Hospital Confinement Indemnity Insurance Plan for Noblesville Schools

YOUR HOSPITAL CONFINEMENT INDEMNITY INSURANCE PLAN For Employees of Noblesville Schools D12970 (11/25) All Eligible Employees, excluding Bus Drivers, working 30 hours or more per week

GROUP HOSPITAL CONFINEMENT INDEMNITY INSURANCE CERTIFICATE OF COVERAGE RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 Claims: 888-238-4840 Customer Service: 877-236-7564 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 POLICY EFFECTIVE DATE: January 1, 2026 GOVERNING JURISDICTION: Indiana THIS IS LIMITED BENEFIT INDEMNITY COVERAGE Benefits are paid for Hospital Confinements and other covered losses 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 Hospital Confinement or other covered losses 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. Signed for ReliaStar Life Insurance Company at its home office in Minneapolis, Minnesota on the Policy effective date. Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary RL-HI2-CERT-20-IN 1 D12970 (11/25)

Florida residents: The benefits of the Policy providing your coverage are governed primarily by the law of a state other than Florida. TABLE OF CONTENTS Section Page Cover Page...................................................................................................................................... 1 Table of Contents............................................................................................................................. 2 Schedule of Benefits......................................................................................................................... 3 Definitions........................................................................................................................................ 5 General Provisions........................................................................................................................... 7 Benefits............................................................................................................................................ 11 Exclusions........................................................................................................................................ 12 Claims.............................................................................................................................................. 13 RL-HI2-CERT-20-IN 2 D12970 (11/25)

RL-HI2-CERT-20-IN 3 D12970 (11/25) SCHEDULE OF BENEFITS EMPLOYER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 ELIGIBLE CLASS(ES) All Eligible Employees, excluding Bus Drivers, working 30 hours or more per week in Active Employment with the Employer in the United States. You must be an Employee of the Employer and in an eligible class. Temporary and seasonal workers are excluded from coverage. ELIGIBILITY WAITING PERIOD Persons in an eligible class on or before the Policy effective date: End of month in which You begin Active Employment. Persons entering an eligible class after the Policy effective date: End of month in which You begin Active Employment. Exception: if you were hired on the first of the month, the waiting period is waived. REHIRE If your employment with the Employer ends and you are rehired within 90 days, your previous Active Employment while in an eligible class will apply toward the Eligibility Waiting Period. All other Policy provisions apply. WHO PAYS FOR THE COVERAGE You pay the cost of your coverage. BENEFIT AMOUNTS DAILY CONFINEMENT AMOUNT(S) $250 CONFINEMENT DAILY BENEFITS Facility Confinement Benefits Hospital Confinement 1 times the daily Confinement amount per day, up to a maximum of 90 days per Confinement Critical Care Unit (CCU) Confinement 1 times the daily Confinement amount per day, up to a maximum of 15 days per Confinement Admission Benefits Hospital Admission $1,000 for the first day of Hospital Confinement, once per Confinement Only one type of facility Confinement or admission benefit is payable per day. Each type of admission benefit is payable 8 times per calendar year. Any combination of facility Confinement and admission benefits payable will not exceed a total of 106 days during a period of Confinement.

RL-HI2-CERT-20-IN 4 D12970 (11/25) OBSERVATION UNIT DAILY BENEFIT Observation unit benefit $100 per day, up to a maximum of one day per calendar year. An observation unit benefit is not payable for any day that a facility Confinement or admission benefit is payable.

RL-HI2-CERT-20-IN 5 D12970 (11/25) DEFINITIONS Accident or Accidental means an unforeseen event that results in a bodily Injury. Active Employment means you are working for the Employer for earnings that are paid regularly and you are performing the material and substantial duties of your regular occupation. Your work site must be one of the following:  The Employer's usual place of business;  An alternative work site at the direction of the Employer, including your home; or  A location to which your job requires you to travel. Normal vacation is considered Active Employment. Temporary and seasonal workers are excluded from coverage. Certificate means the document that explains the parts of the Policy which apply to eligible Insured Persons. It may include riders, endorsements or amendments. Confined or Confinement means that on the advice of a Doctor, your assignment to a bed as a resident inpatient in a Hospital or Critical Care Unit (CCU). There must be a charge for room and board, other than in any government, military or veterans’ facility for which there is no charge for room and board. Critical Care Unit means a specifically designated part of a Hospital commonly referred to as an intensive care unit which meets all of the following requirements:  It provides the highest level of medical care and is restricted to patients who are critically ill or injured and who require intensive comprehensive observation and care.  It is separate and apart from the surgical recovery room and from rooms, beds and wards customarily used for patient confinement.  It is permanently equipped with special lifesaving equipment for the care of the critically ill or injured.  It is under constant and continuous observation by a specially trained nursing staff assigned exclusively to the intensive care unit on a 24 hour basis.  It is assigned a Doctor on a full-time basis. Critical Care Unit does not include a sub-acute intensive care unit that provides a level of medical care below intensive care, but above a regular private or semi-private room or ward such as a step-down unit. Doctor means a person other than you or any family member, who is licensed to practice medicine in the state in which treatment is received and providing treatment or advice in accordance with the license. State law may require consideration of professional services of a practitioner other than a medical doctor. If so, then this definition includes persons recognized as qualified to treat the condition for which claim is made by the state in which treatment is received. Eligibility Waiting Period means the continuous period of time (shown in the SCHEDULE OF BENEFITS) that you must be in Active Employment in an eligible class before you are eligible for coverage under the Policy. Employee means a person who is a citizen or legal resident of the United States in Active Employment with the Employer in the United States. Employer means the Policyholder and includes any division, subsidiary or affiliated company named in the Policy.

RL-HI2-CERT-20-IN 6 D12970 (11/25) Hospital means an institution that is run for the care and treatment of sick or injured persons as in-patients and which, on its premises or in facilities available to the Hospital on a pre-arranged basis, fully meets each of the following requirements:  It is operated in accordance with the laws pertaining to hospitals in the jurisdiction in which it is located.  It is under the supervision of a medical staff and has one or more Doctors available at all times.  It provides 24 hours a day service by registered graduate nurses (RNs).  It is not an institution or any part of an institution used as: a hospice unit, including any bed designated as a hospice or a swing bed; a convalescent home; a rest or nursing facility; a free-standing surgical center; an extended-care facility; a skilled nursing facility; or a facility primarily affording custodial, educational care or care for the aged. Injury means a bodily Injury that is the direct result of an Accident and not related to any other cause. Injuries must be independent of Sickness, disease, bodily infirmity and other causes. Insured Person means an Employee who is eligible for coverage under the Policy, becomes covered according to the terms of the Policy, and whose coverage remains in effect according to the terms of the Policy. Policy means the written group insurance contract between us and the Policyholder. Policyholder means the Employer to which the Policy is issued and who sponsors the coverage for its Employees. Sickness means illness, infection, disease or any other abnormal physical condition that is not due to an Injury. Sickness includes pregnancy, infection and any other abnormal physical condition that is not caused by an Accident.

