Underwriting & Approval -

This LifeRing Group Term Life and 10 Year Level Premium Term Insurance Plans are underwritten by

These Plans are medically underwritten based on the information you provide on your Group Term Life or Ten Year Level Premium Term enrollment form(s) and possible additional medical information as indicated below. It is important that you complete your Form truthfully and completely.

In some cases, New York Life may request a physical exam, EKG, or blood test during the underwriting process. Often this can be conducted at your convenience in your office or at home. (There is no charge to you for the exam and blood test.) You also may be asked to provide clarifying information relating to your medical history and answers on your application.

We suggest you read this coverage description carefully and compare it to the other similar plans to assure that it meets your criteria for coverage.

Your Credit Union incurs costs in providing oversight and administrative support for this sponsored plan. To provide and maintain this valuable benefit, it is reimbursed for these costs. The sponsoring Credit Union also receives a fee in connection with the Plan, which is applied to help support all member services for your Credit Union.

If you have questions ... or would like assistance in completing your Group Term Life or Ten Year Level Premium Term enrollment form(s)... call toll free: 1 800 223-8646 weekdays between 8 a.m. and 5:00 p.m., Central Time.

New York Life and Aon are licensed to transact business in the 50 United States, the District of Columbia and Canada. The plan is not available in Oregon and Quebec, Canada.

Residents of Florida: Thomas D. Roebig is a licensed Florida agent for service of Florida residents.

Residents of California: Aon is domiciled in Illinois at 123 North Wacker Drive, Chicago Illinois 60606 and is licensed in California under #0763901.

Information regarding insurability will be treated as confidential. In considering whether the persons in your request for insurance qualify for coverage, we will rely on the medical information you provide, and on the information you authorize us to obtain from your doctor, other medical practitioners and facilities, and other insurance companies to which you have applied for insurance and MIB, Inc. (Medical Information Bureau). New York Life will not disclose such information to anyone except those you authorize or where required by law. We may make a brief report to MIB; however, we will not disclose our underwriting decision. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information we will make a determination as to whether your request for insurance can be approved. MIB is a nonprofit membership organization of life insurance companies which operates an information exchange on behalf of its members. When you apply for insurance or submit a claim for benefits to an MIB member company, medical or nonmedical information may be given to the Bureau, which may then be furnished to member companies. Upon written request to New York Life or MIB, you will be provided with non-medical information; medical information, however, will be given only to a physician you designate (except in certain jurisdictions where you may choose to receive medical information directly).The following also applies to residents of New Mexico: In addition, PROTECTED PERSONS¹ have a right of access to certain CONFIDENTIAL ABUSE INFORMATION² we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. If we cannot provide the coverage you request, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. For U.S. residents your request is handled in accordance with the Fair Credit Reporting Act procedures. MIB's information office is P.O. Box 105, Essex Station, Boston, MA 02112, telephone 617-426-3660.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean there is any insurance in force before the effective date is determined by New York Life. 4/96 ed

¹ Protected person means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.

² Confidential Abuse Information means information about: acts of domestic or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.

This description of the Plan is intended to be a brief outline of the coverage offered, and not a contract of insurance. Complete details on benefits and provisions are included in the Certificate of Insurance issued to each insured.

Your 30 - Day Free Look

If you are not 100% satisfied with the terms of your Insurance Certificate, you may return it without claim within 30 days. Any premiums you have paid will be refunded promptly and your insurance will be invalidated. You will have no further obligation of any kind.

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