GroupCancer. About Our Company. American Public Life Insurance Company. Solutions and Options for Your Peace of Mind

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1 American Public Life Insurance Company EZ2DoBizWithH About Our Company Solutions and Options for Your Peace of Mind American Public Life, rated A- (excellent) by A.M. Best,* is domiciled in Oklahoma with operating offices in Jackson, Mississippi. The company was founded in 1945 and is currently licensed to transact business in 45 states and the District of Columbia. In July 2000, American Public was acquired by the American Fidelity Corporation and became part of the American Fidelity Group. For many years the Company has focused on Worksite Marketing and specialized in voluntary supplemental insurance products. These products include Cancer, Specified Disease, Intensive Care, Accident, Medical Supplement, Whole Life, Disability Income and Dental. This specialty marketing approach has enabled the Company to develop support and service systems that are specifically directed toward handling this unique type of business. The Company has earned a reputation of prompt and effective administration and service to its payroll accounts and individual policyholders. The Company offers a variety of insurance plans, allowing a participant to choose the plan with benefits and premiums that suit the individual need and budget of the employee. Employees then have an option, rather than the take it or leave it proposition. American Public Life provides coverage for thousands of employees of school systems, city governments, county/parish governments, state governments and commercial businesses. * Best Insurance Reports: Life and Health, United States and Canada, 2005 Edition. (A- is 4 out of 16 with 1 being the highest). GroupCancer A Specified Disease Cancer Indemnity Insurance Policy American Public Life Insurance Company A member of the American Fidelity Group American Public Life Insurance Company P.O. Box 925 Jackson, Mississippi (Sales Department) This brochure does not constitute the full contract and is intended to provide basic information about American Public Life Insurance Company s Group Cancer insurance policy, GC-3. For specific details, please consult an actual policy and its provisions. APSB (08/06) GC-3 Group Cancer Gen/GA/LA/OK/TX

2 Why Group Cancer Insurance is Worth Having New cancer cases in America are diagnosed at the rate of about 3,835 per day. 1 Most cancers are not inherited, but rather are the result of damage to genes that occurs during one s lifetime. 1 The overall cost for cancer in 2005 was $209.9 billion. 1 35% of all costs for cancer are direct medical costs, while the remaining 65% of costs are indirect. 1 The ratio of new cancer cases in 2006 is projected to be 51% male, 49% female. 1 A male in the U.S.A. has a 1 in 2 chance of developing cancer over his lifetime. 1 An estimated 212,920 new cases of invasive breast cancer are expected to occur among women in the U.S. this year. 1 Look What Group Cancer Has to Offer Available through the convenience of payroll deduction. Available to employees working as little as 18 hours per week. You may convert your Group Cancer policy to an individual policy if you change jobs or leave the group. Pays benefits regardless of other health insurance coverage. Family coverage available. Guaranteed Issue and Simplified underwriting available. 6 Available to groups as small as 10 employees. 7 1 American Cancer Society: Cancer Facts and Figures 2006, pages 1, 3, 4, 9 & LIMRA International Worksite Marketing of Voluntary Benefits: The Consumer Perspective The MetLife Study of Employee Benefits Trends 2005, MetLife. 4 U.S. Group Disability Insurance: Executive Summary, LIMRA International, 2nd Quarter 2005 page 5. 5 Health Affairs: The Policy Journal of the Health Sphere, MarketWatch: Illness and Injury as Contributors to Bankruptcy 2 February In the state of Florida, simplified underwriting is not available. 7 Minimum group size in the state of Florida is 200 eligible employees.

3 So Why Choose Voluntary Benefits? Top reasons employees give for purchasing voluntary benefits include low price, having the right product at the right time, and the convenience of payroll deduction. 2 Four in ten employees are concerned about becoming a financial burden on family, friends or loved ones. 3 Employees rank benefits as the top aspect of job satisfaction. 4 Many health insurance policies prove to be too skimpy in the face of serious illness. 5 Frequently Asked Questions If I leave the group or terminate my employment, may I take my coverage with me? No, Group Cancer Insurance is only available while you are an employee of your employer or a member of an approved trade association. Your coverage terminates on the date that you cease employment or cease to become a member of the association. If I leave the group or terminate my employment, may I convert my coverage to an individual policy? Yes. You will be entitled to convert to an individual policy of insurance issued by us without evidence of insurability provided you notify us in writing within 31 days. If my covered child ceases to be an eligible dependent, is there a coverage available for them? Yes. If your covered child ceases to be eligible for coverage under your Group Cancer policy, they may convert to an individual policy of insurance issued without proof of insurability based on the provisions stated within your certificate of coverage. Does this policy pay benefits regardless of other insurance that I may have? Yes. Benefits are payable regardless of any other insurance you have. How is the radiation and chemotherapy benefit paid? Radiation and chemotherapy benefits are paid on an indemnity basis. If you have one or more covered radiation and chemotherapy benefits in a month, the full indemnity selected will be paid. May I assign my benefits? You may assign your benefits or have them paid directly on to you. It s your choice. What are the ages that American Public Life Insurance Company will issue this policy? Full time employees ages 18 years or over working at least 18 hours per week are eligible. For members of approved associations, coverage is available to members age May I apply to cover my dependents? Eligible dependents may be covered for the same benefits as the primary insured. Will my premiums go up as my age changes? No, your premiums are based on your age at the time your policy is issued. Rates may be changed for everyone in the group based on group experience.

