    and

•   the person making the request resides in a jurisdiction that permits portability.




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coi-eport                                                                                                    32
CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT
Request Period

To continue Portability Eligible Insurance under a different group policy, We must receive a completed
request form within the Request Period described below.

If written notice of the option to continue Portability Eligible Insurance is given within 15 days before or after
the date such insurance ends, the Request Period begins on the date the insurance ends and expires 31
days after such date.

If written notice of the option to continue Portability Eligible Insurance is given more than 15 days after but
within 90 days of the date such insurance ends, the Request Period begins on the date the insurance ends
and expires 45 days after the date of the notice.

If written notice of the option to continue Portability Eligible Insurance is not given within 90 days of the date
such insurance ends, the Request Period begins on the date the insurance ends and expires at the end of
such 90 day period.

Amount of the New Certificate

To be eligible for Portability Your Portability Eligible Insurance must equal or exceed $20,000.

The maximum amount of Portability Eligible Insurance that may be continued is the lesser of:

•   the total amount of all such insurance in effect immediately prior to the date it ends; and
•   For residents of all states other than Michigan $1,000,000. For Residents of Michigan. The maximum
    amount is limited by law and in 2003 the maximum is $166,000.

Premiums for the New Certificate.

When a request to continue Portability Eligible Insurance is made under this subsection, the first premium
must be paid during the Request Period. All premium payments must be made directly to Us. When We
issue the new certificate, We will also provide a schedule of premiums and payment instructions.

Right to Convert Life Insurance Amounts Not Continued

Any amount of Life Insurance not continued under this subsection may be converted under the section
entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU.

If You Die Within 31 Days of the Date Portability Eligible Insurance Ends

If You die within 31 days of the date Portability Eligible Insurance ends and an application for a new certificate
is not received by Us during such period, We will determine whether to pay insurance in accordance with the
section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU. If an application for a new certificate
was received by Us during such period, We will only pay benefits for the Portability Eligible Insurance applied
for in accordance with this subsection.

If You are Totally Disabled on the Date Your Employment Ends.

If You are Totally Disabled on the date Your employment ends and You elect to continue Portability Eligible
Insurance as provided in this subsection, You may at a later date become approved for the continuation of
insurance under the section entitled LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE
INSURANCE ENDS WHILE YOU ARE TOTALLY DISABLED. If You are so approved, all insurance continued
under this Portability subsection will end and We will return any premium paid by You for such insurance.




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coi-eport                                                                                                       33
CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT

AT THE EMPLOYER’S OPTION { TC "At The Employer's Option"\l 2}

The Employer has elected to continue insurance by paying premiums for employees who cease Active Work
in an eligible class for any of the reasons specified below. If Your insurance is continued, insurance for Your
Dependents may also be continued.

Insurance will continue for the following periods:

1. for the period You cease Active Work in an eligible class due to injury or Sickness, up to 9 months;

2. for the period You cease Active Work in an eligible class due to part-time work, layoff or strike, up to 2
   months;

3. for the period You cease Active Work in an eligible class due to any other Employer approved leave of
   absence, up to 2 months.

4. for the period You cease Active Work in an eligible class due to any Employer approved leave of absence
   because of a call-up to active military service, up to 24 months.

At the end of any of the continuation periods listed above, Your insurance will be affected as follows:

•   if You resume Active Work in an eligible class at this time, You will continue to be insured under the
    Group Policy;

•   if You do not resume Active Work in an eligible class at this time, Your employment will be considered to
    end and Your insurance will end in accordance with the DATE YOUR INSURANCE ENDS subsection of
    the section entitled ELIGIBILITY PROVISIONS: INSURANCE FOR YOU.

If Your insurance ends, Your Dependents’ insurance will also end in accordance with the DATE INSURANCE
FOR YOUR DEPENDENTS ENDS subsection of the section entitled ELIGIBILITY PROVISIONS:
INSURANCE FOR YOUR DEPENDENTS.

In addition to the Continuation of Insurance options described above, You may have the right to convert to a
policy of individual life insurance. We urge You to read the section entitled LIFE INSURANCE: CONVERSION
OPTION FOR YOU or the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOUR
DEPENDENTS.




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coi-eport                                                                                                       34
EVIDENCE OF INSURABILITY
{ TC "EVIDENCE OF INSURABILITY"\l 1}We require evidence of insurability satisfactory to Us as follows:

1. In order to become covered for an amount of Optional Life Insurance greater than the Non-Medical Issue
   Amount as shown in the SCHEDULE OF BENEFITS.

    If You do not give Us evidence of Your insurability, or if such evidence of insurability is not accepted by
    Us as satisfactory, the amount of Your Optional Life Insurance will be limited to the Non-Medical Issue
    Amount.

2. If You make a request during an annual enrollment period to increase the amount of Your Optional Life
   Insurance to an option which is more than one level above Your current amount of Optional Life
   Insurance.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, the amount of Your Optional Life Insurance may still increase under the following conditions;

    •   if Your current level of Optional Life Insurance is below the Non-Medical Issue Amount and the option
        one level higher is also below the Non-Medical Issue Amount, Your Optional Life Insurance will be
        increased to the option one level higher than Your current level.

    •   if Your current level of Optional Life Insurance is below the Non-Medical Issue Amount and the option
        one level higher is above the Non-Medical Issue Amount, Your Optional Life Insurance will be
        increased to the Non-Medical Issue Amount.

    If Your current level of Optional Life Insurance is above the Non-Medical Issue Amount and You do not
    give Us evidence of insurability or the evidence of insurability is not accepted by Us as satisfactory, Your
    Optional Life Insurance will not be increased.

    The Non-Medical Issue Amount is shown in the SCHEDULE OF BENEFITS.

3. If You make a request during an annual enrollment period to increase the amount of Your Optional Life
   Insurance to an option which is one level above Your current amount of Optional Life Insurance and the
   requested amount is more than the Non-Medical Issue Amount as shown in the SCHEDULE OF
   BENEFITS.

    If Your current amount is at or below the Non-Medical Issue Amount and You do not give Us evidence of
    insurability or the evidence of insurability is not accepted by Us as satisfactory, the amount of Your
    Optional Life Insurance will be limited to the Non-Medical Issue Amount.

    If Your current amount is greater than the Non-Medical Issue Amount and You do not give Us evidence of
    insurability or the evidence of insurability is not accepted by Us as satisfactory, the amount of Your
    Optional Life Insurance will not be increased.

4. If You make a request to increase the amount of Your Optional Life Insurance.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, the amount of Your Optional Life Insurance will not be increased.

5. When You make a late request for Optional Life Insurance. A late request is one made more than 31
   days after You become eligible.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, You will not be covered for Optional Life Insurance.

6. For Optional Life Insurance, if You were Hospitalized within 90 days preceding the date You enroll.


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EVIDENCE OF INSURABILITY
    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, You will not be covered for Optional Life Insurance.

7. In the case of transferred business, if You did not elect coverage under the prior plan for which You were
   eligible.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, You will not be covered for Optional Life Insurance.

8. In order to become covered for an amount of Life Insurance for Your Dependent Spouse greater than the
   Non-Medical Issue Amount for Your Dependent Spouse as shown in the SCHEDULE OF BENEFITS.

    If You do not give Us evidence of the insurability of Your Dependent Spouse, or if such evidence of
    insurability is not accepted by Us as satisfactory, the amount of Life Insurance for Your Dependent
    Spouse will be limited to the Non-Medical Issue Amount for Your Dependent Spouse.

9. If You make a request during an annual enrollment period to increase the amount of Life Insurance for
   Your Dependents to an option which is more than one level above Your Dependent's current amount of
   Life Insurance.

    If You do not give Us evidence of insurability for Your Dependent or the evidence of insurability for Your
    Dependent is not accepted by Us as satisfactory, the amount of Life Insurance for Your Dependents may
    still increase under the following conditions;

    •   If the current level of Life Insurance for Your Dependents is below the Non-Medical Issue Amount
        and the option one level higher is also below the Non-Medical Issue Amount, Life Insurance for Your
        Dependents will be increased to the option one level higher than Your Dependent's current level; or

    •   If the current level of Life Insurance for Your Dependents is below the Non-Medical Issue Amount
        and the option one level higher is above the Non-Medical Issue Amount, Life Insurance for Your
        Dependents will be increased to the Non-Medical Issue Amount.

    If the current level is above the Non-Medical Issue Amount and You do not give Us evidence of
    insurability or the evidence of insurability is not accepted by Us as satisfactory, the insurance will not be
    increased.

    The Non-Medical Issue Amount is shown in the SCHEDULE OF BENEFITS.

10. If You make a request during an annual enrollment period to increase the amount of Life Insurance for
    Your Dependents to an option which is one level above Your Dependent's current amount of Life
    Insurance and the requested amount is more than the Non-Medical Issue Amount as shown in the
    SCHEDULE OF BENEFITS.

    If the current amount of Life Insurance for Your Dependents is at or below the Non-Medical Issue Amount
    and You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, the amount will be limited to the Non-Medical Issue Amount.

    If the current amount of Life Insurance for Your Dependents is greater than the Non-Medical Issue
    Amount and You do not give Us evidence of insurability or the evidence of insurability is not accepted by
    Us as satisfactory, the amount will not be increased.

11. In order for You to increase the amount of Life Insurance for Your Dependents.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, the amount of Life Insurance for Your Dependents will not be increased.


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EVIDENCE OF INSURABILITY
12. If You make a late request for Life Insurance for Your Dependents. A late request is one made more than
    31 days after Your Dependent becomes eligible.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, Your Dependents will not be covered for Life Insurance.

13. If Your Dependent was Hospitalized within 90 days preceding the date You enroll Your Dependent for Life
    Insurance.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, Your Dependents will not be covered for Life Insurance.

14. In the case of transferred business, if You did not elect coverage under the prior plan for which Your
    Dependents were eligible.

    If You do not give Us evidence of insurability or the evidence of insurability is not accepted by Us as
    satisfactory, Your Dependents will not be covered for Life Insurance.

The evidence of insurability is to be given at Your expense.




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LIFE INSURANCE: FOR YOU
{ TC "LIFE INSURANCE: FOR YOU"\l 1}If You die, Proof of Your death must be sent to Us. When we receive
such Proof with the claim, We will review the claim and if We approve it, will pay the Beneficiary the Life
Insurance in effect on the date of Your death.

PAYMENT OPTIONS

We will pay the Life Insurance in one sum. Other modes of payment may be available upon request. For
details, call Our toll free number shown on the Certificate Face Page.




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LIFE INSURANCE: FOR YOUR DEPENDENTS
{ TC "LIFE INSURANCE: FOR YOUR DEPENDENTS"\l 1}If a Dependent dies, Proof of the Dependent’s
death must be sent to Us. When We receive such Proof with the claim, We will review the claim and if We
approve it, will pay the Beneficiary the Life Insurance amount in effect on the date of the Dependent’s death.

PAYMENT OPTIONS

We will pay the Life Insurance in one sum. Other modes of payment may be available upon request. For
details, call Our toll free number shown on the Certificate Face Page.




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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU
{ TC "LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU"\l 1}For purposes of this
section, the term “ABO Eligible Life Insurance” refers to each of Your Life Insurance benefits for which the
Accelerated Benefit Option is shown as available in the Schedule of Benefits.

If You become Terminally Ill, You or Your legal representative have the option to request Us to pay ABO
Eligible Life Insurance before Your death. This is called an accelerated benefit. The request must be made
while ABO Eligible Life Insurance is in effect.

Terminally Ill or Terminal Illness means that due to injury or sickness, You are expected to die within 6
months.

Requirements For Payment of an Accelerated Benefit

Subject to the conditions and requirements of this section, We will pay an accelerated benefit to You or Your
legal representative if:

•   the amount of each ABO Eligible Life Insurance benefit to be accelerated equals or exceeds $20,000; and
•   the ABO Eligible Life Insurance to be accelerated has not been assigned; and
•   We have received Proof that You are Terminally Ill.

We will only pay an accelerated benefit for each ABO Eligible Life Insurance benefit once.

Proof of Your Terminal Illness

We will require the following Proof of Your Terminal Illness:

•   a completed accelerated benefit claim form;
•   a signed Physician’s certification that You are Terminally Ill; and
•   an examination by a Physician of Our choice, at Our expense, if We request it.

You or Your legal representative should contact the Employer to obtain a claim form and information
regarding the accelerated benefit.

Upon Our receipt of Your request to accelerate benefits, We will send You a letter with information about the
accelerated benefit payment You requested. Our letter will describe the amount of the accelerated benefits
We will pay and the amount of Life Insurance remaining after the accelerated benefit is paid.

Accelerated Benefit Amount

We will pay an accelerated benefit up to the percentage shown in the SCHEDULE OF BENEFITS for each
ABO Eligible Life Insurance benefit in effect for You, subject to the following:

    Maximum accelerated benefit amount. The maximum amount We will pay for each ABO Eligible Life
    Insurance benefit is shown in the SCHEDULE OF BENEFITS.

    Scheduled reduction of an ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance
    benefit is scheduled to reduce within the 6 month period after the date You or Your legal representative
    request an accelerated benefit, We will calculate the accelerated benefit using the amount of such ABO
    Eligible Life Insurance that will be in effect immediately after the reduction(s) scheduled for such period.

    Scheduled end of ABO Eligible Life Insurance Benefit. If an ABO Eligible Life Insurance benefit is
    scheduled to end within 6 months after the date You or Your legal representative request an accelerated
    benefit, We will not pay an accelerated benefit for such ABO Eligible Life Insurance benefit.

    Previous conversion of an ABO Eligible Life Insurance Benefit. We will not pay an accelerated
    benefit for any amount of ABO Eligible Life Insurance which You previously converted under the section
    entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU.


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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOU
We will pay the accelerated benefit in one sum unless You or Your legal representative select another
payment mode.

Effect of Payment of an Accelerated Benefit

    On premium for Your Life Insurance. After We pay the accelerated benefit, any premium You are
    required to pay will be based upon the amount of Your Life Insurance remaining after the accelerated
    benefit is paid.

    On Your Life Insurance at Your death. The amount of Life Insurance that We will pay at Your death will
    be decreased by:

    •   the amount of the accelerated benefit paid by Us.

    On Your Life Insurance at conversion. The amount to which You are entitled to convert under the
    section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU, will be decreased by:

    •   the amount of the accelerated benefit paid by Us.

Date Your Option to Accelerate Benefits Ends

The accelerated benefit option will end on the earliest of:

•   the date ABO Eligible Life Insurance ends;
•   the date You or Your legal representative assign all ABO Eligible Life Insurance; or
•   the date You or Your legal representative have accelerated all ABO Eligible Life Insurance benefits.




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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOUR
DEPENDENT SPOUSE
{ TC "LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOUR DEPENDENT SPOUSE"\l
1}If Your Spouse becomes Terminally Ill, You or Your legal representative have the option to request Us to
pay Life Insurance for Your Spouse before his death. This is called an accelerated benefit. The request must
be made while Life Insurance for Your Spouse is in effect.

Terminally Ill or Terminal Illness means that due to injury or sickness, Your Spouse is expected to die within
6 months.

Requirements For Payment of an Accelerated Benefit

Subject to the conditions and requirements of this section, We will pay an accelerated benefit to You or Your
legal representative if:

•   the amount of Life Insurance for the Terminally Ill Spouse equals or exceeds $20,000; and
•   the ABO Eligible Life Insurance to be accelerated has not been assigned; and
•   We have received Proof that Your Spouse is Terminally Ill.

We will only pay an accelerated benefit for Life Insurance for Your Spouse once.

Proof of Your Spouse’s Terminal Illness

We will require the following Proof of Your Spouse’s Terminal Illness:

•   a completed accelerated benefit claim form;
•   a signed Physician’s certification that Your Spouse is Terminally Ill; and
•   an examination by a Physician of Our choice, at Our expense, if We request it.

You or Your legal representative should contact the Employer to obtain a claim form and information
regarding the accelerated benefit.

Upon Our receipt of Your request to accelerate benefits, We will send You a letter with information about the
accelerated benefit payment You requested. Our letter will describe the amount of the accelerated benefits
We will pay and the amount of Life Insurance remaining after the accelerated benefit is paid.

Accelerated Benefit Amount

We will pay an accelerated benefit up to the percentage shown in the SCHEDULE OF BENEFITS for the
amount of Life Insurance in effect for a Terminally Ill Spouse, subject to the following:

    Maximum accelerated benefit amount. The maximum amount We will pay is shown in the SCHEDULE
    OF BENEFITS.

    Scheduled reduction of Life Insurance for a Terminally Ill Spouse. If the Life Insurance in effect for a
    Terminally Ill Spouse is scheduled to reduce within the 6 month period after the date You or Your legal
    representative request an accelerated benefit, We will calculate the accelerated benefit using the amount
    of Life Insurance that will be in effect for Your Spouse immediately after the reduction(s) scheduled for
    such period.

    Scheduled end of Life Insurance for a Terminally Ill Spouse. If the Life Insurance in effect for a
    Terminally Ill Spouse is scheduled to end within 6 months after the date You or Your legal representative
    request an accelerated benefit, We will not pay an accelerated benefit.




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LIFE INSURANCE: ACCELERATED BENEFIT OPTION (ABO) FOR YOUR
DEPENDENT SPOUSE
We will pay the accelerated benefit in one sum unless You or Your legal representative select another
payment mode.

Effect of Payment of an Accelerated Benefit

    On Premium for Life Insurance. Any premium You are required to pay for Life Insurance for Your
    Spouse for whom We paid an accelerated benefit will be based upon the amount of Life Insurance for
    Your Spouse remaining after payment of the accelerated benefit.

    On Payment of Life Insurance at a Spouse’s death. The amount of Life Insurance that We will pay at
    death of Your Spouse for whom We paid an accelerated benefit will be decreased by:

    •   the amount of the accelerated benefit paid by Us for Your Spouse.

    On Life Insurance at conversion. The amount to which Your Spouse for whom We paid an accelerated
    benefit is entitled to convert under the section entitled LIFE INSURANCE: CONVERSION OPTION FOR
    YOUR DEPENDENTS provision will be decreased by:

    •   the amount of the accelerated benefit paid by Us for Your Spouse.

Date Your Option to Accelerate Benefits Ends

The accelerated benefit option for Your Spouse will end on the earliest of:

•   the date Life Insurance for Your Spouse ends;
•   the date Your rights in Life Insurance for Your Spouse are assigned; or
•   the date You or Your legal representative have accelerated all Dependent
    Life Insurance benefits.




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LIFE INSURANCE: CONVERSION OPTION FOR YOU
{tc "LIFE INSURANCE: CONVERSION OPTION FOR YOU" \l 1}If Your Life Insurance ends for any of the
reasons stated below, You have the option to buy an individual policy of life insurance (“new policy”) from Us
during the Application Period in accordance with the conditions and requirements of this section. This is
referred to as the “option to convert”. Evidence of Your insurability will not be required.

When You Will Have the Option to Convert

You will have the option to convert when:

•   Your Life Insurance ends because:

    •   You cease to be in an eligible class; or
    •   Your employment ends; or
    •   the Group Policy ends provided You have been insured for Life Insurance for at least 5 years; or
    •   the Group Policy is amended to end Life Insurance for an eligible class of which You are a member,
        provided You have been insured for Life Insurance for at least 5 years.

A reduction in the amount of Your Life Insurance as a result of the payment of an accelerated benefit will not
give rise to a right to convert under this section.

Application Period

If You opt to convert Your Life Insurance for any of the reasons stated above, We must receive a completed
conversion application form from You within the Application Period described below.

If You are given Written notice of the option to convert within 15 days before or after the date Your Life
Insurance ends, the Application Period begins on the date that such Life Insurance ends and expires 31 days
after such date.

If You are given Written notice of the option to convert more than 15 days after the date Your Life Insurance
ends, the Application Period begins on the date such Life Insurance ends and expires 15 days from the date
of such notice. In no event will the Application Period exceed 91 days from the date Your Life Insurance ends.

Option Conditions

The option to convert is subject to these conditions:

1. Our receipt within the Application Period of:

    •   Your Written application for the new policy; and
    •   the premium due for such new policy;

2. The premium rates for the new policy will be based on:

    •   Our rates then in use;
    •   the form and amount of insurance;
    •   Your class of risk; and
    •   Your attained age when Your Life Insurance ends;

3. the new policy may be on any form then customarily offered by Us excluding term insurance;

4. the new policy will be issued without an accidental death and dismemberment benefit, a continuation
   benefit, an accelerated benefit option, a waiver of premium benefit or any other rider or additional benefit;
   and

5. the new policy will take effect on the 32nd day after the date Your Life Insurance ends; this will be the case
   regardless of the duration of the Application Period.


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LIFE INSURANCE: CONVERSION OPTION FOR YOU
Maximum Amount of the New Policy

If Your Life Insurance ends due to the end of the Group Policy or the amendment of the Group Policy to end
Life Insurance for an eligible class of which You are a member, the maximum amount of insurance that You
may elect for the new policy is the lesser of:

•   the amount of Your Life Insurance that ends under the Group Policy less the amount of life insurance for
    which You become eligible under any group policy within 31 days after the date insurance ends under the
    Group Policy; or

•   $2,000

If Your Life Insurance ends for any other reason, the maximum amount of insurance that You may elect for
the new policy is the amount of Your Life Insurance that ends under the Group Policy.

If You Die Within 31 Days After Your Life Insurance Ends

If You die within 31 days after Your Life Insurance ends, Proof of Your death must be sent to Us. When We
receive such Proof with the claim, We will review the claim and if We approve it will pay the Beneficiary the
amount of Life Insurance You were entitled to convert.

Effect of Previous Conversion

If You obtained a new policy through this conversion option and Your Life Insurance is later continued under
the section entitled LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED, We will only pay Your Life Insurance under such section if the new
policy is returned to Us. If the new policy is returned to us, We will refund to Your estate the premium paid for
such policy without interest, less any debt incurred under such policy. If the new policy is not returned to Us,
We will only pay the life insurance in effect under such new policy.

We will not pay insurance under both the Group Policy and the new policy.




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LIFE INSURANCE: CONVERSION OPTION FOR YOUR DEPENDENTS
{ TC "LIFE INSURANCE: CONVERSION OPTION FOR YOUR DEPENDENTS"\l 1}If Life Insurance for a
Dependent ends for any of the reasons stated below, You or the dependent will have the option to buy from
Us an individual policy of life insurance (“new policy”) during the Application Period in accordance with the
conditions and requirements of this section. This is referred to as “the option to convert”. Evidence of the
Dependent’s insurability will not be required.

When You or a Dependent Will Have the Option to Convert

You will have the option to convert Life Insurance for a Dependent when:

•   Life Insurance for the Dependent ends because:

    •      You cease to be in an eligible class ; or
    •      Your employment ends ; or
    •      the Group Policy ends provided You have been insured for Life Insurance for the Dependent for at
           least 5 years; or
    •      the Group Policy is amended to end Life Insurance for Dependents for an eligible class of which You
           are a member, provided You have been insured for Life Insurance for the Dependent for at least 5
           years.

A reduction in the amount of Life Insurance for a Dependent as a result of the payment of an accelerated
benefit will not give rise to a right to convert under this section.

A Dependent will have the option to convert when Life Insurance ends because such Dependent ceases to
qualify as a Dependent as defined in this certificate.

You must notify the Employer in the event that a Dependent ceases to qualify as a Dependent as defined in
this certificate.

Application Period

If You or a Dependent opt to convert as stated above, We must receive a completed conversion application
form within the Application Period described below.

If Written notice of the option to convert is given within 15 days before or after the date Life Insurance for the
Dependent ends, the Application Period begins on the date that such Life Insurance ends and expires 31
days after such date.

If Written notice of the option to convert is given more than 15 days after the date Life Insurance for the
Dependent ends, the Application Period begins on the date such Life Insurance ends and expires 15 days
from the date of such notice. In no event will the Application Period exceed 91 days from the date Life
Insurance for the Dependent ends.

Option Conditions

The option to convert is subject to these conditions:

1. Our receipt within the Application Period of:

    •      a Written application for the new policy for the Dependent; and
    •      the premium due for such new policy;

2. the premium rates for the new policy will be based on:

    •      Our rates then in use;
    •      the form and amount of insurance;
    •      the Dependent’s class of risk; and
    •      the Dependent’s attained age when Life Insurance for such Dependent ends;

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LIFE INSURANCE: CONVERSION OPTION FOR YOUR DEPENDENTS
3. the new policy may be on any form then customarily offered by Us excluding term insurance;

4. the new policy will be issued without an accidental death and dismemberment benefit, a continuation
   benefit, an accelerated benefit option, waiver of premium benefit or any other rider or additional benefit;
   and

5. the new policy will take effect on the 32nd day after the date Life Insurance for the Dependent ends; this
   will be the case regardless of the duration of the Application Period.

