ASCP Term Life Insurance PLAN DESCRIPTION
	Get up to $300,000 in coverage
	You can apply for $20,000 to $300,000 in protection, if you are a U.S. resident under age 65 at the time you apply and are actively-at-work (at least 30 hours per week) and performing all the regular duties of your occupation. It's a great way to help make sure your coverage keeps pace with your financial and personal responsibilities, even if you already have some life insurance through your employer, or individually. All levels of coverage are subject to medical evidence of insurability as determined by The Hartford.† Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you. Cover your spouse for up to $150,000 Your spouse, under age 65 and a U.S resident, can apply for one-half of your selected coverage— up to a maximum of $150,000 — at the same affordable group rates available to members. This added protection is vital for today’s two-income households and even if the spouse does not work outside of the home. Separated and divorced spouses are not eligible. Affordable group premiums ASCP has put the combined buying power of thousands of members to work for you. Click here to find out how affordable it is to get high-limit protection for your family’s financial future. Term Life Insurance Plan rates Benefits to help with critical illness If you or your covered spouse under age 65 are diagnosed with a Critical Illness and have satisfied the coverage waiting period, you may be eligible for a critical illness benefit of $5,000 -$25,000 (but not more than 70% of your life benefit amount). This one-time payment can help you pay the high cost of fighting such a disease, and will reduce the total benefit amount paid to the beneficiary upon the insured’s death. This benefit is not available in all states. Critical Illness means Cancer, Heart Attack, or Stroke. Cancer means the presence of a malignancy characterized by the uncontrolled and abnormal growth and spread of malignant cells in any part of the body. This includes Hodgkin’s Disease, leukemia, lymphoma, carcinoma, sarcoma, or malignant tumor. It does not include other conditions which may be considered pre-cancerous, including, but not limited to: leukoplakia, actinic keratosis, carcinoid, hyperplasia, polycythemia, nonmalignant melanoma, moles, basal cell carcinoma, or similar diseases or lesions. Cancer does not mean carcinoma in situ. Heart Attack means a myocardial infarction only. Heart attack does not include any other disease, arrhythmia or injury involving the cardiovascular system. Cardiac arrest not caused by a myocardial infarction is not a heart attack. Stroke means a cerebrovascular accident which results in paralysis lasting more than 24 hours and produces measurable neurological deficit persisting for at least 30 days following the occurrence of the Stroke. Stroke does not mean a head injury, transient ischemic attack, or chronic cerebrovascular insufficiency. Other valuable provisions of the plan • Waiver of premiums for disability If you become Totally Disabled for six straight months before age 60 and provide adequate proof of your disability, your Term Life insurance, if covered, will continue without further premium payments for as long as you continue to be Totally Disabled. Total Disability, if you are employed, means the inability to engage in any occupation or profession for wage or profit. If you are not employed, it means the inability to perform the usual and customary activities of a person of like age and sex in good health. Premium payments must resume when disability ceases. • Portable protection Since the ASCP Plan is not tied to your job, its protection follows you throughout your career and after you retire. • Conversion privilege The ASCP Term Life Plan provides the opportunity to convert your term life policy to a permanent individual policy with no medical examination. You can choose to convert your coverage when you cease to be insured for any reason except voluntary non-payment of premiums, termination of the Master Policy, or termination of a class of insureds under the Master Policy, subject to certain conditions that will be described in your Certificate of Insurance. • Name your own beneficiary You can name your beneficiaries at the time you apply and change your designation any time you wish simply by filing the appropriate written form with the insurance company. You will be the beneficiary of your spouse’s coverage, unless you request otherwise. • Exclusions If a Covered Person commits suicide: a) while sane or insane; b) during his or her first two years of coverage under the Policy; we will only pay an amount equal to the premium paid for coverage to the date of death. The Life Insurance Benefit is payable if a Covered Person is insured under the Policy and commits suicide after the two year period. The two year suicide exclusion, stated above, will also apply if a Covered Person commits suicide during the two years immediately following an increase in coverage under the Policy. In that event, the Amount of Insurance payable will equal the Amount of Insurance in force prior to the increase plus an amount equal to the premium paid for the increase to the date of death. This benefit does not cover death: a) occurring while in the armed forces of any country or international authority; b) caused or contributed to by accident while occurring while riding in or on, boarding or alighting from any aircraft: 1) as a pilot, crewmember or student pilot; or 2) as a flight instructor or examiner. The Critical Illness Benefit will not be payable: if the Covered