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DocuSign Envelope ID: EE765B38-37EF-4402-B4E9-8B82F98E2EE8 <br /> UNITEDHEALTHCARE INSURANCE COMPANY <br /> A Stock Company <br /> 185 Asylum Street,Hartford, Connecticut <br /> Phone: 1-860-702-5000 <br /> UnitedHealthcare Insurance Company ("Company") agrees to reimburse the Policyholder as outlined under <br /> the provisions of this Excess Loss Insurance Policy("Policy"). <br /> This Policy is legally binding between the Policyholder and UnitedHealthcare Insurance Company. The <br /> consideration for this Policy includes, but is not limited to, the Application and the Payment of premiums <br /> as provided hereinafter. <br /> The Policyholder is entitled to the reimbursement described in this Policy if the Policyholder is eligible for <br /> insurance under the provisions of this Policy. Reimbursement is subject to the terms and conditions of this <br /> Policy. <br /> The first premium is due on the first(1st) day of the Policy Period. Subsequent monthly premiums are due <br /> on the first (1st) day of each month thereafter. The premium is not considered Paid until the Company <br /> receives the premium payment. <br /> All periods of coverage will begin and end 12:01 a.m.local time at the principal office of the Policyholder. <br /> This Policy is delivered in and is governed by the laws of the state of issue. <br /> IN WITNESS WHEREOF UnitedHealthcare Insurance Company has caused this Policy to be executed <br /> by its President and Secretary. <br /> IMPORTANT NOTICE - READ YOUR POLICY CAREFULLY <br /> This Policy is a legal contract between you and us. We issued it on the basis that the information in your <br /> application is correct and complete. Check this information carefully.If it is not correct and complete,write <br /> to our Administrative Office and provide the correct and complete information. <br /> Jeffrey Alter,President Michael J. McDonnell, Secretary <br /> STOP LOSS INSURANCE POLICY <br /> IMPORTANT CANCELLATION INFORMATION- <br /> Please Read The Provision Entitled"Termination Provisions" <br /> Found on Page TERM <br /> UHIELIP-NC(07l06) 1 <br />