RL-ACC3-CERT2-23-IN 1 D12967 (11/25) GROUP ACCIDENT INSURANCE CERTIFICATE OF COVERAGE RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 Claims: 855-730-2902 Customer Service: 877-236-7564 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CAC2 POLICY EFFECTIVE DATE: January 1, 2026 GOVERNING JURISDICTION: Indiana THIS IS LIMITED BENEFIT INDEMNITY COVERAGE Benefits are paid for Covered Accidents as defined in the Certificate. The Policy does not constitute comprehensive health insurance coverage (often referred to as “major medical insurance coverage”). In addition, the Policy does not satisfy the requirement of minimum essential coverage under the Affordable Care Act. Benefits are paid under the Policy for Covered Accidents as indemnity insurance and are not intended to cover medical expenses. ReliaStar Life Insurance Company certifies that we have issued the group Policy listed above to the Policyholder. The Policy is available for you to review if you contact the Policyholder for more information. This is your Certificate as long as you are eligible for coverage and you become insured. Please read it carefully and keep it in a safe place. This Certificate replaces any other Certificates we may have given you for the same level of coverage under the Policy. This Certificate summarizes and explains the parts of the Policy which apply to you. The Certificate is part of the group Policy but by itself is not a policy. Your coverage may be changed under the terms and conditions of the Policy. The Policy is delivered in and is governed by the laws of the governing jurisdiction and to the extent applicable by the Employee Retirement Income Security Act of 1974 (ERISA) and any amendments. For purposes of effective dates and ending dates under the Policy, all days begin at 12:01 a.m. standard time at the Policyholder's address and end at 12:00 midnight standard time at the Policyholder's address. The coverage under the Policy is conditionally renewable according to the terms and provisions of the Policy. In this Certificate, “you” and “your” refer to an Employee who is eligible for coverage under the Policy; “we”, “us” and “our” refer to ReliaStar Life Insurance Company. Exclusions may apply. Please read your Certificate carefully. Signed for ReliaStar Life Insurance Company at its home office in Minneapolis, Minnesota on the Policy effective date. Amelia (Amy) J. Vaillancourt President Melissa A. O'Donnell Secretary