Senior Apartments: Independent senior living communities, (also known as retirement communities or independent retirement communities), is housing designed for seniors 55 and older. Available in all states except: CA, FL, HI, LA, MS, MT, NV. Property restrictions may apply based on state/county.

Assisted Living: Assisted living communities are designed to provide residents assistance with basic activities of daily living such as: bathing, grooming, dressing and more. 20 bed minimum to qualify. No skilled care or nursing homes. Available in all states except: CA, FL, HI, LA, OK, MS, MT, NV. Property restrictions may apply based on state/county.

Churches: Houses of Worship for all religious denominations. Available in all states except: CA, FL, LA, MS, MT, NV. $50,000 combined minimum premium of property, general liability, umbrella, workers’ compensation. Property restrictions may apply based on state/county.

Quote & Request Bind Church Mutual

Pre-Qualification1. Verify risk eligibility by reviewing the Pre-Qualification Questionnaire – applies to both Senior Apartments and Assisted Living facilities2. Coastal guidelines

How to Obtain a Quote1. Complete NTrack Full Quote application a. Classify as: Senior Apartments, Assisted Living, or Church - as appropriate2. NEA Placement Specialist will review the submission and email appropriate supplemental (survey) application to you for completion3. 5 years of Loss Runs are required with submission a. New ventures may be acceptable subject to resumes and written summary of experience 4. Current state regulatory inspection documentations for Senior Living facilities are required5. Manual quote will be inserted into your Dashboard a. Please allow up to 30 days from receipt of all information for delivery of manual quote b. You will receive an email when quote is added to your Dashboard6. Fax or email all supplemental information to NEA NY Office - Fax 716-954-2255; Email: Northeastteam@neagencies.com TX Office - Fax 210-695-7031; Email: Northeastteamtx@neagencies.com

How to Request Bind1. Request bind through NTrack a. Signed and dated Acord applications required (Note: The Full Quote NTrack application will automatically populate the Acord applications – accessible on your Dashboard)2. Direct Bill only

Servicing1. For policy changes, endorsements, claims, billing questions please contact NEA.

*Church Mutual is an authorized company through the NEA Expanded Market Program. DBA: Northeast Agen-cies Insurance Services, CA License # 0B45336; in GA, DBA: NEA Insurance Services; in TX, DBA: Northeast Brokeage Agencies, Inc.; in UT, DBA: Northeast Insurance Agencies, Inc.

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CMIC SENIOR LIVING PRE-QUALIFYING QUESTIONNAIRE Name:

Address:

City and State:

Contact Name:

Telephone No.:

QUESTIONS:

1. Are any of your facilities a nursing home? (If yes, DNQ.) Yes No

2. Do you have 20 or more residents in your facility? (If no, DNQ.)

If yes, how many do you have, and how many are you licensed

for? (Less than 50% occupancy, DNQ.)

Yes No

*3. Are the residents of your facility 55 years or older?

(Up to 20% non-elderly is acceptable.) If not, how many?

Yes No

4. Are any of your residents mentally ill or developmentally disabled?

If yes, how many? (More than 20%, including non-elderly, DNQ.)

Yes No

5. Are any of your facilities converted dwellings over 1 story?

(If yes, DNQ.)

Yes No

6. Are any of your buildings frame construction and over 2 stories?

If yes, do they have an automatic sprinkler system (100%)? (If no, DNQ.)

Yes

Yes

No

No

7. Has your facility been in operation for more than one year?

If no, how many years of experience does the facility management

have?

Yes No

8. Who is your current insurance carrier and what coverages do you have? (A lapse in coverage may disqualify the prospect.)

9. What is your current policy expiration date?

10. Does your facility offer/include any of the following services:

a. Home Health Care Services? (Services provided to non-residents that do not live on the premises.)

If yes, what percentage of gross revenue does it represent? (If more than 10%, DNQ)

Yes

No

b. Consulting Operations for Senior Living Facilities?

If yes, what percentage of gross revenue does it represent?

(Refer to Underwriting)

Yes No

* Not applicable to independent apartments

2-12-13

Underwriting Notice #5 RE: Coastal Guidelines Background: The coastal guidelines have been in place since 2008, with changes throughout the years. This document now puts them all in one easily viewable place. Update: There is an update at the top of the guidelines, regarding policies that have lapsed for nonpay. If these risks are in areas listed in the guidelines as ineligible, we will not reinstate or rewrite the risk.

COASTAL GUIDELINES

Updated 01-13

Update 1-13: Any insured risk we presently have that is an ineligible area as listed below, will

not be reinstated or rewritten if coverage lapses.

Atlantic Seacoast – North to South

Maine, New Hampshire, Massachusetts, Rhode Island, Connecticut

Risks are ineligible if located on an island. If a bridge is crossed or use of ferry

transportation is needed to reach the risk, the risk is not eligible.

No field binding authority on Cape Cod. Requirements to submit for review include,

minimum $1,000 deductible, prior carrier loss runs from past three years, seasonal

facilities must have winter maintenance program. Wind percentage deductibles should

be encouraged on all business exposed to the coast.

New York

No field binding authority on Long Island within ½ mile of the coast. Prior carrier loss

run information is required. Wind percentage deductibles should be encouraged on all

business exposed to the coast.

New Jersey

Risks are ineligible if located on a barrier island, if less than 1 mile from the coast

excluding the barrier islands, and frame structures larger than $3 mill located east of the

Garden State Parkway.

In Monmouth and Cape May Counties only high quality risks are eligible. Maximum

property coverage aggregate exposure of $75 million in Monmouth County and $50

million in Cape May County will be maintained.