Person dies within the 30 day waiting period immediately following a Positive Diagnosis of a Critical Illness; if the Covered Person has already received a Critical Illness Benefit; for a Critical Illness which was Positively Diagnosed prior to the Covered Person’s effective date of coverage under this rider; for any disease, sickness or injury, except as expressly stated herein; for a Critical Illness which is diagnosed by the Insured Person or any member of his or her immediate family; or for a Critical Illness which is contracted as a result of war or acts of war, whether declared or not; injury sustained while in the armed forces of any country. The Critical Illness Benefit is not available in all states. • Coverage remains in force to age 70 Once your Certificate of Insurance is issued, coverage will remain in force until you reach age 70. Your coverage cannot be cancelled on an individual basis as long as: -- your premiums are paid when due; -- you remain a member of ASCP ; -- the Master Policy remains in force; -- your plan of benefits or class of insureds is not terminated under the Master Policy. Coverage of a Covered Dependent terminates on the earliest to occur of: a) the date the Policy is cancelled; or b) the Premium Due Date on or next following the date he or she: 1) in the case of a Covered Spouse, is legally separated or divorced from you; 2) in the case of a Covered Child, no longer qualifies as an Eligible Child as defined; 3) attains the Policy Age Limit shown in the Schedule; or c) the Premium Due Date the required premium is not made, subject to the Grace Period provision; or d) the date your coverage terminated for a class of person to which You belong. However, if dependent's coverage would terminate because of your death, coverage will continue until the Premium Due Date on or next following your death. • Effective date of coverage Your coverage will become effective on the date shown on your Certificate of Insurance, provided the required premium has been paid and you are actively at work on that date or, if not employed, you are able to carry out all the normal and customary activities of a person of like age and sex in good health. If you or your covered spouse is not actively at work on the date the insurance is effective, coverage will not become effective until the first day of the month on or next following the date you or your spouse is actively at work. Notice of Insurance Information Practices: To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning your insurability. You are our most important source of information, but we may also contact other sources such as medical professionals and institutions, employers and other insurance companies. While all information regarding your insurability will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items of information to third parties without your specific authorization. INVESTIGATIVE CONSUMER REPORTS As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside insurance reporting organization. Personal information may be collected from others regarding your general reputation and lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in connection with the preparation of the investigative consumer report. You have the right to send a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation. PERSONAL HISTORY INTERVIEW To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance. MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company , or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com. ACCESS, CORRECTION AND DISCLOSURE You can obtain access to personal information about you contained in our policy files by sending us a written request. You may also request any necessary corrections, amendments or deletion of any information in our files which you believe to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice providing further description of the circumstances under which information about you may be disclosed and the types of persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further information or access to your personal information, please send your written request to: Hartford Life Insurance Company or Hartford Life and Accident Insurance Company, 200 Hopmeadow St., Simsbury, CT 06089. The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company. PA-9369 It’s easy to apply for the ASCP Term Life Insurance Plan. Subject to pre-existing conditions limitations. Get instructions and an application 100% Satisfaction Guarantee Our satisfaction guarantee makes it possible for you to examine the ASCP Term Life Insurance Plan without risk. If you aren’t satisfied with the coverage, simply return your Certificate of Insurance within 30 days for a full refund minus any claims paid. ASCP TERM LIFE INSURANCE PLAN
	Endorsed and recommended by: American Society for Clinical Pathology 2100 West Harrison Street Chicago, IL 60612 www.ascp.org
	Administered by: JZA Affinity 7735 Old Georgetown Road, Suite 800 Bethesda, MD 20814 1-800-865-2727 x1792 240-482-1892
Simsbury, CT	Underwritten by: Hartford Life and Accident Insurance Company About the Underwriter The Hartford® is The Hartford Financial Services Group, Inc. and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.
	DISCLAIMER: This website explains the general purpose of the insurance described, but in no way changes or affects Master Policy AGL-1654 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by the Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states. Policy Form # SRP-1153 A (HLA)(1654) Click here to apply for the ASCP Term Life Insurance Plan