2018 small business health option program (shop) rates for ...2018 small business health option...
TRANSCRIPT
2018 Small Business Health Option Program (SHOP)Rates for January 1, 2018 through March 31, 2018
Area 4
Area 5
Area 6
Area 7
Area 8
Area 9
Area 10
Area 11
Area 12
Area 13
Plans not available
Plans are approved to market in allcounties on the Public Exchange exceptCook, DuPage, Kane, Lake and McHenry.
Rating Areas
Area 4Age HMO 500
PlatinumHMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $366.24 $327.05 $275.25 $269.17 $322.08 $328.57 $306.82 $341.01 $309.97 $288.04
15 $398.79 $356.12 $299.71 $293.10 $350.71 $357.77 $334.09 $371.32 $337.52 $313.64
16 $411.24 $367.23 $309.07 $302.25 $361.66 $368.94 $344.52 $382.91 $348.06 $323.43
17 $423.68 $378.35 $318.42 $311.40 $372.60 $380.11 $354.95 $394.50 $358.59 $333.22
18 $437.09 $390.32 $328.50 $321.25 $384.39 $392.13 $366.18 $406.98 $369.94 $343.76
19 $450.49 $402.29 $338.57 $331.10 $396.18 $404.16 $377.41 $419.46 $381.28 $354.31
20 $464.38 $414.68 $349.01 $341.30 $408.39 $416.62 $389.04 $432.39 $393.03 $365.22
21 $478.74 $427.51 $359.80 $351.86 $421.02 $429.50 $401.07 $445.76 $405.19 $376.52
22 $478.74 $427.51 $359.80 $351.86 $421.02 $429.50 $401.07 $445.76 $405.19 $376.52
23 $478.74 $427.51 $359.80 $351.86 $421.02 $429.50 $401.07 $445.76 $405.19 $376.52
24 $478.74 $427.51 $359.80 $351.86 $421.02 $429.50 $401.07 $445.76 $405.19 $376.52
25 $480.65 $429.22 $361.24 $353.27 $422.70 $431.22 $402.67 $447.54 $406.81 $378.03
26 $490.23 $437.77 $368.44 $360.30 $431.12 $439.81 $410.70 $456.46 $414.91 $385.56
27 $501.72 $448.03 $377.07 $368.75 $441.23 $450.12 $420.32 $467.16 $424.64 $394.59
28 $520.39 $464.70 $391.10 $382.47 $457.65 $466.87 $435.96 $484.54 $440.44 $409.28
29 $535.71 $478.38 $402.62 $393.73 $471.12 $480.61 $448.80 $498.81 $453.41 $421.33
30 $543.37 $485.22 $408.37 $399.36 $477.86 $487.48 $455.21 $505.94 $459.89 $427.35
31 $554.86 $495.48 $417.01 $407.81 $487.96 $497.79 $464.84 $516.64 $469.62 $436.39
32 $566.35 $505.74 $425.64 $416.25 $498.07 $508.10 $474.47 $527.33 $479.34 $445.42
33 $573.53 $512.16 $431.04 $421.53 $504.38 $514.54 $480.48 $534.02 $485.42 $451.07
34 $581.19 $519.00 $436.80 $427.16 $511.12 $521.41 $486.90 $541.15 $491.90 $457.10
35 $585.02 $522.42 $439.68 $429.97 $514.49 $524.85 $490.11 $544.72 $495.14 $460.11
36 $588.85 $525.84 $442.55 $432.79 $517.85 $528.29 $493.32 $548.28 $498.38 $463.12
37 $592.68 $529.26 $445.43 $435.60 $521.22 $531.72 $496.52 $551.85 $501.63 $466.13
38 $596.51 $532.68 $448.31 $438.42 $524.59 $535.16 $499.73 $555.42 $504.87 $469.14
39 $604.17 $539.52 $454.07 $444.05 $531.33 $542.03 $506.15 $562.55 $511.35 $475.17
40 $611.83 $546.36 $459.82 $449.68 $538.06 $548.90 $512.57 $569.68 $517.83 $481.19
41 $623.32 $556.62 $468.46 $458.12 $548.17 $559.21 $522.19 $580.38 $527.56 $490.23
42 $634.33 $566.45 $476.74 $466.21 $557.85 $569.09 $531.42 $590.63 $536.88 $498.89
43 $649.65 $580.13 $488.25 $477.47 $571.32 $582.83 $544.25 $604.90 $549.84 $510.94
44 $668.80 $597.23 $502.64 $491.55 $588.16 $600.01 $560.29 $622.73 $566.05 $526.00
45 $691.30 $617.32 $519.55 $508.09 $607.95 $620.20 $579.15 $643.68 $585.09 $543.69
46 $718.11 $641.27 $539.70 $527.79 $631.53 $644.25 $601.61 $668.64 $607.79 $564.78
47 $748.27 $668.20 $562.37 $549.96 $658.05 $671.31 $626.87 $696.72 $633.31 $588.50
48 $782.74 $698.98 $588.27 $575.29 $688.37 $702.23 $655.75 $728.82 $662.49 $615.61
49 $816.73 $729.33 $613.82 $600.27 $718.26 $732.73 $684.23 $760.47 $691.25 $642.34
50 $855.03 $763.53 $642.60 $628.42 $751.94 $767.09 $716.31 $796.13 $723.67 $672.46
51 $892.85 $797.31 $671.03 $656.22 $785.20 $801.02 $748.00 $831.34 $755.68 $702.21
52 $934.50 $834.50 $702.33 $686.83 $821.83 $838.38 $782.89 $870.12 $790.93 $734.97
53 $976.63 $872.12 $733.99 $717.79 $858.88 $876.18 $818.18 $909.35 $826.59 $768.10
54 $1,022.11 $912.73 $768.17 $751.22 $898.88 $916.98 $856.28 $951.70 $865.08 $803.87
55 $1,067.59 $953.35 $802.35 $784.65 $938.87 $957.79 $894.39 $994.04 $903.57 $839.64
56 $1,116.90 $997.38 $839.41 $820.89 $982.24 $1,002.02 $935.70 $1,039.96 $945.31 $878.42
57 $1,166.69 $1,041.84 $876.83 $857.48 $1,026.03 $1,046.69 $977.41 $1,086.32 $987.45 $917.58
58 $1,219.83 $1,089.30 $916.77 $896.54 $1,072.76 $1,094.37 $1,021.93 $1,135.80 $1,032.42 $959.37
59 $1,246.16 $1,112.81 $936.56 $915.89 $1,095.92 $1,117.99 $1,043.99 $1,160.31 $1,054.71 $980.08
60 $1,299.30 $1,160.26 $976.50 $954.95 $1,142.65 $1,165.66 $1,088.50 $1,209.79 $1,099.69 $1,021.88
61 $1,345.26 $1,201.30 $1,011.04 $988.73 $1,183.07 $1,206.90 $1,127.01 $1,252.59 $1,138.58 $1,058.02
62 $1,375.42 $1,228.24 $1,033.71 $1,010.89 $1,209.59 $1,233.95 $1,152.27 $1,280.67 $1,164.11 $1,081.74
63 $1,413.24 $1,262.01 $1,062.13 $1,038.69 $1,242.85 $1,267.88 $1,183.96 $1,315.88 $1,196.12 $1,111.49
64+ $1,436.22 $1,282.53 $1,079.40 $1,055.58 $1,263.06 $1,288.50 $1,203.21 $1,337.28 $1,215.57 $1,129.56
H
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $253.18 $292.96 $272.85 $249.68 $240.30 $242.30 $210.54 $253.00 $301.68 $220.52
15 $275.69 $319.00 $297.11 $271.87 $261.66 $263.84 $229.26 $275.49 $328.49 $240.12
16 $284.29 $328.95 $306.38 $280.36 $269.83 $272.07 $236.41 $284.09 $338.75 $247.62
17 $292.90 $338.91 $315.65 $288.85 $278.00 $280.31 $243.57 $292.69 $349.00 $255.11
18 $302.17 $349.63 $325.64 $297.98 $286.79 $289.17 $251.28 $301.95 $360.04 $263.18
19 $311.43 $360.36 $335.63 $307.12 $295.59 $298.04 $258.98 $311.21 $371.08 $271.25
20 $321.03 $371.46 $345.97 $316.59 $304.70 $307.23 $266.96 $320.80 $382.52 $279.61
21 $330.96 $382.95 $356.67 $326.38 $314.12 $316.73 $275.22 $330.72 $394.35 $288.26
22 $330.96 $382.95 $356.67 $326.38 $314.12 $316.73 $275.22 $330.72 $394.35 $288.26
23 $330.96 $382.95 $356.67 $326.38 $314.12 $316.73 $275.22 $330.72 $394.35 $288.26
24 $330.96 $382.95 $356.67 $326.38 $314.12 $316.73 $275.22 $330.72 $394.35 $288.26
25 $332.28 $384.48 $358.10 $327.69 $315.38 $318.00 $276.32 $332.04 $395.93 $289.41
26 $338.90 $392.14 $365.23 $334.21 $321.66 $324.33 $281.83 $338.66 $403.81 $295.18
27 $346.85 $401.33 $373.79 $342.05 $329.20 $331.93 $288.43 $346.59 $413.28 $302.10
28 $359.75 $416.27 $387.70 $354.78 $341.45 $344.29 $299.16 $359.49 $428.66 $313.34
29 $370.34 $428.52 $399.11 $365.22 $351.50 $354.42 $307.97 $370.08 $441.28 $322.56
30 $375.64 $434.65 $404.82 $370.44 $356.53 $359.49 $312.37 $375.37 $447.59 $327.18
31 $383.58 $443.84 $413.38 $378.27 $364.07 $367.09 $318.98 $383.30 $457.05 $334.09
32 $391.53 $453.03 $421.94 $386.11 $371.60 $374.69 $325.59 $391.24 $466.52 $341.01
33 $396.49 $458.77 $427.29 $391.00 $376.32 $379.44 $329.71 $396.20 $472.43 $345.34
34 $401.79 $464.90 $433.00 $396.23 $381.34 $384.51 $334.12 $401.49 $478.74 $349.95
35 $404.43 $467.96 $435.85 $398.84 $383.85 $387.04 $336.32 $404.14 $481.90 $352.25
36 $407.08 $471.03 $438.70 $401.45 $386.37 $389.58 $338.52 $406.79 $485.05 $354.56
37 $409.73 $474.09 $441.56 $404.06 $388.88 $392.11 $340.72 $409.43 $488.21 $356.87
38 $412.38 $477.16 $444.41 $406.67 $391.39 $394.65 $342.92 $412.08 $491.36 $359.17
39 $417.67 $483.28 $450.12 $411.89 $396.42 $399.71 $347.33 $417.37 $497.67 $363.78
40 $422.97 $489.41 $455.82 $417.11 $401.45 $404.78 $351.73 $422.66 $503.98 $368.40
41 $430.91 $498.60 $464.38 $424.95 $408.98 $412.38 $358.34 $430.60 $513.44 $375.31
42 $438.52 $507.41 $472.59 $432.45 $416.21 $419.67 $364.67 $438.20 $522.51 $381.94
43 $449.11 $519.66 $484.00 $442.90 $426.26 $429.80 $373.47 $448.79 $535.13 $391.17
44 $462.35 $534.98 $498.27 $455.95 $438.83 $442.47 $384.48 $462.02 $550.91 $402.70
45 $477.91 $552.98 $515.03 $471.29 $453.59 $457.36 $397.42 $477.56 $569.44 $416.25
46 $496.44 $574.43 $535.01 $489.57 $471.18 $475.10 $412.83 $496.08 $591.53 $432.39
47 $517.29 $598.55 $557.48 $510.13 $490.97 $495.05 $430.17 $516.92 $616.37 $450.55
48 $541.12 $626.12 $583.16 $533.63 $513.59 $517.85 $449.98 $540.73 $644.76 $471.31
49 $564.62 $653.31 $608.48 $556.80 $535.89 $540.34 $469.53 $564.21 $672.76 $491.77
50 $591.09 $683.95 $637.01 $582.91 $561.02 $565.68 $491.54 $590.67 $704.31 $514.83
51 $617.24 $714.20 $665.19 $608.70 $585.83 $590.70 $513.29 $616.79 $735.46 $537.60
52 $646.03 $747.52 $696.22 $637.09 $613.16 $618.26 $537.23 $645.57 $769.77 $562.68
53 $675.16 $781.22 $727.61 $665.82 $640.80 $646.13 $561.45 $674.67 $804.47 $588.05
54 $706.60 $817.60 $761.49 $696.82 $670.65 $676.22 $587.59 $706.09 $841.94 $615.44
55 $738.04 $853.98 $795.37 $727.83 $700.49 $706.31 $613.74 $737.51 $879.40 $642.82
56 $772.13 $893.42 $832.11 $761.44 $732.84 $738.93 $642.09 $771.57 $920.02 $672.51
57 $806.55 $933.25 $869.20 $795.39 $765.51 $771.87 $670.71 $805.96 $961.03 $702.49
58 $843.29 $975.76 $908.80 $831.62 $800.38 $807.03 $701.26 $842.67 $1,004.80 $734.49
59 $861.49 $996.82 $928.41 $849.57 $817.65 $824.45 $716.40 $860.86 $1,026.49 $750.34
60 $898.23 $1,039.33 $968.00 $885.80 $852.52 $859.61 $746.95 $897.57 $1,070.27 $782.34
61 $930.00 $1,076.09 $1,002.24 $917.13 $882.68 $890.01 $773.37 $929.32 $1,108.12 $810.01
62 $950.85 $1,100.22 $1,024.71 $937.69 $902.47 $909.97 $790.71 $950.16 $1,132.97 $828.17
63 $976.99 $1,130.47 $1,052.89 $963.47 $927.28 $934.99 $812.45 $976.29 $1,164.12 $850.94
64+ $992.88 $1,148.85 $1,070.01 $979.14 $942.36 $950.19 $825.66 $992.16 $1,183.05 $864.78
Area 5H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $385.51 $344.26 $289.74 $283.34 $339.03 $345.86 $322.97 $358.95 $326.29 $303.19
15 $419.78 $374.86 $315.49 $308.53 $369.17 $376.61 $351.68 $390.86 $355.29 $330.14
16 $432.88 $386.56 $325.34 $318.16 $380.69 $388.36 $362.65 $403.06 $366.38 $340.45
17 $445.99 $398.26 $335.18 $327.79 $392.21 $400.12 $373.63 $415.26 $377.47 $350.75
18 $460.10 $410.86 $345.79 $338.16 $404.62 $412.78 $385.45 $428.40 $389.41 $361.85
19 $474.21 $423.46 $356.39 $348.53 $417.03 $425.44 $397.27 $441.54 $401.36 $372.95
20 $488.82 $436.51 $367.38 $359.27 $429.88 $438.55 $409.51 $455.14 $413.72 $384.44
21 $503.94 $450.01 $378.74 $370.38 $443.18 $452.11 $422.18 $469.22 $426.52 $396.33
22 $503.94 $450.01 $378.74 $370.38 $443.18 $452.11 $422.18 $469.22 $426.52 $396.33
23 $503.94 $450.01 $378.74 $370.38 $443.18 $452.11 $422.18 $469.22 $426.52 $396.33
24 $503.94 $450.01 $378.74 $370.38 $443.18 $452.11 $422.18 $469.22 $426.52 $396.33
25 $505.96 $451.81 $380.25 $371.86 $444.95 $453.92 $423.87 $471.10 $428.23 $397.92
26 $516.03 $460.81 $387.83 $379.27 $453.82 $462.96 $432.31 $480.48 $436.76 $405.84
27 $528.13 $471.61 $396.92 $388.16 $464.45 $473.81 $442.44 $491.74 $446.99 $415.35
28 $547.78 $489.16 $411.69 $402.60 $481.74 $491.44 $458.91 $510.04 $463.63 $430.81
29 $563.91 $503.56 $423.81 $414.46 $495.92 $505.91 $472.42 $525.06 $477.28 $443.49
30 $571.97 $510.76 $429.87 $420.38 $503.01 $513.14 $479.17 $532.56 $484.10 $449.83
31 $584.07 $521.56 $438.96 $429.27 $513.65 $524.00 $489.31 $543.83 $494.34 $459.35
32 $596.16 $532.36 $448.05 $438.16 $524.28 $534.85 $499.44 $555.09 $504.57 $468.86
33 $603.72 $539.11 $453.73 $443.72 $530.93 $541.63 $505.77 $562.13 $510.97 $474.80
34 $611.78 $546.31 $459.79 $449.64 $538.02 $548.86 $512.53 $569.63 $517.80 $481.14
