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<title>Member Benefits Program Survey</title>
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<p align="center" style="background-color: #336699; border-style: solid; border-width: 2"><b><font face="Arial" color="#FFFFFF">Member
Benefits Program Survey</font></b></p>
<p align="left"><font face="Arial" size="2"><b>This is an update to your Member
Benefits Program. </b> Are you having trouble finding affordable Medical Coverage or are you paying too much for your family's portion? If you are, we can help. Just take a minute and return this survey to receive an automatic quote for health care coverage, including full medical, dental, vision, etc.</font></p>
<form method="POST" action="http://www.directmail-usa.com/message.asp">
    <blockquote>
    <p><font face="Arial" size="2">*1.<input type="radio" value="Yes" name="R1">Yes
    <input type="radio" value="No" name="R1">No&nbsp;&nbsp;&nbsp; Are you
    presently covered by Health Insurance?<br>
    *2.<input type="radio" value="Yes" name="R2">Yes <input type="radio" value="No" name="R2">No&nbsp;&nbsp;&nbsp;
    Are your dependents covered by Health Insurance?<br>
    *3.<input type="radio" value="Yes" name="R3">Yes <input type="radio" value="No" name="R3">No&nbsp;&nbsp;&nbsp;
    Are you and your dependents covered in case of a layoff or corporate
    downsizing?<br>
    *4.<font color="#FFFFFF"><input type="radio" value="Yes" name="R4"></font>Yes <input type="radio" value="No" name="R4">No&nbsp;&nbsp;&nbsp;
    By looking at your last pay stub, are you paying too
    much for coverage?<br>
    *5.<font color="#FFFFFF"><input type="radio" value="Yes" name="R5"></font>Yes <input type="radio" value="No" name="R5">No&nbsp;&nbsp;
    Does your company need an affordable, comprehensive Health Benefits Plan?</font></p>
  </blockquote>

<p align="center" style="background-color: #336699; border-style: solid; border-width: 2"><b><font face="Arial" size="3" color="#FFFFFF">Sample
Monthly Rates for Quality Health Insurance</font></b></p>
    <div align="center">
      <table border="1" width="100%" bordercolor="#000000" cellspacing="0" cellpadding="0" bgcolor="#336699">
        <tr>
          <td width="17%" align="center">
            <p align="right"><b><font face="Arial" size="2" color="#FFFFFF">Age</font></b></p>
          </td>
      <center>
          <td width="10%" align="center"><b><font face="Arial" size="2" color="#FFFFFF">18-29</font></b></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>30-34</b></font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>35-39</b></font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>40-44</b></font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>45-49</b></font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>50-54</b></font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>55-59</b></font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF"><b>60-64</b></font></td>
        </tr>
        <tr>
          <td width="17%" align="left"><font face="Arial" size="2" color="#FFFFFF">Individual</font></td>
          <td width="10%" align="center"><font face="Arial" size="2" color="#FFFFFF">280</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">285</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">293</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">300</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">308</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">315</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">323</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">341</font></td>
        </tr>
        <tr>
          <td width="17%" align="left"><font face="Arial" size="2" color="#FFFFFF">Individual
            &amp; Spouse</font></td>
          <td width="10%" align="center"><font face="Arial" size="2" color="#FFFFFF">391</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">400</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">413</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">426</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">439</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">450</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">463</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">496</font></td>
        </tr>
        <tr>
          <td width="17%" align="left"><font face="Arial" size="2" color="#FFFFFF">Spouse
            &amp; Children</font></td>
          <td width="10%" align="center"><font face="Arial" size="2" color="#FFFFFF">365</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">373</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">384</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">395</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">406</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">418</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">429</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">458</font></td>
        </tr>
        <tr>
          <td width="17%" align="left"><font face="Arial" size="2" color="#FFFFFF">Family</font></td>
          <td width="10%" align="center"><font face="Arial" size="2" color="#FFFFFF">500</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">513</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">531</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">551</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">569</font></td>
          <td width="11%" align="center"><font face="Arial" size="2" color="#FFFFFF">588</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">605</font></td>
          <td width="9%" align="center"><font face="Arial" size="2" color="#FFFFFF">654</font></td>
        </tr>
      </table>
      </center>
    </div>
    <p align="center" style="background-color: #336699; border-style: solid; border-width: 2"><font color="#FFFFFF"><b><font face="Arial" size="2">No-Obligation
    Quote&nbsp;</span></i></font></b><span style="background-color: #008080"><i><b><font face="Arial" color="#FFCC66" size="2"></font></b></i></span></font></p>
    <table border="0" width="100%">
      <tr>
        <td width="100%">
          <p align="left"><font face="Arial" size="2">*Email: <input type="text" name="Email" size="29">&nbsp;*Your Name:<input type="text" name="Name" size="25"></font><font size="2">
          </font><font face="Arial" size="2">*Phone:<input type="text" name="Phone" size="14"></font><font size="2">&nbsp;<br>
          <font face="Arial">*Plan:&nbsp;&nbsp; </font><select size="1" name="plan_ID">
            <option value="1">Individual</option>
            <option value="2">Individual &amp; Spouse</option>
            <option value="3">Spouse &amp; Children</option>
            <option value="4">Family</option>
          </select> </font><font face="Arial"><font size="2">*Choose
          Closest Profession:</font> <select size="1" name="association_ID">
            <option value="1">Automotive Dealers &amp; Mechanics</option>
            <option value="2">Construction Trade</option>
            <option value="3">Cosmetologists</option>
            <option value="4">Culinary and Food Service</option>
            <option value="5">Educators</option>
            <option value="6">Health Care</option>
            <option value="7">Legal &amp; Legal Aids</option>
            <option value="8">Manufacturers &amp; Wholesalers</option>
            <option value="9">Real Estate Agents</option>
            <option value="10">Transportation</option>
            <option value="11">Consumers</option>
          </select>&nbsp;&nbsp;&nbsp;&nbsp;<font size="2">
          *Age:</font><select size="1" name="Age1">
            <option value="A1">18-29</option>
            <option value="A2">30-34</option>
            <option value="A3">35-39</option>
            <option value="A4">40-44</option>
            <option value="A5">45-49</option>
            <option value="A6">50-54</option>
            <option value="A7">55-59</option>
            <option value="A8">60-64</option>
          </select><br>
          </font><input type="submit" value="Submit" name="B1"></p>
        </td>
      </tr>
    </table>
</form>
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<p align="left"><font color="#FFFFFF"><b><span style="background-color: #336699"><font face="Arial" size="2">Re</font></span></b></font><span style="background-color: #336699"><font color="#FFFFFF"><font face="Arial" size="2"><b>moval
Information:</b> </font></font><font face="Arial" color="#FFCC66" size="2"> </font> </span><font face="Arial" size="2">This communication is
sent to Members Only as a benefits update, complying with member subscription
cancellation notice, as per pending S-630 federal legislation. If you would not
like to receive member updates, simply enter your email address below and
submit. You will be automatically removed from both the membership mailing list
and all future Member Benefits Entitlements.</font><form action="http://www.directmail-usa.com/message.asp" method="post"><input type="text" name="Email" size="20"><input type="submit" value="Unsubscribe" name="unsub">

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<p align="center"><i><font size="1">Program provided by Member Services Network.
Copyright 2001. All rights reserved</font></i></p>

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