Eligibility Requirements: You must be enrolled in SAMBA’s Group Term Life Insurance Plan. If you are requesting supplemental benefits for your spouse, he or she must be enrolled in the Dependent Group Term Life Insurance Plan. Evidence of insurability is required.

Benefits offered by the Plan:

• Accelerated Death Benefit: If you have a Terminal Medical Condition, the Accelerated Death Benefit can make a difficult time a little easier for your family. The plan can make available up to 75% of your Supplemental Group Term Life insurance amount, up to a maximum of $250,000. This can be used to help pay medical expenses or begin putting the family’s financial affairs in order. A Terminal Medical Condition is one that, with reasonable medical certainty will result in death within 12 months and was diagnosed by a physician on or after coverage became effective. The same benefit is available under spouse’s coverage. This benefit terminates on the earlier of the date this benefit is paid or the date the policy terminates.

• Retirement Coverage: The Supplemental Plan may be continued into retirement with no reduction in the amount of coverage.

Rates effective January 1, 2004