Attachment I.docx

U-BMC-302-A SC (10120)

Blanket Accident Insurance Certificate

ZURICH

ZURICH AMERICAN INSURANCE COMPANY

1299 Zurich Way Schaumburg, Illinois 60196

This is a summary of the accident insurance We provide on behalf of the Policyholder to You if You are within a class of eligible persons described in Section I - Schedule and if the required premiums are paid when due.

THE INSURANCE EVIDENCED BY THIS CERTIFICATE PROVIDES ACCIDENT COVERAGE ONLY THIS IS A SUMMARY OF COVERAGE ONLY WHICH SUMMARIZES AND EXPLAINS THE PARTS OF THE

POLICY WHICH APPLY TO YOU.

FOR ALL TERMS AND CONDITIONS OF COVERAGE, PLEASE REVIEW THE POLICY ISSUED TO THE POLICYHOLDER AND ON FILE WITH THEM AT THEIR PLACE OF BUSINESS. YOU CAN OBTAIN A COPY OF THE POLICY FROM THE POLICYHOLDER.

THIS CERTIFICATE IS NOT AN INSURANCE POLICY. IN THE EVENT OF A CONFLICT OF PROVISIONS BETWEEN THE POLICY AND THIS CERTIFICATE, THE PROVISIONS OF THE POLICY WILL GOVERN

PLEASE READ THIS CERTIFICATE CAREFULLY

IN WITNESS WHEREOF, this Company has executed and attested these presents and, where required by law, has caused the Policy to be countersigned by its duly Authorized Representative(s).

President

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NON-PARTICIPATING

TABLE OF CONTENTS

SECTION DESCRIPTION

U-BMC-302-A SC (10/20)

Page 8 of9

Section I Section II Section Ill Section IV Section V Section VI Section VII Section VIII Section IX Section X Section XI

SCHEDULE

ELIGIBILITY AND EFFECTIVE DATES OF INSURANCE DEFINITIONS

GENERAL EXCLUSIONS GENERAL LIMITATIONS PREMIUMS

TERMINATION OF INSURANCE HOW TO FILE A CLAIM PAYMENT OF CLAIMS GENERAL POLICY CONDITIONS BENEFITS

I. POLICYHOLDER:

II. POLICY NUMBER:

Ill. POLICY INCEPTION DATE:

IV. POLICY PERIOD:

V. CONTRACT SITUS:

SECTION I - SCHEDULE

Winthrop University 701 Oakland Avenue Rock Hill, South Carolina 29733 MCB-4850979 August 1, 2025 August 1, 2025 to August 1, 2026 (All Insurance begins and ends at 12:01 a.m. at the Policyholder's address) South Carolina

VI. ELIGIBILITY AND CLASSIFICATION OF INSURED

The following individuals are eligible to become Insureds upon the submission of completed enrollment material, if required:

If an Insured suffers a Covered Injury resulting in a Covered Loss, and he or she is covered under more than one Class, We will pay only one benefit, the largest benefit.

VII. COVERED ACTIVITY(IES):

Class I: While participating in sponsored, scheduled and supervised intercollegiate games, practice, conditioning, and authorized team travel to and from events for the following sports:

Men: Baseball, Basketball, Cheerleading, Cross Country, Golf, Soccer, Track & Field, E-Sports, Corn Hole, Cycling, Disk Golf Women: Basketball, Cheerleading, Cross Country, Golf, Soccer, Lacrosse, Softball, Volleyball, Track & Field, E-Sports, Corn Hole, Cycling, Disk Golf

Class II

Prospective Student Athletes while on campus during an official visit for which the athlete was invited by the Policyholder, up to two (2) Chaperones of prospective Student Athletes, while the Chaperones are on campus during an official visit by the Student Athlete. A Chaperone may be a parent, grandparent, legal guardian, spouse, sibling, aunt, or uncle whose names are reported to, and on file with the Policyholder prior to a prospective Student Athlete's visit.

VIII. AGGREGATE LIMIT OF LIABILITY $1,000,000.00 per Covered Accident

IX. BENEFITS:

Accident Medical Expense Benefit

Cardiac Injury Extension

Class I, Class II

Class I, Class II

See Benefit Rider

See Benefit Rider

U-BMC-380-B SC (01/20)

U-BMC-393-A SC (10/20)

X. REPORTING AND NOTICE ADDRESSES:

Claim Reporting:

Bob McCloskey Insurance P.O. Box 511 Matawan, NJ 07747 800-445-3126

XI. PREMIUMS:

Benefits under the Policy are Non-Contributory.

SECTION II - ELIGIBILITY AND EFFECTIVE DATES OF INSURANCE INSURED'S EFFECTIVE DATE Your coverage under the Policy begins on the latest of:

1. the Policy Inception Date shown in the Schedule;

2. the date for which the first premium for Your coverage is paid; or

3. the date You become a member of an eligible class of persons as described in the ELIGIBILITY AND CLASSIFICATION OF INSUREDS section on the Schedule;

A change in Your coverage under the Policy due to a change in Your eligible class becomes effective on the later of:

1. when the change in Your eligible class occurs; or

2. if the change requires a change in premium, the date the first changed premium is paid.

However, a change in coverage applies only with respect to Accidents that occur after the change becomes effective.

SECTION Ill - DEFINITIONS Accident or Accidental means a sudden, unexpected, specific and abrupt event that occurs by chance at an identifiable time and place during the Policy term.

Active means a member as defined by the Policyholder based on elements relating to the relationship between the organization and its members, the school and its students. the creditor and its debtors, or the vendor and its vendees, etc..

Aggregate Limit of Liability means the total Accidental Death Benefit . and Accidental Dismemberment Benefit . and Exposure and Disappearance Benefit , We will pay for a Covered Accident set forth in the Schedule. For purposes of the Aggregate Limit of Liability provision, a Covered Accident will arise out of a single event and include a resulting Covered Loss. If the total benefits under the Aggregate Limit of Liability is not enough to pay full benefits to each Insured, We will pay each one a reduced benefit based upon the proportion that the Aggregate Limit of Liability bears to the total benefits which would otherwise be paid.

Certificate means this Blanket Accident Insurance Certificate.

Contributory means the Insured is required to pay all or a portion of the premium. Whether the benefits are Contributory or Non-Contributory is stated in the Schedule.

Covered Accident means an Accident that results in a Covered Loss.

Covered Activity(ies) means those activities set out in the COVERED ACTIVITIES section of the Schedule.

Covered Injury means bodily injury directly caused by Accidental means which is independent of all other causes, results from a Covered Accident, occurs while the Insured is insured under the Policy and participating in a Covered Activity, and results in a Covered Loss.

Covered Loss means a loss which meets the requisites of one or more benefits or additional benefits, results from a Covered Injury, and for which benefits are payable under the Policy.

Domestic Partner means as defined in the Policyholder's medical plan as on file and approved by Us.

To qualify as a Domestic Partner, the following requirements must be met:

1. You and Your Domestic Partner must have an intimate, committed relationship of mutual caring, and have agreed to be responsible for each other's welfare;

2. You and Your Domestic Partner must have lived together in such a relationship for a period of not less than six consecutive months at the same resi.dence address;

3. You and Your Domestic Partner must both be at least 18 years of age;

4. neither You nor Your Domestic Partner are legally married;

5. You and Your Domestic Partner are not Related by blood or adoption;

6. You and Your Domestic Partner are each other's sole Domestic Partner and intend to remain so indefinitely; and

7. You and Your Domestic Partner must be of the same sex, and if applicable law permitted, would be married. The existence of the relationship between Your Domestic Partner and You must be evidenced by:

1. Your Domestic Partner being named as the primary beneficiary in the event of Your death under Your retirement plan or 401(k) plan, if You maintain such a plan;

2. at least one of the following:

a. designation of Your Domestic Partner as a primary beneficiary under Your will; or

b. designation of Your Domestic Partner as a primary beneficiary for Your life insurance;

3. at least one of the following:

a. joint ownership of real estate (whether by mortgage, lease or deed);

b. joint ownership of a motor vehicle; or

c. joint ownership of a bank account; and

4. a completed, active certification of Domestic Partner status form on file with the Policyholder.

To be active, You will not have completed a Termination of Domestic Partner status form with respect to Your Domestic Partner.

Foreign National means a person who is a citizen of a country or other jurisdiction other than the United States of America and who is not a resident of the United States of America.

Insured means any person who is eligible for coverage under the Policy as provided in the ELIGIBILITY AND CLASSIFICATION OF INSUREDS section of the Schedule, and who completes the enrollment material, if required.

Limb means an arm or a leg.

Non-Contributory means the Insured is not required to contribute toward the premium. Whether the benefits are Contributory or Non-Contributory is stated in the Schedule.

Physician means a person who is:

1. a doctor of medicine, osteopathy, psychology or other legally qualified practitioner of a healing art that We recognize or are required by law to recognize;

2. licensed to practice in the jurisdiction where care is being given;

3. practicing within the scope of that license; and

4. not related to You by blood or marriage.

Plan means the coverages and/or benefits selected in the Schedule.

Policy means the Blanket Accident Insurance Policy issued to the Policyholder. Policyholder means the entity named as such in the Schedule.

Spouse means Your legally married Spouse.

We, Us, and Our means Zurich American Insurance Company or Our authorized representative.

You or Your means the Insured to whom a Certificate is issued.

SECTION IV - GENERAL EXCLUSIONS

A loss will not be a Covered Loss if it is caused by, contributed to, or results from:

1. suicide or any attempt at suicide or intentionally self-inflicted injury or any attempt at intentionally self-inflicted injury.

2. war or any act of war, whether declared or undeclared.

3. involvement in any type of active military service. Reserve or National Guard active duty training is not excluded, unless it extends beyond thirty-one (31) consecutive days.

4. illness or disease, regardless of how contracted; medical or surgical treatment of illness or disease; or complications following the surgical treatment of illness or disease; except for Accidental ingestion of contaminated foods.

5. participation in the commission or attempted commission of any felony.

6. parasailing, bungee jumping, heli-skiing, scuba diving or any other extra-hazardous activity.

7. being intoxicated while operating a motor vehicle.

a. An Insured will be conclusively presumed to be intoxicated if the level of alcohol in his or her blood exceeds the amount at which a person is presumed, under the law of the locale in which the Accident occurred, to be intoxicated, if operating a motor vehicle.

b. An autopsy report from a licensed medical examiner, law enforcement officer reports, or similar items will be considered proof of the lnsured's intoxication.

8. being under the influence of any narcotic unless taken on the advice of a Physician.

