Supplies Application       For use when applying for 2002 or 640 Plan             Application A-LTC(99)  (32 kb) 2002 Brochure             Brochure # B-2002-0997  (505 kb) HIPAA Notice       Must have if applying for 200, 690 or 640 Plan             Form # HHA  (120 kb) LTC Replacement Notice       For use if replacing a LTC Policy with the 2002 Plan             Form # LTC-RN  (6 kb) Supplemental Application       Must have if applying for 2002 or 640 Plan             Form # LTC-SA  (19 kb) 2002 Rate Book       Rates for the 2002 Plan             Rate Book # 01/01-2002  (59 kb) 690 Application             Application # A690  (16 kb) 690 Brochure             Brochure # B690  (303 kb) Medicare Duplication Notice             Form # MDN-8  (15 kb) Replacement Notice       Must have if replacing a policy with the 690 Plan             Form # RN-30  (70 kb) 690 Rate Book             690 Rates  (45 kb) 640 Brochure             Brochure # B-640  (109 kb) LTC Replacement Notice       Must have if replacing a policy with the 640 Plan             Form # LTC-640 RN  (6 kb) 640 Rate Book             640 Rate Book  (22 kb)

Preferred Marketing Associates, Ltd. 3530 North 163rd Plaza (163rd & Maple) Omaha, NE 68116 (402)397-9787 Toll Free 1-800-777-0723