CalSuranceE & O P r o g r a m S p e c i a l i s t s

RAgents of Lincoln Bene�t Life

Enrollment FormClaims Made & Reporting Errors & Omissions Coverage

Policy Period: July 1, 2009 to July 1, 2010By purchasing this insurance, agents become members of the Financial Sales Professionals Risk Purchasing Group, a group formed and operating pursuant to the Liability

Risk Retention Act of 1986 (15 USC 3901 et seq.). There is no additional charge for membership.

Brown & Brown of California, Inc. dba CalSurance Associates*(dba CalSurance Brokerage in New York) California License # 0B02587LBL_EF063009v9

Instructions........................ Complete ALL sections of this form and include your signature at the bottom. Return this form along with payment or Payment Authorization Form (if applicable) to: If Paying by Credit Card or ACH (Debit to Checking) please fax to: (800) 607-6875. If Mailing a check send to: Brown & Brown of California, Inc. dba CalSurance Associates*, P.O. Box 7048, Orange, CA 92863-7048Coverage Questions.............Call Brown & Brown of California, Inc. dba CalSurance Associates* at (800) 745-7189 or email at info@calsurance.comReminder...............................ALL sections must be completed. Incomplete forms will take additional time to process. Faxed forms take approximately 3-5 business days to process. Please allow up to ten (10) business days if mailed.Certificates of Insurance......Call CalSurance at (800) 745-7189 or Go on-line: www.calsurance.com - Certificate Reprinting - Sponsoring Group - Lincoln Benefit Life Company

Effective Date of Coverage

NOTICE: Effective date of coverage cannot be prior to your date of contract

with the sponsor and cannot be backdated to a prior month.

Limit of Liability: $1,000,000 Each CLaim / Aggregate $2,000,000 Each Claim / Aggregate $2,000,000 Each Claim / $3,000,000 Aggregate Coverage Level*: Tier I.......Excludes Securities Coverage Tier II......Includes Securities Coverage

* Please refer to the “Outline of Coverage” for coverage Tier details** Limitations, conditions and exclusions apply (See Specimen Policy for details).

(Rates are inclusive of a $15.00 non-refundable administration fee.)

Section 2 - Effective Date and Amount Due

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Enter amount from PREMIUM TABLE(included in this packet) which corresponds to the above selections:

$

Section 3 - Payment Options (Please select one)Check or Money Order

Payment in Full Only; No Installments

Payment in fullPayment in four (4) installments ($7.50 fee per installment)

Payment in fullPayment in four (4) installments ($7.50 fee per installment)

Debit to Checking (Please complete Payment Authorization Form)

Credit Card (Please complete Credit Card Information below)

NOTICE: If a payment option is not selected, the selection by default will be payment in FULL.

Please review the installment schedule (included within this enrollment packet) carefully. I authorize Brown & Brown of California, Inc. dba CalSurance Associates to process the installment charges according to the installment schedule included within this enrollment packet. If any of the scheduled installment dates are within 7 days of the date this enrollment form is processed, the amount due will be divided between the available installment dates. I also understand that if payment is declined, coverage shall terminate upon ten (10) day Notice of Cancellation. Payment may be made within the specified ten (10) day period along with a Decline Processing Fee of $50 to maintain coverage. Should payment be declined a second time, the entire amount due for the remainder of the policy period will be due in full within the specified ten (10) day period to maintain coverage.

(Billing through Brown & Brown of California, Inc., dba CalSurance Associates)Credit Card Information Discover Master Card VisaAccount #: (Please note, Debit Cards or American Express are not accepted!)

Expiration Date Cardholder’s Name

Cardholder’s Signature

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/

Section 4 - Representations and Warranties I understand and agree to the following: I must be a currently contracted agent with Lincoln Benefit Life Company (Sponsor). Otherwise, I may not be considered an insured under this policy, and claims made against me may not be covered. Should my contract with the sponsor terminate for any reason, coverage will continue until the end of the policy period provided that the premium is paid in full.

