Group Accidental Death & Dismemberment Insurance

Underwritten by:

Federal Insurance Company,

a member insurer of the Chubb Group of Insurance Companies 202B Hall's Mill Road, PO Box 1650

Whitehouse Station, New Jersey 08889-1650

Important Notice - Please Read this Description of Coverage Carefully As a handy reference guide, please read this document and keep it in a safe place with your other insurance documents. This description of coverage is not a contract of insurance but is a summary of the principal provisions of the insurance while in effect. Complete policy provisions are contained In the Master Policy, 99086275, which can be obtained by contacting the Policy Administrator. This insurance is subject to the eligibility and effective date requirements of the group policy issued to: POLICYHOLDER: Nation Safe Drivers

GROUP POLICY NO.: 99086275

MEMBER ELIGIBILITY - All active registered dues paying members of the Policyholder covered under plan 201 / 205 & U1 / U3 as on file with the administrator, and their Spouse or Domestic Partner and their Dependent Child(ren) if coverage is elected for those individuals. If, subject to all the terms and conditions of this policy a person is eligible for insurance under multiple Classes of Insured Persons described above, then such person will only be insured under the Class which provides the Insured Person the largest Benefit Amount for the loss that has occurred. Coverage begins the first day of the first month following the Insured Person’s enrollment date. DATE MEMBER’S INSURANCE TAKES EFFECT – Insurance becomes effective on the latest of: 1) the effective date of this policy, 2) the date on which such person first meets the eligibility criteria as the Insured Person; or 3) the beginning of the period for which required premium is paid for such Insured Person.

DATE MEMBERS' INSURANCE ENDS – Insurance for the Insured Person automatically terminates on the earliest of: 1) the termination date of this policy 2) the expiration of the period for which required premium has been paid for such Insured Person; 3) the date on which a person no longer meets the eligibility criteria as the Insured Person; or 4) the date on which We pay out 100% of the Principal Sum. ACCIDENTAL DEATH AND DISMEMBERMENT BENEFITS

We will pay the applicable Benefit Amount if an Accident results in a covered Loss not otherwise excluded. The Accident must result from an insured Hazard and occur while an Insured Person is insured under this policy, while it is in force. The covered Loss must occur within one (1) year after the Accident. Private Passenger Automobile Business and Pleasure Hazard means all circumstances, subject to the terms and conditions of this policy, arising from and occurring while an Insured Person is entering, exiting, driving or riding in a Private Passenger Automobile. This Private Passenger Automobile Business and Pleasure Hazard does not apply while an Insured Person is 1) driving or riding as a passenger in, entering or exiting a Private Passenger Automobile in a race or contest of any type; or 2) in any vehicle that is licensed to carry passengers for hire. PRINCIPAL SUM - The Member’s Principal Sum is $10,000. The following are Losses insured and the corresponding Benefit Amount expressed as a percentage of the Principal Sum: 100% for Loss of Life, 100% for Loss of Speech and Loss of Hearing; 100% for Loss of Speech and one of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 100% for Loss of Hearing and one of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 100% for Loss of Hands (Both), Loss of Feet (Both), Loss of Sight or a combination of any two of Loss of Hand, Loss of Foot or Loss of Sight of One Eye; 50% for Loss of Hand, Loss of Foot or Loss of Sight of One Eye (Any one of each); 50% for Loss of Speech or Loss of Hearing; 25% for Loss of Thumb and Index Finger of the same hand.

If an Insured Person suffers multiple covered Losses as the result of one (1) Accident, then We will only pay the single largest Benefit Amount applicable to all such covered Losses suffered.

If more than one (1) Insured Person suffers a Loss, Covered Loss or Loss of Property in the same Accident, then We will not pay more than the Policy Aggregate Limit of Insurance shown above. If an accident results in Benefit Amounts becoming payable, which when totaled, exceed the applicable Policy Aggregate Limit of Insurance shown above, then the Policy Aggregate Limit of Insurance will be divided proportionally among the Insured Persons, based on each applicable Benefit Amount. Extensions of Insurance: Disappearance: If an Insured Person has not been found within one (1) year of the disappearance, stranding, sinking, or wrecking of any Conveyance in which an Insured Person was an occupant at the time of the Accident, then it will be assumed, subject to all other terms and conditions of this policy, that an Insured Person has suffered Loss of Life insured under this policy. Exposure: Accident includes unavoidable exposure to elements arising from an insured Hazard. ADDITIONAL BENEFITS

