Disclosures, Terms, and Exclusions

Cancellation policy:

I may cancel automatic payments at any time by calling Customer Service at (800) 992-8044. I understand that I may terminate the scheduled payments by providing notification to the Customer Service team five (5) business day prior to the next scheduled payment date. This advance notice allows processing time to ensure the termination occurs prior to the next scheduled payment date. Automatic payment termination cannot be guaranteed with respect to notice provided outside of this window.

If I am not satisfied with my membership, I may cancel within thirty (30) days from my membership’s effective date and I may be eligible to receive a full refund on the monthly membership dues collected for that month. All cancellations must be directed to Customer Service at (800) 992-8044. Cancellations are processed Monday–Friday from 8:30 a.m. to 4:30 p.m. CST Time. All cancellation requests must be made five (5) days prior to the billing date in order to cancel the membership for that month. This advance notice allows processing time to ensure the cancellation occurs prior to the next scheduled payment date. Cancellations cannot be guaranteed with respect to notice provided outside of this window. If a cancellation request is received on or after the recurring billing date and the payment has been drafted, the membership will terminate prior to the next billing date and the member will be covered through the next month.

By submitting a claim during the first 30 days, I acknowledge and agree that such a submission constitutes acceptance of the membership, the products, and their terms and submission of such a claim constitutes a waiver of any and all refund rights, including those noted in the foregoing paragraph.

Policy Form Disclosure:

Group Term Life Insurance is issued on Form Series GLC-3002. This product and its features are subject to state availability and may vary by state. Certain exclusions and limitations may apply.

Rate Information

The following rates apply for coverage underwritten by Guarantee Trust Life Insurance Company as part of your membership in the Affinity Consumer Alliance. The rates by plan are: 20000 Accident Only Life: Member Only = $5.64 per month, 15000 Accident Only Life: Member Only = $4.23 per month, 10000 Accident Only Life: Member Only = $2.82 per month.

Life Insurance Termination:

Coverage is subject to termination in accordance with the Association Group Master Policy provisions. Notice of termination provided to the Association is considered notification to all Association Members and will not be sent to you individually by GTL. Your right to the provided and stated Life Insurance Policy/Certificate is also terminated as of the termination date requested or assigned by cancelation of your membership in Affinity Consumer Alliance please see Cancelation Policy for more details.

DMPO Disclaimer:

Guarantee Trust Life Insurance Company (GTL) provides the Group Term Life Only insurance. GTL does not provide nor is affiliated with the discount programs provided as a part of membership in Affiliated Consumer Alliance.

Co-Brand Disclosure:

The following list of companies are separate legal entities and have sole financial responsibility for their own products.

Spartan
Affinity Consumer Alliance
Guarantee Trust Life Insurance Company

CONSENT TO ELECTRONIC DELIVERY:

You have the option of downloading your certificate electronically. If you choose to do so, you are consenting to accept electronic delivery of your certificate. You also have the right at any time to receive a hard copy of your certificate. If you choose this option, please call

1-(800) 992-8044.

Accidental Death Benefit Exclusions:

If, within 90 days from the date of an Accident which occurs while coverage is in force, Injury from such Accident results in a loss covered by this benefit, We will pay the benefit in the amount set opposite such loss, as shown on the Schedule of Benefits. If more than one such loss is sustained as the result of one Accident, We will pay only one amount, the largest to which the Covered Person is entitled.

This benefit is subject to all the terms, conditions and exclusions of this Certificate. Exclusions: No benefits are payable for any loss caused by:

Suicide or intentionally self-inflicted Injury while sane or insane.
War or any act of war, declared or undeclared.
Travel, or flight in or descent from any kind of aircraft unless as a fare paying passenger on a regularly scheduled flight.
As a passenger on an official flight of the Military Airlift Command of the United States or similar air transport services of other countries.
Infections, except infections which occur simultaneously with or through a cut or wound sustained as the direct result of an Injury, independent of any other cause; and
The non-accidental ingestion of a contaminated substance.
Being under the influence of alcohol or any drug unless administered and taken as prescribed by a Doctor.
Participation in an attempt to commit an assault or felony, or participation in a riot.
Voluntary gas inhalation or poison voluntarily taken, administered or inhaled.
Riding or driving as a professional in any kind of race for prize money or profit.

SUICIDE EXCLUSION

If a Covered Person dies as the result of suicide or any attempt at suicide, while sane or insane within two years of his Effective Date of coverage, We will be liable only for an amount equal to the Premium paid.

With respect to an increase in the amount of insurance, We will consider the two year period to begin as of the effective date of such increase.

Our return of such Premium will be in lieu of all other benefits under this Certificate which may have been payable for that Covered Person.