Other than the Overview and Page Directory displayed below, the text presented in this web page is directly from the booklet provided by Paul Revere Life Insurance Company, which describes the major provisions of the Group Long-Term Disability (LTD) Policy issued to American Bank. It has been edited only insofar as necessary for it to be viewed on this website.

Disability Insurance Overview

Full-time employees are eligible to be covered under the Group Long-Term Disability Plan on the first of the month following 90 days service. If you become disabled during your employment with American Bank, and remain disabled for 90 or more days, the plan pays 70% of your basic monthly earnings, to a maximum of $5,000 per month. The plan will typically pay until you recover, reach age 65, or die. If you are employed and over 65 when you become disabled, there is coverage for a limited period. "Disability" defined as your inability to perform your own or any occupation because of illness or injury. There are differences in the benefit amounts payable and the time benefits will be paid based on whether you are disabled for your own occupation or for any occupation.


Page Directory

What is the definition of "Disablity" and "Disabled"?

What is the difference in "any occupation" and "own occupation"?

What does the Plan pay?

What is a "Residual Disability" Benefit?

What are the pre-existing conditions limitations?

Summary Plan Description, as required by the Employee Retirement Income Security Act (ERISA)


BENEFIT SUMMARY

FOR GROUP INSURANCE

EMPLOYER: AMERICAN NATIONAL

BAN K OF FLOR I DA

CLASS NUMBER: 1

GROUP POLICY NUMBER: G­47753

EFFECTIVE DATE OF THE GROUP INSURANCE POLICY:

June 1, 1994

This Benefit Summary replaces any and all information previously received on this Paul Revere benefit.

Home Office: 18 Chestnut Street, Worcester, MA 01608­1528


BENEFIT SUMMARY

ELIGIBILITY PROVISIONS

Classification of Eligible Employees:

Class 1 ­ Employees Earning $35,000.00 Or More Annually

You are eligible for insurance on the later of the effective date of this

Policy, or the first day of the month occurring on or after the date you

have worked full­time for the employer for 90 consecutive days.

SCHEDULE OF INSURANCE

Amount of Disability Income Benefit:

70 % of your Basic Monthly Earnings;

Maximum Benefit ­ $ 5000 per month;

Minimum Benefit ­ 15% of basic monthly earnings up to a maximum of $100.

Maximum Benefit Period:

Insured's Age Maximum

When Disability Benefit

Begins Period

Less than age 60 to age 65

age 60 5 years

age 61 4 years

age 62 42 months

age 63 36 months

age 64 30 months

age 65 24 months

age 66 21 months

age 67 18 months

age 68 15 months

age 69 and over 12 months

Elimination Period: 90 Days


Benefit Reductions

While you are disabled, you may be eligible for benefits from other income sources. If so, we reduce our benefit by the amount of Primary and Family Social Security and such other benefits paid or payable.

A list of other income sources which will reduce your benefit, will be found in your certificate, in the section entitled Benefit Reductions.

TABLE OF CONTENTS

DEFIN ITIONS

GENERAL PROVISIONS

Employees Eligible/Effective Date of Insurance/Change in Amounts of Insurance/Termination of Insurance/Other Provisions

LONG TERM DISABILITY INCOME BENEFIT

Benefit/Maximum Benefit Period/Residual Disability Benefit

BENEFIT REDUCTIONS

Estimated Social Security Benefits

 

LIMITATIONS

Exclusions/Pre­Existing Condition Limitation/ Other Limitations

CLAIMS

Notice of Claim/Claim Forms/Time for Submitting Claim Forms/Extension of Time Limit/Medical Exams/Time for Payment of Claims/Choice of Doctor/Action at Law

MISCELLANEOUS PROVISIONS

Entire Contract/Time Limit for Certain Defenses/Misstatements/ Incontestability/

Misrepresentation/Rescission/Certificates of Insurance/insurance Information/

Clerical Errors or Delays


DEFIN ITIONS

Here are some terms used in the Group Policy. Other terms are defined in the benefit section of the Group Policy. All defined terms are important in describing policyholder rights and our rights under the Group Policy. Please refer back to these meanings as you

read your booklet­certificate. Masculine pronouns used in the Group Policy apply to both sexes.

ACCUMULATION PERIOD means the period of time equal to two times the Elimination Period shown in the Benefit Summary during which you must satisfy your Elimination Period. The Accumulation Period is subject to the continuous period of disability provision as well as all other policy provisions.

CALENDAR YEAR means the time period which starts January 1st and ends December 31st each year.

DOCTOR means a person who is licensed to practice the healing arts and who is practicing within the scope of his license. This term covers only a licensed medical practitioner whose services are required to be covered by the law of the jurisdiction where the treatment is rendered.

EMPLOYEE means any person who works for the employer. An employee must be paid by the employer for work done at the employer's usual place of business or some other location which is usual for the employee's particular duties.

EMPLOYER means the policyholder and all participating employers or a branch or division of the policyholder.

EVIDENCE OF INSURABILITY means proof given to us that an employee is insurable. This proof must be based on medical information and must be acceptable to us.

FULL­TIME means, for an employee, a work week of at least thirty hours.

INJURY means accidental injury sustained while you are insured under the Group Policy.

LICENSED PROFESSIONAL means a person who must hold a current license from the licensing authority of the jurisdiction in which he works or practices in order to work legally in his own occupation or profession. Except in the case of a health practitioner whose license has been revoked or restricted due to his testing positive for human immunodeficiency virus (HIV), a licensed professional will not be considered disabled solely as a result of the loss, restriction, or revocation of his license. A health practitioner who has his license revoked or restricted due to a positive test for H IV may be considered disabled if he suffers a loss of income as specified in the definition of disability.

