Conversion Privilege

If your entire amount of life insurance is discontinued because of a change in your eligibility status or your termination in this plan, and you are under 65 years of age, you are entitled to purchase an individual life insurance policy issued by the Insurer, subject to the following conditions:

1. The amount of the individual policy shall not exceed the amount of insurance for which the Member was covered when coverage was discontinued, subject to a maximum of $200,000.
2. The individual policy shall be, at the Member’s option, in the form of a convertible one year term assurance, or a term to age 65 or an ordinary life plan.  This individual policy shall be without dividends and without disability waiver or other supplementary benefits.
3. The premium for the individual policy shall be determined by the Insurer according to:
   i)    the insurer’s current rates for your attained age the birthday immediately prior to the date of issue of the individual policy;
   ii)    the class of risk to which you then belong; and
   iii)    the form and amount of the individual policy.
4. The first premium and written application for the individual policy shall be delivered to the Insurer within 31 days after the date on which your insurance is terminated.
5. Insurance under the individual policy shall be effective at the end of the 31 day period described above.
6. Evidence of insurability shall not be required for such individual policy.

If you die within the 31-day period during which you could have converted, the Insurer shall pay the maximum amount of insurance you could have converted.  If an individual policy has already been issued through conversion, no payment shall be made through this provision unless the individual policy is surrounded without payment of claim.  Upon surrender the Insurer shall refund premiums paid on the individual policy.  A beneficiary designated in any conversion application shall be the beneficiary under this provision.

Note:    This conversion privilege does not apply to life insurance that is terminating or reducing because you retire or attain a certain age specified in the Group Policy.