35 $615.81 $549.91 $462.82 $452.60 $541.57 $552.48 $515.90 $573.39 $521.21 $484.32
36 $619.85 $553.51 $465.85 $455.57 $545.11 $556.10 $519.28 $577.14 $524.62 $487.49
37 $623.88 $557.11 $468.88 $458.53 $548.66 $559.71 $522.66 $580.89 $528.03 $490.66
38 $627.91 $560.71 $471.91 $461.49 $552.20 $563.33 $526.04 $584.65 $531.44 $493.83
39 $635.97 $567.91 $477.97 $467.42 $559.29 $570.56 $532.79 $592.16 $538.27 $500.17
40 $644.04 $575.11 $484.03 $473.35 $566.38 $577.80 $539.55 $599.66 $545.09 $506.51
41 $656.13 $585.91 $493.12 $482.23 $577.02 $588.65 $549.68 $610.92 $555.33 $516.02
42 $667.72 $596.26 $501.83 $490.75 $587.21 $599.05 $559.39 $621.72 $565.14 $525.14
43 $683.85 $610.66 $513.95 $502.61 $601.40 $613.51 $572.90 $636.73 $578.79 $537.82
44 $704.00 $628.66 $529.10 $517.42 $619.12 $631.60 $589.79 $655.50 $595.85 $553.67
45 $727.69 $649.81 $546.90 $534.83 $639.95 $652.85 $609.63 $677.55 $615.89 $572.30
46 $755.91 $675.02 $568.11 $555.57 $664.77 $678.17 $633.27 $703.83 $639.78 $594.50
47 $787.66 $703.37 $591.97 $578.90 $692.69 $706.65 $659.87 $733.39 $666.65 $619.46
48 $823.94 $735.77 $619.24 $605.57 $724.60 $739.20 $690.26 $767.17 $697.36 $648.00
49 $859.72 $767.72 $646.13 $631.87 $756.07 $771.30 $720.24 $800.49 $727.64 $676.14
50 $900.04 $803.72 $676.43 $661.50 $791.52 $807.47 $754.01 $838.03 $761.76 $707.85
51 $939.85 $839.27 $706.35 $690.76 $826.53 $843.19 $787.37 $875.10 $795.46 $739.16
52 $983.69 $878.42 $739.30 $722.98 $865.09 $882.52 $824.10 $915.92 $832.57 $773.64
53 $1,028.04 $918.02 $772.63 $755.58 $904.09 $922.30 $861.25 $957.21 $870.10 $808.51
54 $1,075.91 $960.77 $808.61 $790.76 $946.19 $965.25 $901.35 $1,001.78 $910.62 $846.16
55 $1,123.79 $1,003.52 $844.59 $825.95 $988.29 $1,008.21 $941.46 $1,046.36 $951.14 $883.82
56 $1,175.69 $1,049.87 $883.60 $864.10 $1,033.94 $1,054.77 $984.95 $1,094.69 $995.07 $924.64
57 $1,228.10 $1,096.67 $922.99 $902.62 $1,080.03 $1,101.79 $1,028.85 $1,143.49 $1,039.43 $965.86
58 $1,284.04 $1,146.63 $965.03 $943.73 $1,129.22 $1,151.98 $1,075.71 $1,195.57 $1,086.77 $1,009.85
59 $1,311.76 $1,171.38 $985.86 $964.10 $1,153.60 $1,176.84 $1,098.93 $1,221.38 $1,110.23 $1,031.65
60 $1,367.69 $1,221.33 $1,027.90 $1,005.21 $1,202.79 $1,227.03 $1,145.80 $1,273.46 $1,157.58 $1,075.64
61 $1,416.07 $1,264.53 $1,064.26 $1,040.77 $1,245.34 $1,270.43 $1,186.33 $1,318.51 $1,198.52 $1,113.69
62 $1,447.82 $1,292.88 $1,088.12 $1,064.10 $1,273.26 $1,298.91 $1,212.92 $1,348.07 $1,225.39 $1,138.66
63 $1,487.63 $1,328.43 $1,118.04 $1,093.36 $1,308.27 $1,334.63 $1,246.28 $1,385.14 $1,259.09 $1,169.97
64+ $1,511.82 $1,350.03 $1,136.22 $1,111.14 $1,329.54 $1,356.33 $1,266.54 $1,407.66 $1,279.56 $1,188.99
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $266.51 $308.38 $287.21 $262.82 $252.95 $255.05 $221.62 $266.31 $317.56 $232.12
15 $290.20 $335.79 $312.74 $286.19 $275.43 $277.72 $241.32 $289.98 $345.79 $252.76
16 $299.26 $346.27 $322.50 $295.12 $284.03 $286.39 $248.85 $299.04 $356.58 $260.65
17 $308.32 $356.75 $332.26 $304.05 $292.63 $295.06 $256.38 $308.09 $367.37 $268.54
18 $318.07 $368.04 $342.78 $313.67 $301.88 $304.39 $264.50 $317.83 $379.00 $277.03
19 $327.83 $379.33 $353.29 $323.29 $311.14 $313.73 $272.61 $327.58 $390.62 $285.53
20 $337.93 $391.02 $364.18 $333.25 $320.73 $323.40 $281.01 $337.68 $402.66 $294.33
21 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
22 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
23 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
24 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
25 $349.77 $404.72 $376.94 $344.93 $331.97 $334.73 $290.86 $349.51 $416.77 $304.64
26 $356.74 $412.78 $384.45 $351.81 $338.59 $341.40 $296.65 $356.47 $425.07 $310.71
27 $365.10 $422.46 $393.46 $360.05 $346.52 $349.40 $303.61 $364.83 $435.04 $317.99
28 $378.69 $438.18 $408.10 $373.45 $359.42 $362.41 $314.90 $378.41 $451.22 $329.83
29 $389.84 $451.08 $420.12 $384.44 $370.00 $373.07 $324.17 $389.55 $464.51 $339.54
30 $395.41 $457.53 $426.12 $389.94 $375.29 $378.41 $328.81 $395.12 $471.15 $344.39
31 $403.77 $467.20 $435.13 $398.19 $383.22 $386.41 $335.76 $403.47 $481.11 $351.68
32 $412.13 $476.88 $444.15 $406.43 $391.16 $394.41 $342.72 $411.83 $491.08 $358.96
33 $417.36 $482.93 $449.78 $411.58 $396.12 $399.41 $347.06 $417.05 $497.30 $363.51
34 $422.93 $489.38 $455.78 $417.08 $401.41 $404.75 $351.70 $422.62 $503.94 $368.36
35 $425.72 $492.60 $458.79 $419.83 $404.05 $407.41 $354.01 $425.40 $507.26 $370.79
36 $428.51 $495.83 $461.79 $422.58 $406.70 $410.08 $356.33 $428.19 $510.59 $373.22
37 $431.29 $499.05 $464.79 $425.33 $409.34 $412.75 $358.65 $430.97 $513.91 $375.65
38 $434.08 $502.28 $467.80 $428.08 $411.99 $415.42 $360.97 $433.76 $517.23 $378.07
39 $439.66 $508.72 $473.81 $433.57 $417.28 $420.75 $365.60 $439.33 $523.87 $382.93
40 $445.23 $515.17 $479.81 $439.07 $422.57 $426.09 $370.24 $444.90 $530.51 $387.78
41 $453.59 $524.85 $488.82 $447.32 $430.51 $434.09 $377.19 $453.25 $540.47 $395.07
42 $461.60 $534.12 $497.46 $455.22 $438.11 $441.76 $383.85 $461.26 $550.02 $402.04
43 $472.75 $547.02 $509.47 $466.21 $448.69 $452.42 $393.12 $472.40 $563.30 $411.75
44 $486.69 $563.14 $524.49 $479.95 $461.92 $465.76 $404.71 $486.32 $579.91 $423.89
45 $503.06 $582.09 $542.14 $496.10 $477.46 $481.43 $418.33 $502.69 $599.42 $438.15
46 $522.57 $604.67 $563.16 $515.34 $495.98 $500.10 $434.55 $522.18 $622.67 $455.15
47 $544.52 $630.06 $586.81 $536.98 $516.81 $521.10 $452.80 $544.11 $648.82 $474.26
48 $569.60 $659.08 $613.84 $561.72 $540.61 $545.11 $473.66 $569.18 $678.70 $496.11
49 $594.34 $687.71 $640.50 $586.11 $564.09 $568.78 $494.23 $593.89 $708.18 $517.65
50 $622.21 $719.95 $670.54 $613.60 $590.54 $595.45 $517.40 $621.74 $741.39 $541.93
51 $649.73 $751.80 $700.20 $640.74 $616.66 $621.79 $540.29 $649.24 $774.18 $565.90
52 $680.04 $786.87 $732.86 $670.63 $645.43 $650.80 $565.49 $679.53 $810.29 $592.30
53 $710.70 $822.34 $765.90 $700.86 $674.53 $680.14 $590.99 $710.16 $846.82 $619.00
54 $743.79 $860.64 $801.56 $733.50 $705.94 $711.81 $618.51 $743.24 $886.26 $647.82
55 $776.89 $898.94 $837.23 $766.14 $737.35 $743.48 $646.03 $776.31 $925.70 $676.65
56 $812.77 $940.46 $875.90 $801.53 $771.41 $777.82 $675.87 $812.16 $968.45 $707.90
57 $849.00 $982.38 $914.95 $837.26 $805.79 $812.50 $706.00 $848.37 $1,011.62 $739.46
58 $887.67 $1,027.12 $956.62 $875.39 $842.50 $849.50 $738.16 $887.01 $1,057.70 $773.14
59 $906.83 $1,049.30 $977.27 $894.29 $860.68 $867.84 $754.09 $906.16 $1,080.53 $789.83
60 $945.50 $1,094.04 $1,018.94 $932.42 $897.38 $904.85 $786.25 $944.80 $1,126.61 $823.51
61 $978.95 $1,132.74 $1,054.99 $965.40 $929.13 $936.85 $814.06 $978.22 $1,166.46 $852.64
62 $1,000.90 $1,158.14 $1,078.64 $987.05 $949.96 $957.86 $832.31 $1,000.15 $1,192.61 $871.75
63 $1,028.42 $1,189.98 $1,108.30 $1,014.19 $976.08 $984.20 $855.19 $1,027.65 $1,225.40 $895.73
64+ $1,045.14 $1,209.33 $1,126.32 $1,030.68 $991.95 $1,000.20 $869.10 $1,044.36 $1,245.33 $910.29
Area 6H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $412.50 $368.36 $310.02 $303.18 $362.77 $370.07 $345.57 $384.08 $349.12 $324.42
15 $449.17 $401.10 $337.57 $330.13 $395.02 $402.96 $376.29 $418.22 $380.16 $353.26
16 $463.19 $413.62 $348.11 $340.43 $407.35 $415.54 $388.04 $431.27 $392.02 $364.28
17 $477.21 $426.14 $358.65 $350.73 $419.68 $428.12 $399.78 $444.32 $403.89 $375.31
18 $492.31 $439.62 $369.99 $361.83 $432.95 $441.66 $412.43 $458.38 $416.67 $387.19
19 $507.41 $453.10 $381.34 $372.93 $446.23 $455.21 $425.08 $472.44 $429.44 $399.06
20 $523.04 $467.06 $393.09 $384.42 $459.98 $469.24 $438.18 $487.00 $442.68 $411.36
21 $539.22 $481.51 $405.25 $396.31 $474.21 $483.75 $451.73 $502.06 $456.37 $424.08
22 $539.22 $481.51 $405.25 $396.31 $474.21 $483.75 $451.73 $502.06 $456.37 $424.08
23 $539.22 $481.51 $405.25 $396.31 $474.21 $483.75 $451.73 $502.06 $456.37 $424.08
24 $539.22 $481.51 $405.25 $396.31 $474.21 $483.75 $451.73 $502.06 $456.37 $424.08
25 $541.38 $483.44 $406.87 $397.90 $476.11 $485.69 $453.54 $504.07 $458.20 $425.78
26 $552.16 $493.07 $414.98 $405.82 $485.59 $495.36 $462.57 $514.11 $467.32 $434.26
27 $565.10 $504.62 $424.70 $415.33 $496.97 $506.97 $473.41 $526.16 $478.28 $444.44
28 $586.13 $523.40 $440.51 $430.79 $515.47 $525.84 $491.03 $545.74 $496.07 $460.97
29 $603.39 $538.81 $453.47 $443.47 $530.64 $541.32 $505.49 $561.81 $510.68 $474.55
30 $612.01 $546.51 $459.96 $449.81 $538.23 $549.06 $512.71 $569.84 $517.98 $481.33
31 $624.96 $558.07 $469.68 $459.32 $549.61 $560.67 $523.56 $581.89 $528.93 $491.51
32 $637.90 $569.63 $479.41 $468.83 $560.99 $572.28 $534.40 $593.94 $539.89 $501.69
33 $645.99 $576.85 $485.49 $474.78 $568.10 $579.53 $541.17 $601.47 $546.73 $508.05
34 $654.61 $584.55 $491.97 $481.12 $575.69 $587.27 $548.40 $609.50 $554.03 $514.83
35 $658.93 $588.41 $495.22 $484.29 $579.48 $591.14 $552.01 $613.52 $557.68 $518.23
36 $663.24 $592.26 $498.46 $487.46 $583.28 $595.01 $555.63 $617.53 $561.34 $521.62
37 $667.55 $596.11 $501.70 $490.63 $587.07 $598.88 $559.24 $621.55 $564.99 $525.01
38 $671.87 $599.96 $504.94 $493.80 $590.87 $602.75 $562.86 $625.57 $568.64 $528.40
39 $680.50 $607.67 $511.43 $500.14 $598.45 $610.49 $570.08 $633.60 $575.94 $535.19
40 $689.12 $615.37 $517.91 $506.48 $606.04 $618.23 $577.31 $641.63 $583.24 $541.97
41 $702.06 $626.93 $527.64 $516.00 $617.42 $629.84 $588.15 $653.68 $594.19 $552.15
42 $714.47 $638.00 $536.96 $525.11 $628.33 $640.97 $598.54 $665.23 $604.69 $561.91
43 $731.72 $653.41 $549.92 $537.79 $643.50 $656.45 $613.00 $681.30 $619.29 $575.48
44 $753.29 $672.67 $566.13 $553.65 $662.47 $675.80 $631.07 $701.38 $637.55 $592.44
45 $778.63 $695.30 $585.18 $572.27 $684.76 $698.54 $652.30 $724.97 $659.00 $612.37
46 $808.83 $722.27 $607.88 $594.47 $711.32 $725.63 $677.60 $753.09 $684.56 $636.12
47 $842.80 $752.60 $633.41 $619.43 $741.19 $756.10 $706.05 $784.72 $713.31 $662.84
48 $881.62 $787.27 $662.58 $647.97 $775.33 $790.93 $738.58 $820.87 $746.16 $693.37
49 $919.91 $821.46 $691.36 $676.10 $809.00 $825.28 $770.65 $856.51 $778.57 $723.48
50 $963.05 $859.98 $723.78 $707.81 $846.94 $863.98 $806.79 $896.68 $815.08 $757.41
51 $1,005.65 $898.02 $755.79 $739.12 $884.40 $902.19 $842.48 $936.34 $851.13 $790.91
52 $1,052.56 $939.91 $791.05 $773.60 $925.66 $944.28 $881.78 $980.02 $890.83 $827.80
53 $1,100.01 $982.28 $826.71 $808.47 $967.39 $986.85 $921.53 $1,024.20 $930.99 $865.12
54 $1,151.23 $1,028.02 $865.21 $846.12 $1,012.44 $1,032.81 $964.44 $1,071.90 $974.35 $905.41
55 $1,202.46 $1,073.77 $903.71 $883.77 $1,057.49 $1,078.76 $1,007.36 $1,119.59 $1,017.71 $945.70
56 $1,258.00 $1,123.36 $945.45 $924.59 $1,106.33 $1,128.59 $1,053.89 $1,171.31 $1,064.71 $989.38
57 $1,314.08 $1,173.44 $987.59 $965.81 $1,155.65 $1,178.90 $1,100.87 $1,223.52 $1,112.17 $1,033.48
58 $1,373.93 $1,226.89 $1,032.58 $1,009.80 $1,208.29 $1,232.60 $1,151.01 $1,279.25 $1,162.83 $1,080.56
59 $1,403.59 $1,253.37 $1,054.87 $1,031.59 $1,234.37 $1,259.20 $1,175.85 $1,306.86 $1,187.93 $1,103.88
60 $1,463.44 $1,306.82 $1,099.85 $1,075.59 $1,287.01 $1,312.90 $1,226.00 $1,362.59 $1,238.59 $1,150.95
