PLAN ltr 01 01 2024 00

115 W Wausau Ave Wausau WI 54401-2875 PO Box 8046 Wausau WI 54402-8046 DEPAUW UNIVERSITY April 12, 2024 Plan Number: 7670-00-413597 Dear Valued Customer: With this letter, we are sending your modified Health summary plan description (SPD). This SPD, referred to as the plan document, will be the basis for the administration of your Health Plan. Also enclosed is the Acceptance Page, which formally approves the plan document. Please sign, retain a copy for your records, and return one copy to your UMR strategic account executive as soon as possible. Note, however, that since the corresponding system changes have been implemented, this document is considered final, whether or not a signature is received. This document will be posted to the UMR member web portal upon UMR’s receipt of your signature, or within 14 days of your receipt of the document if a signature is not received by UMR. Please note that UMR will not print booklets until a signature is received. It is also important that the information in your formally approved plan document agrees with any material distributed to your employees since this document will contain the terms of plan coverage. Any applicable stop loss policies typically rely on the last formally approved plan document when determining coverage. If the plan document distributed to your employees does not accurately describe the way your plan is actually being administered, the result can be a lapse or delay in stop loss coverage. Important: To prevent such lapses or delays in coverage, be sure to return the signed Acceptance Page to your UMR strategic account executive as soon as possible. If applicable, submit a copy of the Acceptance Page along with a copy of your current plan document to your stop loss carrier, which will constitute required notice of plan terms and conditions. Please keep a copy for your records. If you have any questions, please contact your UMR strategic account executive. Thank you for your business. Japeth Alibo Case Installations Enclosure 715.841.2000 / 866.881.0800 (T) www.UMR.com