Exhibit_D.pdf

LE Staff Group Life Insurance Benefit Plan – MSG Detachment Staff Rider Exhibit D

LES Group Life Insurance Services Solicitation

STC10017R0005

Exhibit D

MSG Staff Rider

Locally hired household employees of the Marine Security Guard (MSG) Detachment are eligible to fully participate in the g r o u p l i f e insurance plan for U.S. Embassy, Abu

Dhabi, if the following conditions are met:

1. Insurance provider will bill the employer (MSG-Detachment) directly.

2. All current household employees of the MSG- Detachment assigned to their respective official Government residences and paid under an MSG-Detachment account are eligible. All cost for MSG-Detachment employees are the responsibility of the employing office, not the U.S. Government.

3. The MSG-Detachment employees shall be identified under a separate task order.

The COR will make subsequent additions or deletions to this list in writing. All such revisions shall be consolidated and a new task order will be issued by the

Contracting Officer.

4. The MSG-Detachment has the discretion to include their household staff in the life insurance plan, that fact will be specified in the individual employment contract(s).

MSG-Detachment staff insurance benefits coverage and levels will be the same as coverage and levels outlined in the U.S. Embassy Life Insurance Plan.

Number of All Insured MSG-Detachment Staff Abu Dhabi Dubai Total

Number of Employees 1 0 1

Number of Employees (Male) 0 0 0

Number of Employees (Female) 1 0 1

Number of Employees (Married) 0 0 0

Number of Employees (Single) 0 0 0

Total of All MSG Detachment Insured Members 1 0 1