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Tribal Premium Rates for the Federal Employees Health Benefits Program
HMO (Regional Plans with Specific Service Areas)
Alabama Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Alabama Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Alabama Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Alabama Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Alabama Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Alabama Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Alabama Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Alabama Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Alabama Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Alabama UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Alaska Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Alaska Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Alaska Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Alaska Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Alaska Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Alaska Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Alaska Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Alaska Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Alaska Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Arizona Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Arizona Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Arizona Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Arizona Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Arizona Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Arizona Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Arizona Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Arizona Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Arizona Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Arizona Aetna Open Access - High Self
WQ1
1125.02
1161.16
510.84
650.32
24.02
Arizona Aetna Open Access - High Self & Family
WQ2
2731.52
2819.27
1184.02
1635.25
41.92
Arizona Aetna Open Access - High Self Plus One
WQ3
2704.46
2791.34
1092.26
1699.08
61.21
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R61
678.10
718.79
510.84
207.95
28.57
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R62
1525.70
1617.27
1184.02
433.25
45.74
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R63
1457.91
1545.38
1092.26
453.12
61.80
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R64
542.01
574.54
430.91
143.63
8.13
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R65
1219.51
1292.68
969.51
323.17
18.29
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R66
1165.32
1235.24
926.43
308.81
17.48
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R94
494.15
523.81
392.86
130.95
7.41
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R95
1111.85
1178.56
883.92
294.64
16.68
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R96
1062.45
1126.19
844.64
281.55
15.94
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R91
620.64
657.89
493.42
164.47
9.31
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R92
1396.42
1480.20
1110.15
370.05
20.95
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R93
1334.34
1414.40
1060.80
353.60
20.02
Arizona Humana Health Plan, Inc. - Standard Self
C74
726.57
784.10
510.84
273.26
45.41
Arizona Humana Health Plan, Inc. - Standard Self & Family
C75
1634.73
1764.19
1184.02
580.17
83.63
Arizona Humana Health Plan, Inc. - Standard Self Plus One
C76
1562.06
1685.73
1092.26
593.47
98.00
Arizona Humana Health Plan, Inc. - High Self
C71
862.59
1017.88
510.84
507.04
143.17
Arizona Humana Health Plan, Inc. - High Self & Family
C72
1940.84
2290.19
1184.02
1106.17
303.52
Arizona Humana Health Plan, Inc. - High Self Plus One
C73
1854.58
2188.40
1092.26
1096.14
308.15
Arizona Humana Health Plan, Inc. - High Self
BF1
1361.43
1429.50
510.84
918.66
55.95
Arizona Humana Health Plan, Inc. - High Self & Family
BF2
3063.15
3216.27
1184.02
2032.25
107.29
Arizona Humana Health Plan, Inc. - High Self Plus One
BF3
2926.99
3073.35
1092.26
1981.09
120.69
Arizona Humana Health Plan, Inc. - Standard Self
BF4
916.07
1154.25
510.84
643.41
226.06
Arizona Humana Health Plan, Inc. - Standard Self & Family
BF5
2061.17
2597.08
1184.02
1413.06
490.08
Arizona Humana Health Plan, Inc. - Standard Self Plus One
BF6
1969.57
2481.66
1092.26
1389.40
486.42
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
450.32
443.84
332.88
110.96
-1.62
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1035.73
1020.85
765.64
255.21
-3.72
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
968.20
954.27
715.70
238.57
-3.48
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
679.19
724.77
510.84
213.93
33.46
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1697.95
1811.90
1184.02
627.88
68.12
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1460.23
1558.25
1092.26
465.99
72.35
Arizona UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
WF1
New Plan
522.86
392.15
130.71
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
WF2
New Plan
1236.39
927.29
309.10
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
WF3
New Plan
1124.05
843.04
281.01
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
VD1
New Plan
522.02
391.52
130.50
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
VD2
New Plan
1234.37
925.78
308.59
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
VD3
New Plan
1122.23
841.67
280.56
New Plan
Arkansas Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Arkansas Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Arkansas Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Arkansas Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Arkansas Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Arkansas Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Arkansas Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Arkansas Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Arkansas QualChoice - High Self
DH1
716.37
752.20
510.84
241.36
23.71
Arkansas QualChoice - High Self & Family
DH2
1868.49
1961.96
1184.02
777.94
47.64
Arkansas QualChoice - High Self Plus One
DH3
1391.56
1461.18
1092.26
368.92
21.03
Arkansas QualChoice - Standard Self
DH4
559.30
587.25
440.44
146.81
6.99
Arkansas QualChoice - Standard Self & Family
DH5
1458.82
1531.75
1148.81
382.94
18.24
Arkansas QualChoice - Standard Self Plus One
DH6
1086.45
1140.77
855.58
285.19
13.58
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
California Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
California Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
California Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
California Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
California Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
California Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
California Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
California Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
California Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
California Aetna Open Access - High Self
2X1
763.92
880.53
510.84
369.69
104.49
California Aetna Open Access - High Self & Family
2X2
1793.44
2067.24
1184.02
883.22
227.97
California Aetna Open Access - High Self Plus One
2X3
1758.27
2026.70
1092.26
934.44
242.76
California Anthem Blue Cross Select HMO - High Self
B31
770.29
774.13
510.84
263.29
-8.28
California Anthem Blue Cross Select HMO - High Self & Family
B32
1733.18
1768.91
1184.02
584.89
-10.10
California Anthem Blue Cross Select HMO - High Self Plus One
B33
1609.94
1641.16
1092.26
548.90
5.55
California Blue Shield of California - Access + HMO Self
SI1
779.29
833.84
510.84
323.00
42.43
California Blue Shield of California - Access + HMO Self & Family
SI2
1792.40
1917.85
1184.02
733.83
79.62
California Blue Shield of California - Access + HMO Self Plus One
SI3
1714.44
1834.45
1092.26
742.19
94.34
California Blue Shield of California - TRIO HMO Self
SI4
705.08
740.33
510.84
229.49
23.13
California Blue Shield of California - TRIO HMO Self & Family
SI5
1621.69
1702.76
1184.02
518.74
35.24
California Blue Shield of California - TRIO HMO Self Plus One
SI6
1551.18
1628.73
1092.26
536.47
51.88
California Health Net of California - Basic Self
P61
332.37
324.37
243.28
81.09
-2.00
California Health Net of California - Basic Self & Family
P62
797.70
778.46
583.85
194.61
-4.81
California Health Net of California - Basic Self Plus One
P63
731.23
713.59
535.19
178.40
-4.41
California Health Net of California - Standard Self
LP4
945.64
1013.31
510.84
502.47
55.55
California Health Net of California - Standard Self & Family
LP5
2269.54
2431.95
1184.02
1247.93
116.58
California Health Net of California - Standard Self Plus One
LP6
2080.41
2229.28
1092.26
1137.02
123.20
California Health Net of California - High Self
LP1
993.05
1048.36
510.84
537.52
43.19
California Health Net of California - High Self & Family
LP2
2383.33
2516.06
1184.02
1332.04
86.90
California Health Net of California - High Self Plus One
LP3
2184.72
2306.40
1092.26
1214.14
96.01
California Health Net of California - High Self
LB1
1361.40
1510.56
510.84
999.72
137.04
California Health Net of California - High Self & Family
LB2
3267.38
3625.38
1184.02
2441.36
312.17
California Health Net of California - High Self Plus One
LB3
2995.09
3323.26
1092.26
2231.00
302.50
California Health Net of California - Standard Self
LB4
1289.41
1340.54
510.84
829.70
39.01
California Health Net of California - Standard Self & Family
LB5
3094.59
3217.28
1184.02
2033.26
76.86
California Health Net of California - Standard Self Plus One
LB6
2836.71
2949.18
1092.26
1856.92
86.80
California Health Net of California - Basic Self
T41
790.29
881.83
510.84
370.99
79.42
California Health Net of California - Basic Self & Family
T42
1896.70
2116.40
1184.02
932.38
173.87
California Health Net of California - Basic Self Plus One
T43
1738.62
1940.06
1092.26
847.80
175.77
California Kaiser Foundation Health Plan, Inc. Northern California Region - Basic Self
KC1
640.81
652.08
489.06
163.02
2.82
California Kaiser Foundation Health Plan, Inc. Northern California Region - Basic Self & Family
KC2
1499.44
1525.85
1144.39
381.46
6.60
California Kaiser Foundation Health Plan, Inc. Northern California Region - Basic Self Plus One
KC3
1499.44
1525.85
1092.26
433.59
0.74
California Kaiser Foundation Health Plan, Inc. Northern California Region - High Self
591
992.49
1000.46
510.84
489.62
-4.15
California Kaiser Foundation Health Plan, Inc. Northern California Region - High Self & Family
592
2369.14
2388.21
1184.02
1204.19
-26.76
California Kaiser Foundation Health Plan, Inc. Northern California Region - High Self Plus One
593
2369.14
2388.21
1092.26
1295.95
-6.60
California Kaiser Foundation Health Plan, Inc. Northern California Region - Standard Self
594
797.57
809.88
510.84
299.04
0.19
California Kaiser Foundation Health Plan, Inc. Northern California Region - Standard Self & Family
595
1866.28
1895.08
1184.02
711.06
-17.03
California Kaiser Foundation Health Plan, Inc. Northern California Region - Standard Self Plus One
596
1866.28
1895.08
1092.26
802.82
3.13
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - Standard Self
NZ4
534.67
566.80
425.10
141.70
8.03
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - Standard Self & Family
NZ5
1235.72
1309.95
982.46
327.49
18.56
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - Standard Self Plus One
NZ6
1235.72
1309.95
982.46
327.49
18.56
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - High Self
NZ1
731.03
776.92
510.84
266.08
33.77
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - High Self & Family
NZ2
1689.55
1795.67
1184.02
611.65
60.29
California Kaiser Foundation Health Plan, Inc. Northern California Region: Fresno - High Self Plus One
NZ3
1689.55
1795.67
1092.26
703.41
80.45
California Kaiser Foundation Health Plan, Inc. Southern California Region - Standard Self
624
431.36
466.31
349.73
116.58
8.74
California Kaiser Foundation Health Plan, Inc. Southern California Region - Standard Self & Family
625
996.93
1077.70
808.28
269.42
20.19
California Kaiser Foundation Health Plan, Inc. Southern California Region - Standard Self Plus One
626
996.93
1077.70
808.28
269.42
20.19
California Kaiser Foundation Health Plan, Inc. Southern California Region - High Self
621
687.20
735.41
510.84
224.57
36.09
California Kaiser Foundation Health Plan, Inc. Southern California Region - High Self & Family
622
1588.25
1699.66
1184.02
515.64
65.58
California Kaiser Foundation Health Plan, Inc. Southern California Region - High Self Plus One
623
1588.25
1699.66
1092.26
607.40
85.74
Colorado Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Colorado Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Colorado Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Colorado Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Colorado Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Colorado Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Colorado Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Colorado Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Colorado Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self
WW1
594.71
636.35
477.26
159.09
10.41
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self & Family
WW2
1448.11
1549.49
1162.12
387.37
25.34
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self Plus One
WW3
1352.95
1447.66
1085.75
361.91
23.67
Colorado Humana Health Plan, Inc. - High Self
NR1
696.22
821.51
510.84
310.67
113.17
Colorado Humana Health Plan, Inc. - High Self & Family
NR2
1566.46
1848.41
1184.02
664.39
236.12
Colorado Humana Health Plan, Inc. - High Self Plus One
NR3
1496.84
1766.27
1092.26
674.01
243.76
Colorado Humana Health Plan, Inc. - Standard Self
NR4
522.30
569.31
426.98
142.33
11.76
Colorado Humana Health Plan, Inc. - Standard Self & Family
NR5
1175.20
1280.98
960.74
320.24
26.44
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NR6
1122.94
1224.02
918.02
306.00
25.27
Colorado Humana Health Plan, Inc. - Basic Self
RZ1
496.95
521.80
391.35
130.45
6.21
Colorado Humana Health Plan, Inc. - Basic Self & Family
RZ2
1118.13
1174.03
880.52
293.51
13.98
Colorado Humana Health Plan, Inc. - Basic Self Plus One
RZ3
1068.47
1121.90
841.43
280.47
13.35
Colorado Humana Health Plan, Inc. - High Self
NT1
626.86
764.77
510.84
253.93
97.22
Colorado Humana Health Plan, Inc. - High Self & Family
NT2
1410.48
1720.79
1184.02
536.77
184.15
Colorado Humana Health Plan, Inc. - High Self Plus One
NT3
1347.75
1644.28
1092.26
552.02
215.08
Colorado Humana Health Plan, Inc. - Standard Self
NT4
501.41
541.52
406.14
135.38
10.03
Colorado Humana Health Plan, Inc. - Standard Self & Family
NT5
1128.21
1218.45
913.84
304.61
22.56
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NT6
1078.09
1164.35
873.26
291.09
21.57
Colorado Humana Health Plan, Inc. - Basic Self
R21
491.77
531.12
398.34
132.78
9.84
Colorado Humana Health Plan, Inc. - Basic Self & Family
R22
1106.50
1195.00
896.25
298.75
22.13
Colorado Humana Health Plan, Inc. - Basic Self Plus One
R23
1057.31
1141.90
856.43
285.47
21.14
Colorado Kaiser Foundation Health Plan of Colorado - Standard Self
654
586.67
671.30
503.48
167.82
21.15
Colorado Kaiser Foundation Health Plan of Colorado - Standard Self & Family
655
1325.91
1517.12
1137.84
379.28
47.80
Colorado Kaiser Foundation Health Plan of Colorado - Standard Self Plus One
656
1325.91
1517.12
1092.26
424.86
93.38
Colorado Kaiser Foundation Health Plan of Colorado - High Self
651
738.94
789.17
510.84
278.33
38.11
Colorado Kaiser Foundation Health Plan of Colorado - High Self & Family
652
1670.05
1783.51
1184.02
599.49
67.63
Colorado Kaiser Foundation Health Plan of Colorado - High Self Plus One
653
1670.05
1783.51
1092.26
