GENERAL MAJOR MEDICAL BENEFITSMaximum Lifetime Benefit

For Active Members Ages 50-59 (Annual Maximum - $175,000

For Active Members Ages 60-65 (Annual Maximum - $125,000)

For Active Members Ages 66 & over (Annual Maximum - $100,000)

Benefit Period

Internal Plan Limits per insured Aids or Aids related IllnessesTransplants for Members Ages 50-59Transplants for Members Ages 60-65Transplants for Members Ages 66 & overCongenital Disorders (New Born)

Deductible per Calendar YearPer each individual insuredPer Family

Carry over Provision

Co-insurance payment: Local Benefitper calendar year Thereafter to the maximum

Co-insurance Payment: Overseas BenefitPre-certified overseas treatment within Managed Care Network (within the Caribbean and Colombia)

Emergency treatment (within the Caribbean and Colombia)

Pre-certified overseas treatment outside of Managed Care Network (within the Caribbean and Colombia)

Not approved or Not Pre-Certified

Pre-existing Condition (Maximum per Disability)Limitation Period

Hospital Room & BoardLocal (Caricom)Overseas (Non-Caricom)

Intensive Care Room & BoardLocal (Caricom)

Overseas (Non-Caricom)

Private Duty NursingMaximum per 8-hour shift - in private residence (Day)Maximum per 8-hour shift - in hospital (Night)Maximum per 8-hour shift - in private residence (Night)

Physiotherapy and other Health-care Professional GroupsMaximum per Treatment

Maximum Treatment per calendar year

Doctors' Visits

Office

Home

Hospital

Specialist Visit by Referral Only (Cardiologist & Gynaecologiests are excluded from the referral requirement)

Maximum Visits per calendar year

Emergency Doctor's Visits Benefit (Home & Hospital)Local Ground Ambulance

Other Hospital Services

Miscellaneous Expense

Surgical Expense

Prescription DrugsAnnual Maximum

Diagnostic ExpenseAnnual Maximum

Medical Air Transportation Benefit (Economy Airfare)Maximum trips per Calendar Year

BENEFIT MAXIMUMS/LIMITS

$500,000.00

$500,000.00

$200,000.00

Lifetime

Preventative Care Benefits Annual Maximum - MembersAnnual Maximum - Spouses

The below procedures/tests are eligible for reimbursement under Preventative Care up to the above limits for Members & Spouses

Annual Physical for MEMBERS ONLY, includinga) Blood Pressure Checkb) Respiratory Checkc) Complete Urinalysis

Blood Profile, includingi) Fasting Blood Sugarii) Total Cholesterol Checkiii) Haemoglobiniv) Estimated Sedimentation Rate (ESR) Test

Annual Gynaecological and Pap Smear test for each female member or spouse of a male member

Annual Mammogram for each female member or spouse of male member age 50 and over

Annual Protology/Prostate inclusive of PSA test Examination for each male member or spouse of female member age 50 and over

DENTAL BENEFITSMaximum per calendar yearDeductible per calendar yearLevel 1 - PreventativeLevel 2 - RestorativeLevel 3 - Major Restorative

VISION BENEFITSMaximum per calendar yearDeductible per calendar yearBenefit payment

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Contact us: barp@lynchbrokers.com or (246) 230-5051

GENERAL MAJOR MEDICAL BENEFITSMaximum Lifetime Benefit

For Active Members Ages 50-59 (Annual Maximum - $175,000

For Active Members Ages 60-65 (Annual Maximum - $125,000)

For Active Members Ages 66 & over (Annual Maximum - $100,000)

Benefit Period

Internal Plan Limits per insured Aids or Aids related IllnessesTransplants for Members Ages 50-59Transplants for Members Ages 60-65Transplants for Members Ages 66 & overCongenital Disorders (New Born)

Deductible per Calendar YearPer each individual insuredPer Family

Carry over Provision

Co-insurance payment: Local Benefitper calendar year Thereafter to the maximum

Co-insurance Payment: Overseas BenefitPre-certified overseas treatment within Managed Care Network (within the Caribbean and Colombia)

Emergency treatment (within the Caribbean and Colombia)

Pre-certified overseas treatment outside of Managed Care Network (within the Caribbean and Colombia)

Not approved or Not Pre-Certified

Pre-existing Condition (Maximum per Disability)Limitation Period

Hospital Room & BoardLocal (Caricom)Overseas (Non-Caricom)

Intensive Care Room & BoardLocal (Caricom)

Overseas (Non-Caricom)

Private Duty NursingMaximum per 8-hour shift - in private residence (Day)Maximum per 8-hour shift - in hospital (Night)Maximum per 8-hour shift - in private residence (Night)

