LIMITED BENEFIT POLICY

Providing Limited Benefits for Hospital Confinement

This unique plan combines a Daily Hospital Benefit with a Rider covering Dental, Vision and Hearing Services. There is also a Return of Premium Rider available in some states.

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Plan Features: • Daily Hospital Benefit of $100 to $400 (depending on the age) up to a maximum of 10 days per period of care • Dental, Vision and Hearing Care Expenses are paid at 80% after a $100 calendar year deductible, up to $1,000 maximum per calendar year (Rider Form R-DVH-3(06) • Dental Services must be performed by a licensed dentist, and includes, but not limited to, the cost of cleanings, exams, filings, x-rays, root canals, bridges or dentures. There is no waiting period, except for services to replace or repair existing dentures or bridges there is a 12 month waiting period. • Vision Services must be performed by a licensed Ophthalmologist or Optometrist, and includes visits for refractions, cost of eyeglasses or contact lenses. There is no waiting period, except for services to replace or repair existing eyeglasses or contact lenses there is a 12 month waiting period. • Hearing Services includes cost of initial hearing aids and repairs. Replacement of or repair to existing hearing aides are not covered by this Rider. • No network, see any licensed Dentist, Ophthalmologist or Optometrist • Plan available to residents in the following states: Arizona, Arkansas, Colorado, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Missouri, Nebraska, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin • Return of Premium (Rider R-RPH-1(06) returns 50% of the amount of premiums you paid for the Hospital Confinement Benefits if no hospital claims have been paid for a period of 5 consecutive policy years. The Return of Premium rider is available in the following states: Arizona, Colorado, Idaho, Illinois, Kentucky, Louisiana, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina and Utah • Individual coverage for ages 25 to 99 years old (18 - 99 in Pennsylvania) (Note spouses must apply separately. Dependent children are not covered.) • Guaranteed Renewable for Life!

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Underwritten by: National States Insurance Company 1830 Craig Park Court, St Louis, Missouri 63146 Policy Form MAS-1(06)

This is a brief description of the important features of the Policy. The Policy itself will detail the rights and obligations, of you and the insurance company, as well as the Benefits, Exceptions and Limitations contained therein. Please note loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. The Policy provisions vary by state; see complete state details listed under the tab titled Exclusions & Limitations.

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Benefits Details

DAILY HOSPITAL BENEFIT If you are confined in a hospital as a resident inpatient, because of injury or sickness, the policy pays the daily rate per day for each day you are confined up to a maximum of 10 days per Period of Care.   The maximum time for which this Hospital Confinement Benefit shall be payable is 365 days for all Periods of Care combined.   OPTIONAL BENEFITS The following benefit rider premium is automatically included with the quote for the Value Care Plus Dental.   Dental, Vision and Hearing Care Expense Rider Form R-DVH-3(06) (Optional) The premiums for this rider are automatically included with the plan quote.   This rider covers the services of all licensed dentists, visits to an Ophthalmologist or Optometrist and cost of initial hearing aids and repairs to initial hearing aids.   You must pay the first $100.00 of covered expenses in each calendar year. We will pay 80% of covered expenses after the $100.00 deductible. We will pay up to a maximum of $1,000.00 under this Rider in any one calendar year.   Covered expenses are usual and customary expenses you incur while this Rider is in effect for the services and supplies shown in paragraphs 1, 2, and 3 below. Usual and customary expense means the usual fee charged by your doctor for a given service and which is within the range of fees charged by other doctors in the same area for similar services.   1. Services of a licensed dentist including the cost of fillings, prophylaxis, bridges, crowns, and dentures, prescribed as necessary by a dentist. Replacement or repair of existing bridges or dentures will not be covered until after this Rider has been in effect for 12 months or more.   2. Visits for the purpose of eye refractions to a licensed ophthalmologist or optometrist including the cost of eyeglasses or contact lenses prescribed by such doctor. Replacement of existing eyeglasses or contact lenses will not be covered until after this Rider has been in effect for 12 months or more.   3. The cost of initial hearing aids first required while this Rider is in force, and prescribed as necessary by a doctor, including repairs to such hearing aids. Replacement of, or repair to, existing hearing aids is not covered by this Rider.   Return of Premium Rider R-RPH-1(06) (Optional) The premiums for this rider are automatically included with the plan quote for residents in the states of: Arizona, Colorado, Idaho, Illinois, Kentucky, Louisiana, Missouri, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Utah   If no Hospital Confinement Benefits have been paid under the policy for a period of 5 consecutive policy years, 50% of the premium you paid for the base policy (optional rider premium not included) will be returned to you. The policy must remain in continuous effect without lapse, and you must be alive, for the entire 5 years.   Policy Guaranteed Renewable for Life at your Option subject to our table of premium rates in effect at the time of renewal. You have the right to continue the policy as long as you pay the premiums on time. The Company may increase premiums on all policies of this type in your state. The Company cannot raise premiums just on your policy because of a change in your health, or claims that you file.

