Unum Group Life and AD&D Employee Certificate Booklet

General Provisions

When Days Begin and End Certificate of Coverage

For the purpose of all dates under this certificate, all days begin at 12:01 a.m. and end at 12:00 midnight. We will provide the Employer with a certificate for distribution to each insured Employee. The certificate describes: - the coverage to which an Insured may be entitled; - to whom we will make a payment; and - the limitations, exclusions, and requirements that apply to an Insured's coverage. If the provisions of this certificate conflict with the provisions of the policy, the provisions of the policy will govern. Coverage for an Insured is provided under the provisions of this certificate. The provisions of this certificate are made part of the policy issued to the Policyholder. The policy consists of all provisions of the policy, the provisions of this certificate, the Policyholder's application, and all related schedules, riders, amendments, and endorsements. The policy and this certificate may be cancelled or modified by the Employer at any time without the Insured's consent. Any cancellation or modification to the policy or certificate requested by the Employer will take effect on the date agreed upon by us and the Employer. Any policy and certificate modifications resulting in an increase to an Insured's coverage may be subject to Evidence of Insurability Requirements. Once age reductions begin, an Insured's Life and AD&D Benefit Amount will not increase or decrease due to a plan change made by the Employer. All policy and certificate modifications will take effect according to the provisions in the Start of Coverage section of this certificate. No other person, including a broker or agent, may change or waive any part of this policy. This Policyholder and Unum may mutually agree to change this policy at any time without the Insured's consent. No change to this policy will be effective unless signed by an officer of our company and endorsed on or attached to this policy. Any statements made by you will be considered a representation and not a warranty. Such statements will not be used to avoid insurance, reduce benefits, or deny a claim unless they are included in an application in Writing from you. An Assignment transfers all or part of your legal title and rights under the policy and this certificate to someone else, known as an "assignee." We will recognize your assignee(s) as owners of the rights you transferred under the policy and this certificate if: - the Written form has been signed by you and the assignee and the Assignment in its Written form is acceptable to us; and - in our discretion, we may reject and have no obligation under an Assignment unless a signed or certified copy of the Written Assignment has been received and recorded by us prior to the loss. An Assignment will take effect on the date you sign the Assignment. However, if we have taken any action or made any payment before we receive a notice of the Assignment, that Assignment will not go into effect for those actions taken or payments made prior to our receipt of the notice of Assignment. Unless stated otherwise in, or allowed by the Assignment, the assignment does not change a beneficiary designation. You are responsible for assuring the validity of any assignment. Please verify with your own legal counsel that your Assignment meets the legal requirements in your state. We will take legal or other action, if appropriate to do so, to cancel, to deny, or limit coverage or benefits based on statements made in signed applications for coverage, including Evidence of Insurability forms, only when a death, disability or Covered Loss occurs during the first two years after an Insured's Coverage Effective Date. However, in

Certificate of Coverage Contents

Cancellation or Modification to the Policy and this Certificate of Coverage

Policy Change Authority

Representation in Applications

Assignment

Contestability

UA-GTLC21-1

Group Life and Accidental Death and Dismemberment Certificate

(1/1/2025) 35

Unum Life Insurance Company of America

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