RL-HI2-CERT-20-IN 7 D12970 (11/25) GENERAL PROVISIONS ELIGIBILITY If you are working for the Employer in an eligible class (shown on the SCHEDULE OF BENEFITS), the date you are eligible for coverage is the later of the following:  The Policy effective date.  The day after you complete your Eligibility Waiting Period. EFFECTIVE DATE OF COVERAGE You will be covered at 12:01 a.m. standard time at the Policyholder’s address on the latest of the following:  The date you are eligible for coverage, if you apply for coverage on or before that date.  The first day of the month following the date you apply for coverage.  The first day of the month following the date you return to Active Employment, if you are not in Active Employment when your coverage would otherwise become effective. Exception: Coverage starts on a non-working day if you were in Active Employment on your last scheduled working day before the non-working day. Non-working days include time off for the following: vacations, personal holidays, weekends and holidays, approved nonmedical leave of absence and paid time off for nonmedical-related absences. EFFECTIVE DATE OF CHANGES TO COVERAGE Once your coverage begins, any increased or additional coverage will take effect on the latest of the following:  The date of the increased or additional coverage, if you are in Active Employment.  The date you return to Active Employment, if you are not in Active Employment due to Injury or Sickness. Any decrease in coverage will take effect immediately but will not affect a payable claim that occurs prior to the decrease. CHANGE OF INSURANCE CARRIERS If you are not in Active Employment due to Injury or Sickness on the effective date of the Employer’s coverage under our Policy, and you were covered under the Employer’s prior group policy of hospital confinement or fixed indemnity insurance at the time the Employer's coverage under our Policy became effective, we will provide continuity of coverage under our Policy. In order for this provision to apply, the prior policy's coverage must be similar to our Policy. If you are not in Active Employment due to Injury or Sickness on the effective date of our Policy, and you would otherwise be eligible to become insured under our Policy, we will provide limited coverage under our Policy. Coverage under this provision will begin on our Policy effective date and will continue until the earliest of the following:  The date you return to Active Employment.  The end of any period of continuance or extension provided under the prior policy.  The date coverage would otherwise end, according to the provisions of our Policy. Your coverage under this provision is subject to payment of premiums. Any benefits payable under this provision will be paid as if the prior policy had remained in force. We will reduce our payment by any amount for which the prior carrier is liable. If your coverage ends under this provision, or if you were not covered under the Employer's prior policy on the date that policy terminated, the EFFECTIVE DATE OF COVERAGE provision under our Policy will apply. TERMINATION OF COVERAGE Your coverage under the Policy ends on the earliest of the following dates:  The date the Policy terminates.  The date you are no longer in an eligible class.  The date your eligible class is no longer covered.  The date you voluntarily cancel your coverage.

RL-HI2-CERT-20-IN 8 D12970 (11/25)  The end of the period for which you paid premiums, if you stop making a required premium contribution, subject to the grace period.  The end of the Policyholder's grace period, if the Policyholder does not remit premium to us by the end of such period.  The last day you are in Active Employment. We will provide coverage for a payable claim that occurs while you are covered under the Policy. POLICY TERMINATION The Policy can be terminated either by us or by the Policyholder. We may terminate the Policy for any of the following reasons:  There is less than 15% participation of those eligible persons who pay all or part of their premium for the Policy.  The Policyholder does not promptly provide us with information that is reasonably required.  Fewer than 25 persons are insured under the Policy.  The premium is not paid in accordance with the provisions of the Policy.  We determine that there is a significant change in the size, occupation or age of the eligible class(es) as a result of a corporate transaction such as a merger, divestiture, acquisition, sale or reorganization of the Policyholder and/or its persons.  We stop providing the type of coverage under this Policy to all groups in the Policy issue state. We reserve the right to review and terminate all class(es) covered under the Policy if any class(es) cease(s) to be covered. If the Policyholder fails to pay the full premium due by the end of the grace period, the Policy will terminate according to the GRACE PERIOD provision. If we terminate the Policy for reasons other than the Policyholder's failure to pay premiums, written notice will be mailed to the Policyholder at least 60 days prior to the termination date. The Policyholder may terminate the Policy by written notice delivered to us at our home office prior to the termination date. When both the Policyholder and we agree, the Policy can be terminated on an earlier date. If the Policyholder or we terminate the Policy, coverage will end at 12:00 midnight standard time at the Policyholder's address on the termination date. If the Policy is terminated, the termination will not affect a payable claim. PORTABILITY Portability means you have the option to continue your coverage after it would otherwise terminate, if certain conditions are met. You must elect portability before you reach age 75. To continue your coverage, you must apply for portability and pay the first premium within 31 days of the date your coverage would otherwise terminate due to any of the following:  You retire or terminate employment with the Employer, if coverage remains in effect under the Policy for other Insured Persons.  The Policyholder terminates coverage under the Policy for all Insured Persons, and does not replace it with a similar insurance plan.  You are no longer eligible for coverage under the Policy. You can decrease but not increase the ported coverage amount. Ported coverage is subject to all the terms of the Policy and this Certificate.

RL-HI2-CERT-20-IN 9 D12970 (11/25) Premiums will be billed directly to you. Continued premium payment is required to keep coverage in force. The initial premium will be based on the portability premium rates in effect at the time you apply for portability. We may change the portability premium rates at any time upon 60 days written notice to you. Coverage continued under this provision will end on the earliest of the following:  The end of the period for which you paid premiums, if you stop making a required premium contribution, subject to the grace period.  The date you die.  The date the Policy terminates and coverage for all Insured Persons under the Policy terminates, upon 60 days written notice of termination. GRACE PERIOD The Policyholder has a grace period of 60 days for the payment of any premium due except the first. During the grace period the Policy will remain in force. If full payment is not received by us by the end of the grace period, the Policy will automatically terminate at the end of the grace period. The Policyholder is required to pay a pro rata premium for any period the Policy was in force during the grace period. There is no grace period if the Policyholder gives us advance written notice of termination, or if we have given the Policyholder advance written notice of termination as described under the POLICY TERMINATION provision. If you are on portability, you also have a grace period of 31 days for the payment of any premium due. During the grace period your coverage will remain in force. If full payment is not received by us by the end of the grace period, your coverage will automatically terminate at the end of the grace period. A pro rata premium payment is required for any period your coverage was in force during the grace period. REPRESENTATIONS NOT WARRANTIES We consider any statements the Policyholder and you make in an application to be representations and not warranties. No statements made by you will be used to reduce or deny any claim or to cancel your coverage unless both of the following are true:  The statement is in writing and is signed by you.  A copy of that statement is given to you or your personal representative. INCONTESTABILITY The validity of the Policy will not be contested, except for nonpayment of premiums, after the Policy has been in force for two years after its date of issue. No statement made by you in an application or enrollment form relating to your insurability will be used to contest the insurance for which the statement was made after the coverage has been in force for two years during your lifetime. CLERICAL ERROR Clerical error or omission by us or by the Policyholder will not:  Prevent you from receiving coverage, if you are entitled to coverage under the terms of the Policy.  Cause coverage to begin or continue for you when the coverage would not otherwise be effective. If the Policyholder gives us information about you that is incorrect, we will do both of the following:  Use the facts to decide whether you are eligible for coverage under the Policy and in what amounts.  Make a fair adjustment of the premium. MISSTATEMENT OF AGE If premiums are based on your age and you have misstated your age, we will make a fair adjustment of benefits to reflect the amount that the premium paid would have purchased at your true age. We may require satisfactory proof of your age before paying any claim. ASSIGNMENT No assignment of benefits under the Policy is valid, unless otherwise specified in the Policy.

