Modified Repayment Plan Approval and Modified Letter of Agreement, dated March 13, 2025, by and between the Centers for Medicare and Medicaid Services and Bright Health Insurance Company of Florida

Dear Messrs. Matushak and Craig:

In September 14, 2023, Bright Health Insurance Company of Florida (BHIC-FL-12379) (“you” or “your”) entered an 18-month Repayment Plan Agreement to pay their outstanding 2022 benefit year risk adjustment charges. BHIC-FL-12379 has since requested to modify the existing Repayment Plan Agreement to extend the Repayment Plan Agreement an additional 18 months to pay their outstanding 2022 benefit year risk adjustment charges totaling $199,258,518.15.1

For the Centers for Medicare & Medicaid Services (CMS) to grant this modification to extend the Repayment Plan Agreement an additional 18 months BHIC-FL-12379 must:

1.Sign and submit this letter to provide your written understanding and agreement to the terms of this Letter of Agreement concerning the CMS approved modification no later than 11:59 p.m. ET on March 14, 2025. The signed Letter of Agreement must be sent to CCIIOInvoices@cms.hhs.gov.

2.Make monthly payments of $1,000 for the duration of the repayment agreement, due the 15th of each month, March 15, 2025 through August 15, 2026.

3.Pay an interim balloon payment of $83.494 million, within 30 calendar days of written notice from CMS of HHS approval to waive all paid and accrued interest. Should HHS approve the waiver of interest paid and accrued on the outstanding debts and if BHIC-FL-12379 makes the interim balloon payment referenced above within 30-days of such waiver, the full amount of the

interim balloon payment will be applied to principal. Should HHS deny the request to waive all paid and accrued interest, upon 30-calendar day notice to BHIC-FL-12379, then BHIC-FL-12379 must pay an interim balloon payment of $49.407 million, which shall be applied first to outstanding penalties,2 second to administrative charges,3 third to interest, and last to principal.

4.Agree to pay to CMS 76.6% of any surplus funds4 currently held by any insurance company that is an affiliate of BHIC-FL-12379 that are hereafter released to or on the behalf of BHIC-FL-12379, within 30 calendar days of receipt of such funds by any entity receiving on behalf of BHIC-FL-12379, and to take all reasonably necessary and available steps to secure the timely release of such funds to CMS for the benefit of issuers of risk adjustment covered plans eligible to receive 2022 benefit year risk adjustment payments in the state market risk pools impacted by the under collection of the 2022 benefit year risk adjustment charges owed by BHIC-FL-12379.5

5.Pay a final balloon payment for the full balance of outstanding principal and interest, no later than 11:59 p.m. ET on September 15, 2026.6

Unless otherwise specified above, payments will be applied first to outstanding penalties,7 second to administrative charges,8 third to interest, and last to principal.

All payments must be submitted electronically. To submit payments, you must visit www.pay.gov and then select and complete the CMS Health Insurance Marketplace and Premium Stabilization Programs Payment Form.

CMS attached the updated installment payment and amortization schedule (“Payment Plan”), which reflects the most recent invoice balance, setting forth the additional 18-month installment payment amounts and due dates, with the full balance of outstanding principal and interest due no later than September 15, 2026. By entering into this Letter of Agreement, as shown by your signature below, you agree that the Payment Plan is incorporated fully into this Letter of Agreement, and that this Letter of Agreement modifies the existing Repayment Plan Agreements dated September 14, 2023, along with the attached installment and amortization schedule to constitute the entire Repayment Plan Agreement (“Agreement”) between CMS and BHIC-FL- 12379, subject to all applicable laws, rules, and regulations.

6 As reflected on the attached installment and amortization schedule, the estimated final balloon payment amount is based on the minimum interim balloon and monthly payment obligations of BHIC-FL-12379 over the course of the Repayment Plan Agreement. Any additional payments would reduce the amount of the final balloon payment.

7 Supra note 2.

8 Supra note 3.

As outlined in the Payment Plan, CMS will assess interest at the rate provided for under 45 C.F.R. § 30.18(b), unless HHS waives the collection of accrued interest in accordance with 45 C.F.R. § 30.18(g). You will be charged your current interest rate of 11.5%, which is the interest rate established in the Initial Invoice. Each installment payment will be due on the 15th of each month over the course of the next 18 months, except that any payment due date that falls on a holiday or weekend will be due the next following business day.

If you fail to meet the terms of this Agreement, specifically those specified in 1-5 above, the Payment Plan incorporated into this Letter of Agreement, and the Agreement itself between CMS and BHIC-FL-12379, will not remain effective and will instead become null and void, and the unpaid balance of the total debt will become immediately due and payable. Failure to make timely payment in accordance with the Payment Plan, or entering liquidation, constitutes default. In the event of default, CMS will initiate debt collection, and the full balance of the debt will become immediately due and payable.

You are permitted to make early payment, or to pay off the entire debt early, without penalty. Any early payment9 will be applied in accordance with the payment priority outlined in 45 C.F.R. § 30.18(f), which based on the current outstanding balance reflected on the Payment Plan, would be applied to the outstanding interest balance first, if applicable, and then the principal balance. In the event there remains a principal balance after the early payment, the monthly installment payment amounts would not change unless notified by CMS.

/s/ Elizabeth E. Parish -S

I attest that I am an individual that is legally and financially able to obligate Bright Health Insurance Company of Florida, HIOS ID BHIC-FL-12379, and agree to the terms of the Agreement as set forth above, including all attachments and all documents incorporated herein.