Amendment for SF30-0001-OPE approved.docx

19MY3022R0001

Amendment 0001 Continuation of Block 14.

2. Section B, paragraph B.2, paragraph Minimum and Maximum Amounts is hereby deleted and replaced with the revised paragraph:

MINIMUM AND MAXIMUM AMOUNTS

During the Base Year of the contract, and during the option year that might be exercised, the United States Government (USG) shall place orders totaling a minimum of RM 15,000,000. This reflects the contract minimum guarantee for each period of performance. The amount of all orders, for base and all option years shall not exceed RM 66,000,000. This reflects the contract maximum.”

3. Sections B.2.3, B.2.4, B.2.5, B.2.6, B.2.7 are hereby deleted and replaced with the revised paragraphs:

B.2.3 Base Year of Contract

Monthly Rates Per Premium

Total Price for Base Year (d x12)**

*estimated number of premiums does not include any Riders (B.1.1) **does not include any premiums for Riders.

B.2.4 First Option Year of Contract

Monthly Rates Per Premium

SST

Total Price for First Option Year (d x12)**

B.2.5 Second Option Year of Contract

Monthly Rates Per Premium

Total Price for Second Option Year (d x 12)**

B.2.6 Third Option Year of Contract

Monthly Rates Per Premium

Total Price for Third Option Year (d x 12)**

B.2.7 Fourth Option Year of Contract

Monthly Rates Per Premium

Total Price for Fourth Option Year (d x 12)**

4. Section C, paragraph C.1.1.9 is hereby deleted and replaced with the revised paragraph:

C.1.1.9 Hearing Aids: Minimum Coverage – 80% Examinations and Treatment: 80% Minimum Coverage

Hearing Aid Apparatus: Limited to one apparatus per ear up to a maximum of RM 6,300 per covered individual per three-year period. 80% Minimum Coverage: with annual cap.

5. Section C, paragraph C.1.1.10 is hereby deleted and replaced with the revised paragraph:

C.1.1.10 Optical Care: Minimum Coverage – 80% Examinations and Treatment: 80% Minimum Coverage

Prescription lenses and frames or contact lenses: Covered up to a maximum of RM 1250 per covered individual every two years. 80% Minimum Coverage; with annual cap.

6. Section C, paragraph C.1.1.11 is hereby deleted and replaced with the revised paragraph:

C.1.1.11 Dental Care: Minimum Coverage – 80% Examinations and Treatment: Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a maximum of RM 6,300 per covered individual per contract year. 80% Minimum Coverage: with annual cap.

Orthodontia: Treatment is covered only if treatment begins before age 18, or if required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per covered individual up to a maximum of RM 2400 lifetime limit. 80% Minimum Coverage; with contract lifetime cap.

7. Section C, paragraph C.1.1.15 is hereby deleted and replaced with the revised paragraph:

C.1.1.15 HIV/AIDS: 100% up to RM 42,000 per contract year per covered individual Medications to suppress opportunistic infections (such as tuberculosis or toxoplasmosis for covered individuals who have HIV/AIDS). Brief courses of anti-retroviral drugs

8. Section C, paragraph C.1.2 is hereby deleted and replaced with the revised paragraph:

C.1.2 Annual Maximum Limit - The maximum annual reimbursement per covered individual per contract year, not including expenses defined under Exclusions and Limitations or those covered under C.1.1.15 and HIV/AIDS- RM 106,000

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