PERIOD OF DISABILITY means a continuous period of time during which an employee is disabled as a result of injury or sickness whether from one or more causes.

POLICY YEAR means the 12 month period commencing on the anniversary of the date this Group Policy began.

SICKNESS mean an illness or disease. It also includes pregnancy.

TRIAL WORK DAY means any length of time during a 24-hour period that you attempt to return to work at any occupation.

WE, US or OUR means The Paul Revere Life Insurance Company.

GENERAL PROVISIONS

BECOMING ELIGIBLE FOR INSURANCE

If you are a full­time employee in an eligible class shown in the Benefit Summary, and you are a citizen of the United States or a permanent resident of the United States, Canada or Puerto Rico, you become eligible for insurance on the day you complete the waiting period. If you are not a citizen, you are considered to be ineligible for insurance if you leave the United States, Canada or Puerto Rico for 180 or more consecutive days. However, this provision will not be applicable if an exception is applied for in writing and is approved by us. The waiting period is shown in the Benefit Summary. Please review the section of this certificate entitled Effective Date of Employee Insurance to determine when your insurance becomes effective.

EFFECTIVE DATE OF EMPLOYEE INSURANCE

You must be actively at work on the date your insurance goes into effect.

If you are absent because of sickness or injury, insurance does not begin until you return to work on a full ­time basis .

CONTRIBUTORY INSURANCE means that you pay part of the cost of

your insurance.

If any part of your insurance is contributory, all of your insurance will

become effective on the earliest of the following dates:

1. the date you become eligible for insurance, provided you enroll for it on or before that date;

2. the date you enroll for insurance, provided such date is within days after the date you become eligible for insurance; or

3. the date we approve your evidence of insurability. Evidence is required if you enroll more than thirty­one days after you become eligible for insurance. Evidence must be submitted at your expense.

_

If any part of your insurance is contributory, no other part of your insurance may become effective until the earliest of the three dates shown above. Some contributory insurance may be refused without affecting the other parts of your insurance, but only if the refusal is in writing and we agree to it.

NON­CONTRIBUTORY INSURANCE means that the employer pays all of the cost of the insurance. If all of your insurance is non­contributory, it will become effective on the date you are eligible for insurance.

REINSTATEMENT

If you request us to reinstate your insurance which terminated while you were still eligible to be insured by the Group Policy, we must first receive evidence of insurability. If evidence must be given, it must be done at your expense. Your insurance begins on the date we approve the evidence.

CHANGE IN AMOUNTS OF INSURANCE

The amount of insurance for which you are eligible is shown in the Benefit Summary. The benefits offered and the amounts of those benefits may vary by class.

Benefits may increase or decrease due to a change in class or earnings. The employer must:

  1. determine the effective date of the change;
  2. report the change to us in writing; and
  3. submit the correct premium amount reflecting the change.

If a change in your earnings is reported to us after the date you cease active, full­time work, we reserve the right to determine:

  1. the effective date of the change; and
  2. if the change will be used in calculating benefits.

The provisions of the Group Policy may be revised after its effective date. You become insured for the revised benefits on the effective date of the revision, subject to the applicable pre­existing condition limitation.

You must be actively at work on the date a change in the amount of your insurance becomes effective. If the effective date of the change occurs on a vacation, holiday or weekend, you must have been actively at work on the last scheduled working day. If you are not actively at work because of sickness or injury, a change does not become effective until you return to full­time work.

TERMINATION OF EMPLOYEE INSURANCE

Your insurance automatically terminates on the earliest of:

1. the date the Group Policy terminates;

2. the first day for which you fail or refuse to make any required premium contribution;

  1. the first day for which premium for you is not paid;
  2. the date you no longer work in an eligible class; or

5. the date you no longer work for your employer.

You are no longer eligible for insurance when you cease full­time work in an eligible class. However, your insurance continues while you receive disability benefits under the Group Policy. If, on the date you are no longer disabled as defined, you return to work for your employer and premium payments on your behalf are resumed from the date you returned to work, insurance continues. Insurance terminates immediately if you do not return to work for your employer or if premium payments are not made on your behalf.

RECURRENT DISABILITY ­ SAME INJURY OR SICKNESS

To be eligible for total or residual disability benefits, you must be continuously disabled by the same injury or sickness through the elimination period and through any period for which benefits may be paid. However, if at any time after completion of your elimination period you cease to be disabled for any period of less than 6 months, but are then again disabled by the same injury or sickness, your period of disability may be considered to be continuous. This means that you do not have to again complete your elimination period for that injury or sickness. However, no benefit is payable for any day you are not disabled. The gross amount payable, prior to any adjustments as outlined within the Group Policy, would be the amount in force at the time of the original date of disability. Additionally, the benefit period during which total disability benefits ­ your own occupation ­ or residual disability benefits may be paid is not extended by the period that you are not disabled. A recurrent disability ends on the first to occur of:

1. the last day of 6 consecutive months during which you were not disabled by the same injury or sickness; or

2. the first day you cease to be disabled by the same injury or sickness, if you are subsequently disabled by another separate and distinct injury or sickness; or

  1. the date the last benefit for the injury or sickness becomes due; or
  2. the date you become eligible for group long term disability insurance under another group plan.

LONG TERM DISABILITY INCOME BENEFIT

DEFIN ITIONS

Here are some terms used in the Group Policy. Other terms used in the Group Policy are defined in the Definitions section contained in General Provisions. Other terms may also be defined in the specific provisions that may be contained in this Long Term Disability Income Benefit. All defined terms are important in describing policyholder rights and our rights under the Group Policy. Please refer back to these meanings as you read your booklet­certificate. Masculine pronouns used in the Group Policy apply to both sexes.