This is a claims made and reported policy. I have no knowledge of any pending claim or incident that could give rise to a claim under the proposed policy, and if any such claim exists, or knowledge or information exists and any claim or action arises there from, it is excluded from coverage for which this enrollment form applies. A potential gap in coverage may occur if I elect an effective date that is not continuous with my prior expiration date, and may result in denial of a claim.

Signature (Required) Date

Section 1 - Your Information (Please Print Clearly)

First Name Last Name

Mailing Address (if different than street address)

City Zip CodeState

Contact Phone Number Fax Number

E-mail

Street Address

(Select One)

(Select One)

For Faster Online Enrollment:www.calsurance.com/LBL

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- -Social Security Number (Required)

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CalSuranceE & O P r o g r a m S p e c i a l i s t s

RAgents of Lincoln Bene�t LifeErrors & Omissions Program

Outline of Coverage

Policy Period: July 1, 2009 to July 1, 2010

Issuing Carrier:Zurich American Insurance Company, an Admitted CarrierRated: A (XV) A.M. Best “The information obtained from A.M. Best dated December 11, 2008 is not in any way CalSurance’s warranty or guaranty of the financial stability of the insurer in question, and that the information is current only as of the date of the publication.”

Program Administrator:Brown & Brown of California, Inc. dba CalSurance(dba CalSurance Brokerage in New York)P. O. Box 7048, Orange, CA 92863-7048800-745-7189 Phone; 800-607-6875 FaxCA License #0B02587

Claims Administrator:Brown & Brown of California, Inc. dba Lancer Claims681 South Parker Street, Suite 200, Orange, CA 92868Phone: 800-821-0540

Insured (includes but is not limited to):1. The Agents and/or General Agents of Lincoln Benefit Life who have enrolled for coverage and have paid the appropriate premium for the coverage selected; 2. Any corporation, partnership or other business entity which engages in "Professional Services" and which is owned by the Insured Agent and then only with respect to those operations of the business entity related to the "Professional Services" provided by the Insured Agent;3. Any person acting on behalf of the Insured Agent, who was or is an employee of the Insured Agent or the Insured Agent’s business entity, or a partner, officer, director or stockholder of the Insured Agent’s business entity and then only with respect to "Professional Services" provided by the Insured Agent; and4. The heirs, executors, administrators or legal representatives of the Insured Agent In the event of death, incapacity or bankruptcy.

Coverage:The Company shall pay, subject to the deductible, Damages and Defense Costs from a Claim first made and reported in writing during the Certificate Period, or any applicable Extended Reporting Period, provided that:1. The Claim arises out of a negligent act, error or omission of an "Insured" rendering or failing to render "Professional Services" for others in the conduct of the Insured Agent’s profession as an Agent, General Agent, notary public, or Registered Representative; or 2. The Claim is for a Personal Injury caused by an offense arising out of rendering or failing to render "Professional Services" for others in the conduct of the Insured Agent’s profession identified above.

Professional Services (Includes but is not limited to):Tier I:• The sale or servicing of: a. Life insurance, accident and health insurance, long term care insurance, insurance workers’ compensation insurance as part of a 24-hour accident and health insurance product, disability income insurance and fixed annuities; or b. Single employer employee benefit plans funded with those products listed in a. above;• Financial planning, advice and consultation solely in connection with any of the products listed in a. and b. above

Tier II:Includes Tier I plus the following:• Financial Planner, Financial Consultant, Investment Counselor, Investment Advisor or Registered Investment Advisor services incidental to Tier I above.• The supervision and training by a General Agent over the conduct of any Insured.• The sale or servicing of: a. Variable annuities, flexible and scheduled premium annuities and variable life insurance; and b. Mutual funds registered with the Securities and Exchange Commission and sold by a Registered Representative through a Broker/Dealer registered with FINRA (formerly known as the NASD)/SEC, provided that the Insured Registered Representative has a contract with the Broker/Dealer at the time that the sale took place.

