Quick facts about this proposal 

Presented to 

Leesburg, City Of 
501 W Meadow St 
Leesburg, FL 34748 


SIC Code: 9111 


Presented by 

Sun Life Financial 
Two Harbour Place 
302 Knights Run Avenue 
Suite 760 
Tampa, FL 33602 
Tel: 813-225-4011 
Fax: 813-228-2529 


Benefits quoted 

Employee Basic Life, Employee Basic AD&D, Employee Optional 
Life, Employee Optional AD&D, Spouse Optional Life, and Child 
Optional Life 


Proposed Effective Date 

October 1, 2012 


Things to know 

• 
This quote shows a summary of proposed benefits, rates, and 
underlying assumptions. It is not part of the group policy or 
a legal contract with Sun Life Financial or its affiliated 
companies. 
• 
This proposal is valid for 60 days from April 18, 2012, 
and only for the proposed Effective Date. 
• 
A copy of the current carrier’s booklet is required at time 
of sale. 
• 
This proposal is for fully insured, nonparticipating coverage 
that terminates at retirement, unless otherwise noted. 
• 
The rates shown are subject to recalculation pending a) final 
enrollment, b) census data, and c) review of any additional 
data requested in the proposal. Please review the assumptions 
for information about how the rates were derived. 
April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 1 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Producer licensing 


All Sun Life Financial companies require producers using insurance quotes we 
issue for the purpose of soliciting, selling, or negotiating insurance to be 
licensed both by the state where the prospective client is located and by any 
state where the solicitation, sale, or negotiation of insurance occurs, if 
different. This requirement pertains to all forms of solicitation, sale, or 
negotiation of insurance, including but not limited tosolicitation, sale, or 
negotiation conducted in person, by telephone, by e-mail, by fax or otherwise. 


Producer compensation 


All Sun Life Financial companies may pay the selling broker, agency, or third 
party administrator compensation for the promotion, sale, and renewal of the 
products and services offered in this proposal. In addition to our standard 
compensation arrangements, we may make additional cash payments or 
reimbursements to selling brokers in recognition of their marketing and 
distribution activities, persistency levels, and volume of business. We 
encourage brokers and their clients to discuss what commission or other 
compensation may be paid in connection with the purchase of products and 
services from the company. 


Plan and rates 


This proposal is based on employee census information provided. Acceptance of 
the group and final rates will be determined in the Home Office based on actual 
enrollment and case experience, if required. Terms and conditions of any 
coverage under the policy will be determined by all necessary final data and by 
underwriting rules, minimum participation requirements, and policy provisions 
in effect on the date coverage begins. 


Underwriting companies 


The Sun Life Financial group of companies operates under the "Sun Life 
Financial" name. In the United States and elsewhere, insurance products are 
offered by members of the Sun Life Financial group that are insurance 
companies. Sun Life Financial Inc., the publicly traded holding company for the 
Sun Life Financial group of companies, is not an insurance company and does not 
guarantee the obligations of these insurance companies. Each insurance company 
relies on its own financial strength and claims-paying ability. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
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Basic Life 
Benefit highlights 

We are pleased to offer Basic Life insurance to employers, with 
the benefits employees want. Here are some highlights of our 
Basic Life coverage: 


