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PREMIUM PROVISIONS <br />Initial Monthly Premium Rates <br />The initial monthly premium rates to be charged for employee coverage and/or child/spouse coverage, if applicable, are <br />shown on the following page(s). <br />The first premium is due and payable on the effective date of The Policy. Subject to The Policy's grace period provision, <br />all premiums after the first must be paid when or before they are due. <br />Premiums are based on the employee's age on his or her effective date and thereafter on the first day of the month <br />following the month in which his or her birthday occurs. <br />For Lang Term Disability Benefits, the amount of an employee's Indexed Pre -disability Earnings which is disregarded in <br />determining his or her Monthly Benefit because of the Maximum Monthly Benefit limitation will also be disregarded in <br />determining the amount of the total insured payroll. <br />The Initial Monthly Premium Rates may be converted as follows <br />To Convert Rates to: <br />Use a Conversion Factor of: <br />annual rates <br />11.8227 <br />semi-annual rates <br />5.9557 <br />quarterly rates <br />2.9852 <br />Grace Period <br />The Company will allow the Policyholder a 60 day grace period for the payment of all premiums after the first. During this <br />60 day period, The Policy will stay in force. If the owed premium is not paid by the 60th day, The Policy will automatically <br />terminate. If the Policyholder gives The Company written advance notice of an earlier cancellation date, The Policy will <br />terminate on the earlier date. Premium is due for each day The Policy is in force. <br />Monthly Premium Rate Guarantee <br />Initial Monthly Premium Rates are guaranteed as follows: <br />Benefit <br />Rate Guarantee Period <br />Long Term Disability Benefits <br />until January 1, 2020 <br />Basic Life Insurance <br />until January 1, 2020 <br />Supplemental Life Insurance <br />until January 1, 2020 <br />Supplemental Dependent Life Insurance <br />until January 1, 2020 <br />Basic Accidental Death and Dismemberment Benefit <br />until January 1, 2020 <br />Supplemental Accidental Death and Dismemberment Benefit <br />until January 1, 2020 <br />Subject to the Rate Guarantee Period shown above, The Company has the right to change premium rates on any <br />premium due date if: <br />1) written notice is delivered to the Policyholder's last address on record; and <br />2) the change is effective at least 31 days after the date of notice. <br />The Rate Guarantee Period supersedes only those provisions appearing elsewhere in this Policy which give The <br />Company the right to change the premium rates, and then, only for the period of time for which the rates are guaranteed. <br />However, The Company may change the premium rates during the Rate Guarantee Period if there is a change in The <br />Policy, or if there is a 10% increase or decrease in the number of insured Employees, or if the Policyholder adds or <br />deletes a subsidiary or affiliated business entity. The Company may also change the premium rates during the Rate <br />Guarantee Period if there has been a material misstatement in the reported experience during the pre -sale process. The <br />Rate Guarantee Period in no way affects, amends or supersedes any other provision in The Policy. <br />Form GBD-1000 A (10/08) (CA) 4 <br />55A-9 <br />