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4 . Aggregate Reimbursement Maximum $ 1 , 000 , 000 . . per Policy Period <br /> 5 . Monthly Aggregate Accommodation Provision applicable ? ❑ Yes ❑✓ No <br /> Monthly Aggregate Accommodation premium $ <br /> Paid : E] annually in advance ❑ per employee per month [] monthly <br /> 6 . Reimbursement Option : <br /> Covered expenses incurred on or after the Policy Effective Date and paid during the Policy Period <br /> with : <br /> Run -in Period of months Run - in Limit $ <br /> Run -out Period of 3 months Run -out Limit $ <br /> 7 . Minimum Aggregate Attachment Point : <br /> a . 95 % of the first Monthly Aggregate Attachment Point x 12 ; or <br /> b . $ <br /> 8 . Monthly Aggregate Attachment Factors <br /> Covered Units <br /> Employee $665 . 46 <br /> 9 . Aggregate Excess Loss Terminal Provision ❑ Yes ZNo <br /> a . Terminal Run -out Period : months <br /> b . Terminal Factors <br /> Covered Units <br /> 10 . Aggregate Excess Loss premium $ 1 . 80 <br /> Paid : ❑ annually in advance ✓❑ per employee per month ❑ monthly <br /> E . Medical Conversion Privilege (Available at initial policy issue only) ❑ Yes ✓❑ No <br /> a . $ per conversion <br /> b . $ monthly rate per employee <br /> LG 1320 10/02 3 <br />