Exhibit_C5_-_Securian_Term_Life_Certificate.pdf

MHC-96-13180.4 Minnesota Life 1

EdF70642 4-2009

Employee Group Term Life Certificate of Insurance

Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101-2098

POLICYHOLDER: Superior Court of California, County of San Bernardino

POLICY NUMBER: 33849-G

Read Your Certificate Carefully

You are insured under the group policy shown on the specifications page attached to this certificate. This certificate summarizes the principal provisions of the group policy that affect you. The provisions summarized in this certificate are subject in every respect to the group policy. You may examine the group policy at the principal office of the policyholder during regular working hours.

Right to Cancel

It is important to us that you are satisfied with this certificate after it is issued. If you are not satisfied with this certificate, you may cancel it by delivering or mailing a written notice or sending a telegram to Minnesota Life Insurance Company (Minnesota Life), 400 Robert Street North, St. Paul, Minnesota 55101-2098 and returning the certificate before midnight of the 30th day after you received this certificate.

Notice given by mail and return of the certificate by mail are effective on being postmarked, properly addressed, and postage prepaid. If you return this certificate, you will receive, within 10 days of the date we receive a notice of cancellation, a full refund of any premiums you have paid.

Upon cancellation of this certificate, it will be void as if it had never been issued.

Secretary President

TABLE OF CONTENTS

Definitions General Information Premiums Death Benefit

Termination Conversion Right Additional Information

GROUP TERM LIFE CERTIFICATE OF INSURANCE

gp508 Typewritten Text Effective January 1, 2020 as revised on July 11, 2022

F. MHC-50393 A

CERTIFICATE SPECIFICATIONS PAGE

GENERAL INFORMATION

POLICYHOLDER:

Superior Court of California, County of San Bernardino

POLICY NUMBER:

33849-G

ASSOCIATED COMPANIES:

All subsidiaries and affiliates reported to Minnesota Life by the policyholder for inclusion in the policy.

POLICY SITUS:

State of California

POLICY EFFECTIVE DATE:

August 1, 2010. This specifications page represents the plan in effect as of January 1, 2020 as revised on July 11, 2022.

This certificate and/or certificate specifications page replaces any and all certificates and/or certificate specifications pages previously issued to you under the group policy. Please replace any certificate and/or certificate specifications page previously issued to you with this new certificate and/or specifications page.

ELIGIBLE GROUP:

The group is composed of all employees of the policyholder and its associated companies scheduled to work in regular positions, and elected officials, who are in the Eligible Classes below. All references to “employee” shall include an elected official, unless the context requires otherwise.

MINIMUM PARTICIPATION

REQUIREMENT:

There is no minimum participation requirement under this policy.

ENROLLMENT PERIOD:

Not applicable for noncontributory insurance; 31 days from the first day of eligibility for contributory insurance.

WAITING PERIOD: For basic life: The first day of the pay period following the pay period in which the employee works and receives pay for one-half plus one of the regularly scheduled hours.

For grandfathered optional life: None

For supplemental life: The first day of the pay period following the time requirements established in the employee’s Memorandum of Understanding (MOU), Exempt Compensation Plan, salary ordinance or contract.

MINIMUM HOURS

PER WEEK REQUIRED:

40 hours per pay period

F. MHC-50393 B

PLAN OF INSURANCE

EMPLOYEE TERM LIFE BENEFIT SCHEDULE

Basic Life Insurance

Eligible Class Number Eligible Class Name

Insurance Amount:

Job Share (Bi-weekly)

Insurance Amount:

Full-Time (Regular position budgeted for 40 Hours or More, Bi-weekly)

1 Exempt Groups A & B N/A $75,000

2 Supervisory N/A $40,000*

3 Superior Court Commissioner and CEO N/A $75,000

4 Support Services N/A $25,000**

5 Exempt Groups C & D

(includes former class #5)

N/A $60,000

8 Official Court Reporter N/A $25,000**

9 Professional

(includes former class #7)

N/A $40,000*

10 Interpreters N/A $25,000** 11 Contract Employees Contract Specific Contract Specific

*Will increase to $50,000 January 1, 2017 **Will increase to $35,000 July 1, 2017

Grandfathered Optional Life Insurance

Eligible Employees Insurance Amount Elected Superior Court Judges (Appointed or Elected before 11/04/1994) who were covered for grandfathered optional life coverage on July 31, 2009 under a prior policy.

$50,000

Supplemental Life Insurance

Eligible Employees Insurance Amount Employees whose Memorandum of Understanding (MOU), Exempt Compensation Plan, salary ordinance or contract states they are eligible.

An amount elected by the employee, in an increment of $10,000, subject to a maximum of $700,000.