4 Insurance Policy Schedule of Benefits (Form GC-3) Option 1 Option 2 Option 3 Radiation Therapy/Chemotherapy/Immunotherapy Benefit We will pay the indemnity amount shown in the Schedule of Benefits when the Covered receives Radiation, Chemotherapy, or Immunotherapy. We will pay only one Radiation/ Chemotherapy/Immunotherapy benefit per month regardless of the number of radioactive, chemotherapy or immunotherapy treatments received during the month. This benefit is payable only when the Covered receives covered therapy and covered drugs as shown in the definition of Radiation/Chemotherapy/Immunotherapy in this Policy/Certificate. This benefit does not cover other procedures related to radiation and chemotherapy treatment such as treatment planning, treatment management or consultation. Design and construction of treatment devices, radiation dosimetry calculation, lab tests, x-rays, scans, medical supplies and equipment used in administration (IV solutions, needles, dressings, pumps, catheters, etc.) are not covered under this benefit. Anti-nausea drugs are not covered under this benefit. This benefit does not include any drugs/medicines covered under the Drugs and Medicine Benefit or the Hormone Therapy Benefit. Hormone Therapy Benefit Following a diagnosis of Cancer of a Covered, we will pay the indemnity amount shown in the Schedule of Benefits for hormone therapy treatment prescribed by a Physician. Hormone therapy means the use or manipulation of hormones, natural or synthetic, to prevent growth of malignancy. This benefit covers the drugs and medicines only. It does not include associated administrative processes. This benefit does not include any drugs or medicines covered under the Drugs and Medicine Benefit or the Radiation Therapy/Chemotherapy/Immunotherapy Benefit. Drugs and Medicine Benefit We will pay the indemnity amount shown in the Schedule of Benefits for anti-nausea and pain medication prescribed by a Physician and administered to a Covered, who is also receiving Radiation Therapy/Chemotherapy/ Immunotherapy, a covered surgery, or a Bone Marrow/Stem Cell Transplant. This benefit covers drugs and medicines only. It does not include associated administrative charges. This benefit does not include drugs or medicines covered under the Radiation/Chemotherapy/ Immunotherapy Benefit or the Hormone Therapy Benefit. Hospital Confinement Benefit We will pay the indemnity amount shown in the Schedule of Benefits when a Covered requires Hospital Confinement for at least 18 continuous hours for the treatment of a covered Cancer or the treatment of a condition or disease directly caused by Cancer or the treatment of Cancer. We will not pay this benefit for outpatient treatment or a stay of less than 18 hours in an observation unit or Emergency Room. When the Covered s Hospital Confinement continues for more than 90 days, this benefit will be paid in lieu of all other benefits payable for the Covered during such Hospital Confinement beginning on the 91st day. Outpatient Hospital or Ambulatory Surgical Center Benefit When a surgical procedure is performed on an outpatient basis in a Hospital or at an Ambulatory Surgical Center on a Covered for a diagnosed Cancer, we will pay the indemnity amount shown in the Schedule of Benefits for the facility fee charged by such Hospital or Ambulatory Surgical Center. Surgical procedures for Skin Cancer are not covered under this benefit. U.S. Government or Charity Hospital or HMO Benefit We will pay the indemnity amount shown in the Schedule of Benefits if an itemized list of services is not available because a Covered is (1) Confined in a charity Hospital or a Hospital owned or operated by the United States Government; or (2) Covered under a Health Maintenance Organization (H.M.O.) or a Diagnostic Related Group (D.R.G.) where no charges are made to the Covered. If this option is elected, we will pay the amount shown in the Schedule of Benefits. If the Covered is confined as an Inpatient in a Hospital as a result of Cancer or Dread Disease, we will pay benefits for each full day of confinement. If outpatient services are provided we will pay the benefit for each day that outpatient surgery is performed or outpatient therapy is received for Cancer covered by this Policy/Certificate. This benefit will be paid in lieu of any amounts payable under provisions A. through O. $500 per calendar month of treatment, $6,000 per 12 month period $50 per treatment, 12 treatments per $150 per confinement; $50 per prescription, $50 per calendar month $100 per day for the first 90 days; $100 per day thereafter in lieu of all other benefits $200 per day surgery is performed Inpatient, $100 per day of Hospital Confinement in lieu of benefits A. through O. Outpatient, $100 per day of service in lieu of benefits A. through O. $1,000 per calendar month of treatment, $12,000 per 12 month period $50 per treatment, 12 treatments per $150 per confinement; $50 per prescription, $100 per calendar month $200 per day for the first 90 days; $200 per day thereafter in lieu of all other benefits $400 per day surgery is performed Inpatient, $200 per day of Hospital Confinement in lieu of benefits A. through O. Outpatient, $200 per day of service in lieu of benefits A. through O. $1,500 per calendar month of treatment, $18,000 per 12 month period $50 per treatment, 12 treatments per $150 per confinement; $50 per prescription, $150 per calendar month $300 per day for the first 90 days; $300 per day thereafter in lieu of all other benefits $600 per day surgery is performed Inpatient, $300 per day of Hospital Confinement in lieu of benefits A. through O. Outpatient, $300 per day of service in lieu of benefits A. through O.