9. travel or flight in any aircraft except as a fare-paying passenger on a regularly scheduled charter or commercial flight.

10 a cardiovascular event or stroke caused by exertion prior to or at the same time as an Accident.

11. participation in any team sport or any other athletic activity unless mentioned in the Covered Activities.

12. any condition for which the Insured is entitled to benefits under any Workers' Compensation Act, No Fault Auto Coverage or similar law.

13. the Insured riding in or driving any type of motor vehicle as part of a speed contest or scheduled race, including testing such vehicle on a track, speedway or proving ground.

14. any loss incurred while outside the United States, its territories or Canada.

SECTION V- GENERAL LIMITATIONS

Benefits are payable only for Covered Losses incurred as a result of participation in Covered Activities.

LIMITATION ON MULTIPLE COVERED LOSSES If You suffer more than one Covered Loss as a result of the same Accident, We will pay only one benefit, the largest benefit.

LIMITATION ON MULTIPLE COVERED ACTIVITIES: If You suffer a Covered Loss while participating in more than one Covered Activity, We will pay only one benefit, the largest benefit .

LIMITATION ON MULTIPLE BENEFITS: If You can recover benefits under more than one of the Benefits stated in the Schedule, as a result of the same Accident, We will pay only one benefit, the largest benefit.

LIMITATION ON MULTIPLE COVERED POLICIES: If You can recover benefits under more than one accident policy written by Zurich American Insurance Company, We will pay under only one policy, the policy which offers You the largest benefit.

SECTION VI - PREMIUMS

A. PREMIUMS: Premiums are due and payable to Us at the rates and in the manner described in the Schedule.

B. GRACE PERIOD: Premiums are due for the Policy on or before the premium due date or renewal date, whichever applies. If a renewal premium is not paid when it is due, there is a thirty-one (31) day Grace Period (the "Grace Period") to pay. During the Grace Period, the Policy will stay in force. There will not be a Grace Period if We have given notice, at least thirty (30) days in advance, that We are going to terminate the Policy.

SECTION VII - TERMINATION OF INSURANCE

A POLICY RENEWAL AND TERMINATION:

RENEWAL: The Policy will automatically renew for an additional twelve-month (12) period unless either party expresses its intent to terminate as specified herein.

TERMINATION BY POLICYHOLDER: The Policyholder may terminate the Policy by delivering to Us a written notice to end the Policy at least thirty (30) days in advance of such termination. We will calculate and return the unearned premium, if any, using a standard short rate table. The Policyholder will send Us any additional amounts owed, if any, between the Policy's paid to date and the official date of termination.

TERMINATION BY US: We may terminate the Policy by giving the Policyholder at least thirty (30) days notice of Our intent to terminate. Such notice will state the exact date the Policy will terminate. We will mail a notice of such termination to the Policyholder's last address shown in Our records.

We may also, at any time, end the Policy for non-payment of premium on any premium due date if the payment is not received prior to the end of the Grace Period. We will mail a notice of such termination to the Policyholder's last address shown in Our records.

Termination will be without prejudice to any claim which commenced prior to the effective date of termination.

SECTION VIII - HOW TO FILE A CLAIM

A. NOTICE: You or Your beneficiary, or someone on Your behalf, must give Us written notice of the Covered Loss within ninety (90) days of such Covered Loss, or as soon thereafter as reasonably possible. The notice must name You and the Policy Number. To request a claim form, You or Your beneficiary, or someone on Your behalf may contact Us at 800-445-3126. The notice must be sent to the address shown on the Schedule, or any of Our agents. Notice to Our agents is considered notice to Us.

B. CLAIM FORMS: We will send the claimant Proof of Covered Loss forms within fifteen (15) days after We receive notice. If the claimant does not receive the Proof of Covered Loss form in fifteen (15) days after submitting notice, he or she can send Us a detailed written report of the claim and the extent of the Covered Loss. We will accept this report as a Proof of Covered Loss if sent within the time fixed below for filing a Proof of Covered Loss.

C. PROOF OF COVERED LOSS: Written Proof of Covered Loss, acceptable to Us, must be sent within ninety (90) days of the Covered Loss. Failure to furnish Proof of Covered Loss acceptable to Us within such time will neither invalidate nor reduce any claim if it was not reasonably possible to furnish the Proof of Covered Loss, and the proof was provided as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one

(1) year from the time proof is otherwise required.

SECTION IX- PAYMENT OF CLAIMS

A. TIME OF PAYMENT: We will pay claims for all Covered Losses, other than Covered Losses for which the Policy provides any periodic payment, immediately upon receipt of written proof of loss that is acceptable to Us. Unless an optional periodic payment is stated or chosen, any Covered Loss to be paid in periodic payments will be paid at the end of each four-week period. The unpaid balance, which remains when Our liability ends, will then be paid when We receive the Proof of Covered Loss that is acceptable to Us.

B. WHO WE WILL PAY:

1. LOSS OF YOUR LIFE: Covered Losses resulting from Your death are paid to the named beneficiary at the time of death. If there is no beneficiary named or the named beneficiary predeceases or dies at the same time as You, We will pay the benefit to Your estate.

