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<br />TABLE OF CONTENTS
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<br />Schedule of BenefIts....., ,....... ,...,....,....,.... ......,..,...... .............,'.... ........,..,....,.., .............,.., .......,..,.. ............ 3
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<br />Defmitions ..... .......... .... ........ ..... ..., ... ......, ........"""",. ,.,.,. ,. ."..., ..... ..... ... ,.. ,.,..""" ,., ,., ,." ..". ,.. ..,. ,..", ,.." ,.,." 4
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<br />General Provisions,.........,.,..,.."...."..,.,......,...,.,.""..,.,.,..,.,.,...".,....,.",.."...""...,.."..,..".",.."..,.,.. .,...,."",. 9
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<br />Claims Procedures.".,........,........,..".....".....,..,.."........,........,.......,..""..,.,.",.,...............,.....,..",.",. ...,.,.,... 11
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<br />Eligibility..,.......................,....,.......,.......""",.,.......,....,.......,....,....".,.",.,...".."""",....,. ...."..,...".,."..,.,.,... 13
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<br />Effective Dates .."",.".,.",.""".".."."",."",.,..",.".,..,...........,.......,...."..........,......,.........,....,....,..... ....,....... 13
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<br />Individual Termination...., ...., :...,....,.... ....,.........., ......, ............. ..............., ..............,... ..............,....,...,.., ..... 15
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<br />Policy Termination ,.., ,.".." ,...,.." ",...,.,., ,.,.,...,.,., ,.", ". .."" '" ",... "., ...."., ...,.......,.. ..."."" ,.." ,., ,..,., "...." ,..." 16
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<br />Conversion Privilege ............. ,.,..,........,.. ...,.... ............ ,.....,.., ..", ".., ..,..,.. ". ... ..... ....... .....,.. ,.,......,.,........ ..... 17
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<br />Premiums and Premium Rates..............,...........,............................................,....,..,..,....",.......,................. 18
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<br />Total Disability Monthly BenefIt....,......... ..................., .......,..,.. ....... .............. ...... ......... ......., ......... ....., ..... 19
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<br />Partial Disability Monthly BenefIt." ..,.. ,... ......,...,., ,.,., "... "... ,.,., ,." ,., ,.,., ,..,.,..".,., ,., .., ,...... ,... ,., .... ,. ,.., ..,..... 20
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<br />Other Income BenefIts .... .., .., ......., ,.......,.,..,..." "..,.,.... "........"." ",.,.. ..,........ ......,....", ,.,..,. ,.....,.....,... ,........ 22
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<br />Recurrent Disability.."..,.,...,.,."'.."'....".,............................,.,..,...,..,.,...,......,.......,....................""'. """..... 23
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<br />Exclusions..........""."."..".,.,..,.,..,.,..,.....,........,......................,........,........................,.".,. .".".".....,.."........ 24
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<br />SpecifIed Injuries or Sicknesses Limitation..,..............,.........,.........................................,......"......."........ 25
<br />Voluntary Vocational Rehabilitation BenefIt Provision............................................................................ 26
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<br />Reasonable Accommodation BenefIt ......... "......., ,...,.. ...... ".........,., ,.... ...... .......... ...... ,..", .,., ,.,..,..", ....,. .,., 27
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<br />Prior Insurance Credit Upon Transfer ofInsurance Carriers..................................................................... 28
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<br />Family Income BenefIt .... .......... .., ,.... ,...,.,., ,......... ....... ................... ........... ......." "."" "...", ,. ,........,.,....... ... 29
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<br />GL3001-LTD-2
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<br />2
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<br />01/01/01
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