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STANDARD INSURANCE COMPANYA Stock Life Insurance Company900 SW Fifth AvenuePortland, Oregon 97204-1282(503) 321-7000GROUP LIFE INSURANCE POLICYPolicyholder:Kent County Levy CourtPolicy Number:170253-AEffective Date:July 1, 2022The consideration for this Group Policy is the application of the Policyholder and the payment by thePolicyholder of premiums as provided herein.Subject to the Policyholder Provisions and the Incontestability Provisions, this Group Policy (a) isissued for the Initial Rate Guarantee Period shown in the Coverage Features, and (b) may be renewedfor successive renewal periods by the payment of the premium set by us on each renewal date. Thelength of each renewal period will be set by us, but will not be less than 12 months.For purposes of effective dates and ending dates under this Group Policy, all days begin and end at12:00 midnight Standard Time at the Policyholder's address.This policy includes an Accelerated Benefit. Death benefits will be reduced if an AcceleratedBenefit is paid. The receipt of this benefit may be taxable and may affect your eligibility forMedicaid or other government benefits or entitlements. However, if you meet the definition of"terminally ill individual" according to the Internal Revenue Code Section 101, your AcceleratedBenefit may be non-taxable. You should consult your personal tax and/or legal advisor beforeyou apply for an Accelerated Benefit.All provisions on this and the following pages are part of this Group Policy. "You" and "your" mean theMember. "We", "us", and "our" mean Standard Insurance Company. Other defined terms appear withtheir initial letters capitalized. Section headings, and references to them, appear in boldface type.STANDARD INSURANCE COMPANYByPresident and CEOGP190–LIFE/S399Corporate Secretary
Table of ContentsCOVERAGE FEATURES . 1GENERAL POLICY INFORMATION . 1BECOMING INSURED . 1PREMIUM CONTRIBUTIONS. 3SCHEDULE OF INSURANCE . 4REDUCTIONS IN INSURANCE . 9OTHER BENEFITS . 10OTHER PROVISIONS . 10PREMIUM RATES AND RENEWALS . 11LIFE INSURANCE . 14A. Insuring Clause . 14B. Amount Of Life Insurance . 14C. Changes In Life Insurance . 14D. Repatriation Benefit . 14E. Suicide Exclusion: Life Insurance . 14F. When Life Insurance Becomes Effective . 15G. When Life Insurance Ends . 15H. Reinstatement Of Life Insurance . 16DEPENDENTS LIFE INSURANCE . 16A. Insuring Clause . 16B. Amount Of Dependents Life Insurance . 16C. Changes In Dependents Life Insurance. 16D. Suicide Exclusion: Dependents Life Insurance . 17E. Definitions For Dependents Life Insurance . 17F. Becoming Insured For Dependents Life Insurance . 17G. When Dependents Life Insurance Ends . 18ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE . 18A. Insuring Clause . 18B. Definition Of Loss For AD&D Insurance . 18C. Amount Payable . 19D. Changes In AD&D Insurance . 19E. AD&D Insurance Exclusions . 19F. Additional AD&D Benefits . 19G. Becoming Insured For AD&D Insurance . 21H. When AD&D Insurance Ends . 22ACTIVE WORK PROVISIONS . 22PORTABILITY OF INSURANCE . 22WAIVER OF PREMIUM . 23ACCELERATED BENEFIT . 24RIGHT TO CONVERT. 26CLAIMS . 27ASSIGNMENT. 29BENEFIT PAYMENT AND BENEFICIARY PROVISIONS . 29ALLOCATION OF AUTHORITY . 32TIME LIMITS ON LEGAL ACTIONS . 32INCONTESTABILITY PROVISIONS . 32CLERICAL ERROR AND MISSTATEMENT . 33TERMINATION OR AMENDMENT OF THE GROUP POLICY . 33DEFINITIONS . 34POLICYHOLDER PROVISIONS . 35
Index of Defined TermsLoss, 18Accelerated Benefit, 24Active Work, Actively At Work, 22AD&D Insurance, 34Air Bag System, 20Annual Earnings, 34Automobile, 19Beneficiary, 30Child, 34Civil Union Partner, 35Class Definition, 2Contributory, 34Conversion Period, 26Dependent, 17Dependents Life Insurance, 34Earnings Period, 11Eligibility Waiting Period, 34Employer(s), 1Evidence Of Insurability, 34Grace Period, 12Group Policy, 35Group Policy Effective Date, 1Group Policy Number, 1Guarantee Issue Amount (forDependents Life Insurance), 2Guarantee Issue Amount (for Plan 2), 2Initial Rate Guarantee Period, 12Injury, 35Insurance (for Accelerated Benefit), 26Insurance (for Right to Convert), 26Insurance (for Waiver Of Premium), 23L.L.C. Owner-Employee, 35Leave Of Absence Period, 10Life Insurance, 35Maximum Conversion Amount, 10Member, 1Minimum Participation, 13Minimum Participation Number, 13Minimum Participation Percentage(s),13Minimum Time Insured, 10Noncontributory, 35Notice of Rate Change, 12P.C. Partner, 35Physician, 35Policyholder, 1Pregnancy, 35Premium Due Dates, 12Premium Rates, 11Prior Plan, 35Proof Of Loss, 27Qualifying Event, 26Qualifying Medical Condition, 25Recipient, 31Right To Convert, 26Seat Belt System, 19Sickness, 35Spouse, 35Totally Disabled, 23Waiting Period (for Waiver Of Premium),24Waiver Of Premium, 23War, 19You, Your (for Right To Convert), 26
