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Individual Health Insurance From Colonial Medical Insurance Company

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					     Individual Health Insurance
                 From
Colonial Medical Insurance Company




                September 27, 2004
             Individual Health Insurance from Colonial Medical Insurance Company




                       Colonial Medical is an innovative      Colonial Medical is a progressive,
                       company focused on providing the       forward thinking organization. We
                       best in international healthcare       are well positioned to deliver
                       that meets the needs of our            international comprehensive health
                       clients. We are part of the            benefits packages through our
                       Colonial Insurance Group – a           Premier Health line of products:
                       prominent composite insurance              Group Health
                       company offering a full range of          Vision
                       insurance products through our             Dental
The Colonial           companies in Bermuda, Bahamas,             Group Life                        A
Group of               Cayman Islands, and the British            Group AD&D                        progressive,
Companies              Virgin Islands. AM Best has                Income Replacement
                                                                                                    forward
                       recognized the Group’s                     -   Short Term Disability
                       performance and stability with an          -   Long Term Disability          thinking
                       A- (excellent) rating.                 Our solid reputation in Bermuda is    organization
                       Our goal is to deliver the best        a result of our proven track record
                       insurance products to our clients in   of client satisfaction. We offer:
                       a cost-effective and service               comprehensive flexible
                       oriented manner. We accomplish             worldwide medical coverage
                       this through our focus on                  with the freedom to choose
                       underwriting and administrative            when, and where you access
                       excellence in Health, Pensions,            care;
                       Property and Casualty, Life and
                                                                 access to the top medical
                       Financial Services.
                                                                 facilities through our
                       The Group’s Medical Companies
                                                                 established preferred provider
                       process a total volume of
                                                                 networks in the US, Canada and
   A winning           approximately 300,000 claims
                                                                 the UK;
  combination:         annually and have a total of
                       approximately 24,000 insured.             24hr/7day worldwide assistance
our client-focused
                                                                 in case of medical emergencies;
 approach backed
 by highly trained                                               a professional customer service
 staff and state-of-                                             department dedicated to
the-art technology                                                                                  A health plan
                                                                 providing assistance on issues
                                                                                                    focused on your
                                                                 or concerns that may arise;
                                                                                                    needs
                                                                 market-leading claims
                                                                 turnaround time averaging 3-5
                                                                 working days;

                                                                 a strong preventative care
                                                                 program.

                                                              Our philosophy is simple: deliver a
                                                              cost effective, easy-to-use,
                                                              comprehensive health package
                                                              that supports client choice and
                                                              fosters wellbeing.
          Individual Health Insurance from Colonial Medical Insurance Company


                            SCHEDULE OF BENEFITS- HEALTH CARE
                             NATURE OF COVER                                         LEVEL OF COVERAGE
A. HEALTH CARE                                                                              COVERED
    Overall Lifetime Maximum Per Insured:                                                US$ 2,000,000
    Insured Persons:                                                               Employee and Dependents


After the satisfaction of the Annual Deductible (or Excess) as shown, Colonial Medical Insurance Company
Limited will reimburse for all covered medical services received, as set forth in this section as follows:
    MEDICAL COVER IN USA                                                                    COVERED
    Insured Persons:                                                               Employee and Dependents
    Percentage of Reasonable and Customary Cost (After Deductible).                   PPO            Non-PPO
Benefits are payable at the percentage shown until the out of pocket limit has        90%             70%
been met.
    MEDICAL COVER IN CANADA                                                                 COVERED
    Insured Persons:                                                               Employee and Dependents
    Percentage of Reasonable and Customary Cost(After deductible) Benefits            PPO            Non-PPO
are payable at the percentage shown until the out of pocket limit has been
met.                                                                                  90%             70%

    PRECERTIFICATION REQUIREMENT
For covered medical services, the insured are required to obtain prior approval    Employee and Dependents
from Colonial Medical Insurance Company Limited for the following treatments
q   Hospitalization
q   Outpatient Surgery (Hospital or Doctor’s Office)
Non-Compliance will result in a reduction of the reimbursement percentage to                  50%
(Please see Certificate Booklet for details)


    MEDICAL COVER WORLDWIDE
                                                                                          COVERED
    (other than USA and Canada)
                                                                                   Employee and Dependents
    Insured Persons:
   Percentage of Reasonable and Customary Cost (Not including the
                                                                                              100%
Deductible).