2. ALL OTHER CLAIMS: Benefits are to be paid to You.

3. If a Foreign National is entitled to benefits for a Covered Loss and We are unable to make payment directly to him or her because of legal restrictions in the country or jurisdiction where such Foreign National is located, We will either: (1) pay the benefits to a bank account owned by the Foreign National in the United States of America;

or (2) if no such bank account is established or maintained, We will pay the benefits to the Policyholder on behalf of the Foreign National. It will then be the responsibility of the Policyholder to remit the benefit to such Foreign National. Payment of the benefit to the Policyholder will release Us from any further liability to the Foreign National. If the Policyholder does not remit the payment to the Foreign National, the Policyholder will indemnify Us and hold Us harmless against any and all liability incurred by Us including, but not limited to, interest, penalties, and attorneys' fees in connection with, arising or resulting from such failure to remit payment. The Policyholder will not be considered the beneficiary under the Policy if payment is made to the Policyholder in accordance with this provision.

4. Any payment We make will fully discharge Us to the extent of the payment.

SECTION X - GENERAL POLICY CONDITIONS

A. BENEFICIARIES: You have the sole right to name a beneficiary. The beneficiary has no interest in the Policy other than to receive certain payments. Unless an irrevocable beneficiary is named, You may change the beneficiary at any time unless he or she has assigned the interest in the Policy. In such case, the person to whom You have assigned the interest in the Policy may have the right to change the beneficiary. Consent to a change by a prior beneficiary is not needed. Any beneficiary designation must be in writing on a form acceptable to Us.

B. CHANGE OR WAIVER: A change or waiver of any terms or conditions of the Policy must be issued by Us in writing and signed by one of Our executive officers. No agent has authority to change or waive Policy terms or conditions. A failure to exercise any of Our rights under the Policy will not be deemed as a waiver of such rights in the same or future situations.

C. CLERICAL ERROR: A clerical error or omission will not increase or continue Your coverage, which otherwise would not be in force. If You apply for insurance for which You are not eligible, We will only be liable for any premiums paid to Us.

D. SUIT AGAINST US: No action on this Policy may be brought until sixty (60) days after written Proof of Covered Loss has been sent to Us. Any action must commence within three (3) years, (five (5) years in Kansas and Tennessee; and six (6) years in South Carolina and Wisconsin) of the date the written Proof of Covered Loss was required to be submitted. If the law of the state where the Insured lives makes such limit void, then the action must begin within the shortest time period permitted by law.

E. PHYSICAL EXAMINATION AND AUTOPSY: We have the right to examine You when and as often as We may reasonably request while the claim is pending. Such examination will be at Our expense. We can have an autopsy performed unless forbidden by law. The autopsy must be performed in South Carolina.

F. CHOICE OF SERVICE PROVIDER: You have the sole right to choose Your duly licensed Physician and hospital.

G. TIME LIMIT ON CERTAIN DEFENSES: In the absence of fraud, statements made by the Policyholder or You are deemed representations and not warranties. No such statement will cause Us to deny or reduce the benefits due under the Policy or be used as a defense of a claim, unless it is contained in a signed written application. After two years from the date coverage starts no such statement (except age) will cause the Policy to be contested.

H. MISSTATEMENT OF AGE: If Your age has been misstated, We will adjust the benefits under the Policy to those that would be applicable at the correct age.

SECTION XI - BENEFITS

ACCIDENTAL DEATH BENEFIT

If You suffer a loss of life as a result of a Covered Injury, We will pay the applicable amount shown in the Schedule.The death must occur within 365 Days of the Covered Injury.

ACCIDENTAL DISMEMBERMENT BENEFIT

If a Covered Injury to You results in any of the following Covered Losses, We will pay the percentage shown below. The Covered Loss must occur within 365 days of the Covered Accident.

The benefit amount is based on the maximum amount shown in the Schedule for the person suffering the Covered Loss.

Covered Loss of Both Hands or Both Feet One Hand and One Foot

Percentage of Maximum Amount 100% 100%

For purposes of this Benefit, DEFINITIONS is amended to include the following:

Covered Loss means:

1. For a foot or hand, actual severance through or above the ankle or wrist joint;

2. For thumb and index finger, complete severance through or above the metacarpophalangeal joint of both digits;

3. Total and permanent loss of sight;

4. Total and permanent loss of speech; or

5. Total and permanent loss of hearing.

Plegia means a permanent, complete and irreversible loss of voluntary movement that affects motor function of one

(1) or more Limbs. Proof of total Plegia may be required by Us on a periodic basis. Benefits are not payable for paralysis caused by a stroke.

This benefit is payable based on the following table.

Plegia must continue for 12 consecutive months and be determined by Our competent medical authority. EXPOSURE AND DISAPPEARANCE BENEFIT If You are exposed to weather because of an Accident and this results in a Covered Loss, We will pay the applicable amount shown in the Schedule subject to all Policy terms.

If the conveyance in which You are riding disappears, is wrecked, or sinks, and You are not found within 365 days of the event, We will presume that You lost Your life as a result of injury. If travel in such conveyance was covered under the terms of the Policy, We will pay the applicable amount shown in the Schedule, subject to all Policy terms. We have the right to recover the benefit if We find that You survived the event.

Accident Medical Expense Benefit with Sublimits - South Carolina

U-BMC-380-B SC (01/20)

Zurich American Insurance Company 1299 Zurich Way Schaumburg, Illinois 60196

THIS RIDER CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This rider modifies insurance provided under the Blanket Accident Insurance Policy.

