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1 Is E&O Insurance Necessary? You Decide!!! Statistics prove that one out of every seven Insurance Agents will report an Errors and Omissions claim this year. Insurance Agents rank fourth among professions in number of lawsuits being filed against them. They are preceded only by physicians, attorneys and accountants. PRODUCERS PROFESSIONAL LIABILITY INSURANCE PROGRAM HIGHLIGHTS PLAN SPONSOR: FIDELITY & GUARANTY LIFE Basic liability limit is $1,000,000 per claim and annual aggregate per agent with optional $2,000,000 limit available; Program Annual Aggregate Limit $10,000,000; Deductibles: $500 0 per claim for Fidelity & Guaranty Life products, $2,500 for products of other companies; Defense costs are provided within the limit of liability; Underwritten By: Columbia Casualty Insurance Company, a CNA Insurance Group Company,, has been selected to underwrite this program because, along with their many years experience in producing Agents and Brokers coverage, they offer: Underwriting stability and financial solvency, evidenced by an A.M. Best rating of A XV (Excellent Excellent) and an experienced claims staff providing expert knowledge and counsel. CONTACT: I NSURANCE S PECIALTIES S ERVICES, INC York Road Suite D4 Jamison, PA Phone: 800/ Fax: 215/ Limited insolvency coverage for admitted carriers with B++ or better A.M. Best Rating at time coverage was obtained or account placed; Flexible Coverage Options to include or exclude Variable Life, Variable Annuities and Mutual Funds coverage (Your choice de- pending on your needs); Optional extended reporting periods for retired,, disabled or de- ceased agents; Full prior acts coverage for qualified agents. Competitive Premium Rates: Basic Coverage (excludes Mutual Funds & Variable Products) Annual Cost per Agent $1,000,000 Limit (Option #1): $ $2,000,000 Limit (Option #2): $ Optional Coverage (includes Mutual Funds & Variable Products) Annual Cost per Agent $1,000,000 Limit (Option #3): $ $2,000,000 Limit (Option #4): $ NOTE: Premium for Midterm Enrollments is Prorated. (See Schedule) NOTE: These highlights summarize some of the more important features of the Fidelity & Guaranty Life Insurance Company Professional Liability Pro- gram. This is not meant to be a legal interpretation of the policy provisions. For specific answers to questions you may contact Insurance Specialties Services, Inc. (ISSI) for more details. FOR PRODUCER USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC Fidelity & Guaranty Life is the marketing name of Fidelity Guaranty Life Insurance Company issuing insurance in the United States outside of New York and in New York only, Fidelity & Guaranty Life Insurance Company of New York. Each Fidelity & Guaranty Life Company is solely responsible for its contractual commitments.

2 PRODUCERS PROFESSIONAL LIABILITY INSURANCE PROGRAM E&O Plan Enrollment Form PLAN SPONSOR: FIDELITY & GUARANTY LIFE INSURANCE COMPANY Name Telephone Social Security Number Address City State Zip I am a: General Agent Producer Appointed With: Fidelity & Guaranty Life Date Appointed by Company Agent Number Number of years licensed as an agent and/or broker 1. Has applicant or anyone for whose actions applicant is responsible been the subject of disciplinary action by any insurance authority? 2. Has any policy or application for errors and omissions insurance or reinsurance on behalf of the applicant or any of its partners, executive officers or directors, to the knowledge of the applicant, on behalf of its predecessors in business, been declined, cancelled or refused renewal within the last five years? 3. Have any errors and omissions claims been made against the applicant, any of the present partners, executive officers or directors, or to the knowledge of the applicant, against its predecessors in business, or any partners, executive officers or directors within the last ten years? 4. Are there any circumstances that may result in an errors and omissions claim being made against the applicant, its predecessor in business, or any past or present partners, executive officers or directors? 5. List any prior E&O carrier information (If none, state none. ) No Yes (if yes, attach full details) No Yes (if yes, attach full details) No Yes (if yes, attach full details, stating E&O carrier handling claim, etc.) No Yes (if yes, attach full details) Carrier Name Expiration Dates Policy Number Limit 6. Percentage of your total business placed with Fidelity & Guaranty Life Insurance Company or Fidelity & Guaranty Life Insurance Company of New York (circle one) % Enrollee hereby warrants and represents that the statements and answers to questions made herewith and attachments hereto are true, and enrollee has not omitted or misrepresented any information. Enrollee understands and agrees that the completion of this form does not bind any company to issuance of an insurance policy or certificate. Signature Date Check Enclosed (Make check payable to ISSI) Payment by Visa or MasterCard Card Number Expiration Date Amount Authorized: Address of Cardholder if different than above: If you are a TEXAS AGENT LICENSED AS A CORPORATION, please provide the corporation name: Coverage Amount (Select) Annual Premium $1 Million (Option #1) : Excludes Sale of Mutual Funds and Variable Products $690 per producer $2 Million (Option #2) : Excludes Sale of Mutual Funds and Variable Products $811 per producer $1 Million (Option #3) ; Includes Sale of Mutual Funds & Variable Products $822 per producer $2 Million (Option #4) : Includes Sale of Mutual Funds & Variable Products $1,029 per producer Amount: $ PRIOR ACTS COVERAGE: the policy will apply to prior act committed but only in the event you: a)have maintained prior continuous & consecutive E&O coverage, and b) you had no prior knowledge or awareness of facts or circumstances that could result in a claim being made against you All agents to be covered must apply individually and pay according to the enrollment premium schedule. Your payment must accompany this application. The plan effective date is: JANUARY 1. For agents enrolling after JANUARY 1, premium will be prorated according to the Enrollment Premium Schedule. Coverage expires December 31. More information about Errors and Omissions Insurance is available in the Fidelity & Guaranty Life Insurance Company brochure ADMIN5595 This is a Claims Made Policy. RETURN COMPLETED FORM TO: Insurance Specialties Services, Inc. (ISSI) 2370 York Road, D4 Jamison, PA Phone: (800) Fax: (215) ADMIN4956 ( ) E&O coverage underwritten by Continental Casualty Insurance Group, New York, NY Administered by Insurance Specialties Services, Inc., Jamison, PA