COVERAGE FEATURESThis section contains many of the features of your group life insurance. Other provisions, includingexclusions and limitations, appear in other sections. Please refer to the text of each section for fulldetails. The Table of Contents and the Index of Defined Terms help locate sections and definitions.GENERAL POLICY INFORMATIONGroup Policy Number:170253-AType of Insurance Provided:Life Insurance:YesDependents Life Insurance:Class 1:YesClass 2:NoAccidental Death And Dismemberment(AD&D) Insurance:Member:Class 1:YesClass 2:NoDependents:Class 1:YesClass 2:NoPolicyholder:Kent County Levy CourtEmployer(s):Kent County Levy CourtGroup Policy Effective Date:July 1, 2022Policy Issued in:DelawareBECOMING INSUREDTo become insured for Life Insurance you must: (a) Be a Member; (b) Complete your Eligibility WaitingPeriod; and (c) Meet the requirements in Life Insurance and Active Work Provisions. The Active Workrequirement does not apply to Members who are retired and eligible on the Group Policy Effective Date.The requirements for becoming insured for coverages other than Life Insurance are set out in the text.Definition of Member:You are a Member if you are one of the following:1. An active employee of the Employer who is regularlyworking at least 35 hours each week; or2. An employee of the Employer who retired under theEmployer's retirement program.You are not a Member if you are:1. A temporary or seasonal employee.2. A leased employee.06/16/2022-1-170253-A
3. An independent contractor.4. A full time member of the armed forces of any country.Class Definition:Class 1:Active MembersClass 2:Retired MembersClasses for retired Members do not include a Member who is covered under Waiver Of Premium.Eligibility Waiting Period:Class 1:You are eligible on one of the following dates, but not beforethe Group Policy Effective Date:If you are a Member on the Group Policy Effective Date, youare eligible on the first day of the calendar month following30 consecutive days as a Member.If you become a Member after the Group Policy EffectiveDate, you are eligible on the first day of the calendar monthfollowing 30 consecutive days as a Member.Class 2:If you are a Member on the Group Policy Effective Date, youare eligible on that date.If you become a Member after the Group Policy EffectiveDate, you are eligible on the date you become a Member.Evidence Of Insurability:Required:a. For late application for Contributory insurance.b. For reinstatements if required.c. For Members and Dependents eligible but not insuredunder the Prior Plan.d. For any Plan 2 Life Insurance Benefit in excess of theGuarantee Issue Amount of 300,000. However, thisrequirement will be waived on the Group Policy EffectiveDate for an amount equal to the amount of additionallife insurance under the Prior Plan on the day before theGroup Policy Effective Date, if you apply on or beforethe Group Policy Effective Date.e. For any Dependents Life Insurance Benefit for yourSpouse in excess of the Guarantee Issue Amount of 50,000. However, this requirement will be waived onthe Group Policy Effective Date for an amount equal tothe amount of dependents life insurance under the PriorPlan on the day before the Group Policy Effective Date,if you apply on or before the Group Policy Effective Date.f.06/16/2022For any increase resulting from a plan or option changeyou elect.-2-170253-A
