1. UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000 PER PERSON $4,000 MAXIMUM PER FAMILY 100% FOR REMAINDER OF CALENDAR YEAR WHEN SERVICES ARE IN BCBS NETWORK

2. PREVENTIVE CARE CHARGES  IMMUNIZATIONS  ROUTINE PHYSICAL EXAMINATIONS  EYE/HEARING EXAMINATIONS 100% COVERAGE - NO DEDUCTIBLE $750 per person per plan year

3. HOSPITAL CHARGES Inpatient Surgery Outpatient Surgery Maternity Delivery Hospital Stay 90% COVERAGE AFTER DEDUCTIBLE

4. NON-HOSPITAL CHARGES  AMBULANCE SERVICE  OFFICE VISITS  PREADMISSION TESTING 80% COVERAGE AFTER DEDUCTIBLE

5. MEDCALL  Emergency Room Referral  Surgical Services 90% UCR paid when referred by MedCall.  80% without referral  Non-Surgical 80% UCR  70% without referral

6. HOME HEALTH CARE/HOSPICE CARE INPATIENT PSYCHIATRIC TREATMENT MATERNITY ADMISSIONS SUBSTANCE ABUSE TREATMENT SURGERY ADMISSIONS (inpatient & outpatient) DIAGNOSTIC TESTS UNICARE, INCORPORATED 1-800-233-5765 Unicare Medical Utilization Review

7. PHARMACY PROGRAM u Network of Retail Pharmacies u Services Outside of Network u 90 Day Maximum Drug Supply ¶ $10 co-payment for generic ¶ $25 co-payment for preferred brand name ¶ 20% of non-preferred brand name cost ($40 min. and $100 max.)

8. VISION CARE PROGRAM  BLUE CHOICE VISION PROVIDERS  LensCrafters  Independent Optometrists  Independent Ophthalmologists  VISION DISCOUNTS  LensCrafters Preset Vision Packages  ~Silver, Gold, and Blue Choices~  30% Off Eyeglasses/Frames/Lenses/Lab Fees  25% Off Non-Prescription Sunglasses  Low Fixed Prices on Contact Lenses

9. MEDICAL SERVICE UNIVERSITY SYSTEM OF GEORGIA COVERAGE ANYWHERE IN THE WORLD (Subject to Balance Billing effective 01/01/2003) HEALTH MAINTENANCE ORGANIZATIONS ONLY ACUTE CARE AND LIFE THREATENING EMERGENCIES COVERED OUTSIDE OF SERVICE AREA

10. UNIVERSITY SYSTEM OF GEORGIA COST PER MONTH - Employee-$140.62 -Employee/Spouse $295.20 -Employee/Child$253.00 -Family $407.64