2014-143 HR - Magellan Behavior Health Inc for Employee Assistance Program $15,456

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ACC> CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/17/2014 9/23/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOckton Co1Tlpanies,LLC NE CONTACT 1185 Avenue of the Americas,Suite 2010 PHONE FAX New York 10036 E-MAILo Ex A/C No 646-572-7300 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Lexin ton Insurance Com arl 19437 INSURED MAGELLAN HEALTH SERVICES,INC. INSURER B:Lib Mutual Fir Insurance man 23035 1345009 55 NOD ROAD INSURER C:Ube=Insurance Co oration 42404 AVON CT 06001 INSURER 0: INSURER E: INSURER F: COVERAGES MAGHE01 CERTIFICATE NUMBER: 11461505 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP LIMITS LTR IN D POLICY NUMBER MM/DDIYYYY MM/DD/YYYY GENERAL LIABILITY H RR A N N 7055341 6/17/2013 6/17/2014 DAMAGE TO RENTED X MMERCIAL GENE BILITY PREMISES(Ea occurrence) $ 50,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 X POLICY PECOT- LOC $ $ AUTOMOBILE LIABILITY N N AS2-651-004219-1 13 10/1/2013 10/1/2014 (Ea accident) $ 1,000,000 IX ANY AUTO BODILY INJURY(Per person) $ XX} {XXX ALL OWNED SCHEDULED BODILY INJURY Per accident } XXJG XX AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ XrXXXXXX HIRED AUTOS AUTOS $ XXXXXXX COMP.$1,00 X COLL.$1,00 A UMBRELLA LIAB OCCUR N N 7055342 6/17/2013 6/17/2014 EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB x CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ x XXXXXX WORKERS COMPENSATION C AND EMPLOYERS'LIABILITY YIN N WC7-651-004219-103 10/1/2013 1011/2014 X TORY LIMIT ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1 000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A MANAGECARE LIAB. N N 079331689 6/17/2013 6/17/2014 $10,000,000 per Med Incident A CLAIMS MADE SIR applies per policy $10,000,000 Aggregate A terms&conditions DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11461505 AUTHORIZED REPRESENTATIVE MAGELLAN HEALTH SERVICES,INC. 55 NOD ROAD AVON CT 06001 ' � a ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 81988-2010 ACORD CORPORATION.All rights reserved