• 
Value-Added Services: Employers with non-contributory 
coverage can choose the Value-Added Services package that 
best fits the needs of their employees. These non-insurance 
services are included in the price of your Basic Life 
coverage. 
. 
Choice #1: Emergency Travel Assistance for employees 
and dependents traveling 100+ miles from home, and 
Identity Theft Protection for employees. Services 
provided by Assist America.4 
. 
Choice #2: Online Will Preparation for employees and 
spouses, and Claimant Support Services for claimants 
and their families needing professional grief, legal, 
or financial counseling. Services are provided over 
the telephone by ComPsych.®4 
• 
Accelerated Benefits: Terminally-ill employees may access a 
portion of their death benefit while they are alive. 
• 
Waiver of Premium: Waiver benefits protect employees who 
are totally disabled, as defined by the policy, and who 
meet age requirements. Employers can customize the 
elimination period or choose no elimination period—a 
popular choice because it means easy tracking and immediate 
benefits for eligible employees. 
• 
Claims Settlement: Beneficiaries receive a complimentary 
interest-bearing account or a lump-sum payment. 
Availability and coverage may vary by state. 
• 
Accidental Death & Dismemberment (AD&D): Protection for 
covered Accidental Death and injuries such as 
Speech/Hearing, Loss of Limb, Loss of Use of a Limb Due to 
Quadriplegia, Paraplegia, or Hemiplegia, plus Thumb and 
Index finger—all with a standard 365-day loss period. Many 
optional riders can be added, including Seat Belt, Air Bag, 
Helmet, Business Travel, Bereavement Counseling, and Child 
and/or Spouse Education Benefits. 
• 
Voluntary Benefits: Attractive programs provide the 
coverage employees want, with simple, flexible plan designs 
and hassle-free enrollments. 
• 
Portability: In states that allow it, groups of 50+ covered 
lives receive Portability as a standard feature. So, when 
coverage ends for reasons other than sickness, injury, 
retirement, or termination of the employer’s plan, 
employees can buy a portable Term Life policy without 
Evidence of Insurability. Availability may vary by state. 
Group Basic Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under 
policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote #3 
Page 3 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



• 
Continuation: Groups of 50+ covered lives in states where 
Portability is not available may elect Continuation at 
point of sale. Continuation allows employees, when their 
coverage ends, to continue their Group Term coverage 
without Evidence of Insurability. They can continue this 
coverage as long as the group policy is in force. This 
coverage is in addition to any state-mandated Continuation 
benefits. 
• 
Service Guarantees: We are pleased to offer a Life Service 
Guarantee, which covers the speed and accuracy of our 
claims processing as well as how quickly we respond to our 
customers’ phone calls. In addition, we include an overall 
satisfaction guarantee to ensure that our customers are 
100% satisfied with our service. Available to all 100% 
employer-paid and partially employer-paid plans. 
Footnote information is located in the "General disclosures" section on the last page of this proposal. 


Group Basic Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under 
policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote #3 
Page 4 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Basic Life 

Plan design and rates 

Employee Basic Life and AD&D plan design 

Employee Basic Life 
Eligible employees: All Full-Time United States Employees working in the United States who are scheduled to work a 
minimum of 30 hours per week for Class 1 
All Eligible Retired Employees for Class 2 
Effective Date: 
Class description: 
October 1, 2012 
Class 1 
All Active Employees 
Waiting Period: 30 days of employment 
Benefit amount: Flat $50,000 
Maximum benefit: $50,000 
Guaranteed Issue: Lesser of current or $50,000 
Contributions: Non-contributory 
Participation requirement: 100.00% 

Class description: 
Class 2 
All Eligible Retirees 
Benefit Options $1,000 , $5,000 , $6,000 or $15,000 
Guaranteed Issue: Grandfathering existing amounts 
Contributions: Contributory 

Employee Basic AD&D 
Eligible employees: All Full-Time United States Employees working in the United States who are scheduled to work a 
minimum of 30 hours per week 
Effective Date: 
Class description: 
October 1, 2012 
Class 1 
All Active Employees 
Benefit amount: Flat $50,000 
Maximum benefit: $50,000 
Compulsory coverage: Yes 
Contributions: Non-contributory 
Participation requirement: 100.00% 

Basic Life rates 
Class 1 

Coverage 
Eligible 
employees 
Monthly 
rate 
Estimated 
monthly 
volume 
Estimated 
monthly 
premium 
Estimated 
annual 
premium 
Employee Basic Life: 458 $0.138 $22,900,000 $3,160 $37,922 
Employee Basic AD&D 458 $0.020 $22,900,000 $458 $5,496 
Total estimated premium for Class 1: $3,618 $43,418 
Rate basis: Per $1,000 of volume 

