ENROLLMENT BASED ADMINISTRATIVE CALCULATION                                     
                                     Product/Sub Group-8 Digit/Payroll Location                                      

INVOICE NUMBER:     230131587845                                           PAGE:               1 of 41           
BILL ACCOUNT NUMBER:2401631001                                             PAID CLAIMS MONTH:  January 2023      
BILL ACCOUNT NAME:  Utz Quality Foods                                      CLAIMS PAID THRU:   01/27/2023        
CLIENT NUMBER:      240163                                                 BILL CYCLE:         4 of 4            
CLIENT NAME:        Utz Quality Foods                                      PREPARED DATE:      01/31/2023        

                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
2T HM Life Insurance Stop Loss Specific FAM*
  025620-00
    ACCTS                                                              11                                    $50.65                                 $557.15
      ADM                                                              31                                    $50.65                               $1,570.15
     ALTO                                                               1                                    $50.65                                  $50.65
    CKPT2                                                               3                                    $50.65                                 $151.95
    CLARK                                                               3                                    $50.65                                 $151.95
    CLEVE                                                               1                                    $50.65                                  $50.65
     DALL                                                               1                                    $50.65                                  $50.65
    FESPL                                                               6                                    $50.65                                 $303.90
    FLEET                                                               2                                    $50.65                                 $101.30
     FRED                                                               1                                    $50.65                                  $50.65
    GFPLT                                                               4                                    $50.65                                 $202.60
     HAN4                                                               1                                    $50.65                                  $50.65
     HART                                                               1                                    $50.65                                  $50.65
    HCOMP                                                               4                                    $50.65                                 $202.60
    HCSLS                                                               3                                    $50.65                                 $151.95
    INADM                                                               2                                    $50.65                                 $101.30
     INDY                                                               2                                    $50.65                                 $101.30
    INVAZ                                                              16                                    $50.65                                 $810.40
    INVIN                                                               8                                    $50.65                                 $405.20
    JACKS                                                               2                                    $50.65                                 $101.30
    KCSLS                                                               1                                    $50.65                                  $50.65
    KMPLT                                                               4                                    $50.65                                 $202.60
     MARM                                                               1                                    $50.65                                  $50.65
     MASS                                                               1                                    $50.65                                  $50.65
     MKTG                                                               3                                    $50.65                                 $151.95

                                                                                                                                               PAGE:2 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     MONT                                                               2                                    $50.65                                 $101.30
     PLT1                                                               2                                    $50.65                                 $101.30
    PLT18                                                               1                                    $50.65                                  $50.65
     PLT2                                                              13                                    $50.65                                 $658.45
    PLT22                                                               1                                    $50.65                                  $50.65
     PLT3                                                              27                                    $50.65                               $1,367.55
     PLT4                                                              18                                    $50.65                                 $911.70
     PLT5                                                               7                                    $50.65                                 $354.55
     PLT7                                                               2                                    $50.65                                 $101.30
    PLTAD                                                              10                                    $50.65                                 $506.50
    PTOHD                                                               4                                    $50.65                                 $202.60
    RETAI                                                               1                                    $50.65                                  $50.65
     ROCH                                                               1                                    $50.65                                  $50.65
    RWPLT                                                               6                                    $50.65                                 $303.90
    SALES                                                               2                                    $50.65                                 $101.30
    SBPLT                                                               3                                    $50.65                                 $151.95
    SBSLS                                                               1                                    $50.65                                  $50.65
    SBUNB                                                               1                                    $50.65                                  $50.65
    SLSUP                                                               6                                    $50.65                                 $303.90
     STVL                                                               1                                    $50.65                                  $50.65
    TAMPA                                                               1                                    $50.65                                  $50.65
    TMPLT                                                               3                                    $50.65                                 $151.95
    TMSLS                                                               2                                    $50.65                                 $101.30
      W44                                                               1                                    $50.65                                  $50.65
     WILM                                                               1                                    $50.65                                  $50.65
    WILSO                                                               1                                    $50.65                                  $50.65
     ZALA                                                               1                                    $50.65                                  $50.65
  025620-00 Total                                                     232                                                                        $11,750.80
  025620-01
    ACCTS                                                              14                                    $50.65                                 $709.10
      ADM                                                              41                                    $50.65                               $2,076.65
     ALTO                                                               1                                    $50.65                                  $50.65

                                                                                                                                               PAGE:3 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      ASH                                                               2                                    $50.65                                 $101.30
     BETH                                                               1                                    $50.65                                  $50.65
    BFALL                                                               1                                    $50.65                                  $50.65
    CHAMB                                                               1                                    $50.65                                  $50.65
     CHAR                                                               2                                    $50.65                                 $101.30
     CHES                                                               1                                    $50.65                                  $50.65
    CKPT2                                                               3                                    $50.65                                 $151.95
    CLARK                                                               5                                    $50.65                                 $253.25
    CLEVE                                                               5                                    $50.65                                 $253.25
     DALL                                                               1                                    $50.65                                  $50.65
     DEPT                                                               1                                    $50.65                                  $50.65
     FAIR                                                               2                                    $50.65                                 $101.30
    FESPL                                                              10                                    $50.65                                 $506.50
    FLEET                                                               7                                    $50.65                                 $354.55
    FORPK                                                               1                                    $50.65                                  $50.65
     FRED                                                               1                                    $50.65                                  $50.65
     FREE                                                               2                                    $50.65                                 $101.30
    GFPLT                                                               8                                    $50.65                                 $405.20
     HAN4                                                               1                                    $50.65                                  $50.65
    HCOMP                                                               3                                    $50.65                                 $151.95
    HCSLS                                                               1                                    $50.65                                  $50.65
    INRDC                                                               1                                    $50.65                                  $50.65
    INVAZ                                                               8                                    $50.65                                 $405.20
    INVIN                                                              17                                    $50.65                                 $861.05
    JACKS                                                               5                                    $50.65                                 $253.25
    JOHNS                                                               1                                    $50.65                                  $50.65
    KCSLS                                                               5                                    $50.65                                 $253.25
     KENN                                                               1                                    $50.65                                  $50.65
     KILG                                                               1                                    $50.65                                  $50.65
    KMPLT                                                               1                                    $50.65                                  $50.65
     LANC                                                               1                                    $50.65                                  $50.65
     LAUR                                                               1                                    $50.65                                  $50.65

                                                                                                                                               PAGE:4 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    MANAS                                                               4                                    $50.65                                 $202.60
     MASS                                                               1                                    $50.65                                  $50.65
     MEMP                                                               1                                    $50.65                                  $50.65
     MKTG                                                               3                                    $50.65                                 $151.95
     MOBL                                                               1                                    $50.65                                  $50.65
     NEAS                                                               1                                    $50.65                                  $50.65
      NEW                                                               2                                    $50.65                                 $101.30
    OHRDC                                                               1                                    $50.65                                  $50.65
     PITT                                                               1                                    $50.65                                  $50.65
     PLT1                                                               3                                    $50.65                                 $151.95
    PLT18                                                              12                                    $50.65                                 $607.80
     PLT2                                                              57                                    $50.65                               $2,887.05
    PLT22                                                               1                                    $50.65                                  $50.65
     PLT3                                                              65                                    $50.65                               $3,292.25
     PLT4                                                              34                                    $50.65                               $1,722.10
     PLT5                                                              19                                    $50.65                                 $962.35
     PLT7                                                               2                                    $50.65                                 $101.30
     PLT9                                                               2                                    $50.65                                 $101.30
    PLTAD                                                              17                                    $50.65                                 $861.05
    PTOHD                                                              16                                    $50.65                                 $810.40
     RALE                                                               2                                    $50.65                                 $101.30
    RG039                                                               1                                    $50.65                                  $50.65
     ROAN                                                               1                                    $50.65                                  $50.65
    RWADM                                                               1                                    $50.65                                  $50.65
    RWPLT                                                              10                                    $50.65                                 $506.50
    SALES                                                               2                                    $50.65                                 $101.30
    SBADM                                                               1                                    $50.65                                  $50.65
    SBPLT                                                               4                                    $50.65                                 $202.60
    SBSLS                                                               1                                    $50.65                                  $50.65
    SBUNB                                                               5                                    $50.65                                 $253.25
    SBUNM                                                               3                                    $50.65                                 $151.95
      SLC                                                               1                                    $50.65                                  $50.65

                                                                                                                                               PAGE:5 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    SLSUP                                                              10                                    $50.65                                 $506.50
     STVL                                                               1                                    $50.65                                  $50.65
    TAMPA                                                               1                                    $50.65                                  $50.65
    TMPLT                                                               7                                    $50.65                                 $354.55
    TMSLS                                                               4                                    $50.65                                 $202.60
     W040                                                               1                                    $50.65                                  $50.65
      W36                                                               1                                    $50.65                                  $50.65
      W44                                                               1                                    $50.65                                  $50.65
     WALD                                                               3                                    $50.65                                 $151.95
     WILM                                                               1                                    $50.65                                  $50.65
     WORC                                                               2                                    $50.65                                 $101.30
  025620-01 Total                                                     464                                                                        $23,501.60
  025620-02
    ACCTS                                                              10                                    $50.65                                 $506.50
      ADM                                                              13                                    $50.65                                 $658.45
     AUBU                                                               1                                    $50.65                                  $50.65
    CKPT2                                                               2                                    $50.65                                 $101.30
    CLARK                                                               2                                    $50.65                                 $101.30
     FAIR                                                               2                                    $50.65                                 $101.30
    FESPL                                                               2                                    $50.65                                 $101.30
    FLEET                                                               2                                    $50.65                                 $101.30
     FRAZ                                                               1                                    $50.65                                  $50.65
    GFADM                                                               1                                    $50.65                                  $50.65
    GFPLT                                                               2                                    $50.65                                 $101.30
     HAN4                                                               1                                    $50.65                                  $50.65
     HART                                                               2                                    $50.65                                 $101.30
    HCOMP                                                               4                                    $50.65                                 $202.60
    HCSLS                                                               1                                    $50.65                                  $50.65
    INVIN                                                               4                                    $50.65                                 $202.60
     LAUR                                                               1                                    $50.65                                  $50.65
     LEBA                                                               1                                    $50.65                                  $50.65
     MARM                                                               1                                    $50.65                                  $50.65

