Contracting with Neishloss & Fleming, Inc. is now easier than ever! Neishloss & Fleming, Inc. offers the services of SureLC

for contracting with various Health, Life, and Senior carriers.

With the exception of a few carriers, you will be able to contract for multiple carriers in about eight minutes or less with

the click of a mouse. You can complete your agent profile and submit your complete contracting requests to Neishloss &

Fleming, Inc. without having to fill out a single piece of paper!

To begin contracting through SureLC, simply follow the link below to get started:

https://surelc.surancebay.com/sbweb/agency/283

Once the page loads, select “New User?” to register for SureLC

(NOTE: If you have already registered for SureLC and you are

adding a carrier to your profile, simply log in using the Login

and Password that you previously created).

A new page will reload that looks like this:

The only thing that you need to remember is to list

Neishloss & Fleming, Inc. on the Affiliation Line.

You will then enter all of your personal information

into the requested fields, click “Add Me” and

SureLC will pull your information from the NIPR

database. After the data transfer is complete, you

will be able to change/update any of the pre-

populated information as well as upload a copy of

your voided check, proof of E&O insurance,

Signature Page and N&F agent addendum (both

documents are provided in this pack immediately

following this page and must be attached to

SureLC).

If you do not have access to a scanner, please feel free to use the provided fax cover sheet and fax the forms (as well as

a copy of your voided check for EFT) to 412-561-6432 and we will email them to you in PDF format.

At the end of this pack you will find a SureLC FAQ containing additional information on the SureLC online contracting

process.

If you have any questions at all, give us a call at 800-562-7733. We look forward to working with you!

By signing and electronically submitting this form, I am agreeing to contract for the carrier(s) listed above at the stated commission level with

the stated hierarchy.

Date:

I, , would like to be appointed for

Foresters Final Expense through Neishloss & Fleming, Inc. My Commission level for this carrier is

110% .

Should you have any questions, please call me at .

Sincerely,

Agent Name

Carrier Name

Commission Level

Phone Number

Agent Signature

Signature Authorization

PLEASE READ THIS AUTHORIZATION, SIGN IN THE BOX BELOW AND

SUBMIT THIS FORM BY FOLLOWING THE INSTRUCTIONS PROVIDED

ON THE COVER PAGE.

I, ____________________________________, hereby authorize

SuranceBay, LLC and its general agency customers (the “Authorized

Parties”) to affix or append a copy of my signature, as set forth below,

to any and all required signature fields on forms and agreements of

any insurance carrier (a “Carrier”) designated by me through the

SureLC software or through any other means, including without

limitation, by e-mail or orally. The Authorized Parties shall be

permitted to complete and submit all such forms and agreements on

my behalf for the purpose of becoming authorized to sell Carrier

insurance products. I hereby release, indemnify and hold harmless the

Authorized Parties against any and all claims, demands, losses,

damages, and causes of action, including expenses, costs and

reasonable attorneys' fees which they may sustain or incur as a result

of carrying out the authority granted hereunder.

By my signature below, I certify that the information I have submitted

to the Authorized Parties is correct to the best of my knowledge and

acknowledge that I have read and reviewed the forms and agreements

which the Authorized Parties have been authorized to affix my

signature. I agree to indemnify and hold any third party harmless from

and against any and all claims, demands, losses, damages, and causes

of action, including expenses, costs and reasonable attorneys' fees

which such third party may incur as a result of its reliance on any form

or agreement bearing my signature pursuant to this authorization.

Please sign in the center of the box below. Please use BLACK ink.