5 Insurance Policy Schedule of Benefits (Form GC-3) Option 1 Option 2 Option 3 Transportation and Lodging Benefit We will pay the amount shown in the Schedule of Benefits for transportation of a Covered, who has been diagnosed as having Cancer, to receive covered Radiation Therapy, Chemotherapy, Immunotherapy treatment, Bone Marrow/Stem Cell Transplant, or surgery in a Hospital that is at least 50 miles away from the Covered s residence, using the most direct route. Such Hospital must be prescribed by a Physician and be the nearest Hospital which offers the specialized treatment. If treatment is received on an outpatient basis, we will also pay the amount shown in the Schedule of Benefits for the Covered s lodging in a single room in a motel, hotel or other accommodation acceptable to us while the Covered is receiving the specialized treatment. Travel must be by scheduled bus, plane or train, or by car and be within the United States or its Territories. Travel will be paid at the stated rate shown in the Schedule of Benefits per mile for up to 1,000 miles round trip. Benefits for travel will be paid for up to 12 round trips per. Benefits will be provided for only one mode of transportation per round trip. If the Covered receives treatment while Hospital Confined, benefits for transportation will be paid once per Hospital Confinement. Benefits for lodging will be paid only on those days the Covered received outpatient treatment. Family Member Transportation and Lodging Benefit We will pay for one adult family member to be near a Covered who is receiving covered Radiation Therapy, Chemotherapy, Immunotherapy treatment, Bone Marrow/Stem Cell Transplant, or surgery due to Cancer in a non-local Hospital. Non-local means the Hospital is at least 50 miles away from the Covered s residence, using the most direct route. We will pay the amount shown in the Schedule of Benefits for the family member s: (1) lodging in a single room in a motel, hotel or other accommodation acceptable to us; and (2) travel by scheduled bus, plane or train, or by car. Travel will be paid at the stated rate per mile shown in the Schedule of Benefits for up to 1,000 miles round trip. If the family member and the Covered who is receiving treatment travel in the same car or lodge in the same room, benefits for travel and lodging will only be paid under the Transportation and Lodging Benefit. Benefits for travel will be paid for up to 12 round trips per. Benefits will be provided for only one mode of transportation per round trip. Travel must be within the United States or its Territories. If the Covered receives treatment while Hospital Confined, benefits for travel and/or lodging will be paid once per Hospital Confinement. If treatment is received on an outpatient basis, benefits for travel and/or lodging will be paid only on those days the Covered received outpatient treatment. Attending Physician Benefit When a Covered requires the services of a Physician, other than a surgeon, while Hospital Confined for the treatment of Cancer, we will pay the indemnity amount shown in the Schedule of Benefits for one Physician s visit per day. Surgical Benefit When a surgical operation is performed on a Covered for a covered diagnosed Cancer, Skin Cancer, or for reconstructive surgery due to Cancer, we will pay the lesser of: (1) the surgical unit value assigned to the procedure multiplied by the Unit Dollar Amount shown in the Schedule of Benefits; or (2) the Maximum Per Operation amount shown in the Schedule of Benefits. We will use the most current Physician s Relative Value table and the Current Procedural Terminology (CPT) Code to determine the surgical unit value assigned to each procedure. An indemnity benefit will be calculated as follows: Unit Dollar Amount shown in the Schedule of Benefits x surgical unit value = Benefit Amount (up to the amount shown per operation in the Schedule of Benefits). This benefit will be paid for surgery performed in or out of the Hospital. Two or more surgical procedures performed through the same incision will be considered one operation and benefits will be limited to the most expensive procedure. Two or more surgical procedures performed through different incisions will be considered two operations and benefits will be paid for each procedure. In no case will the benefit payable for one operation exceed the amount per operation in the Schedule of Benefits. Diagnostic surgeries that result in a negative diagnosis of Cancer are not covered under this benefit. Bone marrow surgeries are paid under the Bone Marrow/Stem Cell Transplant Benefit. Surgeries required to implant a permanent prosthetic device are covered under the Prosthesis Benefit. In Oklahoma: This benefit is payable for reconstructive breast surgery performed on a nondiseased breast to establish symmetry with a diseased breast when reconstructive surgery on the diseased breast is performed while covered under this policy. Reconstructive surgery to the nondiseased breast must occur within 24 months of the reconstructive surgery of the diseased breast. Transportation,.40 per mile, 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Outpatient Lodging, $50 per day up to 50 days per Transportation,.40 per mile 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Lodging, $50 per day up to 50 days per $30 per day while Hospital Confined $15 per surgical unit; $1,600 Maximum per Operation Transportation,.40 per mile, 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Outpatient Lodging, $50 per day up to 50 days per Transportation,.40 per mile 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Lodging, $50 per day up to 50 days per $40 per day while Hospital Confined $30 per surgical unit; $3,200 Maximum per Operation Transportation,.40 per mile, 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Outpatient Lodging, $50 per day up to 50 days per Transportation,.40 per mile 1,000 miles round trip. Benefits for transportation paid up to 12 round trips per Lodging, $50 per day up to 50 days per $50 per day while Hospital Confined $45 per surgical unit; $4,800 Maximum per Operation

