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The Peace of Mind People Short Term Medical Insurance Galena Plans Brought to you by Southern Guaranty Insurance Company www sgicinsurance com

Welcome Dear Member Welcome to the Southern Guaranty Insurance Company SGIC community SGIC is a US based insurance company with its corporate headquarters in Clearwater FL Who is SGIC SGIC is an independent family owned and operated insurance company offering a new Short Term Medical product the Galena Plans SGIC has an A Better Business Bureau rating and a B AM Best rating Our employees are excited to bring you personalized support to help you navigate your health insurance coverage Our mission is to bring affordable healthcare alternatives to the average American In the following pages you will find a summary of your health insurance plan and how you can contact us so we can answer any of your questions Our vision is to provide peace of mind through a more personal approach to the difficult to navigate medical insurance industry Thank you for joining us we look forward to helping you on your journey with us Sincerely The SGIC Family The Peace of Mind People

Why our STM Product is Right for You The Healthcare solution that fits your evolving lifestyle Are you Self Employed An Early Retiree Waiting for Employer Benefits Between Jobs If any of these descriptions represent you OR if you are looking for other health insurance solutions then our health plans are right for you The benefits to buying SGIC Galena Plans are Low cost alternative Can be more than half the cost of other medical plans Easy Enrollment Enroll at anytime no qualifying event needed Flexibility Multiple plan designs Various policy lengths Range of deductible and coinsurance options Nationwide Network Coverage with Hospitals and Doctors across the United States National PPO Network No balance billing with In Network Providers Pre existing conditions and coverage limits disclosure This coverage is not required to comply with certain federal market requirements principally those contained in the Affordable Care Act ACA Review your Certificate carefully to be sure you are aware of and understand any exclusions and limitations regarding coverage of pre existing conditions or health benefits Your coverage may also have lifetime and or annual limits on health benefits

MultiPlan Network MultiPlan is the industry s most comprehensive provider of healthcare cost management solutions Through MultiPlan s Limited Benefit Plan Network you have access to providers specialists and hospitals nationwide at discounted rates Practitioners in all 50 States Doctors and Physicians includes Specialists Hospitals or Surgical Centers Clinics and Specialty Centers Laboratories and Imaging Centers Find participating providers online at www multiplan com You are participating in MultiPlan s Limited Benefit Plan Network To take full advantage of the pre negotiated network rates select a Preferred In Network Provider There will be no balance billing if you select a provider within this network