DISABLED OR DISABILITY ­ these unqualified terms may mean either total disability or residual disability. The Group Policy provides benefits for:

  1. total disability from any occupation;
  2. total disability from your own occupation; and
  3. residual disability.

The definitions of these terms follow. One or more may apply to you.

Totally disabled from any occupation. or total disability from any occupation means:

1. because of injury or sickness, you are completely prevented from engaging in any occupation for which you are or may become suited by education, training or experience; and

2. you are receiving Doctor's Care. We will waive this requirement if we receive written proof acceptable to us that further Doctor's Care would be of no benefit to you.

Totally disabled from your own occupation or total disability from your own occupation means:

1. because of injury or sickness, you cannot perform the important duties of your own occupation;

2. you are receiving Doctor's Care. We will waive this requirement if we receive written proof acceptable to us that further Doctor's Care would be of no benefit to you; and

3. you do not work at all.

Totally disabled or total disability may mean either totally disabled from any occupation or totally disabled from your own occupation as shown above. If you work other than full time at your own job, you may be considered to be residually disabled.

Residually disabled or residual disability means, after a continuous period of disability which lasts at least as long as your elimination period:

  1. (A) you are prevented, by the same injury or sickness which caused your disability, from performing one or more of the important duties of your own occupation; or

(B) you work at your own or some other occupation on less than a full­time basis; and

2. you are receiving Doctor's Care. We will waive this requirement if we receive written proof acceptable to us that further Doctor's Care would be of no benefit to you; and

3. you do not earn more than 80% of your prior earnings.

Additional Provisions Pertaining to Disability:

You shall not be considered disabled solely as a result of the loss, restriction, revocation or non­renewal of any license, permit or certification necessary to perform the duties of any occupation. Rather, your disability will be determined relative to your inability to work as a result of total or residual disability as defined in the Group Policy. However, if you are a health practitioner, and your license is lost or restricted as a result of your testing positive for human immunodeficiency virus (HIV), your disability may be determined based on a loss of income as may be specified in the definition of disability.

DOCTOR'S CARE means the regular and personal care of a Doctor which under prevailing medical standards, is appropriate for the condition causing the disability.

EARNINGS (EMPLOYEES) means, for purposes of determining an employee's total disability benefit, your basic, annual, monthly or weekly pay based on a work week of not more than 40 hours, prior to becoming disabled and as last reported to us in writing by your employer and verified by us. It includes earnings received from commissions and productivity incentives but not bonuses, overtime or other special pay. Commissions are averaged for the lesser of the 24 month period immediately prior to the date disability begins or the period of employment. Earnings from sources other than the employer are not included in determining total disability benefits.

ELIMINATION PERIOD means the length of time that you must wait before benefits begin. The Elimination Period must be satisfied within the Accumulation Period. The length of your Elimination Period is shown in the Benefit Summary. During your Elimination Period, you must be either totally or residually disabled from your own occupation.

However, you may attempt to return to work on a Trial Work Day basis during the Accumulation Period. These Trial Work Days do not cause your Elimination Period to end, but they do not count toward satisfying your Elimination Period.

PRIOR EARNINGS means, for the purposes of determining your residual disability benefit, the greater of:

1. your average monthly earnings for the 12 whole calendar months immediately preceding your last regular day of active, full­time work; or

2. your highest average monthly earnings for any two successive years during the 5 year period immediately preceding your last regular day of active full­time work.

Your prior earnings amount is first determined relative to your last regular day of active full­time work. During a continuous period of disability the amount of prior earnings used to calculate your residual disability benefit will be increased by 7% of the initial amount on each anniversary of the completion of your elimination period.

You may attempt to return to your job for a certain number of trial work days during your elimination period. Your prior earnings amount is not calculated to any trial work day, but to your last regular day of active full­time work.

RETIREMENT PLAN means, for the purpose of determining benefit reductions, a plan which provides retirement benefits to employees. It includes any retirement plan which:

1. is part of any federal, state, county, municipal or association retirement system; or

2. you, as an insured employee, are eligible for as a result of your job with the employer.

The term does not include:

1. profit sharing plans;

2. thrift plans;

3. Individual Retirement Accounts (IRA's

4. Tax Sheltered Annuities (TSA's);

5. Stock Ownership Plans ESOP's); or

6. Keogh Plans.

When used in the Group Policy, the term "Retirement Benefits" means the following benefits payable from a retirement plan:

  1. retirement benefits payable from the employer's retirement plan upon early or normal retirement; or
  2. disability benefits payable from the employer's retirement plan.


WHAT WE PAY

We pay monthly benefits to you if you become totally disabled while insured due to injury or sickness. You must be under Doctor's Care as defined in the Group Policy, while totally disabled. The maximum amount we pay is shown in the Benefit Summary.

Benefits for Insurance Class 1 (Employees earning more than $35,000 per year)

Class 1 - The Total Disability Benefit ­ Your Own Occupation

During any continuous period of disability immediately following completion of your elimination period, but before the end of your benefit period, we pay you a monthly total disability benefit for each whole month in which you are totally disabled from your own occupation.

If you work other than full­time at your own job, you may qualify for monthly residual disability benefits.

Benefit payments may be reduced if you receive income from other sources. When and how this occurs is described in the section entitled Benefit Reductions.

Benefits for Insurance Class 2 (Employees earning more than $20,000 but less than $35,000 per year)

Class 2 - The Total Disability Benefit - Any Occupation

During any continuous period of disability, after completion of your elimination period, but before the end of your benefit period, we pay you a monthly total disability benefit for each whole month in which you are totally disabled from any occupation.

