Document:

EX-10.5

 Exhibit 10.5 
 Execution Version 
 AMENDED AND RESTATED EXECUTIVE
NONCOMPETITION AGREEMENT 
 THIS AMENDED AND RESTATED EXECUTIVE NONCOMPETITION AGREEMENT (this
“Agreement”) is made as of March 18, 2012, but effective as of the Closing (as defined in the Purchase Agreement), by and between Communications Infrastructure Investments, LLC (the “Company”), and Dan Caruso,
(the “Executive”). Capitalized terms used herein and not defined shall have the meanings ascribed to them in the Company’s Third Amended and Restated Limited Liability Company Agreement, dated as of the date hereof (as amended
from time to time, the “LLC Agreement”) by and among the Company and the persons named on Schedule A thereto. 

RECITALS 

WHEREAS, the Executive is employed by the Company or one of its Subsidiaries; 

WHEREAS, the Executive and the Company are parties to the Executive Noncompetition Agreement, dated January 5, 2011 (the
“Original Agreement”), which superseded the Executive Noncompetition Agreement, dated December 29, 2010; 

WHEREAS, the Executive has been issued Common Units, and Bear Equity, LLC (“Bear Equity”) has been issued Class B
Preferred Units (“Executive Preferred Units”) on behalf of the Executive; 
 WHEREAS, in order to make
available needed capital in connection with a strategic business acquisition, the Company desires to issue Class C Preferred Units to the 2012 Investors pursuant to the Purchase Agreement; 

WHEREAS, the Executive has substantial knowledge and experience in the Company’s and its Subsidiaries’ businesses and intimate
knowledge of their customers, processes, trade secrets and other business information; 
 WHEREAS, the Executive will benefit
substantially as a result of the 2012 Investors’ investment in the Company, including through the expansion of the Company’s and its Subsidiaries’ businesses as a result of the strategic business acquisition to be financed with the
funds to be invested by the 2012 Investors; and 
 WHEREAS, the 2012 Investors and the other Members wish to protect the value
of their investment in the Company from the risk of competition posed by the Executive and it is a condition to the obligations of the 2012 Investors under the Purchase Agreement that the Original Agreement be amended and restated as set forth
herein; 
 NOW THEREFORE, in consideration of the foregoing, the agreements set forth below, and the parties’ desire to
preserve the value inherent in the Company for their mutual benefit and the benefit of the 2012 Investors and the other Members, the Executive, intending to be legally bound hereby, agrees with the Company as follows: 

[CARUSO NON-COMPETE] 

 1. Definitions. 

“Bear Equity” has the meaning specified in the Preamble to this Agreement. 

“Board” means the Company’s Board of Managers. 

“Cause” means the Executive’s: (i) dishonesty of a material nature with respect to the Company (including, but
not limited to, theft or embezzlement of the Company’s or any of its Subsidiaries’ funds or assets); (ii) conviction of, or guilty plea or no contest plea, to a felony charge or any misdemeanor involving moral turpitude, or the entry
of a consent decree with any governmental body; (iii) noncompliance in any material respect with any laws or regulations, foreign or domestic, affecting the operation of the Company’s or any of its Subsidiaries’ business, if such
noncompliance is likely to have a material adverse effect on the Company or any of its Subsidiaries; (iv) violation of any express direction or any rule, regulation or policy established by the Board that is consistent with the terms of this
Agreement, which violation, if reasonably susceptible to cure, is not cured within ten (10) days of written notice thereof from the Board (or, if such violation cannot feasibly be cured within said 10 day period and the Executive has not cured
such violation within a reasonable amount of time after using best efforts), and if such violation is likely to have a material adverse effect on the Company or any of its Subsidiaries; (v) material breach of this Agreement, which breach, if
reasonably susceptible to cure, is not cured within ten (10) days of written notice thereof from the Board (or, if such material breach cannot feasibly be cured within said 10 day period and the Executive has not cured such material breach
within a reasonable amount of time after using best efforts) or material breach of the Executive’s fiduciary duties to the Company or any of its Subsidiaries; or (vi) gross incompetence, gross neglect, or gross misconduct in the
performance of the Executive’s duties. 
 “Competing Business” means any business engaged in owning or
operating fiber networks. 
 “Executive Preferred Units” has the meaning specified in the Preamble to this
Agreement. 
 “Expiration Date” has the meaning specified in Section 2 of this Agreement. 

