Document 8279kj3mD3xa79JX9YRw5MOJa

KETROPOUOAH 1272 DSUTUJC5 COMPART Croup Policy lo. 8577*0 ployses of V bearing date of *hy 29, 19*0 rewritten December 1. 1956 kAYBSSTOS-MMKATIAB. I2TC. (Barela called the Bnployer/ iby endorsed as follova i Effective aa of ita date of iaauo by substituting for aubaactioa A o: a _2__Croup Hospital Expense Insurance 6uppleaentary AgrsejKnt form 0.076325 sd to aaid Croup Policy aa a part thereof, the following: ------ "(A) The Hospital acpcass Insurance on any Employee iaaured under this Suppleaeatary Agreement shall autoaatieally eeaae on sha A$.t tersdaatioa of hia snployaeat occurs. Temlaatloa of eaployaest, for the purpeeea of Hospital Expense Insurance hereunder. Beans cessation of active work aa an Eaployse is defined in Section 1 hereof , except that (i) in ease of the absence of aa Employee from active work because of sickness or Injury, hia exployaeat nay, for the purposes of his Hospital Zxpease Insurance here under, be deeaed to continue until temlanteO by the Employer, or (ii) in case of the absence of an bployee froa active work because of leave of absence or te^orary lay-off, hia eoployasst nay, for the purposes of his Hospital Expense Insurance hereunder, be deeaed to continue until terminated by the bployer but la no easo beyond the expiration of a period of two eeatbs following the date suen loavo or apaonco or iny-pix cocaacasou< "" In the case of either of the foregoing exceptions. Hospital Btponao Inauraaco hereunder on such fixployee shall autoaatieally scaac oa the onto sueh termination of his saployacnt by the laployw occurs as evidenced to the Insurance Company by the E^loyer, whether by notiflontion or by eeaaa- tiea of preaiun payaeat oa aeoount of such b^ployoo's Hospital Tipsuee Insurance horouadar," MEZMPCUSAI XZR DBURAJTCX COMPAXT, . Registrar .6365-* ry 19*8 Donald A. Odoll Tloe-Prasidsnt and Secretary oo Effective aa of its data of issue Supplementary Agreement Pern 0.B.F.6325 attached to Group Policy Bo. 8577-0 la andoraad to ellsinata subsection (a) of Section 5. v I Registrar) Pom 0.6331 HEEROPOLJTAH LIFE XBSURABCB COKPWW, &,c3 P^PQX r.-ta .u Vie.- iv. a id. ii!. .i.nl iinerot&ry IN VltHESS VHSKEOf^h^^Amnpalimn tat* InaunmJZat^fT haa aauaad riua 1jah* amawak *- r.--.. I~'1iP-rTm0 d*"** *N--_----------- ! ".. __ -- m ska rf*cT ** */ th* tuah las lu * dw daw atf mu* *t dia iwal--aaiwr jSLef &Z.v/Z&L *> ani* Ca d B. 19___ out. cm fcwlWl