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R-02-10-10-13E2 - 10/10/2002RESOLUTION NO. R- 02- 10- 10 -13E2 WHEREAS,the City of Round Rock is currently purchasing stop loss reinsurance from Excess, Inc., acting as the Managing General Underwriter, with ACE American Insurance Company providing the underwriting; and WHEREAS, the City wishes to renew its agreement with Excess, Inc. to continue to provide stop loss reinsurance for the period of December 1, 2002 to November 30, 2003; Now Therefore BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS, That the Mayor is hereby authorized and directed to execute the necessary documents to renew the City's stop loss reinsurance with Excess, Inc., acting as the Managing General Underwriter, with AIG Life Insurance Company providing the underwriting. The City Council hereby finds and declares that written notice of the date, hour, place and subject of the meeting at which this Resolution was adopted was posted and that such meeting was open to the public as required by law at all times during which this Resolution and the subject matter hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act, Chapter 551, Texas Government Code, as amended. RESOLVED this 10th day of October, 2002. T ST_ 0: \ waox \RESOL0tx \Rl1010E2. CHRISTINE R. MARTINEZ, City Secret WELL, Mayor City of Round Rock, Texas y AIGLIFE AIG LIFE INSURANCE COMPANY One Alico Plaza Wilmington, DE 19801 EXCESS LOSS INDEMNITY POLICY et, pqu). In consideration of the payment of the premium, the statements in the Master Application, a copy of which is attached to and made part of this Policy, and subject to the terms, conditions and limitations of this Policy, the AIG Life Insurance Company, herein called the Company, does hereby issue this Policy to Policyholder Policy Number: 316 - Address: The first payment of premium is due and payable on or before the Effective Date of this Policy shown in the Schedule and all other premiums are due and payable as set forth in the Payment of Premiums provision as long as the Policy is in force. The Policy Year shall begin and end at 12:01 a.m. Standard Time at the address of the Policyholder shown in this Policy. The Policyholder understands the liability assumed under the portion of the employee benefit plan which he is self - insuring and further understands that he is exempted from Article 1.14 -1 of the Texas Insurance Code only if a qualified employee benefits plan has been filed and meets the requirements of ERISA. THIS IS NOT A POLICY OF WORKERS' COMPENSATION INSURANCE. THE EMPLOYER DOES NOT BECOME A SUBSCRIBER TO THE WORKERS' COMPENSATION SYSTEM BY PURCHASING THIS POLICY, AND IF THE EMPLOYER IS A NON - SUBSCRIBER, THE EMPLOYER LOSES THOSE BENEFITS WHICH WOULD OTHERWISE ACCRUE UNDER THE WORKERS' COMPENSATION LAWS. THE EMPLOYER MUST COMPLY WITH THE WORKERS' COMPENSATION LAW AS IT PERTAINS TO NON - SUBSCRIBERS AND THE REQUIRED NOTIFICATIONS THAT MUST BE FILED AND POSTED. IN WITNESS WHEREOF, the Company has caused this Policy to be signed by its President and Secretary. 55350TX President Secretary Excess Loss Indemnity Policy SCHEDULE - Excess Loss Indemnity Policy Policyholder POLICY #: Address EFFECTIVE DATE: January 1, 2000 EXPIRATION DATE: January 1, 2001 NOTE: Coverage is only applicable to the category for which a retention amount is shown below. If no retention amount is shown, coverage is not provided for that category. (A) SPECIFIC EXCESS INSURANCE (1) Specific Retention Amount per Covered Person for the Policy Year $ 10,000 (2) Limit of Liability $ 990,000 (3) Reimbursement Factor 100% (4) Premium Rates Payable per Covered Unit for the Policy Year: ( ) Composite Basis S - $ (x) Single/Family Basis F - $ (5) Organ Transplant Endorsement Rate Payable per Covered Unit for the Included in Policy Year Specific Rates (B) AGGREGATE EXCESS INSURANCE (1) Monthly Aggregate Retention Amount Factor for Medical S - $ F - $ (2) Anticipated Annual Aggregate Retention Amount $ (3) Minimum Aggregate Retention Amount $ (4) Limit of Liability $ 1,000,000 (5) Reimbursement Factor 100% (6) Monthly Premium Rate Payable per Covered Unit for the Policy Year $ (C) MINIMUM PREMIUM $ (D) COVERED BENEFITS (x) Medical (x) Prescription Drug ( ) Dental ( ) Vision ( ) Other (E) PAYMENT BASIS (x) Incurred in 12 Months and Paid in 12 Months (F) ENDORSEMENTS (x) Organ Transplant; (x) Paid Claims; (x) Waiver of Actively at Work; (x) Prescription Drug; (x)Specific Advance Funding; (x) Monthly Aggregate Accommodation; (G) ADMINISTRATOR OF BENEFIT PLAN 55350TX PAGE I - Definitions 2 II - Specific Excess Insurance 3 III - Aggregate Excess Insurance 4 IV - Limitations of Coverage 4 V - Exclusions 4 VI - General Conditions 6 VII - Administration of Claims under the Plan 7 VIII - Uniform Provisions 8 55350TX Table of Contents I - DEFINITIONS ACTIVELY AT WORK means that the Covered Person is performing on a full time basis all regular duties of his or her normal occupation on the Effective Date of this Policy, or on his or her last regularly scheduled work day prior to that Effective Date, or on the date a Covered Person becomes eligible, if after the Effective Date of this Policy. ANNUAL AGGREGATE RETENTION AMOUNT for the Policy Year, or any fraction thereof if this Policy terminates or is canceled during the Policy Year, means that portion of the Eligible Expenses that is wholly retained by the Policyholder calculated multiplying the number of Covered Units by the Covered Units' corresponding Monthly Aggregate Retention Amount Factor applied for each policy month, or the Minimum Aggregate Retention Amount shown in the Schedule, whichever is greater. BENEFIT PLAN (also called the Plan) means the welfare benefits the Policyholder has agreed to provide under a plan of benefits for the Covered Units, as defined in a written form of such Plan, which is in effect on the Effective Date of this Policy, and any amendments to such plan to which this Policy applies. BENEFIT PLAN PAYMENTS ON AN INCURRED AND PAID BASIS means, for a Policy Year, the total dollar amount of benefits to which Covered Units or Covered Persons become entitled under the Plan, subject to any limitations of the Policy, and which are paid during the Policy Year. Such amount of benefits shall only include the Eligible Expenses incurred on or after the Effective Date of this Policy. Such amount of benefits shall not include deductibles, coinsurance amounts, or any expenses or claims which are not payable or reimbursable under the terms of the Plan, nor shall it include expenses which are payable or reimbursable from any other source. No cost of claim payment or expense of litigation shall be included. An Eligible Expense will be considered to be incurred at the time the service or the supply to which it relates is provided. Drafts or checks issued shall be counted as amounts paid provided sufficient funds are then available to cover such payments. COVERED PERSON means each person, individually, who is a Covered Unit, or, in the case of a dependent, a member of a Covered Unit. COVERED UNIT means an employee, an employee and his or her dependents, or such other defined unit as agreed upon in writing between the Company and the Policyholder. DATE OF ISSUE means the date printed on the draft or check. It may be no later than the last day of the Policy Year. ELIGIBLE EXPENSES means the charges which are covered and paid under the Plan, subject to any limitations of this Policy. EXPERIMENTAL PROCEDURE means any medical procedure, equipment, treatment or course of treatment, or drugs or medicines that are: (a) limited to research; (b) not proven in an objective manner to have therapeutic value or benefit; (c) restricted to use by medical facilities capable of carrying out scientific studies; (d) of questionable medical effectiveness; or (e) would be considered inappropriate medical treatment. To determine whether a procedure is experimental, the Company will consider, among other things, commissioned studies, opinions and references to or by the American Medical Association, the Federal Food and Drug Administration, the Department of Health and Human Services, the National Institutes of Health, the Council of Medical Specialty Societies and any other association or program or agency that has the authority to review or regulate medical testing or treatment. LIMIT OF LIABILITY means the amount shown in the Schedule which is the maximum payable under this Policy to the Policyholder for the Policy Year. 55350TX 2 MINIMUM AGGREGATE RETENTION AMOUNT means the amount shown in the Schedule which is wholly retained by the Policyholder regardless of how long this Policy remains in force. MONTHLY AGGREGATE RETENTION AMOUNT FACTOR means the factor which is multiplied by the number of Covered Units each policy month of the Policy Year to determine the Annual Aggregate Retention Amount. NUMBER OF COVERED UNITS means the total number of Covered Units existing in any one policy month. The Number of Covered Units anticipated for the first policy month of the Policy Year is shown as Initial Enrollment in the Schedule. The Number of Covered Units for subsequent policy months will be determined on a monthly basis in accordance with the definition of Covered Units and with the eligibility requirements of the Plan. ORGAN TRANSPLANT PROCEDURES means kidney, cornea, heart, lung, heart-lung, liver, pancreas and bone marrow (including autologous bone marrow) transplants. POLICY YEAR means the period from 12:01 a.m. Standard Time on the Effective Date to 12:01 a.m. Standard Time on the Expiration Date as shown on the Schedule of this Policy except as provided in the Cancellation and Payment of Premiums Sections of this Policy. Unless otherwise stated and endorsed, the Policy Year will be assumed to be twelve (12) months. REIMBURSEMENT FACTOR means the percentage shown in the Schedule which will determine the dollar amount of the Limit of Liability which will be paid to the Policyholder. Separate Reimbursement Factors may apply each to the Aggregate Excess Insurance and to the Specific Excess Insurance. SPECIFIC RETENTION AMOUNT means the amount specified in the Schedule which is wholly retained by the Policyholder per Covered Person for the Policy Year. TOTALLY DISABLED means that the Covered Person is hospital confined or is unable to engage in the normal activities of a person in good health of like age and sex on the Effective Date of this Policy or on the date the Covered Person becomes eligible under the Plan if other than the Effective Date of this Policy. II - SPECIFIC EXCESS INSURANCE A. The Company will, subject to the terms, conditions and limitations of this Policy, reimburse the Policyholder for the amount, if any, of the Specific Excess Benefit, within sixty (60) days after receipt by the Company of documentation acceptable to the Company of both proof of loss and verification of Payment of Benefits under the Plan. B. The Specific Excess Benefit for the Policy Year is the total amount of the Plan Benefit Payments on An Incurred And Paid Basis for a Covered Person less the Specific Retention Amount, multiplied by the Reimbursement Factor. The amount of this benefit shall not exceed the Limit of Liability shown on the Schedule for Specific Excess Insurance. C. If a Covered Person incurs Eligible Expenses, a single Specific Retention Amount shall apply for such Covered Person to those Eligible Expenses which are incurred and paid during the Policy Year. 55350TX 3 III - AGGREGATE EXCESS INSURANCE A. After the end of the Policy Year (whether by normal expiration, termination, or cancellation), the Company will, subject to the terms, conditions and limitations of this Policy, reimburse the Policyholder for the Amount of the Aggregate Excess Benefit, if any, within sixty (60) days after receipt by the Company of documentation acceptable to the Company of both proof of loss and verification of Payment of Benefits under the Plan. B. The Aggregate Excess Benefit for the Policy Year is the total amount of Benefit Plan Payments On An Incurred and Paid Basis, less: (1) the Annual Aggregate Retention Amount, and (2) the Specific Excess Benefit which has been or will be reimbursed by the Company under the Specific Excess Insurance, multiplied by the Reimbursement Factor. The amount of this benefit shall not exceed the Limit of Liability shown in the Schedule for Aggregate Excess Insurance. IV - LIMITATIONS OF COVERAGE A. The Company has no responsibility or obligation under this Policy to directly reimburse any Covered Person or provider of professional or medical services for any benefits which the Policyholder has agreed to provide under the terms of the Plan. The Company's sole liability hereunder is to the Policyholder, subject to the terms, conditions and limitations of the Policy. B. If a Covered Person is not Actively At Work or is Totally Disabled on the Effective Date of coverage under this Policy, Eligible Expenses shall include only those expenses incurred on or after the date the Covered Person returns to work full -time or the Total Disability ends, and the Covered Person meets the eligibility requirements of the Plan. C. Coverage of expenses for the treatment of Mental and Nervous Conditions is limited to $25,000.00 in excess of the Specific Retention Amount. D. Any reimbursement amount payable to a Policyholder who has retained the services of a Preferred Provider Organization or any other organization providing discounted provider services or supplies to the Policyholder will be the actual amount paid by the Policyholder after the application of all discounts. V - EXCLUSIONS This Policy will not reimburse the Policyholder for any loss or expense caused by or resulting from any of the following: 1. Expenses incurred while the Plan is not in force. 2. Expenses resulting from the provision of weekly income benefits or any dental, vision, hearing or prescription drug program, unless specifically endorsed hereon. 3. Liability assumed by the Policyholder under any contract or service agreement other than the Plan. 55350TX 4 4. Expenses resulting from services which: are not medically necessary; are in excess of the usual and customary charge for the locality where administered; or are in excess of Plan Benefits. 5. Expenses for accidental bodily injury or sickness for which the Covered Person would be entitled to benefits under any Worker's Compensation or Occupational Disease policy whether or not such policy is actually in force. 6. Expenses for the administration of claims or other service(s) provided by the Administrator. 7. Any consulting fees. 8. Expenses of litigation. 9. With respect to each Covered Person who is eligible for benefits under Medicare, a benefit otherwise payable under this Policy shall be reduced by the amount of any similar Medicare benefit so that the total reimbursements hereunder on behalf of a Covered Person shall not exceed one hundred percent (100 %) of the Covered Person's actual expenses. It will be conclusively presumed that each Covered Person eligible for benefits under Medicare became covered for all parts of Medicare to which he or she is entitled on the earliest possible date and thereafter maintained such coverage in force. 10. Expenses for any bodily injury or sickness incurred by a Covered Person that were the result of a Covered Person committing or attempting to commit an assault or a felony or from a Covered Person engaging in an illegal occupation. 11. Expenses incurred in connection with suicide or any intentionally self - inflicted injury or illness, whether the Covered Person was sane or insane when he or she committed the act. 12. Expenses for experimental procedures, drugs, or research studies, or for any services or supplies not considered legal in the United States. 13. Expenses incurred by a live organ donor unless the donor is a Covered Person under this Policy. Expenses of a live organ donor shall not be considered as eligible expenses of the organ recipient, unless the donor is without insurance, in which case, a maximum or $10,000 shall be considered as Eligible Expenses of the recipient. 