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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
463.84
500.02
375.02
125.00
9.04
Alabama Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Alabama Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Alabama Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Alabama Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Alabama Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Alabama Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Alabama Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Alabama Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Alaska Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Alaska Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Alaska Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Alaska Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Alaska Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Alaska Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Alaska Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Alaska Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Alaska Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Arizona Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Arizona Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Arizona Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Arizona Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Arizona Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Arizona Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Arizona Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Arizona Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Arizona Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Arizona Aetna Open Access - High Self
WQ1
1161.16
1345.67
523.42
822.25
171.93
Arizona Aetna Open Access - High Self & Family
WQ2
2819.27
3267.25
1218.21
2049.04
413.79
Arizona Aetna Open Access - High Self Plus One
WQ3
2791.34
3234.86
1121.16
2113.70
414.62
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R61
718.79
812.24
523.42
288.82
80.87
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R62
1617.27
1827.50
1218.21
609.29
176.04
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R63
1545.38
1746.29
1121.16
625.13
172.01
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R64
574.54
649.22
486.92
162.30
18.67
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R65
1292.68
1460.72
1095.54
365.18
42.01
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R66
1235.24
1395.81
1046.86
348.95
40.14
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R94
523.81
570.96
428.22
142.74
11.79
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R95
1178.56
1284.62
963.47
321.15
26.51
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R96
1126.19
1227.55
920.66
306.89
25.34
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R91
657.89
717.08
523.42
193.66
29.19
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R92
1480.20
1613.41
1210.06
403.35
33.30
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R93
1414.40
1541.69
1121.16
420.53
66.93
Arizona Humana Health Plan, Inc. - Standard Self
C74
784.10
893.86
523.42
370.44
97.18
Arizona Humana Health Plan, Inc. - Standard Self & Family
C75
1764.19
2011.17
1218.21
792.96
212.79
Arizona Humana Health Plan, Inc. - Standard Self Plus One
C76
1685.73
1921.73
1121.16
800.57
207.10
Arizona Humana Health Plan, Inc. - High Self
C71
1017.88
1160.38
523.42
636.96
129.92
Arizona Humana Health Plan, Inc. - High Self & Family
C72
2290.19
2610.83
1218.21
1392.62
286.45
Arizona Humana Health Plan, Inc. - High Self Plus One
C73
2188.40
2494.79
1121.16
1373.63
277.49
Arizona Humana Health Plan, Inc. - High Self
BF1
1429.50
1472.38
523.42
948.96
30.30
Arizona Humana Health Plan, Inc. - High Self & Family
BF2
3216.27
3312.77
1218.21
2094.56
62.31
Arizona Humana Health Plan, Inc. - High Self Plus One
BF3
3073.35
3165.52
1121.16
2044.36
63.27
Arizona Humana Health Plan, Inc. - Standard Self
BF4
1154.25
1246.59
523.42
723.17
79.76
Arizona Humana Health Plan, Inc. - Standard Self & Family
BF5
2597.08
2804.84
1218.21
1586.63
173.57
Arizona Humana Health Plan, Inc. - Standard Self Plus One
BF6
2481.66
2680.21
1121.16
1559.05
169.65
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
522.86
622.22
466.67
155.55
24.84
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1236.39
1471.54
1103.66
367.88
58.78
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1124.05
1337.77
1003.33
334.44
53.43
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
443.84
528.17
396.13
132.04
21.08
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1020.85
1214.76
911.07
303.69
48.48
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
954.27
1135.55
851.66
283.89
45.32
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
724.77
782.12
523.42
258.70
44.77
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1811.90
1955.35
1218.21
737.14
109.26
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1558.25
1681.57
1121.16
560.41
94.42
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
522.02
621.21
465.91
155.30
24.80
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1234.37
1469.13
1101.85
367.28
58.69
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1122.23
1335.58
1001.69
333.89
53.33
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Arkansas Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Arkansas Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Arkansas Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Arkansas Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Arkansas Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Arkansas Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Arkansas Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Arkansas Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Arkansas QualChoice - High Self
DH1
752.20
767.26
523.42
243.84
2.48
Arkansas QualChoice - High Self & Family
DH2
1961.96
2001.20
1218.21
782.99
5.05
Arkansas QualChoice - High Self Plus One
DH3
1461.18
1490.43
1117.82
372.61
3.69
Arkansas QualChoice - Standard Self
DH4
587.25
599.00
449.25
149.75
2.94
Arkansas QualChoice - Standard Self & Family
DH5
1531.75
1562.43
1171.82
390.61
7.67
Arkansas QualChoice - Standard Self Plus One
DH6
1140.77
1163.63
872.72
290.91
5.72
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
California Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
California Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
California Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
California Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
California Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
California Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
California Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
California Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
California Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
California Aetna Open Access - High Self
2X1
880.53
936.67
523.42
413.25
43.56
California Aetna Open Access - High Self & Family
2X2
2067.24
2199.02
1218.21
980.81
97.59
California Aetna Open Access - High Self Plus One
2X3
2026.70
2155.90
1121.16
1034.74
100.30
California Anthem Blue Cross Select HMO - High Self
B31
774.13
774.13
523.42
250.71
-12.58
California Anthem Blue Cross Select HMO - High Self & Family
B32
1768.91
1768.91
1218.21
550.70
-34.19
California Anthem Blue Cross Select HMO - High Self Plus One
B33
1641.16
1641.16
1121.16
520.00
-28.90
California Blue Shield of California - Access + HMO Self
SI1
833.84
858.87
523.42
335.45
12.45
California Blue Shield of California - Access + HMO Self & Family
SI2
1917.85
1975.39
1218.21
757.18
23.35
California Blue Shield of California - Access + HMO Self Plus One
SI3
1834.45
1889.49
1121.16
768.33
26.14
California Health Net of California - Basic Self
P61
324.37
364.04
273.03
91.01
9.92
California Health Net of California - Basic Self & Family
P62
778.46
873.73
655.30
218.43
23.82
California Health Net of California - Basic Self Plus One
P63
713.59
800.93
600.70
200.23
21.83
California Health Net of California - High Self
LP1
1048.36
1012.98
523.42
489.56
-47.96
California Health Net of California - High Self & Family
LP2
2516.06
2431.17
1218.21
1212.96
-119.08
California Health Net of California - High Self Plus One
LP3
2306.40
2228.57
1121.16
1107.41
-106.73
California Health Net of California - High Self
LB1
1510.56
1550.64
523.42
1027.22
27.50
California Health Net of California - High Self & Family
LB2
3625.38
3721.49
1218.21
2503.28
61.92
California Health Net of California - High Self Plus One
LB3
3323.26
3411.35
1121.16
2290.19
59.19
California Health Net of California - Standard Self
LB4
1340.54
1466.14
523.42
942.72
113.02
California Health Net of California - Standard Self & Family
LB5
3217.28
3518.71
1218.21
2300.50
267.24
California Health Net of California - Standard Self Plus One
LB6
2949.18
3225.50
1121.16
2104.34
247.42
California Health Net of California - Basic Self
T41
881.83
894.18
523.42
370.76
-0.23
California Health Net of California - Basic Self & Family
T42
2116.40
2146.04
1218.21
927.83
-4.55
California Health Net of California - Basic Self Plus One
T43
1940.06
1967.20
1121.16
846.04
-1.76
California Kaiser Permanente - Fresno California - Standard Self
NZ4
566.80
590.11
442.58
147.53
5.83
California Kaiser Permanente - Fresno California - Standard Self & Family
NZ5
1309.95
1363.87
1022.90
340.97
13.48
California Kaiser Permanente - Fresno California - Standard Self Plus One
NZ6
1309.95
1363.87
1022.90
340.97
13.48
California Kaiser Permanente - Fresno California - High Self
NZ1
776.92
802.99
523.42
279.57
13.49
California Kaiser Permanente - Fresno California - High Self & Family
NZ2
1795.67
1855.86
1218.21
637.65
26.00
California Kaiser Permanente - Fresno California - High Self Plus One
NZ3
1795.67
1855.86
1121.16
734.70
31.29
California Kaiser Permanente - Northern California - Basic Self
KC1
652.08
652.08
489.06
163.02
0.00
California Kaiser Permanente - Northern California - Basic Self & Family
KC2
1525.85
1525.85
1144.39
381.46
0.00
California Kaiser Permanente - Northern California - Basic Self Plus One
KC3
1525.85
1525.85
1121.16
404.69
-28.90
California Kaiser Permanente - Northern California - High Self
591
1000.46
1014.54
523.42
491.12
1.50
California Kaiser Permanente - Northern California - High Self & Family
592
2388.21
2421.86
1218.21
1203.65
-0.54
California Kaiser Permanente - Northern California - High Self Plus One
593
2388.21
2421.86
1121.16
1300.70
4.75
California Kaiser Permanente - Northern California - Standard Self
594
809.88
822.68
523.42
299.26
0.22
California Kaiser Permanente - Northern California - Standard Self & Family
595
1895.08
1925.11
1218.21
706.90
-4.16
California Kaiser Permanente - Northern California - Standard Self Plus One
596
1895.08
1925.11
1121.16
803.95
1.13
California Kaiser Permanente - Southern California - Standard Self
624
466.31
473.44
355.08
118.36
1.78
California Kaiser Permanente - Southern California - Standard Self & Family
625
1077.70
1094.21
820.66
273.55
4.13
California Kaiser Permanente - Southern California - Standard Self Plus One
626
1077.70
1094.21
820.66
273.55
4.13
California Kaiser Permanente - Southern California - High Self
621
735.41
750.19
523.42
226.77
2.20
California Kaiser Permanente - Southern California - High Self & Family
622
1699.66
1733.83
1218.21
515.62
-0.02
California Kaiser Permanente - Southern California - High Self Plus One
623
1699.66
1733.83
1121.16
612.67
5.27
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Colorado Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Colorado Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Colorado Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Colorado Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Colorado Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Colorado Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Colorado Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Colorado Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Colorado Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self
WW1
636.35
636.35
477.26
159.09
0.00
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self & Family
WW2
1549.49
1549.49
1162.12
387.37
0.00
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self Plus One
WW3
1447.66
1447.66
1085.75
361.91
0.00
Colorado Humana Health Plan, Inc. - High Self
NR1
821.51
961.18
523.42
437.76
127.09
Colorado Humana Health Plan, Inc. - High Self & Family
NR2
1848.41
2162.64
1218.21
944.43
280.04
Colorado Humana Health Plan, Inc. - High Self Plus One
NR3
1766.27
2066.52
1121.16
945.36
271.35
Colorado Humana Health Plan, Inc. - Standard Self
NR4
569.31
666.08
499.56
166.52
24.19
Colorado Humana Health Plan, Inc. - Standard Self & Family
NR5
1280.98
1498.73
1124.05
374.68
54.44
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NR6
1224.02
1432.08
1074.06
358.02
52.02
Colorado Humana Health Plan, Inc. - Basic Self
RZ1
521.80
532.24
399.18
133.06
2.61
Colorado Humana Health Plan, Inc. - Basic Self & Family
RZ2
1174.03
1197.52
898.14
299.38
5.87
Colorado Humana Health Plan, Inc. - Basic Self Plus One
RZ3
1121.90
1144.33
858.25
286.08
5.61
Colorado Humana Health Plan, Inc. - High Self
NT1
764.77
833.60
523.42
310.18
56.25
Colorado Humana Health Plan, Inc. - High Self & Family
NT2
1720.79
1875.66
1218.21
657.45
120.68
Colorado Humana Health Plan, Inc. - High Self Plus One
NT3
1644.28
1792.27
1121.16
671.11
119.09
Colorado Humana Health Plan, Inc. - Standard Self
NT4
541.52
590.27
442.70
147.57
12.19
Colorado Humana Health Plan, Inc. - Standard Self & Family
NT5
1218.45
1328.12
996.09
332.03
27.42
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NT6
1164.35
1269.13
951.85
317.28
26.19
Colorado Humana Health Plan, Inc. - Basic Self
R21
531.12
621.40
466.05
155.35
22.57
Colorado Humana Health Plan, Inc. - Basic Self & Family
R22
1195.00
1398.17
1048.63
349.54
50.79
Colorado Humana Health Plan, Inc. - Basic Self Plus One
R23
1141.90
1336.03
1002.02
334.01
48.54
Colorado Kaiser Permanente - Colorado - Standard Self
654
671.30
660.83
495.62
165.21
-2.61
Colorado Kaiser Permanente - Colorado - Standard Self & Family
655
1517.12
1493.46
1120.10
373.36
-5.92
Colorado Kaiser Permanente - Colorado - Standard Self Plus One
656
1517.12
1493.46
1120.10
373.36
-51.50
Colorado Kaiser Permanente - Colorado - High Self
651
789.17
772.89
523.42
249.47
-28.86
Colorado Kaiser Permanente - Colorado - High Self & Family
652
1783.51
1746.75
1218.21
528.54
-70.95
Colorado Kaiser Permanente - Colorado - High Self Plus One
653
1783.51
1746.75
1121.16
625.59
-65.66
Colorado Kaiser Permanente - Colorado - Basic Self
N41
484.77
445.51
334.13
111.38
-9.81
Colorado Kaiser Permanente - Colorado - Basic Self & Family
N42
1095.60
1095.94
821.96
273.98
0.08
Colorado Kaiser Permanente - Colorado - Basic Self Plus One
N43
1095.60
1006.85
755.14
251.71
-22.19
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
443.84
528.17
396.13
132.04
21.08
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1020.85
1214.76
911.07
303.69
48.48
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
954.27
1135.55
851.66
283.89
45.32
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
724.77
782.12
523.42
258.70
44.77
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1811.90
1955.35
1218.21
737.14
109.26
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1558.25
1681.57
1121.16
560.41
94.42
