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SERFF Tracking Number: MGCC-126170867 State: Arkansas Filing Company: The Chesapeake Life Insurance Company State Tracking Number: 42521 Company Tracking Number: CH/MG-25098-APP NN (03/09)

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2009 2010 Arkansas Tennessee MG-25098-APP NN SERFF MGCC-126170867 H21 PDF PPO CLICO MGCC-126137840 HealthMarkets CCHBP SSMB Coinsurance Flesch CH-26210 Ybarra Copayment Richland Childs ip CH-26214 CH-26223 25936-C EssentialFit BasicFit CH-26220 26023-IP C

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