Pacific Cross Insurance Company

MEDICAL PLANS: Health Insurance Plan

PREMIUMS (in US$)											For Renewal Only 61-65
AGE BANDS	0-3	4-18	19-25	26-30	31-35	36-40	41-45	46-50	51-55	56-60	For Renewal Only 61-65
STANDARD MEDICAL PLAN	1,161	1,161	2,091	2,240	2,390	2,539	2,764	2,919	3,423	3,888	4,979
Optional Benefits Private Room	254	254	368	368	414	414	466	466	595	600	692
US$2,000,000 Benefit	200	200	200	200	200	200	200	200	200	200	200
COMPREHENSIVE MEDICAL PLAN	1,990	2,303	3,488	3,640	3,850	4,041	4,302	4,468	5,056	5,569	6,621
Optional Benefit US$3,000,000 Benefit	150	150	150	150	150	150	150	150	150	150	150
ADDITIONAL BENEFIT PLANS
Dental Benefit	300	600	600	600	600	600	600	600	600	600	600
Vision Benefit	165	165	165	165	165	165	165	165	165	165	165
Personal Accident Benefit	Rate for Class 1 Occupation - $1.00 per 1,000 Rate for Class 2 Occupation - $1.25 per 1,000 Rate for Class 3 Occupation is available on request
Travel Benefit	85	85	85	85	85	85	85	85	85	85	85
Rental Car Protection	Not available below age 23					75 for ages 23 to 75

NOTE:

15% geographical loading applies to residents in E.U.Countries and Switzerland.
20% geographical loading applies to residents in Hong Kong.
Geographical loading for North American residents is available on request.
US$2,000,000 and US$3,000,000 benefit options can be renewed up to age 75 and are subject to availability.
Medical premiums for age over 65 are available on request.