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Connecticut Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Connecticut Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Connecticut Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Connecticut Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Connecticut Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Connecticut Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Connecticut Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Connecticut Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Delaware Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Delaware Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Delaware Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Delaware Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Delaware Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Delaware Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Delaware Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Delaware Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Delaware Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Delaware Aetna Open Access - Basic Self
P34
1310.08
1505.53
523.42
982.11
182.87
Delaware Aetna Open Access - Basic Self & Family
P35
3040.68
3494.34
1218.21
2276.13
419.47
Delaware Aetna Open Access - Basic Self Plus One
P36
3010.54
3459.73
1121.16
2338.57
420.29
Delaware Aetna Open Access - High Self
P31
1456.61
1588.23
523.42
1064.81
119.04
Delaware Aetna Open Access - High Self & Family
P32
3531.54
3850.71
1218.21
2632.50
284.98
Delaware Aetna Open Access - High Self Plus One
P33
3496.55
3812.58
1121.16
2691.42
287.13
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
District Of Columbia Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
District Of Columbia Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
District Of Columbia Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
District Of Columbia Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
District Of Columbia Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
District Of Columbia Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
District Of Columbia Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
District Of Columbia Aetna Open Access - High Self
JN1
1137.57
1176.57
523.42
653.15
26.42
District Of Columbia Aetna Open Access - High Self & Family
JN2
2557.43
2645.05
1218.21
1426.84
53.43
District Of Columbia Aetna Open Access - High Self Plus One
JN3
2532.10
2618.85
1121.16
1497.69
57.85
District Of Columbia Aetna Open Access - Basic Self
JN4
697.10
714.42
523.42
191.00
4.74
District Of Columbia Aetna Open Access - Basic Self & Family
JN5
1595.34
1634.92
1218.21
416.71
5.39
District Of Columbia Aetna Open Access - Basic Self Plus One
JN6
1464.99
1501.33
1121.16
380.17
7.44
District Of Columbia Aetna Saver (Open Access) - Saver Self
QQ4
595.21
595.21
446.41
148.80
0.00
District Of Columbia Aetna Saver (Open Access) - Saver Self & Family
QQ5
1362.14
1362.12
1021.59
340.53
0.00
District Of Columbia Aetna Saver (Open Access) - Saver Self Plus One
QQ6
1250.82
1250.82
938.12
312.70
0.00
District Of Columbia CareFirst BlueChoice - Standard Self
2G4
845.54
887.81
523.42
364.39
29.69
District Of Columbia CareFirst BlueChoice - Standard Self & Family
2G5
2008.96
2109.42
1218.21
891.21
66.27
District Of Columbia CareFirst BlueChoice - Standard Self Plus One
2G6
1691.06
1775.61
1121.16
654.45
55.65
District Of Columbia CareFirst BlueChoice - HDHP Self
B61
570.09
570.09
427.57
142.52
0.00
District Of Columbia CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1354.51
1015.88
338.63
0.00
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1140.17
855.13
285.04
0.00
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self
B64
705.99
723.67
523.42
200.25
5.10
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1677.46
1719.38
1218.21
501.17
7.73
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1412.02
1447.29
1085.47
361.82
8.82
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self
T71
420.12
427.72
320.79
106.93
1.90
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self & Family
T72
1026.16
1099.52
824.64
274.88
18.34
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One
T73
934.90
951.84
713.88
237.96
4.24
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
571.55
598.28
448.71
149.57
6.68
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1314.50
1376.05
1032.04
344.01
15.39
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1314.50
1376.05
1032.04
344.01
15.39
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self
E31
722.82
746.24
523.42
222.82
10.84
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1662.53
1716.35
1218.21
498.14
19.63
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1662.53
1716.35
1121.16
595.19
24.92
District Of Columbia M.D. IPA - High Self
JP1
876.61
950.89
523.42
427.47
61.70
District Of Columbia M.D. IPA - High Self & Family
JP2
2458.04
2666.28
1218.21
1448.07
174.05
District Of Columbia M.D. IPA - High Self Plus One
JP3
1712.04
1857.09
1121.16
735.93
116.15
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
486.57
519.91
389.93
129.98
8.34
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1119.11
1195.81
896.86
298.95
19.17
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1046.13
1117.81
838.36
279.45
17.92
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
714.89
770.40
523.42
246.98
42.93
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1694.29
1825.83
1218.21
607.62
97.35
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1536.99
1656.33
1121.16
535.17
90.44
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
521.50
554.62
415.97
138.65
8.28
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1462.26
1555.15
1166.36
388.79
23.23
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1018.46
1083.18
812.39
270.79
16.18
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Florida Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Florida Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Florida Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Florida Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Florida Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Florida Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Florida Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Florida Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Florida Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Florida AvMed - HDHP Self
WZ1
805.16
762.08
523.42
238.66
-55.66
Florida AvMed - HDHP Self & Family
WZ2
1871.35
1762.00
1218.21
543.79
-143.54
Florida AvMed - HDHP Self Plus One
WZ3
1622.34
1528.67
1121.16
407.51
-122.57
Florida AvMed - Standard Self
ML4
709.24
820.97
523.42
297.55
99.15
Florida AvMed - Standard Self & Family
ML5
1726.81
1998.92
1218.21
780.71
237.92
Florida AvMed - Standard Self Plus One
ML6
1489.37
1724.06
1121.16
602.90
205.79
Florida Capital Health Plan - High Self
EA1
680.62
690.47
517.85
172.62
2.47
Florida Capital Health Plan - High Self & Family
EA2
1577.33
1600.19
1200.14
400.05
5.72
Florida Capital Health Plan - High Self Plus One
EA3
1488.41
1509.99
1121.16
388.83
-7.32
Florida Humana CoverageFirst and Humana Value Plan - Value Self
W94
513.59
585.48
439.11
146.37
17.97
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
W95
1155.57
1317.33
988.00
329.33
40.44
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
W96
1104.20
1258.79
944.09
314.70
38.65
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
W91
607.10
692.10
519.08
173.02
21.25
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
W92
1365.95
1557.18
1167.89
389.29
47.80
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
W93
1305.27
1487.98
1115.99
371.99
45.67
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
QP1
725.05
768.56
523.42
245.14
30.93
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
QP2
1633.54
1731.56
1218.21
513.35
63.83
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
QP3
1560.93
1654.58
1121.16
533.42
64.75
Florida Humana CoverageFirst and Humana Value Plan - Value Self
QP4
519.35
550.51
412.88
137.63
7.79
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
QP5
1168.48
1238.60
928.95
309.65
17.53
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
QP6
1116.57
1183.56
887.67
295.89
16.75
Florida Humana CoverageFirst and Humana Value Plan - Value Self
MJ4
519.61
561.19
420.89
140.30
10.40
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
MJ5
1169.13
1262.67
947.00
315.67
23.39
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MJ6
1117.18
1206.55
904.91
301.64
22.35
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
MJ1
948.07
1023.92
523.42
500.50
63.27
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MJ2
2133.15
2303.80
1218.21
1085.59
136.46
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MJ3
2038.36
2201.44
1121.16
1080.28
134.18
Florida Humana CoverageFirst and Humana Value Plan - Value Self
X24
493.18
512.89
384.67
128.22
4.93
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
X25
1109.66
1154.05
865.54
288.51
11.10
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X26
1060.35
1102.77
827.08
275.69
10.60
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
X21
582.99
606.30
454.73
151.57
5.82
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X22
1311.74
1364.22
1023.17
341.05
13.12
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X23
1253.44
1303.58
977.69
325.89
12.53
Florida Humana Medical Plan, Inc. - Standard Self
LL4
1074.95
1193.21
523.42
669.79
105.68
Florida Humana Medical Plan, Inc. - Standard Self & Family
LL5
2418.61
2684.65
1218.21
1466.44
231.85
Florida Humana Medical Plan, Inc. - Standard Self Plus One
LL6
2311.12
2565.33
1121.16
1444.17
225.31
Florida Humana Medical Plan, Inc. - High Self
LL1
1659.15
1708.94
523.42
1185.52
37.21
Florida Humana Medical Plan, Inc. - High Self & Family
LL2
3733.06
3845.05
1218.21
2626.84
77.80
Florida Humana Medical Plan, Inc. - High Self Plus One
LL3
3567.14
3674.15
1121.16
2552.99
78.11
Florida Humana Medical Plan, Inc. - High Self
EE1
1115.14
1248.93
523.42
725.51
121.21
Florida Humana Medical Plan, Inc. - High Self & Family
EE2
2509.07
2810.15
1218.21
1591.94
266.89
Florida Humana Medical Plan, Inc. - High Self Plus One
EE3
2397.59
2685.30
1121.16
1564.14
258.81
Florida Humana Medical Plan, Inc. - Standard Self
EE4
997.12
1116.77
523.42
593.35
107.07
Florida Humana Medical Plan, Inc. - Standard Self & Family
EE5
2243.50
2512.71
1218.21
1294.50
235.02
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EE6
2143.79
2401.04
1121.16
1279.88
228.35
Florida Humana Medical Plan, Inc. - Standard Self
E24
716.02
766.13
523.42
242.71
37.53
Florida Humana Medical Plan, Inc. - Standard Self & Family
E25
1611.00
1723.78
1218.21
505.57
78.59
Florida Humana Medical Plan, Inc. - Standard Self Plus One
E26
1539.40
1647.14
1121.16
525.98
78.84
Florida Humana Medical Plan, Inc. - High Self
E21
1202.65
1286.83
523.42
763.41
71.60
Florida Humana Medical Plan, Inc. - High Self & Family
E22
2705.86
2895.27
1218.21
1677.06
155.22
Florida Humana Medical Plan, Inc. - High Self Plus One
E23
2585.61
2766.60
1121.16
1645.44
152.09
Florida Humana Medical Plan, Inc. - High Self
EX1
893.40
1018.49
523.42
495.07
112.51
Florida Humana Medical Plan, Inc. - High Self & Family
EX2
2010.10
2291.53
1218.21
1073.32
247.24
Florida Humana Medical Plan, Inc. - High Self Plus One
EX3
1920.77
2189.68
1121.16
1068.52
240.01
Florida Humana Medical Plan, Inc. - Standard Self
EX4
732.23
834.73
523.42
311.31
89.92
Florida Humana Medical Plan, Inc. - Standard Self & Family
EX5
1647.51
1878.15
1218.21
659.94
196.45
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EX6
1574.28
1794.67
1121.16
673.51
191.49
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
701.44
750.62
523.42
227.20
36.60
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
2104.29
2251.90
1218.21
1033.69
113.42
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1508.07
1613.89
1121.16
492.73
76.92
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Georgia Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Georgia Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Georgia Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Georgia Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Georgia Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Georgia Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Georgia Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Georgia Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Georgia Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Georgia Aetna Open Access - High Self
2U1
1733.36
1805.85
523.42
1282.43
59.91
Georgia Aetna Open Access - High Self & Family
2U2
3992.69
4159.72
1218.21
2941.51
132.84
Georgia Aetna Open Access - High Self Plus One
2U3
3953.15
4118.53
1121.16
2997.37
136.48
Georgia Blue Open Access POS - High Self
QM1
625.17
656.41
492.31
164.10
7.81
Georgia Blue Open Access POS - High Self & Family
QM2
1640.47
1689.68
1218.21
471.47
15.02
Georgia Blue Open Access POS - High Self Plus One
QM3
1377.74
1446.62
1084.97
361.65
17.22
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
S94
551.89
612.60
459.45
153.15
15.18
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
S95
1241.74
1378.35
1033.76
344.59
34.16
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
S96
1186.58
1317.10
987.83
329.27
32.63
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
S91
693.14
769.41
523.42
245.99
63.69
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
S92
1559.61
1731.15
1218.21
512.94
123.04
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
S93
1490.28
1654.21
1121.16
533.05
135.03
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
AD4
737.53
826.04
523.42
302.62
75.93
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
AD5
1659.41
1858.52
1218.21
640.31
164.92
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
AD6
1585.68
1775.95
1121.16
654.79
161.37
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
AD1
973.38
1090.18
523.42
566.76
104.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
AD2
2190.07
2452.86
1218.21
1234.65
228.60
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
AD3
2092.74
2343.86
1121.16
1222.70
222.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
LM1
679.23
747.13
523.42
223.71
53.90
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
LM2
1528.30
1681.12
1218.21
462.91
80.84
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
LM3
1460.36
1606.41
1121.16
485.25
117.15
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
LM4
642.55
706.81
523.42
183.39
22.75
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
LM5
1445.71
1590.29
1192.72
397.57
36.14
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
LM6
1381.47
1519.64
1121.16
398.48
53.11
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RM1
648.53
719.88
523.42
196.46
34.33
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RM2
1459.23
1619.74
1214.81
404.93
40.12
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RM3
1394.36
1547.74
1121.16
426.58
77.99
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DN4
726.03
813.15
523.42
289.73
74.54
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DN5
1633.52
1829.53
1218.21
611.32
161.82
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DN6
1560.93
1748.24
1121.16
627.08
158.41
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
DN1
780.61
874.27
523.42
350.85
81.08
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
DN2
1756.37
1967.12
1218.21
748.91
176.56
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
DN3
1678.30
1879.71
1121.16
758.55
172.51
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RJ1
598.09
669.85
502.39
167.46
17.94
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RJ2
1345.72
1507.22
1130.42
376.80
40.37
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RJ3