Certain Evidence Of Insurability Requirements Will Be Waived. Your insurance is subject to allother terms of the Group Policy.One Time Open Enrollment Period: July 1, 2022 through July 31, 2022 (Members who applyduring this period will have their coverage go into effect on July 1, 2022).If you were eligible for or insured for additional life insurance or dependents life insurance under thePrior Plan on the day before the Group Policy Effective Date, certain Evidence Of Insurabilityrequirements will be waived with respect to Plan 2 (additional) Life Insurance and Dependents LifeInsurance.1. If you were eligible but not insured for additional life insurance under the Prior Plan on the daybefore the Group Policy Effective Date, requirements a. and c. above will be waived for you if youapply for an amount of Plan 2 (additional) Life Insurance up to the Guarantee Issue Amount duringyour Employer’s One Time Open Enrollment Period.2. If you were insured for an amount of additional life insurance less than the Guarantee Issue Amountunder the Prior Plan on the day before the Group Policy Effective Date, requirement f. above will bewaived for you if you apply for an increase in your Plan 2 (additional) Life Insurance up to theGuarantee Issue Amount during your Employer’s One Time Open Enrollment Period. However,Evidence Of Insurability is required to become insured for any Plan 2 (additional) Life InsuranceBenefit that exceeds the Guarantee Issue Amount.3. If your Spouse was eligible but not insured for dependents life insurance under the Prior Plan on theday before the Group Policy Effective Date, requirements a. and c. above will be waived for yourSpouse if you apply for Dependents Life Insurance for your Spouse up to the Guarantee IssueAmount during your Employer’s One Time Open Enrollment Period.4. If your Spouse was insured for an amount of dependents life insurance less than the GuaranteeIssue Amount under the Prior Plan on the day before the Group Policy Effective Date requirement f.above will be waived for your Spouse if you apply for an increase in Dependents Life Insurance foryour Spouse up to the Guarantee Issue Amount during your Employer’s One Time Open EnrollmentPeriod. However, Evidence Of Insurability is required to become insured for any Dependents LifeInsurance Benefit for your Spouse that exceeds the Guarantee Issue Amount.5. If your Child was eligible but not insured for dependents life insurance under the Prior Plan on theday before the Group Policy Effective Date, requirements a. and c. above will be waived for your Childif you apply for Dependents Life Insurance for your Child up to 15,000 during your Employer’s OneTime Open Enrollment Period.6. If your Child was insured for an amount of dependents life insurance less than 15,000 under thePrior Plan on the day before the Group Policy Effective Date, requirement f. above will be waived foryour Child if you apply for an increase in Dependents Life Insurance for your Child up to 15,000during your Employer’s One Time Open Enrollment Period.PREMIUM CONTRIBUTIONSLife Insurance:Plan 1 (basic):NoncontributoryPlan 2 (additional):Class 1:ContributoryClass 2:Not applicable06/16/2022-3-170253-A
AD&D Insurance:Member:Plan 1:Class 1:NoncontributoryClass 2:Not applicableClass 1:ContributoryClass 2:Not applicableClass 1:ContributoryClass 2:Not applicableClass 1:ContributoryClass 2:Not applicablePlan 2:Spouse:Child:Dependents Life Insurance:Spouse:Class 1:ContributoryClass 2:Not applicableClass 1:ContributoryClass 2:Not applicableChild:If you are a retired Member whose Life Insurance under the Waiver Of Premium provision is scheduledto end, you may apply for Life Insurance under the Group Policy as a Retired Member within 31 daysfollowing the date your coverage under the Waiver Of Premium provision ends.SCHEDULE OF INSURANCESCHEDULE OF LIFE INSURANCEFor you:Life Insurance Benefit:You will become insured under Plan 1 if you meet the requirements to become insured underthe Group Policy.If you are an active Member and insured under Plan 1, you may also become insured underany one option of Plan 2 if you meet the requirements to become insured under Plan 2 LifeInsurance under the Group Policy. Plan 2 is a Contributory plan requiring premiumcontributions from Members.You may be insured under Plan 1 and any one option of Plan 2 at any one time.A Member may not be insured as both an active Member and a retired Member. Retired membersare not eligible for Plan 2 Life Insurance.06/16/2022-4-170253-A
