Premium of Global Elite II are not guaranteed. AXA China Region Insurance Company (Bermuda) Limited (Incorporated in Bermuda with limited liability) (

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Global Elite II Health Plan 寰宇特選 II 醫療計劃 Premium Table 保費表 A

Premium of Global Elite II are not guaranteed. AXA China Region Insurance Company (Bermuda) Limited (Incorporated in Bermuda with limited liability) ( the Company ) reserves the right to change all or any part of this policy including the Benefits Schedule and/or any of the terms and conditions, but only for the reasons shown in the policy at each policy anniversary. Premium of Global Elite II will be adjusted based on the attained age of the insured on each policy anniversary and according to the prevailing premium at the time of renewal. You may refer to your financial consultant or the Company for more information on renewal premium. The information furnished herein by the Company is only to be used for reference purposes. 寰宇特選 II 的保費並非保證, 安盛保險 ( 百慕達 ) 有限公司 ( 於百慕達註冊成立的有限公司 )( 本公司 ) 保留於每個保單週年重新檢討及調整全部或部份保單內容包括保險賠償表及 / 或任何條款及條件之權利, 但只限於保單內所列明之原因 寰宇特選 II 保費會於每個保單週年續保時, 根據被保人的已屆及當時適用之保費作出調整 請聯絡您的理財顧問或本公司以取得更多續保保費詳情 此處由本公司提供的資料只可用於參考之用

List of Principal Country of Residence The country where the insured lives or intends to live for most of the Policy Year being 185 days or more and which will be shown as the insured s address and place of residence in our records. Name Zone Country/Territory Code Afghanistan 6 AFG Albania 6 ALB Alderney 4 GBA Algeria 6 ALG American Samoa 4 ASA Andorra 5 AND Angola 6 ANG Anguilla 4 AGU Antarctica 5 ANT Antigua & Barduda 4 ANB Argentina 4 ARG Armenia 5 ARM Aruba 4 ARU Australia 5 AUS Austria 5 AUT Azerbaijan 6 AZR Azores 5 AZO Bahamas 4 BHS Bahrain 2 BRN Bangladesh 4 BDH Barbados 4 BDS Belgium 5 BEL Belize 4 BLZ Benin 6 BEN Bermuda 4 BER Bhutan 5 BHU Bolivia 4 BOL Bosnia & Herzegovir 6 BOS Botswana 6 BTW Bouvet Island 6 BOV Brazil 4 BRZ British Indian Ocean Territory 6 BIO Brunei Darussalam 6 BRU Bulgaria 5 BUL Burkina Faso 5 BKF Burundi 5 BRD Cambodia 6 CAM Cameroon 6 CMR Canada 6 CDN Canary Islands 4 CYI Cape Verde 6 CVI Cayman Islands 4 CAY Central African Republic 5 CAR Chad 6 CHD Chile 4 CHL China 7 CHN Christmas Island 5 CHR Cocos (Keeling) Islands 5 COC Colombia 4 COL Comoros 6 COM Cook Islands 5 COK Costa Rica 4 CRC Cote d lvoire 6 COT Croatia 6 CRO Cyprus 5 CYP Czech Republic 6 CZH Denmark 6 DMK Djibouti 6 DJB Dominica 4 DOM Dominican Republic 4 DOM Ecuador 4 ECU Egypt 6 EGP El Salvador 4 ELS Equatorial Guinea 5 EGU Eritrea 6 ERI Estonia 5 EST Ethiopia 6 ETH Falkland Islands (Malvinas) 4 FAK Faroe Islands 6 FIS Fiji 5 FIJ Finland 5 FIN France 5 FRA French Guiana 5 FGU French Polynesia 5 FPO French Southern Territories 5 FST Gabon 5 GAB Gambia 6 GAM Georgia 5 GEO Germany 4 GER Name Zone Country/Territory Code Ghana 6 GHA Gibraltar 4 GBZ Greece 2 GCE Greenland 6 GRE Grenada 4 GND Guadeloupe 4 GUD Guam 5 GUA Guatemala 2 GTM Guernsey 4 GBG Guinea 6 GUI Guinea-Bissau 6 GUB Guyana 4 GUY Haiti 4 HAI Heard and McDonald Islands 5 HMI Herm 5 HRM Holy See (Vatican City State) 4 VAT Honduras 2 HON Hong Kong 2 HGK Hungary 6 HUN Iceland 6 ICL India 6 IND Indonesia 5 IDS Iraq 4 IRQ Ireland 4 IRL Isle of Man 4 GBM Israel 2 ISL Italy 4 ITL Jamaica 4 JAM Japan 6 JAP Jersey 3 GBJ Jordan 5 JOR Kazakhstan 6 KAZ Kenya 4 KEN Kiribati 5 KIR Kuwait 4 KWT Kyrgyzstan 5 KYR Lao People s Democratic Rep 5 LAO Latvia 5 LAT Lebanon 4 LEB Lesotho 5 LSO Liberia 5 LIB Libyan Arab Jamahiriya 5 LBY Liechtenstein 4 LCH Lithuania 5 LIT Luxembourg 6 LUX Macau 2 MCA Madagascar 6 MAD Madeira 4 MAE Malawi 5 MLW Malaysia 6 MAL Maldives 5 MDS Mali 6 MAI Malta 6 MLT Marshall Islands 5 MIS Martinique 4 MAR Mauritania 6 MRT Mauritius 5 MAU Mayotte 5 MAY Mexico 2 MEX Micronesia Federated States 5 MIC Moldova (Republic of) 5 MOL Monaco 4 MNC Mongolia 4 MNG Montenegro 5 MTG Montserrat 4 MON Morocco 6 MOR Mozambique 6 MOZ Namibia 5 NMB Nauru 5 NAU Nepal 5 NEP Netherlands 6 HOL Netherlands Antilles 4 NEA New Caledonia 5 NCL New Zealand 6 NZL Nicaragua 4 NCA Niger 5 NGR Nigeria 5 NIG Niue 5 NIU Norfolk Island 5 NOF Name Zone Country/Territory Code Northern Mariana Islands 5 NMI Norway 6 NOR Oman 5 UAO Pakistan 6 PAK Palau 5 PAL Panama 4 PAN Papua New Guinea 6 PNG Paraguay 4 PGY Peru 4 PER Philippines 6 PHI Pitcairn 5 PIT Poland 6 POL Portugal 4 POR Puerto Rico 4 PRC Qatar 5 UAQ Republic of Macedonia 6 MAC Reunion 5 RUN Romania 6 ROM Russian Federation 3 RUS Rwanda 5 RWA Saint Helena 4 SHL Saint Kitts and Nevis 4 STK Saint Lucia 4 STL Saint Pierre and Miquelon 4 SPM Samoa 5 SAU San Marino 5 SMA Sao Tome and Principe 5 SAO Sark 4 GBS Saudi Arabia 4 SDA Senegal 5 SGL Serbia 5 SER Seychelles 5 SEY Sierra Leone 5 SLN Singapore 3 SGP Slovakia 6 SLV Slovenia 6 SLO Solomon Islands 5 SOI South Africa 5 RSA South Korea (Republic of) 6 KOR Spain 3 ESP Sri Lanka 6 SRL St Vincent and the Grenadines 4 STV Sth Georgia and Sth Sandwich Is 4 SGS Suriname 4 SME Svalbard and Jan Mayen 5 SVA Swaziland 5 SWZ Sweden 6 SWE Switzerland 3 SWI Taiwan 4 TWN Tajikistan 5 TAJ Tanzania (United Republic of) 5 TNZ Thailand 5 THI Timor-Leste 5 TIM Togo 6 TOG Tokelau 5 TOK Tonga 5 TNG Trinidad and Tobago 4 TAT Tunisia 5 TUN Turkey 5 TRK Turkmenistan 5 TUR Turks and Caicos Islands 4 TUK Tuvalu 5 TUV UAE 4 UAE Uganda 5 EAU Ukraine 5 UKR United Kingdom 3 GBR Uruguay 4 UGY Uzbekistan 5 UZB Vanuatu 5 VAN Venezuela 4 VNZ Vietnam 5 VIT Virgin Islands (British) 4 VIK Virgin Islands (US) 4 VIU Wallis and Futuna Islands 5 WAL Western Sahara 5 SAH Yemen 4 YEM Zambia 5 ZAM We define as Afghanistan, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Mongolia, Myanmar, Nepal, North Korea, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, Vietnam We define excluding USA as excluding USA We define as Note: No country in the List of Principal Country of Residence currently belongs to Zone 1. Hong Kong, Macau and Taiwan are respectively considered as country for the purposes of this policy. 1