1285.92
1440.23
1080.17
360.06
38.58
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
Q71
762.80
846.71
523.42
323.29
71.33
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
Q72
1716.33
1905.11
1218.21
686.90
154.59
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
Q73
1640.02
1820.43
1121.16
699.27
151.51
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
CB4
1250.45
1137.89
523.42
614.47
-125.14
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
CB5
2813.50
2560.31
1218.21
1342.10
-287.38
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
CB6
2688.47
2446.51
1121.16
1325.35
-270.86
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
CB1
1148.57
1274.89
523.42
751.47
113.74
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
CB2
2584.40
2868.67
1218.21
1650.46
250.08
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
CB3
2469.61
2741.27
1121.16
1620.11
242.76
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self
DG1
1321.93
1388.03
523.42
864.61
53.52
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family
DG2
2974.34
3123.06
1218.21
1904.85
114.53
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One
DG3
2842.19
2984.30
1121.16
1863.14
113.21
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DG4
1171.84
1300.76
523.42
777.34
116.34
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DG5
2636.70
2926.71
1218.21
1708.50
255.82
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DG6
2519.57
2796.71
1121.16
1675.55
248.24
Georgia Kaiser Permanente - Georgia - High Self
F81
730.04
751.10
523.42
227.68
8.48
Georgia Kaiser Permanente - Georgia - High Self & Family
F82
1649.87
1697.50
1218.21
479.29
13.44
Georgia Kaiser Permanente - Georgia - High Self Plus One
F83
1649.87
1697.50
1121.16
576.34
18.73
Georgia Kaiser Permanente - Georgia - Standard Self
F84
552.33
581.10
435.83
145.27
7.19
Georgia Kaiser Permanente - Georgia - Standard Self & Family
F85
1248.26
1313.26
984.95
328.31
16.25
Georgia Kaiser Permanente - Georgia - Standard Self Plus One
F86
1248.26
1313.26
984.95
328.31
16.25
Georgia Kaiser Permanente - Georgia - Basic Self
LA1
393.36
418.90
314.18
104.72
6.38
Georgia Kaiser Permanente - Georgia - Basic Self & Family
LA2
888.98
946.66
710.00
236.66
14.42
Georgia Kaiser Permanente - Georgia - Basic Self Plus One
LA3
888.98
946.66
710.00
236.66
14.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
701.44
750.62
523.42
227.20
36.60
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
2104.29
2251.90
1218.21
1033.69
113.42
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1508.07
1613.89
1121.16
492.73
76.92
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Guam Calvo's SelectCare - Standard Self
B44
396.74
429.78
322.34
107.44
8.26
Guam Calvo's SelectCare - Standard Self & Family
B45
1152.73
1248.72
936.54
312.18
24.00
Guam Calvo's SelectCare - Standard Self Plus One
B46
782.10
847.21
635.41
211.80
16.28
Guam Calvo's SelectCare - High Self
B41
491.55
521.69
391.27
130.42
7.53
Guam Calvo's SelectCare - High Self & Family
B42
1301.89
1381.77
1036.33
345.44
19.97
Guam Calvo's SelectCare - High Self Plus One
B43
959.23
1018.07
763.55
254.52
14.71
Guam TakeCare - HDHP Self
KX1
124.24
120.53
90.40
30.13
-0.93
Guam TakeCare - HDHP Self & Family
KX2
339.32
323.16
242.37
80.79
-4.04
Guam TakeCare - HDHP Self Plus One
KX3
306.11
290.94
218.21
72.73
-3.80
Guam TakeCare - Standard Self
JK4
389.24
404.45
303.34
101.11
3.80
Guam TakeCare - Standard Self & Family
JK5
1102.31
1145.39
859.04
286.35
10.77
Guam TakeCare - Standard Self Plus One
JK6
767.15
797.14
597.86
199.28
7.49
Guam TakeCare - High Self
JK1
492.35
497.81
373.36
124.45
1.36
Guam TakeCare - High Self & Family
JK2
1174.40
1187.38
890.54
296.84
3.24
Guam TakeCare - High Self Plus One
JK3
972.73
983.49
737.62
245.87
2.69
Hawaii Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Hawaii Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Hawaii Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Hawaii Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Hawaii Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Hawaii Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Hawaii Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Hawaii Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Hawaii HMSA Plan - High Self
871
631.24
631.24
473.43
157.81
0.00
Hawaii HMSA Plan - High Self & Family
872
1419.02
1419.02
1064.27
354.75
0.00
Hawaii HMSA Plan - High Self Plus One
873
1383.07
1383.07
1037.30
345.77
0.00
Hawaii HMSA Plan - Standard Self
874
430.97
453.83
340.37
113.46
5.72
Hawaii HMSA Plan - Standard Self & Family
875
968.83
1020.18
765.14
255.04
12.83
Hawaii HMSA Plan - Standard Self Plus One
876
944.23
994.28
745.71
248.57
12.51
Hawaii Kaiser Permanente - Hawaii - High Self
631
675.55
675.55
506.66
168.89
0.00
Hawaii Kaiser Permanente - Hawaii - High Self & Family
632
1506.51
1506.51
1129.88
376.63
0.00
Hawaii Kaiser Permanente - Hawaii - High Self Plus One
633
1506.51
1506.51
1121.16
385.35
-28.90
Hawaii Kaiser Permanente - Hawaii - Standard Self
634
481.15
505.18
378.89
126.29
6.00
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family
635
1072.98
1126.52
844.89
281.63
13.39
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One
636
1072.98
1126.52
844.89
281.63
13.39
Idaho Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Idaho Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Idaho Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Idaho Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Idaho Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Idaho Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Idaho Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Idaho Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Idaho Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Idaho Altius Health Plan - High Self
9K1
1009.06
1048.36
523.42
524.94
26.72
Idaho Altius Health Plan - High Self & Family
9K2
2231.52
2318.46
1218.21
1100.25
52.75
Idaho Altius Health Plan - High Self Plus One
9K3
2209.42
2295.50
1121.16
1174.34
57.18
Idaho Altius Health Plan - HDHP Self
9K4
529.23
672.49
504.37
168.12
35.81
Idaho Altius Health Plan - HDHP Self & Family
9K5
1106.04
1405.43
1054.07
351.36
74.85
Idaho Altius Health Plan - HDHP Self Plus One
9K6
1084.37
1377.85
1033.39
344.46
73.37
Idaho Altius Health Plan - Standard Self
DK4
761.30
883.11
523.42
359.69
109.23
Idaho Altius Health Plan - Standard Self & Family
DK5
1681.23
1950.20
1218.21
731.99
234.78
Idaho Altius Health Plan - Standard Self Plus One
DK6
1664.56
1930.87
1121.16
809.71
237.41
Idaho Kaiser Permanente - Washington Core - Standard Self
544
604.13
618.02
463.52
154.50
3.47
Idaho Kaiser Permanente - Washington Core - Standard Self & Family
545
1389.53
1421.44
1066.08
355.36
7.98
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One
546
1389.53
1421.44
1066.08
355.36
7.98
Idaho Kaiser Permanente - Washington Core - High Self
541
845.74
863.76
523.42
340.34
5.44
Idaho Kaiser Permanente - Washington Core - High Self & Family
542
1860.65
1900.25
1218.21
682.04
5.41
Idaho Kaiser Permanente - Washington Core - High Self Plus One
543
1860.65
1900.25
1121.16
779.09
10.70
Idaho Kaiser Permanente - Washington Core - Prosper Self
PT4
New Plan
390.00
292.50
97.50
New Plan
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family
PT5
New Plan
1091.98
818.99
272.99
New Plan
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One
PT6
New Plan
944.67
708.50
236.17
New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Illinois Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Illinois Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Illinois Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Illinois Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Illinois Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Illinois Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Illinois Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Illinois Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Illinois Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Illinois Blue Preferred - High Self
9G1
833.21
874.23
523.42
350.81
28.44
Illinois Blue Preferred - High Self & Family
9G2
1858.87
1984.52
1218.21
766.31
91.46
Illinois Blue Preferred - High Self Plus One
9G3
1760.59
1862.12
1121.16
740.96
72.63
Illinois Blue Preferred - Standard Self
9G4
600.62
633.66
475.25
158.41
8.26
Illinois Blue Preferred - Standard Self & Family
9G5
1707.01
1758.23
1218.21
540.02
17.03
Illinois Blue Preferred - Standard Self Plus One
9G6
1543.71
1574.58
1121.16
453.42
1.97
Illinois Health Alliance HMO - Standard Self
K84
668.14
683.56
512.67
170.89
3.86
Illinois Health Alliance HMO - Standard Self & Family
K85
1803.99
1584.35
1188.26
396.09
-223.88
Illinois Health Alliance HMO - Standard Self Plus One
K86
1547.78
1461.61
1096.21
365.40
-90.12
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
GB4
758.14
788.47
523.42
265.05
17.75
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
GB5
1705.77
1774.00
1218.21
555.79
34.04
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
GB6
1629.96
1695.16
1121.16
574.00
36.30
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
GB1
1180.53
1227.74
523.42
704.32
34.63
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
GB2
2656.14
2762.39
1218.21
1544.18
72.06
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
GB3
2538.12
2639.65
1121.16
1518.49
72.63
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
MW4
754.91
807.76
523.42
284.34
40.27
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1698.52
1817.40
1218.21
599.19
84.69
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1623.05
1736.67
1121.16
615.51
84.72
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
916.02
1025.96
523.42
502.54
97.36
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
2061.15
2308.48
1218.21
1090.27
213.14
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
1969.50
2205.86
1121.16
1084.70
207.46
Illinois Humana Health Plan, Inc. - Standard Self
754
951.90
1045.35
523.42
521.93
80.87
Illinois Humana Health Plan, Inc. - Standard Self & Family
755
2141.77
2352.03
1218.21
1133.82
176.07
Illinois Humana Health Plan, Inc. - Standard Self Plus One
756
2046.59
2247.53
1121.16
1126.37
172.04
Illinois Humana Health Plan, Inc. - High Self
751
1238.94
1369.01
523.42
845.59
117.49
Illinois Humana Health Plan, Inc. - High Self & Family
752
2787.61
3080.33
1218.21
1862.12
258.53
Illinois Humana Health Plan, Inc. - High Self Plus One
753
2663.74
2943.42
1121.16
1822.26
250.78
Illinois Humana Health Plan, Inc. - High Self
9F1
1938.32
2015.85
523.42
1492.43
64.95
Illinois Humana Health Plan, Inc. - High Self & Family
9F2
4361.20
4535.64
1218.21
3317.43
140.25
Illinois Humana Health Plan, Inc. - High Self Plus One
9F3
4167.35
4334.03
1121.16
3212.87
137.78
Illinois Humana Health Plan, Inc. - Standard Self
AB4
1149.53
1241.70
523.42
718.28
79.59
Illinois Humana Health Plan, Inc. - Standard Self & Family
AB5
2586.44
2793.90
1218.21
1575.69
173.27
Illinois Humana Health Plan, Inc. - Standard Self Plus One
AB6
2471.50
2669.72
1121.16
1548.56
169.32
Illinois Humana Health Plan, Inc. - Basic Self
AB1
756.64
786.91
523.42
263.49
17.69
Illinois Humana Health Plan, Inc. - Basic Self & Family
AB2
1702.50
1770.60
1218.21
552.39
33.91
Illinois Humana Health Plan, Inc. - Basic Self Plus One
AB3
1626.84
1691.91
1121.16
570.75
36.17
Illinois Humana Health Plan, Inc. - Basic Self
RW1
748.24
819.04
523.42
295.62
58.22
Illinois Humana Health Plan, Inc. - Basic Self & Family
RW2
1683.54
1842.86
1218.21
624.65
125.13
Illinois Humana Health Plan, Inc. - Basic Self Plus One
RW3
1608.73
1760.96
1121.16
639.80
123.33
Illinois Union Health Service - High Self
761
744.08
782.06
523.42
258.64
25.40
Illinois Union Health Service - High Self & Family
762
1901.64
1962.91
1218.21
744.70
27.08
Illinois Union Health Service - High Self Plus One
763
1668.33
1732.34
1121.16
611.18
35.11
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
521.50
554.62
415.97
138.65
8.28
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1462.26
1555.15
1166.36
388.79
23.23
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1018.46
1083.18
812.39
270.79
16.18
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Indiana Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Indiana Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Indiana Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Indiana Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Indiana Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Indiana Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Indiana Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Indiana Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Indiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Indiana Health Alliance HMO - Standard Self
K84
668.14
683.56
512.67
170.89
3.86
Indiana Health Alliance HMO - Standard Self & Family
K85
1803.99
1584.35
1188.26
396.09
-223.88
Indiana Health Alliance HMO - Standard Self Plus One
K86
1547.78
1461.61
1096.21
365.40
-90.12
Indiana Humana CoverageFirst - CDHP Self
TC1
659.47
738.57
523.42
215.15
50.28
Indiana Humana CoverageFirst - CDHP Self & Family
TC2
1483.73
1661.79
1218.21
443.58
72.65
Indiana Humana CoverageFirst - CDHP Self Plus One
TC3
1417.82
1587.95
1121.16
466.79
112.34
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
MW4
754.91
807.76
523.42
284.34
40.27
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1698.52
1817.40
1218.21
599.19
84.69
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1623.05
1736.67
1121.16
615.51
84.72
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
916.02
1025.96
523.42
502.54
97.36
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
2061.15
2308.48
1218.21
1090.27
213.14
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
1969.50
2205.86
1121.16
1084.70
207.46
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
X34
615.12
645.88
484.41
161.47
7.69
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1384.05
1453.25
1089.94
363.31
17.30
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1322.53
1388.66
1041.50
347.16
16.53
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
799.44
839.41
523.42
315.99
27.39
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1798.77
1888.71
1218.21
670.50
55.75
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1718.82
1804.77
1121.16
683.61
57.05
Indiana Humana Health Plan of Ohio, Inc. - High Self
A61
1500.98
1576.03
523.42
1052.61
62.47
Indiana Humana Health Plan of Ohio, Inc. - High Self & Family
A62
3377.23
3546.10
1218.21
2327.89
134.68
Indiana Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
3227.14
3388.49
1121.16
2267.33
132.45
Indiana Humana Health Plan of Ohio, Inc. - Standard Self
A64
1172.17
1230.78
523.42
707.36
46.03
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2637.42
2769.30
1218.21
1551.09
97.69
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2520.20
2646.19
1121.16
1525.03
97.09
Indiana Humana Health Plan, Inc. - Standard Self
754
951.90
1045.35
523.42
521.93
80.87
Indiana Humana Health Plan, Inc. - Standard Self & Family
755
2141.77
2352.03
1218.21
1133.82
176.07
Indiana Humana Health Plan, Inc. - Standard Self Plus One
756
2046.59
2247.53
1121.16
1126.37
172.04
Indiana Humana Health Plan, Inc. - High Self
751
1238.94
1369.01
523.42
845.59
117.49
Indiana Humana Health Plan, Inc. - High Self & Family
752
2787.61
3080.33
1218.21
1862.12
258.53
Indiana Humana Health Plan, Inc. - High Self Plus One
753
2663.74
2943.42
1121.16
1822.26
250.78
Indiana Humana Health Plan, Inc. - High Self
MH1
1104.96
1215.48
523.42
692.06
97.94
Indiana Humana Health Plan, Inc. - High Self & Family
