Group Critical Illness Insurance Certificate

In the event of death or incapacity, the beneficiary or representative shall be given a copy. Policy Termination

We may terminate coverage on or after the first anniversary of the Policy Effective Date. We or the Subscriber may terminate coverage on any Premium Due Date. Written or authorized electronic notice by certified mail must be given at least 31 days prior to such Premium Due Date. Failure by the Subscriber to pay premiums when due or within the Grace Period shall be deemed notice to Us to terminate coverage at the end of the period for which premium was paid. Termination will not affect a claim for a Covered Loss that is the result, directly and independently of all other causes, of a loss that occurs while coverage was in effect. Agency The Employer is acting as an agent of the Employee for transactions relating to coverage under the Policy. The actions of the Subscriber shall not be considered the actions of Us, and We are not liable for any of their acts or omissions. Clerical Error A Covered Person's coverage will not be affected by error or delay in keeping records of coverage under this Policy. If such an error is found, the premium will be adjusted fairly. A failure to perform, including perform in a timely manner or in a manner prescribed by the Policy, any of the following shall not constitute a clerical error under this provision: 1. enroll or apply for coverage; 2. submit Evidence of Insurability; 3. report notice or provide proof of claim; 4. pay premiums. Conformity with Statutes Any provisions in conflict with the requirements of any state or federal law that apply to this Policy are automatically changed to satisfy the minimum requirements of such laws. Policy Changes We may agree with the Subscriber to modify coverage without the Covered Person’s consent. Workers’ Compensation Insurance This Policy is not in place of and does not affect any requirements for coverage under any Workers’ Compensation law. Examination of the Policy This Policy will be available for inspection at the Subscriber's or Our office during regular business hours. Examination of Records We will be permitted to examine all of the Subscriber's records relating to this Policy. Examination may occur at any

reasonable time while the Policy is in force. Examination may also occur: 1. at any time for two years after the expiration of this Policy; or, if later, 2. upon the final adjustment and settlement of all claims under this Policy. Ownership of Records All records maintained by Us are, and shall remain, Our property. GCI-02-CE1900.00

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