Document:

Amended and Restated Deferred Compensation Plan

 Exhibit 10.1 
 HEALTHCARE SERVICES GROUP, INC. 
 AMENDED AND RESTATED 

DEFERRED COMPENSATION PLAN 

 ARTICLE 1. 
 STATEMENT OF PURPOSE 
 Section 1.1 General
Purpose. 
 The purpose of the Healthcare Services Group, Inc. Amended and Restated Deferred Compensation
Plan as set forth herein and as the same may hereafter be amended (the “Plan”), is to secure and retain the services of a select group of management or highly compensated employees (the “Key Employees”) of Healthcare Services
Group, Inc. (the “Company”) and its “Affiliates” (as hereinafter defined and, together with the Company, the “Employer”), and to provide additional retirement benefits to these Key Employees who have devoted
extraordinary energies to the Employer. 
 Section 1.2 Effective Date. 

The Plan, as amended and restated, shall (except as otherwise provided herein) be effective with respect to amounts
deferred hereunder as of January 1, 2013 (the “Effective Date”) and thereafter. The Plan was previously amended and restated effective January 1, 2009 to incorporate the changes required under Section 409A of the
“Code” (as hereinafter defined) (the “409A Effective Date”). For amounts deferred under the Plan as of January 1, 2005 and prior to the 409A Effective Date, the Plan shall be operated in good faith compliance with
Section 409A of the Code, including, as applicable, IRS Notice 2005-1 and the Proposed Treasury Regulations issued with respect to Section 409A of the Code on October 4, 2005 (for taxable years beginning prior to January 1,
2008). The original effective date of the Plan is January 1, 2000. 
 Section 1.3 Internal Revenue
Code and ERISA;  
 General Creditor Status of Participants. 

 

	 	(a)	 Tax Qualification under the Internal Revenue Code. 

It is intended that the Plan not be a tax-qualified plan under Section 401(a) or Section 403(a) of the
Internal Revenue Code of 1986, as amended (the “Code”). 
  

	 	(b)	 Status under the Employee Retirement Income Security Act of 1974. 

It is intended that the Plan be entitled to all statutory and regulatory exemptions under the Employee Retirement Income
Security Act of 1974, as amended (“ERISA”) applicable to unfunded plans maintained by an employer primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees within the
meaning of Sections 201(2), 301(a)(3) and 401(a)(1) of ERISA. 
  

	 	(c)	 Creditor Status of Participants. 

 It is intended that all benefits be paid from the general assets of the Company, that benefits accrued under the Plan be unfunded for ERISA and Code purposes until paid, and that, as to unpaid accrued
benefits under the Plan, each Participant is an unsecured general creditor of the Company. 

 ARTICLE 2. 
 DEFINITIONS 
 Section 2.1 “Account”
means the entire interest of the Participant in the Plan. 
 Section 2.2 “Affiliate” means
any and all persons with whom or with which the Company would be considered a single employer under Section 414(b) or (c) of the Code, applied by using the “at least 80%” ownership threshold set forth in Sections 1563(a)(1),
(2) and (3) and Treasury Regulation Section 1.414(c)-2, respectively, instead of the “at least 50%” ownership threshold set forth in Treasury Regulation Section 1.409A-1(h)(3). 

Section 2.3 “Age” means the chronological age (in years) attained by the Employee at the most
recent past anniversary of the date of his or her birth. 
 Section 2.4 “Beneficiary”
means the person, persons or entity entitled to receive benefits by reason of the death of a Participant under the Plan. 
 Section 2.5 “Board” means the Board of Directors of the Company. 
 Section 2.6 “Code” means the Internal Revenue Code of 1986, as amended, and successor statutes of similar purpose. A reference to any specific Section of the Code shall be a
reference to the same or similar text if that Section is renumbered or redesignated and a reference to one or more Sections of a successor statute addressing the same or parallel concepts. 

Section 2.7 “Committee” means the committee appointed by the Board, consisting of three (3) or
more individuals, which shall be responsible for the administration of the Plan. Members of the Committee may be Participants and may be members of the Board. 
 Section 2.8 “Deferral Year” means a Plan Year with respect to which a Salary Deferral Election applies. Notwithstanding any provision of this Plan to the contrary, a Deferral Year
must be a Plan Year with respect to which a Participant provides services to the Employer. 
 Section 2.9
“Disability” (including any words of similar import) means the condition under which the Participant (i) is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental
impairment which can be expected to result in death or can be expected to last for a continuous period of not less than 12 months, or (ii) is, by reason of any medically determinable physical or mental impairment which can be expected to result
in death or can be expected to last for a continuous period of not less than 12 months, receiving income replacement benefits for a period of not less than 3 months under an accident and health plan covering employees of the Employer. 

Section 2.10 “Earnings” means an Employee’s total W-2 compensation earned with respect to
services rendered to or on behalf of the Employer, exclusive of income attributable to the exercise of stock options and the receipt of automobile allowances. Notwithstanding the foregoing, effective for Deferral Years beginning on or after
January 1, 2009, “Earnings” means 

  
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the sum of an Employee’s (i) base salary (exclusive of income attributable to the exercise of stock options and the receipt of automobile allowances), payable to the Employee during the
Deferral Year in respect of services performed during Deferral Year, in accordance with the Employer’s normal payroll practices, and (ii) incentive compensation, payable to the Employee (A) as of June 30 of the Deferral Year in
respect of services performed during the first quarter of the Deferral Year, (B) as of December 31 of the Deferral Year, in respect of services performed during the second and third quarters of the Deferral Year and (C) as of
January 31 of the Plan Year immediately following the Deferral Year, in respect of services performed during the fourth quarter of the Deferral Year. Nothing contained herein shall be construed by any party as requiring the Employer to pay any
incentive compensation to any Employee for any Deferral Year, and the decision to do so shall be made by the Committee in its sole and absolute discretion. 
 Section 2.11 “Employee” means a person having a common law employer/employee relationship with the Employer. The term shall not include persons characterized by the Employer as
“independent contractors,” “leased employees” or “consultants,” regardless of whether such persons may be characterized for income or payroll tax withholding or liability, worker’s compensation payments or
unemployment compensation premium calculations by the IRS or other governmental authority. 
 Section 2.12
“Employment Termination Date” means the date on which the Participant sustains a Separation from Service. 
 Section 2.13 “IRS” means the Internal Revenue Service. 
 Section 2.14 “Key Employee” means an Employee selected for participation in the Plan by the Committee and who is employed in any of the following executive or management capacities:

 (a) Corporate executive and corporate management personnel; 

(b) Divisional and Regional Managers; and 

(c) District Managers. 
 Section 2.15 “Plan” means the Healthcare Services Group, Inc. Amended and Restated Deferred Compensation as set forth herein, and as the same may hereafter be amended. 

Section 2.16 “Participant” means a Key Employee who is eligible to participate in the Plan.

 Section 2.17 “Plan Administrator” means the Committee. 

Section 2.18 “Plan Year” means the calendar year. 

Section 2.19 “Retirement” means a Participant’s Separation from Service on or after attaining
age 60. Effective for Deferral Years after 2012, “Retirement” shall mean a Participant’s Separation from Service on or after attaining age 55. 

  
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 Section 2.20 “Salary Deferral Election” means an
election by a Participant to defer a portion of his or her Earnings for a given Deferral Year, pursuant to an election to do so in accordance with the provisions of Section 4.1 hereof. 

Section 2.21 “Separation from Service” means the death, Retirement or Termination of Employment of
the Participant. For purposes of this Section 2.21, 
 (a) the employment relationship is treated as
remaining intact while the Participant is on military leave, sick leave or other bona fide leave of absence if the period does not exceed six months, or if longer, so long as the individual retains a right to reemployment with any member of the
Employer under an applicable statute or by contract; 
 (b) a leave of absence constitutes a bona fide leave of
absence only if there is a reasonable expectation that the Participant will return to perform services for any member of the Employer; and 
 (c) if the period of leave exceeds six months and the Participant does not retain a right to reemployment under an applicable statute or by contract, the employment relationship is deemed to terminate on
the first date immediately following such six-month period. 
 Section 2.22 “Scheduled
Distribution” means a payment scheduled to be made on a date certain (on or about February 15) while the Participant is still employed by the Employer. A Scheduled Distribution shall be available to Participants for Salary Deferral
Elections effective on or after January 1, 2013. 
 Section 2.23 “Specified Employee”
means a Participant who, as of the date of his or her Separation from Service, is a key employee of any member of the Employer the stock of which is publicly traded on an established securities market (within the meaning of Treasury Regulation
Section 1.897-1(m)) or otherwise. For purposes of this Section 2.22, 
 (a) a Participant is a key
employee if such Participant meets the requirements of Section 416(i)(1)(A)(i), (ii) or (iii) of the Code (applied in accordance with the regulations thereunder and disregarding Section 416(i)(5)) at any time during the 12-month
period ending on a Specified Employee Identification Date; 
 (b) if a Participant is a key employee as of a
Specified Employee Identification Date, he or she is treated as a key employee under the Plan for the entire 12-month period beginning on the Specified Employee Effective Date; and 

(c) for purposes of identifying a Specified Employee by applying the requirements of Section 416(i)(1)(A)(i),
(ii) and (iii) of the Code, the definition of compensation under Treasury Regulation Section 1.415(c)-2(a) is used, applied as if the Company were not using any safe harbor provided in Treasury Regulation Section 1.415(c)-2(d),
were not using any of the elective special timing rules provided in Treasury Regulation Section 1.415(c)-2(e), and were not using any of the elective special rules provided in Treasury Regulation Section 1.415(c)-2(g). Notwithstanding the
foregoing, the Company may elect to use any available definition of compensation under Section 415 of the Code and the Treasury regulations 

  
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thereunder, including any available safe harbor and any available election under the timing rules or special rules, provided that the definition is applied consistently to all employees of the
Employer for purposes of identifying Specified Employees. However, once a list of Specified Employees has become effective, the Employer shall be prohibited from changing the definition of compensation for purposes of identifying Specified Employees
for the period with respect to which such list is effective. 
 Section 2.24
“Specified Employee Effective Date” means April 1st immediately following the Specified Employee Identification Date. 
 Section 2.25 “Specified Employee Identification Date” means December 31st. 
 Section 2.26 “Stock” means the voting common stock of HCSG, $0.01 par value per share. 
 Section 2.27 “Termination of Employment” means the Participant’s termination of employment with the Employer for any reason other than death or Retirement, including on account
of Disability, where the Participant and the Employer reasonably anticipate either that no further services would be performed by the Participant for the Employer after a certain date or that the level of bona fide services that the Participant
would perform after such date (whether as an employee or independent contractor) would permanently decrease to no more than 20% of the average level of bona fide services performed over the immediately preceding 36-month period (or full period of
services to the Employer if less than 36 months). For purposes of this Section 2.26, periods during which the Participant is on an unpaid leave of absence are disregarded (including for purposes of determining the relevant 36-month period), and
periods during which the Participant is on a paid bona fide leave of absence are treated as periods during which the Participant provided services at the level which the Participant would have been required to perform the services to receive the
compensation if not on a bona fide leave of absence. 
 Section 2.28 “Trust” means the
trust established by the Company with Bank of America, N.A., as trustee (“Trustee”), pursuant to that certain Trust Agreement dated as of October 18, 2012, as amended or amended and restated from time to time (the “Trust
Agreement”), for the purpose of receiving contributions from the Company and retaining such contributions (and the proceeds thereof from investments, including the proceeds of any life insurance policies owned by the trust, if any) as a source
of funds to assist the Company in meeting its obligation to provide benefits under the Plan. 

Section 2.29 “Valuation Date” means mean any day on which the New York Stock Exchange or any
successor to its business is open for trading, or such other date as may be designated by the Committee. 

Section 2.30 “Valuation Funds” means the funds selected by the Committee and listed on the attached
Exhibit “A,” to be used as earnings indices described in Section 4.3. The Valuation Funds so listed on Exhibit “A” are subject to change from time to time as the Committee, in its sole discretion, deems necessary or
appropriate. No provision of this Plan shall be construed as giving any Participant an interest in any of these Valuation Funds, nor shall any provision require the Employer or the Trustee to make any investment in any such funds. 

  
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 Section 2.31 “Vesting Date” means the date specified
in Section 4.2(b) that a Participant becomes fully vested in the Stock allocated to that Participant’s Account pursuant to Section 4.2(a). 
 ARTICLE 3. 
 PARTICIPATION 

Section 3.1 Eligibility. 

Participation in the Plan shall be strictly limited to Key Employees. 

Section 3.2 Commencement of Participation. 

Each Key Employee employed by the Employer on the original effective date set forth in Section 1.2 hereof and who
elects to participate in the Plan shall become a Participant as of such date. Every other Key Employee shall become a participant on the first day of the Plan Year coincident or next following the date such individual became a Key Employee.

 Section 3.3 Cessation of Participation. 

Each Participant shall remain a Participant until the later to occur of: 

(a) his or her Employment Termination Date; or 

(b) the date on which he or she receives a distribution of the entire balance of his or her Account, so that he or she
then has no remaining balance in his or her Account. 
 ARTICLE 4. 

ELECTION OF DEFERRALS, 
 INVESTMENT OF DEFERRAL, PAYMENT OF BENEFITS 

Section 4.1 Election of Deferral. 

(a) General Rule. Each year, every Participant may irrevocably elect to defer the receipt of up to twenty-five
percent (25%) of his or her Earnings payable for any Deferral Year, in respect of services to be performed by the Participant for the Employer for such Deferral Year, by filing a Salary Deferral Election with the Plan Administrator prior to the
end of the Plan Year immediately preceding the Deferral for the applicable Deferral Year. Such Salary Deferral Election shall apply to both base salary and incentive compensation. For avoidance of doubt, a Participant shall not have the ability to
designate a different percentage to be deferred with respect to either element of Earnings for any given Deferral Year. A Salary Deferral Election shall be in the manner prescribed by the Plan Administrator. 

(b) Initial Deferral Election. Notwithstanding Section 4.1(a) of the Plan, in the case of the first Plan
Year during which a Key Employee becomes eligible to 

  
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participate in the Plan, the Key Employee may file a Salary Deferral Election with the Plan Administrator within 30 days after the date on which he or she becomes so eligible, with respect to
Earnings paid for services to be performed during such Plan Year (the initial Deferral Year) after the effective date of the Salary Deferral Election contained therein. 