PRODUCERIDXXX

TO: FROM:

Contracting

COMPANY: DATE:

FAX NUMBER: TOTAL NO. OF PAGES INCLUDING COVER:

412-561-6432

RE:

Supporting Documentation for SureLC

URGENT FOR REVIEW PLEASE COMMENT PLEASE REPLY PLEASE RECYCLE

Please find attached my information to complete the SureLC contracting process. I do not have access to a scanner to attach the documents in PDF format. I have included the following documents:

N&F Contracting Addendum SureLC Signature Page Proof of E&O Voided Check Supporting Documents for Background Questions

Below you will find my contact information in case all documents have not been received as well as to return the forms: Agent Name: Phone Number: Email Address:

2 2 7 5 S W A L L O W H I L L R O A D , B U I L D I N G 3 0 0 , T H E B O U R S E , P I T T S B U R G H , P A 1 5 2 2 0

V O I C E ( 8 0 0 ) 5 6 2 - 7 7 3 3 F A X ( 4 1 2 ) 5 6 1 - 6 4 3 2 W W W . N E I S H L O S S . C O M

SureLC FAQ

Do I have to install software onto my computer to use SureLC? No, you do not have to install software to enjoy the benefits of SureLC. You can access SureLC through a web link on the Neishloss & Fleming, Inc. website.

How long does it take to set up my SureLC agent profile? You can be set up in SureLC and ready to submit contracting through SureLC in about 8 minutes.

Will I be required to complete a new agent profile each time I log into SureLC? No! After you complete your initial agent profile in SureLC, your information will be saved for the next time you want to contract for a carrier.

Can I select and submit contracting for multiple carriers at one time using SureLC? You will be able to submit multiple contracts while logged in to SureLC; however you cannot select multiple carrier contracts at one time because SureLC does ask additional questions based upon the carrier selected.

How do I electronically sign the contracting forms in SureLC? You have two options for loading your signature into the SureLC website.

The first option is to physically sign the Agent Signature document, scan it into your computer, and manually attach the document. The second option is to use your mouse to create an e-signature in the SureLC database. When completing the Agent Profile section of your profile, you will have the option to select the method you wish to use.

How do I get a copy of my voided check, E&O, and Signature Page into SureLC? You have a few options of uploading this information into the SureLC database. The first option is to scan and upload a copy of the documents and manually attach them to SureLC. The second option (which is a new feature to SureLC) is to use your computer’s webcam and take a picture of the documents. The webcam picture will automatically load the documents into the documents tab of SureLC.

If appointment fees are required for a carrier, am I able to pay them through SureLC via credit card? Unfortunately, if an appointment fee is required, you will need to send a check to Neishloss & Fleming, Inc. via USPS as SureLC is not set up to accept fee payment electronically. The fees can be mailed to:

Neishloss & Fleming, Inc. Attn: Administrative Division 2275 Swallow Hill Rd. Building 300 Pittsburgh, PA 15220

Commission Schedule – PLRAGT12 Page 1 of 3 May 2012

Commission Schedule – PLRAGT12 Effective July 30th 2012 Rates of Commission: Final Expense Whole Life Product This Schedule shall form part of the General Agent Agreement. Commission rates stated in this or any General Agent Commission Schedule are payable to the General Agent (GA) only on production written by the GA, based on the GA Commission Schedule in effect as of the Certificate application signed date.

GRADED BENEFIT WHOLE LIFE / IMMEDIATE BENEFIT WHOLE LIFE FIRST YEAR

RATES Issue Age

50-80

FIRST YEAR RATES

Issue Age 81-85

RENEWAL RATES Year 2

RENEWAL RATES

Years 3-5

RENEWAL RATES

Years 6-10

RENEWAL RATES

Years 11+

110.00% 80.00% 5.75% 5.75% 4.00% 1.30%

MODIFIED BENEFIT WHOLE LIFE

FIRST YEAR RATES RENEWAL RATES Years 2-5

RENEWAL RATES Years 6-10

RENEWAL RATES Years 11+

50.00% 3.00% 2.25% 1.30% First-year Annualized Commissionable Premium The first-year annualized commissionable premium is the annualized first-year premium. The certificate fee for Plan Right sold through VSOP (Voice Sales Over Phone) is non-commissionable while the fee for face-to face sales is commissionable. First Year Commission Calculation – Life Products First year compensation on life Certificates will be paid at issue when the Certificate is issued standard as applied for and has the appropriate Cash with Application (CWA – as defined by Certificate Services – see Toolkit on Foresters’ website). First year compensation on cases with outstanding requirements such as life amendments, premium shortages greater than $5.00, as well as COD cases will be paid upon submission of the outstanding requirements. First premium on PAC (FPOP) – If there is an Advance Commission Addendum in effect; commission is advanced when PAC is applied. First Year Commission Chargebacks First year commissions are deducted in the current month on insurance products for losses processed at Foresters due to first-year lapses, cancellations, product not taken and first-year surrenders.

