THIS IS AN EXACT COPY OF YOUR POLICY EXCEPT FOR YOUR SPECIFIC INFORMATION SUCH AS NAME, ADDRESS, COVERAGE, AND PREMIUMS TEN DAY FREE LOOK
|
|
- Anna Goodwin
- 8 years ago
- Views:
Transcription
1 American Century Life Insurance Company of Texas (a stipulated premium company) 9708 Congressional Dr. Plano, TX Phone (855) , Fax (855) THIS IS AN EXACT COPY OF YOUR POLICY EXCEPT FOR YOUR SPECIFIC INFORMATION SUCH AS NAME, ADDRESS, COVERAGE, AND PREMIUMS This is a legal contract between the Owner of this Policy and Us. It is issued in return for Your Application and first premium. We agree to pay the Proceeds of this Policy to the Beneficiary if the Insured dies while this Policy is in force, We receive satisfactory proof of the Insured's death, and this Policy's provisions are met. TEN DAY FREE LOOK You may cancel this Policy within 10 days of receiving it. Return the Policy to us at Our Home Office or to your sales agent. As soon as you deliver or mail the Policy to us it is treated as if it was never issued. We will refund your premium payment when we receive the Policy back. After the 10-day period you may cancel the Policy by notifying us in writing that You wish to do so. Cancellation of Your Policy will be effective on the date We receive your written notice unless Your notice specifies a later date. We will promptly refund any premium paid for coverage after the cancellation date. Cancellation of this Policy will be without prejudice to any claim made prior to the termination of this Policy. Coverage under this Policy and any attached riders will be limited in the event of Suicide by the Insured as described in the Suicide provision. IN WITNESS WHEREOF, the Company has caused this Policy to be executed at Our Home Office as of the Effective Date. The provisions and conditions on this and the following pages are part of this Policy. Roni Ido Secretary Raz Silberman President Premiums payable during the lifetime of the Insured until policy expiration or until the death of the Insured. Nonparticipating Policy. 1
2 IMPORTANT NOTICE To obtain information or make a complaint: AVISO IMPORTANTE Para obtener información o para presentar una queja: You may call American Century Life Insurance Company of Texas s toll-free telephone number for information or to make a complaint at: Usted puede Ilamar al número de teléfono gratuito de American Century Life Insurance Company of Texas s para obtener información o para presentar una queja al: (855) (855) You may also write to American Century Life Insurance Company of Texas at: American Century Life Insurance Co. of TX (A Stipulated Premium Company) 9708 Congressional Dr. Plano, TX FAX: (855) customerservice@acl-tx.com Usted también puede escribir a American Century Life Insurance Company of Texas: American Century Life Insurance Co. of TX (A Stipulated Premium Company) 9708 Congressional Dr. Plano, TX FAX: (855) customerservice@acl-tx.com You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights, or complaints at: Ustede puede comunicarse con el Departamento de Seguros de Texas para obtener información sobre compañías, coberturas, derechos, o quejas al: You may write the Texas Department of Insurance: P.O. Box Austin, TX Fax: (512) Web: ConsumerProtection@tdi.texas.gov PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact American Century Life Insurance Company of Texas first. If the dispute is not resolved, you may contact the Texas Department of Insurance. Usted puede escribir al Departamento de Seguros de Texas a: P.O. Box Austin, TX Fax: (512) Sitio web: ConsumerProtection@tdi.texas.gov DISPUTAS POR PRIMAS DE SEGUROS O RECLAMACIONES: Si tiene una disputa relacionada con su prima de seguro o con una reclamación, usted debe comunicarse con American Century Life Insurance Company of Texas primero. Si la disputa no es resuelta, usted puede comunicarse con el Departamento de Seguros de Texas. ATTACH THIS NOTICE TO YOUR POLICY: ADJUNTE ESTE AVISO A SU PÓLIZA : This notice is for information only and does not Este aviso es solamente para propósitos informativos y become a part or condition of the attached no se convierte en parte o condición del documento document. adjunto. 2
3 TABLE OF CONTENTS Policy Schedule... 4 Definitions... 5 Premiums and Reinstatement... 5 Ownership, Beneficiary & Assignment Rights... 6 Termination... 6 Conversion Privilege... 6 Payment of Proceeds... 7 General Provisions
4 POLICY SCHEDULE BENEFITS OF THIS POLICY UNITS OF COVERAGE AMOUNT OF PROCEEDS ANNUAL PREMIUM TERM LIFE POLICY INSURED AMOUNT: $XX,XXX.XX INSURED: John Smith INSURED'S AGE: XX OWNER: John Smith BENEFICIARY: As stated in the Application unless subsequently changed as provided in this Policy POLICY NUMBER: XXXXXX TOTAL PREMIUMS: $XX.XX EFFECTIVE DATE: POLICY ANNIVERSARY: POLICY EXPIRATION DATE: XXXXXX XXXXXX XXXXXX RESERVE INTEREST RATE: 3.5% REINSTATEMENT INTEREST RATE: 6% MODES OF PREMIUM PAYMENT AVAILABLE: ANNUAL: $XX.XX SEMI-ANNUAL: $XX.XX QUARTERLY: $XX.XX The effective date and Insured's Age for each benefit and unit of coverage is the Effective Date for this Policy unless otherwise specified above. 4
5 DEFINTIONS AGE: The Insured's Age at the Insured's last birthday. APPLICATION: The paper You signed to get this Policy. A copy is attached. BENEFICIARY: The person named to receive the Proceeds in the event of the Insured's death while this Policy is in force. EFFECTIVE DATE: The effective date of coverage provided by this Policy. See the Policy Schedule. INSURED: The person whose life is insured under this Policy. The Insured is named in the Policy Schedule. LAPSE: Termination of this Policy for non-payment of the required premiums. OWNER, YOU, YOURS: The person who has the right to change the Beneficiary and to exercise all rights under this Policy. The Owner may be someone other than the Insured and is shown in the Policy Schedule unless subsequently changed. POLICY: This Life Insurance Policy. POLICY ANNIVERSARY: The same day and month as the Effective Date for each succeeding year this Policy remains in force. POLICY SCHEDULE: Page 3 of this Policy. PREMIUM: The amount paid for coverage under this Policy. PROCEEDS: The amount We are obligated to pay under the terms of this Policy as shown in the Policy Schedule. WE, OUR, US, THE COMPANY: American Century Life Insurance Company of Texas. PREMIUMS AND REINSTATEMENT: Premium Payments The first premium is due on the Effective Date. Premiums will include rider premiums, if any. All premiums after the first premium are payable on or before the date they are due and must be paid to Us at Our Home Office or to an agent of the Company. If You want a receipt for premium payment, We will give You one upon request. Grace Period You have a 31-day Grace Period to pay each premium due. The Grace Period starts on the date the premium is due and ends 31 days later. Each premium due must be received at Our Home Office within the Grace Period. During the Grace Period this Policy will remain in force. In case of the Insured's death during the Grace Period, premiums due will be deducted from this Policy's Proceeds. When a premium is due and not paid by the end of its Grace Period, this Policy will Lapse. Reinstatement This Policy may be reinstated at any time within three years after it has Lapsed and before the Policy Expiration Date provided: A written application for reinstatement is submitted to Us; Evidence of insurability satisfactory to Us is furnished; and All overdue premiums are paid with interest at the Reinstatement Interest Rate shown in the Policy Schedule. Coverage under any reinstated policy will not begin until We approve the application for reinstatement.