Plan 1 (basic):Class 1:1 times your Annual Earnings, rounded to the nexthigher multiple of 1,000, if not already a multipleof 1,000. The maximum amount is 200,000.Class 2: 5,000Plan 2 (additional):Class 1:Your choice of one of the following options:Option 1: 0.5 times your Annual Earnings,rounded to the next higher multiple of 1,000, ifnot already a multiple of 1,000. The maximumamount is 500,000.Option 2: 1 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Option 3: 2 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Option 4: 3 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Class 2:Not applicable. Retired members are not eligible forPlan 2 (additional) Life Insurance.The combined maximum benefit of your Plan 1 (basic) and Plan 2 (additional) Life InsuranceBenefit may not exceed 8 times your Annual Earnings.The Repatriation Benefit:The expenses incurred to transport your body to amortuary near your primary place of residence, butnot to exceed 5,000 or 10% of the Life InsuranceBenefit, whichever is less.Dependents Life Insurance Benefit:If you are insured under Plan 2 Life Insurance, you may apply for Dependents Life Insurance foryour Dependents. You may elect to insure your Spouse, your Child, or both.For your Spouse:Class 1:You may apply for Dependents Life Insurance foryour Spouse in multiples of 10,000 from 10,000to 150,000.Class 2:Not applicable. Retired members are not eligible forDependents Life Insurance for your Spouse.The amount of Dependents Life Insurance for your Spouse may not exceed 100% of the amountof your Plan 2 Life Insurance.For your Child:Class 1:06/16/2022 15,000-5-170253-A
Class 2:Not applicable. Retired members are not eligible forDependents Life Insurance for your Child.The amount of Dependents Life Insurance for your Child may not exceed 100% of the amount ofyour Plan 2 Life Insurance.SCHEDULE OF AD&D INSURANCEFor you:Plan 1 AD&D Insurance Benefit:Class 1:If you are insured for Plan 1 Life Insurance, youare insured for Plan 1 AD&D Insurance. Theamount of your Plan 1 AD&D Insurance Benefit isequal to the amount of your Plan 1 Life InsuranceBenefit. The amount payable for certain Losses isless than 100% of the AD&D Insurance Benefit.See AD&D Table Of Losses.Class 2:Not applicable. Retired Members are not eligible forPlan 1 AD&D Insurance.Plan 2 AD&D Insurance Benefit:Class 1:If you are insured for Plan 2 Life Insurance, youmay apply for Plan 2 AD&D Insurance. Theamount payable for certain Losses is less than100% of the AD&D Insurance Benefit. See AD&DTable Of Losses. You may apply for Plan 2 AD&DInsurance by choosing one of the following options:Option 1: 0.5 times your Annual Earnings,rounded to the next higher multiple of 1,000, ifnot already a multiple of 1,000. The maximumamount is 500,000.Option 2: 1 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Option 3: 2 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Option 4: 3 times your Annual Earnings, roundedto the next higher multiple of 1,000, if not alreadya multiple of 1,000. The maximum amount is 500,000.Class 2:Not applicable. Retired Members are not eligible forPlan 2 AD&D Insurance.Seat Belt Benefit:Class 1:The amount of the Seat Belt Benefit is the lesser of(1) 10,000 or (2) the amount of AD&D InsuranceBenefit payable for loss of life.Class 2:Not applicable.06/16/2022-6-170253-A
Air Bag Benefit:Class 1:The amount of the Air Bag Benefit is the lesser of (1) 5,000; or (2) the amount of AD&D InsuranceBenefit payable for Loss of your life.Class 2:Not applicable.Career Adjustment Benefit:Class 1:The tuition expenses for training incurred by yourSpouse within 36 months after the date of yourdeath, exclusive of board and room, books, fees,supplies and other expenses, but not to exceed 5,000 per year, or the cumulative total of 10,000or 25% of the AD&D Insurance Benefit, whicheveris less.Class 2:Not applicable.Child Care Benefit:Class 1:The total child care expense incurred by yourSpouse within 36 months after the date of yourdeath for all Children under age 13, but not toexceed 5,000 per year, or the cumulative total of 10,000 or 25% of the AD&D Insurance Benefit,whichever is less.Class 2:Not applicable.Higher Education Benefit:Class 1:The tuition expenses incurred per Child within 4years after the date of your death at an accreditedinstitution of higher education, exclusive of boardand room, books, fees, supplies and other expenses,but not to exceed 5,000 per year, or the cumulativetotal of 20,000 or 25% of the AD&D InsuranceBenefit, whichever is less.Class 2:Not applicable.Line of Duty Benefit:Class 1:The Lesser of (1) 50,000; or (2) 100% of the amountof the AD&D Insurance Benefit otherwise payablefor the Loss.Class 2:Not applicable.06/16/2022-7-170253-A