(c) Vesting of Earnings. The portion of a Participant’s Account attributable to any Salary Deferral Election
shall be fully vested as of the date on which the applicable Earnings are credited to such Account. 
 (d)
Termination of Salary Deferral Election for a Given Deferral Year. A Participant’s obligation to defer Earnings under a given Salary Deferral Election will terminate as of December 31 of each year. 

Section 4.2 Employer Matching. 

(a) Allocation Rules. The Company shall contribute and allocate to each Participant’s Account, as of the
last day of each Deferral Year, the number of full shares of Stock obtained by dividing an amount equal to twenty-five percent (25%) of the first fifteen percent (15%) of Earnings deferred by the Participant for such Deferral Year (the
“Deferral Year”) pursuant to the election described in Section 4.1, by the Market Price of the Stock on the last day of the Deferral Year. For this purpose Market Price shall mean the closing price of the Stock on the last day of the
Deferral Year or if there was no trading of the Stock on such date, the closing price on the nearest prior business day on which trading occurred on a recognized securities exchange. Notwithstanding the foregoing, stock certificates in respect of
allocations under this Section 4.2(a) shall be credited to the Account no later than January 31st of the Plan Year immediately following the Deferral Year. To be eligible to receive an allocation of Stock pursuant to this
Section 4.2(a), a Participant must be employed by the Employer on the last day of the Deferral Year. 

(b) Each Key Employee who becomes eligible and elects to participate in the Plan shall have a fully vested
nonforfeitable interest in the Stock allocated to his or her Account, if still employed by the Employer, on the last day of the Plan Year which commences on or after the third anniversary of the first day of the first Plan Year in which a Key
Employee elects to make contributions to the Plan. In the event a Participant’s experiences a Separation from Service for any reason other than death, Disability or Retirement prior to the Participant’s Vesting Date, all Stock previously
allocated to such Participant’s Account shall be forfeited and held by the Trustee to be allocated in subsequent years pursuant to Section 4.2(a) hereof. 

Section 4.3 Investment of Deferrals and Matching Contributions. 

(a) Except as otherwise provided under Section 4.2(a) with respect to Stock certificates, the Company shall
contribute to the Trust all amounts deferred and contributed hereunder within ten (10) business days of the date such amounts would otherwise have been paid to a Participant pursuant to the Company’s standard payroll practices. All amounts
contributed to the Trust and the earnings thereon shall be held by the trustee of the Trust and invested in accordance with the terms of the Trust Agreement. Without in any way limiting the generality of the foregoing, and subject to such
limitations as may from time to time be required by law or imposed by the Committee, and subject further to such operating rules and 

  
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procedures as may be imposed from time to time by the Committee, each Participant may express to the Committee a preference as to how the portion of the Participant’s Account attributable to
Earnings (the “Earnings Sub-Account”) should be constructively invested among the Valuation Funds. Such preference shall designate the percentage of the Participant’s Earnings Sub-Account which is requested to be constructively
invested in each Valuation Fund. 
 (b) A Participant’s expression of investment preference shall be made
telephonically, via the recordkeeper’s telephone voice response system, or electronically, via the recordkeeper’s Internet web access system, each as established by the recordkeeper, at the Employer’s direction, for the purpose of
recording the Participant’s investment elections among the Valuation Funds. Such investment elections shall serve merely as earnings indices for the Participant’s Account, and neither the Employer nor the Committee nor the Trustee shall be
obligated to follow such elections. The Employer shall not be obligated to invest any funds in connection with this Plan, including, but not limited, with respect to distributions under Section 4.4, 4.5 and 4.6 hereof. 

(c) Whether or not a Participant’s investment preferences are followed with respect to actual investments, the
Participant’s Earnings Sub-Account will be credited with earnings or losses as follows. As of each Valuation Date, the net earnings or losses (as defined below) of each Valuation Fund since the preceding Valuation Date shall be allocated among
all Earnings Sub-Accounts in accordance with the preferences indicated by each Participant as though the Earnings Sub-Accounts had been invested in the Valuation Fund in accordance with each Participant’s indicated preference. For purposes of
this allocation, the Earnings Sub-Account of each Participant will consist of the balance of the Earnings Sub-Account as of the preceding Valuation Date, adjusted: (i) by adding thereto the Participant deferrals made since the preceding
Valuation Date and (ii) by subtracting therefrom all distributions made to the Participant or to a Beneficiary or Beneficiaries. 
 (d) For purposes of this Section 4.3, the Earnings Sub-Account shall include the cash value of dividends (“Dividend Equivalents”) declared by the Company on the Stock allocated to a
Participant’s Account. Such Dividend Equivalents, to the extent declared, shall be allocated to the purchase additional shares of Stock, in a manner determined by the Committee in its sole discretion, as of the end of each calendar quarter
within a Plan Year. 
 Section 4.4 Payment of Benefits. 

(a) Initial Deferral Elections. 

(i) Subject to the vesting requirements contained herein, the Plan Administrator shall direct the Trustee of the Trust
to pay the Participant, in a single lump sum within ninety (90) days following the Employment Termination Date, the portion of the Participant’s Account that consists of Participant deferrals allocated to the Earnings Sub-Account prior to
the end of the 2009 Deferral Year (together with any earnings, losses, or Dividend Equivalents thereon pursuant to Section 4.3) and shares of Stock contributed by the Company prior to the end of the 2009 Deferral Year, valued as of the
applicable Valuation Date. 
 (ii) For each Deferral Year after 2009 and prior to 2013, a Participant shall
designate the time and form of distribution of Participant deferrals allocated to 

  
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the Earnings Sub-Account during each such Deferral Year (together with any earnings, losses, or Dividend Equivalents thereon pursuant to Section 4.3) and shares of Stock contributed by the
Company during each such Deferral Year, pursuant to an irrevocable written distribution election filed by the Participant (in the manner prescribed by the Plan Administrator) prior to the commencement of each such Deferral Year, and, subject to the
vesting requirements contained herein, the Plan Administrator shall direct the Trustee to reimburse the Company so that it may pay the Participant such amounts pursuant to such distribution election(s), valued as of the applicable Valuation Date.
Each such distribution election shall apply to the subsequent Deferral Year unless and until the Participant files a new distribution election for the forthcoming Deferral Year; provided, however, that if the Participant never files a distribution
election, all such amounts shall be paid in a single lump sum within ninety (90) days following the Participant’s Employment Termination Date. Such distribution election(s) shall allow the Participant to choose to have such amounts
distributed either (1upon a Scheduled Distribution while employed with the Company (2) within ninety (90) days following the Retirement. In the event the Participant terminates employment prior to reaching Retirement, the Participant shall
receive a lump sum payment for amounts deferred after January 1, 2013 
 (iii) For each Deferral Year
after 2012, a Participant shall designate the time and form of distribution of Participant deferrals allocated to the Earnings Sub-Account during each such Deferral Year (together with any earnings, losses, or Dividend Equivalents thereon pursuant
to Section 4.3) and shares of Stock contributed by the Company during each such Deferral Year, pursuant to an irrevocable distribution election filed by the Participant (in the manner prescribed by the Plan Administrator) prior to the
commencement of each such Deferral Year, and, subject to the vesting requirements contained herein, the Plan Administrator shall direct the Trustee of the Trust to pay to the Company the amount necessary to pay the Participant such amounts pursuant
to such distribution election(s), valued as of the applicable Valuation Date. Each such distribution election shall apply to the subsequent Deferral Year unless and until the Participant files a new distribution election for the forthcoming Deferral
Year; provided, however, that if the Participant never files a distribution election, all such amounts shall be paid in a single lump sum within ninety (90) days following the Participant’s Employment Termination Date. Such distribution
election(s) shall allow the Participant to choose to have such amounts distributed either: 
  

	 	1)	 after a five (5) year deferral period, a Scheduled Distribution of such that the amounts will be distributed in the February that follows the
fifth anniversary of the first day of the Deferral Year in a single lump sum or five (5) substantially equivalent annual installments (as elected); 

 

	 	2)	 within ninety (90) days following the Participant’s Retirement in a lump sum or up to five (5) substantially equivalent annual
installments (as elected), 

  

	 	3)	 within ninety (90) days following the date of the Participant’s Employment Termination Date in a single lump sum;

 provided, however, that if the Participant undergoes a Separation from Service (other than
on account of Retirement), all remaining payments due to the Participant shall be paid in a single lump sum within ninety (90) days following the Participant’s Employment Termination Date. 

  
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 (iv) With respect to the Earnings Sub-Account, on the payment date (or each
payment date in the case of annual installments) set forth in this Section 4.4(a), Trust investments, which may or may not include any Valuation Funds, shall be liquidated on a pro-rata basis (regardless of whether or not a Participant’s
investment preferences were followed with respect to actual investments), in an amount equal to such portion of the Account that is to be paid on such date(s). The Earnings Sub-Account shall be distributed in cash. Shares of Stock allocated to a
Participant’s Account shall be distributed in-kind. 
 (v) For purposes of this Section 4.4(a), each
installment payment shall be treated as a series of separate payments and shall be determined by dividing the Account balance as of the Valuation Date by the remaining number of installment payments. 

(b) Subsequent Deferral Election. For amounts with respect to each Deferral Year after 2012, a Participant may
delay the timing of a previously-scheduled payment or may change the form of a payment only if such subsequent deferral election meets all of the following requirements: 

(i) the subsequent deferral election shall not take effect until at least 12 months after the date on which it is made;

 (ii) the election must be made at least 12 months prior to the date the payment is scheduled to be made. For
installment payments, the election must be made at least 12 months prior to the date the first payment in such installment was scheduled to be made; and 
 (iii) the subsequent deferral election must delay the payment for at least five years from the date the payment would otherwise have been made. For installment payments, the delay is measured from the
date the first payment was scheduled to be made. 
 (c) Specified Employees. Notwithstanding any
provision of this Plan to the contrary, if the Participant is considered a Specified Employee at Separation from Service under such procedures as established by the Company in accordance with Code Section 409A, benefit distributions under
Section 4.4(a) that are made upon Separation from Service may not, to the extent required by Code Section 409A, commence prior to the earlier of the date of the Participant’s death or the expiration of the six-month period measured
from the date of the Participant’s Separation from Service; provided that to the extent permitted by Code Section 409A, only payments scheduled to be paid during the first six (6) months after the date of such Separation from Service
shall be delayed and such delayed payments shall be paid in a single sum on the first day of the seventh month following the date of such Separation from Service. 

Section 4.5 Early Distribution of Benefits. 

A Participant may request a distribution due to Unforeseeable Emergency by submitting a written request to the Plan
Administrator accompanied by evidence to demonstrate that the circumstances being experienced qualify as an Unforeseeable Emergency. The Plan Administrator shall have the authority to require such evidence as it deems necessary to

  
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determine if a distribution is warranted. If an application for a hardship distribution due to an Unforeseeable Emergency is approved, the distribution shall be limited to amounts contributed by
the Participant to the Plan pursuant to Section 4.1 (and the earnings thereon) and shall be further limited to an amount sufficient to meet the emergency, plus amounts necessary to pay taxes reasonably anticipated as a result of the
distribution. The allowed distribution shall be payable in a single lump sum in cash as soon as possible after approval of such distribution, but in any event within ninety (90) days after the occurrence of the Unforeseeable Emergency, with the
exact date of such payment to be determined by the Plan Administrator in its sole discretion. For purposes of making any such payment, the Account shall be valued as of the applicable Valuation Date, and the Participant shall direct the Trustee to
liquidate Trust investments (regardless of whether or not a Participant’s investment preferences were followed with respect to actual investments), which may or may not include any Valuation Funds, in an amount equal to such portion. In the
event the Participant fails to direct the Trustee as provided in the preceding sentence, on the payment date, Trust investments, which may or may not include any Valuation Funds, shall be liquidated on a pro-rata basis (regardless of whether or not
a Participant’s investment preferences were followed with respect to actual investments), in an amount equal to such portion. The Earnings Sub-Account shall be distributed in cash. Shares of Stock allocated to a Participant’s Account shall
be distributed in-kind. As used herein, “Unforeseeable Emergency” shall mean (i) a severe financial hardship to the Participant resulting from an illness or accident of the Participant, the Participant’s spouse, a Beneficiary, or
the Participant’s dependent (as defined in Section 152 of the Code, without regard to Section 152(b)(1), (b)(2) and (d)(1)(B)), (ii) loss of the Participant’s property due to casualty (including the need to rebuild a home
following damage to a home not otherwise covered by insurance, for example, not as a result of a natural disaster), or (iii) other similar extraordinary and unforeseeable circumstances arising as a result of events beyond the control of the
Participant, which may include, if applicable, (x) the imminent foreclosure of or eviction from the Participant’s primary residence, (y) the need to pay for medical expenses, including non-refundable deductibles, as well as the costs
of prescription drug medication, and (z) the need to pay for the funeral expenses of the Participant’s spouse, a Beneficiary or the Participant’s dependent (as defined in Section 152 of the Code, without regard to
Section 152(b)(1), (b)(2) and (d)(1)(B)). Except as otherwise provided in clause (iii) of the immediately preceding sentence, the purchase of a home and the payment of college tuition are not Unforeseeable Emergencies. In the event of any
such withdrawal and distribution during any Plan Year as a result of an Unforeseeable Emergency, the Participant’s Salary Deferral Election for such Plan Year shall be deemed automatically revoked for such Plan Year. This section shall be
interpreted in a manner consistent with Section 409A of the Code. The circumstances that will constitute an “Unforeseeable Emergency” will depend upon the facts of each case, but, in any event, payment may not be made if such hardship
is or may be relieved: 
 (a) Through reimbursement or compensation by insurance or otherwise; 

(b) By liquidation of the Participant’s assets, to the extent that liquidation of such assets would not itself
cause severe financial hardship, or 
 (c) By cessation of deferrals under the Plan. 

  
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 Where a payment is made to a Specified Employee on account of the
occurrence of an Unforeseeable Emergency, the payment need not be delayed because the Specified Employee has a Separation from Service after incurring the Unforeseeable Emergency. 