14. Expenses resulting from war, whether declared or undeclared, hostilities, invasion or civil war. 15. Expenses resulting from injury or illness that is the result of a nuclear or radioactive accident. VI - GENERAL CONDITIONS PREMIUM: The premium basis and rates for this Policy will be as shown in the Schedule. Upon termination of this Policy, the earned premium shall be computed in accordance with the premium and exposure basis shown in the Schedule. If the earned premium exceeds the premium paid, the 55350TX 5 Policyholder shall pay the excess to the Company; if less, the Company shall return the unearned portion of the premium paid to the Policyholder subject to the Minimum Premium, if any, shown in the Schedule. MINIMUM PREMIUM: The Minimum Premium payable will be the amount shown in the Schedule or, in the event of termination or cancellation, the sum of all monthly premium rates payable, multiplied by the Minimum Enrollment shown in the Schedule multiplied by the number of policy months. PAYMENT OF PREMIUMS: Premiums are due in advance on the first day of each month. A period of thirty-one (31) days will be granted for payment of each premium, during which period the Policy will continue in force, but the Policyholder shall remain liable to the Company for the unpaid premium. Should a premium otherwise due not be paid during such period, this Policy will terminate without further notice on the date the unpaid premium was due. DATA REQUIRED: The Policyholder will maintain adequate records acceptable to the Company and provide any information required by the Company in its sole judgment, to administer this Policy. The Company may periodically examine any of the Policyholder's records including those of the Policyholder's Administrator, relating to the insurance under the Policy and any claims filed under the Plan. CLERICAL ERROR: Clerical error, whether by the Policyholder or by the Company, in keeping any records pertaining to the coverage, will not invalidate coverage otherwise validly in force or continue coverage otherwise terminated. AMENDMENTS TO THE POLICY: This Policy may be amended at any time with the mutual consent of the Company and the Policyholder, however, no such amendment shall be effective unless confirmed by an endorsement issued to form part of this Policy. AMENDMENTS TO THE PLAN AND /OR ADMINISTRATIVE AGREEMENT: The Policyholder will provide the Company with a copy of all Benefit Plan documents (i.e. booklets, brochures, sub -group variations, etc.) prior to the Effective Date of this Policy. The Policyholder shall also provide the Company with prompt written notice of any changes in the Benefit Plan. The Company reserves the right to refuse to apply this Policy to any change in the Benefit Plan unless and until and only to the extent provided in an endorsement issued by the Company to form part of this Policy. At the time that the Policyholder provides the Company with the Benefit Plan documents, the Policyholder will provide the Company with a copy of the written agreement between the Policyholder and the Administrator. The Policyholder shall provide the Company with a copy of any and all changes to such agreement prior to their effective date. The notices required by this provision shall be sent directly to the Company at One Alico Plaza, P.O. Box 667, Wilmington, DE 19899. NOTICE: For the purposes of any notice required from the Company under the provisions of this Policy, notice to the Administrator shall be considered notice the Policyholder. VII - ADMINISTRATION OF CLAIMS UNDER THE PLAN: 1. The Policyholder shall undertake at all times to employ the services of an Administrator, who shall be deemed the agent of the Policyholder. 55350TX 6 2. The Administrator, acting on behalf of the Policyholder, under the Plan, shall: a, supervise the administration and adjustments of all claims and verify the accuracy and computation of all claims; b. maintain accurate records of all claims payments; c. provide the Company on or before the 15th day of each and every policy month, on a reporting form supplied by the Company, the following data as respects the immediately preceding policy month: 1. Number of Covered Units 2, Premium paid d. supervise funding of the Plan by the Policyholder. 55350TX 7 3. Amount of paid claims 4. Amount of unpaid processed claims on hand AUDIT: The Company shall have the right to inspect and audit all records and procedures of: (1) the Policyholder; (2) its Administrator; and (3) any other organization involved in the administration or adjudication of claims. The Company may require, upon request, proof of records satisfactory to the Company that payment has been made to the provider of such services or benefits which are the basis for any claim hereunder. NOTICE OF CLAIM: The Policyholder shall provide immediate written notification to the Company when it becomes evident that benefits have been or will be incurred which will exceed the Specific Retention Amount of this Policy. The Policyholder shall provide immediate written notification to the Company when a Covered Person incurs Eligible Expenses for any of the following diagnoses: 1. Head or spinal cord 5. Acquired Immune Deficiency injuries Syndrome 2. Severe Bum cases 6. Cancer 3. Severe Trauma 7. Severe Strokes 4. Premature Birth 8. Organ Transplants In addition to the above notice requirements, the Policyholder shall provide written notification to the Company within thirty (30) days after Plan benefit payments for any Covered Person exceeding fifty (50 %) percent of the Specific Retention Amount have been made. Notwithstanding the above failure to furnish written notice within the time required shall neither invalidate nor reduce any claim if it was not reasonably possible to give such written notification within such time; provided that such written notification is furnished as soon as reasonably possible but in no event later than six (6) months after the date that written notification of Plan benefit payment is otherwise required. No claim for reimbursement shall be considered under this Policy unless it is received by the Company in writing no later than two (2) years after the date of receipt of the first written notification to the Company of the payment by the Policyholder under the Plan. NOTICE OF APPEAL: Any objection, notice of legal action, or complaint received on a claim processed by the Policyholder or its Administrator, and on which it reasonably appears benefits will be payable under this Policy shall be brought to the immediate attention of the Claims Department of the Company. SUBROGATION: The Policyholder or Plan Administrator shall pursue all actions that the Policyholder may have against a third party because of any claim resulting in a Plan payment by the Policyholder. The Policyholder or Plan Administrator shall account to the Company for all amounts recovered. If the Policyholder or Plan Administrator fails to pursue any action against a third party and the Company has made excess benefit payments to the Policyholder under this Policy, the Company shall be subrogated to all rights of the Policyholder. The Policyholder shall cooperate fully and do all things necessary and required for the Company to pursue any action to recover against the third party. Any amounts recovered by the Policyholder, Administrator, or the Company in such action shall be used first to reimburse the expenses of recovery and then to reimburse the Company for any payments made to the Policyholder. VIII - UNIFORM PROVISIONS ENTIRE CONTRACT: The entire contract is made up of this Policy, the application, and any attached riders and endorsements. TIME LIMIT ON CERTAIN DEFENSES: In the absence of fraud, all statements made by the Policyholder shall be deemed representations and not warranties. 55350TX 8 If these statements appear as part of the written Master Application or other written instrument signed by the Policyholder, we may use them to contest the Policy. If we do, we will furnish the Policyholder with a copy of the document in question. After two (2) years, only fraudulent misstatements may be used to contest the Policy coverage under the Policy. CHANGES: Notice to any broker or agent or knowledge possessed by any broker or agent or by any other person shall not effect a waiver of a change in any part of this Policy or stop the Company from asserting any right under the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by endorsement issued to form a part of this Policy. ASSIGNMENT: Assignment of interest under this Policy shall not bind the Company until its consent is endorsed hereon. CANCELLATION: This Policy may be canceled by the Policyholder by surrendering the Policy to the Company or by mailing to the Company at its Administrative Offices in Wilmington, Delaware, written notice stating when thereafter such cancellation shall be effective. This Policy may be canceled by the Company by mailing to the Policyholder written notice stating when, not less than thirty (30) days thereafter such cancellation shall be effective. The mailing of notice shall be sufficient proof of notice. The time of surrender or the effective date and hour of cancellation stated in the notice shall become the end of the Policy Year. Delivery of such written notice by the Policyholder or by the Company shall be equivalent to mailing. If the Policyholder cancels coverage, earned premium shall be computed in accordance with the customary short rate table and procedure. If the Company cancels coverage, earned premium shall be computed pro rata. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective. Payment or tender of unearned premium is not a condition of cancellation. This Policy will be considered cancelled upon termination of the underlying Benefit Plan. LEGAL ACTION: No action at law or in equity shall be brought to recover on this Policy prior to the expiration of sixty (60) days after written proof of loss has been furnished in accordance with the requirements of this Policy. No such action shall be brought after the expiration of three (3) years after the time written proof of loss is required to be furnished. CONFORMITY WITH STATE STATUTES: If any time limitation of this Policy with respect to giving notice of claim or furnishing proof of loss or bringing action is less than that permitted by the law of the state in which the Policyholder resides, such limitation is hereby extended to agree with the minimum period permitted by such law. 55350TX 9 AIGLIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) ENDORSEMENT 1 This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1, 2000 and expires at the same time as the Policy. It is hereby understood and agreed that in consideration of the premium paid, the policy is amended to include the following additional coverage excluded in Section V - Exclusions, item 13: SPECIFIED ORGAN TRANSPLANT COVERAGE Subject to all conditions and limitations of the policy, the Company agrees to reimburse the Policyholder for Eligible Expenses in excess of the Specified Retention Amount resulting from or directly related to the completion of a kidney, cornea, heart, lung, bone marrow, heart -lung, liver, or pancreas human organ transplant and/or tissue transplant. This Endorsement provides coverage only for Eligible Expenses incurred while this Endorsement is in effect and paid during the Benefit Period. The Company also agrees to reimburse the Policyholder for surgical, storage, and transportation costs directly related to the donation of a human organ used in an organ transplant procedure covered under this rider, subject to a maximum of $10,000 for each organ transplant procedure completed. All benefits provided as stated in this Endorsement are subject to a lifetime maximum of $1,000,000. While this Endorsement is in effect, the coverage provided shall apply to all current and new Covered Units. In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. 53704 President Secretary AIGLIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) It is hereby understood and agreed that: ENDORSEMENT 2 This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1, 2000 and expires at the same time as the Policy. 1. A Claim is deemed to be paid on the date the Policyholder's payment check or draft is issued, provided sufficient funds are then available to cover such payments, and it is: a. placed in the United States mail or other means of delivery to the payee, and b. paid upon presentation. 2. The provisions of Section IV- LIMITATIONS OF COVERAGE Part B "Actively at Work" and "Totally Disabled" are hereby waived for those individuals as reasonably disclosed on the Addendum to Excess Loss Indemnity Application. 3. Prescription Drug Programs, from Section V- Exclusions, Item 2, is included as Eligible Expenses under the Aggregate Excess Insurance. 4. The term "incurred and paid" wherever used in the policy is hereby amended to read "Paid." In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. President Secretary 53705 Page 1 of 2 53705 AIGLIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) ENDORSEMENT 3 This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1 2000 and expires at the same time as the Policy. It is hereby understood and agreed that this group is eligible for Specific Advance Funding under the following guidelines: The administrator may request, on behalf of the Insured, Advance Funding of eligible processed claims when these conditions have been satisfied. 1. Eligible claims paid by the Employer have exceeded an amount equal to or greater than the applicable Specific Retention amount shown in this policy. 2. The Company has received the premium for the month for which the Advance is requested. 3. The Advance requested must be for a minimum of $1,000.00 and must be requested during the policy year or no later than 21 days following the end of the policy period as defined in this contract. 4. Funds advanced under this benefit must be used to pay the providers within 5 working days after receiving the advance. Payment within this time period will be deemed to constitute payment within the Policy Period, even if the actual payment occurs after the end of the Policy Period. If the funds are not used as required within this time frame, the Company reserves the right to require repayment of the advance. Advance funding requests will be processed according to the Company's normal published claim turnaround time. In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. Page 2 of 2 53705 5. Any portion of the advance not used to pay eligible expenses (due to additional discounts or any other reason) must be returned to the Company within 5 days. 6. The Company reserves the right to withhold a portion of The Advance due to discounts, hospital bill audits or Pre- Screen audits. President Secretary AIGLIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1, 2000 and expires at the same time as the Policy. It is hereby understood and agreed that: ENDORSEMENT 4 MONTHLY AGGREGATE BENEFIT Benefit In any month in which the total Claims paid to date exceeds items 1 and 2 below by at least $5,000 the Policyholder may request reimbursement under the Aggregate Excess Benefit. 