It is hereby understood and agreed that the following changes are made and incorporated into the Policy:

SCHEDULE

Benefit

Maximum Benefit per Insured per Covered Accident

Deductible per Insured per Covered Accident Co-Insurance: Our share of Usual and Customary Expenses per Insured per Covered Accident

ACCIDENT MEDICAL

Class I: $90,000.00, Class II: $90,000.00 per Insured per Covered Accident

Class I: $0,Class II: $0

Class I: 100%,Class II: 100%

We will pay Our share of the Usual and Customary Expenses for Medically Necessary Covered Medical Service(s) incurred by the Insured resulting from a Covered Accident while participating in a Covered Activity, up to the Maximum Benefit shown on the Schedule. Coverage is provided in excess of the Deductible and subject to the co-insurance shown in the above Schedule provided that:

1. the first treatment or service occurs within 180 Days of the Covered Injury; and

2. the medical expenses are incurred within Class I: 104 Weeks.Class II: 104 Weeks of the Covered Injury.

For this benefit only, the following definitions apply:

Covered Medical Service(s) means any of the following services when Medically Necessary for a Covered Injury:

1. Hospital room and board expenses: the daily room rate when an Insured is Hospital Confined and general nursing care is provided and charged for by the Hospital. In computing the expenses payable under this benefit, the date of admission will be counted but not the date of discharge.

2. Ancillary or miscellaneous inpatient Hospital expenses: services and supplies including operating room, laboratory tests, anesthesia and medicines (excluding take home drugs) when Hospital Confined.

3. Medical Emergency care (room and supplies) expenses incurred within twenty-four (24) hours of an Accident and including the emergency room or attending Physician's charges, X-rays, laboratory procedures, use of the emergency room and supplies.

4. Outpatient surgical room and supply expenses for use of the surgical facility (including ambulatory surgical facilities).

5. Diagnostic X-rays, laboratory procedures and tests.

6. Treatment for heat stroke and heat exhaustion

7. Physician non-surgical treatment/examination expenses (excluding medicines) including the Physician's initial visit, each necessary follow-up visit and consultation visits when referred by the attending physician.

8. Physician's surgical expenses that require singular or multiple surgical procedures during the same operative session through the same or different incision, We will pay only one benefit, the largest of the procedures performed. The Physician's surgical procedure(s) must be the result of a Covered Injury.

9. Anesthesiologist expenses for pre-operative screening and administration of anesthesia during a Physician's surgical procedure whether on an inpatient or outpatient basis. The Physician's surgical procedure(s) must be the result of a Covered Injury.

10. Assistant Physician expenses.

11. The services of a Registered Nurse (the nurse cannot be a member of the lnsured's immediate family).

12. Physiotherapy expenses on an inpatient or outpatient basis. Expenses include treatment and office visits connected with such treatment when prescribed by a Physician, including diathermy, ultrasonic, whirlpool, or heat treatments, adjustments, manipulation, massage or any form of physical therapy and/or occupational therapy.

13. Radiological procedures including cardiac imaging and nuclear medicine and molecular imaging related to a Covered Injury and prescribed by a Physician.

14. Diagnostic imaging expenses including Magnetic Resonance Imaging (MRI) and Computed Axial Tomography (CAT) Scan related to a Covered Injury and prescribed by a Physician.

15. Ambulance expenses for transportation from the emergency site to the Hospital .

16. Rehabilitative limb braces, wheelchairs and other medical equipment or appliances prescribed by a Physician and related to the Covered Injury. It must be durable medical equipment that:

a. is primarily and customarily used to serve a medical purpose;

b. can withstand repeated use; and

c. generally is not useful to a person in the absence of injury.

No benefits will be paid for rental charges in excess of the purchase price.

We will not cover computers, motor vehicles or modifications to a motor vehicle, ramps and installation costs.

17. Eyeglasses, contact lenses or hearing aids damaged or destroyed as a result of a Covered Injury and prescribed by a Physician.

18. Prescription drug expenses for Covered Injuries, prescribed by a Physician and administered on an outpatient basis.

19. Expenses for blood, blood transfusions and oxygen (including delivery of tanks and equipment and its administration).

20. Dental treatment for teeth , gums or structures directly supporting the teeth performed as a result of a Covered Injury.

21. Treatment resulting from complications of pregnancy due to a Covered Injury.

Custodial Services means medical and non-medical care, including, but not limited to, services which are:

1. related to watching or protecting the Insured if as a result of a Covered Injury they are deemed by a Physician to require daily preventative care for a period of one (1) to ninety (90) days;

2. related to performing, or assisting the Insured in performing any activities of daily living such as: walking, grooming, bathing, dressing, getting in or out of bed, toileting, eating, preparing foods, or taking medications that can be either self-administered or require medical assistance;

3. performed by trained or skilled medical personnel; and

4. which, in the absence of inpatient hospital care, would otherwise be required.

Deductible means a dollar amount of the Usual and Customary Expenses which must be incurred as an out-of pocket expense, by an Insured for each Covered Injury, before benefits are payable under this Policy. The Deductible amount is shown on the Schedule.

Emergency means a condition caused by a Covered Injury which:

1. presents a severe or acute symptom requiring immediate care and the failure to obtain such care could reasonably result in serious deterioration of the lnsured's condition or place his or her life in jeopardy; and

2. the severe or acute symptom occurs suddenly and unexpectedly.

