Certificate Document Modification Overview Visitors CareSM (VIC) Plan B Product Update Effective Date: May 1, 2019

Summary of Notable Changes Various formatting changes have been made to your certificate to make the most frequently needed information easier to find. To improve our service, we have also made various language modifications to increase consistency across our portfolio; these changes help us help you! Please note the following benefit enhancements and changes: Certificate of Insurance: • Deleted and replaced “Home Country” with “Country of Residence” • Deleted and replaced “Host Country” with “Destination Country” Benefit Summary: • Language updates for grammar and consistency • Coverage Limit / Maximum Amount for Eligible Medical Expenses

o Deleted and replaced “Lifetime” Maximum Limit to “Period of Coverage per Injury or Illness” Maximum Limit o Updated 04.30.19: Area of Coverage: Deleted and replaced with United States only • Pre-existing Condition

o New section • Acute Onset of Pre-existing Condition

o New benefit/section

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• Inpatient Services

o Inpatient Physician . Benefit increase Maximum per visit: $60 Maximum visits per day: 1 Maximum visits: 30

o Hospital Room / Board . Subparagraph Added: Includes Extended Care Facility

o Chemotherapy and Radiation Therapy . New Benefit Maximum Limit: $1,100 • Outpatient Services

o Outpatient Physician . Benefit increase Maximum per visit: $60 Maximum visits per day: 1 Maximum visits: 30

o Urgent Care Clinic . New Benefit: Maximum per visit: $60 Maximum visits: 10

o Diagnostic Laboratory and Radiology . Benefit decrease: Maximum Limit: $450 . New limitation: Maximum per procedure: $250

o Chemotherapy and Radiation Therapy . New Benefit: Maximum Limit: $1,100

o Home Nursing Care . New Benefit: Maximum Limit: $550 Provided by a Home Health Care Agency Upon direct transfer from an acute care Facility

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o Extended Care Facility Deleted in its entirety (refer to Inpatient Services, Hospital Room / Board)

o Durable Medical Equipment . New Benefit Maximum Limit: $1,000 • Emergency Services

o Common Carrier Accidental Death . Benefit increase and update (family maximum removed): Not subject to Deductible Not subject to Period of Coverage Maximum Limit Maximum Limit: $25,000 Approved in advance and Coordinated by the Company

o Emergency Medical Evacuation . New Benefit Maximum Limit: $25,000 Not subject to Deductible Not subject to the Period of Coverage Maximum Limit Approved in advance and coordinated by the Company

o Return of Mortal Remains . New Benefit Maximum Limit: $25,000 Not subject to deductible Return of Insured Person’s Mortal Remains to Country of Residence Local burial/cremation Maximum Limit: $5,000 Approved in advance and coordinated by the Company

Detailed Changes The following details are provided to assist you in identifying the changes to your Certificate. Please refer to your previous and new Certificates for actual language. Please note that the Provision order of the contract language may have changed in certain areas and are noted in the detailed changes. Provision Modification Cover Pages • Cover photo deleted and replaced photo • Language updates for grammar and consistency A. Benefit Summary Language updates for grammar and consistency B. Agreement Language updates for grammar and consistency C. Conditions and General Provisions • Language updates for grammar and consistency • Effective date changed to April 1, 2019 (1) Entire Agreement Language updates for grammar and consistency (2) Premium Language updates for grammar and consistency

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Provision Modification (3) Claims Notification • Language updates for grammar and consistency • Proof of Claim incorporated into provision • Added paragraph after Proof of Claim, (a)(iii): If the claims are submitted electronically, copies of the above items are acceptable; however, the Company reserves the right to request the original documents.

