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Value Med Insurance Plan Sickness & Accident, Hospital & Medical Insurance THIS POLICY PROVIDES LIMITED BENEFITS Plan Features: • Benefits are Paid Directly to You if requested • Pays Indemnity benefits for Hospital Confinement and Doctor Office Visits • Pays benefits for Hospital Out Patient and Ambulance Services • Pays Benefits in Addition to any Other Insurance coverage • Issue Ages 18 through 64 years old • Dependent Child Coverage Available to Age 19 or 25 if a Full Time Student • Guaranteed Renewable to age 65 years old • Use any Doctor, Hospital or Licensed Provider

GAC Quote   Select Your State*: Select State AlabamaArizonaArkansasCaliforniaColoradoDelawareDCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKentuckyLouisianaMarylandMichiganMississippiMissouriNebraskaNevadaNew MexicoOhioOklahomaPennsylvaniaSouth CarolinaTennesseeTexasUtahVirginiaWest VirginiaWisconsinWyoming Gender Age Self: Select Male Female 1819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364 Spouse: Select Male Female Select 1819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364 Number of Children: Choose Plan Value Med Insurance Plan TO VIEW BENEFIT DETAILS- CLICK HERE Daily Hospital Cash Option 1 ($1000 - From First Day) Option 2 ($500 - From First Day) Option 3 ($100 - From First Day) 24 Hour Accident Coverage TO VIEW BENEFIT DETAILS - CLICK HERE   Quote Now Re-run Quote   *If your state is not listed call your agent or GAC at 1-800-366-2467

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Product   Premium $  Value Health Insurance Plan Classic Monthly: Semi Annual: Annual: Silver Monthly: Semi Annual: Annual: Gold Monthly: Semi Annual: Annual: Platinum Monthly: Semi Annual: Annual:

Product   Premium $  Value HIP Insurance Plan Classic Monthly: Semi Annual: Annual: Silver Monthly: Semi Annual: Annual: Gold Monthly: Semi Annual: Annual: Platinum Monthly: Semi Annual: Annual:

Daily Hospital Cash Select Option: Option 1 ($1000 - From First Day) Option 2 ($500 - From First Day) Option 3 ($100 - From First Day) Product   Premium $  Value Med Insurance Plan Details **Monthly: * Quarterly: * Semi Annual: * Annual: *

Product   Premium $ Select  Value Access Guarantee* Option 1 Option 2 Option 3 Option 4 Product   Premium $ Select  Value Access Guarantee** Option 5 Option 6 Option 7 Option 8 Product   Premium $ Select  Value Access Guarantee** Option 5 Option 9

Product   Premium $ Select  24 Hour Accident Coverage* Coverage $ 2,500 Coverage $ 5,000 Coverage $ 7,500 Coverage $ 10,000

Product   Premium $ Select 24 Hour Accident Limited Benefit Coverage* Coverage $2,000 Coverage $5,000 Coverage $7,500

Product Monthly Premium $ Select  Value Rx Drug Card *

Product Monthly Premium $ Select  Value ER Plan *

Product Monthly Cost $ Select  VBA Truckers Occupational Accident   Insurance Program *

Product Monthly Membership Fee $ Select  NCE Membership - EDS* **

Product Monthly Membership Fee $* Select  VBA OptumHealth Allies*

Product Monthly Membership Fee $* Select  CallMD*

Product   Premium $  Value Care Plus Dental Plan Details Monthly: * Quarterly: * Semi Annual: * Annual: *

Modify Quote Apply Now     **Monthly Payment modes available by bank draft or credit card (list bill is available for 5 or more, call GAC for instructions at 1-800-366-2467). If you selected Quarterly, Semi Annual or Annual, the first payment can be paid by bank draft or credit card. The insurance company will send you a bill when future payments are due. *Includes VBA Membership Dues: $5.00 Monthly Mode; $15.00 Quarterly Mode; $30 Semi Annual Mode; or $60 Annual Mode

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