Class 2 

Coverage 
Eligible 
employees 
Monthly 
rate 
Estimated 
monthly 
volume 
Estimated 
monthly 
premium 
Estimated 
annual 
premium 
Employee Basic Life: 97 $2.46 $1,021,000 $2,512 $30,140 
Total estimated premium for Class 2: $2,512 $30,140 
Rate basis: Per $1,000 of volume 

Group Basic Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 5 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Totals 

Coverage 
Total eligible 
employees 
Total estimated 
monthly volume 
Total estimated 
monthly premium 
Total estimated 
annual premium 
Employee Basic Life 555 $23,921,000 $5,947 $68,062 
Employee Basic AD&D $22,900,000 $458 $5,496 
Total estimated premium: $6,405 $73,558 
Rate basis: Per $1,000 of volume 

Included in this plan: 

• 
A flat 10.00% broker commission 
• 
24-month rate guarantee from the Effective Date 
• 
Employee age reductions: None. 
• 
Waiver of Premium: For employees with an approved disability prior to age 65, premium is waived until age 65 or for 12 
months (whichever is later). For employees disabled after age 65 but prior to age 70, premium is waived for 12 months. 
There is no elimination period to satisfy before the Waiver of Premium begins. This provision is applicable to Class 1 
Waiver of Premium is provided on the following benefits: Employee Basic Life. 
• 
Portability: Coverage may be ported upon termination of active employment for Class 1. 
• 
Conversion Privilege 
• 
Employee Accelerated Death Benefit of 75.00% to a maximum of $500,000 for Class 1 
• 
Coverage will be continued on a premium paying basis for a period of 1 month(s) during a layoff for Class 1. 
• 
Coverage will be continued on a premium paying basis for a period of 1 month(s) during a leave of absence approved 
by the policyholder for Class 1. 
• 
Coverage will be continued on a premium paying basis for a period of 12 month(s) during a period of injury or sickness 
for Class 1. 
· Employee coverage is rounded to the next highest $1,000. 
Class 1 
• 
Earnings definition: Earnings are defined as the current earnings reported by the employer. Earnings include 
deductions made for pre-tax contributions to a qualified deferred compensation plan, Section 125 plan, or flexible 
spending account. Earnings do not include commissions, bonuses, overtime, or any other compensation. 
• 
24-hour AD&D coverage for Class 1 
• 
Special AD&D benefits: 
· Business Travel benefit 
· Seat Belt benefit 
· Air Bag benefit 
· Bereavement Counselling benefit 
· Helmet benefit 
· Dependent Education—Child benefit 
· Dependent Education—Spouse benefit 
Footnote information is located in the "General disclosures" section on the last page of this proposal. 


Group Basic Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 6 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Basic Life 
Assumptions 

• 
Standard Sun Life Financial policy language is offered, 
including coverage options for leave of absence, layoff, or 
termination. 
• 
This proposal assumes completion and approval of the Group 
Life Insurance Transition Statement prior to the Effective 
Date. This statement addresses employees who are not 
Actively at Work. 
• 
We require a copy of the prior carrier's policy at the 
point of sale. 
• 
This proposal assumes there is common ownership of the 
business units. 
• 
We require notification of completed mergers and 
acquisitions. 
• 
Sun Life requires a final census before the point of sale 
and reserves the right to re-rate the proposal upon 
verification of dates of birth, genders, salaries, and 
occupations. 
• 
Evidence of Insurability is required for late entrants, 
coverage increases, and coverage in excess of the 
Guaranteed Issue amount. Increases in coverage due to 
earnings increases or to a change in an employee's eligible 
class do not require Evidence of Insurability except when 
the new coverage amount exceeds the Guaranteed Issue amount 
or when coverage is increasing by more than $20,000 and by 
more than 15%. 
Group Basic Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under 
policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote #3 
Page 7 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Optional Life 
Benefit highlights 

