Accidents Happen...

Consider Accidental Death

InsuranceUnderwritten by New York Life Insurance Company

Now Available

to $1,000,000 This Group Accidental Death insurance (AD) pays your beneficiary if your death results from a covered accidental injury within one year of the injury. This payment is in addition to any life insurance you may have. AD covers you 24 hours a day, every day of the year, worldwide. There are no health questions to answer, and your acceptance is guaranteed.

AD is for people who are active, travel, engage in sports—particularly those who are young in fact or in spirit. Do you walk, run, hike, bike, or boat? Do you climb a ladder or a mountain? Do you ski, or swim, or snorkel, or scuba? Do you fish, hunt, or camp? Do you travel by train? By plane? Car? Motorcycle? If so, AD is probably for you.

Some people think that AD is like travel accidentor flight insurance. It really isn't. Travel accident customarily pays benefits for accidental death only while you are a passenger on commercial transportation, referred to as "common carriers." But AD also covers deaths from falls and falling objects, fires and firearms, poisoning, choking, suffocating, drowning, common-carrier and personal travel—even homicides.

How much insurance is available?Age Amount

18-64 $50,000 – 1,000,00065-69 50,000 – 500,00070-74 50,000 – 250,000

Over 130,000 people die from falls, car crashes,

and other accidents each year. 1

Accidents are the number one

cause of deathfor those under age 44.

2

What is Accidental Death Insurance?

Who should have AD?

AD vs. Travel Accident Insurance

For the same affordable premium, benefits will be increased:• By 10% if death is due to an accident on a

“common carrier” (airplane, bus, taxi, train, etc.)• By the cost (up to $5,000) of preparing your

body for burial or cremation and transporting it to the place of burial or cremation if death occurs in a foreign country

Coverage will continue until age 75 if premiums are paid when due and the group policy remains in force.

ExclusionsBenefits will not be paid (1) if the accident causing death occurs before insurance begins and premium is paid; or (2) if death occurs during, is due to, or is related to suicide (MO residents, suicide not excluded unless intended at time of application), drug abuse, war, active duty in an armed service, flying in a non-certified aircraft, flying as a crew member except on a regularly scheduled commercial flight, committing a felony or assault, or participating in an illegal occupation or activity.1Centers for Disease Control (CDC), 2015 2National Center for Health Statistics, 20143Deaths From Unintentional Injury Among Adults Aged 65 and Over: United States, 2000–2013. CDC, May 2015 4Centers for Disease Control (CDC), 2015

Group Accidental Death Insurance is Underwritten by New York Life Insurance Company

on policy form G-16000-10CA Insurance License #0780003; 705020

SMRU #1690380 © M&A 9/2016

Questions? 800-635-7801 weekdays 8:30am–6:00pm ET

meyerandassoc.com/NYL/ADinfo@meyerandassoc.com

Other Items of Note

• Online: Visit meyerandassoc.com/NYL/AD• On paper:

How To Purchase AD

Meyer and Associates18 Washington Avenue

Chatham NJ 07928

1. Complete the Enrollment Form.2. Complete the EFT form, or write a check

payable to “Collegiate Alumni Trust” for your first 6-month premium.

3. Mail the forms (and check) to the Administrator:

Alumni/ae, students, faculty, and staff of sponsoring alumni/ae associations, and eligible family members may apply. Each must be at least age 18 but under 75 when applying. Eligible family members are spouses, domestic partners, parents, children, and siblings. Any of them may apply—even if you do not apply.

Premiums are under 20¢ a day for $100,000 of AD insurance.

Have you ever purchased AD insurance, or even the more restrictive accident insurance? If so, you’d probably agree that premiums for this AD plan are affordable. In fact, they are less than half of premiums for AD plans available through some other sponsors, such as banks and credit unions.

85% of all injuries for those aged 65 and over are caused by accidents.

For people of all ages, accidents are the

third leading cause of death. 4

3

Who is eligible?

How much does AD cost?

Monthly Premiums for Select Amounts

Current as of September 2016

Monthly automatic withdrawal from your bank (EFT). You do not write checks or worry about paying late. There is no processing fee for this convenience.

