Plan Group Name

PLAN A

Deductible Coverage Level
Medigap 65 - Maryland  $1,123.00 100%
Age Gender Individual Parent/Child Hus / Wife Family
0 - 64 B $133.42 N/A N/A N/A
65 - 69 B $105.30 N/A N/A N/A
70 - 74 B $123.31 N/A N/A N/A
75 - 79 B $142.53 N/A N/A N/A
80 - 84 B $164.06 N/A N/A N/A
85 - 149 B $175.40 N/A N/A N/A

Legend: M = Male, F = Female, B = Both

Rates subject to change without notice