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A. If your group life insurance ends because of separation from State service or because you enter a class which provides a lower benefit, you may apply for an individual policy of life insurance (called a conversion policy) without giving information about your health. You can obtain a conversion form from your Human Resources Office. Conversion is subject to the following conditions.

1. You may apply for any of United’s individual life insurance policies, except term insurance. You may NOT apply for any disability or other supplementary benefits.

2. You may apply for an amount which is not more than the amount of your terminated or reduced group life insurance.

3. The premium for your conversion policy will be at United’s standard rate for that type of policy, according to your age on the date the policy takes effect.

4. You must submit your written application and your first conversion premium to United within 31 days after your group life insurance ends or reduces.

B. If you have been insured at least three years and your group life insurance ends

(1) because the policy is discontinued or

(2) because the class of employees to which you belong is no longer eligible for group life insurance,

You may apply within 31 days for an individual policy of life insurance without giving information about your health. Conversion is subject to conditions 1, 3 and 4 above. Your converted life insurance may not exceed the lesser of:

(a) $3,000 or

(b) the amount of your terminated life insurance under the policy less the amount of any other group life insurance for which you become eligible within 31 days.

C. If you die within the period you could have applied for a conversion policy, United will pay the amount of group life insurance you were entitled to convert.

D. If a conversion policy has been issued to you, payment will be made at your death under your Continued Employee Life Insurance Coverage During Total Disability provision only if the conversion policy is surrendered without claim other than for the return of the conversion premiums you paid.

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