Plan Group Name

PLAN C

Deductible Coverage Level
Medigap 65 - Maryland  $0.00 100%
Age Gender Individual Parent/Child Hus / Wife Family
0 - 64 B $348.52 N/A N/A N/A
65 - 69 B $151.14 N/A N/A N/A
70 - 74 B $176.99 N/A N/A N/A
75 - 79 B $204.60 N/A N/A N/A
80 - 84 B $235.50 N/A N/A N/A
85 - 149 B $251.73 N/A N/A N/A

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

Rates subject to change without notice