691.25
87.79
Colorado Kaiser Foundation Health Plan of Colorado - Basic Self
N41
429.85
484.77
363.58
121.19
13.73
Colorado Kaiser Foundation Health Plan of Colorado - Basic Self & Family
N42
971.43
1095.60
821.70
273.90
31.04
Colorado Kaiser Foundation Health Plan of Colorado - Basic Self Plus One
N43
971.43
1095.60
821.70
273.90
31.04
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
450.32
443.84
332.88
110.96
-1.62
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1035.73
1020.85
765.64
255.21
-3.72
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
968.20
954.27
715.70
238.57
-3.48
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
679.19
724.77
510.84
213.93
33.46
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1697.95
1811.90
1184.02
627.88
68.12
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1460.23
1558.25
1092.26
465.99
72.35
Connecticut Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Connecticut Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Connecticut Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Connecticut Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Connecticut Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Connecticut Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Connecticut Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Connecticut Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Delaware Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Delaware Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Delaware Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Delaware Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Delaware Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Delaware Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Delaware Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Delaware Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Delaware Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Delaware Aetna Open Access - Basic Self
P34
1298.46
1310.08
510.84
799.24
-0.50
Delaware Aetna Open Access - Basic Self & Family
P35
3013.75
3040.68
1184.02
1856.66
-18.90
Delaware Aetna Open Access - Basic Self Plus One
P36
2983.89
3010.54
1092.26
1918.28
0.98
Delaware Aetna Open Access - High Self
P31
1485.21
1456.61
510.84
945.77
-40.72
Delaware Aetna Open Access - High Self & Family
P32
3600.91
3531.54
1184.02
2347.52
-115.20
Delaware Aetna Open Access - High Self Plus One
P33
3565.25
3496.55
1092.26
2404.29
-94.37
District Of Columbia Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
District Of Columbia Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
District Of Columbia Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
District Of Columbia Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
District Of Columbia Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
District Of Columbia Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
District Of Columbia Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
District Of Columbia Aetna Open Access - High Self
JN1
1119.13
1137.57
510.84
626.73
6.32
District Of Columbia Aetna Open Access - High Self & Family
JN2
2515.98
2557.43
1184.02
1373.41
-4.38
District Of Columbia Aetna Open Access - High Self Plus One
JN3
2491.04
2532.10
1092.26
1439.84
15.39
District Of Columbia Aetna Open Access - Basic Self
JN4
680.46
697.10
510.84
186.26
4.52
District Of Columbia Aetna Open Access - Basic Self & Family
JN5
1557.25
1595.34
1184.02
411.32
-7.74
District Of Columbia Aetna Open Access - Basic Self Plus One
JN6
1430.00
1464.99
1092.26
372.73
9.32
District Of Columbia Aetna Saver - Saver Self
QQ4
New Plan
595.21
446.41
148.80
New Plan
District Of Columbia Aetna Saver - Saver Self & Family
QQ5
New Plan
1362.14
1021.61
340.53
New Plan
District Of Columbia Aetna Saver - Saver Self Plus One
QQ6
New Plan
1250.82
938.12
312.70
New Plan
District Of Columbia CareFirst BlueChoice - Standard Self
2G4
797.68
845.54
510.84
334.70
35.74
District Of Columbia CareFirst BlueChoice - Standard Self & Family
2G5
1895.25
2008.96
1184.02
824.94
67.88
District Of Columbia CareFirst BlueChoice - Standard Self Plus One
2G6
1595.34
1691.06
1092.26
598.80
70.05
District Of Columbia CareFirst BlueChoice - HDHP Self
B61
518.27
570.09
427.57
142.52
12.95
District Of Columbia CareFirst BlueChoice - HDHP Self & Family
B62
1231.38
1354.51
1015.88
338.63
30.79
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One
B63
1036.51
1140.17
855.13
285.04
25.91
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self
B64
New Plan
705.99
510.84
195.15
New Plan
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
New Plan
1677.46
1184.02
493.44
New Plan
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
New Plan
1412.02
1059.02
353.00
New Plan
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self
T71
420.12
420.12
315.09
105.03
0.00
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self & Family
T72
1026.16
1026.16
769.62
256.54
0.00
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self Plus One
T73
934.90
934.90
701.18
233.72
0.00
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self
E34
521.76
571.55
428.66
142.89
12.45
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self & Family
E35
1199.99
1314.50
985.88
328.62
28.62
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self Plus One
E36
1199.99
1314.50
985.88
328.62
28.62
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self
E31
692.68
722.82
510.84
211.98
18.02
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self & Family
E32
1593.15
1662.53
1184.02
478.51
23.55
District Of Columbia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self Plus One
E33
1593.15
1662.53
1092.26
570.27
43.71
District Of Columbia M.D. IPA - High Self
JP1
790.86
876.61
510.84
365.77
73.63
District Of Columbia M.D. IPA - High Self & Family
JP2
2217.54
2458.04
1184.02
1274.02
194.67
District Of Columbia M.D. IPA - High Self Plus One
JP3
1544.53
1712.04
1092.26
619.78
141.84
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
495.69
486.57
364.93
121.64
-2.28
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1140.06
1119.11
839.33
279.78
-5.23
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1065.72
1046.13
784.60
261.53
-4.90
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
667.94
714.89
510.84
204.05
34.83
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1582.99
1694.29
1184.02
510.27
65.47
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1436.05
1536.99
1092.26
444.73
75.27
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
437.06
521.50
391.13
130.37
21.11
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1225.49
1462.26
1096.70
365.56
59.19
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
853.56
1018.46
763.85
254.61
41.22
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Florida Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Florida Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Florida Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Florida Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Florida Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Florida Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Florida Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Florida Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Florida Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Florida AvMed - HDHP Self
WZ1
813.30
805.16
510.84
294.32
-20.26
Florida AvMed - HDHP Self & Family
WZ2
2003.32
1871.35
1184.02
687.33
-177.80
Florida AvMed - HDHP Self Plus One
WZ3
1561.60
1622.34
1092.26
530.08
35.07
Florida AvMed - Standard Self
ML4
709.22
709.24
510.84
198.40
-12.10
Florida AvMed - Standard Self & Family
ML5
1837.05
1726.81
1184.02
542.79
-156.07
Florida AvMed - Standard Self Plus One
ML6
1418.43
1489.37
1092.26
397.11
42.50
Florida Capital Health Plan - High Self
EA1
690.41
680.62
510.47
170.15
-21.54
Florida Capital Health Plan - High Self & Family
EA2
1726.08
1577.33
1183.00
394.33
-193.56
Florida Capital Health Plan - High Self Plus One
EA3
1484.41
1488.41
1092.26
396.15
-21.67
Florida Humana CoverageFirst and Humana Value Plan - Value Self
W94
485.23
513.59
385.19
128.40
7.09
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
W95
1091.78
1155.57
866.68
288.89
15.95
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
W96
1043.25
1104.20
828.15
276.05
15.24
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
W91
573.58
607.10
455.33
151.77
8.38
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
W92
1290.58
1365.95
1024.46
341.49
18.85
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
W93
1233.20
1305.27
978.95
326.32
18.02
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
QP1
684.02
725.05
510.84
214.21
28.91
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
QP2
1541.09
1633.54
1184.02
449.52
46.62
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
QP3
1472.58
1560.93
1092.26
468.67
62.68
Florida Humana CoverageFirst and Humana Value Plan - Value Self
QP4
489.95
519.35
389.51
129.84
7.35
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
QP5
1102.36
1168.48
876.36
292.12
16.53
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
QP6
1053.37
1116.57
837.43
279.14
15.80
Florida Humana CoverageFirst and Humana Value Plan - Value Self
MJ4
504.49
519.61
389.71
129.90
3.78
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
MJ5
1135.10
1169.13
876.85
292.28
8.51
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MJ6
1084.63
1117.18
837.89
279.29
8.13
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
MJ1
854.10
948.07
510.84
437.23
81.85
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MJ2
1921.75
2133.15
1184.02
949.13
165.57
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MJ3
1836.36
2038.36
1092.26
946.10
176.33
Florida Humana CoverageFirst and Humana Value Plan - Value Self
X24
470.30
493.18
369.89
123.29
5.72
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
X25
1058.16
1109.66
832.25
277.41
12.87
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X26
1011.14
1060.35
795.26
265.09
12.31
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
X21
555.92
582.99
437.24
145.75
6.77
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X22
1250.82
1311.74
983.81
327.93
15.23
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X23
1195.24
1253.44
940.08
313.36
14.55
Florida Humana Medical Plan, Inc. - Standard Self
LL4
866.91
1074.95
510.84
564.11
195.92
Florida Humana Medical Plan, Inc. - Standard Self & Family
LL5
1950.48
2418.61
1184.02
1234.59
422.30
Florida Humana Medical Plan, Inc. - Standard Self Plus One
LL6
1863.81
2311.12
1092.26
1218.86
421.64
Florida Humana Medical Plan, Inc. - High Self
LL1
1610.81
1659.15
510.84
1148.31
36.22
Florida Humana Medical Plan, Inc. - High Self & Family
LL2
3624.31
3733.06
1184.02
2549.04
62.92
Florida Humana Medical Plan, Inc. - High Self Plus One
LL3
3463.24
3567.14
1092.26
2474.88
78.23
Florida Humana Medical Plan, Inc. - High Self
EE1
914.05
1115.14
510.84
604.30
188.97
Florida Humana Medical Plan, Inc. - High Self & Family
EE2
2056.62
2509.07
1184.02
1325.05
406.62
Florida Humana Medical Plan, Inc. - High Self Plus One
EE3
1965.25
2397.59
1092.26
1305.33
406.67
Florida Humana Medical Plan, Inc. - Standard Self
EE4
817.31
997.12
510.84
486.28
167.69
Florida Humana Medical Plan, Inc. - Standard Self & Family
EE5
1838.92
2243.50
1184.02
1059.48
358.75
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EE6
1757.19
2143.79
1092.26
1051.53
360.93
Florida Humana Medical Plan, Inc. - Standard Self
E24
633.64
716.02
510.84
205.18
46.77
Florida Humana Medical Plan, Inc. - Standard Self & Family
E25
1425.67
1611.00
1184.02
426.98
70.56
Florida Humana Medical Plan, Inc. - Standard Self Plus One
E26
1362.29
1539.40
1092.26
447.14
106.57
Florida Humana Medical Plan, Inc. - High Self
E21
985.77
1202.65
510.84
691.81
204.76
Florida Humana Medical Plan, Inc. - High Self & Family
E22
2217.93
2705.86
1184.02
1521.84
442.10
Florida Humana Medical Plan, Inc. - High Self Plus One
E23
2119.35
2585.61
1092.26
1493.35
440.59
Florida Humana Medical Plan, Inc. - High Self
EX1
744.51
893.40
510.84
382.56
136.77
Florida Humana Medical Plan, Inc. - High Self & Family
EX2
1675.09
2010.10
1184.02
826.08
289.18
Florida Humana Medical Plan, Inc. - High Self Plus One
EX3
1600.63
1920.77
1092.26
828.51
294.47
Florida Humana Medical Plan, Inc. - Standard Self
EX4
653.77
732.23
510.84
221.39
57.95
Florida Humana Medical Plan, Inc. - Standard Self & Family
EX5
1470.97
1647.51
1184.02
463.49
95.75
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EX6
1405.60
1574.28
1092.26
482.02
130.62
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
662.03
701.44
510.84
190.60
25.09
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
1986.10
2104.29
1184.02
920.27
72.36
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1423.37
1508.07
1092.26
415.81
59.03
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Georgia Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Georgia Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Georgia Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Georgia Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Georgia Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Georgia Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Georgia Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Georgia Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Georgia Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Georgia Aetna Open Access - High Self
2U1
1584.29
1733.36
510.84
1222.52
136.95
Georgia Aetna Open Access - High Self & Family
2U2
3649.36
3992.69
1184.02
2808.67
297.50
Georgia Aetna Open Access - High Self Plus One
2U3
3613.22
3953.15
1092.26
2860.89
314.26
Georgia Blue Open Access POS - High Self
QM1
595.40
625.17
468.88
156.29
7.44
Georgia Blue Open Access POS - High Self & Family
QM2
1577.38
1640.47
1184.02
456.45
17.26
Georgia Blue Open Access POS - High Self Plus One
QM3
1318.40
1377.74
1033.31
344.43
14.83
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
S94
520.65
551.89
413.92
137.97
7.81
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
S95
1171.47
1241.74
931.31
310.43
17.56
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
S96
1119.41
1186.58
889.94
296.64
16.79
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
S91
653.92
693.14
510.84
182.30
18.82
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
S92
1471.32
1559.61
1169.71
389.90
22.07
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
S93
1405.93
1490.28
1092.26
398.02
46.54
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
AD4
658.52
737.53
510.84
226.69
62.06
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
AD5
1481.61
1659.41
1184.02
475.39
104.99
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
AD6
1415.77
1585.68
1092.26
493.42
139.48
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
AD1
797.83
973.38
510.84
462.54
163.43
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
AD2
1795.13
2190.07
1184.02
1006.05
349.11
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
AD3
1715.35
2092.74
1092.26
1000.48
351.72
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
LM1
631.71
679.23
509.42
169.81
11.88
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
LM2
1421.42
1528.30
1146.23
382.07
26.72
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
LM3
1358.24
1460.36
1092.26
368.10
28.54
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
LM4
514.02
642.55
481.91
160.64
32.14
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
LM5
1156.57
1445.71
1084.28
361.43
72.29
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
LM6
1105.17
1381.47
1036.10
345.37
69.08
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RM1
594.99