Class 2 - The Total Disability Benefit ­ Your Own Occupation

During any of the first 60 months of any continuous period of disability immediately following completion of your elimination period, but before the end of your benefit period, we pay you a monthly total disability benefit for each whole month in which you are totally disabled from your own occupation.

If you work other than full­time at your own job, you may qualify for monthly residual disability benefits.

Benefit payments may be reduced if you receive income from other sources. When and how this occurs is described in the section entitled Benefit Reductions.


Benefits for Insurance Class 3 (Employees earning less than $20,000 per year)

Class 3 - The Total Disability Benefit - Any Occupation

During any continuous period of disability, after completion of your elimination period, but before the end of your benefit period, we pay you a monthly total disability benefit for each whole month in which you are totally disabled from any occupation.

Class 3 - The Total Disability Benefit ­ Your Own Occupation

During any of the first 24 months of any continuous period of disability immediately following completion of your elimination period, but before the end of your benefit period, we pay you a monthly total disability benefit for each whole month in which you are totally disabled from your own occupation.

If you work other than full­time at your own job, you may qualify for monthly residual disability benefits.

Benefit payments may be reduced if you receive income from other sources. When and how this occurs is described in the section entitled Benefit Reductions.

WHEN WE PAY BENEFITS

Benefits begin to accrue on the first day after you complete the elimination period shown in the Benefit Summary. Benefits are paid at the end of each month while you are disabled.

MAXIMUM BENEFIT PERIOD

The maximum benefit period is shown in the Benefit Summary. It is the maximum length of time for which we pay benefits. It applies to all periods of disability, whether from one or more causes. In no case do we pay benefits after the earlier of:

1. the date you are no longer totally disabled;

  1. the date you reach the maximum age shown in the Benefit Summary;
  2. the date you die; or

4. the date you receive retirement benefits under your employer's retirement plan, and these monthly benefits are equal to or exceed the long term disability benefits under the Group Policy.

If the maximum benefit period is limited to a certain number of years or months rather than age, the full benefit period may be restored after you have worked full­time for six consecutive months.

PARTIAL MONTH PAYMENT

For any day a total or residual disability benefit is payable in a period of less than a whole month, we pay one­thirtieth of the applicable monthly benefit.

RECOVERY OF OVERPAYMENTS

If any benefit amount is overpaid, we have the right to recover the amount overpaid. We may do this in a variety of ways which include but are not limited to deducting the amount overpaid from any future payments.

REHABILITATION BENEFIT

We will pay for the cost of services incurred in connection with a program of vocational rehabilitation if:

1. We enter into an agreement with you on both the program and the services; and

2. the cost of the services is not covered by another plan or program;

Participating in such a program will not affect your eligibility for benefits under the Group Policy.

RESIDUAL DISABILITY INCOME BENEFIT

RETURN TO WORK ADJUSTMENT BENEFIT FOR RESIDUAL DISABILITY

When you return to work from any continuous period of disability immediately following completion of your Elimination Period, but before the end of your benefit period, we pay you a monthly benefit for each whole month following your return to work while you are residually disabled .

WHAT WE PAY

During the first 12 months that you return to work for any employer during any continuous period of disability and while you continue to meet applicable definitions pertaining to residual disability:

1. the requirement that your loss of earnings must exceed 20% will not apply; and

2. in lieu of the disability benefit, we will pay a special Return to Work Adjustment Benefit.

The amount of the Return to Work Adjustment Benefit will be the amount of the total disability benefit otherwise payable after reduction for other income sources. The Return to Work Adjustment Benefit will be further reduced to the extent that the sum of the benefit, your Actual Monthly Residual Earnings from any employer and other income sources as defined in the Benefit Reductions section would exceed 100% of your prior earnings.

For the purpose of calculating the Return to Work Adjustment Benefit, after 12 monthly disability benefits have been paid, your amount of prior earnings in any continuous period of disability is increased by 7% of your initial prior earnings amount on each anniversary of the completion of the Elimination Period.

MAXIMUM BENEFIT PERIOD

The Return to Work Adjustment benefits are not paid beyond the first to occur of:

1. the date the 12th monthly Return to Work Adjustment benefit is paid during any continuous period of disability;

2. the date you are no longer disabled;

  1. the date you reach the maximum age shown in the Benefit Summary;
  2. the date you die;

5. the date benefits become payable under any other employer's group long term disability insurance plan;

6. the date you receive retirement benefits under your employer's retirement plan, which are equal to or exceed the long term disability benefits under the Group Policy.

During any continuous period of disability immediately following completion of your elimination period, but before the end of your benefit period, we pay you a monthly benefit for each whole month in which you are residually disabled.

DEFINITIONS

The following are terms used within the Residual Disability Benefit and the Return to Work Adjustment Benefit.

INITIAL TOTAL DISABILITY BENEFIT means the benefit that would have been payable immediately following the completion of the elimination period after integration with Social Security and/or other income sources.

LOSS OF EARNINGS means your Prior Earnings minus your Actual Monthly Residual Earnings for the month the benefit is due. This difference must be due to the injury or sickness causing the residual disability.

ACTUAL MONTHLY RESIDUAL EARNINGS means your salary, wages, commissions, bonuses, fees, and income earned for services performed. If you own any portion of a business or profession, it means the following:

Sole Proprietor earnings means the net profit of the business for federal income tax purposes. Net profit is defined as gross business revenues less deductible operating expenses.

Partner earnings means the partner's proportionate share of the partnership net profit as reported for federal income tax purposes. Net profit is defined as gross partnership revenues less deductible operating expenses multiplied by the partner's ownership percentage.

Employee/Shareholder earnings means the total of gross salary, pension/profit sharing plan contributions made on behalf of the individual, and the proportionate share of the current year corporate net profit.

