Plans Marketed for 8/01/2007 Effective Dates and After
   
PPO Plans - 8/01/07   PPO Plans - 6/01/08
PPO 08 100/70 ChoicePOS 08 100/70
PPO 08 90/60 ChoicePOS 08 90/60
PPO 08 80/50 ChoicePOS 08 80/50
   
CoverageFirst Plans - 8/01/07   CoverageFirst Plans - 6/01/08
CoverageFirst 08 100/70 CoverageFirst 08 Choice POS 100/70
CoverageFirst 08 80/50 CoverageFirst 08 Choice POS 80/50
   
High Deductible Health Plans - 8/01/07   High Deductible Health Plans - 6/01/08
HDHP 08 100/70 HDHP 08 Choice POS 100/70
HDHP 08 90/60 HDHP 08 Choice POS 90/60
HDHP 08 80/50 HDHP 08 Choice POS 80/50
   
HMO   Vision - 6/01/08
HMO Plan 2 Option 72 Vision Optimum
HMO Plan 2 Option 80 Vision Focus
HMO Plan 75 Option 001 Vision Advantage
HMO Plan 75 Option 002  
HMO Plan 75 Option 003 Dental - 6/01/08
HMO Plan 75 Option 004 Dental Traditional Preferred
HMO Plan 75 Option 005 Dental PPO
HMO Plan 75 Option 006  
   
Drug Cards   PPO Riders
$10/$20/$40 Rx3 PPO PPO 24 Hour Coverage
$10/$20/$40/25% Rx4 PPO PPO 500 Supplemental Accident Rider
$10/$30/$50/25% Rx4 PPO PPO Deductible Carry-over Rider
$10/$35/$55/25% Rx4 PPO PPO Vision Plan 471
$30/$20/$10/$0 RxImpact  
$5/$15/$35/25% HMO Drug Card  
$10/$20/$40/25% HMO Drug Card  
$10/$25/$45/25% HMO Drug Card  
   
   
Plans Marketed Before 7/31/2007
Coverage First PPO 02 100 70 Standard Copay 100 70
Coverage First PPO 02 80 60 Standard Copay 70 50
High Deductible Health Plan 100 70

Standard Copay 80 50

High Deductible Plan 80 50 Standard Copay 90 60
High Deductible Plan 90 60 Standard Copay Value 100 70
HMO Plan 2 Opt 72 Standard Copay Value 80 50
HMO Plan 75 Opt 001 Standard Copay Value 90 60
HMO Plan 75 Opt 002 Standard PCA Coinsurance 100 70
HMO Plan 75 Opt 003 Standard PCA Coinsurance 80 50
HMO Plan 75 Opt 004 Standard PCA Coinsurance 90 60
HMO Plan 75 Opt 005 Standard PCA Coinsurance Value 100 70
HMO Plan 75 Opt 006 Standard PCA Coinsurance Value 90 60
PPO Rx 10-20-40-25  
PPO Rx 10-25-45-25  
PPO Rx 10-30-50-25  
PPO Rx 10-35-55-25  
PPO Rx 10-20-40  
PPO Rx Impact Grid Sheet