GERBER LIFE INSURANCE COMPANY 1311 Mamaroneck Avenue

White Plains, New York 10605

GL-LBM-P-2012-CN 1

______________________________________________________________________________ POLICYHOLDER: The Corps Network GROUP POLICY NUMBER: GLSPW1201 GROUP POLICTERM OF COVERAGE EFFECTIVE DATE: June 30, 2012 TERMINATION DATE June 29, 2013 GROUP POLICY ISSUE DATE: June 30, 2012 STATE OF ISSUE: District of Columbia ______________________________________________________________________________

Gerber Life Insurance Company, herein called the Company or We, Us or Our, in consideration of the Application for this Group Policy and the timely payment of Premiums, agrees, subject to the terms and conditions of the Policy, to insure those defined by the Policyholder as Eligible Persons under this Policy.

This Policy describes the terms and conditions of insurance. It goes into effect, subject to its applicable terms and conditions, at 12:01 AM on the Policy Effective Date shown above, at the Policyholder’s address. Coverage ends at 12:00 A.M. on the Policy Termination Date. The laws of the State of Issue shown above govern this Policy.

We and the Policyholder agree to all of the terms of this Policy.

IN WITNESS WHEREOF Gerber Life Insurance Company has caused this Policy to be executed on the Date of Issue to take effect on the Effective Date. Signed by the Company:

President and CEO Secretary

• GROUP LIMITED BENEFIT HEALTH INSURANCE POLICY •

• NON-PARTICIPATING •

THIS POLICY IS NONRENEWABLE

Maternity Benefits may contain a limited maximum benefit under this Policy. Please reference the Schedule of Benefits in the group or individual plan contract.

THIS POLICY PROVIDES LIMITED BENEFIT ACCIDENT AND HEALTH INSURANCE.

IT DOES NOT PROVIDE MAJOR MEDICAL OR COMPREHENSIVE MEDICAL INSURANCE.

PLEASE READ THIS POLICY CAREFULLY.

GL-LBM-P-2012-CN 2

TABLE OF CONTENTS

Schedule of Benefits ......................................................................................................................... 3

General Definitions ........................................................................................................................... 8

Eligibility, Effective Date and Termination Provisions .................................................................... 13

Continuation Provision .................................................................................................................... 14

Common Exclusions ....................................................................................................................... 15

Claim Provisions ............................................................................................................................. 16

Administrative Provisions ............................................................................................................... 18

General Provisions ......................................................................................................................... 20

Accident Indemnity Benefits ........................................................................................................... 22

Conditions of Coverage .................................................................................................................. 23

Specified Activity Coverage ..................................................................................................... 23

24-Hour Coverage .................................................................................................................... 24

Scope of Coverage ......................................................................................................................... 25

Description of Limited Health Expense Benefits ............................................................................ 26

GL-LBM-P-2012-CN 3

SCHEDULE OF BENEFITS This Policy is intended to be read in its entirety. In order to understand all the conditions, exclusions and limitations applicable to its benefits, please read all the policy provisions carefully. This Policy provides coverage to Corpsmembers only and does not provide any insurance for dependents. Minimum Participation Requirement 100% of all Eligible Persons, unless a Corpsmember

provides a signed waiver form to the Policyholder’s sponsoring service organization along with proof of other coverage.

Eligible Persons:

Class 1 All active Corpsmembers for whom the appropriate premium has been paid, who are contracted with a sponsoring service organization of the Policyholder for a limited term of service (usually up to one year or 1,700 hours) and actively performing their assigned duties on a regular and consistent basis under the direction and instruction of the sponsoring service organization at: a) an alternative work site at the direction of the Policyholder’s

sponsoring service organization; b) a location to which the Corpsmember must travel to perform the job;

or c) a location in the United States, its territories and possessions.

Class 2 All Corpsmembers

a. who meet the requirements of Class 1; and b. whose effective dates of coverage under this Policy are later than

its Effective Date: and c. who have selected continued coverage.

An eligible Corpsmember may be a foreign national; however coverage is provided for Covered Expenses Incurred in the United States only.

CONDITIONS OF COVERAGE

The benefits provided by this Policy will be paid, subject to applicable conditions, limitations and exclusions, under the following coverages.

Specified Activity Coverage Covered Activity All assigned duties performed under

the direction and instruction of the Policyholder’s sponsoring service organization

24-Hour Coverage

Eligibility Waiting Period The Eligibility Waiting Period is the period of time Covered Person must be in a covered class to be eligible for this insurance. It will be extended by the number of days the Covered Person is not in Active Service.

Waiting Period Any waiting period outlined by the Policyholder’s sponsoring service organization and defined in its

GL-LBM-P-2012-CN 4

enrollment materials

GL-LBM-P-2012-CN 5

INDEMNITY BENEFITS ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Principal Sum $10,000 Loss must occur within 365 days of the Covered Accident

Schedule of Covered Losses Covered Loss Benefit Loss of Life 100% of the Principal Sum Loss of Both Hands 100% of the Principal Sum Loss of Both Feet 100% of the Principal Sum Loss of Sight of Both Eyes 100% of the Principal Sum Loss of One Hand and One Foot 100% of the Principal Sum Loss of One Hand and Sight in One Eye 100% of the Principal Sum Loss of One Foot and Sight in One Eye 100% of the Principal Sum Loss of Speech and Hearing in Both Ears 100% of the Principal Sum Loss of One Arm or One Leg 50% of the Principal Sum Loss of Sight in One Eye 50% of the Principal Sum Loss of Speech or Hearing in Both Ears 50% of the Principal Sum Loss of One Hand or One Foot 50% of the Principal Sum Loss of Thumb and Index Finger of the Same Hand 25% of the Principal Sum

GL-LBM-P-2012-CN 6

LIMITED HEALTH EXPENSE BENEFITS This Schedule of Benefits provides a brief outline of the Limited Health Expense Benefits provided by this Policy. Please read the Description of Benefits section for full details. All maximum amounts, benefit limits and coinsurance percentages apply on a per Covered Person basis for each Covered Accident or Covered Sickness unless otherwise indicated. The Lifetime Maximum Benefit is the maximum payable under all policies providing similar benefits and issued to the Policyholder. When benefits are expressed as a percentage, the amount payable will equal the Usual and Customary Charge for the Covered Expense multiplied by the percentage indicated. The Deductible must be satisfied once for each Covered Person during the Service Year before benefits are payable, and can be satisfied by a combination of Covered Expenses for Injury or Sickness. When the Deductible is satisfied, no further deductible amounts will apply for Injury or Sickness for the remainder of the Service Year. Limited Health Expense Benefit Lifetime Maximum $50,000 per Injury or Sickness