6 OWNERSHIP, BENEFEIARY & ASSIGNMENT RIGHTS Owner You are the Owner for this Policy unless otherwise stated in the Application. lf a different Owner is stated, such designation will remain in effect until the Owner changes it. The Owner may exercise all the rights under this Policy during the Insured's lifetime by making written request to Us. All the rights of the Owner are subject to the rights of any assignee and of any irrevocable Beneficiary We have on record. If the Owner dies before the Insured, the rights of the Owner may be exercised by the Owner's estate. If the Insured is less than Age 18 on the Effective Date, ownership will automatically pass to the Insured on the Policy Anniversary when the Insured attains Age 18. Beneficiary The Beneficiary is as named in the Application unless changed as provided for in this Policy. If a Beneficiary dies before the Insured, the interest of that Beneficiary will pass to the Owner. If the Owner is not living at that time, all Proceeds will be paid to the Owner's estate. If any Beneficiary dies within 15 days of the Insured's death, We will pay the Proceeds as though that Beneficiary dies before the Insured. We may rely on affidavits or other evidence in identifying the persons in any class named as Beneficiary. Any payment We make in good faith based on this shall satisfy what We owe on this Policy to such extent. Changes in Beneficiary The Owner may change the Beneficiary by filing a written notice with Us. If an irrevocable Beneficiary has been named in this Policy and is still living, that person's written consent will be needed for any Beneficiary change. This change will not take effect until recorded by Us at Our Home Office. Once recorded, the change will be effective as of the date the request was signed; but, this change will be subject to any payment or other action We took before recording it. Assignment This Policy may be assigned. We are not responsible for the validity of any assignment. When an assignment is filed with Us and We have recorded it at our Home Once. The Owner's right and those of any revocable Beneficiary will be subject to it. Any assignment is subject to any action taken by Us before We receive and record it. TERMINATION This Policy and any attached riders will Lapse on the earliest of the following: The end of the Grace Period of any unpaid premiums; When the Owner gives Us a written request to do so; The date of the Insured's death; or The Policy Expiration Date shown in the Policy Schedule. PAYMENT OF PROCEEDS Proof of Death All Proceeds payable because of the Insured's death will be paid when We receive sufficient proof of death. Appropriate forms for giving Us proof of death will be made available to the Beneficiary upon request. In no event will the Proceeds be paid later than two months following the date We receive sufficient proof of death. Premium Adjustment at Death Any portion of the paid premium which applies to a period beyond the date of the Insured's death will be added to the Proceeds of this Policy. Premiums waived under any waiver of premium rider attached to this Policy will not be included in this adjustment. Any Renewal premium which is due and unpaid at the time of death will be deducted from the Proceeds provided that death occurs within the Grace Period for such Renewal premium.
7 Lump Sum We will pay the Proceeds in a lump sum (cash) unless otherwise agreed. We will pay the benefits at Our Home Office. This Policy must be returned in to Us when We pay the benefit. In case there is more than one beneficiary listed on the policy and no specific instructions were provided to Us, We will split the benefits payment equally among all beneficiaries. Interest on Payment We will add interest to the Proceeds if it is not paid within 30 days after We receive due proof of the death of the Insured. We will figure the interest from the date of receipt of the Insured's dealt until the date of Our payment. The Interest rate will be 3% per year. Protection of Proceeds To the extent permitted by law no payment of Proceeds or interest will be subject to the claims of any creditors of the Beneficiary or to any legal process against the Beneficiary. GENERAL PROVISIONS Entire Policy The contract between the Owner and Us includes this Policy, the Policy Application and any riders or endorsements attached to this Policy by Us. This Policy is issued in return for the Application and the first premium. All statements made in the Application, in the absence of fraud, are representations and not warranties. We cannot use any statement to invalidate this Policy or to defend against a claim unless that statement is contained in the Application. We can only make changes to this Policy if the Owner agrees. Only Our President or any of Our Vice Presidents, Secretaries, or Assistant Secretaries can change or waive the terms of this Policy. No sales agent or any other person can do so. Any changes must be in writing and signed by one of these officers. Incontestability We cannot use any statement to invalidate this Policy or to defend against a claim unless that statement is contained in the Application. The policy shall be incontestable after having been in force during lifetime of each insured for a period of two (2) full years from date of issue or six months from any date of reinstatement thereof except for the failure of the Insureds to pay the specified premiums when due or within the grace period allowed. Any reinstatement for which We require an application showing insurability will be incontestable after this Policy has been in force during the Insured's lifetime for two years from the effective date of reinstatement. Any contest of a reinstatement will be based on material misrepresentation the reinstatement application. Suicide If the Insured, whether sane or insane, dies by suicide or self-destruction within two years from the Effective Date, this Policy and any attached riders will terminate and Our liability will be limited to a refund of the amount equal to the premiums paid for this Policy and any attached riders.
