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<br />'STANDARD INSURANCE COMPANY <br /> <br />A Mutual Life Insurance Company <br />900 SW Fifth Avenue <br />Portland, Oregon 97204-1282 <br />(503) 321-7000 <br /> <br />Dedicated to Excellence <br /> <br />GROUP LIFE INSURANCE POLICY <br /> <br />Policyowner: <br />Policy Number: <br />Effective Date: <br /> <br />ABC Company <br />SAMPLE - LI, AD&D, DLI, Sup. LI <br />Jtme 1, 1995 <br /> <br />The consideration for this Group Policy is the application of the Policyowner and the payment by the Policyowner of <br />premiums as provided herein. <br /> <br />Subject to the Policyowner Provisions and the Incontestability Provisions, this Group Policy (a) is issued for <br />the Initial Rate Guarantee Period shown in the Coverage Features, and (b) may be renewed for successive <br />renewal periods by the payment of the premium set by us on each renewal date. The length of each renewal period <br />will be set by us, but will not be less than 12 months. <br /> <br />For purposes of effective dates and ending dates tmder this Group Policy, all days begin and end at 12:00 midnight <br />Standard Time at the Policyowner's address. <br /> <br />This policy includes an Accelerated Benefit. The receipt of this benefit may be taxable and may affect <br />your eligibility for Medicaid or other government benefits or entitlements. You should consult your <br />personal tax and/or legal advisor before you apply for an Accelerated Benefit. . <br /> <br />All provisions on this and the following pages are part of this Group Policy. "You" and "your" mean the Member. <br />"'We", "us", and "our" mean Standard Insurance Company. Other defined terms appear with their initial letters <br />capitalized. Section headings, and references to them, appear in bold face type. <br /> <br />STANDARD INSURANCE COMPANY <br />By <br /> <br />~~Z~ <br /> <br />President <br /> <br />~w! d~ <br /> <br />Secretary <br /> <br />GPl90-UFE <br /> <br />* Prinud on recycled paper. <br />