Professional Documents
Culture Documents
Certificate of Insurance
Deductible $0, $100, $250, $500, $1,000 or $2,500 per Insured Person, as indicated
on the Declaration
Coinsurance for Eligible Medical Expenses
Coinsurance Plan pays 100% Plan pays 80% Plan pays 100%
• In addition to Deductible Insured pays 0% Insured pays 20% Insured pays 0%
Out of Pocket Maximum $0 $1,000 $0
Pre-certification
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