                                                                                                                                               PAGE:6 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     MEMP                                                               1                                    $50.65                                  $50.65
     MOBL                                                               2                                    $50.65                                 $101.30
    NERDC                                                               1                                    $50.65                                  $50.65
     PARK                                                               1                                    $50.65                                  $50.65
     PLT1                                                               3                                    $50.65                                 $151.95
    PLT18                                                               4                                    $50.65                                 $202.60
     PLT2                                                              10                                    $50.65                                 $506.50
     PLT3                                                               9                                    $50.65                                 $455.85
     PLT4                                                              10                                    $50.65                                 $506.50
     PLT5                                                               9                                    $50.65                                 $455.85
     PLT6                                                               2                                    $50.65                                 $101.30
     PLT7                                                               3                                    $50.65                                 $151.95
     PLT9                                                               2                                    $50.65                                 $101.30
    PLTAD                                                               5                                    $50.65                                 $253.25
     PROV                                                               1                                    $50.65                                  $50.65
    PTOHD                                                               3                                    $50.65                                 $151.95
     RALE                                                               1                                    $50.65                                  $50.65
    RETAI                                                               1                                    $50.65                                  $50.65
     RICH                                                               1                                    $50.65                                  $50.65
     ROAN                                                               1                                    $50.65                                  $50.65
    RWPLT                                                               1                                    $50.65                                  $50.65
    SALES                                                               3                                    $50.65                                 $151.95
    SBSLS                                                               2                                    $50.65                                 $101.30
    SBUNB                                                               4                                    $50.65                                 $202.60
    SBUNM                                                               1                                    $50.65                                  $50.65
    SLSUP                                                               4                                    $50.65                                 $202.60
    TAMPA                                                               1                                    $50.65                                  $50.65
    TMPLT                                                               1                                    $50.65                                  $50.65
    TMSLS                                                               2                                    $50.65                                 $101.30
    WILSO                                                               1                                    $50.65                                  $50.65
     ZALA                                                               1                                    $50.65                                  $50.65
  025620-02 Total                                                     144                                                                         $7,293.60

                                                                                                                                               PAGE:7 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  025620-70
    COBRA                                                               3                                    $50.65                                 $151.95
  025620-70 Total                                                       3                                                                           $151.95
  025620-71
      ADM                                                               1                                    $50.65                                  $50.65
    COBRA                                                               2                                    $50.65                                 $101.30
  025620-71 Total                                                       3                                                                           $151.95
  025620-72
    COBRA                                                               3                                    $50.65                                 $151.95
  025620-72 Total                                                       3                                                                           $151.95
2T HM Life Insurance Stop Loss Specific FAM* Total                    849                                                                        $43,001.85
                                                                                                                                                            
Fiduciary Services
  025620-00
    ACCTS                                                              16                                     $1.50                                  $24.00
      ADM                                                              80                                     $1.50                                 $120.00
     ALTO                                                               1                                     $1.50                                   $1.50
     BENS                                                               1                                     $1.50                                   $1.50
    BFALL                                                               2                                     $1.50                                   $3.00
     BUFF                                                               1                                     $1.50                                   $1.50
     CHES                                                               2                                     $1.50                                   $3.00
    CKPT2                                                              17                                     $1.50                                  $25.50
    CLARK                                                               9                                     $1.50                                  $13.50
    CLEVE                                                               2                                     $1.50                                   $3.00
     CUMB                                                               2                                     $1.50                                   $3.00
     DALL                                                               1                                     $1.50                                   $1.50
     FAIR                                                               1                                     $1.50                                   $1.50
    FESPL                                                              21                                     $1.50                                  $31.50
    FLEET                                                               3                                     $1.50                                   $4.50
    FORPK                                                               5                                     $1.50                                   $7.50
     FRED                                                               1                                     $1.50                                   $1.50
    GFPLT                                                              47                                     $1.50                                  $70.50

                                                                                                                                               PAGE:8 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     HAN1                                                               3                                     $1.50                                   $4.50
     HAN4                                                               1                                     $1.50                                   $1.50
     HART                                                               3                                     $1.50                                   $4.50
    HCOMP                                                               5                                     $1.50                                   $7.50
    HCSLS                                                               4                                     $1.50                                   $6.00
     HOOK                                                               1                                     $1.50                                   $1.50
    INADM                                                               3                                     $1.50                                   $4.50
     INDY                                                               3                                     $1.50                                   $4.50
    INRDC                                                               2                                     $1.50                                   $3.00
    INVAZ                                                              46                                     $1.50                                  $69.00
    INVIN                                                              43                                     $1.50                                  $64.50
    JACKS                                                               3                                     $1.50                                   $4.50
    JOHNS                                                               1                                     $1.50                                   $1.50
    KCSLS                                                               3                                     $1.50                                   $4.50
    KMPLT                                                               7                                     $1.50                                  $10.50
     MARM                                                               1                                     $1.50                                   $1.50
     MASS                                                               3                                     $1.50                                   $4.50
     MKTG                                                               6                                     $1.50                                   $9.00
     MONT                                                               2                                     $1.50                                   $3.00
     NASH                                                               2                                     $1.50                                   $3.00
      NEW                                                               1                                     $1.50                                   $1.50
    OHRDC                                                               2                                     $1.50                                   $3.00
     PARK                                                               1                                     $1.50                                   $1.50
     PITT                                                               1                                     $1.50                                   $1.50
     PLT1                                                               6                                     $1.50                                   $9.00
    PLT18                                                              24                                     $1.50                                  $36.00
     PLT2                                                              57                                     $1.50                                  $85.50
    PLT22                                                               2                                     $1.50                                   $3.00
     PLT3                                                             133                                     $1.50                                 $199.50
     PLT4                                                              69                                     $1.50                                 $103.50
     PLT5                                                              30                                     $1.50                                  $45.00
     PLT7                                                               7                                     $1.50                                  $10.50

                                                                                                                                               PAGE:9 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     PLT9                                                               1                                     $1.50                                   $1.50
    PLTAD                                                              21                                     $1.50                                  $31.50
    PTOHD                                                              10                                     $1.50                                  $15.00
     RALE                                                               1                                     $1.50                                   $1.50
    RETAI                                                               5                                     $1.50                                   $7.50
     RICH                                                               1                                     $1.50                                   $1.50
     ROCH                                                               1                                     $1.50                                   $1.50
    RWPLT                                                              20                                     $1.50                                  $30.00
    SALES                                                               4                                     $1.50                                   $6.00
    SBPLT                                                               6                                     $1.50                                   $9.00
    SBSLS                                                               4                                     $1.50                                   $6.00
    SBUNB                                                              19                                     $1.50                                  $28.50
    SLSUP                                                              14                                     $1.50                                  $21.00
     STVL                                                               1                                     $1.50                                   $1.50
    TAMPA                                                               6                                     $1.50                                   $9.00
    TMPLT                                                              14                                     $1.50                                  $21.00
    TMSLS                                                               3                                     $1.50                                   $4.50
     W040                                                               4                                     $1.50                                   $6.00
      W44                                                               1                                     $1.50                                   $1.50
     WALD                                                               1                                     $1.50                                   $1.50
     WILD                                                               1                                     $1.50                                   $1.50
     WILM                                                               1                                     $1.50                                   $1.50
    WILMC                                                               1                                     $1.50                                   $1.50
    WILSO                                                               1                                     $1.50                                   $1.50
     ZALA                                                               3                                     $1.50                                   $4.50
  025620-00 Total                                                     831                                                                         $1,246.50
  025620-01
    ACCTS                                                              27                                     $1.50                                  $40.50
      ADM                                                             111                                     $1.50                                 $166.50
     ALTO                                                               1                                     $1.50                                   $1.50
      ASH                                                               2                                     $1.50                                   $3.00
     AUBU                                                               4                                     $1.50                                   $6.00

                                                                                                                                              PAGE:10 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     BETH                                                               1                                     $1.50                                   $1.50
    BFALL                                                               2                                     $1.50                                   $3.00
     BIRM                                                               1                                     $1.50                                   $1.50
     CARR                                                               2                                     $1.50                                   $3.00
    CHAMB                                                               3                                     $1.50                                   $4.50
     CHAR                                                               2                                     $1.50                                   $3.00
     CHES                                                               1                                     $1.50                                   $1.50
    CKPT2                                                              18                                     $1.50                                  $27.00
    CKWH2                                                               1                                     $1.50                                   $1.50
    CLARK                                                              16                                     $1.50                                  $24.00
    CLEVE                                                               6                                     $1.50                                   $9.00
     DALL                                                               3                                     $1.50                                   $4.50
     DENV                                                               2                                     $1.50                                   $3.00
     DEPT                                                               1                                     $1.50                                   $1.50
     FAIR                                                               3                                     $1.50                                   $4.50
    FESAD                                                               1                                     $1.50                                   $1.50
    FESPL                                                              35                                     $1.50                                  $52.50
    FLEET                                                              15                                     $1.50                                  $22.50
    FORPK                                                               5                                     $1.50                                   $7.50
     FRAZ                                                               2                                     $1.50                                   $3.00
     FRED                                                               3                                     $1.50                                   $4.50
     FREE                                                               2                                     $1.50                                   $3.00
    GFADM                                                               2                                     $1.50                                   $3.00
    GFPLT                                                              52                                     $1.50                                  $78.00
     HAN1                                                               1                                     $1.50                                   $1.50
     HAN4                                                               3                                     $1.50                                   $4.50
    HCOMP                                                               5                                     $1.50                                   $7.50
    HCSLS                                                               1                                     $1.50                                   $1.50
     INDY                                                               4                                     $1.50                                   $6.00
    INRDC                                                               3                                     $1.50                                   $4.50
    INVAZ                                                              19                                     $1.50                                  $28.50
    INVIN                                                              46                                     $1.50                                  $69.00

