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<html> <head> <title>nos garanties santé PG 42901</title> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> </head> <body bgcolor="#FFFFFF"> <table width="640" border="0" cellspacing="0" cellpadding="0" align="center"> <tr valign="bottom" align="center"> <td height="52"><img src="images/garantie.gif" width="220" height="50"></td> </tr> <tr valign="bottom" align="center"> <td height="5"><img src="images/filet4.gif" width="500" height="7"></td> </tr> </table> <br> <table width="630" border="0" cellspacing="0" cellpadding="0" align="center"> <tr> <td colspan="2"> <p><font face="Arial, Helvetica, sans-serif" size="1">Pour tous les autres soins, consultez-nous, nous vous renseignerons au 04 77 43 20 50. <br> Le détail complet de nos prestations est à votre disposition sur simple demande. <br> RO : Régime Obligatoire de Sécurité Sociale<br> Les pourcentages et les forfaits de cette garantie sont calculés sur la base des tarifs fixés par les organismes Sécurité Sociale et incluent leurs remboursements.</font></p> </td> </tr> </table> <br> <table width="639" border="0" cellspacing="0" cellpadding="1" align="center"> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><img src="images/hospi.gif" width="300" height="50"></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="63"><img src="images/brio.gif" width="54" height="61"></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="63"><img src="images/chic.gif" width="54" height="61"></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="63"><img src="images/recital.gif" width="54" height="61"></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">HONORAIRES, FRAIS DE SÉJOUR</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" size="1" face="Arial, Helvetica, sans-serif">100%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">Suppléments d’honoraires KC et Anesthésie</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">150%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">150%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">170%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">Suppléments d’honoraires PROFESSEURS</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">170-190%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">170-190%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="1">200-220%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">CHAMBRE PARTICULIÈRE</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">24,39 € à <br> 32,78 €</font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1"><br> selon conventions</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">24,39 € à <br> 32,78 €</font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1"><br> selon conventions</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">45,73 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">FRAIS D'ACCOMPAGNANT</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">19,82 €</font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1"> </font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">19,82 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="1">19,82 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">FORFAIT JOURNALIER hospitalier à partir du 1er jour</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">MAISON DE REPOS, CONVALESCENCE ET PSYCHIATRIE</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font size="1" face="Arial, Helvetica, sans-serif"> </font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">Chambre particulière, limite 60 jours par an</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">21,34 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">21,34 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">Forfait journalier, limite 60 jours par an</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font color="#FFFFFF" face="Arial, Helvetica, sans-serif" size="1">10,67 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">TRANSPORT accord RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">100%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><font face="Arial, Helvetica, sans-serif" size="1"><img src="images/maladie.gif" width="163" height="32"></font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100"><font size="1" face="Arial, Helvetica, sans-serif"> </font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">ACTES EN K DE DIAGNOSTIC ET TRAITEMENT</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">125%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">ANALYSE-AUXILIAIRES MÉDICAUX-RADIOS-accord RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">100%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">CONSULTATIONS VISITES</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">125%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">PHARMACIE</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">100%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">VACCINS forfait annuel</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">76,22 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><font size="1"><img src="images/dentaire.gif" width="163" height="32"></font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="5"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">sur devis avec imprimé dentaire complété.</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">SOINS</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">100%</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">PROTHÈSES DENTAIRES FIXES</font></td> <td bgcolor="#99CC33" align="center" valign="top" height="15" width="100"> </td> <td bgcolor="#FFCC00" align="center" valign="top" height="15" width="100"> </td> <td bgcolor="#0000CC" align="center" valign="top" height="15" width="100"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• accord RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">182,94 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">213,43 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">243,9</font><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">2 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• refus RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">114,34 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">137,20 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">167,69 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">PROTHÈSES DENTAIRES MOBILES accord RO, refus RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" colspan="3" height="15"><font face="Arial, Helvetica, sans-serif" size="1">sur avis dentiste conseil</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">ORTHODONTIE accord RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">304,90 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">335,39 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">381,1</font><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">2 €</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><font size="1"><img src="images/optique.gif" width="163" height="32"></font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="18"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="18"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="18"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">Dans la limite de </font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">152,45 €</font><font face="Arial, Helvetica, sans-serif" size="1"> par enfant et par an</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">LUNETTES</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15" > </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15" > </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15" > </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Verres + montures</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">400%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">435%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">470%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" height="15" bgcolor="#FFCC00" ><font face="Arial, Helvetica, sans-serif" size="1">• Forfait monture</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">76,22 €</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">LENTILLES ET VERRES DE CONTACT</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15" > </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• accord RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">400%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">400%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">435%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" height="15" bgcolor="#FFCC00" ><font face="Arial, Helvetica, sans-serif" size="1">• refus RO</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">45,73 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">76,22 €</font></td> </tr> <tr> <td align="left" valign="middle" colspan="2" width="300" bgcolor="#FFCC00" ><img src="images/acoustic.gif" width="163" height="32" align="middle"></td> <td bgcolor="#99CC33" align="center" valign="middle" width="100"><font face="Arial, Helvetica, sans-serif" size="1">140%</font></td> <td bgcolor="#FFCC00" align="center" valign="middle" width="100"><font face="Arial, Helvetica, sans-serif" size="1">165%</font></td> <td bgcolor="#0000CC" align="center" valign="middle" width="100"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">300%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><font size="1"><img src="images/orthoped.gif" width="163" height="32"></font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15" > </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Petit appareillage</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">120%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">120%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">200%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Grand appareillage</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">120%-155%</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">120%-155%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">200%-235%</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" ><font face="Arial, Helvetica, sans-serif" size="1"><img src="images/42901.gif" width="163" height="32"></font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100"> </td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">ASSISTANCE PLUS - vie pratique</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">oui</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">oui</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">oui</font></td> </tr> <tr> <td align="left" valign="top" colspan="2" width="300" bgcolor="#FFCC00" height="25" ><font face="Arial, Helvetica, sans-serif" size="1">NAISSANCE</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="25"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">38,11 </font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">€ à <br> 76,22 €</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="25"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">76,22 </font><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">€ à <br> 152,45 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="25"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1"><font color="#FFFFFF">91,47 </font><font color="#FFFFFF">€ à <br> 182,94 €</font></font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Chambre particulière par jour</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">30,49 €</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">TRAVAILLEUSES FAMILIALES</font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">40%</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">CURE THERMALE </font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"> </td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"> </td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Honoraires </font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">100%</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">100%</font></td> </tr> <tr> <td align="left" valign="bottom" colspan="2" width="300" bgcolor="#FFCC00" height="15" ><font face="Arial, Helvetica, sans-serif" size="1">• Forfait </font></td> <td bgcolor="#99CC33" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" size="1">non</font></td> <td bgcolor="#FFCC00" align="center" valign="top" width="100" height="15"><font color="#000000" face="Arial, Helvetica, sans-serif" size="1">121,96 €</font></td> <td bgcolor="#0000CC" align="center" valign="top" width="100" height="15"><font face="Arial, Helvetica, sans-serif" color="#FFFFFF" size="1">152,45 €</font></td> </tr> </table> <br> <table width="630" border="0" cellspacing="0" cellpadding="0" align="center"> <tr> <td><font face="Arial, Helvetica, sans-serif" size="1"><b>Document 2002 non contractuel</b>. Les prestations décrites ci-dessus sont limitées aux frais réels et aux accords <br> conventionnels départementaux ou nationaux conclus avec les tiers par la mutuelle. <br> Elles ne comprennent aucun remboursement complémentaire consécutif à un accident du travail, et pour la maternité se limitent aux prestations prévues pour la naissance. Les pourcentages de cette garantie sont calculés sur la base des tarifs conventionnels ou homologués par les organismes de Sécurité Sociale en vigueur au 6 octobre 2001.</font></td> </tr> </table> <p> </p> </body> </html>