PRIOR EARNINGS means the greater of:

your average monthly earnings for the 12 whole calendar months immediately preceding your last regular day of active full­time work; or

your highest average monthly earnings for any two successive years during the 5 year period immediately preceding your last regular day of active full­time work.

WH AT WE PAY

We will pay you monthly disability benefits while you are residually disabled, as defined. During the first 12 months we will pay a monthly benefit according to the Return to Work Adjustment benefit provisions. After the first 12 months of residual disability your residual disability benefit is proportionate to your total disability benefit. The proportion depends on the Actual Monthly Residual Earnings you receive from work. To determine the monthly residual disability benefit payable after the first 12 months, we use this formula:

Loss of Earnings X The Initial Total = The Employee's Residual Prior Earnings Disability Benefit Disability Benefit

If the Loss of Earnings for any month is 80% or more of Prior Earnings, we will pay the total disability benefit. However, if the Loss of Earnings is less than 20% of Prior Earnings, then no Residual Disability Benefit is payable.

For the purpose of calculating this benefit, after 12 monthly residual disability benefits have been paid, your amount of prior earnings in any continuous period of disability is increased by 7% of your initial prior earnings amount on each anniversary of the completion of your elimination period .

BENEFIT PERIOD

Residual disability benefits are not paid beyond the first to occur of:

1. the date you are no longer residually disabled,

2. the date you reach the maximum age shown in the Benefit Summary;

3. the date you die;

4. the date benefits become payable to you under any employer's group long term disability insurance plan;

5. the date benefits would cease, according to any exclusion or limitation contained in the Group Policy; or

6. the date you receive retirement benefits under your employer's retirement plan, which are equal to or exceed the long term disability benefits under the Group Policy.

BENEFIT REDUCTIONS

While you are disabled, you may be eligible for benefits from other income sources. If so, we reduce our benefit by the amount of such other benefits paid or payable.

Listed below are other income sources which will

reduce our benefit.

1. Social Security benefits including either: Primary Social Security benefits only; or Primary and Family Social Security benefits received by you or your dependents on account of your disability or retirement. Your Benefit Summary shows those Social Security benefits which will reduce your benefits. If you fail to apply for Social Security benefits, we determine the amount you were eligible to receive and, for the purposes of this insurance, you will be considered to receive that amount.

A general Social Security cost of living adjustment which takes effect after long term disability benefits become paid or payable to you is not used to reduce your benefit.

2. Other disability benefits paid or payable under:

  1. Statutory Disability ("Cash Sickness") Plans, where applicable;
  2. Canadian Federal or Provincial Disability Benefits;

c. Railroad Retirement Act Disability Benefits; or

d. Disability benefits with which we are required by law to integrate.

3. Workers' Compensation;

4. Total or residual disability benefits from another group disability plan provided by the employer;

5. Group disability benefits from the following plans, but only if the plan is employer­sponsored:

  1. Association Plans;
  2. Fraternal Benefit Plans; or
  3. Union Plans.

Employer­sponsored means a plan that is endorsed, promoted, or facilitated by the employer. For example, if the employer makes payroll deductions for the plan, or permits solicitation or enrollment of the plan on company premises and/or company time, we would consider the plan to be employer­sponsored, even if you pay the entire premium.

6. Disability benefits which are part of your employer's retirement plan;

7. Retirement benefits attributable to employer contributions. For benefits that an employee receives under an employer's retirement plan, we will end benefits under the Group Policy if retirement benefits are equal to or greater than our long term disability benefit.


BENEFIT REDUCTIONS

If any of these benefits is paid or payable in other than a monthly sum, we divide the amount into equal monthly amounts in order to reduce the monthly benefit. The number of monthly amounts depends on the length of time the benefit award covers. If no length of time is stated in the benefit award, we divide the amount into sixty equal payments. If any of these benefits is paid or payable on a retroactive basis, we may adjust our monthly payments in order to offset any overpayment which results.

Listed below are other income sources which will not reduce our benefit:

  1. Individual disability insurance;
  2. Social Security Cost of Living increases;
  3. Deferred compensation;
  4. Salary continuation plans, either formal or informal;
  5. Savings and investment accounts, whether individually purchased or provided or sponsored by the employers, such as:
  6. IRA's
  7. Stock Option Plans
  8. Thrift Plans (e.g. 401(k);
  9. Profit Sharing Plans' Tax Sheltered Annuities; or
  10. Keogh Plans.
  1. Disability benefits from the following plans purchased as individual coverage, not provided or sponsored by the employer:
  2. Association Plans
  3. Fraternal Benefit Plans; or
  4. Union Plans
  1. Credit disability insurance;
  2. No-fault disability benefits, except where we are requiired by law to integrate;
  3. Loss of Time awards or settlements involving liability insurance or court actions;
  4. Government or military pensions;
  5. Disabled veterans' benefits; or
  6. Retirement benefits attributable to your contributions.


ESTIMATED SOCIAL SECURITY BENEFITS

For the purposes of this section, the term Social Security benefits means disability or unreduced retirement benefits which you, your spouse or any of your dependents are entitled to receive on account of your disability under:

  1. the United States Social Security Act;
  2. the Canada Pension Plan;
  3. the Quebec Pension Plan; or
  4. any similar law, plan or act.

As part of your proof of loss, we require that you furnish us evidence that you have duly applied for all other income sources for which you are or may become eligible. In the case of Social Security benefits, this includes:

1. making due application for such benefits; and

2. if your initial application is denied, and if we so recommend, making any and all available appeals.

Until you have given us written proof that all available appeals have been exhausted, we may:

  1. estimate your monthly Social Security benefit; and
  2. reduce our monthly benefit to you by that amount.

If we reduce your benefits on this basis, and if all of your appeals are denied, we restore the reduced amounts to you in one payment.