Section 4.6 No Acceleration of Retirement Benefit or Termination Benefit. Neither a Participant nor the
Employer may accelerate the time or schedule of any payment scheduled to be made under the Plan. Notwithstanding the foregoing, the time or schedule of any payment may be accelerated in any of the following circumstances: 

(a) Domestic Relations Orders. The Plan Administrator may accelerate the time or schedule of a payment under the
Plan to an individual other than the Participant, or a payment under the Plan may be made to an individual other than the Participant, to the extent necessary to fulfill a domestic relations order (as defined in Section 414(p)(1)(B) of the
Code). Any such payment reflecting an assigned percentage of the Participant’s Account as of a date certain shall be construed as requiring such assignment to be calculated with reference to such date, or, if administratively preferable to the
Committee in its sole and absolute discretion, the last day of the month in which such date certain occurs (the “Assignment Date”). For purposes of making any distribution under this Section 4.6(a), if the domestic relations order
provides that earnings and losses shall be taken into account from the Assignment Date through the date of distribution or any earlier date, the Account, for distribution purposes, shall be valued as of the applicable Valuation Date; and if the
domestic relations order does not provide that earnings and losses shall be taken into account, or affirmatively provides that earnings and losses shall not be taken into account, the value of the Account as of the Assignment Date shall be the value
of the Account for distribution purposes; 
 (b) Payment of Employment Taxes. The Plan Administrator may
accelerate the time or schedule of a payment under the Plan, or a payment may be made under the Plan, to (x) pay the Federal Insurance Contributions Act (“FICA”) tax imposed under Section 3101, 3121(a) or 3121(v)(2) of the Code
or (y) pay the income tax at the source on wages imposed under Section 3401 of the Code or the corresponding withholding provisions of applicable state, local or foreign tax laws. However, the total payment under this clause (ii) may
not exceed the aggregate of the FICA amount and the income tax withholding related to the FICA amount Payment shall be based on the value of the Account as of the applicable Valuation Date; or 

(c) Payment Upon Income Inclusion Under Section 409A. The Plan Administrator may accelerate the time or
schedule of a payment under the Plan, or a payment may be made under the Plan, at any time that the Plan fails to meet the requirements of Section 409A of the Code and the Final Regulations. Such payment may not exceed the amount required to be
included in income as a result of the failure to comply with the requirements of Section 409A of the Code and the Treasury Regulations promulgated thereunder. Payment shall be based on the value of the Account as of the applicable Valuation
Date. 
 For purposes of making any payment under this Section 4.6, the following rules shall apply: the Participant shall
direct the Trustee to liquidate Trust investments (regardless of whether or not a Participant’s investment preferences were followed with respect to actual investments), which may or may not include any Valuation Funds, in an amount equal to
such portion of the Account. In the event the Participant fails to direct the Trustee as provided in the preceding sentence, on the payment date, Trust investments, which may or may not include any Valuation Funds, shall

  
 12 

 
be liquidated on a pro-rata basis (regardless of whether or not a Participant’s investment preferences were followed with respect to actual investments), in an amount equal to such portion.
The Earnings Sub-Account shall be distributed in cash. Shares of Stock allocated to a Participant’s Account shall be distributed in-kind. 
 ARTICLE 5. 
 BENEFICIARY DESIGNATIONS 

Section 5.1 Designation by Participant. 

Each Participant shall have the right to designate one or more primary Beneficiaries and one or more contingent
Beneficiaries to receive the amount represented by his or her Account in the event of his or her death. Beneficiary designation(s) shall be made in the manner as may be prescribed by the Plan Administrator. The Participant shall have the right to
revoke or change Beneficiary designations from time to time, and each such change shall constitute a revocation of all prior designations. No Beneficiary designation shall be effective unless in writing and delivered to the Plan Administrator prior
to the death of the Participant. Any such Beneficiary designation shall be subordinate to any court order applicable to the Participant’s interest in the Plan. 

Section 5.2 Default Provision. 

If a Participant dies without having designated a Beneficiary, or if no such designated Beneficiary survives the
Participant, any benefit payable by reason of the death of the Participant shall be payable to his or her surviving spouse, or, if there is no surviving spouse, to his or her surviving children, in equal shares. If the Participant dies with no
surviving spouse or children, any benefit shall be paid to the Participant’s estate. 
 ARTICLE 6. 

PLAN ADMINISTRATION 
 Section 6.1 Authority and Delegation. 
 In general,
affairs of the Plan shall be administered by the Plan Administrator subject to the supervision and review of the Board. However, the Plan Administrator has the right, but not the obligation, to delegate any of its duties and authorities hereunder to
any person or persons not disabled, as a matter of law, to perform such duties or to exercise such authorities. The Plan Administrator shall provide written reports to the Board, no less frequently than annually, concerning the operation of the Plan
and Trust since the date of the last report. 
 Section 6.2 Duties, Responsibilities and Authority of
the Plan Administrator. 
 The Plan Administrator shall have the following duties and the authority to take
such actions as are reasonably necessary and desirable to discharge the same: 
 (a) to maintain and preserve
records relating to each Participant and each Beneficiary; 

  
 13 

 (b) to recommend to the Board what sums, if any, should be contributed to
the Plan; 
 (c) to prepare and to furnish to each Participant and to others entitled to receive the same, all
information and notices required under Federal law or the provisions of the Plan; 
 (d) to prepare and file or
publish and distribute, as required by law, all returns, reports, notices, descriptions and other information required under law to be so filed or published and distributed; 

(e) to construe all provisions of the Plan, to correct any defect therein, and to supply any omissions therefrom, as
more fully described in Section 6.4 of the Plan; 
 (f) to arrange for bonding, if necessary; 

(g) to determine eligibility for benefits and to provide procedures for the appeal of denied claims for benefits;

 (h) to determine whether any court order, including a domestic relations order described in
Section 414(p)(1)(B) of the Code, is applicable to the interest of the Participant under the Plan and to take such action as is appropriate in connection with such order; 

(i) to solicit, receive, retain and act upon Beneficiary designations and other communications received from the
Participant and others; 
 (j) to promulgate such policies, procedures and rules of general and specific
application as the Plan Administrator, in its discretion, deems necessary or desirable to administer the Plan and to further the purposes for which it exists, and from time to time to change such policies, procedures and rules; 

(k) to publish forms to be used in connection with the administration of the Plan and to determine the circumstances in
which the use of such forms will be required; 
 (l) to determine whether or not the consent of any person is
required in connection with the exercise of any rights or privileges under the Plan and to withhold action pending the receipt of such consent where required; 
 (m) to delegate to qualified persons or entities such of its ministerial duties as it sees fits to so delegate and to rescind such delegations; provided, however, that the Plan Administrator shall remain
responsible for the authorized acts of the delegatees; 
 (n) to provide the trustees of the Trust with the
information required pursuant to the Trust Agreement; and 

  
 14 

 (o) to exercise such other powers and discharge such other duties and
responsibilities as are specified in the Plan as being within the province of the Plan Administrator. 

Section 6.3 Reporting and Disclosure. 

The Plan Administrator shall keep all individual and group records relating to each Participant, his or her Beneficiary
(or Beneficiaries) and others having an interest in his or her benefits under the Plan and the Trust and all other records as may be necessary or desirable, in the judgment of the Plan Administrator, for the proper operation of the Plan. Such
records shall be made available for examination and copying by the Participant and his or her Beneficiary (or Beneficiaries); provided, however, that each Participant and representative shall have the right to see or copy only those records
pertaining to such person and those records and documents of general application. 
 Section 6.4
Construction of the Plan. 
 The Plan Administrator shall take such steps as are considered necessary
and appropriate to remedy any inequity that results from incorrect information received or communicated in good faith or as the consequence of an administrative error. The Plan Administrator shall interpret the Plan and shall determine the questions
arising thereunder in the administration, interpretation and application of the Plan. The Plan Administrator shall reconcile any inconsistency under the Plan and shall supply any omissions with respect to the Plan. Subject to Section 7.3, all
such corrections, reconciliations, interpretations and supplied omissions shall be final and binding on all parties. 
 Section 6.5 Engagement of Assistants and Advisers. 

The Company shall have the right to engage the services of such persons and organizations as it, in its sole discretion,
deems necessary or advisable to facilitate the operation of the Plan and the accomplishment of its purposes. 

Section 6.6 Bonding. 

HCSG shall arrange for such bonding as is required by law, but no bonding in excess of the amount required by law shall
be required under the Plan or the Trust. 
 Section 6.7 Discretion. 

The Plan Administrator shall have the greatest lawful degree of discretion in the administration and construction of the
Plan. The manner in which the Plan is administered or construed shall not be guided by, and there shall be no precedential value ascribed to, the manner in which the Plan was administered or construed at an earlier date, nor shall the manner in
which any plan, fund, program or arrangement similar to the Plan be considered precedential to the manner in which the Plan is to be administered or construed. 

  
 15 

 ARTICLE 7. 
 CLAIMS AND REVIEW 
 Section 7.1 Claims
Procedure. 
 If the Participant or the Participant’s Beneficiary (hereinafter the
“Claimant”) is denied all or a portion of an expected benefit under the Plan for any reason, he or she may file a claim with the Committee. The Committee shall notify the Claimant within thirty (30) days of allowance or denial of the
claim. The notice of the Committee’s decision shall be in writing, sent by mail to Claimant’s last known address, and, if a denial of the claim, shall contain the following information: the specific reasons for the denial; specific
reference to pertinent provisions of the Plan on which the denial is based; if applicable, a description of any additional information or material necessary to perfect the claim and an explanation of why such information or material is necessary;
and an explanation of the review process. 
 Section 7.2 Request for Review. 

A Claimant is entitled to request a review by the Board of any denial of his or her claim by the Committee. The request
for review must be submitted to the Board in writing within sixty (60) days of receipt of the notice of the denial. Absent a request for review within the sixty (60) day period, the claim will be deemed to be conclusively denied.

 Section 7.3 Review Procedure. 

The Claimant or his or her representative shall be entitled to review all pertinent documents and to submit issues and
comments in writing to the Board. The Board in their sole discretion may afford the Claimant a hearing. The Board shall render a review decision in writing within sixty (60) days after receipt of a request for a review. The Claimant shall
receive written notice of the Board’s review decision, which shall contain specific reasons for the decision with references to the pertinent provisions of the Plan. 

Section 7.4 Disability Claims Review Procedure. 

(a) Initial Claim. 
 A Claimant may make a claim for benefit under the Plan or request a specific interpretation or ruling under the Plan regarding such Claimant’s status as a Participant with a Disability by submitting
a written claim for benefits to the Committee. 
 If such claim is denied, in whole or in part, the Committee
shall provide the Claimant with written notification of such adverse benefit determination within 45 days after the receipt of the claim. This time period may be extended twice by 30 days (for a total of 60 days) if the Committee both determines
that such an extension is necessary due to matters beyond the control of the Plan and notifies the Claimant of the circumstances requiring the extension of time and the date by which the Committee expects to render a decision. Any such notification
shall be made prior to the expiration of the initial 45-day or 30-day period, as applicable. 

  
 16 

 If such an extension is necessary due to the Claimant’s failure to
submit the information necessary to decide the claim, the notice of extension shall specifically describe the required information, and the Claimant shall be afforded at least 45 days within which to provide the specified information. If the
Claimant delivers the requested information within the time specified, any 30-day extension period shall begin after the claimant has provided that information. If the Claimant fails to deliver the requested information within the time specified,
the Committee may decide the claim without that information. 
 A Claimant may file any claim himself or
herself or may designate another person as his or her “authorized representative” by notifying the Committee in writing of that person’s designation. In that case, all subsequent notices are provided to claimant through his or her
authorized representative and decisions concerning that claim shall be given to that representative. 
 Any
written notice of adverse benefit determination shall include the following information: 
 (i) the specific
reason or reasons for the denial; 
 (ii) reference to the specific Plan provisions on which the determination
is based; 
 (iii) a description of any additional material or information necessary for the claimant to seek
review and an explanation of why such material or information is necessary; 
 (iv) a description of the
Plan’s review procedures and the time limits applicable to such procedures, including a statement of the Claimant’s right to bring legal action in federal court under the federal pension law known as ERISA, if the Claimant’s claim on
review is denied; and 
 (v) disclosure of any internal rule, guideline, protocol or similar criterion relied
on in making the adverse determination. 
 Any failure of the Committee to respond to the Claimant’s claim
for benefit within the allotted time period, including extensions, shall be deemed to be a denial of such claim by all parties. 
 (b) Appeal of Denied Claim. 
 If a Claimant’s claim
is denied or a Claimant or his or her authorized representative has not received a response within the initial 45-day period or extended 30-day or 60-day period, as applicable, the Claimant or his or her authorized representative, as applicable, may
request a review by notice given in writing to the Committee. A Claimant or his or her authorized representative, as applicable, shall have at least 180 days after the receipt of the denial notice to appeal the denial. 

  
 17 

 In connection with a Claimant’s or authorized representative’s
right to appeal the Committee’s initial determination regarding the claim, the Claimant or authorized representative, as applicable, also: 
 (i) may review pertinent documents and submit issues and comments in writing; 
 (ii) is entitled to have the review of the adverse benefit determination take into account all new information, whether or not presented or available at the initial determination. No deference will be
afforded to the initial determination; 
 (iii) will be given the opportunity to submit written comments,
documents, records, or any other information relevant to the claim; 
 (iv) will, upon request and free of
charge, be provided with reasonable access to, and copies of, all documents, records, and other information relevant to the claim for benefits, including all documents defined by applicable U.S. Department of Labor regulations; 

(v) is entitled to have the review conducted by a person different from the person who made the initial determination
and such person will not be the original decision maker’s subordinate; 
 (vi) is entitled to be given a
review that takes into account all comments, documents, records, and other information submitted by the Claimant or authorized representative, as applicable, relating to the claim, regardless of whether such information was submitted or considered
in the initial benefit determination; 
 (vii) is entitled to, in the case of a claim denied on the grounds of
a medical judgment, have Committee consult with a health professional with appropriate training and experience. The health care professional who is consulted on appeal will not be the individual, if any, who was consulted during the initial
determination or a subordinate; and 
 (viii) if the advice of a medical or vocational expert was obtained by
the Committee in connection with the denial of the claim, will be provided with the names of each such expert, regardless of whether the advice was relied upon. 