(4) Appealing a Claim Language updates for grammar and consistency

(5) Assignment, Change or Waiver Language updates for grammar and consistency (6) Service of Suit; Venue; Choice of Law; Trial by Language updates for grammar and consistency Court (7) Misrepresentation Language updates for grammar and consistency (8) Insolvency No changes (9) Subrogation Clause Language updates for grammar and consistency (10) Other Insurance Language updates for grammar and consistency (11) Cancellation by Insured Person Language updates for grammar and consistency (12) Applicable Currency Language updates for grammar and consistency (13) Cooperation Language updates for grammar and consistency (14) Claim Settlement Language updates for grammar and consistency (15) Fraudulent Claims No changes (16) Arbitration No changes (17) Termination of Master Policy Language updates for grammar and consistency (18) Termination of Coverage for Insured Persons • Language updates for grammar and consistency • Added: (j) the cancellation date specified by the Company pursuant to the CONDITIONS AND GENERAL PROVISIONS, CANCELLATION BY INSURED PERSON provision (k) the cancellation date specified by the Insured Person pursuant to the CONDITIONS AND GENERAL PROVISIONS, RENEWAL; AMENDMENTS provision

(19) Renewal / Amendment Language updates for grammar and consistency (20) Patient Advocacy Language updates for grammar and consistency (21) Right of Recovery Language updates for grammar and consistency (22) Explanation or Verification of Benefits Language updates for grammar and consistency

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Provision Modification D. Eligibility • Language updates for grammar and consistency • Renumbering of provision due to deletions and merging of subparagraphs • Item (3): Deleted “fifteen (15)” and replaced with “fourteen (14)” (formerly (5)) • Formerly item (5): Deleted in its entirety; states in part: for Insured Persons sixty-five (65) years … • Updated 05.01.19 Item (7): (change italicized) on the Effective Date and on subsequent renewal dates, must have legally departed the Country of Residence and legally entered or in transit to the Destination Country • Item (7): Added (formerly (2), (3); merged; updated): on the Effective Date and on subsequent renewal dates, must have legally departed the Country of Residence and legally entered the Destination Country

E. Pre-certification Requirements Language updates for grammar and consistency (1) Specific Requirements Language updates for grammar and consistency

(2) General Requirements Language updates for grammar and consistency

(3) Loss of Coverage / Benefits for Non-Compliance Language updates for grammar and consistency with Pre-Certification Requirements (4) Emergency Pre-certification No changes (5) Concurrent Review No changes (6) Appeal Process Language updates for grammar and consistency F. Eligible Medical Expenses • Language updates for grammar and consistency • Renumbering of provision due to deleting and merging of subparagraphs • Inpatient Services

o Item (1)(a): Deleted and replaced (formerly (1) (a) and (f): daily room and board, nursing services, Ancillary Services including the use of the observation, operating, Treatment or recovery room

o Item (1)(b): Deleted and replaced: daily room and board, nursing services and Ancillary Services in an Intensive Care Unit

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Provision Modification

Eligible Medical Expenses continued o Item (1)(c): Added (formerly under outpatient services): Extended Care Facility following an acute Hospital Inpatient stay are to be included in the per day Hospital room and board limits shown in the BENEFIT SUMMARY

o Item (1)(f): Deleted and replaced (formerly item (h): Inpatient Physician and specialist consultation visits

o Item (1)(g): Deleted and replaced (formerly item (d): surgeon and assistant surgeon including services and supplies

o Item (1)(g): Deleted and replaced (formerly item (d): surgeon and assistant surgeon including services and supplies

o Item (1)(i): Added private duty nursing

o Items (2((a) and (b) (formerly): deleted in its entirety; moved to Outpatient Services • Outpatient Services

o Items (3)(a): Added (formerly under inpatient services) Emergency Treatment of an Injury, even if Hospital confinement is not required

o Items (3)(b): Added (formerly under inpatient services) Emergency Treatment of an Illness; however, Charges for use of the Emergency room itself will not be covered unless the Insured Person is directly admitted to the Hospital as Inpatient for further Treatment of that Illness

o Items (3)(c): Added (formerly under (5)(e), (f)): Emergency Local Ambulance Transport necessarily incurred in connection with: (i) an Injury (ii) an Illness resulting in Hospital confinement as an Inpatient

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Provision Modification

Eligible Medical Expenses continued o Items (3)(f): Added: pre-admission testing

o Items (3)(i): Added: o surgeon and assistant surgeon services o Items (3)(k): Added: radiation therapy or Treatment and chemotherapy

o Items (3)(n): Added: Home Nursing Care in bed by a qualified licensed professional, provided by a Home Health Care Agency upon direct transfer from an acute care Hospital

o 05.01.19: Item (4) added: Charges incurred while in transit to the Destination Country if the Insured Person has legally departed from his/her Home Country on the Effective Date of coverage

o 05.01.19UItem (5) added: Charges incurred while in transit to his/her Country of Residence if the Insured Person has legally departed the Host Country and expenses are incurred during the Period of Coverage.