RL-HI2-CERT-20-IN 10 D12970 (11/25) AGENCY For purposes of the Policy, the Policyholder acts on its own behalf or as your agent. Under no circumstances will the Policyholder be deemed our agent. CONSUMER NOTICE Questions regarding your policy or coverage should be directed to: ReliaStar Life Insurance Company 877-236-7564 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 You may file a grievance with us either orally or in writing using the contact information above. We maintain a grievance procedure as required by Indiana law. You may contact us at any time to obtain information about this procedure and how to file a grievance. If you (a) need the assistance of the governmental agency that regulates insurance; or (b) have a complaint you have been unable to resolve with your insurer you may contact the Department of Insurance by mail, telephone or email: State of Indiana Department of Insurance Consumer Services Division 311 West Washington Street, Suite 300 Indianapolis, Indiana 46204 Consumer Hotline: (800) 622-4461; (317) 232-2395 Complaints can be filed electronically at www.in.gov/idoi. CONFORMITY WITH STATE STATUTES Any provision of the Policy which, on the Policy effective date and each subsequent Policy anniversary date, conflicts with any law that applies in the jurisdiction where the Policy is issued, is automatically amended to conform to the minimum requirements of such law. CHANGES TO POLICY OR CERTIFICATE No agent, representative or employee of ours or of any other entity may change or waive the terms of the Policy, or of any Certificate or rider issued under it, except in writing signed by one of our executive officers and endorsed or attached to the Policy. If there is a conflict between the terms of this Certificate or any attached rider and the Policy, the Policy controls.

RL-HI2-CERT-20-IN 11 D12970 (11/25) BENEFITS We will pay a benefit as shown on the SCHEDULE OF BENEFITS for an eligible Confinement or other covered loss that occurs on or after your coverage effective date, subject to the EXCLUSIONS of this Certificate. CONFINEMENT DAILY BENEFITS Only one type of facility Confinement benefit is payable per day. Confinement benefits are payable for each day you are Confined up to the maximums shown on the SCHEDULE OF BENEFITS. Re-Confinements to a Hospital or Critical Care Unit (CCU) that occur within 90 days after being discharged for the same or a related condition are considered to be part of the previous period of Confinement. A Confinement that begins more than 90 days after discharge for a previous period of Confinement is considered a new Confinement. A Confinement benefit will not be payable for any day that an admission benefit is payable. Admission: Only one type of admission benefit is payable per day. Admission benefits are payable upon admission to a Hospital or Critical Care Unit (CCU) for Confinement as an inpatient due to treatment of an Injury or Sickness. The first day of Confinement must occur on or after your coverage effective date. The number of admission benefits payable during a period of Confinement are limited as shown on the SCHEDULE OF BENEFITS. Hospital Confinement: Benefits are payable if you are Confined in a Hospital on an inpatient basis due to treatment of an Injury or Sickness. Critical Care Unit (CCU) Confinement: Benefits are payable if you are Confined in a Critical Care Unit on an inpatient basis due to treatment of an Injury or Sickness. Once the CCU Confinement benefits have been paid for the maximum number of days in the SCHEDULE OF BENEFITS, any remaining days of Hospital Confinement during the same period of Confinement will be payable under the Hospital Confinement daily benefit, up to the maximum number of days in the SCHEDULE OF BENEFITS. OBSERVATION UNIT DAILY BENEFIT Observation unit benefit: Benefits are payable if you are admitted to a Hospital observation unit for at least 4 consecutive hours other than as an inpatient. This benefit is not payable for any day that a facility Confinement or admission benefit is payable. An observation unit is a specified area within a Hospital, apart from the Emergency Room, where a patient can be monitored following outpatient surgery or following treatment in the Emergency Room by a Doctor, and that fully meets each of the following requirements:  It is under the direct supervision of a Doctor or registered nurse.  It is staffed by nurses assigned specifically to that unit.  It provides care seven days per week, 24 hours per day.

RL-HI2-CERT-20-IN 12 D12970 (11/25) EXCLUSIONS Benefits are not payable for any loss caused in whole or directly by any of the following:  Participation or attempt to participate in a felony or illegal activity.  Operation of a motorized vehicle while intoxicated. Intoxication means your blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the Accident occurred.  Suicide, attempted suicide or any intentionally self-inflicted Injury, while sane or insane.  War or any act of war, whether declared or undeclared (excluding acts of terrorism).  Loss sustained while on active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.  Misuse of alcohol or taking of drugs, other than under the direction of a Doctor. Exception: This exclusion does not apply to a Confinement in an eligible Hospital for the purpose of treatment for alcoholism or drug addiction.  Elective surgery, except when required for appropriate care as determined by a Doctor as a result of your Injury or Sickness.  Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.  Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, any aircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is not excluded.  Engaging in hang-gliding, bungee jumping, parachuting, sailgliding, parasailing, parakiting, kitesurfing or any similar activities.  Practicing for, or participating in, any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received.