“Good Reason” means the occurrence of any of the following events: (A) a substantial adverse change in the nature
or scope of the Executive’s responsibilities, authorities, powers, functions or duties attached to the Executive’s position with the Company or any of its Subsidiaries as of the date of this Agreement; (B) the relocation of the
offices at which the Executive is principally employed to any other location that is more than 75 miles from the current location of such offices; or (C) the Executive’s title as of the date of this Agreement is changed in any manner,
other than as a result of a promotion. Notwithstanding the foregoing, the occurrence of any event specified in paragraphs (A), (B) or (C) shall not be deemed to be “Good Reason” if the Executive fails to voluntarily terminate his
employment under this Agreement within sixty (60) days following such event. 
 “Protected Territory”
shall mean, prior to the Termination Date, the world, and commencing on and after the Termination Date, shall include the United States and any other geographic area in which the Company or any of its Subsidiaries conducts business as of the
Termination Date, or has developed an intention to conduct business in such geographic area on or before the Termination Date and for which the Company or any of its Subsidiaries has prepared or commissioned the preparation of a business plan or
study on or before the Termination Date. 

  
 2 

 “Termination Date” shall mean the date the Executive’s employment with
the Company or any of its Subsidiaries is terminated, whether by the Executive or the Company or any of its Subsidiaries 
 2.
Term. The term of this Agreement shall be for a period commencing on the Closing Date (as defined in the Purchase Agreement) and ending 5 years thereafter (the “Non-Compete Term”) subject to the terms and conditions below.
Notwithstanding the foregoing, in the event the Executive’s employment with the Company or any of its Subsidiaries is terminated by the Company or any of its Subsidiaries for any reason other than for Cause or if the Executive voluntarily
terminates his employment with the Company or any of its Subsidiaries for Good Reason, including, but not limited to, by reason of death or disability, then the term of this Agreement (including all restrictions contained in Section 3) shall
immediately expire and be of no further force or effect. For the avoidance of doubt, in the event the Executive’s employment with the Company or any of its Subsidiaries is terminated by the Company or any of its Subsidiaries for Cause OR if the
Executive voluntarily terminates his employment with the Company or any of its Subsidiaries for any reason other than Good Reason, then the term of this Agreement (including all restrictions contained in Section 3) shall continue in full force
and effect for the full Non-Compete Term referenced above. Notwithstanding the foregoing, in the event (i) prior to an Initial Public Offering, the Company issues additional Common Units (or other profits interests or similar incentive equity
in the Company) and the Executive fails to receive a grant of at least twenty-five percent (25%) of such issuances (without the Executive’s prior approval) or (ii) the Company elects and/or appoints a Chairman of the Board other than
the Executive (without the Executive’s prior approval), then the Executive shall have the right (but not the obligation) to elect one of the following options: (a) if the Executive elects to have full and immediate acceleration of vesting
on all unvested Executive Preferred Units under the Vesting Agreement, dated December 29, 2010, and the Vesting Agreement, dated January 5, 2011, then such accelerated vesting shall immediately occur and the Executive shall remain subject
to all of the terms and conditions of this Agreement for the remainder of the Non-Compete Term referenced above, and (b) if the Executive elects not to have full and immediate acceleration of vesting under such circumstances, then the Executive
shall not thereafter be subject to any of the terms and conditions of this Agreement and this Agreement shall immediately expire and be of no further force and effect and the Original Agreement shall not be reinstated (however, if the Executive
elects this option (b) AND continues to be employed by the Company or any of its Subsidiaries, then the Executive will be subject to the terms and conditions of this Agreement ONLY for so long as the Executive’s employment with the Company
or any of its Subsidiaries continues – after which such restrictions shall immediately expire). If the Executive is going to exercise the referenced election, the Executive must do so within sixty (60) days of the date the Executive fails
to receive a grant of twenty-five percent (25%) of additional Common Units issued by the Company or the Chairman of the Board is elected and/or appointed. For the avoidance of doubt, the above two options are not conditioned on or subject to
the termination of the Executive’s employment with the Company or any of its Subsidiaries. If the Purchase Agreement is terminated by its terms and the LLC Agreement is not in full force and effect, then this Agreement shall terminate and be of
no further force or effect and the Original Agreement shall be reinstated in its entirety. 

  
 3 

 3. Noncompetition and Nonsolicitation. 

(a) Noncompetition. During the term of this Agreement, the Executive agrees that the Executive will not, singly,
jointly, or as a partner, member, employee, agent, officer, director, stockholder, equity holder, lender, consultant, independent contractor, or joint venturer of any other Person, or in any other capacity, directly, indirectly or beneficially
(except (i) as a passive holder of not more than one percent (1%) of the outstanding stock of any company listed on a national securities exchange, or actively traded in a national over-the-counter market, (ii) as a passive
participant in any venture capital fund where his interest therein does not exceed one percent (1%) of the total capital commitments, (iii) as Executive Chairman of EnVysion, (iv) as an employee, manager, director or owner of MCCC ICG
Holdings LLC, or (v) as a director or owner of GTS Group (i.e. Consortium 1 S.a.r.l. and its affiliated companies) (collectively, “Permitted Activities”)), own, manage, operate, join, control, or participate in the ownership,
management, operation or control of, or permit the use of his name by, or work for, or provide consulting, financial or other assistance to, or be connected in any manner with, a Competing Business within the Protected Territory; 

(b) Nonsolicitation; No-hire. During the term of this Agreement, the Executive agrees that the Executive will not,
singly, jointly, or as a partner, member, employee, agent, officer, director, stockholder, equity holder, lender, consultant, independent contractor, or joint venturer of any other Person, or in any other capacity, directly, indirectly or
beneficially induce or attempt to induce (i) any Person which is a customer of the Company or any of its Subsidiaries, or which otherwise is a contracting party with the Company or any of its Subsidiaries, as of the date hereof or at any time
hereafter during the term of this Agreement, to cease doing business with or to terminate, alter or amend any written or oral agreement or understanding with the Company or any of its Subsidiaries, or (ii) any Person which is an employee or
contractor of the Company or any of its Subsidiaries as of the date hereof or at any time hereafter during the term of this Agreement to terminate or otherwise separate their employment or contractor arrangement with the Company or any of its
Subsidiaries, or recruit, solicit or hire any such Person. 
 4. Injunctive Relief. The Executive agrees that the breach
of this Agreement by the Executive will cause irreparable damage to the Company and that in the event of such breach the Company shall have, in addition to any and all remedies of law, the right to an injunction, specific performance or other
equitable relief to prevent the violation of the Executive’s obligations hereunder. The Executive waives any requirement by the Company to provide any bond or other security in connection with such injunction, specific performance or other
equitable relief. 
 5. Amendments; Waiver. Any amendment to or modification of this Agreement, and any waiver of any
provision hereof, shall be in writing and shall require the prior written approval of the Company. Any waiver by the Company of a breach of any provision of this Agreement shall not operate or be construed as a waiver of any subsequent breach
hereof. 

  
 4 

 6. Enforcement. The Company and the Executive agree that the covenants set forth in
this Agreement shall be enforced to the fullest extent permitted by law. Accordingly if, in any judicial or similar proceedings, a court or any similar judicial body shall determine that such covenant is unenforceable because it covers too extensive
a geographical area or survives too long a period of time, or for any other reason, then the parties intend that such covenant shall be deemed to cover only such maximum geographical area and maximum period of time, and shall otherwise be deemed to
be limited in such manner, as will permit enforceability by such court or similar body. The Company and the Executive further agree that covenants set forth in this Agreement are reasonable in all the circumstances for the protection of the
legitimate interests of the Company and its Members. In the event that any one or more of such covenants shall, either taken by itself or themselves together, be adjudged to go beyond what is reasonable in all the circumstances for the protection of
the interests of the Company and its Members, but would be adjudged reasonable if any particular covenant or covenants or parts thereof were deleted, restricted or limited in a particular manner, then the said covenants shall apply with such
deletions, restrictions or limitations, as the case may be. 
 7. Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Delaware applicable to contracts made and to be performed therein. 
 8.
Consent to Jurisdiction. The Executive hereby agrees to submit to the exclusive jurisdiction of the court in and of the State of Delaware and to the courts to which the decisions of appeal of such courts may be taken and consents that service
of process with respect to all courts in and of the State of Delaware may be made by registered mail to Executive’s address set forth on page 1 hereof. 
 9. Successors and Assigns. The Company shall have the right to assign this Agreement to its successors and assigns, and all covenants and agreements hereunder shall inure to the benefit of and be
enforceable by said successors or assigns; provided, however, that the parties hereto agree that in the event of any such assignment by the Company, the phrase “Competing Business” shall, for purposes of being applied to
Executive’s obligations hereunder to the assignee, be limited to the businesses of the Company and its Subsidiaries as of the date of such assignment. 
 10. Captions; Gender and Number. The captions of the sections of this Agreement are for convenience of reference only and in no way define, limit or affect the scope or substance of any section of
this Agreement. The gender and number used in this Agreement are used as reference terms only and shall apply with the same effect whether the parties are of the masculine, neuter or feminine gender, corporate or other form, and the singular shall
likewise include the plural. 
 11. Entire Agreement. This Agreement and each related agreement to which the undersigned
are a party constitute the full and entire understanding and agreement between the parties with regard to the subjects hereof and thereof and supersede all prior agreements and understandings, whether oral or written, with respect thereto and
hereto. 

  
 5 

 12. Original Agreement. Notwithstanding anything in the Agreement to the contrary,
the Original Agreement shall remain in effect in the event the Closing does not occur. 
 [Remainder of page intentionally
left blank] 

  
 6 

 IN WITNESS WHEREOF, this Agreement has been executed as of the date and year first Above
written. 
  

			
	COMPANY:
	
	COMMUNICATIONS INFRASTRUCTURE
	INVESTMENTS, LLC
		
	By:	 	 /s/ Scott Beer

	Name:	 	Scott Beer
	 Title:
	 	General Counsel
	
	EXECUTIVE:
	
	/s/ Dan Caruso
	Dan Caruso

  
 [CARUSO NON-COMPETE]Form of Incentive Compensation Plan Restricted Stock Unit Award Agreement

 EXHIBIT 10.2(T) 

Schedule A 

Notice of Restricted Stock Unit Grant 
  

					
	Participant:	  	[•]
		
	Company:	  	WellPoint, Inc.
		
	Notice:	  	You have been granted the following award of restricted stock units of common stock of the Company in accordance with the terms of the Plan and the attached
Restricted Stock Unit Award Agreement.
		
	Plan:	  	WellPoint Incentive Compensation Plan
		
	Grant:	  	 Grant Date: [•]
 Number of Restricted Stock Units: [•]

		
	Period of Restriction:	  	The Period of Restriction applicable to the number of your Restricted Stock Units listed in the “Shares” column below shall commence on the Grant Date and
shall lapse on the date listed in the “Lapse Date” column below.
			
		  	Shares	  	Lapse Date
		
		  	In the event that a Change of Control (as defined in the Plan) occurs before your Termination, your Restricted Stock Unit Grant will remain subject to the terms of
this Agreement, unless the successor company does not assume the Restricted Stock Unit Grant. If the successor company does not assume the Restricted Stock Unit Grant, then the Period of Restriction shall immediately lapse upon a Change of
Control.
		
	Rejection:	  	If you do not want to accept your Restricted Stock Units, please return this Agreement, executed by you on the last page of this Agreement, at any time within sixty
(60) days after the Grant Date to WellPoint, Inc., 120 Monument Circle, Indianapolis, Indiana 46204, Attention: Stock Administration. Do not return a signed copy of this Agreement if you accept your Restricted Stock Units. If you do not
return a signed copy of this Agreement within sixty (60) days after the Grant Date, you will have accepted your Restricted Stock Units and agreed to the terms and conditions set forth in this Agreement and the terms and conditions of the
Plan.

  
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October 2012 
  

 Restricted Stock Unit Award Agreement 

This Restricted Stock Unit Award Agreement (this “Agreement”) dated as of the Grant Date (the “Grant Date”) set forth
in the Notice of Restricted Stock Unit Grant attached as Schedule A hereto (the “Grant Notice”) is made between WellPoint, Inc. (the “Company”) and the Participant set forth in the Grant Notice. The Grant Notice is included in
and made part of this Agreement. 
 1. Period of Restriction. The Period of Restriction with respect to the Restricted
Stock Units shall be as set forth in the Grant Notice (the “Period of Restriction”). The Participant acknowledges that prior to the expiration of the applicable portion of the Period of Restriction, the Restricted Stock Units may not be
sold, transferred, pledged, assigned, encumbered, alienated, hypothecated or otherwise disposed of (whether voluntary or involuntary or by operation of law by judgment, levy, attachment, garnishment or any other legal or equitable proceedings
(including bankruptcy)). Upon the expiration of the applicable portion of the Period of Restriction described in the attached Grant Notice, the restrictions set forth in this Agreement with respect to the Restricted Stock Units theretofore subject
to such expired Period of Restriction shall lapse and the Shares covered by the related portion of the award shall be delivered, except as may be provided in accordance with Section 10 hereof. 

2. Ownership. Upon expiration of the applicable portion of the Period of Restriction described in the attached Grant Notice, the
Company shall transfer the Shares covered by the related portion of the award to the Participant’s account with the Company’s captive broker. 
 3. Termination. 
 (a) Termination by Company without Cause. If the
Participant’s Termination is by the Company or an Affiliate without Cause (as that term is defined in the WellPoint, Inc. Executive Agreement Plan (the “Agreement Plan”)), the restrictions upon the Restricted Stock shall continue to
lapse throughout the Period of Restriction. 
 (b) Death and Disability. If the Participant’s Termination is due to
death or Disability (for purposes of this Agreement, as defined in the applicable WellPoint Long-Term Disability Plan), then the Period of Restriction shall immediately lapse, causing any restrictions which would otherwise remain on the Restricted
Stock Units to immediately lapse. 
 (c) Other Terminations. Unless Section 3(d) is applicable, if the
Participant’s Termination is by the Company or an Affiliate with Cause (as that term is defined in the Agreement Plan) or by the Participant for any reason other than death or Disability, then all Restricted Stock Units for which the Period of
Restriction had not lapsed prior to the date of such Termination shall be immediately forfeited. 
 (d) Termination after
Change in Control. If after a Change in Control the Participant’s Termination is (i) by the Company or an Affiliate without Cause (for purposes of this Agreement, defined as a violation of “conduct” as such term is defined in
the WellPoint HR Corrective Action Policy and if the Participant participates in the WellPoint, Inc. Executive Agreement Plan (the “Agreement Plan”), the Key Associate Agreement or the Key Sales Associate Agreement also as defined in that
plan or agreement) or (ii), if the Participant participates in the Agreement Plan, by the Participant for Good Reason (as defined in the Agreement Plan), then the Period of Restriction on all Restricted Stock Units shall immediately lapse,
causing any restrictions which would otherwise remain on the Restricted Stock Units to immediately lapse. 
 (e) Clawback
Provision. Notwithstanding any other provisions of this Agreement to the contrary, in the event that the Participant is a non-executive participant in the Agreement Plan or is an Executive (as defined by the Company) at the time of the
Participant’s Termination, regardless of whether the Executive is then a participant in the Agreement Plan, the Restricted Stock Units shall be forfeited if the Participant breaches any provision of Section 3.6 or 3.10 of the Agreement
Plan, in which case the Participant shall be subject to the “Return of Consideration” provision contained in Section 3.7 of the Agreement Plan. 
 4. Transferability of the Restricted Stock Units. The Participant shall have the right to appoint any individual or legal entity in writing, on a Designation of Beneficiary form, as his/her
beneficiary to receive any Restricted Stock Units (to the extent not previously terminated or forfeited) under this Agreement upon the Participant’s death. Such designation under this Agreement may be revoked by the Participant at any time and
a 

  
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new beneficiary may be appointed by the Participant by execution and submission to the Company, or its designee, of a revised Designation of Beneficiary form to this Agreement. In order to be
effective, a designation of beneficiary must be completed by the Participant on the Designation of Beneficiary form and received by the Company, or its designee, prior to the date of the Participant’s death. If the Participant dies without such
designation, the Restricted Stock Units will become part of the Participant’s estate. 
 5. Dividend Equivalents. In
the event the Company declares a dividend on Shares (as defined in the Plan), for each unvested Restricted Stock Unit on the dividend payment date, the Participant shall be credited with a Dividend Equivalent, payable in cash, with a value equal to
the value of the declared dividend. The Dividend Equivalents shall be subject to the same restrictions as the unvested Restricted Stock Units to which they relate. No interest or other earnings shall be credited on the Dividend Equivalents. Subject
to continued employment with the Company and Affiliates, the restrictions with respect to the Dividend Equivalents shall lapse at the same time and in the same proportion as the initial award of Restricted Stock Units. No additional Dividend
Equivalents shall be accrued for the benefit of the Participant with respect to record dates occurring prior to, or with respect to record dates occurring on or after the date, if any, on which the Participant has forfeited the Restricted Stock
Units or any Restricted Stock Units have been settled. For any specified employee, any Dividend Equivalents subject to Code Section 409A and payable upon a termination of employment shall be subject to a six month delay. The Dividend
Equivalents shall be subject to all such other provisions set forth herein, and may be used to satisfy any or all obligations for the payment of any tax attributable to the Dividend Equivalents and/or Restricted Stock Units. 

6. Taxes and Withholdings. Upon the expiration of the applicable portion of the Period of Restriction (and delivery of the
underlying Shares), or as of which the value of any Restricted Stock Units first becomes includible in the Participant’s gross income for income tax purposes, the Participant shall satisfy all obligations for the payment of any tax attributable
to the Restricted Stock Units. The Participant shall notify the Company if the Participant wishes to pay the Company in cash, check or with shares of WellPoint common stock already owned for the satisfaction of any taxes of any kind required by law
to be withheld with respect to such Restricted Stock Units. Any such election made by the Participant must be irrevocable, made in writing, signed by the Participant, and shall be subject to any restrictions or limitations that the Compensation
Committee of the Board of Directors of the Company (“Committee”), in its sole discretion, deems appropriate. If the Participant does not notify the Company in writing at least 14 days prior to the applicable lapse of the Period of
Restriction, the Committee is authorized to take any such other action as may be necessary or appropriate, as determined by the Committee, to satisfy all obligations for the payment of such taxes. Such other actions may include withholding the
required amounts from other compensation payable to the Participant, a sell-to-cover transaction or such other method determined by the Committee, in its discretion. 
 7. No Rights as a Shareholder. The Participant shall have no rights of a shareholder (including, without limitation, dividend and voting rights) with respect to the Restricted Stock Units, for
record dates occurring on or after the Grant Date and prior to the date any such Restricted Stock Units vest in accordance with this Agreement. 
 8. No Right to Continued Employment. Neither the Restricted Stock Units nor any terms contained in this Agreement shall confer upon the Participant any express or implied right to be retained in
the employment or service of the Company or any Affiliate for any period, nor restrict in any way the right of the Company, which right is hereby expressly reserved, to terminate the Participant’s employment or service at any time for any
reason. The Participant acknowledges and agrees that any right to have restrictions on the Restricted Stock Units lapse is earned only by continuing as an employee of the Company or an Affiliate at the will of the Company or such Affiliate, or
satisfaction of any other applicable terms and conditions contained in the Plan and this Agreement, and not through the act of being hired, being granted the Restricted Stock Units or acquiring Shares hereunder. 

9. The Plan. This Agreement is subject to all the terms, provisions and conditions of the Plan, which are incorporated herein by
reference, and to such regulations as may from time to time be adopted by the Committee. Unless defined herein, capitalized terms are as defined in the Plan. In the event of any conflict between the provisions of the Plan and this Agreement, the
provisions of the Plan shall control, and this Agreement shall be deemed to be modified accordingly. The Plan and the prospectus describing the Plan can be found on the Company’s HR intranet. A paper copy of the Plan and the prospectus shall be
provided to the Participant upon the Participant’s written request to the Company at WellPoint, Inc., 120 Monument Circle, Indianapolis, Indiana 46204, Attention: Corporate Secretary, Shareholder Services Department. 

  
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October 2012 
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 10. Compliance with Laws and Regulations. 