1. The greater of the year to date cumulative total of the Monthly Aggregate Retention Amount for the Coverage Period, or the year to date prorated Minimum Aggregate Retention Amount, and 2. Any previous reimbursement(s). Conditions The initial request for reimbursement cannot be made prior to the end of the 90 day period following the first day of the Coverage Period. The request for reimbursement must: 1. Be made in writing; and 2. Be made on or before the 21st of the month following the month for which the reimbursement is requested. The Company must have received a report showing the monthly census, the total of the monthly claims paid and the total of the claims paid in excess of the Specific Deductible. Additionally, the Company reserves the right to perform an audit in connection with any request for a reimbursement prior to disbursement. Page 1 of 2 53705 Reconciliation At the end of the Coverage Period, the Aggregate Excess Benefit will be calculated on a year -to- date basis and will be equal to the year -to -date aggregate claims less the greater of (a) the year -to -date Aggregate Retention Amount or (b) the Minimum Aggregate Retention Amount indicated on the Schedule page. If, as a result of the calculation, it is determined that prior reimbursements exceed the amount that would have been payable under the Aggregate Benefit had the reimbursement(s) not been made, the Company, at its option may require repayment of the overpayment or may reduce subsequent reimbursements under the Aggregate or Specific Excess Benefits by the amount of the overpayment. The Policyholder agrees to repay the amount of any overpayment within 60 days of written notice from the Company of the amount due. If repayment is not made within such period, interest at the rate of 10% per annum will be added to the amount due and must be remitted to the Company. Termination If the Policyholder's insurance under the Aggregate Excess Benefit terminates before the end of the Coverage Period, this benefit will automatically terminate. In such a case, the date of termination will be considered the end of the Coverage Period and a determination of any Aggregate Excess Benefit will be made at that time, subject to the Minimum Aggregate Retention Amount shown on the Schedule page. In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. Page 2 of 2 53705 President Secretary AIGLIFE AIG LIFE INSURANCE COMPANY SPECIFIC "Run -Out" Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) ENDORSEMENT 5 This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1. 2000 and expires at the same time as the Policy. It is hereby understood and agreed that: The total amount of "Run -Out" benefits to which Covered Units or Covered Persons become entitled under this Policy shall only include the Eligible Expenses incurred in the Policy Year of 11/01/2000 to 11/01/2001 as defined in Section I Definitions of the Policy, and paid during the period of 11/01/2000 to 02/01/2001, The run -out provision stated above will not be applicable in the event of the termination of this Policy by the Insured prior to the Expiration Date as shown on the Schedule page. In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. 53705 President U// Secretary AIGLIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 (hereinafter called the Company) This endorsement is attached to and made part of Policy No. 316 -0000, written on Form 55350TX, and is subject to all the terms and conditions of the Policy. It takes effect on 1. 2000 and expires at the same time as the Policy. It is hereby understood and agreed that: SPECIFIC and AGGREGATE "RUN -IN" ENDORSEMENT 6 The total amount of "Run -in" benefits to which Covered Persons become entitled under this Policy shall only include the Eligible Expenses incurred on or after 12/01/1999 and received by the Administrator of the Plan for payment. These Eligible Expenses must be picl during the Policy Period of 12/01/2000 to 12/01/2001 as defined in Section I DEFINITIONS of this Policy. In witness whereof, this Endorsement has been signed by the President and Secretary of the Company. 53705 eitatclk President !/fJ Secretary DATE: October 7, 2002 SUBJECT: City Council Meeting — October 10, 2002 ITEM: 13.E.2. Consider a resolution renewing the City's existing excess loss indemnity policy (stop loss reinsurance). Resource: Teresa Bledsoe, Human Resources Director History: The City's self - insured medical plan has three principal components: a health care provider, claims administration, and stop loss reinsurance. The City has selected AIG Life Insurance Company for the stop loss reinsurance. Funding: General Fund, Water/Waster Utility Fund Cost: The cost of this insurance is a function of the number of employees and dependent units covered. Source of funds: City contribution and Employee paid premiums for dependent health care. Impact: The stop loss reinsurance provides coverage for the City's health benefit plan claim payments, which exceed limits the City has chosen to self - insure. Benefit: This coverage protects the City's self - funded plan from catastrophic financial losses. Public Comment: N/A Sponsor: N/A AIG LIFE AIG LIFE INSURANCE COMPANY Incorporated as A CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 Medical Excess, LLC One Macarthur Place Suite 620 South Coast Metro, California 92707 (800) 634 -7462 Mail All Payments To Lock Box Address Of: Medical Excess, LLC Dept. 2173 Los Angeles, CA 90084 -2173 POLICYHOLDER: City of Round Rock POLICYHOLDER ADDRESS: 221 E. Main St., Round Rock, TX 78664 POLICY NUMBER: 467 -4113 POLICY EFFECTIVE DATE: December 1, 2003 POLICY ANNIVERSARY DATE: December 1 of each succeeding year PREMIUM DUE DATE: Premium is due on the Policy Effective Date and the first of each calendar month thereafter. AIG Life Insurance Company (herein called the Company), in consideration of the application made by the Policyholder, attached to and made a part of this Policy, payment of the initial premium on the Effective Date of this Policy, the payment of all subsequent premiums when due, and the continual compliance by the Policyholder with all the terms and conditions of this Policy, agrees to reimburse the Policyholder for certain Plan Benefits the Policyholder has provided under a self- funded benefit plan (Plan). Such reimbursement will be subject to all the terms and conditions of this Policy. All periods of time under this Policy will begin and end at 12:01 A.M. local time at the Policyholder's address. By acceptance of this Policy, the Policyholder (Employer) understands the liability assumed under the portion of the Policyholder's employee benefit plan which is self - insured and further understands that the Policyholder is exempt from Article 1.14 -1 of the Texas Insurance Code (Unauthorized Insurance) only if a qualified employee benefit plan has been filed and meets the requirements of ERISA. IN WITNESS WHEREOF, AIG Life Insurance Company has caused the Policy to be executed as of the Effective Date. M20005 -TX Secretary EXCESS LOSS POLICY President TABLE OF CONTENTS SCHEDULE OF COVERAGES DEFINITIONS SPECIFIC EXCESS LOSS BENEFIT AGGREGATE EXCESS LOSS BENEFIT CLAIMS PROVISIONS EXCLUSIONS AND LIMITATIONS PREMIUMS TERMINATION OF COVERAGE GENERAL PROVISIONS 3 6 9 9 9 11 12 13 14 M20005 -TX 2 of 16 SCHEDULE OF COVERAGES POLICYHOLDER: City of Round Rock POLICYHOLDER ADDRESS: 221 E. Main St., Round Rock, TX 78664 POLICY NUMBER: 467 -4! 13 COVERAGE PERIOD: From December 1, 2003 Through November 30, 2004 Classes of Covered Participants Number of Covered Enrollment at the beginning of the Coverage Period Included Participants Not Included Active Employees and their Eligible Dependents ® 612 ❑ Retired Employees and their Eligible Dependents ® ❑ Disabled Employees and their Eligible Dependents ® ❑ COBRA Employees and their Eligible Dependents ® ❑ Enrollment By Coverage Categories Single Employee 344 Family 268 Benefit Options (Describe all medical plan choices available to all employees during Open Enrollment whether they are included or not included under Stop Loss.) Plan Description Included Not Included Designated Third Party Administrators (TPA(s)): TPA Name TPA Address Great West Life & Annuity PBM #204, 1150 N. Loop 1604 West # 108, San Antonio, TX 78248 Designated Preferred Provider Network(s): PPO Name PPO Address Covered Zips /States Great West Healthcare 13045 Tesson Ferry Rd., St. Louis, MO 63128 TX M20005 -TX 3 of 16 SCHEDULE OF COVERAGES CONTINUED SPECIFIC EXCESS LOSS SPECIFIC COVERAGE: Included Specific Deductible Amount per Covered Participant per Coverage Period: $50,000 Lifetime Limit of Liability per Covered Participant: $950,000 Lifetime Limit of Liability for Mental, Nervous, Drug and Alcohol Abuse: As Stated in the Plan Document. Specific Percentage Reimbursable per Covered Participant: 100% Monthly Premium Rate(s) Payable Per Covered Participant Unit for the Coverage Period: Single Employee S42.59 Family $106.73 MINIMUM PREMIUM: ® Is the greater of 1) the sum of the first four months Premiums and 2) the first month's Premium Multiplied by four. ❑ Not Applicable Specific Benefit Period: Eligible Expenses Incurred from December 1, 2002 through November 30, 2004 and Paid from December 1, 2003 through November 30, 2004. SPECIFIC BENEFITS COVERED NOT COVERED Medical ® ❑ Prescription Drug Plan (Card) ❑ El ENDORSEMENTS INCLUDED NOT INCLUDED Specific Terminal Liability Endorsement ❑ Adjusted Specific Deductible Endorsement ❑ El Experimental/Investigational & Medical Necessity Endorsement ® ❑ Specific Cash Flow Assistance Benefit ® ❑ Aggregating Specific Corridor Endorsement ❑ El ❑ Flat Corridor Amount ❑ Factor ❑ Minimum Corridor Amount ADDITIONS INCLUDED NOT INCLUDED Quota Share ❑ El Hospital Reimbursement Limitation ❑ El EXCLUSIONS INCLUDED NOT INCLUDED Organ and Tissue Transplant Exclusion Endorsement ❑ El M20005 -TX 4 of 16 SCHEDULE OF COVERAGES CONTINUED AGGREGATE EXCESS LOSS AGGREGATE COVERAGE: Included Monthly Aggregate Factors: Single Employee $324.18 Family $849.07 Estimated Annual Aggregate Attachment Point: $4,068,824.00 Minimum Aggregate Attachment Point: $4,068,824.00 Lifetime Limit of Liability for the Coverage Period $1,000,000 Maximum Eligible Expenses per Covered Participant accumulating toward the Aggregate Excess Loss Benefit $50,000.00 Aggregate Percentage Reimbursable: l00% AGGREGATE PREMIUM PAYABLE: Per Employee Per Month of: $3.58 MINIMUM PREMIUM: Is the greater of 1) the sum of the first four months Premiums and 2) the first month's Premium Multiplied by four. ❑ Not Applicable Aggregate Benefit Period: Eligible Expenses Incurred from December 1, 2002 through November 30, 2004 and Paid from December 1, 2003 through November 30, 2004. Aggregate Benefits Medical Prescription Drug Dental Vision Weekly Income OPTIONAL AGGREGATE ENDORSEMENTS: ❑ Monthly Aggregate Protection Endorsement Premium: ❑ Premium Rate Per Employee Per Month: ❑ Included In Above Aggregate Premium ❑ Annual Premium: ❑ Aggregate Terminal Liability Endorsement Premium: ❑ Premium Rate Per Employee Per Month: ❑ Included In Above Aggregate Premium ❑ Annual Premium: M20005 -TX 5 of 16 Covered Not Covered 0 ® ❑ ® ❑ O El O El DEFINITIONS ACTIVELY AT WORK means: 1. With respect to an Eligible Employee -- the employee is present on a full -time basis (as defined in the Policyholder's Plan) and is capable of performing his/her normal job duties. Persons absent from work due to regularly scheduled vacation or maternity leave will be considered Actively at Work. 2. with respect to an Eligible Dependent — the Dependent is able to perform all the normal activities of a person in good health of the same age and sex and is not being confined in a provider facility because of injury or sickness. Persons not Actively At Work on the date of the Excess Loss Disclosure Statement is executed who are required to be disclosed but have not been disclosed on the Excess Loss Disclosure Statement will not be considered a Covered Participant under the Policyholder's Plan for the purposes of this Policy. ADJUSTED SPECIFIC DEDUCTIBLE means the amount shown on the Adjusted Specific Deductible Endorsement and is the amount of expense that the Policyholder is responsible to pay before Excess Loss benefits are reimbursable under the Policy. The Adjusted Specific Deductible applies separately to each Covered Participant shown in the Adjusted Specific Deductible Endorsement. ANNUAL AGGREGATE ATTACHMENT POINT means for the Coverage Period, or any portion of the Coverage Period, the amount of the Eligible Expenses that the Policyholder is responsible to pay. The Annual Aggregate Attachment Point must be met in each Coverage Period and will be determined at the end of each Coverage Period. It is equal to the greater of the cumulative total of the Monthly Aggregate Attachment Points for the Coverage Period and the Minimum Aggregate Attachment Point. If this Policy is terminated before the end of the Coverage Period the Company will not pro -rate the Annual Aggregate Attachment Point. BENEFIT OPTIONS are shown on the Schedule of Coverages and include all medical plan choices available to the participants in the Plan during an Open Enrollment period. BENEFIT PERIOD is shown on the Schedule of Coverages and means the period of time in which an Eligible Expense must be incurred by the Covered Participant and Paid by the Plan to be eligible for reimbursement under this Policy. This period does not alter the Policy Effective Date and Coverage Period, nor does it waive the eligibility requirements of this Policy. If the Policy is terminated prior to the end of the Coverage Period the Benefit Period ends on the termination date. CLAIMS means requests for reimbursement made by the Policyholder for Eligible Expenses incurred by a Covered Participant, which are processed by the Third Party Administrator, paid by the Policyholder according to the terms of the Plan Document and eligible for reimbursement under this Policy. Claims will only include payments for Covered Benefits that are covered in the Plan Document and are included in the Schedule of Coverages. Claims will not include any amounts paid for expenses or charges listed in the Exclusions and Limitations sections of the Policy. CLAIM INCURRED DATE means the date a service or supply is provided to the Covered Participant, or the dates of a rental period but excluding dates beyond the end of the Coverage Period. With respect to disability income benefits (if disability income benefits are included as Covered Benefits) Claim Incurred Date means the date each periodic benefit payment is payable to the Covered Participant but excluding dates beyond the end of the Coverage Period. CLAIM PAID DATE means the date which is printed on the Policyholder's payment check or draft, provided: • sufficient funds are then available to cover such payments, and • both occur within the Benefit Period, and • the check or draft is placed in the United States mail, or is electronically deposited directly to the payee, within the Benefit Period, and • is payable upon presentation. If the above conditions are not satisfied the Claim Paid Date will be the first date that all of the above conditions have been satisfied. COVERAGE PERIOD means the period shown in Schedule of Coverages during which the Company will be liable for Claims. A Coverage Period begins at 12:01 A.M., on the Policy Anniversary Date. In no event will a Coverage Period extend beyond the date Excess Loss Insurance under this Policy terminates. M20005 -TX 6 of 16 COVERED PARTICIPANT means an individual covered under the Plan who is covered under one of the Benefit Options included under this Policy as shown in the Schedule of Coverages. Covered Participants may include a covered employee; a covered dependent of a covered employee; a participating COBRA continuee and his or her dependents; and a covered retiree and his or her dependents. All classes of Covered Participants will be indicated on the Application form included as part of this Policy and will be included on the Schedule of Coverages. Any person the Company could reasonably have expected to be disclosed but who was not disclosed by the Policyholder and the TPA (or Broker) in the Excess Loss Disclosure Statement will not be a Covered Participant under the Plan for the purposes of this Policy. The Claims of a Covered Participant who becomes covered under the Policyholder's Plan after the Policy Effective Date will be Covered under this Policy on the date the Covered Participant is covered under the Plan provided the Covered Participant is eligible for benefits by the terms of the Plan and is Actively At Work on such date. If a Covered Participant is not Actively At Work on such date, coverage under this Policy will not be effective until the Covered Participant is again Actively At Work. It is further understood that an individual who becomes a Covered Participant by changing benefit options to a Benefit Option included under this Policy from a Benefit Option not included through an open enrollment process during the Coverage Period will not be considered eligible for coverage under