Once the insured’s coinsurance portion or out-of-pocket expenses requirement, where applicable, has been met,
all subsequent incurred covered expenses are payable at 100% of the allowable maximum charges, same as the
WORLWIDE coverage, for the remainder of that calendar year. For details regarding covered expenses,
reimbursements, limitations and exclusions, please refer to the applicable policy provisions of this certificate
booklet.
        Individual Health Insurance from Colonial Medical Insurance Company


Deductible Options
   Annual Deductibles           Individual:                               US$250        $500         $1,000
                                Family:                                   US$500        $1,000       $2,000

   Annual Out-Of-Pocket Maximum (Includes Deductibles)
                                                                          US$1,000      $2,500       $5,000
                                Individual:
                                                                          US$2,000      $5,000       $10,000
                                Family:


      Room and Board: Hospital's average semi-private charge per day of confinement.
      Maternity Expense: Treated as any other illness with a maximum for normal delivery of $10,000 and
      Caesarean of $12,000.
      Infertility: Procedures directly related to diagnosis are covered. Treatment, prescription drugs,
      and or other methods to bypass (i.e. In-vitro) are not covered.
      Routine Nursery: As any other treatment including room and board, physician charges and
      circumcision for males prior to discharge to a maximum of $25,000 Lifetime.
      Prescription Drugs:                                                                     Name
      Prescription Drug Card in USA                                                  Brand             Generic
      Usage of the Prescriptions Card in the USA, deductible waived, no
      need to file for reimbursement, no claims form to be completed and
                                                                                     80%                 90%
      Plan will pay


      Outside of USA or Non-usage of the Prescription Card will be
      subject to the calendar year deductible and claim forms need to be
      filed for reimbursement for both Brand names and Generic plan
                                                                                               80%
      reimbursement will be


      Expenses for oral contraceptives and contraceptive devices are
      excluded. Expenses for prenatal vitamins and smoking cessation
      products are excluded


      Mental Illness, Alcohol and Drug Abuse*                                      $25,000 Lifetime Maximum
      *In-Patient (In hospital) - Lifetime Mental Illness, Alcohol and Drug
      Abuse Maximum Per Insured subject to Plan Lifetime maximum                             60 Days
       Reimbursement: Mental Illness                                                As any other treatment
                        Alcohol and Drug Abuse                                                 50%
       *Lifetime Mental Illness, Alcohol and Drug Abuse Maximum Per
       Insured (Out-of-Hospital) subject to plan lifetime maximum benefit                    80 Visits
       Reimbursement: Mental Illness                                                As any other treatment
                        Alcohol and Drug Abuse                                                 50%
       *Calendar Year Mental Illness, Alcohol and Drug Abuse Maximum
       (Out-of-Hospital) subject to plan Calendar Year maximum benefit                       15 Visits
       * Does not count towards Annual Out-Of-Pocket Maximum, where
         applicable. Benefits are subject to the Deductible.
     Individual Health Insurance from Colonial Medical Insurance Company