For your Spouse:AD&D Insurance Benefit:Class 1:If your Spouse is insured for Dependents LifeInsurance, you may apply for Dependents AD&DInsurance for your Spouse. You may apply forDependents AD&D for your Spouse in multiples of 10,000, from 10,000 to 150,000. The amountpayable for certain Losses is less than 100% of theAD&D Insurance Benefit. See AD&D Table OfLosses.Class 2:Not applicable. Retired Members are not eligible forDependents AD&D Insurance for your Spouse.Seat Belt Benefit:Class 1:The amount of the Seat Belt Benefit is the lesser of(1) 10,000 or (2) the amount of AD&D InsuranceBenefit payable for Loss of life.Class 2:Not applicable.Air Bag Benefit:Class 1:The amount of the Air Bag Benefit is the lesser of (1) 5,000; or (2) the amount of AD&D InsuranceBenefit payable for Loss of life.Class 2:Not applicable.For your Child:AD&D Insurance Benefit:Class 1:If your Child is insured for Dependents LifeInsurance, you may apply for Dependents AD&DInsurance for your Child. You may apply forDependents AD&D Insurance Benefit for yourChild in the amount of 15,000. The amountpayable for certain Losses is less than 100% of theAD&D Insurance Benefit. See AD&D Table OfLosses.Class 2:Not applicable. Retired Members are not eligible forDependents AD&D Insurance for your Child.Seat Belt Benefit:Class 1:The amount of the Seat Belt Benefit is the lesser of(1) 10,000 or (2) the amount of AD&D InsuranceBenefit payable for Loss of life.Class 2:Not applicable.Air Bag Benefit:Class 1:The amount of the Air Bag Benefit is the lesser of (1) 5,000; or (2) the amount of AD&D InsuranceBenefit payable for Loss of life.Class 2:Not applicable.06/16/2022-8-170253-A
AD&D TABLE OF LOSSESThe amount payable is a percentage of the AD&D Insurance Benefit or the Dependents AD&DInsurance Benefit in effect on the date of the accident and is determined by the Loss suffered asshown in the following table:Percentage Payable:Loss:a.Life100%b.One hand, one foot or sight of oneeyec.Two or more of the Losses listedin b. above50%100%No more than 100% of your AD&D Insurance will be paid for all Losses resulting from oneaccident.REDUCTIONS IN INSURANCEIf you reach an age shown below, the amount of insurance will be the amount determined from theSchedule Of Insurance, multiplied by the appropriate percentage below:Plan 1 (basic) Life Insurance:Class 1:Age Of MemberPercentage70 or over50%Class 2:Insurance for retired Members is not subject to reductionsdue to age.Plan 1 AD&D Insurance:Class 1:Age Of MemberPercentage70 or over50%Class 2:Not applicable.Plan 2 (additional) Life Insurance:Class 1:Age Of MemberPercentage70 or over50%Class 2:Not applicable.Plan 2 AD&D Insurance:Class 1:Age Of MemberPercentage70 or over50%Class 2:06/16/2022Not applicable.-9-170253-A
Dependents Life and AD&D Insurance for your Spouse:Class 1:Age Of MemberPercentage70 or over50%Class 2:Not applicable.OTHER BENEFITSWaiver Of Premium:Class 1: YesClass 2: NoAccelerated Benefit:Class 1: YesClass 2: NoOTHER PROVISIONSLimits on Right To Convert ifGroup Policy terminatesor is amended:Minimum Time Insured:5 yearsMaximum Conversion Amount: 10,000Suicide Exclusion:Applies to:a. Plan 2 Life Insuranceb. Dependents Life Insurance on your Spousec. AD&D InsuranceLeave Of Absence Period:60 daysInsurance Eligible For Portability:If as a retired Member you are insured or eligible forinsurance under the Group Policy, the amount eligible forportability will be reduced by the amount of coveragecontinued under the Group Policy, subject to the amountsbelow.For you:Life InsuranceYesMinimum amount: 10,000Maximum amount: 500,000AD&D InsuranceYesMinimum amount: 10,000Maximum amount: 500,00006/16/2022- 10 -170253-A