Hospital means an institution which:

1. operates pursuant to applicable local laws and regulations governing such facilities;

2. primarily and continuously provides medical care and treatment to sick and injured persons on an inpatient basis;

3. operates facilities for medical and surgical diagnosis and treatment by or under the supervision of Physicians; and

4. provides 24-hour nursing service by or under the supervision of Registered Nurses (R.N.) or graduated nurses.

Hospital does not mean any institution or part thereof which is used primarily as:

1. a nursing home, convalescent home, or skilled nursing facility;

2. a place of rest, custodial care, or for the aged;

3. a clinic; or

4. a place for the treatment of mental illness, alcoholism or substance abuse.

However, a place for the treatment of mental illness, alcoholism or substance abuse will be regarded as a Hospital if it is:

1. part of the institution that meets the requirements in subparagraphs 1 - 4 above; and

2. listed in the American Hospital Association Guide as a general Hospital.

Hospital Confined means admission to a Hospital as an inpatient for at least 24 consecutive hours by a Physician. A Hospital stay that does not result in charges to the Insured is not a hospital confinement under this rider unless there is no charge because the Hospital is a United States government facility.

In Force Policy means any multiple group, group-type, family or individual health care policy covering the Insured and in effect at the time of the Covered Injury, or subsequently thereafter, other than the Policy to which this rider is attached.

Medically Necessary means that the medical service or treatment:

1. is for the diagnosis, treatment or care of the Covered Injury for which it is prescribed or performed;

2. meets standards of medical practice; and

3. is ordered by a Physician.

Medical Repatriation means transporting an Insured back to his or her Principal Residence or to the school where he or she was registered. Such repatriation shall only result from the Insured being injured during a Covered Activity.

Pre-existing Condition means a condition for which an Insured received any diagnosis, medical advice or treatment or had taken any prescription medicines during the three (3) months to five (5) years immediately preceding the effective date of coverage.

Principal Residence means the legal domicile of the Insured Usual and Customary Expense(s) means an amount(s) that: (1) does not exceed the usual cost for similar treatment, services or supplies in the locality in which it is incurred; or for a Hospital room and board charge other than for stay in an intensive care unit, does not exceed the Hospital's most common charge for semi-private room and board or the fee set by the workers' compensation insurance fee schedule, if applicable; and (2) does not include charges that would not have been made if no insurance existed and (3) does not exceed the cost of a generic drug, if available.

EXCLUSIONS:

In addition to the General Exclusions stated in the Policy, We will not cover expenses under this additional benefit for:

1. Cosmetic, plastic or restorative surgery unless Medically Necessary for the treatment of the Covered Injury.

2. Any medical expenses related to pregnancy unless Medically Necessary for the treatment of the Covered Injury.

3. Covered Injury for which the Insured is entitled to benefits under Workers Compensation Benefits, Employer Liability Law, or any statutorily mandated coverage.

4. Personal comfort or convenience items, such as but not limited to Hospital telephone charges, television rental, guest meals, or internet charges.

5. Treatment by any immediate family member or member of the lnsured's household.

6. Expenses incurred for dental care, treatment, repair or replacement of sound natural teeth unless Medically Necessary for the treatment of the Covered Injury.

7. Expenses incurred for eye examinations, contact lenses or the fitting, repair or replacement of these items unless Medically Necessary for the treatment of the Covered Injury.

8. A hernia of any kind unless the direct result of a Covered Injury.

9. Routine physical examinations and related medical services, elective treatment or surgery, experimental or investigative treatments or procedures.

10. Expenses incurred for psychological or psychiatric counseling of any kind or any expense for treatment of mental or nervous diseases or disorders.

11. Expenses which the Insured is not legally obligated to pay.

12. Expenses for Custodial Services or services provided by a private duty nurse unless such expenses are incurred as a result of a Covered Injury, as prescribed by a Physician.

13. Expenses related to the repair or replacement of existing artificial limbs, eyes, or other prosthetic appliances, or rental of existing medical equipment unless for the purpose of modifying the item because the Covered Injury has caused further impairment of the underlying bodily condition.

EXCESS INTEGRATED

The benefit amount for this benefit is payable in excess of any In Force Policy and its applicable deductible. In the event and only in the event of the reduction or exhaustion of the limit of insurance of the In Force Policy solely as the result of actual payment of benefits covered thereunder, this Policy shall pay excess of the reduced limit of insurance of the In Force Policy and its applicable deductible. This Policy shall only pay pursuant to the terms and conditions of this Policy and no other policy.

We will pay Our share of the Usual and Customary amount, reduced by the payment of any other insurance plan. This Policy will recognize payment by any other insurance plan as reducing or satisfying the deductible amount of this Policy. In no event will We pay more than the maximum amount stated in this rider.

If no In Force Policy exists, this Policy will pay benefits on a primary basis subject to the deductible and coinsurance amounts stated on the Schedule and a fifty percent (50%) reduction of the benefit will be made to the amount otherwise payable.

EXTENSION OF BENEFITS

If a Covered Accident commences while this rider is in force as to an Insured, benefits otherwise payable under this rider for the Covered Accident causing the Total Disability will also be paid for any Usual and Customary expenses incurred after the termination of insurance for an Insured if, from the date of such termination to the date such expenses are incurred, the Insured is Totally Disabled by reason of such Covered Accident. Such benefits shall be payable only during the continuance of such disability for a period of ninety (90) days.