The Committee normally shall issue a decision on an appealed claim involving a Disability determination not later than
45 days following receipt of the written appeal. If the Committee determines that special circumstances require an extension of time for a decision on review, the review period may be extended by an additional 45 days (90 days in total). The
Committee shall notify the Claimant or authorized representative, as applicable, in writing if an additional 45 day extension is needed. Any such notice shall be delivered prior to the expiration of the initial 45 day period and shall describe the
special circumstances requiring the extension and set forth the date by which the Committee expects the claim to be decided. 
 If an extension is necessary due to a Claimant’s or authorized representative’s, as applicable, failure to submit the information necessary to decide the appeal,

  
 18 

 
the notice of extension will specifically describe the required information, and the Claimant or authorized representative, as applicable, will be afforded at least 45 days to provide the
specified information. If the Claimant or authorized representative, as applicable, delivers the requested information within the time specified, the 45 day extension of the appeal period will begin after such information has been provided. If the
Claimant or authorized representative, as applicable, fails to deliver the requested information within the time specified, the Committee may decide the appeal without that information. 

Following a denial of a claim on review, the Committee will provide the Claimant or authorized representative, as
applicable, with a written notice containing the following information: 
 (i) the specific reason or reasons
for the denial; 
 (ii) references to the specific Plan provisions on which the denial is based; 

(iii) a statement disclosing any internal rule, guideline, protocol or similar criterion relied on in making the adverse
determination; 
 (iv) a statement that the claimant or authorized representative, as applicable, is entitled
to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claim for benefits, including documents not relied upon in deciding the appeal. For this purpose a
document is considered “relevant” if it (1) was relied upon in making the benefit determination on the claim; (2) was submitted, considered, or generated in the course of deciding the claim, whether or not relied upon in deciding
the claim; (3) demonstrates compliance with the administrative processes and safeguards designed to ensure that benefit claims are decided in accordance with governing Plan documents and that Plan provisions have been applied consistently with
respect to similarly situated claimants; or (4) constitutes a statement of policy or guidance with respect to the Plan concerning the denied treatment option or benefit for the Claimant’s diagnosis, without regard to whether such statement
was relied upon in deciding the benefit; 
 (v) a statement describing any voluntary appeal procedures offered
by the Plan and the Claimant’s or authorized representative’s, as applicable, right to obtain the information about such procedures, and right to bring an action in federal court under federal law; and (1) if an internal rule,
guideline, protocol, or other similar criterion was relied upon in making the adverse determination, the specific rule, guideline, protocol, or other similar criterion; or a statement that such rule, guideline, protocol, or other similar criterion
was relied upon in making the adverse determination; (2) if the denial is based on a medical necessity or experimental treatment or similar exclusion or limit an explanation of the scientific or clinical judgment for the determination, applying
the terms of the Plan to the Claimant’s medical circumstances; and (3) a statement as follows: ‘You and your plan may have other voluntary alternative dispute resolution options, such as mediation. One way to find out what may be
available is to contact your local U.S. Department of Labor Office and your State insurance regulatory agency;’ and 

  
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 (vi) a statement describing the Claimant’s or authorized
representative’s, as applicable, right to bring an action in federal court under Section 502(a) of ERISA with respect to such denial of benefits. 
 ARTICLE 8. 
 PLAN AMENDMENT AND TERMINATION 

Section 8.1 Amendment. 

The provisions of the Plan may be amended at any time and from time to time by the Board or any subcommittee thereof or
any officer of the Company to whom the Board has delegated such authority. Any such amendment shall be by written instrument, shall be communicated to the Participants, and shall not deprive the Participant of any benefit previously earned or
accrued as of the date of the proposed amendment. 
 Section 8.2 Plan Termination. 

(a) The Company reserves the right to terminate the Plan in whole or in part at any time and without notice to any
person or entity. Notwithstanding the foregoing, no such termination shall deprive the Participant of any benefit earned or accrued as of the date of the proposed termination. Subject to Section 8.2(b), in the event of any such termination, the
Trustee shall distribute Plan benefits at the time specified for payment of such benefits to the Participant or his or her designated Beneficiary in accordance with Section 4.4 or Section 4.5, as the case may be. A termination of the Plan
shall be duly authorized by the Board or any subcommittee thereof or any officer of the Company to whom the Board has delegated such authority. Upon a termination of the Plan for any reason, each Participant shall become fully vested in all of the
Stock contributed and allocated to his or her Account pursuant to Section 4.2(a). 
 (b) In the event of a
Change In Control (hereinafter defined), the Plan may be terminated and, within the ninety (90) days following the Change In Control, the unpaid Account balances of all Participants shall be distributed in a single lump sum. For purposes of
this subparagraph, the Plan will be treated as terminated as a result of a Change In Control only if all substantially similar arrangements sponsored by the Company are also terminated, so that the Participants of the Plan and participants of any
similar plan receive all amounts of compensation deferred under such arrangements within 12 months of the termination date. A “Change In Control” shall occur on the date upon which: 

(i) any one person, or more than one person acting as a group (as determined under Treas. Reg. 1.409A-3(i)(5)(v)(B)),
acquires (or has acquired during the 12 month period ending on the date of the most recent acquisition by such person or persons) ownership of securities of the Company representing 35% or more of the combined voting power of the Company’s then
outstanding securities; 

  
 20 

 (ii) a majority of the members of the Board is replaced during any 12-month
period by Directors whose appointment or election is not endorsed by a majority of the members of the Board before the date of the appointment or election; or 
 (iii) any one person, or more than one person acting as a group (as determined under Treas. Reg. 1.409A-3(i)(5)(v)(B)), acquires (or has acquired during the 12-month period ending on the date of the most
recent acquisition by such person or persons) assets from the Company that have an aggregate gross fair market value equal to or more than 40 percent of the aggregate gross fair market value of all of the assets of the Company immediately prior to
such acquisition or acquisitions. For this purpose, “gross fair market value” means the value of the assets of the Company, or the value of the assets being disposed of, without regard to any liabilities associated with such assets.

 ARTICLE 9. 
 MISCELLANEOUS PROVISIONS 
 Section 9.1
Non-alienation of Benefits. 
 None of the payments, benefits or rights of the Participant or any
Beneficiary shall be subject to any claim of any creditor other than the Company, and, in particular, to the fullest extent permitted by law, all such payments, benefits and rights shall be free from attachment, garnishment, trustee’s process
or any other legal or equitable process available to any creditor of the Participant or any Beneficiary of the Participant other than the Company. Neither the Participant nor any Beneficiary shall have the right to alienate, anticipate, commute,
pledge, encumber or assign any of the benefits or payments which he or she may expect to receive, contingently or otherwise, under the Plan or the Trust, except that the Participant may designate one or more Beneficiaries as hereinabove provided.
Notwithstanding the foregoing, effective as of the 409A Effective Date, the Trustee, if requested by the Company, or the Company may make “payment” (as defined in this Section 9.1) to an individual who is not a Participant to the
extent such payment is required under the terms of a domestic relations order within the meaning of Section 414(p)(1)(B) of the Code (a “Domestic Relations Order”). Without in any way limiting the generality of the foregoing, the
making of any payment by the Trustee or the Company, as applicable, to an individual who is not a Participant, if made pursuant to the terms of a Domestic Relations Order, shall be construed by all parties as exempt from the prohibitions against
anticipation, assignment, alienation, encumbrance, attachment, garnishment, levy, execution or other legal or equitable process contained herein, but only to the extent required to implement the terms of such Domestic Relations Order with respect to
such payment. For purposes of this Section 9.1, “payment” shall be limited to (i) an actual distribution of cash, in respect of the Participant’s Earnings Sub-Account, (ii) an in-kind distribution of shares of Stock and
(iii), solely for purposes of effectuating a payment described in (i) or (ii), a transfer on the books and records of the Plan of beneficial ownership of all or a portion of the Participant’s benefits under the Plan to the individual(s)
identified in the Domestic Relations Order. Under no circumstances shall the Plan permit any individual(s) identified in a Domestic Relations Order to maintain an Account hereunder. 

  
 21 

 Section 9.2 Terms of Employment. 

Neither the establishment of the Plan nor any modification thereof, nor the creation of any fund, Trust or account, nor
the admission of any person to participation in the Plan, nor the payment of any benefits shall be construed as giving any Employee the right to be retained in the service of the Employer; and each Employee shall remain subject to retention in the
employ of Employer and to discharge from such employ to the same extent and on the same conditions as if the Plan was never adopted. 
 Section 9.3 Severability of Provisions. 
 If any
provision of the Plan is found by a court of competent jurisdiction to be unlawful or unenforceable, such provision shall be deemed null and void, and the balance of the Plan shall continue in full force and effect, as if such unlawful or
unenforceable provision had not been included. 
 Section 9.4 Effect on Other Parties. 

The Plan as set forth herein, and as amended from time to time, shall be binding upon the heirs, executors,
administrators, successors, assigns and other personal representatives of the Participant. 
 Section 9.5
Headings and Captions. 
 The headings and captions herein are provided for reference and convenience
only, shall not be considered part of the Plan and shall not be employed in the construction of the Plan. 

Section 9.6 Gender and Number. 

All provisions in the Plan are intended to be gender-neutral. Accordingly, except where otherwise clearly indicated by
context, the masculine, feminine and neuter form of any word shall include all other gender-designating forms, the singular shall include the plural and vice-versa. 

Section 9.7 Payments to Legally Incapacitated Persons. 

Any benefit payable to or for the benefit of a minor, an incompetent person or other person incapable of effectively
receipting therefor shall be deemed paid when paid to such person’s guardian or to the party providing or reasonably appearing to provide for the care of such person, and such payments shall fully discharge the payor, the Plan Administrator,
the Employer and all other parties with respect thereto. 
 Section 9.8 Reliance on Data and
Consents. 
 The Employer, the Plan Administrator and all other person or entities associated with the
operation of the Plan and the provision of benefits under the Plan, may reasonably rely on the veracity, the accuracy and the completeness of all data provided by the Participant, his or her Beneficiary (or Beneficiaries), and his or her
representatives, including, without limitation, data with respect to age, health and marital status. Furthermore, the Employer and the Plan Administrator with respect to the Plan may reasonably rely on all

  
 22 

 
consents and designations filed under the Plan, regardless of by whom filed, without duty to inquire into the genuineness of any such consent or designation. None of the aforementioned persons or
entities associated with the operation of the Plan, or the benefits provided under the Plan shall have any duty to inquire into any such data, and all may rely on such data being current to the date of presentation, it being the duty of
Participants, Beneficiaries and their respective representatives to advise appropriate parties of any change in such data. 
 Section 9.9 Entire Agreement. 
 This instrument shall
constitute the entire agreement among the parties with respect to the subject matter hereof, and shall supersede all previous understandings on the subject. 
 Section 9.10 Controlling-Law. 
 The Plan shall be
construed and enforced according to the law of the Commonwealth of Pennsylvania to the extent not preempted by Federal law, which shall otherwise control. 
 This Amended and Restated Deferred Compensation Plan is hereby approved and adopted this 18th day of October, 2012. 

 

			
	 HEALTHCARE SERVICES GROUP, INC.

		
	 BY:
	 	 /s/ John C. Shea

		 	 Chief Financial Officer and Secretary

  
 23 

 EXHIBIT “A” 

VALUATION FUNDS 
 Effective as of the Effective Date, the Valuation Funds under the Plan shall include the following: 
  

	 	1.	 American Funds Euro Pacific Growth 

  

	 	2.	 BlackRock Equity Dividend Fund 

  

	 	3.	 BlackRock Global Allocation Fund 

  

	 	4.	 Delaware Emerging Markets Fund 

  

	 	5.	 ING Real Estate Fund 

  

	 	6.	 Ivy High Income Fund 

  

	 	7.	 JP Morgan Government Bond Fund 

  

	 	8.	 JP Morgan Large Cap Growth Fund 

  

	 	9.	 Nuveen Santa Barbara Dividend Growth Fund 

  

	 	10.	 PIMCO Commodity Real Return Strategy Fund 

  

	 	11.	 PIMCO Real Return Fund 

  

	 	12.	 PIMCO Total Return Fund 

  

	 	13.	 Principal MdCap Blend Fund 

  

	 	14.	 Templeton Global Bond Fund 

  

	 	15.	 Wells Fargo Adv Small Cap Value FundOfficers' Certificate and Company Order, dated October 22, 2012, for the 0.850%

 Exhibit 4.1 
 UNITEDHEALTH GROUP INCORPORATED 
 $625,000,000 0.850% Notes due
October 15, 2015 
 Officers’ Certificate and Company Order 

Pursuant to the Indenture, dated as of February 4, 2008 (the “Indenture”), between UnitedHealth Group Incorporated, a
Minnesota corporation (the “Company”), and U.S. Bank National Association, as trustee (the “Trustee”), and resolutions adopted by the Company’s Board of Directors on October 30, 2007, this Officers’ Certificate and
Company Order is being delivered to the Trustee to establish the terms of a series of Securities in accordance with Section 301 of the Indenture, to establish the form of the Securities of such series in accordance with Section 201 of the
Indenture, to request the authentication and delivery of the Securities of such series pursuant to Section 303 of the Indenture and to comply with the provisions of Section 102 of the Indenture. This Officers’ Certificate and Company
Order shall be treated for all purposes under the Indenture as a supplemental indenture thereto. 
 All conditions precedent
provided for in the Indenture relating to (i) the establishment of a series of Securities, (ii) the establishment of the form of Securities of such series and (iii) the procedures for authentication and delivery of such series of
Securities have been complied with. 
 Capitalized terms used herein and not otherwise defined herein shall have the meanings
assigned to them in the Indenture. 
  

	A.	Establishment of a Series of Securities pursuant to Section 301 of the Indenture. 

There is hereby established pursuant to Section 301 of the Indenture a series of Securities which shall have the following terms:

  

	 	(1)	The Securities shall bear the title “0.850% Notes due October 15, 2015” (referred to herein as the “Notes”). 