                                                                                                                                              PAGE:11 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    JACKS                                                               7                                     $1.50                                  $10.50
    JOHNS                                                               2                                     $1.50                                   $3.00
    KCPLT                                                               2                                     $1.50                                   $3.00
    KCSLS                                                              18                                     $1.50                                  $27.00
     KENN                                                               1                                     $1.50                                   $1.50
     KILG                                                               1                                     $1.50                                   $1.50
    KMPLT                                                               8                                     $1.50                                  $12.00
     LANC                                                               1                                     $1.50                                   $1.50
     LAUR                                                               3                                     $1.50                                   $4.50
     LEBA                                                               2                                     $1.50                                   $3.00
    MANAS                                                               4                                     $1.50                                   $6.00
     MARM                                                               1                                     $1.50                                   $1.50
     MASS                                                               3                                     $1.50                                   $4.50
     MEMP                                                               3                                     $1.50                                   $4.50
     MKTG                                                              10                                     $1.50                                  $15.00
     MOBL                                                               1                                     $1.50                                   $1.50
     NASH                                                               2                                     $1.50                                   $3.00
     NEAS                                                               2                                     $1.50                                   $3.00
      NEW                                                               4                                     $1.50                                   $6.00
    OHRDC                                                               2                                     $1.50                                   $3.00
     PITT                                                               2                                     $1.50                                   $3.00
     PLT1                                                              15                                     $1.50                                  $22.50
    PLT18                                                              31                                     $1.50                                  $46.50
     PLT2                                                             146                                     $1.50                                 $219.00
    PLT22                                                               2                                     $1.50                                   $3.00
     PLT3                                                             155                                     $1.50                                 $232.50
     PLT4                                                             103                                     $1.50                                 $154.50
     PLT5                                                              63                                     $1.50                                  $94.50
     PLT7                                                              16                                     $1.50                                  $24.00
     PLT9                                                              13                                     $1.50                                  $19.50
    PLTAD                                                              26                                     $1.50                                  $39.00
    PTOHD                                                              28                                     $1.50                                  $42.00

                                                                                                                                              PAGE:12 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     RALE                                                               3                                     $1.50                                   $4.50
    RETAI                                                               1                                     $1.50                                   $1.50
    RG039                                                               1                                     $1.50                                   $1.50
     RICH                                                               2                                     $1.50                                   $3.00
     ROAN                                                               1                                     $1.50                                   $1.50
     ROCH                                                               2                                     $1.50                                   $3.00
    RWADM                                                               1                                     $1.50                                   $1.50
    RWPLT                                                              43                                     $1.50                                  $64.50
    SALES                                                               3                                     $1.50                                   $4.50
    SBADM                                                               2                                     $1.50                                   $3.00
    SBPLT                                                               7                                     $1.50                                  $10.50
    SBSLS                                                               3                                     $1.50                                   $4.50
    SBUNB                                                              28                                     $1.50                                  $42.00
    SBUNM                                                               4                                     $1.50                                   $6.00
      SLC                                                               1                                     $1.50                                   $1.50
    SLSUP                                                              21                                     $1.50                                  $31.50
     STVL                                                               1                                     $1.50                                   $1.50
    TAMPA                                                               3                                     $1.50                                   $4.50
    TMPLT                                                              22                                     $1.50                                  $33.00
    TMSLS                                                               4                                     $1.50                                   $6.00
     W040                                                               9                                     $1.50                                  $13.50
      W36                                                               1                                     $1.50                                   $1.50
      W41                                                               2                                     $1.50                                   $3.00
      W44                                                               2                                     $1.50                                   $3.00
     WALD                                                               3                                     $1.50                                   $4.50
     WEVR                                                               1                                     $1.50                                   $1.50
     WILM                                                               2                                     $1.50                                   $3.00
    WILMC                                                               1                                     $1.50                                   $1.50
     WORC                                                               3                                     $1.50                                   $4.50
    WRIVR                                                               1                                     $1.50                                   $1.50
     ZALA                                                               3                                     $1.50                                   $4.50
  025620-01 Total                                                    1264                                                                         $1,896.00

                                                                                                                                              PAGE:13 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  025620-02
    ACCTS                                                              18                                     $1.50                                  $27.00
      ADM                                                              49                                     $1.50                                  $73.50
      ASH                                                               1                                     $1.50                                   $1.50
     AUBU                                                               1                                     $1.50                                   $1.50
     BETH                                                               1                                     $1.50                                   $1.50
     BIRM                                                               1                                     $1.50                                   $1.50
     BUFF                                                               1                                     $1.50                                   $1.50
     BURL                                                               1                                     $1.50                                   $1.50
     CHAR                                                               1                                     $1.50                                   $1.50
    CKPT2                                                               5                                     $1.50                                   $7.50
    CLARK                                                               4                                     $1.50                                   $6.00
     DALL                                                               1                                     $1.50                                   $1.50
     DENV                                                               1                                     $1.50                                   $1.50
     DEPT                                                               1                                     $1.50                                   $1.50
     FAIR                                                               3                                     $1.50                                   $4.50
    FESPL                                                               2                                     $1.50                                   $3.00
    FLEET                                                               6                                     $1.50                                   $9.00
    FORPK                                                               3                                     $1.50                                   $4.50
     FRAZ                                                               1                                     $1.50                                   $1.50
     FRED                                                               1                                     $1.50                                   $1.50
    GFADM                                                               1                                     $1.50                                   $1.50
    GFPLT                                                              12                                     $1.50                                  $18.00
     HAN1                                                               2                                     $1.50                                   $3.00
     HAN4                                                               3                                     $1.50                                   $4.50
     HART                                                               3                                     $1.50                                   $4.50
    HCOMP                                                               5                                     $1.50                                   $7.50
    HCSLS                                                               1                                     $1.50                                   $1.50
     HOOK                                                               1                                     $1.50                                   $1.50
     INDY                                                               2                                     $1.50                                   $3.00
    INRDC                                                               3                                     $1.50                                   $4.50
    INVAZ                                                               2                                     $1.50                                   $3.00

                                                                                                                                              PAGE:14 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    INVIN                                                              11                                     $1.50                                  $16.50
    JACKS                                                               1                                     $1.50                                   $1.50
    KCSLS                                                               2                                     $1.50                                   $3.00
     KILG                                                               1                                     $1.50                                   $1.50
    KMPLT                                                               1                                     $1.50                                   $1.50
     LAUR                                                               2                                     $1.50                                   $3.00
     LEBA                                                               1                                     $1.50                                   $1.50
    LROCK                                                               1                                     $1.50                                   $1.50
    MANAS                                                               1                                     $1.50                                   $1.50
     MARM                                                               1                                     $1.50                                   $1.50
     MEMP                                                               1                                     $1.50                                   $1.50
     MKTG                                                               2                                     $1.50                                   $3.00
     MOBL                                                               3                                     $1.50                                   $4.50
     NASH                                                               2                                     $1.50                                   $3.00
     NEAS                                                               1                                     $1.50                                   $1.50
    NERDC                                                               1                                     $1.50                                   $1.50
    NNEWS                                                               1                                     $1.50                                   $1.50
     PARK                                                               1                                     $1.50                                   $1.50
     PITT                                                               1                                     $1.50                                   $1.50
     PLT1                                                               3                                     $1.50                                   $4.50
    PLT18                                                               9                                     $1.50                                  $13.50
     PLT2                                                              37                                     $1.50                                  $55.50
    PLT22                                                               2                                     $1.50                                   $3.00
     PLT3                                                              46                                     $1.50                                  $69.00
     PLT4                                                              27                                     $1.50                                  $40.50
     PLT5                                                              26                                     $1.50                                  $39.00
     PLT6                                                               3                                     $1.50                                   $4.50
     PLT7                                                               9                                     $1.50                                  $13.50
     PLT9                                                               7                                     $1.50                                  $10.50
    PLTAD                                                               9                                     $1.50                                  $13.50
     PROV                                                               2                                     $1.50                                   $3.00
    PTOHD                                                               8                                     $1.50                                  $12.00

                                                                                                                                              PAGE:15 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     RALE                                                               1                                     $1.50                                   $1.50
    RETAI                                                               1                                     $1.50                                   $1.50
     RICH                                                               1                                     $1.50                                   $1.50
     ROAN                                                               1                                     $1.50                                   $1.50
     ROCH                                                               1                                     $1.50                                   $1.50
    RWPLT                                                              22                                     $1.50                                  $33.00
    SALES                                                               4                                     $1.50                                   $6.00
    SBPLT                                                               3                                     $1.50                                   $4.50
    SBSLS                                                               3                                     $1.50                                   $4.50
    SBUNB                                                              13                                     $1.50                                  $19.50
    SBUNM                                                               1                                     $1.50                                   $1.50
    SLSUP                                                              12                                     $1.50                                  $18.00
     STVL                                                               1                                     $1.50                                   $1.50
     SYRA                                                               1                                     $1.50                                   $1.50
    TAMPA                                                               2                                     $1.50                                   $3.00
    TMPLT                                                              15                                     $1.50                                  $22.50
    TMSLS                                                               2                                     $1.50                                   $3.00
     TUSC                                                               2                                     $1.50                                   $3.00
     W040                                                               2                                     $1.50                                   $3.00
      W44                                                               1                                     $1.50                                   $1.50
     WALD                                                               2                                     $1.50                                   $3.00
    WILSO                                                               3                                     $1.50                                   $4.50
     WORC                                                               1                                     $1.50                                   $1.50
     ZALA                                                               3                                     $1.50                                   $4.50
  025620-02 Total                                                     458                                                                           $687.00
  025620-70
    COBRA                                                               6                                     $1.50                                   $9.00
  025620-70 Total                                                       6                                                                             $9.00
  025620-71
      ADM                                                               2                                     $1.50                                   $3.00
    COBRA                                                               9                                     $1.50                                  $13.50
  025620-71 Total                                                      11                                                                            $16.50