GENERAL PROVISIONS FOR EMPLOYEE INSURANCE

AGE REDUCTIONS:

(Grandfathered Optional and Supplemental Life Only)

The amount of grandfathered optional and supplemental insurance on an employee age 70 or older shall be a percentage of the amount otherwise provided by the plan of insurance applicable to such employee in accordance with the following table:

Age of Employee 70 – 74 75 – 79

80 and over

Amount of Optional/Supplemental Insurance

65% 45% 30%

Reduced amounts will be rounded to the next higher multiple of $10,000 if not already a multiple thereof. Age reductions will apply the first day of the month following an insured employee’s applicable birthday.

F. MHC-50393 C

RETIREMENT REDUCTIONS: All insurance terminates at retirement, except as provided for under the portability provision.

CONTRIBUTORY/NONCONTRIBUTORY: Basic insurance is noncontributory insurance; grandfathered optional and supplemental insurance is contributory insurance.

GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an employee can receive without evidence of insurability when first eligible under the plan provided enrollment is made within the enrollment period. The amounts are as follows:

For basic insurance: All basic insurance is guaranteed issue.

For grandfathered optional insurance: All grandfathered optional insurance is guaranteed issue.

For supplemental insurance: $250,000

EVIDENCE OF INSURABILITY: Evidence of insurability is required for an amount of insurance greater than the guaranteed issue amount.

EFFECTIVE DATE OF INCREASES

AND DECREASES DUE TO CHANGE

IN ELIGIBLE CLASS:

The date of the change in eligible class. All increases are subject to the actively at work requirement.

DEPENDENTS BENEFIT SCHEDULE

DEPENDENTS TERM LIFE INSURANCE:

An employee does not need to be insured for supplemental life insurance to elect dependents life insurance.

The amount of insurance on a dependent may not exceed 100% of the total amount of insurance the employee has in force on himself/herself.

Spouse Life Insurance

Eligible Class Amount of Spouse Life Insurance

All Employees An amount elected by the employee, in an increment of $10,000, subject to a maximum of $200,000

Child Life Insurance

Eligible Class Amount of Child Life Insurance

All Employees An amount elected by the employee, in an increment of $5,000, subject to a maximum of $20,000.

An employee’s first eligible newborn child is automatically covered for $5,000 for 31 days from the child’s live birth. To continue coverage on the first child, the employee must elect child coverage within those 31 days; otherwise the coverage shall terminate at the end of the 31-day period.

F. MHC-50393 D

GENERAL PROVISIONS FOR DEPENDENTS INSURANCE

SPOUSE AGE REDUCTIONS: The amount of insurance on an insured spouse age 70 or older shall be a percentage of the amount otherwise provided by the plan of insurance applicable to such spouse in accordance with the following table:

Age of Spouse

70 – 74 75 – 79

80 and over

Amount of Spouse Insurance 65% 45% 30%

Age reductions will apply the first day of the month following an insured spouse’s applicable birthday.

CONTRIBUTORY/NONCONTRIBUTORY: Dependents insurance is contributory insurance.

GUARANTEED ISSUE AMOUNT: Guaranteed issue is the maximum amount of insurance an eligible dependent can receive without evidence of insurability when first eligible under the plan provided enrollment is made within the enrollment period*. The amounts are as follows:

For spouse insurance: $20,000 For child insurance: $20,000

*As an exception, evidence of insurability is never required of a child, but enrollment opportunities are limited to a period of initial eligibility, annual enrollment, or within 31 days of a qualified status change.

EVIDENCE OF INSURABILITY: Evidence of insurability is required as stated in the certificate and for an amount of insurance greater than the guaranteed issue amount.

EFFECT OF EMPLOYEE’S RETIREMENT: All dependents insurance terminates upon the employee’s retirement except as provided under the portability provision.

ADDITIONAL INFORMATION

SUICIDE EXCLUSION FOR LIFE

INSURANCE:

The suicide exclusion described in the policy applies to grandfathered optional, supplemental and spouse life insurance. It does not apply to basic or child life insurance.

WAIVER OF PREMIUM APPLICATION: Applies to contributory and noncontributory employee insurance.

REINSTATEMENT PERIOD: There is no reinstatement under this certificate. An employee who loses eligibility and later again becomes eligible shall be treated the same as an employee who is first eligible under the plan.

F. MHC-50393 E

ONE-TIME ANNUAL ENROLLMENT:

(Effective January 1, 2018)

During the policyholders 2018 annual enrollment, the following election changes can be made without providing evidence of insurability:

• An employee may elect spouse life insurance up to the guaranteed issue amount of $20,000.

• An employee may elect any amount of child life insurance, up to the plan maximum of $20,000.

Coverage will be effective on January 1, 2018 following the enrollment, subject to the actively at work requirement for the employee and the hospitalization/confinement clause for the dependent.

(Effective January 1, 2019)

During the policyholders 2019 annual enrollment, the following election

Coverage will be effective on January 1, 2019 following the enrollment, (Effective January 1, 2020)

During the policyholders 2020 annual enrollment, the following election

Coverage will be effective on January 1, 2020 following the enrollment, F. MHC-50393 F

ANNUAL ENROLLMENTS: During the policyholder’s annual open enrollment, the following election changes can be made:

• An employee may make changes to his or her supplemental life elections, however elections that exceed $250,000 for supplemental life insurance when combined with the amount, if any of Variable Group Universal Life (VGUL) coverage under Minnesota Life Policy 55052-G, will require evidence of insurability.

