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.

Hospital Confinement Indemnity Insurance Plan for Noblesville Schools - Page 22 Hospital Confinement Indemnity Insurance Plan for Noblesville Schools Page 21 Page 23