Limits Available (Defense Costs Outside Limits):$1,000,000 each Claim$1,000,000 aggregate each “Named Certificate Holder” OR$2,000,000 each Claim$2,000,000 aggregate each “Named Certificate Holder” OR$2,000,000 each Claim$3,000,000 aggregate each “Named Certificate Holder”No Policy Aggregate

Deductibles: (applicable to Damages Only) $ 500 each Claim for products of Lincoln Benefit LifeCompany$1,500 for all other covered products or services

Retroactive Date:The earlier of the inception date of the Insured Agent’s first: (1) claims made agent’s professional liability policy from which date coverage has been maintained in force without interruption; or (2) contract with Lincoln Benefit Life that has been maintained in force without interruption.

Extended Reporting Period: If a contract between an Insured Agent and the sponsor terminates during the Policy Period, coverage continues until the expiration date of the policy.

Automatic: If such contract termination occurs within 90 days of the end of the policy period, the Insured Agent shall have a free Automatic Extended Reporting Period from the end of the Policy Period until ninety (90) days after the date of contract termination to report in writing any Claim that is first made during such period and arises out of a negligent act, error or omission or Personal Injury which occurred before the end of the Policy Period and on or after the Retroactive Date. No coverage shall be provided in the event the Insured Agent has any other applicable insurance. This Automatic Extended Reporting Period shall be included within the Automatic Two (2) Year Extended Reporting Period below or the Optional Extended Reporting Period, if such is purchased.

Automatic (2-year Extended Reporting Period for Retirement, Disability or Death): If such contract termination is by reason of the Insured Agent’s retirement from the business of providing "Professional Services", total and permanent disability, or death, the Insured Agent shall have a free Automatic Extended Reporting Period from the end of the Policy Period until two (2) years after such termination date to report in writing any Claim which is first made during said Extended Reporting Period and arises out of a negligent act, error or omission or Personal Injury which occurred before the end of the Policy Period and on or after the Retroactive Date. No coverage shall be provided in the event the Insured Agent has any other applicable insurance. This Automatic Extended Reporting Period shall be included within the Optional Extended Reporting Period, if such is purchased.

Optional Extended Reporting Period: If such contract termination is by reason of the Insured Agent’s retirement from the business of providing "Professional Services", total and permanent disability, or death, an Optional Extended Reporting Period from:

a. the end of the Policy Period until three (3) years after such termination date to report in writing any Claim which is first made during said Extended Reporting Period and arises out of a negligent act, error or omission or Personal Injury which occurred before the end of the Policy Period and on or after the Retroactive Date may be purchased for an additional premium of 200% of the Insured Agent’s last annual premium within sixty (60) days of such date of termination; or

b. the end of the Policy Period until five (5) years after such termination date to report in writing any Claim which is first made during said Extended Reporting Period and arises out of a negligent act, error or omission or Personal Injury which occurred before the end of the Policy Period and on or after the Retroactive Date may be purchased for an additional premium of 300% of the Insured Agent’s last annual premium within sixty (60) days of such date of termination.

This document is a summary of the coverage provided. All statements contained herein are subject to all terms, Conditions

and Exclusions of the actual policy. A copy of the policy is available by calling CalSurance at 800-745-7189.

LBL_HL_052609v4Page 2 of 5

CalSuranceE & O P r o g r a m S p e c i a l i s t s

RAgents of Lincoln Bene�t LifeErrors & Omissions Program

Outline of Coverage

Exclusions: The Policy does not apply to any Claim:

