GOVERNMENT EMPLOYEES HEALTH ASSOCIATION, INC. QUESTIONNAIRE TO ALL MEMBERS OF THE ASSOCIATION BENEFIT PLAN

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP87-00868R000100060043-3
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: December 22, 2016
• Document Release Date: July 16, 2009
• Sequence Number: 43
• Publication Date: June 1, 1962
• Content Type: MISC

Approved For Release 2009/07/16: CIA-RDP87-00868R000100060043-33
0 CIA INTERNAL USE ONLY V
June 1962
GOVERNMENT EMPLOYEES HEALTH ASSOCIATION, INC.
QUESTIONNAIRE TO ALL MEMBERS OF THE ASSOCIATION BENEFIT PLAN
1. We are currently exploring the feasibility of group hospitaliza-
tion insurance to cover the parents of members of the Association Benefit
Plan. The underwriter, Mutual of Omaha, has submitted a tentative offer
subject to the following conditions:
Eligibility: Open to parents of member and spouse, aged 65 or over.
Grandparents or collateral relatives such as uncles or
aunts are not eligible.
Coverage: Covers hospitalization expense due to accident or illness.
Good in any regularly licensed hospital, anywhere in the
world.
Benefits: Up to $12.00 per day for hospital room and board and cer-
tain extras for a maximum of 60 days in one calendar year.
Up to $250.00 for surgical operations payable on a sched-
uled basis according to the nature of the operation.
Cost: The monthly premium charge will be approximately $13.85
per couple or $6.95 per individual covered.
2. In order to assist us in further negotiations with the under-
writer, we will need information concerning the extent of interest in
such plan and the number of potential participants. If you have eligible
members in your family, whom you would like to consider for this coverage,
please fill out the attached form and return to the Insurance Branch,
Room 1-J-33, Headquarters Building. This does not oias!..itute an appli-
cation for coverage nor does it obligate you in any v.,o,y,
,
---------------
I am interested in the hospitalization plan for parents.
The following members of my family are eligible:
Father / / Father-in-law
Mother 1 / Mother-in-law
Comments:
Signature
CIA INTERNAL USE ONLY
Approved For Release 2009/07/16: CIA-RDP87-00868R000100060043-3
 Approved For Release 2009/07/16: CIA-RDP87-00868R000100060043-3
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Approved For Release 2009/07/16: CIA-RDP87-00868R000100060043-3
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