   Skilled Nursing Facility: As any other treatment.
   Home Health Care: As any other treatment up to a US$ 7,500 Lifetime Maximum.
   Chiropractic Services: As any other treatment up to a US$ 750 Calendar Year Maximum.
   Hospice Care Services: As any other treatment up to a US$ 10,000 Lifetime Maximum.
   TMJ Treatment: As any other treatment US$ 1,000 Lifetime Maximum.
   Dental Care: Limited to accidental injury of sound, natural teeth sustained while covered under the
   plan.
PREVENTIVE CARE (Subject to Calendar Year Maximums (CYM) with no deductible and 12 month
Waiting period)
Child Immunizations & Routine Medical Exams: 100% coinsurance not subject to deductible for children
from birth to age 18 for immunization against diphtheria, hepatitis B, measles, mumps, pertussis, polio,
rubella, tetanus, varicella, haemophilus influenza B, and hepatitis A.
Child Preventive Care Services: 100% coinsurance not subject to deductible. Services include: health
history, physical examinations, development assessments, anticipatory guidance, appropriate immunizations
and laboratory tests.
Child Preventive Care is subject to the following limitations:                Calendar Year Maximum
    Child - Birth to age 12 months                                                    US$ 350
    Child -13 months through age 17                                                   US$ 100
    Child - Age 18 to 23 (only if full time student)                                  US$ 200
Adult Routine Physical Exams: 90% coinsurance not subject to the deductible for charges made for or in
connection with the overall health and well being for Employees and Spouses or Domestic Partners age 18
years and over. Calendar Year Maximum US$ 500.
   Papanicolaou Screening Test: Treated like any other illness but not subject to deductible. Up to one
   test per calendar year for all eligible females.
   Prostate Cancer Screening: Treated like any other illness but not subject deductible. One test per
   calendar year for males age 50 or over.
   Mammograms: Treated like any other illness not subject to deductible per the following schedule:
          Ages 35-39: one baseline exam.
          Ages 40-49: one exam every one or two years for asymptomatic women, but no sooner
          than two years after a woman's baseline.
          Age 50 & over: one exam annually.
          Any Age: Whenever prescribed by a physician.
PRE-CERTIFICATION AND PRE-EXISTING CONDITION LIMITATION
   Outside of the United States and Canada, pre-certification is required from Colonial Medical for
   the following treatments.
             - Hospitalization and outpatient surgery
   Within the United States and Canada, pre-certification is required from Colonial Insurance
   Company Limited for all treatments/services with the exception of emergency medical transportation.
    In all cases regardless of location, deductibles apply.
   U.S. and Canada Pre-Admission Certification and Continued Stay Review (PAC/CSR): Will apply with
   penalties for pre-certification non-compliance for U.S./Canada confinements/outpatient surgery.
   Benefits are reduced 50% for any admission (or outpatient surgery) not certified or additional days not
   deemed medically necessary.
            Individual Health Insurance from Colonial Medical Insurance Company

Pre-Existing Condition Limitation: Are waived after the first twelve (12) months of continues coverage
       under the plan. A pre-existing condition is any medical condition the insured received treatments for,
       incurred medical expenses, received a diagnosis from a physician in connection with that injury or sickness
       or taken any prescriptions within twelve (12) months prior to the effective date of the plan.




VISION CARE COVER (subject to a 12 month Waiting Period)                                      COVERED
       Insured Persons:                                                              Employee and Dependents
       Percentage of Reasonable and Customary Cost:                                             100%
       Annual Deductibles           Individual:                                                 None
                                    Family:                                                     None
       Annual Maximum Benefit Per Insured:                                                    US$ 150




   -      MEDICAL EVACUATION AND ASSISTANCE                                                   COVERED
       Insured Persons:                                                              Employee and Dependents
       Lifetime Maximum Benefit Per Insured:                                                US$ 150,000




SPECIAL CONDITIONS:

Coverage in North American (United States and Canada), is limited to 90 days per year. A person must reside
outside of North America in order to be eligible.
        Individual Health Insurance from Colonial Medical Insurance Company