Pre-existing Conditions Limited to $5,000 during the Term of Coverage, payable the same as any other condition thereafter, subject to the Limited Health Expense Benefit Maximum

Deductible $100 must be satisfied each Service Year Coinsurance 80% of the first $4,500 after any applied Deductible;

100% thereafter up to the Limited Health Expense Benefit Maximum

Out-of-Pocket Maximum $1,000, including the Deductible, per Service Year Not applicable to the Right of Reimbursement Benefit Period During the Term of Coverage Covered Expenses

In-Patient Hospital Services Daily Hospital Room and Board Daily ICU Benefits Hospital Miscellaneous Services Outpatient Hospital Services Pre-admission Testing Emergency Room Treatment Use of Surgical Facilities Physician Services Surgery Anesthesia Abortion, only if performed by a Physician Inpatient VisitsOffice Visits Outpatient Diagnostic X-ray and Laboratory Services Outpatient Prescription Drugs

GL-LBM-P-2012-CN 7

Including hormone replacement therapy for treatment of menopause Limited to 90-day supply Nursing Services Physiotherapy

Maximum Benefit Inpatient Treatment Subject to the Limited Health Expense Benefit

Maximum Outpatient Treatment $500 for all Benefit Periods combined

Ambulance Services Medical Equipment Rental Medical Services and Supplies Dental Services Limited to $200 for dental treatment or x-rays in

connection with Injury to sound natural teeth Home Health Care

Minimum Hospital Stay 5 consecutive days or more Home Health Care must begin within 7 consecutive days after the Minimum Hospital Stay

Preventive Care

Benefits payable for the following services are subject to the Limited Health Expense Benefit Maximum but are limited to $150 per Benefit Period. The Deductible does not apply to these services.

Complete health assessments Routine physicals Blood pressure screening Cholesterol screening Glucose – blood level screening Prostate – rectal examination for Covered Persons age 40 and over Colorectal Cancer screening Immunizations Other similar services when recommended by a Physician

Benefits for the following services are paid at 100%, subject to the Limited Health Benefit Expense Maximum. The Deductible does not apply to these services.

Annual pap smear Annual cervical cytological screening Baseline mammogram Breast evaluation and screening mammogram

GL-LBM-P-2012-CN 8

Treatment of Mental, Alcohol and Controlled Substance Disorders Subject to the Limited Health Expense Benefit

Maximum except as shown below

Mental Disorders Inpatient and Residential Care Benefits are payable for up to 60 days per year, in

the same manner and subject to the same conditions and limitations as any other Sickness

Outpatient Visits Coinsurance 75% for the first 40 visits per year; 60% for each visit

thereafter per year

Alcohol or Controlled Substance Abuse

Detoxification Benefits are payable up to 12 days per year, in the same manner and subject to the same conditions and limitations as any other Sickness

Inpatient/Residential Care Benefits are payable up to 60 days per year, in the

same manner and subject to the same conditions and limitations as any other Sickness

Outpatient Visits

Coinsurance 80% for the first 40 visits per year; 60% for each visit thereafter per year

RATE TABLE

Premium Rates $151.91 per month for each Covered Person Mode of Premium Payment monthly Premium Due Dates Policy Effective Date and the first day of each modal

period thereafter Contributions The cost of this insurance is paid:

Class 1 - by the Policyholder’s sponsoring service organization; and Class 2 – by the Covered Person.

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GENERAL DEFINITIONS

Please note that certain words used in this Policy have specific meanings. The words defined below and capitalized within the text of this Policy have the meanings set forth below.

Active Service means that the Covered Person is either: 1. actively performing his assigned duties on a regular work day, either at one of the

Policyholder’s alternative work sites or at some other location to which the Covered Person’s assigned duties require him to travel; or

2. on a scheduled non-working day, only if the Covered Person was in Active Service on the preceding scheduled workday.

A Covered Person will also be deemed in Active Service on any day he is absent from work during an approved leave or solely due to a Health Status Related Factor. Please read the Continuation Provision section of this Policy for information on continuation after eligibility for coverage would otherwise end.

Air Ambulance means services provided by means of a fixed or roto-winged aircraft equipped with life support and medical apparatus. Ambulance Services means services provided by a commercial or municipal ambulance service. Benefit Period means the period of time, as stated in the Schedule of Benefits, within which benefits will be paid. Civil Union means a same-sex relationship similar like marriage that is recognized by law. Company or We, Us, Our, means Gerber Life Insurance Company, domiciled in New York. Controlled Substance means any drug or substance, other than alcohol, that has the capacity to affect behavior and is regulated by law with respect to its possession and use. Corpsmember means a person who: 1. is registered and contracted with of one of the Policyholder’s sponsoring service

organizations for a limited term of service, either as part of a national program or a state or local-based program; and

2. defined in one of the classes of Eligible Persons in the Schedule of Benefits. Covered Accident means a sudden, unforeseeable event that results, directly and independently of all other causes, in an Injury and meets all of the following conditions: 1. occurs while the Covered Person is insured under this Policy and subject to the Conditions of

Coverage; 2. is not contributed to by disease, Sickness, or mental or bodily infirmity; and 3. is not otherwise excluded under the terms of this Policy. Covered Expenses means the lesser of the Usual and Customary charge and the maximum benefit shown, for Medically Necessary services or supplies listed in the Schedule of Benefits and described in the Limited Health Expense Benefits section of this Policy. Covered Expenses must be Incurred by a Covered Person, while he is covered under this policy, for Medically Necessary treatment of injuries sustained in a Covered Accident or for a Covered Sickness.