Galena Plans by SGIC Summary of Benefits Economy Summary of Benefits All benefits are subject to Deductible and Plan Coinsurance unless indicated by an asterisk Deductible 5 000 7 500 or 10 000 2 500 5 000 7 500 or 10 000 2 500 5 000 7 500 or 10 000 Coinsurance 50 50 70 30 or 80 20 50 50 70 30 or 80 20 50 50 70 30 or 80 20 Coinsurance Maximum 5 000 or 10 000 5 000 or 10 000 2 500 5 000 or 10 000 Coverage Period Maximum 500 000 1 000 000 2 000 000 ECONOMY Doctor Office STANDARD ELITE This is Your Plan Deductible 5 000 7 500 or 10 000 Coinsurance 50 50 70 30 or 80 20 Coinsurance Maximum 5 000 or 10 000 Coverage Period Maximum 500 000 Office Visit Copay Primary 40 Specialty 60 Copay Primary 40 Specialty 60 Copay Primary 30 Specialty 45 Wellness Visit Up to 250 per coverage period 40 Copay 40 Copay Urgent Care 60 Copay 60 Copay 60 Copay Emergency Room Accident 500 Copay Sickness 750 Copay Accident 500 Copay Sickness 750 Copay Accident 500 Copay Sickness 750 Copay Ambulance Services Ground Up to 250 Air Up to 1 000 Ground Up to 500 Air Up to 1 000 Ground Up to 1 000 Air Up to 2 500 Inpatient Surgery 2 000 per Covered Surgery up to 1 per term 4 000 per Covered Surgery up to 2 per term 8 000 per Covered Surgery up to 3 per term Outpatient Surgery 2 000 per Covered Surgery up to 1 per term 4 000 per Covered Surgery up to 1 per term 8 000 per Covered Surgery up to 2 per term Emergency Services Surgical Office 1 000 per Covered Surgery up to 1 per term 1 000 per Covered Surgery up to 2 per term 1 000 per Covered Surgery up to 3 per term Urgent Care 60 Copay Standard Room ICU Up to 1 500 per day Up to 2 500 per day Up to 3 000 per day Emergency Room Accident 500 Copay Sickness 750 Copay Inpatient Doctor Visits Up to 60 per visit Up to 80 per visit Up to 100 per visit Ambulance Services Ground Up to 250 Air Up to 1 000 Outpatient Diagnostics Up to 500 per term Up to 1 000 per term Copay Pathology 40 Radiology 60 Inpatient Surgery 2 000 per Covered Surgery up to 1 per term Advanced Radiology MRI CT PET Up to 1 000 per term Up to 1 500 per term 250 copay Outpatient Surgery 2 000 per Covered Surgery up to 1 per term Professional Covered OT PT Up to 40 per day Up to 60 per day Up to 60 per day Chiropractic Visits Mental Health Not Covered Not Covered Up to 60 per day Surgical Office 1 000 per Covered Surgery up to 1 per term Unless specified otherwise the following benefits are for the Insured and each Covered Dependent subject to the plan Deductible Coinsurance Percentage Coinsurance Maximum and Coverage Period Maximum chosen Benefits are limited to the maximum allowable expense for each Covered Person in addition to any specific limits stated in the policy Inpatient Not Covered Not Covered 100 per day up to 30 days Standard Room ICU Up to 1 500 per day Indicates copay only and not subject to deductible and plan coinsurance Professional Not Covered 50 per day up to 10 days 100 per day up to 10 days Inpatient Doctor Visits Up to 60 per visit Emergency Services Surgical Benefits Inpatient Hospital Expenses Specialty Services Indicates copay only and not subject to deductible and plan coinsurance All benefit limits listed above are per covered person No benefits will be paid for a health condition that exists 12 months prior to the date your insurance takes effect State rules may vary Unless specified otherwise the following benefits are for the Insured and each Covered Dependent subject to the plan Deductible Coinsurance Percentage Coinsurance Maximum and Coverage Period Maximum chosen Benefits are limited to the maximum allowable expense for each Covered Person in addition to any specific limits stated in the policy Doctor Office Office Visit Copay Primary 40 Specialty 60 Wellness Visit Up to 250 per coverage period Surgical Benefits Inpatient Hospital Expenses Specialty Services Outpatient Diagnostics Up to 500 per term Advanced Radiology MRI CT PET Up to 1 000 per term Professional Covered OT PT Up to 40 per day Please see your certificate for full benefit details All benefits are subject to deductible and plan coinsurance unless indicated by an asterisk All benefit limits listed are per covered person No benefits will be paid for a health condition that exists 12 months prior to the date your insurance takes effect State rules may vary