 

	 	(2)	The aggregate principal amount of the Notes to be issued pursuant to this Officers’ Certificate and Company Order shall be limited to $625,000,000 except for
(a) Notes authenticated and delivered upon registration of, transfer of, or in exchange for, or in lieu of, other Notes pursuant to Section 304, 305, 306, or 1007 of the Indenture, (b) Notes which, pursuant to Section 303 of the
Indenture, are deemed never to have been authenticated and delivered thereunder and (c) any Securities of this series which are issued in the manner contemplated by paragraph 18(a) hereof. 

 

	 	(3)	Interest will be payable to the Person in whose name a Note (or any Predecessor Security) is registered at the close of business on the Regular Record Date (as defined
below) immediately preceding each Interest Payment Date (as defined below). In the event that a payment of principal or interest is due on a date that is not a Business Day (as defined below), the related payment of principal or interest shall be
made on the next succeeding Business Day with the same force and effect as if made on the date such payment was due, and no interest shall accrue on the amount so payable for the period from and after such Interest Payment Date or date of Maturity,
as the case may be. “Business Day” shall mean any day other than a Saturday, a Sunday or a day on which banking institutions in New York, New York or Minneapolis, Minnesota or at the place of payment are authorized or obligated by law,
regulation or executive order to remain closed. 

	 	(4)	The Stated Maturity of the Notes shall be October 15, 2015. 

  

	 	(5)	The Notes shall bear interest at the rate of 0.850% per annum (based upon a 360-day year of twelve 30-day months), from October 22, 2012 or from the most
recent Interest Payment Date to which interest has been paid or duly provided for, as the case may be, payable semi-annually in arrears on April 15 and October 15 in each year, commencing April 15, 2013, until the principal thereof is
paid or made available for payment. Each such April 15 and October 15 shall be an “Interest Payment Date” for the Notes, and each April 1 and October 1 (whether or not a Business Day), as the case may be, immediately
preceding an Interest Payment Date for the Notes shall be the “Regular Record Date” for the interest payable on such Interest Payment Date. 

 The provision related to interest on overdue principal in Section 501 of the Indenture shall not be applicable to the Notes. 

 

	 	(6)	Principal of (and premium, if any) and interest on the Notes will be payable, and, except as provided in Section 305 of the Indenture with respect to a Global
Security (as defined below), the transfer of the Notes will be registrable and Notes will be exchangeable for notes bearing identical terms and provisions at the corporate trust office of U.S. Bank National Association, in St. Paul, Minnesota. The
method of such payment shall be by wire transfer for Notes held in book-entry form or at the option of the Company by check mailed to the Person entitled thereto as shown on the Security Register. 

 

	 	(7)	To the extent not inconsistent with the terms hereof, the redemption provisions set forth in Article IV of the Indenture shall apply to the Notes. The Notes will be
redeemable as follows: 

  

	 	(a)	Optional Redemption. The Notes will be subject to redemption, in whole or in part, at any time before October 15, 2015 (their Stated Maturity), at the
option of the Company at a Redemption Price equal to the greater of (i) 100% of the principal amount of the Notes to be redeemed and (ii) the sum of the present values of the remaining scheduled payments of principal and interest on the
Notes to be redeemed (excluding the portion of any such interest accrued to the Redemption Date) discounted to the Redemption Date on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Yield (as defined
below), plus 10 basis points, plus, in each case, accrued and unpaid interest thereon to, but not including, the Redemption Date. 

 For this purpose, the following terms have the following meanings: 
  

	 	•	 	 “Treasury Yield” means, with respect to any Redemption Date, the rate per year equal to the semi-annual equivalent yield to maturity or
interpolated (on a day-count basis) yield to maturity of the applicable Comparable Treasury Issue, assuming a price for such Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the applicable Comparable Treasury
Price for such Redemption Date. 

  

	 	•	 	 “Comparable Treasury Issue” means the United States Treasury security selected by an Independent Investment Banker appointed by the Trustee
after consultation with the Company as having an actual or interpolated maturity comparable to the remaining term of the Notes being redeemed, or such other maturity that would be utilized at the time of selection and in accordance with customary
financial practice, 

  
 2 

	 	 
in pricing new issues of corporate debt securities of comparable maturity to the remaining term of the Notes being redeemed. 

 

	 	•	 	 “Comparable Treasury Price” means, with respect to any Redemption Date, (i) the average of the Reference Treasury Dealer Quotations for
such Redemption Date, after excluding the highest and lowest such Reference Treasury Dealer Quotations for such Redemption Date, or (ii) if the Trustee obtains fewer than four such Reference Treasury Dealer Quotations, the average of all such
Reference Treasury Dealer Quotations. 

  

	 	•	 	 “Independent Investment Banker” means any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated,
Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo Securities, LLC or their respective successors or, if such firms are unwilling or unable to select the Comparable Treasury Issue, one of the
remaining Reference Treasury Dealers appointed by the Trustee after consultation with the Company. 

  

	 	•	 	 “Reference Treasury Dealer” means (i) any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated,
Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo Securities, LLC or their affiliates and any other primary U.S. Government securities dealer in the United States (a “Primary Treasury
Dealer”) designated by, and not affiliated with, any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells
Fargo Securities, LLC; provided, however, that if J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo
Securities, LLC or any of their respective affiliates shall cease to be a Primary Treasury Dealer, the Company will appoint another Primary Treasury Dealer as a substitute for such entity and (ii) any other Primary Treasury Dealer selected by
the Trustee. 

  

	 	•	 	 “Reference Treasury Dealer Quotations” means, with respect to each Reference Treasury Dealer and any Redemption Date, the average, as
determined by the Trustee, of the bid and asked prices for the applicable Comparable Treasury Issue (expressed, in each case, as a percentage of its principal amount) quoted in writing to the Trustee by such Reference Treasury Dealer at 5:00 p.m. on
the third Business Day preceding such Redemption Date. 

 A notice of redemption may provide that it is
subject to certain conditions that will be specified in the notice. If those conditions are not met, the redemption notice will be of no effect and the Company will not be obligated to redeem the Notes. 

A partial redemption of the Notes may be effected on a pro rata basis (and in such manner as complies with applicable legal and stock
exchange requirements, if any) or in such method as the Trustee, in the exercise of its reasonable discretion, deems fair and appropriate. The Trustee may provide for the selection for redemption of portions in amounts of $1,000 or whole multiples
of $1,000; except that if all of the Notes of a 

  
 3 

 
Holder are to be redeemed, the entire outstanding amount of Notes held by such Holder, even if not a multiple of $1,000, shall be redeemed. 

Notice of any redemption will be mailed at least 30 days but not more than 60 days before the Redemption Date to each Holder of the Notes
to be redeemed. 
 Unless any Note called for redemption shall not be paid upon surrender thereof for redemption, on and after
the Redemption Date interest will cease to accrue on the Notes or portions thereof called for redemption. 
  

	 	(b)	Special Mandatory Redemption. In the event that the Company does not consummate the First Step Amil Acquisition (as defined below) on or prior to March 31,
2013 or if, prior to March 31, 2013, the share purchase agreement with respect to the Amil Acquisition (as defined below) is terminated (each event, a “Special Mandatory Redemption Triggering Event”), the Company will be required to
redeem all of the Notes of this series (the “Special Mandatory Redemption”) on the Special Mandatory Redemption Date (as defined below) at a redemption price equal to 101% of the aggregate principal amount of the Notes of this series (the
“Special Mandatory Redemption Price”), plus accrued and unpaid interest thereon to, but not including, the Special Mandatory Redemption Date, subject to the right of Holders of record as of the close of business on a Regular Record Date to
receive interest due on the related Interest Payment Date. 

 No later than 60 days after the occurrence of the
Special Mandatory Redemption Triggering Event (as such date is determined by the Company in its sole judgment), a notice will be transmitted to each Holder of the Notes of this series, stating, among other matters, that the Special Mandatory
Redemption Triggering Event has occurred and setting forth the Special Mandatory Redemption Date, the Special Mandatory Redemption Price and, to the extent applicable, the other matters set forth in Section 404 of the Indenture. On or prior to
10:00 a.m., Central Time, on the Special Mandatory Redemption Date, the Company will deposit with the Trustee an amount of money sufficient to pay the Special Mandatory Redemption Price of, and (except if the Special Mandatory Redemption Date shall
be an Interest Payment Date) accrued and unpaid interest on, all of the Notes of this series. Notice of redemption having been given as aforesaid, the Notes of this series will, on the Special Mandatory Redemption Date, become due and payable at the
Special Mandatory Redemption Price, and on and after such date (unless the Company shall default in the payment of the Special Mandatory Redemption Price and accrued and unpaid interest) interest will cease to accrue on the Notes of this series.

 The Trustee will have no duty to monitor or determine whether or not the Special Mandatory Redemption Triggering Event has
occurred. The Trustee may conclusively presume that the Special Mandatory Redemption Triggering Event has not occurred unless and until the Company notifies the Trustee in writing that the Special Mandatory Redemption Triggering Event has occurred.

 For purposes of the Special Mandatory Redemption provisions of the Notes of this series, the following terms have the
following meanings: 

  
 4 

	 	•	 	 “Amil Acquisition” means the acquisition by the Company of up to 90% of the outstanding common shares of Amil Participações
S.A. in a two-step transaction. 

  

	 	•	 	 “First Step Amil Acquisition” means the acquisition by the Company of approximately 60% of the outstanding common shares of Amil
Participações S.A. 

  

	 	•	 	 “Special Mandatory Redemption Date” means the 30th day (or if such day is not a Business Day, the first Business Day thereafter) following
the transmission of the notice of Special Mandatory Redemption referred to herein. 

  

	 	(8)	The Company shall not be obligated to redeem or purchase any Notes pursuant to any sinking fund or analogous provisions. 

If a Change of Control Triggering Event (as defined below) occurs, unless the Company has exercised its option to redeem all the Notes of
this series, the Company shall be required to make an offer (a “Change of Control Offer”) to each Holder of the Notes of this series to repurchase all or any part (equal to $2,000 or an integral multiple of $1,000 in excess thereof) of
that Holder’s Notes on the terms set forth herein. In a Change of Control Offer, the Company shall be required to offer payment in cash equal to 101% of the aggregate principal amount of Notes of this series repurchased, plus accrued and unpaid
interest, if any, on the Notes of this series repurchased to, but not including, the date of repurchase (a “Change of Control Payment”). Within 30 days following any Change of Control Triggering Event or, at the Company’s option,
prior to any Change of Control, but after public announcement of the transaction that constitutes or may constitute the Change of Control, a notice shall be transmitted to Holders of the Notes of this series describing the transaction that
constitutes or may constitute the Change of Control Triggering Event and offering to repurchase such Notes on the date specified in the notice, which date shall be no earlier than 30 days and no later than 60 days from the date such notice is
transmitted (a “Change of Control Payment Date”). The notice shall, if transmitted prior to the date of consummation of the Change of Control, state that the offer to purchase is conditioned on the Change of Control Triggering Event
occurring on or prior to the Change of Control Payment Date. 
 In order to accept the Change of Control Offer, the Holder must
deliver to the Paying Agent, at least five Business Days prior to the Change of Control Payment Date, the Holder’s Note together with the form entitled “Election Form” (which form is annexed to the Note) duly completed, or a telegram,
telex, facsimile transmission or a letter from a member of a national securities exchange, or the Financial Industry Regulatory Authority or a commercial bank or trust company in the United States setting forth: 

 

	 	(i)	the name of the Holder of the Note; 

  

	 	(ii)	the principal amount of the Note; 

  

	 	(iii)	the principal amount of the Note to be repurchased; 

  

	 	(iv)	the certificate number or a description of the tenor and terms of the Note; 

 

	 	(v)	a statement that the Holder is accepting the Change of Control Offer; and 

  
 5 

	 	(vi)	a guarantee that the Note, together with the form entitled “Election Form” duly completed, will be received by the Paying Agent at least five Business Days
prior to the Change of Control Payment Date. 

 Any exercise by a Holder of its election to accept the Change of
Control Offer shall be irrevocable. The Change of Control Offer may be accepted for less than the entire principal amount of the Note, but in that event the principal amount of the Note remaining outstanding after repurchase must be equal to $2,000
or an integral multiple of $1,000 in excess thereof. 
 On the Change of Control Payment Date, the Company shall, to the extent
lawful: 
  

	 	(i)	accept for payment all Notes of this series or portions of such Notes properly tendered pursuant to the Change of Control Offer; 

 

	 	(ii)	deposit with the Paying Agent an amount equal to the Change of Control Payment in respect of all Notes of this series or portions of such Notes properly tendered; and

  

	 	(iii)	deliver or cause to be delivered to the Trustee the Notes of this series properly accepted together with an Officers’ Certificate stating the aggregate principal
amount of Notes of this series or portions of such Notes being repurchased. 