GL-LBM-P-2012-CN 9

Covered Person means an Eligible Person, as defined in the Schedule of Benefits, for whom required premium has been paid when due and for whom coverage under this Policy remains in force. A Covered Person does not include any person performing services for the Policyholder: 1. pursuant to an independent contractor relationship with the Policyholder; 2. subject to the terms of a leasing agreement between the Policyholder and a leasing

organization; 3. who receives income which is reported by the Policyholder on IRS form 1099; or 4. in a foreign country. Covered Sickness means illness or disease which begins and for which Covered Expenses are incurred while the Covered Person is insured under this Policy. Sickness includes normal pregnancy and complications of pregnancy. All related conditions and recurring symptoms of Sickness will be considered one Sickness. Deductible means the amount of Covered Expenses that each Covered Person must Incur before benefits are paid under this Policy. The Deductible applies separately to each Covered Person. Elective Surgery/Elective Treatment means, but is not limited to the following: 1. surgery and/or treatment for biofeedback-type services 2. circumcision; 3. corns, calluses and bunions; 4. deviated nasal septum, including sub-mucous resection and/or surgical correction thereof,

except for purulent sinusitis; 5. family planning; 6. fertility tests; 7. impotence, organic or otherwise; 8. infertility (male or female) including any service or supplies rendered for the purpose or with

the intent of inducing conception; 9. learning disabilities; 10. sleep disorders, including testing thereof; 11. temporomandibular joint dysfunction; 12. tubal ligation; 13. vasectomy 14. gender identity disorders; and 15. erectile dysfunction. He, Him or His means an individual, male or female. Health Care Plan means any contract, policy or other arrangement for benefits or services for medical care or dental care under: 1. group or blanket insurance, whether on an insured or self-funded basis; 2. hospital or medical service organizations on a group basis; 3. Health Maintenance Organizations and Preferred Provider Organizations on a group basis; 4. group lab or management plans; 5. employee benefit organization plans; 6. professional association plans on a group basis; or 7. any other group employee welfare benefit plan as defined in the Employee Retirement

Income Security Act of 1974, as amended.

GL-LBM-P-2012-CN 10

Health Status-Related Factor means any of the following applicable to a Covered Person: 1. health status, including any medical condition, physical and mental; 2. prior claim experience; 3. receipt of health care; 4. medical history; 5. evidence of insurability, including any conditions resulting from any acts of domestic violence; 6. any prior or current disability; and 7. genetic information, including but not limited to information about a Covered Person’s genes,

gene products, inherited characteristics that may derive from him or a family member; any information about carrier status derived from laboratory tests, physical examinations, family histories and direct analysis of genes or chromosomes.

Home Health Care means nursing care and treatment in a Covered Person’s home by a Hospital licensed or certified to provide Home Health Care services or by a licensed or certified Home Health Care agency if: 1. institutionalization of the Covered Person would have been required if home health care was

not provided; and 2. the Covered Person’s Physician establishes and approves in writing the plan of treatment

covering the home health care service.

Home Health Care includes, but is not limited to, daily living care services such as cooking, feeding, bathing, dressing and personal hygiene, which the Covered Person is unable to perform for Himself. Hospital means an institution that meets all of the following: 1. it is licensed as a Hospital pursuant to applicable law; 2. it is primarily and continuously engaged in providing medical care and treatment to sick and

injured persons; 3. it is managed under the supervision of a staff of medical doctors; 4. it provides 24-hour nursing services by or under the supervision of a graduate registered

nurse (R.N.); 5. it has medical, diagnostic and treatment facilities, with major surgical facilities on its

premises, or available on a prearranged basis; 6. it charges for its services. The term Hospital does not include a clinic, facility, or unit of a Hospital for: 1. rehabilitation, convalescent, custodial, educational or nursing care; 2. the aged; or 3. a Veteran’s Administration Hospital or Federal Government Hospitals unless services are

rendered on an emergency basis and a legal liability exists for the charges made to the Covered Person for services provided in the absence of insurance.

Hospital Stay means a Medically Necessary confinement in a Hospital, ordered by a Physician, over one or more nights when room and board and general nursing care are provided at a per diem charge made by the Hospital. The Hospital Stay must result directly and independently of all other causes from a Covered Accident or a Covered Sickness. Separate Hospital Stays due to the same Covered Accident or Covered Sickness will be treated as one Hospital Stay unless (a) separated by at least 90 days or (b) a Covered Person returns to Active Service for 30 or more days between Hospital Stays.

A Hospital Stay for maternity shall include a period of 48 hours following a vaginal delivery and 96 hours following a Cesarean section.

GL-LBM-P-2012-CN 11

Immediate Family Member means any of the following: 1. the lawful spouse, partner to a Civil Union, child, parent, grandparent, brother or sister of the

Covered Person; 1. step-relatives in the same categories; or 2. a person who reared the Covered Person or whom the Covered Person reared. Incurred or Incurs means an obligation to pay for a Covered Expense for treatment, service or purchase of supplies, deemed to be the date it is provided to the Covered Person. Injury means bodily harm which: 1. results, directly and independently of Sickness and all other causes to a Covered Person;

and 2. occurs while the Covered Person is insured under this Policy and subject to the Conditions of

Coverage. Inpatient means a Covered Person who is confined for at least one full day’s Hospital room and board. The requirement that a person be charged for room and board does not apply to confinement in a Veteran’s Administration Hospital or Federal Government Hospital. In such case, the term “Inpatient” shall mean a Covered Person who is required to be confined for a period of at least a full day, as billed by the Hospital. Intensive Care Unit means a section, ward, or wing within a Hospital which is separated from other Hospital facilities and: 1. is operated exclusively for the purpose of providing professional treatment for critically ill

patients; 2. has special supplies and equipment necessary for such treatment which is available on a

standby basis for immediate use; 3. provides room and board, and constant observation by registered graduate nurses or other

specialty trained Hospital personnel; and 4. is not maintained for the purpose of providing normal post-operative recovery treatment or

service. Medically Necessary; Medical Necessity means care, services or supplies provided by a Hospital, Physician, or other covered provider that are required to identify or treat a Covered Accident, a Covered Sickness or other covered loss and which are: 1. consistent with the diagnosis and treatment of the Covered Accident, Covered Sickness or

other covered loss; 2. appropriate with the standards of good medical practice; 3. not solely for the convenience of a Covered Person; 4. the most appropriate supply or level of service which can be safely provided; and 5. not considered experimental or investigative; and 6. are not otherwise excluded under the terms of this Policy. The fact that a Physician may prescribe, authorize or direct a service does not of itself make it Medically Necessary or covered by this Policy. Nurse means a professional, licensed, graduate registered nurse (R.N.), a professional, licensed practical nurse (L.P.N.) or a Certified Registered Nurse Anesthetist (CRNA). Orthopedic Appliances means braces and appliances including durable medical equipment that: 1. are primarily and customarily used to serve a medical purpose, can withstand repeated use;

and 2. generally are not useful to the Covered Person in the absence of Injury or Sickness.