• Electing spouse life insurance requires evidence of insurability.

Coverage will go into effect on January 1 following the annual enrollment for coverage that does not require evidence of insurability, or on the date we approve evidence of insurability if later. Increases in coverage are subject to the actively at work requirement for employees and the hospitalization/confinement clause for dependents.

QUALIFIED STATUS CHANGES: An employee who experiences a Qualified Status Change as determined by the policyholder may make the following election changes, provided enrollment is made within 31 days of the status change event:

• An employee may make changes to his or her supplemental life elections, however elections that exceed $250,000 for supplemental life insurance when combined with the amount, if any, of Variable Group Universal Life (VGUL) coverage under Minnesota Life Policy 55052-G, will require evidence of insurability.

• Electing spouse life insurance requires evidence of insurability.

Coverage will be effective on the date of the election, or on the date we approve evidence of insurability if later. Increases in coverage are subject to the actively at work requirement for employees and the hospitalization/confinement clause for dependents.

Qualified Status Change shall be as defined by IRC Section 125. The change in plan must be consistent with the change in status.

SUPPLEMENTS TO THE CERTIFICATE

Accelerated Benefits Dependents Benefits Portability Waiver of Premium

MHC-96-13181.4 Minnesota Life 2

Definitions age

Attained age as of most recent birthday.

application

Your application for insurance under the group policy and, if required, your evidence of insurability application.

associated company

Any company which is a subsidiary or affiliate of the policyholder which is designated by the policyholder and agreed to by us to participate under the group policy.

certificate effective date

The date your coverage under this certificate becomes effective.

contributory insurance

Insurance for which you are required to make premium contributions.

earnings

Your basic rate of compensation not including commissions, overtime or premium pay, bonuses, or any other additional compensation.

employee

An individual who is employed by the policyholder or by an associated company, or an elected official. All references to “employee” in the certificate and supplements thereto shall include an elected official, unless the context requires otherwise. The term employee does not include temporary employees nor corporate directors who are not otherwise employees.

employer

The policyholder or any designated associated companies.

evidence of insurability

Evidence satisfactory to us of the good health of the prospective insured and any other underwriting information we require.

insured

A person who is eligible for and becomes insured according to the terms of this certificate.

non-work day

A day on which you are not regularly scheduled to work, including scheduled time off for vacations, personal holidays, weekends and holidays, and approved leaves of absence for non-medical reasons.

Non-work day does not include time off for medical leave of absence, temporary layoff, employer suspension of operations in total or in part, strike, and any time off due to sickness or injury including sick days, short-term disability, or long-term disability.

noncontributory insurance

Insurance for which you are not required to make premium contributions.

policyholder

The owner of the group policy as shown on the specifications page attached to this certificate.

specifications page

The outline which summarizes your coverage under the policyholder’s plan of insurance.

waiting period

The period, if any, of continuous employment with the employer required prior to becoming eligible for coverage under this certificate. The waiting period is shown on the specifications page attached to this certificate.

we, our, us

Minnesota Life Insurance Company.

you, your, certificate holder

An insured employee.

General Information

What is your agreement with us?

You are insured under the group policy shown on the specifications page attached to this certificate. Your application as defined under this certificate is attached and is a part of this certificate. This certificate summarizes the principal provisions of the group policy that affect your life insurance coverage. The provisions summarized in this certificate are subject in every respect to the group policy.

Any statements made in your application as defined in this certificate will, in the absence of fraud, be considered representations and not warranties. Also, any statement made will not be used to void your insurance nor defend against a claim unless the statement is contained in the application attached to your certificate.

This certificate is issued in consideration of your application and the payment of the required premium.

Can this certificate be amended?

Yes. We retain the right to amend this certificate at any time the policyholder and we agree to amend it, without your consent. Any amendment will be without prejudice to

MHC-96-13181.4 Minnesota Life 3 any claim incurred for benefits prior to the date of the amendment.

Who is eligible for insurance?

You are eligible if you:

(1) are a member of the group and of an eligible class as defined in the group policy; and

(2) work for the employer for at least the number of hours per week shown as the minimum hours per week requirement on the specifications page attached to this certificate; and

(3) have satisfied the waiting period as shown on the specifications page attached to this certificate;

and

(4) meet the actively at work requirement as shown in the section entitled “What is the actively at work requirement?”.

Are retired employees eligible for insurance?

All insurance terminates at retirement, except as provided for under the portability provision.

What is the actively at work requirement?

To be eligible to become insured or to receive an increase in the amount of insurance, you must be actively at work performing your usual duties at the employer’s normal place of business, or at other places the employer’s business requires you to travel.