We are pleased to offer Optional Life insurance with no-hassle 
administration. Here are some highlights of our Optional Life 
coverage: 


• 
Accelerated Benefits: Terminally-ill employees may access a 
portion of their death benefit while they are alive. 
• 
Waiver of Premium: Waiver benefits protect employees who 
are totally disabled, as defined by the policy, and who 
meet age requirements. Employers can customize the 
elimination period, or choose no elimination period-a 
popular choice because it means easy tracking and immediate 
benefits for eligible employees. 
• 
Claims Settlement: Beneficiaries receive a complementary 
interest-bearing checking account or a lump-sum payment. 
Availability and coverage may vary by state. 
• 
Accidental Death & Dismemberment (AD&D): Protection for 
covered Accidental Death and injuries such as 
Speech/Hearing, Loss of Limb, Loss of Use of a Limb Due to 
Quadriplegia, Paraplegia, or Hemiplegia, plus Thumb and 
Index Finger-all with a standard 365-day loss period. Many 
optional riders can be added, including Seat Belt, Air Bag, 
Helmet, Business Travel, Bereavement Counseling, and Child 
and/or Spouse Education Benefits. 
• 
Voluntary Benefits: Attractive programs provide the 
coverage employees want, with simple, flexible plan designs 
and hassle-free enrollments. 
• 
Portability: In states that allow it, groups of 50+ covered 
lives receive Portability as a standard feature. So when 
coverage ends for reasons other than sickness, injury, 
retirement, or termination of the employer’s plan, 
employees can buy a portable Term Life policy without 
Evidence of Insurability. Availability may vary by state. 
• 
Continuation: Groups of 50+ covered lives in states where 
Portability is not available may elect Continuation at 
point of sale. Continuation allows employees, when their 
coverage ends, to continue their Group Term coverage 
without Evidence of Insurability. They can continue this 
coverage as long as the group policy is in force. This 
coverage is in addition to any state-mandated Continuation 
benefits. 
Group Optional Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) 
under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote #3 
Page 8 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Optional Life 

Plan design & rates 

Employee Optional Life, AD&D, and Dependent Optional Life plan design 

Employee Optional Life 
Eligible employees: All Full-Time United States Employees working in the United States enrolled in Employee Basic 
Life Insurance who are scheduled to work a minimum of 30 hours per week 
Effective Date: 
Class description: 
October 1, 2012 
Class 1 
All Employees 
Waiting Period: 30 days of employment 
Benefit amount: Increments of $10,000 
Maximum benefit: $300,000 
Minimum benefit: $10,000 
Guaranteed Issue: Amount $120,000 
Participation requirement: 25.00% 

Employee Optional AD&D 
Eligible employees: All Full-Time United States Employees working in the United States enrolled in Employee Basic 
Life Insurance who are scheduled to work a minimum of 30 hours per week 
Effective Date: 
Class description: 
October 1, 2012 
Class 1 
All Employees 
Benefit amount: Increments of $10,000 
Maximum benefit: $300,000 
Compulsory coverage: Yes 

* Employee must elect Optional Life to elect Optional AD&D 
Spouse Optional Life AD&D 
Eligible employees: All Full-Time United States Employees working in the United States enrolled in Employee Optional 
Life Insurance who are scheduled to work a minimum of 30 hours per week 
Effective Date: 
Class description: 
October 1, 2012 
Class 1 
All Employees 
Spouse benefit amount: Increments of $5,000 
Spouse maximum benefit: $150,000 
Minimum benefit: $5,000 
Spouse Guaranteed Issue: Amount $30,000 
Maximum % of employee 
coverage: 
50.00% 