Commission Schedule – PLRAGT12 Page 2 of 3 May 2012

If the GA has signed an Advance Commission Addendum (“Addendum”) and commissions have been advanced on a life Certificate issued on or after the effective date of the Addendum (defined as the date that Foresters processed the Addendum) and pursuant to the terms thereof, the GA shall repay immediately to Foresters an amount equal to the difference between commissions advanced less the portion of commissions earned based on premiums paid to Foresters. If the GA’s signed Advance Commission Addendum is revoked by Foresters, then commissions on Certificates issued on or after the effective date of that revocation shall, subject to the provision for Non-Accidental Death in First year below, be deemed to have been earned on the date that a premium is received by Foresters and credited to the GA’s account, and shall not be charged back on any Certificate that goes out of force (other than product not taken) in the first twelve months of the first Certificate year. If the GA has not signed an Advance Commission Addendum, commissions shall, subject to the provision for Non-Accidental Death in First Year below, be deemed to have been earned on the date that a premium is received by Foresters and credited to the GA’s account, and shall not be charged back on any Certificate that lapses or otherwise goes out of force (other than product not taken) in the first twelve months of the first certificate year. Indebtedness It is understood and agreed that you shall be responsible to Foresters for your indebtedness owed by you, as well as for the indebtedness of your licensed Producer, if any, whether or not termination of such licensed Producer occurs. If at any time your commission account with Foresters is negative, the total negative amount will be applied as follows in that order towards the indebtedness until both a. and b. below are reduced to a zero balance:

a) 100% of your total first year and renewal commissions to your personal production indebtedness.

b) Foresters reserves the right to apply up to 100% of your first year, renewal and any other commissions to your indebtedness for any licensed Producers.

Non-Accidental Death in First Year For Plan Right Modified Death Benefit (PRML) and Plan Right Graded Death Benefit (PRGL), any first year Non-Accidental Death will generate a 100% commission chargeback (i.e. all commissions are considered not earned and are reversed) to the writing agent and the uplines. For Plan Right Level Death Benefit (PRWL), no commissions are charged back on Non-Accidental Deaths. Pre-paid Premiums First year compensation is not payable on premiums that are pre-paid for future renewal year premium payments. Where applicable, renewal commissions will be paid on those premiums as they are allocated to each Certificate year. Reinstatements If the reinstatement occurs in the first year of the Certificate and was a reinstatement of a first year lapse or surrender, first year compensation previously deducted is re-credited in the month the reinstatement was processed at Foresters.

Commission Schedule – PLRAGT12 Page 3 of 3 May 2012

Controlled Business All business written on an agent’s own life, their spouse/partner or their children/step-children is considered “controlled” business. Likewise, all business written whereby the agent is the payor, policy owner or beneficiary will also be considered “controlled” business. For all “controlled” business, the commissions will be paid out as earned regardless of your compensation arrangement. Replacement Rules A Certificate is regarded as a replacement Certificate if it meets the definition of “Replacement” set out in state regulation and Foresters written policies. First year compensation from replacements of any business from products provided by Foresters is based on the increase in annualized commissionable premium only. This is applicable to all replacements identified as such at the time of submission and for partial or full term conversions where the old Certificate has been in force for less than 24 months. Any Certificate that is issued within 13 months of a lapsed Certificate on the same life (either pre- or post-application date) will be considered a replacement and first year compensation will be reduced. No first year compensation is paid on internal rollover money. Additional compensation rules regarding Replacement Rules can be found on Foresters’ website. Returned Premiums If Foresters returns a premium or part thereof to the insured for any reason, the GA shall waive all right to the commission, if any, relating thereto and shall repay to Foresters any commission received in respect thereof.