If you sign our Social Security Reimbursement Agreement, we agree not to reduce your benefits by estimated Social Security benefits while your appeals are pending. In the Social Security Reimbursement Agreement, you promise to pay us back for any overpayment of your long term disability claim which results from a retroactive award of Social Security benefits. If you do not pay us back, we have the right to recover our overpayment from any future benefits which may be due you.

If you qualify for Social Security benefits, it is to your advantage to receive them. This is because of:

  1. Social Security retirement rules;
  2. Medicare eligibility rules; and

3. Social Security benefit cost of living increases which will not reduce the future benefits we pay to the employee.

With proper authorization from you and your doctor, we will give you or your legal representative information from our claim file to assist in any appeal of denied Social Security benefits.

WORKERS' COMPENSATION BENEFITS

If you are disabled due to an employment related injury, you should file for workers' compensation benefits. Receipt of workers' compensation benefits will reduce disability benefits under the Group Policy.

As part of your proof of loss, we require that you furnish us evidence that you have duly applied for all other income sources for which you are or may become eligible. In the case of workers' compensation benefits this includes:

1. making due application for such benefits; and

2. if your initial application is denied, and if we so recommend, making any and all available appeals.

We must receive written proof that all available appeals have been exhausted .

When you sign our Workers' Compensation Reimbursement Agreement, you promise to pay us back for any overpayment of your long term disability claim which results from a retroactive award of workers' compensation benefits. If you do not pay us back, we have the right to recover our overpayment from any future benefits which may be due you.


LIMITATIONS

WHAT WE DO NOT PAY

We do not pay benefits for any disabilities that result from:

1. war or any act or accident of war, whether declared or undeclared;

2. active participation in a riot;

3. committing or attempting to commit a felony; or

4. an intentionally self­inflicted injury.

We also do not pay any benefits during any period in which you are

incarcerated .

PRE­EXISTING CONDITIONS LIMITATION

Any period of disability due to a pre­existing condition is not covered.

PRE­EXISTING CONDITION means a condition which:

1. is caused by an injury or sickness; and requires you, during the six months just before becoming insured, to:

a. consult a doctor; or

b. seek diagnosis or advice or receive medical care or treatment;

or

c. undergo hospital admission or doctor's visits for testing or for

diagnostic studies; or

d. obtain services, supplies, prescription drugs or medicines.

This limitation does not apply to disabilities which begin after you have met either one of the conditions shown below, whichever occurs first:

  1. you work full­time while insured by the Group Policy and are not absent from work due to this pre­existing condition for at least twelve consecutive months;
  2. you remain insured for twenty­four consecutive months.

EXCEPTION TO PRE­EXISTING CONDITIONS LIMITATION

The pre­existing conditions limitation does not apply if you:

1. were insured by the prior group long term disability policy on the

date before the Group Policy takes effect; and

2. would have been either:

a. covered for the condition under the prior plan if that plan remained in force; or

b. upon the first to occur of the following events:

1) you work full­time while insured by the Group Policy and are not absent from work due to the pre­existing condition for at least twelve consecutive months; or

  1. you have been insured for twenty­four months under:

a) the prior group policy; or

b) a combination of the prior group policy and the Group Policy.

If these conditions are met, we pay benefits. However, during the time period when any pre­existing conditions limitation would have applied, no monthly benefit will be greater than the lesser of:

1. the monthly benefit payable under the Group Policy; or

2. the monthly benefit which would have been paid under the prior

group policy.

Payment will not be made beyond the first to occur of:

  1. the date benefits cease under the Group Policy; or
  2. the date benefits would have ceased under the prior group policy.

Any payment we make is reduced by any payments made for the same disability under the prior policy.

PRE­EXISTING CONDITIONS LIMITATION APPLIES TO REVISED BENEFITS

After its effective date, the Group Policy may be revised to increase the long term disability benefit payable or decrease the elimination period. In either event, benefits for a disability due to a pre­existing condition are limited to the amount of benefits that would have been payable had the revision not taken place.

For purposes of this provision, PRE­EXISTING CONDITION means a condition which:

1. is caused by an injury or sickness; and

2. requires you, during the six months immediately prior to the revision

effective date to:

a. consult a doctor; or

b. seek diagnosis or advice or receive medical care or treatment; or

c. undergo hospital admission or doctor's visits for testing or for diagnostic studies; or

d. obtain services, supplies, prescription drugs or medicines.

This limitation does not apply to disabilities which begin after you have met either one of the conditions shown below, whichever occurs first.

1. You work full­time while insured by the Group Policy, and are not

absent from work due to the pre­existing condition for at least twelve consecutive months after the revision effective date; or

2. You remain insured for twenty­four consecutive months after the revision effective date.

OTHER LIMITATIONS

For any disability which is caused or contributed to by a psychiatric disorder, alcoholism, drug abuse or the use of any drug other than one administered on a doctor's advice, benefits are payable for up to twenty­four months whether or not you are hospital confined. After twenty­four months, subject to all other policy provisions, we pay benefits only if you continue to be hospital confined due to the disability, and for up to three months after the date you are no longer confined.

If you remain disabled after benefits cease and are again hospital confined, benefits may be resumed, subject to all other policy provisions, during:

  1. one additional hospital confinement; and
  2. the three month period following the confinement.

No additional benefits are payable for any disability resulting from a psychiatric disorder, alcoholism or drug abuse.

HOSPITAL CONFINED means being confined, for fourteen or more consecutive days, as a bed patient in a licensed hospital or as a resident in an institution licensed to treat psychiatric disorders, drug abuse or alcoholism. It may not be a rest home or a nursing home.

PSYCHIATRIC DISORDER means neurosis, psychoneurosis, psychopathy or psychosis .

