National Union Fire Insurance Company of Pittsburgh, Pa.
Insured: ________________________
Group Name: Morrisville State College
Policy #: CHH0000951	Effective Date: 08/01/2010
Identification No.: ________________________

The Covered Person on the reverse side of this card, and such dependents as are listed on the enrollment form are entitled to the benefits stated in the plan. For benefits please call: Maksin Management Corp. 1-877-440-6838 Send your itemized medical and hospital bills to: Maksin Management Corp. PO Box 2647, Camden, NJ 08101-2647 To secure a claim form, go to: www.maksin.com NEIC# 22195 Express Scripts – Bin: 003858   Processor Control: A4   Group Number: AQ3A