648.53
486.40
162.13
13.38
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RM2
1338.74
1459.23
1094.42
364.81
30.13
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RM3
1279.24
1394.36
1045.77
348.59
28.78
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DN4
684.93
726.03
510.84
215.19
28.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DN5
1541.06
1633.52
1184.02
449.50
46.63
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DN6
1472.58
1560.93
1092.26
468.67
62.68
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
DN1
736.41
780.61
510.84
269.77
32.08
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
DN2
1656.94
1756.37
1184.02
572.35
53.60
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
DN3
1583.31
1678.30
1092.26
586.04
69.32
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RJ1
564.24
598.09
448.57
149.52
8.46
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RJ2
1269.56
1345.72
1009.29
336.43
19.04
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RJ3
1213.12
1285.92
964.44
321.48
18.20
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
Q71
620.17
762.80
510.84
251.96
96.92
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
Q72
1395.38
1716.33
1184.02
532.31
183.47
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
Q73
1333.35
1640.02
1092.26
547.76
214.42
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
CB4
976.91
1250.45
510.84
739.61
261.42
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
CB5
2198.06
2813.50
1184.02
1629.48
569.61
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
CB6
2100.37
2688.47
1092.26
1596.21
562.43
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
CB1
990.36
1148.57
510.84
637.73
146.09
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
CB2
2228.42
2584.40
1184.02
1400.38
310.15
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
CB3
2129.34
2469.61
1092.26
1377.35
314.60
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
DG1
1283.43
1321.93
510.84
811.09
26.38
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
DG2
2887.71
2974.34
1184.02
1790.32
40.80
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
DG3
2759.40
2842.19
1092.26
1749.93
57.12
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DG4
937.91
1171.84
510.84
661.00
221.81
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DG5
2110.29
2636.70
1184.02
1452.68
480.58
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DG6
2016.50
2519.57
1092.26
1427.31
477.40
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - High Self
F81
696.09
730.04
510.84
219.20
21.83
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - High Self & Family
F82
1573.15
1649.87
1184.02
465.85
30.89
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - High Self Plus One
F83
1573.15
1649.87
1092.26
557.61
51.05
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Standard Self
F84
526.20
552.33
414.25
138.08
6.53
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Standard Self & Family
F85
1189.22
1248.26
936.20
312.06
14.76
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Standard Self Plus One
F86
1189.22
1248.26
936.20
312.06
14.76
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Basic Self
LA1
New Plan
393.36
295.02
98.34
New Plan
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Basic Self & Family
LA2
New Plan
888.98
666.74
222.24
New Plan
Georgia Kaiser Foundation Health Plan of Georgia, Inc. - Basic Self Plus One
LA3
New Plan
888.98
666.74
222.24
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
662.03
701.44
510.84
190.60
25.09
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
1986.10
2104.29
1184.02
920.27
72.36
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1423.37
1508.07
1092.26
415.81
59.03
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Guam Calvo's SelectCare - Standard Self
B44
403.50
396.74
297.56
99.18
-1.69
Guam Calvo's SelectCare - Standard Self & Family
B45
1172.36
1152.73
864.55
288.18
-4.91
Guam Calvo's SelectCare - Standard Self Plus One
B46
795.43
782.10
586.58
195.52
-3.34
Guam Calvo's SelectCare - High Self
B41
518.09
491.55
368.66
122.89
-6.63
Guam Calvo's SelectCare - High Self & Family
B42
1372.22
1301.89
976.42
325.47
-17.58
Guam Calvo's SelectCare - High Self Plus One
B43
1011.03
959.23
719.42
239.81
-12.95
Guam TakeCare - HDHP Self
KX1
103.72
124.24
93.18
31.06
5.13
Guam TakeCare - HDHP Self & Family
KX2
278.05
339.32
254.49
84.83
15.32
Guam TakeCare - HDHP Self Plus One
KX3
250.45
306.11
229.58
76.53
13.92
Guam TakeCare - Standard Self
JK4
389.81
389.24
291.93
97.31
-0.14
Guam TakeCare - Standard Self & Family
JK5
1103.87
1102.31
826.73
275.58
-0.39
Guam TakeCare - Standard Self Plus One
JK6
768.24
767.15
575.36
191.79
-0.27
Guam TakeCare - High Self
JK1
471.86
492.35
369.26
123.09
5.13
Guam TakeCare - High Self & Family
JK2
1125.52
1174.40
880.80
293.60
12.22
Guam TakeCare - High Self Plus One
JK3
932.23
972.73
729.55
243.18
10.12
Hawaii Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Hawaii Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Hawaii Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Hawaii Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Hawaii Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Hawaii Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Hawaii Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Hawaii Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Hawaii HMSA Plan - High Self
871
606.95
631.24
473.43
157.81
6.07
Hawaii HMSA Plan - High Self & Family
872
1364.44
1419.02
1064.27
354.75
13.64
Hawaii HMSA Plan - High Self Plus One
873
1329.88
1383.07
1037.30
345.77
13.30
Hawaii HMSA Plan - Standard Self
874
New Plan
430.97
323.23
107.74
New Plan
Hawaii HMSA Plan - Standard Self & Family
875
New Plan
968.83
726.62
242.21
New Plan
Hawaii HMSA Plan - Standard Self Plus One
876
New Plan
944.23
708.17
236.06
New Plan
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - High Self
631
658.58
675.55
506.66
168.89
4.25
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - High Self & Family
632
1468.63
1506.51
1129.88
376.63
9.47
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - High Self Plus One
633
1468.63
1506.51
1092.26
414.25
12.21
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - Standard Self
634
444.69
481.15
360.86
120.29
9.12
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - Standard Self & Family
635
991.64
1072.98
804.74
268.24
20.33
Hawaii Kaiser Foundation Health Plan, Inc. Hawaii Region - Standard Self Plus One
636
991.64
1072.98
804.74
268.24
20.33
Idaho Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Idaho Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Idaho Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Idaho Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Idaho Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Idaho Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Idaho Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Idaho Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Idaho Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Idaho Altius Health Plan - High Self
9K1
935.24
1009.06
510.84
498.22
61.70
Idaho Altius Health Plan - High Self & Family
9K2
2068.26
2231.52
1184.02
1047.50
117.43
Idaho Altius Health Plan - High Self Plus One
9K3
2047.78
2209.42
1092.26
1117.16
135.97
Idaho Altius Health Plan - HDHP Self
9K4
506.91
529.23
396.92
132.31
5.58
Idaho Altius Health Plan - HDHP Self & Family
9K5
1059.41
1106.04
829.53
276.51
11.66
Idaho Altius Health Plan - HDHP Self Plus One
9K6
1038.64
1084.37
813.28
271.09
11.43
Idaho Altius Health Plan - Standard Self
DK4
712.44
761.30
510.84
250.46
36.74
Idaho Altius Health Plan - Standard Self & Family
DK5
1573.30
1681.23
1184.02
497.21
62.10
Idaho Altius Health Plan - Standard Self Plus One
DK6
1557.70
1664.56
1092.26
572.30
81.19
Idaho Kaiser Foundation Health Plan of Washington - Standard Self
544
585.17
604.13
453.10
151.03
4.74
Idaho Kaiser Foundation Health Plan of Washington - Standard Self & Family
545
1345.91
1389.53
1042.15
347.38
10.90
Idaho Kaiser Foundation Health Plan of Washington - Standard Self Plus One
546
1345.91
1389.53
1042.15
347.38
10.90
Idaho Kaiser Foundation Health Plan of Washington - High Self
541
815.40
845.74
510.84
334.90
18.22
Idaho Kaiser Foundation Health Plan of Washington - High Self & Family
542
1793.91
1860.65
1184.02
676.63
20.91
Idaho Kaiser Foundation Health Plan of Washington - High Self Plus One
543
1793.91
1860.65
1092.26
768.39
41.07
Illinois Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Illinois Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Illinois Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Illinois Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Illinois Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Illinois Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Illinois Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Illinois Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Illinois Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Illinois Blue Preferred - High Self
9G1
782.36
833.21
510.84
322.37
38.73
Illinois Blue Preferred - High Self & Family
9G2
1681.07
1858.87
1184.02
674.85
131.97
Illinois Blue Preferred - High Self Plus One
9G3
1591.81
1760.59
1092.26
668.33
143.11
Illinois Blue Preferred - Standard Self
9G4
558.72
600.62
450.47
150.15
10.47
Illinois Blue Preferred - Standard Self & Family
9G5
1587.91
1707.01
1184.02
522.99
73.27
Illinois Blue Preferred - Standard Self Plus One
9G6
1436.02
1543.71
1092.26
451.45
82.02
Illinois Health Alliance HMO - Standard Self
K84
642.44
668.14
501.11
167.03
6.42
Illinois Health Alliance HMO - Standard Self & Family
K85
1734.61
1803.99
1184.02
619.97
23.55
Illinois Health Alliance HMO - Standard Self Plus One
K86
1488.24
1547.78
1092.26
455.52
33.87
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
GB4
616.37
758.14
510.84
247.30
93.21
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
GB5
1386.82
1705.77
1184.02
521.75
175.05
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
GB6
1325.18
1629.96
1092.26
537.70
206.41
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
GB1
936.91
1180.53
510.84
669.69
231.50
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
GB2
2108.04
2656.14
1184.02
1472.12
502.27
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
GB3
2014.37
2538.12
1092.26
1445.86
498.08
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
MW4
608.81
754.91
510.84
244.07
91.87
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1369.79
1698.52
1184.02
514.50
172.05
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1308.93
1623.05
1092.26
530.79
203.56
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
757.06
916.02
510.84
405.18
146.84
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
1703.41
2061.15
1184.02
877.13
311.91
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
1627.67
1969.50
1092.26
877.24
316.16
Illinois Humana Health Plan, Inc. - Standard Self
754
855.66
951.90
510.84
441.06
84.12
Illinois Humana Health Plan, Inc. - Standard Self & Family
755
1925.24
2141.77
1184.02
957.75
170.70
Illinois Humana Health Plan, Inc. - Standard Self Plus One
756
1839.67
2046.59
1092.26
954.33
181.25
Illinois Humana Health Plan, Inc. - High Self
751
1212.06
1238.94
510.84
728.10
14.76
Illinois Humana Health Plan, Inc. - High Self & Family
752
2727.14
2787.61
1184.02
1603.59
14.64
Illinois Humana Health Plan, Inc. - High Self Plus One
753
2605.92
2663.74
1092.26
1571.48
32.15
Illinois Humana Health Plan, Inc. - High Self
9F1
1700.27
1938.32
510.84
1427.48
225.93
Illinois Humana Health Plan, Inc. - High Self & Family
9F2
3825.60
4361.20
1184.02
3177.18
489.77
Illinois Humana Health Plan, Inc. - High Self Plus One
9F3
3655.56
4167.35
1092.26
3075.09
486.12
Illinois Humana Health Plan, Inc. - Standard Self
AB4
1094.77
1149.53
510.84
638.69
42.64
Illinois Humana Health Plan, Inc. - Standard Self & Family
AB5
2463.28
2586.44
1184.02
1402.42
77.33
Illinois Humana Health Plan, Inc. - Standard Self Plus One
AB6
2353.78
2471.50
1092.26
1379.24
92.05
Illinois Humana Health Plan, Inc. - Basic Self
AB1
615.16
756.64
510.84
245.80
92.01
Illinois Humana Health Plan, Inc. - Basic Self & Family
AB2
1384.15
1702.50
1184.02
518.48
172.44
Illinois Humana Health Plan, Inc. - Basic Self Plus One
AB3
1322.64
1626.84
1092.26
534.58
203.92
Illinois Humana Health Plan, Inc. - Basic Self
RW1
623.55
748.24
510.84
237.40
81.51
Illinois Humana Health Plan, Inc. - Basic Self & Family
RW2
1402.96
1683.54
1184.02
499.52
148.78
Illinois Humana Health Plan, Inc. - Basic Self Plus One
RW3
1340.63
1608.73
1092.26
516.47
181.31
Illinois MercyCare Health Plans - High Self
EY1
764.05
785.92
510.84
275.08
9.75
Illinois MercyCare Health Plans - High Self & Family
EY2
1994.01
2050.99
1184.02
866.97
11.15
Illinois MercyCare Health Plans - High Self Plus One
EY3
1642.81
1689.78
1092.26
597.52
21.30
Illinois MercyCare Health Plans - Standard Self
EY4
New Plan
609.59
457.19
152.40
New Plan
Illinois MercyCare Health Plans - Standard Self & Family
EY5
New Plan
1590.85
1184.02
406.83
New Plan
Illinois MercyCare Health Plans - Standard Self Plus One
EY6
New Plan
1310.68
983.01
327.67
New Plan
Illinois Union Health Service - High Self
761
681.74
744.08
510.84
233.24
50.22
Illinois Union Health Service - High Self & Family
762
1711.71
1901.64
1184.02
717.62
144.10
Illinois Union Health Service - High Self Plus One
763
1511.23
1668.33
1092.26
576.07
131.43
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
437.06
521.50
391.13
130.37
21.11
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1225.49
1462.26
1096.70
365.56
59.19
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
853.56
1018.46
763.85
254.61
41.22
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Indiana Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Indiana Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Indiana Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Indiana Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Indiana Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Indiana Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Indiana Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Indiana Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Indiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Indiana Health Alliance HMO - Standard Self
K84
642.44
668.14
501.11
167.03
6.42
Indiana Health Alliance HMO - Standard Self & Family
K85
1734.61
1803.99
1184.02
619.97
23.55
Indiana Health Alliance HMO - Standard Self Plus One
K86
1488.24
1547.78
1092.26
455.52
33.87
Indiana Humana CoverageFirst - CDHP Self
TC1
622.12
659.47
494.60
164.87
9.34
Indiana Humana CoverageFirst - CDHP Self & Family
TC2
1399.75
1483.73
1112.80
370.93
20.99
Indiana Humana CoverageFirst - CDHP Self Plus One
TC3
1337.55
1417.82
1063.37
354.45
20.06
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
MW4
608.81
754.91
510.84
244.07
91.87
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1369.79
1698.52
1184.02
514.50
172.05
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1308.93
1623.05
1092.26
530.79
203.56
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
757.06
916.02
510.84
405.18
146.84
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
1703.41
2061.15
1184.02
877.13
311.91
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
1627.67
1969.50
1092.26
877.24
316.16
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
X34
570.27
615.12
461.34
153.78
11.21
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1283.12
1384.05
1038.04
346.01
25.23
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1226.07
1322.53
991.90
330.63
24.11
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
684.65
799.44
510.84
