 | Physician Office Visits |  | Diagnostic Testing |  | Hospitalization |  | Surgery | Inpatient |  | Outpatient |
|  | Anesthesia |  | Prescription Drug Discounts * |  | Insured Generic Drug Coverage Available |  | Accident Medical Expense |  | Emergency Room |  | Rehabilitation Facilities |  | Wellness Benefits |  | Maternity Included |  | AD&D |  | Vision Care |  | Optional Dental Plan Available |  | 24 Hour Nurse Hotline * |
|  | Guaranteed Issue For Eligible Employees & Dependents |  | No Participation Requirements |  | First Dollar Coverage - No Deductibles Or Coinsurance |  | Includes PPO Network Access * - No Penalties For Using Non-Network Providers |  | Employer Determines Class(es) Of Eligible Employees |  | No Coordination Of Benefits |  | 6 Month Pre-Existing Conditions Limitation - Applies To Hospitalization And Surgery Only |  | Benefits Are Assignable |  | Employer Can Pay Some, All Or None Of The Premium |
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