RL-ACC3-SPR2-23-IN 3 SPR-12967 (11/25) PORTABILITY If you continue your coverage under the Certificate’s PORTABILITY provision, then your Spouse’s coverage under this rider may also be continued at the same time. Continued premium payment is required to keep your Spouse’s coverage in force. You may decrease the continued Spouse coverage amount based on the available amounts on the Certificate’s SCHEDULE OF BENEFITS. You may not increase the continued Spouse coverage amount. Continued Spouse coverage under this provision is subject to all the terms of this rider. PORTABILITY FOLLOWING DEATH OR DIVORCE If you die or divorce, your Spouse may elect to continue Spouse coverage under this rider if certain conditions are met. Your Spouse must have been insured under this rider on the date of your death or divorce, your Spouse must be under age 75, and your Spouse must elect portability and pay the first premium within 31 days of the date of your death or divorce. If your Spouse continues coverage under this provision, your Spouse will become the owner of their Spouse coverage under this rider. Your Spouse may decrease the continued Spouse coverage amount based on the amounts available on the Certificate’s SCHEDULE OF BENEFITS. Your Spouse may not increase the continued Spouse coverage amount. Coverage continued under this provision is subject to all the terms of this rider. Premiums will be billed directly to your Spouse. Continued premium payment is required to keep coverage in force. The initial premium will be based on the portability premium rates in effect at the time your Spouse elects portability. We may change the portability premium rates at any time upon 31 days Written notice to your Spouse. Coverage continued under this provision will end on the earliest of the following: The end of the period for which premiums for this rider are paid if the next premium is not paid by its due date, subject to the GRACE PERIOD provision. The date your Spouse attains age 75. The date your Spouse voluntarily cancels coverage under this rider. The date your Spouse dies. The date the Policy terminates because we stop providing accident coverage to all groups in the Policy issue state and coverage for all Covered Persons under the Policy terminates. We will provide 60 days Written notice of termination. GRACE PERIOD Refer to the GRACE PERIOD provision in the Certificate if you are continuing coverage under the Certificate’s PORTABILITY provision. If your Spouse is continuing coverage under the PORTABILITY FOLLOWING DEATH OR DIVORCE provision, your Spouse has a grace period of 60 days for the payment of any premium due. During this grace period, your Spouse’s coverage will remain in force. If the full premium payment is not received by us by the due date, we will give Written notification to your Spouse that if the premium is not paid by the end of the grace period, then all coverage under this rider will terminate on the last day of the grace period. If we fail to give such Written notice, coverage will continue in effect until the date such notice is given. We may extend the grace period by giving Written notice of such intent to your Spouse, and such notice will specify that all coverage will terminate on that date if the premium remains unpaid. A pro rata premium payment is required for any period your Spouse’s coverage was in force during the grace period.
Accident Insurance Plan for Noblesville Schools Employees Page 26 Page 28