* Employee must elect Optional Life to elect Dependent Optional Life 
Group Optional Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 9 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Child Optional Life 
Eligible employees: All Full-Time United States Employees working in the United States enrolled in Employee Optional 
Life Insurance who are scheduled to work a minimum of 30 hours per week 
Effective Date: October 1, 2012 
Class 1 
Class description: All Employees 
Child benefit amount: Increments of $1,000 
Child maximum benefit: 
Child guaranteed issue: 
$10,000 
$10,000 
Minimum Benefit: $1,000 
Full child benefit begins: 6 months 
Child benefit by age: 14 days to 6 months $500 
Child eligibility: Unmarried dependent children from 14 days to age 19 or 23 if full-time student 
Maximum % of employee 
coverage: 
50.00% 

* Employee must elect Optional Life to elect Dependent Optional Life 
Optional Life rates 

Employee Optional Life 
Age band 
Eligible 
employees 
Monthly 
rate 
Estimated 
monthly volume 
Estimated 
monthly premium 
0-19 0 
20-24 15 
25-29 34 
30-34 52 
35-39 50 
40-44 78 
45-49 79 
50-54 64 
55-59 39 
60-64 53 
65-69 33 
70-74 21 
75-79 17 
80-84 16 
85-999 4 
Rate basis: Per $1,000 of volume 
$0.090 
$0.090 
$0.090 
$0.110 
$0.160 
$0.220 
$0.330 
$0.570 
$0.930 
$1.050 
$1.910 
$3.100 
$10.170 
$10.170 
$10.170 
$0 
$240,000 
$930,000 
$340,000 
$1,330,000 
$2,165,000 
$1,885,000 
$1,335,000 
$300,000 
$515,000 
$0 
$0 
$0 
$0 
$0 
$0 
$22 
$84 
$37 
$213 
$476 
$622 
$760 
$279 
$541 
$0 
$0 
$0 
$0 
$0 

Totals 

Coverage 
Total eligible 
employees 
Monthly 
rate 
Total estimated 
monthly volume 
Total estimated 
monthly premium 
Total estimated 
annual premium 
Employee Optional 555 N/A $9,040,000 $3,034 $36,408 
Life 
Employee Optional 555 $0.02 $9,040,000 $180 $2,170 
AD&D 
Total estimated premium: $3,214 $38,578 
Rate basis: Per $1,000 of volume 

Group Optional Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
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Spouse Optional Life 
Age band 
0-19 
20-24 
25-29 
30-34 
35-39 
40-44 
45-49 
50-54 
55-59 
60-64 
65-69 
70-74 
75-79 
80-84 
85-90 
Optional AD&D : $.02 / $1,000 
Eligible employees 
3 
18 
46 
50 
62 
72 
68 
59 
46 
33 
46 
Monthly rate 
$0.090 
$0.090 
$0.090 
$0.110 
$0.160 
$0.220 
$0.330 
$0.570 
$0.930 
$1.050 
$1.910 
$3.100 
$10.170 
$10.170 
$10.170 

Coverage Total eligible employees Monthly rate 
Child Optional Life 555 $0.05 
Rate basis: Per $1,000 of volume 

Included in this plan: 

• 
A flat 10.00% broker commission 
• 
24-month rate guarantee from the Effective Date 
• 
Employee age reductions: None. 
• 
Spouse age reductions: None 
• 
Waiver of Premium: For employees with an approved disability prior to age 65, premium is waived until age 65 or for 12 
months (whichever is later). For employees disabled after age 65 but prior to age 70, premium is waived for 12 months. 
There is no elimination period to satisfy before the Waiver of Premium begins. 
Waiver of Premium is provided on the following benefits: Employee Optional Life. 
• 
Portability: Coverage may be ported upon termination of active employment. 
• 
Conversion Privilege (may vary by state for dependent children) 
• 
Employee Accelerated Death Benefit of 75.00% to a maximum of $500,000 
• 
Coverage will be continued on a premium paying basis for a period of 1 month(s) during a layoff. 
• 
Coverage will be continued on a premium paying basis for a period of 1 month(s) during a leave of absence approved by 
the policyholder. 
• 
Coverage will be continued on a premium paying basis for a period of 12 month(s) during a period of injury or sickness. 
• 
Employee coverage is rounded to the next highest $1,000. 
• 
Earnings definition: Earnings are defined as the current earnings reported by the employer. Earnings include deductions 
made for pre-tax contributions to a qualified deferred compensation plan, Section 125 plan, or flexible spending account. 
Earnings do not include commissions, bonuses, overtime, or any other compensation. 
• 
24-hour AD&D coverage 
• 
Special AD&D benefits: 
· Business Travel benefit 
· Seat Belt benefit 
· Air Bag benefit 
· Bereavement Counselling benefit 
· Helmet benefit 
· Dependent Education—Child benefit 
· Dependent Education—Spouse benefit 
Group Optional Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 11 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Optional Life 
Assumptions 

