PRESCRIPTION DRUG RIDER OPTIONS
RX RIDER	RX COPAY
A = RX081047	$7/15/30
B = RX081048	$10/20/30
C = RX081050	$10/25/40
D = RX081051	$15/25/50
E = RX081247	$7/15/30 with $100/200 deductible
F = RX081248	$10/20/30 with $100/200 deductible
G = RX081250	$10/25/40 with $100/200 deductible
H = RX081251	$15/25/50 with $100/200 deductible