Standard Summary of Benefits Elite Summary of Benefits This is Your Plan This is Your Plan Deductible 2 500 5 000 7 500 or 10 000 Coinsurance 50 50 70 30 or 80 20 Coinsurance Maximum 5 000 or 10 000 Coverage Period Maximum 1 000 000 Deductible 2 500 5 000 7 500 or 10 000 Coinsurance 50 50 70 30 or 80 20 Coinsurance Maximum 2 500 5 000 or 10 000 Coverage Period Maximum 2 000 000 Doctor Office Doctor Office Office Visit Copay Primary 40 Specialty 60 Wellness Visit 40 Copay Emergency Services Urgent Care 60 Copay Emergency Room Accident 500 Copay Sickness 750 Copay Ambulance Services Ground Up to 500 Air Up to 1 000 Surgical Benefits Inpatient Surgery 4 000 per Covered Surgery up to 2 per term Outpatient Surgery 4 000 per Covered Surgery up to 1 per term Surgical Office 1 000 per Covered Surgery up to 2 per term Inpatient Hospital Expenses Standard Room ICU Up to 2 500 per day Inpatient Doctor Visits Up to 80 per visit Specialty Services All benefits are subject to deductible and plan coinsurance unless indicated by an asterisk All benefit limits listed are per covered person No benefits will be paid for a health condition that exists 12 months prior to the date your insurance takes effect State rules may vary Unless specified otherwise the following benefits are for the Insured and each Covered Dependent subject to the plan Deductible Coinsurance Percentage Coinsurance Maximum and Coverage Period Maximum chosen Benefits are limited to the maximum allowable expense for each Covered Person in addition to any specific limits stated in the policy Indicates copay only and not subject to deductible and plan coinsurance Office Visit Copay Primary 30 Specialty 45 Wellness Visit 40 Copay Emergency Services Urgent Care 60 Copay Emergency Room Accident 500 Copay Sickness 750 Copay Ambulance Services Ground Up to 1 000 Air Up to 2 500 Surgical Benefits Inpatient Surgery 8 000 per Covered Surgery up to 3 per term Outpatient Surgery 8 000 per Covered Surgery up to 2 per term Surgical Office 1 000 per Covered Surgery up to 3 per term Inpatient Hospital Expenses Standard Room ICU Up to 3 000 per day Inpatient Doctor Visits Up to 100 per visit Specialty Services Outpatient Diagnostics Copay Pathology 40 Radiology 60 Advanced Radiology MRI CT PET e e 250 copay Outpatient Diagnostics Up to 1 000 per term Advanced Radiology MRI CT PET e Up to 1 500 per term Professional Covered OT PT Up to 60 per day Professional Covered OT PT Up to 60 per day Chiropractic Visits Up to 60 per day Mental Health Professional 50 per day up to 10 days Mental Health Inpatient 100 per day up to 30 days Professional 100 per day up to 10 days Please see your certificate for full benefit details Please see your certificate for full benefit details All benefits are subject to deductible and plan coinsurance unless indicated by an asterisk All benefit limits listed are per covered person No benefits will be paid for a health condition that exists 12 months prior to the date your insurance takes effect State rules may vary Unless specified otherwise the following benefits are for the Insured and each Covered Dependent subject to the plan Deductible Coinsurance Percentage Coinsurance Maximum and Coverage Period Maximum chosen Benefits are limited to the maximum allowable expense for each Covered Person in addition to any specific limits stated in the policy Indicates copay only and not subject to deductible and plan coinsurance

What to Know About Short Term Medical Plans From our years of experience working in the health insurance industry and helping members effectively control costs below are important details that you should be aware of with your short term medical plan Pre Existing Conditions One of the biggest differences between our Plans and those available from the ACA Exchange is a Pre Existing Condition Limitation If you haven t been diagnosed or treated for a medical condition in the past 12 months or experienced symptoms that should have led you to get care but did not this rule will not impact you Waiting Period This plan has waiting periods which include Next day coverage for injuries 5 day waiting period for sickness 30 day waiting period for cancer Plan Benefits This plan only covers the benefits listed in your certificate Some benefits also include visit and or coverage period limits Refer to your certificate for more information The application of cost sharing is as follows copays deductible and coinsurance Understand What is Not Covered Knowing exactly what your Short Term Medical Insurance does and does not cover is important To give you the best possible experience we offer this summary of what is not covered Please see your Certificate for a list of complete details Pre existing conditions Sicknesses that begin by occurrence of symptoms and or receipt of treatment during the waiting period which is 5 days following the effective date Outpatient Prescription Drugs Dental and Vision services Contraceptive drugs and devices Pregnancy and related services except for Complications of Pregnancy Treatment services and supplies for a Covered Dependent who is a newborn child not yet discharged from the Hospital Routine foot care Treatment of acne or varicose veins allergy testing and allergy injections speech therapy and diagnosis or treatment of a sleeping disorder Diabetes diabetic equipment supplies and self management training Genetic testing Hearing exams hearing aids or fitting of hearing aids Treatment for cataracts Weight loss non smoking exercise or similar programs Illness or injury that is self inflicted caused while under the influence or while engaged in a felony in a hazardous occupation or activity in military service or while participating in interscholastic or intercollegiate sports Surgery during the first 6 months after the Effective Date of Coverage for a Covered Person for a total or partial hysterectomy unless it is Medically Necessary due to a diagnosis of carcinoma subject to all other coverage provisions including but not limited to the preexisting condition exclusion tonsillectomy adenoidectomy repair of deviated nasal septum Pre Authorization Pre Authorization is required for all inpatient hospitalizations outpatient surgeries durable medical equipment and prosthetics Call 888 275 7916 to get your services pre authorized Pre Authorization does not guarantee coverage or any type of surgery involving the sinus myringotomy tympanotomy herniorrhaphy or cholecystectomy A pre existing condition is an illness injury or condition for which medical advice diagnosis care or treatment was recommended or received from a Physician within 12 months prior to enrollment For more details please see your certificate State exclusions may vary

