CONTINUATION OF INSURANCE WITH PREMIUM PAYMENT (continued) If written notice of the option to Port is not given within 91 days of the date such insurance ends, the Request Period: begins on the date the insurance ends, and expires at the end of such 91 day period. Amount of the New Certificate The amount of Ported Insurance for You and for Your Dependents that may be continued is shown in the SCHEDULE OF BENEFITS. However, at the time of Porting You may change the amount of Portability Eligible Insurance in the following circumstances: Your Increase in Amount For Portability Eligible Life Insurance At the time of Porting, You may increase the amount of Your Portability Eligible Life Insurance. This may be done in increments of $25,000, up to a maximum ported amount of $2,000,000. To be eligible for this increased amount, You must provide evidence of Your insurability satisfactory to us, at Your expense. If We approve the increase, it will take effect on the date We state in Writing. Spouse or State-Registered Domestic Partner Increase in Amount For Portability Eligible Dependent Life Insurance At the time of Porting, the amount of Your Spouse or State-Registered Domestic Partner’s (or Your former Spouse or State-Registered Domestic Partner’s) Portability Eligible Dependent Life Insurance may be increased. This may be done in increments of $25,000, up to a maximum ported amount of $250,000. To be eligible for this increased amount, Your Spouse or State- Registered Domestic Partner (or Your former Spouse or State-Registered Domestic Partner) must provide evidence of insurability satisfactory to us, at Your Spouse or State-Registered Domestic Partner’s (or Your former Spouse or State-Registered Domestic Partner’s) expense. If We approve the increase, it will take effect on the date We state in Writing. Child Increase in Amount For Portability Eligible Dependent Life Insurance At the time of Porting, if Your former Child is making the request to continue Portability Eligible Dependent Life Insurance because they no longer meet the definition of a Child, that former Child is eligible to increase coverage by $25,000. To be eligible for this increased amount, Your former Child must give evidence of insurability satisfactory to Us at Your former Child’s expense. If we approve the increase, it will take effect on the date We state in Writing. You and/or Your Dependent(s) Decrease in Amount If We receive a request to decrease an amount of insurance, any such decrease will take place on the date We state in Writing. Premiums for the New Certificate All premium payments for ported insurance must be made directly to Us. When We issue the new certificate, We will also provide a schedule of premiums and payment instructions. You are not required to provide evidence of insurability to Port Your existing amount of Portability Eligible Life Insurance. However, to qualify for a lower premium rate, You may give us, at Your expense, evidence of Your insurability satisfactory to Us. If We determine that the evidence satisfies Us, We will notify You that the lower premium rates will apply to You. GCERT2024-WSHCA-WA-LIFE-EMPLOYEE1 57