61 $1,515.21 $1,353.04 $1,138.75 $1,113.63 $1,332.53 $1,359.34 $1,269.36 $1,410.79 $1,282.40 $1,191.66
62 $1,549.18 $1,383.38 $1,164.28 $1,138.60 $1,362.41 $1,389.81 $1,297.82 $1,442.42 $1,311.15 $1,218.38
63 $1,591.78 $1,421.42 $1,196.30 $1,169.91 $1,399.87 $1,428.03 $1,333.51 $1,482.08 $1,347.20 $1,251.88
64+ $1,617.66 $1,444.53 $1,215.75 $1,188.93 $1,422.63 $1,451.25 $1,355.19 $1,506.18 $1,369.11 $1,272.24
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $285.17 $329.97 $307.32 $281.22 $270.66 $272.91 $237.13 $284.95 $339.79 $248.37
15 $310.52 $359.30 $334.64 $306.22 $294.72 $297.16 $258.21 $310.28 $369.99 $270.45
16 $320.21 $370.51 $345.09 $315.78 $303.91 $306.44 $266.27 $319.97 $381.54 $278.89
17 $329.90 $381.73 $355.53 $325.33 $313.11 $315.71 $274.33 $329.65 $393.09 $287.33
18 $340.34 $393.80 $366.78 $335.63 $323.02 $325.70 $283.01 $340.08 $405.53 $296.42
19 $350.78 $405.88 $378.03 $345.92 $332.93 $335.69 $291.69 $350.51 $417.96 $305.51
20 $361.59 $418.39 $389.68 $356.58 $343.19 $346.04 $300.68 $361.32 $430.84 $314.93
21 $372.77 $431.33 $401.73 $367.61 $353.80 $356.74 $309.98 $372.49 $444.17 $324.67
22 $372.77 $431.33 $401.73 $367.61 $353.80 $356.74 $309.98 $372.49 $444.17 $324.67
23 $372.77 $431.33 $401.73 $367.61 $353.80 $356.74 $309.98 $372.49 $444.17 $324.67
24 $372.77 $431.33 $401.73 $367.61 $353.80 $356.74 $309.98 $372.49 $444.17 $324.67
25 $374.26 $433.06 $403.34 $369.08 $355.22 $358.17 $311.22 $373.98 $445.95 $325.97
26 $381.72 $441.68 $411.37 $376.43 $362.29 $365.30 $317.42 $381.43 $454.83 $332.46
27 $390.66 $452.03 $421.01 $385.26 $370.78 $373.86 $324.86 $390.37 $465.49 $340.25
28 $405.20 $468.86 $436.68 $399.59 $384.58 $387.78 $336.95 $404.90 $482.81 $352.92
29 $417.13 $482.66 $449.54 $411.36 $395.90 $399.19 $346.87 $416.82 $497.03 $363.31
30 $423.09 $489.56 $455.96 $417.24 $401.56 $404.90 $351.83 $422.78 $504.13 $368.50
31 $432.04 $499.91 $465.61 $426.06 $410.05 $413.46 $359.27 $431.72 $514.79 $376.29
32 $440.99 $510.26 $475.25 $434.88 $418.55 $422.02 $366.71 $440.66 $525.45 $384.08
33 $446.58 $516.73 $481.27 $440.40 $423.85 $427.37 $371.36 $446.24 $532.12 $388.95
34 $452.54 $523.63 $487.70 $446.28 $429.51 $433.08 $376.32 $452.20 $539.22 $394.15
35 $455.52 $527.09 $490.91 $449.22 $432.34 $435.94 $378.80 $455.18 $542.78 $396.75
36 $458.51 $530.54 $494.13 $452.16 $435.17 $438.79 $381.28 $458.16 $546.33 $399.34
37 $461.49 $533.99 $497.34 $455.10 $438.00 $441.64 $383.76 $461.14 $549.88 $401.94
38 $464.47 $537.44 $500.56 $458.04 $440.83 $444.50 $386.24 $464.12 $553.44 $404.54
39 $470.44 $544.34 $506.98 $463.92 $446.50 $450.21 $391.19 $470.08 $560.54 $409.73
40 $476.40 $551.24 $513.41 $469.81 $452.16 $455.91 $396.15 $476.04 $567.65 $414.93
41 $485.35 $561.59 $523.05 $478.63 $460.65 $464.48 $403.59 $484.98 $578.31 $422.72
42 $493.92 $571.51 $532.29 $487.08 $468.79 $472.68 $410.72 $493.55 $588.53 $430.19
43 $505.85 $585.31 $545.15 $498.85 $480.11 $484.10 $420.64 $505.47 $602.74 $440.58
44 $520.76 $602.57 $561.22 $513.55 $494.26 $498.37 $433.04 $520.37 $620.51 $453.56
45 $538.28 $622.84 $580.10 $530.83 $510.89 $515.13 $447.61 $537.88 $641.38 $468.82
46 $559.16 $647.00 $602.60 $551.42 $530.70 $535.11 $464.97 $558.74 $666.26 $487.01
47 $582.64 $674.17 $627.90 $574.57 $552.99 $557.58 $484.50 $582.20 $694.24 $507.46
48 $609.48 $705.22 $656.83 $601.04 $578.46 $583.27 $506.82 $609.02 $726.22 $530.84
49 $635.95 $735.85 $685.35 $627.14 $603.58 $608.60 $528.83 $635.47 $757.75 $553.89
50 $665.77 $770.36 $717.49 $656.55 $631.89 $637.14 $553.62 $665.27 $793.29 $579.86
51 $695.22 $804.43 $749.23 $685.59 $659.84 $665.32 $578.11 $694.69 $828.38 $605.51
52 $727.65 $841.96 $784.18 $717.57 $690.62 $696.36 $605.08 $727.10 $867.02 $633.76
53 $760.45 $879.91 $819.53 $749.92 $721.75 $727.75 $632.36 $759.88 $906.11 $662.33
54 $795.86 $920.89 $857.69 $784.85 $755.36 $761.64 $661.81 $795.27 $948.30 $693.17
55 $831.28 $961.87 $895.86 $819.77 $788.97 $795.53 $691.26 $830.65 $990.50 $724.01
56 $869.67 $1,006.29 $937.24 $857.63 $825.42 $832.27 $723.18 $869.02 $1,036.25 $757.46
57 $908.44 $1,051.15 $979.02 $895.87 $862.21 $869.38 $755.42 $907.76 $1,082.44 $791.22
58 $949.82 $1,099.03 $1,023.61 $936.67 $901.48 $908.97 $789.83 $949.10 $1,131.75 $827.26
59 $970.32 $1,122.75 $1,045.70 $956.89 $920.94 $928.59 $806.88 $969.59 $1,156.17 $845.12
60 $1,011.70 $1,170.63 $1,090.30 $997.69 $960.21 $968.19 $841.29 $1,010.94 $1,205.48 $881.15
61 $1,047.48 $1,212.04 $1,128.86 $1,032.98 $994.18 $1,002.44 $871.04 $1,046.70 $1,248.12 $912.32
62 $1,070.97 $1,239.21 $1,154.17 $1,056.14 $1,016.47 $1,024.91 $890.57 $1,070.16 $1,276.10 $932.78
63 $1,100.42 $1,273.29 $1,185.91 $1,085.18 $1,044.42 $1,053.10 $915.06 $1,099.59 $1,311.19 $958.43
64+ $1,118.31 $1,293.99 $1,205.19 $1,102.83 $1,061.40 $1,070.22 $929.94 $1,117.47 $1,332.51 $974.01
Area 7H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $339.25 $302.95 $254.97 $249.34 $298.35 $304.36 $284.21 $315.88 $287.14 $266.81
15 $369.41 $329.88 $277.63 $271.51 $324.87 $331.41 $309.48 $343.95 $312.66 $290.53
16 $380.94 $340.17 $286.30 $279.98 $335.01 $341.75 $319.14 $354.69 $322.42 $299.59
17 $392.47 $350.47 $294.96 $288.46 $345.15 $352.10 $328.80 $365.43 $332.18 $308.66
18 $404.89 $361.56 $304.29 $297.58 $356.07 $363.24 $339.20 $376.99 $342.69 $318.43
19 $417.31 $372.65 $313.63 $306.71 $366.99 $374.38 $349.60 $388.55 $353.19 $328.19
20 $430.17 $384.13 $323.29 $316.16 $378.30 $385.91 $360.37 $400.52 $364.08 $338.31
21 $443.47 $396.01 $333.29 $325.94 $390.00 $397.85 $371.52 $412.91 $375.34 $348.77
22 $443.47 $396.01 $333.29 $325.94 $390.00 $397.85 $371.52 $412.91 $375.34 $348.77
23 $443.47 $396.01 $333.29 $325.94 $390.00 $397.85 $371.52 $412.91 $375.34 $348.77
24 $443.47 $396.01 $333.29 $325.94 $390.00 $397.85 $371.52 $412.91 $375.34 $348.77
25 $445.24 $397.59 $334.62 $327.24 $391.56 $399.44 $373.01 $414.56 $376.84 $350.17
26 $454.11 $405.51 $341.29 $333.76 $399.36 $407.40 $380.44 $422.82 $384.35 $357.14
27 $464.76 $415.02 $349.29 $341.59 $408.72 $416.95 $389.35 $432.73 $393.36 $365.51
28 $482.05 $430.46 $362.29 $354.30 $423.93 $432.46 $403.84 $448.83 $407.99 $379.11
29 $496.24 $443.14 $372.95 $364.73 $436.41 $445.19 $415.73 $462.05 $420.01 $390.27
30 $503.34 $449.47 $378.28 $369.94 $442.65 $451.56 $421.68 $468.65 $426.01 $395.85
31 $513.98 $458.98 $386.28 $377.76 $452.01 $461.11 $430.59 $478.56 $435.02 $404.22
32 $524.63 $468.48 $394.28 $385.59 $461.37 $470.66 $439.51 $488.47 $444.03 $412.59
33 $531.28 $474.42 $399.28 $390.48 $467.22 $476.62 $445.08 $494.67 $449.66 $417.83
34 $538.37 $480.76 $404.61 $395.69 $473.46 $482.99 $451.03 $501.27 $455.66 $423.41
35 $541.92 $483.92 $407.28 $398.30 $476.58 $486.17 $454.00 $504.58 $458.67 $426.20
36 $545.47 $487.09 $409.95 $400.91 $479.70 $489.36 $456.97 $507.88 $461.67 $428.99
37 $549.02 $490.26 $412.61 $403.51 $482.82 $492.54 $459.94 $511.18 $464.67 $431.78
38 $552.56 $493.43 $415.28 $406.12 $485.94 $495.72 $462.91 $514.49 $467.67 $434.57
39 $559.66 $499.76 $420.61 $411.34 $492.18 $502.09 $468.86 $521.09 $473.68 $440.15
40 $566.75 $506.10 $425.94 $416.55 $498.42 $508.45 $474.80 $527.70 $479.68 $445.73
41 $577.40 $515.61 $433.94 $424.37 $507.78 $518.00 $483.72 $537.61 $488.69 $454.10
42 $587.60 $524.71 $441.61 $431.87 $516.75 $527.15 $492.26 $547.11 $497.33 $462.12
43 $601.79 $537.39 $452.27 $442.30 $529.23 $539.88 $504.15 $560.32 $509.34 $473.28
44 $619.53 $553.23 $465.61 $455.34 $544.83 $555.80 $519.01 $576.84 $524.35 $487.23
45 $640.37 $571.84 $481.27 $470.66 $563.16 $574.50 $536.47 $596.24 $541.99 $503.62
46 $665.21 $594.02 $499.94 $488.91 $585.00 $596.78 $557.28 $619.37 $563.01 $523.16
47 $693.14 $618.96 $520.93 $509.44 $609.57 $621.84 $580.69 $645.38 $586.66 $545.13
48 $725.07 $647.48 $544.93 $532.91 $637.65 $650.48 $607.44 $675.11 $613.68 $570.24
49 $756.56 $675.59 $568.59 $556.05 $665.34 $678.73 $633.81 $704.42 $640.33 $595.00
50 $792.04 $707.27 $595.26 $582.13 $696.54 $710.56 $663.53 $737.46 $670.36 $622.90
51 $827.07 $738.56 $621.59 $607.88 $727.35 $741.99 $692.88 $770.08 $700.01 $650.46
52 $865.65 $773.01 $650.58 $636.23 $761.28 $776.60 $725.21 $806.00 $732.66 $680.80
53 $904.68 $807.86 $679.91 $664.92 $795.60 $811.61 $757.90 $842.34 $765.69 $711.49
54 $946.81 $845.48 $711.57 $695.88 $832.65 $849.41 $793.20 $881.56 $801.35 $744.62
55 $988.94 $883.10 $743.24 $726.85 $869.70 $887.21 $828.49 $920.79 $837.01 $777.76
56 $1,034.62 $923.89 $777.57 $760.42 $909.87 $928.18 $866.76 $963.32 $875.67 $813.68
57 $1,080.74 $965.08 $812.23 $794.32 $950.43 $969.56 $905.39 $1,006.26 $914.70 $849.95
58 $1,129.96 $1,009.03 $849.22 $830.50 $993.72 $1,013.72 $946.63 $1,052.09 $956.37 $888.67
59 $1,154.35 $1,030.81 $867.55 $848.42 $1,015.17 $1,035.60 $967.07 $1,074.80 $977.01 $907.85
60 $1,203.58 $1,074.77 $904.55 $884.60 $1,058.46 $1,079.76 $1,008.31 $1,120.64 $1,018.67 $946.56
61 $1,246.15 $1,112.79 $936.54 $915.89 $1,095.90 $1,117.96 $1,043.97 $1,160.28 $1,054.71 $980.04
62 $1,274.09 $1,137.74 $957.54 $936.43 $1,120.47 $1,143.02 $1,067.38 $1,186.29 $1,078.35 $1,002.02
63 $1,309.12 $1,169.02 $983.87 $962.17 $1,151.28 $1,174.45 $1,096.73 $1,218.91 $1,108.00 $1,029.57
64+ $1,330.41 $1,188.03 $999.87 $977.82 $1,170.00 $1,193.55 $1,114.56 $1,238.73 $1,126.02 $1,046.31
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $234.53 $271.38 $252.75 $231.28 $222.59 $224.44 $195.03 $234.36 $279.45 $204.27
15 $255.38 $295.50 $275.21 $251.84 $242.38 $244.39 $212.37 $255.19 $304.29 $222.43
16 $263.35 $304.72 $283.81 $259.70 $249.94 $252.02 $218.99 $263.15 $313.79 $229.37
17 $271.32 $313.94 $292.40 $267.56 $257.51 $259.65 $225.62 $271.12 $323.29 $236.31
18 $279.91 $323.88 $301.65 $276.03 $265.66 $267.87 $232.76 $279.70 $333.52 $243.79
19 $288.49 $333.81 $310.90 $284.49 $273.80 $276.08 $239.90 $288.28 $343.75 $251.27
20 $297.38 $344.10 $320.48 $293.26 $282.24 $284.59 $247.29 $297.16 $354.34 $259.01
21 $306.58 $354.74 $330.39 $302.33 $290.97 $293.39 $254.94 $306.35 $365.30 $267.02
22 $306.58 $354.74 $330.39 $302.33 $290.97 $293.39 $254.94 $306.35 $365.30 $267.02
23 $306.58 $354.74 $330.39 $302.33 $290.97 $293.39 $254.94 $306.35 $365.30 $267.02
24 $306.58 $354.74 $330.39 $302.33 $290.97 $293.39 $254.94 $306.35 $365.30 $267.02
25 $307.81 $356.16 $331.71 $303.54 $292.13 $294.56 $255.96 $307.58 $366.76 $268.09
26 $313.94 $363.25 $338.32 $309.59 $297.95 $300.43 $261.06 $313.70 $374.07 $273.43
27 $321.30 $371.77 $346.25 $316.84 $304.94 $307.47 $267.18 $321.05 $382.83 $279.84
28 $333.25 $385.60 $359.13 $328.63 $316.28 $318.91 $277.12 $333.00 $397.08 $290.25
29 $343.06 $396.95 $369.71 $338.31 $325.60 $328.30 $285.28 $342.81 $408.77 $298.80
30 $347.97 $402.63 $374.99 $343.14 $330.25 $333.00 $289.36 $347.71 $414.62 $303.07
31 $355.33 $411.14 $382.92 $350.40 $337.23 $340.04 $295.48 $355.06 $423.38 $309.48
32 $362.68 $419.66 $390.85 $357.66 $344.22 $347.08 $301.59 $362.41 $432.15 $315.88
33 $367.28 $424.98 $395.81 $362.19 $348.58 $351.48 $305.42 $367.01 $437.63 $319.89
34 $372.19 $430.65 $401.09 $367.03 $353.24 $356.18 $309.50 $371.91 $443.47 $324.16