                                                                                                                                              PAGE:16 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  025620-72
    COBRA                                                               7                                     $1.50                                  $10.50
  025620-72 Total                                                       7                                                                            $10.50
Fiduciary Services Total                                             2577                                                                         $3,865.50
                                                                                                                                                            
HDHP PPO
  025620-00
    ACCTS                                                              16                                    $21.00                                 $336.00
      ADM                                                              80                                    $21.00                               $1,680.00
     ALTO                                                               1                                    $21.00                                  $21.00
     BENS                                                               1                                    $21.00                                  $21.00
    BFALL                                                               2                                    $21.00                                  $42.00
     BUFF                                                               1                                    $21.00                                  $21.00
     CHES                                                               2                                    $21.00                                  $42.00
    CKPT2                                                              17                                    $21.00                                 $357.00
    CLARK                                                               9                                    $21.00                                 $189.00
    CLEVE                                                               2                                    $21.00                                  $42.00
     CUMB                                                               2                                    $21.00                                  $42.00
     DALL                                                               1                                    $21.00                                  $21.00
     FAIR                                                               1                                    $21.00                                  $21.00
    FESPL                                                              21                                    $21.00                                 $441.00
    FLEET                                                               3                                    $21.00                                  $63.00
    FORPK                                                               5                                    $21.00                                 $105.00
     FRED                                                               1                                    $21.00                                  $21.00
    GFPLT                                                              47                                    $21.00                                 $987.00
     HAN1                                                               3                                    $21.00                                  $63.00
     HAN4                                                               1                                    $21.00                                  $21.00
     HART                                                               3                                    $21.00                                  $63.00
    HCOMP                                                               5                                    $21.00                                 $105.00
    HCSLS                                                               4                                    $21.00                                  $84.00
     HOOK                                                               1                                    $21.00                                  $21.00
    INADM                                                               3                                    $21.00                                  $63.00

                                                                                                                                              PAGE:17 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     INDY                                                               3                                    $21.00                                  $63.00
    INRDC                                                               2                                    $21.00                                  $42.00
    INVAZ                                                              46                                    $21.00                                 $966.00
    INVIN                                                              43                                    $21.00                                 $903.00
    JACKS                                                               3                                    $21.00                                  $63.00
    JOHNS                                                               1                                    $21.00                                  $21.00
    KCSLS                                                               3                                    $21.00                                  $63.00
    KMPLT                                                               7                                    $21.00                                 $147.00
     MARM                                                               1                                    $21.00                                  $21.00
     MASS                                                               3                                    $21.00                                  $63.00
     MKTG                                                               6                                    $21.00                                 $126.00
     MONT                                                               2                                    $21.00                                  $42.00
     NASH                                                               2                                    $21.00                                  $42.00
      NEW                                                               1                                    $21.00                                  $21.00
    OHRDC                                                               2                                    $21.00                                  $42.00
     PARK                                                               1                                    $21.00                                  $21.00
     PITT                                                               1                                    $21.00                                  $21.00
     PLT1                                                               6                                    $21.00                                 $126.00
    PLT18                                                              24                                    $21.00                                 $504.00
     PLT2                                                              57                                    $21.00                               $1,197.00
    PLT22                                                               2                                    $21.00                                  $42.00
     PLT3                                                             133                                    $21.00                               $2,793.00
     PLT4                                                              69                                    $21.00                               $1,449.00
     PLT5                                                              30                                    $21.00                                 $630.00
     PLT7                                                               7                                    $21.00                                 $147.00
     PLT9                                                               1                                    $21.00                                  $21.00
    PLTAD                                                              21                                    $21.00                                 $441.00
    PTOHD                                                              10                                    $21.00                                 $210.00
     RALE                                                               1                                    $21.00                                  $21.00
    RETAI                                                               5                                    $21.00                                 $105.00
     RICH                                                               1                                    $21.00                                  $21.00
     ROCH                                                               1                                    $21.00                                  $21.00

                                                                                                                                              PAGE:18 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    RWPLT                                                              20                                    $21.00                                 $420.00
    SALES                                                               4                                    $21.00                                  $84.00
    SBPLT                                                               6                                    $21.00                                 $126.00
    SBSLS                                                               4                                    $21.00                                  $84.00
    SBUNB                                                              19                                    $21.00                                 $399.00
    SLSUP                                                              14                                    $21.00                                 $294.00
     STVL                                                               1                                    $21.00                                  $21.00
    TAMPA                                                               6                                    $21.00                                 $126.00
    TMPLT                                                              14                                    $21.00                                 $294.00
    TMSLS                                                               3                                    $21.00                                  $63.00
     W040                                                               4                                    $21.00                                  $84.00
      W44                                                               1                                    $21.00                                  $21.00
     WALD                                                               1                                    $21.00                                  $21.00
     WILD                                                               1                                    $21.00                                  $21.00
     WILM                                                               1                                    $21.00                                  $21.00
    WILMC                                                               1                                    $21.00                                  $21.00
    WILSO                                                               1                                    $21.00                                  $21.00
     ZALA                                                               3                                    $21.00                                  $63.00
  025620-00 Total                                                     831                                                                        $17,451.00
  025620-70
    COBRA                                                               6                                    $21.00                                 $126.00
  025620-70 Total                                                       6                                                                           $126.00
HDHP PPO Total                                                        837                                                                        $17,577.00
                                                                                                                                                            
HM Life Insurance Stop Loss Specific IND*
  025620-00
    ACCTS                                                               5                                    $18.13                                  $90.65
      ADM                                                              49                                    $18.13                                 $888.37
     BENS                                                               1                                    $18.13                                  $18.13
    BFALL                                                               2                                    $18.13                                  $36.26
     BUFF                                                               1                                    $18.13                                  $18.13
     CHES                                                               2                                    $18.13                                  $36.26

                                                                                                                                              PAGE:19 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    CKPT2                                                              14                                    $18.13                                 $253.82
    CLARK                                                               6                                    $18.13                                 $108.78
    CLEVE                                                               1                                    $18.13                                  $18.13
     CUMB                                                               2                                    $18.13                                  $36.26
     FAIR                                                               1                                    $18.13                                  $18.13
    FESPL                                                              15                                    $18.13                                 $271.95
    FLEET                                                               1                                    $18.13                                  $18.13
    FORPK                                                               5                                    $18.13                                  $90.65
    GFPLT                                                              43                                    $18.13                                 $779.59
     HAN1                                                               3                                    $18.13                                  $54.39
     HART                                                               2                                    $18.13                                  $36.26
    HCOMP                                                               1                                    $18.13                                  $18.13
    HCSLS                                                               1                                    $18.13                                  $18.13
     HOOK                                                               1                                    $18.13                                  $18.13
    INADM                                                               1                                    $18.13                                  $18.13
     INDY                                                               1                                    $18.13                                  $18.13
    INRDC                                                               2                                    $18.13                                  $36.26
    INVAZ                                                              30                                    $18.13                                 $543.90
    INVIN                                                              35                                    $18.13                                 $634.55
    JACKS                                                               1                                    $18.13                                  $18.13
    JOHNS                                                               1                                    $18.13                                  $18.13
    KCSLS                                                               2                                    $18.13                                  $36.26
    KMPLT                                                               3                                    $18.13                                  $54.39
     MASS                                                               2                                    $18.13                                  $36.26
     MKTG                                                               3                                    $18.13                                  $54.39
     NASH                                                               2                                    $18.13                                  $36.26
      NEW                                                               1                                    $18.13                                  $18.13
    OHRDC                                                               2                                    $18.13                                  $36.26
     PARK                                                               1                                    $18.13                                  $18.13
     PITT                                                               1                                    $18.13                                  $18.13
     PLT1                                                               4                                    $18.13                                  $72.52
    PLT18                                                              23                                    $18.13                                 $416.99

                                                                                                                                              PAGE:20 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     PLT2                                                              44                                    $18.13                                 $797.72
    PLT22                                                               1                                    $18.13                                  $18.13
     PLT3                                                             106                                    $18.13                               $1,921.78
     PLT4                                                              51                                    $18.13                                 $924.63
     PLT5                                                              23                                    $18.13                                 $416.99
     PLT7                                                               5                                    $18.13                                  $90.65
     PLT9                                                               1                                    $18.13                                  $18.13
    PLTAD                                                              11                                    $18.13                                 $199.43
    PTOHD                                                               6                                    $18.13                                 $108.78
     RALE                                                               1                                    $18.13                                  $18.13
    RETAI                                                               4                                    $18.13                                  $72.52
     RICH                                                               1                                    $18.13                                  $18.13
    RWPLT                                                              14                                    $18.13                                 $253.82
    SALES                                                               2                                    $18.13                                  $36.26
    SBPLT                                                               3                                    $18.13                                  $54.39
    SBSLS                                                               3                                    $18.13                                  $54.39
    SBUNB                                                              18                                    $18.13                                 $326.34
    SLSUP                                                               8                                    $18.13                                 $145.04
    TAMPA                                                               5                                    $18.13                                  $90.65
    TMPLT                                                              11                                    $18.13                                 $199.43
    TMSLS                                                               1                                    $18.13                                  $18.13
     W040                                                               4                                    $18.13                                  $72.52
     WALD                                                               1                                    $18.13                                  $18.13
     WILD                                                               1                                    $18.13                                  $18.13
    WILMC                                                               1                                    $18.13                                  $18.13
     ZALA                                                               2                                    $18.13                                  $36.26
  025620-00 Total                                                     599                                                                        $10,859.87
  025620-01
    ACCTS                                                              13                                    $18.13                                 $235.69
      ADM                                                              70                                    $18.13                               $1,269.10
     AUBU                                                               4                                    $18.13                                  $72.52
    BFALL                                                               1                                    $18.13                                  $18.13