SUBROGATION

We have the right to recover from any third party all payments including future payments, which We have made to the Insured or on behalf of the lnsured's Spouse or Domestic Partner, child, heirs, guardians or executors or will be obligated to pay in the future to the Insured, from any Third Party. If the Insured recovers from any third party, We will be reimbursed first from such recovery to the extent of Our payments to or on behalf of the Insured. The Insured agrees to assist Us in preserving its rights against any third party, including but not limited to, signing subrogation forms supplied by Us. Attorney's fees and costs will be paid by Us from the amounts recovered.

Except for the above, this rider does not vary, alter, waive, or extend any of the terms of the Policy to which it is attached.

Effective Date: August 1, 2025 Attached to and forming a part of Policy/Certificate No. MCB-4850979

Aggregate Deductible Endorsement

Zurich American Insurance Company 1299 Zurich Way Schaumburg, Illinois 60196

U-BMC-383-A CW (01/20)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This endorsement modifies insurance provided under the Blanket Accident Insurance Policy.

It is hereby understood and agreed that the following changes are made and incorporated into the Policy:

SCHEDULE

Aggregate Deductible (applies to Accident Medical Expense Benefit only): Aggregate Deductible: $220,000.00

AGGREGATE DEDUCTIBLE LIMITATION

The Aggregate Deductible is the amount that must be incurred and paid by the Policyholder before Accident Medical Expense Benefits become payable under this Policy. The Aggregate Deductible amount is shown in the Schedule of this Endorsement.

Retention Amount The Covered Medical Services applied to the Aggregate Deductible amounts are the Policyholder's Retention Amount. The Retention Amount is self-insured by the Policyholder. The Retention Amount is the amount of claims that the Policyholder must incur and pay for the Policy year.

Any portion of a claim incurred prior to the termination of the Policy that is applicable to the Retention Amount will not be affected by the termination; that portion of the claim will remain the responsibility of the Policyholder.

The Policyholder's bankruptcy, insolvency, or inability to pay the Retention Amount will not increase Our obligations under the Policy.

Legal Suit If a claim or suit is brought against Us under the Policy, We will defend Ourselves and the Policyholder will indemnify Us up to the amount for which the Policyholder is liable under the Policy as if said action were a claim or suit brought against the Policyholder.

Effective Date: August 1, 2025 Attached to and forming a part of Policy/Certificate No. MCB-4850979

Cardiac Injury Extension

Zurich American Insurance Company 1299 Zurich Way Schaumburg, Illinois 60196

U-BMC-393-A SC (10/20)

THIS RIDER CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

This rider modifies insurance provided under the Blanket Accident Insurance Policy/Certificate.

It is hereby understood and agreed that the following changes are made and incorporated into the Policy/Certificate:

The Accidental Death, and Accidental Dismemberment, Accident Medical Expense, benefits are extended to apply to Cardiac Injury.

For the purposes of this benefit only, the following definitions apply:

Cardiac Injury means a sudden Heart or Circulatory Malfunction if the first symptoms of such malfunction are medically diagnosed:

1. while the Insured is covered under the Policy;and

2. while the Insured is participating in a Covered Activity;and

3. within 72 hours of the Covered Activity.

The Insured must be under age 90 and must not have been medically diagnosed that he or she has, nor received any Medical Care for:

1. a Heart or Circulatory Malfunction; or

2. hypertension, angina, or other heart or circulatory condition. within 5 years prior to the date of the Covered Activity.

Heart or Circulatory Malfunction means a sudden and serious malfunction of the heart or circulatory system as a result of coronary thrombosis, cerebral vascular accident, myocardial infarction, and cardiac arrest, diagnosed by a Physician. Heart or Circulatory Malfunction does not refer to conditions such as hypertension and angina.

Medical Care means necessary:

1. medical or surgical treatment, services and supplies;and

2. hospital, nursing and ambulance services. Each item of Medical Care must be:

1. prescribed by a Physician; and

2. for the sole purpose of treating the Injury.

This rider is subject to the limitations in Section V General Limitations of the Policy/Certificate.

Except for the above, this rider does not vary, alter, waive, or extend any of the terms of the Policy to which it is attached. Effective Date: August 1, 2025 Attached to and forming a part of Policy/Certificate No. MCB-4850979

IN WITNESS WHEREOF, this Company has executed and attested these presents and, where required by law, has caused the Policy to be countersigned by its duly Authorized Representative(s).

C./ /./ £i1i#' I President

//i:_-:..7' ii i< ,1 If?_ t j YJ1UJL1/.l )F ��tt�rlf:'- , _; i) .JU Corporate Secretary

Residents of South Carolina who hold life insurance, annuities, or health insurance policies should know that the insurance companies and health maintenance organizations (HMOs) licensed in this state to write these types of insurance are required by law to be members of the South Carolina Life and Accident and Health Insurance Guaranty Association (SCLAHIGA). The purpose of SCLAHIGA is to assure that policyholders will be protected, within limits, in the unlikely event that a member insurer becomes financially unable to meet its obligations. If this happens, SC LAH I GA will assess its other member insurance companies for the money to pay the claims of insured persons who live in this state and, in some cases, to keep coverage in force. However, the valuable extra protection provided by these insurers through SCLAHIGA is limited. Consumers should shop around for insurance coverage and exercise care and diligence when selecting insurance coverage.Summary of the South Carolina Life and Accident and Health Insurance Guaranty Association Act and Notice Concerning Coverage Limitations and Exclusions

Disclaimer Under South Carolina law, the South Carolina Life and Accident and Health Insurance Guaranty Association (SCLAHIGA) may provide coverage of certain direct life insurance policies, accident and health insurance policies, annuity contracts and contracts supplemental to life, accident and health insurance policies and annuity contract claims (covered claims) if the insurer becomes impaired or insolvent. South Carolina law does not require the SCLAHIGA to provide coverage for every policy. COVERAGE MAY NOT BE AVAILABLE FOR YOUR POLICY.