35 $374.64 $433.49 $403.74 $369.45 $355.57 $358.52 $311.54 $374.36 $446.40 $326.30
36 $377.09 $436.33 $406.38 $371.87 $357.89 $360.87 $313.58 $376.81 $449.32 $328.43
37 $379.55 $439.17 $409.02 $374.28 $360.22 $363.22 $315.62 $379.26 $452.24 $330.57
38 $382.00 $442.01 $411.67 $376.70 $362.55 $365.56 $317.66 $381.71 $455.16 $332.71
39 $386.90 $447.68 $416.95 $381.54 $367.20 $370.26 $321.73 $386.61 $461.01 $336.98
40 $391.81 $453.36 $422.24 $386.38 $371.86 $374.95 $325.81 $391.52 $466.85 $341.25
41 $399.17 $461.87 $430.17 $393.63 $378.84 $381.99 $331.93 $398.87 $475.62 $347.66
42 $406.22 $470.03 $437.77 $400.59 $385.54 $388.74 $337.80 $405.91 $484.02 $353.80
43 $416.03 $481.38 $448.34 $410.26 $394.85 $398.13 $345.95 $415.72 $495.71 $362.35
44 $428.29 $495.57 $461.55 $422.36 $406.49 $409.87 $356.15 $427.97 $510.32 $373.03
45 $442.70 $512.24 $477.08 $436.56 $420.16 $423.66 $368.13 $442.37 $527.49 $385.58
46 $459.87 $532.11 $495.59 $453.50 $436.46 $440.09 $382.41 $459.53 $547.95 $400.53
47 $479.18 $554.46 $516.40 $472.54 $454.79 $458.57 $398.47 $478.83 $570.96 $417.35
48 $501.26 $580.00 $540.19 $494.31 $475.74 $479.69 $416.83 $500.88 $597.27 $436.58
49 $523.03 $605.19 $563.65 $515.77 $496.39 $500.52 $434.93 $522.63 $623.20 $455.54
50 $547.55 $633.57 $590.08 $539.96 $519.67 $523.99 $455.32 $547.14 $652.43 $476.90
51 $571.77 $661.59 $616.18 $563.85 $542.66 $547.17 $475.46 $571.34 $681.28 $497.99
52 $598.44 $692.45 $644.92 $590.15 $567.97 $572.70 $497.64 $598.00 $713.07 $521.22
53 $625.42 $723.67 $674.00 $616.75 $593.58 $598.52 $520.08 $624.95 $745.21 $544.72
54 $654.55 $757.37 $705.38 $645.47 $621.22 $626.39 $544.30 $654.06 $779.92 $570.09
55 $683.67 $791.07 $736.77 $674.20 $648.86 $654.26 $568.52 $683.16 $814.62 $595.45
56 $715.25 $827.61 $770.80 $705.34 $678.83 $684.48 $594.78 $714.71 $852.24 $622.96
57 $747.14 $864.50 $805.16 $736.78 $709.09 $714.99 $621.29 $746.57 $890.24 $650.73
58 $781.17 $903.88 $841.83 $770.34 $741.39 $747.56 $649.59 $780.58 $930.78 $680.37
59 $798.03 $923.39 $860.01 $786.96 $757.39 $763.69 $663.61 $797.43 $950.88 $695.05
60 $832.06 $962.76 $896.68 $820.52 $789.69 $796.26 $691.91 $831.43 $991.42 $724.69
61 $861.49 $996.82 $928.40 $849.55 $817.63 $824.43 $716.38 $860.84 $1,026.49 $750.33
62 $880.80 $1,019.17 $949.21 $868.59 $835.96 $842.91 $732.44 $880.14 $1,049.51 $767.15
63 $905.02 $1,047.19 $975.31 $892.48 $858.94 $866.09 $752.58 $904.35 $1,078.37 $788.24
64+ $919.74 $1,064.22 $991.17 $906.99 $872.91 $880.17 $764.82 $919.05 $1,095.90 $801.06
Area 8H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $327.69 $292.62 $246.28 $240.84 $288.18 $293.98 $274.52 $305.10 $277.34 $257.71
15 $356.82 $318.63 $268.17 $262.25 $313.80 $320.11 $298.92 $332.23 $302.00 $280.62
16 $367.95 $328.58 $276.54 $270.43 $323.59 $330.11 $308.25 $342.59 $311.42 $289.38
17 $379.09 $338.52 $284.91 $278.62 $333.39 $340.10 $317.58 $352.96 $320.85 $298.14
18 $391.08 $349.23 $293.92 $287.43 $343.94 $350.86 $327.63 $364.13 $331.00 $307.57
19 $403.08 $359.94 $302.94 $296.25 $354.48 $361.62 $337.68 $375.30 $341.15 $317.00
20 $415.50 $371.03 $312.27 $305.38 $365.41 $372.76 $348.08 $386.87 $351.66 $326.77
21 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
22 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
23 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
24 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
25 $430.06 $384.04 $323.22 $316.08 $378.22 $385.83 $360.29 $400.43 $363.99 $338.23
26 $438.63 $391.69 $329.66 $322.38 $385.75 $393.51 $367.46 $408.40 $371.24 $344.97
27 $448.91 $400.87 $337.38 $329.93 $394.79 $402.74 $376.07 $417.97 $379.94 $353.05
28 $465.62 $415.79 $349.94 $342.21 $409.48 $417.72 $390.07 $433.53 $394.08 $366.19
29 $479.32 $428.03 $360.24 $352.28 $421.54 $430.02 $401.55 $446.29 $405.68 $376.97
30 $486.18 $434.15 $365.39 $357.32 $427.57 $436.17 $407.29 $452.67 $411.48 $382.36
31 $496.46 $443.33 $373.12 $364.88 $436.61 $445.39 $415.91 $462.24 $420.18 $390.44
32 $506.74 $452.51 $380.84 $372.43 $445.65 $454.62 $424.52 $471.82 $428.88 $398.53
33 $513.16 $458.25 $385.67 $377.15 $451.30 $460.38 $429.90 $477.80 $434.32 $403.58
34 $520.02 $464.37 $390.82 $382.19 $457.33 $466.53 $435.64 $484.18 $440.12 $408.97
35 $523.44 $467.43 $393.40 $384.71 $460.34 $469.60 $438.51 $487.37 $443.02 $411.67
36 $526.87 $470.49 $395.97 $387.23 $463.35 $472.68 $441.39 $490.56 $445.92 $414.36
37 $530.30 $473.55 $398.55 $389.75 $466.37 $475.75 $444.26 $493.75 $448.82 $417.06
38 $533.72 $476.61 $401.12 $392.27 $469.38 $478.83 $447.13 $496.94 $451.72 $419.75
39 $540.58 $482.73 $406.28 $397.30 $475.41 $484.97 $452.87 $503.32 $457.53 $425.14
40 $547.43 $488.85 $411.43 $402.34 $481.44 $491.12 $458.61 $509.70 $463.33 $430.53
41 $557.71 $498.03 $419.15 $409.90 $490.48 $500.35 $467.22 $519.28 $472.03 $438.62
42 $567.56 $506.83 $426.56 $417.14 $499.14 $509.18 $475.48 $528.45 $480.37 $446.37
43 $581.27 $519.07 $436.86 $427.21 $511.20 $521.48 $486.96 $541.21 $491.97 $457.15
44 $598.40 $534.37 $449.74 $439.80 $526.26 $536.85 $501.31 $557.17 $506.47 $470.62
45 $618.54 $552.34 $464.87 $454.60 $543.97 $554.91 $518.18 $575.91 $523.51 $486.45
46 $642.53 $573.77 $482.90 $472.23 $565.07 $576.44 $538.28 $598.25 $543.81 $505.32
47 $669.51 $597.86 $503.18 $492.06 $588.80 $600.65 $560.88 $623.37 $566.65 $526.54
48 $700.35 $625.40 $526.36 $514.73 $615.92 $628.31 $586.72 $652.09 $592.75 $550.80
49 $730.77 $652.56 $549.21 $537.08 $642.67 $655.60 $612.20 $680.40 $618.49 $574.72
50 $765.03 $683.16 $574.97 $562.27 $672.80 $686.34 $640.91 $712.31 $647.50 $601.67
51 $798.87 $713.38 $600.40 $587.14 $702.56 $716.70 $669.26 $743.82 $676.14 $628.28
52 $836.14 $746.66 $628.41 $614.53 $735.34 $750.13 $700.48 $778.52 $707.68 $657.59
53 $873.83 $780.32 $656.74 $642.23 $768.49 $783.95 $732.05 $813.61 $739.58 $687.24
54 $914.53 $816.66 $687.32 $672.14 $804.28 $820.46 $766.14 $851.50 $774.02 $719.24
55 $955.22 $853.00 $717.90 $702.05 $840.06 $856.97 $800.24 $889.39 $808.46 $751.24
56 $999.34 $892.40 $751.06 $734.48 $878.86 $896.55 $837.20 $930.47 $845.81 $785.94
57 $1,043.89 $932.18 $784.54 $767.22 $918.04 $936.51 $874.52 $971.95 $883.51 $820.98
58 $1,091.44 $974.64 $820.28 $802.16 $959.86 $979.17 $914.35 $1,016.22 $923.75 $858.37
59 $1,115.00 $995.67 $837.98 $819.48 $980.58 $1,000.31 $934.09 $1,038.15 $943.69 $876.90
60 $1,162.54 $1,038.13 $873.72 $854.42 $1,022.39 $1,042.96 $973.92 $1,082.42 $983.93 $914.29
61 $1,203.66 $1,074.85 $904.62 $884.64 $1,058.56 $1,079.85 $1,008.37 $1,120.71 $1,018.74 $946.63
62 $1,230.65 $1,098.95 $924.90 $904.48 $1,082.29 $1,104.07 $1,030.98 $1,145.84 $1,041.58 $967.86
63 $1,264.49 $1,129.17 $950.34 $929.35 $1,112.05 $1,134.42 $1,059.33 $1,177.35 $1,070.22 $994.47
64+ $1,285.05 $1,147.53 $965.79 $944.46 $1,130.13 $1,152.87 $1,076.55 $1,196.49 $1,087.62 $1,010.64
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $226.53 $262.12 $244.13 $223.40 $215.00 $216.79 $188.38 $226.36 $269.92 $197.31
15 $246.67 $285.42 $265.84 $243.26 $234.11 $236.06 $205.13 $246.48 $293.92 $214.85
16 $254.37 $294.33 $274.13 $250.85 $241.42 $243.43 $211.53 $254.18 $303.09 $221.55
17 $262.07 $303.24 $282.43 $258.45 $248.73 $250.80 $217.93 $261.87 $312.26 $228.26
18 $270.36 $312.83 $291.37 $266.62 $256.60 $258.74 $224.83 $270.16 $322.14 $235.48
19 $278.65 $322.42 $300.30 $274.80 $264.47 $266.67 $231.72 $278.44 $332.02 $242.70
20 $287.24 $332.36 $309.56 $283.27 $272.62 $274.89 $238.86 $287.02 $342.25 $250.18
21 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
22 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
23 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
24 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
25 $297.30 $344.01 $320.41 $293.20 $282.17 $284.52 $247.24 $297.08 $354.25 $258.95
26 $303.23 $350.86 $326.79 $299.04 $287.80 $290.19 $252.16 $303.00 $361.31 $264.11
27 $310.33 $359.09 $334.45 $306.05 $294.54 $296.99 $258.07 $310.10 $369.78 $270.30
28 $321.88 $372.45 $346.89 $317.44 $305.50 $308.04 $267.67 $321.64 $383.54 $280.36
29 $331.36 $383.41 $357.11 $326.78 $314.49 $317.11 $275.55 $331.11 $394.83 $288.61
30 $336.10 $388.90 $362.21 $331.45 $318.99 $321.65 $279.49 $335.85 $400.47 $292.74
31 $343.20 $397.12 $369.87 $338.46 $325.74 $328.45 $285.40 $342.95 $408.94 $298.93
32 $350.31 $405.34 $377.53 $345.47 $332.48 $335.25 $291.31 $350.05 $417.41 $305.12
33 $354.75 $410.48 $382.32 $349.85 $336.70 $339.50 $295.01 $354.49 $422.70 $308.99
34 $359.49 $415.96 $387.42 $354.52 $341.19 $344.04 $298.95 $359.22 $428.35 $313.11
35 $361.86 $418.71 $389.98 $356.86 $343.44 $346.30 $300.92 $361.59 $431.17 $315.18
36 $364.23 $421.45 $392.53 $359.20 $345.69 $348.57 $302.89 $363.96 $433.99 $317.24
37 $366.60 $424.19 $395.08 $361.53 $347.94 $350.84 $304.86 $366.32 $436.82 $319.30
38 $368.97 $426.93 $397.64 $363.87 $350.19 $353.10 $306.83 $368.69 $439.64 $321.37
39 $373.70 $432.41 $402.74 $368.54 $354.69 $357.64 $310.77 $373.43 $445.28 $325.50
40 $378.44 $437.89 $407.85 $373.21 $359.18 $362.17 $314.71 $378.16 $450.93 $329.62
41 $385.55 $446.12 $415.51 $380.22 $365.93 $368.97 $320.62 $385.26 $459.40 $335.81
42 $392.36 $454.00 $422.85 $386.94 $372.39 $375.49 $326.28 $392.07 $467.51 $341.74
43 $401.83 $464.96 $433.06 $396.28 $381.38 $384.56 $334.16 $401.54 $478.80 $350.00
44 $413.68 $478.67 $445.82 $407.97 $392.63 $395.90 $344.01 $413.37 $492.92 $360.31
45 $427.60 $494.77 $460.82 $421.69 $405.84 $409.22 $355.59 $427.28 $509.50 $372.44
46 $444.18 $513.96 $478.70 $438.05 $421.58 $425.09 $369.38 $443.85 $529.26 $386.88
47 $462.84 $535.55 $498.80 $456.44 $439.28 $442.94 $384.89 $462.49 $551.49 $403.13
48 $484.16 $560.22 $521.78 $477.47 $459.52 $463.34 $402.62 $483.80 $576.89 $421.70
49 $505.18 $584.54 $544.44 $498.20 $479.47 $483.46 $420.10 $504.81 $601.95 $440.01
50 $528.87 $611.96 $569.97 $521.57 $501.96 $506.13 $439.80 $528.48 $630.17 $460.65
51 $552.26 $639.02 $595.18 $544.64 $524.16 $528.52 $459.26 $551.85 $658.05 $481.02
52 $578.03 $668.83 $622.94 $570.04 $548.61 $553.18 $480.68 $577.60 $688.74 $503.46
53 $604.08 $698.99 $651.03 $595.74 $573.34 $578.12 $502.35 $603.64 $719.79 $526.16
54 $632.22 $731.54 $681.34 $623.48 $600.04 $605.04 $525.74 $631.75 $753.31 $550.66
55 $660.35 $764.09 $711.66 $651.23 $626.74 $631.96 $549.14 $659.86 $786.83 $575.16
56 $690.85 $799.38 $744.53 $681.31 $655.69 $661.15 $574.50 $690.33 $823.18 $601.73
57 $721.64 $835.01 $777.72 $711.68 $684.92 $690.62 $600.11 $721.11 $859.87 $628.55
58 $754.51 $873.05 $813.14 $744.09 $716.12 $722.08 $627.45 $753.95 $899.04 $657.18
59 $770.80 $891.89 $830.70 $760.15 $731.57 $737.66 $640.99 $770.23 $918.44 $671.37
60 $803.67 $929.92 $866.12 $792.57 $762.77 $769.12 $668.32 $803.07 $957.61 $699.99
61 $832.10 $962.82 $896.76 $820.60 $789.75 $796.33 $691.96 $831.48 $991.48 $724.76
62 $850.75 $984.40 $916.86 $839.00 $807.46 $814.18 $707.48 $850.12 $1,013.71 $741.00
63 $874.15 $1,011.47 $942.07 $862.07 $829.66 $836.57 $726.93 $873.50 $1,041.58 $761.38
64+ $888.36 $1,027.92 $957.39 $876.09 $843.15 $850.17 $738.75 $887.70 $1,058.52 $773.76