A. Arising out of any act, error or omission of the Insured committed with dishonest, fraudulent, malicious or knowingly wrongful purpose or intent; however, notwithstanding the foregoing, the Insured shall be afforded a defense, subject to the terms of this Policy, until the allegations are subsequently proven by a final adjudication. In such event, the Insured shall reimburse the Company for all Defense Costs incurred by the Company;B. Alleging bodily injury, sickness or death of any person, or to injury or destruction of any tangible property, including loss of use thereof;C. Alleging the liability of others assumed by the Insured under any contract or agreement unless such liability would have attached to the Insured even in the absence of such agreement;D. By an enterprise which one or more Insureds own, operate, control or manage; or any Claim by an enterprise which owns, operates, controls or manages an Insured;E. Based upon or arising out of any Pension, Profit Sharing, Health and Welfare or other Employee Benefit Plan or Trust sponsored by the Insured as an employer;F. Arising out of the Insured making representations, promises or guarantees as to the future value of any investment including but not limited to, representations, promises or guarantees as to interest rates, fluctuation in interest rates, future premium payments or market value(s);G. Arising out of services performed by the Insured as an actuary, accountant, attorney, real estate agent or real estate broker, named fiduciary or third party claims administrator;H. Arising out of, or contributed to by, any commingling of, or use of client funds;I. Arising out of, directly or indirectly, the insolvency, receivership, bankruptcy, or inability to pay of any organization in which the Insured 1. Has placed or obtained a client's coverage; 2. Has placed a client's funds; or 3. Has recommend a client invest. However, this exclusion shall not apply if the Claim is based upon the insolvency, receivership, liquidation or inability to pay of any insurance company that was rated as A- or better by A.M. Best Company at the time the business was placed, obtained or recommended;J. Arising out of the Insured's activities in computer programming or processing if the resulting programs or software are sold or distributed or if a fee is charged for use of such program or software;K. Made against any Insured or the Sponsor by: 1. Any Insured; 2. Any Sponsor; 3. Any Broker Dealer; 4. Any other insurance company; 5. Any other insurance agency; or 6. Any person or entities who in the past were, but are not currently, parties to an agent contract with the Sponsor;L. Arising out of the use of confidential information by an Insured, including but not limited to such use for the purpose of replacement of coverage;M. Arising out of the Insured's inability or refusal to pay or collect premium, claim or tax monies, including surcharges or assessments of any kind; N. Arising out of or involving investment products partially or totally owned by the Insured;O. Arising from or contributed to by the placement of client's coverage or funds directly or indirectly with any organization which is not licensed to do business in the state or jurisdiction with authority to regulate such business. However, this exclusion does not apply to any Claim arising from or contributed to by the placement of client's coverage or funds directly or indirectly with any organization which is an eligible surplus lines insurance company in the state or jurisdiction with authority to regulate such business;

P. Arising out of the brokering of structured settlements; however, this exclusion does not apply to any Claim arising from or contributed to the sale of annuity products used to fund the structured settlements;Q. Arising out of the ownership, formation, operation or administration of, or advice regarding, referral to, recommendation of or placement of coverage with any health maintenance organization (HMO), preferred provider organization (PPO), risk retention group, self insurance program or purchasing group; provided, however, that this exclusion shall not apply to advice regarding, referral to, recommendation of or placement of coverage with any HMO or PPO that are fully insured through an insurance company rated A- or better by A.M. Best;R. Arising out of or based upon: 1. The Federal Telephone Consumer Protection Act (47 U.S.C. sec 227), Drivers Privacy Protection Act (18 U.S.C. sec. 2721-2725) or Controlling the Assault of Non-Solicited Pornography and Marketing Act (15 U.S.C. sec. 7701, et seq.); or 2. Any other federal, state or local statute, regulation or ordinance that imposes liability for the: a. Unlawful use of telephone, electronic mail, internet, computer, facsimile machine or other communication or transmission device; or b. Unlawful use, collection, dissemination, disclosure or redisclo sure of personal information in any manner by an Insured or on behalf of any Insured;S. Arising out of the purchase, sale or the giving of advice regarding: 1. Commodities, commodity future contracts, or option contracts other than covered call option contracts; 2. Any security priced under five dollars ($5.00) at the time of purchase; 3. Promissory notes or other non-securitized evidence of debt; or 4. Viatical settlements, life settlements or any security backed by either viatical or life settlements;T. Brought by, or on behalf of, the Securities Investor Protection Corporation, or any governmental, quasi-governmental, regulatory, or self-regulatory entity, whether directly or indirectly; however, this exclusion shall not apply to any Claim by such entity to enforce its rights as a direct customer of the Insured or Sponsor;U. Brought by, or on behalf of, any clearing agency or arising out of any function of any Insured or Sponsor as a clearing agency;V. Arising out of the Insured's activities in exercising discretionary authority, management or control over a customer's account; W. Arising out of or based upon infringement of patent, copyright, trademark, service mark, trade dress or trade name, unfair competition or piracy, theft or wrongful taking of concepts including using another's advertising ideas or other intellectual property; X. For Personal Injury: 1. Sustained by any Insured or Sponsor; 2. Caused by or at the direction of the Insured with the knowledge that the offense would violate the rights of another and would inflict Personal Injury; 3. Arising out of oral or written publication of material, if done or at the direction of the Insured with knowledge of its falsity; 4. Arising out of an electronic chatroom or bulletin board the Insured hosts, owns or over which the Insured exercises control; or 5. Arising out of the unauthorized used of another's name or product in the Insured's email address, domain name or metatag, or any other similar tactics to mislead another's potential customer;Y. Arising out of alleged discrimination of any kind;Z. Prior to the first effective date of coverage issued to the Insured Agent, no Insured had any basis: 1. To believe that any Insured had knowledge of any negligent act, error or omission or Personal Injury; 2. To foresee that any such negligent act, error or omission or Personal Injury or any related negligent act, error or omission or Personal Injury might reasonably be expected to be the basis of a Claim