8 If the Insured, whether sane or Insane, dies by suicide or self-destruction within two years from the effective date of reinstatement, our liability will be limited to a refund of the amount equal to the premiums paid since the effective date of reinstatement. War Exclusion If the Insured dies as a result, directly or indirectly, of war, declared or undeclared; of action by military forces; of any act or hazard of such war or action; of service in the military, naval, or air forces or in civilian forces auxiliary thereto; or from any cause while a member of such military, naval or air forces of any country at war, declared or undeclared, of any country engaged in such military action; Our liability will be limited to a refund of the amount equal to the premiums paid for this Policy and any attached riders. Misstatement of Age If Your Age was misstated in the Application, this Policy's benefits will be changed to those the premium paid would have provided for the correct Age. If the correct Age exceeded Our maximum Age for issuing this Policy, all premiums paid without interest will be returned as full settlement of Our liability. Physical Examination and Autopsy We have the right, at Our expense, to have the Insured examined by physicians when reasonably necessary and to have an autopsy performed when it is not prohibited by law. A claim must be pending. Conformity With State Statutes The law of Your State of residence applies. If this Policy conflicts with Your State's laws on the Effective Date, it is considered changed to meet those laws. The change will be to the law's minimum requirement. Basis of Reserves Reserves are calculated: On the basis of the Commissioner's 2001 Standard Ordinary Mortality Table, age last birthday and the Reserve Interest Rate shown in the Policy Schedule; Calculated according to the Commissioner's Reserve Valuation Method; and On the assumption that the death benefit is paid immediately upon Death. Non Participation This Policy will not participate in any surplus distribution We may make. Terms of Coverage The initial term of this Policy begins on the Effective Date shown in the Policy Schedule at 12:00, noon, Standard Time of the place where the Owner then resides and ends at 12:00, noon, Standard Time of the place where the Owner then resides on the date specified in the Termination provision. Premiums payable during the lifetime of the Insured until Policy expiration or until the death of the Insured Nonparticipating Policy
9 IMPORTANT INFORMATION ABOUT COVERAGE UNDER THE TEXAS LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION (For insurers declared insolvent or impaired on or after September 1, 2011) Texas law establishes a system to protect Texas policyholders if their life or health insurance company fails. The Texas Life and Health Insurance Guaranty Association ( the Association ) administers this protection system. Only the policyholders of insurance companies that are members of the Association are eligible for this protection which is subject to the terms, limitations, and conditions of the Association law. (The law is found in the Texas Insurance Code, Chapter 463.) It is possible that the Association may not protect all or part of your policy because of statutory limitations. Eligibility for Protection by the Association When a member insurance company is found to be insolvent and placed under an order of liquidation by a court or designated as impaired by the Texas Commissioner of Insurance, the Association provides coverage to policyholders who are: Residents of Texas (regardless of where the policyholder lived when the policy was issued) Residents of other states, ONLY if the following conditions are met: 1. The policyholder has a policy with a company domiciled in Texas; 2. The policyholder s state of residence has a similar guaranty association; and 3. The policyholder is not eligible for coverage by the guaranty association of the policyholder s state of residence. Limits of Protection by the Association Accident, Accident and Health, or Health Insurance: For each individual covered under one or more policies: up to a total of $500,000 for basic hospital, medical-surgical, and major medical insurance, $300,000 for disability or long term care insurance, or $200,000 for other types of health insurance. Life Insurance: Net cash surrender value or net cash withdrawal value up to a total of $100,000 under one or more policies on a single life; or Death benefits up to a total of $300,000 under one or more policies on a single life; or Total benefits up to a total of $5,000,000 to any owner of multiple non-group life policies. Individual Annuities: Present value of benefits up to a total of $250,000 under one or more contracts on any one life. Group Annuities: Present value of allocated benefits up to a total of $250,000 on any one life; or Present value of unallocated benefits up to a total of $5,000,000 for one contractholder regardless of the number of contracts. Aggregate Limit: $300,000 on any one life with the exception of the $500,000 health insurance limit, the $5,000,000 multiple owner life insurance limit, and the $5,000,000 unallocated group annuity limit. These limits are applied for each insolvent insurance company. Insurance companies and agents are prohibited by law from using the existence of the Association for the purpose of sales, solicitation, or inducement to purchase any form of insurance. When you are selecting an insurance company, you should not rely on Association coverage. For additional questions on Association protection or general information about an insurance company, please use the following contact information. Texas Life and Health Insurance Guaranty Association Texas Department of Insurance 515 Congress Avenue, Suite 1875 P.O. Box Austin, Texas Austin, Texas or or