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Exclusions and Limitations

EXCEPTIONS AND LIMITATIONS AND

PREEXISTING CONDITIONS LIMITATION TERMS

This is not a Medicare Supplement Policy. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, available from the Company.

The plan EXCEPTIONS AND LIMITATIONS are listed below.

Please note they vary by state. The applicable states are indicated above the clause.

Arkansas, Arizona, Colorado, Iowa, Indiana, Illinois, Louisiana, Missouri, Nebraska, Nevada, New Mexico, Ohio, Tennessee, Virginia and Wisconsin:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental disease or disorder, alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States.

Georgia:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental disease or disorder, intoxicants or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States; illegal occupation.

Idaho:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: elective abortion, treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental or nervous disorder, alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness, trauma, infection, or other diseases of the involved part; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States.

Kentucky:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental disease or disorder, alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States.

North Carolina:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental disease or disorder, alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); care or service received outside the United States; service or supplies for the treatment of an occupational injury or sickness which are paid under the North Carolina Workers' Compensation Act only to the extent such services or supplies are the liability of the employee, employer or workers' compensation insurance carrier according to a final adjudication under the North Carolina Workers' Compensation Act or an order of the North Carolina Industrial Commission approving a settlement agreement under the North Carolina Workers' Compensation Act.

Oklahoma:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not, while serving in the military or an auxiliary unit attached to the military or working in an area of war whether voluntary or as required by an employer; mental disease or disorder, alcoholism or drug addiction (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States.

Pennsylvania:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental or nervous disorders without demonstrable organic origin, alcoholism; drug addiction (unless addiction results from the voluntary taking of drugs prescribed or administered by a licensed doctor or from the involuntary taking of drugs); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service paid under Workers' Compensation Act, Occupational Disease law or by United States Longshoreman's Harbor Worker's Compensation Act; care or service received outside the United States. This policy will not duplicate any benefits provided by a Motor Vehicle Responsibility Law. This policy does not provide coverage for loss due to dementia and Alzheimer's Disease.

South Carolina and Utah:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental or nervous disorder, alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury;cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law; care or service received outside the United States.

South Dakota:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss for the treatment of alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor). This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether declared or not; mental disease or disorder; dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service paid under workers' compensation or occupational disease law; care or service received outside the United States.

Texas:

EXCEPTIONS AND LIMITATIONS   This policy does not cover loss resulting from: treatment, injury or sickness resulting from war or any act of war, whether war is declared or not; mental or nervous disorder without demonstrable organic disease; alcohol or drug abuse (unless the result of narcotics administered or prescribed by a doctor); dental treatment, except for injury; cosmetic surgery, except when necessary to restore normal bodily function or for reconstructive purposes incidental to or following surgery resulting from sickness or injury; being engaged in an illegal occupation; any type of care or service for which you have no legal obligation to pay in the absence of insurance (except Medicaid); any type of care or service covered under workers' compensation or occupational disease law.