288.60
102.67
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1540.48
1798.77
1184.02
614.75
212.46
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1472.01
1718.82
1092.26
626.56
221.14
Indiana Humana Health Plan of Ohio, Inc. - High Self
A61
1172.64
1500.98
510.84
990.14
316.22
Indiana Humana Health Plan of Ohio, Inc. - High Self & Family
A62
2638.48
3377.23
1184.02
2193.21
692.92
Indiana Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
2521.22
3227.14
1092.26
2134.88
680.25
Indiana Humana Health Plan of Ohio, Inc. - Standard Self
A64
930.28
1172.17
510.84
661.33
229.77
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2093.17
2637.42
1184.02
1453.40
498.42
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2000.16
2520.20
1092.26
1427.94
494.37
Indiana Humana Health Plan, Inc. - Standard Self
754
855.66
951.90
510.84
441.06
84.12
Indiana Humana Health Plan, Inc. - Standard Self & Family
755
1925.24
2141.77
1184.02
957.75
170.70
Indiana Humana Health Plan, Inc. - Standard Self Plus One
756
1839.67
2046.59
1092.26
954.33
181.25
Indiana Humana Health Plan, Inc. - High Self
751
1212.06
1238.94
510.84
728.10
14.76
Indiana Humana Health Plan, Inc. - High Self & Family
752
2727.14
2787.61
1184.02
1603.59
14.64
Indiana Humana Health Plan, Inc. - High Self Plus One
753
2605.92
2663.74
1092.26
1571.48
32.15
Indiana Humana Health Plan, Inc. - High Self
MH1
883.98
1104.96
510.84
594.12
208.86
Indiana Humana Health Plan, Inc. - High Self & Family
MH2
1988.96
2486.19
1184.02
1302.17
451.40
Indiana Humana Health Plan, Inc. - High Self Plus One
MH3
1900.56
2375.69
1092.26
1283.43
449.46
Indiana Humana Health Plan, Inc. - Standard Self
MH4
722.39
859.65
510.84
348.81
125.14
Indiana Humana Health Plan, Inc. - Standard Self & Family
MH5
1625.37
1934.18
1184.02
750.16
262.98
Indiana Humana Health Plan, Inc. - Standard Self Plus One
MH6
1553.13
1848.23
1092.26
755.97
269.43
Iowa Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Iowa Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Iowa Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Iowa Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Iowa Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Iowa Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Iowa Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Iowa Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Iowa Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Iowa Health Alliance HMO - Standard Self
K84
642.44
668.14
501.11
167.03
6.42
Iowa Health Alliance HMO - Standard Self & Family
K85
1734.61
1803.99
1184.02
619.97
23.55
Iowa Health Alliance HMO - Standard Self Plus One
K86
1488.24
1547.78
1092.26
455.52
33.87
Iowa HealthPartners - Standard Self
V34
428.09
459.92
344.94
114.98
7.96
Iowa HealthPartners - Standard Self & Family
V35
1042.82
1120.41
840.31
280.10
19.40
Iowa HealthPartners - Standard Self Plus One
V36
946.08
1016.45
762.34
254.11
17.59
Iowa HealthPartners - High Self
V31
790.31
712.31
510.84
201.47
-90.12
Iowa HealthPartners - High Self & Family
V32
1925.21
1735.20
1184.02
551.18
-235.84
Iowa HealthPartners - High Self Plus One
V33
1746.57
1574.21
1092.26
481.95
-198.03
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
532.16
610.42
457.82
152.60
19.56
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1223.93
1403.98
1052.99
350.99
45.01
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1144.11
1312.42
984.32
328.10
42.07
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
671.95
720.18
510.84
209.34
36.11
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1679.86
1800.48
1184.02
616.46
74.79
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1444.69
1548.41
1092.26
456.15
78.05
Iowa UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Kansas Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Kansas Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Kansas Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Kansas Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Kansas Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Kansas Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Kansas Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Kansas Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Kansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Kansas Aetna Open Access - High Self
HA1
881.01
1099.93
510.84
589.09
206.80
Kansas Aetna Open Access - High Self & Family
HA2
2081.11
2598.18
1184.02
1414.16
471.24
Kansas Aetna Open Access - High Self Plus One
HA3
2060.54
2572.53
1092.26
1480.27
486.32
Kansas Aetna Open Access - Standard Self
HA4
707.85
716.37
510.84
205.53
-3.60
Kansas Aetna Open Access - Standard Self & Family
HA5
1670.78
1690.89
1184.02
506.87
-25.72
Kansas Aetna Open Access - Standard Self Plus One
HA6
1654.25
1674.16
1092.26
581.90
-5.76
Kansas Humana CoverageFirst and Humana Value Plan - Value Self
PH4
428.35
484.03
363.02
121.01
13.92
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
963.82
1089.10
816.83
272.27
31.32
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
920.96
1040.67
780.50
260.17
29.93
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
600.95
715.11
510.84
204.27
54.03
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1352.13
1609.03
1184.02
425.01
86.98
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1292.05
1537.51
1092.26
445.25
122.24
Kansas Humana Health Plan, Inc. - High Self
MS1
1625.63
1723.17
510.84
1212.33
85.42
Kansas Humana Health Plan, Inc. - High Self & Family
MS2
3657.66
3877.12
1184.02
2693.10
173.63
Kansas Humana Health Plan, Inc. - High Self Plus One
MS3
3495.09
3704.81
1092.26
2612.55
184.05
Kansas Humana Health Plan, Inc. - Standard Self
MS4
952.77
1067.00
510.84
556.16
102.11
Kansas Humana Health Plan, Inc. - Standard Self & Family
MS5
2143.79
2400.78
1184.02
1216.76
211.16
Kansas Humana Health Plan, Inc. - Standard Self Plus One
MS6
2048.50
2294.09
1092.26
1201.83
219.92
Kentucky Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Kentucky Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Kentucky Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Kentucky Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Kentucky Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Kentucky Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Kentucky Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Kentucky Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Kentucky Humana CoverageFirst - CDHP Self
TC1
622.12
659.47
494.60
164.87
9.34
Kentucky Humana CoverageFirst - CDHP Self & Family
TC2
1399.75
1483.73
1112.80
370.93
20.99
Kentucky Humana CoverageFirst - CDHP Self Plus One
TC3
1337.55
1417.82
1063.37
354.45
20.06
Kentucky Humana CoverageFirst - CDHP Self
6N1
633.64
766.70
510.84
255.86
97.45
Kentucky Humana CoverageFirst - CDHP Self & Family
6N2
1425.69
1725.08
1184.02
541.06
184.64
Kentucky Humana CoverageFirst - CDHP Self Plus One
6N3
1362.31
1648.40
1092.26
556.14
215.56
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self
X34
570.27
615.12
461.34
153.78
11.21
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1283.12
1384.05
1038.04
346.01
25.23
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1226.07
1322.53
991.90
330.63
24.11
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
684.65
799.44
510.84
288.60
102.67
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1540.48
1798.77
1184.02
614.75
212.46
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1472.01
1718.82
1092.26
626.56
221.14
Kentucky Humana Health Plan of Ohio, Inc. - High Self
A61
1172.64
1500.98
510.84
990.14
316.22
Kentucky Humana Health Plan of Ohio, Inc. - High Self & Family
A62
2638.48
3377.23
1184.02
2193.21
692.92
Kentucky Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
2521.22
3227.14
1092.26
2134.88
680.25
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self
A64
930.28
1172.17
510.84
661.33
229.77
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2093.17
2637.42
1184.02
1453.40
498.42
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2000.16
2520.20
1092.26
1427.94
494.37
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self
W61
585.78
608.62
456.47
152.15
5.71
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1318.01
1369.44
1027.08
342.36
12.86
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1259.42
1308.58
981.44
327.14
12.29
Kentucky Humana Health Plan, Inc. - High Self
MI1
1123.14
1381.45
510.84
870.61
246.19
Kentucky Humana Health Plan, Inc. - High Self & Family
MI2
2527.03
3108.24
1184.02
1924.22
535.38
Kentucky Humana Health Plan, Inc. - High Self Plus One
MI3
2414.71
2970.09
1092.26
1877.83
529.71
Kentucky Humana Health Plan, Inc. - Standard Self
MI4
811.92
885.00
510.84
374.16
60.96
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MI5
1826.80
1991.21
1184.02
807.19
118.58
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MI6
1745.62
1902.75
1092.26
810.49
131.46
Kentucky Humana Health Plan, Inc. - High Self
MH1
883.98
1104.96
510.84
594.12
208.86
Kentucky Humana Health Plan, Inc. - High Self & Family
MH2
1988.96
2486.19
1184.02
1302.17
451.40
Kentucky Humana Health Plan, Inc. - High Self Plus One
MH3
1900.56
2375.69
1092.26
1283.43
449.46
Kentucky Humana Health Plan, Inc. - Standard Self
MH4
722.39
859.65
510.84
348.81
125.14
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MH5
1625.37
1934.18
1184.02
750.16
262.98
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MH6
1553.13
1848.23
1092.26
755.97
269.43
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
532.16
610.42
457.82
152.60
19.56
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1223.93
1403.98
1052.99
350.99
45.01
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1144.11
1312.42
984.32
328.10
42.07
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
671.95
720.18
510.84
209.34
36.11
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1679.86
1800.48
1184.02
616.46
74.79
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1444.69
1548.41
1092.26
456.15
78.05
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Louisiana Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Louisiana Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Louisiana Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Louisiana Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Louisiana Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Louisiana Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Louisiana Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Louisiana Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
BC4
596.57
674.14
505.61
168.53
19.39
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
BC5
1342.29
1516.80
1137.60
379.20
43.63
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
BC6
1282.62
1449.37
1087.03
362.34
41.69
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
BC1
751.10
901.33
510.84
390.49
138.11
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
BC2
1690.02
2028.02
1184.02
844.00
292.17
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
BC3
1614.90
1937.89
1092.26
845.63
297.32
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
AE1
864.05
1071.42
510.84
560.58
195.25
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
AE2
1944.06
2410.63
1184.02
1226.61
420.74
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
AE3
1857.68
2303.51
1092.26
1211.25
420.16
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
AE4
734.05
807.45
510.84
296.61
61.28
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
AE5
1651.63
1816.79
1184.02
632.77
119.33
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
AE6
1578.22
1736.04
1092.26
643.78
132.15
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Maine Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Maine Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Maine Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Maine Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Maine Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Maine Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Maine Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Maine Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Maine Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Maryland Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Maryland Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Maryland Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Maryland Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Maryland Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Maryland Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Maryland Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Maryland Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Maryland Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Maryland Aetna Open Access - High Self
JN1
1119.13
1137.57
510.84
626.73
6.32
Maryland Aetna Open Access - High Self & Family
JN2
2515.98
2557.43
1184.02
1373.41
-4.38
Maryland Aetna Open Access - High Self Plus One
JN3
2491.04
2532.10
1092.26
1439.84
15.39
Maryland Aetna Open Access - Basic Self
JN4
680.46
697.10
510.84
186.26
4.52
Maryland Aetna Open Access - Basic Self & Family
JN5
1557.25
1595.34
1184.02
411.32
-7.74
Maryland Aetna Open Access - Basic Self Plus One
JN6
1430.00
1464.99
1092.26
372.73
9.32
Maryland Aetna Saver - Saver Self
QQ4
New Plan
595.21
446.41
148.80
New Plan
Maryland Aetna Saver - Saver Self & Family
QQ5
New Plan
1362.14
1021.61
340.53
New Plan
Maryland Aetna Saver - Saver Self Plus One
QQ6
New Plan
1250.82
938.12
312.70
New Plan
Maryland CareFirst BlueChoice - Standard Self
2G4
797.68
845.54
510.84
334.70
35.74
Maryland CareFirst BlueChoice - Standard Self & Family
2G5
1895.25
2008.96
1184.02
824.94
67.88
Maryland CareFirst BlueChoice - Standard Self Plus One
2G6
1595.34
1691.06
1092.26
598.80
70.05
Maryland CareFirst BlueChoice - HDHP Self
B61
518.27
570.09
427.57
142.52
12.95
Maryland CareFirst BlueChoice - HDHP Self & Family
B62
1231.38
1354.51
1015.88
338.63
30.79
Maryland CareFirst BlueChoice - HDHP Self Plus One
B63
1036.51
1140.17
855.13
285.04
25.91
Maryland CareFirst BlueChoice - Blue Value Plus Self
B64
New Plan
705.99
510.84
195.15
New Plan
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family
B65
New Plan
1677.46
1184.02
493.44
New Plan
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
New Plan
1412.02
1059.02
353.00
New Plan
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self
T71
420.12
420.12
315.09
105.03
0.00
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self & Family
T72
1026.16
1026.16
769.62
256.54
0.00
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self Plus One
T73
934.90
934.90
701.18
233.72
0.00
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self
E34
521.76
571.55
428.66
142.89
12.45
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self & Family
E35
1199.99
1314.50
985.88
328.62
28.62
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self Plus One
E36
1199.99
1314.50
985.88
328.62
28.62
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self
E31
692.68
722.82
510.84
211.98
18.02
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self & Family
E32
1593.15
1662.53
1184.02
478.51
23.55
Maryland Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self Plus One
E33
1593.15
1662.53
1092.26
570.27
43.71
Maryland M.D. IPA - High Self
JP1
790.86
876.61
510.84
365.77
73.63
Maryland M.D. IPA - High Self & Family
JP2
2217.54
2458.04
1184.02
1274.02
194.67
Maryland M.D. IPA - High Self Plus One
JP3
1544.53
1712.04
1092.26
619.78
141.84
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
495.69
486.57
364.93
121.64
-2.28
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1140.06
1119.11
839.33
279.78
-5.23
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1065.72