• 
Standard Sun Life Financial policy language is offered, 
including coverage options for leave of absence, layoff, or 
termination. 
• 
If the minimum participation is not met, the Guaranteed 
Issue amount, policy provisions, and rates are subject to 
change. 
• 
Dependents are eligible for coverage only when the employee 
is enrolled in Employee Optional Life. Dependent coverage 
amounts are subject to state requirements. 
• 
Optional Life is available only when a Basic Life plan is 
written by Sun Life Financial and when no other 
contributory, employer-sponsored life plans are offered. 
• 
If coverage is compulsory, employees who elect Employee 
Optional Life coverage automatically receive AD&D coverage 
equal to their Employee Optional Life amount. 
• 
Increases in coverage due to earnings increases or to a 
change in an employee’s class do not require Evidence of 
Insurability except when the new coverage amount exceeds 
the Guaranteed Issue amount or when coverage is increasing 
by more than $20,000 and by more than 15%. 
• 
We require notification of completed mergers and 
acquisitions. 
• 
This proposal assumes there is common ownership of the 
business units. 
• 
Sun Life requires a final census before the point of sale 
and reserves the right to re-rate the proposal upon 
verification of dates of birth, genders, salaries, and 
occupations. 
• 
We require a copy of the prior carrier's contract is 
required at the point of sale. 
Group Optional Life and AD&D coverage is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) 
under policy form series 93P-LH. 


April 18, 2012 
Proposal for Leesburg, City Of Quote #3 
Page 12 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



Disclosures 


Policy disclosures 

Eligibility 
Actively at Work Requirement 


An employee must be actively at work on his/her effective date 
for coverage to become effective. If an employee is not actively 
at work on his or her effective date, coverage will not become 
effective until the employee is again actively at work. An 
employee who is not actively at work on the effective date solely 
because it is not a regularly scheduled work day will be deemed 
to be actively at work. Coverage for dependents who are hospital 
confined due to illness or injury will be effective on the date 
they are no longer hospital confined. Hospital confined does not 
apply to a newborn child. 


Actively at Work Exception for Life Insurance 
An Employee may become insured under this Policy on the POLICY 
EFFECTIVE DATE, subject to all of the following conditions: 


• 
he was insured under the prior insurer’s group Life policy 
immediately prior to the POLICY EFFECTIVE DATE; and 
• 
he is not Actively at Work on the POLICY EFFECTIVE DATE; and 
• 
he is a member of an Eligible Class under this Policy; and 
• 
premiums for the Employee are paid up to date; and 
• 
he is not receiving or eligible to receive benefits under the 
prior insurer’s group Life policy. 
Any Life benefit payable will be the lesser of: 
-the Life benefit payable under this Policy; or 
-the Life benefit payable under the prior insurer’s group Life 
policy had it remained in force. 
All other provisions of Sun Life’s Policy will apply. 