6 Insurance Policy Schedule of Benefits (Form GC-3) Option 1 Option 2 Option 3 Anesthesia Benefit We will pay the amount shown in the Schedule of Benefits for the services of an anesthesiologist received as a result of a covered surgery. Hospital Confinement is not required to receive this benefit. Services of an anesthesiologist for bone marrow transplants are covered under the Bone Marrow/Stem Cell Transplant Benefit. Services of an anesthesiologist for Skin Cancer or surgical prosthesis implantation are not covered under this benefit. Inpatient Special Nursing Services Benefit We will pay the indemnity amount shown in the Schedule of Benefits for full-time special nursing care (other than that regularly furnished by a Hospital) while a Covered is Hospital Confined for treatment of Cancer. Full-time means at least eight consecutive hours during a 24-hour period. Such care must be provided by a Nurse, as defined in this Policy/Certificate; be prescribed by a Physician; and be Medically Necessary for the treatment of Cancer. Experimental Treatment Benefit We will provide coverage for Experimental Treatment prescribed by a Physician for the treatment of Cancer the same as we provide coverage for any non-experimental treatment covered under this Policy/Certificate. This benefit is payable for treatments received in or out of the Hospital. This benefit does not provide coverage for treatments received outside of the United States or its Territories. Blood, Plasma and Platelets Benefit We will pay the indemnity amount shown in the Schedule of Benefits for blood, plasma and platelets. This does not include any laboratory processes. This benefit is payable in or out of the Hospital. Colony stimulating factors are not covered under this benefit. Benefits for Blood, Plasma, and Platelets are ONLY provided under this benefit. Prosthesis Benefit We will pay the indemnity amount shown in the Schedule of Benefits for a surgically implanted prosthetic device received due to Cancer that manifested after the 30th day following the Effective Date, provided the implantation of such device is prescribed by a Physician as a direct result of surgery for Cancer. This benefit does not cover prosthetic related supplies such as special bras or ostomy pouches and supplies. Temporary prosthetic devices used as tissue expanders are covered under the Surgical Benefit. In Oklahoma: This benefit is payable after the Effective Date Dread Disease Benefit We will pay the indemnity amount shown in the Schedule of Benefits for each period of Hospital Confinement of a Covered for treatment of a Dread Disease, as defined in this Policy/Certificate. Benefits for Dread Disease are ONLY provided under this provision of the Policy/Certificate. Hospice Care Benefit When a Covered has been diagnosed by a Physician as terminally ill due to Cancer and requires hospice care, we will pay the indemnity amount shown in the Schedule of Benefits for each day care is received. Care must be directed by a licensed hospice organization in the patient s home, or on an outpatient or short-term inpatient basis in a hospice facility. Hospice care is defined as palliative and supportive care for the terminally ill. Hospice care must be provided by a licensed agency under the direction of a Physician. This benefit does not include: well baby care; volunteer services; meals; housekeeping services; or family support after the death of the Covered. The Covered is considered to be terminally ill if expected to live six months or less. Second and Third Surgical Opinion Benefit We will pay the indemnity amount shown in the Schedule of Benefits for a second surgical opinion when the attending Physician recommends surgery as treatment of a diagnosed Cancer. The second surgical opinion must be obtained from the consulting Physician prior to surgery. If the second surgical opinion disagrees with the first, we will pay the amount shown in the Schedule of Benefits for a third surgical opinion. This benefit is payable once per diagnosis of Cancer. Surgical opinions for reconstructive, Skin Cancer, or prosthesis surgeries are not covered under this benefit. 25% of the amount paid for covered surgery $150 per day while Hospital Confined Paid in the same manner and under the same s as any other treatment in the Schedule of Benefits $150 per day, $7,500 per $1,000 per device (includes surgical fee); one device per site, two devices per lifetime $100 per day of Hospital Confinement, up to 90 days $50 per day; lifetime $9,000 $300 per diagnosis of Cancer; additional $300 if third opinion required 25% of the amount paid for covered surgery $150 per day while Hospital Confined Paid in the same manner and under the same s as any other treatment in the Schedule of Benefits $200 per day, $10,000 per $2,000 per device (includes surgical fee); one device per site, two devices per lifetime $200 per day of Hospital Confinement, up to 90 days $75 per day; lifetime $13,500 $300 per diagnosis of Cancer; additional $300 if third opinion required 25% of the amount paid for covered surgery $150 per day while Hospital Confined Paid in the same manner and under the same s as any other treatment in the Schedule of Benefits $250 per day, $12,500 per $3,000 per device (includes surgical fee); one device per site, two devices per lifetime $300 per day of Hospital Confinement, up to 90 days $100 per day; lifetime $18,000 $300 per diagnosis of Cancer; additional $300 if third opinion required