1046.13
784.60
261.53
-4.90
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
667.94
714.89
510.84
204.05
34.83
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1582.99
1694.29
1184.02
510.27
65.47
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1436.05
1536.99
1092.26
444.73
75.27
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
437.06
521.50
391.13
130.37
21.11
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1225.49
1462.26
1096.70
365.56
59.19
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
853.56
1018.46
763.85
254.61
41.22
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Massachusetts Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Massachusetts Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Massachusetts Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Massachusetts Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Massachusetts Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Massachusetts Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Massachusetts Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Michigan Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Michigan Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Michigan Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Michigan Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Michigan Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Michigan Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Michigan Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Michigan Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Michigan Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Michigan Blue Care Network of Michigan - High Self
LX1
734.72
742.86
510.84
232.02
-3.98
Michigan Blue Care Network of Michigan - High Self & Family
LX2
1792.64
1812.59
1184.02
628.57
-25.88
Michigan Blue Care Network of Michigan - High Self Plus One
LX3
1689.81
1708.57
1092.26
616.31
-6.91
Michigan Blue Care Network of Michigan - High Self
K51
943.45
957.73
510.84
446.89
2.16
Michigan Blue Care Network of Michigan - High Self & Family
K52
2301.95
2336.82
1184.02
1152.80
-10.96
Michigan Blue Care Network of Michigan - High Self Plus One
K53
2169.90
2202.72
1092.26
1110.46
7.15
Michigan Health Alliance Plan - High Self
521
763.84
787.89
510.84
277.05
11.93
Michigan Health Alliance Plan - High Self & Family
522
1863.72
1922.44
1184.02
738.42
12.89
Michigan Health Alliance Plan - High Self Plus One
523
1756.82
1812.14
1092.26
719.88
29.65
Michigan Health Alliance Plan - Standard Self
GY4
598.35
614.23
460.67
153.56
3.97
Michigan Health Alliance Plan - Standard Self & Family
GY5
1460.01
1498.77
1124.08
374.69
9.69
Michigan Health Alliance Plan - Standard Self Plus One
GY6
1376.22
1412.78
1059.59
353.19
9.14
Michigan Priority Health - High Self
LE1
912.10
919.58
510.84
408.74
-4.64
Michigan Priority Health - High Self & Family
LE2
2143.44
2161.01
1184.02
976.99
-28.26
Michigan Priority Health - High Self Plus One
LE3
2006.64
2023.06
1092.26
930.80
-9.25
Michigan Priority Health - Standard Self
LE4
504.44
539.33
404.50
134.83
8.72
Michigan Priority Health - Standard Self & Family
LE5
1185.45
1267.44
950.58
316.86
20.50
Michigan Priority Health - Standard Self Plus One
LE6
1109.79
1186.53
889.90
296.63
19.18
Michigan Priority Health - Value Self
Y41
New Plan
473.24
354.93
118.31
New Plan
Michigan Priority Health - Value Self & Family
Y42
New Plan
1112.13
834.10
278.03
New Plan
Michigan Priority Health - Value Self Plus One
Y43
New Plan
1041.13
780.85
260.28
New Plan
Minnesota Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Minnesota Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Minnesota Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Minnesota Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Minnesota Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Minnesota Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Minnesota Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Minnesota Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Minnesota HealthPartners - Standard Self
V34
428.09
459.92
344.94
114.98
7.96
Minnesota HealthPartners - Standard Self & Family
V35
1042.82
1120.41
840.31
280.10
19.40
Minnesota HealthPartners - Standard Self Plus One
V36
946.08
1016.45
762.34
254.11
17.59
Minnesota HealthPartners - High Self
V31
790.31
712.31
510.84
201.47
-90.12
Minnesota HealthPartners - High Self & Family
V32
1925.21
1735.20
1184.02
551.18
-235.84
Minnesota HealthPartners - High Self Plus One
V33
1746.57
1574.21
1092.26
481.95
-198.03
Mississippi Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Mississippi Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Mississippi Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Mississippi Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Mississippi Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Mississippi Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Mississippi Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Mississippi Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Missouri Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Missouri Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Missouri Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Missouri Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Missouri Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Missouri Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Missouri Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Missouri Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Missouri Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Missouri Aetna Open Access - High Self
HA1
881.01
1099.93
510.84
589.09
206.80
Missouri Aetna Open Access - High Self & Family
HA2
2081.11
2598.18
1184.02
1414.16
471.24
Missouri Aetna Open Access - High Self Plus One
HA3
2060.54
2572.53
1092.26
1480.27
486.32
Missouri Aetna Open Access - Standard Self
HA4
707.85
716.37
510.84
205.53
-3.60
Missouri Aetna Open Access - Standard Self & Family
HA5
1670.78
1690.89
1184.02
506.87
-25.72
Missouri Aetna Open Access - Standard Self Plus One
HA6
1654.25
1674.16
1092.26
581.90
-5.76
Missouri Blue Preferred - High Self
9G1
782.36
833.21
510.84
322.37
38.73
Missouri Blue Preferred - High Self & Family
9G2
1681.07
1858.87
1184.02
674.85
131.97
Missouri Blue Preferred - High Self Plus One
9G3
1591.81
1760.59
1092.26
668.33
143.11
Missouri Blue Preferred - Standard Self
9G4
558.72
600.62
450.47
150.15
10.47
Missouri Blue Preferred - Standard Self & Family
9G5
1587.91
1707.01
1184.02
522.99
73.27
Missouri Blue Preferred - Standard Self Plus One
9G6
1436.02
1543.71
1092.26
451.45
82.02
Missouri Humana CoverageFirst and Humana Value Plan - Value Self
PH4
428.35
484.03
363.02
121.01
13.92
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
963.82
1089.10
816.83
272.27
31.32
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
920.96
1040.67
780.50
260.17
29.93
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
600.95
715.11
510.84
204.27
54.03
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1352.13
1609.03
1184.02
425.01
86.98
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1292.05
1537.51
1092.26
445.25
122.24
Missouri Humana Health Plan, Inc. - High Self
MS1
1625.63
1723.17
510.84
1212.33
85.42
Missouri Humana Health Plan, Inc. - High Self & Family
MS2
3657.66
3877.12
1184.02
2693.10
173.63
Missouri Humana Health Plan, Inc. - High Self Plus One
MS3
3495.09
3704.81
1092.26
2612.55
184.05
Missouri Humana Health Plan, Inc. - Standard Self
MS4
952.77
1067.00
510.84
556.16
102.11
Missouri Humana Health Plan, Inc. - Standard Self & Family
MS5
2143.79
2400.78
1184.02
1216.76
211.16
Missouri Humana Health Plan, Inc. - Standard Self Plus One
MS6
2048.50
2294.09
1092.26
1201.83
219.92
Missouri UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Montana Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Montana Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Montana Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Montana Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Montana Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Montana Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Montana Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Montana Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Montana Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Nebraska Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Nebraska Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Nebraska Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Nebraska Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Nebraska Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Nebraska Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Nebraska Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Nebraska Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Nevada Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Nevada Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Nevada Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Nevada Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Nevada Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Nevada Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Nevada Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Nevada Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Nevada Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Nevada Health Plan of Nevada, Inc. - High Self
NM1
658.54
706.98
510.84
196.14
31.51
Nevada Health Plan of Nevada, Inc. - High Self & Family
NM2
1560.67
1675.48
1184.02
491.46
68.98
Nevada Health Plan of Nevada, Inc. - High Self Plus One
NM3
1251.25
1343.29
1007.47
335.82
23.01
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
450.32
443.84
332.88
110.96
-1.62
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1035.73
1020.85
765.64
255.21
-3.72
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
968.20
954.27
715.70
238.57
-3.48
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
679.19
724.77
510.84
213.93
33.46
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1697.95
1811.90
1184.02
627.88
68.12
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1460.23
1558.25
1092.26
465.99
72.35
Nevada UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
WF1
New Plan
522.86
392.15
130.71
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
WF2
New Plan
1236.39
927.29
309.10
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
WF3
New Plan
1124.05
843.04
281.01
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
VD1
New Plan
522.02
391.52
130.50
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
VD2
New Plan
1234.37
925.78
308.59
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
VD3
New Plan
1122.23
841.67
280.56
New Plan
New Hampshire Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
New Hampshire Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
New Hampshire Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
New Hampshire Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
New Hampshire Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
New Hampshire Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
New Hampshire Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
New Jersey Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
New Jersey Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
New Jersey Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
New Jersey Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
New Jersey Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
New Jersey Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
New Jersey Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
New Jersey Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
New Jersey Aetna Open Access - High Self
JR1
1409.79
1544.75
510.84
1033.91
122.84
New Jersey Aetna Open Access - High Self & Family
JR2
3256.46
3568.20
1184.02
2384.18
265.91
New Jersey Aetna Open Access - High Self Plus One
JR3
3224.20
3532.84
1092.26
2440.58
282.97
New Jersey Aetna Open Access - Basic Self
JR4
1163.41
1373.28
510.84
862.44
197.75
New Jersey Aetna Open Access - Basic Self & Family
JR5
2696.33
3182.68
1184.02
1998.66
440.52
New Jersey Aetna Open Access - Basic Self Plus One
JR6
2669.62
3151.16
1092.26
2058.90
455.87
New Jersey Aetna Open Access - Basic Self
P34
1298.46
1310.08
510.84
799.24
-0.50
New Jersey Aetna Open Access - Basic Self & Family
P35
3013.75
3040.68
1184.02
1856.66
-18.90
New Jersey Aetna Open Access - Basic Self Plus One
P36
2983.89
3010.54
1092.26
1918.28
0.98
New Jersey Aetna Open Access - High Self
P31
1485.21
1456.61
510.84
945.77
-40.72
New Jersey Aetna Open Access - High Self & Family
P32
3600.91
3531.54
1184.02
2347.52
-115.20
New Jersey Aetna Open Access - High Self Plus One
P33
3565.25
3496.55
1092.26
2404.29
-94.37
New Jersey GHI Health Plan - Standard Self
804
925.97
1004.66
510.84
493.82
66.57
New Jersey GHI Health Plan - Standard Self & Family
805
2246.47
2437.41
1184.02
1253.39
145.11
New Jersey GHI Health Plan - Standard Self Plus One
806
2153.84
2336.92
1092.26
1244.66
157.41
New Jersey GHI Health Plan - HDHP Self
811
New Plan
676.35
507.26
169.09
New Plan
New Jersey GHI Health Plan - HDHP Self & Family
812
New Plan
1478.71
1109.03
369.68
New Plan
New Jersey GHI Health Plan - HDHP Self Plus One
813
New Plan
1450.09
1087.57
362.52
New Plan
New Mexico Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
New Mexico Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
New Mexico Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
New Mexico Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
New Mexico Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
New Mexico Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
New Mexico Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
New Mexico Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
New Mexico Presbyterian Health Plan - High Self
P21
740.31
840.99
510.84
330.15
88.56
New Mexico Presbyterian Health Plan - High Self & Family
P22
1739.75
1976.30
1184.02
792.28
190.72
New Mexico Presbyterian Health Plan - High Self Plus One
P23
1680.53
1909.03
1092.26
816.77
202.83
New Mexico Presbyterian Health Plan - Standard Self
PS4
622.66
710.28
510.84
199.44
43.78
New Mexico Presbyterian Health Plan - Standard Self & Family
PS5
1463.28
1669.16
1184.02
485.14
119.32
New Mexico Presbyterian Health Plan - Standard Self Plus One
PS6
1413.45
1612.35
1092.26
520.09
166.73
New Mexico Presbyterian Health Plan - Wellness Self
PS1
New Plan
619.88
464.91
154.97
New Plan
New Mexico Presbyterian Health Plan - Wellness Self & Family
PS2
New Plan
1456.76
1092.57
364.19
New Plan
New Mexico Presbyterian Health Plan - Wellness Self Plus One
PS3
New Plan
1407.19
1055.39
351.80
New Plan
New Mexico True Health New Mexico - High Self
EL1
New Plan
620.17
465.13
155.04
New Plan
New Mexico True Health New Mexico - High Self & Family
EL2
New Plan
1464.47
1098.35
366.12
New Plan
New Mexico True Health New Mexico - High Self Plus One
EL3
New Plan
1388.03
1041.02
347.01
New Plan
New York Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
New York Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
New York Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
New York Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
New York Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
New York Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
New York Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
New York Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
New York Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
New York Aetna Open Access - High Self
JC1
1303.06
1320.37
510.84
809.53
5.19
New York Aetna Open Access - High Self & Family
JC2
3219.84
3262.57
1184.02
2078.55
-3.10