RL-HI2-CERT-20-IN 13 D12970 (11/25) CLAIMS NOTICE OF CLAIM Written notice of your claim should be given to us within 30 days after the date of loss. The notice may be given to us at our home office or to our authorized agent or administrator. Failure to give notice within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such notice within that time and the notice was given as soon as reasonably possible. CLAIM FORM The claim form is available from the Employer or you can request a claim form from us. If you do not receive the form from us within 15 days of your request, you may send us written proof of claim without waiting for the form. If such written proof of claim covers the occurrence, character and extent of the loss within the time period below for proof of claim, you will be deemed to have complied with the requirements for providing proof of claim. FILING A CLAIM The claim form(s) may require completion by you and the Employer and your attending Doctor. The completed form(s) and any attachments indicated on the form(s) as required should be sent directly to us at the address indicated on the form. PROOF OF CLAIM You must send us written proof of your claim within 90 days after the date of loss. Failure to give such proof within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such proof within that time, and the proof was given as soon as reasonably possible. However, in any event, you must provide proof of claim no later than one year after the time proof is otherwise required, except in the absence of legal capacity. PHYSICAL EXAMINATION We may require you to be examined by one or more Doctors or other medical practitioners of our choice. We will pay for this examination. We can require an examination as often as it is reasonable to do so while your claim is pending. We may also require you to be interviewed by our authorized representative. Failure to comply with this request may result in denial or termination of benefits. BENEFIT PAYMENTS Benefits are payable to you unless otherwise specified. Once a claim has been approved, we will make payment immediately upon receipt of due written proof of claim. Any accrued benefits that are payable at your death will be paid to the first survivor(s) who is/are living on the date of your death, in the following order: 1. Your spouse. 2. Your natural and adopted children, in equal shares. 3. Your grandchildren, in equal shares. 4. Your parents, in equal shares. 5. Your siblings, in equal shares. 6. Your estate. If a survivor entitled to receive a payment dies before receiving it, we will make payment to that person’s estate. If a survivor entitled to receive a payment has a special needs trust established, we will make payment to that person’s trust instead of to the person directly. “Spouse” in this provision means your lawful spouse. Any payment we make in good faith will discharge our liability as to the extent of such payment. We will pay the benefits in one sum or in a method comparable to one sum. LEGAL ACTION You can start legal action regarding a claim no earlier than 60 days after written proof of claim has been given to us, and no later than three years from the time proof of claim is required, unless otherwise provided under federal law. Nothing in this provision waives, extends or tolls any applicable statute of limitations governing any claim relating in any way to your coverage.

CERTIFICATE ENDORSEMENT For Group Hospital Confinement Indemnity Insurance RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 This endorsement is made a part of the Hospital Confinement Indemnity Insurance Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate. Except as expressly changed by this endorsement, the terms used in this endorsement have the same meaning as in the Certificate. EFFECTIVE DATE The endorsement effective date is the effective date of the Certificate. ENDORSED PROVISIONS Your Certificate has been changed. The following provision(s) are amended to read as follows: Confined or Confinement means that on the advice of a Doctor, your assignment to a bed as a resident inpatient in a Hospital or Critical Care Unit (CCU). Confined or Confinement includes being admitted to a Hospital observation unit for 20 hours or more. An observation unit is a specified area within a Hospital, apart from the Emergency Room, where a patient can be monitored by a Doctor, and that fully meets each of the following requirements:  It is under the direct supervision of a Doctor or registered nurse.  It is staffed by nurses assigned specifically to that unit.  It provides care seven days per week, 24 hours per day. There must be a charge for room and board for the confinement, other than in any government, military or veterans’ facility or Hospital observation unit for which there is no charge for room and board. OBSERVATION UNIT DAILY BENEFIT Observation unit benefit: Benefits are payable if you are admitted to a Hospital observation unit for at least 4 consecutive hours but less than 20 consecutive hours other than as an inpatient. This benefit is not payable for any day that a facility Confinement or admission benefit is payable. An observation unit is a specified area within a Hospital, apart from the Emergency Room, where a patient can be monitored by a Doctor, and that fully meets each of the following requirements:  It is under the direct supervision of a Doctor or registered nurse.  It is staffed by nurses assigned specifically to that unit.  It provides care seven days per week, 24 hours per day. Executed at our home office: 250 Marquette Avenue, Suite 900 Minneapolis, Minnesota 55401 Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary RL-HI2-END-22 1 COU-12970 (11/25)

RL-HI2-SPR-18-IN 1 SPR-12970 (11/25) SPOUSE HOSPITAL CONFINEMENT INDEMNITY RIDER RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 This rider is made a part of the Hospital Confinement Indemnity Insurance Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate, unless changed by this rider. Unless expressly changed by this rider, the terms used in this rider have the same meaning as in the Certificate. CONTENTS Section Page Schedule of Benefits............................................................................................... 1 Definitions............................................................................................................... 1 General Provisions................................................................................................. 1 Spouse Benefits...................................................................................................... 3 Exclusions.............................................................................................................. 3 Claims.................................................................................................................... 3 SCHEDULE OF BENEFITS WHO PAYS FOR THE COVERAGE You pay the cost of coverage under this rider. BENEFIT AMOUNTS The benefit amounts for your Spouse are 100% of the Employee BENEFIT AMOUNTS as shown in the SCHEDULE OF BENEFITS section of the Certificate. DEFINITIONS General terms defined in the DEFINITIONS section of the Certificate regarding medical conditions and eligibility apply to your Spouse. Spouse means your lawful spouse. GENERAL PROVISIONS ELIGIBILITY If you are covered under the Policy, then your Spouse is eligible under this rider on the latest of the following:  The Policy effective date.  The date this rider is available to the eligible class of Insured Persons to which you belong.  Your Hospital Confinement Indemnity coverage effective date.  The date of your marriage. If your Spouse is covered under the Policy as an Employee, then your Spouse is not eligible for coverage under this rider.

RL-HI2-SPR-18-IN 2 SPR-12970 (11/25) EFFECTIVE DATE Your Spouse will be covered at 12:01 a.m. standard time at the Policyholder’s address on the latest of the following:  The date your Spouse is eligible for coverage, if you apply for Spouse coverage on or before that date.  The first day of the month following the date you apply for Spouse coverage.  The first day of the month following the date you return to Active Employment, if you are not in Active Employment when your Spouse’s coverage would otherwise become effective. Exception: Coverage starts on a non-working day if you were in Active Employment on your last scheduled working day before the non-working day. Non- working days include time off for the following: vacations, personal holidays, weekends and holidays, approved nonmedical leave of absence and paid time off for nonmedical-related absences. EFFECTIVE DATE OF CHANGES TO COVERAGE Once your Spouse’s coverage begins, any increased or additional coverage due to an increase in the Employee coverage amount will take effect on the same date as the Employee coverage increase. Any decrease in coverage due to a decrease in the Employee coverage amount will take effect on the same date as the Employee coverage decrease, but will not affect a payable claim that occurs prior to the decrease. TERMINATION This rider terminates on the earliest of the following:  The date your Certificate terminates.  The date this rider is terminated for all Insured Persons under the Policy.  The date you voluntarily cancel this rider.  The date your Spouse is no longer an eligible Spouse as defined by this rider. See the PORTABILITY FOLLOWING DEATH OR DIVORCE provision below.  The end of the period for which premiums are paid, if the next required premium contribution is not paid, subject to the grace period. PORTABILITY If you are approved by us to continue your coverage under the Certificate’s PORTABILITY provision, then this rider can also be continued during portability. PORTABILITY FOLLOWING DEATH OR DIVORCE If you die or divorce, your Spouse can apply to continue Spouse coverage if certain conditions are met. Your Spouse must have been insured under this rider on the date of your death or divorce, your Spouse must be under age 75 and your Spouse must apply for portability and pay the first premium within 31 days of the date of your death or divorce. If your Spouse is approved by us for portability, your Spouse will become the owner of the Spouse coverage that was previously provided under this rider. Your Spouse can decrease but not increase the ported coverage amount. Ported coverage is subject to all the terms of the Policy and Certificate. Premiums will be billed directly to your Spouse. Continued premium payment is required to keep coverage in force. The initial premium will be based on the portability premium rates in effect at the time your Spouse applies for portability. We may change the portability premium rates at any time upon 60 days written notice to your Spouse. Coverage continued under this provision will end on the earliest of the following:  The end of the period for which your Spouse paid premiums, if your Spouse stops making a required premium contribution, subject to the grace period.  The date your Spouse dies.  The date the Policy terminates and coverage for all Insured Persons under the Policy terminates, upon 60 days written notice of termination.

