LRFA
Latvian Relief Fund of America, Inc.

Mutual assistance and trust since 1952
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Health Care Benefit Plans


Helps cover hospital and physician expenses. Free choice of doctors. No physical exam required.

Monthly Fees

Monthly Fees For The Year 2010

PLAN

COVERED MEMBER

BENEFIT GROUP FEES

AGE GROUPS

GROUPS WITH  OR WITHOUT CHILDREN

20% 50% 80%

A

$10,000

18-25 years without children $20.00 $48.00 $87.00
with children $26.00 $61.00 $126.00
25 years and over without children $23.00 $59.00 $103.00
with children $28.00 $75.00 $144.00

B

$20,000

18-25 years

without children $37.00 $96.00 $174.00
with children $47.00 $122.00 $252.00

25 years and over

without children $44.00 $118.00 $206.00
with children $54.00 $150.00 $288.00

C

$70,000

18-25 years

without children $56.00 $142.00 $303.00
with children $74.00 $183.00 $444.00

25 years and over

without children $66.00 $174.00 $365.00
with children $84.00 $225.00 $506.00

Medical expenses, not exceeding amounts mentioned below, will be covered 100%, according to the following chart:

Not exceeding

$25.00

A-20% and B-20%
Not exceeding

$50.00

A-50% and B-50%
Not exceeding

$75.00

A-80% and B-80%
Not exceeding

$100.00

C-20%, C-50%, and C-80%

These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.

 

© 2005 LRFA   -   P.O. Box 8857, Elkins Park, PA 19027-0857   -   lrfa @ lrfa.org

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