 The Company shall not be required to
make a Change of Control Offer upon the occurrence of a Change of Control Triggering Event if a third party makes such an offer in the manner, at the times and otherwise in compliance with the requirements for an offer made by the Company and the
third party purchases all Notes of this series properly tendered and not withdrawn under its offer. In addition, the Company shall not repurchase any Notes of this series if there has occurred and is continuing on the Change of Control Payment Date
an Event of Default under the Indenture, other than a default in the payment of the Change of Control Payment upon a Change of Control Triggering Event. 
 The Company shall comply with the requirements of Rule 14e-1 under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and any other securities laws and regulations thereunder
to the extent those laws and regulations are applicable in connection with the repurchase of the Notes of this series as a result of a Change of Control Triggering Event. To the extent that the provisions of any such securities laws or regulations
conflict with the Change of Control Offer provisions of the Notes of this series, the Company shall comply with those securities laws and regulations and shall not be deemed to have breached its obligations under the Change of Control Offer
provisions of the Notes of this series by virtue of any such conflict. 
 For purposes of the Change of Control Offer provisions
of the Notes of this series, the following terms have the following meanings: 
  

	 	•	 	 “Change of Control” means the occurrence of any of the following: (1) the direct or indirect sale, lease, transfer, conveyance or other
disposition (other than by way of merger or consolidation), in one or more series of related transactions, of all or substantially all of the assets of the Company and its Subsidiaries, taken as a whole, to any person, other than the Company or a
Subsidiary; (2) the consummation of any transaction (including, without limitation, any merger or consolidation) the result of 

  
 6 

	 	 
which is that any person becomes the beneficial owner (as defined in Rules 13d-3 and 13d-5 under the Exchange Act), directly or indirectly, of more than 50% of the Company’s outstanding
Voting Stock or other Voting Stock into which the Company’s Voting Stock is reclassified, consolidated, exchanged or changed, measured by voting power rather than number of shares; (3) the Company consolidates with, or merges with or into,
any person, or any person consolidates with, or merges with or into, the Company, in any such event pursuant to a transaction in which any of the Company’s outstanding Voting Stock or the Voting Stock of such other person is converted into or
exchanged for cash, securities or other property, other than any such transaction where the shares of the Company’s Voting Stock outstanding immediately prior to such transaction constitute, or are converted into or exchanged for, a majority of
the Voting Stock of the surviving person or any direct or indirect parent company of the surviving person immediately after giving effect to such transaction; (4) the first day on which a majority of the members of the Company’s Board of
Directors are not Continuing Directors; or (5) the adoption of a plan relating to the Company’s liquidation or dissolution. Notwithstanding the foregoing, a transaction shall not be deemed to involve a Change of Control under clause
(2) above if (i) the Company becomes a direct or indirect wholly-owned subsidiary of a holding company and (ii)(A) the direct or indirect holders of the Voting Stock of such holding company immediately following that transaction are
substantially the same as the holders of the Company’s Voting Stock immediately prior to that transaction or (B) immediately following that transaction no person (other than a holding company satisfying the requirements of this sentence)
is the beneficial owner, directly or indirectly, of more than 50% of the Voting Stock of such holding company. The term “person,” as used in this definition, has the meaning given thereto in Section 13(d)(3) of the Exchange Act.

  

	 	•	 	 “Change of Control Triggering Event” means the occurrence of both a Change of Control and a Rating Event. 

 

	 	•	 	 “Continuing Directors” means, as of any date of determination, any member of the Company’s Board of Directors who (1) was a member
of such Board of Directors on the date the Notes of this series were issued or (2) was nominated for election, elected or appointed to such Board of Directors with the approval of a majority of the Continuing Directors who were members of such
Board of Directors at the time of such nomination, election or appointment (either by a specific vote or by approval of the Company’s proxy statement in which such member was named as a nominee for election as a director).

  

	 	•	 	 “Fitch” means Fitch, Inc., and its successors. 

 

	 	•	 	 “Investment Grade Rating” means a rating equal to or higher than BBB- (or the equivalent) by Fitch, Baa3 (or the equivalent) by Moody’s
and BBB- (or the equivalent) by S&P, and the equivalent investment grade credit rating from any replacement Rating Agency or Rating Agencies selected by the Company. 

 

	 	•	 	 “Moody’s” means Moody’s Investors Service, Inc., and its successors. 

  
 7 

	 	•	 	 “Rating Agencies” means (1) each of Fitch, Moody’s and S&P; and (2) if any of Fitch, Moody’s or S&P ceases to
rate the Notes of this series or fails to make a rating of such Notes publicly available for reasons outside of the Company’s control, a “nationally recognized statistical rating organization” within the meaning of Rule
15c3-1(c)(2)(vi)(F) under the Exchange Act selected by the Company (as certified by a resolution of the Company’s Board of Directors) as a replacement agency for Fitch, Moody’s or S&P, or all of them, as the case may be.

  

	 	•	 	 “Rating Event” means the rating on the Notes of this series is lowered by each of the three Rating Agencies and the Notes of this series are
rated below an Investment Grade Rating by each of the three Rating Agencies on any day during the period (which period shall be extended so long as the rating of the Notes of this series is under publicly announced consideration for a possible
downgrade by any of the Rating Agencies) commencing on the date of the first public notice of the occurrence of a Change of Control or the Company’s intention to effect a Change of Control and ending 60 days following consummation of such
Change of Control. 

  

	 	•	 	 “S&P” means Standard & Poor’s Rating Services, a division of The McGraw-Hill Companies, Inc., and its successors.

  

	 	•	 	 “Voting Stock” means, with respect to any specified “person” (as that term is used in Section 13(d)(3) of the Exchange Act) as
of any date, the capital stock of such person that is at the time entitled to vote generally in the election of the board of directors of such person. 

  

	 	(9)	The Notes shall not be convertible into shares of Common Stock of the Company or exchangeable for any other securities. 

 

	 	(10)	The Trustee shall be the Security Registrar and the Paying Agent. 

  

	 	(11)	The amount of payments of principal of and any premium or interest on the Notes will not be determined with reference to an index. 

 

	 	(12)	The Notes shall be subject to the covenants and definitions set forth in the Indenture. 

 

	 	(13)	The Notes will be issued only in fully registered form and the minimum initial purchase amounts of the Notes shall be $2,000 and any whole multiples of $1,000 in excess
thereof. 

  

	 	(14)	The Notes shall be subject to the Events of Default specified in Section 701, paragraphs (i) through (vii), of the Indenture. 

 

	 	(15)	The portion of the principal amount of the Notes which shall be payable upon declaration of acceleration of maturity thereof shall not be less than the principal amount
thereof. 

  

	 	(16)	 The Notes shall be “Global Securities” as defined in the Indenture, and shall be deposited with, or on behalf of, The Depository Trust
Company, New York, New York, as Depositary, registered in the name of a nominee of the Depositary. So long as the Depositary or its nominee is the registered holder of any Global Security, the Depositary or its nominee, as the case may be, shall be
considered the sole Holder of the Notes represented by such Global Security for all 

  
 8 

	 	
purposes under the Indenture. The forms and terms of the Notes and the Trustee’s certificate of authentication shall be substantially as set forth on Exhibit B hereto. The terms and
provisions contained in the form of Notes set forth in Exhibit B shall constitute, and are hereby expressly made, a part of the Indenture as supplemented by this Officers’ Certificate and Company Order. 

 

	 	(17)	The defeasance provisions set forth in Article IX of the Indenture shall apply to the Notes. 

 

	 	(18)	The following additional terms shall apply to the Notes: 

  

	 	(a)	Further Issuances. The Company may, so long as no Event of Default has occurred, without the consent of the Holders of the Notes, issue additional notes with the
same terms as the Notes in accordance with the corporate authority existing at the time of such additional issuance, and such additional notes shall be considered part of the same series under the Indenture as the Notes and will vote together with
the Notes as one class on all matters with respect to the Notes. 

  

	 	(b)	Transfer and Exchange. 

  

	 	(i)	The transfer and exchange of Global Securities or beneficial interests therein shall be effected through the Depositary, in accordance with this Officers’
Certificate and Company Order (including applicable restrictions on transfer set forth herein, if any) and the procedures of the Depositary therefor. A transferor of a beneficial interest in a Global Security shall deliver to the Security Registrar
a written order given in accordance with the Depositary’s procedures containing information regarding the participant account of the Depositary to be credited with a beneficial interest in the Global Security. The Security Registrar shall, in
accordance with such instructions, instruct the Depositary to credit to the account of the Person specified in such instructions a beneficial interest in the Global Security and to debit the account of the Person making the transfer the beneficial
interest in the Global Security being transferred. Each Holder of a Security agrees to indemnify the Company and the Trustee against any liability that may result from the transfer, exchange or assignment of such Holder’s Security in violation
of any provision of the Indenture and/or applicable United States federal or state securities law. 

  

	 	(ii)	Each Global Security shall bear the global security legend set forth on Exhibit A hereto. 

 

	 	(19)	The CUSIP number for the global Note is 91324P BX9 and the ISIN number for the global Note is US91324PBX96. 

 

	B.	Establishment of Forms of Securities Pursuant to Section 201 of Indenture. 

It is hereby established, pursuant to Section 201 of the Indenture, that the Global Security representing the Notes shall be
substantially in the form attached as Exhibit B hereto. 
  

	C.	Order for the Authentication and Delivery of Securities Pursuant to Section 303 of the Indenture. 

It is hereby ordered pursuant to Section 303 of the Indenture that the Trustee authenticate, in the manner provided by the Indenture,
the Notes in the aggregate principal amount of $625,000,000 registered in the name of Cede & Co., which Notes have been heretofore duly executed by the proper officers of the 

  
 9 

 
Company and delivered to you as provided in the Indenture, and to deliver said authenticated Notes to or on behalf of The Depository Trust Company on or before 10:30 a.m., Central Standard Time,
on October 22 2012. 
  

	D.	Other Matters. 

 The
Company has provided to the Trustee true and correct copies of resolutions adopted by the Board of Directors of the Company on October 30, 2007, January 18, 2008 and November 2, 2010; such resolutions have not been further
amended, modified or rescinded and remain in full force and effect; and such resolutions (together with this Officers’ Certificate and Company Order) are the only resolutions or other action adopted by the Company’s Board of Directors or
any committee thereof or by any officers of the Company relating to the offering and sale of the Notes. 
 The undersigned
Senior Vice President and Chief Accounting Officer being an Authorized Representative as defined in the resolutions of the Board of Directors of the Company adopted on October 30, 2007 certifies that (i) he has approved the terms of the
Notes as set forth in this Officers’ Certificate and Company Order, (ii) he has approved and ratified the terms and form of the Underwriting Agreement (the “Underwriting Agreement”) and Pricing Agreement (the “Pricing
Agreement”), each dated October 17, 2012, by and among the Company and J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS
Securities LLC and Wells Fargo Securities, LLC, as representatives of the underwriters named in Schedule I to the Pricing Agreement, and (iii) he has approved and ratified the Indenture, all in accordance with the authority of such officer
pursuant to such resolutions. 
 The undersigned have read the pertinent sections of the Indenture including the related
definitions contained therein. The undersigned have examined the resolutions adopted by the Board of Directors of the Company. In the opinion of the undersigned, the undersigned have made such examination or investigation as is necessary to enable
the undersigned to express an informed opinion as to whether or not the conditions precedent to (i) the establishment of the Notes, (ii) the establishment of the forms of the Notes and (iii) the authentication of the Notes, contained
in the Indenture have been complied with. In the opinion of the undersigned, such conditions have been complied with. 
 Simpson
Thacher & Bartlett LLP, Kuai H. Leong, Senior Deputy General Counsel for the Company, and Hogan Lovells US LLP are entitled to rely on this Officers’ Certificate and Company Order in connection with the opinions they are rendering
pursuant to Sections 10(b), 10(c), and 10(d), respectively, of the Underwriting Agreement. 
 [SIGNATURE PAGE TO FOLLOW]

  
 10 

 IN WITNESS WHEREOF, the undersigned have executed this Officers’
Certificate and Company Order this 22nd day of October,
2012. 
  

	
	UNITEDHEALTH GROUP INCORPORATED
	
	/s/ Robert W. Oberrender
	Robert W. Oberrender
	Senior Vice President and Treasurer
	
	/s/ Richard J. Mattera
	Richard J. Mattera
	Senior Deputy General Counsel and Assistant Secretary

 SIGNATURE PAGE TO 2015 NOTES
OFFICERS’ CERTIFICATE AND COMPANY ORDER 

 EXHIBIT A 
 FORM OF LEGENDS 
  

Global Security Legend 

THIS NOTE IS A GLOBAL SECURITY WITHIN THE MEANING OF THE INDENTURE HEREINAFTER REFERRED TO BELOW AND IS REGISTERED IN THE NAME OF A
DEPOSITORY OR A NOMINEE OF A DEPOSITORY. THIS NOTE IS EXCHANGEABLE FOR NOTES REGISTERED IN THE NAME OF A PERSON OTHER THAN THE DEPOSITORY OR ITS NOMINEE ONLY IN THE LIMITED CIRCUMSTANCES DESCRIBED IN THE INDENTURE, AND NO TRANSFER OF THIS NOTE
(OTHER THAN A TRANSFER OF THIS NOTE AS A WHOLE BY THE DEPOSITORY TO A NOMINEE OF THE DEPOSITORY OR BY A NOMINEE OF THE DEPOSITORY TO THE DEPOSITORY OR ANOTHER NOMINEE OF THE DEPOSITORY) MAY BE REGISTERED EXCEPT IN THE LIMITED CIRCUMSTANCES DESCRIBED
IN THE INDENTURE. 
 UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY (55
WATER STREET, NEW YORK, NEW YORK) TO THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME AS REQUESTED BY AN AUTHORIZED
REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY AND ANY PAYMENT IS MADE TO CEDE & CO., ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL SINCE THE REGISTERED OWNER HEREOF, CEDE & CO.,
HAS AN INTEREST HEREIN. 

 EXHIBIT B 
 FORM OF GLOBAL SECURITY 
 [See attached.] 

  
 1 

 THIS NOTE IS A GLOBAL SECURITY WITHIN THE MEANING OF THE INDENTURE HEREINAFTER REFERRED TO BELOW AND IS
REGISTERED IN THE NAME OF A DEPOSITORY OR A NOMINEE OF A DEPOSITORY. THIS NOTE IS EXCHANGEABLE FOR NOTES REGISTERED IN THE NAME OF A PERSON OTHER THAN THE DEPOSITORY OR ITS NOMINEE ONLY IN THE LIMITED CIRCUMSTANCES DESCRIBED IN THE INDENTURE, AND NO
TRANSFER OF THIS NOTE (OTHER THAN A TRANSFER OF THIS NOTE AS A WHOLE BY THE DEPOSITORY TO A NOMINEE OF THE DEPOSITORY OR BY A NOMINEE OF THE DEPOSITORY TO THE DEPOSITORY OR ANOTHER NOMINEE OF THE DEPOSITORY) MAY BE REGISTERED EXCEPT IN THE LIMITED
CIRCUMSTANCES DESCRIBED IN THE INDENTURE. 
 UNLESS THIS CERTIFICATE IS PRESENTED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPOSITORY TRUST
COMPANY (55 WATER STREET, NEW YORK, NEW YORK) TO THE ISSUER OR ITS AGENT FOR REGISTRATION OF TRANSFER, EXCHANGE OR PAYMENT, AND ANY CERTIFICATE ISSUED IS REGISTERED IN THE NAME OF CEDE & CO. OR SUCH OTHER NAME AS REQUESTED BY AN AUTHORIZED
REPRESENTATIVE OF THE DEPOSITORY TRUST COMPANY AND ANY PAYMENT IS MADE TO CEDE & CO., ANY TRANSFER, PLEDGE OR OTHER USE HEREOF FOR VALUE OR OTHERWISE BY OR TO ANY PERSON IS WRONGFUL SINCE THE REGISTERED OWNER HEREOF, CEDE & CO.,
HAS AN INTEREST HEREIN. 
  

