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<br />FEB-4-2002 09:43 FROM:BROWN & BROWN 305 822 5687 <br /> <br />TO: 9P3059493113 <br /> <br />P:2/3 <br /> <br />AETNA US HEAL. THeN<<: <br /> <br />HMO 15 <br /> <br />FINANCIAL <br />Dedl.lCti:lle: SioglelFamily <br />Coinsurance <br />CoinGurance limit: Single/Family <br />LIfetime M"Qmum Benerlt <br /> <br />Fa Referred <br />NlA <br />N/A <br />NlA <br />NlA <br /> <br />PRIMARY CARE PHYSICWI VISITS <br />Office HOln <br />After HoursIHome VISits <br /> <br />$15 c>>-pay <br />$15 co-pay <br /> <br />SPECIAL TV CARE <br />Office VIsits <br />OIaQn~tic Outpatient Testing <br />Outpatient Therapy <br /> <br />OUTPATIENT SURGERY <br /> <br />$15 COopay <br />$15 co-pay <br />$15 eo-pay <br /> <br />$ 0 co-pay <br /> <br />HOSPITALIZATION <br />SKILLED NURSING FACIUTY <br />EMERGENCY ROOM <br /> <br />$ 0 ~pay/A <br /> <br />$ 0 c~/A <br />_eo.pay <br /> <br />HoME CARE <br /> <br />MATERNITY <br />F"1I'St 08 visit <br />Hospital <br /> <br />MENTAL HEALTH <br />Inp81ient <br />outpat\ent <br /> <br />SUBSTANCE ABUSE <br />DsloIdflcation <br />Inpatient Rehabilitation <br />OUtpatient Rehabilitation <br /> <br />Naco-pay <br /> <br />$15 ClO-pay <br />$0 co-p~/A <br /> <br />$ 0 et>-pe:fIA, 30 days <br />$25 co-payN, 20 visits <br /> <br />$ 0 co-pay/A <br />$ 0 co-payl3O days <br />$15000p?IJN <br /> <br />P~IVE CAR.e <br />Routine Eye Exam <br />Routine Physicals <br />Immurriz.atiorl$ <br />Routine Mammography <br />Routine GYN Exam <br /> <br />CHIROPRACTIC CARE <br /> <br />$15 co-pay <br />$15 co-pay <br />$151>>f)8Y <br />$15 co.pay <br />$15 co-pay <br /> <br />$15 oo-payl2O visits <br /> <br />DURABLE MEDICAL EQUIPMENT <br /> <br />$ 0 e>>pay <br /> <br />PRESCRIPTIONS <br /> <br />$10115130 wlBC <br /> <br />To mccIYe maximum beoefils ilH1etWOl'k (rel'elmd} ~ must be provldB;l or mtlrred by lhe PlIItiClpaling primary care physiciarr you <br />~. In-networl( (refBn'ed) berKJGtt; 8fe provided by the fla'NA U.S. I-Ieallhcare. All benefits are prlMded in ~ with the <br />appllcoblG group contract and irl5\ll1mC9 CIi!I1ificate. <br /> <br />Exhibit" N' <br />