Quote & Request Bind Church Mutual

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1 Quote & Request Bind Church Mutual Senior Apartments: Independent senior living communities, (also known as retirement communities or independent retirement communities), is housing designed for seniors 55 and older. Available in all states except: CA, FL, HI, LA, MS, MT, NV. Property restrictions may apply based on state/ county. Assisted Living: Assisted living communities are designed to provide residents assistance with basic activities of daily living such as: bathing, grooming, dressing and more. 20 bed minimum to qualify. skilled care or nursing homes. Available in all states except: CA, FL, HI, LA, OK, MS, MT, NV. Property restrictions may apply based on state/county. Churches: Houses of Worship for all religious denominations. Available in all states except: CA, FL, LA, MS, MT, NV. $50,000 combined minimum premium of property, general liability, umbrella, workers compensation. Property restrictions may apply based on state/ county. Pre-Qualification 1. Verify risk eligibility by reviewing the Pre-Qualification Questionnaire applies to both Senior Apartments and Assisted Living facilities 2. Coastal guidelines How to Obtain a Quote 1. Complete NTrack Full Quote application a. Classify as: Senior Apartments, Assisted Living, or Church - as appropriate 2. NEA Placement Specialist will review the submission and appropriate supplemental (survey) application to you for completion 3. 5 years of Loss Runs are required with submission a. New ventures may be acceptable subject to resumes and written summary of experience 4. Current state regulatory inspection documentations for Senior Living facilities are required 5. Manual quote will be inserted into your Dashboard a. Please allow up to 30 days from receipt of all information for delivery of manual quote b. You will receive an when quote is added to your Dashboard 6. Fax or all supplemental information to NEA NY Office - Fax ; rtheastteam@neagencies.com TX Office - Fax ; rtheastteamtx@neagencies.com How to Request Bind 1. Request bind through NTrack a. Signed and dated Acord applications required (te: The Full Quote NTrack application will automatically populate the Acord applications accessible on your Dashboard) 2. Direct Bill only Servicing 1. For policy changes, endorsements, claims, billing questions please contact NEA. *Church Mutual is an authorized company through the NEA Expanded Market Program. DBA: rtheast Agencies Insurance Services, CA License # 0B45336; in GA, DBA: NEA Insurance Services; in TX, DBA: rtheast Brokeage Agencies, Inc.; in UT, DBA: rtheast Insurance Agencies, Inc.

2 CMIC SENIOR LIVING PRE-QUALIFYING QUESTIONNAIRE Name: Address: City and State: Contact Name: Telephone.: QUESTIONS: 1. Are any of your facilities a nursing home? (If yes, DNQ.) 2. Do you have 20 or more residents in your facility? (If no, DNQ.) If yes, how many do you have, and how many are you licensed for? (Less than 50% occupancy, DNQ.) *3. Are the residents of your facility 55 years or older? (Up to 20% non-elderly is acceptable.) If not, how many? 4. Are any of your residents mentally ill or developmentally disabled? If yes, how many? (More than 20%, including non-elderly, DNQ.) 5. Are any of your facilities converted dwellings over 1 story? (If yes, DNQ.) 6. Are any of your buildings frame construction and over 2 stories? If yes, do they have an automatic sprinkler system (100%)? (If no, DNQ.) 7. Has your facility been in operation for more than one year? If no, how many years of experience does the facility management have? 8. Who is your current insurance carrier and what coverages do you have? (A lapse in coverage may disqualify the prospect.) 9. What is your current policy expiration date? 10. Does your facility offer/include any of the following services: a. Home Health Care Services? (Services provided to non-residents that do not live on the premises.) If yes, what percentage of gross revenue does it represent? (If more than 10%, DNQ) b. Consulting Operations for Senior Living Facilities? If yes, what percentage of gross revenue does it represent? (Refer to Underwriting) * t applicable to independent apartments Page 1 of 2

3 Underwriting tice #5 RE: Coastal Guidelines Background: The coastal guidelines have been in place since 2008, with changes throughout the years. This document now puts them all in one easily viewable place. Update: There is an update at the top of the guidelines, regarding policies that have lapsed for nonpay. If these risks are in areas listed in the guidelines as ineligible, we will not reinstate or rewrite the risk.

4 COASTAL GUIDELINES Updated Update 1-13: Any insured risk we presently have that is an ineligible area as listed below, will not be reinstated or rewritten if coverage lapses. Atlantic Seacoast rth to South Maine, New Hampshire, Massachusetts, Rhode Island, Connecticut Risks are ineligible if located on an island. If a bridge is crossed or use of ferry transportation is needed to reach the risk, the risk is not eligible. field binding authority on Cape Cod. Requirements to submit for review include, minimum $1,000 deductible, prior carrier loss runs from past three years, seasonal facilities must have winter maintenance program. Wind percentage deductibles should be encouraged on all business exposed to the coast. New York field binding authority on Long Island within ½ mile of the coast. Prior carrier loss run information is required. Wind percentage deductibles should be encouraged on all business exposed to the coast. New Jersey Risks are ineligible if located on a barrier island, if less than 1 mile from the coast excluding the barrier islands, and frame structures larger than $3 mill located east of the Garden State Parkway. In Monmouth and Cape May Counties only high quality risks are eligible. Maximum property coverage aggregate exposure of $75 million in Monmouth County and $50 million in Cape May County will be maintained. field binding authority east of the Garden State Parkway from the Southern tip of New Jersey north to Perth Amboy. Wind percentage deductibles should be encouraged on all business exposed to the coast.