If you are not actively at work on the date coverage would otherwise begin, or on the date an increase in your amount of insurance would otherwise be effective, you will not be eligible for the coverage or increase until you return to active work. However, if the absence is on a non-work day, coverage will not be delayed provided you were actively at work on the work day immediately preceding the non-work day.

Except as otherwise provided for in this certificate, you are eligible to continue to be insured only while you remain actively at work.

When will we require evidence of insurability?

Evidence of insurability will be required if:

(1) the specifications page attached to this certificate states that evidence of insurability is required; or

(2) the insurance is contributory and you do not enroll within the enrollment period shown on the specifications page attached to this certificate; or

(3) the insurance for which you previously enrolled did not go into effect or was terminated because you failed to make a required premium contribution; or

(4) during a previous period of eligibility, you failed to submit required evidence of insurability or that which was submitted was not satisfactory to us; or

(5) you are insured by an individual policy issued under the terms of the conversion right section.

When does insurance become effective?

Insurance becomes effective on the date that all of the following conditions have been met:

(1) you meet all eligibility requirements; and

(2) if required, you apply for the insurance on forms which are approved by us; and

(3) we are satisfied with your evidence of insurability, if we require evidence; and

(4) we receive the required premium.

Can your coverage be continued during sickness, injury, leave of absence or temporary layoff?

Yes. The employer may continue your noncontributory insurance or allow you to continue your contributory insurance when you are absent from work due to sickness, injury, leave of absence, or temporary layoff.

Continuation of your insurance is subject to certain time limits and conditions as stated in the group policy. If you stop active work for any reason, you should discuss with the employer what arrangements may be made to continue your insurance.

Premiums

When and how often are your premium contributions due?

Unless the policyholder and we have agreed to some other premium payment procedure, any premium contributions you are required to make for contributory insurance are to be paid by you to the policyholder on a monthly basis. We apply premiums consecutively to keep the insurance in force.

How is the premium determined?

The premium will be the premium rate multiplied by the number of $1,000 units of insurance in force on the date premiums are due. The premium may also be computed by any other method on which the policyholder and we agree.

We may change the premium rate:

(1) on any premium due date following the expiration of any rate guarantee period; or

(2) anytime, if the policy terms are amended.

Death Benefit

What is the amount of the death benefit?

The amount of the death benefit is the amount of insurance shown on the specifications page attached to this certificate.

Can you request a change in the amount of your contributory insurance?

Yes. If the policyholder’s plan of insurance, as reflected in the specifications page attached to the group policy, MHC-96-13181.4 Minnesota Life 4 allows for a choice of amounts of insurance for the insured’s class, you can request an increase or a decrease in the amount of your contributory insurance within the limitations of the policyholder’s plan of insurance, including any limitations on when and how often such requests may be made.

If you request an increase in the amount of your contributory insurance, we will require evidence of insurability, unless otherwise noted on the specifications page.

When will changes in your coverage amount be effective?

Requested increases in the amount of your contributory insurance, if approved, are effective on the date we approve the increase. Requested decreases in the amount of your contributory insurance are effective on the first day of the month following receipt of your request for a decrease, or if different, according to the administrative practices of the employer.

Requests for a change made during a special enrollment period offered by the employer will not become effective prior to the general effective date of elections made during that enrollment.

Increases and decreases in insurance amounts which result from a change in your eligible class or earnings will be effective as shown on the specifications page attached to this certificate.

All increases in the amount of insurance are subject to the actively at work requirement.

When will the death benefit be payable?

We will pay the death benefit upon receipt at our home office of written proof satisfactory to us that you died while insured under this certificate. All payments by us are payable from our home office.

The death benefit will be paid in a single sum or by any other method agreeable to us and the beneficiary. We will pay interest on the death benefit from the date of your death until the date of payment. Interest will be at an annual rate determined by us, but never less than 4% per year compounded annually, or the minimum required by state law, whichever is greater.

Payment of the death benefit will extinguish our liability under the certificate for which the death benefit has been paid.

To whom will we pay the death benefit?

We will pay the death benefit to the beneficiary or beneficiaries. A beneficiary is named by you to receive the death benefit to be paid at your death. You may name one or more beneficiaries. You cannot name the policyholder or an associated company of the policyholder as a beneficiary.

You may also choose to name a beneficiary that you cannot change without the beneficiary’s consent. This is called an irrevocable beneficiary.

If there is more than one beneficiary, each will receive an equal share, unless you have requested another method in writing. To receive the death benefit, a beneficiary must be living on the date of your death. In the event a beneficiary is not living on the date of your death, that beneficiary’s portion of the death benefit shall be equally distributed to the remaining surviving beneficiaries. In the event of the simultaneous deaths of you and a beneficiary, the death benefit will be paid as if you survived the beneficiary.

If there is no eligible beneficiary, or if you do not name one, we will pay the death benefit to:

(1) your lawful spouse or registered domestic partner if living; otherwise

(2) your natural or legally adopted child (children) in equal shares, if living; otherwise

(3) your parents in equal shares, if living; otherwise

(4) your brothers and sisters in equal shares, if living;

otherwise

(5) the personal representative of your estate.