Maximum Amount of the New Policy

If Life Insurance for a Dependent ends due to the end of the Group Policy or the amendment of the Group
Policy to end Life Insurance for Dependents for an eligible class of which You are a member, the maximum
amount of insurance that may be elected for the new policy is the lesser of:

•   the amount of Life Insurance for the Dependent that ends under the Group Policy less the amount of life
    insurance for dependents for which You become eligible under any group policy within 31 days after the
    date insurance ends under the Group Policy; or

•   $2,000

If Life Insurance for a Dependent ends for any other reason , the maximum amount of insurance that may be
elected for the new policy is the amount of Life Insurance for the Dependent that ends under the Group
Policy.

If a Dependent Dies Within the 31 Days After Life Insurance for a Dependent Ends

If a Dependent dies within 31 days after the date Life Insurance for the Dependent ends, Proof of the
Dependent’s death must be sent to Us. When we receive such Proof with the claim, We will review the claim
and if We approve it, will pay the Beneficiary the amount of Life Insurance for the Dependent that could have
been converted.




co/l/dep                             Total Document Page 110 of 224                                         47
LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED
{ TC "LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS WHILE YOU ARE
TOTALLY DISABLED"\l 1}
For All Active Full Time Employees:

If Your Life Insurance ends while You are Totally Disabled, You may at a later date become eligible to
continue certain Life Insurance under this section during the period You are Totally Disabled. Premium
payment will not be required. We will determine Your eligibility for this continuation after We receive Proof
that You have satisfied the conditions and requirements of this section.

For the purpose of this section, the Life Insurance that You may become eligible to continue (“Continuation
Eligible Life Insurance”) refers to Your:

•   Optional Life Insurance;

to the extent that such insurance was in effect for You on the date Your Continuation Eligible Life Insurance
ended.

Continuation Eligible Life Insurance does not include Life Insurance amounts accelerated under the section
entitled LIFE INSURANCE: ACCELERATED BENEFIT OPTION FOR YOU.

Total Disability must begin before You attain age 60 and while You are insured for Continuation Eligible Life
Insurance.

Total Disability or Totally Disabled means, for purposes of this section, that due to an injury or sickness:

•   You are unable to perform the material duties of Your regular job; and
•   You are unable to perform any other job for which You are fit by education, training or experience.

TOTAL DISABILITY AND PROOF REQUIREMENTS

You will become eligible for this continuation if Your Total Disability continues without interruption from the
date You become Totally Disabled through the end of the Continuation Waiting Period.

Continuation Waiting Period means the period which begins on the date You become Totally Disabled and
which expires 9 consecutive months after such date.

Please refer to the Important Notice that appears at the end of this section for information on insurance during
the Continuation Waiting Period.

If You were disabled when Your insurance ended, You should contact Us as soon as reasonably possible to
advise Us that You were disabled on the date such insurance ended. After the Continuation Waiting Period
expires, You must send Us Proof that You were Totally Disabled when Your Continuation Eligible Life
Insurance ended and that such Total Disability has continued without interruption through the expiration of the
Continuation Waiting Period. You must do this within 3 months following the expiration of the Continuation
Waiting Period.

As part of such Proof, We may choose a Physician to examine You to verify that You are eligible for this
continuation. If We do so, We will pay for such exam. After We receive and review Your Proof, We will
determine if You are approved for this continuation. We will send You Written notice advising whether You
are approved.

To verify that You continue to be Totally Disabled without interruption after Our initial approval, We may
periodically request that You send Us Proof that You continue to be Totally Disabled. We will not ask for such
Proof more than once each year.




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LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED
DATE CONTINUATION ENDS

The Continuation Eligible Life Insurance continued under this section may be reduced on account of Your age
or as otherwise described in this certificate and will end at the earliest of:

1. the date You die;
2. the date Your Total Disability ends;
3. the date You do not give Us Proof of Totally Disability, as required;
4. the date You refuse to be examined by Our Physician, as required; or
5. the date You attain age 65.

OPTION TO CONVERT YOUR CONTINUATION ELIGIBLE LIFE INSURANCE

When a continuation under this section ends, You may buy an individual policy of life insurance from Us. The
details of this option are described in the section entitled LIFE INSURANCE: CONVERSION OPTION FOR
YOU. For the purpose of that section, the end of this continuation will be considered the end of Your
employment. You may not use the conversion option described in such section if:

•   before the end of the Application Period for conversion You return to Active Work in an eligible class and
    become insured under the Group Policy; or

•   You have already converted all of Your Continuation Eligible Life Insurance under such section.

IF YOU DIE DURING CONTINUATION

If You die while Your Continuation Eligible Life Insurance is being continued under this section, Proof of Your
death must be sent to Us within one year of Your death. Proof includes supporting documentation that Total
Disability continued with no interruption from the date Your Life Insurance ended until the date of Your death.

When We receive such Proof with the claim, We will review the claim and if We approve it, will pay the
Beneficiary the Continuation Eligible Life Insurance continued under this section.

Effect of Previous Conversion

If You converted Your Continuation Eligible Life Insurance to an individual policy, We will only pay the
Continuation Eligible Life Insurance under this section if such individual policy is returned to Us. If it is
returned to Us, We will refund to Your estate the premiums paid for such policy without interest, less any debt
incurred under such policy.

If You do not return such individual policy to Us, We will pay the life insurance in effect under the individual
policy.

We will not pay insurance under both the Group Policy and the individual policy.

IMPORTANT NOTICE

On the date Your insurance ends, We will not know whether You will be able to satisfy the Total Disability and
Proof Requirements specified above. For this reason, We urge You to consider taking the following steps:

Step 1. When Your Continuation Eligible Life Insurance ends, ask the Employer if such insurance will be
continued with premium payment. If the answer is yes, ask if such continuation will be for at least 12 months.
If the answer is yes, file a claim for continuation of insurance under this section at the end of the Continuation
Waiting Period.



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LIFE INSURANCE: ELIGIBILITY FOR CONTINUATION IF LIFE INSURANCE ENDS
WHILE YOU ARE TOTALLY DISABLED
If the Employer will not continue Your Continuation Eligible Life Insurance as described in Step 1, proceed to
Step 2.

Step 2. Read the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU. You have the
option to convert Your Continuation Eligible Life Insurance to an individual policy of insurance with premium
payment.

If the Employer will not continue Your Continuation Eligible Life Insurance as described in Step 1 and You do
not convert to an individual policy as described in Step 2:

•   You will not be insured should You die during the Continuation Waiting Period; and

•   You may not be eligible to convert Your Continuation Eligible Life Insurance at the end of the
    Continuation Waiting Period if We do not approve You for the continuation under this section.




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FILING A CLAIM
{ TC "FILING A CLAIM"\l 1}The Employer should have a supply of claim forms. Obtain a claim form from the
Employer and fill it out carefully. Return the completed claim form with the required Proof to the Employer.
The Employer will certify Your insurance under the Group Policy and send the certified claim form and Proof
to Us.

When we receive the claim form and Proof We will review the claim and, if We approve it, We will pay benefits
subject to the terms and provisions of this certificate and the Group Policy.

CLAIMS FOR LIFE INSURANCE BENEFITS

    When a claimant files a claim for Life Insurance benefits, Proof should be sent to Us as soon as is
    reasonably possible after the death of an insured. If we approve the claim, we will pay benefits subject to
    the terms and provisions of this certificate and the Group Policy.




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GENERAL PROVISIONS
{tc "GENERAL PROVISIONS" \l 1}Assignment{tc "Assignment" \l 2}

You may assign Your Life Insurance rights and benefits under the Group Policy as a gift or as a viatical
assignment.

We will recognize the assignee(s) under such assignment as owner(s) of Your right, title and interest in the
Group Policy if:

1. a Written form satisfactory to Us, affirming this assignment, has been completed;
2. the Written form has been Signed by You and the assignee(s);
3. the Employer acknowledges that the Life Insurance being assigned is in force on the life of the assignor;
   and
4. the Written form is delivered to Us for recording.

Viatical assignments may only be made after Your Life Insurance has been in effect under this certificate for 2
years. However, you may make a viatical assignment before the end of the 2 year period if you are Terminally
Ill.

Terminally Ill means that You are expected to die within 6 months. As Proof of Your Terminal Illness You or
Your legal representative must send Us a signed Physician’s certification that You are Terminally Ill. We may
also request an exam by a Physician of Our choice, at Our expense.

Beneficiary{tc "Beneficiary" \l 2}

You may designate a Beneficiary in Your application or enrollment form. You may change Your Beneficiary at
any time. To do so, You must send a Signed and dated, Written request to the Employer using a form
satisfactory to Us. Your Written request to change the Beneficiary must be sent to the Employer within 30
days of the date You Sign such request.

You do not need the Beneficiary’s consent to make a change. When We receive the change, it will take effect
as of the date You Signed it. The change will not apply to any payment made in good faith by Us before the
change request was recorded.

If two or more Beneficiaries are designated and their shares are not specified, they will share the insurance
equally.

If there is no Beneficiary designated or no surviving designated Beneficiary at Your death, We may determine
the Beneficiary to be one or more of the following who survive You:

1.   Your Spouse;
2.   Your Child(ren);
3.   Your parent(s); or
4.   Your siblings(s)

For Your Life Insurance for Your Dependents, We will pay You as the Beneficiary, if alive. If You are not alive,
We may determine the Beneficiary to be one or more of the following who survive You:

1.   Your Spouse;
2.   Your child(ren);
3.   Your parent(s); or
4.   Your sibling(s)

If You and any Dependent die within a 24 hour period, We will pay the Dependent’s Life Insurance to the
Beneficiary receiving payment of Your Life Insurance or, We may pay Your estate.

Instead of making payment to any of the above, we may pay Your estate. Any payment made in good faith
will discharge our liability to the extent of such payment.

If a Beneficiary or payee is a minor or incompetent to receive payment, We will pay that person’s guardian.
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GENERAL PROVISIONS

Suicide{tc "Suicide" \l 2}

For Optional Life

If You commit suicide within 2 years from the date Life Insurance for You takes effect, We will not pay such
insurance and Our liability will be limited as follows:

•   any premium paid by You will be returned to the Beneficiary.
•   any premium paid by the Employer will be returned to the Employer.

If You commit suicide 2 years from the date an increase in Your Life Insurance takes effect, We will pay to the
Beneficiary the amount of insurance in effect on the day before the increase. Any premium You paid for the
increase will be returned to the Beneficiary. Any premium paid by the Employer for the increase will be
returned to the Employer.

For Dependent Life

If a Dependent commits suicide within 2 years from the date Life Insurance for such Dependent takes
effect, We will not pay such insurance and Our liability will be limited as follows:

•   any premium paid by You will be returned to the Beneficiary.
•   any premium paid by the Employer will be returned to the Employer.

If a Dependent commits suicide within 2 years from the date an increase in Life Insurance for such Dependent
takes effect, We will pay to the Beneficiary the amount of insurance in effect on the day before the increase.
Any premium You paid for the increase will be returned to the Beneficiary. Any premium paid by the
Employer for the increase will be returned to the Employer.

Entire Contract{tc "Entire Contract" \l 2}

Your insurance is provided under a contract of group insurance with the Employer. The entire contract with
the Employer is made up of the following:

1. the Group Policy and its Exhibits, which include the certificate(s);
2. the Employer's application; and
3. any amendments and/or endorsements to the Group Policy.

Incontestability: Statements Made by You{tc "Incontestability: Statements Made By You" \l 2}

Any statement made by You will be considered a representation and not a warranty. We will not use such
statement to avoid insurance, reduce benefits or defend a claim unless the following requirements are met:

1. the statement is in a Written application or enrollment form;
2. You have Signed the application or enrollment form; and
3. a copy of the application or enrollment form has been given to You or Your Beneficiary.

We will not use Your statements which relate to insurability to contest life insurance after it has been in force
for 2 years during Your life, unless the statement is fraudulent. In addition, We will not use such statements
to contest an increase or benefit addition to such insurance after the increase or benefit has been in force for
2 years during Your life, unless the statement is fraudulent.

Misstatement of Age{tc "Mistatement of Age" \l 2}

If Your or Your Dependent’s age is misstated, the correct age will be used to determine if insurance is in
effect and, as appropriate, We will adjust the benefits and/or premiums.



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GENERAL PROVISIONS
Conformity with Law{tc "Conformity With Law" \l 2}

If the terms and provisions of this certificate do not conform to any applicable law, this certificate shall be
interpreted to so conform.

Autopsy{tc "Autopsy" \l 2}

We have the right to make a reasonable request for an autopsy where permitted by law. Any such request
will set forth the reasons We are requesting the autopsy.




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                          Privacy Notice To Our Customers

THIS PRIVACY NOTICE IS GIVEN TO YOU ON BEHALF OF METROPOLITAN LIFE
INSURANCE COMPANY.

TO PLAN SPONSORS AND GROUP INSURANCE CERTIFICATE HOLDERS: This notice
explains how we treat information we receive about anyone who applies for or obtains our
products and services under employee benefit plans that we insure or group insurance
contracts that we issue. Please note that we refer to these individuals in this notice by using
the term "you", as if this notice were being addressed to these individuals.

Why We Need to Know About You: We need to know about you so that we can provide you with
the insurance and other products and services you’ve asked for. We may also need information from
you and others to help us verify your identity in order to prevent money laundering and terrorism.

What we need to know about you includes your address, age and other basic information. But we
may have to know more about you, including your finances, employment, health, hobbies or
business you conduct with us, with other MetLife companies (our “affiliates”) or with other
companies.

How We Learn about You: What we know about you we get mostly from you. But we may also
have to find out more about you from other sources in order to make sure that what we know about
you is correct and complete. Those sources may include your adult relatives, employers, consumer
reporting agencies, health care providers and others. Some of our sources may give us reports, and
they may disclose what they know about you to others.

How We Protect What We Know About You: We treat what we know about you confidentially.
Our employees are told to take care in handling your information. They may get information about
you only when there is a good reason to do so. We take steps to make our computer data bases
secure and to safeguard the information we have about you.

How We Use and Disclose What We Know About You: We may use anything we know about you
to help us serve you better. We may use it, and disclose it to our affiliates and others, for any
purpose allowed by law. For instance, we may use your information, and disclose it to others, in
order to:

• Help us evaluate your request for a MetLife          • Help us run our business
  product or service
                                                       • Process data for us
• Help us process claims and other transactions
                                                       • Perform research for us
• Confirm or correct what we know about you
                                                       • Audit our business
• Help us prevent fraud, money laundering,
  terrorism and other crimes by verifying what we      • Help us comply with the law
  know about you




                                Total Document Page 118 of 224
Other reasons we may disclose what we know about you include:

•   Doing what a court or government agency requires us to do; for example, complying with a
    search warrant or subpoena
•   Telling another company what we know about you, if we are or may be selling all or any part of
    our business or merging with another company
•   Telling a group customer about its members’ claims or cooperating in a group customer’s audit of
    our service
•   Giving information to the government so that it can decide whether you may get benefits that it
    will have to pay for
•   Telling your health care provider about a medical problem that you have but may not be aware of
•   Giving your information to a peer review organization if you have health insurance with us
•   Giving your information to someone who has a legal interest in your insurance, such as someone
    who lent you money and holds a lien on your insurance or benefits

Generally, we will disclose only the information we consider reasonably necessary to disclose.

We may use what we know about you in order to offer you our other products and services. We
may disclose this information (other than consumer reports and health information) to our affiliates
so that they can offer their products and services, or ours, to you. By law, we don’t have to let you
prevent these disclosures. Our affiliates include life, car and home insurers, securities firms,
broker-dealers, a bank, a legal plans company and financial advisors. In the future, we may have
affiliates in other businesses.

We may also provide information to others outside of the MetLife companies, such as marketing
companies, to help us offer our products and services to you. If we have joint marketing
agreements with other financial services companies, we may give them information about you so
that they can offer their products and services to you; however, we cannot do this if the state law
that applies to you does not allow it. Except for joint marketing arrangements, we do not make any
other disclosures of your information to other companies who want to sell their products or services
to you. For example, we will not sell your name to a catalog company. And we will not disclose
any consumer report or health information to other companies so that they can offer their products
and services, or ours, to you.

How You Can See and Correct Your Information: Generally, we will let you review what we know
about you if you ask us in writing. Medical information will generally be disclosed through the
licensed physician you choose or as otherwise required by law. (Because of its legal sensitivity, we
will not show you anything that we learned in connection with a claim or lawsuit.) If you tell us that
what we know about you is incorrect, we will review it. If we agree with you, we will correct our
records. If we do not agree with you, you may tell us in writing, and we will include your statement
when we give your information to anyone outside MetLife.

How You Can Get Other Material from Us: In addition to any other privacy notice we may give you,
we must give you a summary of our privacy policy once each year. You may have other rights under
the law. If you want to know more about our privacy policy, please contact us at our website,
www.metlife.com, or write to your MetLife insurance company, c/o MetLife Privacy Office, P.O. Box
2006, Aurora, Illinois 60507-2006.

                                                                                       CPN-GLB-2003




                                 Total Document Page 119 of 224
Exhibit D   KCDC’s LTD Certificate




                              Total Document Page 120 of 224
                                  Metropolitan Life Insurance Company
                          One Madison Avenue, New York, New York 10010-3690

                                      CERTIFICATE OF INSURANCE
                                          for the Employees of
                            Knoxville's Community Development Corporation
                                          (called the Employer)

This is your Certificate of Insurance for Long Term Disability Insurance as long as you are insured under
This Plan. The Group Policy and this Certificate may be changed or canceled according to the terms,
conditions and provisions of the Group Policy. This Certificate describes the benefits under the Plan in
effect as of January 01, 2005. Any prior Certificate relating to the coverage set forth herein is void.

MetLife in its discretion has authority to interpret the terms, conditions, and provisions of the entire contract.
This includes the Group Policy, Certificate and any Amendments.

The Group Policy is delivered in and administered according to the laws of the governing jurisdiction.

Whenever a reference to "you" or "your" is made in this Certificate of Insurance, it means the covered
Employee. Reference to "we", "us" or "our" means MetLife. Reference to "This Plan" means that part of the
Employer's plan of benefits that is insured by MetLife.




                                   C. Robert Henrikson
                                   President and Chief Operating Officer

Group Policy No.: TM 05579023-G

Florida Residents: The benefits of the policy providing your coverage are governed primarily by
the law of a state other than Florida.

For Maryland residents: The group insurance policy providing coverage under
this certificate was issued in a jurisdiction other than Maryland and may not
provide all of the benefits required by Maryland law.
Form G.24303-Cert.
                                                                                  All Active Full Time Employees
                                                                                                    NB 02/08/2005




                                       Total Document Page 121 of 224
For Texas Residents:                                 Para Residentes de Texas:

            IMPORTANT NOTICE                                     AVISO IMPORTANTE
To obtain information or make a complaint:           Para obtener informacion o para someter una
                                                     queja:

You may call MetLife’s toll free telephone number    Usted puede llamar al numero de telefono gratis de
for information or to make a complaint at            MetLife para informacion o para someter una queja
                                                     al

                 1-800-275-4638                                       1-800-275-4638


You may contact the Texas Department of              Puede comunicarse con el Departmento de
Insurance to obtain information on companies,        Seguros de Texas para obtener informacion acerca
coverages, rights or complaints at                   de companias, coberturas, derechos o quejas al


                 1-800-252-3439                                       1-800-252-3439


You may write the Texas Department of Insurance      Puede escribir al Departmento de Seguros de
P.O. Box 149104                                      Texas
Austin, TX 78714-9104                                P.O. Box 149104
Fax # (512) 475-1771                                 Austin, TX 78714-9104
                                                     Fax # (512) 475-1771

PREMIUM OR CLAIM DISPUTES: Should You                DISPUTAS SOBRE PRIMAS O RECLAMOS: Si
have a dispute concerning Your premium or about      tiene una disputa concerniente a su prima o a un
a claim You should contact MetLife first. If the     reclamo, debe comunicarse con MetLife primero.
dispute is not resolved, You may contact the Texas   Si no se resuelve la disputa, puede entonces
Department of Insurance.                             comunicarse con el departamento (TDI).

ATTACH THIS NOTICE TO YOUR CERTIFICATE:              UNA ESTE AVISO A SU CERTIFICADO:
This notice is for information only and does not     Este aviso es solo para proposito de informacion y
become a part or condition of the attached           no se convierte en parte o condicion del
document.                                            documento adjunto.




                                   Total DocumentiiiPage 122 of 224
Arkansas residents please be advised of the following:

                             IMPORTANT NOTICE

IF YOU HAVE A QUESTION CONCERNING YOUR COVERAGE OR A CLAIM,
FIRST CONTACT YOUR GROUP EMPLOYER OR GROUP ACCOUNT
ADMINISTRATOR. IF, AFTER DOING SO, YOU STILL HAVE A CONCERN, YOU
MAY CALL METLIFE'S TOLL-FREE TELEPHONE NUMBER:

                                1-800-275-4638

IF YOU ARE STILL CONCERNED AFTER CONTACTING BOTH YOUR GROUP
EMPLOYER AND METLIFE, YOU SHOULD FEEL FREE TO CONTACT:

                   ARKANSAS INSURANCE DEPARTMENT
                      CONSUMER SERVICES DIVISION
                            1200 WEST THIRD
                   LITTLE ROCK, ARKANSAS 72201-1904




                        Total DocumentivPage 123 of 224
California residents please be advised of the following:

                              IMPORTANT NOTICE

TO OBTAIN ADDITIONAL INFORMATION, OR TO MAKE A COMPLAINT,
CONTACT METLIFE AT:

               METROPOLITAN LIFE INSURANCE COMPANY
                        1 MADISON AVENUE
                       NEW YORK, NY 10010
         ATTN: CORPORATE CONSUMER RELATIONS DEPARTMENT
                           1-800-275-4638

IF, AFTER CONTACTING METLIFE REGARDING A COMPLAINT, YOU FEEL
THAT A SATISFACTORY RESOLUTION HAS NOT BEEN REACHED, YOU MAY
FILE A COMPLAINT WITH THE CALIFORNIA INSURANCE DEPARTMENT AT:

                  CALIFORNIA DEPARTMENT OF INSURANCE
                         300 SOUTH SPRING STREET
                          LOS ANGELES, CA 90013
                      1-800-927-4357 (within California)
                      1-213-897-8921 (outside California)




                        Total DocumentvPage 124 of 224
Georgia residents please be advised of the following:

                             IMPORTANT NOTICE

The laws of the state of Georgia prohibit insurers from unfairly discriminating
against any person based upon his or her status as a victim of family violence.




                        Total DocumentviPage 125 of 224
Utah residents please be advised of the following:

                                 NOTICE TO POLICYHOLDERS

Insurance companies licensed to sell life insurance, health insurance, or annuities in the State of Utah are
required by law to be members of an organization called the Utah Life and Health Insurance Guaranty
Association ("ULHIGA"). If an insurance company that is licensed to sell insurance in Utah becomes
insolvent (bankrupt), and is unable to pay claims to its policyholders, the law requires ULHIGA to pay some
of the insurance company's claims. The purpose of this notice is to briefly describe some of the benefits and
limitations provided to Utah insureds by ULHIGA.

                                 PEOPLE ENTITLED TO COVERAGE
      ·      You must be a Utah resident.
      ·      You must have insurance coverage under an individual or group policy.

                                          POLICIES COVERED
      ·      ULHIGA provides coverage for certain life, health and annuity insurance policies.

                                  EXCLUSIONS AND LIMITATIONS
Several kinds of insurance policies are specifically excluded from coverage. There are also a number of
limitations to coverage. The following are not covered by ULHIGA:
      ·      Coverage through an HMO.
      ·      Coverage by insurance companies not licensed in Utah.
      ·      Self-funded and self-insured coverage provided by an employer that is only administered by
             an insurance company.
      ·      Policies protected by another state's Guaranty Association.
      ·      Policies where the insurance company does not guarantee the benefits.
      ·      Policies where the policyholder bears the risk under the policy.
      ·      Re-insurance contracts.
      ·      Annuity policies that are not issued to and owned by an individual, unless the annuity policy is
             issued to a pension benefit plan that is covered.
      ·      Policies issued to pension benefit plans protected by the Federal Pension Benefit Guaranty
             Corporation.
      ·      Policies issued to entities that are not members of the ULHIGA, including health plans,
             fraternal benefit societies, state pooling plans and mutual assessment companies.




                                     Total DocumentviiPage 126 of 224
                              LIMITS ON AMOUNT OF COVERAGE
Caps are placed on the amount ULHIGA will pay. These caps apply even if you are insured by more than
one policy issued by the insolvent company. The maximum ULHIGA will pay is the amount of your coverage
or $500,000 — whichever is lower. Other caps also apply:
       ·       $100,000 in net cash surrender values.
       ·       $500,000 in life insurance death benefits (including cash surrender values).
       ·       $500,000 in health insurance benefits.
       ·       $200,000 in annuity benefits — if the annuity is issued to and owned by an individual or the
               annuity is issued to a pension plan covering government employees.
       ·       $5,000,000 in annuity benefits to the contract holder of annuities issued to pension plans
               covered by the law. (Other limitations apply).
       ·       Interest rates on some policies may be adjusted downward.