New York Aetna Open Access - High Self Plus One
JC3
3187.99
3230.26
1092.26
2138.00
16.60
New York Aetna Open Access - Basic Self
JC4
1063.21
1102.42
510.84
591.58
27.09
New York Aetna Open Access - Basic Self & Family
JC5
2593.37
2689.03
1184.02
1505.01
49.83
New York Aetna Open Access - Basic Self Plus One
JC6
2567.72
2662.44
1092.26
1570.18
69.05
New York CDPHP - Standard Self
SG4
577.57
629.61
472.21
157.40
13.01
New York CDPHP - Standard Self & Family
SG5
1732.66
1792.64
1184.02
608.62
14.15
New York CDPHP - Standard Self Plus One
SG6
1155.14
1303.25
977.44
325.81
37.03
New York CDPHP - High Self
SG1
870.29
991.25
510.84
480.41
108.84
New York CDPHP - High Self & Family
SG2
2610.55
2825.05
1184.02
1641.03
168.67
New York CDPHP - High Self Plus One
SG3
1740.55
2051.88
1092.26
959.62
285.66
New York GHI Health Plan - Standard Self
804
925.97
1004.66
510.84
493.82
66.57
New York GHI Health Plan - Standard Self & Family
805
2246.47
2437.41
1184.02
1253.39
145.11
New York GHI Health Plan - Standard Self Plus One
806
2153.84
2336.92
1092.26
1244.66
157.41
New York GHI Health Plan - HDHP Self
811
New Plan
676.35
507.26
169.09
New Plan
New York GHI Health Plan - HDHP Self & Family
812
New Plan
1478.71
1109.03
369.68
New Plan
New York GHI Health Plan - HDHP Self Plus One
813
New Plan
1450.09
1087.57
362.52
New Plan
New York HIP of Greater NY - Standard Self
YL4
658.60
813.87
510.84
303.03
138.38
New York HIP of Greater NY - Standard Self & Family
YL5
1884.68
2339.98
1184.02
1155.96
409.47
New York HIP of Greater NY - Standard Self Plus One
YL6
1169.22
1480.25
1092.26
387.99
95.69
New York HIP of Greater NY - High Self
511
985.36
1071.05
510.84
560.21
73.57
New York HIP of Greater NY - High Self & Family
512
2821.39
3081.98
1184.02
1897.96
214.76
New York HIP of Greater NY - High Self Plus One
513
1755.46
1948.55
1092.26
856.29
167.42
New York Independent Health - Standard Self
C54
701.83
711.62
510.84
200.78
-2.33
New York Independent Health - Standard Self & Family
C55
1894.95
1921.38
1184.02
737.36
-19.40
New York Independent Health - Standard Self Plus One
C56
1789.65
1814.61
1092.26
722.35
-0.71
New York Independent Health - High Self
QA1
727.63
762.67
510.84
251.83
22.92
New York Independent Health - High Self & Family
QA2
1964.56
2059.18
1184.02
875.16
48.79
New York Independent Health - High Self Plus One
QA3
1855.43
1944.80
1092.26
852.54
63.70
New York Independent Health - HDHP Self
QA4
590.57
592.87
444.65
148.22
0.58
New York Independent Health - HDHP Self & Family
QA5
1524.84
1533.13
1149.85
383.28
-3.37
New York Independent Health - HDHP Self Plus One
QA6
1421.20
1429.61
1072.21
357.40
2.10
North Carolina Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
North Carolina Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
North Carolina Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
North Carolina Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
North Carolina Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
North Carolina Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
North Carolina Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
North Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
North Dakota Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
North Dakota Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
North Dakota Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
North Dakota Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
North Dakota Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
North Dakota Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
North Dakota Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
North Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
North Dakota HealthPartners - Standard Self
V34
428.09
459.92
344.94
114.98
7.96
North Dakota HealthPartners - Standard Self & Family
V35
1042.82
1120.41
840.31
280.10
19.40
North Dakota HealthPartners - Standard Self Plus One
V36
946.08
1016.45
762.34
254.11
17.59
North Dakota HealthPartners - High Self
V31
790.31
712.31
510.84
201.47
-90.12
North Dakota HealthPartners - High Self & Family
V32
1925.21
1735.20
1184.02
551.18
-235.84
North Dakota HealthPartners - High Self Plus One
V33
1746.57
1574.21
1092.26
481.95
-198.03
Ohio Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Ohio Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Ohio Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Ohio Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Ohio Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Ohio Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Ohio Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Ohio Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Ohio Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Ohio AultCare Insurance Company - High Self
3A1
769.49
842.03
510.84
331.19
60.42
Ohio AultCare Insurance Company - High Self & Family
3A2
1900.67
2079.78
1184.02
895.76
133.28
Ohio AultCare Insurance Company - High Self Plus One
3A3
1615.94
1768.24
1092.26
675.98
126.63
Ohio AultCare Insurance Company - HDHP Self
3A4
373.25
437.62
328.22
109.40
16.09
Ohio AultCare Insurance Company - HDHP Self & Family
3A5
1194.33
1401.25
1050.94
350.31
51.73
Ohio AultCare Insurance Company - HDHP Self Plus One
3A6
709.13
831.96
623.97
207.99
30.71
Ohio Humana CoverageFirst and Humana Value Plan - Value Self
X34
570.27
615.12
461.34
153.78
11.21
Ohio Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1283.12
1384.05
1038.04
346.01
25.23
Ohio Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1226.07
1322.53
991.90
330.63
24.11
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
684.65
799.44
510.84
288.60
102.67
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1540.48
1798.77
1184.02
614.75
212.46
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1472.01
1718.82
1092.26
626.56
221.14
Ohio Humana Health Plan of Ohio, Inc. - High Self
A61
1172.64
1500.98
510.84
990.14
316.22
Ohio Humana Health Plan of Ohio, Inc. - High Self & Family
A62
2638.48
3377.23
1184.02
2193.21
692.92
Ohio Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
2521.22
3227.14
1092.26
2134.88
680.25
Ohio Humana Health Plan of Ohio, Inc. - Standard Self
A64
930.28
1172.17
510.84
661.33
229.77
Ohio Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2093.17
2637.42
1184.02
1453.40
498.42
Ohio Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2000.16
2520.20
1092.26
1427.94
494.37
Ohio Humana Health Plan of Ohio, Inc. - Basic Self
W61
585.78
608.62
456.47
152.15
5.71
Ohio Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1318.01
1369.44
1027.08
342.36
12.86
Ohio Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1259.42
1308.58
981.44
327.14
12.29
Ohio Medical Mutual of Ohio - Standard Self
644
857.76
1027.78
510.84
516.94
157.90
Ohio Medical Mutual of Ohio - Standard Self & Family
645
2058.62
2466.71
1184.02
1282.69
362.26
Ohio Medical Mutual of Ohio - Standard Self Plus One
646
1887.04
2261.16
1092.26
1168.90
348.45
Ohio Medical Mutual of Ohio - Standard Self
X64
805.96
849.42
510.84
338.58
31.34
Ohio Medical Mutual of Ohio - Standard Self & Family
X65
1934.29
2038.60
1184.02
854.58
58.48
Ohio Medical Mutual of Ohio - Standard Self Plus One
X66
1773.07
1868.71
1092.26
776.45
69.97
Ohio Medical Mutual of Ohio - Basic Self
X61
461.72
439.99
329.99
110.00
-5.43
Ohio Medical Mutual of Ohio - Basic Self & Family
X62
1108.12
1055.95
791.96
263.99
-13.04
Ohio Medical Mutual of Ohio - Basic Self Plus One
X63
1015.78
967.96
725.97
241.99
-11.95
Ohio Medical Mutual of Ohio - Basic Self
UX1
482.56
440.14
330.11
110.03
-10.61
Ohio Medical Mutual of Ohio - Basic Self & Family
UX2
1158.15
1056.34
792.26
264.08
-25.46
Ohio Medical Mutual of Ohio - Basic Self Plus One
UX3
1061.65
968.33
726.25
242.08
-23.33
Ohio Medical Mutual of Ohio - Basic Self
YF1
490.56
440.14
330.11
110.03
-12.61
Ohio Medical Mutual of Ohio - Basic Self & Family
YF2
1177.37
1056.34
792.26
264.08
-30.26
Ohio Medical Mutual of Ohio - Basic Self Plus One
YF3
1079.26
968.33
726.25
242.08
-27.73
Ohio Medical Mutual of Ohio - Standard Self
YF4
919.84
968.98
510.84
458.14
37.02
Ohio Medical Mutual of Ohio - Standard Self & Family
YF5
2207.60
2325.55
1184.02
1141.53
72.12
Ohio Medical Mutual of Ohio - Standard Self Plus One
YF6
2023.60
2131.74
1092.26
1039.48
82.47
Oklahoma Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Oklahoma Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Oklahoma Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Oklahoma Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Oklahoma Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Oklahoma Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Oklahoma Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Oklahoma GlobalHealth - Standard Self
IM4
602.16
622.94
467.21
155.73
5.19
Oklahoma GlobalHealth - Standard Self & Family
IM5
1505.40
1557.38
1168.04
389.34
12.99
Oklahoma GlobalHealth - Standard Self Plus One
IM6
1204.32
1245.90
934.43
311.47
10.39
Oklahoma GlobalHealth - High Self
IM1
619.00
659.27
494.45
164.82
10.07
Oklahoma GlobalHealth - High Self & Family
IM2
1547.52
1648.16
1184.02
464.14
54.81
Oklahoma GlobalHealth - High Self Plus One
IM3
1238.01
1318.53
988.90
329.63
20.13
Oregon Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Oregon Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Oregon Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Oregon Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Oregon Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Oregon Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Oregon Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Oregon Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Oregon Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Oregon Kaiser Foundation Health Plan of the Northwest - Standard Self
574
620.30
647.96
485.97
161.99
6.92
Oregon Kaiser Foundation Health Plan of the Northwest - Standard Self & Family
575
1425.00
1488.54
1116.41
372.13
15.88
Oregon Kaiser Foundation Health Plan of the Northwest - Standard Self Plus One
576
1425.00
1488.54
1092.26
396.28
37.87
Oregon Kaiser Foundation Health Plan of the Northwest - High Self
571
706.68
729.93
510.84
219.09
11.13
Oregon Kaiser Foundation Health Plan of the Northwest - High Self & Family
572
1596.16
1648.70
1184.02
464.68
6.71
Oregon Kaiser Foundation Health Plan of the Northwest - High Self Plus One
573
1596.16
1648.70
1092.26
556.44
26.87
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
450.32
443.84
332.88
110.96
-1.62
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1035.73
1020.85
765.64
255.21
-3.72
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
968.20
954.27
715.70
238.57
-3.48
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
679.19
724.77
510.84
213.93
33.46
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1697.95
1811.90
1184.02
627.88
68.12
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1460.23
1558.25
1092.26
465.99
72.35
Oregon UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
WF1
New Plan
522.86
392.15
130.71
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
WF2
New Plan
1236.39
927.29
309.10
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
WF3
New Plan
1124.05
843.04
281.01
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
VD1
New Plan
522.02
391.52
130.50
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
VD2
New Plan
1234.37
925.78
308.59
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
VD3
New Plan
1122.23
841.67
280.56
New Plan
Pennsylvania Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Pennsylvania Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Pennsylvania Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Pennsylvania Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Pennsylvania Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Pennsylvania Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Pennsylvania Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Pennsylvania Aetna Open Access - High Self
YE1
938.12
1215.13
510.84
704.29
264.89
Pennsylvania Aetna Open Access - High Self & Family
YE2
2355.62
3051.19
1184.02
1867.17
649.74
Pennsylvania Aetna Open Access - High Self Plus One
YE3
2332.29
3020.98
1092.26
1928.72
663.02
Pennsylvania Aetna Open Access - Basic Self
P34
1298.46
1310.08
510.84
799.24
-0.50
Pennsylvania Aetna Open Access - Basic Self & Family
P35
3013.75
3040.68
1184.02
1856.66
-18.90
Pennsylvania Aetna Open Access - Basic Self Plus One
P36
2983.89
3010.54
1092.26
1918.28
0.98
Pennsylvania Aetna Open Access - High Self
P31
1485.21
1456.61
510.84
945.77
-40.72
Pennsylvania Aetna Open Access - High Self & Family
P32
3600.91
3531.54
1184.02
2347.52
-115.20
Pennsylvania Aetna Open Access - High Self Plus One
P33
3565.25
3496.55
1092.26
2404.29
-94.37
Pennsylvania Geisinger Health Plan - Standard Self
GG4
729.17
822.73
510.84
311.89
81.44
Pennsylvania Geisinger Health Plan - Standard Self & Family
GG5
1669.46
1883.68
1184.02
699.66
168.39
Pennsylvania Geisinger Health Plan - Standard Self Plus One
GG6
1575.54
1777.71
1092.26
685.45
176.50
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
495.69
486.57
364.93
121.64
-2.28
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1140.06
1119.11
839.33
279.78
-5.23
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1065.72
1046.13
784.60
261.53
-4.90
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
667.94
714.89
510.84
204.05
34.83
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1582.99
1694.29
1184.02
510.27
65.47
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1436.05
1536.99
1092.26
444.73
75.27
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Pennsylvania UPMC Health Plan - Standard Self
YT4
New Plan
904.09
510.84
393.25
New Plan
Pennsylvania UPMC Health Plan - Standard Self & Family
YT5
New Plan
2121.97
1184.02
937.95
New Plan
Pennsylvania UPMC Health Plan - Standard Self Plus One
YT6
New Plan
2032.46
1092.26
940.20
New Plan
Pennsylvania UPMC Health Plan - HDHP Self
YS4
New Plan
775.80
510.84
264.96
New Plan
Pennsylvania UPMC Health Plan - HDHP Self & Family
YS5
New Plan
1791.05
1184.02
607.03
New Plan
Pennsylvania UPMC Health Plan - HDHP Self Plus One
YS6
New Plan
1721.72
1092.26
629.46
New Plan
Pennsylvania UPMC Health Plan - High Self
YS1
New Plan
1142.35
510.84
631.51
New Plan
Pennsylvania UPMC Health Plan - High Self & Family
YS2
New Plan
2684.87
1184.02
1500.85
New Plan
Pennsylvania UPMC Health Plan - High Self Plus One
YS3
New Plan
2570.69
1092.26
1478.43
New Plan
Pennsylvania UPMC Health Plan - HDHP Self
8W4
573.58
610.63
457.97
152.66
9.27
Pennsylvania UPMC Health Plan - HDHP Self & Family
8W5
1317.59
1405.00
1053.75
351.25
21.85
Pennsylvania UPMC Health Plan - HDHP Self Plus One
8W6
1268.04
1351.63
1013.72
337.91
20.90
Pennsylvania UPMC Health Plan - High Self
8W1
872.78
936.39
510.84
425.55
51.49
Pennsylvania UPMC Health Plan - High Self & Family
8W2
2051.31
2200.84
1184.02
1016.82
103.70
Pennsylvania UPMC Health Plan - High Self Plus One
8W3
1964.13
2107.28
1092.26
1015.02
117.48
Pennsylvania UPMC Health Plan - Standard Self
UW4
651.86
673.68
505.26
168.42
5.46
Pennsylvania UPMC Health Plan - Standard Self & Family
UW5
1523.80
1580.74
1184.02
396.72
11.11
Pennsylvania UPMC Health Plan - Standard Self Plus One
UW6
1459.27
1514.20
1092.26
421.94
29.26
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self
ZJ1
365.11
390.24
292.68
97.56
6.28
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self & Family
ZJ2
821.49
878.06
658.55
219.51
14.14
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self Plus One
ZJ3
784.98
839.02
629.27
209.75
13.51
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self
891
407.38
390.04
292.53
97.51
-4.33
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self & Family
