Sample Completed Summary Coverage - naic.org
5 of 6 Insurance Company 1: PPO Plan 1 Policy Period: 1/1/2011 – 12/31/2011 Coverage Examples Coverage for: Individual + Spouse | Plan Type: PPO Questions: Call 1-800-XXX-XXXX or visit us at www.insurancecompany.com. If you aren’t clear about any of the terms used in this form, see the Glossary at www.insuranceterms.gov. …
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