Notice of Protection Provided by Utah Life and Health Insurance Guaranty Association

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1 Ntice f Prtectin Prvided by Utah Life and Health Insurance Guaranty Assciatin This ntice prvides a brief summary f the Utah Life and Health Insurance Guaranty Assciatin ("the Assciatin") and the prtectin it prvides fr plicyhlders. This safety net was created under Utah law, which determines wh and what is cvered and the amunts f cverage. The Assciatin was established t prvide prtectin in the unlikely event that yur life, health, r annuity insurance cmpany becmes financially unable t meet its bligatins and is taken ver by its insurance regulatry agency. If this shuld happen, the Assciatin will typically arrange t cntinue cverage and pay claims, in accrdance with Utah law, with funding frm assessments paid by ther insurance cmpanies. The basic prtectins prvided by the Assciatin are: Life Insurance $500,000 in death benefits $200,000 in cash surrender r withdrawal values Health Insurance $500,000 in hspital, medical and surgical insurance benefits $500,000 in lng-term care insurance benefits $500,000 in disability incme insurance benefits $500,000 in ther types f health insurance benefits Annuities $250,000 in withdrawal and cash values The maximum amunt f prtectin fr each individual, regardless f the number f plicies r cntracts, is $500,000. Special rules may apply with regard t hspital, medical and surgical insurance benefits. Nte: Certain plicies and cntracts may nt be cvered r fully cvered. Fr example, cverage des nt extend t any prtin f a plicy r cntract that the insurer des nt guarantee, such as certain investment additins t the accunt value f a variable life insurance plicy r a variable annuity cntract. Cverage is cnditined n residency in this state and there are substantial limitatins and exclusins. Fr a cmplete descriptin f cverage, cnsult Utah Cde, Title 31A, Chapter 28. Insurance cmpanies and agents are prhibited by Utah law t use the existence f the Assciatin r its cverage t encurage yu t purchase insurance. When selecting an insurance cmpany, yu shuld nt rely n Assciatin cverage. If there is any incnsistency between Utah law and this ntice, Utah law will cntrl. T learn mre abut the abve prtectins, as well as prtectins relating t grup cntracts r retirement plans, please visit the Assciatin's website at r cntact: Utah Life and Health Insurance Guaranty Assc. 60 East Suth Temple, Suite 500 Salt Lake City UT (801) Utah Insurance Department 3110 State Office Building Salt Lake City UT (801) A written cmplaint abut misuse f this ntice r the imprper use f the existence f the Assciatin may by filed with the Utah Insurance Department at the abve address.

2 STANDARD INSURANCE COMPANY A Stck Life Insurance Cmpany 900 SW Fifth Avenue Prtland, Oregn (503) GROUP LONG TERM DISABILITY INSURANCE POLICY POLICYHOLDER: University f Utah GROUP POLICY NUMBER: A GROUP POLICY EFFECTIVE DATE: June 22, 2012 GROUP POLICY ANNIVERSARY DATE: Each future January 1 STATE OF ISSUE: Utah This grup lng term disability insurance plicy is issued t the Plicyhlder by Standard Insurance Cmpany (Standard). PLEASE READ THE ENTIRE POLICY. IT IS IMPORTANT. A table f cntents can be fund n the next page. Defined terms appear with their initial letters capitalized. Standard issues this grup lng term disability insurance plicy in cnsideratin f the payment f required premiums. STANDARD INSURANCE COMPANY By GPTC1002-LTD

3 TABLE OF CONTENTS PART 1: GROUP POLICY SCHEDULE... 1 PART 2: THE GROUP POLICY... 1 The Grup Plicy...1 Change f Grup Plicy...1 Certificates...2 Incntestability f the Grup Plicy r Emplyer Cverage Under the Grup Plicy...2 PART 3: PREMIUM PAYMENT... 2 Payment f Premiums...2 Premium Rates...2 Grace Perid...3 PART 4: LEAVES OF ABSENCE AND OTHER ABSENCE... 3 PART 5: GENERAL PROVISIONS... 4 Plicyhlder Infrmatin t be Given t Standard...4 Hw the Grup Plicy Can Be Terminated...4 (A) By the Plicyhlder...4 (B) By Standard...4 Assignment f the Grup Plicy by the Plicyhlder...4 Ntice f Suit...4 Agency and Release...4 Effect n Wrkers' Cmpensatin, State Disability Insurance...4