Physiotherapy and other Health-care Professional GroupsMaximum per Treatment

Maximum Treatment per calendar year

Doctors' Visits

Office

Home

Hospital

Specialist Visit by Referral Only (Cardiologist & Gynaecologiests are excluded from the referral requirement)

Maximum Visits per calendar year

Emergency Doctor's Visits Benefit (Home & Hospital)Local Ground Ambulance

Other Hospital Services

Miscellaneous Expense

Surgical Expense

Prescription DrugsAnnual Maximum

Diagnostic ExpenseAnnual Maximum

Medical Air Transportation Benefit (Economy Airfare)Maximum trips per Calendar Year

$50,000.00$250,000.00$125,000.00$125,000.00$150,000.00

$750.002

Last 3 months of the calendar year

75% on 1st $ 50,000.00100%

80% on the 1st $50,000.00, 100% thereafter

80% on the 1st $50,000.00, 100% thereafter

75% on the 1st $200,000.00, 100% thereafter

40% - no stop loss will apply

$750.00

12 months

$400.00$2,000.00

2.5 times Average Semi-Private Room Rate

2.5 times Average Semi-Private Room Rate

Preventative Care Benefits Annual Maximum - MembersAnnual Maximum - Spouses

The below procedures/tests are eligible for reimbursement under Preventative Care up to the above limits for Members & Spouses

Annual Physical for MEMBERS ONLY, includinga) Blood Pressure Checkb) Respiratory Checkc) Complete Urinalysis

Blood Profile, includingi) Fasting Blood Sugarii) Total Cholesterol Checkiii) Haemoglobiniv) Estimated Sedimentation Rate (ESR) Test

Annual Gynaecological and Pap Smear test for each female member or spouse of a male member

Annual Mammogram for each female member or spouse of male member age 50 and over

Annual Protology/Prostate inclusive of PSA test Examination for each male member or spouse of female member age 50 and over

DENTAL BENEFITSMaximum per calendar yearDeductible per calendar yearLevel 1 - PreventativeLevel 2 - RestorativeLevel 3 - Major Restorative

VISION BENEFITSMaximum per calendar yearDeductible per calendar yearBenefit payment

GENERAL MAJOR MEDICAL BENEFITSMaximum Lifetime Benefit

For Active Members Ages 50-59 (Annual Maximum - $175,000

For Active Members Ages 60-65 (Annual Maximum - $125,000)

For Active Members Ages 66 & over (Annual Maximum - $100,000)

Benefit Period

Internal Plan Limits per insured Aids or Aids related IllnessesTransplants for Members Ages 50-59Transplants for Members Ages 60-65Transplants for Members Ages 66 & overCongenital Disorders (New Born)

Deductible per Calendar YearPer each individual insuredPer Family

Carry over Provision

Co-insurance payment: Local Benefitper calendar year Thereafter to the maximum

Co-insurance Payment: Overseas BenefitPre-certified overseas treatment within Managed Care Network (within the Caribbean and Colombia)

Emergency treatment (within the Caribbean and Colombia)

Pre-certified overseas treatment outside of Managed Care Network (within the Caribbean and Colombia)

Not approved or Not Pre-Certified

Pre-existing Condition (Maximum per Disability)Limitation Period

Hospital Room & BoardLocal (Caricom)Overseas (Non-Caricom)

Intensive Care Room & BoardLocal (Caricom)

Overseas (Non-Caricom)

Private Duty NursingMaximum per 8-hour shift - in private residence (Day)Maximum per 8-hour shift - in hospital (Night)Maximum per 8-hour shift - in private residence (Night)

Physiotherapy and other Health-care Professional GroupsMaximum per Treatment

Maximum Treatment per calendar year

Doctors' Visits

Office

Home

Hospital

Specialist Visit by Referral Only (Cardiologist & Gynaecologiests are excluded from the referral requirement)

Maximum Visits per calendar year

Emergency Doctor's Visits Benefit (Home & Hospital)Local Ground Ambulance

Other Hospital Services

Miscellaneous Expense

Surgical Expense

Prescription DrugsAnnual Maximum

Diagnostic ExpenseAnnual Maximum

Medical Air Transportation Benefit (Economy Airfare)Maximum trips per Calendar Year

$80.00$80.00N/A

75% to a maximum of $7010

75% to a maximum of $60

75% to a maximum of $60

75% to a maximum of $80

75% to a maximum of $80

75% to a maximum of $250

75% of R&C

75% of R&C

75% of R&C

75% of R&C

75% of R&C$1,200.00

75% of R&C$2,500.00

75%2

Preventative Care Benefits Annual Maximum - MembersAnnual Maximum - Spouses

The below procedures/tests are eligible for reimbursement under Preventative Care up to the above limits for Members & Spouses

