LIFE INSURANCE AND
ACCIDENTAL DEATH AND DISMEMBERMENT COVERAGE

The life and accidental death and dismemberment insurance are fully insured by The Union Labor Life Insurance Company and provided by the Plan for all participants except self-pay participants. (Please see the “Extended Coverage” section of this booklet).

SCHEDULE OF BENEFITS

LIFE INSURANCE

Employee Life Insurance

If you die of any cause while you are an active Plan participant, your beneficiary will receive a life insurance benefit of $25,000.

Dependent Life Insurance

If your spouse or child dies from any cause while covered under the Plan as your dependent, you will receive a life insurance benefit of $2,500.

Beneficiary

If your beneficiary does not outlive you or you have not selected a beneficiary, payment will be made in one sum to the first surviving beneficiary in the following sequence:

1. Lawful spouse;
2. Child or children including legally adopted children;
3. Parent or parents;
4. Brothers and sisters; or
5. Your estate.

If two or more persons are entitled to benefits, they will share equally. You may change your beneficiary at any time by filing the required card with the Administrative Office.

If you have named your spouse as beneficiary and you later divorce, or have the marriage annulled, the beneficiary designation is automatically revoked. A former spouse will no longer be your beneficiary unless you fill out a new beneficiary designation card naming your former spouse and file it with the Administrative Office.

Life Insurance Coverage

If you become totally disabled while covered by the Plan and before you reach age 60, your group life insurance will remain in effect at no cost to you. However, you will be required to submit proof of total disability periodically to Union Labor Life.

Your beneficiary will be entitled to the full benefit if your total disability continues until the date of your death, as long as acceptable written proof of your disability is submitted to Union Labor Life.

To qualify for this disability premium waiver, you must apply within one year of the date you lose eligibility for coverage.

Accelerated Benefits for Terminal Illness

If you are an active member who has been continuously insured for a maximum of two years and you become terminally ill, up to 50% (but not less than $5,000) of your life insurance benefit may be paid to you in advance of your death, accelerated subject to the terms and conditions of the Accelerated Benefits provision. Payment of the Accelerated Benefit shall be made in one lump sum to you or to whomever you designate. Once the Accelerated Benefit has been paid, your life insurance amount will be reduced by the amount of the Accelerated Benefit. The amount of life insurance available for conversion will be reduced by the amount of the Accelerated Benefit. Only one Accelerated Benefit is payable during your lifetime.

If you die after a request is made for the Accelerated Benefit, but before such benefit is paid, the Accelerated Benefit is not payable. In this case, the full life insurance benefit will be paid to your beneficiary as if no request for Accelerated Benefits has been made.

You or your legal representative must make the request for payment of the Accelerated Benefit to The Union Labor Life Insurance Company in writing. A diagnosis of terminal illness must be made by a licensed qualified physician (other than yourself or a member of your family). You must provide proof satisfactory to Union Labor Life of the diagnosis and terminal illness; such proof shall include clinical, radiological and laboratory evidence. This proof must be obtained at your own expense.

"Terminal illness" or "terminally ill" means that while insured under this Plan a determination is made that you have a life expectancy of six months or less as the result of a medical condition caused by injury, disease or illness.

Union Labor Life shall not be responsible for any tax or any other effects of any Accelerated Benefits payment. You must consult a personal tax advisor to determine any potential tax implications.

This Accelerated Benefit provision is not available for any reason other than terminal illness. Likewise, this benefit is not available:

1. If your life insurance benefit is less than $10,000;
2. When all or a portion of your life insurance benefits are to be paid as a part of a divorce settlement;
3. If your life insurance has been in force for less than two years, or if you are not an active employee;
4. If you are totally disabled on the effective date of this provision;
5. If you are required by law to use this benefit to meet the claims of creditors, whether in bankruptcy or otherwise;
6. If you are required by a government agency to use this benefit provision to apply for, obtain or keep a government benefit or entitlement; or
7. If the injury, disease or illness which caused the medical condition is caused by intentional self-inflicted injury or attempted suicide.

ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE

Accidental Dismemberment Insurance

If you suffer one of the following losses because of and within 90 days of an accident, you will receive benefits as shown below:

With regard to hands and feet, loss shall mean severance at or above the wrist or ankle joint; with regard to eyes, total and irrecoverable loss of sight.

If you suffer more than one loss in a single accident, payment will be made only for the loss for which the largest amount is payable.

Exclusions

This benefit is not payable for accidental death or dismemberment which results from:

1. Bodily or mental infirmity; ptomaines; bacterial infections (except infections caused by pyogenic infection through a cut or wound); or disease or illness of any kind;
2. Self-inflicted injury or suicide while sane or insane;
3. Participation in a felony; or
4. Military service, war or insurrection.

The insurance benefits described in this section are not assignable during the lifetime of the insured person nor may the beneficiary assign any installments.

All insurance benefits are provided under a master insurance policy with The Union Labor Life Insurance Company. In the event of a dispute, the terms of the group policy will prevail over the terms of this Plan description.

Facility of Payment

If you or your dependents are not legally capable of giving valid receipt for a benefit payment, Union Labor Life has the right (if there is no legal guardian) to pay the party it believes is entitled to such payment by reason of having incurred funeral or other expenses incident to the last illness or death of the claimant, but not to exceed the amount allowed by state law. Once such payment is made, Union Labor Life has no further obligation with respect to the amount so paid.

Claims and Appeals Procedures

The claims and appeals procedures for the Life and AD&D insurance are available from Union Labor Life. If you would like a free copy of the claims and appeals, call Union Labor Life directly.

Examinations

Union Labor Life will have the right and opportunity through its medical representatives to examine any living insured during the pendency of a claim and so often as it may reasonably require.

Union Labor Life will also have the right to request an autopsy in case of death, where it is not forbidden by law.

Legal Actions

No legal action can be brought until at least 60 days after written proof of loss to Union Labor Life. No legal action can be brought more than three years after the date written proof of loss is required.

This limitation, and the time permitted to filing this notice of claim and proof of loss, is extended to comply with the minimum requirements of the state in which the claimant resides at the time his insurance under this plan is in effect.