Semiannual bills payable by check. Semiannual premiums are six times monthly premiums. A fee of $6, subject to change, is added to each bill.

Payment Options

AmountAge

18-64Age

65-69Age

70-74$ 100,000 $ 5.40 $ 5.40 $ 5.40 250,000 13.50 13.50 13.50 500,000 27.00 27.00 N/A1,000,000 54.00 N/A N/A

Insurance Amount Age 18-64 Age 65-69 Age 70-74

1 Month 6 Months 1 Month 6 Months 1 Month 6 Months$50,000 2.70 16.20 2.70 16.20 2.70 16.20 100,000 5.40 32.40 5.40 32.40 5.40 32.40 150,000 8.10 48.60 8.10 48.60 8.10 48.60 200,000 10.80 64.80 10.80 64.80 10.80 64.80 250,000 13.50 81.00 13.50 81.00 13.50 81.00 300,000 16.20 97.20 16.20 97.20 NA* NA* 350,000 18.90 113.40 18.90 113.40 NA* NA* 400,000 21.60 129.60 21.60 129.60 NA* NA* 450,000 24.30 145.80 24.30 145.80 NA* NA* 500,000 27.00 162.00 27.00 162.00 NA* NA* 550,000 29.70 178.20 NA* NA* NA* NA* 600,000 32.40 194.40 NA* NA* NA* NA* 650,000 35.10 210.60 NA* NA* NA* NA* 700,000 37.80 226.80 NA* NA* NA* NA* 750,000 40.50 243.00 NA* NA* NA* NA* 800,000 43.20 259.20 NA* NA* NA* NA* 850,000 45.90 275.40 NA* NA* NA* NA* 900,000 48.60 291.60 NA* NA* NA* NA* 950,000 51.30 307.80 NA* NA* NA* NA*

1,000,000 54.00 324.00 NA* NA* NA* NA* Current as of September 2016 *Accidental Death insurance is available from $50,000 to $1,000,000 (in $1,000 multiples). The maximum available at age 65 is $500,000, and the maximum at age 70 is $250,000.

Current Premiums for Select Amounts

Name Birth Date Mr./Ms./Dr. First Middle Initial Last Mo./Day/Yr.

AddressNo. & Street City State Zip

Male Female Insurance amount requested: $(Minimum $50,000, Maximum $1,000,000)

Account # (If currently insured)

Beneficiary Relationship

First Middle Initial Last Social Security #

%

My eligibility status is (check one): Alumnus/a Student Faculty/Staff Member Eligible Family Member If Eligible Family Member (check one): Spouse/Domestic Partner Parent Adult Child Adult Sibling

I understand insurance begins on the first day of the month after the Administrator receives this form and my premium. I apply to become a Subscriber to the Collegiate Alumni Trust. CAT enables members of sponsoring organizations to purchase life insurance through a single group insurance policy. Subscribing to CAT costs nothing but is required to become insured. I request that any dividend resulting from my participation in this program be paid to the Sponsor named above or to any other entity designated by that Sponsor from time to time, unless I rescind this request by written notice to the Group Policyholder at least 90 days before the policy anniversary date.