Coverage is generally conditioned upon residence in this state. Other conditions that may preclude or exclude coverage are described in this notice. Even if coverage is provided, there are significant limits and exclusions. Please read the entire notice for further details on limitations and exclusions.

Insurance companies and insurance agents are prohibited by law from using the existence of the SCLAHIGA or its coverage to sell you an insurance policy. You should not rely on the availability of coverage under SCLAHIGA when selecting an insurer. The South Carolina Life and Accident and Health Insurance Guaranty Association or the Department of Insurance will respond to any questions you may have which are not answered by this document.

If you think the law has been violated, you may file a written complaint with the SCLAHIGA or the South Carolina Department of Insurance at the addresses listed below:

South Carolina Life and Accident and Health Insurance Guaranty Association Attention: Executive Director P.O. Box 8625 Columbia, SC 29202 South Carolina Department of Insurance Attention: Office of Consumer Services 1201 Main Street, Suite 1000 Columbia, SC 29201 Electronic complaint submission via www.doi.sc.gov/complaint

Please attach copies of all pertinent documentation. You may submit a written complaint or a complaint electronically to the Department through submission of the electronic form on the Department's website at www.doi.sc.gov/complaint. You should receive a response to your complaint within 10 days.

U-GU-886-A SC (08/23)

This safety-net coverage is provided for in the South Carolina Life and Accident and Health Insurance Guaranty Association Act (the Act). The following summary of the Act's coverages, exclusions and limits does not cover all provisions of the Act; nor does it in any way change any person's rights or obligations under the Act or the rights or obligations of the SCLAHIGA.

COVERAGE

Generally, individuals will be protected by the SCLAHIGA if they live in this state and hold a covered life, accident, health or annuity policy, plan or contract issued by an insurer (including a health maintenance organization) authorized to conduct business in South Carolina. The beneficiaries, payees or assignees of insured persons may also be protected if they live in another state unless circumstances described under the Act exclude coverage.

EXCLUSIONS FROM COVERAGE

Persons who hold a covered life, accident, health or annuity policy, plan or contract are not protected by SCLAHIGA if: They are eligible for protection under the laws of another state (This may occur when the insolvent insurer was incorporated in another state whose guaranty association protects insureds who live outside that state.);

· The insurer was not authorized to do business in this state; or

· They acquired rights to receive payments through a structured settlement factoring agreement. SCLAHIGA also does not provide coverage for:

· A portion of a policy or contract or part thereof not guaranteed by the member insurer, or under which the risk is borne by the policy or contract owner;

· A policy or contract of reinsurance, unless assumption certificates have been issued;

· Interest rate or crediting rate yields or similar factors employed in calculating value changes that exceed an average rate;

· Any policy or contract issued by assessment mutuals, fraternals, and nonprofit hospital and medical service plans;

· Benefits payable by an employer, association or other person under: (a) a multiple employer welfare arrangement; (b) a minimum premium group insurance plan; (c) a stop-loss group insurance plan; or (d) an administrative services contract;

· A portion of a policy or contract to the extent that it provides for (a) dividends or experience rating credits; (b) voting rights; or (c) payment of any fees or allowances to any person, including the policy or contract owner, in connection with the service to or administration of the policy or contract;

· A portion of a policy or contract to the extent that the assessments required by Section 38-29-80 with respect to the policy or contract are preempted by federal or state law;

· An obligation that does not arise under the express written terms of the policy or contract issued by the member insurer to the enrollee, certificate holder, contract owner or policy owner, including without limitation: (a) Claims based on marketing materials; (b) Claims based on side letters, riders or other documents that were issued by the member insurer without meeting applicable policy or contract form filing or approval requirements; (c) Misrepresentations of or regarding policy or contract benefits; (d) Extra-contractual claims; or (e) A claim for penalties or consequential or incidental damages;

· An unallocated annuity contract;

· A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to Medicare Part C or D or Medicaid; or

· Interest or other changes in value to be determined by the use of an index or other external references but which have not been credited to the policy or contract or as to which the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes impaired or insolvent insurer, whichever is earlier.

LIMITS ON AMOUNTS OF COVERAGE

The South Carolina Life and Accident and Health Insurance Guaranty Association Act also limits the amount that SCLAHIGA is obligated to pay for covered claims. The benefits for which SCLAHIGA may become liable shall in no event exceed the lesser of the following:

· With respect to one life, regardless of the number of policies or contracts: $300,000 in life insurance death benefits, or not more than $300,000 in net cash surrender and net cash withdrawal values for life insurance;

· For health insurance benefits: (a) $300,000 for coverages not defined as disability income insurance or health benefit plans or long-term care insurance, including any net cash surrender and net cash withdrawal values; (b) $300,000 for disability income insurance; (c) $300,000 for long-term care insurance; (d) $500,000 for health benefit plans; or

· $300,000 in the present value of…