THIS IS AN EXACT COPY OF YOUR POLICY EXCEPT FOR YOUR SPECIFIC INFORMATION SUCH AS NAME, ADDRESS, COVERAGE, AND PREMIUMS
American Century Life Insurance Company of Texas (a stipulated premium company) Phone (855) 966-1111, Fax (855) 855-0181 THIS IS AN EXACT COPY OF YOUR POLICY EXCEPT FOR YOUR SPECIFIC INFORMATION SUCH AS
More informationqueja: 1-800-955-7736 1-800-328-4090 1-800-252-3439 1-800-252-3439
IMPORTANT NOTICE To obtain information or make a complaint: AVISO IMPORTANTE Para obtener información o para someter una queja: You may call ReliaStar Life's toll-free telephone number for information
More informationGROUP ANNUITY CONTRACT
. Home Office: Administrative Office: 2000 Heritage Way 5910 Mineral Point Road Waverly, IA 50677 Madison, WI 53705 Phone: 800.798.6600 Phone: 800.999.8786 GROUP ANNUITY CONTRACT This Group Annuity Contract
More informationFORT DEARBORN LIFE Insurance Company
FORT DEARBORN LIFE Insurance Company (A stock life insurance company herein called "We", "Us", "Our") Chicago, Illinois Administrative Office: 2400 Lakeside Blvd. Richardson, TX 75082-7399 Policyholder:
More informationADVANTAGE ELITE SELECT TERM POLICY
ADVANTAGE ELITE SELECT TERM POLICY LEVEL GUARANTEE TERM INSURANCE Face Amount payable at death during the term period Premiums as stated on the Policy Information Page Conversion Privilege Renewal Privilege
More informationYOUR GROUP LIFE INSURANCE PLAN
YOUR GROUP LIFE INSURANCE PLAN For Employees of City of Laredo 6CC000 B-14330 (05-14) CONTENTS CERTIFICATION PAGE............................................. 2 SCHEDULE OF BENEFITS...........................................
More informationGroup Term Life Insurance
Group Term Life Insurance Certificate of Insurance for Retiree CITY OF AUSTIN F019127-0001 Class 1-02 Products and services marketed under the Dearborn National brand and the star logo are underwritten
More informationTerm Life Insurance. Retiree Benefit Booklet CITY OF HOUSTON F019122-0001. Class 1-02A and 1-02B
Term Life Insurance Retiree Benefit Booklet CITY OF HOUSTON F019122-0001 Class 1-02A and 1-02B Products and services marketed under the Dearborn National brand and the star logo are underwritten and/or
More informationWORKERS' COMPENSATION NOTICE THE INSURANCE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS' COMPENSATION INSURANCE.
The Lincoln National Life Insurance Company A Stock Company Home Office Location: Fort Wayne, Indiana Group Insurance Service Office: 8801 Indian Hills Drive, Omaha, NE 68114-4066 (402) 361-7300 CERTIFIES
More informationVoluntary Term Life Insurance
Voluntary Term Life Insurance Employee Benefit Booklet City of San Antonio GFZ03414-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are underwritten and/or
More informationBanner Life Insurance Company. 3275 Bennett Creek Avenue. Frederick, Maryland 21704. 800-638-8428. [Jane Doe], or subsequently changed by the Owner
RENEWABLE AND CONVERTIBLE TERM LIFE INSURANCE. Banner Life Insurance Company. 3275 Bennett Creek Avenue. Frederick, Maryland 21704. 800-638-8428 Insured - [John Doe] Face Amount - [$1,000,000] Policy Number
More informationAMERICAN GENERAL LIFE Insurance Company. 2727-A Allen Parkway, Houston, Texas 77019 1-800-487-5433
AMERICAN GENERAL LIFE Insurance Company 2727-A Allen Parkway, Houston, Texas 77019 1-800-487-5433 American General Life Insurance Company, a stock Company, referred to in this Policy as We/Us/Our, will
More informationYOUR EMPLOYEE BENEFIT PLAN
YOUR EMPLOYEE BENEFIT PLAN Retirement Life Insurance Program Catholic Diocese of Cleveland 1404 East Ninth Street, 8 th Floor Cleveland, OH 44114-2570 (216) 696-6525 TO OUR RETIRED EMPLOYEES: All of us
More informationMissouri State University
Group Life Insurance Certificate Missouri State University IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationYOUR BENEFIT PLAN. University of Louisville
YOUR BENEFIT PLAN University of Louisville Class 2: Employees who retired with 7 or more years of service with the Employer who have attained age 60 or Retired Employees with 7 or more years of service
More informationNew York University. Full Time Active Faculty (100), Administrative and Professional Staff (102) and Professional Research Staff (103)
New York University Full Time Active Faculty (100), Administrative and Professional Staff (102) and Professional Research Staff (103) Employee Term Life Coverage Basic and Optional Plans Dependents Term
More informationBaylor University Policy No. 24220
Baylor University Policy No. 24220 Certificate for Baylor University Supplementary Contract providing Dependents Group Life Insurance Benefits This certificate becomes a part of, and should be attached
More informationMissouri State University
Group Life Insurance Certificate Missouri State University IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationCERTIFICATE OF INSURANCE. HARTFORD LIFE INSURANCE COMPANY Hartford, Connecticut
LIFE INSURANCE CERTIFICATE OF INSURANCE HARTFORD LIFE INSURANCE COMPANY Hartford, Connecticut Policy Number: Policyholder: AGL-1566 Professional Golfers' Association of America We have issued a Policy
More informationYOUR GROUP INSURANCE PLAN BENEFITS NORTH EAST INDEPENDENT SCHOOL DISTRICT EMPLOYEES
YOUR GROUP INSURANCE PLAN BENEFITS NORTH EAST INDEPENDENT SCHOOL DISTRICT EMPLOYEES The enclosed certificate is intended to explain the benefits provided by the Plan. It does not constitute the Policy
More informationIn this policy you, your and yours refer to the Owner of this policy and the Company, us, we and our refer to Reserve National Insurance Company.