GL-LBM-P-2012-CN 12

Outpatient means a Covered Person who receives treatment, services and supplies while not an Inpatient in a Hospital. Physician means a licensed health care provider practicing within the scope of his license and rendering care and treatment to a Covered Person that is appropriate for the condition and locality and who is not: 1. employed or retained by the Policyholder; or 2. living in the Covered Person’s household; or 3. a Covered Person’s Immediate Family Member. Pre-Existing Condition means any condition for which the Covered Person has received any diagnosis, medical advice, care or treatment within the 6-month period immediately preceding his effective date of coverage. Benefits for Appropriate Care of a Pre-Existing Condition may be limited. Please read the Description of Limited Health Expense Benefits section for any applicable limitations. Prescription Drugs are drugs which: 1. under Federal law may only be dispensed by written prescription; and 2. are approved for general use by the Food and Drug Administration. Service Year means the period of time from the date a Covered Person’s insurance begins under this Policy until his one-year anniversary, subject to this Policy’s Cancellation provision. Term of Coverage means the period, beginning on June 30, 2012 and ending on June 29, 2013, during which coverage under this Policy is in force. Usual and Customary Charge means the normal charge, in the absence of insurance, made by the provider of any Medically Necessary service or supply, but not more than the prevailing charge in the area: 1. for a like service by a provider with similar training or experience; or 2. for a supply that is identical or substantially equivalent.

GL-LBM-P-2012-CN 13

ELIGIBILITY, EFFECTIVE DATE AND TERMINATION PROVISIONS Policy Effective Date We agree to provide Limited Benefit Health Insurance described in this Policy in consideration of the Policyholder’s application and payment of the initial premium when due. Insurance coverage begins on the Policy Effective Date shown on this Policy’s first page. Eligibility A person becomes eligible for insurance under this Policy on the date he meets all of the requirements of one of the Covered Classes and completes any Eligibility Waiting Period, as shown in the Schedule of Benefits. Eligible Corpsmembers who are foreign nationals will be afforded coverage for Covered Expenses Incurred in the United States only. All eligible Corpsmembers are required to enroll for coverage under this Policy unless a signed waiver form and satisfactory proof of other insurance is provided to the Policyholder’s sponsoring service organization. If an eligible Corpsmember waives coverage and loses the other insurance during the Term of Coverage, the Corpsmember must enroll for coverage under this Policy. In any other case, an eligible Corpsmember who waives coverage will only be able to enroll for coverage under this Policy if the other insurance has terminated. Non-Discrimination Due to Health Status The Policy shall not establish rules for eligibility for medical benefits, including continued eligibility for any Covered Person under the Policy, that are based on one or more Health Status-Related Factors of the Covered Person. In addition, the Policy shall not require an individual otherwise eligible for coverage under the terms of this Policy to pay a premium or otherwise contribute an amount which exceeds the amount paid by a similarly situated Covered Person solely due to a Health Status-Related Factor. Effective Date for Individuals Insurance becomes effective for an Eligible Person on the latest of the following dates: 1. the effective date of this Policy; or 2. the date the person becomes eligible. Corpsmembers who exit a program and return, either to the same program or to a different program, may enroll with an effective date matching the first day of service of their second term. If a Corpsmember signs on for a second term and there is no break in service, the member will be allowed to enroll on the anniversary date of when their initial service started; however, under no circumstances will the combined period of coverage under this Policy exceed 364 days. Effective Date of Changes Any increase or decrease in the amount of insurance for the Covered Person resulting from a change in benefits provided by this Policy or a change in Covered Class will take effect on the date of such change. Increases will take effect subject to any Active Service requirement. Termination of Insurance Please read the Continuation Provision section of this Policy for information on continuation after eligibility for coverage would otherwise end. The insurance on a Covered Person will end on the earliest date below: 1. the date this Policy or insurance for a Covered Class is terminated; 2. the date that the Covered Person is no longer in a Covered Class or satisfies eligibility

requirements under this Policy; 3. the 364th day of coverage; 4. the last day of the last period for which premium is paid; 5. the end of any period of continuation, as provided in the Continuation Provision; 6. the date that the plan of benefits under which the Covered Person is covered is

terminated.

Termination will not affect a claim for Covered Expenses Incurred while coverage was in effect.

GL-LBM-P-2012-CN 14

CONTINUATION PROVISION The Continuation Provision described below is subject to the Policyholder’s continuing this Policy in force. Any coverage continued under this provision will terminate on the date the Policyholder terminates this Policy. Continuation of Coverage Exiting Corpsmembers may be eligible for continued coverage under Class 2, subject to the specific Corps Network program in which they are a member. Corpsmembers should contact their program for more information regarding continued coverage. Under no circumstances will the combined period of coverage under this Policy exceed 364 days.

GL-LBM-P-2012-CN 15

COMMON EXCLUSIONS In addition to any benefit-specific exclusions, benefits will not be paid for any Covered Accident or Covered Sickness which, directly or indirectly, in whole or in part, is caused by or results from any of the following unless coverage is specifically provided for by name in the Accident Indemnity Benefits or Limited Health Expense Benefits section of the Policy: 1. suicide or any attempt thereat, while sane or insane, or any intentionally self-inflicted

Injury or Sickness, unless as a result of a medical condition or an act of domestic violence;

2. an act of war, whether declared or undeclared, or while performing police duty as a member of any military or naval organization. This exclusion includes a Covered Accident occurring or Sickness contracted while in the service of any military, naval or air force of any country engaged in war; (The Company will refund the pro rata unearned premium for any such period the Covered Person is not covered.);

3. any treatment received or expenses incurred during a period of time that insurance for a Covered Person is not in force;

4. any service, supply or treatment that is not provided by or at the direction of a Physician, or is inconsistent with standards of medical practice for the applicable condition;

5. treatment of any accident occurring or Sickness first manifesting itself outside the United States, its territories and possessions;

6. with respect to Accidental Death and Dismemberment Benefits only: a. the Covered Person’s participation in a riot, civil commotion, civil disobedience,

insurrection or unlawful assembly, unless the loss occurs while a Covered Person is acting in a lawful manner and within the scope of authority;

b. the Covered Person’s committing, attempting to commit, or taking part in a felony or assault;

c. participation in a contest of speed in power driven vehicles, parachuting, parasailing, bungee jumping or hang gliding;

d. air travel, except: i. as a fare paying passenger on a commercial airline on a regularly scheduled

route; ii. on a charter flight operated by a scheduled airline; or iii. as a passenger for transportation only and not as a pilot or crew member.

e. any loss sustained or contracted in consequence of the Covered Person’s being intoxicated;

f. any loss sustained or contracted resulting directly from the Covered Person’s voluntary use of illegal drugs, intentional taking of over the counter medication not in accordance with recommended dosage and warning instructions, or intentional misuse of prescription drugs.

