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I <br /> Y Y <br /> EXCESS LOSS SCHEDULE OF BENEFITS <br /> Applies to Policy Period : from 10-01 -2004 to 10-01 -2005 <br /> 7 . Minimum Aggregate Attachment Point <br /> 95 % of the first Monthly Aggregate Attachment Point x 12 <br /> 8 . Monthly Aggregate Attachment Factors <br /> Covered Units <br /> Composite $665 .46 <br /> 9 . Aggregate Excess Loss Terminal Provision applicable? ❑Yes 0 No <br /> 10 . Aggregate Excess Loss premium $ 1 . 80 <br /> Paid : per employee per month <br /> E . Medical Conversion Privilege E]Yes 0 No <br /> F . Endorsements Included <br /> ❑ Individual Excess Loss Advance Funding Endorsement <br /> ❑ Excess Loss Alternate Reimbursement Endorsement <br /> G . Additional Information <br /> " Run-out Period (s ) do not apply if this Policy terminates prior to the end of the Policy Period <br /> H . Associated Companies <br /> Name Effective Date Termination Date <br /> N/A <br /> LGC 8802 03/02 3 of 3 <br />