                     SCHEDULE OF BENEFITS - DENTAL AND ORTHODONTIC CARE



                               NATURE OF COVER                           LEVEL OF COVERAGE
B. DENTAL CARE                                                                 COVERED
   Insured Persons:                                                     Employee and Dependents
   Percentage of Reasonable and Customary Cost
       Class I                                                                   100%
                  Diagnostic - General
                  Preventive
       Class II                                                                  80%
                  Restorative (Basic)
                  Endodontics
                  Periodontics
                  Prosthodontics - Removable (Maintenance)
                  Prosthodontics - Fixed Bridge (Maintenance)
                  Oral Surgery
       Class III                                                                 50%
                  Restorative (Major)
                  Prosthodontics - Removable (Installation)
                  Prosthodontics - Fixed Bridge (Installation)
   Class III expenses are not covered during the first six months the
   individual is covered.
   Annual Deductibles              Individuals:                                 US$ 50
                                   Family:                                     US$ 150
   Deductibles do not apply to Class I services
                                   Annual Maximum:                            US$ 1,500




C. ORTHODONTIC COVER (Subject to a 6 month Waiting Period)                     COVERED
   Insured Persons:                                                     Employee and Dependents
   Percentage of Reasonable and Customary Cost:                                  50%
   Annual Deductibles              Individual:                                   None
                                   Family:                                       None
   Lifetime Maximum Benefit Per Insured:                                      US$ 1,500
             Individual Health Insurance from Colonial Medical Insurance Company




HEALTH CARE

PRE-CERTIFICATION
In all cases, Insured Employees are requested to obtain a prior approval from Colonial Insurance for the
following treatments:


    •   Hospitalization and outpatient surgery
    •   Dental crowns, bridges and dentures
    •   Orthodontic work


Pre-Certification is required for the above medical treatments, services and supplies obtained within the
United States and Canada except in the case of local emergency transportation. Failure to follow the Pre-
Certification procedures in the United States or Canada will result in a 50% reduction in the normal payment
(benefit).


Hospitalization, outpatient surgery and medical transportation
    Pre-certification is required in all cases of hospitalization, outpatient surgery, and medical transportation
    (except for local emergency transportation). Plan payments may be reduced up to 50% of normal payment
    if the Insured does not follow the per-certification instructions or if a pre-certification agreement is not
    obtained from Colonial Insurance.


•   When a doctor recommends hospitalization, the Insured should discuss with him whether an alternative
    such as surgery performed on an outpatient basis, skilled nursing care, or home health care might not be
    advisable.


•   The Insured is required to contact Colonial Insurance's pre-certification counselor one or two weeks
    before entering a hospital or undergoing outpatient surgery. The telephone numbers of Colonial Insurance
    are listed on the Insured's Medical Identification Card. If an emergency hospitalization occurs, Colonial
    Insurance must be contacted within 72 hours of admission.
         Individual Health Insurance from Colonial Medical Insurance Company




                                             Policy Provisions


•   When possible, the Insured should take hospital pre-admission X-ray and laboratory tests outside the
    hospital before he is admitted.


•   The Insured should not enter the hospital on Friday or Saturday unless it is an emergency.


•   The Insured should review the hospital bill and inform Colonial Insurance if he finds errors.


•   For elective operations, the Insured Person must obtain a second surgical opinion from Colonial Insurance.
    Elective operations included, but are not restricted to the following:


    •   Coronary bypass
    •   Reconstruction of hip
    •   Surgery of the big toe to correct deformity (including bunion)
    •   Removal of uterus (hysterectomy)
    •   Surgery of the back (laminectomy/fusion)
    •   Removal of knee cartilage
    •   Dilation and curettage
    •   Cataract removal
    •   Surgical removal of hemorrhoids
    •   Removal of prostate (complete or partial)
    •   removal of gall bladder
    •   Bone surgery of the foot
    •   Removal of all or part of the kneecap
    •   Surgical reconstruction of the nose (including submucous resection)
    •   Surgery of tendon sheath (wrist only)
    •   Removal of tonsils and/or adenoids
    •   Surgery of the breast
    •   Hernia repair
    •   Varicose vein surgery


A. Dental treatment and orthodontic work
    The Insured Employee is required to submit the dentist or the orthodontist’s treatment plan to Colonial
    Insurance and to obtain pre-certification of benefits before major work is started.