                                          DISCLAIMER
       PLEASE READ CAREFULLY:
      ·    COVERAGE FROM ULHIGA MAY BE UNAVAILABLE UNDER THIS
POLICY OR, IF AVAILABLE, IT MAY BE SUBJECT TO SUBSTANTIAL LIMITATIONS
OR EXCLUSIONS. THE DESCRIPTION OF COVERAGES CONTAINED IN THIS
DOCUMENT IS AN OVERVIEW. IT IS NOT A COMPLETE DESCRIPTION. YOU
CANNOT RELY ON THIS DOCUMENT AS A DESCRIPTION OF COVERAGE. FOR A
COMPLETE DESCRIPTION OF COVERAGE, CONSULT THE UTAH CODE, TITLE
31A, CHAPTER 28.
     ·    COVERAGE IS CONDITIONED ON CONTINUED RESIDENCY IN THE
STATE OF UTAH.
     ·     THE PROTECTION THAT MAY BE PROVIDED BY ULHIGA IS NOT A
SUBSTITUTE FOR CONSUMERS' CARE IN SELECTING AN INSURANCE COMPANY
THAT IS WELL-MANAGED AND FINANCIALLY STABLE.
     ·    INSURANCE COMPANIES AND INSURANCE AGENTS ARE REQUIRED
BY LAW TO GIVE YOU THIS NOTICE. THE LAW DOES, HOWEVER, PROHIBIT THEM
FROM USING THE EXISTENCE OF ULHIGA AS AN INDUCEMENT TO SELL YOU
INSURANCE.
     ·    THE ADDRESS OF ULHIGA, AND THE INSURANCE DEPARTMENT
ARE PROVIDED BELOW.
                                   Utah Life and Health Insurance
                                       Guaranty Association
                                        955 E. Pioneer Rd.
                                        Draper, Utah 84114
                                     Utah Insurance Department
                                  State Office Building, Room 3110
                                     Salt Lake City, Utah 84114




                                                viii
                                   Total Document Page 127 of 224
Virginia residents please be advised of the following:


          IMPORTANT INFORMATION REGARDING YOUR INSURANCE

In the event you need to contact someone about this insurance for any reason please
contact your agent. If no agent was involved in the sale of this insurance, or if you
have additional questions you may contact the insurance company issuing this
insurance at the following address and telephone number:

                        Metropolitan Life Insurance Company
                                 1 Madison Avenue
                            New York, New York 10010
                  Attn: Corporate Customer Relations Department

To phone in a claim related question, you may call Claims Customer Service at:

                                  1-800-275-4638

If you have been unable to contact or obtain satisfaction from the company or the
agent, you may contact the Virginia State Corporation Commission's Bureau of
Insurance at:


                              Life and Health Division
                                Bureau of Insurance
                                   P.O. Box 1157
                               Richmond, VA 23209

                          1-800-552-7945 - In-state toll-free
                          1-804-371-9691 - Out-of-state


Written correspondence is preferable so that a record of your inquiry is maintained.
When contacting your agent, company or the Bureau of Insurance, have your policy
number available.




                         Total DocumentixPage 128 of 224
Wisconsin residents please be advised of the following:


KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS


PROBLEMS WITH YOUR INSURANCE? - If you are having problems with your
insurance company or agent, do not hesitate to contact the insurance company or
agent to resolve your problem.


                      Metropolitan Life Insurance Company
                                Customer Service
                             4100 Boy Scout Blvd
                                Tampa, FL 33607
                                 1-800-811-8319


You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a
state agency which enforces Wisconsin's insurance laws, and file a complaint. You
can contact the OFFICE OF THE COMMISSIONER OF INSURANCE by contacting:


                    Office of the Commissioner of Insurance
                             Complaints Department
                                  P.O. Box 7873
                            Madison, WI 53707-7873
           1-800-236-8517 outside of Madison or 266-0103 in Madison.




                        Total DocumentxPage 129 of 224
                                                          TABLE OF CONTENTS
Section                                                                                                                                                 Page

CERTIFICATE OF INSURANCE .................................................................................................................... i
PLAN HIGHLIGHTS...................................................................................................................................... 1
  Employee Eligibility .................................................................................................................................... 1
  Long Term Disability Benefits.................................................................................................................... 1
  Limitations.................................................................................................................................................. 2
  Contributions ............................................................................................................................................. 3
  Benefits Checklist....................................................................................................................................... 3
EMPLOYEE ELIGIBILITY ............................................................................................................................. 3
LONG TERM DISABILITY BENEFITS........................................................................................................... 5
  Monthly Benefit .......................................................................................................................................... 5
  Reduction of Benefits - Other Income Benefits........................................................................................... 9
  Supplemental Benefits............................................................................................................................. 13
    Survivors Benefit .................................................................................................................................. 13
  Temporary Recovery................................................................................................................................ 13
  Concurrent Disability ............................................................................................................................... 14
  Limitations................................................................................................................................................ 14
    Limitation for Pre-existing Conditions.................................................................................................... 14
    Limitation for Disabilities Due to Particular Conditions .......................................................................... 14
    Limitation for Alcohol, Drug or Substance Abuse or Dependency....................................................... 16
  Exclusions................................................................................................................................................ 16
TERMINATION OF COVERAGE ................................................................................................................ 16
EXTENSION OF BENEFITS........................................................................................................................ 18
CLAIMS ....................................................................................................................................................... 18




                                                      Total DocumentxiPage 130 of 224
                                        PLAN HIGHLIGHTS

This Plan Highlights section is a summary of your Long Term Disability Benefits and provisions.
See the rest of your Certificate for more information.

It is important to read the rest of your Certificate. It describes your benefits as well as any
exclusions and limitations that apply to these benefits. Please read it carefully. You should talk
with your Employer if you have any questions.

You will notice that some of the terms used in your Certificate begin with capital letters. These
terms have special meanings. They are explained in this Certificate.

                                       Employee Eligibility

Eligible Employee: All Active Full Time Employees working at least 30 hours each week.
However, if you do not have regular work hours you will be an Eligible Employee if you have
worked at least an average of 30 hours a week during the preceding 12 calendar months (or during
your period of employment if less than 12 months).

Eligibility Waiting Period:

        Active Employees on and after January 01, 2005: 90 days of continuous service as an
        Employee.

Eligibility Date: January 01, 2005 or the first day of the calendar month after you complete the
Eligibility Waiting Period, whichever is later.

                                  Long Term Disability Benefits

Monthly Benefit: 60% of your Predisability Earnings, but not more than the Maximum Monthly
Benefit below, reduced by Other Income Benefits. Other Income Benefits are described in Section
B. of Long Term Disability Benefits.

Maximum Monthly Benefit: $5,000

Minimum Monthly Benefit: $100. The Minimum Monthly Benefit will not apply if you are in an
Overpayment situation or are receiving income from employment.

Elimination Period: 90 days of continuous Disability




                                                  1
                                 Total Document Page 131 of 224
Maximum Benefit Duration: The duration shown below:

Age on Date                                       Maximum Benefit
Disability Starts                                 Duration

Less than 60                                      To age 65
     60                                           60 months
     61                                           48 months
     62                                           42 months
     63                                           36 months
     64                                           30 months
     65                                           24 months
     66                                           21 months
     67                                           18 months
     68                                           15 months
69 and over                                       12months


Work Incentive:

         Work while Disabled: No offset for employment earnings during the first 24 months after
         you have satisfied your Elimination Period. However, your Monthly Benefit may be
         reduced if the total income you are receiving (including Rehabilitation Incentive and
         Family Care Expenses) exceeds 100% of your Predisability Earnings or Indexed
         Predisability Earnings.

         Rehabilitation Incentive: Your Monthly Benefit, before reduction for Other Income Benefits, is
         increased by 10% while participating in an approved Rehabilitation Program.

         Family Care Expenses: While participating in an approved Rehabilitation Program, up to $250
         per month incurred for Eligible Family Care Expenses for each Eligible Family Member during the
         first 24 months after you have satisfied the Elimination Period.

Survivors Benefit: A lump sum equal to 6 times the Monthly Benefit before reductions for Other Income
Benefits.

                                            Limitations

         Limitation for Pre-existing Conditions: Coverage for Pre-existing Conditions begins 12 months
         after your Effective Date of coverage.

         Limitation For Disabilities Due to Particular Conditions

         Limitation for Disability due to (i) Mental or Nervous Disorders or Diseases; or (ii)
         Neuromusculoskeletal and Soft Tissue Disorder; or (iii) Chronic Fatigue Syndrome:

         24 Monthly Benefits in your lifetime, or the Maximum Benefit Duration, whichever is less.
         Benefits may be paid beyond 24 months as described in the provision, subject to certain
         requirements.

         Limitation for Drug, Alcohol or Substance Abuse or Dependency:

         One period of Disability in your lifetime for up to: 24 Monthly Benefits; your successful
         completion of an approved rehabilitative program; your ceasing or refusing to participate
         in a rehabilitative program; or the Maximum Benefit Duration; whichever is less.




                                     Total Document2Page 132 of 224
                                           Contributions

Non-Contributory Insurance is coverage for which the Employer pays the entire premium.
Contributory Insurance is coverage for which you have to pay all or any part of the premium.
Please see your Employer regarding any contributions you may need to make for the coverage
under This Plan.

                                         Benefits Checklist

In order to receive benefits under This Plan, you must provide to us at your expense, and subject
to our satisfaction, all of the following documents. These are explained in this Certificate. Initial
submission of these documents should be made no later than the 12th week following your
original date of disability.

        Ö       Proof of Disability.

        Ö       Evidence of continuing Disability.

        Ö       Proof that you are under the Appropriate Care and Treatment of a Doctor throughout your
                Disability.

        Ö       Information about Other Income Benefits.

        Ö       Any other material information related to your Disability which may be requested by us.


Form G.24303-A


                                       EMPLOYEE ELIGIBILITY

Active Employee

You are an Active Employee if you:

1. are an Eligible Employee working for the Employer doing all the material duties of your
   occupation at (i) your usual place of business; or (ii) some other location that your Employer's
   business requires you to be;

2. are a citizen or legal resident of the United States or Canada; and

3. are not a temporary or seasonal Employee.

You will be deemed an Active Employee if:

1. you meet the above conditions; and

2. you are absent from work solely due to vacation days, holidays, scheduled days off, or
   approved leaves of absence not due to Disability.

For Contributory Insurance, if you make written application for coverage no later than 31 days after your
Eligibility Date and agree to have the required contributions deducted from your pay, you will be covered
on the later of:




                                       Total Document3Page 133 of 224
1. your Eligibility Date;

2. the date you meet the Active Employee requirements; or

3. the date of your written application.

However, if you were eligible for coverage under the prior plan but did not elect to be covered under the
prior plan, you will be required to provide Evidence of Good Health satisfactory to us. Your coverage will
become effective when we approve your Evidence of Good Health.

If you are an Active Employee and make written application more than 31 days after your Eligibility Date,
you will be required to provide Evidence of Good Health satisfactory to us. Your coverage will become
effective on the later of:

1. the date we approve your Evidence of Good Health; or

2. the date you meet the Active Employee requirements.

"Evidence of Good Health" is a statement providing your medical history. We will use this statement to
determine your insurability under This Plan. This statement must be provided to us at your expense.

Continuity of Coverage upon Replacement of Plans

In order to prevent a loss of coverage because of a transfer of insurance carriers, This Plan will
provide coverage for you if:

1. you were covered under the prior carrier’s plan that This Plan replaced at the time of transfer;
   and

2. you are an Eligible Employee and you are not an Active Employee.

Coverage will only be provided if the required payment toward the cost of your coverage is made to us.

The benefit payable will be that which would have been paid by the prior carrier had coverage remained in
force, less any benefit for which the prior carrier is liable.

Changes in Amount of Monthly Benefit

The amount of your Monthly Benefit may change as a result of a change in your earnings or class.
The new Monthly Benefit amount:

1. will take effect on the date of the change; and

2. will apply only to Disabilities commencing thereafter.

However, if you are not an Active Employee on the above date, the new Monthly Benefit amount will take
effect on the date you are again an Active Employee.


Form G.24303-B




                                      Total Document4Page 134 of 224
                             LONG TERM DISABILITY BENEFITS

A. Monthly Benefit

You will be paid a Monthly Benefit, in accord with Plan Highlights, if we determine that:

1. you are Disabled; and

2. you became Disabled while covered under This Plan.

Benefits will begin to accrue on the date following the day you complete your Elimination Period. Payment of
the Monthly Benefit will start on the date one month after completion of the Elimination Period. Subsequent
payments will be made each month thereafter. Payment is based on the number of days you are Disabled
during each one month period.

Contributions are not required for the time that Monthly Benefits are payable.

After we determine that you are Disabled, your Monthly Benefits will not be affected by:

1. termination of This Plan;

2. termination of your coverage; or

3. any plan change that is effective after the date you became Disabled.

When Benefits End

Monthly Benefits will end on the earliest of the following dates:

1. the end of the Maximum Benefit Duration;

2. the end of the period specified in the Limitation for Disabilities Due to Particular Conditions and the
   Limitation For Alcohol, Drug or Substance Abuse or Dependency;

3. the date you are no longer Disabled;

4. the date you fail to provide us with any of the information listed in Plan Highlights under Benefits
   Checklist;

5. the day you die;

6. the date you cease or refuse to participate in a Rehabilitation Program as described in Work
   Incentive; or

7. the date you fail to attend a medical examination requested by us as described in Medical
   Examination.

Elimination Period

Your Elimination Period begins on the day you become Disabled. It is a period of time during which
no benefits are payable. Your Elimination Period is shown in Plan Highlights. You must be under
the continuous care of a Doctor during your Elimination Period. You may temporarily recover from
your Disability during your Elimination Period. If you then become Disabled again due to the same
or related condition, you may not have to begin a new Elimination Period.




                                      Total Document5Page 135 of 224
Temporary Recovery During Your Elimination Period

If you return to work for 30 days or less during your Elimination Period, those days will count
towards your Elimination Period. However, if you return to work for more than 30 days before
satisfying your Elimination Period, you will have to begin a new Elimination Period.

Temporary Recovery means you cease to be Disabled. During a period of Temporary Recovery you will
not qualify for any change in coverage caused by a change in any of the following:

1. the rate of earnings used to determine your Predisability Earnings; or

2. the terms, provisions, or conditions shown in your Certificate of Insurance.

Definition of Disability

"Disabled" or "Disability" means that, due to sickness, pregnancy or accidental injury, you are
receiving Appropriate Care and Treatment from a Doctor on a continuing basis; and

1. during your Elimination Period and the next 24 month period, you are unable to earn more than
   80% of your Predisability Earnings or Indexed Predisability Earnings at your Own Occupation
   for any employer in your Local Economy; or

2. after the 24 month period, you are unable to earn more than 60% of your Indexed Predisability Earnings
   from any employer in your Local Economy at any gainful occupation for which you are reasonably
   qualified taking into account your training, education, experience and Predisability Earnings .

Your loss of earnings must be a direct result of your sickness, pregnancy or accidental injury. Economic
factors such as, but not limited to, recession, job obsolescence, paycuts and job-sharing will not be
considered in determining whether you meet the loss of earnings test.

For an employee whose occupation requires a license, "loss of license" for any reason does not, in itself,
constitute Disability.

"Appropriate Care and Treatment" means medical care and treatment that meet all of the following:

1. it is received from a Doctor whose medical training and clinical experience are suitable for
    treating your Disability;

2. it is necessary to meet your basic health needs and is of demonstrable medical value;

3. it is consistent in type, frequency and duration of treatment with relevant guidelines of national
    medical, research and health care coverage organizations and governmental agencies;

4. it is consistent with the diagnosis of your condition; and

5. its purpose is maximizing your medical improvement.

"Doctor" means a person who: (i) is legally licensed to practice medicine; and (ii) is not related to
you. A licensed medical practitioner will be considered a Doctor:

1. if applicable state law requires that such practitioners be recognized for the purposes of
    certification of disability; and

2. the care and treatment provided by the practitioner is within the scope of his or her license.




                                      Total Document6Page 136 of 224
"Own Occupation" means the activity that you regularly perform and that serves as your source of income. It
is not limited to the specific position you held with your Employer. It may be a similar activity that could be
performed with your Employer or any other employer.

"Local Economy" means the geographic area surrounding your place of residence which offers reasonable
employment opportunities. It is an area within which it would not be unreasonable for you to travel to secure
employment. If you move from the place you resided on the date you became Disabled, we may look at
both that former place of residence and your current place of residence to determine local economy.

Work Incentive

While you are Disabled, you are encouraged to work or participate in a Rehabilitation Program
during your Elimination Period or while Monthly Benefits are being paid to you. Reimbursement for
Eligible Family Care Expenses may also be available when you work or participate in an approved
Rehabilitation Program while Disabled.

When you work while Disabled, you will receive the sum of the following amounts:

1. your Monthly Benefit (including your Rehabilitation Incentive when applicable);

2. the amount of your earnings for working while Disabled; and

3. the amount of Family Care Expenses for which you are eligible.

During the 24 month period following your Elimination Period your Monthly Benefit will be reduced if the total
amount you receive from the above sources and Other Income Benefits exceeds 100% of your Predisability
Earnings or Indexed Predisability Earnings. Your Monthly Benefit will be reduced by that portion of the
amount you receive which exceeds 100% of your Predisability Earnings or Indexed Predisability Earnings.

After the 24 month period described above, your Monthly Benefit will be reduced by 50% of your earnings
from working while Disabled. Your Monthly Benefit will be further reduced if the total amount you receive
from the above sources and Other Income Benefits exceeds 100% of your Indexed Predisability Earnings.
Your Monthly Benefit will be reduced by that portion of the amount you receive which exceeds 100% of your
Indexed Predisability Earnings.

If your Monthly Benefit is reduced as a result of your receiving earnings from any work or service while
Disabled, the Minimum Monthly Benefit will not apply.

Monthly Benefit payments will cease on the date you refuse to participate in a Rehabilitation Program in
which we determine you are able to participate.

"Rehabilitation Program" means:

1. a return to active employment by you on either a part-time or full-time basis in an attempt to
   enable you to resume gainful employment or service in an occupation for which you are
   reasonably qualified taking into account your training, education, experience and past
   earnings; or

2. participating in vocational training or physical therapy. This must be deemed by one of our
   rehabilitation coordinators to be appropriate.

Rehabilitation Incentive

While Disabled, your Monthly Benefit, before reduction for Other Income Benefits, is increased by
10% when you participate in a Rehabilitation Program approved by us.




                                     Total Document7Page 137 of 224
Family Care Expenses

This provision applies during the first 24 months following the date you have satisfied the
Elimination Period.

While Disabled, when you work or participate in a Rehabilitation Program approved by us, you will be
reimbursed for Eligible Family Care Expenses incurred with respect to each Eligible Family Member.

“Eligible Family Member” means a person who is:

1. living with you as part of your household; and

2. chiefly dependent on you for support.

"Eligible Family Care Expenses" mean the monthly expenses incurred by you in order for you to
participate in a Rehabilitation Program, up to $250 for each Eligible Family Member. These are expenses
incurred:

1. to provide child care with respect to an Eligible Family Member under age 13. Child care must be
   provided by a licensed child care facility or other qualified child care provider. The child care provider
   may not be a member of your immediate family or living in your residence.

2. to provide care to an Eligible Family Member who as a result of a mental or physical impairment, is
    incapable of caring for himself or herself. Family Care Expenses for services provided by a member
    of your immediate family or any one living in your residence will not be reimbursed.

Eligible Family Care Expenses do not include expenses for which you are eligible for reimbursement
under any other group plan or from any other source.

You must provide satisfactory proof to us that you incurred such charges. You must give us proof that the
Eligible Family Member is incapable of caring for himself or herself and is chiefly dependent on you for
support. The proof must be satisfactory to us.

Predisability Earnings

"Predisability Earnings" means the amount of your gross salary or wages from your Employer as of
the day before your Disability began. This is calculated on a monthly basis.

This may include contributions you make through a salary reduction agreement with your Employer
to any of the following:

1. an Internal Revenue Code (IRC) Section 401(k), 403(b) or 457 deferred compensation
   arrangement;

2. an executive nonqualified deferred compensation arrangement; and

3. amounts contributed to your fringe benefits according to a salary reduction agreement under an
   IRC Section 125 plan.




                                     Total Document8Page 138 of 224
Predisability Earnings do not include:

1. awards, commissions and/or bonuses;

2. overtime pay;

3. your Employer's contributions on your behalf to any deferred compensation arrangement or
   pension plan; or

4. any other compensation.

If you do not have regular work hours, your Predisability Earnings are based on the average number of
hours you worked per month during the preceding 12 calendar months (or during your period of employment
if less than 12 months). In no event will the number of hours be more than 173 hours.

Indexed Predisability Earnings

Indexed Predisability Earnings means your Predisability Earnings increased by 7%.

The first increase will take place on the date the 13th Monthly Benefit is payable. Subsequent increases will
take effect on each anniversary of the first increase. You must have been continually receiving Monthly
Benefits under This Plan.

B. Reduction of Benefits - Other Income Benefits

Your Monthly Benefit is reduced by Other Income Benefits shown below. The Monthly Benefit
payable to you:

1. will not be less than the amount shown in Plan Highlights under Minimum Monthly Benefit
   (except in the case of an Overpayment or while receiving work earnings);

2. will not be further reduced due to cost-of-living increases payable under Other Income Benefits after the
   correct reduction has been determined;

3. will not be reduced by any reasonable attorney fees included in any award or settlement; and

4. will not be reduced by any sources other than those shown below.

If you receive Other Income Benefits in a lump sum instead of in monthly payments, you must provide to
us satisfactory proof of the breakdown of: (i) the amount attributable to lost income; and (ii) the time
period for which the lump sum is applicable. If you do not provide this information to us, we may reduce
your Monthly Benefit by an amount equal to the Monthly Benefit otherwise payable. We will reduce the
Monthly Benefit each month until the lump sum has been exhausted. However, if we are given proof of
the time period and amount attributable to lost income, we will make a retroactive adjustment.

List of Sources of Other Income Benefits

1. Federal Social Security Act, Railroad Retirement Act, Canada Pension Plan, or any
   provincial pension or disability plan, or the Canada Old Age Security Act

        a. benefits that you receive, are entitled to receive or would have been eligible to
           receive upon making timely application because of your disability or retirement will be
           counted; and




                                     Total Document9Page 139 of 224
       b. benefits available with respect to your spouse and dependents (regardless of marital status or
          their place of residence) because of your disability or retirement will be counted. If you are
          divorced or legally separated, benefits paid directly to your dependents and not taken into
          constructive receipt by you will not be counted.

       Estimating Social Security Benefits

       We reserve the right to reduce your Monthly Benefit by estimating the Social Security
       disability benefits you may be eligible to receive.

       Your Monthly Benefit will not be reduced by estimated Social Security disability benefits
       during the first 24 months of Monthly Benefit payments if, prior to the end of the 6 month
       period following the date you became disabled:

       1. you provide proof that you have applied for Social Security disability benefits;

       2. you have signed the Reimbursement Agreement which confirms that you will repay all
          Overpayments; and

       3. you have signed the form authorizing the Social Security Administration to release
          information on awards directly to us.

       If you have not received approval or final denial of your claim from the Social Security
       Administration by the end of this 24 month period, we will begin reducing your Monthly Benefit by
       an estimate of Social Security disability benefits. For purposes of this section, final denial of your
       claim means that you have received a “Notice of Denial of Benefits” from an Administrative Law
       Judge.

       In any case, when you do receive approval or final denial of your claim from the Social Security
       Administration:

       1. your Monthly Benefit will be adjusted; and

       2. you must promptly refund to us an amount equal to all Overpayments. If you do not promptly
          make such a refund to us, we may, at our option, reduce or offset against any future benefits
          payable to you, including the Minimum Benefit.

2. Group Insurance Policies

       Group insurance policies will be counted if the Employer contributes towards them or
       makes payroll deduction for any of the following:

       a. other group health insurance policies will be counted to the extent that they provide benefits
          for loss of time from work due to disability; and

       b. a group life policy that provides installment payments for permanent total disability will be
          counted.

3. Work Earnings, Rehabilitation Incentive, and Family Care Expenses will not be used to reduce
   your Monthly Benefit except as described in Work Incentive.




                                                 10
                                    Total Document Page 140 of 224
4. Employer's Retirement Plan

      Benefits for disability and/or retirement that you receive under the Employer's retirement
      plan will be counted to the extent they are attributable to the Employer's contributions.