Can you add or change beneficiaries?

Yes. You can add or change beneficiaries if all of the following are true:

(1) your coverage is in force; and

(2) we have written consent of all irrevocable beneficiaries; and

(3) you have not assigned the ownership of your insurance.

A request to add or change a beneficiary must be made in writing. All requests are subject to our approval. A change will take effect as of the date it is signed, but will not affect any payment we make or action we take before receiving your notice.

Termination

When does your coverage terminate?

Your coverage ends on the earliest of the following:

(1) the date the group policy ends; or

(2) the date you no longer meet the eligibility requirements; or

(3) the date the group policy is amended so you are no longer eligible; or

(4) 31 days (the grace period) after the due date of any premium contribution which is not paid; or

(5) the last day for which premium contributions have been paid following your written request to cease participation under this certificate.

If your coverage under the group policy terminates due to non-payment of premiums, your coverage may be

MHC-96-13181.4 Minnesota Life 5 reinstated if all premiums due are paid and received by us within 31 days of the date of termination and during your lifetime.

Can your insurance be reinstated after termination?

Yes. When your coverage terminates because you are no longer eligible, and you become eligible again within the time frame shown on the specifications page, your coverage may be reinstated.

Provided you are not then covered by an individual policy issued under the terms of the conversion right section, your coverage under the group policy shall be reinstated automatically, without evidence of insurability or satisfaction of any waiting period. Your amount of insurance will be that which applies to the classification to which you then belong, on the date you again become eligible. If the policyholder’s plan of insurance provides for contributory insurance under the group policy, your amount of contributory insurance will be limited to that for which you were insured immediately prior to the loss of coverage.

When does the group policy terminate?

The policyholder may terminate the group policy by giving us 31 days prior written notice. We reserve the right to terminate the group policy on the earliest of the following to occur:

(1) 31 days (the grace period) after the due date of any premiums which are not paid; or

(2) on any subsequent policy anniversary after the date the number of employees insured is less than any minimum established by us or as required by applicable state law; or

(3) 31 days after we provide the policyholder with notice of our intent to terminate the group policy.

Conversion Right

What is the conversion right?

You may convert this insurance to a new individual life insurance policy if all or part of your life insurance under the group policy terminates.

You may convert up to the full amount of terminated insurance if termination occurs because:

(1) you move from one existing eligible class to another; or

(2) you are no longer in an eligible class; or

(3) the group policy is terminated; or

(4) the group policy is changed to reduce or terminate your insurance.

The conversion right is not available if your coverage under the group policy terminates due to failure to make, when due, required premium contributions.

You may convert your insurance to any type of individual policy of life insurance then customarily issued by us for purposes of conversion, except term insurance. The individual policy will not include any supplemental benefits, including, but not limited to, any disability benefits, accidental death and dismemberment benefits, or accelerated benefits.

How do you convert your insurance?

You convert your insurance by applying for an individual policy and paying the first premium within 31 days after your group insurance terminates. No evidence of insurability will be required.

How is the premium for the individual policy determined?

We base the premium for the individual policy on the plan of insurance, your age, and the class of risk to which you belong on the date of the conversion.

When is the individual policy effective?

The individual policy takes effect 31 days after the group insurance provided under the group policy terminates.

What happens if you die during the 31-day period allowed for conversion?

If you die during the 31-day period allowed for conversion, we will pay a death benefit regardless of whether or not an application for coverage under an individual policy has been submitted. The death benefit will be the amount of insurance you would have been eligible to convert under the terms of the conversion right section.

We will return any premium you paid for an individual policy to your beneficiary named under the group policy.

In no event will we be liable under both the group policy and the individual policy.

Additional Information

What if your age has been misstated?

If your age has been misstated, the death benefit payable will be that amount to which you are entitled based on your correct age. A premium adjustment will be made so that the actual premium required at your correct age is paid.

Is there a suicide exclusion?

The specifications page attached to this certificate indicates what insurance, if any, is subject to the suicide exclusion outlined below.

When applicable, this suicide exclusion limits our liability to an amount equal to the premiums paid if you, whether sane or insane, die by suicide within two years of the effective date of your insurance.

If there has been an increase in your amount of insurance for which you were required to apply or for which we required evidence of insurability, and if you die by suicide within two years of the effective date of the increase, our

MHC-96-13181.4 Minnesota Life 6 liability with respect to that increase will be limited to the premiums paid and attributable to such increase.

When does your insurance become incontestable?

Except for fraud or the non-payment of premiums, after your insurance has been in force during your lifetime for two years from the effective date of your coverage, we cannot contest your coverage. However, if there has been an increase in the amount of insurance for which you were required to apply or for which we required evidence of insurability, then, to the extent of the increase, any loss which occurs within two years of the effective date of the increase will be contestable.

Any statements you make in your application as defined under this certificate will, in the absence of fraud, be considered representations and not warranties. Also, any statement you make will not be used to void your insurance, nor defend against a claim, unless the statement is contained in the application attached to your certificate.