4 PART 1: GROUP POLICY SCHEDULE ELIGIBLITY Emplyer(s): Eligible Class: University f Utah Huse Staff Emplyees; including interns, residents and fellws in the Graduate Medical Educatin Apprved Prgrams (GMEAP) INITIAL PREMIUM RATES FOR ALL INSURED EMPLOYEES Mnthly Incme Benefit: 0.229% f cvered Mnthly Wage Base. PART 2: THE GROUP POLICY The Grup Plicy The Grup Plicy is the entire cntract between Standard and the Plicyhlder. Standard will prvide benefits accrding t the terms f the Grup Plicy. The Grup Plicy cnsists f this grup lng term disability insurance plicy issued by Standard t the Plicyhlder and identified by the Grup Plicy Number, the Plicyhlder's attached applicatin, grup lng term disability insurance certificates with the same Grup Plicy Number, and any amendments r endrsements t the plicy r certificates. The Plicyhlder's rights r the rights f any Emplyee will nly be affected by prvisins that are part f the Grup Plicy. Only an executive fficer f Standard may: bind Standard by making a prmise r a representatin; r accept a representatin that relates t the Grup Plicy. Change f Grup Plicy Only an executive fficer f Standard may apprve a change t the Grup Plicy r waive any f its prvisins. Any change will be endrsed n r added t the Grup Plicy in writing. Changes may be made withut the cnsent f Emplyees. Standard may change the Grup Plicy in whle r in part if: (1) the change in the Grup Plicy is either requested by the Plicyhlder r is made t satisfy any legal requirement that applies t the Grup Plicy; r (2) the change affects Standard's administratin f the Grup Plicy and is intended t apply t all similar grup insurance plicies that are affected by the change. Standard will give the Plicyhlder written ntice f Standard's intent t make this kind f a change at least 90 days in advance f the effective date f the change. Payment f the next premium due under the Grup Plicy will be the Plicyhlder's acceptance f the change, unless the Plicyhlder rejects the change, in writing, prir t its effective date. GPTC1002-LTD (Printed 08/08/2012) ( A)

5 Certificates Standard will issue t the Plicyhlder grup lng term disability insurance certificates t be given t each insured Emplyee. The certificate will set frth the main features f the Grup Plicy that apply t the Emplyee. Incntestability f the Grup Plicy r Emplyer Cverage Under the Grup Plicy Any statement made by the Plicyhlder t btain the Grup Plicy r made by an Emplyer t btain cverage under the Grup Plicy is a representatin and nt a warranty. N misrepresentatin by the Plicyhlder r Emplyer will be used t deny a claim, r t deny the validity f the Grup Plicy r the Emplyer's cverage under the Grup Plicy unless: (1) the Grup Plicy wuld nt have been issued r the Emplyer s cverage under the Grup Plicy wuld nt have been apprved if Standard had knwn the truth; and (2) Standard has given the Plicyhlder r Emplyer a cpy f a written instrument signed by the Plicyhlder r Emplyer which cntains the misrepresentatin. The validity f the Grup Plicy r the Emplyer's cverage under the Grup Plicy will nt be cntested after it has been in frce fr tw years, except fr nnpayment f premiums r fraudulent misrepresentatins. PART 3: PREMIUM PAYMENT Payment f Premiums Premiums are t be paid by the Plicyhlder at Standard's hme ffice. The first premium is due n the Grup Plicy Effective Date. Future premiums are due n the first day f each mnth thereafter. The Plicyhlder may pay premiums n r befre their due dates. Failure t pay a premium when due is a default. Premiums will be paid fr all insured Emplyees but nt fr an Emplyee t whm benefits are being paid under the Grup Plicy. Standard shall credit t the Plicyhlder any payment f premiums made in errr. A credit shall be given nly fr the payments made in errr during the year in which the errr is fund and reprted t Standard. Premium Rates Initial premium rates fr all insured Emplyees are shwn in PART 1: GROUP POLICY SCHEDULE. Standard may, as f any premium due date, change the premium rates fr this insurance. A change in rates may be made nly after Standard has given the Plicyhlder at least 180 days written ntice f the change. The premium rates are guaranteed frm the Grup Plicy Effective Date until January 1, 2016, except when: (1) Standard and the Plicyhlder r the Emplyer mutually agree t change premium rates r cverage under the Grup Plicy; r (2) a change r clarificatin in law r gvernmental regulatin affects the risk assumed under the Grup Plicy; r (3) factrs material t underwriting the risk Standard assumed under the Grup Plicy with respect t an Emplyer, including, but nt limited t, the number f persns insured, age, insured earnings fr all Emplyees, gender, r ccupatinal classificatin, change by 25% r mre; r GPTC1002-LTD (Printed 08/08/2012) ( A)

