Agmt 2004 Hartford Life Insurance Company

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T NOTICE OFNON-COVERAGE CALIFORNIA LIFE ANl) HEALTH INSURANCE GU.A-RANTEE ASSOCIATION ACT This policy is NOT covered by The California Life and Health Insurance Guarantee Associaiian 13XCI,IISIONS FROM COVERAGE The following are not covered by the California Life and Health Instaance Guarantee Association: • T Tnall ~si~d anmrity contracts; $~atis, contracts which are not issued to and ow.[~d. by individuals and which guaran#ea rights to group contract holders, not individuals; • Employer and as~ciation plains, to the extent they are self-funded or uninsured; • Syathebc guaranteed interest contracts; • Arty policy ar portion of a policy which is not guaranteed by the insurer or forwhich the individual has assumed the risk, such as a variable contract sold by prospectus; • Any policy of *P+n~TMm*~ unless an assumption certificate was issued; • Interest zate yields that exceed an average rate; • Any portion of a contract that provides dividends or experience rating credits. A determination as to whethez an;nc~*rA*~~ oo~act is covered under the Guarantee Association or whether an anxnrity corrtract is aIlocated or unallocated must initially be made by the insurer based. an ~ lmowledge of the specific contract offered. Also, yon are not protected by this Association if: Their insurer was not authorized to do business in this state when it issued the policy or contract; Tye policy was issued by a health care service plan (HIviO), Hhre Cross, Blue Shield, a charitable organization, a fraternal benefit. society, a mandatory state pooling Plan, a mutual assessment campa~, an insuasnce exchange or a grartks and annuities society; You are eligible for protection under, the laws of another skate, This may occaar when the insolvent insurer was incorporated in another state whose guaranty association protects insru~eds who live outside that state, Tnc~xzmct companies or $» agelrtr are required by law to give or seal you this notice. However, insurance companies and their agents are prohibited by law from using the eacistence ofthe Gum~antee Association to induce you to purchase any kind of irrsruance policy. If you have questions concerning this notice, you may contact: California Life and Health Insuranoe ar Consumer Service Divisicm Guarantee. Asaoeiatiozi Califontia Department of Insurance P ;O. Box 17319 3Q0 South Spring Street BeverlyHr7ls, CA 90209-3319 Los Angeles, CA 90013 (213) 782-0182 1-800-927-4357 or (213) 897-8921 Questions as to specific policies or annuities should be directed to the insurance company offering the product. Hir144oS-1 (Revised 3/2001)