Applicant’s Signature X

Date GPA-AD3

FRAUD NOTICE – For Residents of all states except those listed below: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and may subject such person to criminal and civil penalties. RESIDENTS OF CO: the following also applies: Any insurance company or agent who defrauds or attempts to defraud an insured shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies. RESIDENTS OF AL/AR/LA/RI: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. RESIDENTS OF CA: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which may be a crime and may subject such person to criminal and civil penalties. The falsity of any statement in the application for any policy shall not bar the right to recovery under the policy unless such false statement was made with actual intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer. RESIDENTS OF D.C.: WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits, if false information materially related to a claim was provided by the applicant. RESIDENTS OF FL: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an applica-tion containing any false, incomplete, or misleading information is guilty of a felony of the third degree. RESIDENTS OF KS: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance may be guilty of insurance fraud as determined by a court of law. RESIDENTS OF ME: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits. RESIDENTS OF MD: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. RESIDENTS OF NJ: WARNING: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. RESIDENTS OF NY: Any person who knowingly and with intent to defraud any insurance company or any other person files an application for insurance or statement of claim containing any materially false information, or conceals for the pur-pose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime, and shall also be subject to civil penalty not to exceed five thousand dollars and the stated value of the claim for each such violation. RESIDENTS OF OK: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony. RESIDENTS OF PUERTO RICO: Any person who, knowingly and with the intent to defraud, presents false information in an insurance request form, or who presents, helps or has presented a fraudulent claim for the payment of a loss or other benefit, or presents more than one claim for the same damage or loss, will incur a felony, and upon conviction will be penalized for each violation with a fine no less than five thousand (5,000) dollars nor more than ten thousand (10,000) dollars, or imprisonment for a fixed term of three (3) years, or both penalties. If aggravated circumstances prevail, the fixed established imprisonment may be increased to a maximum of five (5) years; if attenuating circumstances prevail, it may be reduced to a minimum of two (2) years. RESIDENTS OF TN/WA: It is a crime to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines, and denial of insurance benefits. RESIDENTS OF VA: Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing false or deceptive statements may have violated state law. 7.2013 ed

AccidentAl deAth insurAnceenrollment Form

Sign and date above, make a copy for your records, and mail this request with payment (EFT Authorization Form or Check) to the Administrator: Meyer and Associates u 18 Washington Avenue u Chatham, NJ 07928

800-635-7801 weekdays 8:30am-6:00pm ET u Fax 973-635-7578 u www.MeyerandAssoc.com

SIGN & DATE

Beneficiary Relationship

First Middle Initial Last Social Security #

%

New York Life Insurance Company, New York, NY 10010

NYLAD-9/16

Sponsored by (Please fill in name of your alumni association/school)

Social Security #:

Authorization for

Electronic Funds Transfer

Applicant Name: Group Policy Number: Policyholder: Collegiate Alumni Trust or Collegiate Alumni Trust II Administrator: Meyer and Associates Insurance Account Number: (to be completed by Administrator) Monthly Premium Withdrawal for EFT: (to be completed by Administrator)

This agreement with Meyer and Associates is for Electronic Funds Transfer (EFT) to pay your insurance premium without using a check. An electronic debit will be submitted to your bank so the amount will be deducted automatically from your bank account on, or shortly after, the first business day of each month to pay your premium for that month. The debit will appear on your bank statement as “Meyer and Assoc LifeInsPrem.” If your premium increases for any reason, for example, due to an automatic benefit increase, (1) we will notify you of the new monthly premium at least four weeks in advance and (2) EFT will be processed for the new monthly premium amount. You may change banks or end EFT by giving us written notice that we receive by the 24th of the month before the change. If you end EFT, you will receive semiannual bills (payable by check or money order), including a service fee, currently $6 per billing cycle.

For new accounts, the first EFT draw will be for two months of premium. For the third month of coverage and thereafter, EFT draws are for one month of premium. For accounts initially paid by check and switching to EFT, EFT draws are for one month of premium. EFT Preference (select one)

Start monthly payments via EFT. I am providing bank account information. Keep current EFT arrangements. I authorize EFT payments for the above by using the bank account information that is on file for my current/previous life insurance account. (You do not need to complete Bank Account Information.) Continue making monthly payments via EFT. I am providing new bank account information.

Bank Account Information

I would like to make monthly payments via EFT using the following bank account information:

Name on Bank Account: Bank Name: Routing Number: (requires 9 digits; see image below to find this number)

Bank Account Number: (not to exceed 17 digits; see image below to find this number)

1 Routing Number (requires 9 digits) 2 Bank Account Number (not to exceed 17 digits) 3 Check Number

Signature of Applicant By executing this form, you (1) authorize EFT, (2) agree to give us timely written notice of all relevant changes to your address and bank account, and (3) understand that (a) normal overdraft fees apply to items that cannot be collected and (b) we reserve the right to correct clerical errors.

Applicant’s Signature X Date

© 2016 Meyer and Associates EFT – 11/16

If you have any questions, please contact the Administrator:

Meyer and Associates 18 Washington Avenue Chatham, NJ 07928 800-635-7801 Fax: 973-635-7578 info@meyerandassoc.com