MH2
2486.19
2734.83
1218.21
1516.62
214.45
Indiana Humana Health Plan, Inc. - High Self Plus One
MH3
2375.69
2613.26
1121.16
1492.10
208.67
Indiana Humana Health Plan, Inc. - Standard Self
MH4
859.65
945.62
523.42
422.20
73.39
Indiana Humana Health Plan, Inc. - Standard Self & Family
MH5
1934.18
2127.62
1218.21
909.41
159.25
Indiana Humana Health Plan, Inc. - Standard Self Plus One
MH6
1848.23
2033.05
1121.16
911.89
155.92
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Iowa Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Iowa Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Iowa Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Iowa Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Iowa Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Iowa Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Iowa Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Iowa Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Iowa Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Iowa Health Alliance HMO - Standard Self
K84
668.14
683.56
512.67
170.89
3.86
Iowa Health Alliance HMO - Standard Self & Family
K85
1803.99
1584.35
1188.26
396.09
-223.88
Iowa Health Alliance HMO - Standard Self Plus One
K86
1547.78
1461.61
1096.21
365.40
-90.12
Iowa HealthPartners - Standard Self
V34
459.92
509.41
382.06
127.35
12.37
Iowa HealthPartners - Standard Self & Family
V35
1120.41
1240.94
930.71
310.23
30.13
Iowa HealthPartners - Standard Self Plus One
V36
1016.45
1125.80
844.35
281.45
27.34
Iowa HealthPartners - High Self
V31
712.31
668.07
501.05
167.02
-34.45
Iowa HealthPartners - High Self & Family
V32
1735.20
1627.38
1218.21
409.17
-142.01
Iowa HealthPartners - High Self Plus One
V33
1574.21
1476.41
1107.31
369.10
-112.85
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
610.42
692.86
519.65
173.21
20.61
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1403.98
1593.56
1195.17
398.39
47.40
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1312.42
1489.63
1117.22
372.41
44.31
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
720.18
776.84
523.42
253.42
44.08
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1800.48
1942.11
1218.21
723.90
107.44
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1548.41
1670.22
1121.16
549.06
92.91
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Kansas Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Kansas Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Kansas Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Kansas Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Kansas Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Kansas Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Kansas Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Kansas Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Kansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Kansas Aetna Open Access - High Self
HA1
1099.93
1156.52
523.42
633.10
44.01
Kansas Aetna Open Access - High Self & Family
HA2
2598.18
2731.91
1218.21
1513.70
99.54
Kansas Aetna Open Access - High Self Plus One
HA3
2572.53
2704.89
1121.16
1583.73
103.46
Kansas Aetna Open Access - Standard Self
HA4
716.37
901.36
523.42
377.94
172.41
Kansas Aetna Open Access - Standard Self & Family
HA5
1690.89
2127.54
1218.21
909.33
402.46
Kansas Aetna Open Access - Standard Self Plus One
HA6
1674.16
2106.48
1121.16
985.32
403.42
Kansas Humana CoverageFirst and Humana Value Plan - Value Self
PH4
484.03
527.61
395.71
131.90
10.89
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
1089.10
1187.12
890.34
296.78
24.51
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
1040.67
1134.36
850.77
283.59
23.42
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
715.11
758.03
523.42
234.61
30.34
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1609.03
1705.58
1218.21
487.37
62.36
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1537.51
1629.77
1121.16
508.61
63.36
Kansas Humana Health Plan, Inc. - High Self
MS1
1723.17
1796.84
523.42
1273.42
61.09
Kansas Humana Health Plan, Inc. - High Self & Family
MS2
3877.12
4042.89
1218.21
2824.68
131.58
Kansas Humana Health Plan, Inc. - High Self Plus One
MS3
3704.81
3863.17
1121.16
2742.01
129.46
Kansas Humana Health Plan, Inc. - Standard Self
MS4
1067.00
1200.59
523.42
677.17
121.01
Kansas Humana Health Plan, Inc. - Standard Self & Family
MS5
2400.78
2701.34
1218.21
1483.13
266.37
Kansas Humana Health Plan, Inc. - Standard Self Plus One
MS6
2294.09
2581.32
1121.16
1460.16
258.33
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Kentucky Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Kentucky Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Kentucky Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Kentucky Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Kentucky Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Kentucky Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Kentucky Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Kentucky Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Kentucky Humana CoverageFirst - CDHP Self
TC1
659.47
738.57
523.42
215.15
50.28
Kentucky Humana CoverageFirst - CDHP Self & Family
TC2
1483.73
1661.79
1218.21
443.58
72.65
Kentucky Humana CoverageFirst - CDHP Self Plus One
TC3
1417.82
1587.95
1121.16
466.79
112.34
Kentucky Humana CoverageFirst - CDHP Self
6N1
766.70
828.04
523.42
304.62
48.76
Kentucky Humana CoverageFirst - CDHP Self & Family
6N2
1725.08
1863.07
1218.21
644.86
103.80
Kentucky Humana CoverageFirst - CDHP Self Plus One
6N3
1648.40
1780.29
1121.16
659.13
102.99
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self
X34
615.12
645.88
484.41
161.47
7.69
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1384.05
1453.25
1089.94
363.31
17.30
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1322.53
1388.66
1041.50
347.16
16.53
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
799.44
839.41
523.42
315.99
27.39
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1798.77
1888.71
1218.21
670.50
55.75
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1718.82
1804.77
1121.16
683.61
57.05
Kentucky Humana Health Plan of Ohio, Inc. - High Self
A61
1500.98
1576.03
523.42
1052.61
62.47
Kentucky Humana Health Plan of Ohio, Inc. - High Self & Family
A62
3377.23
3546.10
1218.21
2327.89
134.68
Kentucky Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
3227.14
3388.49
1121.16
2267.33
132.45
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self
A64
1172.17
1230.78
523.42
707.36
46.03
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2637.42
2769.30
1218.21
1551.09
97.69
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2520.20
2646.19
1121.16
1525.03
97.09
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self
W61
608.62
639.06
479.30
159.76
7.61
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1369.44
1437.93
1078.45
359.48
17.12
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1308.58
1374.01
1030.51
343.50
16.36
Kentucky Humana Health Plan, Inc. - High Self
MI1
1381.45
1436.72
523.42
913.30
42.69
Kentucky Humana Health Plan, Inc. - High Self & Family
MI2
3108.24
3232.54
1218.21
2014.33
90.11
Kentucky Humana Health Plan, Inc. - High Self Plus One
MI3
2970.09
3088.91
1121.16
1967.75
89.92
Kentucky Humana Health Plan, Inc. - Standard Self
MI4
885.00
920.40
523.42
396.98
22.82
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MI5
1991.21
2070.86
1218.21
852.65
45.46
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MI6
1902.75
1978.84
1121.16
857.68
47.19
Kentucky Humana Health Plan, Inc. - High Self
MH1
1104.96
1215.48
523.42
692.06
97.94
Kentucky Humana Health Plan, Inc. - High Self & Family
MH2
2486.19
2734.83
1218.21
1516.62
214.45
Kentucky Humana Health Plan, Inc. - High Self Plus One
MH3
2375.69
2613.26
1121.16
1492.10
208.67
Kentucky Humana Health Plan, Inc. - Standard Self
MH4
859.65
945.62
523.42
422.20
73.39
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MH5
1934.18
2127.62
1218.21
909.41
159.25
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MH6
1848.23
2033.05
1121.16
911.89
155.92
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
610.42
692.86
519.65
173.21
20.61
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1403.98
1593.56
1195.17
398.39
47.40
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1312.42
1489.63
1117.22
372.41
44.31
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
720.18
776.84
523.42
253.42
44.08
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1800.48
1942.11
1218.21
723.90
107.44
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1548.41
1670.22
1121.16
549.06
92.91
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Louisiana Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Louisiana Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Louisiana Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Louisiana Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Louisiana Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Louisiana Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Louisiana Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Louisiana Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
BC4
674.14
741.54
523.42
218.12
49.59
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
BC5
1516.80
1668.46
1218.21
450.25
71.05
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
BC6
1449.37
1594.30
1121.16
473.14
110.80
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
BC1
901.33
991.47
523.42
468.05
77.56
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
BC2
2028.02
2230.82
1218.21
1012.61
168.61
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
BC3
1937.89
2131.68
1121.16
1010.52
164.89
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
AE1
1071.42
1210.69
523.42
687.27
126.69
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
AE2
2410.63
2724.04
1218.21
1505.83
279.22
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
AE3
2303.51
2602.99
1121.16
1481.83
270.58
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
AE4
807.45
912.43
523.42
389.01
92.40
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
AE5
1816.79
2052.98
1218.21
834.77
202.00
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
AE6
1736.04
1961.72
1121.16
840.56
196.78
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Maine Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Maine Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Maine Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Maine Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Maine Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Maine Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Maine Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Maine Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Maine Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Maryland Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Maryland Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Maryland Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Maryland Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Maryland Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Maryland Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Maryland Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Maryland Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Maryland Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Maryland Aetna Open Access - High Self
JN1
1137.57
1176.57
523.42
653.15
26.42
Maryland Aetna Open Access - High Self & Family
JN2
2557.43
2645.05
1218.21
1426.84
53.43
Maryland Aetna Open Access - High Self Plus One
JN3
2532.10
2618.85
1121.16
1497.69
57.85
Maryland Aetna Open Access - Basic Self
JN4
697.10
714.42
523.42
191.00
4.74
Maryland Aetna Open Access - Basic Self & Family
JN5
1595.34
1634.92
1218.21
416.71
5.39
Maryland Aetna Open Access - Basic Self Plus One
JN6
1464.99
1501.33
1121.16
380.17
7.44
Maryland Aetna Saver (Open Access) - Saver Self
QQ4
595.21
595.21
446.41
148.80
0.00
Maryland Aetna Saver (Open Access) - Saver Self & Family
QQ5
1362.14
1362.12
1021.59
340.53
0.00
Maryland Aetna Saver (Open Access) - Saver Self Plus One
QQ6
1250.82
1250.82
938.12
312.70
0.00
Maryland CareFirst BlueChoice - Standard Self
2G4
845.54
887.81
523.42
364.39
29.69
Maryland CareFirst BlueChoice - Standard Self & Family
2G5
2008.96
2109.42
1218.21
891.21
66.27
Maryland CareFirst BlueChoice - Standard Self Plus One
2G6
1691.06
1775.61
1121.16
654.45
55.65
Maryland CareFirst BlueChoice - HDHP Self
B61
570.09
570.09
427.57
142.52
0.00
Maryland CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1354.51
1015.88
338.63
0.00
Maryland CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1140.17
855.13
285.04
0.00
Maryland CareFirst BlueChoice - Blue Value Plus Self
B64
705.99
723.67
523.42
200.25
5.10
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1677.46
1719.38
1218.21
501.17
7.73
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1412.02
1447.29
1085.47
361.82
8.82
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self
T71
420.12
427.72
320.79
106.93
1.90
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self & Family
T72
1026.16
1099.52
824.64
274.88
18.34
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One
T73
934.90
951.84
713.88
237.96
4.24
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
571.55
598.28
448.71
149.57
6.68
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1314.50
1376.05
1032.04
344.01
15.39
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1314.50
1376.05
1032.04
344.01
15.39
Maryland Kaiser Permanente - Mid-Atlantic States - High Self
E31
722.82
746.24
523.42
222.82
10.84
Maryland Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1662.53
1716.35
1218.21
498.14
19.63
Maryland Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1662.53
1716.35
1121.16
595.19
24.92
Maryland M.D. IPA - High Self
JP1
876.61
950.89
523.42
427.47
61.70
Maryland M.D. IPA - High Self & Family
JP2
2458.04
2666.28
1218.21
1448.07
174.05
Maryland M.D. IPA - High Self Plus One
JP3
1712.04
1857.09
1121.16
735.93
116.15
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
486.57
519.91
389.93
129.98
8.34
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1119.11
1195.81
896.86
298.95
19.17
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1046.13
1117.81
838.36
279.45
17.92
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
714.89
770.40
523.42
246.98
42.93
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1694.29
1825.83
1218.21
607.62
97.35
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1536.99
1656.33
1121.16
535.17
90.44
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
521.50
554.62
415.97
138.65
8.28
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1462.26
1555.15
1166.36
388.79
23.23
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1018.46
1083.18
812.39
270.79
16.18
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Massachusetts Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Massachusetts Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Massachusetts Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Massachusetts Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Massachusetts Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Massachusetts Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Massachusetts Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Michigan Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Michigan Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Michigan Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Michigan Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Michigan Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Michigan Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Michigan Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Michigan Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Michigan Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Michigan Blue Care Network of Michigan - High Self