G. Acute Onset of Pre-existing Conditions New provision (1) Subject to the applicable Deductible and Coinsurance and the various limits and sub-limits set forth in the BENEFIT SUMMARY, and the Terms of this insurance, including without limitation the CONDITIONS AND RESTRICTIONS subparagraph below, and in the event the Insured Person suffers or experiences an Acute Onset of a Pre-existing Condition during the Period of Coverage for which immediate Treatment is essential and necessary to stabilize the Pre-existing Condition, the Insured Person will be reimbursed up to the amount shown in the BENEFIT SUMMARY for Eligible Medical Expenses incurred during the Period of Coverage with respect to the Acute Onset of the Pre-existing Condition. (2) CONDITIONS AND RESTRICTIONS: To be eligible for the foregoing limited coverage and benefits for an Acute Onset of a Pre-existing Condition, the Insured Person must be in compliance with all Terms of this insurance. The Company will provide such coverage and benefits only when all of the following conditions

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Provision Modification Acute Onset of Pre-existing Conditions continued and restrictions have been met. At the time of the Acute Onset of the Pre-existing Condition: (a) Treatment must be obtained within twenty-four (24) hours of the sudden and Unexpected outbreak or reoccurrence (b) the Insured Person must be under seventy (70) years of age (c) the Insured Person must not be traveling against or in disregard of the recommendations, established Treatment programs, or medical advice of a Physician or other healthcare provider the Insured Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing Condition (d) the Insured Person must not be traveling during a period of time when the Insured Person is preparing or waiting for, involved in, or undertaking a new, changed or modified Treatment program with respect to the Pre-existing Condition, and is not traveling subsequent to any such new, changed or modified Treatment program having been advised or recommended (e) the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment (f) the Insured Person must be traveling outside their Country of Residence.

H. Common Carrier Accidental Death Benefit Language updates for grammar and consistency I. Emergency Medical Evacuation Benefit Language updates for grammar and consistency J. Incidental Trip Language updates for grammar and consistency K. Return of Mortal Remains Language updates for grammar and consistency L. Exclusions • Language updates for grammar and consistency • Renumbering of provision due to deleting and merging of subparagraphs • Item (1): Deleted and replaced (formerly (1), (2): WAR; MILITARY ACTION; TERRORISM: The Company shall not be liable for and will not provide coverage or benefits for any claim or Charges incurred with respect to any Illness, Injury, or other consequence, whether directly or indirectly, proximately or remotely occasioned by,

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Provision Heading Modification Exclusions continued contributed to by, or traceable to or arising or incurred in connection with or as a result of the Insured Person’s active and voluntary planning or coordination of or participation in any of the following acts or event occurrences: (a) war, invasion, act of foreign enemy hostilities, warlike operations (whether war be declared or not), or civil war (b) mutiny, riot, strike, military or popular uprising, insurrection, rebellion, revolution, military or usurped power any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the Government de jure or de facto or to the influencing of it by violence of any type (c) martial law or state of siege or any events or causes which determine the proclamation or maintenance of martial law or state of siege (d) any use of radiological, chemical, nuclear or biological weapons or any other radiological, chemical, nuclear or biological events of any type (e) any act of Terrorism. Any claim, Charges, Illness, Injury or other consequence happening or arising during the existence of abnormal conditions (whether physical or otherwise), whether or not directly or indirectly, proximately or remotely occasioned by, or contributed to by, traceable to, or arising in connection with, any of the said occurrences shall be deemed and considered to be consequences for which the Company shall not be liable under the Master Policy or this Certificate, except to the extent that the Insured Person shall prove that he/she was a victim, innocent bystander, and there was no contributory fault chargeable to the Insured Person. • Item (2): Updated (formerly (3)): Charges resulting directly or indirectly from or relating to any Pre-existing Condition, defined as a medical or health condition (whether physical or mental, regardless of the cause of the condition) are excluded from coverage under this insurance