Can your insurance be assigned?

Yes. However, we will not be bound by an assignment of the certificate or of any interest in it unless it is made as a written instrument, and you file the original instrument or a certified copy with us at our home office, and we send you an acknowledged copy.

We are not responsible for the validity of any assignment.

You are responsible for ensuring that the assignment is legal in your state and that it accomplishes your intended goals. If a claim is based on an assignment, we may require proof of interest of the claimant. A valid assignment will take precedence over any claim of a beneficiary.

Is the policyholder required to maintain records?

Yes. The policyholder is required to maintain adequate records of any information necessary for us to administer this certificate. We own the records relating to the insurance provided by this certificate, and can obtain them from the policyholder at any reasonable time.

If a clerical error is made in keeping records on the insurance under the group policy, it will not affect otherwise valid insurance. A clerical error does not continue insurance which is otherwise stopped. If an error causes a change in premium payment, we will make a fair adjustment.

Will the provisions of this certificate conform with state law?

Yes. If any provision in this certificate, or in the provisions of the group policy, is in conflict with the laws of the state governing the certificates or the group policy, the provision will be deemed to be amended to conform to such laws.

MHC-96-13185 Minnesota Life 1

EdF70644 4-2009

Accelerated Benefits Certificate Supplement

Minnesota Life Insurance Company - A Securian Company 400 Robert Street North • St. Paul, Minnesota 55101-2098

Benefits received under this Accelerated Benefits Certificate Supplement may be taxable. You should seek assistance from a personal tax advisor prior to requesting an accelerated payment of death benefits.

General Information

This certificate supplement is subject to every term, condition, exclusion, limitation, and provision of your certificate unless otherwise expressly provided for herein.

What does this supplement provide?

This supplement provides for the accelerated payment of either the full or a partial amount of an insured’s death benefit provided under your certificate. If an insured has a terminal condition as defined in this supplement, you may request an accelerated payment of the applicable death benefit.

Definitions accelerated benefit

The amount of the death benefit we will pay if the insured is eligible under this supplement.

death benefit

The amount of the insured’s life insurance as shown on the specifications page attached to your certificate.

immediate family

Your spouse, children, parents, grandparents, grandchildren, brothers and sisters, and their spouses.

insured

For purposes of this supplement, an insured employee.

physician

An individual who is licensed to practice medicine or treat illness in the state in which treatment is received. This does not include you or a member of your immediate family.

Terminal Condition

What is a terminal condition?

A terminal condition is a condition caused by sickness or accident which directly results in a life expectancy of twelve months or less.

What evidence do we require of the insured’s terminal condition?

We must be given evidence that satisfies us that the insured’s life expectancy, because of sickness or accident, is twelve months or less. That evidence must include certification by a physician.

Do we have the right to obtain independent medical verification?

Yes. We retain the right to have the insured medically examined at our own expense to verify the insured’s medical condition. We may do this as often as reasonably required while accelerated benefits are being considered or paid.

Payment of Accelerated Benefit

How do we calculate the accelerated benefit?

We will multiply the death benefit by the accelerated benefit factor to determine the accelerated benefit available.

How do we calculate the accelerated benefit factor?

The accelerated benefit factor will be stated as a percentage of the insured’s death benefit. When we calculate this factor, we will consider the insured’s age and gender.

We will also base our calculation on certain assumptions, which we may change from time to time, including but not limited to assumptions about:

(1) expected future premiums; and

(2) the insured’s life expectancy.

What are the conditions for the payment of an accelerated benefit?

We will consider the payment of an accelerated benefit, subject to all of the following conditions:

(1) coverage must be in force and all premiums due must be fully paid; and

(2) application must be made in writing and in a form which is satisfactory to us. We will tell you what form is required; and

(3) you must be the sole owner of the certificate; and

(4) the insured’s insurance must not have an irrevocable beneficiary.

MHC-96-13185 Minnesota Life 2

EdF70644 4-2009

Who may request an accelerated payment of the death benefit?

You may request an accelerated payment of the insurance on your life.

Is the request for an accelerated benefit voluntary?

Yes. An accelerated benefit will be made available on a voluntary basis only. An accelerated benefit under this supplement is not intended to cause an involuntary reduction of the death benefit ultimately payable to the named beneficiary. Therefore, payment of the death benefit cannot be accelerated under this supplement if the insured:

(1) is required by law to use this option to meet the claims of creditors, whether in bankruptcy or otherwise; or

(2) is required by a government agency to use this option in order to apply for, obtain, or keep a government benefit or entitlement.

Is there a minimum or maximum death benefit eligible for an accelerated benefit?

Yes. The minimum death benefit to be eligible for an accelerated benefit under this supplement is $10,000.

The maximum death benefit to be eligible for an accelerated benefit is 100% of the insured’s death benefit.

Do you have to take the entire accelerated benefit?

No. You may choose to receive a partial accelerated benefit. If you do so, the insured’s remaining coverage will stay in force.