this Policy until the Company has received notification of the change and has approved the Covered Participant for coverage under this Policy. Coverage for expenses incurred by a Covered Participant, other than a COBRA continuee, who is not Actively At Work on the date the Excess Loss Disclosure Statement is executed shall be limited to the length of time specified in the Policyholder's Plan Document on file with the Company. In no event, however, shall coverage extend beyond the end of the Benefit Period. These individuals must be disclosed prior to the Policy Effective Date in order to be considered eligible for coverage under this Policy. Failure to disclose will result in the denial of all such coverage provided by this Policy for those individuals meeting the above definition. COVERED PARTICIPANT UNIT means one employee if the employee has no dependents. If the employee has dependents, Covered Participant Unit means the employee together with the dependents. The Company and the Policyholder may agree to another definition of a Covered Participant Unit. Covered Participant Units are used to calculate the Annual Aggregate Attachment Point. Coverage for a single day will be considered covered for the entire month for the purposes of calculating the aggregate attachment. DISCLOSURE means the disclosure forms completed and signed by the Policyholder and the TPA (or Broker) and attached to and made a part of this Policy. For a renewed Policy, claim information (including paid claims, known illnesses, case management records and other requested information) provided in lieu of the completed Disclosure form will constitute Disclosure for purposes of renewal. Disclosure information must be provided in a timely manner. Non - Disclosure will result in the need to re- underwrite and/or deny coverage. ELIGIBLE EXPENSES means those expenses which the Policyholder is required to pay in accordance with the Plan Document to a Covered Participant or to another person for providing a service or tangible product to a Covered Participant in treatment of an illness or injury; or, for a period of total disability because of illness or injury, if disability income benefits are provided by the Plan Document and are covered by this Policy, as shown in the Schedule of Coverages. Eligible Expenses do not include expenses that are in excess of, or not covered by, the Plan; or, are specifically excluded or limited by this Policy, the Schedule of Coverages, any Endorsements, or any Amendments. Eligible Expenses do not include any payment for the cost,of administering the Plan. EXPERIMENTAL/INVESTIGATIONAL has the meaning as defined in the Plan. If there is no definition in the Plan, then, for the purposes of this Policy, the meaning shall be as given in the Experimental/Investigational & Medical Necessity Endorsement attached to and made a part of this Policy. While the determination of benefits under the Plan is the sole responsibility of the Policyholder, the Company reserves the right to interpret the terms and conditions of the Plan as it applies to this Policy. The Company will make a final determination as to whether a service or supply is Experimental/Investigational under this Policy. LARGE CLAIM means paid and/or pending Eligible Expenses equal to or greater than 50% of the Specific Deductible. MAXIMUM REIMBURSEMENT means the Specific Lifetime Limit of Liability per Covered Participant for the Specific Excess Loss benefit and the Aggregate Limit of Liability for the Coverage Period for the Aggregate Excess Loss benefit as shown in the Schedule of Coverages. M20005 -TX 7 of 16 MEDICALLY NECESSARY or MEDICAL NECESSITY has the meaning as defined in the Plan. If there is no definition in the Plan, then, for the purposes of this Policy, the meaning shall be as given in the ExperimentaUInvestigational & Medical Necessity Endorsement attached to and made a part of this Policy. While the determination of benefits under the Plan is the sole responsibility of the Policyholder, the Company reserves the right to interpret the terms and conditions of the Plan as it applies to this Policy. The Company will make a final determination as to whether a service or supply is Medically Necessary under this Policy. MINIMUM AGGREGATE ATTACHMENT POINT means the amount shown in Schedule of Coverages. This amount is the lowest possible Attachment Point for the applicable Coverage Period. If coverage under this Policy terminates before the end of the Coverage Period, the Company will not prorate the Minimum Aggregate Attachment Point. MINIMUM PREMIUM is defined on the Schedule of Coverages. The Minimum Premium must be paid prior to the termination date if this Policy is terminated prior to the end of the Coverage Period. If the Policy terminates prior to the end of the Coverage Period and the Minimum Premium has not been paid by the termination date the Company may, at its option, either offset the shortfall in the actual premiums paid against any claims submitted for reimbursement, or rescind the Policy, or seek the required Minimum Premium through a collection agency. If the Policy is rescinded the Company will refund the excess of the actual premiums paid over actual claim reimbursements within thirty (30) days of the termination date. If actual claim reimbursements exceed the actual premium paid the Policyholder will pay to the Company the excess of claims reimbursed over premiums paid within thirty (30) days of notice by the Company. If repayment in full is not made within this thirty day period, the Company will be entitled to assess monthly a late payment fee equal to 0.5% per month (6% per annum) of the outstanding balance. MONTHLY AGGREGATE ATTACHMENT POINT means the amount calculated monthly by multiplying the appropriate Monthly Aggregate Factors by the corresponding Covered Participant Units for the month. PAID CLAIM means an Eligible Expense paid by the Claim Paid Date. PLAN means the Policyholder's self- funded benefit plan as described in its Plan Document, to or on behalf of Covered Participants, and approved for attachment herein, by the Company. A copy of the plan document is attached to this Policy for the purpose of determining the Company's liability under this Policy. The Plan must be in effect on the Policy Effective Date. No changes to the Policyholder's Plan, including the Designated Third Party Administrator(s) or the Preferred Provider Organization(s), will be recognized by this Policy without prior notification to, and written approval by, the Company. A change in the Plan may result in a change in premium, factors, percentages, limits or maximum amounts as set forth in the Schedule of Coverages or termination of this Policy. PLAN BENEFITS means eligible amounts properly Incurred and Paid under the Plan to a Covered Participant or to a provider of services to a Covered Participant, PLAN DOCUMENT means the Summary Plan Description and other information as required by ERISA. POTENTIAL LARGE CLAIM means any Eligible Expense resulting from a condition, or event, included in the list of Potential Large Claims shown in the Claims Provision section of this Policy whether or not any Eligible Expenses have actually been paid. REIMBURSEMENT PERCENTAGE means the percentage of paid claims which the Company will reimburse the Policyholder as shown in the Schedule of Coverages. Separate reimbursement percentages may apply to the Aggregate Excess Loss benefit and to the Specific Excess Loss benefit. SPECIFIC DEDUCTIBLE means the amount of expense that must be wholly paid by the Policyholder with respect to each Covered Participant, (or Covered Family, if the Family deductible option is shown on the Schedule of Coverages) for each Coverage Period before Excess Loss benefits are reimbursable under the Policy. It is shown in the Schedule of Coverages. This amount applies separately for each Coverage Period. FAMILY SPECIFIC DEDUCTIBLE means the amount of Eligible Expenses which must be paid by the Plan for any Covered Family member or combination of Covered Family members for each Coverage Period before Specific Excess Loss benefits are reimbursable under the Policy. It is shown in the Schedule of Coverages. THIRD PARTY ADMINSTRATOR means a firm or person which has been retained by the Policyholder to be the Policyholder's agent and attomey -in -fact to pay claims in accordance with the Plan Document and/or provide other administrative services on behalf of the Policyholder's Man. M20005 -TX 8 of 16 SPECIFIC EXCESS LOSS BENEFIT The Schedule of Coverages indicates whether Specific Excess Loss insurance is provided under this Policy. If, while this Policy is in effect, the Eligible Expenses for a Covered Participant for the applicable Benefit Period exceed the Specific Deductible, the Company will reimburse the Policyholder, subject to the terms and conditions of this Policy including the limits set forth in the Schedule of Coverages, within sixty (60) days after: • the Company's acceptance of the proof of loss as a satisfactory proof; the Company's receipt of proof of payment of the benefits by the Policyholder under the Plan to, or on behalf of, the Covered Participant, which payment by the Policyholder is expressly agreed to be a condition precedent to reimbursement; and the completion of an audit of the claim, if requested by either the Policyholder or the Company. The amount of the reimbursement will be equal to the Specific Percentage Reimbursable times the amount by which Claims exceed the Specific Deductible amount, but will not exceed the Lifetime Limit of Liability. The Company will not reimburse any expenses that are in excess of the Plan's lifetime maximum, if any. For purposes of determining whether such Lifetime Limit of Liability or the Plan's lifetime maximum have been exceeded, Eligible Expenses incurred or paid in all prior periods are included. Claims for any Covered Participant during the Coverage Period will be determined according to the terms of the Benefit Period as listed in the Schedule of Coverages. The Specific Deductible applies separately to each Covered Participant (or Covered Family, if the Family deductible is shown on the Schedule of Coverages) during a Benefit Period. AGGREGATE EXCESS LOSS BENEFIT The Schedule of Coverages indicates whether Aggregate Excess Loss insurance is provided under this Policy. If the Eligible Expenses for the applicable Benefit Period (subject to the Maximum Eligible Expenses per Covered Participant accumulating toward the Aggregate Excess Loss benefit) exceed the Annual Aggregate Attachment Point for the Coverage Period, the Company will reimburse the Policyholder (subject to the terms and conditions of this Policy including the limits set forth in the Schedule of Coverages) within sixty (60) days after: • The Company's acceptance of proof of loss as satisfactory proof; and • The Company's receipt of proof of payment of Eligible Expenses under the Plan; and • Completion by the Company, or its designee, of a satisfactory on -site audit of the Claims, eligibility and all records relevant to a claim under the Aggregate Excess Loss benefit, if the Company elects to do so. The amount of the reimbursement will be equal to the Aggregate Percentage Reimbursable times the amount by which Claims exceed the Annual Aggregate Attachment Point, but will not exceed the Limit of Liability for the Coverage Period. CLAIMS PROVISIONS Claims Administration The TPA will be the Policyholder's agent in performing duties under this Policy and will not be the agent of the Company. The Company will not be held liable for any act or omission of the TPA. The Company will only reimburse the Policyholder for claims paid by the TPA that are paid in accordance with the Plan. The TPA, acting on behalf of the Policyholder, under the Policyholder's Plan, shall: • Audit, calculate and pay all Eligible Expenses in accordance with the Policyholder's Plan. • Provide the Company with periodic reports, including monthly reports of Eligible Expenses paid. The monthly report shall provide the following information: • Eligible Expenses paid; • Eligible Expenses pending; and Number of Covered Participants or Covered Participant Units in each category shown on the Schedule of Coverages. • Report the following events within 10 days of their occurrence: • Notice of Eligible Expenses that reach 50% of the Specific Deductible; and • Potential Large Claims M20005 -TX 9 of 16 Maintain a monthly record of expenses not covered by the Plan and expenses paid for by the Plan but excluded from Eligible Expenses under this Policy. Management of Large Claims The Policyholder or the TPA must notify the Company in writing within ten (10) business days of receiving information indicating that Eligible Expenses qualify as a Large Claim or Potential Large Claim. If the Policyholder receives information that any Claim may be or become a Large Claim, the Policyholder will immediately notify the TPA. Medical Management The Policyholder agrees to famish clinical information about Covered Participants who could incur or have incurred actual claims under this Policy when requested by the Company. The Company will make available to the Policyholder and the TPA, without obligation, preferred services to benefit the Plan and its Covered Participants. The Policyholder agrees to allow the Company to identify and offer services that would benefit the Policyholder's Covered Participants. If the Company recommends alternative care and treatment that is not provided for in the Plan and the Policyholder allows charges for such recommended care and treatment to be considered eligible under the Plan, then charges will be considered Eligible Expenses under this policy. Notice of Excess Loss Claims • Aggregate Excess Loss Claim. The Policyholder will give written notice to the Company within thirty-one (3I) days of the date Eligible Expenses have reached the Annual Aggregate Attachment Point. Specific Excess Loss Claim. The Policyholder will give written notice of individual Specific Excess Loss claims to the Company within thirty -one (31) days of the date the Eligible Expenses, with respect to a Covered Participant (or Covered Family), have reached the Specific Deductible for the Benefit Period. Notwithstanding the above, failure to furnish written notice within the time required shall neither invalidate, nor reduce, any Claim if it was not reasonably possible to give such written notification within such time. In such case written notification must be furnished as soon as reasonably possible but in no event later than six (6) months after the date that written notification of Plan benefit payment is otherwise required (the `Final Notification Date "). No request for reimbursement under this Policy shall be considered unless the Policyholder has notified the Company as required above. The reimbursement request must be received by the Company in writing no later than the later of the Final Notification Date, referenced above, and six months after the last day of the Benefit Period. Notice of Appeal by Covered Participant If a Covered Participant appeals a denial, or limitation, of benefits under the Plan and such benefits, had they been considered covered by the Plan, would result in a Claim under this Policy then the Policyholder must give immediate notice of the appeal to the claims department of the Company. Determination of Benefits While the determination of benefits under the Plan is the sole responsibility of the Policyholder, the Company reserves the right to interpret the terms and conditions of the Plan as it applies to this Policy. The Company has the sole authority to approve or deny reimbursements under this Policy. Potential Large Claims The Company will not reimburse the Policyholder for Eligible Expenses incurred by Covered Participants that qualify as Potential Large Claims, unless disclosed and accepted by the Company. In the event of non - disclosure by the Policyholder, the Company reserves the right to change or modify the premium rates, Monthly Aggregate Attachment Factors, or Specific Deductible amount(s) or adjust the teens of the Aggregate and Specific Excess