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Supplemental Insurance Policies

INSURANCE COMPANY
POLICY TYPE

FORMS

American Family Life Assurance Company
(Payroll Code: AI03 -- Billing Unit: American Family Life Assurance Company)

Cancer	A-9520; A-12000
First-Occurrence Building Benefit	A-70250
Hospital Intensive Care	A-9990
Life	5191
Life Assurance	A-62100-OK, A-62200-OK
Rider Series	A-62250, A-62055-OK, A-62050, A-62051
Personal Accident Expense Plan	A33000
Personal Accident Expense Plan	A-33005OK
Personal Accident Indemnity Plan	A-34100-OK, A-34200-OK
Optional Off-the-Job Accident Disability Rider	A-34050-OK
Optional Sickness Disability Rider	A-34052-OK
Optional Spouse Off-the-Job Accident Disability	A-34053-OK
Personal Cancer Protector Plan	A-59000
First-Occurrence Building Benefit Rider	A-59050
Specified Disease Benefit Rider	A-59052-OK
Personal Hospital Intensive Care	A-1820B-OK
Personal Disability Income Protector	A-57400-OK
3 month Limited Benefit	A-574LB-OK
Personal Disability and Income Protector	A-57000-OK
Personal Accident Indemnity Plan	A-34001-OK
Personal Long-Term Care Plan	A-27000-OK
Long-Term Care Inflation Rider	A-27062
NonForfeiture Benefit Rider	A-27051
Personal Recovery Plus (Specified Event)	A-70200
First-Occurrence Building Benefit	A-070250
Personal Sickness Indemnity Plan	A-45100, A-45200-OK, A-45300-OK
Optional Initial Hospitalization Benefit Rider	A-45050
Voluntary Indemnity Plan	A-442200-OK
Initial Hospitalization Benefit Rider	A-44150, A-44250

American General Life Insurance Company
(Payroll Code: AI36 -- Billing Unit: American General Life Insurance Company)

Accidental Death Benefit	88012
Certificate Application	LD 8239-5G
Certificate Endorsement	L 4412
Children's Insurance Benefit	88420
Family Insurance Benefit	88419
Future Guaranteed Insurability Rider	95101
Group Flexible Premium Adjustable Life Insurance Certificate	88450
Group Master Plan	88451
Group Master Plan	92463
Level Term Life Insurance Benefit on the Spouse of the Insured	91417
Master Policy Application	L 4411
Term Life Insurance Benefit on the Spouse of the Insured	88389
Waiver of Monthly Deduction	88011
Children's Insurance Benefit	82410
Waiver of Monthly Deduction	82001
Terminal Illness Rider (Group Master Plan or Estate Master Select)	91401
Loss of Independent Living Rider	04805
Accidental Death and Dismemberment Rider	04022
Hospital Cash Rider	04025
AIG CriticalCare	03800-37 Rev 0105
AIG EmergencyCare	04120-37
Accident-Only Short-Term Disability Rider (Off the Job)	04023-37
AIG CancerCare Platinum Plus	02183
AIG Worksite Universal Life	08463

American Public Life Insurance Company
(Payroll Code: AI05 -- Billing Unit: American Public Life Insurance Company)

Accident Expense, Death and Dismemberment	A-2 (3/80)
Cancer and Specified Disease	S-CSD-1 (6/83)
Cancer and Specified Disease	BDCPA (7/83)
Cancer and Specified Disease	APL-1 (6/86)
Cancer and Specified Disease	GCPW (6/86)
Cancer and Specified Disease	APLIC-1 (10/90)
Cancer and Specified Disease	APLIC-2 (10/90)
Cancer and Specified Disease	APLIC-3 (10/90)
Convertible Term Life/Decr. Term	S-900 (1/89)
Hospital Intensive Care/Coronary Care	IC-CC-1 (Rev. 8/82)
Hospital Intensive Care/Coronary Care	IC-CC-2 (6/86)
Heart Attack/Stroke	HA/S-1 (6/86)
Intensive Care/Coronary Care	IC/CC-3 (2/90)
Whole Life	WL-1 (11/86)

Assurity Life Insurance Company
(Payroll Code: AI 49 -- Billing Unit: Assurity Life Insurance Company)

