Basic Health Insurance - Insured By Markel Insurance A

Employer Groups: If you have a group with 2 or more (51 or more in CO, FL, IN, MA, NV) employees that would be interested in this coverage, complete the following questionnaire and we will provide you with group rates. Rates can be lower if the employer contributes towards the premium.

Contributory- the employer can select how much of the premium to pay but must, at a minimum, contribute 50% of the Employee Only rate. Contributory rates are blended (not age banded).

Voluntary - the employees pay 100% of all premiums. Voluntary rates are age-banded.

The optional dental & vision plan premiums are the same whether or not there is an employer contribution. These rates are always age-banded.

Associations/Affinity Groups: Custom plans can be put together for your association. If you would like information on how to offer this valuble plan to your members contact us for state availability and information.

Complete the following form to receive your customized group rate.

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Comments

	Coverage Type
Member(s) Age	Member Only	Member + Spouse	Member + Child	Family
Under 30
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 +

Available States (with 2+ eligibles)	Available (with 51+ eligibles only)
Alabama Alaska Arizona Arkansas DC South Delaware Georgia Hawaii Illinois Iowa Kentucky Michigan Mississippi Missouri Montana Nebraska New Mexico North Carolina North Dakota Oklahoma Oregon Pennsylvania Rhode Island Carolina South Dakota Tennessee Texas Virginia Wisconsin Wyoming	Colorado Florida Indiana Massachusetts Nevada
	Pending
	California Maryland
	Not Available
	Connecticut Idaho Kansas Louisiana Maine Minnesota New Hampshire New Jersey New York Ohio Utah Vermont Washington West Virginia
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