In this policy you, your and yours refer to the Owner of this policy and the Company, us, we and our refer to Reserve National Insurance Company. INSURING AGREEMENT WE WILL PAY the benefits provided in
More informationGroup Life Insurance Certificate. Marion County - Oregon
Group Life Insurance Certificate Marion County - Oregon IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationTerm Life and AD&D Insurance
Term Life and AD&D Insurance Employee Benefit Booklet GATESVILLE ISD FFGA161T-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are underwritten and/or
More informationAssociation of Universities for Research in Astronomy (AURA) NOAO/Gemini
Group Life Insurance Certificate Association of Universities for Research in Astronomy (AURA) NOAO/Gemini IMPORTANT NOTICES If you reside in one of the following states, please read the important notices
More informationEmployee Card Misuse Protection
The following Employee Card Misuse Protection is not available for residents of Puerto Rico and U.S. Virgin Islands. Employee Card Misuse Protection DESCRIPTION OF COVERAGE Underwritten by AMEX Assurance
More informationC & A Industries, Inc.
Group Life Insurance Certificate C & A Industries, Inc. IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationLife Insurance - Accelerated Benefits, Death Benefit and Performance
Group Life Insurance Certificate Associated Regional and University Pathologists, Inc. IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona,
More informationUNITED HEALTHCARE INSURANCE COMPANY CERTIFICATE OF COVERAGE FOR
UNITED HEALTHCARE INSURANCE COMPANY GROUP VISION CARE INSURANCE CERTIFICATE OF COVERAGE FOR MATTRESS FIRM, INC. GROUP NUMBER - 704140 Effective Date: October 1, 2008 Offered and Underwritten by UNITED
More informationHARRIS COUNTY AND HARRIS COUNTY FLOOD CONTROL DISTRICT
Term Life Insurance Retiree Benefit Booklet HARRIS COUNTY AND HARRIS COUNTY FLOOD CONTROL DISTRICT F019139-0001 Class 1-02 Products and services marketed under the Dearborn National brand and the star
More informationWORKERS' COMPENSATION NOTICE THE INSURANCE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS' COMPENSATION INSURANCE
The Lincoln National Life Insurance Company A Stock Company Home Office Location: Fort Wayne, Indiana Group Insurance Service Office: 8801 Indian Hills Drive, Omaha, NE 68114-4066 (402) 361-7300 CERTIFIES
More informationNorthwestern Michigan College
Group Life Insurance Certificate Northwestern Michigan College IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationBASIC AND OPTIONAL GROUP TERM LIFE INSURANCE AND DEPENDENTS TERM LIFE INSURANCE FOR UNION EMPLOYEES
BASIC AND OPTIONAL GROUP TERM LIFE INSURANCE AND DEPENDENTS TERM LIFE INSURANCE FOR UNION EMPLOYEES Office of Human Resources Disclosure Notice FOR ARKANSAS RESIDENTS Prudential s Customer Service Office:
More informationCERTIFIES THAT Group Policy No. 000010180461 has been issued to. Fort Bend Independent School District (The Group Policyholder)
The Lincoln National Life Insurance Company A Stock Company Home Office Location: Fort Wayne, Indiana Group Insurance Service Office: 8801 Indian Hills Drive, Omaha, NE 68114-4066 (402) 361-7300 CERTIFIES
More informationThe Lincoln National Life Insurance Company (the "Company") A Stock Company
Lincoln MoneyGuard II Sample Interstate Compact policy Issue State Alabama The Lincoln National Life Insurance Company (the "Company") A Stock Company Home Office: Service Office: State of Issue Department
More informationCANADA PROTECTION PLAN SAMPLE POLICY
CANADA PROTECTION PLAN SAMPLE POLICY Policy underwritten by Foresters Life Insurance Company The following sample policy pages are provided for reference only. They may be incomplete and/or may not reflect
More informationVoluntary Term Life Insurance
Voluntary Term Life Insurance Employee Benefit Booklet CITY OF EULESS, TEXAS GAE10183-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are underwritten
More informationUMBRELLA POLICY PACKET. RACHEL J LAWRENCE November 25, 2011 7701 WURZBACH RD APT 1701 SAN ANTONIO TX 78229-4432. Important Messages
JUM1392 00000 DM00000 UMBRELLA POLICY PACKET RACHEL J LAWRENCE November 25, 2011 7701 WURZBACH RD APT 1701 SAN ANTONIO TX 78229-4432 Effective: 01/01/2012 to 01/01/2013 GAR 01085 52 74 71U Important Messages
More informationTerm Life Insurance. Employee Benefit Booklet CITY OF HOUSTON F019122-0001. Class 1-01
Term Life Insurance Employee Benefit Booklet CITY OF HOUSTON F019122-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are underwritten and/or provided
More informationYOUR GROUP LIFE INSURANCE PLAN
YOUR GROUP LIFE INSURANCE PLAN For Employees of County of El Paso 6CC000 B-10312 (06-14) CONTENTS CERTIFICATION PAGE............................................. 2 SCHEDULE OF BENEFITS...........................................
