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CERTIFICATE OF LIABILITY INSURANCE (29)ACO/20 11,.... ---- .._.., ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM2020YYY) os/za/zozo THIS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services Central, Inc. Phi 1 adel phi a PA office One Liberty Pl ace 1650 Market Street Suite 1000 Philadelphia PA 19103 USA CONTACT PHONE (866) 283-7122 FAX (800) 363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Cigna Corporation Et Al 900 Cottage Grove Road Bloomfield CT 06002 USA INSURER A: Lexington Insurance Company 19437 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: 570082465365 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR LTR TYPE OF INSURANCE 7mDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE OCCUR DAMAGE 10 RENTED PREMISES (Ea occurrence) RECEIVED MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PECOT- LOC J U L 01 PRODUCTS - COMP/OP AGG OTHER: AUTOMOBILE LIABILITY OFFICIAL RECORDS AND (EOacclidentSINGLE LIMIT ANY AUTO LEGISLATIVE SRVCS DEPT. BODILY INJURY ( Per person) OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) AUTOS ONLY HIRED AUTOS ONLY _ NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / N PER STATUTE OTH- ER ANY PROPRIETOR/ PARTNER/ EXECUTIVE OFFICER/MEMBER EXCLUDED? I I N / A E.L. EACH ACCIDENT (Mandatory In NH) If yes, describe under E.L. DISEASE -EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A ManageCare Liab 33085874 Managed Care E&0 07/01/2020 07/01/2021 Agg-Claims Made $15,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II more space Is required) See the attached list of Additional Named Insureds. CERTIFICATE HOLDER City of Clearwater Attn: City Clerk PO Box 4748 Clearwater FL 33758-4748 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c�A�h c�%e.TdQ�C c.Ji�tt+eC�i1 ��✓�A. Holder Identifier : 570082465365 Certificate No ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Additional Named Insureds (1 of 2) Allegiance Benefit Plan Management, Inc. Allegiance Cobra Services, Inc. Bravo Health Mid -Atlantic, Inc. Brighter Inc. Cigna Behavioral Health, Inc. Cigna Corporate Services, LLC Cigna Dental Health of California, Inc. Cigna Dental Health of Delaware, Inc. Cigna Dental Health of Florida, Inc. Cigna Dental Health of Kentucky, Inc. Cigna Dental Health of Maryland, Inc. Cigna Dental Health of New Jersey, Inc. Cigna Dental Health of North Carolina, Inc. Cigna Dental Health of Ohio, Inc. Cigna Dental Health of Pennsylvania, Inc. Cigna Dental Health of Texas, Inc. Cigna Dental Health of Virginia, Inc. Cigna Dental Health Plan of Arizona, Inc. Cigna Dental Health, Inc. Cigna Health and Life Insurance Company Cigna Health Management, Inc. Cigna Healthcare of Arizona, Inc. Cigna Healthcare of California, Inc. Cigna Healthcare of Georgia, Inc. Cigna Healthcare of North Carolina, Inc. Cigna Healthcare of Tennessee, Inc. Cigna Healthcare of Utah, Inc. Cigna Healthcare, Inc. Cigna Life Insurance Company of New York Cigna Onsite Health, LLC Connecticut General Life Insurance Company Express Scripts Holding Company Gulfquest, LP Healthspring Life & Health Insurance Company, Inc. Healthspring of Florida, Inc. Healthspring USA, LLC Healthspring, Inc. Home Physicians Management, LLC Life Insurance Company of North America Newquest Management Northeast, LLC Newquest Management of Alabama, LLC Newquest, LLC Qualcare Alliance Networks, Inc. Qualcare, Inc. Scibal Associates, Inc. Tel -Drug of Pennsylvania, L.L.C. Tel -Drug, Inc. Verity Solutions Group, Inc. Accredo Health Group, Inc. Accredo Health, Incorporated AHG of New York, Inc. Airport Holdings, LLC Biopartners in Care, Inc. Care Continuum, Inc. CareCore National Group, LLC CareCore National Intermediate Holdings, LLC CareCore National, LLC CareCore NJ, LLC CareNext Managed Care, LLC CareNext Post -Acute, LLC Chiro Alliance Corporation CuraScript, Inc. Diversified NY IPA, Inc. Diversified Pharmaceutical Services, Inc. Econdisc Contracting Solutions, LLC ESI Canada ESI GP Canada ULC ESI GP Holdings, Inc. ESI GP2 Canada ULC ESI Mail Order Processing, Inc. ESI Mail Pharmacy Service, Inc. ESI Partnership ESI Resources, Inc. eviCore healthcare MSI, LLC Express Reinsurance Company Express Scripts Administrators LLC Express Scripts Canada Co. Express Scripts Canada Holding Co. Express Scripts Canada Holding, LLC Express Scripts Canada Services Express Scripts Canada Wholesale Express Scripts Holding Company, Inc. Express Scripts Pharmaceutical Procurement, LLC Express Scripts Pharmacy Atlantic, Ltd. Express Scripts Pharmacy Central, Ltd. Express Scripts Pharmacy Ontario, Ltd. Express Scripts Pharmacy West, Ltd. Express Scripts Pharmacy, Inc. Express Scripts Sales Operations, Inc. Express Scripts Senior Care Holdings, Inc. Express Scripts Senior Care, Inc. Express Scripts Services Co. 10/24/19 Additional Named Insureds (2 of 2) Express Scripts Specialty Distribution Services, Inc. Express Scripts Strategic Development, Inc. Express Scripts Utilization Management Company Express Scripts, Inc. Freco, Inc. Freedom Service Company, LLC Healthbridge Reimbursement & Product Support, Inc. Healthbridge, Inc. Innovative Product Alignment, LLC Inside RX, LLC Lynnfield Compounding Center, Inc. Lynnfield Drug, Inc. MAH Pharmacy, LLC Matrix GPO, LLC Matrix Healthcare Services, Inc. Medco Containment Insurance Company of NY Medco Containment Life Insurance Company Medco Health Services, Inc. Medco Health Solutions, Inc. MedSolutions Holdings, Inc. MedSolutions of Texas, Inc. MHS Holdings, CV MSI Health Organization of Texas, Inc. MyM Technology Services, LLC myMatrixx Holdings, LLC myMatrixx-B, LLC Palladian Health of Florida, LLC Palladian Independent Practice Association, LLC Priority Healthcare Corporation Priority Healthcare Distribution, Inc. QPID Health, LLC Specialty Products Acquisitions, LLC SpectraCare Health Care Ventures, Inc. SpectraCare, Inc. 10/24/19