3 PRODUCERS PROFESSIONAL LIABILITY INSURANCE PROGRAM Enrollment Premium Schedule January 1, 2013 to January 1, 2014 $1,000,000 Limit $2,000,000 Limit Entry Date Option #1 Option #2 Option #3 Option #4 1-Jan $ $ $ $1, Jan $ $ $ $ Feb $ $ $ $ Feb $ $ $ $ Mar $ $ $ $ Mar $ $ $ $ Apr $ $ $ $ Apr $ $ $ $ May $ $ $ $ May $ $ $ $ Jun $ $ $ $ Jun $ $ $ $ Jul $ $ $ $ Jul $ $ $ $ Aug $ $ $ $ Aug $ $ $ $ Sep $ $ $ $ Sep $ $ $ $ Oct $ $ $ $ Oct $ $ $ $ Nov $ $ $ $ Nov $87.00 $ $ $ Dec $58.00 $68.00 $69.00 $ Dec $29.00 $34.00 $35.00 $43.00 Note: Rates Listed Above Include Appropriate Premium Tax Options #1 and #2: Exclude Coverage for the Sale of Mutual Funds and Variable Products Options #3 and #4: Include Coverage for the Sale of Mutual Funds and Variable Products FOR PRODUCER USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC Fidelity & Guaranty Life Insurance Company, Baltimore, MD Fidelity &Guaranty Life Insurance Company of New York, New York

4 PRODUCERS PROFESSIONAL LIABILITY INSURANCE PROGRAM CREDIT CARD AUTHORIZATION Please complete this Credit Card Authorization Form per the premium payment schedule and return to INSURANCE SPECIALTIES SERVICES, INC. (ISSI) CUSTOMER NAME: ( ) VISA ( ) MASTERCARD CREDIT CARD # EXPIRATION DATE / / ADDRESS OF CARDHOLDER CARDHOLDER S SIGNATURE BASIC COVERAGE (Excludes Variable & Mutual Fund Products) ANNUAL PREMIUM $1,000,000 Limit (Option #1): $ per Agent $2,000,000 Limit (Option #2): $ per Agent OPTIONAL COVERAGE (Includes Variable & Mutual Fund Products) ANNUAL PREMIUM $1,000,000 Limit (Option #3): $ per Agent $2,000,000 Limit (Option #4): $1,029 1, per Agent AMOUNT: INTERNAL USE ONLY FILE NAME: POLICY #: TRANSACTION DATE: AUTHORIZATION CODE: PREMIUM AMOUNT: FOR PRODUCER USE ONLY. NOT FOR USE WITH THE GENERAL PUBLIC Fidelity & Guaranty Life Insurance Company, Baltimore, MD Fidelity &Guaranty Life Insurance Company of New York, New York

