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' • • <br />~, <br />• INSURANCE <br />PRESENT PLAN 1 <br />SUMMARY OF BENEFITS: <br />$40 room for 30 days <br />All usual hospital services covered in full except blood <br />and plasma <br />ICU in full <br />$500 Surgical Schedule <br />~20~ Anesthesia <br />$5 in-hospital medical for 30 days <br />$300 AIS <br />10/20,000 Major Medical <br />$100 Deductible <br />$50 room allowance <br />Rates effective 2~-Z-75: <br />AMOUNT OF <br />• INCREASE <br />Individual $22.90 + $4.20 $ 2.59 <br />2-Person (Emp. & Spouse) 31.61 9.57 <br />Fam3.ly 40.28 11.76 <br />8pone. 12.91 3.79 <br />!i <br />_._ ._. ~...~a_ :... _. ....... .. .~._._,.,u..._..... a.... _.._ . <br />