主要居留地列表 被保人於保單年度內大部分時間 ( 即 185 日或以上 ) 生活或擬定生活, 並於本公司紀錄列為被保人地址及居留地的國家 名稱區國家 / 地區碼名稱區國家 / 地區碼名稱區國家 / 地區碼 阿富汗 6 AFG 阿爾巴尼亞 6 ALB 奧爾德尼 4 GBA 阿爾及利亞 6 ALG 美屬薩摩亞 4 ASA 安道爾共和國 5 AND 安哥拉 6 ANG 安圭拉島 4 AGU 南極洲 5 ANT 安堤瓜及巴爾布達 4 ANB 阿根廷 4 ARG 亞美利亞 5 ARM 阿魯巴 4 ARU 澳洲 5 AUS 奧地利 5 AUT 阿塞拜疆 6 AZR 亞速爾群島 5 AZO 巴哈馬 4 BHS 巴林 2 BRN 孟加拉 4 BDH 巴巴多斯 4 BDS 比利時 5 BEL 伯利茲 4 BLZ 貝寧 6 BEN 百慕達 4 BER 不丹 5 BHU 玻利維亞 4 BOL 波斯尼亞和黑塞哥維那 6 BOS 博茨瓦納 6 BTW 布維島 6 BOV 巴西 4 BRZ 英屬印度洋地區 6 BIO 汶萊達魯薩蘭國 6 BRU 保加利亞 5 BUL 布基納法索 5 BKF 布隆迪 5 BRD 柬埔寨 6 CAM 喀麥隆 6 CMR 加拿大 6 CDN 加納利群島 4 CYI 佛得角 6 CVI 開曼群島 4 CAY 中非共和國 5 CAR 乍得 6 CHD 智利 4 CHL 中國 7 CHN 聖誕島 5 CHR 科科斯群島 5 COC 哥倫比亞 4 COL 科摩羅 6 COM 庫克群島 5 COK 哥斯達黎加 4 CRC 科特迪瓦 6 COT 克羅地亞 6 CRO 塞浦路斯 5 CYP 捷克 6 CZH 丹麥 6 DMK 吉布提 6 DJB 多米尼加 4 DOM 多明尼加共和國 4 DOM 厄瓜多爾 4 ECU 埃及 6 EGP 薩爾瓦多 4 ELS 赤道幾內亞 5 EGU 厄立特里亞 6 ERI 愛沙尼亞 5 EST 埃塞俄比亞 6 ETH 福克蘭群島 ( 馬爾維納斯群島 ) 4 FAK 法羅群島 6 FIS 斐濟 5 FIJ 芬蘭 5 FIN 法國 5 FRA 法屬圭亞那 5 FGU 法屬波利尼西亞 5 FPO 法國南部地區 5 FST 加蓬 5 GAB 岡比亞 6 GAM 格魯吉亞 5 GEO 德國 4 GER 加納 6 GHA 直布羅陀 4 GBZ 希臘 2 GCE 格陵蘭 6 GRE 格林納達 4 GND 瓜德羅普 4 GUD 關島 5 GUA 危地馬拉 2 GTM 格恩西島 4 GBG 幾內亞 6 GUI 幾內亞比紹 6 GUB 圭亞那 4 GUY 海地 4 HAI 赫德島及麥克唐納島 5 HMI 赫姆 5 HRM 教廷 ( 梵蒂岡城國 ) 4 VAT 洪都拉斯 2 HON 香港 2 HGK 匈牙利 6 HUN 冰島 6 ICL 印度 6 IND 印尼 5 IDS 伊拉克 4 IRQ 愛爾蘭 4 IRL 馬恩島 4 GBM 以色列 2 ISL 意大利 4 ITL 牙買加 4 JAM 日本 6 JAP 澤西 3 GBJ 約旦 5 JOR 哈薩克 6 KAZ 肯尼亞 4 KEN 基里巴斯 5 KIR 科威特 4 KWT 吉爾吉斯 5 KYR 老撾人民民主共和國 5 LAO 拉脫維亞 5 LAT 黎巴嫩 4 LEB 萊索托 5 LSO 利比里亞 5 LIB 阿拉伯利比亞民眾國 5 LBY 列支敦士登 4 LCH 立陶宛 5 LIT 盧森堡 6 LUX 澳門 2 MCA 馬達加斯加 6 MAD 馬德拉群島 4 MAE 馬拉維 5 MLW 馬來西亞 6 MAL 馬爾代夫 5 MDS 馬里 6 MAI 馬耳他 6 MLT 馬紹爾群島 5 MIS 馬提尼克島 4 MAR 毛里塔尼亞 6 MRT 毛里求斯 5 MAU 馬約特 5 MAY 墨西哥 2 MEX 密克羅尼西亞聯邦 5 MIC 摩爾多瓦共和國 5 MOL 摩納哥 4 MNC 蒙古 4 MNG 黑山 5 MTG 蒙特塞拉特島 4 MON 摩洛哥 6 MOR 莫桑比克 6 MOZ 納米比亞 5 NMB 瑙魯 5 NAU 尼泊爾 5 NEP 荷蘭 6 HOL 荷屬安的列斯 4 NEA 新喀里多尼亞 5 NCL 新西蘭 6 NZL 尼加拉瓜 4 NCA 尼日爾 5 NGR 尼日利亞 5 NIG 紐埃島 5 NIU 諾褔克島 5 NOF 北馬里亞納群島 5 NMI 挪威 6 NOR 阿曼 5 UAO 巴基斯坦 6 PAK 帕勞 5 PAL 巴拿馬 4 PAN 巴布亞新幾內亞 6 PNG 巴拉圭 4 PGY 秘魯 4 PER 菲律賓 6 PHI 皮特凱恩 5 PIT 波蘭 6 POL 葡萄牙 4 POR 波多黎各 4 PRC 卡塔爾 5 UAQ 馬其頓共和國 6 MAC 留尼汪島 5 RUN 羅馬尼亞 6 ROM 俄羅斯聯邦 3 RUS 盧旺達 5 RWA 聖赫勒拿島 4 SHL 聖基茨及尼維斯 4 STK 聖盧西亞 4 STL 聖皮埃爾島及密克隆島 4 SPM 薩摩亞 5 SAU 聖馬力諾 5 SMA 聖多美和普林西比 5 SAO 薩克島 4 GBS 沙特阿拉伯 4 SDA 塞內加爾 5 SGL 塞爾維亞 5 SER 塞舌爾 5 SEY 塞拉利昂 5 SLN 新加坡 3 SGP 斯洛伐克 6 SLV 斯洛文尼亞 6 SLO 所羅門群島 5 SOI 南非 5 RSA 南韓 ( 大韓民國 ) 6 KOR 西班牙 3 ESP 斯里蘭卡 6 SRL 聖文森特和格林內丁斯 4 STV 南喬治亞島及南桑威奇群島 4 SGS 蘇里南 4 SME 斯瓦爾巴特群島及揚馬延島 5 SVA 斯威士蘭 5 SWZ 瑞典 6 SWE 瑞士 3 SWI 台灣 4 TWN 塔吉克斯坦 5 TAJ 坦桑尼亞 ( 聯合共和國 ) 5 TNZ 泰國 5 THI 東帝汶 5 TIM 多哥 6 TOG 托克勞群島 5 TOK 湯加 5 TNG 特立尼達和多巴哥 4 TAT 突尼斯 5 TUN 土耳其 5 TRK 土庫曼斯坦 5 TUR 特克斯和凱科斯群島 4 TUK 圖瓦盧 5 TUV 阿拉伯聯合酋長國 4 UAE 烏干達 5 EAU 烏克蘭 5 UKR 英國 3 GBR 烏拉圭 4 UGY 烏茲別克斯坦 5 UZB 瓦努阿圖 5 VAN 委內瑞拉 4 VNZ 越南 5 VIT 英屬維爾京群島 4 VIK 美屬維爾京群島 4 VIU 瓦利斯群島和富圖納群島 5 WAL 西撒哈拉 5 SAH 也門 4 YEM 贊比亞 5 ZAM 指 阿富汗 孟加拉 不丹 汶萊 柬埔寨 中國 香港 印度 印尼 日本 哈薩克 吉爾吉斯 老撾 澳門 馬來西亞 馬爾代夫 蒙古 緬甸 尼泊爾 北韓 巴基斯坦 菲律賓 新加坡 南韓 斯里蘭卡 台灣 塔吉克 泰國 東帝汶 土庫曼 烏茲別克 越南 ( 不包括美國 ) 指 各地, 但不包括美國 指 2 附註 : 現時主要居留地列表中並無任何國家屬於第 1 區 就有關本保單而言, 香港 澳門及台灣均分別地被視為國家

Annual Deductible Option: NIL 每年自付額選擇 : 無 PRESTIGE 特級 COMPREHENSIVE 全面 STANDARD 標準 ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) 0 20,343 2,625 20,864 2,692 44,733 5,772 1 20,343 2,625 20,864 2,692 44,733 5,772 2 20,343 2,625 20,864 2,692 44,733 5,772 3 20,343 2,625 20,864 2,692 44,733 5,772 4 20,343 2,625 20,864 2,692 44,733 5,772 5 20,343 2,625 20,864 2,692 44,733 5,772 6 20,343 2,625 20,864 2,692 44,733 5,772 7 20,343 2,625 20,864 2,692 44,733 5,772 8 20,343 2,625 20,864 2,692 44,733 5,772 9 20,343 2,625 20,864 2,692 44,733 5,772 10 22,634 2,921 23,229 2,997 44,733 5,772 11 24,956 3,220 25,595 3,303 45,492 5,870 12 26,703 3,446 27,386 3,534 48,677 6,281 13 26,735 3,450 27,418 3,538 49,950 6,445 14 27,670 3,570 28,378 3,662 50,046 6,458 15 28,777 3,713 29,513 3,808 52,047 6,716 16 29,928 3,862 30,694 3,961 54,129 6,984 17 31,125 4,016 32,075 4,139 56,294 7,264 18 32,732 4,223 33,564 4,331 58,546 7,554 19 33,665 4,344 35,027 4,520 60,888 7,857 20 35,012 4,518 36,603 4,723 63,324 8,171 21 36,237 4,676 38,250 4,935 66,173 8,538 22 37,506 4,839 39,971 5,158 69,151 8,923 23 38,818 5,009 41,770 5,390 72,608 9,369 24 39,983 5,159 43,650 5,632 76,239 9,837 25 40,982 5,288 45,614 5,886 80,813 10,427 26 41,602 5,368 46,034 5,940 82,861 10,692 27 42,451 5,478 46,954 6,059 84,518 10,906 28 43,434 5,604 48,171 6,216 86,708 11,188 29 45,539 5,876 50,599 6,529 91,078 11,752 30 47,816 6,170 53,129 6,855 95,632 12,340 31 48,201 6,219 53,557 6,911 96,402 12,439 32 49,564 6,395 55,071 7,106 99,127 12,791 33 50,948 6,574 56,608 7,304 101,895 13,148 34 53,134 6,856 59,038 7,618 106,268 13,712 35 53,745 6,935 59,717 7,705 107,491 13,870 36 54,893 7,083 60,993 7,870 109,787 14,166 37 55,458 7,156 61,620 7,951 110,916 14,312 38 55,751 7,194 61,946 7,993 111,503 14,387 39 56,122 7,242 62,357 8,046 112,243 14,483 40 57,267 7,389 63,630 8,210 114,534 14,779 41 58,412 7,537 64,902 8,374 116,824 15,074 42 59,725 7,706 66,358 8,562 119,161 15,376 43 61,159 7,891 67,953 8,768 121,508 15,678 44 62,924 8,119 69,920 9,022 125,154 16,149 45 64,716 8,350 71,906 9,278 128,908 16,633 46 66,214 8,544 73,571 9,493 131,486 16,966 47 67,719 8,738 75,245 9,709 134,116 17,305 48 69,248 8,935 76,944 9,928 136,798 17,651 49 70,786 9,134 78,647 10,148 139,881 18,049 50 72,337 9,334 80,371 10,370 143,359 18,498 51 73,896 9,535 82,111 10,595 146,855 18,949 52 75,476 9,739 83,866 10,821 150,389 19,405 53 78,462 10,124 87,177 11,249 157,449 20,316 54 81,864 10,563 90,960 11,737 165,338 21,334 55 85,326 11,010 94,800 12,232 173,355 22,368 56 88,847 11,464 98,721 12,738 181,493 23,418 57 92,647 11,954 102,943 13,283 190,192 24,541 58 98,021 12,648 108,916 14,054 201,246 25,967 59 104,242 13,451 115,827 14,945 214,001 27,613 60 110,441 14,250 122,703 15,833 226,681 29,249 61 116,960 15,092 129,950 16,768 240,072 30,977 62 123,875 15,984 137,640 17,760 254,285 32,811 63 131,215 16,931 145,797 18,813 269,374 34,758 64 139,009 17,937 154,450 19,929 286,470 36,964 65 147,830 19,075 164,257 21,194 305,785 39,456 66 156,391 20,179 173,772 22,422 326,412 42,118 67 166,197 21,445 184,662 23,827 348,458 44,962 68 177,439 22,895 197,144 25,438 372,014 48,002 69 189,493 24,451 210,537 27,166 397,182 51,249 70 198,356 25,594 220,378 28,436 415,679 53,636 71 208,093 26,851 231,222 29,835 436,008 56,259 72 218,315 28,170 242,574 31,300 457,316 59,009 73 229,010 29,550 254,454 32,833 479,627 61,887 74 240,235 30,998 266,913 34,440 503,021 64,906 75 251,977 32,513 279,969 36,125 522,290 67,392 76 264,297 34,103 293,649 37,890 542,331 69,978 77 277,193 35,767 307,985 39,740 563,167 72,667 78 290,710 37,511 323,001 41,678 584,831 75,462 79 303,687 39,185 337,419 43,538 607,350 78,368 80-99 315,384 40,695 350,428 45,217 630,767 81,389 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,136 4,405 17,068 2,202 18,958 2,446 34,733 4,482 17,068 2,202 18,958 2,446 35,343 4,560 18,564 2,395 20,627 2,662 37,128 4,791 18,750 2,419 20,833 2,688 37,500 4,839 18,937 2,443 21,041 2,715 37,875 4,887 19,127 2,468 21,252 2,742 38,253 4,936 19,318 2,493 21,464 2,770 38,636 4,985 19,511 2,518 21,679 2,797 39,022 5,035 19,706 2,543 21,896 2,825 39,413 5,086 19,903 2,568 22,115 2,854 39,807 5,136 20,699 2,671 22,999 2,968 41,399 5,342 21,527 2,778 23,919 3,086 43,055 5,555 22,389 2,889 24,876 3,210 44,777 5,778 23,284 3,004 25,871 3,338 46,568 6,009 24,215 3,125 26,906 3,472 48,431 6,249 25,184 3,250 27,982 3,611 50,368 6,499 26,191 3,379 29,102 3,755 52,383 6,759 27,239 3,515 30,266 3,905 54,478 7,029 28,329 3,655 31,476 4,061 56,657 7,311 29,462 3,802 32,735 4,224 58,924 7,603 30,640 3,954 34,045 4,393 61,281 7,907 31,866 4,112 35,407 4,569 63,732 8,223 33,141 4,276 36,823 4,751 66,281 8,552 34,466 4,447 38,296 4,941 68,932 8,894 35,845 4,625 39,828 5,139 71,690 9,250 37,279 4,810 41,421 