Fax oerver S/O/2Z014 2:17:36 PM PAGE 1/002 Fax oerver UnitedHealth Group FACSIMILE TRANSMITTAL SHEET TO: Attn: Jeffrey Epstein FROM: United Healthcare COMPANY: PHONE: PHONE: DATE: Wednesday, August 06, 2014 PAGES: 02 COMME. Information included in this document is considered to be UnitedHealthCare’s confidential and/or proprietary business information. Consequently, this information may be used only by the person or entity to which it is addressed by UnitedHealthcare. Such recipient shall be liable for using and protecting UnitedHealthcare’s proprietary business information from further disclosure or misuse, consistent with recipient's contractual obligations under any applicable administrative services agreement, group policy contract, non-disclosure agreement or other applicable contract or law. The report you have received may contain protected health information (PHI) and must be handled according to applicable state and federal law, including, but not limited to HIPAA. Individuals who misuse information may be subject to both civil and criminal penalties. EFTA00283887

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Fax oerver S/B/2014 2:17:36 PM PAGE 2/002 Fax oerver UnitedHealthcare Insurance Company JEFFREY EPSTEIN 6100 RED HOOK QUARTER B-3 ST THOMAS VI 00802 ct of SEIS BS We received your request for verification of coverage. The following members have coverage under the health benefit plan listed above: Health care services for emergency medical treatment only are covered outside the United States. The services must meet clinical guidelines for a non-work related illness or injury. Please note that payment is based on the submitted claim and the actual health care services received, the guidelines and policies in place at the time of service, and vi: plan and eligibility when the services are received. The information in this letter does not guarantee payment or represent a treatment decision. Treatment decisions are made between you and your physician. If you reach the plan's limit for visits, days or dollar amounts before or while receiving any or all of the services listed in this letter, coverage will not be provided for services above the plan's limit, unless your plan states otherwise. If you have questions about this letter or other questions related to your health insurance, please call the toll-free member phone number listed on your health plan ID card. Sincerely, UnitedHealthcare account information, find a physician or facility or learn more about healthy living. Registration is easy and gives you access to useful tools and information to help you take charge of your health and health care. EFTA00283888