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Total Dental, Vision & Hearing Premium
Coverage Type
Maximum Benefit (Per Person)
Deductible Amount
Premium Amount with Incremental Preventive Services Coverage (60% yr. 1; 70% yr. 2; 80% yr. 3; 90% yrs. 4+)
Premium Amount with Full Preventive Services Coverage (100% all yrs.)
$100
$50
$0
$100 Disappearing
Total Lump Sum Cancer Premium
Total Cancer Treatment Premium
$0.00/month
Total Senior Hospital Indemnity Premium
Hospital Confinement (per day)
Hospital Confinement Period (days)
Observation Room
Hospital Admission
Skilled Nursing Facility (per day)
Emergency Room
Ambulance (Ground/Water)
Ambulance (Air)
Total Lump Sum Heart Premium
Total Premium
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