Termination 
Termination of Employee’s Insurance 


An Employee will cease to be insured on the earliest of the 
following dates: 


• 
the date this Policy terminates. 
• 
the date the Employee is no longer in an Eligible Class. 
• 
the date the Employee’s Class is no longer included for 
insurance. 
• 
the last day for which any required premium has been paid. 
• 
the date the Employee retires, unless the employee is eligible 
for retiree coverage. 
• 
the date employment terminates. Ceasing to be Actively at Work 
will be deemed termination of employment, except: 
April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 13 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



o 
insurance will be continued for an Employee absent due 
to a disability during any period the premium is being 
waived 
o 
the Policyholder may continue the insurance by paying 
the required premiums during a layoff or approved 
leave of absence, limited to the time period specified 
in the policy 
o 
insurance may be continued for up to 3 months of the 
Employee’s paid vacation. 
o 
insurance may be continued after an Employee is absent 
from work due to Injury or Sickness for a time period 
specified in the policy (applicable to Life and AD&D 
insurance coverages only). 
• 
the date the Employee requests, in writing, to have his 
insurance terminated. 
• 
the date the Employee ceases to be Actively at Work due to a 
labor dispute, including any strike, work slowdown, or 
lockout. 
• 
the date the Employee enters active duty in any armed service 
during a time of war (declared or undeclared). 
While this Policy is in force, the Policyholder may continue an 
Employee’s coverage pursuant to the Family and Medical Leave Act 
of 1993, as amended or continue coverage pursuant to a state 
required continuation period (if any). 


While this Policy is in force, the Policyholder may continue an 
Employee’s coverage pursuant to the Uniformed Services Employment 
and Reemployment Rights Act (USERRA). 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
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Termination of Dependent’s Insurance 


A Dependent will cease to be insured on the earliest of the 
following dates: 


• 
the date this Policy terminates. 
• 
the date the Employee ceases to be insured. 
• 
the date the Employee is no longer in an Eligible Class for 
Dependent Insurance. 
• 
the date the Dependent ceases to qualify as a Dependent. 
• 
the last day for which any required premium has been paid for 
insurance on the Dependent. 
• 
the date the Employee requests, in writing, to have his 
Dependent Insurance terminated. 
• 
the date the Employee dies. 
• 
the date the Dependent Spouse attains the spouse termination 
age, if included on the plan 
• 
the date the Dependent enters active duty in any armed service 
during a time of war (declared or undeclared). 
• 
the date the Employee retires. 
Termination of the Policy or Employer’s Participation 


The policy or the employer’s participation under the policy will 
terminate if: 


• 
the required premium is not paid within the premium grace 
period. 
• 
employee or dependent (if applicable) participation falls 
below the required levels * 
• 
the employer fails to promptly provide information which we 
require or fails to perform obligations pertaining to the 
policy * 
• 
the number of covered employees insured under the plan falls 
below ten 
*We will provide written notice to the employer at least 30 


* days in advance of coverage termination for reasons other 
than premium non-payment (45 days or 60 days advance notice 
will be given where required by applicable state law) 
If the employer requests cancellation, coverage will terminate on 
the first premium due date after we receive written notice. 


Basic Life/AD&D and Optional Life/AD&D 

Exclusions 


If the Employee’s cause of death is suicide: 


• 
No amount of contributory Life or contributory Dependent Life 
Insurance is payable if the suicide occurs within 24 months 
after the Employee’s Insurance is effective. If there was 
prior coverage in place, any period of time the Employee was 
insured for the same amount of Life Insurance under the 
previous insurer’s group Life policy will count towards 
completion of the 24 months. 
• 
No increased or additional amount of Life Insurance is payable 
if the suicide occurs within 24 months after the increased or 
additional amount of Basic Life Insurance is effective. 
• 
No amount of Life Insurance in excess of the Guaranteed Issue 
Amount is payable if the suicide occurs within 24 months after 
April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 15 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



the amount in excess of the Guaranteed Issue Amount is 
effective. 