Return of Premium Rider	CIR018
Disability Waiver	CIR016
Automatic Benefit Increase	A-DR205
Return of Premium Rider	A-DR208
Residual Benefit Rider	R-D220
Guaranteed Insurability Rider	RD221
Hospital Benefit Rider	A-DR202
Home Modification Rider	A-DR210
Retroactive Injury Benefit	RD222
Critical Illness	CI005 (OK)
Accidental Death Benefit	A-R126 (OK)
Spouse Rider	CIR-010 (OK)
Dependent Child Rider	CIR014 (OK)
Critical Illness	CI007 (OK)
Spouse Rider	CIR012 (OK)
Children's Rider	CIR020 (OK)
Personal Disability	A-D100 (OK)
Supplemental DI Rider	A-DR200 (9/95)
Simplified Life	A-LN00 (OK)
Accident Expense Policy	AAW-A117OK
Family Rider	AAW-AR260OK
Outpatient Sickness	AAW-DR225OK
Intensive Care Benefit	AAW-DR226OK
Private Duty Nurse	AAW-DR227OK
Surgical and Anesthesia and Additional Benefits	AAW-DR228OK
Surgical Anesthesia and Additional Benefits	AAW-DR230OK
Disability Income Policy	AAW-D113OK
Sickness Benefits	AAW-DR220N0
Emergency Accident	AAW-DR221
Accidental Death and Dismemberment	AAW-DR222
Cancer Expense	AAW-C120 OK
Cancer Expense Rider	AAW-CR261 OK
Cancer Expense Rider	AAW-CR262 OK
Cancer Expense Rider	AAW-CR263 OK
Cancer Expense Rider	AAW-CR264 OK
Accident Expense	W A200 OK
Accident Expense (Off the Job)	W A205 OK
Short Term Disability Income Rider	R WA201 OK
Short Term Disability Income Rider (Off the Job)	R WA251 OK
Universal Life	9900
Accidental Death Rider	0027
Level Term Insurance Rider (20-Year)	0150
Additional Insured Rider Level Term (20-Year)	0151
Rider to Apply Monthly Payments and Waive Monthly Deductions in Case of Total Disability	0153

Central States of Omaha
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)

Policy	C01OK (Actuary No. 1632-92-0014 only)
ICU Rider	8121OK
Policy	C02OK
ICU Rider	8122OK
Return of Premium	8018
First Occurrence Rider	8119

Citizens Insurance Company
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)

Accidental Death	ADP-781
Cancer and Dread Disease	ACC-182; ACC-487-OK
Cancer and Dread Disease	ACC 585-OK
Cancer 1st Occurrence Benefit Rider	FOB-487
Heart Attack and Stroke	HASP-487-OK
Intensive Care Unit Rider	AIC-487-OK
Life	GDBWL 3/83; 35PL 1/83
Return of Premium Refund Benefit Rider	RPI-487

Columbian Life Insurance Company
(Payroll Code: AI50 -- Billing Unit: Columbian Life Insurance Company)

20 Year Level Term -- Critical Life	1F559B-CL
Accelerated Benefit Rider-Critical Illness to Age 85	1H803P-CL
Payro Waiver of Premium Rider	1H805B-CL
Waiver of Premium Rider	1H800B-CL
Accidental Death of Insured before Age 70 Rider	1H801-CL
Automatic Increase Rider	1H804-CL
Child Term Insurance Rider	1H802-CL
Universal Life Certificate	9F133H-CL
Waiver of Monthly Deduction Rider	9CC02-CL
Child Term Insurance Rider	9C402B-CL

Conseco Health Insurance Company (formerly Capitol American Life Insurance Co.)
(Payroll Code: AI06 -- Billing Unit: Conseco Health Insurance Company)

Accident Secure (AD&D and Accident Insurance)	BM000/PS1OK-A
LifeChoices Series	CH000/PS1OK-A
Benefit Rider	CH0B1/IS1ST-A
Benefit Rider	IS003/EA1OK-AA
Benefit Rider	SD090/EA1ST-A
Pulse Protection (Heart & Stroke Insurance)	KH000/PS1OK-BZ
Worksite Universal Life	CIC-3001-OK

EMC National Life (pay to Pre-Paid Legal Casualty, Inc.)
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)

Cancer & Specified Disease Policy	HP 9370 OK 8-99
First Occurrence Rider	AMH 9372 8-99
The EMCNL Protector for Cancer	HP3000