No field binding authority east of the Garden State Parkway from the Southern tip of

New Jersey north to Perth Amboy.

Wind percentage deductibles should be encouraged on all business exposed to the

coast.

Delaware

No field binding authority for risks East of Hwy 113 in Sussex County. Wind percentage

deductibles should be encouraged on all business exposed to the coast.

Maryland

No field binding authority for risks in Worcester and Wicomico Counties. Wind

percentage deductibles should be encouraged on all business exposed to the coast.

Virginia

Any new business less than 3 miles from the coast is ineligible. For purposes of defining

distance, the coast begins on the mainland. Risks are ineligible if located on a barrier

island. Wind percentage deductibles should be encouraged on renewal business.

North Carolina

Any new business located less than 10 miles west of the Intracoastal Waterway is

ineligible. Risks located on the Outer Banks are ineligible.

Field binding authority is suspended in each of the following counties: Brunswick,

Pender, Onslow, Carteret, Beaufort, New Hanover, Pamlico, Hyde, Dare, Tyrrell,

Pasquotank, Camden, Currituck.

Wind percentage deductibles should be encouraged on all business exposed to the

coast.

South Carolina

Any new business that is less than 25 miles from the Atlantic coast is ineligible. This

includes the cities of Myrtle Beach, Hilton Head and Charleston. Wind deductibles

should be encouraged on all business exposed to the coast.

Georgia

Risks located on any barrier island are ineligible. Wind percentage deductibles should

be encouraged on all business exposed to the coast. The areas around Savannah and

Brunswick require specific attention.

Florida

No new business accepted in Florida. The current Florida book is to be reduced by

$1.5Billion TIV and to 1,300 accounts in force by year-end 2008. Renewals are subject

to a mandatory minimum 2% windstorm deductible. Wind deductibles of 5% or more

are encouraged.

Gulf of Mexico – East to West

Alabama

Any risk that is South of I10 in Alabama is ineligible. Risks located on Dauphin Island or

any other barrier island are ineligible. Any risk located within 5 miles of Mobile Bay is

ineligible.

Baldwin and Mobile counties have limitations as to total accumulated property

exposure allowed ($30M and $75M respectively).

The sales staff has no binding authority for risks south of I65 and North of I10. Wind

percentage deductibles should be encouraged on all business exposed to the coast.

Mississippi

The following are ineligible as new business.

1. All property located in the counties of Hancock, Harrison, Jackson and 2. All property in the county of Pearl River South of a line from the

Louisiana/Mississippi border to the northwest border of Hancock and Pearl River counties.

A minimum 2% wind deductible is required on all new policies insuring property in the

counties of Stone, George, and the remainder of Pearl River.

Renewal Business in the new business ineligible area as stated above is to be reviewed

for possible non-renewal. If renewed, minimum wind deductibles are mandatory as

follows based upon construction type: 5% frame and masonry veneer, 2% all other

constructions.

Renewal business in counties of Stone, George, and the remainder of Pearl River as

identified above are required to have a minimum wind deductible of 2% for all

construction classes.

Louisiana

The following are ineligible for new business.

1. All properties located south of Highway 10 from the Texas border east to Baton Rouge,

2. South of Highway 12 from Baton Rouge to St. Tammany Parish, and 3. All properties located in St. Tammany Parish.

A minimum 2% wind deductible is required on all new policies insuring property north of

the ineligible area identified above and in the parishes of Beauregard, Allen, Evangeline,

St. Landry, Pointe Coupee, West Feliciana, East Feliciana, St. Helena, Tangipanoa,

Washington, Calcasien, Jefferson, West Baton Rouge, East Baton Rouge, Livingston,

Davis, Acadia, Lafayette, St. Martin, and Iberville.

Renewal business in the new business ineligible area as stated above is to be

reviewed for possible non-renewal (with knowledge that the state has imposed

limitations on our ability to cancel/nonrenew business subject to natural catastrophe

loss). If renewed, minimum wind deductibles are mandatory as follows based upon

construction type: 5% frame and masonry veneer, 2% all other construction types.

A minimum 2% wind deductible is required on all renewal business in the ineligible area

identified above and in the parishes of Beauregard, Allen, Evangeline, St. Landry, Pointe

Coupee, West Feliciana, East Feliciana, St. Helena, Tangipanoa, Washington, Calcasien,

Jefferson, West Baton Rouge, East Baton Rouge, Livingston, Davis, Acadia, Lafayette, St.

Martin, and Iberville.

Texas

Risks located less than 25 miles from the coast, or eligible for TX wind pool, are ineligible

for wind/hail coverage. Wind coverage is available to be written through the wind pool.

Harris County is closed to new business and the field has no binding authority.

Windstorm percentage deductibles should be used where appropriate with

consideration given to properties within 100 miles of the coast.

Page 2 of 2

c. Adult Day Care?

If yes, what percentage of gross revenue does it represent?

(Refer to Underwriting)

Yes No

11. How many of your residents are non-ambulatory (unable to evacuate the facility without assistance)?

(Greater than 20%, DNQ.)

12. Do you have security and monitoring systems in place for diagnosed Alzheimer/Dementia residents? (If no, DNQ.)

Yes No

13. Does your facility provide any diagnostic medical services or skilled medical care?

(If yes, DNQ.)

Yes No

*14. Are you licensed under state eligible classifications and regulations?

(If no, DNQ.)

Yes No

15. Do you have favorable state inspections? (If no, DNQ.) Yes No

16. What is the age of your building? (If more than 30 years old, must have electrical, cooling/heating system, and roof updated before quoting.)

17. How many stories tall is your building? (If over 6 stories, refer to Underwriting.)

* Not applicable to independent apartments