Helpful Hint: If you are unsure about who your current beneficiaries are, call Prudential at (800) 778-3827 to confirm them.                                             Helpful Hint: The Supplemental Life Enrollment Form can be used to make changes to your coverage, (i.e. adding or dropping a spouse or child), your address or your beneficiary.

Your Beneficiary Benefits are paid to your designated beneficiary in the event of your death. You may name or change your beneficiary at any time by completing a beneficiary form and mailing it to Prudential. If you run out of room on the form, you may submit additional beneficiaries on a separate note. All attached notes must be signed and dated. Your change is not effective until the plan receives your documentation. If you do not name a beneficiary or none of your designated beneficiaries survive you, payment is made to the first of the following: Your spouse Equal shares to your children Equal shares to your parents Equal shares to your sisters and brothers Your estate If you elect dependent life coverage, you are automatically the beneficiary of your spouse and children. If you list more than one beneficiary, payment will be divided evenly among them unless you requested otherwise. You may change your beneficiary at any time by completing the change information on the Supplemental Life Insurance enrollment form. Accelerated Death Benefits If you have been diagnosed with a terminal illness and according to your physician, have less than 12 months to live, accelerated death benefits allow you to take a cash advance of a portion of your total life insurance benefit. You can request up to 50 percent of the supplemental life policy amount, up to $75,000. All accelerated death benefit requests are subject to state approval. Accelerated death benefits are not available for spouse or dependent coverage. When Coverage Begins Your coverage will begin on the first of the month after your first contribution from your pay, as long as you are actively at work on that day. To Collect Benefits When a covered member dies, a certified copy of the death certificate must be sent to the address below. Benefits are paid to the beneficiary (or beneficiaries) on file. When a covered dependent dies, benefits are payable to the contract holder upon written proof of death. For more information on beneficiaries, see Your Beneficiary. Prudential Insurance Company of America Group Life Administration, Attn: Sherri Benge PO Box 13676 Philadelphia, PA 19101-3676 (800) 778-3827 Conversion to an Individual Policy If you are separated from state employment, you have the option of converting your supplemental life insurance to an individual policy, without furnishing medical evidence of insurability. You must apply for the individual policy, and submit the first premium payment to the insurance company within 31 days of your separation from state employment. If you would like to make the conversion, you must call Prudential at (800) 778-3827, contact a local Prudential representative by visiting www.prudential.com or download the Conversion Privilege Form, Supplemental Group Life. Portability In lieu of the conversion feature, you are eligible to take advantage of the portability feature. Portability is an option that enables you to obtain similar Prudential group term life insurance coverage after you terminate employment. You must apply for the portability option within 45 days of your termination date of coverage. Evidence of insurability is not required to become insured for continued coverage. However, if you submit evidence and Prudential decides the evidence is satisfactory, you will pay lower premium rates. Reduction of Benefits The amount of life insurance under the portability feature reduces on the basis of attained age as follows: At age 65 the benefit reduces to 65 percent; At age 70 the benefit reduces to 50 percent; and In no case will the amount of insurance be less than $5,000. When contacting Prudential, you may be asked to provide your group number. The group number for State of Ohio exempt employees is: LG-93046-OH. End of Continued Coverage Your coverage will end when the first of the following occur: The date of the Group Contract ends. The last day of the month in which you fail to pay the required premiums. You attain age 90. When your coverage ends for (a) or (c) above, you have the right to convert your coverage to an individual contract.