Loss benefits. List of Potential Large Claims: Eligible Expenses for conditions which qualify as Potential Large Claims are listed below. The Company retains the right to add or delete from the list of Potential Large Claims with thirty (30) days advance written notice to the Policyholder: • Transplants, whether completed or anticipated • Dialysis, home infusion or injection therapy other than insulin or vitamins • Cancer, Brain Tumor • Multiple Trauma or Severe Burns • High Risk Maternity/ Premature Birth • Brain or spinal cord injury M20005 -TX 10 of 16 • Severe Stroke • Morbid obesity/ Gastric Bypass • Acquired Immune Deficiency Syndrome Cardiac/ Circulatory/ Pulmonary Disorders Degenerative Muscular/ Neurological Disorders Diabetic Complications Hemophilia/ Bleeding Disorders Acute/ Chronic Renal Ventilator Assisted Individuals Any inpatient confinement greater than seven (7) days including acute rehabilitation or skilled nursing care Audit The Company shall have the right to inspect and audit all records and procedures of the Policyholder, the TPA, and any other organization involved in the administration or processing of claims. The Company may require, upon request, proof of records satisfactory to it that payment has been made to the provider of such services or supplies which are the basis for any claim reimbursable under this Policy. Subrogation If the Policyholder is entitled to recover from third parties for benefits paid under the Plan, such amounts cannot be used to satisfy either the Specific Deductible or Annual Aggregate Attachment Point. The Company will not reimburse the Policyholder for any Eligible Expense recovered from a third party. If the Company has reimbursed the Policyholder for all or part of an Eligible Expense and the Policyholder later recovers any part of the Eligible Expense from a third party, the Policyholder must repay the Company to the extent of the Company's reimbursement regardless of whether the Policy is still in force on the date of recovery. The Policyholder's repayment may be reduced by reasonable and necessary expenses incurred in recovering from the third party. If the Policyholder fails to pursue a valid claim for an Eligible Expense against a third party and the Company is required to reimburse the Policyholder for such Eligible Expense, the Company shall be subrogated to the Policyholder's rights to pursue the Claim. Any amount the Company recovers shall first be used to pay the Company's expenses of collection and then applied toward any amount the Company paid or is required to pay to the Policyholder under the Policy. Any remaining amount will be paid to the Policyholder. EXCLUSIONS AND LIMITATIONS The Company will not reimburse the Policyholder for expenses that: 1. have been reimbursed by another company or reinsurance company or are reimbursable under a government or privately supported medical research program; 2. are not incurred and paid during the Benefit Period; 3. exceed the Lifetime Limit of Liability (for Specific Excess Loss) or the Limit of Liability (for Aggregate Excess Loss); 4. have been excluded, or adjusted, under the terms of the Adjusted Specific Deductible Endorsement or the Aggregating Specific Corridor Agreement; 5. are for any injury or illness arising out of, or m the course of, any employment for wage or profit for which the Covered Participant is entitled to benefits under any Workers Compensation or occupational disease policy whether or not such policy is actually in force; 6. are for the cost of administration of claims, investigation expenses, payments or other services provided by the TPA, consulting fees, or any other fees or expenses incurred by the Plan that are not defined as Plan Benefits: 7. are recoverable from any person responsible for causing the injury or sickness which gave rise to the benefit provided under the Plan or from any other company or other organization providing benefits or services for the injury or sickness which gave rise to the benefits under the Plan. If a Covered Participant is eligible for Medicare, as their primary payor, benefits under this Policy will be reduced by the amount of any Medicare benefits received by the Covered Participant so that total reimbursement will not exceed I00% of the Covered Participant's actual Eligible Expenses; 8. are payments for treatment or services which are considered Experimental or Investigational as defined in the Plan or as defined in the ExperimentaV Investigational & Medical Necessity Endorsement if not defined in the Plan; 9. are any amount in excess of the amount payable under the Plan; 10. are caused by or result from war, declared or undeclared, invasion, acts of foreign enemies, hostilities, civil war, rebellion, insurrection, military or usurped power, or martial law or confiscation by order of any government or public authority; M20005 -TX l l of 16 11. are for legal fees or expenses related to litigation with claimants under the Policyholder's Plan including but not limited to compensatory, punitive, exemplary or extra contractual damages, fines or statutory penalties; 12. are payments for treatment or services which are not Medically Necessary as defined in the Plan or as defined in the Experimental/ Investigational & Medical Necessity Endorsement if not defined in the Plan; 13. result from dental, vision, prescription drugs, hearing care or weekly income unless specifically included in the Schedule of Coverages; 14. are incurred by any affiliate or subsidiary company of the Policyholder not included in the Policy at issue, unless specifically added by Rider, Letter of Agreement, or Endorsement; 15. are paid in accordance with amendments, endorsements, letters of agreement to the Plan prior to the date such documents are approved by the Company in writing; 16. are incurred by the Policyholder for non - compliance with any legal statute or regulation; 17. are incurred for the treatment of any illness or injury resulting from mental and nervous disorders, alcohol or drug abuse when such expenses exceed the Lifetime Maximum or Policy limitations for such disorders as shown in the Schedule of Coverages; or 18. are in excess of the usual and customary charges, as referenced in the Plan, for the service or supply in the locality where such service or supply is received regardless of any preferred provider contract that exists with the provider of such service or supply. PREMIUMS Payment of Premiums The Policyholder, or the TPA (if instructed by the Policyholder), must pay all premiums to the Company lock box at the lock box address shown on the cover page of this Policy on or before the Premium Due Date. Subject to the Grace Period, coverage will terminate if a premium is not paid when due. Premiums are shown on the Schedule of Coverages. Grace Period The Company will allow a Grace Period of thirty -one (31) days for payment of each premium except the fast. If the Policyholder does not pay the premium due within the Grace Period, insurance under this Policy will terminate as of the Premium Due Date for the unpaid premium. Minimum Premium The Minimum Premium, as stated in the Schedule of Coverages, must be paid prior to the termination date if this Policy is terminated prior to the end of the Coverage Period. Reimbursements under this Policy may be limited and coverage under this Policy may be rescinded entirely if the Minimum Premium is not paid. The Minimum Premium requirement only applies if the Policy is terminated prior to the end of the Coverage Period. The limitations on reimbursements and coverage are listed in the Effect of Termination provision in the TERMINATION OF COVERAGE section of this Policy. Premium Taxes If by present or future law, administrative ruling or judicial decision, premium taxes are ever assessed against the Policyholder or the Company with respect to Claims paid under the Policyholder's Plan, the Policyholder will save and hold harmless the Company from such premium tax liability. The Policyholder will reimburse the Company for the amount of such premium tax liability plus any other interest penalty or cost incurred by the Company on account of such premium tax assessment. Such reimbursement will be due and payable by the Policyholder at the end of each Coverage Period for any tax expense determined by the Company. Renewal Rating Provision The Company has the right to establish new Premium Rates and Monthly Aggregate Factors on each Policy Anniversary Date. The Company will provide the Policyholder advance written notice of any change in Premium Rates or Monthly Aggregate Factors at renewal no later than thirty -one (31) days prior to the Policy Anniversary Date or within thirty-one (31) days after the Company receives the required claims and enrollment data needed for the renewal, if later than thirty -one (31) days prior to the Policy Anniversary Date. Changes in Premium Rates and Monthly Aggregate Factors The Company reserves the right to change the Premium Rates and/or the Monthly Aggregate Factors for a Coverage Period (retroactive to the beginning of the Coverage Period) if the average Paid Claims for the last two Coverage Months of the immediately preceding Coverage Period exceeds 125% of the average Paid Claims for all other prior Coverage Months in that preceding Coverage Period. M20005 -TX 12 of 16 The Company has the right to establish new Premium Rates and/or new Monthly Aggregate Factors at any time during a Coverage Period if: the number of enrolled Covered Participant Units changes by more than 25% from the Enrollment shown on the Schedule of Coverages; the number of enrolled Covered Participant Units changes by more than 25% in any three consecutive month period; the number of enrolled Covered Participant Units changes by more than 15% in any one month; the Company discovers an individual who it could reasonably have expected to be disclosed and who was not disclosed and whom the Company determines to be an unacceptable risk; an amendment (change) is made to the Plan, including a change in the Preferred Provider Organization(s) or TPA(s); or a change in the terms of the Excess Loss coverage occurs. TERMINATION OF COVERAGE By the Policyholder The Policyholder may terminate this Policy on any Premium Due Date by giving the Company at least thirty -one (31) days written notice. The Minimum Premium must be paid by the Policyholder prior to the termination date. The cancellation will be effective on the earlier of the end of the period for which the Group has paid premiums or the next Premium Due Date. By the Company The Company may terminate this Policy by giving the Policyholder 3l days written notice. The effective date and hour of cancellation stated in the notice shall become the end of the Coverage Period. The Company can only terminate this Policy for the following reasons: I. it is determined that the Policyholder has failed to perform any of its duties or obligations under this Policy; or 2. a petition in bankruptcy is filed with respect to the Plan or the Policyholder, whether voluntary or involuntary, or the Plan, or the Policyholder, becomes subject to liquidation, receivership or conservatorship; 3. the percentage of employees participating in one or more Health Maintenance Organizations, prepaid plans, or insurance plans exceeds 40% of employees eligible to participate in the Plan, unless the Company has agreed in writing to continue coverage; or 4. the Policyholder fails to provide the information required in the Excess Loss Disclosure Statement. Automatic This Policy will automatically terminate without notification required upon the earliest of the following dates: L the date of the Policyholder's Plan terminates; or 2. the date the Policyholder fails to: (a) provide money when needed for the timely payment of claims under the Plan, (b) renew insurance under this Policy; or (c) maintain the agreement with the TPA(s) stated on the application, or with a TPA(s) approved in advance by the Company; or 5. at the end of any Grace Period when the premium due remains unpaid; or 6. the date the Plan is found to be in violation of Federal law; or 7. the date the Group ceases to meet the underwriting regulations for this coverage in force on the effective date of this Policy; or 8. sixty (60) days after the Policy Effective Date if the Policyholder has failed to furnish the Company with any information or materials requested by the Company. Such information or materials must be of reasonable nature to allow the Company to determine its liability under this Policy. If the Policy is terminated for this cause, the Company's sole liability will be to return any monies given by the Policyholder as consideration for this Policy less other expenses paid by the Company under this Policy. If such amounts paid by the Company are greater than the amounts paid by the Policyholder, the Policyholder shall pay the amount of the deficit to the Company within thirty days of notice from the Company. If repayment in full is not made within this thirty day period, the Company will be entitled to assess monthly a late payment fee equal to 0.5% per month (6% per annum) of the outstanding balance. If a Covered Participant makes a material misrepresentation on a claim for benefits under the Plan, the Company will not reimburse the Policyholder for payments resulting from such misrepresentation. If a Covered Participant ceases to meet the Plan's definition of an "eligible person" or a "dependent,' that Covered Participant's expenses are not eligible for reimbursement. M20005 -TX 13 of 16 Ineligibility of a Covered Participant's coverage ends the Covered Participant's and the Covered Participant's dependents' coverage under this Policy, effective on the date of ineligibility. Ineligibility of a dependent's coverage ends the dependent's coverage and rights under the Policy, effective on the date of ineligibility. Effect of Termination The Company will not refund any portions of premium paid by the Policyholder whose Policy or Plan terminated during the Coverage Period, provided the Minimum Premium has been paid to the Company by the termination date, except as described above. The Company has no obligation to reimburse the Policyholder for any Plan Benefits, which are incurred after the date this Policy is terminated. If the Policy terminates prior to the end of the Coverage Period and the Minimum Premium has not been paid by the termination date the Company may, at its option, either offset the shortfall in the actual premium against any claims submitted for reimbursement, or rescind the Policy, or seek the required Minimum Premium through a collection agency. If the Policy is rescinded the Company will refund the excess of the actual premiums paid over the actual claim reimbursements within thirty (30) days of the termination date. If actual claim reimbursements exceed the actual premiums paid the Policyholder will pay to the Company the excess of claims reimbursed over premiums paid within thirty (30) days of notice by the Company. If repayment in full is not made within this thirty day period, the Company will be entitled to assess monthly a late payment fee equal to 0.5% per month (6% per annum) of the outstanding balance. Renewal The Company may choose not to renew the Policyholder's coverage under this Policy by giving the Policyholder thirty-one (31) days advance written notice. Otherwise, the Company will send a renewal offer to the Policyholder. It will outline the premium rates, aggregate factors, and policy terms for the next Coverage Period. The renewal will be effective only if the Policyholder accepts such offer in writing in accordance with the Policy's terms and conditions. GENERAL PROVISIONS Assignment Assignment of interest under this Policy shall not bind the Company until its consent is endorsed hereon. Amendments to the Policy This Policy may be amended if requested in writing and the Company approves it, however, no such amendment shall be effective unless confirmed by an endorsement issued to form a part of this Policy. The endorsement must be signed by the Company's President or by one of its Vice Presidents. No other person