Fidelity Life Association
(Payroll Code: AI58 -- Billing Unit: Fidelity Life Association)

Lifetime Benefit Term	WP300 Group Policy; WC300 Certificate
Rider: Child Term Rider	W3P02
Rider: Accidental Death Benefit	W3P00
Rider: Waiver of Premium	W3P01
Rider: Accelerated Benefit for Long Term Care and Terminal Illness	W3P07COK
Rider: Extension of Benefits	W3P09

Guarantee Trust Life Insurance Company
(Payroll Code: AI55 -- Billing Unit: Guarantee Trust Life Insurance Company)

Accident Only Policy -- includes limited benefits for disability income	G0760
Cancer Plan	G0330 (OK)

Humana (pay to Pre-Paid Legal Casualty, Inc.)
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)

Cancer Insurance (Application)	HIC-CAN-APP-OK 05/09
Cancer Insurance Policy Brochure (Outline of Coverage)	HIC-OOC-OK 5/09
Intensive Care Rider	HIC-ICR-OK 5/09
Payment Benefit Rider	HIC-POBR-OK 5/09

John Hancock Life Insurance Company
(Payroll Code: AI57 -- Billing Unit: John Hancock Life Insurance Company)

Group Long-Term Care Insurance	D-LTC(2002-2)
Limitations and Exclusions	D-EXCL(2002-2) OK
Additional Benefits: Inflation Benefits	D-LTC-INF(2002-2)
Additional Benefits: Nonforfeiture Benefits	D-LTC-NF(2002-2)
Additional Benefits: Contingent Nonforfeiture Benefit	D-LTC-CNF(2002-2)
Additional Benefits: Return of Premium Benefits	D-LTC-ROP(2002-2)
Additional Benefits: SharedCare Benefit	D-LTC-SHC(2002-2)
General Provisions	D-GEN(2002-2)
Claims Provisions	D-CLAIM(2002-2) OK
Table of Contents for Exhibit/booklet portion	D-TOC(2002-2)
Definitions	D-DEF(2002-2) OK
Coordination of Benefits	D-COB(2002-2)
Premiums	D-PREM(2002-2)
Termination of Coverage	D-TERM(2002-2)
Miscellaneous Provisions	D-MISC(2002-2)
Policy Shell Face Page	P-FACE(2002-2) OK
Table of Contents	P-TOC(2002-2)
Master Schedule	P-MS(2002-2)
Premiums	P-PREM(2002-2)
Miscellaneous Provisions	P-MISC(2002-2)
Certificate Face Page	C-FACE(2002-2) OK
Schedule of Benefits	C-SOB(2002-2)
Policyholder Application	PHAPP(2002-2)
Simplified Policyholder Application	GLTC-PHAPP(2002-2)
Individual Insured Application	GLTC-APP-STD(2003-10) OK
Individual Insured Simplified Application	GLTC-APP-SIMP(2003-10) OK
Outline of Coverage	GLTC-DIS(2002-2) OK
Long-Term Care Insurance Personal Worksheet	GLTC-SUIT(2002-2)
Long Term Care Insurance Potential Rate Increase Disclosure Form	LTC-RID(2002-2)
Notice of Information Practices	LTC-INFO(2002-2)
Policy Amendment Form	P-AMD(2002-2)
John Hancock Leading Edge	LTC-06-OK
John Hancock Custom Care II Enhanced	LTC-03 OK 10/03

Kanawha Insurance Company
(Payroll Code: AI50 -- Billing Unit: Columbian Life Insurance Company)

Accident Plus - accident reimbursement	60830 9/03 OK
24 Hour Coverage Rider - For Accident Plus	60831 9/03
Accident Total Disability Benefits Rider	60832 9/03
Fracture and Dislocation Benefits Rider	60833 9/03
Hospital Intensive Care Unit Benefits Rider	60834 9/03
Supplemental First Diagnosis Cancer Benefit Policy	70160 2/98 OK
Return of Premium Benefit Rider	70170 2/98
Return of Premium Benefit Rider	70170 2/98
Supplemental Cancer Only Benefit Policy	70240 4/98 OKLAHOMA
Cancer Lump Sum First Diagnosis Benefit Rider	70245 4/98 OK
Cancer Wellness Benefit Rider	70250 4/98 OKLAHOMA
Optional Cancer Hospital Indemnity Benefit Rider	70255 4/98 OKLAHOMA
Cancer Travel Benefit Rider	70265 4/98 OKLAHOMA
Secure Life – whole life policy	00455
Loss of Work Rider	00456
Level Term to Age 65 Rider	20465
Family Level Term	40705
Accidental Death, Dismemberment and Loss of Sight Rider	60534
Waiver of Premium Rider	WP0101
Automatic Benefit Increase Rider	00457
CriticalLife - term to age 80	8013 OK