5,345 74,557 9,620 38,770 5,003 43,077 5,558 77,539 10,005 40,320 5,203 44,801 5,781 80,641 10,405 41,933 5,411 46,593 6,012 83,867 10,822 46,451 5,994 51,613 6,660 92,903 11,987 48,548 6,264 53,942 6,960 97,096 12,529 50,085 6,463 55,651 7,181 100,171 12,925 51,961 6,705 57,734 7,450 103,922 13,409 53,618 6,918 59,576 7,687 107,237 13,837 55,273 7,132 61,414 7,924 110,546 14,264 56,655 7,310 62,950 8,123 113,311 14,621 58,074 7,493 64,527 8,326 116,148 14,987 59,489 7,676 66,094 8,528 118,898 15,342 61,242 7,902 68,037 8,779 121,733 15,707 62,882 8,114 69,866 9,015 123,988 15,998 65,002 8,387 72,224 9,319 127,383 16,437 67,505 8,710 75,012 9,679 132,093 17,044 70,131 9,049 77,919 10,054 137,063 17,686 72,990 9,418 81,100 10,465 142,775 18,423 75,979 9,804 84,420 10,893 148,754 19,194 79,059 10,201 87,844 11,335 154,862 19,982 82,314 10,621 91,463 11,802 161,438 20,831 86,887 11,211 96,545 12,457 169,659 21,891 92,238 11,902 102,485 13,224 180,398 23,277 96,335 12,430 107,042 13,812 185,468 23,931 102,474 13,222 113,858 14,691 198,025 25,552 109,078 14,075 121,204 15,639 211,742 27,322 115,401 14,890 128,220 16,545 223,551 28,845 123,357 15,917 137,065 17,686 241,083 31,107 130,384 16,824 144,872 18,693 254,057 32,782 137,830 17,785 153,144 19,761 268,568 34,654 145,936 18,830 162,145 20,922 285,857 36,885 154,958 19,995 172,173 22,216 305,136 39,372 163,078 21,042 181,199 23,381 322,775 41,648 169,837 21,914 188,710 24,350 337,930 43,604 176,783 22,811 196,425 25,345 353,572 45,622 182,911 23,601 203,235 26,224 365,823 47,203 189,528 24,455 210,584 27,172 379,060 48,911 197,603 25,497 219,557 28,330 395,201 50,994 205,684 26,540 228,536 29,489 411,368 53,080 212,906 27,472 236,562 30,524 425,816 54,944 220,993 28,515 245,553 31,684 441,997 57,032 230,526 29,745 256,134 33,050 461,046 59,490 238,825 30,816 265,362 34,240 477,650 61,632 251,976 32,513 279,970 36,125 503,947 65,025 8,190 1,057 9,100 1,174 16,379 2,113 8,435 1,088 9,373 1,209 16,871 2,177 8,688 1,121 9,654 1,246 17,377 2,242 8,862 1,143 9,847 1,271 17,725 2,287 9,128 1,178 10,044 1,296 18,079 2,333 9,399 1,213 10,345 1,335 18,441 2,379 9,591 1,238 10,604 1,368 18,809 2,427 9,784 1,262 10,832 1,398 19,186 2,476 10,076 1,300 11,045 1,425 19,628 2,533 10,378 1,339 11,271 1,454 20,216 2,609 10,631 1,372 11,568 1,493 20,823 2,687 10,832 1,398 11,915 1,537 21,448 2,767 11,032 1,423 12,273 1,584 22,091 2,850 11,234 1,450 12,641 1,631 22,754 2,936 11,497 1,483 12,957 1,672 23,323 3,009 11,784 1,521 13,281 1,714 23,906 3,085 12,020 1,551 13,547 1,748 24,384 3,146 12,383 1,598 13,956 1,801 25,120 3,241 12,631 1,630 14,235 1,837 25,623 3,306 12,883 1,662 14,519 1,873 26,135 3,372 13,109 1,691 14,774 1,906 26,592 3,431 13,338 1,721 15,032 1,940 27,058 3,491 13,572 1,751 15,295 1,974 27,531 3,552 13,809 1,782 15,563 2,008 28,013 3,615 14,051 1,813 15,835 2,043 28,503 3,678 14,338 1,850 16,112 2,079 29,002 3,742 14,660 1,892 16,394 2,115 29,510 3,808 15,105 1,949 17,005 2,194 30,608 3,949 15,586 2,011 18,200 2,348 32,759 4,227 16,061 2,072 18,978 2,449 34,161 4,408 16,560 2,137 19,821 2,558 35,677 4,603 17,024 2,197 20,487 2,643 36,877 4,758 17,760 2,292 21,453 2,768 38,615 4,983 18,242 2,354 22,088 2,850 39,758 5,130 18,829 2,430 22,742 2,934 40,935 5,282 19,395 2,503 23,457 3,027 42,223 5,448 20,084 2,591 24,200 3,123 43,560 5,621 20,276 2,616 24,357 3,143 43,843 5,657 21,512 2,776 25,663 3,311 46,194 5,961 22,332 2,882 26,980 3,481 48,565 6,266 23,522 3,035 28,164 3,634 50,695 6,541 24,702 3,187 29,376 3,790 52,876 6,823 26,025 3,358 30,650 3,955 55,170 7,119 27,209 3,511 31,935 4,121 57,483 7,417 28,671 3,699 33,226 4,287 59,807 7,717 30,708 3,962 35,210 4,543 63,379 8,178 32,707 4,220 37,531 4,843 67,556 8,717 35,008 4,517 39,481 5,094 71,066 9,170 37,314 4,815 41,460 5,350 74,627 9,629 39,877 5,145 44,307 5,717 79,753 10,291 41,965 5,415 46,628 6,017 83,930 10,830 44,863 5,789 49,848 6,432 89,726 11,578 50,844 6,561 56,493 7,289 101,688 13,121 54,323 7,009 60,359 7,788 108,646 14,019 58,355 7,530 64,839 8,366 116,711 15,059 63,298 8,167 70,331 9,075 126,595 16,335 66,516 8,583 73,907 9,536 133,032 17,165 69,760 9,001 77,511 10,001 139,520 18,003 73,022 9,422 81,136 10,469 146,045 18,845 74,866 9,660 83,185 10,734 149,733 19,320 77,163 9,957 85,736 11,063 154,325 19,913 81,265 10,486 90,295 11,651 162,530 20,972 85,106 10,981 94,562 12,202 170,212 21,963 87,434 11,282 97,149 12,535 174,869 22,564 90,704 11,704 100,783 13,004 181,409 23,408 95,716 12,350 106,351 13,723 191,432 24,701 99,298 12,813 109,626 14,145 197,327 25,462 108,189 13,960 120,210 15,511 216,377 27,920 ZONE 2 第 2 區 3

Annual Deductible Option: 12,000 or 1,500 每年自付額選擇 :12,000 或 1,500 ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) 第 2 區 ZONE 2 0 12,206 1,575 12,518 1,615 26,840 3,463 1 12,206 1,575 12,518 1,615 26,840 3,463 2 12,206 1,575 12,518 1,615 26,840 3,463 3 12,206 1,575 12,518 1,615 26,840 3,463 4 12,206 1,575 12,518 1,615 26,840 3,463 5 12,206 1,575 12,518 1,615 26,840 3,463 6 12,206 1,575 12,518 1,615 26,840 3,463 7 12,206 1,575 12,518 1,615 26,840 3,463 8 12,206 1,575 12,518 1,615 26,840 3,463 9 12,206 1,575 12,518 1,615 26,840 3,463 10 13,580 1,753 13,937 1,798 26,840 3,463 11 14,974 1,932 15,357 1,982 27,295 3,522 12 16,022 2,068 16,432 2,120 29,206 3,769 13 16,041 2,070 16,451 2,123 29,970 3,867 14 16,602 2,142 17,027 2,197 30,028 3,875 15 17,266 2,228 17,708 2,285 31,228 4,030 16 17,957 2,317 18,416 2,377 32,477 4,190 17 18,675 2,410 19,245 2,483 33,776 4,358 18 19,639 2,534 20,138 2,599 35,128 4,532 19 20,199 2,606 21,016 2,712 36,533 4,714 20 21,007 2,711 21,962 2,834 37,994 4,903 21 21,742 2,806 22,950 2,961 39,704 5,123 22 22,504 2,903 23,983 3,095 41,491 5,354 23 23,291 3,005 25,062 3,234 43,565 5,621 24 23,990 3,095 26,190 3,379 45,743 5,902 25 24,589 3,173 27,368 3,532 48,488 6,256 26 24,961 3,221 27,620 3,564 49,717 6,415 27 25,471 3,287 28,172 3,635 50,711 6,544 28 26,060 3,362 28,903 3,730 52,025 6,713 29 27,323 3,526 30,359 3,917 54,647 7,051 30 28,690 3,702 31,877 4,113 57,379 7,404 31 28,921 3,731 32,134 4,147 57,841 7,463 32 29,738 3,837 33,043 4,264 59,476 7,675 33 30,569 3,944 33,965 4,382 61,137 7,889 34 31,880 4,114 35,423 4,571 63,761 8,227 35 32,247 4,161 35,830 4,623 64,495 8,322 36 32,936 4,250 36,596 4,722 65,872 8,500 37 33,275 4,294 36,972 4,771 66,550 8,587 38 33,451 4,316 37,168 4,796 66,902 8,632 39 33,673 4,345 37,414 4,828 67,346 8,690 40 34,360 4,433 38,178 4,926 68,720 8,867 41 35,047 4,522 38,941 5,024 70,094 9,044 42 35,835 4,624 39,815 5,137 71,497 9,226 43 36,695 4,735 40,772 5,261 72,905 9,407 44 37,754 4,871 41,952 5,413 75,092 9,689 45 38,830 5,010 43,144 5,567 77,345 9,980 46 39,728 5,126 44,143 5,696 78,892 10,180 47 40,631 5,243 45,147 5,825 80,470 10,383 48 41,549 5,361 46,166 5,957 82,079 10,591 49 42,472 5,480 47,188 6,089 83,929 10,829 50 