TABLE OF CONTENTS Page SCHEDULE OF BENEFITS ............................................................................................................................................. 1.0 DEFINITIONS ................................................................................................................................................................... 2.0 GENERAL PROVISIONS ................................................................................................................................................. 3.0 Entire Contract Changes Incontestability Records Maintained Clerical Error Misstatement of Facts Assignment Conformity With State Laws Certificate of Insurance Policy Termination LIMITATIONS ................................................................................................................................................................... 4.0 INDIVIDUAL ELIGIBILITY, EFFECTIVE DATE AND TERMINATION ............................................................................. 5.0 General Group Eligibility Requirements Effective Date of Individual Insurance Termination of Individual Insurance Continuation of Individual Insurance Individual Reinstatement CONVERSION PRIVILEGE ............................................................................................................................................. 6.0 PREMIUMS ...................................................................................................................................................................... 7.0 Premium Payment Premium Rate Grace Period BENEFICIARY AND FACILITY OF PAYMENT ............................................................................................................... 8.0 SETTLEMENT OPTIONS ................................................................................................................................................ 9.0 WAIVER OF PREMIUM IN EVENT OF TOTAL DISABILITY ........................................................................................ 10.0 ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE ................................................................................... 11.0 TOTAL LOSS OF USE ................................................................................................................................................... 12.0 SEAT BELT AND AIR BAG BENEFIT ........................................................................................................................... 13.0 CLAIMS PROVISIONS ................................................................................................................................................... 14.0 DEPENDENT LIFE INSURANCE .................................................................................................................................. 15.0 EXTENSION OF COVERAGE UNDER THE FAMILY AND MEDICAL LEAVE ACT AND UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) ......................................................... 16.0 PORTABILITY ................................................................................................................................................................ 17.0 GROUP TERM LIFE INSURANCE ACCELERATED BENEFIT RIDER ........................................................................ 18.0 LRS-6422-1 Ed. 3/82