5 IMPORTANT FEATURES OF THE PLAN Consult Master Policy For Complete Details Your choice of four coverage options: Deductibles: Option #1: $1million limit excludes coverage for sale of mutual funds and variable products $ Option #2: $2million limit excludes coverage for sale of mutual funds and variable products $ Option #3: $1million limit includes coverage for sale of mutual funds and variable products $ Option #4: $2million limit includes coverage for sale of mutual funds and variable products $1, $500 Per Agent Fidelity & Guaranty Life Products $2,500 Per Agent Outside Business $5,000 Per Registered Representative Mutual Funds & Variable Products (All Apply to Both Defense & Indemnity) Annual Program Limit: $10 Million Defense Costs Coverage: Provided inside the limit of liability. Limited insolvency endorsement: Covers claims for carriers rated B++ or better by A.M. Best. Coverage includes unlicensed staff. Unlimited Extended Reporting Period: Provided at no additional charge for the Agents, General Agent, Registered Representative, or Registered Investment Adviser insured under the policy and not terminated for a disciplinary reason and not insured elsewhere Awareness Provision: Offers protection by allowing you to report circumstance that may become a claim in the future. Broad coverage includes: Agent as a General Agent, Retired or Disabled Agents, Licensed and unlicensed support staff, Notary, Financial Planning involving sale and service of covered products, Estates, heirs, assigns, legal representatives, and spouses or domestic partners. Insurer: Rated A (Excellent):XV by A.M. Best Prior Acts Coverage: back to date of first continuous uninterrupted professional liability policy

6 F&G Agents E&O Program Questions & Answers Who is covered? You, as an agent with a current agent s agreement with Fidelity & Guaranty Life are the named insured. Your staff, acting on your behalf are also covered under your policy, but only if they did not receive commission income pursuant to a contract with any other insurance company and only with regard to Professional Services provided by you, your heirs, executors, administrators and legal representatives should you die, become disabled or bankrupt. Will my partnership or corporation be covered if it is named in a claim? Yes, your partnership or corporation will be covered for claims arising out of professional services provided by you for others as long as the claim arises out of activities and products otherwise covered by this policy. Is there coverage for past wrongful acts? Yes. Coverage applies for claims arising from wrongful acts back to the prior acts date, which is the date of your first continuous uninterrupted E&O professional liability coverage. Is coverage limited to products of the program sponsor? No. This program offers coverage for various products and activities, but retentions may differ. Is there coverage for property/casualty insurance products? No. What happens if my coverage terminates? Your coverage will terminate due to non-renewal, non payment of premium or cancellation upon your request. If you have not been terminated for a disciplinary reason or non-payment of premium and have not secured coverage elsewhere, you are entitled to an Unlimited Duration Extended Reporting Period (ERP). The applicable ERP is with respect to a claim made during such ERP arising out of a wrongful act committed after the applicable prior acts date but before the termination date. What if I am replacing my current E&O coverage? Most E&O if not all of these E&O policies include an awareness provision. You should report any incidents or situations which you feel could give rise to an E&O claim in the future to your current carrier. Your failure to do so could leave you without coverage for these claims if it is determined you had prior knowledge of the situation or incident at the time of your enrollment in this E&O program. What is a claim? A claim means a written demand for monetary damages or a civil adjudicatory or arbitration proceeding for monetary damages against an insured for a wrongful act. What is a Wrongful Act? Is any negligent act, error or omission of or personal injury (libel, slander, defamation, etc) caused by the insured in rendering or failing to render professional services. What does claims made and reported mean? Claims made and reported means that a claim must be both first made against you and reported during the policy period or extended reporting period (ERP) and subsequent to the retroactive date. What if the claimant wishes to negotiate for a settlement of a claim? Let your E&O carrier handle it. Do not admit liability or discuss the situation with anyone but your E&O carrier or their representative. Under the terms of your E&O policy they have the right and the duty to provide you with a defense and negotiate any settlements on your behalf. What if the claim arises out of the insolvency of the insurer with which the coverage was placed? If, at the time the coverage was placed, obtained or recommended the insurer has a A.M. Best rating of B++ or better, you are covered for claims based upon insolvency, receivership, liquidation or the inability to pay of the insurer providing the coverage or in which the funds were placed. When and how do I report a claim? Claims should be reported to the insurer at the address stated in your certificate of insurance and master policy as soon as possible and during the certificate period or any immediately following, certificate period or, in the event of cancellation or non-renewal, within 30 days immediately following the cancellation or non-renewal. If a lawsuit is received do not delay. These documents require a response within a time limit, usually 20 days. Do not discuss your situation with anyone other than your E&O carrier, their representative or your attorney. Do not admit liability, agree to anything, incur any expenses or attempt to negotiate without first obtaining the written consent of your E&O carrier. Failure to do so could invalidate your coverage under the terms of the policy. For More Information Contact? Insurance Specialties Services, Inc York Road, Suite D4 Jamison, PA Phone: (800) Fax: (215)