      Benefits under the Employer's retirement plan that are payable for disability is money
      which:

      a. is payable under a retirement plan due to a disability as defined in that plan; and

      b. does not reduce the amount of money which would have been paid as retirement
         benefits at the normal retirement age under the plan if the disability had not occurred.
         (If the payment does cause such a reduction it will be deemed a retirement benefit as
         defined below.)

      Benefits under the Employer's retirement plan that are payable upon retirement is money
      which:

      a. is payable under the Employer's retirement plan either in a lump sum or in the form of
          periodic payments;

      b. is payable upon:

          i. the later of age 62 or normal retirement age as defined in the retirement plan;

          ii. early retirement age as defined in the retirement plan. (You must have voluntarily
              elected to receive payments prior to your normal retirement age); or

          iii. disability as defined in the retirement plan. (You must have voluntarily elected to
               receive payment prior to your normal retirement age and such payment does
               reduce the amount of money which would have been paid at the normal
               retirement age under the plan if the disability had not occurred); and

          NOTE: You will be considered to have voluntarily elected to receive payments if you
          file an application for benefits with the Retirement Plan and request the start of
          payments prior to your normal retirement age.

      c. does not represent contributions made by you. Payments which represent your contributions
         are deemed to be received over your expected remaining life regardless of when such
         payments are actually received.




                                               11
                                  Total Document Page 141 of 224
       The Employer's Retirement Plan is a plan which provides retirement benefits to
       Employees and which is not funded wholly by Employee contributions. The term shall not
       include the following, regardless of the source of contributions:

       a. profit sharing plans;

       b. thrift or savings plans;

       c. non-qualified plans of deferred compensation;

       d. plans under IRC Section 401(k) or 457;

       e. individual retirement accounts (IRA);

       f. tax sheltered annuities (TSA) under IRC Section 403(b);

       g. stock ownership plans; or

       h. Keogh (HR-10) plans.

5. No-fault Auto Laws

       Only the basic reparations portion for loss of income of a law providing for payments
       without determining fault in connection with automobile accidents will be counted.
       Supplemental disability benefits you buy under a no-fault auto law will not be counted.

6. Other Programs or Plans including:

       a.    a compulsory benefit program of any government which provides payment for loss of
            time from your job because of your disability will be counted;

       b. any other group disability income plan, fund, or other arrangement, no matter what
          called, if the Employer contributes toward it or makes payroll deductions for it, will be
          counted; or

       c. any sick pay or other salary continuation, other than vacation pay, paid to you by the
          Employer will be counted.

7. Workers' Compensation or a Similar Law

       Periodic benefits and substitutes and exchanges for periodic benefits will be counted.

8. Occupational Disease Laws

9. Maritime Maintenance & Cure

10. Third Party Recovery

       The amount of recovery you receive for loss of income as a result of claims against a
       third party by judgment, settlement or otherwise.

11. Unemployment Insurance Law or Program




                                                  12
                                     Total Document Page 142 of 224
Exceptions to Other Income Benefits

Other Income Benefits will not include:

1. group credit or mortgage disability insurance benefits; or

2. early retirement benefits not taken into constructive receipt; or

3. individual insurance policies.

C. Supplemental Benefits

Survivors Benefit

If you die while you are receiving benefit payments under This Plan, your spouse or unmarried
children under age 25 may be eligible for a lump sum Survivors Benefit.

The amount of the Survivors Benefit is equal to 6 times the Monthly Benefit before reductions for
Other Income Benefits. The amount of Survivors Benefit payable is reduced by any Overpayment
which we are entitled to recover.

We will pay the Survivors Benefit to your Eligible Survivor, if the following conditions are met:

1. you have completed your Elimination Period;

2. you are eligible to receive a Monthly Benefit at the time of death;

3. you have an Eligible Survivor; and

4. proof of your death is provided to us.

An Eligible Survivor is one of the following:

1. your surviving spouse; or

2. if there is no surviving spouse, your unmarried children or your spouse's unmarried children
    under age 25. The term children also includes adopted children and children placed for
    adoption until legal adoption. Payment will be divided into equal shares among the eligible
    children.

We will pay a Survivors Benefit to your Eligible Survivor on the date one month after the last Monthly Benefit
payment was made before your death. However, if there is no Eligible Survivor on the date payment is due
to be paid, no payment will be made.

Payment to a minor child may be made to an adult who submits proof satisfactory to us that he/she has
assumed custody and support of the child.

D. Temporary Recovery

Once benefits become payable under This Plan, you may Temporarily Recover from your Disability.
If you become Disabled again due to the same or related condition, you may not have to begin a
new Elimination Period.




                                                   13
                                      Total Document Page 143 of 224
Once you have satisfied your Elimination Period, a period of Temporary Recovery is your return to work for
less than 6 months for each period of Temporary Recovery.

During the Temporary Recovery you will not qualify for any change in coverage caused by a
change in any of the following:

1. the rate of earnings used to determine your Predisability Earnings; or

2. the terms, provisions, or conditions shown in your Certificate of Insurance.

If your recovery lasts longer than the Temporary Recovery period allowed when you become Disabled again
you will have to begin a new Elimination Period.

E. Concurrent Disability

If a new Disability occurs while Monthly Benefits are payable, it will be treated as part of the same
period of Disability. Monthly Benefits will continue while you remain Disabled. They will be subject
to both of the following:

1. the Maximum Benefit Duration; and

2. Limitations and Exclusions that apply to the new cause of Disability.


F. Limitations

Limitation for Pre-existing Conditions

You may be Disabled due to a Pre-existing Condition. No benefits are payable under This Plan in
connection with that Disability unless your Elimination Period starts after you have been an Active
Employee under This Plan for 12 consecutive months.

A Pre-existing Condition is an injury, sickness, or pregnancy for which you in the 3 months before
your Effective Date:

1. received medical treatment, care, or services;

2. took prescription medications or had medications prescribed; or

3. had symptoms or conditions which would cause a reasonably prudent person to seek diagnosis, care,
   or treatment.

If you cannot satisfy the above limitation and you were covered under the plan that This Plan replaced at the
time of transfer, benefits may be payable under This Plan. We will give consideration towards the
continuous time you were covered under the prior plan and This Plan. If you then satisfy the above
limitation, the maximum Monthly Benefit payable under This Plan will not exceed the lesser of: (i) the
Maximum Benefit under This Plan; and (ii) the maximum benefit under the prior plan.

Limitation For Disabilities Due to Particular Conditions

Monthly Benefits are limited to 24 months during your lifetime if you are Disabled due to a




                                                  14
                                     Total Document Page 144 of 224
1. Mental or Nervous Disorder or Disease, unless the Disability results from:

        a. schizophrenia;

        b. bipolar disorder;

        c. dementia; or

        d. organic brain disease.

"Mental or Nervous Disorder or Disease" means a medical condition of sufficient severity to meet the
diagnostic criteria established in the current Diagnostic And Statistical Manual Of Mental Disorders. You
must be receiving Appropriate Care and Treatment for your condition by a mental health Doctor.

2. Neuromusculoskeletal and soft tissue disorder including, but not limited to, any disease or
   disorder of the spine or extremities and their surrounding soft tissue; including sprains and
   strains of joints and adjacent muscles, unless the Disability has objective evidence of:

        a. seropositive arthritis;

        b. spinal tumors, malignancy, or vascular malformations;

        c. radiculopathies;

        d. myelopathies;

        e. traumatic spinal cord necrosis; or

        f. musculopathies.

        Glossary of Terms Used in This Section

        Seropositive Arthritis: An inflammatory disease of the joints supported by clinical findings
        of arthritis plus positive serological tests for connective tissue disease.

        Spinal: Components of the bony spine or spinal cord.

        Tumors: Abnormal growths which may be malignant or benign.

        Vascular Malformations: Abnormal development of blood vessels.

        Radiculopathies: Disease of the peripheral nerve roots supported by objective clinical findings of
        nerve pathology.

        Myelopathies: Disease of the spinal cord supported by objective clinical findings of spinal cord
        pathology.

        Traumatic Spinal Cord Necrosis: Injury or disease of the spinal cord resulting from traumatic
        injury with resultant paralysis.

        Musculopathies: Disease of muscle fibers, supported by pathological findings on biopsy or
        electromyography (EMG).

3. Chronic fatigue syndrome and related conditions.




                                                  15
                                     Total Document Page 145 of 224
In no event will Monthly Benefits be payable longer than the Maximum Benefit Duration shown in the Plan
Highlights.

Limitation For Alcohol, Drug or Substance Abuse or Dependency

If you are Disabled due to alcohol, drug or substance abuse or dependency, Monthly Benefits are
limited to one period of Disability during your lifetime. You must be participating in an available
rehabilitative program recommended by a Doctor. An available rehabilitative program is a program
available to you through either: (i) another group plan of the Employer (such as an Employee
Assistance Program or Medical Plan); or (ii) services generally available to the public through local
community services at no or minimal cost to you. In no event will Monthly Benefit payments be
made beyond the earlier of:

1. the date 24 Monthly Benefit payments have been made;

2. the date you are no longer participating in the rehabilitative program;

3. the date you refuse to participate in an available rehabilitative program; or

4. the date you complete the rehabilitative program.

G. Exclusions

This Plan does not cover any Disability which results from or is caused by or contributed to

1. war, insurrection, or rebellion;

2.   active participation in a riot;

3. intentionally self-inflicted injuries or attempted suicide; or

4.   committing a felony.


Form G.24303-1

                                   TERMINATION OF COVERAGE

This provision applies to you if you are not Disabled.

You will cease to be covered on the earliest of the following dates:

1. the date This Plan terminates;

2. the date you cease to be an Eligible Employee;

3. the date you stop making any required contributions;

4. the date you go on strike or are locked out; or

5. the date you are laid-off.




                                                    16
                                       Total Document Page 146 of 224
Approved Leave of Absence

Your Employer may continue your coverage for an approved leave of absence by paying the
required premium payments. Coverage may continue until the earliest of:

1. the date the Employer stops paying the required premium;

2. the date the leave ends; or

3. the last day of the month in which your leave of absence begins.

In the event the leave qualifies under the Family and Medical Leave Act of 1993 (FMLA), the period may
be extended for a period agreed to by you and your Employer. It may not exceed 12 weeks following the
date the leave begins. Your Employer must continue to pay the required premium.

Reinstatement of Coverage

If your coverage ends, you may become covered again as an Eligible Employee. Coverage is
subject to the following:

1. If your coverage ends because you cease to be an Eligible Employee, and if you become an
    Eligible Employee again within 3 months, the Eligibility Waiting Period will be waived. For
    Contributory Insurance you will not have to provide Evidence of Good Health.

2. If your coverage ends because you cease making the required contribution while on an approved Family
    Medical Leave Act (FMLA) leave of absence, and you become an Eligible Employee again within 31
    days of the earlier of:

    a. the end of the period of leave you and your Employer agreed upon; or

    b. the end of the 12 week period following the date your leave began;

    the Eligibility Waiting Period will be waived and for Contributory Insurance, you will not have to
    provide Evidence of Good Health.

3. In all other cases for Contributory Insurance, if your coverage ends because you fail to make the
    required contribution, you must provide Evidence of Good Health to become covered again.

4. If you become covered again as described in 1. and 2. above, the Pre-existing Condition
    Limitation will be applied as if there had been no gap in coverage.


Form G.24303-D




                                                  17
                                     Total Document Page 147 of 224
                                   EXTENSION OF BENEFITS

This provision applies if your coverage ceases while you are Disabled.

During your Elimination Period your coverage will continue while you are continuously Disabled until
the end of your Elimination Period. Benefits will begin after the end of your Elimination Period. Your
coverage will continue in either of the following situations:

1. This Plan terminates; or

2. you cease to be an Eligible Employee but required payments are made to us for Contributory
   Insurance.

Benefits are payable if your Disability began while coverage was in force and continues without
interruption after termination.

Extension of benefits beyond the period coverage was in force is limited to the Maximum Benefit
Duration. Extension of benefits is subject to all of the following:

1. your Elimination Period; and

2. payment of any required contributions; and

3. all other applicable provisions of This Plan.


Form G.24303-C


                                                   CLAIMS
Notice of Disability

Notify us of your Disability as soon as you are able.

To notify us you may call us directly. You may obtain this phone number from you’re Employer. You will be
instructed on how to give proof of Disability. You will be required to answer all questions concerning your
Disability.

If you do not receive statements or instructions within 15 days after you have notified us, you may submit
your statement in a letter.

Proof of Disability

Provide proof of Disability within 3 months after the end of your Elimination Period.

No benefits are payable for claims submitted more than one year after the date of Disability. However,
you can request that benefits be paid for late claims if you can show that:

1. it was not reasonably possible to give written proof of Disability during the one year period; and

2. proof of Disability satisfactory to us was given to us as soon as was reasonably possible.




                                                   18
                                      Total Document Page 148 of 224
Documentation

At your expense, you must provide documented proof of your Disability. Proof includes, but is not limited
to:

1. the date your Disability started;

2. the cause of your Disability; and

3. the prognosis of your Disability.

You will be required to provide signed authorization for us to obtain and release medical and financial
information, and any other items we may reasonably require in support of your Disability.

These will include but are not limited to:

1. proof of continuing Disability;

2. proof you have applied, or are not eligible, for Other Income Benefits. If you do not provide proof you
   have applied for Other Income Benefits, we may reduce your Monthly Benefit. The reduction will be
   based on our estimate of what you would be eligible to receive through proper and timely pursuit;

3. proof that you applied for Social Security disability benefits until denied at the Administrative Law
   Judge level; and

4. proof you have applied for Workers' Compensation benefits or benefits under a similar law. If you do
   not provide proof that you have applied for these benefits, we may reduce your Monthly Benefit. The
   reduction will be based on our estimate of what you would be eligible to receive through proper and
   timely pursuit.

If you do not provide satisfactory documentation within 60 days after the date we ask for it, your claim
may be denied.

Method of Payment

When we determine you are Disabled:

1. Monthly Benefits are paid one month after you qualify for them. Such benefits will be paid on a monthly
   basis thereafter.

2. Benefits will be paid to you. However, benefits unpaid at your death will be paid to:

    a. your spouse, if living; otherwise

    b. your children, if living, divided equally;

    c. your estate. If benefits are payable to your estate, we may pay up to $1,500 to someone related
       to you by blood or by marriage whom we deem entitled to this amount. We will be discharged to
       the extent of any payment made in good faith.

3. Monthly Benefits due for a period of less than a month will be paid at a daily rate of 1/30th of the Monthly
   Benefit payable.




                                                    19
                                       Total Document Page 149 of 224
Right To Recover Overpayments

We have the right to recover from you any amount that we determine to be an Overpayment. You have
the obligation to refund to us any such amount. Our rights and your obligations in this regard are also set
forth in the reimbursement agreement you are required to sign when you become eligible for benefits
under This Plan. This agreement: (i) confirms that you will repay all Overpayments; and (ii) authorizes us
to obtain any information relating to Other Income Benefits.

An Overpayment occurs when we determine that the total amount paid by us on your claim is more than
the total of the benefits due under This Plan. This includes any Overpayments resulting from:

1. retroactive awards received from sources shown in the List of Other Income Benefits;

2. fraud; or

3. any error we make in processing your claim.

The Overpayment equals the amount we paid in excess of the amount we should have paid under This
Plan. In the case of a recovery from a source other than This Plan, our Overpayment recovery will not be
more than the amount of the recovery.

You have the right to appeal any Overpayment recovery.

An Overpayment also occurs when payment is made by us that should have been made under another
group plan. In that case, we may recover the payment from one or more of the following:

1. any other insurance company;

2. any other organization; or

3. any person to or for whom payment was made.

We may, at our option, recover the Overpayment by:

1. reducing or offsetting against any future benefits payable to you or your survivors;

2. stopping future benefit payments (including Minimum Benefits) which would otherwise be due under
   This Plan. Payments may continue when the Overpayment has been recovered; or

3. demanding an immediate refund of the Overpayment from you.

Legal Actions

No legal action of any kind may be filed against us:

1. within the 60 days after proof of Disability has been given; or

2. more than three years after proof of Disability must be filed. This will not apply if the law in the area
   where you live allows a longer period of time to file proof of Disability.

Medical Examinations

We will have the right to have you examined at reasonable intervals by medical specialists of our choice.
The examination will be at our expense. Failure to attend a medical examination or cooperate with the
medical examiner may be cause for denial or suspension of your benefits.




                                                   20
                                      Total Document Page 150 of 224
Incontestability of Coverage

This Plan cannot be declared invalid after it has been in force for 2 years. It can be declared invalid due to
non-payment of premium.

No statement of health used by any person to get coverage can be used to declare coverage invalid if the
person has been covered under This Plan for 2 years. In order to use a statement of health to deny
coverage before the end of 2 years, it must have been signed by the person. A copy of the signed statement
must be given to the person or the person's beneficiary.

Assignment

You may not assign your benefits. This means that you may not give or transfer your benefits to anyone
else.

Workers' Compensation

This Plan is not in lieu of, and does not affect, any requirement for coverage by Workers' Compensation
Insurance or any government mandated temporary disability income benefits law.


Form G.24303-E




                                                   21
                                      Total Document Page 151 of 224
"THIS IS THE END OF THE CERTIFICATE. THE FOLLOWING IS ADDITIONAL INFORMATION"




                          Total Document Page 152 of 224
                                      SPECIAL SERVICES


                       SOCIAL SECURITY ASSISTANCE PROGRAM

If you become Disabled MetLife provides you with assistance in applying for Social Security
disability benefits. Before outlining the details of this assistance, you should understand why
applying for Social Security disability benefits is important.

Why You Should Apply For Social Security Disability Benefits

Both you and your Employer contribute payroll taxes to Social Security. A portion of those tax
dollars are used to finance Social Security's program of disability protection. Since your tax
dollars help fund this program, it is in your best interest to apply for any benefits to which you may
be entitled. Your spouse and children may also be eligible to receive Social Security disability
benefits due to your Disability.

There are several reasons why it may be to your financial advantage to receive Social Security
disability benefits. Some of them are:

1. Avoids reduced retirement benefits

    Should you become disabled and approved for Social Security disability benefits, Social
    Security will freeze your earnings record as of the date Social Security determines that your
    disability has begun. This means that the months/years that you are unable to work because
    of your disability will not be counted against you in figuring your average earnings for
    retirement and survivors benefit.

2. Medicare Protection

    Once you have received 24 months of Social Security disability benefits, you will have
    Medicare protection for hospital expenses. You will also be eligible to apply for the medical
    insurance portion of Medicare.

3. Trial Work Period

    Social Security provides a trial work period for the rehabilitation efforts of disabled workers
    who return to work while still disabled. Full benefit checks can continue for up to 9 months
    during the trial work period.

4. Cost of Living Increases Awarded by Social Security Will Not Reduce Your Disability
   Benefits

    MetLife will not decrease your Disability benefit by the periodic cost of living increases
    awarded by Social Security. This is also true for any cost of living increases awarded by
    Social Security to your spouse and children.

    This is called a Social Security "freeze." It means that only the Social Security benefit
    awarded to you and your dependents will be used by MetLife to reduce your Disability
    benefit; with the following exceptions:

    a. an error by Social Security in computing the initial amount;

    b. a change in dependent status; or




                                 Total Document Page 153 of 224
    c. your Employer submitting updated earnings records to Social Security for earnings
       received prior to your Disability.

    Over a period of years, the net effect of these cost of living increases can be substantial.

How MetLife Assists You in the Social Security Approval Process

As soon as you apply for Disability benefits, MetLife begins assisting you with the Social Security
approval process.

1. Contact Prior to Application For Social Security Disability Benefits

    Before you even apply for Social Security disability benefits. We will help you determine the
    best time to apply for Social Security disability benefits. A MetLife Case Management
    Specialist begins assisting you with the application process at that time. The Specialist
    personally contacts you by phone to explain, in detail, how to apply for Social Security
    disability benefits and the advantages of doing this. We provide you with a list of items
    needed by Social Security in order to complete your claim.

2. Assistance Throughout the Application Process

    MetLife has a dedicated team of Social Security Specialists. These Specialists, many of
    whom have worked for the Social Security Administration, are also located within our Claim
    Department. They provide expert assistance upfront and help guide you through the
    application process.

3. Guidance Through Appeal Process by Social Security Specialists

    Social Security disability benefits may be initially denied, but are often approved following an
    appeal. If your benefits are denied, our dedicated team of Social Security Specialists provide
    expert assistance on an appeal if your situation warrants continuing the appeal process. They
    guide you through each stage of the appeal process. These stages may include:

    a. Reconsideration by the Social Security Administration

    b. Hearing before an Administrative Law Judge

    c. Review by an Appeals Council established within the Social Security Administration in
       Washington, D.C.

    d. A civil suit in Federal Court

4. Social Security Attorneys and Vendors

    Depending on your individual needs, MetLife may provide a referral to an attorney or vendor
    who specializes in Social Security law. The cost for these attorneys is deducted from the
    amount you must repay to us if the retroactive Social Security disability benefits you later
    receive result in MetLife having paid more Disability benefits than we should have paid.


                             EARLY INTERVENTION PROGRAM

The MetLife Early Intervention Program is offered to all covered Employees, and your
participation is voluntary. The program helps identify early those Employees who might benefit
from vocational analyses and rehabilitation services before they are eligible for Long Term




                                 Total Document Page 154 of 224
Disability Benefits. Early rehabilitation efforts are more likely to reduce the length of your disability
and help you return to work sooner than expected.

If you cannot work, or can only work part-time due to a disability, your Employer will notify
MetLife. Our Rehabilitation Coordinators may be able to assist you by:

1. Reviewing and evaluating your disabling condition, even before a claim for Long Term Disability
   Benefits is submitted (with your consent);

2. Designing individualized return to work plans that focus on your abilities, with the goal of return
   to work;

3. Identifying local community resources;

4. Coordinating services with other benefit providers, including: medical carrier, short term
   disability carrier*, workers’ compensation carrier, and state disability plans;

5. Monitoring return to work plans in progress and modifying them as recommended by the
   attending physician (with your consent).

Our assistance is offered at no cost to either you or your Employer.

    * If you also have MetLife Short Term Disability coverage or Salary Continuance Plan
       Management, these services are provided automatically. Notification by your Employer is
       not necessary.


                                 RETURN TO WORK PROGRAM

Goal of Rehabilitation

The goal of MetLife is to focus on Employees' abilities, instead of disabilities. This "abilities"
philosophy is the foundation of our Return to Work Program. By focusing on what Employees can
do versus what they can't, we can assist you in returning to work sooner than expected.

Incentives For Returning To Work

Your disability plan is designed to provide clear advantages and financial incentives for returning
to work either full-time or part-time, while still receiving a Disability benefit. In addition to financial
incentives, there may be personal benefits resulting from returning to work. Many Employees
experience higher self-esteem and the personal satisfaction of being self-sufficient and productive
once again. If it is determined that you are capable but you do not participate in the Return to
Work Program, your Disability benefits may cease.

Vocational Rehabilitation Services

As a covered Employee you are automatically eligible to participate in our Return to Work
Program. The Program focus is vocational rehabilitation, which means identifying the necessary
training and therapy that can help you return to work. In many cases, this means helping you
return to your former occupation, although rehabilitation can also lead to a new occupation which
is better suited to your condition and makes the most of your abilities.




                                   Total Document Page 155 of 224
There is no additional cost to you for the services we provide, and they are tailored to meet your
individual needs. These services include, but are not limited to, the following:

1. Vocational Analyses

    Assessment and counseling to help determine how your skills and abilities can be applied to
    a new or a modified job with your Employer.

2. Labor Market Surveys

    Studies to find jobs available in your locale that would utilize your abilities and skills.

3. Retraining Programs

    Programs to facilitate return to your previous job, or to train you for a new job.

4. On-Site Job Analyses

    Analyses to determine what modifications may be made to maximize your employment
    opportunities.

5. Job Modifications/Accommodations

    Changes in your job or accommodations to help you perform the previous job or a similar
    vocation, as required of your Employer under the Americans With Disabilities Act (ADA).

6. Training in Job Seeking Skills

    Special training to identify abilities, set goals, develop resumes, polish interviewing
    techniques, and provide other career search assistance.

Rehabilitation Staff

The Case Management Specialist handling your claim will begin the rehabilitation process. You
may be referred to our professional Rehabilitation staff that includes Registered Nurses and
vocational rehabilitation coordinators. Registered Nurses might address how your medical
condition impacts your ability to return to work. Vocational rehabilitation coordinators will focus on
identifying how your abilities can be best applied to either your previous job or a new job.

These rehabilitation specialists will contact you personally. They will coordinate their activities
with your medical carrier and/or attending physician for a broad understanding of your diagnosis,
prognosis, and expected return to work date.




                                  Total Document Page 156 of 224
Rehabilitation Vendor Specialists

In many situations, the services of independent vocational rehabilitation specialists may be
utilized. Services are obtained at no additional cost to you; MetLife pays for all vendor services.
Selecting a rehabilitation vendor is based on:

1. Attending physician's evaluation and recommendations;

2. Your individual vocational needs; and

3. Vendor's credentials, specialty, reputation, and experience.

When working with vendors, you and your Doctor still maintain control and direction of the case.