may amend the Policy or waive any provision. Bankruptcy and Insolvency In the event of bankruptcy or insolvency of the Policyholder or the Plan, and for purposes of claim payment under this Policy, such bankruptcy or insolvency shall not relieve the Company of its obligation to pay claims otherwise payable to the Policyholder in accordance with the terms, conditions, limitations and exclusions of this Policy. Any requirement in the Policy relating to the actual payment of benefits by the Policyholder under its Plan shall not apply for purposes of this provision. Any such claim payment under this Policy as a result of this provision will be made to the liquidator, receiver, trustee, successor, or such other entity as named by federal or state authority governing such transition. Changes Notice to any broker or agent or knowledge possessed by any broker or agent or by any other person shall not effect a waiver or a change in any part of this Policy or stop the Company from asserting any right under the terms of this Policy; nor shall the terms of this Policy be waived or changed, except by endorsement issued to form a part of this Policy. Changes in Policyholder's Plan or TPA Agreement or Preferred Provider Organization The Policyholder will provide the Company with a signed copy of all Plan documents (i.e. booklets, brochures, sub -group variations, etc.) prior to the effective date of insurance under this Policy. The Policyholder must promptly provide the Company with written notice of any changes in the Policyholder's Plan. The Company reserves the right to refuse to apply this Policy to any change in the Plan unless and until the Company has approved the change, and only to the extent provided in an endorsement issued by the Company to become part of this Policy, and the Policyholder has agreed to pay any changes in the premium rate and has agreed to any changes in the coverage terms required by the Company to accommodate the change in the Plan. If the Company cannot reach an agreement with the Policyholder with respect to the Plan change, the change will not affect insurance under this Policy and the Policy will be administered as if the Plan had not changed. M20005 -TX 14 of 16 At the time that the Policyholder provides the Company with the Plan documents, the Policyholder will provide the Company with a copy of the written agreement between the Policyholder and the TPA(s) The Policyholder shall provide the Company with a copy of any and all changes to such agreement(s) prior to their effective date. The TPA(s), and the Preferred Provider Organization(s), named in the application and/or endorsements to this Policy cannot be changed without the Company's written consent. A TPA, or a Preferred Provider Organization, not approved by the company, may result in modification or termination of this Policy. Clerical Error Clerical error, whether by the Policyholder or by the Company, in keeping any records pertaining to the coverage, will not invalidate coverage otherwise validly in force or continue coverage otherwise terminated. Any clerical error in data that the Policyholder or TPA provides to the Company must be corrected and promptly reported to the Company. The Company will then make an appropriate adjustment in the premiums due or the claims eligible for reimbursement under this Policy. Any refund in premiums that may be due from the Company as a result of clerical error by the Policyholder are limited to the twelve month period prior to the date of request for refund. Conformity With State Statutes While the determination of benefits under the Plan is the sole responsibility of the Policyholder, the Company reserves the right to interpret the terms and conditions of the Plan as it applies to this Policy. This Policy will be interpreted in accordance with the laws of the state where it is issued. If any provision of this Policy conflicts with that law, it will be amended so as to conform. Data and Records The Policyholder and TPA must maintain all records the Company requires and provide the Company monthly with all reasonable data requirements relating to Covered Participants when requested in writing by the Company. The Company or its duly authorized representative has the right to inspect and copy these records and data that relate to this Policy at any reasonable time. Non - disclosed Data This Policy is issued by the Company in reliance upon the Application for Insurance Coverage and the Excess Loss Disclosure Statement, both of which have been executed by the Policyholder and are attached and made a part of this Policy. If this Policy is a renewal, the Company may at its option issue the renewal in reliance upon Claim Information provided by the Policyholder and the TPA without requiring a signed Disclosure Statement. Failure by the Policyholder to disclose on the Disclosure Statement or, in the case of a renewal (if waived by the Company), on the Claims Information submitted in lieu of the Disclosure Statement, individuals for whom disclosure was required will result in the denial of all coverage under this Policy for such individuals. Entire Contract and Misstated Data The entire contract consists of this Policy, the Schedule of Coverages, the Plan Document, application(s), endorsements, riders, letters of agreement issued by the Company, Disclosure Statements and the claim information supplied by the Policyholder, or TPA, in lieu of Disclosure Statements during the renewal process. The Company has relied on information provided by the Policyholder directly or through its TPA in the underwriting of the insurance provided by this Policy. The Policyholder agrees that this information is true and complete. If the Company discovers that this information is not true and complete and if the true and complete information would have affected the premium rate, or any term or condition of the contract, the Company may revise the rates, or any term or condition of the contract, or may terminate this contract by notifying the Policyholder. Legal Action No action at law or in equity shall be brought by the Policyholder to recover on this Policy within sixty (60) days after written proof of loss has been furnished. No action at law or in equity may be brought after two years from the time written proof of loss is required to be furnished. Notice For the purposes of any notice required from the Company under the provisions of this Policy, notice to the last known TPA shall be considered notice to the Policyholder. Notice to the Policyholder will be considered notice to the TPA. Other Coverage or Benefits Payable If any other coverage exists protecting the Policyholder in whole or in part against losses covered by this Policy, the insurance provided by this Policy will apply in excess of such other coverage. Other coverage includes, but is not limited to, group insurance, excess insurance, reinsurance or plan benefits, including insurance or plan benefits established by any federal, state or local law. M20005 -TX 15 of 16 Parties to Policy Except for the provisions relating to the TPA, this Policy involves only the Policyholder and the Company. The Policy does not create any legal relationship between the Policyholder and a Covered Participant or beneficiary under the Policyholder's Plan nor does it create a legal relationship between the Company and a Covered Participant or beneficiary under the Policyholder's Plan. Recovery of Funds Should the Company issue any advancement of funds, or reimbursement of funds, in error, under any provision outlined herein, the Policyholder will refund to the Company such amounts reimbursed, or advanced, in error within thirty (30) calendar days of receipt of written request for such refund by the Company. Any funds owed the Company that are overdue beyond 90 days will be referred to the Company's attorney for collection. Failure to comply may result in offsets from future claim reimbursements. Reporting The Policyholder will furnish the Company with any information required by the Company pertaining to risks covered under this Policy. Such information must be received by the Company in a form, and during a time period, satisfactory to the Company, including the reporting of Covered Participants with certain diagnoses and/or procedures exclusive of Claim Provisions contained herein. The Company will provide reporting requirements and changes periodically. Notification will be provided 30 days prior to change. Time Limit on Certain Defenses In the absence of fraud, all statements made by the Policyholder shall be deemed representations and not warranties. If these statements appear as part of the written application or other written instrument signed by the Policyholder, the Company may use them to contest the Policy. If the Company does contest the Policy, the Company will furnish the Policyholder with a copy of the document in question. After 2 years from the first day of the Coverage Period, only fraudulent misstatements may be used to contest the coverage under this Policy. M20005 -TX 16 of 16 EXPERIMENTAL/INVESTIGATIONAL & MEDICAL NECESSITY ENDORSEMENT TO BE ATTACHED TO AND MADE A PART OF POLICY NO. 467-4113 ISSUED TO City of Round Rock BY AIG LIFE INSURANCE COMPANY It is agreed that the above Policy is endorsed, effective December I. 2003 as follows: In the absence of a definition of "Experimentalllnvestigational" or "Medical Necessity" in the Policyholder's Plan the following definitions will apply to this Policy: Experimentalllnvestigational means any drugs, devices, procedures or treatments such that: its use requires approval by the appropriate federal or other governmental agency which has not been granted, such as, but not limited to, the Federal Drug Administration (FDA); or 2 its use is not yet recognized as acceptable medical practice throughout the United States to treat that illness or injury; or is subject to either: a. a written investigational or research protocol; or b. a written informed consent or protocol used by the treating facility in which reference is made to the drug, device, procedure or treatment as being experimental, investigative, educational, for a research study, or posing an uncertain outcome, or having an unusual risk; or c. a written protocol, protocols or informed consent used by any other facility studying substantially the same drug, device, procedure or treatment which states it is experimental, investigative, educational, for a research study, or posing an uncertain outcome, or having an unusual risk; or d. an ongoing review by an Institutional Review Board (IRB); or 3. it does not have either: a. the positive endorsement of national medical bodies or panels, such as the American Cancer Society, the Agency for Health Care Policy and Research, or the National Cancer Institute; or b. multiple published peer review articles, in a recognized professional medical journal, concerning such drug, device, procedure or treatment and reflecting its reproducibility by non - affiliated sources which the Company determines to be authoritative; or c. trial results which indicate the drug, device, procedure or treatment are at least as effective as the current standard therapy; or 4. it does not meet all applicable state mandated criteria required to not be considered Experimental/Investigational. Any drug, device, procedure or treatment which is deemed to be experimental or investigational in nature by an appropriate technological body established by state or federal government is considered an experimental procedure. Medically Necessary or Medical Necessity means drugs, devices, procedures, treatments, services or supplies provided by a provider facility or a provider individual which are required for treatment of a Covered Participant's illness, injury, diseased condition, or impairment, and are: I. consistent with the diagnosis or symptoms and the Covered Participant is an appropriate candidate for the proposed treatment; 2. appropriate treatment, according to generally accepted standards of medical practice; 3. not provided only as a convenience to the Covered Participant or for the provider; 4. not Investigational or Experimental; 5. not excessive in scope, duration, or intensity to provide safe, adequate, and appropriate treatment. Any service or supply provided at a facility will not be considered medically necessary if the symptoms or condition indicate that it would be safe to provide the service or supply in a less comprehensive setting. The fact that any particular provider individual may prescribe, order, recommend, or approve a service, supply, or level of care does not, of itself, make such treatment medically necessary or make the charge a covered charge. IN WITNESS WHEREOF, AIG Life Insurance Company has caused this Endorsement to be executed as of the effective date shown above. M20014 Secretary President SPECIFIC CASH FLOW ASSISTANCE BENEFIT ENDORSEMENT TO BE ATTACHED TO AND MADE A PART OF POLICY NO. 467 -4113 ISSUED TO CITY OF ROUND ROCK BY AIG LIFE INSURANCE COMPANY It is agreed that the above Policy is endorsed, effective December 1 2003, as follows: Payment of a Specific Excess Loss claim is available to the Policyholder upon meeting all of the following: • The Claims submitted for Cash Flow Assistance have been fully processed by the Third Party Administrator in accordance with the terms of the Plan Document and must be ready for payment under the Plan within the Benefit Period during which the Claim was incurred; and • The Policyholder must have paid Claims at least equal to the Specific Deductible; and • The Claim, and supporting documentation satisfactory to the Company, have been received by the Company no later than fourteen (14) days after the end of the Benefit Period. Requests received after that date are not eligible for Cash Flow Assistance. The Cash Flow Assistance request must be a minimum of $1,000, unless the request is the final claim request for the Specific claimant, in which case there is no minimum. Normal Specific claim audit procedures will be implemented prior to any checks being issued by the Company. These procedures may include withholding a portion of the reimbursement for a Claim based on hospital charges, pending results of hospital pre - screen/audit and/or re- pricing of non -PPO claims or other standard Specific Claim payment procedures. If the foregoing requirements are satisfied, the Company will promptly reimburse the Policyholder for the amount that is eligible for reimbursement under the Specific Excess Loss benefit. The Company's reimbursement may not be deposited until the Plan's payment has been paid. If any portion of the Company's reimbursement is not used to pay the applicable benefits under the Plan for any reason, such portion must be returned to the Company within five working days after it is received by the Policyholder. If the Policyholder fails to comply with any of the above conditions, the right to receive Cash Flow Assistance shall be rescinded. IN WITNESS WHEREOF, AIG Life Insurance Company has caused this Endorsement to be executed as of the effective date shown above. M20016 /Lea 04/ Secretary President AIG LIFE AIG LIFE INSURANCE COMPANY Incorporated as a CAPITAL STOCK COMPANY by the State of Delaware One Alico Plaza, Wilmington, DE 19801 Medical Excess, LLC, One MacArthur Place, Suite 620, South Coast Metro, California 92707 (800) 634 -7462 Applicant (Plan Sponsor): City of Round Rock Proposed Effective Date: December 1, 2003 Name of Employer: City of Round Rock Initial Premium Deposit: 845,445.56 Address: 221 East Main St., Round Rock, TX 78664 Telephone Number: Type of Business: Municipality Other Locations: ❑ Yes ® No If yes, where: If any subsidiary or affiliated companies (under common control through stock ownership, contract etc.) are to be included, list legal name, address and nature of business. Name(s): Address: Type Of Business Broker(s): Address: Watson Wyatt Worldwide 2001 Ross Ave., Suite 4200, Dallas, TX 75201 Third Party Administrator(s): Great West Life & Annuity Insurance Company PPO Name(s): Address Coverage Area Great -West Healthcare 13045 Tesson Ferry Road, St. Louis, MO 