7 Insurance Policy Schedule of Benefits (Form GC-3) Option 1 Option 2 Option 3 Ambulance Benefit We will pay the amount shown in the Schedule of Benefits for transportation of a Covered by air or ground ambulance to a Hospital or from one medical facility to another where the Covered is admitted as an Inpatient and Hospital Confined for at least 18 consecutive hours for the treatment of Cancer. A licensed ambulance company must provide the ambulance service. If air and ground ambulance service are both required in the same day, we will only pay the highest benefit amount. Extended Care Facility Benefit We will pay the indemnity amount shown in the Schedule of Benefits for each day a Covered is confined in an Extended Care Facility due to Cancer and charges are incurred for room and board. Such confinement must be at the direction of a Physician, and begin within 14 days after a Hospital Confinement. This benefit will be paid for up to the same number of days benefits were paid for the Covered s preceding Hospital Confinement. Home Health Care Benefit We will pay the indemnity amount shown in the Schedule of Benefits for Home Health Care required due to Cancer which is prescribed by a Physician in lieu of Hospital Confinement. Such care must be provided by a Nurse, as defined in this Policy/Certificate, or by a Home Health Nurse s Aid under the supervision of a Registered Nurse and begin within 14 days following a covered Hospital Confinement. The caregiver may not be a family member. For the purpose of this benefit Home Health Care is defined as professional nursing services, occupational therapy, respiratory or inhalation therapy and administration of drugs and medicines. This benefit does not include: nutrition counseling; medical social services; medical supplies; prosthesis or orthopedic appliances; rental or purchase of durable medical equipment; drugs or medicines; child-care; meals or housekeeping services. This benefit does not include physical therapy or speech therapy as these therapies are covered under the Physical or Speech Therapy Benefit. This benefit will be paid for up to the same number of days benefits were paid for the Covered s preceding Hospital Confinement. If the Covered qualifies for coverage under the Hospice Care Benefit, the Hospice Care Benefit will be paid in lieu of this benefit. Bone Marrow/Stem Cell Transplant Benefit When a bone marrow transplant or peripheral blood stem cell transplant is performed on a Covered as treatment for a diagnosed Cancer, we will pay the indemnity amount shown in the Schedule of Benefits. This benefit will not be paid for the harvest of bone marrow or stem cells from a donor. This benefit is payable in or out of the Hospital. Waiver of Premium Benefit If, while this Policy/Certificate is in force, and prior to the age of 65, You become disabled due to Cancer and remain so for 90 continuous days, we will pay all premiums due after such 90 days for as long as You remain so disabled. The term disabled means that You are: (1) unable to work at any job for which You are qualified by education, training, or experience; (2) not working at any job for pay or benefits; and (3) under the care of a Physician for the treatment of Cancer. Physical or Speech Therapy Benefit If a Physician advises a Covered to seek physical therapy or speech therapy, we will pay the indemnity amount shown in the Schedule of Benefits for this treatment. Physical or speech therapy must be as a result of Cancer or the treatment of Cancer and be performed by a caregiver licensed in physical or speech therapy. We will pay the amount shown in the Schedule of Benefits, for any combination of physical or speech therapy treatments, for one treatment per day up to four treatments per month up to a lifetime of $1, per Covered. Hair Prosthesis Benefit We will pay the indemnity amount shown in the Schedule of Benefits for a Covered s hair prosthesis needed as a direct result of Cancer or the treatment of Cancer. Benefits for a hair prosthetic will only be paid under this benefit. $200 per ground trip; $2,000 per air trip. Two trips per Hospital Confinement for any combination above $200 per ground trip; $2,000 per air trip. Two trips per Hospital Confinement for any combination above $200 per ground trip; $2,000 per air trip. Two trips per Hospital Confinement for any combination above $100 per day $200 per day $300 per day $100 per day $200 per day $300 per day $500 per, autologous; $1,500 per, non-autologous After 90 day elimination period $25 per visit, 4 visits per calendar month for any combination, lifetime $1000 $50 per hair prosthetic piece, 2 $1,000 per, autologous; $3,000 per, non-autologous After 90 day elimination period $25 per visit, 4 visits per calendar month for any combination, lifetime $1000 $50 per hair prosthetic piece, 2 $1,500 per, autologous; $4,500 per, non-autologous After 90 day elimination period $25 per visit, 4 visits per calendar month for any combination, lifetime $1000 $50 per hair prosthetic piece, 2

8 Optional Riders Critical Illness Rider (Form GHR-102) Option 1 Option 2 Option 3 Cancer Benefit While this rider is in force: (1) if a Physician first diagnoses any Covered with Internal Cancer; and (2) the Date of Diagnosis occurs after the Critical Illness Waiting Period, if applicable; and (3) Internal Cancer is listed on the Policy Schedule as a Covered Critical Illness; we will pay the specified Cancer Maximum Benefit Amount. The Critical Illness Waiting Period and Cancer Maximum Benefit Amount are shown in the Policy/Certificate Schedule. The Cancer Benefit is payable once for any one Covered. Once the Cancer Benefit is paid for a Covered this benefit is no longer available for such Covered. The Cancer Maximum Benefit Amount will reduce by 50% at age 70. In Oklahoma: (2) above does not apply. Heart/Stroke Benefit While this rider is in force: (1) if a Physician first diagnoses any Covered as having a Heart Attack or Stroke; and (2) the Date of Diagnosis occurs after the Critical Illness