7. benefits provided under Medicare or any other governmental programs (except Medicaid) or any state or federal workers’ compensation, employers’ liability or occupational disease law, unless otherwise provided under State or Federal statute;

We will not pay benefits for services or treatment rendered by any person who is: a. employed or retained by the Policyholder; b. living in the Covered Person’s household; c. an Immediate Family Member of a Covered Person, or of His spouse or partner to a

Civil Union; or d. a Covered Person treating himself.

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CLAIM PROVISIONS Notice of Claim Written notice of claim must be given to Us within 30 days after a Covered Expense is Incurred or as soon as reasonably possible. If written notice is not given in that time, the claim will not be invalidated or reduced if it is shown that written notice was given as soon as was reasonably possible. Notice can be given to Us at Our Administrative Office in White Plains, New York, such other place as We may designate for the purpose, or to Our authorized representative. Notice should include the Policyholder’s name and policy number and the Covered Person’s name and address. Claim Forms We will send claim forms for filing proof of loss when We receive notice of a claim. If such forms are not sent within 15 days after We receive notice, the proof requirements will be met by submitting, within the time fixed in this Policy for filing proof of loss, written proof of the nature and extent of the loss for which the claim is made. Proof of Loss Written proof of loss satisfactory to Us must be given to Us at Our office, or to Our authorized representative, within 90 days of the loss for which claim is made. If written notice is not given within that time, no claim will be invalidated or reduced if it is shown that such notice was given as soon as reasonably possible. In any case, written proof must be given not more than one year after the time it is otherwise required, except if proof is not given solely due to the lack of legal capacity. Time of Payment of Claims We will pay benefits due under this Policy for any loss immediately upon receipt of due written or authorized electronic proof of such loss and completion of Our claim investigation. Payment of Claims Benefits for loss of life will be payable in accordance with the Beneficiary provision and these Claim Provisions. All other proceeds payable under this Policy, unless otherwise stated, will be payable to the Covered Person or to his estate. All benefits will be paid in United States currency. If We are to pay benefits to the estate or to a person who is incapable of giving a valid release, We may pay up to $1,000 to a relative by blood or marriage whom We believe is equitably entitled. We may also, at our option, at the death of a Covered Person, pay benefits for Covered Expenses to providers of services and supplies for which this policy provides benefits. Any payment made by Us in good faith pursuant to this provision will fully discharge Us to the extent of such payment and release Us from all liability for such payment. Beneficiary If there is no named beneficiary or surviving beneficiary, or if the Covered Person dies while benefits are payable to him, We may make direct payment to the first surviving class of the following classes of persons: 1. Spouse or partner to a Civil Union; 2. Child or Children; 3. mother or father; 4. sisters or brothers; 5. estate of the Covered Person. Physical Examination and Autopsy We, at Our own expense, have the right and opportunity to examine the Covered Person when and as often as We may reasonably require while a claim is pending and to make an autopsy in case of death where it is not forbidden by law.

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Legal Actions No action at law or in equity may be brought to recover under this Policy less than 60 days after written proof of loss has been furnished as required by this Policy. No such action will be brought more than three years after the time such written proof of loss must be furnished. Right of Reimbursement We are not obligated to pay for expenses due to an Injury for which a third party may be liable or legally responsible. A third party is any person or organization other than the Covered Person. We will ask the Covered Person to sign an agreement immediately after We pay benefits. This agreement will specify that the Covered Person will notify Us in writing whenever the Covered Person makes a claim or the Covered Person’s legal representative makes a claim against a third party or a third party’s insurer for damages due to the Covered Person’s Injury and the Covered Person will reimburse Us for any benefits received which We have paid when the Covered Person recovers money from the third party’s insurer by settlement, judgment or in any other manner. We will also require the Covered Person to sign an assignment of funds due Us from any funds the Covered Person recovers from the third party or its insurer. The amount of reimbursement to Us will be the smaller of: 1. the actual amount paid by Us; or 2. the portion of the amount the Covered Person actually recovered from the judgment or

settlement that exceeds the amount necessary to fully reimburse the Covered Person for out of pocket expenses. Out of pocket expenses include attorney fees.

This provision will not apply in any state where it is prohibited by law.

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ADMINISTRATIVE PROVISIONS Cancellation The Policyholder may cancel this Policy as of any Premium Due Date, by giving Us 31 days advance written notice. We may cancel this policy as of any Premium Due Date if the Policyholder fails to pay premiums, subject to the Grace Period provision below. We may cancel this policy on any Premium Due Date for the following reasons by giving the Policyholder 31 days advance written notice: 1. the Policyholder’s performance of an act of fraud or intentional material

misrepresentation; or 2. the Policyholder’s failure to meet minimum participation requirements or to comply with

contribution rules. Grace Period A Policy Grace Period of 45 days will be granted for payment of required premiums due after the first premium. This Policy will be in force during the Policy Grace Period unless the Policyholder gives Us written notice of cancellation as provided above. If the required premiums are not paid during the Policy Grace Period, insurance will end on the last day of the Grace Period or if the Policyholder replaces coverage provided under this Policy on the cancellation date. The Policyholder is liable to Us for any unpaid premium for the time this Policy was in force. Premiums All premium rates are expressed in, and all premiums are payable in, United States currency. The premiums for this Policy will be based on the rates, as set forth in the Schedule of Benefits or subsequently changed, the plan and amounts of insurance in effect for Covered Persons and the premium mode selected, as shown in the Schedule of Benefits. We will provide notifications of premiums due or premium changes by mail to the most current address in our files, to the Policyholder, or to the Covered Person if coverage is being continued under the Continuation Provision. Premium Payment The total premium for this Policy is the sum of premiums paid: 1. by the Policyholder’s sponsoring service organization for all Covered Persons other than

those described in (2) below; and 2. by Covered Persons who remain eligible for coverage under this Policy’s Continuation

