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<br />"*. .: I. ...'" <br /> <br />AMENDMENT TO BE A TIACHED TO AND MADE PART OF GROUP POLICY NO.: 000011100388 <br /> <br />ISSUED TO: Florida - Life Specimen <br /> <br />The Policy is amended by the addition of the following provisions. <br /> <br />PRIOR INSURANCE CREDIT UPON TRANSFER OF <br />LIFE INSURANCE CARRIERS <br /> <br />This provision prevents loss of life insurance coverage for an Insured Person, which could otherwise occur solely because of a transfer <br />of insurance carriers. This Policy will provide the following Prior Insurance Credit, when it replaces a prior plan, <br /> <br />"Prior Plan" means a prior carrier's group life insurance policy, which this Policy replaced within 1 day of the prior plan's termination <br />date, <br /> <br />FAILURE TO SATISFY ACTIVE WORK RULE, Subject to payment of premiums, this Policy will provide life coverage for a <br />Person who: <br />(1) was insured under the prior plan on its termination date; <br />(2) was otherwise eligible under this Policy; but was not Actively-At-Work due to Injury or Sickness on its Effective <br />Date; <br />(3) is not entitled to any extension of life insurance under the prior plan; and <br />(4) is not Totally Disabled (as dermed in the Extension of Death BenefIt section of this Policy) on the date this Policy <br />takes effect. . <br /> <br />AMOUNT OF LIFE INSURANCE, Until the Person satisfIes this Policy's Active Work rule, the amount of his or her group life <br />insurance under this Policy will not exceed the amount for which the Person was insured under the prior plan on its termination date. <br /> <br />This Amendment takes effect on the effective date of coverage under this Policy. In all other respects, this Policy rertlains the same. <br /> <br />Jefferson Pilot Financial Insurance Company <br /> <br />~~ <br /> <br />Officer of the Company <br /> <br />21 <br /> <br />Prior Ins. Cred. - Life <br />05101/01 <br /> <br />GL1101-AMEND. PCl <br />