Area 9H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $327.69 $292.62 $246.28 $240.84 $288.18 $293.98 $274.52 $305.10 $277.34 $257.71
15 $356.82 $318.63 $268.17 $262.25 $313.80 $320.11 $298.92 $332.23 $302.00 $280.62
16 $367.95 $328.58 $276.54 $270.43 $323.59 $330.11 $308.25 $342.59 $311.42 $289.38
17 $379.09 $338.52 $284.91 $278.62 $333.39 $340.10 $317.58 $352.96 $320.85 $298.14
18 $391.08 $349.23 $293.92 $287.43 $343.94 $350.86 $327.63 $364.13 $331.00 $307.57
19 $403.08 $359.94 $302.94 $296.25 $354.48 $361.62 $337.68 $375.30 $341.15 $317.00
20 $415.50 $371.03 $312.27 $305.38 $365.41 $372.76 $348.08 $386.87 $351.66 $326.77
21 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
22 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
23 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
24 $428.35 $382.51 $321.93 $314.82 $376.71 $384.29 $358.85 $398.83 $362.54 $336.88
25 $430.06 $384.04 $323.22 $316.08 $378.22 $385.83 $360.29 $400.43 $363.99 $338.23
26 $438.63 $391.69 $329.66 $322.38 $385.75 $393.51 $367.46 $408.40 $371.24 $344.97
27 $448.91 $400.87 $337.38 $329.93 $394.79 $402.74 $376.07 $417.97 $379.94 $353.05
28 $465.62 $415.79 $349.94 $342.21 $409.48 $417.72 $390.07 $433.53 $394.08 $366.19
29 $479.32 $428.03 $360.24 $352.28 $421.54 $430.02 $401.55 $446.29 $405.68 $376.97
30 $486.18 $434.15 $365.39 $357.32 $427.57 $436.17 $407.29 $452.67 $411.48 $382.36
31 $496.46 $443.33 $373.12 $364.88 $436.61 $445.39 $415.91 $462.24 $420.18 $390.44
32 $506.74 $452.51 $380.84 $372.43 $445.65 $454.62 $424.52 $471.82 $428.88 $398.53
33 $513.16 $458.25 $385.67 $377.15 $451.30 $460.38 $429.90 $477.80 $434.32 $403.58
34 $520.02 $464.37 $390.82 $382.19 $457.33 $466.53 $435.64 $484.18 $440.12 $408.97
35 $523.44 $467.43 $393.40 $384.71 $460.34 $469.60 $438.51 $487.37 $443.02 $411.67
36 $526.87 $470.49 $395.97 $387.23 $463.35 $472.68 $441.39 $490.56 $445.92 $414.36
37 $530.30 $473.55 $398.55 $389.75 $466.37 $475.75 $444.26 $493.75 $448.82 $417.06
38 $533.72 $476.61 $401.12 $392.27 $469.38 $478.83 $447.13 $496.94 $451.72 $419.75
39 $540.58 $482.73 $406.28 $397.30 $475.41 $484.97 $452.87 $503.32 $457.53 $425.14
40 $547.43 $488.85 $411.43 $402.34 $481.44 $491.12 $458.61 $509.70 $463.33 $430.53
41 $557.71 $498.03 $419.15 $409.90 $490.48 $500.35 $467.22 $519.28 $472.03 $438.62
42 $567.56 $506.83 $426.56 $417.14 $499.14 $509.18 $475.48 $528.45 $480.37 $446.37
43 $581.27 $519.07 $436.86 $427.21 $511.20 $521.48 $486.96 $541.21 $491.97 $457.15
44 $598.40 $534.37 $449.74 $439.80 $526.26 $536.85 $501.31 $557.17 $506.47 $470.62
45 $618.54 $552.34 $464.87 $454.60 $543.97 $554.91 $518.18 $575.91 $523.51 $486.45
46 $642.53 $573.77 $482.90 $472.23 $565.07 $576.44 $538.28 $598.25 $543.81 $505.32
47 $669.51 $597.86 $503.18 $492.06 $588.80 $600.65 $560.88 $623.37 $566.65 $526.54
48 $700.35 $625.40 $526.36 $514.73 $615.92 $628.31 $586.72 $652.09 $592.75 $550.80
49 $730.77 $652.56 $549.21 $537.08 $642.67 $655.60 $612.20 $680.40 $618.49 $574.72
50 $765.03 $683.16 $574.97 $562.27 $672.80 $686.34 $640.91 $712.31 $647.50 $601.67
51 $798.87 $713.38 $600.40 $587.14 $702.56 $716.70 $669.26 $743.82 $676.14 $628.28
52 $836.14 $746.66 $628.41 $614.53 $735.34 $750.13 $700.48 $778.52 $707.68 $657.59
53 $873.83 $780.32 $656.74 $642.23 $768.49 $783.95 $732.05 $813.61 $739.58 $687.24
54 $914.53 $816.66 $687.32 $672.14 $804.28 $820.46 $766.14 $851.50 $774.02 $719.24
55 $955.22 $853.00 $717.90 $702.05 $840.06 $856.97 $800.24 $889.39 $808.46 $751.24
56 $999.34 $892.40 $751.06 $734.48 $878.86 $896.55 $837.20 $930.47 $845.81 $785.94
57 $1,043.89 $932.18 $784.54 $767.22 $918.04 $936.51 $874.52 $971.95 $883.51 $820.98
58 $1,091.44 $974.64 $820.28 $802.16 $959.86 $979.17 $914.35 $1,016.22 $923.75 $858.37
59 $1,115.00 $995.67 $837.98 $819.48 $980.58 $1,000.31 $934.09 $1,038.15 $943.69 $876.90
60 $1,162.54 $1,038.13 $873.72 $854.42 $1,022.39 $1,042.96 $973.92 $1,082.42 $983.93 $914.29
61 $1,203.66 $1,074.85 $904.62 $884.64 $1,058.56 $1,079.85 $1,008.37 $1,120.71 $1,018.74 $946.63
62 $1,230.65 $1,098.95 $924.90 $904.48 $1,082.29 $1,104.07 $1,030.98 $1,145.84 $1,041.58 $967.86
63 $1,264.49 $1,129.17 $950.34 $929.35 $1,112.05 $1,134.42 $1,059.33 $1,177.35 $1,070.22 $994.47
64+ $1,285.05 $1,147.53 $965.79 $944.46 $1,130.13 $1,152.87 $1,076.55 $1,196.49 $1,087.62 $1,010.64
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $226.53 $262.12 $244.13 $223.40 $215.00 $216.79 $188.38 $226.36 $269.92 $197.31
15 $246.67 $285.42 $265.84 $243.26 $234.11 $236.06 $205.13 $246.48 $293.92 $214.85
16 $254.37 $294.33 $274.13 $250.85 $241.42 $243.43 $211.53 $254.18 $303.09 $221.55
17 $262.07 $303.24 $282.43 $258.45 $248.73 $250.80 $217.93 $261.87 $312.26 $228.26
18 $270.36 $312.83 $291.37 $266.62 $256.60 $258.74 $224.83 $270.16 $322.14 $235.48
19 $278.65 $322.42 $300.30 $274.80 $264.47 $266.67 $231.72 $278.44 $332.02 $242.70
20 $287.24 $332.36 $309.56 $283.27 $272.62 $274.89 $238.86 $287.02 $342.25 $250.18
21 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
22 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
23 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
24 $296.12 $342.64 $319.13 $292.03 $281.05 $283.39 $246.25 $295.90 $352.84 $257.92
25 $297.30 $344.01 $320.41 $293.20 $282.17 $284.52 $247.24 $297.08 $354.25 $258.95
26 $303.23 $350.86 $326.79 $299.04 $287.80 $290.19 $252.16 $303.00 $361.31 $264.11
27 $310.33 $359.09 $334.45 $306.05 $294.54 $296.99 $258.07 $310.10 $369.78 $270.30
28 $321.88 $372.45 $346.89 $317.44 $305.50 $308.04 $267.67 $321.64 $383.54 $280.36
29 $331.36 $383.41 $357.11 $326.78 $314.49 $317.11 $275.55 $331.11 $394.83 $288.61
30 $336.10 $388.90 $362.21 $331.45 $318.99 $321.65 $279.49 $335.85 $400.47 $292.74
31 $343.20 $397.12 $369.87 $338.46 $325.74 $328.45 $285.40 $342.95 $408.94 $298.93
32 $350.31 $405.34 $377.53 $345.47 $332.48 $335.25 $291.31 $350.05 $417.41 $305.12
33 $354.75 $410.48 $382.32 $349.85 $336.70 $339.50 $295.01 $354.49 $422.70 $308.99
34 $359.49 $415.96 $387.42 $354.52 $341.19 $344.04 $298.95 $359.22 $428.35 $313.11
35 $361.86 $418.71 $389.98 $356.86 $343.44 $346.30 $300.92 $361.59 $431.17 $315.18
36 $364.23 $421.45 $392.53 $359.20 $345.69 $348.57 $302.89 $363.96 $433.99 $317.24
37 $366.60 $424.19 $395.08 $361.53 $347.94 $350.84 $304.86 $366.32 $436.82 $319.30
38 $368.97 $426.93 $397.64 $363.87 $350.19 $353.10 $306.83 $368.69 $439.64 $321.37
39 $373.70 $432.41 $402.74 $368.54 $354.69 $357.64 $310.77 $373.43 $445.28 $325.50
40 $378.44 $437.89 $407.85 $373.21 $359.18 $362.17 $314.71 $378.16 $450.93 $329.62
41 $385.55 $446.12 $415.51 $380.22 $365.93 $368.97 $320.62 $385.26 $459.40 $335.81
42 $392.36 $454.00 $422.85 $386.94 $372.39 $375.49 $326.28 $392.07 $467.51 $341.74
43 $401.83 $464.96 $433.06 $396.28 $381.38 $384.56 $334.16 $401.54 $478.80 $350.00
44 $413.68 $478.67 $445.82 $407.97 $392.63 $395.90 $344.01 $413.37 $492.92 $360.31
45 $427.60 $494.77 $460.82 $421.69 $405.84 $409.22 $355.59 $427.28 $509.50 $372.44
46 $444.18 $513.96 $478.70 $438.05 $421.58 $425.09 $369.38 $443.85 $529.26 $386.88
47 $462.84 $535.55 $498.80 $456.44 $439.28 $442.94 $384.89 $462.49 $551.49 $403.13
48 $484.16 $560.22 $521.78 $477.47 $459.52 $463.34 $402.62 $483.80 $576.89 $421.70
49 $505.18 $584.54 $544.44 $498.20 $479.47 $483.46 $420.10 $504.81 $601.95 $440.01
50 $528.87 $611.96 $569.97 $521.57 $501.96 $506.13 $439.80 $528.48 $630.17 $460.65
51 $552.26 $639.02 $595.18 $544.64 $524.16 $528.52 $459.26 $551.85 $658.05 $481.02
52 $578.03 $668.83 $622.94 $570.04 $548.61 $553.18 $480.68 $577.60 $688.74 $503.46
53 $604.08 $698.99 $651.03 $595.74 $573.34 $578.12 $502.35 $603.64 $719.79 $526.16
54 $632.22 $731.54 $681.34 $623.48 $600.04 $605.04 $525.74 $631.75 $753.31 $550.66
55 $660.35 $764.09 $711.66 $651.23 $626.74 $631.96 $549.14 $659.86 $786.83 $575.16
56 $690.85 $799.38 $744.53 $681.31 $655.69 $661.15 $574.50 $690.33 $823.18 $601.73
57 $721.64 $835.01 $777.72 $711.68 $684.92 $690.62 $600.11 $721.11 $859.87 $628.55
58 $754.51 $873.05 $813.14 $744.09 $716.12 $722.08 $627.45 $753.95 $899.04 $657.18
59 $770.80 $891.89 $830.70 $760.15 $731.57 $737.66 $640.99 $770.23 $918.44 $671.37
60 $803.67 $929.92 $866.12 $792.57 $762.77 $769.12 $668.32 $803.07 $957.61 $699.99
61 $832.10 $962.82 $896.76 $820.60 $789.75 $796.33 $691.96 $831.48 $991.48 $724.76
62 $850.75 $984.40 $916.86 $839.00 $807.46 $814.18 $707.48 $850.12 $1,013.71 $741.00
63 $874.15 $1,011.47 $942.07 $862.07 $829.66 $836.57 $726.93 $873.50 $1,041.58 $761.38
64+ $888.36 $1,027.92 $957.39 $876.09 $843.15 $850.17 $738.75 $887.70 $1,058.52 $773.76
Area 10H
Age HMO 500 Platinum
HMO 1000 Gold
HMO 2000a Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $385.51 $344.26 $339.03 $289.74 $283.34 $345.86 $322.97 $358.95 $326.29 $303.19
15 $419.78 $374.86 $369.17 $315.49 $308.53 $376.61 $351.68 $390.86 $355.29 $330.14
16 $432.88 $386.56 $380.69 $325.34 $318.16 $388.36 $362.65 $403.06 $366.38 $340.45
17 $445.99 $398.26 $392.21 $335.18 $327.79 $400.12 $373.63 $415.26 $377.47 $350.75
18 $460.10 $410.86 $404.62 $345.79 $338.16 $412.78 $385.45 $428.40 $389.41 $361.85
19 $474.21 $423.46 $417.03 $356.39 $348.53 $425.44 $397.27 $441.54 $401.36 $372.95
20 $488.82 $436.51 $429.88 $367.38 $359.27 $438.55 $409.51 $455.14 $413.72 $384.44
21 $503.94 $450.01 $443.18 $378.74 $370.38 $452.11 $422.18 $469.22 $426.52 $396.33
22 $503.94 $450.01 $443.18 $378.74 $370.38 $452.11 $422.18 $469.22 $426.52 $396.33
23 $503.94 $450.01 $443.18 $378.74 $370.38 $452.11 $422.18 $469.22 $426.52 $396.33
24 $503.94 $450.01 $443.18 $378.74 $370.38 $452.11 $422.18 $469.22 $426.52 $396.33
25 $505.96 $451.81 $444.95 $380.25 $371.86 $453.92 $423.87 $471.10 $428.23 $397.92
26 $516.03 $460.81 $453.82 $387.83 $379.27 $462.96 $432.31 $480.48 $436.76 $405.84
27 $528.13 $471.61 $464.45 $396.92 $388.16 $473.81 $442.44 $491.74 $446.99 $415.35
28 $547.78 $489.16 $481.74 $411.69 $402.60 $491.44 $458.91 $510.04 $463.63 $430.81
29 $563.91 $503.56 $495.92 $423.81 $414.46 $505.91 $472.42 $525.06 $477.28 $443.49
30 $571.97 $510.76 $503.01 $429.87 $420.38 $513.14 $479.17 $532.56 $484.10 $449.83
31 $584.07 $521.56 $513.65 $438.96 $429.27 $524.00 $489.31 $543.83 $494.34 $459.35
32 $596.16 $532.36 $524.28 $448.05 $438.16 $534.85 $499.44 $555.09 $504.57 $468.86
33 $603.72 $539.11 $530.93 $453.73 $443.72 $541.63 $505.77 $562.13 $510.97 $474.80
34 $611.78 $546.31 $538.02 $459.79 $449.64 $548.86 $512.53 $569.63 $517.80 $481.14
35 $615.81 $549.91 $541.57 $462.82 $452.60 $552.48 $515.90 $573.39 $521.21 $484.32
36 $619.85 $553.51 $545.11 $465.85 $455.57 $556.10 $519.28 $577.14 $524.62 $487.49
37 $623.88 $557.11 $548.66 $468.88 $458.53 $559.71 $522.66 $580.89 $528.03 $490.66
38 $627.91 $560.71 $552.20 $471.91 $461.49 $563.33 $526.04 $584.65 $531.44 $493.83
39 $635.97 $567.91 $559.29 $477.97 $467.42 $570.56 $532.79 $592.16 $538.27 $500.17
40 $644.04 $575.11 $566.38 $484.03 $473.35 $577.80 $539.55 $599.66 $545.09 $506.51
41 $656.13 $585.91 $577.02 $493.12 $482.23 $588.65 $549.68 $610.92 $555.33 $516.02
42 $667.72 $596.26 $587.21 $501.83 $490.75 $599.05 $559.39 $621.72 $565.14 $525.14
43 $683.85 $610.66 $601.40 $513.95 $502.61 $613.51 $572.90 $636.73 $578.79 $537.82