Waiting Period, if applicable; and (3) Heart Attack and Stroke are listed on the Policy Schedule as Covered Critical Illnesses; we will pay the specified Heart/Stroke Maximum Benefit Amount. The Critical Illness Waiting Period and Heart/Stroke Maximum Benefit Amount are shown in the Policy/Certificate Schedule. The Heart/Stroke Benefit is payable once for any one Covered. Once the Heart/Stroke Benefit is paid for a Covered this benefit is no longer available for such Covered. The Heart/Stroke Maximum Benefit Amount will reduce by 50% at age 70. $2,500 or $5,000 lump sum benefit; payable once $2,500 or $5,000 lump sum benefit; payable once $2,500 or $5,000 lump sum benefit; payable once $2,500 or $5,000 lump sum benefit; payable once $2,500 or $5,000 lump sum benefit; payable once $2,500 or $5,000 lump sum benefit; payable once Diagnostic Testing Rider (Form GHR-103) Option 1 Option 2 Option 3 Diagnostic Testing Benefit Each, we will pay the amount shown in the Policy/Certificate Schedule for each Covered who receives a screening test that is generally medically recognized to detect internal Cancer including, but not limited to: (1) mammogram; (2) breast ultrasound; (3) breast thermography; (4) breast cancer blood test (CA 15-3); (5) colon cancer blood test (CEA); (6) prostate-specific antigen blood test (PSA) (7) flexible sigmoidoscopy; (8) colonoscopy; (9) virtual colonoscopy; (10) ovarian cancer blood test (CA-125); (11) pap smear (lab test required); (12) chest x-ray; (13) hemocult stool specimen; (14) serum protein electrophoresis (blood test for myeloma) and (15) Thin Prep Pap test. The Covered must incur a charge for the screening test. This benefit is available without a diagnosis of Cancer. This benefit is payable for one test per Covered per. Screening tests payable under this benefit will ONLY be paid under this benefit. Benefits will only be paid for tests performed after the 30-day period following the Covered s effective date of coverage. $25 per unit up to 4 units; payable for one test per Calendar Year $25 per unit up to 4 units; payable for one test per Calendar Year $25 per unit up to 4 units; payable for one test per Calendar Year Hospital Intensive Care Unit Rider (Form GHR-104.R0706) Option 1 Option 2 Option 3 Benefits will be paid beginning with the first day of ICU confinement due to accident or sickness when such confinement begins after the Effective Date of this rider. A day is defined as a 24-hour period. If any Covered is confined to an ICU for only a portion of a day, then a pro rata share of the daily benefit will be paid. Benefits will not be paid for an ICU confinement that begins prior to the Effective Date of this rider. Intensive Care Unit Benefit The indemnity benefit payable under this rider for each full day of ICU confinement is shown on the Policy/Certificate Schedule. This amount is payable for up to 30 days per confinement. Two or more stays in an ICU will be considered a part of the same confinement if: they are separated by less than 30 days; and are due to the same or related cause(s). Ambulance Benefit We will pay the indemnity amount shown in the Policy Schedule for ambulance charges for transportation to a Hospital where the Covered is admitted to an Intensive Care Unit within 24 hours of arrival. $200 per unit up to 4 units $200 per unit up to 4 units $100 $100 $100 $200 per unit up to 4 units The premium and amount of benefits provided vary dependent upon the plan selected.

9 Policy Form GC-3 Renewability - Conditionally Renewable - Premiums Subject to Change The Policy under which this Certificate is issued is conditionally renewable. This means that We have the right to terminate the Policy on any premium due date after the first Policy Anniversary Date. We must give at least a sixty (60) day written notice prior to cancellation. We cannot cancel Your coverage under this Certificate because of change in Your age or health. We can, however, change Your premiums for this Certificate if We change premiums for all similar Certificates issued to the Policyholder. We must give You at least sixty (60) days written notice before We change Your premiums. In Louisiana: Premiums will not increase during the initial twelve (12) months of coverage, and not more than once in any six (6) month period following the initial 12-month period DEFINITIONS Cancer It does not include other conditions which may be considered precancerous or having malignant potential such as: leukoplakia; hyperplasia; acquired immune deficiency syndrome (AIDS); polycythemia; actinic keratosis; myelodysplastic and non-malignant myeloproliferative disorders; aplastic anemia; atypia; non-malignant monocolonal gamopathy; carcinoid; or pre-malignant lesions, benign tumors or polyps. In Texas: It does not include other conditions which may be considered precancerous or having malignant potential such as: leukoplakia; hyperplasia; polycythemia; actinic keratosis; myelodysplastic and non-malignant myeloprolifeative disorders; aplastic anemia; atypia; nonmalignant monocolonal gamopathy; carcinoid; or premalignant lesions, benign tumors or polyps. Hospital A place that is not an institution, or part thereof, used as: a hospice unit, including any bed designated as a hospice or a swing bed; a convalescent home; a rest or nursing facility; a rehabilitative facility; an extended-care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care, or care or treatment for persons suffering from mental diseases or disorders, or care for the aged, or drug or alcohol addiction. Hospital Confinement (Hospital Confined) The Covered must be confined to a bed as a resident Inpatient in a Hospital, or confined in an observation unit or Emergency Room within a Hospital on the advice of a Physician for at least 18 consecutive hours, to be considered one day of Hospital Confinement. One period of confinement