Prescription Drug Plans Medicare Part D Benefit Summary for 2007 Benefits Request Application and full plan details	Contact: Steve Dixon (972) 355-8132 Contact us Walmart $4 drug list

Plan Name Monthly Premium Rx Coverage (Retail pharmacy amounts up to 30-day supply) Save with Mail-Order Humana PDP Standard S5884-080 $12.70 Rx Costs Stage 1 $0-$265 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay * Generic 100% 25% 100% 5% Preferred Brand 100% 25% 100% 5% Non-preferred Brand 100% 25% 100% 5% Specialty 100% 25% 100% 5% Humana PDP Enhanced S5884-020 $19.80 Rx Costs Stage 1 $0-$265 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay * Generic $5 $5 100% 5% Preferred Brand $30 $30 100% 5% Non-preferred Brand $60 $60 100% 5% Specialty 25% 25% 100% 5% Humana PDP Complete S5884-050 $76.60 Rx Costs Stage 1 $0-$265 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay * Generic $5 $5 $5 5% Preferred Brand $30 $30 100% 5% Non-preferred Brand $60 $60 100% 5% Specialty 25% 25% 100% 5%

Humana Formulary

*For this threshold, there is a variable payment. This payment is as follows: For Generic drugs, the payment is $2 or 5%, whichever is greater. For Preferred Brand, Non-Preferred Brand and Specialty Rx drugs, the payment is $5 or 5%, whichever is greater. This information is to be used as a brief summary, refer to policy for complete information on benefits, exclusions and limitations.

Plan Name Monthly Premium Rx Coverage (Retail pharmacy amounts up to 30-day supply) Save with Mail-Order UniCare Rewards Value $27.80 Rx Costs Stage 1 $0-$265 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay ** Generic 100% $5 100% $2.15 to 5% Preferred Brand 100% $29 100% $2.15 to 5% Non-Specialty Injectible 100% 25% 100% $2.15 to 5% Specialty Injectable 100% 25% 100% $2.15 to 5% UniCare Rewards Plus $30.50 Rx Costs Stage 1 $0-$250 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay ** Generic $10 $10 100% $2.15 to 5% Preferred Brand $30 $30 100% $2.15 to 5% Non-Specialty Injectible 30% 30% 100% $2.15 to 5% Injectable drugs 30% 30% 100% $2.15 to 5% UniCare Rewards Premier $44.50 Rx Costs Stage 1 $0-$250 Stage 2 $266-$2400 Stage 3 Over $2400 Stage 4 Over $3850 Rx Type You Pay You Pay You Pay You Pay ** Generic $10 $10 $10 $2.15 to 5% Preferred Brand $30 $30 100% $2.15 to 5% Non-Preferred Brand $60 $60 100% $2.15 to 5% Injectable drugs 30% 30% 100% $2.15 to 5%

** Greater of $2.15 for Generic (including brand drugs with and available generic) and $5.35 for all other drugs, or 5%
Call or request plan Summary of Benefits to see full description of benefits as well as Mail-Order drugs.

This information is to be used as a brief summary, refer to policy for complete information on benefits, exclusions and limitations.

UniCare Formulary

Example if you choose to wait 5 years to enroll in Part D:

At 1 percent per month penalty for 5 years (60 months = 60% penalty). If the Part D average premium is $27.00, add the $16.20 penalty. If you choose a plan which costs $20 add the $16.20 and your plan choice, but your plan now costs $36.20 (81% higher, due to the penalty). This penalty stays with you forever - so there is an incentive to enroll once eligible.