    Pre-certification of benefits means a review by Colonial Insurance of a dentist's or orthodontist’s planned
    treatment and expected charges. If there is a major change in the treatment plan, a revised plan must be
    sent to Colonial Insurance for review.
          Individual Health Insurance from Colonial Medical Insurance Company




                               MEDICAL EVACUATION AND ASSISTANCE



SCOPE OF COVERAGE
In the event the Policyholder has chosen "COVER”, Colonial Insurance pays 100% of the transportation costs
and medical providers’ fees subject to the exclusions and the instructions specified below.


DESCRIPTION OF SERVICES
The Policy covers for all Insured Persons access to the following services that are delivered by Active Claims
Management on behalf of Colonial Insurance.


    •   Complete 24-hour worldwide assistance, 365 days a year


    •   Access to international Preferred Provider Network: To the extent available Insured Persons will
        access an international provider assistance network. This includes hospitals, clinics, doctors,
        ambulance companies, medical equipment companies. Further, Insured Persons will be directed into
        the insurer’s designated preferred provider network when treatment is based in the United States.
        This offers the opportunity for substantial savings in out-of-pocket expenses for the Insured Person.


    •   Assistance in Locating Local and Appropriate Medical Care: Assistance will be provided in finding the
        most appropriate medical attention with careful consideration given to location, language preference,
        specialty and training. The providers will be continually review and updated.


    •   Evaluation and Close Monitoring of Treatment: Services include access to Medical Advisors (MAs) who
        continually consult with the treating doctors and assess the quality of care and treatment plans. The
        evaluation and monitoring begins with the first call for assistance and continues through the recovery
        period.


    •   Pre-Planning of Medical Support in Remote Areas: If the Insured Person has traveled to an area
        where the quality of medical care is in question, Colonial Insurance will proceed with an analysis of the
        region and devise careful contingency plans.



    •   Emergency Medication, Blood and Vaccine Transfers: If legally permissible, Colonial Insurance will
        coordinate and dispatch medications, vaccines, or blood upon the prescribing physician’s
        authorizations.
     Individual Health Insurance from Colonial Medical Insurance Company




                                         Policy Provisions



•   Facilitation of Hospital Admission: Colonial Insurance will provide insurance verification and other
    requirements to expedite admission into foreign hospitals/clinics and to prevent delay or denials of
    treatment.


•   Pre-Certification: Colonial Insurance will provide verification that treatment is appropriate for
    diagnosis and consistent with plan benefits.


•   Continuous Personal Contacts: Colonial Insurance will provide continuous contacts between the family,
    insurance companies, personal physicians in the home area and the employer.


•   Assistance for an Insured Person Traveling Alone and Hospitalized: Colonial Insurance will assist
    dependent children left unattended as a result of the Insured Person’s illness or accident.


•   Coordination of Direct Payment to Providers: Colonial Insurance will coordinate direct payments to
    providers to ensure prompt treatment is rendered.


•   Translation Services: Multilingual assistance coordinators are available to provide translation
    assistance and can provide referrals to local interpreter services.


•   Emergency International Transfer of Funds: Colonial Insurance will coordinate international transfer
    of funds worldwide.


•   Transportation Assistance to Join Sick or Injured Individuals: Should an Insured Person stranded,
    Colonial Insurance can coordinate arrangements for individuals to join the stranded Insured Person.


•   Evacuation: If an Insured Person is involved in an accident or suffers a sudden illness and adequate
    medical facilities are not available, Colonial Insurance will coordinate a medically supervised evacuation
    to the nearest facility capable of providing adequate care.


•   Medically Supervised Repatriation: If it is determined medically advisable, Colonial Insurance will
    coordinate transportation of the Insured Person to a facility nearer their permanent residence
    following stabilization.