                                                                                                                                              PAGE:21 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     BIRM                                                               1                                    $18.13                                  $18.13
     CARR                                                               2                                    $18.13                                  $36.26
    CHAMB                                                               2                                    $18.13                                  $36.26
    CKPT2                                                              15                                    $18.13                                 $271.95
    CKWH2                                                               1                                    $18.13                                  $18.13
    CLARK                                                              11                                    $18.13                                 $199.43
    CLEVE                                                               1                                    $18.13                                  $18.13
     DALL                                                               2                                    $18.13                                  $36.26
     DENV                                                               2                                    $18.13                                  $36.26
     FAIR                                                               1                                    $18.13                                  $18.13
    FESAD                                                               1                                    $18.13                                  $18.13
    FESPL                                                              25                                    $18.13                                 $453.25
    FLEET                                                               8                                    $18.13                                 $145.04
    FORPK                                                               4                                    $18.13                                  $72.52
     FRAZ                                                               2                                    $18.13                                  $36.26
     FRED                                                               2                                    $18.13                                  $36.26
    GFADM                                                               2                                    $18.13                                  $36.26
    GFPLT                                                              44                                    $18.13                                 $797.72
     HAN1                                                               1                                    $18.13                                  $18.13
     HAN4                                                               2                                    $18.13                                  $36.26
    HCOMP                                                               2                                    $18.13                                  $36.26
     INDY                                                               4                                    $18.13                                  $72.52
    INRDC                                                               2                                    $18.13                                  $36.26
    INVAZ                                                              11                                    $18.13                                 $199.43
    INVIN                                                              29                                    $18.13                                 $525.77
    JACKS                                                               2                                    $18.13                                  $36.26
    JOHNS                                                               1                                    $18.13                                  $18.13
    KCPLT                                                               2                                    $18.13                                  $36.26
    KCSLS                                                              13                                    $18.13                                 $235.69
    KMPLT                                                               7                                    $18.13                                 $126.91
     LAUR                                                               2                                    $18.13                                  $36.26
     LEBA                                                               2                                    $18.13                                  $36.26

                                                                                                                                              PAGE:22 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     MARM                                                               1                                    $18.13                                  $18.13
     MASS                                                               2                                    $18.13                                  $36.26
     MEMP                                                               2                                    $18.13                                  $36.26
     MKTG                                                               7                                    $18.13                                 $126.91
     NASH                                                               2                                    $18.13                                  $36.26
     NEAS                                                               1                                    $18.13                                  $18.13
      NEW                                                               2                                    $18.13                                  $36.26
    OHRDC                                                               1                                    $18.13                                  $18.13
     PITT                                                               1                                    $18.13                                  $18.13
     PLT1                                                              12                                    $18.13                                 $217.56
    PLT18                                                              19                                    $18.13                                 $344.47
     PLT2                                                              89                                    $18.13                               $1,613.57
    PLT22                                                               1                                    $18.13                                  $18.13
     PLT3                                                              90                                    $18.13                               $1,631.70
     PLT4                                                              69                                    $18.13                               $1,250.97
     PLT5                                                              44                                    $18.13                                 $797.72
     PLT7                                                              14                                    $18.13                                 $253.82
     PLT9                                                              11                                    $18.13                                 $199.43
    PLTAD                                                               9                                    $18.13                                 $163.17
    PTOHD                                                              12                                    $18.13                                 $217.56
     RALE                                                               1                                    $18.13                                  $18.13
    RETAI                                                               1                                    $18.13                                  $18.13
     RICH                                                               2                                    $18.13                                  $36.26
     ROCH                                                               2                                    $18.13                                  $36.26
    RWPLT                                                              33                                    $18.13                                 $598.29
    SALES                                                               1                                    $18.13                                  $18.13
    SBADM                                                               1                                    $18.13                                  $18.13
    SBPLT                                                               3                                    $18.13                                  $54.39
    SBSLS                                                               2                                    $18.13                                  $36.26
    SBUNB                                                              23                                    $18.13                                 $416.99
    SBUNM                                                               1                                    $18.13                                  $18.13
    SLSUP                                                              11                                    $18.13                                 $199.43

                                                                                                                                              PAGE:23 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    TAMPA                                                               2                                    $18.13                                  $36.26
    TMPLT                                                              15                                    $18.13                                 $271.95
     W040                                                               8                                    $18.13                                 $145.04
      W41                                                               2                                    $18.13                                  $36.26
      W44                                                               1                                    $18.13                                  $18.13
     WEVR                                                               1                                    $18.13                                  $18.13
     WILM                                                               1                                    $18.13                                  $18.13
    WILMC                                                               1                                    $18.13                                  $18.13
     WORC                                                               1                                    $18.13                                  $18.13
    WRIVR                                                               1                                    $18.13                                  $18.13
     ZALA                                                               3                                    $18.13                                  $54.39
  025620-01 Total                                                     800                                                                        $14,504.00
  025620-02
    ACCTS                                                               8                                    $18.13                                 $145.04
      ADM                                                              36                                    $18.13                                 $652.68
      ASH                                                               1                                    $18.13                                  $18.13
     BETH                                                               1                                    $18.13                                  $18.13
     BIRM                                                               1                                    $18.13                                  $18.13
     BUFF                                                               1                                    $18.13                                  $18.13
     BURL                                                               1                                    $18.13                                  $18.13
     CHAR                                                               1                                    $18.13                                  $18.13
    CKPT2                                                               3                                    $18.13                                  $54.39
    CLARK                                                               2                                    $18.13                                  $36.26
     DALL                                                               1                                    $18.13                                  $18.13
     DENV                                                               1                                    $18.13                                  $18.13
     DEPT                                                               1                                    $18.13                                  $18.13
     FAIR                                                               1                                    $18.13                                  $18.13
    FLEET                                                               4                                    $18.13                                  $72.52
    FORPK                                                               3                                    $18.13                                  $54.39
     FRED                                                               1                                    $18.13                                  $18.13
    GFPLT                                                              10                                    $18.13                                 $181.30
     HAN1                                                               2                                    $18.13                                  $36.26

                                                                                                                                              PAGE:24 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     HAN4                                                               2                                    $18.13                                  $36.26
     HART                                                               1                                    $18.13                                  $18.13
    HCOMP                                                               1                                    $18.13                                  $18.13
     HOOK                                                               1                                    $18.13                                  $18.13
     INDY                                                               2                                    $18.13                                  $36.26
    INRDC                                                               3                                    $18.13                                  $54.39
    INVAZ                                                               2                                    $18.13                                  $36.26
    INVIN                                                               7                                    $18.13                                 $126.91
    JACKS                                                               1                                    $18.13                                  $18.13
    KCSLS                                                               2                                    $18.13                                  $36.26
     KILG                                                               1                                    $18.13                                  $18.13
    KMPLT                                                               1                                    $18.13                                  $18.13
     LAUR                                                               1                                    $18.13                                  $18.13
    LROCK                                                               1                                    $18.13                                  $18.13
    MANAS                                                               1                                    $18.13                                  $18.13
     MKTG                                                               2                                    $18.13                                  $36.26
     MOBL                                                               1                                    $18.13                                  $18.13
     NASH                                                               2                                    $18.13                                  $36.26
     NEAS                                                               1                                    $18.13                                  $18.13
    NNEWS                                                               1                                    $18.13                                  $18.13
     PITT                                                               1                                    $18.13                                  $18.13
    PLT18                                                               5                                    $18.13                                  $90.65
     PLT2                                                              27                                    $18.13                                 $489.51
    PLT22                                                               2                                    $18.13                                  $36.26
     PLT3                                                              37                                    $18.13                                 $670.81
     PLT4                                                              17                                    $18.13                                 $308.21
     PLT5                                                              17                                    $18.13                                 $308.21
     PLT6                                                               1                                    $18.13                                  $18.13
     PLT7                                                               6                                    $18.13                                 $108.78
     PLT9                                                               5                                    $18.13                                  $90.65
    PLTAD                                                               4                                    $18.13                                  $72.52
     PROV                                                               1                                    $18.13                                  $18.13

                                                                                                                                              PAGE:25 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    PTOHD                                                               5                                    $18.13                                  $90.65
     ROCH                                                               1                                    $18.13                                  $18.13
    RWPLT                                                              21                                    $18.13                                 $380.73
    SALES                                                               1                                    $18.13                                  $18.13
    SBPLT                                                               3                                    $18.13                                  $54.39
    SBSLS                                                               1                                    $18.13                                  $18.13
    SBUNB                                                               9                                    $18.13                                 $163.17
    SLSUP                                                               8                                    $18.13                                 $145.04
     STVL                                                               1                                    $18.13                                  $18.13
     SYRA                                                               1                                    $18.13                                  $18.13
    TAMPA                                                               1                                    $18.13                                  $18.13
    TMPLT                                                              14                                    $18.13                                 $253.82
     TUSC                                                               2                                    $18.13                                  $36.26
     W040                                                               2                                    $18.13                                  $36.26
      W44                                                               1                                    $18.13                                  $18.13
     WALD                                                               2                                    $18.13                                  $36.26
    WILSO                                                               2                                    $18.13                                  $36.26
     WORC                                                               1                                    $18.13                                  $18.13
     ZALA                                                               2                                    $18.13                                  $36.26
  025620-02 Total                                                     314                                                                         $5,692.82
  025620-70
    COBRA                                                               3                                    $18.13                                  $54.39
  025620-70 Total                                                       3                                                                            $54.39
  025620-71
      ADM                                                               1                                    $18.13                                  $18.13
    COBRA                                                               7                                    $18.13                                 $126.91
  025620-71 Total                                                       8                                                                           $145.04
  025620-72
    COBRA                                                               4                                    $18.13                                  $72.52
  025620-72 Total                                                       4                                                                            $72.52
HM Life Insurance Stop Loss Specific IND* Total                      1728                                                                        $31,328.64