Exceptions: 


• 
The suicide exclusion does not apply to contracts sitused in 
Washington 
• 
The suicide exclusion is 12 months for contracts sitused in 
Colorado, Missouri, and North Dakota 
• 
The suicide exclusion applicable to increased or additional 
amounts of insurance is not applicable to contracts sitused in 
New York. 
• 
The suicide exclusion applicable to amounts in excess of the 
guarantee issue amount is not applicable to contracts sitused 
in New York. 
No Accidental Death or Accidental Dismemberment payment will be 
made for a loss which is due to or results from: 


• 
suicide while sane or insane. 
• 
intentionally self-inflicted injuries. 
• 
bodily or mental infirmity or disease of any kind, or 
infection unless due to an accidental cut or wound. 
• 
committing or attempting to commit an assault, felony or other 
criminal act. 
• 
active participation in a war (declared or undeclared) or 
active duty in any armed service during a time of war. 
• 
active participation in a riot, rebellion, or insurrection. 
• 
injury sustained from any aviation activities, other than 
riding as a fare-paying passenger. 
• 
the Employee's voluntary use of any controlled substance as 
defined in Title II of the Comprehensive Drug Abuse Prevention 
and Control Act of 1970, as now or hereafter amended, unless 
administered on the advice of a Physician. 
• 
the Employee’s operation of any motorized vehicle while 
intoxicated. Intoxicated means the minimum blood alcohol level 
required to be considered operating an automobile under the 
influence of alcohol in the jurisdiction where the accident 
occurred. For the purposes of this Exclusion, "Motorized 
Vehicle" includes, but is not limited to, automobiles, 
motorcycles, boats and snowmobiles. 
April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 16 of 17 SLPC 20013 rev. 06090611 GGOT-1288 



General disclosures 

1. For current financial ratings, please visit www.sunlife.com. 
2. Sun Life Financial is #208 in the 2011 edition of Forbes 
Global 2000 list, as shown on this website, accessed on June 27, 
2011: 
http://www.forbes.com/global2000/#p_1_s_acompanyRankOverall_LifeH
ealthInsurance_All_All. 
3. Based on in force premium for U.S. business. Source: for Life, 
LIMRA, U.S. Group Life Sales and In Force Summary of 2010; for 
Disability, LIMRA, U.S. Group Disability Insurance 2010 Annual 
Sales and In Force Report; for Stop-Loss, based on 2010 net 
premium earned data provided by McKinsey Company. 
4. The following services are not insurance and carry a separate 
charge which is included with the price of your coverage: 
Emergency Travel Assistance, provided by Assist America®; 
Identity Theft Protection, provided by SecurAssist®, an Assist 
America program; and Claimant Support Services, Online Will 
Preparation, and EAP and Work/Life Services provided by 
ComPsych®. Sun Life is not responsible or liable for care, 
services, or advice given by any provider or vendor of the 
Services. Sun Life reserves the right to discontinue any of the 
Services at any time. 
Group insurance policies are underwritten by Sun Life Assurance 
Company of Canada (Wellesley Hills, MA) in all states, except New 
York, under Policy Form Series 93P-LH, 98P-ADD, 02-SL, 07-SL, and 
01C-LH-PT. In New York, group insurance policies are underwritten 
by Sun Life Insurance and Annuity Company of New York (New York, 
NY) under Policy Form Series 93P-LH-NY, 02P-NYSTD, 98P-ADD-NY, 
02-NYSL, 07-NYSL, and 01NYC-LH-PT. Group insurance policies are 
underwritten by Sun Life and Health Insurance Company (U.S.) 
(Wellesley Hills, MA) in all states under Policy Forms Series GPA 
and GP-D (or appropriate state edition). Product offerings may 
not be available in all states and may vary depending on state 
laws and regulations. 


© 2011 Sun Life Assurance Company of Canada, Wellesley Hills, MA 
02481. All rights reserved. Sun Life Financial and the globe 
symbol are registered trademarks of Sun Life Assurance Company of 
Canada. Visit us at www.sunlife.com/us. 


April 18, 2012 
Proposal for Leesburg, City Of Quote # 3 
Page 17 of 17 SLPC 20013 rev. 06090611 GGOT-1288