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JAN -14 -98 WED 12:20 PM OFG INSURANCE SERVICES FAX Na 612 945 9477 P. 06/09 <br />POLICYHOLDER PROVISIONS <br />Wi4AT 16- R1E-64‘T OF-THI INSU4IANCE ?--- <br />The Initial pr iluen for each pion le based on the, initial rate(s) shown beliw. <br />PLAN meansia lure Of cOverti re undo/ thJpvf oy, \• <br />LONQTERM DJSABILITY <br />LIWl'IAL RATS <br />Monthly rate et: .51 % of total covered payroll. <br />TOTAL COVERED PAYROLL means the total amount of monthly earnings <br />for which employees am insured under this plan, <br />WAIVE* UM eREM1 � _, <br />UNUM does not require premfttm payment$ an insured while no or an Is <br />ing gong T Diiabiliity payments under this plan. \, <br />RATE-6UARAi�fTEE --- .-._.z — <br />recely- <br />A change in premium rate will not take effect • - or January 1, 2000. N • ever, <br />UNUM may change premium rates at any tim= • r reasons which a = : he tisk <br />assumed, including those reasons shown below: <br />- a change occurs in this plan design; <br />- a division, subsidiary, or affiliated company is added or deleted; <br />• the number of insureds changes by 25% or more; or <br />- a new law or a change in any existing law Is enacted which applies to this plan. <br />UNUM wti[ notify the PbTh 9tioid'arin writing Must 31 days belbre a p <br />is changed: •A change may-take effect on an earlier date when-both <br />Policyholder agree. ������```` <br />WHEN 1(9FiREMIUMVUEFQ f► OLIGY'.._ ---- <br />Premium Nebel/et s: January 1, 1998'and'theitrst 4ay, of each calendar o th <br />thereafter, i. _' ---- <br />The Policyholder must :lend ell pi w Almma to UNUM en or bcfar4 their respective <br />due date. The premium must be paid in United States dollars. <br />94a <br />EMPLOYER -1 (111 /1998) <br />'SIMI a X 1 ysntn* yr[at0:V 9e 'ET 'T0 <br />Awgwassnieramsoostameaveroragenven <br />Page 63 <br />