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MEDICA CHOICE <br />MASTER GROUP CONTRACT <br />Employer: City of Little Canada Employer Group #: 33062 <br />Effective Date: March 1. 1992 Contract #: 271 Amendment(s) #: <br />INTRODUCTION <br />This Master Group Contract ( "Contract ") is entered into by and between Medica Choice, on behalf of its <br />subsidiary Physicians Insurance Company ( "PIC ") and the employer group named above ( "Employer "), and <br />includes Appendix A and the Certificate of Coverage which are part of this Contract and incorporated by <br />reference. This Contract is delivered in and governed by the laws of the State of Minnesota. <br />In consideration of the monthly Premiums the Employer has agreed to pay, and the payment of Copayments <br />to be paid by or for Members, Medica Choice agrees to arrange to provide Benefits as set out in the Certificate <br />of Coverage. This agreement is subject to all terms and conditions, including limitations and exclusions, set <br />forth in this Contract. <br />TERM OF CONTRACT <br />This Contract will be effective from March 1, 1992 CEffective Date ") to February 28 199j( "Termination <br />Date "). All coverage under this Contract begins at 12:01 a.m. Central Time. <br />Medica Choice or the Employer may cancel this Contract with or without cause after at least 30 days' written <br />notice. <br />If Medica Choice cancels this Contract during its term, and cancellation is due to non - payment of Premiums <br />or the Employer ceases to do business, Medica Choice will notify the Employer in writing of such cancellation. <br />PREMIUMS <br />The monthly Premiums under this Contract are: <br />Class I <br />(Subscriber <br />only) <br />Monthly Premium Rate <br />AGE /SEX RATED. <br />SEE ATTACHED <br />RATE CHART. <br />Class IV <br />(Subscriber and 1 or more Dependents) <br />Monthly Emalover Monthly Enrollee <br />Contribution Contribution <br />EMPLOYER SHALL CONTRIBUTE A MINIMUM <br />OF 100% TOWARDS SINGLE AND 0% TOWARDS <br />FAMILY OF THE MONTHLY PREMIUM RATE. <br />In calculation of this Premium rate $6.20 per member per month is payable for coverage provided under this <br />Contract, $300 deductible and $3000 HMO and Insurance out -of- pocket maximum, and will be remitted by <br />Medica Choice to Physicians Insurance Company. <br />The Premiums are due on the first day of each calendar month at Medica Choice's address set forth below. <br />In calculating the amount of monthly Premiums due by the Employer, Medica Choice considers only those <br />changes to enrollment received before the due date. <br />1 <br />Page 9 <br />