892
932.88
893.21
669.91
223.30
-9.92
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self Plus One
893
914.70
875.79
656.84
218.95
-9.72
Rhode Island Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Rhode Island Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Rhode Island Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Rhode Island Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Rhode Island Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Rhode Island Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Rhode Island Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
South Carolina Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
South Carolina Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
South Carolina Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
South Carolina Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
South Carolina Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
South Carolina Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
South Carolina Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
South Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
South Dakota Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
South Dakota Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
South Dakota Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
South Dakota Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
South Dakota Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
South Dakota Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
South Dakota Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
South Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
South Dakota HealthPartners - Standard Self
V34
428.09
459.92
344.94
114.98
7.96
South Dakota HealthPartners - Standard Self & Family
V35
1042.82
1120.41
840.31
280.10
19.40
South Dakota HealthPartners - Standard Self Plus One
V36
946.08
1016.45
762.34
254.11
17.59
South Dakota HealthPartners - High Self
V31
790.31
712.31
510.84
201.47
-90.12
South Dakota HealthPartners - High Self & Family
V32
1925.21
1735.20
1184.02
551.18
-235.84
South Dakota HealthPartners - High Self Plus One
V33
1746.57
1574.21
1092.26
481.95
-198.03
Tennessee Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Tennessee Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Tennessee Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Tennessee Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Tennessee Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Tennessee Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Tennessee Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Tennessee Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Tennessee Aetna Open Access - High Self
UB1
994.83
1061.19
510.84
550.35
54.24
Tennessee Aetna Open Access - High Self & Family
UB2
2549.26
2719.30
1184.02
1535.28
124.21
Tennessee Aetna Open Access - High Self Plus One
UB3
2524.06
2692.41
1092.26
1600.15
142.68
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self
TT1
665.45
745.31
510.84
234.47
67.74
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TT2
1497.30
1676.98
1184.02
492.96
118.64
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TT3
1430.76
1602.45
1092.26
510.19
146.02
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self
TT4
537.77
682.96
510.84
172.12
37.68
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self & Family
TT5
1209.93
1536.62
1152.47
384.15
81.67
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TT6
1156.16
1468.31
1092.26
376.05
87.01
Tennessee Humana Health Plan, Inc. - High Self
GJ1
963.76
1175.79
510.84
664.95
199.91
Tennessee Humana Health Plan, Inc. - High Self & Family
GJ2
2168.38
2645.44
1184.02
1461.42
431.23
Tennessee Humana Health Plan, Inc. - High Self Plus One
GJ3
2072.01
2527.85
1092.26
1435.59
430.17
Tennessee Humana Health Plan, Inc. - Standard Self
GJ4
815.62
870.13
510.84
359.29
42.39
Tennessee Humana Health Plan, Inc. - Standard Self & Family
GJ5
1835.12
1957.78
1184.02
773.76
76.83
Tennessee Humana Health Plan, Inc. - Standard Self Plus One
GJ6
1753.55
1870.77
1092.26
778.51
91.55
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
418.71
454.74
341.06
113.68
9.00
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
963.08
1045.92
784.44
261.48
20.71
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
900.25
977.71
733.28
244.43
19.37
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
679.03
713.87
510.84
203.03
22.72
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1697.63
1784.71
1184.02
600.69
41.25
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1459.94
1534.87
1092.26
442.61
49.26
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Texas Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Texas Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Texas Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Texas Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Texas Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Texas Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Texas Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Texas Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Texas Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Texas Humana CoverageFirst and Humana Value Plan - Value Self
T34
498.25
528.17
396.13
132.04
7.48
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
T35
1121.08
1188.33
891.25
297.08
16.81
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
T36
1071.27
1135.53
851.65
283.88
16.06
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
T31
654.10
758.75
510.84
247.91
84.39
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
T32
1471.69
1707.16
1184.02
523.14
155.22
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
T33
1406.30
1631.33
1092.26
539.07
187.50
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TV1
707.59
842.03
510.84
331.19
122.32
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TV2
1592.09
1894.60
1184.02
710.58
256.68
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TV3
1521.35
1810.40
1092.26
718.14
263.38
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TV4
579.13
665.99
499.49
166.50
21.72
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TV5
1303.06
1498.51
1123.88
374.63
48.87
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TV6
1245.14
1431.93
1073.95
357.98
46.70
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TU4
508.63
527.71
395.78
131.93
4.77
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TU5
1144.39
1187.38
890.54
296.84
10.74
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TU6
1093.56
1134.62
850.97
283.65
10.26
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TU1
639.38
645.78
484.34
161.44
1.60
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TU2
1438.65
1453.01
1089.76
363.25
3.59
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TU3
1374.69
1388.44
1041.33
347.11
3.44
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TP1
591.48
721.61
510.84
210.77
62.90
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TP2
1330.83
1623.61
1184.02
439.59
106.88
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TP3
1271.70
1551.49
1092.26
459.23
141.31
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TP4
398.93
422.87
317.15
105.72
5.99
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TP5
897.59
951.45
713.59
237.86
13.46
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TP6
857.72
909.18
681.89
227.29
12.86
Texas Humana Health Plan of Texas - Standard Self
UC4
799.87
839.87
510.84
329.03
27.88
Texas Humana Health Plan of Texas - Standard Self & Family
UC5
1799.70
1889.66
1184.02
705.64
44.13
Texas Humana Health Plan of Texas - Standard Self Plus One
UC6
1719.71
1805.68
1092.26
713.42
60.30
Texas Humana Health Plan of Texas - High Self
UC1
977.93
1095.27
510.84
584.43
105.22
Texas Humana Health Plan of Texas - High Self & Family
UC2
2200.36
2464.41
1184.02
1280.39
218.22
Texas Humana Health Plan of Texas - High Self Plus One
UC3
2102.56
2354.86
1092.26
1262.60
226.63
Texas Humana Health Plan of Texas - Basic Self
QX1
619.21
749.26
510.84
238.42
83.62
Texas Humana Health Plan of Texas - Basic Self & Family
QX2
1393.21
1685.84
1184.02
501.82
153.52
Texas Humana Health Plan of Texas - Basic Self Plus One
QX3
1331.29
1610.92
1092.26
518.66
185.84
Texas Humana Health Plan of Texas - Standard Self
EW4
774.00
835.92
510.84
325.08
49.80
Texas Humana Health Plan of Texas - Standard Self & Family
EW5
1741.48
1880.82
1184.02
696.80
93.51
Texas Humana Health Plan of Texas - Standard Self Plus One
EW6
1664.09
1797.21
1092.26
704.95
107.45
Texas Humana Health Plan of Texas - High Self
EW1
1029.06
1131.95
510.84
621.11
90.77
Texas Humana Health Plan of Texas - High Self & Family
EW2
2315.41
2546.94
1184.02
1362.92
185.70
Texas Humana Health Plan of Texas - High Self Plus One
EW3
2212.51
2433.75
1092.26
1341.49
195.57
Texas Humana Health Plan of Texas - Basic Self
QY1
613.67
760.96
510.84
250.12
96.70
Texas Humana Health Plan of Texas - Basic Self & Family
QY2
1380.75
1712.12
1184.02
528.10
182.91
Texas Humana Health Plan of Texas - Basic Self Plus One
QY3
1319.39
1636.05
1092.26
543.79
213.94
Texas Humana Health Plan of Texas - Basic Self
Q21
597.50
734.93
510.84
224.09
74.72
Texas Humana Health Plan of Texas - Basic Self & Family
Q22
1344.35
1653.56
1184.02
469.54
133.45
Texas Humana Health Plan of Texas - Basic Self Plus One
Q23
1284.57
1580.04
1092.26
487.78
166.64
Texas Humana Health Plan of Texas - Basic Self
Q61
588.92
624.26
468.20
156.06
8.83
Texas Humana Health Plan of Texas - Basic Self & Family
Q62
1325.11
1404.61
1053.46
351.15
19.87
Texas Humana Health Plan of Texas - Basic Self Plus One
Q63
1266.20
1342.19
1006.64
335.55
19.00
Texas Humana Health Plan of Texas - Standard Self
UU4
1297.47
1660.77
510.84
1149.93
351.18
Texas Humana Health Plan of Texas - Standard Self & Family
UU5
2919.32
3736.72
1184.02
2552.70
771.57
Texas Humana Health Plan of Texas - Standard Self Plus One
UU6
2789.56
3570.62
1092.26
2478.36
755.39
Texas Humana Health Plan of Texas - High Self
UU1
1471.21
1544.75
510.84
1033.91
61.42
Texas Humana Health Plan of Texas - High Self & Family
UU2
3310.15
3475.66
1184.02
2291.64
119.68
Texas Humana Health Plan of Texas - High Self Plus One
UU3
3163.05
3321.20
1092.26
2228.94
132.48
Texas Humana Health Plan of Texas - Standard Self
UR4
890.89
980.01
510.84
469.17
77.00
Texas Humana Health Plan of Texas - Standard Self & Family
UR5
2004.54
2205.00
1184.02
1020.98
154.63
Texas Humana Health Plan of Texas - Standard Self Plus One
UR6
1915.44
2107.00
1092.26
1014.74
165.89
Texas Humana Health Plan of Texas - High Self
UR1
1291.83
1382.29
510.84
871.45
78.34
Texas Humana Health Plan of Texas - High Self & Family
UR2
2906.65
3110.12
1184.02
1926.10
157.64
Texas Humana Health Plan of Texas - High Self Plus One
UR3
2777.45
2971.91
1092.26
1879.65
168.79
Texas Scott and White Health Plan - Basic Self
A81
605.89
658.10
493.58
164.52
13.05
Texas Scott and White Health Plan - Basic Self & Family
A82
1421.53
1544.21
1158.16
386.05
30.67
Texas Scott and White Health Plan - Basic Self Plus One
A83
1343.01
1458.88
1092.26
366.62
30.87
Texas Scott and White Health Plan - Standard Self
A84
738.68
785.42
510.84
274.58
34.62
Texas Scott and White Health Plan - Standard Self & Family
A85
1733.64
1843.49
1184.02
659.47
64.02
Texas Scott and White Health Plan - Standard Self Plus One
A86
1637.83
1741.59
1092.26
649.33
78.09
Texas Scott and White Health Plan - Basic Self
P81
679.94
678.36
508.77
169.59
-11.63
Texas Scott and White Health Plan - Basic Self & Family
P82
1595.60
1591.89
1184.02
407.87
-49.54
Texas Scott and White Health Plan - Basic Self Plus One
P83
1507.42
1503.93
1092.26
411.67
-29.16
Texas Scott and White Health Plan - Standard Self
P84
826.87
824.94
510.84
314.10
-14.05
Texas Scott and White Health Plan - Standard Self & Family
P85
1940.84
1936.31
1184.02
752.29
-50.36
Texas Scott and White Health Plan - Standard Self Plus One
P86
1833.59
1829.30
1092.26
737.04
-29.96
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
437.06
521.50
391.13
130.37
21.11
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1225.49
1462.26
1096.70
365.56
59.19
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
853.56
1018.46
763.85
254.61
41.22
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Utah Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Utah Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Utah Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Utah Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Utah Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Utah Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Utah Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Utah Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Utah Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Utah Altius Health Plan - High Self
9K1
935.24
1009.06
510.84
498.22
61.70
Utah Altius Health Plan - High Self & Family
9K2
2068.26
2231.52
1184.02
1047.50
117.43
Utah Altius Health Plan - High Self Plus One
9K3
2047.78
2209.42
1092.26
1117.16
135.97
Utah Altius Health Plan - HDHP Self
9K4
506.91
529.23
396.92
132.31
5.58
Utah Altius Health Plan - HDHP Self & Family
9K5
1059.41
1106.04
829.53
276.51
11.66
Utah Altius Health Plan - HDHP Self Plus One
9K6
1038.64
1084.37
813.28
271.09
11.43
Utah Altius Health Plan - Standard Self
DK4
712.44
761.30
510.84
250.46
36.74
Utah Altius Health Plan - Standard Self & Family
DK5
1573.30
1681.23
1184.02
497.21
62.10
Utah Altius Health Plan - Standard Self Plus One
DK6
1557.70
1664.56
1092.26
572.30
81.19
Utah SelectHealth Plan - Standard Self
SF4
619.21
605.00
453.75
151.25
-3.55
Utah SelectHealth Plan - Standard Self & Family
SF5
1411.26
1378.87
1034.15
344.72
-8.09
Utah SelectHealth Plan - Standard Self Plus One
SF6
1411.26
1378.87
1034.15
344.72
-8.09
Utah SelectHealth Plan - HDHP Self
WX1
506.91
527.19
395.39
131.80
5.07
Utah SelectHealth Plan - HDHP Self & Family
WX2
1155.31
1201.53
901.15
300.38
11.55
Utah SelectHealth Plan - HDHP Self Plus One
WX3
1155.31
1201.53
901.15
300.38
11.55
Vermont Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Vermont Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Vermont Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Vermont Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Vermont Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Vermont Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
619.08
759.61
510.84
248.77
94.00
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1417.65
1739.51
1184.02
555.49
201.08
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1389.85
1705.38
1092.26
613.12
265.66
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
916.80
1075.75
510.84
564.91
146.83
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2090.83
2453.32
1184.02
1269.30
316.66
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2070.12
2429.03
1092.26
1336.77
333.24
Vermont Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Vermont Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Vermont Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self
851
659.25
679.03
509.27
169.76
4.95
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self & Family
852
1509.71
1555.02
1166.27
388.75
11.32
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self Plus One
853
1480.27
1524.68
1092.26
432.42
18.74
Virginia Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Virginia Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Virginia Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Virginia Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Virginia Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Virginia Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