Frequently Asked Questions Association Benefits What is an In Network Provider How We Serve At AFRP we seek out quality benefits services and resources to help our members thrive by reducing costs and taking control of their personal health With the group buying power of an Association AFRP members receive discounts on health travel business and consumer products and services In addition we strive to provide our members with valuable information relevant to your life AFRP shares information on wellness lifestyle nutrition and more through our newsletters website and emails Our commitment to membership defines us We will continue seeking out new and improved benefits so that we may remain a valued resource and valued partner for responsible Americans throughout the Thank you for choosing an Association for Responsible Planners AFRP membership plan Below is a summary of your benefits 24 Hour Emergency Roadside Assistance Office Depot OfficeMax CleverRx Red Roof Inn Figo Pet Insurance Motel 6 LifeLock 24 Hour Nurseline VSP Prioritize Wellness Wyndham Hotels Please don t hesitate to contact Member Services at 866 870 7730 or log into your member portal at https www afrp association com for additional details These benefits are applicable to your AFRP Membership and are not provided under your Short Term Medical policy insured by SGIC An In Network Provider is a Physician Hospital or other healthcare Provider that is currently affiliated with the PPO network offered by SGIC to its Policyholders How can I locate my MultiPlan In Network Providers 1 Call member services at 866 870 7730 2 Go to www multiplan com webcenter portal ProviderSearch and select MultiPlan Network and Limited Benefit Plan Why should I go to an In Network Provider 1 In Network Providers will provide better benefits and discounts 2 There is a separate Deductible and higher Coinsurance percentage which leads to more out of pocket costs for you by going to Out ofNetwork Providers 3 You can be balance billed if you see an Out of Network Provider Can I access my Short Term Medical benefits right away Injuries are covered the day after enrollment but there is a 5 day waiting period for sickness Some benefits may not be covered in your plan and pre existing conditions rules apply What are pre existing conditions A pre existing condition is an illness injury or condition for which medical advice diagnosis care or treatment was recommended or received or that had manifested itself in such a manner that would have caused an ordinarily prudent person to seek medical advice diagnosis care or treatment within the 12 months immediately preceding the Covered Person s Coverage Effective Date State rules may vary What is the maximum duration length of my policy You are selecting a Short Term Medical policy term with an auto re apply option that will allow you to extend coverage up to 36 months Your benefit limits deductible and coinsurance will reset each new term of continuous coverage Medical conditions developed during your prior term may not be covered by additional terms Prices may change at the start of each new policy You may cancel at any time Terms and conditions may vary by state Is my policy ACA compliant This coverage is not required to comply with certain federal market requirements principally those contained in the Affordable Care Act ACA Review your Certificate carefully to be sure you are aware of and understand any exclusions and limitations regarding coverage of preexisting conditions or health benefits such as hospitalization emergency services maternity care preventive care prescription drugs and mental health and substance use disorder services Your coverage also has lifetime and or annual limits on health benefits If this coverage expires or you lose eligibility for this coverage you might have to wait until an open enrollment period to get other health insurance coverage What is Pre Authorization Most healthcare plans require a form of pre authorization which is a process that protects you by verifying your procedure is medically necessary For this verification please call us at 888 275 7916 as seen on your ID card These services include all Inpatient Hospitalizations and procedures done at an Outpatient Surgical Facility but please see your certificate for full details You can reach us at 888 275 7916 as seen on your ID card as well What is Coinsurance Maximum The maximum amount of Coinsurance you will pay in a Coverage Period subject to any benefit limits specified in your certificate The Coinsurance Maximum does not include the Deductible and Copays