Leaders Life Insurance Company
(Payroll Code: AI29 -- Billing Unit: Leaders Life Insurance Company)

LifeStyle Plan	LL.17.1
Term to 100	LL-3
10 & 15 Year Term	LL10.15

Liberty National Life Insurance Company
(Payroll Code: AI56 -- Billing Unit: Liberty National Life Insurance Company)

Group Term Life	GL
Career Life Plus	CLP
$3,000 Accident Plan (ADP) (7061)	A-394-K, ED 5-05
Hospital Accident Policy - Individual	7062
Hospital Accident Policy - Family	7062F
Hospital Accident Policy - Single Parent	7062S
Family Cancer Policy - Family	5KH
Family Cancer Policy - Individual	5KG
Family Cancer Policy - Single Parent	5KI

National Teachers Associates Life Insurance Company
(Payroll Code: AI13 -- Billing Unit: National Teachers Associates Life Insurance Company)

Accident Policy	GRA-3001 (1/95)
Cancer Policy	GRC-2004-OK (1/03)
Heart Disease, Heart Attack and Stroke Policy	GRH-1003-OK (10/96)
Disability Income Policy	GRD-6003-OK (10/99)
Spouse Rider - Accident	GRA-SR-OK (1/95)
Child Rider - Accident	GRA-CR-OK (1/95)
ICU Rider - Accident	GRA-ICU-OK (1/95)
All Purpose Impatient Rider	GR-1026-OK (2/03)
ICU - All Purpose Rider	GR-2015-OK (1/03)
Specified Disease Rider	GR-1045-OK (10/96)
Hospital Enhancement Rider	GR-1013-OK (8/98)
Benefit Booster Rider	GR-1056-OK (10/04)
Return of Premium Rider	GR-1082-OK (10/04)
ICU - Heart Only Rider	GR-1025-OK (10/96)
Heart Attack & Stroke First Occurrence Benefit Rider	GR-1035-OK (10/96)
Heart Wellness Rider	GR-1011-OK (6/98)
Cancer Benefit Enhancement Rider	GR-1014-OK (1/03)
Whole Life Insurance Policy	L-1115 (1/94)
Renewable & Convertible Term Life Insurance Policy	L-2225 (1/94)
Convertible Decreasing Term Life Insurance Policy	L-2224 (1/94)
Accidental Death and Dismemberment Rider	L-ADDR.70 (1/94)
Children's Term Insurance Rider	LCR-111 (1/94)
Accident Policy -- Series II	GRA-3002-OK (5/06)
Accident Home Recovery Benefit Rider	GR-AHRBR-OK (3/07)
Heart Disease, Heart Attack & Stroke Policy -- Series III	GRH-1004-OK (9/06)
Heart Benefit Enhancement Rider	GR-HBER-OK (10/07)

National Union Fire Insurance Company of PA
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty, Inc.)

Cancer & Specified Disease Insurance	C30551NUflC
Hospital Intensive Care Rider	C30553NUFIC

Occidental Life Insurance Company
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)

Cancer	HC3B-1 Ed. 7-86
Cancer	HC2-1 Ed. 7-86
Cancer	HC4-1 Ed. 7-86
Group/Franchise Disability	HD1-1 Ed. 3-87
Individual/Limited Benefit-Accident	HA1-1 OK Ed. 5-88
Individual/Whole Life	FOH Ed. 8-86

Pre-Paid Legal Casualty, Inc
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)

Family Plan	PPLSI-233
Law Officers Legal Plan	PPLSI-234

Providential Life Insurance Company
(Payroll Code: AI24 -- Billing Unit: Pre-Paid Legal Casualty Inc.)

Cancer	CC-174
Intensive Care	IC-101

Security Financial Life
(Payroll Code: AI49 -- Billing Unit: Assurity Life Insurance Company)

Universal Life

0430 OK