					
	REGISTERED	 	 UNITEDHEALTH GROUP
 INCORPORATED
	 	$[         ]
	No. [         ]	 	 0.850% Notes due
 October 15, 2015
	 	 CUSIP No. 91324P BX9

ISIN No: US91324PBX96

 UNITEDHEALTH GROUP INCORPORATED, a Minnesota corporation (hereinafter called the
“Company,” which term includes any successor corporation under the Indenture referred to on the reverse side hereof), for value received, hereby promises to pay to CEDE & CO., or registered assigns, the principal sum of
[            ] Dollars ($[            ]) on October 15, 2015 (the “Stated Maturity”), and to pay interest thereon
from October 22, 2012 or from the most recent date to which interest has been paid or duly provided for, semi-annually in arrears on April 15 and October 15 in each year (each, an “Interest Payment Date”), commencing
April 15, 2013, and at Maturity, at the rate of 0.850% per annum, until the principal hereof is paid or duly made available for payment. Interest on this Note shall be calculated on the basis of a 360-day year consisting of twelve 30-day
months. The interest so payable and punctually paid or duly provided for on any Interest Payment Date shall, as provided in the Indenture, be paid to the Person in whose name this Note (or one or more Predecessor Securities) is registered at the
close of business on the “Regular Record Date” for such interest, which shall be the April 1 or October 1 (whether or not a Business Day, as hereinafter defined) immediately preceding each such Interest Payment Date. Any such
interest which is payable, but is not punctually paid or duly provided for, on any Interest Payment Date shall forthwith cease to be payable to the registered Holder hereof on the relevant Regular Record Date by virtue of having been such Holder,
and may be paid (i) to the Person in whose name this Note (or one or more Predecessor Securities) is registered at the close of business on a Special Record Date for the payment of such Defaulted Interest to be fixed by the Trustee, notice
whereof shall be given to the Holder of this Note not less than 10 days prior to such Special Record Date or (ii) in any other lawful manner not inconsistent with the requirements of any securities exchange on which this Note may be listed, and
upon such notice as may be required by such exchange, if, after notice given by the Company to the Trustee of the proposed payment pursuant to this clause (ii), such manner of payment shall be deemed practicable by the Trustee. In the event that a
payment of principal or interest is due on a 

 
date that is not a Business Day (as defined below), the related payment of principal or interest shall be made on the next succeeding Business Day with the same force and effect as if made on the
date such payment was due, and no interest shall accrue on the amount so payable for the period from and after such Interest Payment Date or date of Maturity, as the case may be. “Business Day” shall mean any day other than a Saturday, a
Sunday or a day on which banking institutions in New York, New York or Minneapolis, Minnesota or at the place of payment are authorized or obligated by law, regulation or executive order to remain closed. 

Payment of the principal of and the interest on this Note will be made at the corporate trust office of U.S. Bank National Association,
in St. Paul, Minnesota, in such coin or currency of the United States of America as at the time of payment is legal tender for payment of public and private debts. The method of such payment shall be by wire transfer for a Note held in book-entry
form or at the option of the Company by check mailed to the Person entitled thereto as shown on the Security Register. Payment of the principal of and interest on this Note due at Maturity will be made in immediately available funds upon
presentation of this Note. 
 Reference is hereby made to the further provisions of this Note set forth on the reverse side
hereof, which further provisions shall for all purposes have the same effect as if set forth at this place. 
 Unless the
certificate of authentication hereon has been executed by or on behalf of the Trustee under the Indenture by the manual signature of one of its authorized signatories, this Note shall not be entitled to any benefits under the Indenture or be valid
or obligatory for any purpose. 
 [SIGNATURE PAGE TO FOLLOW] 

  
 2 

 IN WITNESS WHEREOF, the Company has caused this instrument to be duly executed. 

Dated: October 22, 2012 
  

					
	UNITEDHEALTH GROUP INCORPORATED
		
	By:	 	 
		 	Name:	 	Robert W. Oberrender
		 	Title:	 	Senior Vice President and Treasurer
		
	Attest:	 	 
		 	Name:	 	Richard J. Mattera
		 	Title:	 	Senior Deputy General Counsel and Assistant Secretary

 TRUSTEE’S CERTIFICATE OF 

AUTHENTICATION 
  

			
	This is one of the Securities of the series designated herein and issued pursuant to the within-mentioned Indenture.
	
	Dated: October 22, 2012
	
	U.S. BANK NATIONAL ASSOCIATION,
	as Trustee
		
	By:	 	 
		 	Authorized Signatory

 UnitedHealth Group Incorporated 

2015 Notes 

 [REVERSE SIDE OF NOTE] 

This Note is one of a duly authorized issue of securities of the Company (herein called the “Notes”) issued and to be issued in
one or more series under an indenture, dated as of February 4, 2008, between the Company and U.S. Bank National Association, as trustee (the “Trustee,” which term includes any successor trustee), as further supplemented by an
Officers’ Certificate and Company Order dated October 22, 2012 pursuant to Section 301 of the indenture (together, the “Indenture”) between the Company and the Trustee, to which Indenture and all indentures supplemental
thereto reference is hereby made for a statement of the respective rights, limitations of rights, duties and immunities thereunder of the Company, the Trustee and the Holders of the Notes, and the terms upon which the Notes are, and are to be,
authenticated and delivered. This Note is one of the series designated on the face hereof, limited in initial aggregate principal amount to $625,000,000; provided, however, that the Company may, so long as no Event of Default has occurred and
is continuing, without the consent of the Holders of the Notes of this series, issue additional notes with the same terms as the Notes of this series, and such additional notes shall be considered part of the same series under the Indenture as the
Notes of this series. 
 Optional Redemption 
 This Note is redeemable, in whole or in part, at any time before October 15, 2015 (its Stated Maturity), at the option of the Company at a Redemption Price equal to the greater of (i) 100% of
the principal amount of this Note to be redeemed and (ii) the sum of the present values of the remaining scheduled payments of principal and interest on this Note to be redeemed (excluding the portion of any such interest accrued to the
Redemption Date) discounted to the Redemption Date on a semi-annual basis (assuming a 360-day year consisting of twelve 30-day months) at the Treasury Yield (as defined below), plus 10 basis points, plus, in each case, accrued and unpaid interest
thereon to, but not including, the Redemption Date. 
 For this purpose, the following terms have the following meanings:

  

	 	•	 	 “Treasury Yield” means, with respect to any Redemption Date, the rate per year equal to the semi-annual equivalent yield to maturity or
interpolated (on a day count basis) yield to maturity of the applicable Comparable Treasury Issue, assuming a price for such Comparable Treasury Issue (expressed as a percentage of its principal amount) equal to the applicable Comparable Treasury
Price for such Redemption Date. 

  

	 	•	 	 “Comparable Treasury Issue” means the United States Treasury security selected by an Independent Investment Banker appointed by the Trustee
after consultation with the Company as having an actual or interpolated maturity comparable to the remaining term of this Note being redeemed, or such other maturity that would be utilized at the time of selection and in accordance with customary
financial practice, in pricing new issues of corporate debt securities of comparable maturity to the remaining term of this Note being redeemed. 

  

	 	•	 	 “Comparable Treasury Price” means, with respect to any Redemption Date, (i) the average of the Reference Treasury Dealer Quotations for
such Redemption Date, after excluding the highest and lowest such Reference Treasury Dealer Quotations for such Redemption Date, or (ii) if the Trustee obtains fewer than four such Reference Treasury Dealer Quotations, the average of all such
Reference Treasury Dealer Quotations. 

  
 4 

	 	•	 	 “Independent Investment Banker” means any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated,
Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo Securities, LLC or their respective successors or, if such firms are unwilling or unable to select the Comparable Treasury Issue, one of the
remaining Reference Treasury Dealers appointed by the Trustee after consultation with the Company. 

  

	 	•	 	 “Reference Treasury Dealer” means (i) any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated,
Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo Securities, LLC or their affiliates and any other primary U.S. Government securities dealer in the United States (a “Primary Treasury
Dealer”) designated by, and not affiliated with, any of J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells
Fargo Securities, LLC; provided, however, that if J.P. Morgan Securities LLC, Merrill Lynch, Pierce, Fenner & Smith Incorporated, Goldman, Sachs & Co., Morgan Stanley & Co. LLC, UBS Securities LLC and Wells Fargo
Securities, LLC or any of their respective affiliates shall cease to be a Primary Treasury Dealer, the Company will appoint another Primary Treasury Dealer as a substitute for such entity and (ii) any other Primary Treasury Dealer selected by
the Trustee. 

  

	 	•	 	 “Reference Treasury Dealer Quotations” means, with respect to each Reference Treasury Dealer and any Redemption Date, the average, as
determined by the Trustee, of the bid and asked prices for the applicable Comparable Treasury Issue (expressed, in each case, as a percentage of its principal amount) quoted in writing to the Trustee by such Reference Treasury Dealer at 5:00 p.m. on
the third Business Day preceding such Redemption Date. 

 A notice of redemption may provide that it is
subject to certain conditions that will be specified in the notice. If those conditions are not met, the redemption notice will be of no effect and the Company will not be obligated to redeem this Note. 

A partial redemption of the Notes may be effected on a pro rata basis (and in such manner as complies with applicable legal and stock
exchange requirements, if any) or in such method as the Trustee, in the exercise of its reasonable discretion, deems fair and appropriate. The Trustee may provide for the selection for redemption of portions in amounts of $1,000 or whole multiples
of $1,000; except that if all of the Notes of a Holder are to be redeemed, the entire outstanding amount of Notes held by such Holder, even if not a multiple of $1,000, shall be redeemed. 

Notice of any redemption will be mailed at least 30 days but not more than 60 days before the Redemption Date to each Holder of the Notes
to be redeemed. 
 Unless any Note called for redemption shall not be paid upon surrender thereof for redemption, on and after
the Redemption Date interest will cease to accrue on the Notes or portions thereof called for redemption. 
 This Note will not
be entitled to any sinking fund. 
 Special Mandatory Redemption 

In the event that the Company does not consummate the First Step Amil Acquisition (as defined below) on or prior to March 31, 2013 or
if, prior to March 31, 2013, the share purchase agreement with respect to the Amil Acquisition (as defined below) is terminated (each event, a “Special Mandatory Redemption Triggering Event”), the Company will be required to redeem
all of the Notes of this series (the 

  
 5 

 
“Special Mandatory Redemption”) on the Special Mandatory Redemption Date (as defined below) at a redemption price equal to 101% of the aggregate principal amount of the Notes of this
series (the “Special Mandatory Redemption Price”), plus accrued and unpaid interest thereon to, but not including, the Special Mandatory Redemption Date, subject to the right of Holders of record as of the close of business on a Regular
Record Date to receive interest due on the related Interest Payment Date. 
 No later than 60 days after the occurrence of the
Special Mandatory Redemption Triggering Event (as such date is determined by the Company in its sole judgment), a notice will be transmitted to each Holder of the Notes of this series, stating, among other matters, that the Special Mandatory
Redemption Triggering Event has occurred and setting forth the Special Mandatory Redemption Date, the Special Mandatory Redemption Price and, to the extent applicable, the other matters set forth in Section 404 of the Indenture. On or prior to
10:00 a.m., Central Time, on the Special Mandatory Redemption Date, the Company will deposit with the Trustee an amount of money sufficient to pay the Special Mandatory Redemption Price of, and (except if the Special Mandatory Redemption Date shall
be an Interest Payment Date) accrued and unpaid interest on, all of the Notes of this series. Notice of redemption having been given as aforesaid, the Notes of this series will, on the Special Mandatory Redemption Date, become due and payable at the
Special Mandatory Redemption Price, and from and after such date (unless the Company shall default in the payment of the Special Mandatory Redemption Price and accrued and unpaid interest) interest will cease to accrue on the Notes of this series.

 The Trustee will have no duty to monitor or determine whether or not the Special Mandatory Redemption Triggering Event has
occurred. The Trustee may conclusively presume that the Special Mandatory Redemption Triggering Event has not occurred unless and until the Company notifies the Trustee in writing that the Special Mandatory Redemption Triggering Event has occurred.

 For purposes of the Special Mandatory Redemption provisions of the Notes of this series, the following terms have the
following meanings: 
  

	 	•	 	 “Amil Acquisition” means the acquisition by the Company of up to 90% of the outstanding common shares of Amil Participações
S.A. in a two-step transaction. 

  

	 	•	 	 “First Step Amil Acquisition” means the acquisition by the Company of approximately 60% of the outstanding common shares of Amil
Participações S.A. 

  

	 	•	 	 “Special Mandatory Redemption Date” means the 30th day (or if such day is not a Business Day, the first Business Day thereafter) following
the transmission of the notice of Special Mandatory Redemption referred to herein. 

 Change of Control Offer

 If a Change of Control Triggering Event (as defined herein) occurs, unless the Company has exercised its option to
redeem all the Notes of this series, the Company shall be required to make an offer (a “Change of Control Offer”) to each Holder of the Notes of this series to repurchase all or any part (equal to $2,000 or an integral multiple of $1,000
in excess thereof) of that Holder’s Notes on the terms set forth herein. In a Change of Control Offer, the Company shall be required to offer payment in cash equal to 101% of the aggregate principal amount of Notes of this series repurchased,
plus accrued and unpaid interest, if any, on the Notes of this series repurchased to, but not including, the date of repurchase (a “Change of Control Payment”). Within 30 days following any Change of Control Triggering Event or, at the
Company’s option, prior to any Change of Control, but after public announcement of the transaction that constitutes or may constitute the Change of Control, a 

  
 6 

 
notice shall be transmitted to Holders of the Notes of this series describing the transaction that constitutes or may constitute the Change of Control Triggering Event and offering to repurchase
such Notes on the date specified in the notice, which date shall be no earlier than 30 days and no later than 60 days from the date such notice is transmitted (a “Change of Control Payment Date”). The notice shall, if transmitted prior to
the date of consummation of the Change of Control, state that the offer to purchase is conditioned on the Change of Control Triggering Event occurring on or prior to the Change of Control Payment Date. 