                                                                                                                                              PAGE:26 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
PPO
  025620-01
    ACCTS                                                              27                                    $21.00                                 $567.00
      ADM                                                             111                                    $21.00                               $2,331.00
     ALTO                                                               1                                    $21.00                                  $21.00
      ASH                                                               2                                    $21.00                                  $42.00
     AUBU                                                               4                                    $21.00                                  $84.00
     BETH                                                               1                                    $21.00                                  $21.00
    BFALL                                                               2                                    $21.00                                  $42.00
     BIRM                                                               1                                    $21.00                                  $21.00
     CARR                                                               2                                    $21.00                                  $42.00
    CHAMB                                                               3                                    $21.00                                  $63.00
     CHAR                                                               2                                    $21.00                                  $42.00
     CHES                                                               1                                    $21.00                                  $21.00
    CKPT2                                                              18                                    $21.00                                 $378.00
    CKWH2                                                               1                                    $21.00                                  $21.00
    CLARK                                                              16                                    $21.00                                 $336.00
    CLEVE                                                               6                                    $21.00                                 $126.00
     DALL                                                               3                                    $21.00                                  $63.00
     DENV                                                               2                                    $21.00                                  $42.00
     DEPT                                                               1                                    $21.00                                  $21.00
     FAIR                                                               3                                    $21.00                                  $63.00
    FESAD                                                               1                                    $21.00                                  $21.00
    FESPL                                                              35                                    $21.00                                 $735.00
    FLEET                                                              15                                    $21.00                                 $315.00
    FORPK                                                               5                                    $21.00                                 $105.00
     FRAZ                                                               2                                    $21.00                                  $42.00
     FRED                                                               3                                    $21.00                                  $63.00
     FREE                                                               2                                    $21.00                                  $42.00
    GFADM                                                               2                                    $21.00                                  $42.00
    GFPLT                                                              52                                    $21.00                               $1,092.00
     HAN1                                                               1                                    $21.00                                  $21.00

                                                                                                                                              PAGE:27 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     HAN4                                                               3                                    $21.00                                  $63.00
    HCOMP                                                               5                                    $21.00                                 $105.00
    HCSLS                                                               1                                    $21.00                                  $21.00
     INDY                                                               4                                    $21.00                                  $84.00
    INRDC                                                               3                                    $21.00                                  $63.00
    INVAZ                                                              19                                    $21.00                                 $399.00
    INVIN                                                              46                                    $21.00                                 $966.00
    JACKS                                                               7                                    $21.00                                 $147.00
    JOHNS                                                               2                                    $21.00                                  $42.00
    KCPLT                                                               2                                    $21.00                                  $42.00
    KCSLS                                                              18                                    $21.00                                 $378.00
     KENN                                                               1                                    $21.00                                  $21.00
     KILG                                                               1                                    $21.00                                  $21.00
    KMPLT                                                               8                                    $21.00                                 $168.00
     LANC                                                               1                                    $21.00                                  $21.00
     LAUR                                                               3                                    $21.00                                  $63.00
     LEBA                                                               2                                    $21.00                                  $42.00
    MANAS                                                               4                                    $21.00                                  $84.00
     MARM                                                               1                                    $21.00                                  $21.00
     MASS                                                               3                                    $21.00                                  $63.00
     MEMP                                                               3                                    $21.00                                  $63.00
     MKTG                                                              10                                    $21.00                                 $210.00
     MOBL                                                               1                                    $21.00                                  $21.00
     NASH                                                               2                                    $21.00                                  $42.00
     NEAS                                                               2                                    $21.00                                  $42.00
      NEW                                                               4                                    $21.00                                  $84.00
    OHRDC                                                               2                                    $21.00                                  $42.00
     PITT                                                               2                                    $21.00                                  $42.00
     PLT1                                                              15                                    $21.00                                 $315.00
    PLT18                                                              31                                    $21.00                                 $651.00
     PLT2                                                             146                                    $21.00                               $3,066.00
    PLT22                                                               2                                    $21.00                                  $42.00

                                                                                                                                              PAGE:28 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     PLT3                                                             155                                    $21.00                               $3,255.00
     PLT4                                                             103                                    $21.00                               $2,163.00
     PLT5                                                              63                                    $21.00                               $1,323.00
     PLT7                                                              16                                    $21.00                                 $336.00
     PLT9                                                              13                                    $21.00                                 $273.00
    PLTAD                                                              26                                    $21.00                                 $546.00
    PTOHD                                                              28                                    $21.00                                 $588.00
     RALE                                                               3                                    $21.00                                  $63.00
    RETAI                                                               1                                    $21.00                                  $21.00
    RG039                                                               1                                    $21.00                                  $21.00
     RICH                                                               2                                    $21.00                                  $42.00
     ROAN                                                               1                                    $21.00                                  $21.00
     ROCH                                                               2                                    $21.00                                  $42.00
    RWADM                                                               1                                    $21.00                                  $21.00
    RWPLT                                                              43                                    $21.00                                 $903.00
    SALES                                                               3                                    $21.00                                  $63.00
    SBADM                                                               2                                    $21.00                                  $42.00
    SBPLT                                                               7                                    $21.00                                 $147.00
    SBSLS                                                               3                                    $21.00                                  $63.00
    SBUNB                                                              28                                    $21.00                                 $588.00
    SBUNM                                                               4                                    $21.00                                  $84.00
      SLC                                                               1                                    $21.00                                  $21.00
    SLSUP                                                              21                                    $21.00                                 $441.00
     STVL                                                               1                                    $21.00                                  $21.00
    TAMPA                                                               3                                    $21.00                                  $63.00
    TMPLT                                                              22                                    $21.00                                 $462.00
    TMSLS                                                               4                                    $21.00                                  $84.00
     W040                                                               9                                    $21.00                                 $189.00
      W36                                                               1                                    $21.00                                  $21.00
      W41                                                               2                                    $21.00                                  $42.00
      W44                                                               2                                    $21.00                                  $42.00
     WALD                                                               3                                    $21.00                                  $63.00

                                                                                                                                              PAGE:29 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     WEVR                                                               1                                    $21.00                                  $21.00
     WILM                                                               2                                    $21.00                                  $42.00
    WILMC                                                               1                                    $21.00                                  $21.00
     WORC                                                               3                                    $21.00                                  $63.00
    WRIVR                                                               1                                    $21.00                                  $21.00
     ZALA                                                               3                                    $21.00                                  $63.00
  025620-01 Total                                                    1264                                                                        $26,544.00
  025620-02
    ACCTS                                                              18                                    $21.00                                 $378.00
      ADM                                                              49                                    $21.00                               $1,029.00
      ASH                                                               1                                    $21.00                                  $21.00
     AUBU                                                               1                                    $21.00                                  $21.00
     BETH                                                               1                                    $21.00                                  $21.00
     BIRM                                                               1                                    $21.00                                  $21.00
     BUFF                                                               1                                    $21.00                                  $21.00
     BURL                                                               1                                    $21.00                                  $21.00
     CHAR                                                               1                                    $21.00                                  $21.00
    CKPT2                                                               5                                    $21.00                                 $105.00
    CLARK                                                               4                                    $21.00                                  $84.00
     DALL                                                               1                                    $21.00                                  $21.00
     DENV                                                               1                                    $21.00                                  $21.00
     DEPT                                                               1                                    $21.00                                  $21.00
     FAIR                                                               3                                    $21.00                                  $63.00
    FESPL                                                               2                                    $21.00                                  $42.00
    FLEET                                                               6                                    $21.00                                 $126.00
    FORPK                                                               3                                    $21.00                                  $63.00
     FRAZ                                                               1                                    $21.00                                  $21.00
     FRED                                                               1                                    $21.00                                  $21.00
    GFADM                                                               1                                    $21.00                                  $21.00
    GFPLT                                                              12                                    $21.00                                 $252.00
     HAN1                                                               2                                    $21.00                                  $42.00
     HAN4                                                               3                                    $21.00                                  $63.00

                                                                                                                                              PAGE:30 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     HART                                                               3                                    $21.00                                  $63.00
    HCOMP                                                               5                                    $21.00                                 $105.00
    HCSLS                                                               1                                    $21.00                                  $21.00
     HOOK                                                               1                                    $21.00                                  $21.00
     INDY                                                               2                                    $21.00                                  $42.00
    INRDC                                                               3                                    $21.00                                  $63.00
    INVAZ                                                               2                                    $21.00                                  $42.00
    INVIN                                                              11                                    $21.00                                 $231.00
    JACKS                                                               1                                    $21.00                                  $21.00
    KCSLS                                                               2                                    $21.00                                  $42.00
     KILG                                                               1                                    $21.00                                  $21.00
    KMPLT                                                               1                                    $21.00                                  $21.00
     LAUR                                                               2                                    $21.00                                  $42.00
     LEBA                                                               1                                    $21.00                                  $21.00
    LROCK                                                               1                                    $21.00                                  $21.00
    MANAS                                                               1                                    $21.00                                  $21.00
     MARM                                                               1                                    $21.00                                  $21.00
     MEMP                                                               1                                    $21.00                                  $21.00
     MKTG                                                               2                                    $21.00                                  $42.00
     MOBL                                                               3                                    $21.00                                  $63.00
     NASH                                                               2                                    $21.00                                  $42.00
     NEAS                                                               1                                    $21.00                                  $21.00
    NERDC                                                               1                                    $21.00                                  $21.00
    NNEWS                                                               1                                    $21.00                                  $21.00
     PARK                                                               1                                    $21.00                                  $21.00
     PITT                                                               1                                    $21.00                                  $21.00
     PLT1                                                               3                                    $21.00                                  $63.00
    PLT18                                                               9                                    $21.00                                 $189.00
     PLT2                                                              37                                    $21.00                                 $777.00
    PLT22                                                               2                                    $21.00                                  $42.00
     PLT3                                                              46                                    $21.00                                 $966.00
     PLT4                                                              27                                    $21.00                                 $567.00