RL-HI2-SPR-18-IN 3 SPR-12970 (11/25) SPOUSE BENEFITS The benefits for your Spouse are the same as your benefits as shown in the BENEFITS section of the Certificate, based on your Spouse’s Confinement or other covered loss, and subject to the EXCLUSIONS of this rider. EXCLUSIONS Benefits are not payable for any loss caused in whole or directly by any of the following:  Participation or attempt to participate in a felony or illegal activity.  An Accident while your Spouse is operating a motorized vehicle while intoxicated. Intoxication means your Spouse’s blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the Accident occurred.  Suicide, attempted suicide or any intentionally self-inflicted Injury, while sane or insane.  War or any act of war, whether declared or undeclared (excluding acts of terrorism).  Loss sustained while on active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.  Misuse of alcohol or taking of drugs, other than under the direction of a Doctor. Exception: This exclusion does not apply to a Confinement in an eligible Hospital for the purpose of treatment for alcoholism or drug addiction.  Elective surgery, except when required for appropriate care as determined by a Doctor as a result of your Spouse’s Injury or Sickness.  Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.  Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, any aircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is not excluded.  Engaging in hang-gliding, bungee jumping, parachuting, sailgliding, parasailing, parakiting, kitesurfing or any similar activities.  Practicing for, or participating in, any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received. CLAIMS NOTICE OF CLAIM Written notice of your claim should be given to us within 30 days after the date of loss. The notice may be given to us at our home office or to our authorized agent or administrator. Failure to give notice within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such notice within that time and the notice was given as soon as reasonably possible. CLAIM FORM The claim form is available from the Employer or you can request a claim form from us. If you do not receive the form from us within 15 days of your request, you may send us written proof of claim without waiting for the form. If such written proof of claim covers the occurrence, character and extent of the loss within the time period below for proof of claim, you will be deemed to have complied with the requirements for providing proof of claim. FILING A CLAIM The claim form(s) may require completion by you and the Employer and your Spouse’s attending Doctor. The completed form(s) and any attachments indicated on the form(s) as required should be sent directly to us at the address indicated on the form.

RL-HI2-SPR-18-IN 4 SPR-12970 (11/25) PROOF OF CLAIM You must send us written proof of your claim within 90 days after the date of loss. Failure to give such proof within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such proof within that time, and the proof was given as soon as reasonably possible. However, in any event, you must provide proof of claim no later than one year after the time proof is otherwise required, except in the absence of legal capacity. PHYSICAL EXAMINATION We may require your Spouse to be examined by one or more Doctors or other medical practitioners of our choice. We will pay for this examination. We can require an examination as often as it is reasonable to do so while the claim is pending. We may also require your Spouse to be interviewed by our authorized representative. Failure to comply with this request may result in denial or termination of benefits. BENEFIT PAYMENTS Benefits under this rider are payable to you. Once a claim has been approved, we will make payment immediately upon receipt of due written proof of claim. Any accrued benefits that are payable at your death will be paid according to the BENEFIT PAYMENTS provision in the Certificate. For PORTABILITY FOLLOWING DEATH OR DIVORCE, benefits are payable to your Spouse, and any accrued benefits that are payable at the time of your Spouse’s death will be paid to your Spouse’s estate. Any payment we make in good faith will discharge our liability as to the extent of such payment. We will pay the benefits in one sum or in a method comparable to one sum. Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary LEGAL ACTION You can start legal action regarding a claim no earlier than 60 days after written proof of claim has been given to us, and no later than three years from the time proof of claim is required, unless otherwise provided under federal law. Nothing in this provision waives, extends or tolls any applicable statute of limitations governing any claim relating in any way to your Spouse’s coverage. Executed at our Home Office: 250 Marquette Avenue, Suite 900 Minneapolis, MN 55401

RL-HI2-CHR-18-IN 1 CHR-12970 (11/25) CHILDREN’S HOSPITAL CONFINEMENT INDEMNITY RIDER RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 This rider is made a part of the Hospital Confinement Indemnity Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate, unless changed by this rider. Unless expressly changed by this rider, the terms used in this rider have the same meaning as in the Certificate. CONTENTS Section Page Schedule of Benefits............................................................................................... 1 Definitions............................................................................................................... 1 General Provisions................................................................................................. 2 Children Benefits.................................................................................................... 3 Exclusions.............................................................................................................. 4 Claims.................................................................................................................... 4 SCHEDULE OF BENEFITS WHO PAYS FOR THE COVERAGE You pay the cost of coverage under this rider. BENEFIT AMOUNTS The benefit amounts for your Children are 100% of the Employee BENEFIT AMOUNTS as shown in the SCHEDULE OF BENEFITS section of the Certificate. DEFINITIONS General terms defined in the DEFINITIONS section of the Certificate regarding medical conditions and eligibility apply to your Children. Child or Children means a child from birth but less than 26 years of age who is one of the following:  Your natural child.  Your adopted child as of the earlier of the date of placement for the purpose of adoption or the date of entry of an order granting you custody of the child for purposes of adoption.  Your stepchild.  A child or grandchild for whom you are a legal guardian.  Your foster child. The child must also meet all of the following conditions:  Not be on full-time active duty in the armed forces of any country or subdivision thereof.  Legally reside in the United States or its territories or possessions.  Not be insured under the Policy as an Employee or Spouse.