43,402 5,600 48,223 6,222 86,015 11,099 51 44,338 5,721 49,267 6,357 88,113 11,369 52 45,286 5,843 50,320 6,493 90,233 11,643 53 47,077 6,074 52,306 6,749 94,469 12,190 54 49,118 6,338 54,576 7,042 99,203 12,800 55 51,196 6,606 56,880 7,339 104,013 13,421 56 53,308 6,878 59,233 7,643 108,896 14,051 57 55,588 7,172 61,766 7,970 114,115 14,725 58 58,813 7,589 65,350 8,432 120,748 15,580 59 62,545 8,071 69,496 8,967 128,401 16,568 60 66,265 8,550 73,622 9,500 136,009 17,549 61 70,176 9,055 77,970 10,061 144,043 18,586 62 74,325 9,590 82,584 10,656 152,571 19,687 63 78,729 10,159 87,478 11,288 161,624 20,855 64 83,405 10,762 92,670 11,957 171,882 22,178 65 88,698 11,445 98,554 12,716 183,471 23,674 66 93,835 12,107 104,263 13,453 195,847 25,271 67 99,718 12,867 110,797 14,296 209,075 26,977 68 106,463 13,737 118,286 15,263 223,208 28,801 69 113,696 14,671 126,322 16,300 238,309 30,749 70 119,014 15,356 132,227 17,062 249,407 32,182 71 124,856 16,111 138,733 17,901 261,605 33,755 72 130,989 16,902 145,544 18,780 274,390 35,405 73 137,406 17,730 152,672 19,700 287,776 37,132 74 144,141 18,599 160,148 20,664 301,813 38,944 75 151,186 19,508 167,981 21,675 313,374 40,435 76 158,578 20,462 176,189 22,734 325,399 41,987 77 166,316 21,460 184,791 23,844 337,900 43,600 78 174,426 22,507 193,801 25,007 350,899 45,277 79 182,212 23,511 202,451 26,123 364,410 47,021 80-99 189,230 24,417 210,257 27,130 378,460 48,833 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,482 2,643 10,241 1,321 11,375 1,468 20,840 2,689 10,241 1,321 11,375 1,468 21,206 2,736 11,138 1,437 12,376 1,597 22,277 2,875 11,250 1,451 12,500 1,613 22,500 2,903 11,362 1,466 12,625 1,629 22,725 2,932 11,476 1,481 12,751 1,645 22,952 2,962 11,591 1,496 12,878 1,662 23,182 2,991 11,707 1,511 13,007 1,678 23,413 3,021 11,824 1,526 13,138 1,695 23,648 3,052 11,942 1,541 13,269 1,712 23,884 3,082 12,419 1,603 13,799 1,781 24,839 3,205 12,916 1,667 14,351 1,852 25,833 3,333 13,433 1,733 14,926 1,926 26,866 3,467 13,970 1,802 15,523 2,003 27,941 3,605 14,529 1,875 16,144 2,083 29,059 3,749 15,110 1,950 16,789 2,167 30,221 3,899 15,715 2,027 17,461 2,253 31,430 4,055 16,343 2,109 18,160 2,343 32,687 4,217 16,997 2,193 18,886 2,437 33,994 4,387 17,677 2,281 19,641 2,534 35,354 4,562 18,384 2,372 20,427 2,636 36,769 4,744 19,120 2,467 21,244 2,741 38,239 4,934 19,885 2,566 22,094 2,851 39,769 5,131 20,680 2,668 22,978 2,965 41,359 5,336 21,507 2,775 23,897 3,083 43,014 5,550 22,367 2,886 24,853 3,207 44,734 5,772 23,262 3,002 25,846 3,335 46,523 6,003 24,192 3,122 26,881 3,469 48,385 6,243 25,160 3,247 27,956 3,607 50,320 6,493 27,871 3,596 30,968 3,996 55,742 7,192 29,129 3,758 32,365 4,176 58,258 7,517 30,051 3,878 33,391 4,309 60,103 7,755 31,177 4,023 34,640 4,470 62,353 8,045 32,171 4,151 35,746 4,612 64,342 8,302 33,164 4,279 36,848 4,754 66,328 8,558 33,993 4,386 37,770 4,874 67,987 8,773 34,844 4,496 38,716 4,996 69,689 8,992 35,693 4,606 39,656 5,117 71,339 9,205 36,745 4,741 40,822 5,267 73,040 9,424 37,729 4,868 41,920 5,409 74,393 9,599 39,001 5,032 43,334 5,591 76,430 9,862 40,503 5,226 45,007 5,807 79,256 10,226 42,079 5,429 46,751 6,032 82,238 10,612 43,794 5,651 48,660 6,279 85,665 11,054 45,587 5,882 50,652 6,536 89,252 11,516 47,435 6,121 52,706 6,801 92,917 11,989 49,388 6,373 54,878 7,081 96,863 12,499 52,132 6,727 57,927 7,474 101,795 13,135 55,343 7,141 61,491 7,934 108,239 13,966 57,801 7,458 64,225 8,287 111,281 14,359 61,484 7,933 68,315 8,815 118,815 15,331 65,447 8,445 72,722 9,383 127,045 16,393 69,241 8,934 76,932 9,927 134,131 17,307 74,014 9,550 82,239 10,612 144,650 18,664 78,230 10,094 86,923 11,216 152,434 19,669 82,698 10,671 91,886 11,857 161,141 20,792 87,562 11,298 97,287 12,553 171,514 22,131 92,975 11,997 103,304 13,330 183,082 23,623 97,847 12,625 108,719 14,029 193,665 24,989 101,902 13,148 113,226 14,610 202,758 26,162 106,070 13,687 117,855 15,207 212,143 27,373 109,747 14,161 121,941 15,734 219,494 28,322 113,717 14,673 126,350 16,303 227,436 29,347 118,562 15,298 131,734 16,998 237,121 30,596 123,410 15,924 137,122 17,693 246,821 31,848 127,744 16,483 141,937 18,314 255,490 32,966 132,596 17,109 147,332 19,010 265,198 34,219 138,316 17,847 153,680 19,830 276,628 35,694 143,295 18,490 159,217 20,544 286,590 36,979 151,186 19,508 167,982 21,675 302,368 39,015 4,914 634 5,460 704 9,827 1,268 5,061 653 5,624 725 10,123 1,306 5,213 673 5,792 748 10,426 1,345 5,317 686 5,908 763 10,635 1,372 5,477 707 6,026 778 10,847 1,400 5,639 728 6,207 801 11,065 1,427 5,755 743 6,362 821 11,285 1,456 5,870 757 6,499 839 11,512 1,486 6,046 780 6,627 855 11,777 1,520 6,227 803 6,763 872 12,130 1,565 6,379 823 6,941 896 12,494 1,612 6,499 839 7,149 922 12,869 1,660 6,619 854 7,364 950 13,255 1,710 6,740 870 7,585 979 13,652 1,762 6,898 890 7,774 1,003 13,994 1,805 7,070 913 7,969 1,028 14,344 1,851 7,212 931 8,128 1,049 14,630 1,888 7,430 959 8,374 1,081 15,072 1,945 7,579 978 8,541 1,102 15,374 1,984 7,730 997 8,711 1,124 15,681 2,023 7,865 1,015 8,864 1,144 15,955 2,059 8,003 1,033 9,019 1,164 16,235 2,095 8,143 1,051 9,177 1,184 16,519 2,131 8,285 1,069 9,338 1,205 16,808 2,169 8,431 1,088 9,501 1,226 17,102 2,207 8,603 1,110 9,667 1,247 17,401 2,245 8,796 1,135 9,836 1,269 17,706 2,285 9,063 1,169 10,203 1,316 18,365 2,369 9,352 1,207 10,920 1,409 19,655 2,536 9,637 1,243 11,387 1,469 20,497 2,645 9,936 1,282 11,893 1,535 21,406 2,762 10,214 1,318 12,292 1,586 22,126 2,855 10,656 1,375 12,872 1,661 23,169 2,990 10,945 1,412 13,253 1,710 23,855 3,078 11,297 1,458 13,645 1,760 24,561 3,169 11,637 1,502 14,074 1,816 25,334 3,269 12,050 1,555 14,520 1,874 26,136 3,373 12,166 1,570 14,614 1,886 26,306 3,394 12,907 1,666 15,398 1,987 27,716 3,577 13,399 1,729 16,188 2,089 29,139 3,760 14,113 1,821 16,898 2,180 30,417 3,925 14,821 1,912 17,626 2,274 31,726 4,094 15,615 2,015 18,390 2,373 33,102 4,271 16,325 2,107 19,161 2,473 34,490 4,450 17,203 2,219 19,936 2,572 35,884 4,630 18,425 2,377 21,126 2,726 38,027 4,907 19,624 2,532 22,519 2,906 40,534 5,230 21,005 2,710 23,689 3,056 42,640 5,502 22,388 2,889 24,876 3,210 44,776 5,777 23,926 3,087 26,584 3,430 47,852 6,175 25,179 3,249 27,977 3,610 50,358 6,498 26,918 3,473 29,909 3,859 53,836 6,947 30,506 3,937 33,896 4,373 61,013 7,873 32,594 4,205 36,215 4,673 65,188 8,411 35,013 4,518 38,903 5,020 70,027 9,035 37,979 4,900 42,199 5,445 75,957 9,801 39,910 5,150 44,344 5,722 79,819 10,299 41,856 5,401 46,507 6,001 83,712 10,802 43,813 5,653 48,682 6,281 87,627 11,307 44,920 5,796 49,911 6,440 89,840 11,592 46,298 5,974 51,442 6,638 92,595 11,948 48,759 6,292 54,177 6,991 97,518 12,583 51,064 6,589 56,737 7,321 102,127 13,178 52,460 6,769 58,289 7,521 104,921 13,538 54,422 7,022 60,470 7,802 108,845 14,045 57,430 7,410 63,811 8,234 114,859 14,821 59,579 7,688 65,776 8,487 118,396 15,277 64,913 8,376 72,126 9,307 129,826 16,752 4

