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Traveling to the U.S.

Monthly Premiums
Plan A
($500,000)
Plan B
($1,000,000)
Lite
Accident:$100,000
Sickness: $5,000
Age Annual Deductible Per Certificate:
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
Under age 30
$74
$70
$62
$54
$87
$83
$74
$65
$46
$43
$41
$39
30 - 39
$98
$93
$83
$73
$117
$111
$99
$87
$61
$57
$55
$53
40 - 49
$132
$126
$112
$98
$159
$151
$134
$117
$82
$77
$74
$71
50 - 59
$184
$175
$156
$136
$220
$209
$186
$163
$114
$107
$103
$98
60 - 64
$307
$292
$260
$227
$350
$333
$296
$259
$191
$179
$172
$164
65 - 69
$340
$324
$288
$252
$387
$368
$327
$286
$212
$198
$190
$182
70 - 79 *
$352
$335
$298
$261
N/A
N/A
N/A
N/A
$219
$205
$197
$189
Age 80+ **
$405
$386
$343
$300
N/A
N/A
N/A
N/A
$252
$236
$226
$217
Dependent Child
$35
$33
$29
$26
$41
$39
$35
$31
$22
$21
$20
$19
* The Medical Expense Benefit Limit for ages 70 - 79 is $100,000.
** The Medical Expense Benefit Limit for ages 80+ is $15,000.

15 Day or Less
Plan A
($500,000)
Plan B
($1,000,000)
Lite
Accident:$100,000
Sickness: $5,000
Age Annual Deductible Per Certificate:
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
Under age 30
$40
$39
$35
$32
$48
$46
$42
$39
$24
$23
$22
$20
30 - 39
$54
$51
$47
$43
$64
$61
$56
$52
$32
$31
$30
$28
40 - 49
$73
$69
$63
$58
$87
$83
$76
$70
$46
$42
$41
$38
50 - 59
$101
$96
$88
$81
$121
$115
$105
$97
$63
$57
$54
$53
60 - 64
$169
$161
$147
$135
$192
$183
$168
$154
$102
$95
$93
$87
65 - 69
$187
$178
$163
$150
$213
$203
$185
$170
$114
$107
$102
$99
70 - 79 *
$194
$184
$169
$155
N/A
N/A
N/A
N/A
$118
$111
$106
$101
Age 80+ **
$223
$212
$194
$178
N/A
N/A
N/A
N/A
$135
$127
$122
$117
Dependent Child
$19
$18
$16
$15
$23
$21
$20
$18
$12
$11
$10
$9
* The Medical Expense Benefit Limit for ages 70 - 79 is $100,000.
** The Medical Expense Benefit Limit for ages 80+ is $15,000.

Traveling Outside the U.S.

Monthly Premiums
Plan A
($500,000)
Plan B
($1,000,000)
Lite
Accident:$100,000
Sickness: $5,000
Age Annual Deductible Per Certificate:
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
Under age 30
$62
$59
$52
$46
$74
$71
$63
$55
$41
$38
$36
$35
30 - 39
$76
$72
$64
$56
$90
$86
$76
$67
$50
$46
$44
$43
40 - 49
$81
$77
$68
$60
$97
$92
$82
$72
$53
$50
$47
$46
50 - 59
$119
$113
$100
$88
$142
$135
$120
$105
$78
$73
$70
$67
60 - 64
$196
$187
$166
$145
$225
$214
$190
$166
$129
$121
$115
$111
65 - 69
$217
$207
$184
$161
$247
$235
$209
$183
$143
$134
$128
$123
70 - 79 *
$293
$279
$248
$217
N/A
N/A
N/A
N/A
$192
$180
$172
$166
Age 80+ **
$337
$321
$285
$250
N/A
N/A
N/A
N/A
$221
$207
$198
$191
Dependent Child
$34
$32
$28
$25
$40
$38
$34
$30
$22
$21
$20
$19
* The Medical Expense Benefit Limit for ages 70 - 79 is $100,000.
** The Medical Expense Benefit Limit for ages 80+ is $15,000.

15 Day or Less
Plan A
($500,000)
Plan B
($1,000,000)
Lite
Accident:$100,000
Sickness: $5,000
Age Annual Deductible Per Certificate:
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
$250
$500
$1,000
$2,500
Under age 30
$34
$32
$29
$27
$37
$35
$36
$33
$22
$21
$20
$18
30 - 39
$42
$40
$36
$33
$50
$47
$43
$40
$26
$25
$24
$23
40 - 49
$44
$42
$39
$36
$53
$51
$46
$43
$29
$27
$26
$24
50 - 59
$65
$62
$57
$52
$78
$74
$68
$62
$43
$39
$36
$35
60 - 64
$108
$103
$94
$86
$124
$118
$108
$99
$69
$64
$62
$58
65 - 69
$120
$114
$104
$96
$136
$129
$118
$109
$77
$72
$69
$67
70 - 79 *
$161
$153
$140
$129
N/A
N/A
N/A
N/A
$103
$98
$93
$88
Age 80+ **
$185
$177
$161
$149
N/A
N/A
N/A
N/A
$119
$111
$107
$102
Dependent Child
$19
$18
$16
$15
$22
$21
$19
$18
$12
$11
$10
$9
* The Medical Expense Benefit Limit for ages 70 - 79 is $100,000.
** The Medical Expense Benefit Limit for ages 80+ is $15,000.
Optional Benefit - Hazardous Activity Coverage: Add 20% to the rates below.

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