The plan PREEXISTING CONDITIONS LIMITATIONS TERMS are listed below.

Please note they vary by state. The applicable states are indicated above the Terms.

Arkansas, Arizona, Georgia, Iowa, Indiana, Illinois, Kentucky, Louisiana, Missouri, Nebraska, New Mexico, Ohio, Oklahoma, South Dakota, Tennessee, Texas, Utah and Virginia:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is any condition that was diagnosed or treated by a doctor within 6 months prior to the Policy Date, or any condition which produced symptoms within 6 months prior to the Policy Date that would have caused an ordinarily prudent person to seek medical diagnosis or treatment.

Colorado:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is any Injury, sickness, or pregnancy for which a person incurred charges, received medical treatment, consulted a doctor, or took prescription drugs within 6 months prior to the Policy Date.

Idaho:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is a condition that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care or treatment during the 6 months immediately preceding the Policy Date; a condition for which medical advice, diagnosis, care or treatment was recommended or received during the 6 months immediately preceding the Policy Date; or pregnancy existing on the Policy Date.

Nevada:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is a condition, regardless of the cause of the condition, for which medical advise, diagnosis, care or treatment was recommended or received during the 6 months prior to the Policy Date.

North Carolina:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is any condition that was diagnosed or treated by a doctor within 6 months prior to the Policy Date. Loss beginning after the Policy Date and which is due to injury or sickness which is shown on the policy application shall be covered immediately for insureds age 65 and over unless the condition causing the loss has been specifically excluded by rider.

Pennsylvania:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered subject to the Time Limit on Certain Defenses provision in the policy. A preexisting condition is any condition for which medical advice or treatment was recommended by or received from a doctor within 6 months prior to the Policy Date.

South Carolina:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, is not covered. A preexisting condition is a condition for which symptoms existed which would cause an ordinarily prudent person to seek diagnosis, care or treatment within a 6 month period prior to the Policy Date or a condition for which medical advice or treatment was recommended by or received from a doctor within a 6 month period prior to the Policy Date.

Wisconsin:

PREEXISTING CONDITIONS   Loss that is incurred within 6 months after the Policy Date and which results from a preexisting condition, will be covered immediately unless such loss is specifically excluded by rider. A preexisting condition is any condition that was diagnosed or treated by a doctor within 6 months prior to the Policy Date, or any condition which produced symptoms within 6 months prior to the Policy Date that would have caused an ordinarily prudent person to seek medical diagnosis or treatment.

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DEFINITIONS

DEFINITIONS:

"Doctor" means a person other than yourself or a member of your immediate family, such as a parent, spouse, son, daughter, son-in-law, or daughter-in-law, who is licensed by the state in which services are rendered to treat the type of injury or sickness causing the covered loss.

"Hospital Confinement" means confinement in a lawfully operating place for the care and treatment of sick or injured persons as resident bed patients. It must have facilities either on its premises or ready on a prearranged basis for diagnosis, treatment and surgery. It must be under the direction of a doctor. It must have 24-hour nursing service supervised by a registered graduate nurse always on duty or on call. You must be admitted to the acute care part of the hospital and incur charges for daily room and board in order to be considered confined to the hospital, "Hospital" does not include a place or part of any place used as a nursing home, convalescent home, rest home, home for the agents, a place that mainly give custodial or rehabilitee care or similar place.

"Injury" means bodily injury which results from an accident that happens while this policy is in force and causes loss covered by this policy. An injury includes all injuries sustained as a result of one accident.

"Medicare" means the health Insurance for the Aged act, title XVIII of the Social Security Amendments of 1965 as then constituted or later amended.

"Nursing Facility Confinement" means confinement as a resident in a lawfully operating place which is licensed by the state to provide nursing care at a skilled level to resident persons, and which participates in the Medicare program.

"Period of Care" means the time period that begins on the first day of your Hospital Confinement or Nursing Facility Confinement and ends on the last day of such confinement. Periods of Care not separated by 60 days or more during which you did not require or suffer Hospital confinement or Nursing Facility Confinement, will be considered as the same Period of care.