63128 TX Benefit Options (Describe all medical plan choices available to all employees during Open Enrollment whether they are included or not included under Stop Loss.) Plan Description(s): Included Not Included Coverage Applied For: ® Specific Stop Loss ® Aggregate Stop Loss ❑ Life and AD &D — Complete Life Questionnaire Classes of Covered Participants Enrollment at the beeinning of the Coverage Period Active Employees and their Eligible Dependents Retired Employees and their Eligible Dependents Disabled Employees and their Eligible Dependents COBRA Employees and their Eligible Dependents Enrollment By Coverage Categories Single Employee 344 Family 268 M20006 -TX 1 of 4 APPLICATION FOR INSURANCE COVERAGE Address: PBM 6204, 1150 North Loop 1604 West, Sutie 108, San Antonio, TX 78248 Number of Covered Included Participants 612 Not Included Insurance applied for replaces prior coverage as follows: ❑ Yes ® No If yes, Complete Information Below Name of Company Type of Coverage Termination Date SPECIFIC EXCESS LOSS INSURANCE: Included Specific Deductible Amount per Covered Participant for the Coverage Period: $50,000 Lifetime Limit of Liability per Covered Participant: $950,000 Lifetime Limit of Liability for Mental, Nervous, Drug and Alcohol Abuse: As Stated in Plan Document Specific Percentage Reimbursable per Covered Participant: 100% Monthly Premium Rates payable per Covered Participant Unit for the Coverage Period Single Employee $42.59 Family $106.73 MINIMUM PREMIUM: Is the greater of 1) the sum of the first four months Premiums and 2) the first month's Premium Multiplied by four. ❑ Not Applicable Specific Coverage Basis Incurred and Paid Incurred and Paid with Run -In Period of 12 Months Incurred and Paid with Run -Out Period of N/A months Incurred in N/A months and Paid within N/A months Specific Benefits Medical Prescription Drug Plan (Card) Optional Specific Benefits H Specific Terminal Liability ExperimentaVlnvestigational & Medical Necessity Specific Cash Flow Assistance Benefit Aggregating Specific Corridor: 11 Flat Corridor Amount ❑ Factor ❑ Minimum Corridor Amount ❑ Adjusted Specific Deductible: 8 Paid (Renewal Option only) Include Run -In Limit of Covered Not Covered ® ❑ Limit Of Name SIR Liability ID /Comments ADDITIONS Quota Share Hospital Reimbursement Limitation M20006 -TX 2 of 4 INCLUDED NOT INCLUDED EXCLUSIONS INCLUDED NOT INCLUDED Organ and Tissue Transplant Exclusion Endorsement ❑ AGGREGATE EXCESS LOSS INSURANCE: Included Monthly Aggregate Factors: Single Employee $324.18 Family $849.07 Estimated Annual Aggregate Attachment Point: $4,068,824 Minimum Aggregate Attachment Point $4,068,824 Limit of Liability for the Coverage period $1,000,000 Aggregate Percentage Reimbursable: 100% AGGREGATE PREMIUM PAYABLE: Per Employee Per Month of: $3.58 MINIMUM PREMIUM: Is the greater of 1) the sum of the first four months Premiums and 2) the first month's Premium Multiplied by four. ❑ Not Applicable Aggregate Coverage Basis: Incurred and Paid Incurred and Paid with Run -In Period of 12 Months Incurred and Paid with Run -Out Period of N/A months Paid (Renewal Option only) Include Run -In Limit of AGGREGATE BENEFITS COVERED NOT COVERED Medical ® ❑ Prescription Drug ® ❑ Dental ® ❑ Vision ❑ Weekly Income ❑ Optional Aggregate Benefits ❑ Monthly Aggregate Protection Endorsement Premium: ❑ Premium Rate Per Employee Per Month: ❑ Included In Above Aggregate Premium ❑ Annual Premium: ❑ Aggregate Terminal Liability Endorsement Premium: ❑ Premium Rate Per Employee Per Month: ❑ Included In Above Aggregate Premium ❑ Annual Premium: M20006 -TX 3 of 4 The Excess Loss Disclosure Statement is to be completed by the Applicant and will be attached to and become a part of this Application. INSURANCE FRAUD WARNING Any person who with intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement, or conceals information for the purpose of misleading, may be found guilty of insurance fraud and may be subject to criminal and/or civil penalties. The Applicant hereby applies for Stop Loss, Life, and/or other Insurance coverage and: 1. Represents that the answers included in this application, the attached questionnaires and the Excess Loss Disclosure Statement have been reviewed and are true and complete to the best of the Applicant's knowledge and belief; 2. Understands and agrees that insurance applied for shall not become effective until the application for insurance is approved by the Company. 3. Agrees that if the insurance applied for is approved by the Company, the Applicant will pay all premium due after the effective date of insurance, including any premium which may accumulate between the effective date of the insurance and the date the Policy is issued. This Application, as it may be amended, will become part of the Policy, if issued. Signed at: (Time of Signature) This day of: (Day and Month of Signature) Year:(Year of Signature) Signed by: Title 4( .... / 7 5 T .� �v e,ll � •.D' e f' REMARKS: FOR HOME OFFICE USE ONLY Approved: ❑ Yes ❑ No Reviewed /Approved By: Approved Date M20006 -TX 4 of 4 AIG Medical Excess American International Group, Inc. Medical Excess CLAIM SERVICES & PROCEDURES Thank you for placing your Excess of Loss coverage with Medical Excess. We are proud of the fact that you have chosen to work with us and look forward to building upon this relationship. The attached information packet includes outlines of the various Cost Containment services we offer. Please be sure to read this and take advantage of our Medical Management programs and pre - payment Discount Re- pricing services. All of these programs have resulted in tremendous savings to our clients. All of the necessary forms and instructions for filing claims and notifications to Medical Excess are included as well. If you should ever have any questions about our services or forms, please feel free to contact us at (800) 634 -7462. We are always more than happy to answer questions and explain our programs. Table Of Contents Description I. Excess Loss Claim Instructions II. Notification Of Potential Excess Loss Claim III. Medical Case Management IV. Cost Containment Out of Network Discount Services Hospital Audits V. Specific Excess Loss Claim Instructions VI. Advance Funding For Specific Claim VII. Variable Corridor VIII. Aggregate Excess Loss Instructions IX. Advance Aggregate Excess Loss Instructions X. Sample Forms - Exhibits 1 Through 3 Exhibit 1 Exhibit 2 Exhibit 3 XI. Bulletins Medical Excess Excess Loss Claim Instructions In order to assure that you and your clients receive prompt reimbursement /advance funding of claims in excess of the Specific or Aggregate Retention, it is essential that all required information be included when your claim request is first submitted. The following instructions will outline all of the necessary forms and documentation you will need to provide in order for us to properly evaluate and reimburse Excess Loss claims. These administrative guidelines do not alter or amend any terms or provisions of the Excess Loss Indemnity Policy. If you have any questions, please call the Grass Valley Excess Claim Department at (530) 477- 0775 or (888) 539 -2377. Notification Of Potential Excess Loss Claim Medical Excess requires written notification when expenses for any individual have or are expected to reach fifty percent (50 %) of the Specific Retention. The TPA must notify us by submitting the Large Claim Notification form (Exhibit 1) along with pertinent information relating to the claim. It is very important that our Medical Management department receive immediate notification of the following conditions so that a prompt decision may be made as to the need for medical case management and other necessary investigation or documentation. 1. Head or Spinal Cord Injuries 2. Severe Burn Cases 3. Severe Trauma 4. Premature Births 5. Acquired Immune Deficiency Syndrome 6. Cancer 7. Severe Strokes 8. Organ and Bone Marrow Transplants 9. Brain Tumor 10. Severe Rheumatoid Arthritis 11. Cardiac Et Circulatory Disorders 12. Comatose Patient 13. Degenerative Muscular /Neurological Disorders 14. Any Amputations 15. Life Support Systems In Place 16. Dialysis 17. Diabetic Complications Also report to the Medical Excess Medical Management department any other serious conditions which, in your opinion, may require medical case management or result in a Specific Excess Loss claim. Medical Excess Medical Management Medical Excess believes that one of the keys to large claim cost containment is medical case management. However, in order for case management to be truly successful, it has to be implemented as early as possible in the treatment process of a sickness or injury. Medical Excess' Medical Management department has formed unique partnerships with Dimensions In Managed Care (DMC) @ Comprehensive Health Services (CHS), which allows us to offer you and your clients nationwide, on -site case management services. What differentiates our services from other case management programs is the fact that our initial assessments are done on -site. This allows the patient and provider to build a more cohesive relationship with the nurse case manager. In most cases, our carriers will assume the cost of these services. It is our desire to assist you in the management of claim costs at the earliest possible point of service.. Therefore, we ask that you notify our Medical Management Department immediately of any claimant's illness or injury that has the potential to exceed 50% of the Specific Retention. If medical case management is warranted, we will obtain the necessary information from you and coordinate the implementation of case management through one of our contracted vendors. Our Medical Case Management Department is available to aid you with your more complex claims and answer any questions you may have regarding our case management and cost containment programs. Please contact John Richert at.(317) 876 -1250 for answers to all of your questions and concerns regarding these programs. Medical Excess Cost Containment We are all aware that health care can be expensive. There are various ways we can assist you and your clients in controlling medical costs. However, success depends upon the combined efforts of all parties. Medical Excess utilizes nationally recognized cost containment companies to reduce medical costs through the following services: • P.P.O. Network Discounts • Line Item Bill Analysis • Prospective and Retrospective Discount Negotiations • Medical Necessity Reviews • Reasonable and Customary Reviews • Organ Transplant Networks • Subrogation Recovery • Hospital Bill Audits The above services are available to you as part of our ongoing strategy to contain medical costs, while maintaining the superior care your clients have come to expect. PPO /Negotiation discounts Whenever one of our carrier's has potential exposure on a claim and you have notified us of the potential exposure, we request you comply with the following procedures if the provider of service does not currently fall within the group's existing PPO network. 1. Forward all Hospital UB -92 billings over $5,000.00 to our South Coast Metro Claim department. 2. Forward all other provider bills over $2,000.00 to our South Coast Metro Claim department. Upon receipt of these bills, we will search through our database to determine the most appropriate form of discount available. The signed provider discount agreement will then be returned to you within three working days for processing of payment. Accounts with our Advance Funding feature may utilize this product in conjunction with the above, upon satisfaction of the policy terms. Our carriers will honor the fees charged for obtaining discounts when the claim has exceeded the Specific Retention amount. If the total eligible paid claims do not exceed the Specific Retention amount, the cost of these services are the responsibility of the Insured (Employer). Claims should be faxed to (714) 436 -3652 with a cover sheet indicating the attached are being referred for discounting. Questions regarding this program should be addressed to Gerald Addy or Linda Subbiondo at (714) 436 -3600. Medical Excess Hospital Audits - In the absence of PPO /Negotiated discounts, we require that you pend 10% of all hospital bills that are $25,000.00 or greater. If a specific reimbursement claim is filed and an audit has not been performed, we will arrange for an audit with one of our cost containment services. Upon receipt of the audit results, pay the amount due based upon the audit and submit the balance to us for reimbursement. We will include the adjustment payment as part of the specific claim, even if the audit was not completed until after the specific payment period. However, any unbilled charges resulting from the audit should not be paid unless the hospital agrees with the audit results and until the hospital has billed you. Medical Excess Specific Excess Loss Claim Instructions Specific Excess Loss Coverage reimburses the Employer after an individual's, or family's, eligible paid claims exceeds the amount of the Specific retention selected by the Employer. Only expenses covered by the Employer's Plan Document, which are then subject to the terms and conditions of the Excess Loss Indemnity Policy, are eligible for reimbursement. The Excess Loss Indemnity Policy is subject to an Incurred and Paid basis; that is, the underlying expenses must be incurred and paid per the Plan and must be incurred and paid within the time frame set forth in the Payment Basis section of the Policy. According to the terms of the Excess Loss Indemnity Polity in effect at the printing of this Manual, claims shall be deemed to be paid on the date that: (1) the Policyholder's payment check or draft is issued; and (2) provided sufficient funds are then available to cover such payments. Claims shall not be deemed paid until both of these occur and only if the funds remain in the account until the checks or drafts are honored. Once a Specific Claim has exceeded the Specific Retention, the following must be provided. 1) Completed, signed and dated Specific Stop -Loss reimbursement form. (Exhibit 2) 2) Copy of employee's enrollment card with hire date and original effective date of coverage, including all eligible dependents. 3) COBRA election form with qualifying event date, if applicable. 4) HIPAA Creditable Coverage form, if applicable. 5) Copies of all Explanation of Benefits (EOB) attached to their corresponding itemized bill. 6) Copies of all correspondence regarding Coordination of Benefits (COB). 7) Copy of all physicians /surgeons reports and all pertinent hospital records, when applicable. 8) Copy of accident information which should include a detailed description, location and date of accident, if applicable. 9) Copy of investigation reports or documents used to determine any of the following: a) Pre - existing Conditions b) Prior plan's extension of benefits c) Subrogation (Employee's reimbursement agreement) d) Workers' Compensation e) Divorce, separation decrees or court orders f) Full -time student status g) Third -Party Liability /Recovery details h) Employee disability status Following receipt of the above - listed information and any other necessary documentation required to establish proof of loss, Medical Excess will audit the claim and reimburse /advance the Employer as appropriate. Medical Excess Advance Funding For Specific Claims This product allows a group to be eligible for advance funding when it has exceeded the individual or family specific retention. 1. Advances must be requested by completing Medical Excess's regular Specific Reimbursement Request form, and by checking the "Advance" box. 2. The request must indicate the amount of the advance and date of Last check released. 3. Claims should be handled in the usual fashion. However, the checks should be held pending completion of the advance funding process. 4. The advance funding must be used to cover the claim checks for which the advance was requested. 