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LIFE INSURANCE ELECTION OF PORTABILITY COVERAGE Unum Life Insurance Company of America Unum Portability Unit 2211 Congress Street Portland ME 04122 1-800-421-0344 You may be eligible to continue your Life and AD D coverage. Any coverage chosen on this election form will be issued in accordance with the portability provision contained in the employer s Unum group term life coverage and/or accidental death and dismemberment insurance coverage under.

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