Annual Physical for MEMBERS ONLY, includinga) Blood Pressure Checkb) Respiratory Checkc) Complete Urinalysis

Blood Profile, includingi) Fasting Blood Sugarii) Total Cholesterol Checkiii) Haemoglobiniv) Estimated Sedimentation Rate (ESR) Test

Annual Gynaecological and Pap Smear test for each female member or spouse of a male member

Annual Mammogram for each female member or spouse of male member age 50 and over

Annual Protology/Prostate inclusive of PSA test Examination for each male member or spouse of female member age 50 and over

DENTAL BENEFITSMaximum per calendar yearDeductible per calendar yearLevel 1 - PreventativeLevel 2 - RestorativeLevel 3 - Major Restorative

VISION BENEFITSMaximum per calendar yearDeductible per calendar yearBenefit payment

NOTE: Prescription Drugs - reimbursement/Payment limited to "prescribed drugs" as set out and required by law in the insurer's jurisdiction R&C means Reasonable & Customary

GENERAL MAJOR MEDICAL BENEFITSMaximum Lifetime Benefit

For Active Members Ages 50-59 (Annual Maximum - $175,000

For Active Members Ages 60-65 (Annual Maximum - $125,000)

For Active Members Ages 66 & over (Annual Maximum - $100,000)

Benefit Period

Internal Plan Limits per insured Aids or Aids related IllnessesTransplants for Members Ages 50-59Transplants for Members Ages 60-65Transplants for Members Ages 66 & overCongenital Disorders (New Born)

Deductible per Calendar YearPer each individual insuredPer Family

Carry over Provision

Co-insurance payment: Local Benefitper calendar year Thereafter to the maximum

Co-insurance Payment: Overseas BenefitPre-certified overseas treatment within Managed Care Network (within the Caribbean and Colombia)

Emergency treatment (within the Caribbean and Colombia)

Pre-certified overseas treatment outside of Managed Care Network (within the Caribbean and Colombia)

Not approved or Not Pre-Certified

Pre-existing Condition (Maximum per Disability)Limitation Period

Hospital Room & BoardLocal (Caricom)Overseas (Non-Caricom)

Intensive Care Room & BoardLocal (Caricom)

Overseas (Non-Caricom)

Private Duty NursingMaximum per 8-hour shift - in private residence (Day)Maximum per 8-hour shift - in hospital (Night)Maximum per 8-hour shift - in private residence (Night)

Physiotherapy and other Health-care Professional GroupsMaximum per Treatment

Maximum Treatment per calendar year

Doctors' Visits

Office

Home

Hospital

Specialist Visit by Referral Only (Cardiologist & Gynaecologiests are excluded from the referral requirement)

Maximum Visits per calendar year

Emergency Doctor's Visits Benefit (Home & Hospital)Local Ground Ambulance

Other Hospital Services

Miscellaneous Expense

Surgical Expense

Prescription DrugsAnnual Maximum

Diagnostic ExpenseAnnual Maximum

Medical Air Transportation Benefit (Economy Airfare)Maximum trips per Calendar Year

AGE RANGE50-5960-6566-8081 & Over

MEMBER ONLY$126.25$152.40$169.85$186.85

MEMBER & ONE DEPENDENT$239.90$272.40$306.45$333.95

MEMBER & FAMILY$328.80$350.50$398.30$429.75

Preventative Care Benefits Annual Maximum - MembersAnnual Maximum - Spouses

The below procedures/tests are eligible for reimbursement under Preventative Care up to the above limits for Members & Spouses

Annual Physical for MEMBERS ONLY, includinga) Blood Pressure Checkb) Respiratory Checkc) Complete Urinalysis

Blood Profile, includingi) Fasting Blood Sugarii) Total Cholesterol Checkiii) Haemoglobiniv) Estimated Sedimentation Rate (ESR) Test

Annual Gynaecological and Pap Smear test for each female member or spouse of a male member

Annual Mammogram for each female member or spouse of male member age 50 and over

Annual Protology/Prostate inclusive of PSA test Examination for each male member or spouse of female member age 50 and over

DENTAL BENEFITSMaximum per calendar yearDeductible per calendar yearLevel 1 - PreventativeLevel 2 - RestorativeLevel 3 - Major Restorative

VISION BENEFITSMaximum per calendar yearDeductible per calendar yearBenefit payment

PREMIUMS FOR MEDICAL, DENTAL & VISION

100%$300.00$300.00

No Waiting Period$650.00$50.0075%75%75%

No Waiting Period$500.00$50.0075%