(a) The Restricted Stock Units and the obligation of the Company to deliver Shares hereunder shall be subject in all respects to
(i) all applicable Federal and state laws, rules and regulations and (ii) any registration, qualification, approvals or other requirements imposed by any government or regulatory agency or body which the Committee shall, in its discretion,
determine to be necessary or applicable. Moreover, the Company shall not deliver any certificates for Shares to the Participant or any other person pursuant to this Agreement if doing so would be contrary to applicable law. If at any time the
Company determines, in its discretion, that the listing, registration or qualification of Shares upon any national securities exchange or under any state or Federal law, or the consent or approval of any governmental regulatory body, is necessary or
desirable, the Company shall not be required to deliver any certificates for Shares to the Participant or any other person pursuant to this Agreement unless and until such listing, registration, qualification, consent or approval has been effected
or obtained, or otherwise provided for, free of any conditions not acceptable to the Company. 
 (b) The Shares received upon the
expiration of the applicable portion of the Period of Restriction shall have been registered under the Securities Act of 1933 (“Securities Act”). If the Participant is an “affiliate” of the Company, as that term is defined in
Rule 144 under the Securities Act (“Rule 144”), the Participant may not sell the Shares received except in compliance with Rule 144. Certificates representing Shares issued to an “affiliate” of the Company may bear a legend
setting forth such restrictions on the disposition or transfer of the Shares as the Company deems appropriate to comply with Federal and state securities laws. 
 (c) If, at any time, the Shares are not registered under the Securities Act, and/or there is no current prospectus in effect under the Securities Act with respect to the Shares, the Participant shall
execute, prior to the delivery of any Shares to the Participant by the Company pursuant to this Agreement, an agreement (in such form as the Company may specify) in which the Participant represents and warrants that the Participant is purchasing or
acquiring the shares acquired under this Agreement for the Participant’s own account, for investment only and not with a view to the resale or distribution thereof, and represents and agrees that any subsequent offer for sale or distribution of
any kind of such Shares shall be made only pursuant to either (i) a registration statement on an appropriate form under the Securities Act, which registration statement has become effective and is current with regard to the Shares being offered
or sold, or (ii) a specific exemption from the registration requirements of the Securities Act, but in claiming such exemption the Participant shall, prior to any offer for sale of such Shares, obtain a prior favorable written opinion, in form
and substance satisfactory to the Company, from counsel for or approved by the Company, as to the applicability of such exemption thereto. 
 11. Code Section 409A Compliance. Except with respect to Participants who are Retirement eligible or become Retirement eligible before the calendar year containing the second Lapse Date as
shown on the Grant Notice, it is intended that this Agreement meet the short-term deferral exception from Code Section 409A. This Agreement and the Plan shall be administered in a manner consistent with this intent and any provision that would
cause the Agreement or Plan to fail to satisfy this exception shall have no force and effect. 
 12. Notices. All notices
by the Participant or the Participant’s assignees shall be addressed to WellPoint, Inc., 120 Monument Circle, Indianapolis, Indiana 46204, Attention: Stock Administration, or such other address as the Company may from time to time specify. All
notices to the Participant shall be addressed to the Participant at the Participant’s address in the Company’s records. 
 12. Other Plans. The Participant acknowledges that any income derived from the Restricted Stock Units shall not affect the Participant’s participation in, or benefits under, any other benefit
plan or other contract or arrangement maintained by the Company or any Affiliate. 
 13. Recoupment Policy for Incentive
Compensation. The Company’s Recoupment Policy for Incentive Compensation, as may be amended from time to time, shall apply to the Restricted Stock Units, any Shares delivered hereunder and any profits realized on the sale of such Shares to
the extent that the Participant is covered by such policy. If the Participant is covered by such policy, the policy may apply to recoup Restricted Stock Units awarded, any Shares delivered hereunder or profits realized on the sale of such Shares
either before, on or after the date on which the Participant becomes subject to such policy. 

  
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	 	 	WELLPOINT, INC.
			
		 	By:	 	  

		 	Printed:	 	William J. Ryan
		 	Its:	 	Chairman, Compensation Committee
		 		 	WellPoint, Inc. Board of Directors
			
	I DO NOT accept this Restricted Stock Unit:	 		 	
			
	Signature:                            
                                         
                                  	 		 	
			
	Printed
Name:                                        
                                         
              	 		 	Date:                            
                                         
                                         
 

  
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