7 Company Providing Coverage: Rated A (Excellent): XV by A.M. Best Prior Acts Coverage: Date of first continuous uninterrupted professional liability policy Limits of Liability Options Each Insured: $1,000,000/$1,000,000 Each Claim/Aggregate $2,000,000/$2,000,000 Each Claim/Aggregate Retentions: $500 each claim for Life, Accident & Health Products $2,500 each claim for Disability Income Insurance $5,000 each claim for all other products or services *Retentions Apply to Damages and Defense Costs Policy and Per Claim Aggregate* Policy Year Aggregate: $10,000,000 The amount set forth as the Policy Year Aggregate Limit of Liability shall be the maximum Aggregate Limit of Liability of the Insurer for each Policy Year, regardless of the number of Insureds, claims made, or persons or entities bringing such Claims. Per Claim Aggregate: Each Insured s applicable Limit of Liability shall be the maximum Limit of Liability of the Insurer for such Insured, regardless of the number of Insureds, Certificates of Insurance, Claims made, or persons or entities bringing such Claims. Where two or more Insureds are involved in a Claim, the maximum aggregate Limit of Liability of the Insurer for all such Insureds shall be the largest single Limit of Liability applicable to any one of such Insureds. *Does not apply to producers licensed in or practicing in NY state. Defense Costs: Coverage Provided Inside the Limits of Liability Coverage: Basic Coverage: Life, Accident & Health Products Indexed Annuities/Fixed Annuities Optional Coverage: Mutual Funds, Variable Annuities and Variable Life Who Is An Insured?: Agent or General Agent Retired or Disabled Agent or General Agent Registered Representative and/or Registered Investment Advisers, but solely for those Professional Services defined in the policy; Support staff performing enrollment services and not receiving a commission as the result of a producers contract; Your coverage is extended to your estate, heirs, legal representatives, assigns, spouses or domestic partners for a covered claim arising out of your wrongful acts. F&G E&O Program - Highlights Consult The Master Policy For Complete Details Extended Reporting Period (ERP): Your coverage will terminate due to non-renewal, nonpayment of premium or cancellation upon your request. If you have not been terminated for a disciplinary reason or non-payment of premium and have not secured coverage elsewhere, you are entitled to an Unlimited Duration ERP. This ERP applies to claims made during the ERP that arise out of wrongful acts committed after the applicable prior acts retroactive date, but before the full coverage termination date. Professional Services means: For Agents or General Agents: * Life Insurance, accident and health insurance, managed health care organization contracts, preferred provider organization contracts, medicare advantage plans, medical care supplemental insurance; * The sale, attempted sale or servicing of disability income insurance; * The sale, attempted sale or servicing indexed/fixed annuities; * Financial planning activities in conjunction with services described above, whether or not a separate fee is charged; * Services as a notary public; * The supervision, management and training of an agent by a general agent with respect to activities otherwise covered by this policy; For Registered Representatives or Registered Investment Advisers: * The sale, attempted sale or servicing of variable annuities or mutual funds (if purchased) that are registered with the Securities Exchange Commission, if required, through a Broker/Dealer that is a member of FINRA; * Financial planning activities in conjunction with covered products and services, whether or not a fee is charged; * Registered Representative and RIA sale and/or servicing of Variable Products and Mutual Funds. Awareness Provision: Allows you to report a circumstance so that in the event any claim arises out of that circumstance it will be considered covered effective when the incident or circumstance was first reported. Program Administrator: Insurance Specialties Services, Inc. (ISSI) 2370 York Road, Suite D4 Jamison, PA Phone: (800) Fax: (215)

8 E&O Notable Exclusions Consult The Master Policy For A Complete Listing Prior or Pending Litigation; Insured vs. Insured; Claims brought by regulators; Intentional or Dishonest Acts; Bodily injury or Property Damage; Contractual Liability; Promises or Guarantees regarding rates or future market value; Activities performed as an actuary, accountant or attorney; Activities as a Property & Casualty Agent, Real Estate Agent or Broker, or Third Party Administrator, Market Maker or specialist in any securities; Providing of Tax advice, except as incidental to providing of Professional Services; Failure to pay/collect funds; Fee/commission disputes; Commingling/illegal profit; Insolvency except for Companies rated B++ or better by A.M. Best; Own benefit plan/erisa; Design of employee benefit plans; Administration of employee benefit plans; MEWAs or self-funded benefit plans; Viatical Settlements, Life Settlements or Structured Settlements; Stranger Originated Life Insurance (STOLI) or Speculator Originated Life Insurance (SPIN-LIFE) or similar transactions; Sale or servicing of employee benefit plans (other than Group Life & Group Health); Discretionary Authority, except as RIA; Nuclear/Pollution; Anti-trust/price-fixing; Misuse of confidential information; Activities or products when/where not licensed, except placement of surplus lines; Investment banking activities; Proprietary products/funds; Advice as a fiduciary advisor not in accordance with pension protection act; Wrongful Employment Practices; Class Action Claims; Unregistered securities; Professional Services do not include: Reverse mortgages; Variable annuity churning; Fiduciary Advisor Services to employee benefit plans; Sale/attempted sale of securities other than Variable Life,Variable Annuities and MutualFunds; Exchange Traded Funds.

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