44 $704.00 $628.66 $619.12 $529.10 $517.42 $631.60 $589.79 $655.50 $595.85 $553.67
45 $727.69 $649.81 $639.95 $546.90 $534.83 $652.85 $609.63 $677.55 $615.89 $572.30
46 $755.91 $675.02 $664.77 $568.11 $555.57 $678.17 $633.27 $703.83 $639.78 $594.50
47 $787.66 $703.37 $692.69 $591.97 $578.90 $706.65 $659.87 $733.39 $666.65 $619.46
48 $823.94 $735.77 $724.60 $619.24 $605.57 $739.20 $690.26 $767.17 $697.36 $648.00
49 $859.72 $767.72 $756.07 $646.13 $631.87 $771.30 $720.24 $800.49 $727.64 $676.14
50 $900.04 $803.72 $791.52 $676.43 $661.50 $807.47 $754.01 $838.03 $761.76 $707.85
51 $939.85 $839.27 $826.53 $706.35 $690.76 $843.19 $787.37 $875.10 $795.46 $739.16
52 $983.69 $878.42 $865.09 $739.30 $722.98 $882.52 $824.10 $915.92 $832.57 $773.64
53 $1,028.04 $918.02 $904.09 $772.63 $755.58 $922.30 $861.25 $957.21 $870.10 $808.51
54 $1,075.91 $960.77 $946.19 $808.61 $790.76 $965.25 $901.35 $1,001.78 $910.62 $846.16
55 $1,123.79 $1,003.52 $988.29 $844.59 $825.95 $1,008.21 $941.46 $1,046.36 $951.14 $883.82
56 $1,175.69 $1,049.87 $1,033.94 $883.60 $864.10 $1,054.77 $984.95 $1,094.69 $995.07 $924.64
57 $1,228.10 $1,096.67 $1,080.03 $922.99 $902.62 $1,101.79 $1,028.85 $1,143.49 $1,039.43 $965.86
58 $1,284.04 $1,146.63 $1,129.22 $965.03 $943.73 $1,151.98 $1,075.71 $1,195.57 $1,086.77 $1,009.85
59 $1,311.76 $1,171.38 $1,153.60 $985.86 $964.10 $1,176.84 $1,098.93 $1,221.38 $1,110.23 $1,031.65
60 $1,367.69 $1,221.33 $1,202.79 $1,027.90 $1,005.21 $1,227.03 $1,145.80 $1,273.46 $1,157.58 $1,075.64
61 $1,416.07 $1,264.53 $1,245.34 $1,064.26 $1,040.77 $1,270.43 $1,186.33 $1,318.51 $1,198.52 $1,113.69
62 $1,447.82 $1,292.88 $1,273.26 $1,088.12 $1,064.10 $1,298.91 $1,212.92 $1,348.07 $1,225.39 $1,138.66
63 $1,487.63 $1,328.43 $1,308.27 $1,118.04 $1,093.36 $1,334.63 $1,246.28 $1,385.14 $1,259.09 $1,169.97
64+ $1,511.82 $1,350.03 $1,329.54 $1,136.22 $1,111.14 $1,356.33 $1,266.54 $1,407.66 $1,279.56 $1,188.99
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $266.51 $308.38 $287.21 $262.82 $252.95 $255.05 $221.62 $266.31 $317.56 $232.12
15 $290.20 $335.79 $312.74 $286.19 $275.43 $277.72 $241.32 $289.98 $345.79 $252.76
16 $299.26 $346.27 $322.50 $295.12 $284.03 $286.39 $248.85 $299.04 $356.58 $260.65
17 $308.32 $356.75 $332.26 $304.05 $292.63 $295.06 $256.38 $308.09 $367.37 $268.54
18 $318.07 $368.04 $342.78 $313.67 $301.88 $304.39 $264.50 $317.83 $379.00 $277.03
19 $327.83 $379.33 $353.29 $323.29 $311.14 $313.73 $272.61 $327.58 $390.62 $285.53
20 $337.93 $391.02 $364.18 $333.25 $320.73 $323.40 $281.01 $337.68 $402.66 $294.33
21 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
22 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
23 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
24 $348.38 $403.11 $375.44 $343.56 $330.65 $333.40 $289.70 $348.12 $415.11 $303.43
25 $349.77 $404.72 $376.94 $344.93 $331.97 $334.73 $290.86 $349.51 $416.77 $304.64
26 $356.74 $412.78 $384.45 $351.81 $338.59 $341.40 $296.65 $356.47 $425.07 $310.71
27 $365.10 $422.46 $393.46 $360.05 $346.52 $349.40 $303.61 $364.83 $435.04 $317.99
28 $378.69 $438.18 $408.10 $373.45 $359.42 $362.41 $314.90 $378.41 $451.22 $329.83
29 $389.84 $451.08 $420.12 $384.44 $370.00 $373.07 $324.17 $389.55 $464.51 $339.54
30 $395.41 $457.53 $426.12 $389.94 $375.29 $378.41 $328.81 $395.12 $471.15 $344.39
31 $403.77 $467.20 $435.13 $398.19 $383.22 $386.41 $335.76 $403.47 $481.11 $351.68
32 $412.13 $476.88 $444.15 $406.43 $391.16 $394.41 $342.72 $411.83 $491.08 $358.96
33 $417.36 $482.93 $449.78 $411.58 $396.12 $399.41 $347.06 $417.05 $497.30 $363.51
34 $422.93 $489.38 $455.78 $417.08 $401.41 $404.75 $351.70 $422.62 $503.94 $368.36
35 $425.72 $492.60 $458.79 $419.83 $404.05 $407.41 $354.01 $425.40 $507.26 $370.79
36 $428.51 $495.83 $461.79 $422.58 $406.70 $410.08 $356.33 $428.19 $510.59 $373.22
37 $431.29 $499.05 $464.79 $425.33 $409.34 $412.75 $358.65 $430.97 $513.91 $375.65
38 $434.08 $502.28 $467.80 $428.08 $411.99 $415.42 $360.97 $433.76 $517.23 $378.07
39 $439.66 $508.72 $473.81 $433.57 $417.28 $420.75 $365.60 $439.33 $523.87 $382.93
40 $445.23 $515.17 $479.81 $439.07 $422.57 $426.09 $370.24 $444.90 $530.51 $387.78
41 $453.59 $524.85 $488.82 $447.32 $430.51 $434.09 $377.19 $453.25 $540.47 $395.07
42 $461.60 $534.12 $497.46 $455.22 $438.11 $441.76 $383.85 $461.26 $550.02 $402.04
43 $472.75 $547.02 $509.47 $466.21 $448.69 $452.42 $393.12 $472.40 $563.30 $411.75
44 $486.69 $563.14 $524.49 $479.95 $461.92 $465.76 $404.71 $486.32 $579.91 $423.89
45 $503.06 $582.09 $542.14 $496.10 $477.46 $481.43 $418.33 $502.69 $599.42 $438.15
46 $522.57 $604.67 $563.16 $515.34 $495.98 $500.10 $434.55 $522.18 $622.67 $455.15
47 $544.52 $630.06 $586.81 $536.98 $516.81 $521.10 $452.80 $544.11 $648.82 $474.26
48 $569.60 $659.08 $613.84 $561.72 $540.61 $545.11 $473.66 $569.18 $678.70 $496.11
49 $594.34 $687.71 $640.50 $586.11 $564.09 $568.78 $494.23 $593.89 $708.18 $517.65
50 $622.21 $719.95 $670.54 $613.60 $590.54 $595.45 $517.40 $621.74 $741.39 $541.93
51 $649.73 $751.80 $700.20 $640.74 $616.66 $621.79 $540.29 $649.24 $774.18 $565.90
52 $680.04 $786.87 $732.86 $670.63 $645.43 $650.80 $565.49 $679.53 $810.29 $592.30
53 $710.70 $822.34 $765.90 $700.86 $674.53 $680.14 $590.99 $710.16 $846.82 $619.00
54 $743.79 $860.64 $801.56 $733.50 $705.94 $711.81 $618.51 $743.24 $886.26 $647.82
55 $776.89 $898.94 $837.23 $766.14 $737.35 $743.48 $646.03 $776.31 $925.70 $676.65
56 $812.77 $940.46 $875.90 $801.53 $771.41 $777.82 $675.87 $812.16 $968.45 $707.90
57 $849.00 $982.38 $914.95 $837.26 $805.79 $812.50 $706.00 $848.37 $1,011.62 $739.46
58 $887.67 $1,027.12 $956.62 $875.39 $842.50 $849.50 $738.16 $887.01 $1,057.70 $773.14
59 $906.83 $1,049.30 $977.27 $894.29 $860.68 $867.84 $754.09 $906.16 $1,080.53 $789.83
60 $945.50 $1,094.04 $1,018.94 $932.42 $897.38 $904.85 $786.25 $944.80 $1,126.61 $823.51
61 $978.95 $1,132.74 $1,054.99 $965.40 $929.13 $936.85 $814.06 $978.22 $1,166.46 $852.64
62 $1,000.90 $1,158.14 $1,078.64 $987.05 $949.96 $957.86 $832.31 $1,000.15 $1,192.61 $871.75
63 $1,028.42 $1,189.98 $1,108.30 $1,014.19 $976.08 $984.20 $855.19 $1,027.65 $1,225.40 $895.73
64+ $1,045.14 $1,209.33 $1,126.32 $1,030.68 $991.95 $1,000.20 $869.10 $1,044.36 $1,245.33 $910.29
Area 11H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $393.23 $351.14 $295.53 $289.01 $345.82 $352.78 $329.42 $366.13 $332.81 $309.26
15 $428.18 $382.36 $321.80 $314.70 $376.56 $384.14 $358.71 $398.67 $362.40 $336.75
16 $441.54 $394.29 $331.84 $324.52 $388.31 $396.13 $369.90 $411.12 $373.71 $347.26
17 $454.91 $406.22 $341.88 $334.34 $400.06 $408.12 $381.10 $423.56 $385.02 $357.77
18 $469.30 $419.08 $352.70 $344.92 $412.72 $421.03 $393.16 $436.96 $397.20 $369.09
19 $483.69 $431.93 $363.52 $355.50 $425.38 $433.94 $405.21 $450.36 $409.38 $380.41
20 $498.60 $445.24 $374.72 $366.46 $438.49 $447.32 $417.70 $464.24 $422.00 $392.13
21 $514.02 $459.01 $386.31 $377.79 $452.05 $461.15 $430.62 $478.60 $435.05 $404.26
22 $514.02 $459.01 $386.31 $377.79 $452.05 $461.15 $430.62 $478.60 $435.05 $404.26
23 $514.02 $459.01 $386.31 $377.79 $452.05 $461.15 $430.62 $478.60 $435.05 $404.26
24 $514.02 $459.01 $386.31 $377.79 $452.05 $461.15 $430.62 $478.60 $435.05 $404.26
25 $516.08 $460.85 $387.86 $379.30 $453.86 $462.99 $432.34 $480.51 $436.79 $405.88
26 $526.36 $470.03 $395.58 $386.86 $462.90 $472.22 $440.95 $490.09 $445.49 $413.96
27 $538.69 $481.04 $404.85 $395.92 $473.75 $483.29 $451.29 $501.57 $455.93 $423.66
28 $558.74 $498.94 $419.92 $410.66 $491.38 $501.27 $468.08 $520.24 $472.90 $439.43
29 $575.19 $513.63 $432.28 $422.75 $505.84 $516.03 $481.86 $535.55 $486.82 $452.37
30 $583.41 $520.98 $438.46 $428.79 $513.08 $523.41 $488.75 $543.21 $493.78 $458.84
31 $595.75 $531.99 $447.73 $437.86 $523.93 $534.47 $499.09 $554.70 $504.22 $468.54
32 $608.09 $543.01 $457.00 $446.93 $534.78 $545.54 $509.42 $566.18 $514.66 $478.24
33 $615.80 $549.89 $462.80 $452.59 $541.56 $552.46 $515.88 $573.36 $521.19 $484.30
34 $624.02 $557.24 $468.98 $458.64 $548.79 $559.84 $522.77 $581.02 $528.15 $490.77
35 $628.13 $560.91 $472.07 $461.66 $552.41 $563.53 $526.22 $584.85 $531.63 $494.01
36 $632.24 $564.58 $475.16 $464.68 $556.02 $567.21 $529.66 $588.68 $535.11 $497.24
37 $636.36 $568.25 $478.25 $467.70 $559.64 $570.90 $533.11 $592.51 $538.59 $500.47
38 $640.47 $571.93 $481.34 $470.73 $563.25 $574.59 $536.55 $596.34 $542.07 $503.71
39 $648.69 $579.27 $487.52 $476.77 $570.49 $581.97 $543.44 $603.99 $549.03 $510.18
40 $656.92 $586.61 $493.70 $482.82 $577.72 $589.35 $550.33 $611.65 $555.99 $516.64
41 $669.25 $597.63 $502.98 $491.88 $588.57 $600.42 $560.67 $623.14 $566.44 $526.35
42 $681.08 $608.19 $511.86 $500.57 $598.97 $611.02 $570.57 $634.15 $576.44 $535.64
43 $697.53 $622.88 $524.22 $512.66 $613.43 $625.78 $584.35 $649.46 $590.36 $548.58
44 $718.09 $641.24 $539.68 $527.77 $631.51 $644.23 $601.58 $668.60 $607.76 $564.75
45 $742.24 $662.81 $557.83 $545.53 $652.76 $665.90 $621.82 $691.10 $628.21 $583.75
46 $771.03 $688.52 $579.47 $566.69 $678.08 $691.73 $645.93 $717.90 $652.58 $606.39
47 $803.41 $717.43 $603.80 $590.49 $706.55 $720.78 $673.06 $748.05 $679.98 $631.86
48 $840.42 $750.48 $631.62 $617.69 $739.10 $753.98 $704.06 $782.51 $711.31 $660.97
49 $876.92 $783.07 $659.04 $644.51 $771.20 $786.72 $734.64 $816.49 $742.20 $689.67
50 $918.04 $819.79 $689.95 $674.73 $807.36 $823.61 $769.09 $854.78 $777.00 $722.01
51 $958.65 $856.05 $720.47 $704.58 $843.07 $860.04 $803.11 $892.59 $811.37 $753.94
52 $1,003.37 $895.99 $754.08 $737.45 $882.40 $900.16 $840.57 $934.23 $849.22 $789.12
53 $1,048.60 $936.38 $788.07 $770.69 $922.18 $940.75 $878.46 $976.34 $887.50 $824.69
54 $1,097.43 $979.99 $824.77 $806.58 $965.13 $984.56 $919.37 $1,021.81 $928.83 $863.10
55 $1,146.26 $1,023.59 $861.47 $842.47 $1,008.07 $1,028.36 $960.28 $1,067.28 $970.16 $901.50
56 $1,199.21 $1,070.87 $901.26 $881.38 $1,054.63 $1,075.86 $1,004.64 $1,116.57 $1,014.97 $943.14
57 $1,252.67 $1,118.61 $941.44 $920.67 $1,101.65 $1,123.82 $1,049.42 $1,166.35 $1,060.22 $985.18
58 $1,309.72 $1,169.56 $984.32 $962.61 $1,151.82 $1,175.01 $1,097.22 $1,219.47 $1,108.51 $1,030.05
59 $1,337.99 $1,194.80 $1,005.56 $983.39 $1,176.69 $1,200.37 $1,120.90 $1,245.80 $1,132.44 $1,052.29
60 $1,395.05 $1,245.75 $1,048.45 $1,025.32 $1,226.86 $1,251.56 $1,168.70 $1,298.92 $1,180.73 $1,097.16
61 $1,444.40 $1,289.82 $1,085.53 $1,061.59 $1,270.26 $1,295.83 $1,210.04 $1,344.87 $1,222.49 $1,135.97
62 $1,476.78 $1,318.74 $1,109.87 $1,085.39 $1,298.74 $1,324.88 $1,237.17 $1,375.02 $1,249.90 $1,161.44
63 $1,517.39 $1,355.00 $1,140.39 $1,115.24 $1,334.45 $1,361.31 $1,271.19 $1,412.83 $1,284.27 $1,193.38
64+ $1,542.06 $1,377.03 $1,158.93 $1,133.37 $1,356.15 $1,383.45 $1,291.86 $1,435.80 $1,305.15 $1,212.78
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $271.84 $314.55 $292.96 $268.08 $258.01 $260.15 $226.06 $271.64 $323.91 $236.77
15 $296.01 $342.50 $319.00 $291.91 $280.95 $283.28 $246.15 $295.79 $352.70 $257.81
16 $305.25 $353.20 $328.95 $301.02 $289.71 $292.12 $253.83 $305.02 $363.71 $265.86