Annual Deductible Option: 40,000 or 5,000 每年自付額選擇 :40,000 或 5,000 ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) 0 10,172 1,313 10,432 1,346 22,367 2,886 1 10,172 1,313 10,432 1,346 22,367 2,886 2 10,172 1,313 10,432 1,346 22,367 2,886 3 10,172 1,313 10,432 1,346 22,367 2,886 4 10,172 1,313 10,432 1,346 22,367 2,886 5 10,172 1,313 10,432 1,346 22,367 2,886 6 10,172 1,313 10,432 1,346 22,367 2,886 7 10,172 1,313 10,432 1,346 22,367 2,886 8 10,172 1,313 10,432 1,346 22,367 2,886 9 10,172 1,313 10,432 1,346 22,367 2,886 10 11,317 1,461 11,615 1,499 22,367 2,886 11 12,478 1,610 12,798 1,652 22,746 2,935 12 13,352 1,723 13,693 1,767 24,339 3,141 13 13,368 1,725 13,709 1,769 24,975 3,223 14 13,835 1,785 14,189 1,831 25,023 3,229 15 14,389 1,857 14,757 1,904 26,024 3,358 16 14,964 1,931 15,347 1,981 27,065 3,492 17 15,563 2,008 16,038 2,070 28,147 3,632 18 16,366 2,112 16,782 2,166 29,273 3,777 19 16,833 2,172 17,514 2,260 30,444 3,929 20 17,506 2,259 18,302 2,362 31,662 4,086 21 18,119 2,338 19,125 2,468 33,087 4,269 22 18,753 2,420 19,986 2,579 34,576 4,462 23 19,409 2,505 20,885 2,695 36,304 4,685 24 19,992 2,580 21,825 2,816 38,120 4,919 25 20,491 2,644 22,807 2,943 40,407 5,214 26 20,801 2,684 23,017 2,970 41,431 5,346 27 21,226 2,739 23,477 3,030 42,259 5,453 28 21,717 2,802 24,086 3,108 43,354 5,594 29 22,770 2,938 25,300 3,265 45,539 5,876 30 23,908 3,085 26,565 3,428 47,816 6,170 31 24,101 3,110 26,779 3,456 48,201 6,220 32 24,782 3,198 27,536 3,553 49,564 6,396 33 25,474 3,287 28,304 3,652 50,948 6,574 34 26,567 3,428 29,519 3,809 53,134 6,856 35 26,873 3,468 29,859 3,853 53,746 6,935 36 27,447 3,542 30,497 3,935 54,894 7,083 37 27,729 3,578 30,810 3,976 55,458 7,156 38 27,876 3,597 30,973 3,997 55,752 7,194 39 28,061 3,621 31,179 4,023 56,122 7,242 40 28,634 3,695 31,815 4,105 57,267 7,390 41 29,206 3,769 32,451 4,187 58,412 7,537 42 29,863 3,853 33,179 4,281 59,581 7,688 43 30,580 3,946 33,977 4,384 60,754 7,839 44 31,462 4,060 34,960 4,511 62,577 8,075 45 32,358 4,175 35,953 4,639 64,454 8,317 46 33,107 4,272 36,786 4,747 65,743 8,483 47 33,860 4,369 37,623 4,855 67,058 8,653 48 34,624 4,468 38,472 4,964 68,399 8,826 49 35,393 4,567 39,324 5,074 69,941 9,025 50 36,169 4,667 40,186 5,185 71,680 9,249 51 36,948 4,768 41,056 5,298 73,428 9,475 52 37,738 4,870 41,933 5,411 75,195 9,703 53 39,231 5,062 43,589 5,625 78,725 10,158 54 40,932 5,282 45,480 5,869 82,669 10,667 55 42,663 5,505 47,400 6,116 86,678 11,184 56 44,424 5,732 49,361 6,369 90,747 11,709 57 46,324 5,977 51,472 6,642 95,096 12,271 58 49,011 6,324 54,458 7,027 100,623 12,984 59 52,121 6,726 57,914 7,473 107,001 13,807 60 55,221 7,125 61,352 7,917 113,341 14,625 61 58,480 7,546 64,975 8,384 120,036 15,489 62 61,938 7,992 68,820 8,880 127,143 16,406 63 65,608 8,466 72,899 9,407 134,687 17,379 64 69,505 8,969 77,225 9,965 143,235 18,482 65 73,915 9,538 82,129 10,597 152,893 19,728 66 78,196 10,090 86,886 11,211 163,206 21,059 67 83,099 10,723 92,331 11,914 174,229 22,481 68 88,720 11,448 98,572 12,719 186,007 24,001 69 94,747 12,226 105,269 13,583 198,591 25,625 70 99,178 12,797 110,189 14,218 207,840 26,818 71 104,047 13,426 115,611 14,918 218,004 28,130 72 109,158 14,085 121,287 15,650 228,658 29,505 73 114,505 14,775 127,227 16,417 239,814 30,944 74 120,118 15,499 133,457 17,220 251,511 32,453 75 125,989 16,257 139,985 18,063 261,145 33,696 76 132,149 17,052 146,825 18,945 271,166 34,989 77 138,597 17,884 153,993 19,870 281,584 36,334 78 145,355 18,756 161,501 20,839 292,416 37,731 79 151,844 19,593 168,710 21,769 303,675 39,184 80-99 157,692 20,348 175,214 22,609 315,384 40,695 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,068 2,203 8,534 1,101 9,479 1,223 17,367 2,241 8,534 1,101 9,479 1,223 17,672 2,280 9,282 1,198 10,314 1,331 18,564 2,396 9,375 1,210 10,417 1,344 18,750 2,420 9,469 1,222 10,521 1,358 18,938 2,444 9,564 1,234 10,626 1,371 19,127 2,468 9,659 1,247 10,732 1,385 19,318 2,493 9,756 1,259 10,840 1,399 19,511 2,518 9,853 1,272 10,948 1,413 19,707 2,543 9,952 1,284 11,058 1,427 19,904 2,568 10,350 1,336 11,500 1,484 20,700 2,671 10,764 1,389 11,960 1,543 21,528 2,778 11,195 1,445 12,438 1,605 22,389 2,889 11,642 1,502 12,936 1,669 23,284 3,005 12,108 1,563 13,453 1,736 24,216 3,125 12,592 1,625 13,991 1,806 25,184 3,250 13,096 1,690 14,551 1,878 26,192 3,380 13,620 1,758 15,133 1,953 27,239 3,515 14,165 1,828 15,738 2,031 28,329 3,656 14,731 1,901 16,368 2,112 29,462 3,802 15,320 1,977 17,023 2,197 30,641 3,954 15,933 2,056 17,704 2,285 31,866 4,112 16,571 2,138 18,412 2,376 33,141 4,276 17,233 2,224 19,148 2,471 34,466 4,447 17,923 2,313 19,914 2,570 35,845 4,625 18,640 2,405 20,711 2,673 37,279 4,810 19,385 2,502 21,539 2,779 38,770 5,003 20,160 2,602 22,401 2,891 40,321 5,203 20,967 2,706 23,297 3,006 41,934 5,411 23,226 2,997 25,807 3,330 46,452 5,994 24,274 3,132 26,971 3,480 48,548 6,265 25,043 3,232 27,826 3,591 50,086 6,463 25,981 3,353 28,867 3,725 51,961 6,705 26,809 3,459 29,788 3,844 53,619 6,919 27,637 3,566 30,707 3,962 55,273 7,132 28,328 3,655 31,475 4,062 56,656 7,311 29,037 3,747 32,264 4,163 58,074 7,494 29,745 3,838 33,047 4,264 59,449 7,671 30,621 3,951 34,019 4,390 60,867 7,854 31,441 4,057 34,933 4,508 61,994 7,999 32,501 4,194 36,112 4,660 63,692 8,219 33,753 4,355 37,506 4,840 66,047 8,522 35,066 4,525 38,960 5,027 68,532 8,843 36,495 4,709 40,550 5,233 71,388 9,212 37,990 4,902 42,210 5,447 74,377 9,597 39,530 5,101 43,922 5,668 77,431 9,991 41,157 5,311 45,732 5,901 80,719 10,416 43,444 5,606 48,273 6,229 84,830 10,946 46,119 5,951 51,243 6,612 90,199 11,639 48,168 6,215 53,521 6,906 92,734 11,966 51,237 6,611 56,929 7,346 99,013 12,776 54,539 7,038 60,602 7,820 105,871 13,661 57,701 7,445 64,110 8,273 111,776 14,423 61,679 7,959 68,533 8,843 120,542 15,554 65,192 8,412 72,436 9,347 127,029 16,391 68,915 8,893 76,572 9,881 134,284 17,327 72,968 9,415 81,073 10,461 142,929 18,443 77,479 9,998 86,087 11,108 152,568 19,686 81,539 10,521 90,600 11,691 161,388 20,824 84,919 10,957 94,355 12,175 168,965 21,802 88,392 11,406 98,213 12,673 176,786 22,811 91,456 11,801 101,618 13,112 182,912 23,602 94,764 12,228 105,292 13,586 189,530 24,456 98,802 12,749 109,779 14,165 197,601 25,497 102,842 13,270 114,268 14,745 205,684 26,540 106,453 13,736 118,281 15,262 212,908 27,472 110,497 14,258 122,777 15,842 220,999 28,516 115,263 14,873 128,067 16,525 230,523 29,745 119,413 15,408 132,681 17,120 238,825 30,816 125,988 16,257 139,985 18,063 251,974 32,513 4,095 529 4,550 587 8,190 1,057 4,218 544 4,687 605 8,436 1,089 4,344 561 4,827 623 8,689 1,121 4,431 572 4,924 636 8,863 1,144 4,564 589 5,022 648 9,040 1,167 4,700 607 5,173 668 9,221 1,190 4,796 619 5,302 684 9,405 1,214 4,892 631 5,416 699 9,593 1,238 5,038 650 5,523 713 9,814 1,267 5,189 670 5,636 727 10,108 1,305 5,316 686 5,784 747 10,412 1,344 5,416 699 5,958 