5. Claim checks must be released immediately upon receipt of the advance. For administrative purposes, the minimum advance that may be requested is $1,000.00. The request for an advance must be made either within the Policy Term; or no later than 21 days after the expiration of the policy. The above guidelines are to be used in conjunction with Specific Excess Loss claim instructions. Variable Corridor Employers with stable claims experience may need protection against only the most severe claims. Variable Corridor covers these severe claims, increasing cash flow and reducing specific premiums. Medical Excess will reimburse the employer at the end of the policy period for the sum of the claims in excess of the Specific retention and the Variable Corridor up to the limit of liability. However, to alleviate cash flow strains, reimbursement prior to the end of the policy period may be available on a case by case basis. Medical Excess will_ reimburse 80% of reimbursement requests in excess of the Specific retention and the estimated Variable Corridor prior to the end of the polity year. in these cases, the remainder is paid at the end of the policy year after the recalculation of the annual Variable Corridor. The Employers Variable Corridor claims liability is not covered under the Aggregate portion of the Excess Loss coverage. Aggregate Excess Loss Instructions Aggregate Excess Insurance provides for reimbursement to the Employer for eligible paid claims in excess of the greater of the Annual or the Minimum Annual Aggregate Retention, less Specific Excess reimbursements and any applicable Variable Corridor Amount. The Annual Aggregate Retention is calculated in the following manner: Medical Excess The Minimum Annual Retention is set by the underwriter and is shown in the schedule page of the policy. The Annual Aggregate Retention is calculated by multiplying the Monthly Aggregate Factor times the cumulative enrollment for each month of the Policy Year. The greater of the Annual or Minimum Annual Retention will be utilized as the Annual Aggregate Retention. The eligible paid claims are only those claims covered by the Plan Document that are then subject to the terms and conditions of the Excess Loss Indemnity Policy. Paid means that drafts or checks have been issued and cashed (see page 6). Incurred means the date the service or supply to which it relates, was provided. In the first "Excess Loss Indemnity Policy" year, all claims must be incurred and paid within the Policy year, unless the Policy is otherwise endorsed. The renewal year provides for claims incurred after the initial effective date and paid in the Policy Year for which the claim is presented, unless the Excess Loss Indemnity Policy is otherwise endorsed. Once an Aggregate claim is eligible for reimbursement, the following must be provided: 1) Completed, signed and dated Aggregate Stop -Loss Reimbursement form. (Exhibit 3) 2) An employee eligibility listing showing all employees covered under the plan along with any dependents, the effective date of coverage and termination date where applicable. 3) A list of claims with an accumulated total, showing incurred dates, payment dates, check numbers, payment amounts, and employee's claimant's name. Preferably, this list will group paid claims by individual or family for easier verification of Specific claim amounts. 4) Payment of Dental, Pre -Paid Prescription Drug, Vision, Weekly Income, or any other coverage not included in the Aggregate Excess Coverage should not be included in the reimbursement request. Please identify these benefits if they are included in the paid claims listing. 5) Please identify and deduct any refunds, voids and payments outside of the plan if not previously adjusted from the paid claims list. 6) if Aggregate coverage includes run -in claims, only include service dates within the run -in period, and deduct any run -in claims in excess of the indicated maximum. If service dates overlap the beginning or end of the run -in period, please indicate the payment amounts applicable to each period. 7) If Aggregate coverage is provided for a Prescription Card Drug Plan, please submit copies of the drug plan's invoice statements and the employer's reimbursement checks. Administrative fees billed by the drug plan are not a reimbursable expense. 8) Bank Statements for the last month of the policy and the month following the end of the policy. 9) Medical Excess Reserves the right to perform an on -site audit of enrollment, premium, financial and claim records prior to final settlement of any Aggregate claim. Medical Excess Advance Aggregate Excess Loss Instructions Advance Aggregate Excess Insurance provides for reimbursement to the Employer for eligible paid claims equal to, or exceeding by $5,000.00, the year -to -date accumulated Aggregate Retention or Pro Rata Minimum Aggregate Retention, whichever is greater, less the Specific Excess reimbursements, applicable Variable Corridor amount and any previous advances for the same policy year. The Accumulated /Pro- Rata Minimum Aggregate Retention is calculated in the following manner: The Accumulated Aggregate Retention is calculated by multiplying the Monthly Aggregate Factor times the cumulative enrollment through the months for which the advance is being requested. The Pro -Rata Minimum Annual Aggregate Retention is calculated by multiplying the Monthly Aggregate Deductible times the number of months through which the advance is being requested. Such advances may be requested only after the first three month's of coverage have passed when the following conditions are met: 1. Medical Excess has received the premium due for the month for which the advance has been requested. 2. No more than one advance will be made for any one calendar month. The minimum advance is $5,000.00. Claims presented to Medical Excess for advance will be deemed paid in the month for which the advance was made. 3. All Aggregate advance requests must be submitted to Medical Excess within 21 days after the end of the month for which the advance is requested. When the conditions listed above for an Advance Aggregate Stop -Loss claims have been met, the following must be provided: 1. Completed, signed, and dated Aggregate Stop -Loss Reimbursement form with the "Advance" box checked. (Exhibit 3) 2. A list of paid claims for the Excess Loss Policy year -to -date showing Employee /Claimant's Name, incurred dates, payment dates, check numbers, payment amounts, and accumulated total. Preferably, this list will group paid claims by individual or family for easier verification of Specific claim amounts. 3. Please Identify or provide check copies of any plan benefits not yet paid. At the end of the Policy Year, the administrator must submit a final Aggregate submission as outlined in the Aggregate Reimbursement section of this manual to determine if an actual Aggregate claim exists. If advances are greater than the aggregate claim for the Policy year, the Employer must reimburse Medical Excess the amounts advanced in excess of the actual claim. Refunds are due and payable from the Employer within 60 days following the end of the Policy Year. Medical Excess reserves the right to perform an on -site audit of enrollment and claims prior to final settlement of any Aggregate claim. Medical Excess AIG American International Medical Excess Large Case Notification 8777 Purdue Road — Suite 330 Indianapolis, IN 46268 Tel: 317/876 -1250 Fax: 317/472 -0298 Complete this form if you have an ongoing claim that has reached 50% of the Specific Deductible or as soon as you realize that the claim has the possibility of exceeding the Specific Deductible. Also use this form when referring a claimant for Case Management. Group Name: Policy #: Contract Type: Policy Year: Specific Deductible Ernployee: Employment Date: Effective Date: Current Status of EE: Active: Yes ❑ No ❑ If Deceased, Date of Death: Is COBRA applicable? Yes ❑ No ❑ If yes, effective date: Claimant: DOB: Sex: Male ❑ Female ❑ Relationship to Employee: Effective Date: Termination Date: Address: Telephone: Dependent Child over 18? Is he/she a full time student? Yes ❑ No ❑ Diagnosis: Date of Onset: ICD9 Codes: Prognosis: If Accident; Date: Location: Describe how accident occurred: Attending Physician: Telephone #: Address: Inpatient Stay /Surgery Date & Description: Hospital: Telephone 9: Address: TPA: Submitted By: Address: Phone #: Medical Excess Ext: DOB: SSN: Termination Date: Disabled: Yes ❑ No ❑ Yes No Other Coverage ❑ ❑ Claimant is still hospitalized Other Group Insurance: Yes ❑ No ❑ ❑ ❑ Claimant is continuing treatment If yes, Carrier's Name: ❑ ❑ ESRD Onset Date: lnsured's Name: ❑ ❑ Large Case Management DOB: Name of LCM Co.: Medicare: Yes ❑ No ❑ Case Manager's Name: Worker's Comp: Yes ❑ No ❑ Case Manager's Phone #: Auto Insurance: Yes ❑ No ❑ Is PPO in place? Yes ❑ No ❑ Subrogation: Yes ❑ No ❑ If yes, name of vendor: If yes, has a Subrogation agreement been filed: If no, please refer all out -of- network claims in excess Yes ❑ No ❑ of $2,000 to Medical Excess for re- pricing Initial amount Paid to Date: $ Pended Claims Amount: $ Reason: Estimates of future expenses: ❑ Less than $50,000 ❑ $50,000 - $100,000 ❑ $100,000 - $150,000 ❑ $150,000 and above Title: e-mail: Fax #: Date: Send / fax ALL 50% Notices or Case Management Referrals to Medical Excess at the above address /fax number. E -mail to: gabriele.hunter(?aig.com, and cc to: john.richert(o?ai8.com and denise.kazmierzak(d )aig.com HEN AIG American t'a" " Medical Excess SPECIFIC EXCESS LOSS REIMBURSEMENT REQUEST Initial Claim ❑ Subsequent Claim ❑ Final Claim ❑ Advance ❑ Policyholder Policy Number Policy Year Name of Employee Birth Date Hire Date EE's Effective Date Name of Claimant Birth Date Relationship to EE Dep's Effective Date Present Employee Status: Active❑ Disabled ❑ Retired ❑ Retirement Date Last Day Worked Termination Date Diagnosis & ICD 9 Onset Date Total Mailed Payments for this submission: Total Unmailed Payments for this submission (advance) Total Eligible Expenses for this submission ttotal of mailed and Unmailed payments Less Specific Retention: Less Variable Corridor (if applicable): Reimbursement Requested: If advance, date of last check released: Please include the following documentation with your reimbursement request: (if applicable) Enrollment form Current COB Information Full time student status Divorce, separation decrees or court orders COBRA election form Pre- existing /HIPAA Certificate EOB/Paid Claims Report Accident details/police report Itemized bills Physician's statements /operative reports Hospital audits /reviews /discounts Subrogation/TPURecovery details Pre -certs DME — MD's prescription and purchase price Large case management reports Name Case Management Co: I hey Norse& dxc to the lot tiny krva/aig4 the information pn 1ai s ttrtpleeanicorrec and the daimha lesrpaid v aecatiance vith the aerated''s employee benefit plan, oh&ha leer nudep ocf,'oralamdralmdoe s Las /Way Submitted By (Print Name) TPA Name Date Address Telephone Number Fax Number Email Address: Medical Excess Mail To: 333 Crown Point Circle, Grass Valley, CA 95945 530 - 477 -0775 530 - 477 -0696 FAX Leave of Absence Date COBRA Effective Date ESRD Onset Date AIG American Internadonal Group, Inc. Policyholder Policy Number Submitted by (Print Name) Medical Excess AGGREGATE CLAIM REIMBURSEMENT REQUEST Annual Aggregate Request ❑ Monthly Accommodation Request ❑ 1. Total Mailed Claim Payments thru Mo / Day / Yr 2. Less Claims in Excess of Specific Retention 3. Less Extracontractual or Ineligible Payments 4. Less the greater of (a) Min. Annual Agg. Ded., or (b) Calculated Ann. Agg Ded 5. Less Prior Accommodations / Advance 6. Total Amount Requested or Refund Due (If Negative, Amount Due Medical Excess) Please include copies of the following documentation with your submission: • Eligibility listing and/or current census covering all months of the policy to this point through the month in which the claim is being requested. • Paid claims analysis showing incurred date of each loss, payment date, amount paid, and the payee for the period covered by this request. • Check registers showing check numbers and amounts. • Report of all voided checks and refunds or credits through the date signed below. • Monthly Aggregate Report Other documentation, which may have had an affect upon the consideration and payment of this claim, may be requested if necessary in the judgement of the Claim Department I hereby represent that to the best of my knowledge, the information provided is complete and correct, and the claim has been paid in accordance with the Policyholders Employee Benefit Plan, which has been made part of, and attached to the Excess Loss Policy. I certify that all checks were mailed to the payee on or before the last day of the Policy Year for which this claim has been presented. TPA Date Address Telephone Number Email Address Mail To: 333 Crown Point Circle, Grass Valley, CA 95945 530 - 477 -0775 530 - 436 -0696 FAX Policy Year Agg. Deductible Fax Number Medical Excess Bulletins THE FOLLOWING BULLETINS ARE NOT ADDRESSED ELSEWHERE IN THE CLAIMS SECTION OF THIS MANUAL. WE WILL PERIODICALLY SEND SUCH BULLETINS TO OUR ADMINISTRATORS. FOR A QUICK REFERENCE, PLEASE ADD ANY FUTURE CLAIMS BULLETINS TO THIS SECTION OF THE MANUAL SUBROGATION RECOVERY SERVICES Medical Excess currently has an arrangement with The Law Office of Bryan B. Davenport, P.C. to assist with recovery efforts. Medical and disability plan administrators have the potential to recover benefits paid under employee health and other benefit plans. However, millions of dollars are "left on the table" every year because of legal and other complexities associated with enforcing subrogation and right of recovery benefit plan provisions. Mr. Davenport's objective is to assist the Administrators, Employers, and Medical Excess in increasing the amount and frequency of subrogation recoveries to reduce the overall cost of the benefit plan. If you have paid medical benefits to plan beneficiaries that have been involved in: • Automobile Accidents • Defective Product Injuries • Medical Negligence Action • Slip -Fall Accidents • Claims with Third Party Liability The Law Office of Bryan B. Davenport, P.C. can be of assistance to you, your clients and Medical Excess. We encourage our Administrators to continue their efforts in pursuing overpayments and Third Party Liability. However, when attempts are unsuccessful or if you have not secured a recovery firm or legal counsel, please contact us immediately to utilize the services Mr. Davenport. Medical Excess OUT -OF- NETWORK CLAIM DISCOUNTS Medical Excess is pleased to offer a claim discounting service to all of our clients. We have access to several national discount vendors. These vendors have contracts with providers throughout the nation for the purpose of obtaining discounts on out -of- network claims. Savings realized from this program has averaged 13.5% and has been as high as 75 %. This can benefit the bottom line to the plan Et have a dramatic affect on the group's renewal. Refer all of your group's eligible (as defined in the plan document) out -of- network hospital claims over $5,000.00 and all other bills over $2,000.00 to the South Coast Metro Medical Excess claim department prior to issuing payment to the provider. You wilt receive a written explanation of what message must appear on the Explanation of Benefit statement to the provider and the amount of discount to apply to the bill. All vendor fees for this service are fully reimbursable under the specific and aggregate coverages, subject to the normal policy plan /limits. Turnaround time and ease of access are extremely important to both you and your client. Therefore, we strongly recommend that the bills you refer for re- pricing be faxed to our South Coast Metro claim department at (714) 436 -3652. The normal turnaround is two to three working days. This service benefits the T.P.A., Client, Insurer and Employee, providing a total win situation for all involved parties. Please feel free to contact Gerald Addy or Linda Subbiondo at (714) 436 -3600 with any questions regarding this value added service. Just another one of the many reasons to do business with Medical Excess!!! Medical Excess P c()