"Policy Schedule" means the Policy Schedule attached to this policy. The Policy Date, Daily Hospital Benefit Maximum Hospital Days, First renewal date, First Premium, and Renewal Premium are shown I the Policy Schedule.

"Sickness" means sickness or disease which first manifests itself while this policy is in force. A sickness also includes a preexisting condition but only if the loss caused by the preexisting condition incurred 6 months or more after the Policy Date.

The definitions listed above are a sampling from Policy Form MAS-1(06). The definitions may vary by state. Please see the state specific Policy for a the listing of the definitions for that specific state.

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SECURITY & PRIVACY STATEMENT

When you become a GACquote.com customer, you entrust us with your personal data. We consider your data to be private and confidential, and we hold ourselves to the highest standards of trust and fiduciary duty in their safekeeping and use. General Agent Center (GAC) and our partners will not release information about you or your application, policy or claims information, unless one or more of the following conditions are met: We receive your prior written consent. We believe the prospective recipient to be you or your authorized representative. We are required by law to release information to the recipient. Questions about your medical history and physical condition are required by our insurance carrier partners and will be released to the insurer so that they may underwrite your insurance application. GAC will not give or sell information about you to any other company, individual, or group without your prior authorization. GAC will only use information about you to help us better serve your insurance needs or to suggest GAC services or insurance materials that may be of interest to you. To further protect your privacy, our web site uses the highest levels of Internet security, including data encryption, user names and passwords, and other security tools. Occasionally, GAC may conduct marketing surveys or research to help us evaluate products, services, and the changing needs of our customers. It is GAC's policy to keep this information confidential. We will not share individual marketing data gathered from our web site with individuals or business entities not affiliated with GAC. We know that the privacy of your personal information is important to you. In order to provide you with insurance products of the highest quality and with the service you deserve, it may be necessary for us from time to time to collect nonpublic personal and financial information about you (the "Information") and, in certain situations, to share that Information with others. The following notice describes our policies and practices with regard to your Information.

HOW WE PROTECT YOUR INFORMATION

We maintain physical, electronic and procedural safeguards to protect the Information against unauthorized access and use. We restrict access to the Information to those employees who need access to provide products and services to you and your dependents. The personnel who have access are trained in the proper handling of the Information. Employees who violate this strict level of confidentiality are subject to our disciplinary process.

CATEGORIES OF INFORMATION THAT WE COLLECT

In the normal course of business we may collect the following types of Information: Information you provide on applications and other forms (including name and address) Data about your transactions with us (such as types of products you have purchased and your account status) Information gathered on our Web sites through online forms, site visit data and online information-collecting devices known as "cookies"

HOW WE USE YOUR INFORMATION

We may share your information among the Insurance Companies as permitted by law, including for routine business administration. We may share information with non-affiliated companies as allowed by law, such as firms that perform services on our behalf, including the administration and marketing of our products. We require these companies to meet strict privacy standards. We may disclose information to non-affiliated entities when required by law, such as to respond to a subpoena, to prevent fraud or to comply with an inquiry by a government agency.

ACCURACY OF YOUR INFORMATION

We strive to maintain the accuracy of Information that is in our possession about you. In order to help us maintain accuracy, you have the right to reasonably access your information. If you believe any information in our possession is inaccurate, a request can be made to amend or delete the information that you believe to be erroneous. If we concur with the request, we will amend or delete the information in question. You may write our Privacy Office at the address below to receive our complete policy on accessing and amending the Information.

CHANGES TO THIS NOTICE

We reserve the right to change this Notice. We reserve the right to make the revised Notice effective for the Information we already have about you as well as any Information we receive in the future. If we make any material changes to our policies or practices, we will provide you with a copy of a revised Notice. We will post a copy of the current Notice on our websites. The Notice will contain in the top right-hand corner, the effective date.

You may contact our Privacy Office at:

General Agent Center 15575 North 79th Place, Suite 100 Scottsdale, AZ 85260