769 10,724 1,384 5,516 712 6,137 792 11,046 1,425 5,617 725 6,321 816 11,377 1,468 5,749 742 6,479 836 11,662 1,505 5,892 761 6,641 857 11,953 1,543 6,010 776 6,774 874 12,192 1,573 6,192 799 6,978 901 12,560 1,621 6,316 815 7,118 919 12,812 1,653 6,442 831 7,260 937 13,068 1,686 6,555 846 7,387 953 13,296 1,716 6,669 861 7,516 970 13,529 1,746 6,786 876 7,648 987 13,766 1,776 6,905 891 7,782 1,004 14,007 1,808 7,026 907 7,918 1,022 14,252 1,839 7,169 925 8,056 1,040 14,501 1,871 7,330 946 8,197 1,058 14,755 1,904 7,553 975 8,503 1,097 15,304 1,975 7,793 1,006 9,100 1,174 16,380 2,114 8,031 1,036 9,489 1,225 17,081 2,204 8,280 1,069 9,911 1,279 17,839 2,302 8,512 1,099 10,244 1,322 18,439 2,379 8,880 1,146 10,727 1,384 19,308 2,492 9,121 1,177 11,044 1,425 19,879 2,565 9,415 1,215 11,371 1,467 20,468 2,641 9,698 1,252 11,729 1,514 21,112 2,724 10,042 1,296 12,100 1,562 21,780 2,811 10,138 1,308 12,179 1,572 21,922 2,829 10,756 1,388 12,832 1,656 23,097 2,981 11,166 1,441 13,490 1,741 24,283 3,133 11,761 1,518 14,082 1,817 25,348 3,271 12,351 1,594 14,688 1,895 26,438 3,412 13,013 1,679 15,325 1,978 27,585 3,560 13,605 1,756 15,968 2,061 28,742 3,709 14,336 1,850 16,613 2,144 29,904 3,859 15,354 1,981 17,605 2,272 31,690 4,089 16,354 2,110 18,766 2,422 33,778 4,359 17,504 2,259 19,741 2,547 35,533 4,585 18,657 2,408 20,730 2,675 37,314 4,815 19,939 2,573 22,154 2,859 39,877 5,146 20,983 2,708 23,314 3,009 41,965 5,415 22,432 2,895 24,924 3,216 44,863 5,789 25,422 3,281 28,247 3,645 50,844 6,561 27,162 3,505 30,180 3,894 54,323 7,010 29,178 3,765 32,420 4,183 58,356 7,530 31,649 4,084 35,166 4,538 63,298 8,168 33,258 4,292 36,954 4,768 66,516 8,583 34,880 4,501 38,756 5,001 69,760 9,002 36,511 4,711 40,568 5,235 73,023 9,423 37,433 4,830 41,593 5,367 74,867 9,660 38,582 4,979 42,868 5,532 77,163 9,957 40,633 5,243 45,148 5,826 81,265 10,486 42,553 5,491 47,281 6,101 85,106 10,982 43,717 5,641 48,575 6,268 87,435 11,282 45,352 5,852 50,392 6,502 90,705 11,704 47,858 6,175 53,176 6,862 95,716 12,351 49,649 6,407 54,813 7,073 98,664 12,731 54,095 6,980 60,105 7,756 108,189 13,960 ZONE 2 第 2 區 5

Annual Deductible Option: NIL 每年自付額選擇 : 無 ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) 第 3 區 ZONE 3 0 19,692 2,541 19,187 2,476 41,138 5,308 1 19,692 2,541 19,187 2,476 41,138 5,308 2 19,692 2,541 19,187 2,476 41,138 5,308 3 19,692 2,541 19,187 2,476 41,138 5,308 4 19,692 2,541 19,187 2,476 41,138 5,308 5 19,692 2,541 19,187 2,476 41,138 5,308 6 19,692 2,541 19,187 2,476 41,138 5,308 7 19,692 2,541 19,187 2,476 41,138 5,308 8 19,692 2,541 19,187 2,476 41,138 5,308 9 19,692 2,541 19,187 2,476 41,138 5,308 10 21,911 2,827 21,363 2,757 41,138 5,308 11 24,158 3,117 23,538 3,037 41,836 5,398 12 25,849 3,335 25,185 3,250 44,764 5,776 13 26,735 3,450 26,047 3,361 45,936 5,927 14 27,671 3,570 26,960 3,479 47,543 6,135 15 28,777 3,713 28,038 3,618 49,446 6,380 16 29,930 3,862 29,160 3,763 51,423 6,635 17 31,125 4,016 30,471 3,932 53,479 6,901 18 32,370 4,177 31,842 4,109 55,619 7,177 19 33,665 4,344 33,275 4,294 57,844 7,464 20 35,012 4,518 34,773 4,487 60,157 7,762 21 36,238 4,676 36,338 4,689 62,864 8,111 22 37,505 4,839 37,973 4,900 65,694 8,477 23 38,818 5,009 39,682 5,120 68,978 8,900 24 39,982 5,159 41,467 5,351 72,427 9,345 25 40,983 5,288 43,332 5,591 76,773 9,906 26 41,603 5,368 43,733 5,643 78,718 10,157 27 42,451 5,478 44,607 5,756 80,292 10,360 28 43,435 5,606 45,763 5,905 82,373 10,629 29 45,540 5,876 48,068 6,202 86,524 11,164 30 47,816 6,170 50,472 6,513 90,851 11,723 31 48,202 6,220 50,879 6,565 91,583 11,817 32 49,563 6,395 52,317 6,751 94,171 12,151 33 50,947 6,574 53,778 6,939 96,800 12,490 34 53,134 6,856 56,087 7,237 100,955 13,026 35 53,746 6,935 56,731 7,320 102,116 13,176 36 54,893 7,083 57,944 7,477 104,297 13,458 37 55,458 7,156 58,539 7,553 105,371 13,596 38 55,751 7,194 58,849 7,593 105,927 13,668 39 56,122 7,242 59,239 7,644 106,631 13,759 40 57,268 7,389 60,449 7,800 108,808 14,040 41 58,412 7,537 61,657 7,956 110,983 14,320 42 59,724 7,706 63,040 8,134 113,203 14,607 43 61,160 7,892 64,556 8,330 115,433 14,895 44 62,925 8,119 66,424 8,571 118,896 15,341 45 64,715 8,350 68,310 8,814 122,463 15,802 46 66,214 8,544 69,893 9,018 124,912 16,118 47 67,719 8,738 71,483 9,224 127,410 16,440 48 69,249 8,935 73,096 9,432 129,959 16,769 49 70,786 9,134 74,715 9,641 132,886 17,147 50 72,336 9,334 76,352 9,852 136,191 17,573 51 73,897 9,535 78,005 10,065 139,512 18,002 52 75,475 9,739 79,673 10,280 142,870 18,435 53 78,463 10,124 82,819 10,686 149,576 19,300 54 81,864 10,563 86,412 11,150 157,071 20,267 55 85,327 11,010 90,060 11,621 164,688 21,250 56 88,847 11,464 93,786 12,101 172,419 22,248 57 92,647 11,954 97,796 12,619 180,682 23,314 58 98,021 12,648 103,470 13,351 191,184 24,669 59 104,243 13,451 110,035 14,198 203,302 26,233 60 110,441 14,250 116,568 15,041 215,348 27,787 61 116,960 15,092 123,453 15,929 228,068 29,428 62 123,875 15,984 130,758 16,872 241,571 31,170 63 131,216 16,931 138,507 17,872 255,905 33,020 64 139,010 17,937 146,728 18,933 272,146 35,116 65 147,831 19,075 156,044 20,135 290,496 37,483 66 156,390 20,179 165,084 21,301 310,092 40,012 67 166,197 21,445 175,428 22,636 331,035 42,714 68 177,439 22,895 187,287 24,166 353,413 45,602 69 189,493 24,451 200,010 25,808 377,323 48,687 70 198,356 25,594 209,359 27,014 394,896 50,954 71 208,093 26,851 219,661 28,343 414,208 53,446 72 218,315 28,170 230,446 29,735 434,450 56,058 73 229,010 29,550 241,732 31,191 455,647 58,793 74 240,236 30,998 253,567 32,718 477,870 61,661 75 251,977 32,513 265,971 34,319 496,175 64,023 76 264,297 34,103 278,967 35,996 515,214 66,479 77 277,193 35,767 292,586 37,753 535,009 69,033 78 290,710 37,511 306,851 39,594 555,590 71,689 79 303,687 39,185 320,547 41,361 576,982 74,449 80-99 315,384 40,695 332,907 42,956 599,229 77,320 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,393 4,051 15,697 2,025 17,435 2,250 31,942 4,122 15,697 2,025 17,435 2,250 32,502 4,194 17,636 2,276 19,595 2,528 35,271 4,551 17,812 2,298 19,792 2,554 35,625 4,597 17,991 2,321 19,990 2,579 35,981 4,643 18,171 2,345 20,189 2,605 36,341 4,689 18,351 2,368 20,392 2,631 36,704 4,736 18,536 2,392 20,595 2,657 37,071 4,783 18,721 2,416 20,801 2,684 37,442 4,831 18,909 2,440 21,009 2,711 37,816 4,879 19,664 2,537 21,850 2,819 39,328 5,075 20,452 2,639 22,724 2,932 40,902 5,278 21,269 2,744 23,633 3,049 42,539 5,489 22,119 2,854 24,578 3,171 44,240 5,708 23,005 2,968 25,560 3,298 46,009 5,937 23,925 3,087 26,583 3,430 47,850 6,174 24,881 3,210 27,646 3,567 49,764 6,421 25,877 3,339 28,752 3,710 51,754 6,678 26,913 3,473 29,902 3,858 53,824 6,945 27,989 3,611 31,099 4,013 55,977 7,223 29,108 3,756 32,342 4,173 58,216 7,512 30,273 3,906 33,636 4,340 60,546 7,812 31,483 4,062 34,981 4,514 62,967 8,125 32,743 4,225 36,382 4,694 65,485 8,450 34,053 4,394 37,837 4,882 