•   Repatriation of Mortal Remains: Colonial Insurance will assist in obtaining the necessary clearances
    for the return of a Plan Participant’s mortal remains and coordinate the return of the body.
          Individual Health Insurance from Colonial Medical Insurance Company




                                              Policy Provisions


To comply with the terms and conditions of the Policy, the Insured Person should contact Colonial Insurance
for pre-authorization before the Insured Person incurs any evacuation and assistance costs at all. If the
Insured Person fails to follow this condition, he will be liable to pay full costs of any transportation. Colonial
Insurance’s contact information is on the Insured Employee’s Medical Identification Card.



EXCLUSIONS
Medical evacuation and repatriation services are not covered when any of the following is the cause for asking
for an evacuation or repatriation:


•   cases of minor illness or injury which can be adequately treated locally and which do not prevent a person
    from continuing his travel or work


•   cases in which an Insured Person is physically able to return to his country of residence as a sitting
    passenger and without medical escort, unless Colonial Insurance accepts them


•   Cases in which an Insured person is under medical treatment at the time of commencing his journey, or if
    the said journey was undertaken against the advice of his treating physician (sudden aggravation of risk),
    as well as any journey undertaken with the intention of obtaining medical treatment abroad


•   Cases of pregnancy, unless unexpected vital complications arise which cannot be treated locally


•   Cases related to consequences of suicide or attempted suicide


•   Cases related to mental diseases that have already been under treatment


•   In the case an Insured Person takes part voluntarily in armed conflicts, whether civil or military, strikes,
    riots or rebellions


•   Cases in which an Insured Person uses drugs other than those prescribed by a physician, as well as
    consequences due to alcohol abuse


•   In the case an Insured Person participates in sporting competitions, rallies of a professional nature, or
    reputed to be dangerous, as well as in the case of an Insured Person’s exercising a profession known to be
    dangerous


•   in any case where Colonial Insurance has not given pre-authorization of the services provided or costs
    incurred.
            Individual Health Insurance from Colonial Medical Insurance Company



                                               Policy Provisions



                                          DENTAL CARE COVER

The expenses described in the three classes below are reimbursed subject to an annual maximum indicated in
the Schedule of Benefits.


DENTAL SERVICES: CLASS I
The Policy pays the percentage of REASONABLE AND CUSTOMARY COST indicated in the Schedule of
Benefits for necessary diagnostic examinations and preventive treatment. Covered expenses include:


•   regular oral examinations and regular x-rays
•   regular teeth cleaning
•   fluoride applications for children under age 19
•   sealant and space maintainers for children under age 16


           Deductibles do not apply to Class I Services.


DENTAL SERVICES: CLASS II
The Policy pays the percentage of REASONABLE AND CUSTOMARY COST indicated in the Schedule of
Benefits for basic restoration, endodontic, periodontal treatments and oral surgery. Covered expenses
include:
•   oral surgery and related anesthesia
•   amalgam fillings
•   extractions
•   endodontic treatment (including root canal therapy)
•   periodontal treatment (gum disease)
•   repair of crowns, inlays, on-lays, bridgework and dentures


DENTAL SERVICES: CLASS III
The Policy pays the percentage of REASONABLE AND CUSTOMARY COST indicated in the Schedule of
Benefits for necessary crowns, bridges and dentures up to a maximum per tooth and a maximum per calendar
year per insured person as recorded in the Schedule of Benefits. Covered expenses include necessary supplies
and services of a physician for installation or replacement of:
•   fixed bridgework
•   partial or full removable dentures
•   crowns
•   inlays, on-lays
•   gold fillings (only to the extent that the tooth cannot be restored with amalgam, silicate acrylic or plastic
    restoration).
Class III expenses are not covered during the first three months the employee is insured. Prior coverage time
credit will apply. Time credit of prior coverage will apply
          Individual Health Insurance from Colonial Medical Insurance Company




                                          ORTHODONTIC COVER


The Benefit described in this section applies only if the Policyholder has chosen Dental cover as recorded in
the Schedule of Benefits.


