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6. OPTIONAL BENEFIT RIDERS (additional Premiums required) - A checkmark in any of the boxes below
indicates that You have selected the following optional coverage(s):
LUMP SUM HEART AND STROKE RIDER (LY-LSH-RD-FL)
We will pay the Heart and Stroke Diagnosis Benefit if an Insured Person receives a Diagnosis of any of
the Qualifying Events shown in the chart below and subject to the definitions, terms, limitations and
exclusions set forth in the Rider and the following conditions:
a. the Diagnosis must be made within the United States;
b. the Date of Diagnosis is after the Waiting Period has expired;
c. the Date of Diagnosis shall occur while the Insured Person is covered by the Rider; and
d. payment shall be precluded by any general or specific exclusion, limitation, or reduction set forth in
or attached to the Rider and the policy (including, without limitation, the exclusion for any Pre-
Existing Condition) or any failure by the Insured Person to meet any condition precedent.
The amount payable for each Qualifying Event is equal to the percentage times the Heart and Stroke
Diagnosis Benefit Amount shown on the Policy Schedule Page or policy endorsement. The percentage
of the Heart and Stroke Diagnosis Benefit Amount payable for each Qualifying Event is shown beside
the event in the chart below.
Qualifying Events Percentage of Benefit Maximum Percentage of
Amount Payable for each Benefit Amount Payable
Heart Attack
Heart Transplant Qualifying Event 100%
Stroke
Coronary Artery Bypass Surgery* 100%
Aortic Surgery* 100%
Heart Valve Replacement/Repair Surgery* 100%
Angioplasty*
Stent* 25%
25%
25%
10%
10%
*The Coronary Artery Bypass Surgery, Aortic Surgery, Heart Valve Replacement/Repair Surgery,
Angioplasty, and Stent benefits are each payable only once in an Insured Person’s lifetime.
If an Insured Person receives benefits payable for a Qualifying Event that is less than 100% of the Heart
and Stroke Diagnosis Benefit Amount and later receives a Diagnosis for a different Qualifying Event, We
will pay the specified percentage of the Qualifying Event in the chart above, less any prior amounts
paid or payable under this benefit.
If the Date of Diagnosis of two (2) or more Qualifying Events is the same Day, We will pay only one (1)
Heart and Stroke Diagnosis Benefit Amount. We will pay the larger of the Qualifying Event benefits
Diagnosed on the same Day.
The Date of Diagnosis for two (2) or more surgical Treatments performed at the same time and through
a common incision or entry point are considered one (1) operation. We will pay the larger of the
Qualifying Event benefits performed at the same time.
LY-LSC-OC-B-FL 3 10/13
indicates that You have selected the following optional coverage(s):
LUMP SUM HEART AND STROKE RIDER (LY-LSH-RD-FL)
We will pay the Heart and Stroke Diagnosis Benefit if an Insured Person receives a Diagnosis of any of
the Qualifying Events shown in the chart below and subject to the definitions, terms, limitations and
exclusions set forth in the Rider and the following conditions:
a. the Diagnosis must be made within the United States;
b. the Date of Diagnosis is after the Waiting Period has expired;
c. the Date of Diagnosis shall occur while the Insured Person is covered by the Rider; and
d. payment shall be precluded by any general or specific exclusion, limitation, or reduction set forth in
or attached to the Rider and the policy (including, without limitation, the exclusion for any Pre-
Existing Condition) or any failure by the Insured Person to meet any condition precedent.
The amount payable for each Qualifying Event is equal to the percentage times the Heart and Stroke
Diagnosis Benefit Amount shown on the Policy Schedule Page or policy endorsement. The percentage
of the Heart and Stroke Diagnosis Benefit Amount payable for each Qualifying Event is shown beside
the event in the chart below.
Qualifying Events Percentage of Benefit Maximum Percentage of
Amount Payable for each Benefit Amount Payable
Heart Attack
Heart Transplant Qualifying Event 100%
Stroke
Coronary Artery Bypass Surgery* 100%
Aortic Surgery* 100%
Heart Valve Replacement/Repair Surgery* 100%
Angioplasty*
Stent* 25%
25%
25%
10%
10%
*The Coronary Artery Bypass Surgery, Aortic Surgery, Heart Valve Replacement/Repair Surgery,
Angioplasty, and Stent benefits are each payable only once in an Insured Person’s lifetime.
If an Insured Person receives benefits payable for a Qualifying Event that is less than 100% of the Heart
and Stroke Diagnosis Benefit Amount and later receives a Diagnosis for a different Qualifying Event, We
will pay the specified percentage of the Qualifying Event in the chart above, less any prior amounts
paid or payable under this benefit.
If the Date of Diagnosis of two (2) or more Qualifying Events is the same Day, We will pay only one (1)
Heart and Stroke Diagnosis Benefit Amount. We will pay the larger of the Qualifying Event benefits
Diagnosed on the same Day.
The Date of Diagnosis for two (2) or more surgical Treatments performed at the same time and through
a common incision or entry point are considered one (1) operation. We will pay the larger of the
Qualifying Event benefits performed at the same time.
LY-LSC-OC-B-FL 3 10/13
