USA INSURANCENET.COM PREPAIRED FOR: Kitty
H02270101
ONLINE ACCESS CONSECO HEALTH QUOTES
     
QUOTE GOOD FOR: 20 Days POLICY TERM: 12 Months
 
Preparation Date: 02/27/2001
State/Zip: FL/33624
 
NAMES
AGE GENDER SMOKER
1. Ashley 13 FEMALE NO
This quote is valid if "Heart Murmur" IS NOT "ORGANIC".
*Please call 305.387.8920 for more information.
 
..Prescription Drug Card and mail Order Benfits
If your Plan Deductible is................ Your Rx Deductible is
$500 or $750 .................................. $ 100
$1,000, $1,500 or $2,500 .................. $ 250
$5,000 or $10,000 ........................... $ 1,000
   
..Includes initial 12 month rate guarantee.
 
Premium Summary for Conseco Medical Insurance Company's
Classic Choice
****** PPO (Preferred Health Network) Quote ******
PLAN -A- PPO 80/20 of $5,000 COPAY $15 Deduct. $500
Basic Premium $94.26
Optional Benefits $.00
SUBTOTAL: $94.26
Fees: $11.66
TOTAL MONTHLY PREMIUM:
(EFT) $105.92
TOTAL QUARTERLY PREMIUM: $317.77
 
There is a one time $10.00 non-refundable application fee.
 
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customer service:305.387.8920

         
These quotes, dated 02/27/2001, was calculated by Classic Choice Personal Major Medical Proposal System for Windows
version 2.01.00 Actual rates will be the rates in effect on the date the application is signed. All quotes are
subject to verification by Conseco Medical Insurance Co., Schaumburg, IL. [A1.551 Tr1.3216 Cpy1 SRU1 RAdj1
APMF1 PMF1 Lf0 Mat0 D5000/0.515 ]