Covered group = 2 adults. 2 children Assume all services are covered. Routine annual physicals are considered preventative. Costs paid b individual otal uremiums for 12 months Total co-na ents otal deductible otal coinsurance Total famil medical costs Costs paid by insurance com an _ Claim # Claim description 1 mm-qmm-p-wm NHHHHHHHHHH owooqmtt'I-lthIio ln-network pediatrician Preventive care u shots Out-ofnetwork specialist Routine annual physical Routine annual physical ln-network pediatrician ln-netwod( pediatrician lnnetwork pediatrician ln-netwom pediatrician ln-network pediatrician Primary care physician lnnetwork MRI Primary care physician ln-network surgery ln-netwom physical therapy Outofnetwork specialist ln-network physical therapy ln-network physical therapy ln-network pediatrician lnnetwork pediatrician Claim Amount Family member(s) $200 Child 1 $100 2 adults, 2 children $800 Adult 1 $400 Adult 1 $300 Adu|t2 $200 Child 1 $400 Child 2 $150 Child 2 $200 Child 1 $200 Child 1 $450 Adult 2 $2,500 Adult 2 $450 Adult 2 $10,000 Adult 2 $200 Adult 2 $500 Adult 1 $200 Adult 2 $200 Adult 2 $200 Child 1 $200 Child 2 Preventative? Yes Yes Yes