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Your Quote
Individual/ Family Plan
Deduc- tible
Coinsu- rance
PCP Office Visit Copay
Diagnostic Services(Lab & X-ray)
Rx Drugs
Monthly Premium
$030%$15$0$10 Generic; $50 Brand$0.00
$25020%20%20%20%$0.00
$1,00020%$0$0$5 Generic; $25 Brand$0.00
$25050%50%50%50%$0.00
$1,30025%25%25%25%$0.00
$2,50020%$10$0$10 Generic; $75 Brand$0.00
$5,00020%$5$0$5 Generic; $50 Brand$0.00
$2,50050%50%50%50%$0.00
$4,00020%20%20%20%$0.00
$6,3500%$450%; $0 for lab services only0%$0.00