ORTHODOX PRESBYTERIAN HEALTH & WELFARE TRUST
SCHEDULE OF MONTHLY PREMIUMS
EFFECTIVE 02/01/2007

Region 1 - Comprised of Participants in the following states:

Alaska, California, Connecticut, Florida, Hawaii, Illinois, Kansas, Massachusetts, Nevada, New Jersey, New York, Pennsylvania, Tennessee

Region 2 - Comprised of Participants in the following states:

Alabama, Arizona, Arkansas, Colorado, Delaware, Georgia, Indiana, Kentucky, Michigan, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Dakota, Texas, Virginia, West Virginia, Wyoming

Region 3 - Comprised of Participants in the following states:

Idaho, Iowa, Kentucky, Louisiana, Maine, Maryland, Minnesota, Mississippi, New Hampshire, New Mexico, North Carolina, Oregon, South Carolina, Utah, Vermont, Washington, Wisconsin

For All Regions, when ALL covered are Medicare primary, these rates are the same: