Blue Cross Health Coverage

Monthly Premiums:

Plan Options	Individual	Individual +1	Family
Option 1	$3,776.00	$7,363.00	$8,375.00
Option 2	$2,043.00	$3,984.00	$4,370.00
Option 3	$2,270.00	$4,427.00	$5,064.00

Family Indemnity Plan

The Family Indemnity Plan covers up to six family members with one low premium.

Plans/Options	Premium	Individual Death Benefit
A	$384	$80,000
B	$576	$120,000
C	$720	$150,000
D	$1200	$250,000
E	$1920	$400,000

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• In addition to the member, the persons eligible for coverage include parents/in-laws (not yet 76 years old), spouse/significant other and unmarried children between the ages of 1 and 26
• Each family member is insured for the full amount
• Guaranteed coverage
• No medical questions or exams required