Provision. If any premium is not paid when due, this Policy will be cancelled as of the Premium Due Date of the unpaid premiums, except as provided in the Grace Period provision. Changes in Premium Rates We may change the premium rates on any Premium Due Date after the first ten months insurance is in effect by giving at least 31 days advance written notice to the Policyholder. However, We reserve the right to change rates at any time if any of the following events take place: 1. the terms of this Policy change; 2. coverage is reinstated following failure to pay premium during the Grace Period; 3. a change in any federal or state law or regulation is enacted, adopted or amended to the

extent that it affects Our benefit obligations under this Policy; or 4. the Policyholder fails to provide sufficient information, as required by Us, to confirm

adequacy of premiums and rates currently being paid.

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Any increase or decrease in rates will take effect on the date of the applicable change specified above. A pro-rata adjustment will apply from the date of the change to the end of any period for which premium has been paid. Premium Audit We will have the right to audit books and records of the Policyholder at its place of business and during regularly-scheduled business hours, in order to determine the accuracy of premium paid. Reinstatement This Policy may be reinstated if it lapsed for nonpayment of premium. Requirements for reinstatement are written application of the Policyholder satisfactory to Us and payment of all overdue premiums. Any premium accepted in connection with a reinstatement will be applied to the earliest period for which premium was not previously paid. If a Covered Person’s insurance is terminated for any reason, and then again made effective through reinstatement or re-enrollment, only covered loss due to an Injury that is received after the date of reinstatement or re-enrollment or a Sickness that begins more than 10 days after the date of reinstatement or re-enrollment will be covered.

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GENERAL PROVISIONS Entire Contract; Changes This Policy, including the endorsements, amendments and any attached papers constitutes the entire contract of insurance. No change in this Policy will be valid until approved and signed by one of Our executive officers and the Policyholder, and endorsed on or attached to this Policy. No agent has authority to change this Policy or to waive any of its provisions. Misstatement of Fact If a Covered Person has misstated any fact, all amounts payable under this Policy will be such as the premium paid would have purchased had such fact been correctly stated. Certificates We will provide a certificate of insurance for delivery to each Covered Person. Each certificate will list the benefits, conditions and limits of this Policy. It will state to whom benefits will be paid. Assignment We will be bound by an assignment of the Covered Person's insurance under this Policy only when the original assignment or a certified copy of the assignment, signed by the Covered Person and any irrevocable beneficiary, is filed with Us. The assignment will take effect as of the date the Covered Person executes it. However, We will not be liable for any action taken or payment made before We record and acknowledge notice of the change at our Home Office. The assignee may exercise all rights and receive all benefits assigned only while the assignment remains in effect and insurance under this Policy for the Covered Person remains in force. Incontestability 1. Of This Policy All statements made by the Policyholder to obtain this Policy are considered representations and not warranties. No statement will be used to deny or reduce benefits or be used as a defense to a claim, or to deny the validity of this Policy unless a copy of the instrument containing the statement is, or has been, signed by and furnished to the Policyholder. After three years from the Policy Effective Date, no such statement will cause this Policy to be contested except for fraud. 2. Of a Covered Person's Insurance All statements made by a Covered Person are considered representations and not warranties. No statement will be used to deny or reduce benefits or be used as a defense to a claim, unless a copy of the instrument containing the statement is, or has been, signed by and furnished to the claimant. In the event of death or incapacity, the applicable representative shall be given a copy. After three years from the Covered Person’s effective date of insurance, or from the effective date of increased benefits, no such statement will cause insurance or the increased benefits to be contested except for fraud. Reporting Requirements The Policyholder or its authorized agent must report all of the following to Us by the premium due date: 1. the names of all persons insured on the Policy Effective Date; 2. the names of all persons who are insured after the Policy Effective Date; 3. the names of those persons whose insurance has terminated; 4. additional information required by Us.

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Clerical Error A Covered Person's insurance will not be affected by error or delay in keeping records of insurance under this Policy. If such error or delay is found, We will adjust the premium fairly. Conformity with Statutes Any provisions in conflict with the requirements of any state or federal law that applies to this Policy are automatically changed to satisfy the minimum requirements of such laws. Compensation Insurance This Policy is not in place of and does not affect any requirements for coverage under any Workers’ Compensation law.

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ACCIDENT INDEMNITY BENEFITS This Section describes the Accident Indemnity Benefits provided by the Policy. The Principal Sum offered under the Policy, Benefit amounts and any applicable time requirements and limitations are shown in the Schedule of Benefits. Please read this and the General Exclusions section in order to understand all of the terms, conditions and limitations applicable to these benefits. ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS Covered Loss We will pay the benefit for any one of the covered losses listed in the Schedule of Benefits, if the Covered Person suffers a covered loss resulting directly and independently of all other causes from a Covered Accident within the applicable time period specified in the Schedule of Benefits. If the Covered Person sustains more than one covered loss as a result of the same Covered Accident, benefits will be paid for the covered loss for which the largest available benefit is payable. Definitions

Loss of a Hand or Foot means complete Severance through or above the wrist or ankle joint. Loss of Sight means the total, permanent loss of all vision in one eye which is irrecoverable by natural, surgical or artificial means. Loss of Speech means total and permanent loss of audible communication which is irrecoverable by natural, surgical or artificial means. Loss of Hearing means total and permanent loss of ability to hear any sound in both ears which is irrecoverable by natural, surgical or artificial means. Loss of an Arm or Leg means complete Severance through or above the elbow or knee joints. Loss of a Thumb and Index Finger of the Same Hand or Four Fingers of the Same Hand means complete Severance through or above the metacarpophalangeal joints of the same hand (the joints between the fingers and the hand).

Severance means the complete and permanent separation and dismemberment of the part from the body.

Exclusions The exclusions that apply to this benefit are in the Common Exclusions Section.

