April 12, 2024 ACCEPTANCE PAGE Health Plan 7670-00-413597 DEPAUW UNIVERSITY acknowledges that we have reviewed the plan document effective January 1, 2024, and agree that the provisions contained in the plan document will be the basis for the administration of our Health Plan. The Plan Sponsor further represents that the plan document accurately reflects the intent of the Plan Sponsor and agrees that UMR may rely on such document in the administration of the Plan. Accepted by the Plan Sponsor on Date Authorized Signature and Title DEPAUW UNIVERSITY