RL-HI2-CHR-18-IN 2 CHR-12970 (11/25) This definition includes your Child age 26 or older who is incapable of self-sustaining employment due to physical or intellectual disability. Written proof of the Child's incapacity must be furnished to us at our home office within 31 days after the Child reaches the limiting age. We may require, at reasonable intervals, but not more than once a year after the two year period following attainment of the limiting age, evidence satisfactory to us that the incapacity is continuing. Coverage will continue while the Child remains incapable of self-sustaining employment due to physical or intellectual disability and continues to meet the definition of Child except for the age limit. Spouse means your lawful spouse. GENERAL PROVISIONS ELIGIBILITY If you are covered under the Policy, then your Children are eligible under this rider on the latest of the following:  The Policy effective date.  The date this rider is available to the eligible class of Insured Persons to which you belong.  Your Hospital Confinement Indemnity coverage effective date.  The date you acquire a Child by marriage, birth or adoption. If both you and your Spouse are covered under the Policy as an Employee, then only one of you may cover your Children under this rider. If the parent who is covering the Children stops being insured as an Employee then the other parent may apply for Children’s coverage under this rider within 60 days. EFFECTIVE DATE Your Children will be covered at 12:01 a.m. standard time at the Policyholder’s address on the latest of the following:  The date your Children are eligible for coverage, if you apply for Children’s coverage on or before that date.  The first day of the month following the date you apply for Children’s coverage.  The first day of the month following the date you return to Active Employment, if you are not in Active Employment when your Children’s coverage would otherwise become effective. Exception: Coverage starts on a non-working day if you were in Active Employment on your last scheduled working day before the non-working day. Non- working days include time off for the following: vacations, personal holidays, weekends and holidays, approved nonmedical Leave of Absence and paid time off for nonmedical-related absences. If you have coverage under this rider and you acquire a new eligible Child due to birth, marriage or adoption, then the newly eligible Child will be covered automatically from the date of the event. If an adopted newborn Child is placed with you within 30 days of birth, the “event” will be the date of birth. If an adopted Child is placed with you more than 30 days after birth, the “event” will be the date of placement. No additional premium is required. EFFECTIVE DATE OF CHANGES TO COVERAGE Once your Children’s coverage begins, any increased or additional coverage due to an increase in the Employee coverage amount will take effect on the same date as the Employee coverage increase. Any decrease in coverage due to a decrease in the Employee coverage amount will take effect on the same date as the Employee coverage decrease, but will not affect a payable claim that occurs prior to the decrease. TERMINATION Coverage for each Child ends on the earliest of the following:  The date this rider terminates.  The date the Child is no longer an eligible Child as defined by this rider. Eligibility of a Child who is incapable of self-sustaining employment due to physical or intellectual disability ends when there is no longer evidence satisfactory to us that the incapacity is continuing. This rider terminates on the earliest of the following:  The date your Certificate terminates.  The date this rider is terminated for all Insured Persons under the Policy.

RL-HI2-CHR-18-IN 3 CHR-12970 (11/25)  The date you voluntarily cancel this rider.  The date you no longer have any eligible Children covered under this rider. See the PORTABILITY FOLLOWING DEATH provision below.  The end of the period for which premiums are paid, if the next required premium contribution is not paid, subject to the grace period. PORTABILITY If you are approved by us to continue your coverage under the Certificate’s PORTABILITY provision, then this rider can also be continued during portability. PORTABILITY FOLLOWING DEATH If you die and your Spouse is approved by us for portability under the Spouse Hospital Confinement Indemnity Rider, then this rider can be continued under your Spouse’s coverage. Following portability of this rider, Children may be covered only if they would have been eligible for coverage under the eligibility rules in force prior to the death of the Employee. Premiums will be billed directly to your Spouse. Continued premium payment is required to keep coverage in force. The initial premium will be based on the portability premium rates in effect at the time your Spouse applies for portability. We may change the portability premium rates at any time upon 60 days written notice to your Spouse. Coverage continued under this provision will end on the earliest of the following:  The end of the period for which your Spouse paid premiums, if your Spouse stops making a required premium contribution, subject to the grace period.  The date your Spouse dies.  The date there are no longer any eligible Children covered under this rider.  The date the Policy terminates and coverage for all Insured Persons under the Policy terminates, upon 60 days written notice of termination. CHILDREN BENEFITS Benefits are payable for each covered Child. The benefits for your Children are the same as your Employee benefits as shown in the BENEFITS section of the Certificate, based on your Child’s Confinement or other covered loss.

RL-HI2-CHR-18-IN 4 CHR-12970 (11/25) EXCLUSIONS Benefits are not payable for any loss caused in whole or directly by any of the following:  Participation or attempt to participate in a felony or illegal activity.  An Accident while your Child is operating a motorized vehicle while intoxicated. Intoxication means your Child’s blood alcohol content meets or exceeds the legal presumption of intoxication under the laws of the state where the Accident occurred.  Suicide, attempted suicide or any intentionally self-inflicted Injury, while sane or insane.  War or any act of war, whether declared or undeclared (excluding acts of terrorism).  Loss sustained while on active duty as a member of the armed forces of any nation. We will refund, upon written notice of such service, any premium which has been accepted for any period not covered as a result of this exclusion.  Misuse of alcohol or taking of drugs, other than under the direction of a Doctor. Exception: This exclusion does not apply to a Confinement in an eligible Hospital for the purpose of treatment for alcoholism or drug addiction.  Elective surgery, except when required for appropriate care as determined by a Doctor as a result of your Child’s Injury or Sickness.  Riding in or driving any motor-driven vehicle in a race, stunt show or speed test.  Operating, or training to operate, or service as a crew member of, or jumping, parachuting or falling from, any aircraft or hot air balloon, including those which are not motor-driven. Flying as a fare-paying passenger is not excluded.  Engaging in hang-gliding, bungee jumping, parachuting, sailgliding, parasailing, parakiting, kitesurfing or any similar activities.  Practicing for, or participating in, any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received. CLAIMS NOTICE OF CLAIM Written notice of your claim should be given to us within 30 days after the date of loss. The notice may be given to us at our home office or to our authorized agent or administrator. Failure to give notice within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such notice within that time and the notice was given as soon as reasonably possible. CLAIM FORM The claim form is available from the Employer or you can request a claim form from us. If you do not receive the form from us within 15 days of your request, you may send us written proof of claim without waiting for the form. If such written proof of claim covers the occurrence, character and extent of the loss within the time period below for proof of claim, you will be deemed to have complied with the requirements for providing proof of claim. FILING A CLAIM The claim form(s) may require completion by you and the Employer and your Child’s attending Doctor. The completed form(s) and any attachments indicated on the form(s) as required should be sent directly to us at the address indicated on the form. PROOF OF CLAIM You must send us written proof of your claim within 90 days after the date of loss. Failure to give such proof within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such proof within that time, and the proof was given as soon as reasonably possible. However, in any event, you must provide proof of claim no later than one year after the time proof is otherwise required, except in the absence of legal capacity. PHYSICAL EXAMINATION We may require your Child to be examined by one or more Doctors or other medical practitioners of our choice. We will pay for this examination. We can require an examination as often as it is reasonable to do so while the claim is pending. We may also require you to be interviewed by our authorized representative. Failure to comply with this request may result in denial or termination of benefits.