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CONDITIONS OF COVERAGE – Applicable to Accident Indemnity Benefits Only This section describes the Conditions of Coverage under which benefits provided by this Policy become payable. Any benefits are payable only once to each Covered Person per Covered Accident or Injury, even though more than one Condition of Coverage may apply. Please read these and the Common Exclusions sections in order to understand all of the terms, conditions and limitations of coverage. SPECIFIED ACTIVITY COVERAGE We will pay benefits provided by this Policy, subject to all applicable conditions and exclusions, when a Covered Person suffers a covered loss resulting, directly and independently of all other causes, from a Covered Accident or Injury that occurs while in Active Service during one of the Covered Activities shown in the Schedule of Benefits. The Covered Activity must take place: 1. while the Covered Person is actively performing their assigned duties on a regular and

consistent basis under the direction and instruction of the Policyholder’s sponsoring service organization;

2. under one of the Conditions of Coverage shown in the Schedule of Benefits. Exclusions The exclusions that apply to this coverage are in the Common Exclusions

section.

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24-HOUR COVERAGE We will pay benefits provided by this Policy, subject to all applicable conditions and exclusions, when the Covered Person suffers a covered loss resulting directly and independently of all other causes from a Covered Accident or Injury that occurs any time while insured by this Policy. Exclusions The exclusions that apply to this coverage are in the Common Exclusions

Section.

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SCOPE OF COVERAGE Covered Expenses and any applicable Deductibles are shown in the Schedule of Benefits. Full Excess Medical Expense We will pay Covered Expenses: 1. after the Covered Person has satisfied any applicable Deductible; and 2. only when they are in excess of amounts payable by any Other Health Care Plan whether

or not claim has been made for benefits it provides. We will pay benefits without regard to any Coordination of Benefits provision in such Health Care Plan. Non-Duplication of Coverage – This Policy If for any one Covered Accident, Injury or Sickness, the benefits provided under this Policy are payable under more than one provision in this Policy, then benefits will be provided only under the provision providing the greater benefit.

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DESCRIPTION OF LIMITED HEALTH EXPENSE BENEFITS This Section describes the Limited Health Expense Benefits provided by this Policy. Benefit amounts and any applicable benefit-specific maximums or limits are shown in the Schedule of Benefits. Please read these and the Common Exclusions sections in order to understand all of the terms, conditions and limitations applicable to these benefits. LIMITED HEALTH EXPENSE BENEFITS

We will pay benefits shown in the Schedule of Benefits for Covered Expenses Incurred by a Covered Person, subject to all applicable conditions and exclusions, for treatment of an Injury sustained in a Covered Accident or for treatment of a Covered Sickness. All benefit amounts and any applicable maximums are shown in the Schedule of Benefits, and, unless otherwise specified, are payable on a per Covered Person basis.

Covered Expenses In-Patient Hospital Services Room and Board Expenses – We will pay for

1. room and board charges, up to the average semi-private room rate, for each day of a Hospital Stay;

2. confinement in an intensive care unit, in lieu of payment for room and board charges during a Hospital Stay; and

3. Hospital Miscellaneous Services provided during a Hospital Stay. Hospital Miscellaneous Services include, but are not limited to, X-ray, laboratory, in-Hospital physiotherapy, nurse services, orthopedic appliances, pre-admission tests and all necessary charges other than room and board, for services received during a Hospital Stay. These services do not include charges for telephone, radio or television, extra beds or cots, meals for guests, take home items or other convenience items.

Outpatient Hospital Services

We will pay benefits for Outpatient Hospital Services for 1. pre-admission testing for a Hospital Stay that must occur within 7 days of the

testing; 2. health care services provided in the emergency department of a Hospital for

treatment of a Medical Emergency; 3. Ancillary Services routinely available to the emergency department of a

Hospital for treatment of a Medical Emergency; 4. The cost of a voluntary HIV screening test performed on a Covered Person

while the Covered Person is receiving emergency medical services; and 5. the use of surgical facilities.

With respect to benefits payable under items 2, 3 and 4 above: Ancillary Services means standard medical procedures that are reasonably necessary for the diagnosis and treatment of a Covered Person. Medical Emergency means the sudden onset or sudden worsening of a medical condition that manifests itself by symptoms of sufficient severity, including severe pain, that in the absence of immediate medical attention could reasonably be expected by a prudent lay person, who possesses an average knowledge of health and medicine, to result in:

a. placing a Covered Person’s health in serious jeopardy; b. serious impairment of bodily functions; or c. serious dysfunction of any bodily organ or part.

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Physician Services

Surgery – We will pay for Physician’s charges Incurred for: 1. the primary performance of a surgical procedure, including abortion. Two or

more surgical procedures performed through the same incision will be considered as one procedure;

2. assistant surgeon’s duties; 3. a second surgical opinion or consultation; or 4. anesthesia and its administration. In-Patient Hospital Visits – We will pay Physician’s charges during a Covered Person’s Hospital Stay. Outpatient Office Visits – We will pay Physician’s charges for Physician services rendered in his offices or facilities other than a Hospital. Such charges will include Outpatient self-management training and education, including medical nutritional therapy, for the treatment of insulin-dependent diabetes, insulin-using diabetes, gestational diabetes, and non-insulin using diabetes when prescribed by a Physician.

Outpatient Diagnostic, X-Ray and Laboratory Services

We will pay expenses Incurred for diagnostic, x-ray and laboratory tests and procedures ordered by a Physician and performed while the Covered Person is not an Inpatient.

Nursing Services We will pay Covered Expenses Incurred for services other than routine Hospital care,

rendered by a Nurse. Outpatient Physiotherapy We will pay Covered Expenses Incurred for Outpatient physiotherapy, which includes (a)

acupuncture, (b) microthermy, (c) chiropractic adjustment, (d) manipulation, (e) diathermy, (f) massage therapy, (g) heat treatment, and (h) ultrasound treatment.

Ambulance Services We will pay Covered Expenses Incurred for emergency medical services transportation

via ground or air ambulance service to transport a Covered Person from the place where a Covered Accident or Covered Sickness occurred to the nearest Hospital.

Medical Equipment Rental We will pay Covered Expenses Incurred for rental or, if less, for purchase of:

1. a wheelchair, an iron lung, a hospital bed; or 2. other medical equipment that has permanent or temporary therapeutic value for the

Covered Person and that can only be used by him. Examples of items that are not covered include but are not limited to computers, motor vehicles and modifications thereof, ramps and installation costs, eyeglasses and hearing aids.