                                 Total Document Page 157 of 224
                           Privacy Notice To Our Customers

THIS PRIVACY NOTICE IS GIVEN TO YOU ON BEHALF OF METROPOLITAN LIFE
INSURANCE COMPANY.

TO PLAN SPONSORS AND GROUP INSURANCE CERTIFICATE HOLDERS: This notice explains how
we treat information we receive about anyone who applies for or obtains our products and services
under employee benefit plans that we insure or group insurance contracts that we issue. Please note
that we refer to these individuals in this notice by using the term "you", as if this notice were being
addressed to these individuals.

Why We Need to Know About You: We need to know about you so that we can provide you with
the insurance and other products and services you’ve asked for. We may also need information from
you and others to help us verify your identity in order to prevent money laundering and terrorism.

What we need to know about you includes your address, age and other basic information. But we
may have to know more about you, including your finances, employment, health, hobbies or
business you conduct with us, with other MetLife companies (our “affiliates”) or with other
companies.

How We Learn about You: What we know about you we get mostly from you. But we may also
have to find out more about you from other sources in order to make sure that what we know about
you is correct and complete. Those sources may include your adult relatives, employers, consumer
reporting agencies, health care providers and others. Some of our sources may give us reports, and
they may disclose what they know about you to others.

How We Protect What We Know About You: We treat what we know about you confidentially.
Our employees are told to take care in handling your information. They may get information about
you only when there is a good reason to do so. We take steps to make our computer data bases
secure and to safeguard the information we have about you.

How We Use and Disclose What We Know About You: We may use anything we know about you
to help us serve you better. We may use it, and disclose it to our affiliates and others, for any
purpose allowed by law. For instance, we may use your information, and disclose it to others, in
order to:

· Help us evaluate your request for a MetLife             · Help us run our business
  product or service
                                                          · Process data for us
· Help us process claims and other transactions
                                                          · Perform research for us
· Confirm or correct what we know about you
                                                          · Audit our business
· Help us prevent fraud, money laundering,
  terrorism and other crimes by verifying what we         · Help us comply with the law
  know about you




                                  Total Document Page 158 of 224
Other reasons we may disclose what we know about you include:

·   Doing what a court or government agency requires us to do; for example, complying with a
    search warrant or subpoena
·   Telling another company what we know about you, if we are or may be selling all or any part of
    our business or merging with another company
·   Telling a group customer about its members’ claims or cooperating in a group customer’s audit of
    our service
·   Giving information to the government so that it can decide whether you may get benefits that it
    will have to pay for
·   Telling your health care provider about a medical problem that you have but may not be aware of
·   Giving your information to a peer review organization if you have health insurance with us
·   Giving your information to someone who has a legal interest in your insurance, such as someone
    who lent you money and holds a lien on your insurance or benefits

Generally, we will disclose only the information we consider reasonably necessary to disclose.

We may use what we know about you in order to offer you our other products and services. We
may disclose this information (other than consumer reports and health information) to our affiliates
so that they can offer their products and services, or ours, to you. By law, we don’t have to let you
prevent these disclosures. Our affiliates include life, car and home insurers, securities firms,
broker-dealers, a bank, a legal plans company and financial advisors. In the future, we may have
affiliates in other businesses.

We may also provide information to others outside of the MetLife companies, such as marketing
companies, to help us offer our products and services to you. If we have joint marketing
agreements with other financial services companies, we may give them information about you so
that they can offer their products and services to you; however, we cannot do this if the state law
that applies to you does not allow it. Except for joint marketing arrangements, we do not make any
other disclosures of your information to other companies who want to sell their products or services
to you. For example, we will not sell your name to a catalog company. And we will not disclose
any consumer report or health information to other companies so that they can offer their products
and services, or ours, to you.

How You Can See and Correct Your Information: Generally, we will let you review what we know
about you if you ask us in writing. Medical information will generally be disclosed through the
licensed physician you choose or as otherwise required by law. (Because of its legal sensitivity, we
will not show you anything that we learned in connection with a claim or lawsuit.) If you tell us that
what we know about you is incorrect, we will review it. If we agree with you, we will correct our
records. If we do not agree with you, you may tell us in writing, and we will include your statement
when we give your information to anyone outside MetLife.

How You Can Get Other Material from Us: In addition to any other privacy notice we may give you,
we must give you a summary of our privacy policy once each year. You may have other rights under
the law. If you want to know more about our privacy policy, please contact us at our website,
www.metlife.com, or write to your MetLife insurance company, c/o MetLife Privacy Office, P.O. Box
2006, Aurora, Illinois 60507-2006.

                                                                                       CPN-GLB-2003




                                 Total Document Page 159 of 224
Exhibit E   KCDC’s STD Life Certificate




                               Total Document Page 160 of 224
                                  Metropolitan Life Insurance Company
                          One Madison Avenue, New York, New York 10010-3690

                                      CERTIFICATE OF INSURANCE
                                          for the Employees of
                            Knoxville's Community Development Corporation
                                          (called the Employer)

This is your Certificate of Insurance for Short Term Disability Insurance as long as you are insured under
This Plan. The Group Policy and this Certificate may be changed or canceled according to the terms,
conditions and provisions of the Group Policy. This Certificate describes the benefits under the Plan in
effect as of January 01, 2005. Any prior Certificate relating to the coverage set forth herein is void.

MetLife in its discretion has authority to interpret the terms, conditions, and provisions of the entire contract.
This includes the Group Policy, Certificate and any Amendments.

The Group Policy is delivered in and administered according to the laws of the governing jurisdiction.

Whenever a reference to "you" or "your" is made in this Certificate of Insurance, it means the covered
Employee. Reference to "we", "us" or "our" means MetLife. Reference to "This Plan" means that part of the
Employer's plan of benefits that is insured by MetLife.




                                   C. Robert Henrikson
                                   President and Chief Operating Officer

Group Policy No.: TM 05579023-G

Florida Residents: The benefits of the policy providing your coverage are governed primarily by
the law of a state other than Florida.

For Maryland residents: The group insurance policy providing coverage under
this certificate was issued in a jurisdiction other than Maryland and may not
provide all of the benefits required by Maryland law.
Form G.24303-Cert.
                                                                                  All Active Full Time Employees
                                                                                                    NB 02/08/2005




                                       Total Document Page 161 of 224
For Texas Residents:                                 Para Residentes de Texas:

            IMPORTANT NOTICE                                     AVISO IMPORTANTE
To obtain information or make a complaint:           Para obtener informacion o para someter una
                                                     queja:

You may call MetLife’s toll free telephone number    Usted puede llamar al numero de telefono gratis de
for information or to make a complaint at            MetLife para informacion o para someter una queja
                                                     al

                 1-800-275-4638                                       1-800-275-4638


You may contact the Texas Department of              Puede comunicarse con el Departmento de
Insurance to obtain information on companies,        Seguros de Texas para obtener informacion acerca
coverages, rights or complaints at                   de companias, coberturas, derechos o quejas al


                 1-800-252-3439                                       1-800-252-3439


You may write the Texas Department of Insurance      Puede escribir al Departmento de Seguros de
P.O. Box 149104                                      Texas
Austin, TX 78714-9104                                P.O. Box 149104
Fax # (512) 475-1771                                 Austin, TX 78714-9104
                                                     Fax # (512) 475-1771

PREMIUM OR CLAIM DISPUTES: Should You                DISPUTAS SOBRE PRIMAS O RECLAMOS: Si
have a dispute concerning Your premium or about      tiene una disputa concerniente a su prima o a un
a claim You should contact MetLife first. If the     reclamo, debe comunicarse con MetLife primero.
dispute is not resolved, You may contact the Texas   Si no se resuelve la disputa, puede entonces
Department of Insurance.                             comunicarse con el departamento (TDI).

ATTACH THIS NOTICE TO YOUR CERTIFICATE:              UNA ESTE AVISO A SU CERTIFICADO:
This notice is for information only and does not     Este aviso es solo para proposito de informacion y
become a part or condition of the attached           no se convierte en parte o condicion del
document.                                            documento adjunto.




                                   Total DocumentiiiPage 162 of 224
Arkansas residents please be advised of the following:

                             IMPORTANT NOTICE

IF YOU HAVE A QUESTION CONCERNING YOUR COVERAGE OR A CLAIM,
FIRST CONTACT YOUR GROUP EMPLOYER OR GROUP ACCOUNT
ADMINISTRATOR. IF, AFTER DOING SO, YOU STILL HAVE A CONCERN, YOU
MAY CALL METLIFE'S TOLL-FREE TELEPHONE NUMBER:

                                1-800-275-4638

IF YOU ARE STILL CONCERNED AFTER CONTACTING BOTH YOUR GROUP
EMPLOYER AND METLIFE, YOU SHOULD FEEL FREE TO CONTACT:

                   ARKANSAS INSURANCE DEPARTMENT
                      CONSUMER SERVICES DIVISION
                            1200 WEST THIRD
                   LITTLE ROCK, ARKANSAS 72201-1904




                        Total DocumentivPage 163 of 224
California residents please be advised of the following:

                              IMPORTANT NOTICE

TO OBTAIN ADDITIONAL INFORMATION, OR TO MAKE A COMPLAINT,
CONTACT METLIFE AT:

               METROPOLITAN LIFE INSURANCE COMPANY
                        1 MADISON AVENUE
                       NEW YORK, NY 10010
         ATTN: CORPORATE CONSUMER RELATIONS DEPARTMENT
                           1-800-275-4638

IF, AFTER CONTACTING METLIFE REGARDING A COMPLAINT, YOU FEEL
THAT A SATISFACTORY RESOLUTION HAS NOT BEEN REACHED, YOU MAY
FILE A COMPLAINT WITH THE CALIFORNIA INSURANCE DEPARTMENT AT:

                  CALIFORNIA DEPARTMENT OF INSURANCE
                         300 SOUTH SPRING STREET
                          LOS ANGELES, CA 90013
                      1-800-927-4357 (within California)
                      1-213-897-8921 (outside California)




                        Total DocumentvPage 164 of 224
Georgia residents please be advised of the following:

                             IMPORTANT NOTICE

The laws of the state of Georgia prohibit insurers from unfairly discriminating
against any person based upon his or her status as a victim of family violence.




                        Total DocumentviPage 165 of 224
Utah residents please be advised of the following:

                                 NOTICE TO POLICYHOLDERS

Insurance companies licensed to sell life insurance, health insurance, or annuities in the State of Utah are
required by law to be members of an organization called the Utah Life and Health Insurance Guaranty
Association ("ULHIGA"). If an insurance company that is licensed to sell insurance in Utah becomes
insolvent (bankrupt), and is unable to pay claims to its policyholders, the law requires ULHIGA to pay some
of the insurance company's claims. The purpose of this notice is to briefly describe some of the benefits and
limitations provided to Utah insureds by ULHIGA.

                                 PEOPLE ENTITLED TO COVERAGE
      ·      You must be a Utah resident.
      ·      You must have insurance coverage under an individual or group policy.

                                          POLICIES COVERED
      ·      ULHIGA provides coverage for certain life, health and annuity insurance policies.

                                  EXCLUSIONS AND LIMITATIONS
Several kinds of insurance policies are specifically excluded from coverage. There are also a number of
limitations to coverage. The following are not covered by ULHIGA:
      ·      Coverage through an HMO.
      ·      Coverage by insurance companies not licensed in Utah.
      ·      Self-funded and self-insured coverage provided by an employer that is only administered by
             an insurance company.
      ·      Policies protected by another state's Guaranty Association.
      ·      Policies where the insurance company does not guarantee the benefits.
      ·      Policies where the policyholder bears the risk under the policy.
      ·      Re-insurance contracts.
      ·      Annuity policies that are not issued to and owned by an individual, unless the annuity policy is
             issued to a pension benefit plan that is covered.
      ·      Policies issued to pension benefit plans protected by the Federal Pension Benefit Guaranty
             Corporation.
      ·      Policies issued to entities that are not members of the ULHIGA, including health plans,
             fraternal benefit societies, state pooling plans and mutual assessment companies.




                                     Total DocumentviiPage 166 of 224
                              LIMITS ON AMOUNT OF COVERAGE
Caps are placed on the amount ULHIGA will pay. These caps apply even if you are insured by more than
one policy issued by the insolvent company. The maximum ULHIGA will pay is the amount of your coverage
or $500,000 — whichever is lower. Other caps also apply:
       ·       $100,000 in net cash surrender values.
       ·       $500,000 in life insurance death benefits (including cash surrender values).
       ·       $500,000 in health insurance benefits.
       ·       $200,000 in annuity benefits — if the annuity is issued to and owned by an individual or the
               annuity is issued to a pension plan covering government employees.
       ·       $5,000,000 in annuity benefits to the contract holder of annuities issued to pension plans
               covered by the law. (Other limitations apply).
       ·       Interest rates on some policies may be adjusted downward.

                                          DISCLAIMER
       PLEASE READ CAREFULLY:
      ·    COVERAGE FROM ULHIGA MAY BE UNAVAILABLE UNDER THIS
POLICY OR, IF AVAILABLE, IT MAY BE SUBJECT TO SUBSTANTIAL LIMITATIONS
OR EXCLUSIONS. THE DESCRIPTION OF COVERAGES CONTAINED IN THIS
DOCUMENT IS AN OVERVIEW. IT IS NOT A COMPLETE DESCRIPTION. YOU
CANNOT RELY ON THIS DOCUMENT AS A DESCRIPTION OF COVERAGE. FOR A
COMPLETE DESCRIPTION OF COVERAGE, CONSULT THE UTAH CODE, TITLE
31A, CHAPTER 28.
     ·    COVERAGE IS CONDITIONED ON CONTINUED RESIDENCY IN THE
STATE OF UTAH.
     ·     THE PROTECTION THAT MAY BE PROVIDED BY ULHIGA IS NOT A
SUBSTITUTE FOR CONSUMERS' CARE IN SELECTING AN INSURANCE COMPANY
THAT IS WELL-MANAGED AND FINANCIALLY STABLE.
     ·    INSURANCE COMPANIES AND INSURANCE AGENTS ARE REQUIRED
BY LAW TO GIVE YOU THIS NOTICE. THE LAW DOES, HOWEVER, PROHIBIT THEM
FROM USING THE EXISTENCE OF ULHIGA AS AN INDUCEMENT TO SELL YOU
INSURANCE.
     ·    THE ADDRESS OF ULHIGA, AND THE INSURANCE DEPARTMENT
ARE PROVIDED BELOW.
                                   Utah Life and Health Insurance
                                       Guaranty Association
                                        955 E. Pioneer Rd.
                                        Draper, Utah 84114
                                     Utah Insurance Department
                                  State Office Building, Room 3110
                                     Salt Lake City, Utah 84114




                                                viii
                                   Total Document Page 167 of 224
Virginia residents please be advised of the following:


          IMPORTANT INFORMATION REGARDING YOUR INSURANCE

In the event you need to contact someone about this insurance for any reason please
contact your agent. If no agent was involved in the sale of this insurance, or if you
have additional questions you may contact the insurance company issuing this
insurance at the following address and telephone number:

                        Metropolitan Life Insurance Company
                                 1 Madison Avenue
                            New York, New York 10010
                  Attn: Corporate Customer Relations Department

To phone in a claim related question, you may call Claims Customer Service at:

                                  1-800-275-4638

If you have been unable to contact or obtain satisfaction from the company or the
agent, you may contact the Virginia State Corporation Commission's Bureau of
Insurance at:


                              Life and Health Division
                                Bureau of Insurance
                                   P.O. Box 1157
                               Richmond, VA 23209

                          1-800-552-7945 - In-state toll-free
                          1-804-371-9691 - Out-of-state


Written correspondence is preferable so that a record of your inquiry is maintained.
When contacting your agent, company or the Bureau of Insurance, have your policy
number available.




                         Total DocumentixPage 168 of 224
Wisconsin residents please be advised of the following:


KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS


PROBLEMS WITH YOUR INSURANCE? - If you are having problems with your
insurance company or agent, do not hesitate to contact the insurance company or
agent to resolve your problem.


                      Metropolitan Life Insurance Company
                                Customer Service
                             4100 Boy Scout Blvd
                                Tampa, FL 33607
                                 1-800-811-8319


You can also contact the OFFICE OF THE COMMISSIONER OF INSURANCE, a
state agency which enforces Wisconsin's insurance laws, and file a complaint. You
can contact the OFFICE OF THE COMMISSIONER OF INSURANCE by contacting:


                    Office of the Commissioner of Insurance
                             Complaints Department
                                  P.O. Box 7873
                            Madison, WI 53707-7873
           1-800-236-8517 outside of Madison or 266-0103 in Madison.




                        Total DocumentxPage 169 of 224
                                                          TABLE OF CONTENTS
Section                                                                                                                                                 Page

CERTIFICATE OF INSURANCE .................................................................................................................... i
PLAN HIGHLIGHTS...................................................................................................................................... 1
  Employee Eligibility .................................................................................................................................... 1
  Short Term Disability Benefits ................................................................................................................... 1
  Limitations.................................................................................................................................................. 2
  Contributions ............................................................................................................................................. 2
  Benefits Checklist....................................................................................................................................... 2
EMPLOYEE ELIGIBILITY ............................................................................................................................. 2
SHORT TERM DISABILITY BENEFITS ........................................................................................................ 4
  Weekly Benefit........................................................................................................................................... 4
  Reduction of Benefits - Other Income Benefits ......................................................................................... 8
  Temporary Recovery ............................................................................................................................... 11
  Concurrent Disability ................................................................................................................................ 11
  Limitations................................................................................................................................................ 11
    Limitation for Occupational Benefits...................................................................................................... 11
  Exclusions................................................................................................................................................ 11
TERMINATION OF COVERAGE ................................................................................................................ 12
EXTENSION OF BENEFITS........................................................................................................................ 13
CLAIMS ....................................................................................................................................................... 14




                                                      Total DocumentxiPage 170 of 224
                                             PLAN HIGHLIGHTS

This Plan Highlights section is a summary of your Short Term Disability Benefits and provisions. See the
rest of your Certificate for more information.

It is important to read the rest of your Certificate. It describes your benefits as well as any exclusions and
limitations that apply to these benefits. Please read it carefully. You should talk with your Employer if you
have any questions.

You will notice that some of the terms used in your Certificate begin with capital letters. These terms have
special meanings. They are explained in this Certificate.

                                             Employee Eligibility

Eligible Employee: All Active Full Time Employees working at least 30 hours each week. However, if you
do not have regular work hours you will be an Eligible Employee if you have worked at least an average of
30 hours a week during the preceding 12 calendar months (or during your period of employment if less than
12 months).

Eligibility Waiting Period:

        Active Employees on and after January 01, 2005: 90 days of continuous service as an
        Employee.

Eligibility Date: January 01, 2005 or the first day of the calendar month after you complete the Eligibility
Waiting Period, whichever is later.

                                       Short Term Disability Benefits

Weekly Benefit: 60% of your Predisability Earnings, but not more than the Maximum Weekly Benefit
below, reduced by Other Income Benefits. Other Income Benefits are described in Section B. of Short
Term Disability Benefits.

Maximum Weekly Benefit: $1,000

Minimum Weekly Benefit: $20. The Minimum Weekly Benefit will not apply if you are in an Overpayment
situation or are receiving income from employment.

Elimination Period:

        For Accidental Injury: 14 Days of continuous Disability.

        For Sickness and Pregnancy: 14 Days of continuous Disability.

Maximum Benefit Duration: 13 Weeks

Work Incentive:

        Work while Disabled: No offset for employment earnings unless the total income you are
        receiving (including Rehabilitation Incentive and Family Care Expenses) exceeds 100% of your
        Predisability Earnings.

        Rehabilitation Incentive: While participating in an approved Rehabilitation Program your Weekly
        Benefit before reduction for Other Income Benefits is increased by 10%.




                                      Total Document1Page 171 of 224
        Family Care Expenses: While participating in an approved Rehabilitation Program, after
        the later of the date following the day you complete your Elimination Period and the end
        of the 4th week of Disability, up to $60 per week incurred for Eligible Family Care
        Expenses for each Eligible Family Member.

                                             Limitations

Limitation for Occupational Disabilities: Benefits are not payable for any Disability (i) which happens in
the course of any work performed by you for wage or profit; or (ii) for which you are eligible to receive
benefits under any Workers' Compensation or any similar law.

                                           Contributions

Non-Contributory Insurance is coverage for which the Employer pays the entire premium.
Contributory Insurance is coverage for which you have to pay all or any part of the premium.
Please see your Employer regarding any contributions you may need to make for the coverage
under This Plan.

                                         Benefits Checklist

In order to receive benefits under This Plan, you must provide to us at your expense, and subject
to our satisfaction, all of the following documents. These are explained in this Certificate. Initial
submission of these documents should be made no later than the 12th week following your
original date of disability.

        Ö       Proof of Disability.

        Ö       Evidence of continuing Disability.

        Ö       Proof that you are under the Appropriate Care and Treatment of a Doctor throughout your
                Disability.

        Ö       Information about Other Income Benefits.

        Ö       Any other material information related to your Disability which may be requested by us.


Form G.24303-A


                                       EMPLOYEE ELIGIBILITY

Active Employee

You are an Active Employee if you:

1. are an Eligible Employee working for the Employer doing all the material duties of your
   occupation at (i) your usual place of business; or (ii) some other location that your Employer's
   business requires you to be;

2. are a citizen or legal resident of the United States or Canada; and

3. are not a temporary or seasonal Employee.




                                       Total Document2Page 172 of 224
You will be deemed an Active Employee if:

1. you meet the above conditions; and

2. you are absent from work solely due to vacation days, holidays, scheduled days off, or
   approved leaves of absence not due to Disability.

For Contributory Insurance, if you make written application for coverage no later than 31 days after your
Eligibility Date and agree to have the required contributions deducted from your pay, you will be covered
on the later of:

1. your Eligibility Date;

2. the date you meet the Active Employee requirements; or

3. the date of your written application.

However, if you were eligible for coverage under the prior plan but did not elect to be covered under the
prior plan, you will be required to provide Evidence of Good Health satisfactory to us. Your coverage will
become effective when we approve your Evidence of Good Health.

If you are an Active Employee and make written application more than 31 days after your Eligibility Date,
you will be required to provide Evidence of Good Health satisfactory to us. Your coverage will become
effective on the later of:

1. the date we approve your Evidence of Good Health; or

2. the date you meet the Active Employee requirements.

"Evidence of Good Health" is a statement providing your medical history. We will use this statement to
determine your insurability under This Plan. This statement must be provided to us at your expense.

Continuity of Coverage upon Replacement of Plans

In order to prevent a loss of coverage because of a transfer of insurance carriers, This Plan will
provide coverage for you if:

1. you were covered under the prior carrier’s plan that This Plan replaced at the time of transfer;
   and

2. you are an Eligible Employee and you are not an Active Employee.

Coverage will only be provided if the required payment toward the cost of your coverage is made to us.

The benefit payable will be that which would have been paid by the prior carrier had coverage remained in
force, less any benefit for which the prior carrier is liable.

Changes in Amount of Weekly Benefit

The amount of your Weekly Benefit may change as a result of a change in your earnings or class.
The new Weekly Benefit amount:

1. will take effect on the date of the change; and

2. will apply only to Disabilities commencing thereafter.




                                      Total Document3Page 173 of 224
However, if you are not an Active Employee on the above date, the new Weekly Benefit amount will take
effect on the date you are again an Active Employee.


Form G.24303-B


                            SHORT TERM DISABILITY BENEFITS

A. Weekly Benefit

You will be paid a Weekly Benefit, in accord with Plan Highlights, if we determine that:

1. you are Disabled; and

2. you became Disabled while covered under This Plan.

Benefits will begin to accrue on the date following the day you complete your Elimination Period. Payment
of the Weekly Benefit will start on the date one week after completion of the Elimination Period.
Subsequent payments will be made each week thereafter. Payment is based on the number of days you
are Disabled during each one week period.

Contributions are required for the time that Weekly Benefits are payable.

After we determine that you are Disabled, your Weekly Benefits will not be affected by:

1. termination of This Plan;

2. termination of your coverage; or

3. any plan change that is effective after the date you became Disabled.

When Benefits End

Weekly Benefits will end on the earliest of the following dates:

1. the end of the Maximum Benefit Duration;

2. the date you are no longer Disabled;

3. the date you fail to provide us with any of the information listed in Plan Highlights under
    Benefits Checklist;

4. the day you die;

5. the date you cease or refuse to participate in a Rehabilitation Program as described in Work
    Incentive; or

6. date you fail to attend a medical examination requested by us as described in Medical Examination.