LBL_Excl_052709v2

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LBLMatrix071609v6

LLiinnccoollnn BBeenneeffiitt LLiiffee PPrreemmiiuumm TTaabbllee Policy Period: July 2009 to July 2010

PAY IN FULL INSTALLMENTS*

Effective Month Limit Tier I Tier II Tier I Tier II

$1MM/$1MM $ 659 $1,029 4 x $ 172.25 4 x $ 264.75 $2MM/$2MM $ 960 $1,460 4 x $ 247.50 4 x $ 372.50 7/1/2009 $2MM/$3MM $1,147 $1,795 4 x $ 294.25 4 x $ 456.25

$1MM/$1MM $ 605 $ 945 4 x $ 158.75 4 x $ 243.75 $2MM/$2MM $ 881 $1,340 4 x $ 227.75 4 x $ 342.50 8/1/2009 $2MM/$3MM $1,053 $1,647 4 x $ 270.75 4 x $ 419.25

$1MM/$1MM $ 552 $ 860 3 x $ 191.50 3 x $ 294.17 $2MM/$2MM $ 803 $1,219 3 x $ 275.17 3 x $ 413.83 9/1/2009 $2MM/$3MM $ 958 $1,498 3 x $ 326.83 3 x $ 506.83

$1MM/$1MM $ 498 $ 776 3 x $ 173.50 3 x $ 266.17 $2MM/$2MM $ 724 $1,099 3 x $ 248.83 3 x $ 373.83 10/1/2009 $2MM/$3MM $ 864 $1,350 3 x $ 295.50 3 x $ 457.50

$1MM/$1MM $ 444 $ 691 3 x $ 155.50 3 x $ 237.83 $2MM/$2MM $ 645 $ 978 3 x $ 222.50 3 x $ 333.50 11/1/2009 $2MM/$3MM $ 770 $1,202 3 x $ 264.17 3 x $ 408.17

$1MM/$1MM $ 391 $ 607 2 x $ 203.00 2 x $ 311.00 $2MM/$2MM $ 566 $ 858 2 x $ 290.50 2 x $ 436.50 12/1/2009 $2MM/$3MM $ 675 $1,053 2 x $ 345.00 2 x $ 534.00

$1MM/$1MM $ 337 $ 522 2 x $ 176.00 2 x $ 268.50 $2MM/$2MM $ 488 $ 738 2 x $ 251.50 2 x $ 376.50 1/1/2010 $2MM/$3MM $ 581 $ 905 2 x $ 298.00 2 x $ 460.00

