Your Group Long Term Care Plan


Summary of Benefits
Terms You Should Know
Benefits Information
Limitations and Exclusions
Rehabilitation and Alternative Care Plans
Claim Information
Termination of Coverage
General Information


This certificate of Insurance is a part of the entire contract. This certificate is subject to the terms and conditions state on the attached pages, all of which are part of the Policy. The Policy is intended to be a qualified Long Term Care insurance contract under Section 7702B(b) of the internal Revenue Code of 1986.

Policy Number: 119032 001

Caution: If you completed an Application for Long Term Care Insurance which included evidence of insurability, the issuance of this long term care insurance certificate was based upon your responses to the questions on your application. A copy of your Application for Long Term Insurance was retained by you when you applied. If your answers are incorrect or untrue, Unum may have the right to deny benefits or rescind your coverage. The best time to clear up any questions is now, before a claim arises! If, for any reason, any of your answers are incorrect, contact Unum at this address: Unum Life Insurance Company of America, 2211 Congress Street, Portland, Maine 04122.

Guarenteed Renewable

Renewability: The Policy is renewable at the option of the Policyholder and Unum. This means that your coverage under the plan may be changed or ended at the option of the Policyholder or Unum. If your coverage is ended by the Policyholder or Unum, you will have a guarenteed right to elect converted coverage. For more information, see the provision "CONTINUANCE OF COVERAGE".