We are submitting the above referenced forms for the Department’s review and approval. They are new and will not replace any form currently on file with your Department. Enclosed are the applicable rates and supporting actuarial data.
The enclosed forms provide limited benefit medical coverage. The base plan offers a daily benefit when confined to a hospital due to an injury or sickness. Five benefit plans will be offered and include 10 of the 11 benefit riders listed above. The plans will vary by the amount of the benefit. The Return of Premium rider is optional.
In the solicitation of this product we will use application APPH2-13-DC. We have included it in this filing for approval. We would appreciate general approval of this application so that it may be used with similar products approved by your state. Any bracketed information in the application is variable. It is not our intention to make any changes that would cause this application to be out of compliance with any statutory requirements.
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