                                      Total Document4Page 174 of 224
Elimination Period

Your Elimination Period begins on the day you become Disabled. It is a period of time during
which no benefits are payable. Your Elimination Period is shown in Plan Highlights. You must be
under the continuous care of a Doctor during your Elimination Period.

Definition of Disability

"Disabled" or "Disability" means that, due to sickness, pregnancy or accidental injury, you:

1. are receiving Appropriate Care and Treatment from a Doctor on a continuing basis; and

2. are unable to earn more than 80% of your Predisability Earnings at your Own Occupation for
   any employer in your Local Economy.

Your loss of earnings must be a direct result of your sickness, pregnancy or accidental injury. Economic
factors such as, but not limited to, recession, job obsolescence, paycuts and job-sharing will not be
considered in determining whether you meet the loss of earnings test.

For an employee whose occupation requires a license, "loss of license" for any reason does not, in itself,
constitute Disability.

"Appropriate Care and Treatment" means medical care and treatment that meet all of the following:

1. it is received from a Doctor whose medical training and clinical experience are suitable for treating
    your Disability;

2. it is necessary to meet your basic health needs and is of demonstrable medical value;

3. it is consistent in type, frequency and duration of treatment with relevant guidelines of national
    medical, research and health care coverage organizations and governmental agencies;

4. it is consistent with the diagnosis of your condition; and

5. its purpose is maximizing your medical improvement.

"Doctor" means a person who: (i) is legally licensed to practice medicine; and (ii) is not related to you. A
licensed medical practitioner will be considered a Doctor:

1. if applicable state law requires that such practitioners be recognized for the purposes of certification of
    disability; and

2. the care and treatment provided by the practitioner is within the scope of his or her license.

"Own Occupation" means the activity that you regularly perform and that serves as your source of
income. It is not limited to the specific position you held with your Employer. It may be a similar activity
that could be performed with your Employer or any other employer.

"Local Economy" means the geographic area surrounding your place of residence which offers reasonable
employment opportunities. It is an area within which it would not be unreasonable for you to travel to secure
employment. If you move from the place you resided on the date you became Disabled, we may look at
both that former place of residence and your current place of residence to determine local economy.




                                      Total Document5Page 175 of 224
Work Incentive

While you are Disabled, you are encouraged to work or participate in a Rehabilitation Program
during your Elimination Period or while Weekly Benefits are being paid to you. Reimbursement for
Eligible Family Care Expenses may also be available when you work or participate in an approved
Rehabilitation Program while Disabled.

When you work while Disabled, you will receive the sum of the following amounts:

1. your Weekly Benefit (including your Rehabilitation Incentive when applicable);

2. the amount of your earnings for working while Disabled; and

3. the amount of Family Care Expenses for which you are eligible.

Your Weekly Benefit will be reduced if the total amount you receive from the above sources and Other
Income Benefits exceeds 100% of your Predisability Earnings. Your Weekly Benefit will be reduced by that
portion of the total you receive which exceeds 100% of your Predisability Earnings.

If your Weekly Benefit is reduced as a result of your receiving earnings from any work or service while
Disabled, the Minimum Weekly Benefit will not apply.

Weekly Benefit payments will cease on the date you refuse to participate in a Rehabilitation Program in
which we determine you are able to participate.

"Rehabilitation Program" means:

1. a return to active employment by you on either a part-time or full-time basis in an attempt to enable you
   to resume gainful employment or service in an occupation for which you are reasonably qualified taking
   into account your training, education, experience and past earnings; or

2. participating in vocational training or physical therapy. This must be deemed by one of our rehabilitation
   coordinators to be appropriate.

Rehabilitation Incentive

While Disabled, your Weekly Benefit, before reduction for Other Income Benefits, is increased by
10% when you participate in a Rehabilitation Program approved by us.

Family Care Expenses

After the later of the date following the day you complete your Elimination Period and the end of
the 4th week of Disability, when you work or participate in a Rehabilitation Program approved by
us, you will be reimbursed for Eligible Family Care Expenses incurred with respect to each
Eligible Family Member.

"Eligible Family Member" means a person who is:

1. living with you as part of your household; and

2. chiefly dependent on you for support.




                                     Total Document6Page 176 of 224
"Eligible Family Care Expenses" mean the weekly expenses incurred by you in order for you to
participate in a Rehabilitation Program, up to $60 for each Eligible Family Member. These are
expenses incurred:

1. to provide child care with respect to an Eligible Family Member under age 13. Child care must
    be provided by a licensed child care facility or other qualified child care provider. The child care
    provider may not be a member of your immediate family or living in your residence.

2. to provide care to an Eligible Family Member who as a result of mental or physical
   impairment, is incapable of caring for himself or herself. Family Care Expenses for services
   provided by a member of your immediate family or any one living in your residence will not be
   reimbursed.


Eligible Family Care Expenses do not include expenses for which you are eligible for reimbursement
under any other group plan or from any other source.

You must provide satisfactory proof to us that you incurred such charges. You must give us proof that the
Eligible Family Member is incapable of caring for himself or herself and is chiefly dependent on you for
support. The proof must be satisfactory to us.

Predisability Earnings

"Predisability Earnings" means the amount of your gross salary or wages from your Employer as of
the day before your Disability began. This is calculated on a weekly basis.

This may include contributions you make through a salary reduction agreement with your Employer
to any of the following:

1. an Internal Revenue Code (IRC) Section 401(k), 403(b) or 457 deferred compensation
   arrangement;

2. an executive nonqualified deferred compensation arrangement; and

3. amounts contributed to your fringe benefits according to a salary reduction agreement under
   an IRC Section 125 plan.

Predisability Earnings do not include:

1. awards, commissions and/or bonuses;

2. overtime pay;

3. your Employer's contributions on your behalf to any deferred compensation arrangement or
   pension plan; or

4. any other compensation.




                                      Total Document7Page 177 of 224
Your average weekly compensation is determined by adding the following amounts as reported on
the Schedule K-1, Form W-2 or S-Corporation federal income tax return, and dividing by 52 (or by
the number of weeks you were a partner or shareholder, if less than 52):

1. your ordinary income (loss) from trade or business activity(ies); and

2. your guaranteed payments, if you are a partner; or

3. your compensation (as an officer), salary, or wages, if you are an S-Corporation Shareholder.

If you do not have regular work hours, your Predisability Earnings are based on the average number of
hours you worked per week during the preceding 52 calendar weeks (or during your period of employment if
less than 52 weeks). In no event will the number of hours be more than 40 hours.

B. Reduction of Benefits - Other Income Benefits

Your Weekly Benefit is reduced by Other Income Benefits shown below. The Weekly Benefit
payable to you:

1. will not be less than the amount shown in Plan Highlights under Minimum Weekly Benefit
   (except in the case of an Overpayment or while receiving work earnings);

2. will not be further reduced due to cost-of-living increases payable under Other Income Benefits after the
   correct reductions have been determined;

3. will not be reduced by any reasonable attorney fees included in any award or settlement; and

4. will not be reduced by any sources other than those shown below.

If you receive Other Income Benefits in a lump sum instead of in weekly payments, you must
provide to us satisfactory proof of the breakdown of: (i) the amount attributable to lost income;
and (ii) the time period for which the lump sum is applicable. If you do not provide this
information to us, we may reduce your Weekly Benefit by an amount equal to the Weekly Benefit
otherwise payable. We will reduce the Weekly Benefit each month until the lump sum has been
exhausted. However, if we are given proof of the time period and amount attributable to lost
income, we will make a retroactive adjustment.

List of Sources of Other Income Benefits

1. Group Insurance Policies

    Group insurance policies will be counted if the Employer contributes towards them or makes
    payroll deduction for any of the following:

    a. other group health insurance policies will be counted to the extent that they provide benefits for
       loss of time from work due to disability; and

    b. a group life policy that provides installment payments for permanent total disability will be
       counted.

2. Work Earnings, Rehabilitation Incentive and Family Care Expenses will not be used to reduce
   your Weekly Benefit except as described in Work Incentive.




                                     Total Document8Page 178 of 224
3. Employer's Retirement Plan

   Benefits for disability and/or retirement that you receive under the Employer's retirement plan
   will be counted to the extent they are attributable to the Employer's contributions.

   Benefits under the Employer's retirement plan that are payable for disability is money which:

   a. is payable under a retirement plan due to a disability as defined in that plan; and

   b. does not reduce the amount of money which would have been paid as retirement benefits
      at the normal retirement age under the plan if the disability had not occurred. (If the
      payment does cause such a reduction, it will be deemed a retirement benefit as defined
      below.)

   Benefits under the Employer‘s retirement plan that are payable upon retirement is money
   which:

   a. is payable under the Employer‘s retirement plan either in a lump sum or in the form of
       periodic payments;

   b. is payable upon:

       i. The later of age 62 or normal retirement age as defined in the retirement plan;

       ii. Early retirement age as defined in the retirement plan. (You must have voluntarily
           elected to receive payments prior to your normal retirement age); or

       iii. Disability as defined in the retirement plan. (You must have voluntarily elected to
            receive payment prior to your normal retirement age and such payment does reduce
            the amount of money which would have been paid at the normal retirement age
            under the plan if the disability had not occurred); and

       NOTE: You will be considered to have voluntarily elected to receive payments if you file
       an application for benefits with the Retirement Plan and request the start of payments
       prior to your normal retirement age.

   c. does not represent contributions made by you. Payments which represent your
      contributions are deemed to be received over your expected remaining life regardless of
      when such payments are actually received.




                                   Total Document9Page 179 of 224
    The Employer's Retirement Plan is a plan which provides retirement benefits to Employees and
    which is not funded wholly by Employee contributions. The term shall not include the following,
    regardless of the source of contributions:

    a. profit sharing plans;

    b. thrift or savings plans;

    c. non-qualified plans of deferred compensation;

    d. plans under IRC Section 401(k) or 457;

    e. individual retirement account (IRA);

    f. tax sheltered annuity (TSA) under IRC Section 403(b);

    g. stock ownership plans; or

    h. Keogh (HR-10) plan.

4. No-fault Auto Laws

        Only the basic reparations portion for loss of income of a law providing for payments
        without determining fault in connection with automobile accidents will be counted.
        Supplemental disability benefits you buy under a no-fault auto law will not be counted.

5. Other Programs or Plans including:

        a.    a compulsory benefit program of any government which provides payment for loss of
             time from your job because of your disability will be counted;

        b. any other group disability income plan, fund, or other arrangement, no matter what
           called, if the Employer contributes toward it or makes payroll deductions for it, will be
           counted; and

        c. any sick pay or other salary continuation, other than vacation pay, paid to you by the
           Employer will be counted.

6. Third Party Recovery

    The amount of recovery you receive for loss of income as a result of claims against a third
    party by judgment, settlement or otherwise.

7. Unemployment Insurance Law or Program

Exceptions to Other Income Benefits

Other Income Benefits will not include:

1. group credit or mortgage disability insurance benefits; or

2. early retirement benefits not taken into constructive receipt.




                                                   10
                                      Total Document Page 180 of 224
3. individual Insurance policies.

C. Temporary Recovery

Once benefits become payable under This Plan, you may Temporarily Recover from your Disability.
If you become Disabled again due to the same or related condition, you may not have to begin a
new Elimination Period.

Once you have satisfied your Elimination Period, a period of Temporary Recovery is your return to work for
less than 90 days for each period of Temporary Recovery.

During the Temporary Recovery you will not qualify for any change in coverage caused by a change in any
of the following:

1. the rate of earnings used to determine your Predisability Earnings; or

2. the terms, provisions, or conditions shown in your Certificate of Insurance.

If your recovery lasts longer than the Temporary Recovery period allowed, when you become Disabled
again you will have to begin a new Elimination Period.

D. Concurrent Disability

If a new Disability occurs while Weekly Benefits are payable, it will be treated as part of the same
period of Disability. Weekly Benefits will continue while you remain Disabled. They will be subject
to both of the following:

1. the Maximum Benefit Duration; and

2. Limitations and Exclusions that apply to the new cause of Disability.

E. Limitations

Limitation for Occupational Benefits

No benefits are payable for any Disability (i) which happens in the course of any work performed by
you for wage or profit; or (ii) for which you are eligible to receive benefits under any Workers'
Compensation or any similar law.

F. Exclusions

This Plan does not cover any Disability which results from or is caused or contributed to by:

1. war, insurrection, or rebellion;

2. active participation in a riot;

3. intentionally self-inflicted injuries or attempted suicide;

4. committing a felony.




                                                    11
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5. elective treatment or procedures such as, but not limited to:

    a.    cosmetic surgery or treatment primarily to change appearance
    b.    in vitro fertilization
    c.    embryo transfer procedure
    d.    artificial insemination
    e.    sex-change surgery
    f.   reversal of sterilization
    g.    liposuction
    h.    radial keratotomy


Form G.24303-2

                                 TERMINATION OF COVERAGE

This provision applies to you if you are not Disabled.

You will cease to be covered on the earliest of the following dates:

1. the date This Plan terminates;

2. the date you cease to be an Eligible Employee;

3. the date you stop making any required contributions;

4. the date you go on strike or are locked out; or

5. the date you are laid-off.

Approved Leave of Absence

Your Employer may continue your coverage for an approved leave of absence by paying the
required premium payments. Coverage may continue until the earliest of:

1. the date the Employer stops paying the required premium;

2. the date the leave ends; or

3. the last day of the month in which your leave of absence begins.

In the event the leave qualifies under the Family and Medical Leave Act of 1993 (FMLA), the period may
be extended for a period agreed to by you and your Employer. It may not exceed 12 weeks following the
date the leave begins. Your Employer must continue to pay the required premium.

Reinstatement of Coverage

If your coverage ends, you may become covered again as an Eligible Employee. Coverage is
subject to the following:

1. If your coverage ends because you cease to be an Eligible Employee, and if you become an
    Eligible Employee again within 3 months, the Eligibility Waiting Period will be waived. For
    Contributory Insurance you will not have to provide Evidence of Good Health.




                                                  12
                                     Total Document Page 182 of 224
2. If your coverage ends because you cease making the required contribution while on an approved Family
    Medical Leave Act (FMLA) leave of absence, and you become an Eligible Employee again within 31
    days of the earlier of:

    a. the end of the period of leave you and your Employer agreed upon; or

    b. the end of the 12 week period following the date your leave began;

    the Eligibility Waiting Period will be waived and for Contributory Insurance, you will not have to
    provide Evidence of Good Health.

3. In all other cases for Contributory Insurance, if your coverage ends because you fail to make the
    required contribution, you must provide Evidence of Good Health to become covered again.


Form G.24303-D



                                  EXTENSION OF BENEFITS

This provision applies if your coverage ceases while you are Disabled.

During your Elimination Period your coverage will continue while you are continuously Disabled until
the end of your Elimination Period. Benefits will begin after the end of your Elimination Period. Your
coverage will continue in either of the following situations:

1. This Plan terminates; or

2. you cease to be an Eligible Employee but required payments are made to us for Contributory
   Insurance.

Benefits are payable if your Disability began while coverage was in force and continues without
interruption after termination.

Extension of benefits beyond the period coverage was in force is limited to the Maximum Benefit
Duration. Extension of benefits is subject to all of the following:

1. your Elimination Period; and

2. payment of any required contributions; and

3. all other applicable provisions of This Plan.


Form G.24303-C




                                                  13
                                     Total Document Page 183 of 224
                                                   CLAIMS
Notice of Disability

Notify us of your Disability as soon as you are able.

To notify us you may call us directly. You may obtain this phone number from you’re Employer. You will be
instructed on how to give proof of Disability. You will be required to answer all questions concerning your
Disability.

If you do not receive statements or instructions within 15 days after you have notified us, you may submit
your statement in a letter.

Proof of Disability

Provide proof of Disability within 45 days after the end of your Elimination Period.

No benefits are payable for claims submitted more than 3 months after the date of Disability. However,
you can request that benefits be paid for late claims if you can show that:

1. it was not reasonably possible to give written proof of Disability during the 3 month period; and

2. proof of Disability satisfactory to us was given to us as soon as was reasonably possible.

Documentation

At your expense, you must provide documented proof of your Disability. Proof includes, but is not limited
to:

1. the date your Disability started;

2. the cause of your Disability; and

3. the prognosis of your Disability.

You will be required to provide signed authorization for us to obtain and release medical and financial
information, and any other items we may reasonably require in support of your Disability.

These will include but are not limited to:

1. proof of continuing Disability;

2. proof you have applied, or are not eligible, for Other Income Benefits. If you do not provide proof you
   have applied for Other Income Benefits, we may reduce your Weekly Benefit. The reduction will be
   based on our estimate of what you would be eligible to receive through proper and timely pursuit;

3. proof that you applied for Social Security disability benefits until denied at the Administrative Law
   Judge level; and

4. proof you have applied for Workers' Compensation benefits or benefits under a similar law. If you do
   not provide proof that you have applied for these benefits, we may reduce your Weekly Benefit. The
   reduction will be based on our estimate of what you would be eligible to receive through proper and
   timely pursuit.

If you do not provide satisfactory documentation within 60 days after the date we ask for it, your claim
may be denied.



                                                    14
                                       Total Document Page 184 of 224
Method of Payment

When we determine you are Disabled:

1. Weekly Benefits are paid one week after you qualify for them and on a weekly basis thereafter.

2. Benefits will be paid to you. However, benefits unpaid at your death will be paid to:

    a. your spouse, if living; otherwise

    b. your children, if living, divided equally;

    c. your estate. If benefits are payable to your estate, we may pay up to $1,500 to someone related
       to you by blood or by marriage whom we deem entitled to this amount. We will be discharged to
       the extent of any payment made in good faith.

3. Weekly Benefits due for a period of less than a week will be paid at a daily rate of 1/7th of the Weekly
   Benefit payable.

Right To Recover Overpayments

We have the right to recover from you any amount that we determine to be an Overpayment. You have
the obligation to refund to us any such amount. Our rights and your obligations in this regard are also set
forth in the reimbursement agreement you are required to sign when you become eligible for benefits
under This Plan. This agreement: (i) confirms that you will repay all Overpayments; and (ii) authorizes us
to obtain any information relating to Other Income Benefits.

An Overpayment occurs when we determine that the total amount paid by us on your claim is more than
the total of the benefits due under This Plan. This includes any Overpayments resulting from:

1. retroactive awards received from sources shown in the List of Other Income Benefits;

2. fraud; or

3. any error we make in processing your claim.

The Overpayment equals the amount we paid in excess of the amount we should have paid under This
Plan. In the case of a recovery from a source other than This Plan, our Overpayment recovery will not be
more than the amount of the recovery.

You have the right to appeal any Overpayment recovery.

An Overpayment also occurs when payment is made by us that should have been made under another
group plan. In that case, we may recover the payment from one or more of the following:

1. any other insurance company;

2. any other organization; or

3. any person to or for whom payment was made.




                                                   15
                                      Total Document Page 185 of 224
We may, at our option, recover the Overpayment by:

1. reducing or offsetting against any future benefits payable to you or your survivors;

2. stopping future benefit payments (including Minimum Benefits) which would otherwise be due under
   This Plan. Payments may continue when the Overpayment has been recovered; or

3. demanding an immediate refund of the Overpayment from you.

Legal Actions

No legal action of any kind may be filed against us:

1. within the 60 days after proof of Disability has been given; or

2. more than three years after proof of Disability must be filed. This will not apply if the law in the area
   where you live allows a longer period of time to file proof of Disability.

Medical Examinations

We will have the right to have you examined at reasonable intervals by medical specialists of our choice.
The examination will be at our expense. Failure to attend a medical examination or cooperate with the
medical examiner may be cause for denial or suspension of your benefits.

Incontestability of Coverage

This Plan cannot be declared invalid after it has been in force for 2 years. It can be declared invalid due to
non-payment of premium.

No statement of health used by any person to get coverage can be used to declare coverage invalid if the
person has been covered under This Plan for 2 years. In order to use a statement of health to deny
coverage before the end of 2 years, it must have been signed by the person. A copy of the signed statement
must be given to the person or the person's beneficiary.

Assignment

You may not assign your benefits. This means that you may not give or transfer your benefits to anyone
else.

Workers' Compensation

This Plan is not in lieu of, and does not affect, any requirement for coverage by Workers' Compensation
Insurance or any government mandated temporary disability income benefits law.


Form G.24303-E




                                                   16
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"THIS IS THE END OF THE CERTIFICATE. THE FOLLOWING IS ADDITIONAL INFORMATION"




                          Total Document Page 187 of 224
                                        SPECIAL SERVICES

                                 RETURN TO WORK PROGRAM

Goal of Rehabilitation

The goal of MetLife is to focus on Employees' abilities, instead of disabilities. This "abilities"
philosophy is the foundation of our Return to Work Program. By focusing on what Employees can
do versus what they can't, we can assist you in returning to work sooner than expected.

Incentives For Returning To Work

Your disability plan is designed to provide clear advantages and financial incentives for returning
to work either full-time or part-time, while still receiving a Disability benefit. In addition to financial
incentives, there may be personal benefits resulting from returning to work. Many Employees
experience higher self-esteem and the personal satisfaction of being self-sufficient and productive
once again. If it is determined that you are capable but you do not participate in the Return to
Work Program, your Disability benefits may cease.

Vocational Rehabilitation Services

As a covered Employee you are automatically eligible to participate in our Return to Work
Program. The Program focus is vocational rehabilitation, which means identifying the necessary
training and therapy that can help you return to work. In many cases, this means helping you
return to your former occupation, although rehabilitation can also lead to a new occupation which
is better suited to your condition and makes the most of your abilities.

There is no additional cost to you for the services we provide, and they are tailored to meet your
individual needs. These services include, but are not limited to, the following:

1. Vocational Analyses

    Assessment and counseling to help determine how your skills and abilities can be applied to
    a new or a modified job with your Employer.

2. Labor Market Surveys

    Studies to find jobs available in your locale that would utilize your abilities and skills.

3. Retraining Programs

    Programs to facilitate return to your previous job, or to train you for a new job.

4. On-Site Job Analyses

    Analyses to determine what modifications may be made to maximize your employment
    opportunities.

5. Job Modifications/Accommodations

    Changes in your job or accommodations to help you perform the previous job or a similar
    vocation, as required of your Employer under the Americans With Disabilities Act (ADA).




                                   Total Document Page 188 of 224
6. Training in Job Seeking Skills

    Special training to identify abilities, set goals, develop resumes, polish interviewing
    techniques, and provide other career search assistance.

Rehabilitation Staff

The Case Management Specialist handling your claim will begin the rehabilitation process. You
may be referred to our professional Rehabilitation staff that includes Registered Nurses and
vocational rehabilitation coordinators. Registered Nurses might address how your medical
condition impacts your ability to return to work. Vocational rehabilitation coordinators will focus on
identifying how your abilities can be best applied to either your previous job or a new job.

These rehabilitation specialists will contact you personally. They will coordinate their activities
with your medical carrier and/or attending physician for a broad understanding of your diagnosis,
prognosis, and expected return to work date.

Rehabilitation Vendor Specialists

In many situations, the services of independent vocational rehabilitation specialists may be
utilized. Services are obtained at no additional cost to you; MetLife pays for all vendor services.
Selecting a rehabilitation vendor is based on:

1. Attending physician's evaluation and recommendations;

2. Your individual vocational needs; and

3. Vendor's credentials, specialty, reputation, and experience.

When working with vendors, you and your Doctor still maintain control and direction of the case.




                                 Total Document Page 189 of 224
                           Privacy Notice To Our Customers

THIS PRIVACY NOTICE IS GIVEN TO YOU ON BEHALF OF METROPOLITAN LIFE
INSURANCE COMPANY.

TO PLAN SPONSORS AND GROUP INSURANCE CERTIFICATE HOLDERS: This notice explains how
we treat information we receive about anyone who applies for or obtains our products and services
under employee benefit plans that we insure or group insurance contracts that we issue. Please note
that we refer to these individuals in this notice by using the term "you", as if this notice were being
addressed to these individuals.

Why We Need to Know About You: We need to know about you so that we can provide you with
the insurance and other products and services you’ve asked for. We may also need information from
you and others to help us verify your identity in order to prevent money laundering and terrorism.

What we need to know about you includes your address, age and other basic information. But we
may have to know more about you, including your finances, employment, health, hobbies or
business you conduct with us, with other MetLife companies (our “affiliates”) or with other
companies.

How We Learn about You: What we know about you we get mostly from you. But we may also
have to find out more about you from other sources in order to make sure that what we know about
you is correct and complete. Those sources may include your adult relatives, employers, consumer
reporting agencies, health care providers and others. Some of our sources may give us reports, and
they may disclose what they know about you to others.

How We Protect What We Know About You: We treat what we know about you confidentially.
Our employees are told to take care in handling your information. They may get information about
you only when there is a good reason to do so. We take steps to make our computer data bases
secure and to safeguard the information we have about you.

