*Important Notice-How New York Life Underwrites Your Request for Coverage:

Important Information for All Group Life Insurance Plans

Confidentiality:
Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for coverage, we will rely on the information you furnish, and on any information we may ask you to obtain from a doctor, hospital, etc. New York Life will not disclose such information to anyone unless you authorize it or where it is required by law. This information may be seen by New York Life and USBA employees, only on a "need to know" basis in considering your request. When we receive all requested information, we will make a determination as to whether your request for insurance can be approved.

If We Cannot Provide Coverage:
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Although we cannot provide you with any medical information in our files, we will, upon written request, provide such information to a physician you designate.

Important Notice for New Mexico Residents: In addition, protected persons* have a right of access to certain confidential abuse information** we maintain in our files and they may choose to receive such information directly. You have the right to register as a protected person by sending a signed request to the Group Policyholder (USBA) at the address listed on the application. Please include your full name, date of birth, and current address.

Effective Date of Coverage-When We Can Provide the Coverage You Requested:
If we can provide the coverage you requested, it will take effect on the approval date specified provided the premium has been paid. You must also be performing your normal activities on the date of approval. Dependent children insured under Children's Coverage must not be hospital-confined on the date of approval. Payment of premium does not mean coverage is in force before the effective date specified by New York Life.

* "Protected person" means a victim of domestic abuse who has notified us that he or she is or has been a victim of domestic abuse and who is an insured or is a prospective insured.

** "Confidential abuse information" means information about acts of domestic abuse or abuse status, the work or home address or telephone number of a victim of domestic abuse, or the status of an applicant or insured as a family member, employer or associate of a victim of domestic abuse or a person with whom an applicant or insured is know to have a direct, close personal, family or abuse-related counseling relationship.

Florida residents:
Richard D. Colado is a licensed Florida agent for service to Florida residents.

Puerto Rico residents:
Application forms and premium payments are to be sent to:
Mr. Fernando A. Bruno
c/o Global Insurance Agency, Inc.
P.O. Box 9023918
San Juan, PR 00902-3918.

Licensing and Area Limitations

New York Life and USBA are licensed to conduct business in the 50 United States, the District of Columbia and Canada. New York Life is domiciled in New York State and its NAIC Identification Number is 66915. USBA is domiciled in the state of Missouri. Dudley Crow, an employee of USBA, is a licensed California agent whose California License Number is 0794856.

Area Limitations for Certain Group Life Plans: USBA's Group Life Plans are generally available in all 50 States, the District of Columbia and Canada (except Quebec or Puerto Rico). The following plans are not currently available in the states indicated.

• Lean~15 - not available in Florida
• Generation 3 - not available in New York and Utah
• Fifty Plus Group Whole Life - not available in New York and Utah; not available in Washington State to members age 65 and over.

Important Replacement Information for New York Residents

It may not be in your best interest to replace existing life insurance policies or annuity contracts in connection with the purchase of a new life insurance policy, whether issued by the same or a different insurance company. A replacement will occur if, as part of your purchase of a new life insurance policy, existing coverage has been, or is likely to be, lapsed, surrendered, forfeited, assigned, terminated, changed or modified into paid-up or other forms of benefits, loaned against or withdrawn from, reduced in value by use of cash values or other policy values, changed in the length of time or in the amount of insurance that would continue, or continued with a stoppage or reduction in the amount of premium paid. Prior to completing a replacement transaction, you may want to contact the insurance company or agent who sold you the life insurance or annuity contract that will be replaced, to help you decide whether the replacement is in your best interest.