Long Term Care Insurance Policy, Page 5

SAMPLE LONG TERM CARE INSURANCE POLICY

POLICY SCHEDULE - (continued)

If you have selected the Ten-Year Premium Payment Option. This means that Your Policy is fully paid-up and no further premiums will be due at the end of Your tenth Policy year. Prior to the end of Your tenth Policy year, You must make sure that You pay the premiums when they are due to continue this Policy. However, in the event that We find that the premium rates for this Policy form are inadequate prior to the end of the tenth Policy year, We reserve the right to increase Your premium as of the next premium due date.

If you have selected the Paid-Up at Age 65 Payment Option. This means that Your Policy will be paid-up and no further premiums will be due after the Policy anniversary following Your 65th birthday. Prior to this, You must make sure that You pay the premiums when they are due to continue this Policy. However, in the event that We find that the premium rates for this Policy form are inadequate during the premium paying period, We reserve the right to increase Your premium as of the next premium due date.

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