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.