6 (4) the premium cntributin arrangement fr Emplyees is changed r varies frm that stated in the Grup Plicy when issued r last renewed. Any such change in premium rates will reflect nly the change in Standard's risks. Grace Perid The Plicyhlder will be given 60 days frm a premium due date t pay each premium that is due. Insurance will cntinue during this perid. A premium nt paid by the end f this grace perid will bring abut the autmatic terminatin f the Grup Plicy at the end f the grace perid. If the Grup Plicy terminates fr any cause, the Plicyhlder will we all due and unpaid premiums; this includes a pr rata premium fr the time the Grup Plicy was in frce during the grace perid. PART 4: LEAVES OF ABSENCE AND OTHER ABSENCE Leaves f Absence and Other Absence When an Emplyee stps Active Wrk in an Eligible Class, the Plicyhlder may, fr the types f absences described belw, cntinue the insurance f the Emplyee fr nt lnger than the time limit shwn fr each type f absence. Insurance will cntinue and emplyment will be deemed t cntinue, slely fr the purpses f this prvisin, if the required premiums are remitted fr the Emplyee and: (1) the Emplyee is either n a sabbatical r n a leave f absence, with r withut pay, apprved by the cgnizant Vice-President. Insurance may be cntinued t the end f 36 mnths, r, if earlier, the end f such leave; r (2) the Emplyee is n a leave f absence apprved by the Plicyhlder's Bard f Trustees and receives less than ne-quarter pay as lng as such leave is fr: (1) full-time study fr an advanced degree; r (2) wrk in the field f educatin r research such as a Fulbright Award, fundatin grant, r gvernment prject. Insurance may be cntinued t the end f 24 mnths, r, if earlier, the end f such leave; r (3) the Emplyee is n a leave f absence fr pregnancy. Insurance may be cntinued t the end f 4 mnths after the pregnancy ends, r, if earlier, the end f such leave; r (4) the Emplyee is n a family r medical leave apprved by the Plicyhlder. During such leave, insurance may be cntinued t the end f 6 mnths r, if later, the perid required by applicable state r federal law. Emplyment will nt be deemed t cntinue and insurance cannt be cntinued during a sabbatical r leave f absence unless the sabbatical r the leave fr the Emplyee is set frth in a written dcument that is dated n r befre the leave is t start and shws that the Emplyee is scheduled t return t Active Wrk. Fr an Emplyee n leave, the Mnthly Wage Base and premiums will be based n the wages payable by the Emplyer just prir t the start f the leave. During the absences set frth abve, insurance will be cntinued with premium payment in a manner that precludes individual selectin. GPTC1002-LTD (Printed 08/08/2012) ( A)

7 PART 5: GENERAL PROVISIONS Plicyhlder Infrmatin t be Given t Standard On request, the Plicyhlder will give t Standard any infrmatin that is required t: administer the Grup Plicy; and determine changes in premium rates. Standard will have the right at any reasnable time t inspect any recrds in the Plicyhlder's pssessin, cntrl, r custdy that relate t the Grup Plicy r the Emplyees insured under it. Hw the Grup Plicy Can Be Terminated (A) By the Plicyhlder If nt in default f any premium payment, the Plicyhlder may terminate the Grup Plicy as f any premium due date by giving ntice in writing which is received befre such date at Standard's hme ffice. If in default, the Grup Plicy will terminate autmatically as set frth under "Grace Perid" in PART 3: PREMIUM PAYMENT. (B) By Standard Standard may terminate the Grup Plicy as f any date set frth belw by giving ntice in writing which is mailed t the Plicyhlder at least 90 days befre this date: (1) the Grup Plicy Anniversary Date; r (2) any premium due date, if n a prir premium due date fewer than 10 Emplyees were insured under the Grup Plicy. Assignment f the Grup Plicy by the Plicyhlder The Plicyhlder may assign the Grup Plicy. N assignment will bind Standard unless it is in writing and until it is filed at Standard's hme ffice. Standard is nt respnsible fr whether any assignment is valid. Ntice f Suit The Plicyhlder r Emplyer shall prmptly give Standard written ntice f any lawsuit r ther legal prceedings arising under the Grup Plicy. Agency and Release Individuals selected by the Plicyhlder r by any Emplyer t secure cverage under the Grup Plicy r t perfrm their administrative functin under it, represent and act n behalf f the persn selecting them, and d nt represent r act n behalf f Standard. The Plicyhlder, Emplyer and such individuals have n authrity t alter, expand, r extend Standard's liability r t waive, mdify r cmprmise any defense r right Standard may have under the Grup Plicy. The Plicyhlder and each Emplyer hereby release, hld harmless and indemnify Standard frm any liability arising frm r related t any negligence, errr, missin, misrepresentatin, r dishnesty f any f them r their representatives, agents, r emplyees. Effect n Wrkers' Cmpensatin, State Disability Insurance The cverage prvided under the Grup Plicy is nt a substitute fr cverage under a wrkers' cmpensatin r state disability incme benefit law and des nt relieve the Emplyer f any bligatin t prvide such cverage. SB_LTDP2003 GPTC1002-LTD (Printed 08/08/2012) ( A)

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