More informationTRANSAMERICA LIFE INSURANCE COMPANY Home Office: [4333 Edgewood Road NE, Cedar Rapids, IA 52499] A Stock Company
TRANSAMERICA LIFE INSURANCE COMPANY Home Office: [4333 Edgewood Road NE, Cedar Rapids, IA 52499] A Stock Company Subject to the provisions of this Certificate and receipt of due proof of the Insured s
More informationTHIS IS AN ACCIDENTAL DEATH AND REPATRIATION ONLY POLICY
COMMERCIAL ALLIANCE INSURANCE COMPANY 415 LOCKHAVEN DRIVE HOUSTON, TEXAS 77073 POLICY OF INSURANCE CAIC/A&H00004 REPATRIATION INSURANCE THIS IS AN ACCIDENTAL DEATH AND REPATRIATION ONLY POLICY CAIC/A&H00004
More informationLife Insurance - Continuation and Conversion Under the Group Policy
YOUR BENEFIT PLAN Austin Independent School District Employees Retired Prior to September 1, 2013 and Named on the Certificate of Insurance, Page 1 ( fp) Supplemental Life Insurance Certificate Date: September
More informationYOUR BENEFIT PLAN. Reform Pension Board Class 3
YOUR BENEFIT PLAN Reform Pension Board Class 3 Basic Life Insurance Effective May 17, 2006 Reform Pension Board 355 Lexington Avneue, 18th Floor New York, NY 10017 TO OUR EMPLOYEES: All of us appreciate
More informationGROUP TERM LIFE INSURANCE FOR FACULTY / STAFF
GROUP TERM LIFE INSURANCE FOR FACULTY / STAFF Office of Human Resources Disclosure Notice FOR ARKANSAS RESIDENTS Prudential s Customer Service Office: The Prudential Insurance Company of America Prudential
More informationGroup Life Insurance Certificate
Group Life Insurance Certificate Drury University IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents: The
More informationTen Year Term Life Insurance Renewable Term
Ten Year Term Life Insurance Renewable Term Premiums are Guaranteed for the Life of the Contract Convertible Non-Participating Western Life Assurance Company P.O. Box 3300 Winnipeg, Manitoba R3C 5S2 A
More informationTRANSAMERICA LIFE INSURANCE COMPANY Home Office: 4333 Edgewood Road NE, Cedar Rapids, Iowa 52499 A Stock Company
TRANSAMERICA LIFE INSURANCE COMPANY Home Office: 4333 Edgewood Road NE, Cedar Rapids, Iowa 52499 A Stock Company Policyholder: Policy Number: National Rural Letter Carriers Association T20029572 Policy
More informationTexas and governed by its laws, unless otherwise preempted by federal law.
Union Security Insurance Company agrees to provide the insurance described in this and the following pages of the policy, subject to payment of premiums. Policyholder: Community Health Service Agency,
More informationGuaranteed Issue Whole Life Sample Contract. General Provisions
Guaranteed Issue Whole Life Contract General Provisions The contract takes effect on the Policy Date shown in the Benefit and Premium Information Schedule only if the policy has been delivered to the Insured
More informationNotice of Protection Provided by Utah Life and Health Insurance Guaranty Association
Notice of Protection Provided by Utah Life and Health Insurance Guaranty Association This notice provides a brief summary of the Utah Life and Health Insurance Guaranty Association ( the Association )
More informationYOUR BENEFIT PLAN UNITY HEALTH SYSTEM. Basic Term Life, Supplemental Dependent Life, Supplemental Term Life
YOUR BENEFIT PLAN UNITY HEALTH SYSTEM Basic Term Life, Supplemental Dependent Life, Supplemental Term Life Questions about Your Coverage In the event You have questions regarding any aspect of Your coverage,
More informationAetna Life Insurance Company Hartford, Connecticut 06156
Aetna Life Insurance Company Hartford, Connecticut 06156 Amendment (GR-8-CR1) Policyholder: Choctaw Enterprises Group Policy No.: GP- 819977 Rider: Texas ET Dental Issue Date: March 31, 2010 Effective
More informationGroup Life Insurance Certificate
Group Life Insurance Certificate Wesleyan University IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents: The
More informationLevel Premium Whole Life Policy. Dear [John Doe], Your MetLife Policy
Level Premium Whole Life Policy [January 1, 2013] [John M Doe 1 Golden Street Somewhere, CA 90210] MetLife Investors USA Insurance Company Designated Office: [1300 Hall Boulevard Bloomfield, CT 06002 1-800-MET-5000
More informationGroup Life Insurance Certificate
Group Life Insurance Certificate Indiana University IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents: The
More informationDisclosure Notice For Prudential - Supplemental Member Term Life Insurance
Supplemental Member Term Life and Dependent Term Life Insurance Sponsored by Union Benefits Trust Group Contract No. 01049 Insured by The Prudential Insurance Company of America Prudential Group Life Insurance
More informationThe Beneficiaries, Total Premium and Premium Payment Frequency shown are as of the Policy Summary date at the top of this page.
Policy Summary This Policy Summary is dated When your insurance contract renews or if you make a change to your insurance contract that affects the Total Premium, we will send you a new Policy Summary.
More informationMINNESOTA REQUIREMENTS, LIFE INSURANCE GROUP
Edition: 11/2010 MINNESOTA REQUIREMENTS, LIFE INSURANCE GROUP I. Minnesota Specific Requirements to be Included in Life Insurance Policies The following are the requirements that the department analysts
More informationUTAH STATE UNIVERSITY
YOUR BENEFIT PLAN UTAH STATE UNIVERSITY Basic Dependent Life, Basic Term Life, Supplemental Dependent Life, Supplemental Term Life, Basic Accidental Death and Dismemberment Questions or Complaints about
More informationYOUR BENEFIT PLAN FAIRLEIGH DICKINSON UNIVERSITY. Supplemental Dependent Life, Supplemental Term Life, Supplemental Accidental Death and Dismemberment
YOUR BENEFIT PLAN FAIRLEIGH DICKINSON UNIVERSITY Supplemental Dependent Life, Supplemental Term Life, Supplemental Accidental Death and Dismemberment Questions about Your Coverage In the event You have
More informationSAMPLE. means the age of a Life Insured on his or her nearest birthday.
