FRIENDS OF SANTA ANA ZOO (FOSAZ) 7-2016

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POLICY NO:9048876-15 DATE: June 26, 2015 PAGE 4 OF 4 Comments: NONE DIVIDEND DETERMINATION AND TIMING Changes, if any: NONE At the time of dividend payment, you will be provided with a "Policyholder Dividend Result Disclosure Statement" which will include all essential data employed to compute the dividend result, This document will identify any exceptions to the procedures, factors and timing of payment described in this Policyholder Dividend Disclosure Statement and explains such variances. You should be aware that forfeiture of a right to, reduction in the amount of, reduction in any other benefit plan, or delaying the payment of, a policyholder's dividend due to the policyholder's failure to accept renewal of the policy or subsequent policies issued by the same insurer is coercive and illegal and constitutes an unfair practice. However, a reasonable reduction in the amount of policyholder dividend is permissible if the policyholder has elected to be considered for policyholder dividends under a plan which utilizes the premium and loss experience of the policyholder for two or more policy years and the policyholder does not remain insured by the same insurer during the complete term of the multi-year dividend plan. In such instances, the nature of the adjustment must be set forth in this Policyholder Dividend Disclosure Statement and provided to the policyholder within thirty days after the inception of the first policy year for which such election has been made. A "reasonable reduction" in the amount of policyholder dividends is defined as a specifically limited to the application of the most favorable dividend plan for which the policyholder then qualified under the dividend procedures of the insurer unless some alternative dividend plan has been set forth in the Policyholder Dividend Disclosure Statement provided the policyholder. Comments: NONE 15302 (0420151 Authorized Representative fed ay•. e cj�\Vva