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DocuSign Envelope ID: EE765B38-37EF-4402-B4E9-8B82F98E2EE8 <br /> CERTIFICATE OF LIABILITY INSURANCE DATE 04124//2014 2014 /YYYY) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> Marsh USA Inc. NAME: <br /> 333 South 7th Street,Suite 1400 AANNo Exl FAX No): <br /> Minneapolis,MN 55402-2400 EMAIL <br /> Attn:Healthcare,AccounlsOSS @marsh.com Fax 212.948-1307 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIL# <br /> 401115-OLD-PL5M-14-16 INSURER A:Old Republic Insurance Company 24147 <br /> INSURED INSURER B: <br /> UNITEDHEALTH GROUP <br /> 9900 BREN ROAD EAST MN008-W345 INSURER C: <br /> MINNETONKA,MN 55343 INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CHI-004227576-12 REVISION NUMBER:10 <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMIDD/YYYY MM/DD/YYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY D TO( a TED <br /> PREMI SES Ea occurrence) $ <br /> CLAIMS-MADE F-1 OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY <br /> PRO—$ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WC sTATU- oTH- <br /> AND EMPLOYERS'LIABILITY YIN I ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVEâť‘ N!A E.L.EACH ACCIDENT $ `: <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> II yes,describe under <br /> bESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Managed Care MWZZ302190 05/01/2014 05/01/2016 Each Claim $5,000,000 <br /> Professional Liability/E&O RETRO DATE:111177 Annual Aggregate $5,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> UNITEDHEALTH GROUP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 9900 BREN ROAD EAST MN008-W345 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> MINNETONKA,MN 55343 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> of Marsh USA Inc. <br /> Manashi Mukherjee r.- <br /> ©1988-2010 ACORD CORPORATION, All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br /> 1 <br /> : <br />