How We Use and Disclose What We Know About You: We may use anything we know about you
to help us serve you better. We may use it, and disclose it to our affiliates and others, for any
purpose allowed by law. For instance, we may use your information, and disclose it to others, in
order to:

· Help us evaluate your request for a MetLife             · Help us run our business
  product or service
                                                          · Process data for us
· Help us process claims and other transactions
                                                          · Perform research for us
· Confirm or correct what we know about you
                                                          · Audit our business
· Help us prevent fraud, money laundering,
  terrorism and other crimes by verifying what we         · Help us comply with the law
  know about you




                                  Total Document Page 190 of 224
Other reasons we may disclose what we know about you include:

·   Doing what a court or government agency requires us to do; for example, complying with a
    search warrant or subpoena
·   Telling another company what we know about you, if we are or may be selling all or any part of
    our business or merging with another company
·   Telling a group customer about its members’ claims or cooperating in a group customer’s audit of
    our service
·   Giving information to the government so that it can decide whether you may get benefits that it
    will have to pay for
·   Telling your health care provider about a medical problem that you have but may not be aware of
·   Giving your information to a peer review organization if you have health insurance with us
·   Giving your information to someone who has a legal interest in your insurance, such as someone
    who lent you money and holds a lien on your insurance or benefits

Generally, we will disclose only the information we consider reasonably necessary to disclose.

We may use what we know about you in order to offer you our other products and services. We
may disclose this information (other than consumer reports and health information) to our affiliates
so that they can offer their products and services, or ours, to you. By law, we don’t have to let you
prevent these disclosures. Our affiliates include life, car and home insurers, securities firms,
broker-dealers, a bank, a legal plans company and financial advisors. In the future, we may have
affiliates in other businesses.

We may also provide information to others outside of the MetLife companies, such as marketing
companies, to help us offer our products and services to you. If we have joint marketing
agreements with other financial services companies, we may give them information about you so
that they can offer their products and services to you; however, we cannot do this if the state law
that applies to you does not allow it. Except for joint marketing arrangements, we do not make any
other disclosures of your information to other companies who want to sell their products or services
to you. For example, we will not sell your name to a catalog company. And we will not disclose
any consumer report or health information to other companies so that they can offer their products
and services, or ours, to you.

How You Can See and Correct Your Information: Generally, we will let you review what we know
about you if you ask us in writing. Medical information will generally be disclosed through the
licensed physician you choose or as otherwise required by law. (Because of its legal sensitivity, we
will not show you anything that we learned in connection with a claim or lawsuit.) If you tell us that
what we know about you is incorrect, we will review it. If we agree with you, we will correct our
records. If we do not agree with you, you may tell us in writing, and we will include your statement
when we give your information to anyone outside MetLife.

How You Can Get Other Material from Us: In addition to any other privacy notice we may give you,
we must give you a summary of our privacy policy once each year. You may have other rights under
the law. If you want to know more about our privacy policy, please contact us at our website,
www.metlife.com, or write to your MetLife insurance company, c/o MetLife Privacy Office, P.O. Box
2006, Aurora, Illinois 60507-2006.

                                                                                       CPN-GLB-2003




                                 Total Document Page 191 of 224
Exhibit F   KCDC’s LTD and STD Claims Status Report




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Exhibit G    KCDC’s Questionnaire

                    Proposers must include a restatement of the question with their response.

Life and LTD Coverages

1.    Does your submitted proposal comply with each of the General Conditions stated in Exhibit
      H. Scope of Services section of this Request for Proposals?

      Yes ____      No _____

      If no, indicate the Condition number and provide an explanation below:

            Condition                                       Explanation
            Number(s)




Life and AD&D Coverage

1.    Is conversion coverage or waiver of premium available for AD&D coverage?

2.    What type(s) of coverage is available through conversion (whole life, term, etc.) and what are the
      rates for conversion coverage?

3.    Will the employee’s health status be taken into account?

4.    Please describe the provisions for an employee to convert Basic Life coverage to individual
      coverage upon termination of employment or loss of eligibility, including retirement.

5.    Please provide a specimen policy for the coverage proposed.

6.    Describe how the Life (and AD&D if applicable) waiver of premium application process
      coordinates with the filing of LTD claims. Describe the process.

7.    Provide the definition of disability that applies to the waiver of premium process including a
      description of how the following impacts the disability decision process:

             a. Actively at work

             b. An employee’s full or partial return to work on a trial basis either during or after the
                LTD elimination period.

                                    Total Document Page 198 of 224
8.    Is the waiver of premium process the same for Basic and Supplemental Life?

9.    If not, describe any differences.

10.   If waiver of premium is granted for a disabled employee who elected Supplemental Life, does the
      waiver also apply to the amount of Supplemental Spouse or Dependent Life insurance the
      employee has in force?

11.   Describe the process and timing for filing for Basic and Supplemental waiver of premium claims
      keeping in mind Condition 13. included in Section V. Scope of Services.

12.   Must the premium be paid during the waiver of premium waiting period in order for waiver to be
      granted?

13.   If not, please explain the process that must be followed including whether the employee may be
      maintained on the plan as an active employee.

14.   May an employee who is turned down for waiver of premium elect to convert or port Basic and/or
      Supplemental Life coverage to an individual policy in the 31-day period following the denial of
      waiver of premium? Describe the process for notifying the employee.

15.   What happens if an employee dies prior to submitting his/her request for waiver of premium?
      Does claim payment depend on whether premium was paid during the waiver elimination period?

16.   What percent increase or decrease in employee lives will result in a change in the cost of coverage
      during the term of your contract?

17.   Does portability apply to both Basic and Supplemental Life coverage?

18.   Must an employee be “healthy” in order to port?

19.   If so, please specify the health criteria that must be met.

20.   Are spouses and/or dependent child(ren) permitted to port coverage?

21.   If so, must the EE port as well? In other words, may a spouse or dependent child port in the event
      of loss of eligibility due to divorce or exceeding the dependent age limit of the plan while the EE
      continues to be covered as an active employee under the plan?

22.   Are port rates the same as the active employee rates?

23.   Is the port policy identical to the active policy?

24.   Please include port rates with the proposal.

25.   In the event an employee ports coverage and dies while covered under the ported coverage, is their
      experience part of KCDC’s experience or part of your company’s overall port pool?

26.   Is there a maximum age limit for portability rights?


                                      Total Document Page 199 of 224
27.   At what age does ported coverage terminate, if any?

28.   Can Life and AD&D claims be viewed online?

29.   In the event KCDC terminates its policy with your company at the end of the three year contract
      term, will employees covered under a ported policy be terminated from coverage?

30.   What happens if the person who receives an accelerated death benefit is no longer considered
      terminally ill?

              a. Must the benefit be returned?
              b. Will the benefit paid reduce the benefit provided as an active employee?
              c. What is the basis for continued premium payment, the full amount or the reduced
                 amount?

LTD Coverage

31.   Does the standard LTD contract include any cost containment features? If yes, please explain in
      detail. Examples of cost containment features include:

              a.   Specific illness limitations (other than mental/nervous);
              b.   Prudent-person;
              c.   Pre-existing condition exclusion;
              d.   Substance abuse limitations;
              e.   Mandatory rehabilitation (please explain the repercussions of the mandatory program);
              f.   Obtaining Social Security disability approval during a certain time period?

32.   Are discounts applied to these limitations?

33.   If so, describe by limitation.

34.   Does a lifetime limit apply to mental nervous and substance abuse benefits?

35.   If so, how is lifetime defined and does it include benefits paid by a prior KCDC LTD carrier?

36.   What provisions does your policy have regarding presumptive total disability? Describe.

37.   Is the provision applied in the same manner during both the “own” and “any occupation” periods?

38.   Does your contract include CPI indexation? Please explain how this works and to what it applies.

39.   Are there any other features or limitations not mentioned in your summary of proposed benefits
      included in your standard contract?

40.   If so, please explain in detail.

41.   Provide a sample LTD policy document with your proposal.

42.   How does the policy treat employees who are not actively at work on the first day of coverage?


                                         Total Document Page 200 of 224
43.   Describe how continuity of coverage applies under the LTD policy.

44.   Are benefits continued during the “any occupation” period to Social Security Normal Retirement
      Age (SSNRA)? Describe.

45.   What happens if an employee / spouse dies during the EOI approval process?

46.   Describe the quarterly and annual reports you provide. Provide sample reports.

47.   Are the reports available electronically?

48.   Can current and historical bills be viewed and processed online?

49.   Can policies and certificates be viewed and printed?

50.   Can LTD claims be viewed online?

51.   What services are provided in connection with the preparation of Federal and State Tax reporting
      and employee W-2 reporting?

52.   Describe the process for LTD claims disputes.

53.   How much information will you provide to the KCDC in trying to resolve disputed claims?
      Describe any limitations that may apply to this issue.

STD Coverage

54.   Are there any features or limitations not mentioned in your summary of proposed benefits
      included in your standard contract?

55.   If so, please explain in detail.

56.   Provide a sample STD policy document with your proposal

57.   How does the policy treat employees who are not actively at work on the first day of coverage?

58.   Describe the quarterly and annual reports you provide. Provide sample reports.

59.   Are the reports available electronically?

60.   Can current and historical bills be viewed and processed online?

61.   Can policies and certificates be viewed and printed?

62.   Can STD claims be viewed online?

63.   Describe the process for STD claims disputes.

64.   How much information will you provide to KCDC in trying to resolve disputed claims? Describe
      any limitations that may apply to this issue.

                                         Total Document Page 201 of 224
Exhibit H     Scope of Services

                                         General Conditions

The conditions listed below must be met if you submit a proposal to the Knoxville’s Community
Development Corporation (KCDC). If your company cannot meet the terms of the conditions listed
below, you must identify the condition number and provide an explanation to accompany your proposal
submission.

                                   Applicable to All Coverage Quoted
1.    KCDC will award the contract for a January 1, 2012 effective date. KCDC holds its annual
      enrollment meetings in mid-November each year.
2.    Quoted rates contain 10% commissions for Basic Life/AD&D and Supplemental Life and 15%
      commission for STD and LTD.
3.    Basic Life/AD&D coverage levels will change the month following a salary increase that affects
      the amount of an employee’s Basic Life/AD&D, LTD and STD coverage.
4.    All coverage is self-billed (i.e., KCDC will audit the volume and number of lives each month and
      make corrections to the statement with the appropriate remittance).
5.    Employee certificates will be provided to KCDC both electronically and in hard copies upon
      request by KCDC. The production of the employee certificates will be provided at no additional
      cost.
6.    A 31-day grace period is provided for monthly premium payment.
7.    A 90-day notice will be provided to KCDC prior to the cancellation, termination or change in any
      of the contract provisions.
8.    The actively-at-work (AAW) provision will be waived on all plans to cover any claims not
      covered under the current extension of benefits and waiver-of-premium provisions of the current
      MetLife policy
                                Basic Life and AD&D, and Optional Life
9.    KCDC is interested in the addition of an Employee Assistance Program for all KCDC employees
      covered under the Basic Life and AD&D plan. Details concerning this coverage should be
      included in your proposal as well as outlined in the Summary of Current and Proposed Coverage.
10.   The waiver of premium elimination period for Basic Life will match the LTD elimination period
      of 90 days.
11.   Age reductions and age band rate changes will take effect on January 1st each year.

12.   KCDC would like to change the definition of a dependent child to match the changes set forth by
      PPACA: a dependent may be covered up to age 26 regardless of student, financial, or marital
      status. The dependent can also be eligible for coverage under his/her own employer and live
      somewhere other than the employee’s household.
13.   Basic Life and Optional Life include waiver of premium. If the employee qualifies for waiver, his
      or her Optional Life premium will be waived as well.
14.   The employee rate applicable to Supplemental Employee coverage is based on the employee’s age
      and the rate applicable to spouse coverage is based on the employee’s age.
15.   Accidental Death and Dismemberment (AD&D) coverage in an amount equal to the basic life
      insurance will be provided.
16.   Optional Life participation requirements will be waived.
17.   Optional Life Evidence of Insurability approvals will be effective on the date the approval is
      made. They will not be retroactive to the date coverage was requested.


                                    Total Document Page 202 of 224
Exhibit H    Scope of Services-continued

18.   Your Optional Life quote allows for a take over open enrollment period, allowing all KCDC
      employees to elect supplemental life coverage for themselves, their spouse and/or dependent
      children without completing EOI. The contract must contain a continuity of coverage provision
      which assures that no employee will be negatively impacted by the change in carriers
                                              LTD Coverage
19.   No loss no gain will apply to all employees covered under the prior carrier’s LTD plan. The
      contract must contain a continuity of coverage provision which assures that no employee will be
      negatively impacted by the change in carriers.
20.   All pre-existing condition restrictions should be waived for the current insured individuals to the
      extent covered under the current MetLife plan.
                                              STD Coverage
21.   No loss no gain will apply to all employees covered under the prior carrier’s STD plan. The
      contract must contain a continuity of coverage provision, which assures that no employee will be
      negatively impacted by the change in carriers.
22.   All pre-existing condition restrictions should be waived for the current insured individuals to the
      extent covered under the current MetLife plan.




                                    Total Document Page 203 of 224
Exhibit I         Summary of Current and Proposed Coverage

                            Summary of Current and Proposed Coverage
                                              January 1, 2012 Marketing
                                              Combined Life and AD&D
                                Current                       2012 Coverage Change Proposed by:
                                MetLife                       Coverage should be the same as current unless
                                Basic Life/AD&D – 1.5 x       specified otherwise below
                                annual pay
Rate Per $1,000      Volume                                                                  Rate           Volume
             Life                    $0.17     $7,410,000
            AD&D                     $0.02     $7,410,000
Estimated Monthly Premium               $1,407.90                                                   $0.00
Estimated Annual Premium               $16,894.80                                                   $0.00
Rate Guarantee
Benefits
Benefit Class(es) eligible?        All Active Full Time
                                   Employees - work
                                schedule must be at least
                                   30 hours per week




Earnings are defined as ? -     Basic annual earnings are
enter earnings definition         defined as Your gross
                                   annual rate of pay as
                                    determined by Your
                                   Employer, excluding
                                 overtime and other extra
                                             pay.
     Change in earnings takes   The change will take effect
     effect when?                  on the first day of the
                                 month coincident with or
                                 next following the date of
                                Your request or the date of
                                    the change in Your
                                          earnings.
Basic Life and AD&D Amount       1.5 x Your Basic Annual
                                 Earnings (rounded to the
                                    next higher $1,000)

Basic Life and AD&D Maximum              $50,000
Benefit
Basic Life GI Level?                     $50,000



     Rounded to the next?       The amount of insurance
                                will be rounded to the next
                                       higher $1,000.
At Age ? Benefit Is x% of       At age 65, reduces to 65%
Original Volume                         of original




                                          Total Document Page 204 of 224
      At Age ? Benefit Is x% of    At age 70, reduces to 50%
      Original Volume                      of original
      At Age ? Benefit Is x% of                N/A
      Original Volume
      At Age ? Benefit Is x% of                N/A
      Original Volume
      No further reductions                     70
      after age?
      Reduced amount rounds                  $1,000
      to next higher multiple of
      ? - enter amount
Waiver of Premium                  Available after the EE has      Available after the EE has been
                                   been Totally Disabled for 9      disabled for 90 days - match
                                            months.                            LTD EP

       Age EE must be to                 Before age 60
       qualify?
       Applies to AD&D as well?                  No
Life exclusions - list all basic   Physical or mental illness
life exclusions                    or infirmity, or the
                                   diagnosis or treatment of
                                   such illness or infirmity;
                                   infection, other than
                                   occurring in an external
                                   accidental wound; suicide
                                   or attempted suicide;
                                   intentionally self-inflicted
                                   injury; committing or
                                   attempting to commit a
                                   felony; the voluntary intake
                                   or use by any means of:
                                   any drug, medication or
                                   sedative, unless it is taken
                                   as prescribed by a
                                   Physician or an OTC drug,
                                   medication, or sedative
                                   taken as directed, or
                                   alcohol in combination with
                                   any drug, medication, or
                                   sedative, or poison, gas, or
                                   fumes; war, whether
                                   declared or undeclared, or
                                   act of war, insurrection,
                                   rebellion, or riot. Exclusion
                                   for intoxication - No
                                   benefits will be paid for
                                   any loss if the injured party
                                   is Intoxicated at the time of
                                   the incident and is the
                                   operator of a vehicle or
                                   other device involved in
                                   the incident.
Conversion available for basic                   Yes
life?
Conversion available for basic                 No
AD&D?
Portability available for Basic                No
Life?
EE must be healthy to port?                   N/A
Accelerated death benefit of        Up to 50% of Your Basic          Quote the highest percent
x% is available up to x$           Life amount not to exceed                 available
                                           $250,000.


                                              Total Document Page 205 of 224
    Minimum amount                       $20,000              Quote the lowest minimum
    available through                                                 possible
    accelerated death
    benefit?
    Terminally ill as defined               6                  Prefer to be 12 months
    as x months?
AD&D Losses Payable              1.5 x Your Basic Annual
                                        Earnings
    Loss of Life                 1.5 x Your Basic Annual
                                        Earnings



    Loss of one arm and/or         75% of Loss of Life
    one leg



    Loss of one hand               50% of Loss of Life




    Loss of one foot               50% of Loss of Life




    Loss of an eye                 50% of Loss of Life




    Loss of speech or            50% (for each - 100% if
    hearing                          both are lost)
    Loss of thumb and index        25% of Loss of Life
    finger on same hand
    Quadriplegia (upper and        100% of Loss of Life
    lower limbs)
    Triplegia (three limbs)        No benefit available
    Paraplegia (both lower         50% of Loss of Life
    limbs)
    Hemiplegia (one side of        50% of Loss of Life
    body)
    Uniplegia (one limb)            25% of Loss of Life
    Brain Damage (as               100% of Loss of Life
    defined)
    Coma (as defined)           1% monthly, beginning on
                                 the 7th day of the Coma
                                and for the duration of the
                                Coma to a maximum of 60
                                          months
    Additional % to $ if seat   An additional 10% benefit
    belt was worn                  between $1,000 and
                                         $10,000
    Additional % to $ if         An additional 5% benefit
    vehicle equipped with air       between $100 and
    bag                                  $10,000
    Benefit payable for total      No benefit available
    disability




                                          Total Document Page 206 of 224
     Common Carrier benefit          100% of Loss of Life


     Child education benefit of     Up to 4 years; annual
     $ per year for x years          maximum of $5,000;
                                   overall maximum of 10%
                                   of the Full Amount; until
                                   the Child attains age 12
     Spouse education benefit        No benefit available
     of x $ for x years
     Repatriation benefit of x       No benefit available
     $ if x miles from home
     World Wide Travel Assist        No benefit available


     AD&D Exclusions                 Exclusion included?
     Self inflicted injury                    Yes
     excluded
     Under influence of                       Yes
     alcohol or illegal drugs
     excluded
     Act of War excluded                      Yes
     Terrorism excluded -                     No
     specify
     Other Exclusions?            Physical or mental illness
                                  or infirmity, or the
                                  diagnosis or treatment of
                                  such illness or infirmity;
                                  infection, other than
                                  occurring in an external
                                  accidental wound; suicide
                                  or attempted suicide;
                                  intentionally self-inflicted
                                  injury; committing or
                                  attempting to commit a
                                  felony; the voluntary intake
                                  or use by any means of:
                                  any drug, medication or
                                  sedative, unless it is taken
                                  as prescribed by a
                                  Physician or an OTC drug,
                                  medication, or sedative
                                  taken as directed, or
                                  alcohol in combination with
                                  any drug, medication, or
                                  sedative, or poison, gas, or
                                  fumes; war, whether
                                  declared or undeclared, or
                                  act of war, insurrection,
                                  rebellion, or riot. Exclusion
                                  for intoxication - No
                                  benefits will be paid for
                                  any loss if the injured party
                                  is Intoxicated at the time of
                                  the incident and is the
                                  operator of a vehicle or
                                  other device involved in
                                  the incident.
What type of Employee                 Not included currently      Include a 3 session face to face
Assistance Programs (EAP)                                          EAP and indicate whether the
do you include with your                                           life or LTD rate is impacted by
services?                                                                     including.
        Number of face-to-face                N/A
           sessions included?


                                             Total Document Page 207 of 224
Conversion available?                    Yes
Portability available?                   No                    Please include
Minimum benefit that can be              N/A                   Please answer
continued?
Coverage must be in force for x          N/A                   Please answer
period of time to port?
EE must be healthy to port?              N/A                   Please answer
Contributions - % paid by EE      100% employer paid.




                                         Total Document Page 208 of 224
Exhibit I         Summary of Current and Proposed Coverage-continued

                          Summary of Current and Proposed Coverage
                                                      Optional Life
                                                 January 1, 2012 Renewal
                                    Current                     2012 Coverage Change Proposed by:
                                    MetLife                       Coverage should be the same as current unless
                                                                           specified otherwise below
                       Volume       Optional Term Life          Optional Term Life Insurance   Optional Term Life
                                    Insurance                                                  Insurance
Rates                  7,525,000

   Supplemental Employee                 Monthly Rates                                              Monthly Rates
   Life (per $1,000)
   Under 30                                    $0.07
   30-34                                       $0.10
   35-39                                       $0.12
   40-44                                       $0.15
   45-49                                       $0.23
   50-54                                       $0.39
   55-59                                       $0.67
   60-64                                       $1.00
   65-69                                       $1.36
   70+                                         $2.44
   Supplemental Child Life
   $5,000                                      $1.00
   $10,000                                     $2.00
Rate Guarantee
Benefits
Benefit Class(es) eligible?

   Definition of Full Time and         All Active Full Time
   Part Time Employee?                 Employees - work
                                    schedule must be at least
                                       30 hours per week




Earnings are defined as ? - enter   Basic Annual Earnings
earnings definition                 defined as Your gross
                                    annual rate of pay as
                                    determined by Your
                                    Employer, excluding
                                    overtime and extra pay




                                              Total Document Page 209 of 224
   Change in earnings takes      NA
   effect when?




EE Supp Life Maximum Benefit      Lesser of 5 times annual     Provide as much as possible
                                 salary or $500,000 - Supp
                                 Life is not combined with
                                          basic life
EE Supp Life Minimum Benefit               $10,000
EE Supp Life GI Level?                    $100,000             Increase as high as possible
   Rounded to the next?                    $1,000
At Age ? Benefit Is x% of        Age 65, to 65% of original
Original Volume
   At Age ? Benefit Is x% of     Age 70, to 50% of original
   Original Volume
   At Age ? Benefit Is x% of                N/A
   Original Volume
   No further reductions after            Age 70
   age?
   Reduced amount rounds to               $1,000
   next higher multiple of ? -
   enter amount
Waiver of Premium                Available after the EE has   Available after the EE has been
                                 been Totally Disabled for     disabled for 90 days - match
                                         9 months.                        LTD EP
   Age EE must be to qualify?         Before age 60
   If EE receives, does waiver             Yes
   apply to spouse and
   dependant children as well?
Spouse benefit available?        The lesser of 50% of the
                                 Employee's Optional Life
                                  Insurance amount or
                                        $100,000
   Spouse GI level?                      $25,000               Increase as high as possible
   EE must purchase for spouse             Yes
   to purchase
   Maximum amount a spouse               $100,000              Increase as high as possible
   may elect?
   Minimum amount spouse may              $5,000
   elect?
   Spouse amount may not                   50%
   exceed what % of EE's
   amount?
   Spouse age based on EE or          Employee age
   spouse age?
Annual Enrollment Increase          Each year at annual
available                           enrollment, EE and
                                 spouse may increase their
                                    supp life election by
                                 $10,000 up to the EE and
                                      spouse GI limit.