RL-HI2-CHR-18-IN 5 CHR-12970 (11/25) BENEFIT PAYMENTS Benefits under this rider are payable to you. Once a claim has been approved, we will make payment immediately upon receipt of due written proof of claim. Any accrued benefits that are payable at your death will be paid according to the BENEFIT PAYMENTS provision in the Certificate. For PORTABILITY FOLLOWING DEATH, benefits are payable to your Spouse, and any accrued benefits that are payable at the time of your Spouse’s death will be paid to your Spouse’s estate. Any payment we make in good faith will discharge our liability as to the extent of such payment. We will pay the benefits in one sum or in a method comparable to one sum. Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary LEGAL ACTION You can start legal action regarding a claim no earlier than 60 days after written proof of claim has been given to us, and no later than three years from the time proof of claim is required, unless otherwise provided under federal law. Nothing in this provision waives, extends or tolls any applicable statute of limitations governing any claim relating in any way to your coverage. Executed at our Home Office: 250 Marquette Avenue, Suite 900 Minneapolis, MN 55401

RL-HI2-CNT-18 1 CNT-12970 (11/25) CONTINUATION OF INSURANCE RIDER RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 This rider is made a part of the Hospital Confinement Indemnity Insurance Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate, unless changed by this rider. Unless expressly changed by this rider, the terms used in this rider have the same meaning as in the Certificate. CONTENTS Section Page Definitions............................................................................................................... 1 General Provisions................................................................................................. 2 Continuation of Insurance....................................................................................... 2 DEFINITIONS Covered Person means:  You, if you are covered for Hospital Confinement Indemnity insurance under the Policy.  Your Spouse who is covered under your Spouse Hospital Confinement Indemnity Rider.  Your Children who are covered under your Children’s Hospital Confinement Indemnity Rider. Leave of Absence means you are absent from Active Employment for a period of time under a leave granted in writing by the Employer that is in accordance with the Employer’s formal leave policies. Your normal vacation time is not considered a Leave of Absence. Labor Strike means you are absent from Active Employment for a period of time for which continuation of insurance is available under the Employer’s written plan for labor strikes. Temporary Layoff means you are absent from Active Employment for a period of time that has been agreed to in advance in writing by the Employer. Your normal vacation time is not considered a Temporary Layoff.

RL-HI2-CNT-18 2 CNT-12970 (11/25) GENERAL PROVISIONS ELIGIBILITY If you are covered under the Policy, then you are eligible for this rider on the latest of the following:  The Policy effective date.  The date this rider is available to the eligible class of Employees to which you belong.  Your Hospital Confinement Indemnity coverage effective date. EFFECTIVE DATE You will be covered at 12:01 a.m. standard time at the Policyholder’s address on the date you are eligible for this rider. CHANGE OF INSURANCE CARRIERS The CHANGE OF INSURANCE CARRIERS provision in the Certificate is revised to include an Employee whose coverage was being continued under a similar continuation provision in the Employer’s prior group policy of hospital confinement indemnity insurance at the time the Employer's coverage under our Policy became effective. TERMINATION This rider terminates on the earliest of the following:  The date your Hospital Confinement Indemnity insurance terminates.  The date this rider is terminated for all Employees under the Policy.  The date this rider is terminated for the eligible class of Employees to which you belong. CONTINUATION OF INSURANCE If you stop Active Employment due to:  Employer-approved Leave of Absence, or  Temporary Layoff, or  Labor Strike then insurance coverage may be continued under the Policy beyond the date you are no longer in Active Employment, limited to the time period(s) described below. During this continued coverage period, the amount of continued insurance equals the amount in effect the day prior to the continuation period. That amount will reduce or stop according to the Certificate and riders in effect the day prior to the continuation period. Premiums are due during the continuation period on the same basis as on the day prior to the continuation period. Contact the Employer for more information. If an eligible claim occurs while coverage is being continued under this rider, then benefits will be paid as described in the Certificate and riders. Family and Medical Leave If you are on a Leave of Absence as described under the Family and Medical Leave Act of 1993 and any amendments ("FMLA") or any applicable state family and medical leave law ("State FML"), and the Employer's human resource policy provides for continuation of insurance during an FMLA or State FML Leave of Absence, then insurance coverage for all Covered Persons may be continued until the end of the later of:  The leave period permitted by FMLA.  The leave period permitted by state FML. This continuation of coverage includes all riders that were in effect on the date before the FMLA or State FML Leave of Absence began. EMPLOYER-APPROVED LEAVE(S) OF ABSENCE

RL-HI2-CNT-18 3 CNT-12970 (11/25) Sickness or Injury If you are on a Leave of Absence due to your sickness or injury, then insurance coverage for all Covered Persons may be continued until the last day of the month which next follows the date which is 9 months after the date you stopped Active Employment. This continuation of coverage includes all riders that were in effect on the date before the Leave of Absence began. Other Leave of Absence If you are on a Leave of Absence for any other reason, then insurance coverage for all Covered Persons may be continued until the last day of the month which next follows the date which is 60 days after the date you stopped Active Employment. This continuation of coverage includes all riders that were in effect on the date before the Leave of Absence began. TEMPORARY LAYOFF If you stop Active Employment due to a Temporary Layoff, then insurance coverage for all Covered Persons may be continued until the last day of the month which next follows the date which is 2 months after the date you stopped Active Employment. This continuation of coverage includes all riders that were in effect on the date before the Leave of Absence began. LABOR STRIKE If you stop Active Employment due to a Labor Strike, then insurance coverage for all Covered Persons may be continued until the last day of the month which next follows the date which is 2 months after the date you stopped Active Employment. This continuation of coverage includes all riders that were in effect on the date before the Leave of Absence began. CONCURRENT LEAVES OF ABSENCE If you would be eligible for more than one type of continuation under this rider during any one period that you are not in Active Employment, we will consider such periods to be concurrent for the purpose of determining how long your coverage may continue under the Policy. TERMINATION OF CONTINUATION Coverage continued under this rider will end on the earliest of the following:  The end of the continuation period as indicated above.  The end of the period for which premiums are paid if the next premium is not paid by its due date, subject to the grace period.  The date you are eligible under the Policy due to Active Employment.  The date of your death.  The date you become covered under another group hospital confinement indemnity insurance policy as an employee or member.  The date the Policy terminates.  The date coverage for all Employees under the Policy terminates. In no event will coverage for any Covered Person be continued beyond the date coverage would otherwise end according to the termination provision(s) of the Certificate and riders. When this continuation ends, insurance under the Policy will stay in force only if all of the following conditions are met:  Hospital Confinement Indemnity insurance is in force for Employees under the Policy; and  You are in an eligible class for coverage under the Policy; and  Your premium payments are resumed. The amount of insurance will be subject to the Certificate and riders in effect on the date your premium payments are resumed.