LX1
742.86
765.81
523.42
242.39
10.37
Michigan Blue Care Network of Michigan - High Self & Family
LX2
1812.59
1868.58
1218.21
650.37
21.80
Michigan Blue Care Network of Michigan - High Self Plus One
LX3
1708.57
1761.39
1121.16
640.23
23.92
Michigan Blue Care Network of Michigan - High Self
K51
957.73
996.49
523.42
473.07
26.18
Michigan Blue Care Network of Michigan - High Self & Family
K52
2336.82
2431.46
1218.21
1213.25
60.45
Michigan Blue Care Network of Michigan - High Self Plus One
K53
2202.72
2291.97
1121.16
1170.81
60.35
Michigan Health Alliance Plan - High Self
521
787.89
842.18
523.42
318.76
41.71
Michigan Health Alliance Plan - High Self & Family
522
1922.44
2054.93
1218.21
836.72
98.30
Michigan Health Alliance Plan - High Self Plus One
523
1812.14
1937.00
1121.16
815.84
95.96
Michigan Health Alliance Plan - Standard Self
GY4
614.23
557.55
418.16
139.39
-14.17
Michigan Health Alliance Plan - Standard Self & Family
GY5
1498.77
1360.41
1020.31
340.10
-34.59
Michigan Health Alliance Plan - Standard Self Plus One
GY6
1412.78
1282.34
961.76
320.58
-32.61
Michigan Priority Health - High Self
LE1
919.58
1037.29
523.42
513.87
105.13
Michigan Priority Health - High Self & Family
LE2
2161.01
2437.63
1218.21
1219.42
242.43
Michigan Priority Health - High Self Plus One
LE3
2023.06
2282.04
1121.16
1160.88
230.08
Michigan Priority Health - Standard Self
LE4
539.33
587.38
440.54
146.84
12.01
Michigan Priority Health - Standard Self & Family
LE5
1267.44
1380.32
1035.24
345.08
28.22
Michigan Priority Health - Standard Self Plus One
LE6
1186.53
1292.22
969.17
323.05
26.42
Michigan Priority Health - Value Self
Y41
473.24
473.24
354.93
118.31
0.00
Michigan Priority Health - Value Self & Family
Y42
1112.13
1112.13
834.10
278.03
0.00
Michigan Priority Health - Value Self Plus One
Y43
1041.13
1041.13
780.85
260.28
0.00
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Minnesota Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Minnesota Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Minnesota Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Minnesota Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Minnesota Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Minnesota Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Minnesota Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Minnesota Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Minnesota HealthPartners - Standard Self
V34
459.92
509.41
382.06
127.35
12.37
Minnesota HealthPartners - Standard Self & Family
V35
1120.41
1240.94
930.71
310.23
30.13
Minnesota HealthPartners - Standard Self Plus One
V36
1016.45
1125.80
844.35
281.45
27.34
Minnesota HealthPartners - High Self
V31
712.31
668.07
501.05
167.02
-34.45
Minnesota HealthPartners - High Self & Family
V32
1735.20
1627.38
1218.21
409.17
-142.01
Minnesota HealthPartners - High Self Plus One
V33
1574.21
1476.41
1107.31
369.10
-112.85
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Mississippi Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Mississippi Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Mississippi Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Mississippi Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Mississippi Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Mississippi Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Mississippi Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Mississippi Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Missouri Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Missouri Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Missouri Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Missouri Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Missouri Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Missouri Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Missouri Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Missouri Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Missouri Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Missouri Aetna Open Access - High Self
HA1
1099.93
1156.52
523.42
633.10
44.01
Missouri Aetna Open Access - High Self & Family
HA2
2598.18
2731.91
1218.21
1513.70
99.54
Missouri Aetna Open Access - High Self Plus One
HA3
2572.53
2704.89
1121.16
1583.73
103.46
Missouri Aetna Open Access - Standard Self
HA4
716.37
901.36
523.42
377.94
172.41
Missouri Aetna Open Access - Standard Self & Family
HA5
1690.89
2127.54
1218.21
909.33
402.46
Missouri Aetna Open Access - Standard Self Plus One
HA6
1674.16
2106.48
1121.16
985.32
403.42
Missouri Blue Preferred - High Self
9G1
833.21
874.23
523.42
350.81
28.44
Missouri Blue Preferred - High Self & Family
9G2
1858.87
1984.52
1218.21
766.31
91.46
Missouri Blue Preferred - High Self Plus One
9G3
1760.59
1862.12
1121.16
740.96
72.63
Missouri Blue Preferred - Standard Self
9G4
600.62
633.66
475.25
158.41
8.26
Missouri Blue Preferred - Standard Self & Family
9G5
1707.01
1758.23
1218.21
540.02
17.03
Missouri Blue Preferred - Standard Self Plus One
9G6
1543.71
1574.58
1121.16
453.42
1.97
Missouri Humana CoverageFirst and Humana Value Plan - Value Self
PH4
484.03
527.61
395.71
131.90
10.89
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
1089.10
1187.12
890.34
296.78
24.51
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
1040.67
1134.36
850.77
283.59
23.42
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
715.11
758.03
523.42
234.61
30.34
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1609.03
1705.58
1218.21
487.37
62.36
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1537.51
1629.77
1121.16
508.61
63.36
Missouri Humana Health Plan, Inc. - High Self
MS1
1723.17
1796.84
523.42
1273.42
61.09
Missouri Humana Health Plan, Inc. - High Self & Family
MS2
3877.12
4042.89
1218.21
2824.68
131.58
Missouri Humana Health Plan, Inc. - High Self Plus One
MS3
3704.81
3863.17
1121.16
2742.01
129.46
Missouri Humana Health Plan, Inc. - Standard Self
MS4
1067.00
1200.59
523.42
677.17
121.01
Missouri Humana Health Plan, Inc. - Standard Self & Family
MS5
2400.78
2701.34
1218.21
1483.13
266.37
Missouri Humana Health Plan, Inc. - Standard Self Plus One
MS6
2294.09
2581.32
1121.16
1460.16
258.33
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Montana Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Montana Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Montana Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Montana Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Montana Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Montana Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Montana Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Montana Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Montana Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Nebraska Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Nebraska Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Nebraska Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Nebraska Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Nebraska Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Nebraska Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Nebraska Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Nebraska Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Nevada Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Nevada Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Nevada Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Nevada Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Nevada Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Nevada Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Nevada Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Nevada Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Nevada Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Nevada Health Plan of Nevada, Inc. - High Self
NM1
706.98
741.17
523.42
217.75
21.61
Nevada Health Plan of Nevada, Inc. - High Self & Family
NM2
1675.48
1756.50
1218.21
538.29
46.83
Nevada Health Plan of Nevada, Inc. - High Self Plus One
NM3
1343.29
1408.23
1056.17
352.06
16.24
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
522.86
622.22
466.67
155.55
24.84
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1236.39
1471.54
1103.66
367.88
58.78
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1124.05
1337.77
1003.33
334.44
53.43
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
443.84
528.17
396.13
132.04
21.08
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1020.85
1214.76
911.07
303.69
48.48
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
954.27
1135.55
851.66
283.89
45.32
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
724.77
782.12
523.42
258.70
44.77
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1811.90
1955.35
1218.21
737.14
109.26
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1558.25
1681.57
1121.16
560.41
94.42
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
522.02
621.21
465.91
155.30
24.80
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1234.37
1469.13
1101.85
367.28
58.69
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1122.23
1335.58
1001.69
333.89
53.33
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
New Hampshire Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
New Hampshire Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
New Hampshire Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
New Hampshire Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
New Hampshire Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
New Hampshire Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
New Hampshire Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
New Hampshire UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
New Hampshire UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
New Hampshire UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
New Jersey Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
New Jersey Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
New Jersey Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
New Jersey Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
New Jersey Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
New Jersey Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
New Jersey Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
New Jersey Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
New Jersey Aetna Open Access - High Self
JR1
1544.75
1656.81
523.42
1133.39
99.48
New Jersey Aetna Open Access - High Self & Family
JR2
3568.20
3827.03
1218.21
2608.82
224.64
New Jersey Aetna Open Access - High Self Plus One
JR3
3532.84
3789.11
1121.16
2667.95
227.37
New Jersey Aetna Open Access - Basic Self
JR4
1373.28
1429.35
523.42
905.93
43.49
New Jersey Aetna Open Access - Basic Self & Family
JR5
3182.68
3312.70
1218.21
2094.49
95.83
New Jersey Aetna Open Access - Basic Self Plus One
JR6
3151.16
3279.88
1121.16
2158.72
99.82
New Jersey Aetna Open Access - Basic Self
P34
1310.08
1505.53
523.42
982.11
182.87
New Jersey Aetna Open Access - Basic Self & Family
P35
3040.68
3494.34
1218.21
2276.13
419.47
New Jersey Aetna Open Access - Basic Self Plus One
P36
3010.54
3459.73
1121.16
2338.57
420.29
New Jersey Aetna Open Access - High Self
P31
1456.61
1588.23
523.42
1064.81
119.04
New Jersey Aetna Open Access - High Self & Family
P32
3531.54
3850.71
1218.21
2632.50
284.98
New Jersey Aetna Open Access - High Self Plus One
P33
3496.55
3812.58
1121.16
2691.42
287.13
New Jersey GHI Health Plan - Standard Self
804
1004.66
1039.85
523.42
516.43
22.61
New Jersey GHI Health Plan - Standard Self & Family
805
2437.41
2522.72
1218.21
1304.51
51.12
New Jersey GHI Health Plan - Standard Self Plus One
806
2336.92
2418.74
1121.16
1297.58
52.92
New Jersey UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
New Jersey UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
New Jersey UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
New Mexico Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
New Mexico Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
New Mexico Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
New Mexico Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
New Mexico Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
New Mexico Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
New Mexico Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
New Mexico Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
New Mexico Presbyterian Health Plan - High Self
P21
840.99
846.93
523.42
323.51
-6.64
New Mexico Presbyterian Health Plan - High Self & Family
P22
1976.30
1990.34
1218.21
772.13
-20.15
New Mexico Presbyterian Health Plan - High Self Plus One
P23
1909.03
1922.59
1121.16
801.43
-15.34
New Mexico Presbyterian Health Plan - Standard Self
PS4
710.28
706.31
523.42
182.89
-16.55
New Mexico Presbyterian Health Plan - Standard Self & Family
PS5
1669.16
1659.84
1218.21
441.63
-43.51
New Mexico Presbyterian Health Plan - Standard Self Plus One
PS6
1612.35
1603.38
1121.16
482.22
-37.87
New Mexico Presbyterian Health Plan - Wellness Self
PS1
619.88
632.06
474.05
158.01
3.04
New Mexico Presbyterian Health Plan - Wellness Self & Family
PS2
1456.76
1485.36
1114.02
371.34
7.15
New Mexico Presbyterian Health Plan - Wellness Self Plus One
PS3
1407.19
1434.79
1076.09
358.70
6.90
New Mexico True Health New Mexico - High Self
EL1
620.17
639.08
479.31
159.77
4.73
New Mexico True Health New Mexico - High Self & Family
EL2
1464.47
1509.13
1131.85
377.28
11.16
New Mexico True Health New Mexico - High Self Plus One
EL3
1388.03
1430.35
1072.76
357.59
10.58
New Mexico UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
New Mexico UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
New Mexico UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
New York Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
New York Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
New York Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
New York Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
New York Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
New York Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
New York Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
New York Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
New York Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
New York Aetna Open Access - High Self
JC1
1320.37
1459.58
523.42
936.16
126.63
New York Aetna Open Access - High Self & Family
JC2
3262.57
3606.57
1218.21
2388.36
309.81
New York Aetna Open Access - High Self Plus One
JC3
3230.26
3570.88
1121.16
2449.72
311.72
New York Aetna Open Access - Basic Self
JC4
1102.42
1219.86
523.42
696.44
104.86
New York Aetna Open Access - Basic Self & Family
JC5
2689.03
2975.51
1218.21
1757.30
252.29
New York Aetna Open Access - Basic Self Plus One
JC6
2662.44
2946.06
1121.16
1824.90
254.72
New York CDPHP - Standard Self
SG4
629.61
704.56
523.42
181.14
23.74
New York CDPHP - Standard Self & Family
SG5
1792.64
1690.87
1218.21
472.66
-135.96
New York CDPHP - Standard Self Plus One
SG6
1303.25
1564.12
1121.16
442.96
117.15
New York GHI Health Plan - Standard Self
804
1004.66
1039.85
523.42
516.43
22.61
New York GHI Health Plan - Standard Self & Family
805
2437.41
2522.72
1218.21
1304.51
51.12
New York GHI Health Plan - Standard Self Plus One
806
2336.92
2418.74
1121.16
1297.58
52.92
New York HIP of Greater NY - Standard Self