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Provision Heading Modification Exclusions continued • Item (5): Updated (formerly (19)): PREVENTATIVE CARE: Charges for Routine Physical Examinations and immunizations are excluded from coverage under this insurance • Item (6)(d): Updated (formerly (5)(d)): not Medically Necessary for the diagnosis, care or Treatment of the physical condition involved. This also applies when and if they are prescribed, recommended or approved by the attending Physician • Item (6)(g): Added/updated language (formerly (24)) related to Hospice Care • Item (6)(h): Updated (formerly (6)(g)): incurred by an Insured Person who was HIV+ on or before the Initial Effective Date of this insurance, whether or not the Insured Person had knowledge of his/her HIV status prior to the Effective Date, and whether or not the Charges are incurred in relation to or as a result of said status. This exclusion includes Charges for any Treatment or supplies relating to or arising or resulting directly or indirectly from HIV, AIDS virus, AIDS related Illness, ARC Syndrome, AIDS and/or any other Illness arising or resulting from any complications or consequences of any of the foregoing conditions • Item (11): Added: Charges incurred for testing that attempts to measure aspects of an Insured Person’s mental ability, intelligence, aptitude, personality and stress management. Such testing may include but is not limited to psychometric, behavioral and educational testing • Item (12): Deleted and replaced (formerly (10)): Charges incurred while confined primarily to receive Custodial Care, for Educational or Rehabilitative Care that specifically relates to training or retraining an Insured Person to function in a normal or near-normal manner. Such care may include but is not limited to job or vocational training, counseling, occupational therapy and speech therapy • Item (19): Deleted and replaced (formerly (11)(e)): any Illness or Injury sustained while taking part in, practicing or training for: Amateur Athletics; Professional Athletics; or athletic activities that are

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Provision Heading Modification Exclusions continued sponsored by any Governing Body or Authority including the National Collegiate Athletic Association, any other collegiate sanctioning or Governing Body or the International Olympic Committee • Item (20): Added any Illness or Injury sustained while taking part in activities designated as Adventure Sports, which are limited to the following: ; BMX; bobsledding; ; ; caving; hot air ballooning; jungle zip lining; ; ; parascending; rappelling; skydiving; spelunking; wildlife safaris; and • Item (21): Added any Illness or Injury sustained while taking part in activities designated as Extreme Sports, which include but are in no way limited to the following (and include any combination or derivative of the following): BASE jumping; cave ; cliff diving; downhill and racing; ; ; free flying; free running; free skiing; freestyle scootering; ; heli-skiing; ice canoeing; ice ; kitesurfing; mixed martial arts; ; motorcycle racing; motor rally; above elevation of 4500 meters from ground level; parkour; piloting a commercial or non-commercial aircraft; powerbocking; or sub aqua pursuits below a depth of 50 meters; snowmobile racing; truck racing; or whitewater Class VI and higher difficulty; and • Item (22): Added any Illness or Injury sustained while taking part in snow skiing, or snowmobiling where the Insured Person is in violation of applicable laws, rules or regulations of a ski resort, out of bounds or in unmarked or unpatrolled areas • Item (23): Added any Illness or Injury sustained while taking part in backcountry skiing • Item (24): Added: any Illness or Injury sustained while taking part in skiing off-piste • Item (26): Added: any Illness or Injury sustained while taking part in Collision Sports