68,105 8,788 35,415 4,570 39,350 5,077 70,829 9,139 36,832 4,753 40,924 5,281 73,662 9,505 38,304 4,942 42,561 5,492 76,609 9,885 39,837 5,140 44,262 5,711 79,673 10,280 44,129 5,694 49,032 6,327 88,258 11,388 46,121 5,951 51,245 6,612 92,241 11,902 47,581 6,139 52,867 6,822 95,163 12,279 49,363 6,369 54,847 7,077 98,725 12,739 50,937 6,573 56,597 7,303 101,874 13,145 52,510 6,775 58,344 7,528 105,019 13,551 53,822 6,945 59,803 7,717 107,644 13,890 55,170 7,119 61,300 7,910 110,340 14,237 56,515 7,292 62,790 8,102 112,952 14,574 58,180 7,507 64,635 8,340 115,647 14,922 59,737 7,708 66,373 8,564 117,788 15,198 61,753 7,968 68,612 8,853 121,013 15,615 64,130 8,275 71,261 9,195 125,488 16,192 66,624 8,597 74,023 9,551 130,210 16,801 69,340 8,947 77,046 9,941 135,637 17,502 72,180 9,314 80,199 10,348 141,316 18,234 75,106 9,691 83,453 10,768 147,118 18,983 78,199 10,090 86,889 11,211 153,366 19,789 82,543 10,651 91,718 11,835 161,176 20,797 87,625 11,306 97,361 12,563 171,379 22,113 91,518 11,809 101,690 13,121 176,194 22,735 97,351 12,561 108,165 13,957 188,124 24,274 103,624 13,371 115,144 14,857 201,156 25,956 109,632 14,146 121,810 15,717 212,373 27,403 117,188 15,121 130,213 16,802 229,029 29,552 123,865 15,983 137,628 17,758 241,354 31,142 130,939 16,895 145,487 18,773 255,139 32,921 138,639 17,889 154,038 19,876 271,564 35,041 147,210 18,995 163,564 21,105 289,880 37,404 154,924 19,990 172,138 22,211 306,637 39,566 161,345 20,819 179,274 23,132 321,034 41,424 167,944 21,670 186,603 24,078 335,893 43,341 173,767 22,422 193,074 24,913 347,532 44,843 180,051 23,232 200,054 25,813 360,107 46,465 187,724 24,222 208,579 26,913 375,441 48,444 195,400 25,213 217,109 28,014 390,799 50,426 202,260 26,098 224,733 28,998 404,525 52,197 209,944 27,090 233,275 30,100 419,897 54,180 219,000 28,258 243,326 31,397 437,994 56,515 226,883 29,275 252,094 32,528 453,768 58,551 239,377 30,887 265,971 34,319 478,750 61,774 7,781 1,004 8,645 1,115 15,560 2,008 8,014 1,034 8,904 1,149 16,027 2,068 8,255 1,065 9,171 1,183 16,508 2,130 8,419 1,086 9,355 1,207 16,838 2,173 8,630 1,114 9,588 1,237 17,259 2,227 8,846 1,141 9,828 1,268 17,691 2,283 9,067 1,170 10,073 1,300 18,133 2,340 9,293 1,199 10,326 1,332 18,586 2,398 9,572 1,235 10,635 1,372 19,143 2,470 9,859 1,272 10,955 1,414 19,718 2,544 10,155 1,310 11,283 1,456 20,309 2,621 10,459 1,350 11,622 1,500 20,920 2,699 10,773 1,390 11,970 1,545 21,547 2,780 11,097 1,432 12,329 1,591 22,193 2,864 11,374 1,468 12,637 1,631 22,749 2,935 11,659 1,504 12,954 1,671 23,316 3,009 11,892 1,534 13,212 1,705 23,783 3,069 12,284 1,585 13,649 1,761 24,567 3,170 12,530 1,617 13,922 1,796 25,059 3,233 12,779 1,649 14,201 1,832 25,560 3,298 13,004 1,678 14,449 1,864 26,008 3,356 13,231 1,707 14,701 1,897 26,462 3,414 13,463 1,737 14,959 1,930 26,926 3,474 13,699 1,768 15,220 1,964 27,397 3,535 13,938 1,798 15,487 1,998 27,876 3,597 14,182 1,830 15,758 2,033 28,365 3,660 14,431 1,862 16,034 2,069 28,860 3,724 14,538 1,876 16,154 2,084 29,077 3,752 15,411 1,989 17,124 2,210 30,823 3,977 16,181 2,088 17,980 2,320 32,364 4,176 16,910 2,182 18,789 2,424 33,821 4,364 17,671 2,280 19,635 2,534 35,342 4,560 18,466 2,383 20,518 2,647 36,932 4,765 19,111 2,466 21,236 2,740 38,225 4,932 19,685 2,540 21,873 2,822 39,372 5,080 20,177 2,603 22,420 2,893 40,356 5,207 20,581 2,656 22,869 2,951 41,163 5,311 21,096 2,722 23,439 3,024 42,193 5,444 21,622 2,790 24,026 3,100 43,247 5,580 22,163 2,860 24,627 3,178 44,328 5,720 22,606 2,917 25,119 3,241 45,214 5,834 23,736 3,063 26,374 3,403 47,474 6,126 24,805 3,201 27,561 3,556 49,611 6,401 25,921 3,345 28,802 3,716 51,844 6,690 27,087 3,495 30,098 3,884 54,176 6,990 28,712 3,705 31,904 4,117 57,427 7,410 30,722 3,964 34,138 4,405 61,446 7,929 32,873 4,242 36,527 4,713 65,748 8,484 35,447 4,574 39,387 5,082 70,896 9,148 37,884 4,888 42,092 5,431 75,766 9,776 39,867 5,144 44,296 5,716 79,733 10,288 42,620 5,499 47,356 6,110 85,239 10,999 46,002 5,936 51,113 6,595 92,004 11,871 49,149 6,342 54,610 7,046 98,299 12,684 52,798 6,813 58,664 7,570 105,595 13,625 57,269 7,390 63,633 8,211 114,538 14,779 60,182 7,765 66,869 8,628 120,362 15,531 63,117 8,144 70,129 9,049 126,232 16,288 66,068 8,525 73,409 9,472 132,136 17,050 68,599 8,851 75,263 9,711 135,472 17,480 71,476 9,223 78,416 10,118 139,627 18,016 75,267 9,712 82,586 10,656 147,052 18,974 79,033 10,198 86,726 11,190 154,001 19,871 82,216 10,609 90,219 11,641 159,352 20,562 85,927 11,087 94,302 12,168 166,578 21,494 90,540 11,683 99,380 12,823 175,588 22,657 94,333 12,172 103,546 13,361 182,955 23,607 101,226 13,061 111,154 14,342 196,511 25,356 6

Annual Deductible Option: 12,000 or 1,500 每年自付額選擇 :12,000 或 1,500 ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) ex USA ( 不包括美國 ) 0 11,815 1,525 11,512 1,486 24,683 3,185 1 11,815 1,525 11,512 1,486 24,683 3,185 2 11,815 1,525 11,512 1,486 24,683 3,185 3 11,815 1,525 11,512 1,486 24,683 3,185 4 11,815 1,525 11,512 1,486 24,683 3,185 5 11,815 1,525 11,512 1,486 24,683 3,185 6 11,815 1,525 11,512 1,486 24,683 3,185 7 11,815 1,525 11,512 1,486 24,683 3,185 8 11,815 1,525 11,512 1,486 24,683 3,185 9 11,815 1,525 11,512 1,486 24,683 3,185 10 13,147 1,696 12,818 1,654 24,683 3,185 11 14,495 1,870 14,123 1,822 25,102 3,239 12 15,509 2,001 15,111 1,950 26,858 3,466 13 16,041 2,070 15,628 2,017 27,562 3,556 14 16,603 2,142 16,176 2,087 28,526 3,681 15 17,266 2,228 16,823 2,171 29,668 3,828 16 17,958 2,317 17,496 2,258 30,854 3,981 17 18,675 2,410 18,283 2,359 32,087 4,141 18 19,422 2,506 19,105 2,465 33,371 4,306 19 20,199 2,606 19,965 2,576 34,706 4,478 20 21,007 2,711 20,864 2,692 36,094 4,657 21 21,743 2,806 21,803 2,813 37,718 4,867 22 22,503 2,903 22,784 2,940 39,416 5,086 23 23,291 3,005 23,809 3,072 41,387 5,340 24 23,989 3,095 24,880 3,211 43,456 5,607 25 24,590 3,173 25,999 3,355 46,064 5,944 26 24,962 3,221 26,240 3,386 47,231 6,094 27 25,471 3,287 26,764 3,454 48,175 6,216 28 26,061 3,365 27,458 3,543 49,424 6,377 29 27,324 3,526 28,841 3,721 51,914 6,698 30 28,690 3,702 30,283 3,908 54,511 7,034 31 28,921 3,732 30,527 3,939 54,950 7,090 32 29,738 3,837 31,390 4,051 56,503 7,291 33 30,568 3,944 32,267 4,163 58,080 7,494 34 31,880 4,114 33,652 4,342 60,573 7,816 35 32,248 4,161 34,039 4,392 61,270 7,906 36 32,936 4,250 34,766 4,486 62,578 8,075 37 33,275 4,294 35,123 4,532 63,223 8,158 38 33,451 4,316 35,309 4,556 63,556 8,201 39 33,673 4,345 35,543 4,586 63,979 8,255 40 34,361 4,433 36,269 4,680 65,285 8,424 41 35,047 4,522 36,994 4,774 66,590 8,592 42 35,834 4,624 37,824 4,880 67,922 8,764 43 36,696 4,735 38,734 4,998 69,260 8,937 44 37,755 4,871 39,854 5,143 71,338 9,205 45 38,829 5,010 40,986 5,288 73,478 9,481 46 39,728 5,126 41,936 5,411 74,947 9,671 47 40,631 5,243 42,890 5,534 76,446 9,864 48 41,549 5,361 43,858 5,659 77,975 10,061 49 42,472 5,480 44,829 5,785 79,732 10,288 50 43,402 