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for Georgia
	HMO Plans	Balance HMO Plans - lower cost
	Maternity coverage $200 Rx Deductible Better Coinsurance limits	No Maternity Coverage $500 Rx Deductible Higher Coinsurance limits
	Benefits at a Glance	Benefits at a Glance
	Rates	Rates
	Applications - Choose one: Online Application - Select Apply On-line Now Paper Application - Use Black Ink, Mail or Fax in	Applications Paper Application - Use Black Ink, Mail or Fax in
	Full Plan Brochure -Please Call (404) 575-1960 for information	Full Plan Brochure -Please Call (404) 575-1960 for information
	Exclusions and Limitations What's Not Covered	Exclusions and Limitations What's Not Covered
	Provider Network	Provider Network
	Hospitals Medical Centers Call 404 575-1960 to locate Kaiser Doctors	Hospitals Medical Centers Call 404 575-1960 to locate Kaiser Doctors

Blue Cross Blue Shield of Georgia is an Independent Licensee of the Blue Cross Blue Shield Association. BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association Ž Registered marks of the BlueCross BlueShield Association, an Association of Independent BlueCross BlueShield Plans