Enhanced In Hospital: This benefit will pay $125 for each day the Insured Person is In-Hospital if an Accident causes the Insured Person to be In- Hospital. The Elimination Period is zero days. The Enhanced In-Hospital Benefit Amount will not be paid for more than 365 days. The Enhanced In- Hospital Benefit Amount is payable in addition to any other applicable Benefit Amounts under this policy. The Enhanced In-Hospital Benefit Amount will be paid until the earliest of the date 1) the Insured Person dies; 2) the Insured Person is no longer In-Hospital; or 3) the Maximum Number of Days for the Enhanced In-Hospital Benefit Amount, shown in Section IV-C of the Schedule of Benefits, has elapsed. Excess Accident Medical Expense: This benefit will reimburse Medical Expenses up to $1,000 if accidental bodily Injury causes an Insured Person to first incur Medical Expenses for care and treatment of the accidental bodily Injury within 30 days after an accident. The Benefit Amount for Excess Accident Medical Expense is payable only for Medical Expenses incurred within 52 weeks after the date of the accident causing the accidental bodily Injury. The Benefit Amount is subject to a Deductible of $100. The Deductible will be deducted from any Benefit Amount for Accident Medical Expense that We pay. This Deductible applies separately to each Insured Person and each accident. The Benefit Amount for Excess Accident Medical Expense is payable on an excess basis. We will determine the Reasonable and Customary Charge for the covered Medical Expense. We will then reduce that amount by amounts already paid or payable by any Other Plan. We will pay the resulting amount, less the Deductible for Excess Accident Medical Expense but in no event will We pay more than the Benefit Amount for Excess Accident Medical Expense

The Benefit Amount for Excess Accident Medical Expense does not apply to charges and services 1) for which the Insured Person has no obligation to pay; 2) for any injury where worker's compensation benefits or occupational injury benefits are payable; 3) for treatment by a person employed or retained by the Policyholder; 4) for any injury occurring while fighting, except in self-defense; 5) for treatment that is educational, experimental or investigational in nature or that does not constitute accepted medical practice; or 6) for treatment involving conditions caused by repetitive motion injuries, or cumulative trauma and not as the result of an Accidental Bodily Injury. This insurance applies only to Medically Necessary charges and services.

EXCLUSIONS

This policy does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing the insurance. In addition no benefits will be paid for any Accident caused by or resulting from any of the following: 1) an Insured Person’s commission or attempted commission of any illegal act, including but not limited to any felony; 2) an Insured Person being intoxicated, at the time of an Accident. Intoxication is defined by the laws of the jurisdiction where such Accident occurs; 3) an Insured Person being intoxicated, while operating a motorized vehicle at the time of an Accident. Intoxication is defined by the laws of the jurisdiction where such Accident occurs. 4) an Insured Person being under the influence of any narcotic or other controlled substance at the time of an Accident. (This exclusion does not apply if any narcotic or other controlled substance is taken and used as prescribed by a Physician.); 5) an Insured Person being engaged in or participating in a motorized vehicular race or speed contest; 6) an Insured Person participating in any professional sporting activity for which the Insured Person received a salary or prize money; 7) an Insured Person participating in military action while in active military service with the armed forces of any country or established international authority. (This exclusion does not apply to the first 60 consecutive days of active military service with the armed forces of any country or established international authority.); 8) an Insured Person's suicide, attempted suicide or intentionally self-inflicted injury; 9) when the United States of America has imposed any trade or economic sanctions prohibiting insurance of any Accident, Accidental Bodily Injury or Loss; or there is any other legal prohibition against providing insurance of any Accident, Accidental Bodily Injury or Loss; 10) a declared or undeclared War.

DEFINITIONS

Accident or Accidental means a sudden, unforeseen, and unexpected event happening by chance. Accidental Bodily Injury means bodily injury, which is: 1) Accidental; 2) the direct cause of a loss; and 3) is independent of disease, illness or other cause; and 4) occurs while the Insured Person is insured under this policy, which is in force. Accidental Bodily Injury does not include conditions caused by repetitive motion injuries, or cumulative trauma not a result of an Accident, including, but not limited to 1) Osgood-Schlatter's Disease; 2) bursitis; 3) Chondromalacia; 4) shin splints; 5) stress fractures; 6) tendinitis; and 7) Carpal Tunnel Syndrome. Benefit Amount means the amount stated which applies: 1) at the time of an Accident the entire cost of the fare is charged to the Insured Person’s Account during the policy period; 2) to an Insured Person; and 3) for an applicable Hazard. Class means the categories of Insured Persons described in the policy. Company means FEDERAL INSURANCE COMPANY. Conveyance means any motorized craft, vehicle or mode of transportation licensed or registered by a governmental authority with competent jurisdiction. Covered Loss means Accidental Bodily Injury or Loss of Life of the Insured Person. Dependent means a Dependent Child, Spouse, or Domestic Partner of a Primary Insured Person. Dependent Child means the Primary Insured Person’s unmarried child from the moment of birth, including a natural child, grandchild, stepchild, foster child or adopted child from the date of placement with the Primary Insured Person. The Dependent Child must be primarily dependent upon such Primary Insured Person for maintenance and support, and must be 1) under the age of twenty-five (25); 2) under the age of twenty-five (25) and enrolled as a full-time or part time student at an Institution of Higher Learning; or 3) classified as an Incapacitated Dependent Child.. Domestic Partner means a person designated in writing at enrollment by the Primary Insured Person who is registered as a Domestic Partner or legal equivalent under laws of the governing jurisdiction or who: 1) is at least 18 years of age and competent to enter into a contract; 2) is not related to the Primary Insured Person by blood; 3) has exclusively lived with the Primary Insured Person for at least twelve (12) consecutive months prior to the date of enrollment; 4) is not legally married or separated; and 5) as of the date of enrollment, has with the Primary Insured Person at least two (2) of the following financial arrangements: a) a joint mortgage or lease; b) a joint bank account; c) joint title to or ownership of a motor vehicle or status as a joint lessee on a motor vehicle lease; or d) a joint credit card account with a financial institution. Neither the Primary Insured Person nor the Domestic Partner can be married to, nor be in a civil union with anyone else. Elimination Period means the consecutive amount of time as shown in the policy that must elapse before a Benefit Amount becomes payable. The Elimination Period begins on the first day of the Insured Person’s covered Loss. Benefit Amounts are not payable, nor do they accrue, during an Elimination Period. Hazard means the circumstances for which this insurance is provided as stated in Section III of the Schedule of Benefits and described in the Hazard Section of this policy. Hospital means a public or private institution which: 1) is licensed in accordance with the laws of the jurisdiction where it is located; 2) is accredited by the Joint Commission on Accreditation of Hospitals; 3) operates for the reception, care and treatment of sick, ailing or injured persons as in-patients; 4) provides organized facilities for diagnosis and medical or surgical treatment; 5) provides twenty-four (24) hour nursing care; 6) has a Physician or staff of Physicians ; and 7) is not primarily a day clinic, rest or convalescent home, assisted living facility or similar establishment and is not, other than incidentally, a place for the treatment of alcoholics or drug addicts. Immediate Family Member means an Insured Person’s: 1) Spouse or Domestic Partner; 2) children including adopted children or stepchildren; 3) legal guardians or wards; 4) siblings or siblings-in-law; 5) parents or parents-in-law; 6) grandparents or grandchildren; 7) aunts or uncles; 8) nieces and nephews. Immediate Family Member also means a Spouse’s or Domestic Partner’s children, including adopted children or stepchildren; legal guardians or wards; siblings or siblings-in-law; parents or parents-in-law; grandparents or grandchildren; aunts or uncles; nieces or nephews. Incapacitated Dependent Child means a child who, as a result of being mentally or physically challenged, is permanently incapable of self-support and permanently dependent on a Primary Insured Person for support and maintenance. The incapacity must have occurred while the child was under the age of twenty-five (25). In- Hospital means registered as an in-patient and confined to a Hospital while being treated by a Physician. In-Hospital does not include confinement solely for convalescent or nursing care. Insured Person means a person, qualifying as a Class member: 1) who elects insurance; or 2) for whom insurance is elected, 3) and on whose behalf premium is paid. Loss means Accidental: Loss of Foot, Loss of Hand, Loss of Hearing, Loss of Life, Loss of Sight, Loss of Sight of One Eye, Loss of Speech, Loss of Thumb and Index Finger. Loss must occur within one (1) year after the Accident. Loss of Foot means the complete severance of a foot through or above the ankle joint. We will consider such severance a Loss of Foot even if the foot is