Eligibility Requirements: You do not need to be enrolled in any other SAMBA plan to take advantage of the Disability Income Protection Plan. You are eligible to enroll if you work Full-Time and provide evidence of insurability. When you enroll, your spouse and your dependent children under age 22 are also covered for Hospital Confinement benefits.

Law enforcement officers authorized to carry firearms can enroll for full coverage, like any other employee.

If you become Disabled:

• Disability Income Protection Benefit: If you become Disabled, this SAMBA plan provides a monthly income benefit to protect you and your family against financial hardship. After you have been Disabled and unable to work for 60 days, you can qualify for monthly income benefit payments. The plan will pay up to 65% of your Covered Salary Amount. Benefits may continue until you reach age 62 (or for a minimum of 12 months, whichever is later).

• Survivor Benefit: In the event your untimely death occurs while you are collecting monthly income benefits, and your death was caused by or related to the Disability diagnosis for which you were receiving Income Protection Benefits, your spouse or named beneficiary will receive 50% of the monthly income benefits you were entitled to receive. These survivor benefits will continue for 10 years, or until you would have reached age 65, whichever is earlier.

• Residual Disability Benefit: If you receive monthly income benefits for at least 30 days, you may qualify to receive 35% of your monthly benefit while returning to full-time employment on a reduced work schedule as part of a Residual Disability Benefit approved by SAMBA, for up to 90 days.

If you or a dependent are hospitalized:

• Hospital Confinement Benefit: In the event you or your spouse are Confined in a Hospital, the plan pays 70% of your daily earnings (1/360th of your Covered Salary Amount) for the number of days confined, up to 60 days; 35% is payable if your dependent child is hospitalized. Successive periods of confinement due to the same or related cause will be considered one confinement unless separated by 6 months of no hospital confinement.

How benefits and rates are determined

Your annual Covered Salary Amount determines your amount of coverage and is divided by 12 to determine a monthly income figure. Your benefits are 65% of this amount, reduced by Benefit Offsets, and paid monthly. After Benefit Offsets, your monthly benefit will not be less than $200 per month.

Some Key Plan Definitions

Benefit Offsets: Benefit Offsets include all benefits under: (1) Workers Compensation or similar law; (2) any state disability income benefit law or similar law; (3) any other group disability coverage; (4) the Federal Employees’ Retirement System (FERS), the Civil Service Retirement System (CSRS), Social Security or any similar pension or retirement plan; (5) disability benefits through the Veteran’s Administration; (6) state “no fault” auto laws; (7) any amount received by compromise, settlement, or other method resulting from a claim; (8) any sick pay or other salary continuance payable after receiving monthly benefits for 12 months; or (9) any pay received as a result of administrative leave, excused absence, or any other official release from duties without loss of pay and without charge to annual or sick leave.

Confined/Confinement: any Confinement which has been ordered by a Physician and for which the Insured Person is charged for a full day’s room and board. A Hospital provides full-time medical care and treatment under the direction of licensed physicians and Registered Nurses, but does not mean nursing homes, rest homes, convalescent homes, homes for the aged, drug and alcohol rehabilitation centers, or facilities primarily providing custodial, educational, or rehabilitative care.

Covered Salary Amount: Covered Salary is the amount applied for and approved as shown in your Certificate and cannot exceed your Eligible Salary Amount. The Eligible Salary Amount is your gross income, rounded to the next highest $1,000. It includes locality pay, availability pay, or administratively uncontrolled overtime, but does not include bonuses, regular overtime, differential pay allowances, or any other compensation.

Disability or Disabled means that because of injury, sickness, or mental or nervous disorders you are not engaged in any occupation or employment for wage or profit, and (1) during the first 24 months of Disability, you cannot perform all of the material and substantial duties of your regular occupation; and (2) after 24 months of Disability, you are completely unable to perform the material and substantial duties of any occupation for which you are reasonably fit by education, training, or experience. You must be under the regular care of a physician.

Full-Time means working for your employer more than 32 hours per week.

Limitations and Exclusions

If the Disability is due to a Mental or Nervous Disorder benefits are limited to at most 24 months for a single period of Disability. The Lifetime Maximum for Mental and Nervous Disorders is 48 cumulative months. The Lifetime Maximum Benefit is 24 months for the following specified conditions: (1) Carpal Tunnel Syndrome, (2) Chronic Fatigue and similar syndromes and diseases, (3) chemical or environmental sensitivities, (4) certain neuromusculoskeletal or soft-tissue disorders, and (5) symptoms which are not supported, documented or diagnosed through conventional medical tests. Occupational Disabilities are limited to 12 months during a single period of Disability.

Disability or Hospital Confinement due to a Pre-existing Condition must begin at least 24 months after the effective date of coverage to qualify for benefits. A Pre-existing Condition is a sickness or injury for which during the 12 months immediately prior to the effective date you: (1) received medical treatment, consultation, care or services; (2) took prescription medication or had medications prescribed; or (3) had symptoms or conditions which would cause a reasonably prudent person to seek diagnosis, care, or treatment.

Benefits are not payable if you are hospitalized or receiving medical treatment outside the U.S., its territories, or Canada, unless the Insured is temporarily traveling on business or pleasure and we agree in writing to provide coverage. No payments will be made for Disability or Hospital Confinement resulting from: war, declared or undeclared, or acts of war; normal pregnancy; intentionally self-inflected injuries (while sane or insane; for residents of CO or MO while sane); engaging in an illegal act, or in resisting or fleeing arrest; voluntary taking of poison or inhalation of gas; any accident where the blood alcohol content exceeds the legal limit; being under the influence of any narcotic, barbiturate or hallucinatory drug; or any drug or alcohol disorder; for any period of time for which the Insured is incarcerated, whether or not the Total Disability commenced while incarcerated; or while you are in the military or any country or international organization. In addition, for the Hospital Confinement Benefit, any Hospital Confinement which results from cosmetic surgery, except for reconstructive surgery or to treat a congenital malformation of a child, is not covered.

Rates effective January 1, 2004