For your Spouse:Dependents Life InsuranceYesMinimum amount: 5,000Maximum amount: 250,000AD&D InsuranceYesMinimum amount: 5,000Maximum amount: 250,000For your Child:Dependents Life InsuranceYesMinimum amount: 1,000Maximum amount: 25,000AD&D InsuranceYesMinimum amount: 1,000Maximum amount: 25,000Annual Earnings based on:Earnings in effect on your last full day of Active Work.Earnings Period for Commissions(see Definitions):The preceding 12 calendar months.PREMIUM RATES AND RENEWALSPremium Rates:Life Insurance:Plan 1: 0.180 monthly per 1,000 of Life InsurancePlan 2:Class 1:Age of Member on Last July129303540455055606570Class 2:06/16/2022or underthrough 34through 39through 44through 49through 54through 59through 64through 69or over Monthly Rate Per Multiple of 2.210Not applicable.- 11 -170253-A
Dependents Life Insurance:Spouse:Class 1:Age of Member on Last July129303540455055606570or underthrough 34through 39through 44through 49through 54through 59through 64through 69or over Monthly Rate Per Multiple of 4.495Class 2:Not applicable.Class 1: 0.200 monthly per 1,000 of Dependents Life Insurancefor each Member electing Dependents Life Insurance fortheir Children, regardless of the number of Childrencovered.Class 2:Not applicable.Child:AD&D Insurance:Member:Plan 1: 0.017 monthly per 1,000 of AD&D InsurancePlan 2:Class 1: 0.030 monthly per 1,000 of AD&D InsuranceClass 2:Not applicable.Spouse:Class 1: 0.030 monthly per 1,000 of AD&D InsuranceClass 2:Not applicable.Class 1: 0.030 monthly per 1,000 of AD&D Insurance for eachMember electing AD&D Insurance for their Children,regardless of the number of Children covered.Class 2:Not applicable.Child:Premium Due Dates:July 1, 2022 and the first day of each calendar monththereafter.Grace Period:31 daysInitial Rate Guarantee Period:July 1, 2022 to July 1, 2024Notice of Rate Change:90 days06/16/2022- 12 -170253-A
Minimum Participation:Life Insurance:Number:10 insured MembersPercentage:Plan 1 (basic): 100% of Members eligible for Plan 1Plan 2 (additional): The greater of 10 insured Members or20% of Members eligible for Plan 2Dependents Life Insurance:06/16/202220% of insured Members with eligible Dependents mustelect to insure those Dependents- 13 -170253-A
LIFE INSURANCEA. Insuring ClauseIf you die while insured for Life Insurance, we will pay benefits according to the terms of the GroupPolicy after we receive Proof Of Loss satisfactory to us.B. Amount Of Life InsuranceSee the Coverage Features for the Life Insurance schedule.C. Changes In Life Insurance1. IncreasesYou must apply in writing for any elective increase in your Life Insurance.Subject to the Active Work Provisions, an increase in your Life Insurance becomes effective asfollows:a. Increases Subject To Evidence Of InsurabilityAn increase in your Life Insurance subject to Evidence Of Insurability becomes effective onthe date we approve your Evidence Of Insurability.b. Increases Not Subject To Evidence Of InsurabilityAn increase in your Life Insurance not subject to Evidence Of Insurability becomes effectiveon the first day of the calendar month coinciding with or next following the date you applyfor an elective increase or the date of change in your classification, age or Annual Earnings.2. DecreasesA decrease in your Life Insurance because of a change in your classification, age or AnnualEarnings becomes effective on the first day of the calendar month coinciding with or nextfollowing the date of the change.Any other decrease in your Life Insurance becomes effective on the first day of the calendarmonth coinciding with or next following the date the Policyholder or your Employer receives yourwritten request for the decrease.D. Repatriation BenefitThe amount of the Repatriation Benefit is shown in the Coverage Features.We will pay a Repatriation Benefit if all of the following requirements are met.1. A Life Insurance Benefit is payable because of your death.2. You die more than 200 miles from your primary place of residence.3. Expenses are incurred to transport your body to a mortuary near your primary place of residence.E. Suicide Exclusion: Life InsuranceIf your death results from suicide or other intentionally self-inflicted Injury, while sane or insane, 1and 2 below apply.1. The amount payable will exclude the amount of your Life Insurance which is subject to thissuicide exclusion and which has not been continuously in
A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon 97204-1282 (503) 321-7000 GROUP LIFE INSURANCE POLICY Policyholder: Kent County Levy Court Policy Number: 170253-A Effective Date: July 1, 2022 The consideration for this Group Policy is the application of the Policyholder and the payment by the