CLAIMS

WE MUST BE NOTIFIED OF INTENT TO FILE A CLAIM

Written notice of a claim for disability must be given to us. The notice must be in writing and must be filed at our Home Office in Worcester, Massachusetts. Any claim is based on the written notice. The notice must be received by us within thirty days of the first date for which benefits are claimed. If we do not receive notice within thirty days, the claim may be reduced or invalidated. If it can be shown that it was not reasonably possible to submit notice within the thirty day period and it is shown that notice was given as soon as possible, the claim will not be reduced or invalidated.

WE FURN ISH PROOF OF LOSS FORMS

After we receive written notice of claim, we provide a proof of loss form. This form should be furnished within fifteen days after we receive written notice. If we fail to furnish this form within fifteen days, the claimant can meet the time period shown below by submitting written proof which explains the reason for the claim. Written proof should establish facts about the claim such as occurrence, nature and extent of the disability, injury or sickness or the loss involved.

WHEN TO FILE PROOF OF LOSS

The claimant must file written proof of the loss within ninety days of the date disability begins. We have the right to require additional written proof to verify the continuance of any disability. We may request this additional proof as often as we feel is necessary, within reason.

If proof of loss is not submitted and received by us within the required time period, the claim may be reduced or invalidated. If it can be shown that it was not reasonably possible to submit proof within the time period and it is shown that the proof was filed as soon as possible, the claim will not be reduced or invalidated.

WE MAY EXTEND TIME LIMITS

If the time limit that we allow for giving notice of claim or submitting proof of loss is less than the law permits in the state where the claimant lives, we extend our time limit to agree with the minimum period specified by law. That law must exist at the time the Group Policy is issued.

OUR RIGHT TO REQUIRE PROOF OF FINANCIAL LOSS

We have the right to require written proof of financial loss. This includes, but is not limited to:

1. statements of pre­disability income;

2. statements of income received while disabled;

3. evidence that due application has been made for all other available benefits;

4. tax returns, tax statements, and accountants' statements; and 5. any other proof we may reasonably require.

We may perform financial audits at our own expense as often as we may reasonably require. Payment of benefits may be contingent upon receipt of satisfactory proof of financial loss.

OUR RIGHT TO REQUIRE MEDICAL EXAMS

We have the right to require, at our own expense, a medical exam of any claimant as often as it may reasonably be required while a claim is pending.

HOW WE PAY BENEFITS

Any accrued benefits are paid as they accrue during the time we are liable. All accrued benefits payable are subject to receipt of proof of loss. Any unpaid balance at the end of our period of liability is paid within a reasonable length of time after proof of loss is received.

TO WHOM WE PAY BENEFITS

In the case of death, any unpaid accrued benefits are paid, at our option, to your estate or to one of your surviving relatives based on our selection .

All other benefits payable under the Group Policy are paid to you. After we have made payment, our obligation with respect to the amount paid ends.

CHOICE OF DOCTOR

For treatment purposes, you are free to select any doctor. For purposes of disability certification, you must select a doctor who is not related by blood or marriage or who is not an employee of the policyholder.

LEGAL ACTIONS AND LIMITATIONS

No action at law or in equity may be brought to recover under the Group Policy unless proof of loss has been filed according to the terms of the Group Policy. In addition, the claimant must wait sixty days after filing proof of loss before taking action. If any action is to be taken, it must be taken within three years from the end of the sixty day time period. If any time limit in the Group Policy is less than the law specifies in the state where the claimant lives at the time the Group Policy is issued, we extend the time limit to agree with the minimum period specified by such law.

MISCELLANEOUS PROVISIONS

ENTIRE CONTRACT

The Group Policy and any application made by the policyholder or by you make up the entire contract between the parties. All statements made by the policyholder or by you are considered to be representations and not warranties. This means that the statements are made in good faith. No statement voids the Group Policy, reduces the benefits we provide or is used in defense to a claim unless it is contained in a written application and a copy is furnished to you.

TIME LIMIT FOR CERTAIN DEFENSES

After two years from the effective date of the Group Policy, no misstatement by the policyholder, except a fraudulent statement made in the application, may be used to void the Group Policy. After two years, no misstatement by you, except a fraudulent statement made in an application, may be used to deny a claim for any loss or disability that begins after the end of the two year period.

THE EMPLOYER IS OUR AGENT FOR LIMITED PURPOSES

Your employer is considered to be our agent only for these two events:

1. collecting premium; and 2. giving out certificates of insurance.

No agent has the power to change or waive anything in the Group Policy.

MISSTATEMENT

If any important facts about an individual in relation to his insurance are found to be misstated, we adjust our premium to the correct amount. If the misstatement affects the amount of insurance, the true facts are used to determine the correct amount of insurance.

INCONTESTAB I LITY

No statement made by you on an application for insurance or any increase therein may be contested after you have been insured for two consecutive years from the date of application. No statement may be contested unless it is in writing. It must be signed by you and a copy must be given to you or your beneficiary.

MISREPRESENTATION/RESCISSION

Certain amounts of insurance or increases in insurance may be subject to evidence of insurability. If:

1. you make a representation on your application for such an amount; and

2. such misrepresentation was material to our approval of your application; and

3. we discover the misrepresentation within two (2) years of the effective date of the insurance or increase,

then we may, at our option, rescind that amount or increase. This means that the amount or increase will never have been in effect. All premium paid for insurance which is rescinded will be refunded.

WE PROVIDE CERTIFICATES OF INSURANCE

We issue certificates of insurance for each insured employee. These are delivered to your employer to be given to you. The certificate states what the insurance coverage is and to whom we pay benefits.