includes all consecutive calendar days a Covered is confined as an Inpatient in a Hospital. Successive Hospital stays will be considered as one confinement if they are: (1) due to the same or related causes; and (2) separated by less than 30 days. Inpatient A Covered who is admitted as a resident patient to a Hospital and is being charged for room and board facilities. This does not include a person who is confined in an observation unit or Emergency Room in a Hospital. Pre-Existing Condition A Specified Disease for which, within twelve (12) months prior to the Covered s effective date of coverage, medical advice, consultation or treatment, including prescribed medications, was recommended by or received from a member of the medical profession, or for which symptoms manifested in such a manner as would cause an ordinarily prudent person to seek diagnosis, medical advice or treatment. Radiation/Chemotherapy/Immunotherapy As approved by the American Medical Association or the Federal Drug Administration, and as defined in the policy: These therapies must be used for the purpose of modification or destruction of abnormal tissue or to enhance the immune system and not for diagnosis. These therapies do not include other procedures related to radiation and chemotherapy treatment such as treatment planning, treatment management or consultation. Design and construction of treatment devices, radiation dosimetry calculation, lab tests, x-rays, scans, medical supplies and equipment used in administration (IV solutions, needles, dressings, pumps, catheters, etc.) are not included. Anti-nausea drugs are not included. Waiting Period The first thirty (30) days following the effective date of coverage for the Covered. No benefits will be paid for a Specified Disease that is diagnosed or occurs during the Waiting Period. The Waiting Period will be shown on the Certificate Schedule. In Oklahoma: The Waiting Period does not apply Eligible Child You or Your spouse s natural child, adopted child or stepchild who: (1) is unmarried; and (2) is dependent upon you for support; and (3) is under 21 years of age, or under 25 years of age if attending an accredited school full-time. An Eligible Child also includes children of any Eligible Child covered under Your Certificate and any minor under Your charge, care and control, if placed in Your home for adoption. An Eligible Child must meet conditions (1) through (3) listed above. In Georgia: (3) should read as follows: is under 21 years of age, or under 25 years of age if attending an accredited school full-time for five (5) calendar months or more, or would have been eligible to be enrolled and was prevented from being enrolled due to injury or sickness. In Louisiana: Eligible Child: You or Your spouse s natural child, adopted child or stepchild who: (1) is unmarried; and (2) is dependent upon you for support, and (3) is under 21 years of age, or under 25 years of age if attending an accredited college or university, vocational, vocationaltechnicial, trade school, institute or secondary school full-time. An Eligible Child also includes children of any Eligible Child covered under Your Certificate who is in the legal custody of the Eligible Child; any minor under Your charge, care and control, if placed in Your home for adoption pursuant to an adoption agreement executed with a licensed adoption agency, and any minor under Your charge, care, and control placed in Your home following execution of an act of voluntary surrender in favor of You or Your legal representative effective on the date on which the act of voluntary surrender becomes irrevocable. An Eligible Child must meet conditions (1) through (3) listed above. In Texas: Eligible child also includes: any child for whom you must provide medical support under an order issued under Section , Family Code, or enforceable by a court in Texas; grandchildren if those children are dependents for federal income tax purposes; and any minor if you are a part in a suit in which the adoption of the child is sought. ELIGIBILITY AND EFFECTIVE DATE Eligibility If You are working either under contract to or as a Full Time Employee for the Policyholder, or You are a member in or employed by the association, You are eligible for insurance provided You qualify for coverage as defined in the Master Application. You must apply for insurance within thirty (30) days of the Policy Effective Date or the date that You become eligible for coverage. If You do not apply within thirty (30) days of the Policy Effective Date or the date You become eligible for coverage, You may be subject to additional underwriting by Us. In Oklahoma: Eligible persons may be added to the group originally insured under the Policy from time to time, according to the eligibility requirements described in this provision. Dependent Effective Date The effective date of coverage for each eligible Dependent will be the first of the month following Our approval of the application; and receipt of the first premium. A newborn child will become covered automatically on the day he or she is born as long as Your coverage was in force on that date. The newborn child s coverage will not continue past the 31-day period following his or her birth unless: We are notified by the end of the 31-day period of the addition of such newborn child; and any applicable additional premium is paid. Coverage for newborn children will also include coverage for: a newly-born child adopted by You, from the moment of birth, if a petition for adoption was filed within 31 days of the birth of the child; and a child adopted by You from the date of placement for adoption. Coverage for the adopted child will not continue past 31 days after the date of placement unless: We are notified by the end of the 31-day period of the addition of such adopted child; and any applicable additional premium is paid.

