Separation ArrangementsIn connection with your separation, your attention is called to the

Separation Arrangements

In connection with your separation, your attention is called to the following matters

1. Your coverage will be continued for 10 days from date of termination. Under federal law (COBRA), you may Be covered under this policy for up to 18 months by paying the Company the premium amount specified below within 30 days of termination and by subsequently continuing to pay the premium in a timely fashion. Failure to pay the premium within any 30- day period wilt result in discontinuance of the insurance.

Your GROUP PREMIUM RATE is 3. 4%

Your HEALH PLAN NUMBER is 1278- 3421-11

Use this number in alt correspondence concerning your benefits

2 Your GROUP LIFE INSURANCE policy terminates on the last day of your employment, but it can be converted without a physical examination and at a higher individual rate within 30 days of termination. If you wish to do so, contact the insurance company within the next 30 days

If you have any questions about these matters, please call.

Rundell

Personnel Director

If one fails to pay the premium within any 30-day period, then what will happen？

A．He will be fired.

B．He will lose his insurance.

C．The insurance will be discontinued.

D．He must pay some fines.