INSURANCE INFORMATION

Your employer provides us with the information we need to administer this insurance contract and compute the premium. We have the right to verify this information.

CHANGES IN THE GROUP POLICY

We may change the Group Policy if we receive a written request from the policyholder. All changes that are made are stated in riders or amendments to the Group Policy. These documents must be signed by both our President or Secretary and the policyholder. Your consent is not needed to make a policy change.

We may change the Group Policy if there is a change in the Federal Social Security Act which affects our liability. The change will take effect as of the date Federal Social Security Act changes.

CLERICAL ERRORS OR DELAYS

Clerical errors, delays or omissions in posting records made by the employer or by us do not result in the denial of insurance. If there is any delay in posting the date of any termination of insurance, the delay does not extend any insurance provided by the Group Policy.

ASSIGNMENT OF BENEFITS

You may not assign the right, title or interest of this long term disability benefit to a third party.

WORKERS' COMPENSATION

The Group Policy does not affect or take the place of Worker's Compensation Insurance.

IMPORTANT NOTICE

The description of benefits and limitations appearing in the booklet certificate has been prepared by The Paul Revere Life Insurance Company to describe the relevant portions of the Group Policy issued to your employer. In determining what benefits shall or shall not be payable, Paul Revere will make its determination in accordance with the terms of the

Group Policy.

The information appearing on the following pages consists of statements required by the Employee Retirement Income Security Act of 1974 (ERISA), and has been prepared for you by your employer who accepts responsibility for its accuracy and content.

It has been determined by your employer that the combined information in the booklet certificate and on the following pages of this notice is acceptable for use as a Summary Plan Description which document is required to be distributed to you by law.

The Paul Revere Life Insurance Company, as the Claims Administrator, has the full, final, conclusive and binding power to construe and interpret the policy under the plan as may be necessary in order to make claims determinations. The decision of the Claims Administrator shall not be overturned unless arbitrary and capricious or unless there is no rational basis for a decision.

SUMMARY PLAN DESCRIPTION

This document, together with the information contained in your Group

Insurance Booklet­Certificate comprises a Summary Plan Description under the Employee Retirement Income Security Act of 1974 (ERISA).

1. Plan Name:

AMERICAN NATIONAL

BANK OF FLORIDA

Long Term Disability Benefits

2. Plan Number: To Be Determined

3. Plan Sponsor:

AMERICAN NAT IONAL

BAN K OF FLORIDA

2016 Hendricks Ave.

Jacksonville, FL 32207

4. IRS Employer Identification Number: 59­0458709

5. Plan Administrator:

AMERICAN NATIONAL

BANK OF FLORIDA

2016 Hendricks Ave.

Jacksonville, FL 32207

6. Agent for Service of Legal Process:

AMERICAN NATIONAL

BANK OF FLORIDA

2016 Hendricks Ave.

Jacksonville, FL 32207

7. Claims Administrator:

The Paul Revere Life Insurance Company

Group Claims Department

18 Chestnut Street

Worcester, MA 01608

8. Our Plan benefits as identified below are provided in accordance with Group Insurance policies issued by The Paul Revere Life Insurance Company to the Plan Sponsor: Long Term Disability Benefits

9. Plan Year Ends: June 30

10. Contributions toward the costs of the Plan are made by the employer. and are required from employees on the following basis: Noncontributory

11. Conditions pertaining to eligibility to receive benefits and circumstances under which you would lose eligibility for participation or benefits are explained in the Group Insurance descriptive literature.

Claims Review Procedures

If you have a claim, follow the claim procedures described in your Group Insurance Booklet­Certificate, furnished by the Insurance Company and available through the Plan Administrator.

The Insurance Company will furnish to you through the Plan Administrator, an explanation sheet or other information which tells you how your claim payment was determined. You may ask the Plan Administrator for further clarification.

If you think the Insurance Company has made an error concerning your benefits, you have the right to appeal the claim decision in accordance with the procedures outlined below.

1. An appeal of a claim decision must be submitted in writing to the Claims Administrator within 90 days of your receipt of the initial claims decision. Appeals should be directed to the address below and should include the following described information:

The Paul Revere Life Insurance Company

18 Chestnut St.

Worcester, MA 01608­1528

Information to be included:

a. copies of all appropriate correspondence concerning the matter;

b. reasons why you believe the initial claims decision is incorrect, including reference to plan provisions as appropriate; and

c. any additional information important to the appeal and not initially submitted or available.

2. Within 60 days after receipt of your appeal, the Claims Administrator will make a decision, unless additional time is required to conduct a full and fair review.

3. You will be notified in writing as to the Claims Administrator's decision. This decision is final.

Statement of ERISA rights required by federal law and regulation:

If this Plan has more than 100 participants, you are entitled as a participant to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants shall be entitled to:

a. Examine, without charge, at the Plan Administrator's office and at other specified locations all plan documents, including insurance contracts, collective bargaining agreements and copies of all documents filed by the Plan with the U.S. Department of Labor, such as detailed annual reports and plan description.

b. Obtain copies of all Plan documents and other Plan information upon written request to the Plan Administrator. The administrator may make a reasonable charge for the copies.

c. Receive a summary of the Plan's annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report.

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Employee benefit plan. The people who operate your Plan, called "fiduciaries" of the plan have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a welfare benefit or exercising your rights under ERISA. If your claim for a welfare benefit is denied in whole or in part, you must receive a explanation of the reason for the denial. You have the right to have the Plan review and reconsider your claim.

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request materials from the Plan Administrator and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $100 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan's money or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you have any questions about your Plan, you should contact the Plan Administrator.

If you have any questions about this statement or about your rights under ERISA, you should contact the nearest Area Office of the U.S. Labor­Management Services Administration, Department of Labor.