10 In Georgia: Coverage for newborn children will also include coverage for: a newly-born child adopted by You, from the moment of birth, if a petition for adoption was filed within 31 days of the birth of the child; and a child adopted by You from the date of placement for adoption or the final decree of adoption, whichever occurs first. Coverage for the adopted child will not continue past 31 days after the date of placement or final decree unless: We are notified by the end of the 31-day period of the addition of such adopted child; and any applicable additional premium is paid. Dependent Eligibility Your Dependents are eligible for insurance on the date You become eligible for insurance or the date a person becomes a Dependent, whichever is later. Effective Date You must use forms provided by Us when applying for insurance. The insurance will take effect on the requested Certificate Effective Date; or the Certificate Effective Date assigned by Us upon approval of Your application, whichever is later, if Our underwriting rules are met and the premium has been paid. LIMITATIONS AND EXCLUSIONS Pre-Existing Condition Limitation No benefits are payable for any loss incurred during the first year of the Covered s coverage under this Certificate as the result of a Pre-Existing Condition, as defined in this Certificate. Pre-Existing Conditions specifically named or described as excluded in any part of this contract are never covered. Waiting Period This Policy/Certificate contains a 30-day Waiting Period during which no benefits will be paid under this Certificate. If any Covered has a Specified Disease diagnosed before the end of the 30-day period immediately following the Covered s effective date, coverage for that person will apply only to loss that is incurred after one year from the effective date of such person s coverage. If any Covered is diagnosed as having a Specified Disease during the 30-day period immediately following the effective date, the Insured may elect to void the Certificate from the beginning and receive a full refund of premium. If this Certificate replaced Specified Disease Cancer coverage from another company that terminated within 30 days of the effective date of this Certificate, the 30-day Waiting Period will be waived for those Covered s that were covered under the prior coverage. However, the Pre-Existing Condition Limitation paragraph will still apply. Only Loss for Cancer This Policy pays only for loss resulting from definitive Cancer treatment including direct extension, metastatic spread, or recurrence. Proof must be submitted to support each claim. This Policy also covers other conditions or diseases directly caused by Cancer or the treatment of Cancer. This Policy does not cover any other diseases, sickness or incapacity, which existed prior to the diagnosis of Cancer, even though after contracting Cancer it may have been complicated, aggravated or affected by Cancer or the treatment of Cancer except for conditions specifically provided in the Dread Disease Benefit. In Oklahoma: The Waiting Period does not apply In Texas: Only Loss for Cancer- This Certificate pays only for loss resulting from definitive Cancer treatment including direct extension, metastatic spread, or recurrence. Proof must be submitted to support each claim. This Certificate also covers other conditions or diseases directly caused by Cancer or the treatment of Cancer. TERMINATION OF COVERAGE Termination of Certificate Your Insurance coverage will end on the earliest of these dates: (a) the date You no longer qualify as an Insured; (b) the last day of the period for which a premium has been paid, subject to the Grace Period; (c) the date the Policy terminates (See Conversion provision); (d) the date You retire; (e) the date You cease employment, or terminate Your contract with the employer through whom You originally became insured under the Policy (See Conversion provision); or (f) the date We receive Your written request for termination. Termination of Dependent(s) Insurance coverage on Your Dependent(s) will end on the earliest of these dates: (a) the date the coverage under the Certificate terminates; (b) the date the Dependent no longer meets the definition of Dependent, as defined in the Policy/Certificate (See Conversion provision); (c) the date We receive Your written request for termination. In Louisiana: For Insureds who s coverage terminates due to military service, see Termination provision in your Certificate. In Oklahoma: Extension of Benefits. If You and/or the Your Dependents have been covered for at least 6 months under this Certificate and Your employment or the Policy terminates, then the termination shall not affect Your coverage or the coverage of Your Dependents for any continuous loss which commenced while the insurance was in force. The period of extended coverage shall be three (3) months. Premiums must be paid for this Extension of Coverage at the same rate as premiums paid prior to termination. We may end the coverage of any Covered who submits a fraudulent claim. CONVERSION If the Policy is terminated, or You cease employment, or terminate Your contract with the employer through whom You originally became insured under the Policy, this Certificate will terminate. If Your coverage under this Certificate terminates and such termination is not due to non-payment of required premium, You will be entitled to convert to an individual policy of insurance issued by Us without evidence of insurability provided You notify Us in writing within thirty-one (31) days. Premiums will be figured from the premium rate table in effect on the date of conversion. A covered child who ceases to be eligible may convert to an individual policy of insurance, subject to the terms of this provision. A covered spouse who ceases to be eligible for coverage because of divorce or annulment may convert to an individual policy, subject to the terms of this provision. (1) Application for the individual policy and payment of the first premium must be made within 60 days after coverage ceases under this Policy/Certificate. Premiums will be figured from the premium rate table in effect on the date of conversion. (2) The individual policy will be issued without proof of insurability. It will provide benefits that most nearly approximates those of this Policy/ Certificate. (3) The individual policy will take effect the day after coverage ceases under this Policy/Certificate. However, no benefits will be payable under the individual policy for any loss for which benefits are payable under this Policy/Certificate. (4) The Pre-Existing Condition Limitation and Time Limit on Certain Defenses provisions for the individual policy will be figured from the Covered s Effective Date of coverage under this Policy/Certificate. (5) Any benefit s will be figured from the Effective Date of this Policy/Certificate. Critical Illness Form GHR-102 Conditionally Renewable Benefits decrease by 50% at age 70. Subject to company s right to change premium rates. DEFINITIONS Pre-Existing Condition Any sickness or condition for which, prior to the Effective Date of coverage, medical advice, consultation or treatment, including prescribed medications, was recommended by or received from a member of the medical profession, or for which symptoms manifested in such a manner as would cause an ordinarily prudent person to seek diagnosis, medical advice or treatment. Critical Illness Waiting Period The number of days shown in the Policy Schedule following the Effective Date of this rider. No benefits will be paid for a Covered Critical Illness when the Date of Diagnosis occurs during the Critical Illness Waiting Period. In Oklahoma: The number of days shown in the Policy Schedule following the Effective Date of this rider. The Internal Cancer Maximum Benefit Amount and/or Heart/Stroke Maximum Benefit Amount will not be paid for a Covered Critical Illness when the Date of Diagnosis occurs during the Critical Illness Waiting Period. If the Covered s Date of Diagnosis occurs during the Critical Illness Waiting Period, we will pay a benefit equal to 10% of the applicable Maximum Benefit Amount.