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Provision Heading Modification Exclusions continued • Item (27): Deleted and replaced (formerly (11)(g)): any Illness or Injury sustained while taking part in athletic or recreational activities where the Insured Person is not physically or medically fit or does not hold the necessary qualifications to engage in said activities • Item (31): Updated (formerly (11)(h)): any Injury or Illness sustained while operating a moving vehicle after consumption of intoxicating liquor or drugs in excess of the applicable blood/alcohol legal limit, other than drugs taken in accordance with Treatment prescribed and directed by a Physician. For purposes of this exclusion, “vehicle” shall include motorized devices regardless of whether or not a driver or operator license is required (including watercraft and aircraft) and non-motorized bicycles and scooters for which no permit or license is required • Item (39): Deleted and replaced (formerly (11)(q)): any non-surgical Illness or Treatment of the feet, including without limitation: orthopedic shoes; orthopedic prescription devices to be attached to or placed in shoes; Treatment of weak, strained, flat, unstable or unbalanced feet; metatarsalgia, bone spurs, hammer toes or bunions; and any Treatment or supplies for corns, calluses or toenails • Item (47): Added: any Illness or Injury incurred in the Destination Country as a result of epidemics, pandemics, public health emergencies, Natural Disasters, or other disease outbreak conditions that may affect a person’s health when, prior to the Insured Person’s entry into the Destination Country, any of the following were issued regarding the Destination Country (a) the World Health Organization had issued an Emergency Travel Advisory (b) the United States Centers for Disease Control & Prevention had issued a Warning Level 3 (avoid nonessential travel) (c) a similar governmental agency of the Insured Person’s Country of Residence had published, communicated or issued a Travel Warning or Emergency Travel Advisory restriction or official declaration informing the public about such health issues before the Insured Person traveled to the Destination Country

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Provision Heading Modification Exclusions continued • Item (50): Deleted and replaced (formerly (18)): Charges incurred for Treatment or supplies for temporomandibular joint (TMJ) including but not limited to TMJ syndrome, craniomandibular syndrome, chronic TMJ pain, orthognathic Surgery, Le-Fort Surgery or splints • Item (54): Updated (formerly (16) Charges incurred for prosthetics or orthotics • Item (59): Added: • Charges for Treatment of an Illness or Injury for which payment is made or available through a workers' compensation law or a similar law • Item (56): Added: Charges incurred for massage therapy • Item (58): Added: Charges for Treatment of an Illness or Injury for which payment is made or available through a workers' compensation law or a similar law • Item (59): Deleted and replace (formerly 15)): Charges incurred for Dental Treatment, except as specifically provided for hereunder

M. Definitions continued • Added Adventure Sports: Activities undertaken for the purposes of recreation, an unusual experience or excitement. These activities are typically undertaken outdoors and involve a medium degree of risk. Child; Children: An Insured Person who is at least fourteen (14) days old but less than nineteen (19) years of age. Collision Sports: A sport in which the participants purposely hit or collide with each other or inanimate objects, including the ground, with great force and limited to the following: American football, boxing, ice hockey, lacrosse, full contact martial arts, rodeo, rugby and wrestling. Country of Residence: The Country of Residence is the country in which the Insured Person maintains his/her current primary residence or usual place of abode and any country to which the Insured Person pays income taxes based upon employment in that country. In the event there is more than one Country of Residence

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Provision Heading Modification Definitions continued under the above-listed criteria, the Country of Residence is the country meeting the above-listed criteria and listed by the Insured Person as his or her Country of Residence on the Application. Dental Provider; Dentist: A person duly licensed to practice dentistry in the state or country in which the dental service is rendered. Updated 05.01.19 Destination Country: All geographical areas within the United States. Extreme Sports: Recreational activities involving a high degree of risk. These activities often involve speed, height, a high level of physical exertion, and/or highly specialized gear and often carry the potential risk of serious or permanent physical Injury and even death. Facility: Licensed health care entity such as a Hospital, clinic, rehabilitation, and/or Extended Care Facility. Governing Body or Authority: A nationally-recognized controlling organization for a sport or activity, or an organization that provides guidelines and recommendations in safety practices for a sport or activity. Hospice; Hospice Care: Care provided in an Inpatient Facility or at a patient’s home. Initial Effective Date: The date the Insured Person originally obtains coverage under this insurance plan and maintains continuous unbroken coverage thereafter. Sudden and Unexpected Reoccurrence of a Pre-existing Condition: A sudden and unexpected outbreak or reoccurrence of a Pre-existing Condition is a condition: (a) that occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent medical care (b) that occurs after the Effective Date (c) for which Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or reoccurrence. A Pre-existing Condition is not a Sudden and Unexpected Reoccurrence of a Pre-existing Condition where:

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Provision Heading Modification Definitions continued (a) the Pre-existing Condition is chronic, congenital or a condition that gradually becomes worse over time (b) medical care, drugs or Treatments were received, expected, scheduled, or required thirty (30) days prior to the Effective Date. Urgent Care Clinic: A standalone Facility or a Facility located inside a Hospital that staffs Physicians, nurse practitioners (NP) or physician assistants (PA). Urgent Care Clinics provide medical services that are not life- threatening Injuries or Illnesses. Urgent Care Facilities have onsite x-ray equipment and provide Treatment for more severe urgent care services such as broken bones, burns and other non-emergent conditions that Walk-in Clinics are unable to treat. • Deleted and replaced and/or updated: Amateur Athletics: An amateur or other non- professional sporting, recreational, or athletic activity that is organized, sponsored and/or sanctioned, and/or involves regular or scheduled practices, games and/or competitions. Amateur Athletics does not include athletic activities that are non-organized, non-contact, non-collision, and engaged in by the Insured Person solely for recreational, entertainment or fitness purposes. Certificate; Certificate of Insurance: This document as issued to the Insured Person, that describes and provides an outline and evidence of eligible coverages and benefits payable to or for the benefit of the Insured Person under the insurance contract, which includes the Master Policy, Application, Declaration and any Riders. Congenital Disorder: Any abnormality, deformity, disease, Illness, Injury or medical condition present at birth, whether diagnosed or not Deductible: The dollar amount, as selected on the Application and specified in the Declaration, that the Insured Person must pay of ELIGIBLE MEDICAL EXPENSES per Period of Coverage prior to receiving benefits or coverage under this insurance, and not including any applicable Coinsurance. Durable Medical Equipment (DME): Exclusively the following items: a standard basic hospital bed, standard basic wheelchair or the initial orthopedic prosthetic.

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Provision Heading Modification Definitions continued Effective Date; Effective Date of Coverage: The later of (a) the date of coverage for the Insured Person as indicated on the Declaration or (b) the date that the Insured Person departs his/her Country of Residence. Home Nursing Care: Services and/or Treatment provided by a Home Health Care Agency and supervised by a Registered Nurse that are directed toward the Convalescent care of a patient, provided always that such care is Medically Necessary and in lieu of Medically Necessary Inpatient care. Home Nursing Care does not include services or Treatment primarily for Custodial Care or rehabilitative purposes. Maximum Limit: The cumulative total dollar amount of benefit payments and/or reimbursements available to an Insured Person under this insurance. When the Maximum Limit is reached, no further benefits, reimbursements or payments will be available under this insurance. Terms: All Terms, provisions, conditions, definitions, Deductibles, Coinsurance, limits, sub-limits, limitations, wordings, restrictions, requirements, qualifications and/or exclusions that bind the Insured Person as set forth in the Master Policy, Application and any Riders Travel Warning; Emergency Travel Advisory: Published statement or website document issued by the United States Department of State, Bureau of Consular Affairs, Centers for Disease Control and Prevention, United Nations, World Health Organization or similar government or non-governmental agency of the Insured Person’s Country of Residence, warning that travel to specific identified countries, regions or locations poses serious risks to safety and security or exposes the Insured Person to a greater likelihood of life-threatening risks, including but not limited to United States Department of State Travel Advisories levels "3 - Reconsider travel" and "4 - Do not travel." Treated; Treatment: Any and all services and procedures rendered in the management and/or care of a patient for the purpose of identifying, diagnosing, treating, curing, preventing, controlling and/or combating any Illness or Injury, including without limitation: verbal or written advice, consultation, examination, discussion, diagnostic testing or evaluation of any kind, pharmacotherapy or other medication, and/or Surgery. • Deleted in its entirety: Home Country Host Country

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