later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation. Loss of Hand means complete severance, as determined by a Physician, of at least four (4) fingers at or above the metacarpal phalangeal joint on the same hand or at least three (3) fingers and the thumb on the same hand. We will consider such severance a Loss of Hand even if the hand, fingers or thumb are later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation. Loss of Hearing means permanent, irrecoverable and total deafness, as determined by a Physician, with an auditory threshold of more than 90 decibels in each ear. The deafness cannot be corrected by any aid or device, as determined by a Physician. Loss of Life means death, including clinical death, as determined by the local governing medical authority where such death occurs within 365 days after an Accident. Loss of Sight means permanent loss of vision. Remaining vision must be no better than 20/200 using a corrective aid or device, as determined by a Physician. Loss of Sight of One Eye means permanent loss of vision of one eye. Remaining vision in that eye must be no better than 20/200 using a corrective aid or device, as determined by a Physician. Loss of Speech means the permanent, irrecoverable and total loss of the capability of speech without the aid of mechanical devices, as determined by a Physician. Loss of Thumb and Index Finger means complete severance, through the metacarpal phalangeal joints, of the thumb and index finger of the same hand, as determined by a Physician. We will consider such severance a Loss of Thumb and Index Finger even if a thumb, an index finger or both are later reattached. If the reattachment fails and amputation becomes necessary, then We will not pay an additional Benefit Amount for such amputation. Medical Expense means the Reasonable and Customary Charges for Medical Services for the care and treatment of Accidental Bodily Injuries sustained in an Accident. Medically Necessary means a medical or dental service, supply or course of treatment which 1) is ordered or prescribed by a Physician; 2) is appropriate and consistent with the patient's diagnosis; 3) is in accord with current accepted medical or dental practice; and 4) could not be eliminated without adversely affecting the patient's condition. Medical Services means Medically Necessary services, including but not limited to 1) medical care and treatment by a Physician; 2) Hospital room and board and Hospital care, both inpatient and outpatient; 3) drugs and medicines required and prescribed by a Physician; 4) diagnostic tests and x-rays prescribed by a Physician; 5) transportation of the Insured Person in an emergency transportation vehicle from the location where such Insured Person becomes injured to the nearest Hospital where appropriate medical treatment can be obtained; 6) dental care and treatment due to Accidental Bodily Injury; 7) physical therapy, including diathermy, ultrasonic, whirlpool or heat treatment, adjustment, manipulation, massage and the office visit associated with such therapy; 8) treatment performed by a licensed medical professional when prescribed by a Physician, if hospitalization would have been otherwise required; 9) rental of durable medical equipment; 10) artificial limbs and other prosthetic devices; 11) orthopedic appliances or braces. Occupational Injury means an Accidental Bodily Fluid Exposure sustained by the Primary Insured Person during the Policy Period and while such Primary Insured Person is performing duties as a health care professional. Physician means a licensed practitioner of the healing arts, acting within the scope of his or her license to the extent provided by the laws of the jurisdiction in which medical treatment is provided. Physician does not include: 1) an Insured Person; 2) an Immediate Family Member. Policyholder means Nation Safe Driver. Primary Insured Person means an Insured Person who: 1) has a direct relationship with the Policyholder; and 2) where applicable, elects insurance under this policy. Private Passenger Automobile means a four wheeled motor vehicle with a maximum seating capacity of nine (9) people, manufactured, designed and registered as a private passenger vehicle for travel on public roads. Proof of Loss means written evidence acceptable to Us that an Accident, Accidental Bodily Injury or Loss has occurred. Reasonable and Customary Charge means the lesser of 1) the usual charge made by Physicians or other health care providers for a given service or supply; or 2) the charge We reasonably determine to be the prevailing charge made by Physicians or other health care providers for a given service or supply in the geographical area where it is furnished. Reasonable and Customary Charge means the lesser of: 1) the usual charge made by Physicians or other health care providers for a given service or supply; or 2) the charge We reasonably determine to be the prevailing charge made by Physicians or other health care providers for a given service or supply in the geographical area where it is furnished. Spouse means an Insured Person's husband or wife or who is recognized as such by the laws of the jurisdiction in which the Primary Insured Person resides. War means: 1) hostilities following a formal declaration of War by a governmental authority; 2) in the absence of a formal declaration of War by a governmental authority armed, open and continuous hostilities between two countries; or 3) armed, open and continuous hostilities between two factions, each in control of territory, or claiming jurisdiction over the geographic area of hostility. We, Us and Our means FEDERAL INSURANCE COMPANY. BENEFICIARY PROVISIONS

