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| PLAN | EXAM COPAY |
MATERIALS COPAY |
E/L/F/CL |
MATERIALS |
| Silver | $10 | $0 | 12/12/12/12 | $200 allowance every year |
| Gold - MD/GA/SC | $25 | $10 | 12/12/12/12 | $150 allowance every year |
| Gold - TX | $10 | $10 | 12/12/12/12 | $150 allowance every year |
| Gold - AR/MO | $30 | $10 | 12/12/12/12 | $150 allowance every year |
| Platinum | $10 | $10 | 12/12/12/12 | $150 allowance every year |
PLEASE NOTE: BENEFIT INFORMATION HAS CHANGED FOR 2008.
MATERIALS CO-PAY IS IN ADDITION TO THE MEMBER'S MATERIAL ALLOWANCE