Virginia Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Virginia Aetna Open Access - High Self
JN1
1119.13
1137.57
510.84
626.73
6.32
Virginia Aetna Open Access - High Self & Family
JN2
2515.98
2557.43
1184.02
1373.41
-4.38
Virginia Aetna Open Access - High Self Plus One
JN3
2491.04
2532.10
1092.26
1439.84
15.39
Virginia Aetna Open Access - Basic Self
JN4
680.46
697.10
510.84
186.26
4.52
Virginia Aetna Open Access - Basic Self & Family
JN5
1557.25
1595.34
1184.02
411.32
-7.74
Virginia Aetna Open Access - Basic Self Plus One
JN6
1430.00
1464.99
1092.26
372.73
9.32
Virginia Aetna Saver - Saver Self
QQ4
New Plan
595.21
446.41
148.80
New Plan
Virginia Aetna Saver - Saver Self & Family
QQ5
New Plan
1362.14
1021.61
340.53
New Plan
Virginia Aetna Saver - Saver Self Plus One
QQ6
New Plan
1250.82
938.12
312.70
New Plan
Virginia CareFirst BlueChoice - Standard Self
2G4
797.68
845.54
510.84
334.70
35.74
Virginia CareFirst BlueChoice - Standard Self & Family
2G5
1895.25
2008.96
1184.02
824.94
67.88
Virginia CareFirst BlueChoice - Standard Self Plus One
2G6
1595.34
1691.06
1092.26
598.80
70.05
Virginia CareFirst BlueChoice - HDHP Self
B61
518.27
570.09
427.57
142.52
12.95
Virginia CareFirst BlueChoice - HDHP Self & Family
B62
1231.38
1354.51
1015.88
338.63
30.79
Virginia CareFirst BlueChoice - HDHP Self Plus One
B63
1036.51
1140.17
855.13
285.04
25.91
Virginia CareFirst BlueChoice - Blue Value Plus Self
B64
New Plan
705.99
510.84
195.15
New Plan
Virginia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
New Plan
1677.46
1184.02
493.44
New Plan
Virginia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
New Plan
1412.02
1059.02
353.00
New Plan
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self
T71
420.12
420.12
315.09
105.03
0.00
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self & Family
T72
1026.16
1026.16
769.62
256.54
0.00
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Basic Self Plus One
T73
934.90
934.90
701.18
233.72
0.00
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self
E34
521.76
571.55
428.66
142.89
12.45
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self & Family
E35
1199.99
1314.50
985.88
328.62
28.62
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - Standard Self Plus One
E36
1199.99
1314.50
985.88
328.62
28.62
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self
E31
692.68
722.82
510.84
211.98
18.02
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self & Family
E32
1593.15
1662.53
1184.02
478.51
23.55
Virginia Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. - High Self Plus One
E33
1593.15
1662.53
1092.26
570.27
43.71
Virginia M.D. IPA - High Self
JP1
790.86
876.61
510.84
365.77
73.63
Virginia M.D. IPA - High Self & Family
JP2
2217.54
2458.04
1184.02
1274.02
194.67
Virginia M.D. IPA - High Self Plus One
JP3
1544.53
1712.04
1092.26
619.78
141.84
Virginia Optima Health - HDHP Self
PG4
605.19
644.41
483.31
161.10
9.80
Virginia Optima Health - HDHP Self & Family
PG5
1334.99
1421.49
1066.12
355.37
21.62
Virginia Optima Health - HDHP Self Plus One
PG6
1308.80
1393.62
1045.22
348.40
21.20
Virginia Optima Health - High Self
PG1
678.47
692.10
510.84
181.26
1.51
Virginia Optima Health - High Self & Family
PG2
1639.47
1672.36
1184.02
488.34
-12.94
Virginia Optima Health - High Self Plus One
PG3
1639.37
1672.23
1092.26
579.97
7.19
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
495.69
486.57
364.93
121.64
-2.28
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1140.06
1119.11
839.33
279.78
-5.23
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1065.72
1046.13
784.60
261.53
-4.90
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
667.94
714.89
510.84
204.05
34.83
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1582.99
1694.29
1184.02
510.27
65.47
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1436.05
1536.99
1092.26
444.73
75.27
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
437.06
521.50
391.13
130.37
21.11
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1225.49
1462.26
1096.70
365.56
59.19
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
853.56
1018.46
763.85
254.61
41.22
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
AS1
New Plan
525.81
394.36
131.45
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
AS2
New Plan
1243.36
932.52
310.84
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
AS3
New Plan
1130.42
847.82
282.60
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
Y81
New Plan
506.74
380.06
126.68
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
Y82
New Plan
1198.23
898.67
299.56
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
Y83
New Plan
1089.38
817.04
272.34
New Plan
Washington Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Washington Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Washington Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Washington Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Washington Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Washington Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
670.58
712.73
510.84
201.89
30.03
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1535.86
1632.37
1184.02
448.35
50.68
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1505.77
1600.37
1092.26
508.11
68.93
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
785.14
904.50
510.84
393.66
107.24
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
1790.88
2063.10
1184.02
879.08
226.39
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
1773.18
2042.71
1092.26
950.45
243.86
Washington Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Washington Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Washington Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Washington Kaiser Foundation Health Plan of the Northwest - Standard Self
574
620.30
647.96
485.97
161.99
6.92
Washington Kaiser Foundation Health Plan of the Northwest - Standard Self & Family
575
1425.00
1488.54
1116.41
372.13
15.88
Washington Kaiser Foundation Health Plan of the Northwest - Standard Self Plus One
576
1425.00
1488.54
1092.26
396.28
37.87
Washington Kaiser Foundation Health Plan of the Northwest - High Self
571
706.68
729.93
510.84
219.09
11.13
Washington Kaiser Foundation Health Plan of the Northwest - High Self & Family
572
1596.16
1648.70
1184.02
464.68
6.71
Washington Kaiser Foundation Health Plan of the Northwest - High Self Plus One
573
1596.16
1648.70
1092.26
556.44
26.87
Washington Kaiser Foundation Health Plan of Washington - Standard Self
544
585.17
604.13
453.10
151.03
4.74
Washington Kaiser Foundation Health Plan of Washington - Standard Self & Family
545
1345.91
1389.53
1042.15
347.38
10.90
Washington Kaiser Foundation Health Plan of Washington - Standard Self Plus One
546
1345.91
1389.53
1042.15
347.38
10.90
Washington Kaiser Foundation Health Plan of Washington - High Self
541
815.40
845.74
510.84
334.90
18.22
Washington Kaiser Foundation Health Plan of Washington - High Self & Family
542
1793.91
1860.65
1184.02
676.63
20.91
Washington Kaiser Foundation Health Plan of Washington - High Self Plus One
543
1793.91
1860.65
1092.26
768.39
41.07
Washington Kaiser Permanente Washington Options Federal - Standard Self
L11
697.82
727.89
510.84
217.05
17.95
Washington Kaiser Permanente Washington Options Federal - Standard Self & Family
L12
1549.12
1615.90
1184.02
431.88
20.95
Washington Kaiser Permanente Washington Options Federal - Standard Self Plus One
L13
1549.12
1615.90
1092.26
523.64
41.11
Washington Kaiser Permanente Washington Options Federal - HDHP Self
L14
587.17
645.58
484.19
161.39
14.60
Washington Kaiser Permanente Washington Options Federal - HDHP Self & Family
L15
1303.49
1433.14
1074.86
358.28
32.41
Washington Kaiser Permanente Washington Options Federal - HDHP Self Plus One
L16
1303.49
1433.14
1074.86
358.28
32.41
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
450.32
443.84
332.88
110.96
-1.62
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1035.73
1020.85
765.64
255.21
-3.72
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
968.20
954.27
715.70
238.57
-3.48
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
679.19
724.77
510.84
213.93
33.46
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1697.95
1811.90
1184.02
627.88
68.12
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1460.23
1558.25
1092.26
465.99
72.35
Washington UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self
WF1
New Plan
522.86
392.15
130.71
New Plan
Washington UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self & Family
WF2
New Plan
1236.39
927.29
309.10
New Plan
Washington UnitedHealthcare Insurance Company, Inc. Choice Plus Primary Advantage - High Self Plus One
WF3
New Plan
1124.05
843.04
281.01
New Plan
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self
VD1
New Plan
522.02
391.52
130.50
New Plan
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self & Family
VD2
New Plan
1234.37
925.78
308.59
New Plan
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary Advantage - High Self Plus One
VD3
New Plan
1122.23
841.67
280.56
New Plan
West Virginia Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
West Virginia Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
West Virginia Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
West Virginia Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
West Virginia Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
West Virginia Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
810.79
829.23
510.84
318.39
6.32
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1848.71
1890.72
1184.02
706.70
-3.82
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1830.40
1872.00
1092.26
779.74
15.93
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
708.44
819.98
510.84
309.14
99.42
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1622.25
1877.61
1184.02
693.59
209.53
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1590.42
1840.78
1092.26
748.52
224.69
West Virginia Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
West Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Wisconsin Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Wisconsin Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Wisconsin Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Wisconsin Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Wisconsin Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Wisconsin Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
803.99
1073.48
510.84
562.64
257.37
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
1835.41
2450.59
1184.02
1266.57
569.35
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
1817.25
2426.32
1092.26
1334.06
583.40
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1049.04
1003.99
510.84
493.15
-57.17
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2391.35
2288.65
1184.02
1104.63
-148.53
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2367.69
2265.99
1092.26
1173.73
-127.37
Wisconsin Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Wisconsin Dean Health Plan, Inc. - High Self
WD1
1097.14
1147.08
510.84
636.24
37.82
Wisconsin Dean Health Plan, Inc. - High Self & Family
WD2
2523.39
2638.26
1184.02
1454.24
69.04
Wisconsin Dean Health Plan, Inc. - High Self Plus One
WD3
2303.97
2408.86
1092.26
1316.60
79.22
Wisconsin Dean Health Plan, Inc. - Standard Self
WD4
645.67
681.57
510.84
170.73
9.31
Wisconsin Dean Health Plan, Inc. - Standard Self & Family
WD5
1549.62
1635.77
1184.02
451.75
40.32
Wisconsin Dean Health Plan, Inc. - Standard Self Plus One
WD6
1420.51
1499.46
1092.26
407.20
52.07
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self
WJ1
731.03
857.96
510.84
347.12
114.81
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self & Family
WJ2
1900.69
2230.76
1184.02
1046.74
284.24
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self Plus One
WJ3
1608.27
1887.56
1092.26
795.30
253.62
Wisconsin HealthPartners - Standard Self
V34
428.09
459.92
344.94
114.98
7.96
Wisconsin HealthPartners - Standard Self & Family
V35
1042.82
1120.41
840.31
280.10
19.40
Wisconsin HealthPartners - Standard Self Plus One
V36
946.08
1016.45
762.34
254.11
17.59
Wisconsin HealthPartners - High Self
V31
790.31
712.31
510.84
201.47
-90.12
Wisconsin HealthPartners - High Self & Family
V32
1925.21
1735.20
1184.02
551.18
-235.84
Wisconsin HealthPartners - High Self Plus One
V33
1746.57
1574.21
1092.26
481.95
-198.03
Wisconsin MercyCare Health Plans - High Self
EY1
764.05
785.92
510.84
275.08
9.75
Wisconsin MercyCare Health Plans - High Self & Family
EY2
1994.01
2050.99
1184.02
866.97
11.15
Wisconsin MercyCare Health Plans - High Self Plus One
EY3
1642.81
1689.78
1092.26
597.52
21.30
Wisconsin MercyCare Health Plans - Standard Self
EY4
New Plan
609.59
457.19
152.40
New Plan
Wisconsin MercyCare Health Plans - Standard Self & Family
EY5
New Plan
1590.85
1184.02
406.83
New Plan
Wisconsin MercyCare Health Plans - Standard Self Plus One
EY6
New Plan
1310.68
983.01
327.67
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - High Self
TF1
New Plan
1010.36
510.84
499.52
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - High Self & Family
TF2
New Plan
2424.89
1184.02
1240.87
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - High Self Plus One
TF3
New Plan
2273.35
1092.26
1181.09
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self
TF4
New Plan
614.27
460.70
153.57
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self & Family
TF5
New Plan
1474.29
1105.72
368.57
New Plan
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self Plus One
TF6
New Plan
1351.44
1013.58
337.86
New Plan
Wyoming Aetna Advantage - Advantage Self
Z24
New Plan
463.84
347.88
115.96
New Plan
Wyoming Aetna Advantage - Advantage Self & Family
Z25
New Plan
1229.17
921.88
307.29
New Plan
Wyoming Aetna Advantage - Advantage Self Plus One
Z26
New Plan
1020.44
765.33
255.11
New Plan
Wyoming Aetna Direct - CDHP Self
N61
557.33
612.65
459.49
153.16
13.83
Wyoming Aetna Direct - CDHP Self & Family
N62
1405.54
1545.01
1158.76
386.25
34.87
Wyoming Aetna Direct - CDHP Self Plus One
N63
1222.26
1343.55
1007.66
335.89
30.33
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.86
828.47
510.84
317.63
-12.51
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1889.38
1888.45
1184.02
704.43
-46.76
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1870.68
1869.92
1092.26
777.66
-26.43
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
616.53
807.04
510.84
296.20
142.07
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1414.99
1852.18
1184.02
668.16
314.41
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1387.25
1815.86
1092.26
723.60
376.79
Wyoming Aetna HealthFund HDHP - HDHP Self
224
659.71
728.80
510.84
217.96
53.03
Wyoming Aetna HealthFund HDHP - HDHP Self & Family
225
1455.20
1607.60
1184.02
423.58
59.78
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One
226
1426.69
1576.10
1092.26
483.84
123.74
Wyoming Altius Health Plan - High Self
9K1
935.24
1009.06
510.84
498.22
61.70
Wyoming Altius Health Plan - High Self & Family
9K2
2068.26
2231.52
1184.02
1047.50
117.43
Wyoming Altius Health Plan - High Self Plus One
9K3
2047.78
2209.42
1092.26
1117.16
135.97
Wyoming Altius Health Plan - HDHP Self
9K4
506.91
529.23
396.92
132.31
5.58
Wyoming Altius Health Plan - HDHP Self & Family
9K5
1059.41
1106.04
829.53
276.51
11.66
Wyoming Altius Health Plan - HDHP Self Plus One
9K6
1038.64
1084.37
813.28
271.09
11.43
Wyoming Altius Health Plan - Standard Self
DK4
712.44
761.30
510.84
250.46
36.74
Wyoming Altius Health Plan - Standard Self & Family
DK5
1573.30
1681.23
1184.02
497.21
62.10
Wyoming Altius Health Plan - Standard Self Plus One
DK6
1557.70
1664.56
1092.26
572.30
81.19
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service