Medical Services and Supplies We will pay Covered Expenses Incurred for:

1. blood and blood transfusions, including processing and administration; 2. cost and administration of oxygen and other gasses; 3. routine patient care costs of services and supplies furnished to a qualified Covered

Person in connection with participation in an approved clinical trial; and 4. services and supplies for the treatment of insulin-dependent diabetes,

insulin-using diabetes, gestational diabetes, and non-insulin using diabetes when prescribed by a Physician.

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Dental Services We will pay Covered Expenses Incurred for dental treatment, including X-rays, for Injury

to a sound, natural tooth.

Outpatient Prescription Drugs We will pay a benefit for drugs that (a) can only be obtained through a Physician’s written prescription; and (b) are approved for such prescription use by the Food and Drug Administration (FDA), including orally administered anticancer medication used to kill or slow the growth of cancerous cells and drugs furnished to a qualified Covered Person in connection with participation in an approved clinical trial.

Home Health Care We will pay Covered Expenses Incurred for care and treatment rendered to a

Covered Person by a home health care agency, including, but not limited to: 1. part-time nursing care provided or supervised by a registered graduate nurse; 2. part-time home health aide service which consists of caring for the patient; 3. physical, speech and occupational therapies when indicated in conjunction with

the Covered Person’s discharge placement through a rehabilitation facility approved by his Physician and by Us;

4. nutritional counseling; and 5. medical social services by a qualified social worker licensed by the jurisdiction in

which services are rendered. Home Health Care services must be preceded by a Minimum Hospital Stay and must

begin within the specified number of consecutive days of discharge from a Hospital confinement. The Minimum Hospital Stay and the number of days of confinement within which Home Health Care must begin are shown in the Schedule of Benefits.

Preventive Care

We will pay Covered Expenses Incurred by a Covered Person for the following Preventive Care services, subject to any applicable limits shown in the Schedule of Benefits. Preventive Care services are not subject to the Service Year Deductible.

3. One baseline mammogram for women. 4. An annual screening mammogram for women. 5. An annual cytologic screening for women by means of a pap test to detect

cervical cancer through the simple microscopic examination of cells scraped from the surface of the cervix.

6. Cervical cytologic screening for women at any time upon certification by an attending Physician that the test is Medically Necessary.

7. Colorectal cancer screening, performed in compliance with American Cancer Society guidelines.

8. Rectal prostate examination for Covered Persons age 40 and over, and prostate cancer screening performed in accordance with the latest screening guidelines issued by the American Cancer Society for the ages, family histories and frequencies referenced in such guidelines.

9. Complete health assessments. 10. Routine physicals. 11. Immunizations. 12. Blood pressure screening. 13. Cholesterol screening. 14. Glucose - blood level screening. 15. Other similar services when recommended by a Physician.

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Treatment of Mental, Alcohol and Controlled Substance Abuse Disorders We will pay Covered Expenses Incurred for Inpatient and residential care, and Outpatient visits in connection with the treatment of a Covered Person’s mental disorders. Covered Expenses incurred for treatment of mental disorders are subject to any applicable Service Year Deductible, coinsurance percentage and limits shown in the Schedule of Benefits.

We will also pay Covered Expenses Incurred for detoxification, Inpatient and residential care, and Outpatient visits, in connection with the treatment of a Covered Person’s alcohol or controlled substance abuse disorders. Covered Expenses incurred for treatment of alcohol or controlled substance abuse disorders are subject to any applicable Service Year Deductible, coinsurance percentage and limits shown in the Schedule of Benefits.

Excluded Expenses

The following will not be Covered Expenses under this Limited Health Expense Benefit unless specifically provided.

1. rest care or rehabilitative care and treatment, custodial care, and transportation; 2. cosmetic surgery or care, or treatment solely for cosmetic purposes, or

complications therefrom. This exclusion does not apply: a to cosmetic surgery resulting from a Covered Accident, if initial treatment

begins within 364 days of the date of the Covered Accident ; b to reconstruction incidental to or following surgery resulting from a Covered

Accident or Covered Sickness or from trauma, infection or other diseases of the involved part;

c with respect to a mastectomy to: i. all stages of reconstruction of the breast on which the mastectomy has

been performed; ii. surgery and reconstruction of the other breast to produce a symmetrical

appearance; and iii. treatment of physical complications for all stages of the mastectomy,

including lymphedema; 3 pre-marital examinations; 4. any Covered Expense Incurred to the extent that it is paid or payable under any

valid and collectible Health Care Plan; 5. treatment provided in a Veteran’s Administration, Federal or state Hospital or

facility, unless there is a legal obligation to pay; 6. services or treatment provided by persons who do not normally charge for their

services, unless there is a legal obligation to pay; 7. Elective Surgery or Treatment, where there is no Injury or Sickness involved; 8. experimental or investigational health care services unless such services are:

a. prescribed or recommended as Medically Necessary by the Covered Person’s Physician; and

b. approved, on a basis other than limited or experimental, by the American Medical Association or the appropriate medical specialty society for such treatment;

9. Covered Expenses Incurred in excess of the Usual and Customary Charge; 10. Pre-existing Conditions. This exclusion will not apply if the Covered Person:

a. did not receive treatment, care, diagnosis or advice while covered under this Policy during the entire Term of Coverage or under the previous policy issued to the Policyholder; or

b. has been covered under another policy with similar benefits for one complete policy term immediately prior to becoming insured under this Policy.

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The exception to the Pre-existing Condition exclusion will be reduced by the aggregate of the periods of prior creditable coverage applicable to the Covered Person as of his enrollment date under this Policy. Creditable coverage is coverage that the Covered Person had from: a group or blanket plan, Medicare, Medicaid, Indian Health Service, state risk pool, public health plan, Peace Corps service, an individual plan or any other health coverage considered to be creditable coverage under state/federal law or regulations. Prior creditable coverage does not apply if there was a break in coverage of 63 days or more, prior to enrolling under this Policy.

11. treatment of obesity, gastric bypass surgery or weight control; 12. lasik surgery and other surgeries and treatments to correct vision; 13. routine vision care, eyeglasses, contact lenses or examinations or prescriptions

therefor; 14. hearing examinations or fitting of hearing aids; or 15. dental examinations, dental care or treatment unless such care and treatment is

due to an accidental Injury to sound natural teeth within 364 days of a Covered Accident, or is necessary due to congenital disease or anomaly.

Other Exclusions that apply to this Benefit are specified in the Common Exclusions Section.