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<br />PROXY <br />THE CITY OF NORTH OLMSTED <br />Group # 621634 <br />The Plan Sponsor hereby appoints as its proxy, to act for and on its behalf at any and <br />every annual meeting and special meeting of the members of Medical Mutual of Ohio, <br />the person who is Secretary of such corporation at the time of such annual or special <br />meetings, as the case may be, with power of substitution, and empowers such proxy to <br />vote and act for and on behalf of the Plan Sponsor at each such meeting as fully and to <br />the same extent as the Plan Sponsor could do if personally represented thereat. This <br />proxy shall continue in force until ten years from the date hereof unless sooner revoked <br />by a writing signed by the Plan Sponsor and delivered to Medical Mutual of Ohio. <br />By: <br />Title: <br />Date: <br />CCX0202 Page 14 <br />03 eCityofNorthOlmstedSL <br />090102 <br />