DEFINITIONS The following are definitions of some of the terms used in your Equimax Whole Life policy. If you need additional information or clarification please call one of our Individual Customer Service
More informationHarlandale Independent School District. Your Group Life Insurance Plan
Harlandale Independent School District Your Group Life Insurance Plan Identification No. 498203 011 Underwritten by Unum Life Insurance Company of America 2/10/2014 CERTIFICATE OF COVERAGE Unum Life Insurance
More informationHow To Get A Life Insurance Plan In The United States
Tenet Healthcare Corporation Your Group Life and Accidental Death and Dismemberment Plan Identification No. 546864 012 Underwritten by Unum Life Insurance Company of America 5/7/2014 CERTIFICATE OF COVERAGE
More informationGroup Life Insurance Certificate
Group Life Insurance Certificate City of Casper Retirees IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and Maryland residents:
More informationYOUR BENEFIT PLAN NEW YORK MEDICAL COLLEGE
YOUR BENEFIT PLAN NEW YORK MEDICAL COLLEGE Basic Term Life, Supplemental Dependent Life, Supplemental Term Life, Basic Accidental Death and Dismemberment Questions or Complaints about Your Coverage In
More informationEquimax Participating Whole Life Insurance. (For Adults) Optional Riders
Equimax Participating Whole Life Insurance (For Adults) Optional Riders Additional Accidental Death Benefit 1 Disability Waiver of Premium Rider. 3 Children s Protection Rider 6 Guaranteed Insurability
More informationGROUP TERM LIFE INSURANCE
GROUP TERM LIFE INSURANCE Waunakee School District Waunakee, WI Teachers of Wisconsin, Inc. MADISON NATIONAL LIFE INSURANCE COMPANY, INC. Mailing Address: P.O. Box 5008, Madison, Wisconsin 53705 (HEREIN
More information**** READ YOUR CERTIFICATE CAREFULLY ****
P.O. Box 27626 Raleigh, NC 27611-7626 FAT CAT AND ZARD GROUP TERM LIFE INSURANCE CERTIFICATE OF INSURANCE Policyholder: Policy Number: North Carolina Press Association Federal Credit Union 000000004S Issue
More informationVoluntary Short-Term Disability Insurance
Voluntary Short-Term Disability Insurance Employee Benefit Booklet The University of Texas System Group Number: GFZ71778-0001 Class 1-01 Products and services marketed under the Dearborn National brand
More informationSAMPLE DEFINITIONS. means the age of a Life Insured on his or her nearest birthday.
DEFINITIONS The following are definitions of some of the terms used in your Equitable Life Term Life Insurance policy. If you need additional information or clarification please call one of our Individual
More informationSAMPLE DEFINITIONS. means the age of a Life Insured on his or her nearest birthday.
DEFINITIONS The following are definitions of some of the terms used in your Equitable Life Term Life Insurance policy. If you need additional information or clarification please call one of our Individual
More informationKanawha Insurance Company Post Office Box 610 210 South White Street Lancaster, South Carolina, 29721-0610
Kanawha Insurance Company Post Office Box 610 210 South White Street Lancaster, South Carolina, 29721-0610 IMPORTANT INFORMATION ABOUT COVERAGE UNDER THE TEXAS LIFE, ACCIDENT, HEALTH AND HOSPITAL SERVICE
More informationWal-Mart Stores, Inc. Associate Term Life Coverage Basic and Optional Plans Dependents Term Life Coverage Accidental Death and Dismemberment Coverage
Wal-Mart Stores, Inc. Associate Term Life Coverage Basic and Optional Plans Dependents Term Life Coverage Accidental Death and Dismemberment Coverage Disclosure Notice FOR ARKANSAS RESIDENTS Prudential
More informationMAIL LABEL. Agent: XXXXX XXXXX. Policy Number:
MAIL LABEL Agent: Policy Number: Insured: Owner: DATE: May 6, 2013 CANADA PROTECTION PLAN Underwritten by Foresters Life Insurance Company Life Insured Policy Owner Policy Number Policy Date Simplified
More informationGroup Basic Life Insurance Certificate
Group Basic Life Insurance Certificate City of Santa Cruz Fire Unit Employee IMPORTANT NOTICES If you reside in one of the following states, please read the important notices below: Arizona, Florida and
More informationPENNSYLVANIA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION ACT NOTICE
PENNSYLVANIA LIFE AND HEALTH INSURANCE GUARANTY ASSOCIATION ACT NOTICE Residents of Pennsylvania who purchase life insurance, annuities or health insurance should know that the insurance companies licensed
More informationC.B. FLEET COMPANY, INC.
C.B. FLEET COMPANY, INC. Exempt, Non-exempt and Hourly Employees in Grade Level 9 and Below Employee Term Life Coverage Basic and Optional Plans Disclosure Notice FOR ARKANSAS RESIDENTS Prudential s Customer
More informationIMPORTANT NOTICE. To obtain information or make a complaint you may contact your managing general agent at: 1-855-808-7785
Managing General Agent for: Lyndon Southern Insurance Company A Stock Company Jacksonville, FL TEXAS PERSONAL AUTO POLICY For claims call 1-888-224-7740 Para reclamos hable al 1-888-224-7740 Pronto General
More informationCERTIFICATE OF INSURANCE. We agree to pay the benefits provided by the Group Policy according to all its conditions and provisions.