In order to accept the Change of Control Offer, the Holder must deliver to the Paying Agent, at least five Business Days prior to the
Change of Control Payment Date, this Note together with the form entitled “Election Form” (which form is annexed hereto) duly completed, or a telegram, telex, facsimile transmission or a letter from a member of a national securities
exchange, or the Financial Industry Regulatory Authority or a commercial bank or trust company in the United States setting forth: 
 (i) the name of the Holder of this Note; 
 (ii) the principal amount of this Note;

 (iii) the principal amount of this Note to be repurchased; 

(iv) the certificate number or a description of the tenor and terms of this Note; 

(v) a statement that the Holder is accepting the Change of Control Offer; and 

(vi) a guarantee that this Note, together with the form entitled “Election Form” duly completed, will be received by the Paying
Agent at least five Business Days prior to the Change of Control Payment Date. 
 Any exercise by a Holder of its election to
accept the Change of Control Offer shall be irrevocable. The Change of Control Offer may be accepted for less than the entire principal amount of this Note, but in that event the principal amount of this Note remaining outstanding after repurchase
must be equal to $2,000 or an integral multiple of $1,000 in excess thereof. 
 On the Change of Control Payment Date, the
Company shall, to the extent lawful: 
 (i) accept for payment all Notes of this series or portions of such Notes properly
tendered pursuant to the Change of Control Offer; 
 (ii) deposit with the Paying Agent an amount equal to the Change of Control
Payment in respect of all Notes of this series or portions of such Notes properly tendered; and 
 (iii) deliver or cause to be
delivered to the Trustee the Notes of this series properly accepted together with an Officers’ Certificate stating the aggregate principal amount of Notes of this series or portions of such Notes being repurchased. 

The Company shall not be required to make a Change of Control Offer upon the occurrence of a Change of Control Triggering Event if a
third party makes such an offer in the manner, at the times and otherwise in compliance with the requirements for an offer made by the Company and the third party purchases all Notes of this series properly tendered and not withdrawn under its
offer. In addition, the Company shall not repurchase any Notes of this series if there has occurred and is continuing on the Change of Control Payment Date an Event of Default under the Indenture, other than a default in the payment of the Change of
Control Payment upon a Change of Control Triggering Event. 

  
 7 

 The Company shall comply with the requirements of Rule 14e-1 under the Securities Exchange
Act of 1934, as amended (the “Exchange Act”), and any other securities laws and regulations thereunder to the extent those laws and regulations are applicable in connection with the repurchase of the Notes of this series as a result of a
Change of Control Triggering Event. To the extent that the provisions of any such securities laws or regulations conflict with the Change of Control Offer provisions of the Notes of this series, the Company shall comply with those securities laws
and regulations and shall not be deemed to have breached its obligations under the Change of Control Offer provisions of the Notes of this series by virtue of any such conflict. 

For purposes of the Change of Control Offer provisions of the Notes of this series, the following terms are applicable: 

 

	 	•	 	 “Change of Control” means the occurrence of any of the following: (1) the direct or indirect sale, lease, transfer, conveyance or other
disposition (other than by way of merger or consolidation), in one or more series of related transactions, of all or substantially all of the assets of the Company and its Subsidiaries, taken as a whole, to any person, other than the Company or a
Subsidiary; (2) the consummation of any transaction (including, without limitation, any merger or consolidation) the result of which is that any person becomes the beneficial owner (as defined in Rules 13d-3 and 13d-5 under the Exchange Act),
directly or indirectly, of more than 50% of the Company’s outstanding Voting Stock or other Voting Stock into which the Company’s Voting Stock is reclassified, consolidated, exchanged or changed, measured by voting power rather than number
of shares; (3) the Company consolidates with, or merges with or into, any person, or any person consolidates with, or merges with or into, the Company, in any such event pursuant to a transaction in which any of the Company’s outstanding
Voting Stock or the Voting Stock of such other person is converted into or exchanged for cash, securities or other property, other than any such transaction where the shares of the Company’s Voting Stock outstanding immediately prior to such
transaction constitute, or are converted into or exchanged for, a majority of the Voting Stock of the surviving person or any direct or indirect parent company of the surviving person immediately after giving effect to such transaction; (4) the
first day on which a majority of the members of the Company’s Board of Directors are not Continuing Directors; or (5) the adoption of a plan relating to the Company’s liquidation or dissolution. Notwithstanding the foregoing, a
transaction shall not be deemed to involve a Change of Control under clause (2) above if (i) the Company becomes a direct or indirect wholly-owned subsidiary of a holding company and (ii)(A) the direct or indirect holders of the Voting
Stock of such holding company immediately following that transaction are substantially the same as the holders of the Company’s Voting Stock immediately prior to that transaction or (B) immediately following that transaction no person
(other than a holding company satisfying the requirements of this sentence) is the beneficial owner, directly or indirectly, of more than 50% of the Voting Stock of such holding company. The term “person,” as used in this definition, has
the meaning given thereto in Section 13(d)(3) of the Exchange Act. 

  

	 	•	 	 “Change of Control Triggering Event” means the occurrence of both a Change of Control and a Rating Event. 

 

	 	•	 	 “Continuing Directors” means, as of any date of determination, any member of the Company’s Board of Directors who (1) was a member
of such Board of Directors on the date the Notes of this series were issued or (2) was nominated for election, elected or appointed to such Board of Directors with the approval of a majority of the Continuing Directors who were members of

  
 8 

	 	 
such Board of Directors at the time of such nomination, election or appointment (either by a specific vote or by approval of the Company’s proxy statement in which such member was named as a
nominee for election as a director). 

  

	 	•	 	 “Fitch” means Fitch, Inc., and its successors. 

 

	 	•	 	 “Investment Grade Rating” means a rating equal to or higher than BBB- (or the equivalent) by Fitch, Baa3 (or the equivalent) by Moody’s
and BBB- (or the equivalent) by S&P, and the equivalent investment grade credit rating from any replacement Rating Agency or Rating Agencies selected by the Company. 

 

	 	•	 	 “Moody’s” means Moody’s Investors Service, Inc., and its successors. 

 

	 	•	 	 “Rating Agencies” means (1) each of Fitch, Moody’s and S&P; and (2) if any of Fitch, Moody’s or S&P ceases to
rate the Notes of this series or fails to make a rating of such Notes publicly available for reasons outside of the Company’s control, a “nationally recognized statistical rating organization” within the meaning of Rule
15c3-1(c)(2)(vi)(F) under the Exchange Act selected by the Company (as certified by a resolution of the Company’s Board of Directors) as a replacement agency for Fitch, Moody’s or S&P, or all of them, as the case may be.

  

	 	•	 	 “Rating Event” means the rating on the Notes of this series is lowered by each of the three Rating Agencies and the Notes of this series are
rated below an Investment Grade Rating by each of the three Rating Agencies on any day during the period (which period shall be extended so long as the rating of the Notes of this series is under publicly announced consideration for a possible
downgrade by any of the Rating Agencies) commencing on the date of the first public notice of the occurrence of a Change of Control or the Company’s intention to effect a Change of Control and ending 60 days following consummation of such
Change of Control. 

  

	 	•	 	 “S&P” means Standard & Poor’s Rating Services, a division of The McGraw-Hill Companies, Inc., and its successors.

  

	 	•	 	 “Voting Stock” means, with respect to any specified “person” (as that term is used in Section 13(d)(3) of the Exchange Act) as
of any date, the capital stock of such person that is at the time entitled to vote generally in the election of the board of directors of such person. 

 Miscellaneous Provisions 
 If an Event of Default with respect to the
Notes shall occur and be continuing, the principal of the Notes may be declared due and payable in the manner and with the effect provided in the Indenture. 
 The Indenture contains provisions for defeasance at any time of the Company’s obligations in respect of (i) the entire indebtedness of this Note or (ii) certain restrictive covenants with
respect to this Note, in each case upon compliance with certain conditions set forth therein. 
 The Indenture permits, with
certain exceptions as therein provided, the amendment thereof and the modification of the rights and obligations of the Company and the rights of the Holders of the Securities of each 

  
 9 

 
series issued under the Indenture at any time by the Company and the Trustee with the consent of the Holders of not less than a majority in aggregate principal amount of the Securities of all
series at the time Outstanding affected thereby. The Indenture also contains provisions permitting the Holders of specified percentages in aggregate principal amount of the Securities of any series at the time Outstanding to waive certain past
defaults under the Indenture and their consequences. Any such consent or waiver by the Holder of this Note shall be conclusive and binding upon such Holder and upon all future Holders of this Note and of any Notes issued upon the registration of
transfer hereof or in exchange herefor or in lieu hereof, whether or not notation of such consent or waiver is made upon this Note. 
 No reference herein to the Indenture and no provision of this Note or of the Indenture shall alter or impair the obligation of the Company, which is absolute and unconditional, to pay the principal of
(and premium, if any) and interest on this Note, at the time, place and rate, and in the coin or currency, herein and in the Indenture prescribed. 
 As provided in the Indenture and subject to certain limitations set forth therein and in this Note, the transfer of this Note is registrable in the registry books of the Company, upon surrender of this
Note for registration of transfer at the office or agency of the Company where the principal of (and premium, if any) and interest on this Note are payable, duly endorsed, or accompanied by a written instrument of transfer in form satisfactory to
the Company and the Trustee, duly executed by the Holder hereof or by his attorney duly authorized in writing, and thereupon one or more new Notes, of authorized denominations and for the same aggregate principal amount, will be issued to the
designated transferee or transferees. 
 The Notes of this series are issuable only in fully registered form without coupons in
minimal initial purchase amounts of $2,000 and whole multiples of $1,000 in excess thereof. As provided in the Indenture and subject to certain limitations therein set forth, Notes of this series are exchangeable for a like aggregate principal
amount of Notes of this series which are of like tenor for any authorized denomination, as requested by the Holder surrendering the same. 
 No service charge shall be made for any such registration of transfer or exchange, but the Company may require payment of a sum sufficient to cover any tax or other governmental charge payable in
connection therewith, other than in certain cases provided in the Indenture. 
 Prior to due presentment of this Note for
registration of transfer, the Company, the Trustee and any agent of the Company or the Trustee may treat the Person in whose name this Note is registered as the owner hereof for all purposes, whether or not this Note be overdue, and neither the
Company, the Trustee nor any such agent shall be affected by notice to the contrary. 
 This Note shall be governed by and
construed in accordance with the laws of the State of New York, without regard to its conflicts of laws provisions. 
 All
capitalized terms used in this Note which are not defined herein shall have the meanings assigned to them in the Indenture. 

  
 10 

 ASSIGNMENT FORM 
 I or we assign and transfer this Note to 
  

 
  

 
 (Print or type name, address and zip code of
assignee or transferee) 
  
  

(Insert Social Security or other identifying number of assignee or transferee) 
 and irrevocably appoint
                                         
                agent to transfer this Note on the books of the Issuer. The agent may substitute another to act for him. 

 

							
	Dated:
                                         
                   	 		 	Signed:	 	 
		 		 		 	 (Sign exactly as name appears on the other side of this Note)

  

			
		
	Signature Guarantee:	 	 
		 	Participant in a recognized Signature Guarantee Medallion Program (or other signature guarantor program reasonably
acceptable to the Trustee)

  
 11 

 SCHEDULE OF EXCHANGES OF INTERESTS IN THE GLOBAL SECURITY 

Initial Principal Amount at Maturity of Global Security: [            ] Dollars
($[            ]). 
 The following exchanges of a part of this Global Security for
an interest in another Global Security or for a certificated note, or exchanges of a part of another Global Security or certificated note for an interest in this Global Security, have been made: 

 

									
	Date of Exchange	  	
Amount of decrease
 in
 Principal Amount of

this Global Security
	  	
Amount of increase
 in
 Principal Amount of

this Global Security
	  	
Principal Amount of
 this Global Security
 following such

decrease

(or increase)
	  	 Signature of
 authorized officer

of

Trustee or Note
 Custodian

	 	 	 	 	 
	 	  	 	  	 	  	 	  	 
	 	 	 	 	 
	 	  	 	  	 	  	 	  	 
	 	 	 	 	 
	 	  	 	  	 	  	 	  	 

 ELECTION FORM 
 TO BE COMPLETED ONLY IF THE HOLDER 
 ELECTS TO ACCEPT THE CHANGE OF
CONTROL OFFER 
  
  

The undersigned hereby irrevocably requests and instructs the Company to repurchase the within Note (or the portion thereof specified
below), pursuant to its terms, on the Change of Control Payment Date specified in the Change of Control Offer, for the Change of Control Payment specified in the within Note, to the
undersigned,                                , at
                                (please print or typewrite name and address of the
undersigned). 
 For this election to accept the Change of Control Offer to be effective, the Company must receive, at the
address of the Paying Agent set forth below or at such other place or places of which the Company shall from time to time notify the Holder of the within Note, either (i) this Note with this “Election Form” form duly completed, or
(ii) a telegram, telex, facsimile transmission or a letter from a member of a national securities exchange or the Financial Industry Regulatory Authority or a commercial bank or a trust company in the United States setting forth (a) the
name of the Holder of the Note, (b) the principal amount of the Note, (c) the principal amount of the Note to be repurchased, (d) the certificate number or description of the tenor and terms of the Note, (e) a statement that the
option to elect repurchase is being exercised, and (f) a guarantee stating that the Note to be repurchased, together with this “Election Form” duly completed will be received by the Paying Agent five Business Days prior to the Change
of Control Payment Date. The address of the Paying Agent is U.S. BANK NATIONAL ASSOCIATION, 60 Livingston Avenue, EP-MN-WS3C, St. Paul, MN 55107-2292. 
 If less than the entire principal amount of the within Note is to be repurchased, specify the portion thereof (which principal amount must be $2,000 or an integral multiple of $1,000 in excess thereof)
which the Holder elects to have repurchased: $                                .

  
 2

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