RL-HI2-CERT-20-IN 9 D12970 (11/25) Premiums will be billed directly to you. 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 you apply for portability. We may change the portability premium rates at any time upon 60 days written notice to you. Coverage continued under this provision will end on the earliest of the following: The end of the period for which you paid premiums, if you stop making a required premium contribution, subject to the grace period. The date you die. The date the Policy terminates and coverage for all Insured Persons under the Policy terminates, upon 60 days written notice of termination. GRACE PERIOD The Policyholder has a grace period of 60 days for the payment of any premium due except the first. During the grace period the Policy will remain in force. If full payment is not received by us by the end of the grace period, the Policy will automatically terminate at the end of the grace period. The Policyholder is required to pay a pro rata premium for any period the Policy was in force during the grace period. There is no grace period if the Policyholder gives us advance written notice of termination, or if we have given the Policyholder advance written notice of termination as described under the POLICY TERMINATION provision. If you are on portability, you also have a grace period of 31 days for the payment of any premium due. During the grace period your coverage will remain in force. If full payment is not received by us by the end of the grace period, your coverage will automatically terminate at the end of the grace period. A pro rata premium payment is required for any period your coverage was in force during the grace period. REPRESENTATIONS NOT WARRANTIES We consider any statements the Policyholder and you make in an application to be representations and not warranties. No statements made by you will be used to reduce or deny any claim or to cancel your coverage unless both of the following are true: The statement is in writing and is signed by you. A copy of that statement is given to you or your personal representative. INCONTESTABILITY The validity of the Policy will not be contested, except for nonpayment of premiums, after the Policy has been in force for two years after its date of issue. No statement made by you in an application or enrollment form relating to your insurability will be used to contest the insurance for which the statement was made after the coverage has been in force for two years during your lifetime. CLERICAL ERROR Clerical error or omission by us or by the Policyholder will not: Prevent you from receiving coverage, if you are entitled to coverage under the terms of the Policy. Cause coverage to begin or continue for you when the coverage would not otherwise be effective. If the Policyholder gives us information about you that is incorrect, we will do both of the following: Use the facts to decide whether you are eligible for coverage under the Policy and in what amounts. Make a fair adjustment of the premium. MISSTATEMENT OF AGE If premiums are based on your age and you have misstated your age, we will make a fair adjustment of benefits to reflect the amount that the premium paid would have purchased at your true age. We may require satisfactory proof of your age before paying any claim. ASSIGNMENT No assignment of benefits under the Policy is valid, unless otherwise specified in the Policy.
Hospital Confinement Indemnity Insurance Plan for Noblesville Schools Page 9 Page 11