YL4
813.87
900.68
523.42
377.26
74.23
New York HIP of Greater NY - Standard Self & Family
YL5
2339.98
2618.24
1218.21
1400.03
244.07
New York HIP of Greater NY - Standard Self Plus One
YL6
1480.25
1644.59
1121.16
523.43
135.44
New York HIP of Greater NY - High Self
511
1071.05
1050.75
523.42
527.33
-32.88
New York HIP of Greater NY - High Self & Family
512
3081.98
3054.39
1218.21
1836.18
-61.78
New York HIP of Greater NY - High Self Plus One
513
1948.55
1918.63
1121.16
797.47
-58.82
New York Independent Health - Standard Self
C54
711.62
722.15
523.42
198.73
-2.05
New York Independent Health - Standard Self & Family
C55
1921.38
1949.81
1218.21
731.60
-5.76
New York Independent Health - Standard Self Plus One
C56
1814.61
1841.49
1121.16
720.33
-2.02
New York Independent Health - High Self
QA1
762.67
790.94
523.42
267.52
15.69
New York Independent Health - High Self & Family
QA2
2059.18
2135.55
1218.21
917.34
42.18
New York Independent Health - High Self Plus One
QA3
1944.80
2016.91
1121.16
895.75
43.21
New York Independent Health - HDHP Self
QA4
592.87
599.30
449.48
149.82
1.60
New York Independent Health - HDHP Self & Family
QA5
1533.13
1551.36
1163.52
387.84
4.56
New York Independent Health - HDHP Self Plus One
QA6
1429.61
1475.76
1106.82
368.94
11.54
New York UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
New York UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
New York UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
North Carolina Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
North Carolina Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
North Carolina Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
North Carolina Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
North Carolina Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
North Carolina Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
North Carolina Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
North Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
North Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
North Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
North Dakota Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
North Dakota Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
North Dakota Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
North Dakota Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
North Dakota Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
North Dakota Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
North Dakota Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
North Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
North Dakota HealthPartners - Standard Self
V34
459.92
509.41
382.06
127.35
12.37
North Dakota HealthPartners - Standard Self & Family
V35
1120.41
1240.94
930.71
310.23
30.13
North Dakota HealthPartners - Standard Self Plus One
V36
1016.45
1125.80
844.35
281.45
27.34
North Dakota HealthPartners - High Self
V31
712.31
668.07
501.05
167.02
-34.45
North Dakota HealthPartners - High Self & Family
V32
1735.20
1627.38
1218.21
409.17
-142.01
North Dakota HealthPartners - High Self Plus One
V33
1574.21
1476.41
1107.31
369.10
-112.85
North Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
North Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
North Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Northern Mariana Islands Calvo's SelectCare - Standard Self
B44
396.74
429.78
322.34
107.44
8.26
Northern Mariana Islands Calvo's SelectCare - Standard Self & Family
B45
1152.73
1248.72
936.54
312.18
24.00
Northern Mariana Islands Calvo's SelectCare - Standard Self Plus One
B46
782.10
847.21
635.41
211.80
16.28
Northern Mariana Islands Calvo's SelectCare - High Self
B41
491.55
521.69
391.27
130.42
7.53
Northern Mariana Islands Calvo's SelectCare - High Self & Family
B42
1301.89
1381.77
1036.33
345.44
19.97
Northern Mariana Islands Calvo's SelectCare - High Self Plus One
B43
959.23
1018.07
763.55
254.52
14.71
Northern Mariana Islands TakeCare - HDHP Self
KX1
124.24
120.53
90.40
30.13
-0.93
Northern Mariana Islands TakeCare - HDHP Self & Family
KX2
339.32
323.16
242.37
80.79
-4.04
Northern Mariana Islands TakeCare - HDHP Self Plus One
KX3
306.11
290.94
218.21
72.73
-3.80
Northern Mariana Islands TakeCare - Standard Self
JK4
389.24
404.45
303.34
101.11
3.80
Northern Mariana Islands TakeCare - Standard Self & Family
JK5
1102.31
1145.39
859.04
286.35
10.77
Northern Mariana Islands TakeCare - Standard Self Plus One
JK6
767.15
797.14
597.86
199.28
7.49
Northern Mariana Islands TakeCare - High Self
JK1
492.35
497.81
373.36
124.45
1.36
Northern Mariana Islands TakeCare - High Self & Family
JK2
1174.40
1187.38
890.54
296.84
3.24
Northern Mariana Islands TakeCare - High Self Plus One
JK3
972.73
983.49
737.62
245.87
2.69
Ohio Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Ohio Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Ohio Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Ohio Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Ohio Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Ohio Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Ohio Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Ohio Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Ohio Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Ohio AultCare Insurance Company - High Self
3A1
842.03
875.88
523.42
352.46
21.27
Ohio AultCare Insurance Company - High Self & Family
3A2
2079.78
2163.29
1218.21
945.08
49.32
Ohio AultCare Insurance Company - High Self Plus One
3A3
1768.24
1839.24
1121.16
718.08
42.10
Ohio AultCare Insurance Company - HDHP Self
3A4
437.62
465.88
349.41
116.47
7.07
Ohio AultCare Insurance Company - HDHP Self & Family
3A5
1401.25
1491.77
1118.83
372.94
22.63
Ohio AultCare Insurance Company - HDHP Self Plus One
3A6
831.96
885.69
664.27
221.42
13.43
Ohio Humana CoverageFirst and Humana Value Plan - Value Self
X34
615.12
645.88
484.41
161.47
7.69
Ohio Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1384.05
1453.25
1089.94
363.31
17.30
Ohio Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1322.53
1388.66
1041.50
347.16
16.53
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
799.44
839.41
523.42
315.99
27.39
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1798.77
1888.71
1218.21
670.50
55.75
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1718.82
1804.77
1121.16
683.61
57.05
Ohio Humana Health Plan of Ohio, Inc. - High Self
A61
1500.98
1576.03
523.42
1052.61
62.47
Ohio Humana Health Plan of Ohio, Inc. - High Self & Family
A62
3377.23
3546.10
1218.21
2327.89
134.68
Ohio Humana Health Plan of Ohio, Inc. - High Self Plus One
A63
3227.14
3388.49
1121.16
2267.33
132.45
Ohio Humana Health Plan of Ohio, Inc. - Standard Self
A64
1172.17
1230.78
523.42
707.36
46.03
Ohio Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2637.42
2769.30
1218.21
1551.09
97.69
Ohio Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2520.20
2646.19
1121.16
1525.03
97.09
Ohio Humana Health Plan of Ohio, Inc. - Basic Self
W61
608.62
639.06
479.30
159.76
7.61
Ohio Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1369.44
1437.93
1078.45
359.48
17.12
Ohio Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1308.58
1374.01
1030.51
343.50
16.36
Ohio Medical Mutual of Ohio - Basic Self
YF1
440.14
415.05
311.29
103.76
-6.27
Ohio Medical Mutual of Ohio - Basic Self & Family
YF2
1056.34
996.10
747.08
249.02
-15.06
Ohio Medical Mutual of Ohio - Basic Self Plus One
YF3
968.33
913.10
684.83
228.27
-13.81
Ohio Medical Mutual of Ohio - Standard Self
YF4
968.98
985.86
523.42
462.44
4.30
Ohio Medical Mutual of Ohio - Standard Self & Family
YF5
2325.55
2366.04
1218.21
1147.83
6.30
Ohio Medical Mutual of Ohio - Standard Self Plus One
YF6
2131.74
2168.88
1121.16
1047.72
8.24
Ohio Medical Mutual of Ohio - Standard Self
644
1027.78
940.96
523.42
417.54
-99.40
Ohio Medical Mutual of Ohio - Standard Self & Family
645
2466.71
2258.32
1218.21
1040.11
-242.58
Ohio Medical Mutual of Ohio - Standard Self Plus One
646
2261.16
2070.12
1121.16
948.96
-219.94
Ohio Medical Mutual of Ohio - Standard Self
X64
849.42
861.34
523.42
337.92
-0.66
Ohio Medical Mutual of Ohio - Standard Self & Family
X65
2038.60
2067.22
1218.21
849.01
-5.57
Ohio Medical Mutual of Ohio - Standard Self Plus One
X66
1868.71
1894.95
1121.16
773.79
-2.66
Ohio Medical Mutual of Ohio - Basic Self
X61
439.99
405.28
303.96
101.32
-8.68
Ohio Medical Mutual of Ohio - Basic Self & Family
X62
1055.95
972.68
729.51
243.17
-20.82
Ohio Medical Mutual of Ohio - Basic Self Plus One
X63
967.96
891.63
668.72
222.91
-19.08
Ohio Medical Mutual of Ohio - Basic Self
UX1
440.14
411.21
308.41
102.80
-7.23
Ohio Medical Mutual of Ohio - Basic Self & Family
UX2
1056.34
986.92
740.19
246.73
-17.35
Ohio Medical Mutual of Ohio - Basic Self Plus One
UX3
968.33
904.67
678.50
226.17
-15.91
Ohio UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Ohio UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Ohio UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Oklahoma Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Oklahoma Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Oklahoma Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Oklahoma Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Oklahoma Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Oklahoma Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Oklahoma Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Oklahoma GlobalHealth - Standard Self
IM4
622.94
659.92
494.94
164.98
9.25
Oklahoma GlobalHealth - Standard Self & Family
IM5
1557.38
1649.85
1218.21
431.64
42.30
Oklahoma GlobalHealth - Standard Self Plus One
IM6
1245.90
1319.87
989.90
329.97
18.50
Oklahoma GlobalHealth - High Self
IM1
659.27
698.27
523.42
174.85
10.03
Oklahoma GlobalHealth - High Self & Family
IM2
1648.16
1745.66
1218.21
527.45
63.31
Oklahoma GlobalHealth - High Self Plus One
IM3
1318.53
1396.55
1047.41
349.14
19.51
Oklahoma UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Oklahoma UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Oklahoma UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Oregon Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Oregon Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Oregon Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Oregon Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Oregon Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Oregon Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Oregon Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Oregon Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Oregon Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Oregon Kaiser Permanente - Northwest - Standard Self
574
647.96
688.35
516.26
172.09
10.10
Oregon Kaiser Permanente - Northwest - Standard Self & Family
575
1488.54
1581.34
1186.01
395.33
23.20
Oregon Kaiser Permanente - Northwest - Standard Self Plus One
576
1488.54
1581.34
1121.16
460.18
63.90
Oregon Kaiser Permanente - Northwest - High Self
571
729.93
751.68
523.42
228.26
9.17
Oregon Kaiser Permanente - Northwest - High Self & Family
572
1648.70
1697.82
1218.21
479.61
14.93
Oregon Kaiser Permanente - Northwest - High Self Plus One
573
1648.70
1697.82
1121.16
576.66
20.22
Oregon Kaiser Permanente - Northwest - Prosper Self
AM1
New Plan
391.78
293.84
97.94
New Plan
Oregon Kaiser Permanente - Northwest - Prosper Self & Family
AM2
New Plan
926.47
694.85
231.62
New Plan
Oregon Kaiser Permanente - Northwest - Prosper Self Plus One
AM3
New Plan
842.29
631.72
210.57
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
522.86
622.22
466.67
155.55
24.84
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1236.39
1471.54
1103.66
367.88
58.78
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1124.05
1337.77
1003.33
334.44
53.43
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
443.84
528.17
396.13
132.04
21.08
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1020.85
1214.76
911.07
303.69
48.48
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
954.27
1135.55
851.66
283.89
45.32
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
724.77
782.12
523.42
258.70
44.77
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1811.90
1955.35
1218.21
737.14
109.26
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1558.25
1681.57
1121.16
560.41
94.42
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
522.02
621.21
465.91
155.30
24.80
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1234.37
1469.13
1101.85
367.28
58.69
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1122.23
1335.58
1001.69
333.89
53.33
Oregon UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Oregon UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Palau Calvo's SelectCare - Standard Self
B44
396.74
429.78
322.34
107.44
8.26
Palau Calvo's SelectCare - Standard Self & Family
B45
1152.73
1248.72
936.54
312.18
24.00
Palau Calvo's SelectCare - Standard Self Plus One
B46
782.10
847.21
635.41
211.80
16.28
Palau Calvo's SelectCare - High Self
B41
491.55
521.69
391.27
130.42
7.53
Palau Calvo's SelectCare - High Self & Family
B42
1301.89
1381.77
1036.33
345.44
19.97
Palau Calvo's SelectCare - High Self Plus One
B43
959.23
1018.07
763.55
254.52
14.71
Palau TakeCare - HDHP Self
KX1
124.24
120.53
90.40
30.13
-0.93
Palau TakeCare - HDHP Self & Family
KX2
339.32
323.16
242.37
80.79
-4.04
Palau TakeCare - HDHP Self Plus One
KX3
306.11
290.94
218.21
72.73
-3.80
Palau TakeCare - Standard Self
JK4
389.24
404.45
303.34
101.11
3.80
Palau TakeCare - Standard Self & Family
JK5
1102.31
1145.39
859.04
286.35
10.77
Palau TakeCare - Standard Self Plus One
JK6
767.15
797.14
597.86
199.28
7.49
Palau TakeCare - High Self
JK1
492.35
497.81
373.36
124.45
1.36
Palau TakeCare - High Self & Family
JK2
1174.40
1187.38
890.54
296.84
3.24
Palau TakeCare - High Self Plus One
JK3
972.73
983.49
737.62
245.87
2.69
Pennsylvania Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Pennsylvania Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Pennsylvania Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Pennsylvania Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Pennsylvania Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Pennsylvania Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Pennsylvania Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Pennsylvania Aetna Open Access - Basic Self
P34
1310.08
1505.53
523.42
982.11
182.87
Pennsylvania Aetna Open Access - Basic Self & Family
P35
3040.68
3494.34
1218.21
2276.13
419.47
Pennsylvania Aetna Open Access - Basic Self Plus One
P36
3010.54
3459.73
1121.16
2338.57
420.29
Pennsylvania Aetna Open Access - High Self
P31
1456.61
1588.23
523.42
1064.81
119.04
Pennsylvania Aetna Open Access - High Self & Family
P32
3531.54
3850.71
1218.21
2632.50
284.98
Pennsylvania Aetna Open Access - High Self Plus One
P33
3496.55
3812.58
1121.16
2691.42
287.13
Pennsylvania Aetna Open Access - High Self
YE1
1215.13
1206.55
523.42
683.13
-21.16
Pennsylvania Aetna Open Access - High Self & Family
YE2
3051.19
3029.63
1218.21
1811.42
-55.75
Pennsylvania Aetna Open Access - High Self Plus One
YE3
3020.98
2999.64
1121.16
1878.48
-50.24
Pennsylvania Geisinger Health Plan - Standard Self
GG4
822.73
912.69
523.42
389.27
77.38
Pennsylvania Geisinger Health Plan - Standard Self & Family
GG5
1883.68
2089.62
1218.21
871.41
171.75
Pennsylvania Geisinger Health Plan - Standard Self Plus One
GG6
1777.71
1972.08
1121.16
850.92
165.47
Pennsylvania Geisinger Health Plan - Basic Self
AJ1
New Plan
802.06
523.42
278.64
New Plan
Pennsylvania Geisinger Health Plan - Basic Self & Family
AJ2
New Plan
1836.32
1218.21
618.11
New Plan
Pennsylvania Geisinger Health Plan - Basic Self Plus One