INVESTORS HERITAGE LIFE INSURANCE COMPANY 200 Capital Avenue, Frankfort, KY 40601 (800) 422-2011 (Referred to in the Group Policy as the Company, We, Us, Our) CERTIFICATE OF INSURANCE We agree to pay the
More informationThe Regents of the University of California
The Regents of the University of California Employee Term Life Coverage Basic, Core and Supplemental Plans Dependents Term Life Coverage Basic and Expanded Plans Disclosure Notice FOR ARKANSAS RESIDENTS
More informationCertifies that it has issued the group insurance policy shown below and, subject to the terms of that policy you, the Insured, are eligible.
COMPANION LIFE INSURANCE COMPANY 7909 PARKLANE ROAD, SUITE 200, COLUMBIA, SC 29223-5666 PO Box 100102, Columbia, SC 29202-3102 (803) 735-1251 (Herein called Companion Life) Certifies that it has issued
More informationYOUR BENEFIT PLAN THE DOW CHEMICAL COMPANY. Rohm and Haas Company Electronic Materials Retirees
NOTICE TO INSUREDS READ THIS NOTICE CAREFULLY BEFORE ACCESSING THE FOLLOWING INFORMATION. MetLife is providing this electronic document describing the insurance benefits provided for in your certificate
More informationYOUR BENEFIT PLAN. The Ohio State Highway Patrol. All Active Full-Time Employees and Retirees
YOUR BENEFIT PLAN The Ohio State Highway Patrol All Active Full-Time Employees and Retirees Supplemental Life Insurance Dependent Life Insurance Certificate Date: May 1, 2012 The Ohio State Highway Patrol
More informationCONSIDERATION. This Policy is issued in consideration of the Application for this Policy and the payment of the Initial Premium.
Genworth Life Insurance Company (Hereinafter referred to as the Company ) A Stock Company State of Domicile: Delaware Home Office: [6610 West Broad Street, Richmond, VA 23230] Service Center Address: [3100
More informationRoman Catholic Diocese of Dallas. Your Group Life Insurance Plan
Roman Catholic Diocese of Dallas Your Group Life Insurance Plan Identification No. 467788 011 Underwritten by Unum Life Insurance Company of America 12/16/2014 CERTIFICATE OF COVERAGE Unum Life Insurance
More informationI injuries and Social Security Disability Insurance
GUARANTEE TRUST LIFE INSURANCE COMPANY 1275 Milwaukee Avenue Glenview, Illinois 60025 CERTIFICATE OF INSURANCE This is Your Certificate of Insurance (Certificate) while You are insured. It briefly explains
More informationNew York Life Insurance Company
New York Life Insurance Company A Mutual Company Founded in 1845 51 Madison Avenue, New York, NY 10010 GROUP LEVEL TERM LIFE AND DEPENDENT LIFE INSURANCE TO AGE 80 WITH CONTRIBUTIONS EXPECTED, BUT NOT
More informationWORKERS' COMPENSATION NOTICE THE INSURANCE POLICY UNDER WHICH THIS CERTIFICATE IS ISSUED IS NOT A POLICY OF WORKERS' COMPENSATION INSURANCE.
The Lincoln National Life Insurance Company A Stock Company Home Office Location: Fort Wayne, Indiana Group Insurance Service Office: 8801 Indian Hills Drive, Omaha, NE 68114-4066 (402) 361-7300 CERTIFIES
More informationGroup Term Life and AD&D Insurance
Group Term Life and AD&D Insurance Certificate of Insurance for Employee CITY OF AUSTIN F019127-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are underwritten
More informationFamily Term Sample contract
Family Term contract This sample policy contract is provided for your information only. It is not a valid contract or an offer of insurance. (9/17/2015) Dear Policy Owner, We re pleased to provide you
More informationDental Certificate of Insurance Meridian & ValueChoice
Underwritten by SafeHealth Life Insurance Company Dental Certificate of Insurance Meridian & ValueChoice This certificate contains a deductible provision. 1 Important Information Regarding Your Plan Important
More informationAnthem Life & Disability Insurance Company
Anthem Life & Disability Insurance Company Basic Group Term Life Insurance You ve made a good decision in choosing Anthem Life Plan Sponsor: North Colonie Central School District Policy: NY0175 Class:
More informationName of Policyholder: ARCHDIOCESE OF ST. LOUIS. of each policy month
AMENDMENT TO GROUP POLICY GL-677885 PROCESSED ON APRIL 16, 2010. ANY CHANGES BETWEEN THIS POLICY AND THE PREVIOUSLY ISSUED POLICY ARE EFFECTIVE JULY 1, 2010. ALL OTHER TERMS, CONDITIONS AND DATES REMAIN
More informationYOUR EMPLOYEE BENEFIT PLAN
YOUR EMPLOYEE BENEFIT PLAN Group Life Insurance Plan For Active Employees Catholic Diocese of Cleveland 1404 East Ninth Street, 8 th Floor Cleveland, Ohio 44114-2570 (216) 696-6525 TO OUR EMPLOYEES: All
More informationMetropolitan Life Insurance Company 200 Park Avenue, New York, New York 10166
Metropolitan Life Insurance Company 200 Park Avenue, New York, New York 10166 Certifies that, under and subject to the terms and conditions of the Group Policy issued to the Policyholder, coverage is provided
More informationTerm Life Insurance. Employee Benefit Booklet. THE UNIVERSITY OF TEXAS SYSTEM Group Number: GFZ71778-0001 Class 1-01
Term Life Insurance Employee Benefit Booklet THE UNIVERSITY OF TEXAS SYSTEM Group Number: GFZ71778-0001 Class 1-01 Products and services marketed under the Dearborn National brand and the star logo are
More informationONE YEAR TERM INSURANCE RIDER WITH TARGET FACE AMOUNT
ONE YEAR TERM INSURANCE RIDER WITH TARGET FACE AMOUNT While this rider is in force, any dividend credited to this policy will be used to purchase a combination of one year term insurance (OYT) and Dividend
More information