If you elect to receive only a partial accelerated benefit amount available under this supplement, the insured’s remaining death benefit under the certificate must be at least $25,000.

You may reapply for the payment of the remaining amount of insurance at any time. However, we may ask for further satisfactory evidence that the insured meets all requirements for the accelerated benefit.

What is the effect on the insured’s coverage of the receipt of an accelerated benefit?

If you elect to accelerate the full amount of your death benefit, your coverage and all other benefits under the certificate and any certificate supplements for you will end.

If a partial accelerated benefit is chosen, coverage will remain in force and premiums will be reduced accordingly.

The remaining amount of insurance under your certificate will be the full amount of insurance minus the amount of insurance that was accelerated.

How will we pay the accelerated benefit?

We will pay the accelerated benefit in one lump sum or in any other mutually agreeable manner.

To whom will we pay accelerated benefits?

All accelerated benefits will be paid to you unless you validly assign them otherwise. If you die before all payments have been made, we will pay the remainder to the beneficiary named under this certificate. Payment will be made in one lump sum which will be the present value of the payments that remain, using the interest rate we use to determine the payments.

Termination

When does an insured’s coverage under this supplement terminate?

An insured’s coverage ends on the date the insured is no longer covered for life insurance under the group policy.

When does this supplement terminate?

This supplement will terminate on the earlier of:

(1) the date we receive a written request from the policyholder to cancel the Accelerated Benefits Policy Rider; or

(2) the date the group policy is terminated.

Secretary President

MHC-96-13187 Minnesota Life 1

EdF90580 11-20017

Dependents Term Life Insurance Certificate Supplement

General Information

This certificate supplement is issued in consideration of the required premium and is subject to every term, condition, exclusion, limitation, and provision of your certificate unless otherwise expressly provided for herein.

Any Accidental Death and Dismemberment coverage provided by a certificate supplement to your certificate will not apply to dependents coverage provided by this certificate supplement.

What does this supplement provide?

This supplement provides insurance on the lives of your eligible dependents.

What members of your family are eligible for insurance under this supplement?

The following members of your family are eligible for insurance under this supplement:

(1) your lawful spouse who is not legally separated from you or your registered domestic partner, who is not eligible for insurance as an employee under the group policy; and

(2) your natural children, stepchildren children, and legally adopted children and foster children.

Children are eligible from live birth (stillborn and unborn children are not eligible) to the attainment of age 26. Children age 26 or older are eligible if they are physically or mentally disabled, were insured under the group policy and disabled prior to age 26 and are financially dependent on you for more than one-half of their support and maintenance.

A registered domestic partner is an individual who is in registered domestic partnership with you in accordance with California Law.

If both parents of a child qualify as eligible employees under the group policy, the child shall be considered a dependent of only one parent for purposes of this supplement. If any child qualifies as an eligible employee under the group policy, he or she is not eligible to be insured as a dependent child.

Any dependent child who, subsequent to the effective date of your child life insurance, meets the requirements of this provision will become insured on the date he or she so qualifies.

When will we require evidence of insurability?

Evidence of insurability will be required if:

(1) the specifications page attached to your certificate states that evidence of insurability is required; or

(2) the insurance is contributory and you do not enroll for coverage under this supplement within the enrollment period shown on the specifications page attached to your certificate; or

(3) dependents insurance for which you previously enrolled did not go into effect or was terminated because you failed to make a required premium contribution; or

(4) during a previous period of eligibility, you failed to submit evidence of insurability that was required for a dependent or that which was submitted was not satisfactory to us; or

(5) the dependent is insured by an individual policy issued under the terms of the conversion right of this supplement.

When does insurance on a dependent become effective?

Insurance on a dependent becomes effective on the date when all of the following conditions have been met:

(1) the dependent meets all eligibility requirements;

and

(2) if required, you apply for dependents coverage on forms which are approved by us; and

(3) we are satisfied with the dependent’s evidence of insurability, if we require evidence; and

(4) we receive the required premium.

If a dependent is hospitalized or confined because of illness or disease on the date his or her insurance would otherwise become effective, his or her effective date shall be delayed until he or she is released from such hospitalization or confinement. This does not apply to a newborn child. However, in no event will insurance on a dependent be effective before your insurance is effective.

Death Benefit

What is the amount of life insurance on each insured dependent?

The amount of life insurance on each insured dependent is shown on the specifications page attached to your certificate.

To whom will we pay the death benefit?

The death benefit payable under this supplement will be paid to you if living, otherwise to your estate.

MHC-96-13187 Minnesota Life 2

EdF90580 11-20017

Termination

When does an insured dependent’s coverage under this supplement terminate?

An insured dependent’s coverage ends on the earliest of the following:

(1) the date the dependent no longer meets the eligibility requirements; or

(2) 31 days (the grace period) after the due date of any premium contribution which is not paid; or

(3) the last day for which premium contributions have been made following your written request that insurance on your eligible dependents be terminated; or

(4) the date you are no longer covered under the group policy.

