2020 LFG Life Certificate

Insurability and Policy maximums.

YOUR PORTABLE GROUP TERM LIFE INSURANCE The amount of portable group term life insurance you may apply for is subject to the following limits: 1. the maximum amount is equal to the lesser of: a. the amount of insurance that terminated under this policy; or b. $500,000.00. 2. the minimum amount is $10,000.00. This amount is subject to any reductions due to age that may be contained in the portable group term life insurance policy. COVERED DEPENDENT SPOUSE PORTABLE GROUP TERM LIFE INSURANCE The amount of portable group term life insurance a Covered Dependent spouse may apply for is subject to the following limits: 1. the maximum amount is equal to the lesser of: a. the amount of insurance that terminated under this policy; or b. $250,000.00. 2. the minimum amount is $5,000.00. This amount is subject to any reductions due to age that may be contained in the portable group term life insurance policy. COVERED DEPENDENT CHILD PORTABLE GROUP TERM LIFE INSURANCE You or your Covered Dependent spouse may apply for portable group term life insurance for a Covered Dependent child, subject to the following limits: 1. the maximum amount is equal to the lesser of: a. the amount of insurance that terminated under this policy; or b. $15,000.00. 2. the minimum amount is $2,500.00. This amount is subject to any reductions due to age that may be contained in the portable group term life insurance policy.

Form GLC-PTL-13 (continued)

Portable Group Term Life Insurance

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