Page 24 - Appendices for Paul Stelter PDF Version

Chicago Area - Zip Code 60639 Plans highlighted in BLUE only available to those eligible for Medicare prior to 2020
Standardized Medicare Supplement Plans Available - Annual Premium

ERIE FAMILY LIFE INSURANCE COMPANY www.erieinsurance.com (800) 458-0811
Pre-ex: 0 App Fee: $0 Crossover: Yes

Age A B C D F FHD G GHD K L M N
64 & Under $3,782 $5,227 $4,047 $3,533
65 $1,725 $2,137 $1,620 $1,466
70 $1,884 $2,376 $1,820 $1,626
75 $2,209 $2,743 $2,137 $1,937
80 $2,527 $3,215 $2,481 $2,258
85 $2,856 $3,745 $2,885 $2,595
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EVERENCE ASSOCIATION, INC. www.everence.com (800) 348-7468
Pre-ex: 0 App Fee: $0 Crossover: Yes

Age A B C D F FHD G GHD K L M N
64 & Under $3,028 $5,304 $4,359 $3,276 $2,058 $2,350
65 $2,413 $3,481 $3,249 $2,545 $1,058 $1,474
70 $2,605 $4,120 $3,521 $2,753 $1,652 $1,770
75 $2,737 $4,631 $3,734 $2,936 $1,761 $2,008
80 $2,898 $4,996 $4,040 $3,138 $1,911 $2,194
85 $3,028 $5,304 $4,359 $3,276 $2,058 $2,350

EVEREST REINSURANCE COMPANY www.everestre.com/medicaresupplement (813) 638-8984
Pre-ex: 0 App Fee: $25 Crossover: Yes

Age A B C D F FHD G GHD K L M N
64 & Under $3,828 $5,834 $4,988 $6,005 $4,843 $3,326
65 $1,947 $2,538 $2,061 $2,615 $2,004 $1,424
70 $2,148 $2,781 $2,288 $2,865 $2,225 $1,576
75 $2,471 $3,237 $2,704 $3,335 $2,629 $1,866
80 $2,761 $3,732 $3,145 $3,845 $3,057 $2,131
85 $3,039 $4,292 $3,643 $4,421 $3,539 $2,442

Pre-ex = # of months of waiting period for coverage of a pre-existing condition App Fee = one-time charge at the time you apply for a policy Crossover: Yes = claims sent electronically; no paper filing
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