You must notify us or your employer when a dependent is no longer eligible for coverage under this supplement so that premiums may be discontinued. All premiums paid for dependents who are no longer eligible for coverage under this supplement will be refunded without any payment of claim.

When does this supplement terminate?

This supplement will terminate on the earlier of:

(1) the date we receive a written request from the policyholder to cancel the Dependents Term Life Insurance Policy Rider; or

(2) the date the group policy is terminated.

Additional Information

What is the conversion right under this supplement?

If an insured dependent’s coverage under this supplement terminates because he or she is no longer eligible, or because of your death, or because of termination or amendment of this supplement, the insurance may be converted to a policy of individual insurance with Minnesota Life.

Conversion may be requested by you, an insured dependent of legal capacity, or the insured dependent’s guardian, if applicable. All other conditions and provisions of the conversion right section of your certificate to which this supplement is attached will apply.

Does the Waiver of Premium supplement to your certificate apply to insured dependents?

The Waiver of Premium supplement to your certificate will not apply to disabilities for dependents covered under this supplement.

However, if, due to your disability, your insurance is continued in force without further payment of premiums due to the Waiver of Premium supplement to your certificate, any dependents insurance provided by this supplement shall also continue in force without further payment of premiums until the dependent’s eligibility terminates or until your insurance is no longer continued in force due to the Waiver of Premium supplement to your certificate.

This provision is not applicable if the dependent’s insurance has been converted under the conversion right section of this supplement, unless the converted policy is surrendered without claim except for refund of premiums.

MHC-96-13215 Minnesota Life 1 EdF70683 Rev 4-2020

Term Life Insurance Portability Certificate Supplement

General Information This certificate supplement is issued in consideration of the required premium and is subject to every term, condition, exclusion, limitation and provision of your certificate unless otherwise expressly provided for herein.

What does this supplement provide?

This supplement provides for continuation of your group life insurance if you no longer meet the eligibility requirements of your certificate, except as provided for herein.

To continue coverage under the provisions of this supplement, you must make a written request and make the first premium contribution within 31 days after insurance provided by the group policy would otherwise terminate. Evidence of insurability will not be required.

Coverage provided by this supplement will then be deemed effective retroactive to the beginning of the 31-day period. This date is considered to be your portability date and you are then considered to have portability status.

Who is eligible to continue insurance under this supplement?

You are eligible to continue your group life insurance under the terms of this supplement if you, except as provided by this supplement, no longer meet the eligibility requirements of your certificate due to any of the following:

(1) you terminate employment, including retirement;

or

(2) you are no longer in a class eligible for insurance or you are on a leave or layoff; or

(3) a class or group of employees insured under the policy is no longer considered eligible and there is no successor plan for that class or group.

Successor plan means an insurance policy or policies provided by us or another insurer that replaces insurance provided under this policy.

You will not be eligible to request coverage under this supplement if you:

(1) have attained the age of 70; or

(2) have converted your insurance to an individual life policy under the terms of your certificate’s conversion right section; or

(3) were not actively at work due to sickness or injury on the date immediately preceding your portability date; or

(4) lose eligibility due to termination of the group policy.

What insurance can be continued under this supplement?

Basic and supplemental life insurance may be continued under this supplement. If you elect to continue your own coverage according to the provisions of this supplement, you may also elect to continue contributory insurance for any other individual insured under your certificate. You may also continue coverage under all supplements to your certificate by which you were insured immediately preceding your portability date, except for the Term Life Waiver of Premium Certificate Supplement, which shall terminate upon porting.

The amount of insurance continued under this supplement for any individual will be subject to any applicable state law or regulation relating to allowable amounts of insurance.

What is the minimum amount of insurance that can be continued under this supplement?

The minimum amount of insurance that can be continued under this supplement is $10,000 for you and $1,000 for each of your dependents.

What is the maximum amount of insurance that can be continued under this supplement?

The maximum amount of insurance that can be continued under this rider is the amount of insurance that was in force on the insured’s portability date, but not more than $500,000 for you or $100,000 for your spouse/registered domestic partner. However, if the insured is age 65 or older on your portability date, the amount will not be more than 65% of the amount of insurance that was in force on the insured’s portability date, to a maximum of $325,000 for you or $65,000 for your spouse/registered domestic partner.

Will the amount of insurance continued under this supplement change?

Yes. On the first day of the month following the date an insured attains age 65, the amount of insurance on his or her life continued under this supplement will reduce to 65% of the amount of insurance in force on the day prior to attainment of age 65. Insurance terminates at age 70.

MHC-96-13215 Minnesota Life 2 EdF70683 Rev 4-2020

Can you request a change in your amount of insurance continued under this supplement?

Yes. You may elect to reduce the amount of insurance on your life. Your remaining amount of insurance must be at least $10,000.

The amount of insurance continued under this supplement will never increase.

How will premium contributions be paid?

Premium contributions will be paid directly to us by you…