17 $314.48 $363.89 $338.91 $310.13 $298.48 $300.96 $261.52 $314.25 $374.72 $273.91
18 $324.43 $375.40 $349.63 $319.94 $307.93 $310.48 $269.79 $324.20 $386.57 $282.57
19 $334.38 $386.91 $360.36 $329.75 $317.37 $320.01 $278.07 $334.14 $398.43 $291.24
20 $344.69 $398.83 $371.46 $339.92 $327.15 $329.87 $286.64 $344.44 $410.71 $300.22
21 $355.35 $411.17 $382.95 $350.43 $337.27 $340.07 $295.50 $355.09 $423.41 $309.50
22 $355.35 $411.17 $382.95 $350.43 $337.27 $340.07 $295.50 $355.09 $423.41 $309.50
23 $355.35 $411.17 $382.95 $350.43 $337.27 $340.07 $295.50 $355.09 $423.41 $309.50
24 $355.35 $411.17 $382.95 $350.43 $337.27 $340.07 $295.50 $355.09 $423.41 $309.50
25 $356.77 $412.81 $384.48 $351.83 $338.62 $341.43 $296.68 $356.51 $425.10 $310.74
26 $363.88 $421.04 $392.14 $358.84 $345.36 $348.23 $302.59 $363.61 $433.57 $316.93
27 $372.41 $430.91 $401.33 $367.25 $353.46 $356.39 $309.68 $372.13 $443.73 $324.36
28 $386.27 $446.94 $416.27 $380.92 $366.61 $369.66 $321.21 $385.98 $460.25 $336.43
29 $397.64 $460.10 $428.52 $392.13 $377.41 $380.54 $330.66 $397.35 $473.80 $346.33
30 $403.32 $466.68 $434.65 $397.74 $382.80 $385.98 $335.39 $403.03 $480.57 $351.28
31 $411.85 $476.55 $443.84 $406.15 $390.90 $394.14 $342.48 $411.55 $490.73 $358.71
32 $420.38 $486.41 $453.03 $414.56 $398.99 $402.30 $349.58 $420.07 $500.89 $366.14
33 $425.71 $492.58 $458.77 $419.82 $404.05 $407.40 $354.01 $425.40 $507.25 $370.78
34 $431.39 $499.16 $464.90 $425.42 $409.45 $412.84 $358.74 $431.08 $514.02 $375.73
35 $434.24 $502.45 $467.96 $428.23 $412.14 $415.57 $361.10 $433.92 $517.41 $378.21
36 $437.08 $505.74 $471.03 $431.03 $414.84 $418.29 $363.47 $436.76 $520.79 $380.69
37 $439.92 $509.03 $474.09 $433.83 $417.54 $421.01 $365.83 $439.60 $524.18 $383.16
38 $442.77 $512.32 $477.16 $436.64 $420.24 $423.73 $368.19 $442.44 $527.57 $385.64
39 $448.45 $518.90 $483.28 $442.24 $425.63 $429.17 $372.92 $448.12 $534.34 $390.59
40 $454.14 $525.48 $489.41 $447.85 $431.03 $434.61 $377.65 $453.81 $541.12 $395.54
41 $462.67 $535.34 $498.60 $456.26 $439.13 $442.77 $384.74 $462.33 $551.28 $402.97
42 $470.84 $544.80 $507.41 $464.32 $446.88 $450.59 $391.54 $470.49 $561.02 $410.09
43 $482.21 $557.96 $519.66 $475.53 $457.68 $461.47 $400.99 $481.86 $574.57 $419.99
44 $496.42 $574.40 $534.98 $489.55 $471.17 $475.08 $412.81 $496.06 $591.50 $432.37
45 $513.13 $593.73 $552.98 $506.02 $487.02 $491.06 $426.70 $512.75 $611.40 $446.92
46 $533.03 $616.76 $574.43 $525.65 $505.91 $510.11 $443.25 $532.64 $635.12 $464.25
47 $555.41 $642.66 $598.55 $547.72 $527.15 $531.53 $461.87 $555.01 $661.79 $483.75
48 $581.00 $672.26 $626.12 $572.95 $551.44 $556.01 $483.14 $580.57 $692.28 $506.03
49 $606.23 $701.46 $653.31 $597.83 $575.38 $580.16 $504.12 $605.78 $722.34 $528.01
50 $634.66 $734.35 $683.95 $625.87 $602.36 $607.37 $527.76 $634.19 $756.21 $552.77
51 $662.73 $766.83 $714.20 $653.55 $629.01 $634.23 $551.11 $662.24 $789.66 $577.22
52 $693.64 $802.60 $747.52 $684.04 $658.35 $663.82 $576.82 $693.14 $826.50 $604.14
53 $724.91 $838.79 $781.22 $714.88 $688.03 $693.74 $602.82 $724.38 $863.76 $631.38
54 $758.67 $877.85 $817.60 $748.17 $720.07 $726.05 $630.89 $758.12 $903.98 $660.78
55 $792.43 $916.91 $853.98 $781.46 $752.11 $758.36 $658.97 $791.85 $944.20 $690.19
56 $829.03 $959.26 $893.42 $817.55 $786.85 $793.38 $689.40 $828.42 $987.82 $722.06
57 $865.99 $1,002.02 $933.25 $854.00 $821.93 $828.75 $720.13 $865.35 $1,031.85 $754.25
58 $905.43 $1,047.66 $975.76 $892.90 $859.36 $866.50 $752.93 $904.77 $1,078.85 $788.61
59 $924.98 $1,070.28 $996.82 $912.17 $877.91 $885.20 $769.19 $924.30 $1,102.14 $805.63
60 $964.42 $1,115.92 $1,039.33 $951.07 $915.35 $922.95 $801.99 $963.71 $1,149.13 $839.98
61 $998.53 $1,155.39 $1,076.09 $984.71 $947.73 $955.60 $830.36 $997.80 $1,189.78 $869.70
62 $1,020.92 $1,181.29 $1,100.22 $1,006.79 $968.98 $977.02 $848.97 $1,020.17 $1,216.46 $889.19
63 $1,048.99 $1,213.77 $1,130.47 $1,034.47 $995.62 $1,003.89 $872.32 $1,048.23 $1,249.91 $913.64
64+ $1,066.05 $1,233.51 $1,148.85 $1,051.29 $1,011.81 $1,020.21 $886.50 $1,065.27 $1,270.23 $928.50
Area 12H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $445.27 $397.62 $334.64 $327.26 $391.59 $399.47 $373.03 $414.58 $376.86 $350.19
15 $484.85 $432.96 $364.39 $356.35 $426.40 $434.98 $406.19 $451.44 $410.36 $381.32
16 $499.98 $446.47 $375.76 $367.47 $439.70 $448.55 $418.87 $465.53 $423.17 $393.22
17 $515.11 $459.99 $387.13 $378.59 $453.01 $462.13 $431.54 $479.62 $435.98 $405.13
18 $531.41 $474.54 $399.38 $390.57 $467.35 $476.75 $445.20 $494.79 $449.77 $417.94
19 $547.71 $489.09 $411.63 $402.55 $481.68 $491.37 $458.85 $509.97 $463.56 $430.76
20 $564.59 $504.17 $424.32 $414.96 $496.52 $506.51 $472.99 $525.68 $477.85 $444.04
21 $582.05 $519.76 $437.44 $427.79 $511.88 $522.18 $487.62 $541.94 $492.63 $457.77
22 $582.05 $519.76 $437.44 $427.79 $511.88 $522.18 $487.62 $541.94 $492.63 $457.77
23 $582.05 $519.76 $437.44 $427.79 $511.88 $522.18 $487.62 $541.94 $492.63 $457.77
24 $582.05 $519.76 $437.44 $427.79 $511.88 $522.18 $487.62 $541.94 $492.63 $457.77
25 $584.38 $521.84 $439.19 $429.50 $513.93 $524.27 $489.57 $544.11 $494.60 $459.60
26 $596.02 $532.23 $447.94 $438.06 $524.17 $534.71 $499.32 $554.95 $504.45 $468.76
27 $609.99 $544.71 $458.44 $448.32 $536.45 $547.24 $511.03 $567.95 $516.28 $479.74
28 $632.69 $564.98 $475.50 $465.01 $556.41 $567.61 $530.04 $589.09 $535.49 $497.60
29 $651.31 $581.61 $489.50 $478.70 $572.79 $584.32 $545.65 $606.43 $551.25 $512.24
30 $660.63 $589.93 $496.49 $485.54 $580.98 $592.67 $553.45 $615.10 $559.14 $519.57
31 $674.60 $602.40 $506.99 $495.81 $593.27 $605.21 $565.15 $628.11 $570.96 $530.56
32 $688.57 $614.88 $517.49 $506.08 $605.55 $617.74 $576.85 $641.12 $582.78 $541.54
33 $697.30 $622.67 $524.05 $512.49 $613.23 $625.57 $584.17 $649.24 $590.17 $548.41
34 $706.61 $630.99 $531.05 $519.34 $621.42 $633.93 $591.97 $657.92 $598.05 $555.73
35 $711.27 $635.15 $534.55 $522.76 $625.52 $638.10 $595.87 $662.25 $601.99 $559.39
36 $715.92 $639.30 $538.05 $526.18 $629.61 $642.28 $599.77 $666.59 $605.93 $563.06
37 $720.58 $643.46 $541.55 $529.60 $633.71 $646.46 $603.67 $670.92 $609.88 $566.72
38 $725.23 $647.62 $545.05 $533.03 $637.80 $650.64 $607.57 $675.26 $613.82 $570.38
39 $734.55 $655.94 $552.05 $539.87 $645.99 $658.99 $615.38 $683.93 $621.70 $577.71
40 $743.86 $664.25 $559.05 $546.72 $654.18 $667.35 $623.18 $692.60 $629.58 $585.03
41 $757.83 $676.73 $569.55 $556.98 $666.47 $679.88 $634.88 $705.61 $641.40 $596.02
42 $771.22 $688.68 $579.61 $566.82 $678.24 $691.89 $646.10 $718.07 $652.73 $606.55
43 $789.84 $705.31 $593.61 $580.51 $694.62 $708.60 $661.70 $735.41 $668.50 $621.19
44 $813.12 $726.10 $611.10 $597.62 $715.10 $729.49 $681.21 $757.09 $688.20 $639.50
45 $840.48 $750.53 $631.66 $617.73 $739.15 $754.03 $704.12 $782.56 $711.36 $661.02
46 $873.08 $779.64 $656.16 $641.69 $767.82 $783.27 $731.43 $812.91 $738.95 $686.66
47 $909.74 $812.38 $683.72 $668.64 $800.07 $816.17 $762.15 $847.05 $769.98 $715.49
48 $951.65 $849.81 $715.21 $699.44 $836.92 $853.76 $797.26 $886.07 $805.45 $748.45
49 $992.98 $886.71 $746.27 $729.81 $873.27 $890.84 $831.88 $924.55 $840.43 $780.96
50 $1,039.54 $928.29 $781.27 $764.03 $914.22 $932.61 $870.89 $967.90 $879.84 $817.58
51 $1,085.52 $969.35 $815.83 $797.83 $954.66 $973.87 $909.41 $1,010.72 $918.75 $853.74
52 $1,136.16 $1,014.57 $853.88 $835.05 $999.19 $1,019.30 $951.83 $1,057.87 $961.61 $893.57
53 $1,187.38 $1,060.31 $892.38 $872.69 $1,044.24 $1,065.25 $994.74 $1,105.56 $1,004.97 $933.85
54 $1,242.68 $1,109.69 $933.93 $913.33 $1,092.86 $1,114.85 $1,041.07 $1,157.04 $1,051.77 $977.34
55 $1,297.97 $1,159.06 $975.49 $953.97 $1,141.49 $1,164.46 $1,087.39 $1,208.53 $1,098.56 $1,020.83
56 $1,357.92 $1,212.60 $1,020.55 $998.03 $1,194.22 $1,218.25 $1,137.62 $1,264.35 $1,149.31 $1,067.98
57 $1,418.46 $1,266.66 $1,066.04 $1,042.52 $1,247.45 $1,272.55 $1,188.33 $1,320.71 $1,200.54 $1,115.59
58 $1,483.06 $1,324.35 $1,114.60 $1,090.01 $1,304.27 $1,330.51 $1,242.46 $1,380.86 $1,255.22 $1,166.40
59 $1,515.08 $1,352.94 $1,138.66 $1,113.54 $1,332.42 $1,359.23 $1,269.27 $1,410.67 $1,282.32 $1,191.58
60 $1,579.68 $1,410.63 $1,187.21 $1,161.02 $1,389.24 $1,417.20 $1,323.40 $1,470.83 $1,337.00 $1,242.39
61 $1,635.56 $1,460.53 $1,229.21 $1,202.09 $1,438.38 $1,467.33 $1,370.21 $1,522.85 $1,384.29 $1,286.33
62 $1,672.23 $1,493.27 $1,256.77 $1,229.04 $1,470.63 $1,500.22 $1,400.93 $1,556.99 $1,415.33 $1,315.17
63 $1,718.21 $1,534.33 $1,291.32 $1,262.84 $1,511.07 $1,541.48 $1,439.45 $1,599.81 $1,454.24 $1,351.34
64+ $1,746.15 $1,559.28 $1,312.32 $1,283.37 $1,535.64 $1,566.54 $1,462.86 $1,625.82 $1,477.89 $1,373.31
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $307.82 $356.18 $331.73 $303.56 $292.15 $294.58 $255.98 $307.59 $366.78 $268.10
15 $335.18 $387.84 $361.22 $330.54 $318.12 $320.76 $278.73 $334.93 $399.38 $291.93
16 $345.64 $399.94 $372.50 $340.86 $328.05 $330.78 $287.43 $345.39 $411.85 $301.05
17 $356.11 $412.05 $383.77 $351.18 $337.98 $340.79 $296.13 $355.84 $424.31 $310.16
18 $367.37 $425.08 $395.91 $362.29 $348.67 $351.57 $305.50 $367.10 $437.74 $319.97
19 $378.64 $438.12 $408.06 $373.40 $359.37 $362.35 $314.87 $378.36 $451.16 $329.78
20 $390.31 $451.62 $420.63 $384.91 $370.44 $373.52 $324.57 $390.02 $465.07 $339.95
21 $402.38 $465.59 $433.64 $396.81 $381.90 $385.07 $334.61 $402.08 $479.45 $350.46
22 $402.38 $465.59 $433.64 $396.81 $381.90 $385.07 $334.61 $402.08 $479.45 $350.46
23 $402.38 $465.59 $433.64 $396.81 $381.90 $385.07 $334.61 $402.08 $479.45 $350.46
24 $402.38 $465.59 $433.64 $396.81 $381.90 $385.07 $334.61 $402.08 $479.45 $350.46
25 $403.99 $467.45 $435.37 $398.40 $383.43 $386.61 $335.95 $403.69 $481.37 $351.86
26 $412.04 $476.76 $444.05 $406.33 $391.07 $394.31 $342.64 $411.73 $490.96 $358.87
27 $421.69 $487.94 $454.45 $415.86 $400.23 $403.55 $350.67 $421.38 $502.46 $367.28
28 $437.39 $506.10 $471.37 $431.33 $415.13 $418.57 $363.72 $437.06 $521.16 $380.95
29 $450.26 $521.00 $485.24 $444.03 $427.35 $430.89 $374.43 $449.93 $536.50 $392.16
30 $456.70 $528.44 $492.18 $450.38 $433.46 $437.05 $379.78 $456.36 $544.18 $397.77
31 $466.36 $539.62 $502.59 $459.90 $442.62 $446.30 $387.81 $466.01 $555.68 $406.18
32 $476.02 $550.79 $513.00 $469.43 $451.79 $455.54 $395.84 $475.66 $567.19 $414.59
33 $482.05 $557.78 $519.50 $475.38 $457.52 $461.31 $400.86 $481.69 $574.38 $419.85
34 $488.49 $565.23 $526.44 $481.73 $463.63 $467.47 $406.22 $488.13 $582.05 $425.46
35 $491.71 $568.95 $529.91 $484.90 $466.68 $470.56 $408.89 $491.34 $585.89 $428.26
36 $494.93 $572.68 $533.38 $488.08 $469.74 $473.64 $411.57 $494.56 $589.72 $431.07
37 $498.15 $576.40 $536.85 $491.25 $472.79 $476.72 $414.25 $497.78 $593.56 $433.87
38 $501.37 $580.13 $540.32 $494.43 $475.85 $479.80 $416.92 $500.99 $597.39 $436.67
39 $507.80 $587.57 $547.25 $500.77 $481.96 $485.96 $422.28 $507.42 $605.07 $442.28
40 $514.24 $595.02 $554.19 $507.12 $488.07 $492.12 $427.63 $513.86 $612.74 $447.89
41 $523.90 $606.20 $564.60 $516.65 $497.23 $501.36 $435.66 $523.51 $624.24 $456.30
42 $533.15 $616.91 $574.57 $525.77 $506.02 $510.22 $443.36 $532.76 $635.27 $464.36
