Q1. Was your most recent heart bypass, heart angioplasty (including stent placement) or heart valve surgery more than 10 years prior to your effective date?

Q3. Have you ever had or are awaiting a bone marrow or organ transplant?

Q4. In the 24 months prior to your effective date have you been diagnosed with or treated for:

(a) congestive heart failure?

(b) a lung condition with prednisone (or other oral steroid medication) or home oxygen?

(c) kidney or liver failure?

(d) peripheral vascular disease?

Q5. In the 12 months prior to your effective date have you been diagnosed with or been treated for:

(a) a heart attack?

(b) stroke, transient ischemic attack (TIA) or mini-stroke?

(c) cancer (excluding basal or squamous cell skin cancer or breast cancer treated only with hormone therapy)?

(d) internal bleeding?

Q1. Was your most recent heart bypass, heart angioplasty (including stent placement) or heart valve surgery more than 10 years prior to your effective date?

Q3. Have you ever had or are awaiting a bone marrow or organ transplant?

Q4. In the 24 months prior to your effective date have you been diagnosed with or treated for:

(a) congestive heart failure?

(b) a lung condition with prednisone (or other oral steroid medication) or home oxygen?

(c) kidney or liver failure?

(d) peripheral vascular disease?

Q5. In the 12 months prior to your effective date have you been diagnosed with or been treated for:

(a) a heart attack?

(b) stroke, transient ischemic attack (TIA) or mini-stroke?

(c) cancer (excluding basal or squamous cell skin cancer or breast cancer treated only with hormone therapy)?

(d) internal bleeding?

Q1. Was your most recent heart bypass, heart angioplasty (including stent placement) or heart valve surgery more than 10 years prior to your effective date?

Q3. Have you ever had or are awaiting a bone marrow or organ transplant?

Q4. In the 24 months prior to your effective date have you been diagnosed with or treated for:

(a) congestive heart failure?

(b) a lung condition with prednisone (or other oral steroid medication) or home oxygen?

(c) kidney or liver failure?

(d) peripheral vascular disease?

Q5. In the 12 months prior to your effective date have you been diagnosed with or been treated for:

(a) a heart attack?

(b) stroke, transient ischemic attack (TIA) or mini-stroke?

(c) cancer (excluding basal or squamous cell skin cancer or breast cancer treated only with hormone therapy)?

(d) internal bleeding?

Q1. Was your most recent heart bypass, heart angioplasty (including stent placement) or heart valve surgery more than 10 years prior to your effective date?

Q3. Have you ever had or are awaiting a bone marrow or organ transplant?

Q4. In the 24 months prior to your effective date have you been diagnosed with or treated for:

(a) congestive heart failure?

(b) a lung condition with prednisone (or other oral steroid medication) or home oxygen?

(c) kidney or liver failure?

(d) peripheral vascular disease?

Q5. In the 12 months prior to your effective date have you been diagnosed with or been treated for:

(a) a heart attack?

(b) stroke, transient ischemic attack (TIA) or mini-stroke?

(c) cancer (excluding basal or squamous cell skin cancer or breast cancer treated only with hormone therapy)?

(d) internal bleeding?

Q1. Was your most recent heart bypass, heart angioplasty (including stent placement) or heart valve surgery more than 10 years prior to your effective date?

Q3. Have you ever had or are awaiting a bone marrow or organ transplant?

Q4. In the 24 months prior to your effective date have you been diagnosed with or treated for:

(a) congestive heart failure?

(b) a lung condition with prednisone (or other oral steroid medication) or home oxygen?

(c) kidney or liver failure?

(d) peripheral vascular disease?

Q5. In the 12 months prior to your effective date have you been diagnosed with or been treated for:

(a) a heart attack?

(b) stroke, transient ischemic attack (TIA) or mini-stroke?

(c) cancer (excluding basal or squamous cell skin cancer or breast cancer treated only with hormone therapy)?

(d) internal bleeding?