The Policy pays the percentage of REASONABLE AND CUSTOMARY COST indicated in the Schedule of
Benefits for necessary orthodontic treatment subject to a specific lifetime maximum also indicated in the
Schedule of Benefits. Once this limit is reached, the Insured has no right to any further orthodontic
treatment benefit.


Orthodontic expenses are not covered during the first 3 months the employee is insured.
       Individual Health Insurance from Colonial Medical Insurance Company




                             Individual Medical Plans

   Plan 1 $250 Deductible, 90/10 Coinsurance, $1,000 maximum out of pocket
   Plan 2 $500 Deductible, 90/10 Coinsurance, $2,500 maximum out of pocket
   Plan 3 $1000 Deductible,90/10 Coinsurance, $5,000 maximum out of pocket

Plans 1, 2 and 3 require use of PPO, non use of PPO 70% and no maximum out of
pocket, non pre-certification, 50% no maximum out of pocket. Coverage outside
of USA waives the out of pocket maximum and pays 100% after Deductible
               A Prescription Drug card is issued for plans 1, 2 and 3.

                      Children rate applies to first 3 children.

 Rates are shown on a quarterly and annual basis, but can be billed on a quarterly,
                          semi annual or annual basis.
                                         Annual Premiums

                      Plan 1                            Plan 2                             Plan 3
 Ages         Male          Female               Male          Female                Male         Female
 17-24     $ 1,368.00     $ 2,316.00          $ 1,236.00    $     2,052.00        $ 1,068.00    $ 1,752.00
 25-29      1,476.00        2,736.00           1,320.00        2,424.00            1,164.00       2,052.00
 30-34      1,584.00        2,832.00           1,416.00        2,508.00            1,224.00       2,124.00
 35-39      1,752.00        3,048.00           1,572.00        2,688.00            1,344.00       2,268.00
 40-44      1,956.00        3,252.00           1,740.00        2,868.00            1,500.00       2,424.00
 45-49      2,520.00        3,468.00           2,148.00        3,048.00            1,824.00       2,568.00
 50-54      3,048.00        3,996.00           2,688.00        3,504.00            2,268.00       2,952.00
 55-59      4,200.00        4,248.00           3,696.00        3,732.00            3,096.00       3,120.00
 60-64      5,772.00        5,772.00           5,052.00        5,052.00            4,224.00       4,224.00
 65-69      6,708.00        6,708.00            503.00         6,036.00             429.00        5,148.00
Children             $ 564.00                           $ 540.00                           $ 408.00



                                 Dental Annual

                            Insured                                   $ 348.00
                   Insured plus 1 Dependent                              756.00
                      Insured plus Family                              1,020.00
                     Individual Health Insurance from Colonial Medical Insurance Company


                                        Quarterly Premiums

                      Plan 1                            Plan 2                        Plan 3
 Ages        Male           Female             Male            Female          Male          Female
 17-24     $ 342.00        $ 579.00          $ 309.00         $ 513.00       $ 267.00        $ 438.00
 25-29        369.00          684.00           330.00           606.00         291.00          513.00
 30-34        396.00          708.00           354.00           627.00         306.00          531.00
 35-39        438.00          762.00           393.00           672.00         336.00          567.00
 40-44        489.00          813.00           435.00           717.00         375.00          606.00
 45-49        630.00          867.00           537.00           762.00         456.00          642.00
 50-54        762.00          999.00           672.00           876.00         567.00          738.00
 55-59      1,050.00        1,062.00           924.00           933.00         774.00          780.00
 60-64     1,443.00         1,443.00         1,263.00         1,263.00       1,056.00        1,056.00
 65-69     1,677.00         1,677.00         1,509.00         1,509.00       1,287.00        1,287.00
Children             $ 141.00                           $135.00                       $ 102.00



                                Dental Quarterly

                           Insured                                 $ 85.00
                  Insured plus 1 Dependent                          187.00
                     Insured plus Family                            255.00

				
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