43 $546.03 $631.81 $588.45 $538.47 $518.24 $522.54 $454.07 $545.62 $650.61 $475.57
44 $562.12 $650.43 $605.80 $554.34 $533.51 $537.94 $467.45 $561.71 $669.79 $489.59
45 $581.04 $672.31 $626.18 $572.99 $551.46 $556.04 $483.18 $580.60 $692.33 $506.06
46 $603.57 $698.39 $650.46 $595.22 $572.85 $577.61 $501.92 $603.12 $719.18 $525.69
47 $628.92 $727.72 $677.78 $620.21 $596.91 $601.86 $523.00 $628.45 $749.38 $547.77
48 $657.89 $761.24 $709.00 $648.78 $624.41 $629.59 $547.09 $657.40 $783.90 $573.00
49 $686.46 $794.30 $739.79 $676.96 $651.52 $656.93 $570.84 $685.95 $817.94 $597.88
50 $718.65 $831.54 $774.48 $708.70 $682.07 $687.74 $597.61 $718.11 $856.30 $625.92
51 $750.44 $868.33 $808.74 $740.05 $712.24 $718.16 $624.05 $749.88 $894.17 $653.61
52 $785.45 $908.83 $846.47 $774.57 $745.47 $751.66 $653.16 $784.86 $935.89 $684.10
53 $820.86 $949.80 $884.63 $809.49 $779.08 $785.54 $682.60 $820.24 $978.08 $714.94
54 $859.08 $994.03 $925.82 $847.19 $815.36 $822.12 $714.39 $858.44 $1,023.63 $748.23
55 $897.31 $1,038.27 $967.02 $884.89 $851.64 $858.71 $746.18 $896.64 $1,069.17 $781.53
56 $938.75 $1,086.22 $1,011.68 $925.76 $890.97 $898.37 $780.65 $938.05 $1,118.56 $817.62
57 $980.60 $1,134.64 $1,056.78 $967.03 $930.69 $938.42 $815.44 $979.87 $1,168.42 $854.07
58 $1,025.26 $1,186.32 $1,104.91 $1,011.07 $973.08 $981.16 $852.59 $1,024.50 $1,221.64 $892.97
59 $1,047.40 $1,211.93 $1,128.76 $1,032.90 $994.09 $1,002.34 $870.99 $1,046.61 $1,248.01 $912.25
60 $1,092.06 $1,263.61 $1,176.90 $1,076.94 $1,036.48 $1,045.08 $908.13 $1,091.25 $1,301.23 $951.15
61 $1,130.69 $1,308.31 $1,218.53 $1,115.04 $1,073.14 $1,082.05 $940.25 $1,129.84 $1,347.25 $984.79
62 $1,156.04 $1,337.64 $1,245.85 $1,140.04 $1,097.20 $1,106.31 $961.33 $1,155.18 $1,377.46 $1,006.87
63 $1,187.83 $1,374.42 $1,280.11 $1,171.38 $1,127.37 $1,136.73 $987.77 $1,186.94 $1,415.34 $1,034.56
64+ $1,207.14 $1,396.77 $1,300.92 $1,190.43 $1,145.70 $1,155.21 $1,003.83 $1,206.24 $1,438.35 $1,051.38
Area 13H
Age HMO 500 Platinum
HMO 1000 Gold
HMO HSA 1350 Silver
HMO HSA 1900 Silver
HMO 2000a Gold
HMO 2500 Gold
POS 1500b Gold
POS HSA 2000 Gold
POS 2000b Gold
POS 2500 Gold
0-14 $370.09 $330.49 $278.15 $272.01 $325.48 $332.03 $310.05 $344.59 $313.24 $291.07
15 $402.99 $359.86 $302.87 $296.19 $354.41 $361.54 $337.61 $375.22 $341.08 $316.94
16 $415.57 $371.10 $312.32 $305.43 $365.47 $372.82 $348.14 $386.94 $351.73 $326.83
17 $428.15 $382.33 $321.78 $314.68 $376.53 $384.11 $358.68 $398.65 $362.37 $336.72
18 $441.69 $394.43 $331.96 $324.64 $388.44 $396.26 $370.03 $411.26 $373.84 $347.38
19 $455.24 $406.52 $342.14 $334.59 $400.36 $408.41 $381.38 $423.87 $385.30 $358.03
20 $469.27 $419.05 $352.68 $344.90 $412.70 $421.00 $393.13 $436.94 $397.18 $369.07
21 $483.78 $432.01 $363.59 $355.57 $425.46 $434.02 $405.29 $450.45 $409.46 $380.48
22 $483.78 $432.01 $363.59 $355.57 $425.46 $434.02 $405.29 $450.45 $409.46 $380.48
23 $483.78 $432.01 $363.59 $355.57 $425.46 $434.02 $405.29 $450.45 $409.46 $380.48
24 $483.78 $432.01 $363.59 $355.57 $425.46 $434.02 $405.29 $450.45 $409.46 $380.48
25 $485.72 $433.74 $365.04 $356.99 $427.16 $435.76 $406.91 $452.25 $411.10 $382.00
26 $495.39 $442.38 $372.32 $364.10 $435.67 $444.44 $415.02 $461.26 $419.29 $389.61
27 $507.00 $452.75 $381.04 $372.64 $445.88 $454.85 $424.74 $472.07 $429.11 $398.74
28 $525.87 $469.59 $395.22 $386.50 $462.48 $471.78 $440.55 $489.64 $445.08 $413.58
29 $541.35 $483.42 $406.86 $397.88 $476.09 $485.67 $453.52 $504.05 $458.19 $425.76
30 $549.09 $490.33 $412.67 $403.57 $482.90 $492.61 $460.00 $511.26 $464.74 $431.84
31 $560.70 $500.70 $421.40 $412.11 $493.11 $503.03 $469.73 $522.07 $474.56 $440.98
32 $572.31 $511.07 $430.13 $420.64 $503.32 $513.45 $479.46 $532.88 $484.39 $450.11
33 $579.57 $517.55 $435.58 $425.97 $509.70 $519.96 $485.54 $539.64 $490.53 $455.82
34 $587.31 $524.46 $441.40 $431.66 $516.51 $526.90 $492.02 $546.85 $497.08 $461.90
35 $591.18 $527.92 $444.31 $434.51 $519.91 $530.37 $495.26 $550.45 $500.36 $464.95
36 $595.05 $531.37 $447.22 $437.35 $523.32 $533.84 $498.51 $554.05 $503.64 $467.99
37 $598.92 $534.83 $450.12 $440.20 $526.72 $537.32 $501.75 $557.66 $506.91 $471.03
38 $602.79 $538.28 $453.03 $443.04 $530.12 $540.79 $504.99 $561.26 $510.19 $474.08
39 $610.53 $545.20 $458.85 $448.73 $536.93 $547.73 $511.48 $568.47 $516.74 $480.17
40 $618.27 $552.11 $464.67 $454.42 $543.74 $554.68 $517.96 $575.68 $523.29 $486.25
41 $629.88 $562.48 $473.39 $462.95 $553.95 $565.09 $527.69 $586.49 $533.12 $495.38
42 $641.01 $572.41 $481.76 $471.13 $563.73 $575.08 $537.01 $596.85 $542.53 $504.14
43 $656.49 $586.24 $493.39 $482.51 $577.35 $588.97 $549.98 $611.26 $555.64 $516.31
44 $675.84 $603.52 $507.94 $496.73 $594.37 $606.33 $566.19 $629.28 $572.02 $531.53
45 $698.58 $623.82 $525.02 $513.44 $614.36 $626.72 $585.24 $650.45 $591.26 $549.41
46 $725.67 $648.02 $545.39 $533.36 $638.19 $651.03 $607.94 $675.68 $614.19 $570.72
47 $756.15 $675.23 $568.29 $555.76 $664.99 $678.37 $633.47 $704.05 $639.99 $594.69
48 $790.98 $706.34 $594.47 $581.36 $695.63 $709.62 $662.65 $736.49 $669.47 $622.08
49 $825.33 $737.01 $620.28 $606.60 $725.83 $740.44 $691.42 $768.47 $698.54 $649.10
50 $864.03 $771.57 $649.37 $635.05 $759.87 $775.16 $723.85 $804.50 $731.30 $679.54
51 $902.25 $805.70 $678.10 $663.14 $793.48 $809.45 $755.87 $840.09 $763.64 $709.60
52 $944.34 $843.28 $709.73 $694.07 $830.50 $847.21 $791.13 $879.28 $799.27 $742.70
53 $986.91 $881.30 $741.72 $725.36 $867.94 $885.40 $826.79 $918.92 $835.30 $776.18
54 $1,032.87 $922.34 $776.26 $759.14 $908.36 $926.63 $865.29 $961.71 $874.20 $812.32
55 $1,078.83 $963.38 $810.81 $792.92 $948.78 $967.86 $903.80 $1,004.50 $913.10 $848.47
56 $1,128.66 $1,007.88 $848.26 $829.54 $992.60 $1,012.57 $945.54 $1,050.90 $955.27 $887.66
57 $1,178.97 $1,052.81 $886.07 $866.52 $1,036.85 $1,057.71 $987.69 $1,097.75 $997.85 $927.23
58 $1,232.67 $1,100.76 $926.43 $905.99 $1,084.07 $1,105.88 $1,032.68 $1,147.75 $1,043.30 $969.46
59 $1,259.28 $1,124.52 $946.42 $925.55 $1,107.47 $1,129.75 $1,054.97 $1,172.52 $1,065.82 $990.39
60 $1,312.98 $1,172.48 $986.78 $965.02 $1,154.70 $1,177.93 $1,099.96 $1,222.52 $1,111.27 $1,032.62
61 $1,359.42 $1,213.95 $1,021.69 $999.15 $1,195.54 $1,219.60 $1,138.86 $1,265.76 $1,150.58 $1,069.15
62 $1,389.90 $1,241.16 $1,044.59 $1,021.55 $1,222.35 $1,246.94 $1,164.40 $1,294.14 $1,176.38 $1,093.12
63 $1,428.12 $1,275.29 $1,073.32 $1,049.64 $1,255.96 $1,281.23 $1,196.42 $1,329.73 $1,208.73 $1,123.18
64+ $1,451.34 $1,296.03 $1,090.77 $1,066.71 $1,276.38 $1,302.06 $1,215.87 $1,351.35 $1,228.38 $1,141.44
Age POS HSA 2700 Silver
POS 3000 Gold
POS HSA 3600 Silver
POS 4000 Silver
POS 5000 Silver
POS 6500 Silver
POS HSA 6650 Bronze
PPO 3250 Silver
PPO 3500 Gold
PPO HSA 5000 Bronze
0-14 $255.85 $296.05 $275.73 $252.31 $242.83 $244.85 $212.76 $255.66 $304.86 $222.84
15 $278.60 $322.36 $300.24 $274.74 $264.42 $266.61 $231.67 $278.39 $331.96 $242.64
16 $287.29 $332.42 $309.61 $283.32 $272.67 $274.93 $238.91 $287.08 $342.32 $250.22
17 $295.99 $342.49 $318.98 $291.89 $280.93 $283.25 $246.14 $295.77 $352.68 $257.79
18 $305.35 $353.32 $329.07 $301.13 $289.81 $292.21 $253.92 $305.12 $363.84 $265.95
19 $314.72 $364.16 $339.16 $310.36 $298.70 $301.18 $261.71 $314.48 $375.00 $274.10
20 $324.42 $375.38 $349.62 $319.93 $307.91 $310.46 $269.78 $324.17 $386.55 $282.55
21 $334.45 $386.99 $360.43 $329.82 $317.43 $320.06 $278.12 $334.20 $398.51 $291.29
22 $334.45 $386.99 $360.43 $329.82 $317.43 $320.06 $278.12 $334.20 $398.51 $291.29
23 $334.45 $386.99 $360.43 $329.82 $317.43 $320.06 $278.12 $334.20 $398.51 $291.29
24 $334.45 $386.99 $360.43 $329.82 $317.43 $320.06 $278.12 $334.20 $398.51 $291.29
25 $335.79 $388.54 $361.87 $331.14 $318.70 $321.34 $279.23 $335.54 $400.10 $292.46
26 $342.48 $396.28 $369.08 $337.74 $325.05 $327.74 $284.79 $342.22 $408.07 $298.28
27 $350.50 $405.57 $377.73 $345.65 $332.67 $335.42 $291.47 $350.24 $417.64 $305.27
28 $363.55 $420.66 $391.79 $358.51 $345.05 $347.91 $302.32 $363.28 $433.18 $316.63
29 $374.25 $433.04 $403.32 $369.07 $355.20 $358.15 $311.22 $373.97 $445.93 $325.95
30 $379.60 $439.23 $409.09 $374.35 $360.28 $363.27 $315.67 $379.32 $452.31 $330.61
31 $387.63 $448.52 $417.74 $382.26 $367.90 $370.95 $322.34 $387.34 $461.87 $337.61
32 $395.65 $457.81 $426.39 $390.18 $375.52 $378.63 $329.02 $395.36 $471.44 $344.60
33 $400.67 $463.61 $431.80 $395.12 $380.28 $383.43 $333.19 $400.37 $477.41 $348.97
34 $406.02 $469.81 $437.56 $400.40 $385.36 $388.55 $337.64 $405.72 $483.79 $353.63
35 $408.70 $472.90 $440.45 $403.04 $387.90 $391.11 $339.86 $408.39 $486.98 $355.96
36 $411.37 $476.00 $443.33 $405.68 $390.44 $393.67 $342.09 $411.07 $490.17 $358.29
37 $414.05 $479.09 $446.21 $408.32 $392.98 $396.23 $344.31 $413.74 $493.36 $360.62
38 $416.72 $482.19 $449.10 $410.96 $395.52 $398.79 $346.54 $416.41 $496.54 $362.95
39 $422.08 $488.38 $454.86 $416.23 $400.60 $403.92 $350.99 $421.76 $502.92 $367.61
40 $427.43 $494.57 $460.63 $421.51 $405.68 $409.04 $355.44 $427.11 $509.30 $372.27
41 $435.45 $503.86 $469.28 $429.43 $413.29 $416.72 $362.11 $435.13 $518.86 $379.26
42 $443.15 $512.76 $477.57 $437.01 $420.59 $424.08 $368.51 $442.82 $528.03 $385.96
43 $453.85 $525.15 $489.10 $447.57 $430.75 $434.32 $377.41 $453.51 $540.78 $395.28
44 $467.23 $540.63 $503.52 $460.76 $443.45 $447.12 $388.53 $466.88 $556.72 $406.93
45 $482.95 $558.81 $520.46 $476.26 $458.37 $462.17 $401.61 $482.58 $575.45 $420.62
46 $501.68 $580.49 $540.65 $494.73 $476.15 $480.09 $417.18 $501.30 $597.77 $436.94
47 $522.75 $604.87 $563.35 $515.51 $496.14 $500.25 $434.70 $522.35 $622.87 $455.29
48 $546.83 $632.73 $589.30 $539.26 $519.00 $523.30 $454.73 $546.42 $651.56 $476.26
49 $570.57 $660.20 $614.89 $562.67 $541.54 $546.02 $474.47 $570.15 $679.86 $496.94
50 $597.33 $691.16 $643.73 $589.06 $566.93 $571.63 $496.72 $596.88 $711.74 $520.24
51 $623.75 $721.74 $672.20 $615.11 $592.01 $596.91 $518.69 $623.28 $743.22 $543.26
52 $652.85 $755.40 $703.56 $643.81 $619.62 $624.76 $542.89 $652.36 $777.89 $568.60
53 $682.28 $789.46 $735.28 $672.83 $647.56 $652.92 $567.36 $681.77 $812.96 $594.23
54 $714.05 $826.22 $769.52 $704.17 $677.71 $683.33 $593.79 $713.52 $850.82 $621.90
55 $745.82 $862.99 $803.76 $735.50 $707.87 $713.73 $620.21 $745.27 $888.68 $649.58
56 $780.27 $902.85 $840.88 $769.47 $740.56 $746.70 $648.85 $779.69 $929.72 $679.58
57 $815.05 $943.09 $878.37 $803.77 $773.58 $779.99 $677.78 $814.45 $971.17 $709.87
58 $852.18 $986.05 $918.38 $840.38 $808.81 $815.51 $708.65 $851.54 $1,015.40 $742.21
59 $870.57 $1,007.33 $938.20 $858.52 $826.27 $833.12 $723.95 $869.92 $1,037.32 $758.23
60 $907.70 $1,050.29 $978.21 $895.13 $861.51 $868.64 $754.82 $907.02 $1,081.56 $790.56
61 $939.80 $1,087.44 $1,012.81 $926.79 $891.98 $899.37 $781.52 $939.10 $1,119.81 $818.52
62 $960.87 $1,111.82 $1,035.52 $947.57 $911.98 $919.53 $799.04 $960.16 $1,144.92 $836.88
63 $987.30 $1,142.39 $1,063.99 $973.63 $937.05 $944.82 $821.01 $986.56 $1,176.40 $859.89
64+ $1,003.35 $1,160.97 $1,081.29 $989.46 $952.29 $960.18 $834.36 $1,002.60 $1,195.53 $873.87