The Benefit Amount for covered Loss of Life will be paid to the beneficiary designated by an Insured Person. Any Benefit Amount payable due to the Loss of Life of a Dependent Child will be paid to the Primary Insured Person, absent any beneficiary designation by the Dependent Child. If an Insured Person has not chosen a beneficiary or if there is no beneficiary alive when the Insured Person dies, then We will pay the Benefit Amount for Loss of Life to the first surviving party in the following order: a) the Insured Person’s spouse or domestic partner, b) in equal shares to the Insured Person’s surviving children, c) in equal shares to the Insured Person’s surviving parents, d) in equal shares to the Insured Person’s surviving brothers and sisters, e) the Insured Person’s estate. All other Benefit Amounts are paid to the Insured Person, unless otherwise directed by an Insured Person or an Insured Person's designee, or unless otherwise noted. If any beneficiary has not reached the legal age of majority, then We will pay such beneficiary's legal guardian.

CLAIMS PAYMENT PROVISIONS

Claim Notice: Written Claim Notice must be given to Us or any of Our brokers or appointed agents within twenty (20) days after the occurrence or commencement of any Loss covered by this policy or as soon as reasonably possible. Notice must include enough information to identify the Insured Person and Policyholder. Failure to give Claim Notice within twenty (20) days will not invalidate or reduce any otherwise valid claim if notice is given as soon as reasonably possible. Claim Forms: When We receive notice of a claim, We will send the Insured Person or the Insured Person's designee, within fifteen (15) days, forms for giving Proof of Loss to Us. If the Insured Person or the Insured Person's designee does not receive the forms, then the Insured Person or the Insured Person's designee should send Us a written description of the Loss. This written description should include information detailing the occurrence, type and extent of the Loss for which the claim is made. Claim Proof of Loss: For claims involving disability, complete Proof of Loss must be given to Us within thirty (30) days after commencement of the period for which We are liable. Subsequent written proof of the continuance of such disability must be given to Us at such intervals as We may reasonably require. Failure to give complete Proof of Loss within these time frames will not invalidate or reduce any otherwise valid claim if notice is given as soon as reasonably possible, and in no event later than one (1) year after the deadline to submit complete Proof of Loss, except in cases where the claimant lacks legal capacity. For all claims except those involving disability, complete Proof of Loss must be given to Us within ninety (90) days after the date of Loss, or as soon as reasonably possible. We have a right to examine under oath, as often as We may reasonably require, the Insured Person, the Policyholder or the beneficiary. We may also require the Insured Person, the Policyholder or the beneficiary to provide a signed description of the circumstances surrounding the Loss and their interest in the Loss. The Insured Person, the Policyholder and the beneficiary will also produce all records and documents requested by Us and will permit Us to make copies of such records or documents. Claim Payment: For benefits payable involving disability, We will pay the Insured Person the applicable Benefit Amount no less frequently than monthly during the period for which We are liable. All payments by Us are subject to receipt of complete Proof of Loss. For all benefits payable under this policy except those for disability, We will pay the Insured Person or beneficiary the applicable Benefit Amount as soon as We receive complete Proof of Loss if the Insured Person, the Policyholder and the beneficiary, where applicable, have complied with all the terms of this policy. If a claim is contested by Us, then We will notify the Insured Person or beneficiary the reasons for contesting the claim within forty-five (45) days of receipt of complete Proof of Loss. If We request additional information from the Insured Person or beneficiary, then upon receipt of requested information We will pay or deny the claim within sixty

(60) days. All overdue claim payments will bear simple interest at the rate of ten percent (10%) per year. Claim and Suit Cooperation: In the event of a claim under this policy, the Policyholder, the Insured Person or the beneficiary, if applicable, must fully cooperate with Us in Our handling of the claim, including, but not limited to, the timely submission of all medical and other reports, and full cooperation with all physical examinations and autopsies that We may require. If We are sued in connection with a claim under this policy, then the Policyholder, the Insured Person or the beneficiary must fully cooperate with Us in the handling of such suit. The Policyholder, the Insured Person or the beneficiary must not, except at their own expense, voluntarily make any payment or assume any obligation in connection with any suit without Our prior written consent. Governing Jurisdiction and Conformance With Statutes - This policy is governed by the laws of the jurisdiction in which it is delivered to the Policyholder. Any terms of this policy which are in conflict with the applicable statutes, laws or regulations of the jurisdiction in which this policy is delivered are amended to conform to such statutes, laws or regulations. HOW TO FILE A CLAIM

To file a claim contact the Claim Administrator:

Co-ordinated Benefit Plans LLC

P.O. Box 26222, Tampa, FL 33623-3802

PHONE NUMBER 888-***-****

Any person who, knowingly and with intent to defraud any insurance company or other person, files an application for insurance containing any false information, or conceals for the purpose of misleading, information concerning any material fact thereto, commits a fraudulent insurance act, which is a crime. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant or Insured Person. POLICY ADMINISTRATOR

Nation Safe Drivers

800 West Yamato Road, Suite 100

Boca Raton, Florida 33431

800-***-****