DECLARATIONS PAGE - HEALTH PLAN (SYNTHETIC FIXTURE)

== POLICY ==
Policy Type: health
Carrier: Clearpath Health Plan (fictional)
Policy Number: CHP-2026-5520
Named Insured: Household Member A (synthetic)
Status: active

== COVERED ==
Covered Person: member-a

== COVERAGES ==
Coverage: Medical (HMO) | Limit: none | Deductible: 1500
Coverage: Prescription Drugs | Limit: none | Deductible: 250

== PREMIUM ==
Premium Amount: 438.00
Premium Period: 1 month
Prior Premium Amount: 421.00

== DATES ==
Effective Date: 2026-01-01
Renewal Date: 2027-01-01
Premium Due Date: 2026-11-01
Grace Period End: 2026-11-30