AJ3
New Plan
1732.99
1121.16
611.83
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
486.57
519.91
389.93
129.98
8.34
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1119.11
1195.81
896.86
298.95
19.17
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1046.13
1117.81
838.36
279.45
17.92
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
714.89
770.40
523.42
246.98
42.93
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1694.29
1825.83
1218.21
607.62
97.35
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1536.99
1656.33
1121.16
535.17
90.44
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Pennsylvania UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Pennsylvania UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Pennsylvania UPMC Health Plan - Standard Self
YT4
904.09
966.31
523.42
442.89
49.64
Pennsylvania UPMC Health Plan - Standard Self & Family
YT5
2121.97
2268.63
1218.21
1050.42
112.47
Pennsylvania UPMC Health Plan - Standard Self Plus One
YT6
2032.46
2172.78
1121.16
1051.62
111.42
Pennsylvania UPMC Health Plan - HDHP Self
YS4
775.80
808.45
523.42
285.03
20.07
Pennsylvania UPMC Health Plan - HDHP Self & Family
YS5
1791.05
1867.91
1218.21
649.70
42.67
Pennsylvania UPMC Health Plan - HDHP Self Plus One
YS6
1721.72
1795.30
1121.16
674.14
44.68
Pennsylvania UPMC Health Plan - HDHP Self
8W4
610.63
641.66
481.25
160.41
7.75
Pennsylvania UPMC Health Plan - HDHP Self & Family
8W5
1405.00
1476.87
1107.65
369.22
17.97
Pennsylvania UPMC Health Plan - HDHP Self Plus One
8W6
1351.63
1420.71
1065.53
355.18
17.27
Pennsylvania UPMC Health Plan - Standard Self
UW4
673.68
682.22
511.67
170.55
2.13
Pennsylvania UPMC Health Plan - Standard Self & Family
UW5
1580.74
1601.25
1200.94
400.31
3.59
Pennsylvania UPMC Health Plan - Standard Self Plus One
UW6
1514.20
1533.74
1121.16
412.58
-9.36
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self
ZJ1
390.24
457.88
343.41
114.47
16.91
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self & Family
ZJ2
878.06
1030.23
772.67
257.56
38.05
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self Plus One
ZJ3
839.02
984.45
738.34
246.11
36.36
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self
891
390.04
390.04
292.53
97.51
0.00
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self & Family
892
893.21
893.21
669.91
223.30
0.00
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self Plus One
893
875.79
875.79
656.84
218.95
0.00
Rhode Island Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Rhode Island Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Rhode Island Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Rhode Island Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Rhode Island Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Rhode Island Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Rhode Island Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Rhode Island UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Rhode Island UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Rhode Island UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
South Carolina Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
South Carolina Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
South Carolina Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
South Carolina Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
South Carolina Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
South Carolina Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
South Carolina Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
South Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
South Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
South Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
South Carolina UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
South Dakota Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
South Dakota Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
South Dakota Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
South Dakota Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
South Dakota Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
South Dakota Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
South Dakota Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
South Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
South Dakota HealthPartners - Standard Self
V34
459.92
509.41
382.06
127.35
12.37
South Dakota HealthPartners - Standard Self & Family
V35
1120.41
1240.94
930.71
310.23
30.13
South Dakota HealthPartners - Standard Self Plus One
V36
1016.45
1125.80
844.35
281.45
27.34
South Dakota HealthPartners - High Self
V31
712.31
668.07
501.05
167.02
-34.45
South Dakota HealthPartners - High Self & Family
V32
1735.20
1627.38
1218.21
409.17
-142.01
South Dakota HealthPartners - High Self Plus One
V33
1574.21
1476.41
1107.31
369.10
-112.85
South Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
South Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
South Dakota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Tennessee Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Tennessee Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Tennessee Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Tennessee Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Tennessee Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Tennessee Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Tennessee Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Tennessee Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self
TT1
745.31
790.01
523.42
266.59
32.12
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TT2
1676.98
1777.58
1218.21
559.37
66.41
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TT3
1602.45
1698.58
1121.16
577.42
67.23
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self
TT4
682.96
723.93
523.42
200.51
28.39
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self & Family
TT5
1536.62
1628.79
1218.21
410.58
26.43
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TT6
1468.31
1556.43
1121.16
435.27
59.22
Tennessee Humana Health Plan, Inc. - High Self
GJ1
1175.79
1222.82
523.42
699.40
34.45
Tennessee Humana Health Plan, Inc. - High Self & Family
GJ2
2645.44
2751.26
1218.21
1533.05
71.63
Tennessee Humana Health Plan, Inc. - High Self Plus One
GJ3
2527.85
2628.97
1121.16
1507.81
72.22
Tennessee Humana Health Plan, Inc. - Standard Self
GJ4
870.13
904.91
523.42
381.49
22.20
Tennessee Humana Health Plan, Inc. - Standard Self & Family
GJ5
1957.78
2036.08
1218.21
817.87
44.11
Tennessee Humana Health Plan, Inc. - Standard Self Plus One
GJ6
1870.77
1945.60
1121.16
824.44
45.93
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
454.74
485.85
364.39
121.46
7.78
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1045.92
1117.50
838.13
279.37
17.89
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
977.71
1044.59
783.44
261.15
16.72
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
713.87
769.04
523.42
245.62
42.59
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1784.71
1922.64
1218.21
704.43
103.74
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1534.87
1653.47
1121.16
532.31
89.70
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Tennessee UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Tennessee UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Texas Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Texas Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Texas Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Texas Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Texas Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Texas Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Texas Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Texas Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Texas Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Texas Humana CoverageFirst and Humana Value Plan - Value Self
T34
528.17
565.11
423.83
141.28
9.24
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
T35
1188.33
1271.53
953.65
317.88
20.80
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
T36
1135.53
1215.02
911.27
303.75
19.87
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
T31
758.75
811.87
523.42
288.45
40.54
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
T32
1707.16
1826.67
1218.21
608.46
85.32
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
T33
1631.33
1745.51
1121.16
624.35
85.28
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TV1
842.03
909.39
523.42
385.97
54.78
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TV2
1894.60
2046.16
1218.21
827.95
117.37
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TV3
1810.40
1955.24
1121.16
834.08
115.94
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TV4
665.99
719.27
523.42
195.85
29.35
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TV5
1498.51
1618.39
1213.79
404.60
29.97
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TV6
1431.93
1546.48
1121.16
425.32
67.34
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TU4
527.71
600.62
450.47
150.15
18.22
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TU5
1187.38
1351.42
1013.57
337.85
41.01
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TU6
1134.62
1291.38
968.54
322.84
39.19
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TU1
645.78
729.73
523.42
206.31
44.87
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TU2
1453.01
1641.92
1218.21
423.71
60.46
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TU3
1388.44
1568.93
1121.16
447.77
100.66
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TP1
721.61
772.14
523.42
248.72
37.95
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TP2
1623.61
1737.28
1218.21
519.07
79.48
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TP3
1551.49
1660.08
1121.16
538.92
79.69
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TP4
422.87
452.47
339.35
113.12
7.40
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TP5
951.45
1018.05
763.54
254.51
16.65
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TP6
909.18
972.81
729.61
243.20
15.91
Texas Humana Health Plan of Texas - Standard Self
UC4
839.87
898.65
523.42
375.23
46.20
Texas Humana Health Plan of Texas - Standard Self & Family
UC5
1889.66
2021.96
1218.21
803.75
98.11
Texas Humana Health Plan of Texas - Standard Self Plus One
UC6
1805.68
1932.08
1121.16
810.92
97.50
Texas Humana Health Plan of Texas - High Self
UC1
1095.27
1171.95
523.42
648.53
64.10
Texas Humana Health Plan of Texas - High Self & Family
UC2
2464.41
2636.92
1218.21
1418.71
138.32
Texas Humana Health Plan of Texas - High Self Plus One
UC3
2354.86
2519.73
1121.16
1398.57
135.97
Texas Humana Health Plan of Texas - Basic Self
QX1
749.26
817.38
523.42
293.96
55.54
Texas Humana Health Plan of Texas - Basic Self & Family
QX2
1685.84
1839.09
1218.21
620.88
119.06
Texas Humana Health Plan of Texas - Basic Self Plus One
QX3
1610.92
1757.36
1121.16
636.20
117.54
Texas Humana Health Plan of Texas - Standard Self
EW4
835.92
936.24
523.42
412.82
87.74
Texas Humana Health Plan of Texas - Standard Self & Family
EW5
1880.82
2106.50
1218.21
888.29
191.49
Texas Humana Health Plan of Texas - Standard Self Plus One
EW6
1797.21
2012.88
1121.16
891.72
186.77
Texas Humana Health Plan of Texas - High Self
EW1
1131.95
1267.83
523.42
744.41
123.30
Texas Humana Health Plan of Texas - High Self & Family
EW2
2546.94
2852.59
1218.21
1634.38
271.46
Texas Humana Health Plan of Texas - High Self Plus One
EW3
2433.75
2725.82
1121.16
1604.66
263.17
Texas Humana Health Plan of Texas - Basic Self
QY1
760.96
844.65
523.42
321.23
71.11
Texas Humana Health Plan of Texas - Basic Self & Family
QY2
1712.12
1900.47
1218.21
682.26
154.16
Texas Humana Health Plan of Texas - Basic Self Plus One
QY3
1636.05
1816.04
1121.16
694.88
151.09
Texas Humana Health Plan of Texas - Basic Self
Q21
734.93
786.37
523.42
262.95
38.86
Texas Humana Health Plan of Texas - Basic Self & Family
Q22
1653.56
1769.32
1218.21
551.11
81.57
Texas Humana Health Plan of Texas - Basic Self Plus One
Q23
1580.04
1690.63
1121.16
569.47
81.69
Texas Humana Health Plan of Texas - Basic Self
Q61
624.26
699.16
523.42
175.74
19.68
Texas Humana Health Plan of Texas - Basic Self & Family
Q62
1404.61
1573.17
1179.88
393.29
42.14
Texas Humana Health Plan of Texas - Basic Self Plus One
Q63
1342.19
1503.23
1121.16
382.07
46.52
Texas Humana Health Plan of Texas - Standard Self
UU4
1660.77
1608.19
523.42
1084.77
-65.16
Texas Humana Health Plan of Texas - Standard Self & Family
UU5
3736.72
3618.40
1218.21
2400.19
-152.51
Texas Humana Health Plan of Texas - Standard Self Plus One
UU6
3570.62
3457.57
1121.16
2336.41
-141.95
Texas Humana Health Plan of Texas - High Self
UU1
1544.75
1621.99
523.42
1098.57
64.66
Texas Humana Health Plan of Texas - High Self & Family
UU2
3475.66
3649.43
1218.21
2431.22
139.58
Texas Humana Health Plan of Texas - High Self Plus One
UU3
3321.20
3487.25
1121.16
2366.09
137.15
Texas Humana Health Plan of Texas - Standard Self
UR4
980.01
1069.55
523.42
546.13
76.96
Texas Humana Health Plan of Texas - Standard Self & Family
UR5
2205.00
2406.45
1218.21
1188.24
167.26
Texas Humana Health Plan of Texas - Standard Self Plus One
UR6
2107.00
2299.48
1121.16
1178.32
163.58
Texas Humana Health Plan of Texas - High Self
UR1
1382.29
1563.75
523.42
1040.33
168.88
Texas Humana Health Plan of Texas - High Self & Family
UR2
3110.12
3518.45
1218.21
2300.24
374.14
Texas Humana Health Plan of Texas - High Self Plus One
UR3
2971.91
3362.06
1121.16
2240.90
361.25
Texas Scott and White Health Plan - Basic Self
A81
658.10
585.89
439.42
146.47
-18.05
Texas Scott and White Health Plan - Basic Self & Family
A82
1544.21
1374.53
1030.90
343.63
-42.42
Texas Scott and White Health Plan - Basic Self Plus One
A83
1458.88
1298.59
973.94
324.65
-41.97
Texas Scott and White Health Plan - Standard Self
A84
785.42
861.23
523.42
337.81
63.23
Texas Scott and White Health Plan - Standard Self & Family
A85
1843.49
2021.78
1218.21
803.57
144.10
Texas Scott and White Health Plan - Standard Self Plus One
A86
1741.59
1910.05
1121.16
788.89
139.56
Texas Scott and White Health Plan - Basic Self
P81
678.36
603.94
452.96
150.98
-18.61
Texas Scott and White Health Plan - Basic Self & Family
P82
1591.89
1416.96
1062.72
354.24
-53.63
Texas Scott and White Health Plan - Basic Self Plus One
P83
1503.93
1338.68
1004.01
334.67
-77.00
Texas Scott and White Health Plan - Standard Self
P84
824.94
966.68
523.42
443.26
129.16
Texas Scott and White Health Plan - Standard Self & Family
P85
1936.31
2269.43
1218.21
1051.22
298.93
Texas Scott and White Health Plan - Standard Self Plus One
P86
1829.30
2143.96
1121.16
1022.80
285.76
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
521.50
554.62
415.97
138.65
8.28
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1462.26
1555.15
1166.36
388.79
23.23
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1018.46
1083.18
812.39
270.79
16.18
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Texas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Texas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Texas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Utah Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Utah Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Utah Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Utah Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Utah Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Utah Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Utah Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Utah Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Utah Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Utah Altius Health Plan - High Self