5,600 45,811 5,911 81,715 10,544 51 44,338 5,721 46,803 6,039 83,707 10,801 52 45,285 5,843 47,804 6,168 85,722 11,061 53 47,078 6,074 49,691 6,412 89,746 11,580 54 49,118 6,338 51,847 6,690 94,243 12,160 55 51,196 6,606 54,036 6,973 98,813 12,750 56 53,308 6,878 56,272 7,261 103,451 13,349 57 55,588 7,172 58,678 7,571 108,409 13,988 58 58,813 7,589 62,082 8,011 114,710 14,801 59 62,546 8,071 66,021 8,519 121,981 15,740 60 66,265 8,550 69,941 9,025 129,209 16,672 61 70,176 9,055 74,072 9,557 136,841 17,657 62 74,325 9,590 78,455 10,123 144,943 18,702 63 78,730 10,159 83,104 10,723 153,543 19,812 64 83,406 10,762 88,037 11,360 163,288 21,070 65 88,699 11,445 93,626 12,081 174,298 22,490 66 93,834 12,107 99,050 12,781 186,055 24,007 67 99,718 12,867 105,257 13,582 198,621 25,628 68 106,463 13,737 112,372 14,500 212,048 27,361 69 113,696 14,671 120,006 15,485 226,394 29,212 70 119,014 15,356 125,615 16,208 236,938 30,572 71 124,856 16,111 131,797 17,006 248,525 32,068 72 130,989 16,902 138,268 17,841 260,670 33,635 73 137,406 17,730 145,039 18,715 273,388 35,276 74 144,142 18,599 152,140 19,631 286,722 36,997 75 151,186 19,508 159,583 20,591 297,705 38,414 76 158,578 20,462 167,380 21,598 309,128 39,887 77 166,316 21,460 175,552 22,652 321,005 41,420 78 174,426 22,507 184,111 23,756 333,354 43,013 79 182,212 23,511 192,328 24,817 346,189 44,669 80-99 189,230 24,417 199,744 25,774 359,537 46,392 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 18,836 2,431 9,418 1,215 10,461 1,350 19,165 2,473 9,418 1,215 10,461 1,350 19,501 2,516 10,582 1,366 11,757 1,517 21,163 2,731 10,687 1,379 11,875 1,532 21,375 2,758 10,795 1,393 11,994 1,547 21,589 2,786 10,903 1,407 12,113 1,563 21,805 2,813 11,011 1,421 12,235 1,579 22,022 2,842 11,122 1,435 12,357 1,594 22,243 2,870 11,233 1,450 12,481 1,610 22,465 2,899 11,345 1,464 12,605 1,627 22,690 2,927 11,798 1,522 13,110 1,691 23,597 3,045 12,271 1,583 13,634 1,759 24,541 3,167 12,761 1,646 14,180 1,829 25,523 3,293 13,271 1,712 14,747 1,903 26,544 3,425 13,803 1,781 15,336 1,979 27,605 3,562 14,355 1,852 15,950 2,058 28,710 3,704 14,929 1,926 16,588 2,140 29,858 3,853 15,526 2,003 17,251 2,226 31,052 4,007 16,148 2,084 17,941 2,315 32,294 4,167 16,793 2,167 18,659 2,408 33,586 4,334 17,465 2,254 19,405 2,504 34,930 4,507 18,164 2,344 20,182 2,604 36,328 4,687 18,890 2,437 20,989 2,708 37,780 4,875 19,646 2,535 21,829 2,816 39,291 5,070 20,432 2,636 22,702 2,929 40,863 5,273 21,249 2,742 23,610 3,046 42,497 5,483 22,099 2,852 24,554 3,169 44,197 5,703 22,982 2,965 25,537 3,295 45,965 5,931 23,902 3,084 26,557 3,427 47,804 6,168 26,477 3,416 29,419 3,796 52,955 6,833 27,673 3,571 30,747 3,967 55,345 7,141 28,549 3,683 31,720 4,093 57,098 7,367 29,618 3,821 32,908 4,246 59,235 7,643 30,562 3,944 33,958 4,382 61,124 7,887 31,506 4,065 35,006 4,517 63,011 8,131 32,293 4,167 35,882 4,630 64,586 8,334 33,102 4,271 36,780 4,746 66,204 8,542 33,909 4,375 37,674 4,861 67,771 8,744 34,908 4,504 38,781 5,004 69,388 8,953 35,842 4,625 39,824 5,138 70,673 9,119 37,052 4,781 41,167 5,312 72,608 9,369 38,478 4,965 42,757 5,517 75,293 9,715 39,974 5,158 44,414 5,731 78,126 10,081 41,604 5,368 46,228 5,965 81,382 10,501 43,308 5,588 48,119 6,209 84,790 10,940 45,064 5,815 50,072 6,461 88,271 11,390 46,919 6,054 52,133 6,727 92,020 11,873 49,526 6,391 55,031 7,101 96,706 12,478 52,575 6,784 58,417 7,538 102,827 13,268 54,911 7,085 61,014 7,873 105,716 13,641 58,411 7,537 64,899 8,374 112,874 14,564 62,174 8,023 69,086 8,914 120,694 15,574 65,779 8,488 73,086 9,430 127,424 16,442 70,313 9,073 78,128 10,081 137,417 17,731 74,319 9,590 82,577 10,655 144,812 18,685 78,563 10,137 87,292 11,264 153,083 19,753 83,183 10,733 92,423 11,926 162,938 21,025 88,326 11,397 98,138 12,663 173,928 22,442 92,954 11,994 103,283 13,327 183,982 23,740 96,807 12,491 107,564 13,879 192,620 24,854 100,766 13,002 111,962 14,447 201,536 26,005 104,260 13,453 115,844 14,948 208,519 26,906 108,031 13,939 120,032 15,488 216,064 27,879 112,634 14,533 125,147 16,148 225,265 29,066 117,240 15,128 130,265 16,808 234,479 30,256 121,356 15,659 134,840 17,399 242,715 31,318 125,966 16,254 139,965 18,060 251,938 32,508 131,400 16,955 145,996 18,838 262,796 33,909 136,130 17,565 151,256 19,517 272,261 35,131 143,626 18,532 159,583 20,591 287,250 37,064 4,669 602 5,187 669 9,336 1,205 4,808 620 5,342 689 9,616 1,241 4,953 639 5,503 710 9,905 1,278 5,051 652 5,613 724 10,103 1,304 5,178 668 5,753 742 10,355 1,336 5,308 685 5,897 761 10,615 1,370 5,440 702 6,044 780 10,880 1,404 5,576 719 6,196 799 11,152 1,439 5,743 741 6,381 823 11,486 1,482 5,915 763 6,573 848 11,831 1,526 6,093 786 6,770 874 12,185 1,573 6,275 810 6,973 900 12,552 1,619 6,464 834 7,182 927 12,928 1,668 6,658 859 7,397 955 13,316 1,718 6,824 881 7,582 979 13,649 1,761 6,995 902 7,772 1,003 13,990 1,805 7,135 920 7,927 1,023 14,270 1,841 7,370 951 8,189 1,057 14,740 1,902 7,518 970 8,353 1,078 15,035 1,940 7,667 989 8,521 1,099 15,336 1,979 7,802 1,007 8,669 1,118 15,605 2,014 7,939 1,024 8,821 1,138 15,877 2,048 8,078 1,042 8,975 1,158 16,156 2,084 8,219 1,061 9,132 1,178 16,438 2,121 8,363 1,079 9,292 1,199 16,726 2,158 8,509 1,098 9,455 1,220 17,019 2,196 8,659 1,117 9,620 1,241 17,316 2,234 8,723 1,126 9,692 1,250 17,446 2,251 9,247 1,193 10,274 1,326 18,494 2,386 9,709 1,253 10,788 1,392 19,418 2,506 10,146 1,309 11,273 1,454 20,293 2,618 10,603 1,368 11,781 1,520 21,205 2,736 11,080 1,430 12,311 1,588 22,159 2,859 11,467 1,480 12,742 1,644 22,935 2,959 11,811 1,524 13,124 1,693 23,623 3,048 12,106 1,562 13,452 1,736 24,214 3,124 12,349 1,594 13,721 1,771 24,698 3,187 12,658 1,633 14,063 1,814 25,316 3,266 12,973 1,674 14,416 1,860 25,948 3,348 13,298 1,716 14,776 1,907 26,597 3,432 13,564 1,750 15,071 1,945 27,128 3,500 14,242 1,838 15,824 2,042 28,484 3,676 14,883 1,921 16,537 2,134 29,767 3,841 15,553 2,007 17,281 2,230 31,106 4,014 16,252 2,097 18,059 2,330 32,506 4,194 17,227 2,223 19,142 2,470 34,456 4,446 18,433 2,378 20,483 2,643 36,868 4,757 19,724 2,545 21,916 2,828 39,449 5,090 21,268 2,744 23,632 3,049 42,538 5,489 22,730 2,933 25,255 3,259 45,460 5,866 23,920 3,086 26,578 3,430 47,840 6,173 25,572 3,299 28,414 3,666 51,143 6,599 27,601 3,562 30,668 3,957 55,202 7,123 29,489 3,805 32,766 4,228 58,979 7,610 31,679 4,088 35,198 4,542 63,357 8,175 34,361 4,434 38,180 4,927 68,723 8,867 36,109 4,659 40,121 5,177 72,217 9,319 37,870 4,886 42,077 5,429 75,739 9,773 39,641 5,115 44,045 5,683 79,282 10,230 41,159 5,311 45,158 5,827 81,283 10,488 42,886 5,534 47,050 6,071 83,776 10,810 45,160 5,827 49,552 6,394 88,231 11,384 47,420 6,119 52,036 6,714 92,401 11,923 49,330 6,365 54,131 6,985 95,611 12,337 51,556 6,652 56,581 7,301 99,947 12,896 54,324 7,010 59,628 7,694 105,353 13,594 56,600 7,303 62,128 8,017 109,773 14,164 60,736 7,837 66,692 8,605 117,907 15,214 ZONE 3 第 3 區 7