                                         Total Document Page 210 of 224
Dependent Life benefit                $100 from 15 days but         Prefer to have benefit begin from
available                             less than 6 months / 2                      birth
                                       options of $5,000 or
                                        $10,000 for Child 6
                                         months and over
Dependent Life Definition            At least 15 days, under         To age 26 - follow PPACA
                                    age 19; or under age 25 if               definition
                                     a full-time student, not
                                     employed on a full time
                                    basis, and unmarried and
                                        supported by You
   EE must purchase to elect for                Yes
   Dependant?
   Maximum amount available                   $10,000
   for Dependant?
   Minimum amount Dependant                   $5,000
   may elect?
   Dependant rate based on per                Per unit
   unit or # of children covered?
   Dependant Life GI level?                   $10,000
Accelerated death benefit                       Yes                    Quote the highest percent
available for spouse and child?                                                available
   Same min. and max. apply as                  Yes                    Quote the lowest minimum
   EE?                                                                         possible
   Terminally ill is defined as x            6 months                   Prefer to be 12 months
   months?
Conversion available?                           Yes
Portability available?                          Yes
Minimum benefit that can be                   $20,000
continued?
Coverage must be in force for x          No period of time
period of time to port?                     necessary
EE must be healthy to port?                    No
Accelerated death benefit of x%        50% up to $250,000
is available up to x$
   Minimum amount available                   $20,000
   through accelerated death
   benefit?
   Terminally ill as defined as x            6 months
   months?
Supplemental Life Exclusions           If you commit suicide 2
                                       years from the date Life
                                    Insurance takes effect, We
                                           will not pay such
                                     insurance and Our liability
                                      will be limited as follows:
                                     any premium paid by You
                                        will be returned to the
                                      Beneficiary; any premium
                                      paid by the Employer will
                                           be returned to the
                                               Employer.
Contributions - % paid by EE               100% paid by EE




                                             Total Document Page 211 of 224
Exhibit I          Summary of Current and Proposed Coverage-continued

                          Summary of Current and Proposed Coverage
                                            LTD
                                           January 1, 2012 Marketing
                                                   Current                 2012 Coverage             Proposed by:
                                                                              Change
                                                   MetLife               Coverage should be the same as current
                                                   LTD - 60%,            unless specified otherwise below
                                                   $5,000, 90 days
Rates                                 Volume
                     Rate per $100    6,043,312                  $0.64
Estimated Monthly Premium                                   $38,677.20
Estimated Annual Premium                                   $464,126.36
Percentage Change From Current N/A
Annual Dollar Change From          N/A
Current
Rate Guarantee
Benefits
Benefit Class(es) eligible?         All Active Full Time Employees -        All Active Full Time
                                     working at least 30 hours each         Employees - work
                                     week. However, if you do not        schedule must be at least
                                    have regular work hours you will        30 hours per week
                                     be an Eligible Employee if you
                                   have worked at least an average
                                     of 30 hours a week during the
                                   preceding 12 calendar months (or
                                   during your period of employment
                                         if less than 12 months)


Monthly Benefit Percent                          60%
                                     of Your Predisability Earnings
Maximum Monthly Benefit                           $5,000
                     Rounded to                   Dollar
                     the next ?
Minimum Monthly Benefit                          $100                     Greater of $100 or 10%
Elimination Period                              90 days


Benefit Duration                      Prior to age 60 - to age 65         Change to SSRNA vs. to
                                                                                  age 65

                       At Age 60              60 months


                       At age 61              48 months


                       At age 62              42 months


                       Age 63                 36 months

                       Age 64                 30 months




                                        Total Document Page 212 of 224
                         Age 65                    24 months
                         Age 66                    21 months
                         Age 67                    18 months
                         Age 68                    15 months
                         Age 69 and                12 months
                         over


Changes in coverage occur when?         On date of change; and will apply
                                         only to Disabilities commencing
                                                    thereafter

Predisability Earnings are defined      The amount of your gross salary
as?                                     or wages from your Employer as
                                        of the day before your Disability
                                        began - calculated on a monthly
                                        basis - does not include awards,
                                         commissions, and/or bonuses;
                                         overtime pay; your Employer's
                                         contributions on your behalf to
                                           any deferred compensation
                                        arrangement or pension plan; or
                                             any other compensation


Pre-existing condition limitation                      3/12
is defined as ?
Social Security offsets are defined                Full Family
as?
Mental illness limited to?                  24 monthly benefits in your
                                        lifetime, or the Maximum Benefit
                                            Duration, whichever is less.
Substance abuse limited to?              One period of Disability in your
                                           lifetime for up to: 24 Monthly
                                              Benefits; your successful
                                             completion of an approved
                                            rehabilitative program; your
                                        ceasing or refusing to participate
                                        in a rehabilitative program; or the
                                            Maximum Benefit Duration;
                                                  whichever is less


Chronic Fatigue syndrome limited             24 months per lifetime
to?
Soft Tissue illnesses are limited to?        24 months per lifetime




                                             Total Document Page 213 of 224
The following income offsets apply:      Federal Social Security Act,
                                         Railroad Retirement Act, Canada
                                         Pension Plan, or any provincial
                                         pension or disability plan, or the
                                         Canada Old Age Security Act;
                                         Group Insurance policies (if the
                                         Employer contributes towards
                                         them or makes payroll deduction
                                         for any of the following: other
                                         group health insurance policies
                                         will be counted to the extent that
                                         they provide benefits for loss of
                                         time from work due to disability;
                                         and a group life policy that
                                         provides installment payments for
                                         permanent total disability will be
                                         counted; Benefits for disability
                                         and/or retirement that you receive
                                         under the Employer's retirement
                                         plan will be counted to the extent
                                         they are attributable to the
                                         Employer's contributions; No-fault
                                         Auto Laws; Worker's
                                         Compensation or a Similar Law;
                                         Occupational Disease Laws;
                                         Maritime Maintenance & Cure;
                                         Third Party Recovery;
                                         Unemployment Insurance Law or
                                         Program.



Plan allows conversion to an                            No
individual policy at termination?
                           Must EE                      N/A
                           have been
                           covered for
                           X period of
                           time?
Definition of Disability
                           Applicable    Due to sickness, pregnancy or
                           to Own        accidental injury, you are
                           Occupation    receiving Appropriate Care
                           period?       and Treatment from a Doctor
                                         on a continuing basis; and 1)
                                         during your Elimination Period
                                         and the next 24 month period,
                                         you are unable to earn more
                                         than 80% of your Predisability
                                         Earnings or Indexed
                                         Predisability Earnings at your
                                         Own Occupation for any
                                         employer in your Local
                                         Economy
                           Earnings                     20%
                           loss
                           required?




                                               Total Document Page 214 of 224
                         Applicable    After the 24 month period, you           Would prefer to "any
                         to Any        are unable to earn more than           Occupation" earnings loss
                         Occupation?   60% of your Indexed                          to be 80%
                                       Predisability Earnings from
                                       any employer in your Local
                                       Economy at any gainful
                                       occupation for which you are
                                       reasonably qualified taking
                                       into account your training,
                                       education, experience and
                                       Predisability Earnings. For
                                       any employee whose
                                       occupation requires a license,
                                       "loss of license" for any reason
                                       does not, in itself, constitute
                                       disability
                         Earnings                      40%                     Would prefer to be 20%
                         loss
                         required?
Definition of indexed predisability         Your Predisability Earnings
earnings?                                   increased by 7%. The first
                                          increase will take place on the
                                       date of the 13th Monthly Benefit is
                                        payable. Subsequent increases
                                              will take effect on each
                                         anniversary of the first increase.
                                         You must have been continually
                                        receiving Monthly Benefits under
                                                      This Plan.
Plan includes Residual disability?         Yes - 20% earnings loss
Length of time EE may return to        30 days (work days, not calendar
work during Elim. Pd.?                  days) - counts toward satisfying
                                            the elimination period
Plan includes Return to Work                       24 months.
incentive?
Partial Disability provision?           Benefit reduced by 50% of work
                                                    earnings
Rehabilitation Requirements?              While disabled, your Monthly
                                       Benefit, before reduction for Other
                                        Income Benefits, is increased by
                                         10% when you participate in a
                                       Rehabilitation Program approved
                                                      by us.

Conversion available at termination?                  No
Survivor benefit provided?                            Yes
                        Benefit         A lump sum equal to 6 times the
                        provided of    Monthly Benefit before reductions
                        gross or net   for Other Income Benefits (gross)
                        benefit?
                        Payable            You have completed your
                        after?            Elimination Period; you are
                                          eligible to receive a Monthly
                                        Benefit at the time of death; you
                                         have an Eligible Survivor; and
                                        proof of death is provided to us

Recurrent disability provision?         If return to work for 6 months or
                                            less and go out again, the
                                        disability is treated as recurring.




                                             Total Document Page 215 of 224
Is premium waived during the Elim.                       No
Period?
Workplace modification benefit?          Included - there is no cap on this
                                                      benefit
Exclusions?                               War, insurrection, or rebellion;
                                            active participation in a riot;
                                         intentionally self-inflicted injuries
                                              or attempted suicide; or
                                                committing a felony.

Family Care Benefit?                      Family care expense means the
                                          amount you spend for care of a
                                         family member in order for you to
                                            work or be retrained under a
                                           rehabilitation plan. To qualify:
                                            your family member must be
                                          under age 13 or be physically or
                                          mentally incapable of caring for
                                          him/herself, your family member
                                           must be dependent on you for
                                          support and maintenance, AND
                                           the person who cares for your
                                             family member cannot be a
                                           relative. Up to $250 per family
                                              member per month will be
                                          included. This provision applies
                                              during the first 24 months
                                             following the date you have
                                          satisfied the Elimination Period.


Additional benefit payable for loss of                   No                      Include if part of standard
2 activities of daily living (ADL)?                                                        offering
Contributions - % paid by EE?                     50% paid by ER




                                              Total Document Page 216 of 224
Exhibit I          Summary of Current and Proposed Coverage-continued

                          Summary of Current and Proposed Coverage
                                                         STD
                                               January 1, 2012 Renewal
                                   Current                        2012 Coverage Change Proposed by:
                                   MetLife                         Coverage should be the same as current unless
                                                                            specified otherwise below
                                   Short Term Disability

Rates                     Volume        Monthly Rates
   Rate per $100       4,431,877              $0.54
Estimated Monthly Premium
Estimated Annual Premium
Percentage Change From                         N/A
Current
Annual Dollar Change From                      N/A
Current
Rate Guarantee Period
Benefit Class(es) eligible?        All Active Full Time           All Active Full Time Employees -
                                   Employees - working at         work schedule must be at least
                                   least 30 hours each                    30 hours per week
                                   week. However, if you
                                   do not have regular
                                   work hours you will be
                                   an Eligible Employee if
                                   you have worked at
                                   least an average of 30
                                   hours a week during the
                                   preceding 12 calendar
                                   months (or during your
                                   period of employment if
                                   less than 12 months)
Weekly Benefit Percent                    60% of your
                                     Predisability Earnings
Maximum Weekly Benefit                       $1,000
   Rounded to the next?                      Dollar
Minimum Weekly Benefit                        $20
Benefits Commence                  Injury and sickness: on
                                   the 15th consecutive
                                   day of Total Disability or
                                   Disabled and Working

Benefit Duration                             13 weeks
Changes in coverage occurs         Will take effect on the date
when?                              of change; and will apply
                                        only to Disabilities
                                    commencing thereafter




                                          Total Document Page 217 of 224
Predisability Earnings are defined     The amount of your gross
as?                                    salary or wages from your
                                       Employer as of the day
                                       before your Disability
                                       began - calculated on a
                                       weekly basis - does not
                                       include awards,
                                       commissions, and/or
                                       bonuses; overtime pay;
                                       your Employer's
                                       contributions on your
                                       behalf to any deferred
                                       compensation
                                       arrangement or pension
                                       plan; or any other
                                       compensation
Pre-existing condition limitation is              N/A
defined as?
Work related accidents are or are             Not covered
not covered?
Mental illness and substance             24 months in a lifetime
abuse is limited to?
The following income offsets           Group Insurance policies
apply:                                 (if the Employer
                                       contributes towards them
                                       or makes payroll deduction
                                       for any of the following:
                                       other group health
                                       insurance policies will be
                                       counted to the extent that
                                       they provide benefits for
                                       loss of time from work due
                                       to disability; and a group
                                       life policy that provides
                                       installment payments for
                                       permanent total disability
                                       will be counted; Benefits
                                       for disability and/or
                                       retirement that you receive
                                       under the Employer's
                                       retirement plan will be
                                       counted to the extent they
                                       are attributable to the
                                       Employer's contributions;
                                       No-fault Auto Laws; Third
                                       Party Recovery;
                                       Unemployment Insurance
                                       Law or Program.
Plan allows conversion to an                          No
individual policy at termination?
   Must EE have been covered                      N/A
   for X period of time?




                                              Total Document Page 218 of 224
Definition of Disability             Due to sickness,
                                     pregnancy or accidental
                                     injury, you: 1) are
                                     receiving Appropriate
                                     Care and Treatment
                                     from a Doctor on a
                                     continuing basis; and 2)
                                     are unable to earn more
                                     than 80% of your
                                     Predisability Earnings at
                                     your Own Occupation
                                     for any employer in your
                                     Local Economy. For any
                                     employee whose
                                     occupation requires a
                                     license, "loss of license"
                                     for any reason does not,
                                     in itself, constitute
                                     disability.
   Earnings loss required?                       20%
Plan includes Residual disability?                Yes
Recurrent disability provision?        If return to work for 90
                                       days or less and go out
                                        again, the disability is
                                         treated as recurring.
Is premium waived during the                       No
Elim. Period?
Is premium waived while receiving                 No
benefits?
Is rehabilitative employment         While disabled, your
required during the STD benefit      Monthly Benefit, before
period?                              reduction for Other Income
                                     Benefits, is increased by
                                     10% when you participate
                                     in a Rehabilitation
                                     Program approved by us.
Exclusions?                          No benefits paid for
                                     Occupational injuries.
                                     War, insurrection, or
                                     rebellion; active
                                     participation in a riot;
                                     intentionally self-inflicted
                                     injuries or attempted
                                     suicide; or committing a
                                     felony; elective treatment
                                     or procedures such as, but
                                     not limited to: cosmetic
                                     surgery or treatment
                                     primarily to change
                                     appearance, in vitro
                                     fertilization, embryo
                                     transfer procedure,
                                     artificial insemination, sex-
                                     change surgery, reversal
                                     of sterilization, liposuction,
                                     radial keratotomy
Contributions - % paid by EE?                50% paid by ER




                                             Total Document Page 219 of 224
Exhibit J   Rate History to 2005

                                               Life
                           1/1/2005       $0.13
                           1/1/2006       $0.13
                           1/1/2007       $0.13
                           1/1/2008       $0.13
                           1/1/2009       $0.13
                           1/1/2010       $0.17
                           1/1/2011       $0.17

                            AD&D          $0.02 *since inception
                                              LTD
                           1/1/2005       $0.41
                           1/1/2006       $0.41
                           1/1/2007       $0.41
                           1/1/2008       $0.41
                           1/1/2009       $0.41
                           1/1/2010       $0.54
                           1/1/2011       $0.64
                                              STD
                           1/1/2005       $0.41
                           1/1/2006       $0.49
                           1/1/2007       $0.49
                           1/1/2008       $0.49
                           1/1/2009       $0.49
                           1/1/2010       $0.54
                           1/1/2011       $0.54




                                   Total Document Page 220 of 224
Exhibit K   Leave Hours 2011

Person      Seniority    Annual Time        Annual Leave        Sick Leave     Sick Leave
  ID          Date         Accrual            Balance            Accrual        Balance
  230       04/23/2001             6.16             138.96              3.69          184.49
 1,669      05/23/2011             3.08              24.64              3.69           29.52
   30       01/03/2000             6.16             251.78              3.69          164.26
  130       07/01/1974             7.70             211.30              3.69        1,055.77
  169       01/03/1995             6.16             241.70              3.69          721.77
   41       12/11/2006             4.62              74.68              3.69          122.06
  171       11/08/1999             6.16             301.04              3.69          432.21
   55       08/17/1981             6.16             253.86              3.69          798.58
  188       04/17/1995             6.16             190.52              3.69          688.10
   88       05/20/1985             6.16             112.66              3.69        1,826.97
   12       07/31/2000             4.62              83.88              3.69          278.75
   53       03/31/1992             6.16             237.74              3.69          164.04
 1,378      06/14/2010             3.08              21.64              3.69          113.77
  168       01/04/1977             7.70              72.97              3.69          690.76
 1,315      07/16/2007             4.62              33.84              3.69          107.71
  111       04/11/1988             6.16             103.57              3.69          198.74
   56       11/13/1996             6.16             209.84              3.69          138.80
  175       07/23/1990             6.16             314.54              3.69          264.64
  218       06/10/1974             7.70             247.50              3.69        2,325.04
 1,345      02/25/2008             4.62              18.22              3.69            6.90
 1,380      07/12/2010             3.08              58.98              3.69           24.39
  150       06/21/1999             6.16             264.20              3.69        1,066.55
    9       03/09/1998             6.16             151.60              3.69          210.31
  182       02/04/1980             7.70             260.80              3.69        1,221.41
 1,657      01/24/2011             3.08              25.36              3.69           30.73
  179       02/28/2000             6.16              34.26              3.69          589.69
   65       08/15/1977             7.70             227.80              3.69        2,621.26
   68       09/03/1990             6.16             283.84              3.69        1,700.92
  140       08/28/2000             6.16             108.68              3.69          107.72
 1,659      01/31/2011             3.08              49.28              3.69           55.04
  185       09/24/2001             6.16             128.20              3.69          264.40
   64       04/17/2006             4.62             110.80              3.69          297.29
   42       08/23/1982             7.70             246.40              3.69        1,755.47
 1,382      07/26/2010             3.08              12.90              3.69           33.20
   54       10/12/1992             6.16              46.00              3.69          102.60
 1,360      05/04/2009             3.08             102.96              3.69          213.28
   58       02/02/2000             6.16              24.58              3.69           57.07
   48       01/29/1990             6.16             265.36              3.69        1,526.71
  131       02/16/1998             6.16             241.70              3.69          650.30
   96       05/05/1995             6.16             170.69              3.69          163.94
   19       09/02/2003             6.16             230.54              3.69          252.30
   40       03/13/2000             6.16             277.04              3.69          627.71
   87       02/22/1982             7.70             100.40              3.69          351.23

                               Total Document Page 221 of 224
Person   Seniority    Annual Time        Annual Leave        Sick Leave     Sick Leave
  ID       Date         Accrual            Balance            Accrual        Balance
  270    09/01/1997             6.16              40.22              3.69          142.64
   95    04/11/2005             4.62             100.60              3.69          181.14
  149    03/14/1994             6.16              68.84              3.69        1,156.95
  115    08/07/2006             4.62             248.76              3.69          396.77
  193    02/05/1996             6.16             293.04              3.69        1,200.41
  151    09/10/1990             6.16             336.36              3.69          342.95
  235    06/19/2000             6.16              66.16              3.69          371.29
  147    07/30/1984             7.70             253.00              3.69          402.63
  160    02/22/1993             6.16             357.04              3.69        1,349.80
 1,309   05/21/2007             4.62             114.82              3.69          317.47
   28    09/07/2004             3.08              62.48              3.69          145.39
  167    08/28/1989             6.16             241.04              3.69          769.26
  208    11/25/1996             6.16             235.96              3.69          540.34
  176    02/17/1997             6.16             209.52              3.69          671.92
   51    08/28/2000             4.62              45.88              3.69           30.75
  125    01/27/1997             6.16              86.54              3.69           43.69
  202    04/03/2006             4.62              14.86              3.69           64.50
  157    03/16/1998             6.16              34.90              3.69           34.31
  141    06/17/2002             6.16             255.04              3.69          531.33
   86    01/24/1990             6.16             189.18              3.69          287.04
   24    11/22/1999             6.16             271.54              3.69          719.36
  233    09/27/2004             4.62             114.24              3.69          165.07
  103    04/18/1983             6.16             317.04              3.69          781.48
   29    02/27/2006             4.62              26.28              3.69           61.05
  240    11/17/2003             6.16              50.16              3.69           40.76
 1,353   05/27/2008             4.62              67.62              3.69          238.34
   33    06/29/1998             6.16             226.38              3.69          151.30
  222    02/14/2000             6.16              37.92              3.69           36.88
  108    04/30/1984             7.70             269.68              3.69          283.35
  107    10/30/1995             6.16              75.74              3.69          116.20
   45    05/21/2001             6.16              35.20              3.69           22.98
 1,356   09/15/2008             3.08              34.00              3.69            0.44
  128    05/18/1987             6.16             103.55              3.69          477.13
   79    09/19/1989             6.16             251.90              3.69          731.45
   85    05/15/1989             6.16             151.52              3.69          944.08
  238    11/12/2001             6.16             160.02              3.69          132.49
  215    04/28/2003             6.16             300.42              3.69          463.19
   90    01/07/2002             6.16             296.04              3.69          158.07
  148    05/07/1990             6.16              72.54              3.69          864.34
  118    07/21/2004             6.16             187.66              3.69          109.65
  136    09/05/1989             6.16             102.20              3.69          899.07
 1,320   08/13/2007             4.62              72.94              3.69           96.45
 1,376   02/08/2010             3.08              31.62              3.69           10.41
  163    06/29/1998             6.16             303.26              3.69          951.05
  154    01/03/1990             6.16             196.80              3.69           42.25


                            Total Document Page 222 of 224
Person   Seniority    Annual Time        Annual Leave        Sick Leave     Sick Leave
  ID       Date         Accrual            Balance            Accrual        Balance
  113    08/14/1995             6.16             178.40              3.69          346.12
 1,373   04/01/2006             4.62             119.86              3.69          135.57
 1,375   02/01/2010             3.08              73.36              3.69          143.98
  106    08/04/1993             6.16             279.86              3.69          689.35
   18    05/11/1998             6.16             353.04              3.69          349.31
 1,656   01/24/2011             3.08              44.36              3.69           62.73
  178    05/24/1999             6.16             129.64              3.69          592.11
  207    02/12/1990             6.16              93.06              3.69          115.37
   93    02/12/2003             4.62             152.74              3.69          251.07
  213    08/07/1995             6.16             341.04              3.69        1,714.54
 1,367   07/22/1982             7.70             177.07              3.69            0.19
   23    02/04/1991             6.16             152.34              3.69          799.24
  196    08/02/2004             6.16              65.24              3.69          247.84
  237    08/15/2005             4.62             219.46              3.69          481.71
   21    11/11/2002             6.16             127.44              3.69           13.14
   82    04/19/1999             6.16              35.40              3.69           18.95
   62    05/31/2005             4.62             167.06              3.69          129.66
   69    07/31/1980             7.70             321.30              3.69        1,744.05
  198    07/15/2002             6.16              97.48              3.69           91.53
  210    03/23/1992             6.16              85.76              3.69          720.53
 1,379   07/06/2010             3.08              20.48              3.69           52.89
  145    09/04/1987             6.16              69.09              3.69          434.04
  199    01/30/1989             6.16             295.54              3.69        2,090.03
  101    12/18/2000             6.16             227.04              3.69        1,291.32
   72    04/22/2002             6.16             308.46              3.69          386.17
 1,377   06/01/2010             3.08               9.60              3.69           94.77
  124    03/04/1993             6.16             268.13              3.69        1,085.48
  189    08/02/1999             6.16              91.76              3.69          543.09
  177    03/29/1982             6.16              41.82              3.69           32.73
  132    05/22/2000             6.16             241.92              3.69          185.05
 1,365   01/18/1977             7.70             261.94              3.69        1,825.02
  181    04/01/1985             7.70             365.30              3.69        2,232.36
  226    08/14/1984             6.16             111.61              3.69          752.98
  220    02/02/1994             6.16             320.20              3.69          681.65
  162    04/25/1983             7.70              38.08              3.69           39.52
   25    02/10/2003             6.16             232.36              3.69          544.06
 1,341   12/26/2007             4.62              23.44              3.69           10.43
  174    08/01/2005             4.62             128.58              3.69          188.40
  166    10/20/1997             6.16             187.86              3.69          362.44
  142    10/14/2002             6.16              38.96              3.69           12.32
 1,369   04/02/1990             6.16              59.02              3.69            7.57
  133    01/27/2003             6.16              25.24              3.69           94.87
  223    01/03/2005             4.62             278.38              3.69          335.75
  224    08/08/2005             4.62             230.46              3.69           99.21
   92    09/09/2002             6.16             132.12              3.69          545.65


                            Total Document Page 223 of 224
Person   Seniority    Annual Time        Annual Leave        Sick Leave     Sick Leave
  ID       Date         Accrual            Balance            Accrual        Balance
   66    10/07/1991             6.16             205.02              3.69          751.11
 1,321   07/23/2007             4.62              60.76              3.69          119.52
 1,374   07/01/2008             4.62              32.86              3.69           50.57
  102    05/24/1993             6.16             248.52              3.69          965.13
  205    02/01/1990             6.16             279.70              3.69        1,512.63
  100    01/03/2000             6.16              42.16              3.69          259.38
   44    07/28/1997             6.16              88.58              3.69          285.85
 1,354   07/07/2008             4.62              55.76              3.69           62.27
  126    07/21/1998             6.16             225.96              3.69          357.49
  172    06/11/2001             6.16             264.86              3.69          630.00
 1,355   01/31/2000             6.16              74.04              3.69            4.16
 1,318   08/06/2007             4.62              68.64              3.69          157.83
  219    02/10/1992             6.16             279.36              3.69          924.95
 1,371   02/25/2002             6.16             196.44              3.69           38.57
  180    04/29/1985             7.70             334.30              3.69        2,327.97
   59    06/26/2000             6.16              60.44              3.69          211.17
 1,394   09/13/2010             3.08              21.08              3.69           64.44
  156    09/14/1998             6.16             208.34              3.69          634.91
   38    04/11/1988             6.16             126.37              3.69        1,451.93
  191    07/10/2006             4.62              77.00              3.69          234.65
  121    07/25/2005             4.62             202.78              3.69          455.20




                            Total Document Page 224 of 224

								
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