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City of Lakewood: Plan 1 Coverage Period: 01 (0112014- iN3112014 <br />Summary of Benefits and Coverage: What This Plan Covers &What it Costs Coverage for: Single or Family I Plan Type: PPO <br />Questions: Call 800.540.2583 or visit us at MedMutual.com /SBC. Peg, 3 of 8 <br />If you aren t clear about any of the underfeed terms used in this form, seethe Glossary. You can view the Glossary se49assss <br />at Medhlutual.eonBBC or call 800.540.2583 to request a copy. eemlaat ?s?CesSSa-0oo2a <br />City of Lakewood : Plan 1 Coverage Period: 01[01f2014- 1 213112 014 <br />Summary of Benefits and Coverage: What This Plan Covers & What It Costa Coverage for: Single or Family I Plan Type: PPO <br />32 <br />