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CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT GCERT2000 37 coi-np FOR FAMILY AND MEDICAL LEAVE Certain leaves of absence may qualify for continuation of insurance under the Family and Medical Leave Act of 1993 (FMLA), or other legally mandated leave of absence or similar laws. Please contact the Employer for information regarding such legally mandated leave of absence laws. AT YOUR OPTION: PORTABILITY For Supplemental Life Insurance If Your Portability Eligible Insurance ends for any of the reasons stated below, You have the option to continue that insurance under another group policy in accordance with the conditions and requirements of this section. This is referred to as Porting. Evidence of Your insurability will not be required. For purposes of this subsection the term “Portability Eligible Insurance” refers to Your Supplemental Life benefits for which the Portability Eligible Insurance is shown as available in the SCHEDULE OF BENEFITS. When Porting is an Option Porting may only be exercised by a request in Writing during the Request Period specified below. If You choose not to Port, Life Insurance benefits may be converted in accordance with the section entitled LIFE INSURANCE: CONVERSION OPTION FOR YOU. 1 . You may choose to Port if Portability Eligible Insurance ends while You are Actively at Work or on an approved leave of absence because: · You retired from active service with the Employer; or · Your employment ends, due to a reason other than retirement; or · You cease to be in a class that is eligible for such insurance; or · The Policy is amended to end the Portability Eligible Insurance, unless such insurance is replaced by similar insurance under another group insurance policy issued to the Policyholder or its successor; or · This Policy has ended, unless such insurance is replaced by similar insurance under another group insurance policy issued to the Policyholder or its successor. 2 . You may choose to Port the reduced amount of insurance if Your Portability Eligible Insurance is reduced due to: · Your age; or · An amendment to the Plan which affects the amount of insurance for Your class. · the person making the request resides in a jurisdiction that permits this Portability feature. Request Period For You to Port, We must receive a completed request form within the Request Period as described below. If written notice of the option to Port is given within 15 days before or after the date such insurance ends, the Request Period: · begins on the date the insurance ends, and · expires 31 days after the date. If written notice of the option to Port is given more than 15 days after but within 90 days of the date such insurance ends, the Request Period: · begins on the date the insurance ends, and · expires 45 days after the date of the notice.

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