                                                                                                                                              PAGE:31 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     PLT5                                                              26                                    $21.00                                 $546.00
     PLT6                                                               3                                    $21.00                                  $63.00
     PLT7                                                               9                                    $21.00                                 $189.00
     PLT9                                                               7                                    $21.00                                 $147.00
    PLTAD                                                               9                                    $21.00                                 $189.00
     PROV                                                               2                                    $21.00                                  $42.00
    PTOHD                                                               8                                    $21.00                                 $168.00
     RALE                                                               1                                    $21.00                                  $21.00
    RETAI                                                               1                                    $21.00                                  $21.00
     RICH                                                               1                                    $21.00                                  $21.00
     ROAN                                                               1                                    $21.00                                  $21.00
     ROCH                                                               1                                    $21.00                                  $21.00
    RWPLT                                                              22                                    $21.00                                 $462.00
    SALES                                                               4                                    $21.00                                  $84.00
    SBPLT                                                               3                                    $21.00                                  $63.00
    SBSLS                                                               3                                    $21.00                                  $63.00
    SBUNB                                                              13                                    $21.00                                 $273.00
    SBUNM                                                               1                                    $21.00                                  $21.00
    SLSUP                                                              12                                    $21.00                                 $252.00
     STVL                                                               1                                    $21.00                                  $21.00
     SYRA                                                               1                                    $21.00                                  $21.00
    TAMPA                                                               2                                    $21.00                                  $42.00
    TMPLT                                                              15                                    $21.00                                 $315.00
    TMSLS                                                               2                                    $21.00                                  $42.00
     TUSC                                                               2                                    $21.00                                  $42.00
     W040                                                               2                                    $21.00                                  $42.00
      W44                                                               1                                    $21.00                                  $21.00
     WALD                                                               2                                    $21.00                                  $42.00
    WILSO                                                               3                                    $21.00                                  $63.00
     WORC                                                               1                                    $21.00                                  $21.00
     ZALA                                                               3                                    $21.00                                  $63.00
  025620-02 Total                                                     458                                                                         $9,618.00

                                                                                                                                              PAGE:32 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
  025620-71
      ADM                                                               2                                    $21.00                                  $42.00
    COBRA                                                               9                                    $21.00                                 $189.00
  025620-71 Total                                                      11                                                                           $231.00
  025620-72
    COBRA                                                               7                                    $21.00                                 $147.00
  025620-72 Total                                                       7                                                                           $147.00
PPO Total                                                            1740                                                                        $36,540.00
                                                                                                                                                            
Teladoc Services
  025620-00
    ACCTS                                                              16                                     $1.25                                  $20.00
      ADM                                                              80                                     $1.25                                 $100.00
     ALTO                                                               1                                     $1.25                                   $1.25
     BENS                                                               1                                     $1.25                                   $1.25
    BFALL                                                               2                                     $1.25                                   $2.50
     BUFF                                                               1                                     $1.25                                   $1.25
     CHES                                                               2                                     $1.25                                   $2.50
    CKPT2                                                              17                                     $1.25                                  $21.25
    CLARK                                                               9                                     $1.25                                  $11.25
    CLEVE                                                               2                                     $1.25                                   $2.50
     CUMB                                                               2                                     $1.25                                   $2.50
     DALL                                                               1                                     $1.25                                   $1.25
     FAIR                                                               1                                     $1.25                                   $1.25
    FESPL                                                              21                                     $1.25                                  $26.25
    FLEET                                                               3                                     $1.25                                   $3.75
    FORPK                                                               5                                     $1.25                                   $6.25
     FRED                                                               1                                     $1.25                                   $1.25
    GFPLT                                                              47                                     $1.25                                  $58.75
     HAN1                                                               3                                     $1.25                                   $3.75
     HAN4                                                               1                                     $1.25                                   $1.25
     HART                                                               3                                     $1.25                                   $3.75

                                                                                                                                              PAGE:33 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    HCOMP                                                               5                                     $1.25                                   $6.25
    HCSLS                                                               4                                     $1.25                                   $5.00
     HOOK                                                               1                                     $1.25                                   $1.25
    INADM                                                               3                                     $1.25                                   $3.75
     INDY                                                               3                                     $1.25                                   $3.75
    INRDC                                                               2                                     $1.25                                   $2.50
    INVAZ                                                              46                                     $1.25                                  $57.50
    INVIN                                                              43                                     $1.25                                  $53.75
    JACKS                                                               3                                     $1.25                                   $3.75
    JOHNS                                                               1                                     $1.25                                   $1.25
    KCSLS                                                               3                                     $1.25                                   $3.75
    KMPLT                                                               7                                     $1.25                                   $8.75
     MARM                                                               1                                     $1.25                                   $1.25
     MASS                                                               3                                     $1.25                                   $3.75
     MKTG                                                               6                                     $1.25                                   $7.50
     MONT                                                               2                                     $1.25                                   $2.50
     NASH                                                               2                                     $1.25                                   $2.50
      NEW                                                               1                                     $1.25                                   $1.25
    OHRDC                                                               2                                     $1.25                                   $2.50
     PARK                                                               1                                     $1.25                                   $1.25
     PITT                                                               1                                     $1.25                                   $1.25
     PLT1                                                               6                                     $1.25                                   $7.50
    PLT18                                                              24                                     $1.25                                  $30.00
     PLT2                                                              57                                     $1.25                                  $71.25
    PLT22                                                               2                                     $1.25                                   $2.50
     PLT3                                                             133                                     $1.25                                 $166.25
     PLT4                                                              69                                     $1.25                                  $86.25
     PLT5                                                              30                                     $1.25                                  $37.50
     PLT7                                                               7                                     $1.25                                   $8.75
     PLT9                                                               1                                     $1.25                                   $1.25
    PLTAD                                                              21                                     $1.25                                  $26.25
    PTOHD                                                              10                                     $1.25                                  $12.50

                                                                                                                                              PAGE:34 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     RALE                                                               1                                     $1.25                                   $1.25
    RETAI                                                               5                                     $1.25                                   $6.25
     RICH                                                               1                                     $1.25                                   $1.25
     ROCH                                                               1                                     $1.25                                   $1.25
    RWPLT                                                              20                                     $1.25                                  $25.00
    SALES                                                               4                                     $1.25                                   $5.00
    SBPLT                                                               6                                     $1.25                                   $7.50
    SBSLS                                                               4                                     $1.25                                   $5.00
    SBUNB                                                              19                                     $1.25                                  $23.75
    SLSUP                                                              14                                     $1.25                                  $17.50
     STVL                                                               1                                     $1.25                                   $1.25
    TAMPA                                                               6                                     $1.25                                   $7.50
    TMPLT                                                              14                                     $1.25                                  $17.50
    TMSLS                                                               3                                     $1.25                                   $3.75
     W040                                                               4                                     $1.25                                   $5.00
      W44                                                               1                                     $1.25                                   $1.25
     WALD                                                               1                                     $1.25                                   $1.25
     WILD                                                               1                                     $1.25                                   $1.25
     WILM                                                               1                                     $1.25                                   $1.25
    WILMC                                                               1                                     $1.25                                   $1.25
    WILSO                                                               1                                     $1.25                                   $1.25
     ZALA                                                               3                                     $1.25                                   $3.75
  025620-00 Total                                                     831                                                                         $1,038.75
  025620-01
    ACCTS                                                              27                                     $1.25                                  $33.75
      ADM                                                             111                                     $1.25                                 $138.75
     ALTO                                                               1                                     $1.25                                   $1.25
      ASH                                                               2                                     $1.25                                   $2.50
     AUBU                                                               4                                     $1.25                                   $5.00
     BETH                                                               1                                     $1.25                                   $1.25
    BFALL                                                               2                                     $1.25                                   $2.50
     BIRM                                                               1                                     $1.25                                   $1.25

                                                                                                                                              PAGE:35 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     CARR                                                               2                                     $1.25                                   $2.50
    CHAMB                                                               3                                     $1.25                                   $3.75
     CHAR                                                               2                                     $1.25                                   $2.50
     CHES                                                               1                                     $1.25                                   $1.25
    CKPT2                                                              18                                     $1.25                                  $22.50
    CKWH2                                                               1                                     $1.25                                   $1.25
    CLARK                                                              16                                     $1.25                                  $20.00
    CLEVE                                                               6                                     $1.25                                   $7.50
     DALL                                                               3                                     $1.25                                   $3.75
     DENV                                                               2                                     $1.25                                   $2.50
     DEPT                                                               1                                     $1.25                                   $1.25
     FAIR                                                               3                                     $1.25                                   $3.75
    FESAD                                                               1                                     $1.25                                   $1.25
    FESPL                                                              35                                     $1.25                                  $43.75
    FLEET                                                              15                                     $1.25                                  $18.75
    FORPK                                                               5                                     $1.25                                   $6.25
     FRAZ                                                               2                                     $1.25                                   $2.50
     FRED                                                               3                                     $1.25                                   $3.75
     FREE                                                               2                                     $1.25                                   $2.50
    GFADM                                                               2                                     $1.25                                   $2.50
    GFPLT                                                              52                                     $1.25                                  $65.00
     HAN1                                                               1                                     $1.25                                   $1.25
     HAN4                                                               3                                     $1.25                                   $3.75
    HCOMP                                                               5                                     $1.25                                   $6.25
    HCSLS                                                               1                                     $1.25                                   $1.25
     INDY                                                               4                                     $1.25                                   $5.00
    INRDC                                                               3                                     $1.25                                   $3.75
    INVAZ                                                              19                                     $1.25                                  $23.75
    INVIN                                                              46                                     $1.25                                  $57.50
    JACKS                                                               7                                     $1.25                                   $8.75
    JOHNS                                                               2                                     $1.25                                   $2.50
    KCPLT                                                               2                                     $1.25                                   $2.50