5 Delaware field binding authority for risks East of Hwy 113 in Sussex County. Wind percentage deductibles should be encouraged on all business exposed to the coast. Maryland field binding authority for risks in Worcester and Wicomico Counties. Wind percentage deductibles should be encouraged on all business exposed to the coast. Virginia Any new business less than 3 miles from the coast is ineligible. For purposes of defining distance, the coast begins on the mainland. Risks are ineligible if located on a barrier island. Wind percentage deductibles should be encouraged on renewal business. rth Carolina Any new business located less than 10 miles west of the Intracoastal Waterway is ineligible. Risks located on the Outer Banks are ineligible. Field binding authority is suspended in each of the following counties: Brunswick, Pender, Onslow, Carteret, Beaufort, New Hanover, Pamlico, Hyde, Dare, Tyrrell, Pasquotank, Camden, Currituck. Wind percentage deductibles should be encouraged on all business exposed to the coast. South Carolina Any new business that is less than 25 miles from the Atlantic coast is ineligible. This includes the cities of Myrtle Beach, Hilton Head and Charleston. Wind deductibles should be encouraged on all business exposed to the coast. Georgia Risks located on any barrier island are ineligible. Wind percentage deductibles should be encouraged on all business exposed to the coast. The areas around Savannah and Brunswick require specific attention.

6 Florida new business accepted in Florida. The current Florida book is to be reduced by $1.5Billion TIV and to 1,300 accounts in force by year-end Renewals are subject to a mandatory minimum 2% windstorm deductible. Wind deductibles of 5% or more are encouraged. Gulf of Mexico East to West Alabama Any risk that is South of I10 in Alabama is ineligible. Risks located on Dauphin Island or any other barrier island are ineligible. Any risk located within 5 miles of Mobile Bay is ineligible. Baldwin and Mobile counties have limitations as to total accumulated property exposure allowed ($30M and $75M respectively). The sales staff has no binding authority for risks south of I65 and rth of I10. Wind percentage deductibles should be encouraged on all business exposed to the coast. Mississippi The following are ineligible as new business. 1. All property located in the counties of Hancock, Harrison, Jackson and 2. All property in the county of Pearl River South of a line from the Louisiana/Mississippi border to the northwest border of Hancock and Pearl River counties. A minimum 2% wind deductible is required on all new policies insuring property in the counties of Stone, George, and the remainder of Pearl River. Renewal Business in the new business ineligible area as stated above is to be reviewed for possible non-renewal. If renewed, minimum wind deductibles are mandatory as follows based upon construction type: 5% frame and masonry veneer, 2% all other constructions. Renewal business in counties of Stone, George, and the remainder of Pearl River as identified above are required to have a minimum wind deductible of 2% for all construction classes.

7 Louisiana The following are ineligible for new business. 1. All properties located south of Highway 10 from the Texas border east to Baton Rouge, 2. South of Highway 12 from Baton Rouge to St. Tammany Parish, and 3. All properties located in St. Tammany Parish. A minimum 2% wind deductible is required on all new policies insuring property north of the ineligible area identified above and in the parishes of Beauregard, Allen, Evangeline, St. Landry, Pointe Coupee, West Feliciana, East Feliciana, St. Helena, Tangipanoa, Washington, Calcasien, Jefferson, West Baton Rouge, East Baton Rouge, Livingston, Davis, Acadia, Lafayette, St. Martin, and Iberville. Renewal business in the new business ineligible area as stated above is to be reviewed for possible non-renewal (with knowledge that the state has imposed limitations on our ability to cancel/nonrenew business subject to natural catastrophe loss). If renewed, minimum wind deductibles are mandatory as follows based upon construction type: 5% frame and masonry veneer, 2% all other construction types. A minimum 2% wind deductible is required on all renewal business in the ineligible area identified above and in the parishes of Beauregard, Allen, Evangeline, St. Landry, Pointe Coupee, West Feliciana, East Feliciana, St. Helena, Tangipanoa, Washington, Calcasien, Jefferson, West Baton Rouge, East Baton Rouge, Livingston, Davis, Acadia, Lafayette, St. Martin, and Iberville. Texas Risks located less than 25 miles from the coast, or eligible for TX wind pool, are ineligible for wind/hail coverage. Wind coverage is available to be written through the wind pool. Harris County is closed to new business and the field has no binding authority. Windstorm percentage deductibles should be used where appropriate with consideration given to properties within 100 miles of the coast.

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20 c. Adult Day Care? If yes, what percentage of gross revenue does it represent? (Refer to Underwriting) 11. How many of your residents are non-ambulatory (unable to evacuate the facility without assistance)? (Greater than 20%, DNQ.) 12. Do you have security and monitoring systems in place for diagnosed Alzheimer/Dementia residents? (If no, DNQ.) 13. Does your facility provide any diagnostic medical services or skilled medical care? (If yes, DNQ.) *14. Are you licensed under state eligible classifications and regulations? (If no, DNQ.) 15. Do you have favorable state inspections? (If no, DNQ.) 16. What is the age of your building? (If more than 30 years old, must have electrical, cooling/heating system, and roof updated before quoting.) 17. How many stories tall is your building? (If over 6 stories, refer to Underwriting.) * t applicable to independent apartments Page 2 of 2

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