Group Accident Insurance Certificate

1) Under the General Definitions section, item 2 of the second paragraph of the Dependent Child definition includes adopted child as follows:

2. adopted child, beginning with any waiting period pending finalization of the child’s adoption. It also means the legally adopted child of the Employee’s Spouse or domestic partner/Partner to a Civil Union provided the child is living with, and is financially dependent upon the Employee;

2) Under the Portability Provisions section, the following are removed from the Termination of Ported Insurance provision:

• for a Dependent Child, the date the Dependent Child reaches age 26 unless primarily supported by the Employee and incapable of self-sustaining employment by reason of mental or physical handicap or ceases to quality as a Dependent Child; • the date the Spouse or Dependent no longer meets the definition of Spouse or Dependent Child; • the date the Covered Person is considered to reside outside the United States. The Covered Person will be considered to reside outside the United States when the Covered Person has been outside the United States for a total period of 4 months during any 4 consecutive months.

Massachusetts residents:

Under the Continuation of Insurance Provisions section, the following provision is added:

Additional Continuation of Insurance Provisions If an Employee leaves the group due to termination of employment resulting from a Plant Closing or Partial Closing, insurance for such Employee will be continued until the earliest of the following dates: 1. 90 days from the date of the Plant Closing or Partial Closing; 2. The date the Employee becomes eligible for similar benefits. As used in this provision: ''Plant Closing'' means a permanent cessation or reduction of business at a facility which results or will result as determined by the director in the permanent separation of at least 90% of the employees of said facility within a period of six months prior to the date of certification or with such other period as the director shall prescribe, provided that such period shall fall within the six month period prior to the date of certification. ''Partial Closing'' means a permanent cessation of a major discrete portion of the business conducted at a facility which results in the termination of a significant number of the employees of said facility and which affects workers and communities in a manner similar to that of Plant Closings. If an Employee leaves the group for a reason other than as a result of a Plant Closing or Partial Closing, insurance for such Employee will be continued until the earliest of the following dates: 1. 31 days from the date the Employee leaves the group; 2. The date the Employee becomes eligible for similar benefits.

Minnesota residents:

Under the Common Exclusions section, the following changes are made:

a) The exclusion related to intentionally self-inflicted Injury is replaced by the following:

intentionally self-inflicted Injury; and

b) The exclusion related to operating a vehicle while under the influence of alcohol, or drugs is replaced with the following:

• operating any type of vehicle while under the influence of alcohol, or any drug, or narcotic unless administered on the advice of a Physician and taken in accordance with the prescribed dosage, or other

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