                                                                                                                                              PAGE:36 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
    KCSLS                                                              18                                     $1.25                                  $22.50
     KENN                                                               1                                     $1.25                                   $1.25
     KILG                                                               1                                     $1.25                                   $1.25
    KMPLT                                                               8                                     $1.25                                  $10.00
     LANC                                                               1                                     $1.25                                   $1.25
     LAUR                                                               3                                     $1.25                                   $3.75
     LEBA                                                               2                                     $1.25                                   $2.50
    MANAS                                                               4                                     $1.25                                   $5.00
     MARM                                                               1                                     $1.25                                   $1.25
     MASS                                                               3                                     $1.25                                   $3.75
     MEMP                                                               3                                     $1.25                                   $3.75
     MKTG                                                              10                                     $1.25                                  $12.50
     MOBL                                                               1                                     $1.25                                   $1.25
     NASH                                                               2                                     $1.25                                   $2.50
     NEAS                                                               2                                     $1.25                                   $2.50
      NEW                                                               4                                     $1.25                                   $5.00
    OHRDC                                                               2                                     $1.25                                   $2.50
     PITT                                                               2                                     $1.25                                   $2.50
     PLT1                                                              15                                     $1.25                                  $18.75
    PLT18                                                              31                                     $1.25                                  $38.75
     PLT2                                                             146                                     $1.25                                 $182.50
    PLT22                                                               2                                     $1.25                                   $2.50
     PLT3                                                             155                                     $1.25                                 $193.75
     PLT4                                                             103                                     $1.25                                 $128.75
     PLT5                                                              63                                     $1.25                                  $78.75
     PLT7                                                              16                                     $1.25                                  $20.00
     PLT9                                                              13                                     $1.25                                  $16.25
    PLTAD                                                              26                                     $1.25                                  $32.50
    PTOHD                                                              28                                     $1.25                                  $35.00
     RALE                                                               3                                     $1.25                                   $3.75
    RETAI                                                               1                                     $1.25                                   $1.25
    RG039                                                               1                                     $1.25                                   $1.25

                                                                                                                                              PAGE:37 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     RICH                                                               2                                     $1.25                                   $2.50
     ROAN                                                               1                                     $1.25                                   $1.25
     ROCH                                                               2                                     $1.25                                   $2.50
    RWADM                                                               1                                     $1.25                                   $1.25
    RWPLT                                                              43                                     $1.25                                  $53.75
    SALES                                                               3                                     $1.25                                   $3.75
    SBADM                                                               2                                     $1.25                                   $2.50
    SBPLT                                                               7                                     $1.25                                   $8.75
    SBSLS                                                               3                                     $1.25                                   $3.75
    SBUNB                                                              28                                     $1.25                                  $35.00
    SBUNM                                                               4                                     $1.25                                   $5.00
      SLC                                                               1                                     $1.25                                   $1.25
    SLSUP                                                              21                                     $1.25                                  $26.25
     STVL                                                               1                                     $1.25                                   $1.25
    TAMPA                                                               3                                     $1.25                                   $3.75
    TMPLT                                                              22                                     $1.25                                  $27.50
    TMSLS                                                               4                                     $1.25                                   $5.00
     W040                                                               9                                     $1.25                                  $11.25
      W36                                                               1                                     $1.25                                   $1.25
      W41                                                               2                                     $1.25                                   $2.50
      W44                                                               2                                     $1.25                                   $2.50
     WALD                                                               3                                     $1.25                                   $3.75
     WEVR                                                               1                                     $1.25                                   $1.25
     WILM                                                               2                                     $1.25                                   $2.50
    WILMC                                                               1                                     $1.25                                   $1.25
     WORC                                                               3                                     $1.25                                   $3.75
    WRIVR                                                               1                                     $1.25                                   $1.25
     ZALA                                                               3                                     $1.25                                   $3.75
  025620-01 Total                                                    1264                                                                         $1,580.00
  025620-02
    ACCTS                                                              18                                     $1.25                                  $22.50
      ADM                                                              49                                     $1.25                                  $61.25

                                                                                                                                              PAGE:38 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
      ASH                                                               1                                     $1.25                                   $1.25
     AUBU                                                               1                                     $1.25                                   $1.25
     BETH                                                               1                                     $1.25                                   $1.25
     BIRM                                                               1                                     $1.25                                   $1.25
     BUFF                                                               1                                     $1.25                                   $1.25
     BURL                                                               1                                     $1.25                                   $1.25
     CHAR                                                               1                                     $1.25                                   $1.25
    CKPT2                                                               5                                     $1.25                                   $6.25
    CLARK                                                               4                                     $1.25                                   $5.00
     DALL                                                               1                                     $1.25                                   $1.25
     DENV                                                               1                                     $1.25                                   $1.25
     DEPT                                                               1                                     $1.25                                   $1.25
     FAIR                                                               3                                     $1.25                                   $3.75
    FESPL                                                               2                                     $1.25                                   $2.50
    FLEET                                                               6                                     $1.25                                   $7.50
    FORPK                                                               3                                     $1.25                                   $3.75
     FRAZ                                                               1                                     $1.25                                   $1.25
     FRED                                                               1                                     $1.25                                   $1.25
    GFADM                                                               1                                     $1.25                                   $1.25
    GFPLT                                                              12                                     $1.25                                  $15.00
     HAN1                                                               2                                     $1.25                                   $2.50
     HAN4                                                               3                                     $1.25                                   $3.75
     HART                                                               3                                     $1.25                                   $3.75
    HCOMP                                                               5                                     $1.25                                   $6.25
    HCSLS                                                               1                                     $1.25                                   $1.25
     HOOK                                                               1                                     $1.25                                   $1.25
     INDY                                                               2                                     $1.25                                   $2.50
    INRDC                                                               3                                     $1.25                                   $3.75
    INVAZ                                                               2                                     $1.25                                   $2.50
    INVIN                                                              11                                     $1.25                                  $13.75
    JACKS                                                               1                                     $1.25                                   $1.25
    KCSLS                                                               2                                     $1.25                                   $2.50

                                                                                                                                              PAGE:39 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     KILG                                                               1                                     $1.25                                   $1.25
    KMPLT                                                               1                                     $1.25                                   $1.25
     LAUR                                                               2                                     $1.25                                   $2.50
     LEBA                                                               1                                     $1.25                                   $1.25
    LROCK                                                               1                                     $1.25                                   $1.25
    MANAS                                                               1                                     $1.25                                   $1.25
     MARM                                                               1                                     $1.25                                   $1.25
     MEMP                                                               1                                     $1.25                                   $1.25
     MKTG                                                               2                                     $1.25                                   $2.50
     MOBL                                                               3                                     $1.25                                   $3.75
     NASH                                                               2                                     $1.25                                   $2.50
     NEAS                                                               1                                     $1.25                                   $1.25
    NERDC                                                               1                                     $1.25                                   $1.25
    NNEWS                                                               1                                     $1.25                                   $1.25
     PARK                                                               1                                     $1.25                                   $1.25
     PITT                                                               1                                     $1.25                                   $1.25
     PLT1                                                               3                                     $1.25                                   $3.75
    PLT18                                                               9                                     $1.25                                  $11.25
     PLT2                                                              37                                     $1.25                                  $46.25
    PLT22                                                               2                                     $1.25                                   $2.50
     PLT3                                                              46                                     $1.25                                  $57.50
     PLT4                                                              27                                     $1.25                                  $33.75
     PLT5                                                              26                                     $1.25                                  $32.50
     PLT6                                                               3                                     $1.25                                   $3.75
     PLT7                                                               9                                     $1.25                                  $11.25
     PLT9                                                               7                                     $1.25                                   $8.75
    PLTAD                                                               9                                     $1.25                                  $11.25
     PROV                                                               2                                     $1.25                                   $2.50
    PTOHD                                                               8                                     $1.25                                  $10.00
     RALE                                                               1                                     $1.25                                   $1.25
    RETAI                                                               1                                     $1.25                                   $1.25
     RICH                                                               1                                     $1.25                                   $1.25

                                                                                                                                              PAGE:40 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
     ROAN                                                               1                                     $1.25                                   $1.25
     ROCH                                                               1                                     $1.25                                   $1.25
    RWPLT                                                              22                                     $1.25                                  $27.50
    SALES                                                               4                                     $1.25                                   $5.00
    SBPLT                                                               3                                     $1.25                                   $3.75
    SBSLS                                                               3                                     $1.25                                   $3.75
    SBUNB                                                              13                                     $1.25                                  $16.25
    SBUNM                                                               1                                     $1.25                                   $1.25
    SLSUP                                                              12                                     $1.25                                  $15.00
     STVL                                                               1                                     $1.25                                   $1.25
     SYRA                                                               1                                     $1.25                                   $1.25
    TAMPA                                                               2                                     $1.25                                   $2.50
    TMPLT                                                              15                                     $1.25                                  $18.75
    TMSLS                                                               2                                     $1.25                                   $2.50
     TUSC                                                               2                                     $1.25                                   $2.50
     W040                                                               2                                     $1.25                                   $2.50
      W44                                                               1                                     $1.25                                   $1.25
     WALD                                                               2                                     $1.25                                   $2.50
    WILSO                                                               3                                     $1.25                                   $3.75
     WORC                                                               1                                     $1.25                                   $1.25
     ZALA                                                               3                                     $1.25                                   $3.75
  025620-02 Total                                                     458                                                                           $572.50
  025620-70
    COBRA                                                               6                                     $1.25                                   $7.50
  025620-70 Total                                                       6                                                                             $7.50
  025620-71
      ADM                                                               2                                     $1.25                                   $2.50
    COBRA                                                               9                                     $1.25                                  $11.25
  025620-71 Total                                                      11                                                                            $13.75
  025620-72
    COBRA                                                               7                                     $1.25                                   $8.75
  025620-72 Total                                                       7                                                                             $8.75

                                                                                                                                              PAGE:41 of 41
                                                                                                                                                            
                      Group                                     Contracts                                    $ PCPM                    $ PCPM Admin Expense
_____________________________________________________________________________________________________________________________________________________________
                                                                                                                                                            
Teladoc Services Total                                               2577                                                                         $3,221.25
                                                                                                                                                            
Enrollment Based Administrative Calculation Total                                                                                               $135,534.24