POLICY PROVISIONS
(Continued)
Termination of Policy
Hartford Life may terminate the policy for the following reasons by giving the Policyholder 45 days written notice:
e The Policyholder fails to furnish any information which Hartford Life may reasonably require;
The Policyholder fails to perform any of his other obligations pertaining to this policy;
Less than 100% of the persons eligible for coverage on a Non-contributory Basis are insured; or
Less than 75% of the persons eligible for coverage on a Contributory Basis are insured.
Fewer than 10 persons are insured.
In addition, Hartford Life may terminate this policy on any premium due date after the policy has been in force for 12
months.
Certificate
Hartford Life will give the Policyholder an individual Booklet-certificate for each insured employee. The Booklet-
certificate is part of the policy, and will explain the important features of the policy.
Data To Be Furnished
The Policyholder will give Hartford Life all information Hartford Life needs regarding matters pertaining to the
insurance. At any reasonable time while the policy is in force and for | year after that, Hartford Life may inspect any
of the Policyholder's documents, books, or records which may affect the insurance or premiums of this policy.
If the Policyholder gives Hartford Life any incorrect information, the relevant facts will be determined to establish if
insurance is in effect and in what amount.
No person will be deprived of insurance to which he is otherwise entitled or have insurance to which he is not entitled,
because of any misstatement of fact by the Policyholder. Any required adjustment may be made in premiums or
benefits.
No Replacement for Workers' Compensation
The policy does not replace Workers’ Compensation or affect any requirement for Workers' Compensation coverage.
Time Period
All periods begin and end at 12:01 A.M., standard time, at the Policyholder's address.
Jurisdiction
This policy is governed by the laws of the state where it is delivered.
GR-11383-HLA(8) PL-8.00