RL-HI2-CNT-18 4 CNT-12970 (11/25) RETURN TO ACTIVE EMPLOYMENT If coverage is not continued during your Leave of Absence for active military service, and you return to Active Employment while coverage is in force for Employees under the Policy, then coverage for all Covered Persons may be reinstated in accordance with USERRA and applicable state law. If coverage is not continued during any other period that is eligible for continuation under the Policy, and you return to Active Employment while coverage is in force for Employees under the Policy, then the terms of the Certificate and riders will apply. Executed at our Home Office: 250 Marquette Avenue, Suite 900 Minneapolis, MN 55401 Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary

RL-HI2-WELL-18-IN 1 WELL-12970 (11/25) WELLNESS BENEFIT RIDER RELIASTAR LIFE INSURANCE COMPANY 250 Marquette Avenue, Suite 900, Minneapolis, Minnesota 55401 POLICYHOLDER: Noblesville Schools GROUP POLICY NUMBER: 73058-1CHI2 This rider is made a part of the Hospital Confinement Indemnity Insurance Certificate and is subject to all of the provisions, limitations and exclusions of the Policy and Certificate, unless changed by this rider. Unless expressly changed by this rider, the terms used in this rider have the same meaning as in the Certificate. CONTENTS Section Page Schedule of Benefits............................................................................................... 1 Definitions............................................................................................................... 1 General Provisions................................................................................................. 2 Benefits.................................................................................................................. 2 Exclusions.............................................................................................................. 3 Claims.................................................................................................................... 3 SCHEDULE OF BENEFITS WHO PAYS FOR THE COVERAGE The cost of coverage under this rider is automatically included in the cost of your coverage and the cost of your Spouse's coverage and the cost of your Children's coverage. WELLNESS BENEFIT The wellness benefit is payable up to a maximum of one day per Covered Person per calendar year. DEFINITIONS General terms are defined in the DEFINITIONS section of the Certificate and riders. Covered Person means:  You, if you are covered for Hospital Confinement indemnity insurance under the Policy.  Your Spouse who is covered under your Spouse Hospital Confinement Indemnity Rider.  Your Children who are covered under your Children’s Hospital Confinement Indemnity Rider. You: $50 per day Your Spouse: $50 per day Your Children: 100% of your wellness benefit amount, per day, per Child

RL-HI2-WELL-18-IN 2 WELL-12970 (11/25) GENERAL PROVISIONS ELIGIBILITY If you are working for the Employer in an eligible class (shown in the Certificate’s SCHEDULE OF BENEFITS), you are eligible for this rider on the latest of the following dates:  The Policy effective date.  The date this rider is available to the eligible class of Insured Persons to which you belong.  Your Hospital Confinement indemnity coverage effective date. Your Spouse is eligible for coverage under this rider on the later of the date above or the date your Spouse is eligible for coverage under the Spouse Hospital Confinement Indemnity Rider. Your Children are eligible for coverage under this rider on the later of the date above or the date each Child is eligible for coverage under the Children’s Hospital Confinement Indemnity Rider. EFFECTIVE DATE Each Covered Person will be covered at 12:01 a.m. standard time at the Policyholder’s address on the date the Covered Person is eligible for coverage under this rider. TERMINATION This rider will terminate on the earliest of the following:  The date your Certificate terminates.  The date this rider is terminated for all Insured Persons under the Policy.  For your Spouse’s coverage, the date the Spouse Hospital Confinement Indemnity Rider terminates.  For each Child’s coverage, the date your Child’s coverage under the Children’s Hospital Confinement Indemnity Rider terminates. PORTABILITY If you are approved by us to continue your coverage under the Certificate’s PORTABILITY provision, then this rider will also be continued during portability. PORTABILITY FOLLOWING DEATH OR DIVORCE If you die or divorce and your Spouse is approved by us for portability under the Spouse Hospital Confinement Indemnity Rider, then this rider can also be continued under your Spouse’s coverage. BENEFITS We will pay you a wellness benefit for each day that a Covered Person has one or more eligible health screening tests, on or after the Covered Person’s coverage effective date. This benefit is payable up to a maximum of one day per Covered Person per calendar year. The amounts are shown on the SCHEDULE OF BENEFITS. Eligible health screening tests include, but are not limited to: – Blood test for triglycerides – Pap smear or thin prep pap test – Flexible sigmoidoscopy – CEA (blood test for colon cancer) – Stress test on bicycle or treadmill – Fasting blood glucose test – Thermography – PSA (prostate cancer) – Bone marrow testing – Serum cholesterol test for HDL & LDL levels – Hemoccult stool analysis – Serum Protein Electrophoresis (myeloma) – Biometric screenings – Electrocardiogram (EKG) – Routine eye exam – Routine dental exam – Breast ultrasound, sonogram, MRI – Chest x-ray – Mammography – Colonoscopy – CA 15-3 (breast cancer) – Well child/preventive exams for ages 1 through 18

RL-HI2-WELL-18-IN 3 WELL-12970 (11/25) EXCLUSIONS The EXCLUSIONS section of the Certificate and riders does not apply to this rider. CLAIMS The PHYSICAL EXAMINATION provision does not apply to this rider. NOTICE OF CLAIM Written notice of your claim must be given to us during the same Policy year the health screening test occurs or within 30 days of the end of the Policy year, whichever is later. The notice may be given to us at our home office or to our authorized agent or administrator. Failure to give notice within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such notice within that time and the notice was given as soon as reasonably possible. CLAIM FORM The claim form is available from the Employer or you can request a claim form from us. If you do not receive the form from us within 15 days of your request, you may send us written proof of claim without waiting for the form. If such written proof of claim covers the occurrence, character and extent of the loss within the time period below for proof of claim, you will be deemed to have complied with the requirements for providing proof of claim. FILING A CLAIM The claim form(s) may require completion by you and the Employer and the Covered Person’s attending Doctor. The completed form(s) and any attachments indicated on the form(s) as required should be sent directly to us at the address indicated on the form. PROOF OF CLAIM You must send us written proof of your claim within 90 days after the date of the health screening test. Failure to give such proof within this timeframe will not invalidate or reduce any payable claim if it can be shown that it was not reasonably possible to give such proof within that time, and the proof was given as soon as reasonably possible. However, in any event, you must provide proof of claim no later than one year after the time proof is otherwise required, except in the absence of legal capacity. BENEFIT PAYMENTS Benefits under this rider are payable to you unless otherwise specified. Once a claim has been approved, we will make payment immediately upon receipt of due written proof of claim. Any accrued benefits that are payable at your death will be paid according to the BENEFIT PAYMENTS provision in the Certificate. For PORTABILITY FOLLOWING DEATH OR DIVORCE, benefits are payable to your Spouse, and any accrued benefits that are payable at the time of your Spouse’s death will be paid to your Spouse’s estate. Any payment we make in good faith will discharge our liability as to the extent of such payment. We will pay the benefits in one sum. LEGAL ACTION You can start legal action regarding a claim no earlier than 60 days after written proof of claim has been given to us, and no later than three years from the time proof of claim is required, unless otherwise provided under federal law. Nothing in this provision waives, extends or tolls any applicable statute of limitations governing any claim relating in any way to your coverage.

RL-HI2-WELL-18-IN 4 WELL-12970 (11/25) Amelia (Amy) J. Vaillancourt Melissa A. O'Donnell President Secretary Executed at our Home Office: 250 Marquette Avenue, Suite 900 Minneapolis, MN 55401