INDIVIDUAL ELIGIBILITY, EFFECTIVE DATE AND TERMINATION GENERAL GROUP: The general group will be your employees and employees of any subsidiaries, divisions or affiliates named on the Schedule of Benefits. ELIGIBLE CLASSES: The eligible classes will be those persons described on the Schedule of Benefits. EFFECTIVE DATE OF INDIVIDUAL INSURANCE: An Eligible Person must apply in writing for the insurance to go into effect. He/she will become insured on the latest of: (1) the first of the month following the date he/she applies, if he/she applies within thirty-one (31) days of the date he/she is first eligible; or (2) the first of the month following the date we approve any required proof of good health. We require proof of good health if a person applies: (a) after thirty-one (31) days from the date he/she first becomes eligible; or (b) after he/she terminated this insurance but remained in a class eligible for the insurance; or (c) after being eligible for coverage under a prior plan for more than thirty-one (31) days but did not elect to be covered under that prior plan; or (3) the date premium is remitted. Changes in an Insured’s amount of insurance are effective as shown on the Schedule of Benefits. If the Person is not actively at work on the day his/her insurance is to go into effect, the insurance will go into effect on the day he/she returns to active work for one full day. TERMINATION OF INDIVIDUAL INSURANCE: The insurance of an Insured will terminate on the first of the following to occur: (1) the date this Policy terminates; or (2) the date the Insured ceases to be in a class eligible for this insurance; or (3) the end of the period for which premium has been paid for the Insured; or (4) the date the Insured enters military service (not including Reserve or National Guard). INDIVIDUAL REINSTATEMENT: The insurance of a terminated person may be reinstated if he/she is: (1) on an approved leave of absence; or (2) on a temporary lay-off. The Person must return to active work with you within the period of time shown on the Schedule of Benefits. He/she must also be a member of a class eligible for this insurance. The Person will not be required to fulfill the eligibility requirements of this Policy again. The insurance will go into effect on the day he/she returns to active work. If a Person returns after having resigned or having been discharged, he/she will be required to fulfill the eligibility requirements of this Policy again. If a Person returns after terminating at his/her request or for failure to pay premium when due, proof of good health must be approved by us before he/she may be reinstated. LRS-6451-7 Ed. 4/06 Page 6.0

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