$1MM/$1MM $ 283 $ 438 2 x $ 149.00 2 x $ 226.50 $2MM/$2MM $ 409 $ 617 2 x $ 212.00 2 x $ 316.00 2/1/2010 $2MM/$3MM $ 487 $ 757 2 x $ 251.00 2 x $ 386.00

$1MM/$1MM $ 230 $ 353 N/A N/A $2MM/$2MM $ 330 $ 497 N/A N/A 3/1/2010 $2MM/$3MM $ 392 $ 608 N/A N/A

$1MM/$1MM $ 176 $ 269 N/A N/A $2MM/$2MM $ 251 $ 376 N/A N/A 4/1/2010 $2MM/$3MM $ 298 $ 460 N/A N/A

$1MM/$1MM $ 122 $ 184 N/A N/A $2MM/$2MM $ 173 $ 256 N/A N/A 5/1/2010 $2MM/$3MM $ 204 $ 312 N/A N/A

$1MM/$1MM $ 69 $ 100 N/A N/A $2MM/$2MM $ 94 $ 135 N/A N/A 6/1/2010 $2MM/$3MM $ 109 $ 163 N/A N/A

Above premiums include an administration fee of $15 and installment fee, if applicable.

Brown & Brown of California, Inc. dba CalSurance Associates (dba CalSurance Brokerage in New York) California License # 0B02587

*Installments unavailable after February 18, 2010; Payment in Full Only. Installment Dates Are:

1. Date Enrollment is processed;

2. September 1, 2009 (if Enrollment is prior to August 21, 2009);

3. December 1, 2009 (if Enrollment is prior to November 20, 2009); and

4. March 1, 2010 (if Enrollment is prior to February 19, 2010).

Page 4 of 5

Errors and Omissions InsuranceAuthorization Agreement for Pre-Authorized Debits

July 1, 2009 to July 1, 2010SEE PREMIUM TABLE FOR AMOUNTS DUE

I (we) hereby authorize Brown & Brown of California, Inc., dba CalSurance Associates, hereinafter called COMPANY, to initiate electronic debits from my (our) checking account indicated below at the financial institution named below, hereinafter called DEPOSITORY and to debit the same to such account. This authority is to remain in full force and effect until COMPANY and DEPOSITORY have each received written notification from me (or either of us) of its termination in such time as to afford COM-PANY and DEPOSITORY a reasonable opportunity to act on it. Please attach a “voided” check to the bottom of this form. The Enrollment Form will not be processed if a “voided” check is not attached.

I (we) agree that if premiums are not paid on the dates specified below, or in the event the withdrawals are dishonored, coverage shall terminate upon ten (10) days Notice of Cancellation. The agent will be eligible for reinstatement of coverage ONE time only, by paying appropriate premium in addition to a decline processing fee of $50.00.

If choosing to pay in installments, the annual premium plus applicable fees will be divided into equal installments. Installments will be taken upon receipt of Enrollment Form then again on September 1, 2009, December 1, 2009 and March 1, 2010 and a $7.50 processing charge will be added to each installment. I understand that if any of the scheduled installment dates have passed at the time of my enrollment, my premium will be divided between the remaining installment dates.

Name of Financial Institution: ______________________________________________________________________________

Address or Branch: ______________________________________________________________________________________

City: _____________________________________________________ State: ______________ Zip: __________________

Transit / ABA Number: __________________________________ Account Number: __________________________________

This authority is to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and Financial Institution a reasonable opportunity to act on it.

Name: ________________________________________________________________________________________________

Signature: ____________________________________________________ Date: ___________________________________

SIgnature: ____________________________________________________ Date: ___________________________________ (if account requires two (2) signatures)

Please attach a voided check, or photocopy thereof applicable to the above account in the space above. (Enrollment will not be processed without it).

2009January 1

Brown & Brown of California, Inc. dba CalSurance Associates (dba CalSurance Brokerage in New York)

California License # 0B02587 051509v2

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