9K1
1009.06
1048.36
523.42
524.94
26.72
Utah Altius Health Plan - High Self & Family
9K2
2231.52
2318.46
1218.21
1100.25
52.75
Utah Altius Health Plan - High Self Plus One
9K3
2209.42
2295.50
1121.16
1174.34
57.18
Utah Altius Health Plan - HDHP Self
9K4
529.23
672.49
504.37
168.12
35.81
Utah Altius Health Plan - HDHP Self & Family
9K5
1106.04
1405.43
1054.07
351.36
74.85
Utah Altius Health Plan - HDHP Self Plus One
9K6
1084.37
1377.85
1033.39
344.46
73.37
Utah Altius Health Plan - Standard Self
DK4
761.30
883.11
523.42
359.69
109.23
Utah Altius Health Plan - Standard Self & Family
DK5
1681.23
1950.20
1218.21
731.99
234.78
Utah Altius Health Plan - Standard Self Plus One
DK6
1664.56
1930.87
1121.16
809.71
237.41
Utah SelectHealth Plan - Standard Self
SF4
605.00
628.62
471.47
157.15
5.90
Utah SelectHealth Plan - Standard Self & Family
SF5
1378.87
1571.55
1178.66
392.89
48.17
Utah SelectHealth Plan - Standard Self Plus One
SF6
1378.87
1382.96
1037.22
345.74
1.02
Utah SelectHealth Plan - HDHP Self
WX1
527.19
539.48
404.61
134.87
3.07
Utah SelectHealth Plan - HDHP Self & Family
WX2
1201.53
1348.69
1011.52
337.17
36.79
Utah SelectHealth Plan - HDHP Self Plus One
WX3
1201.53
1186.84
890.13
296.71
-3.67
Utah UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Utah UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Utah UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Vermont Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Vermont Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Vermont Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Vermont Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Vermont Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Vermont Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
759.61
839.63
523.42
316.21
67.44
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1739.51
1922.68
1218.21
704.47
148.98
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1705.38
1884.96
1121.16
763.80
150.68
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1075.75
1124.65
523.42
601.23
36.32
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2453.32
2564.88
1218.21
1346.67
77.37
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2429.03
2539.46
1121.16
1418.30
81.53
Vermont Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Vermont Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Vermont Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Vermont UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Vermont UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Vermont UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self
851
679.03
679.03
509.27
169.76
0.00
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self & Family
852
1555.02
1555.02
1166.27
388.75
0.00
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self Plus One
853
1524.68
1524.68
1121.16
403.52
-28.90
Virginia Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Virginia Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Virginia Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Virginia Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Virginia Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Virginia Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
Virginia Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Virginia Aetna Open Access - High Self
JN1
1137.57
1176.57
523.42
653.15
26.42
Virginia Aetna Open Access - High Self & Family
JN2
2557.43
2645.05
1218.21
1426.84
53.43
Virginia Aetna Open Access - High Self Plus One
JN3
2532.10
2618.85
1121.16
1497.69
57.85
Virginia Aetna Open Access - Basic Self
JN4
697.10
714.42
523.42
191.00
4.74
Virginia Aetna Open Access - Basic Self & Family
JN5
1595.34
1634.92
1218.21
416.71
5.39
Virginia Aetna Open Access - Basic Self Plus One
JN6
1464.99
1501.33
1121.16
380.17
7.44
Virginia Aetna Saver (Open Access) - Saver Self
QQ4
595.21
595.21
446.41
148.80
0.00
Virginia Aetna Saver (Open Access) - Saver Self & Family
QQ5
1362.14
1362.12
1021.59
340.53
0.00
Virginia Aetna Saver (Open Access) - Saver Self Plus One
QQ6
1250.82
1250.82
938.12
312.70
0.00
Virginia CareFirst BlueChoice - Standard Self
2G4
845.54
887.81
523.42
364.39
29.69
Virginia CareFirst BlueChoice - Standard Self & Family
2G5
2008.96
2109.42
1218.21
891.21
66.27
Virginia CareFirst BlueChoice - Standard Self Plus One
2G6
1691.06
1775.61
1121.16
654.45
55.65
Virginia CareFirst BlueChoice - HDHP Self
B61
570.09
570.09
427.57
142.52
0.00
Virginia CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1354.51
1015.88
338.63
0.00
Virginia CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1140.17
855.13
285.04
0.00
Virginia CareFirst BlueChoice - Blue Value Plus Self
B64
705.99
723.67
523.42
200.25
5.10
Virginia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1677.46
1719.38
1218.21
501.17
7.73
Virginia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1412.02
1447.29
1085.47
361.82
8.82
Virginia Kaiser Permanente - Mid-Atlantic States - Basic Self
T71
420.12
427.72
320.79
106.93
1.90
Virginia Kaiser Permanente - Mid-Atlantic States - Basic Self & Family
T72
1026.16
1099.52
824.64
274.88
18.34
Virginia Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One
T73
934.90
951.84
713.88
237.96
4.24
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
571.55
598.28
448.71
149.57
6.68
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1314.50
1376.05
1032.04
344.01
15.39
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1314.50
1376.05
1032.04
344.01
15.39
Virginia Kaiser Permanente - Mid-Atlantic States - High Self
E31
722.82
746.24
523.42
222.82
10.84
Virginia Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1662.53
1716.35
1218.21
498.14
19.63
Virginia Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1662.53
1716.35
1121.16
595.19
24.92
Virginia M.D. IPA - High Self
JP1
876.61
950.89
523.42
427.47
61.70
Virginia M.D. IPA - High Self & Family
JP2
2458.04
2666.28
1218.21
1448.07
174.05
Virginia M.D. IPA - High Self Plus One
JP3
1712.04
1857.09
1121.16
735.93
116.15
Virginia Optima Health - HDHP Self
PG4
644.41
605.09
453.82
151.27
-9.83
Virginia Optima Health - HDHP Self & Family
PG5
1421.49
1334.78
1001.09
333.69
-21.68
Virginia Optima Health - HDHP Self Plus One
PG6
1393.62
1308.60
981.45
327.15
-21.25
Virginia Optima Health - High Self
PG1
692.10
719.55
523.42
196.13
14.87
Virginia Optima Health - High Self & Family
PG2
1672.36
1738.69
1218.21
520.48
32.14
Virginia Optima Health - High Self Plus One
PG3
1672.23
1738.56
1121.16
617.40
37.43
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
525.81
599.47
449.60
149.87
18.42
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1243.36
1417.76
1063.32
354.44
43.60
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1130.42
1288.89
966.67
322.22
39.62
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
486.57
519.91
389.93
129.98
8.34
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1119.11
1195.81
896.86
298.95
19.17
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1046.13
1117.81
838.36
279.45
17.92
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
714.89
770.40
523.42
246.98
42.93
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1694.29
1825.83
1218.21
607.62
97.35
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1536.99
1656.33
1121.16
535.17
90.44
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
521.50
554.62
415.97
138.65
8.28
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1462.26
1555.15
1166.36
388.79
23.23
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1018.46
1083.18
812.39
270.79
16.18
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
506.74
576.72
432.54
144.18
17.50
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1198.23
1363.94
1022.96
340.98
41.42
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1089.38
1239.94
929.96
309.98
37.64
Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Washington Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Washington Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Washington Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Washington Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Washington Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Washington Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
712.73
717.04
523.42
193.62
-8.27
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1632.37
1642.27
1218.21
424.06
-24.29
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1600.37
1610.09
1121.16
488.93
-19.18
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
904.50
1058.76
523.42
535.34
141.68
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2063.10
2415.08
1218.21
1196.87
317.79
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2042.71
2391.20
1121.16
1270.04
319.59
Washington Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Washington Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Washington Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Washington Kaiser Permanente - Northwest - Standard Self
574
647.96
688.35
516.26
172.09
10.10
Washington Kaiser Permanente - Northwest - Standard Self & Family
575
1488.54
1581.34
1186.01
395.33
23.20
Washington Kaiser Permanente - Northwest - Standard Self Plus One
576
1488.54
1581.34
1121.16
460.18
63.90
Washington Kaiser Permanente - Northwest - High Self
571
729.93
751.68
523.42
228.26
9.17
Washington Kaiser Permanente - Northwest - High Self & Family
572
1648.70
1697.82
1218.21
479.61
14.93
Washington Kaiser Permanente - Northwest - High Self Plus One
573
1648.70
1697.82
1121.16
576.66
20.22
Washington Kaiser Permanente - Northwest - Prosper Self
AM1
New Plan
391.78
293.84
97.94
New Plan
Washington Kaiser Permanente - Northwest - Prosper Self & Family
AM2
New Plan
926.47
694.85
231.62
New Plan
Washington Kaiser Permanente - Northwest - Prosper Self Plus One
AM3
New Plan
842.29
631.72
210.57
New Plan
Washington Kaiser Permanente - Washington Core - Standard Self
544
604.13
618.02
463.52
154.50
3.47
Washington Kaiser Permanente - Washington Core - Standard Self & Family
545
1389.53
1421.44
1066.08
355.36
7.98
Washington Kaiser Permanente - Washington Core - Standard Self Plus One
546
1389.53
1421.44
1066.08
355.36
7.98
Washington Kaiser Permanente - Washington Core - High Self
541
845.74
863.76
523.42
340.34
5.44
Washington Kaiser Permanente - Washington Core - High Self & Family
542
1860.65
1900.25
1218.21
682.04
5.41
Washington Kaiser Permanente - Washington Core - High Self Plus One
543
1860.65
1900.25
1121.16
779.09
10.70
Washington Kaiser Permanente - Washington Core - Prosper Self
PT4
New Plan
390.00
292.50
97.50
New Plan
Washington Kaiser Permanente - Washington Core - Prosper Self & Family
PT5
New Plan
1091.98
818.99
272.99
New Plan
Washington Kaiser Permanente - Washington Core - Prosper Self Plus One
PT6
New Plan
944.67
708.50
236.17
New Plan
Washington Kaiser Permanente Washington Options Federal - Standard Self
L11
727.89
743.17
523.42
219.75
2.70
Washington Kaiser Permanente Washington Options Federal - Standard Self & Family
L12
1615.90
1649.83
1218.21
431.62
-0.26
Washington Kaiser Permanente Washington Options Federal - Standard Self Plus One
L13
1615.90
1649.83
1121.16
528.67
5.03
Washington Kaiser Permanente Washington Options Federal - HDHP Self
L14
645.58
661.72
496.29
165.43
4.04
Washington Kaiser Permanente Washington Options Federal - HDHP Self & Family
L15
1433.14
1468.98
1101.74
367.24
8.96
Washington Kaiser Permanente Washington Options Federal - HDHP Self Plus One
L16
1433.14
1468.98
1101.74
367.24
8.96
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
522.86
622.22
466.67
155.55
24.84
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1236.39
1471.54
1103.66
367.88
58.78
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1124.05
1337.77
1003.33
334.44
53.43
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
443.84
528.17
396.13
132.04
21.08
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1020.85
1214.76
911.07
303.69
48.48
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
954.27
1135.55
851.66
283.89
45.32
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
724.77
782.12
523.42
258.70
44.77
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1811.90
1955.35
1218.21
737.14
109.26
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1558.25
1681.57
1121.16
560.41
94.42
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
522.02
621.21
465.91
155.30
24.80
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1234.37
1469.13
1101.85
367.28
58.69
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1122.23
1335.58
1001.69
333.89
53.33
Washington UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Washington UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Washington UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
West Virginia Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
West Virginia Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
West Virginia Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
West Virginia Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
West Virginia Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
West Virginia Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
829.23
851.74
523.42
328.32
9.93
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1890.72
1942.03
1218.21
723.82
17.12
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1872.00
1922.81
1121.16
801.65
21.91
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
819.98
821.82
523.42
298.40
-10.74
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1877.61
1881.88
1218.21
663.67
-29.92
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1840.78
1844.96
1121.16
723.80
-24.72
West Virginia Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
West Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
West Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
West Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
West Virginia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Wisconsin Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Wisconsin Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Wisconsin Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Wisconsin Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Wisconsin Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Wisconsin Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1073.48
1094.58
523.42
571.16
8.52
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2450.59
2498.80
1218.21
1280.59
14.02
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2426.32
2474.07
1121.16
1352.91
18.85
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1003.99
1009.93
523.42
486.51
-6.64
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2288.65
2302.15
1218.21
1083.94
-20.69
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2265.99
2279.33
1121.16
1158.17
-15.56
Wisconsin Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Wisconsin Dean Health Plan, Inc. - High Self
WD1
1147.08
1260.87
523.42
737.45
101.21
Wisconsin Dean Health Plan, Inc. - High Self & Family
WD2
2638.26
2900.04
1218.21
1681.83
227.59
Wisconsin Dean Health Plan, Inc. - High Self Plus One
WD3
2408.86
2647.86
1121.16
1526.70
210.10
Wisconsin Dean Health Plan, Inc. - Standard Self
WD4
681.57
685.12
513.84
171.28
0.55
Wisconsin Dean Health Plan, Inc. - Standard Self & Family
WD5
1635.77
1644.26
1218.21
426.05
-25.70
Wisconsin Dean Health Plan, Inc. - Standard Self Plus One
WD6
1499.46
1507.26
1121.16
386.10
-21.10
Wisconsin Dean Health Plan, Inc. - Basic Self
AG1
New Plan
455.07
341.30
113.77
New Plan
Wisconsin Dean Health Plan, Inc. - Basic Self & Family
AG2
New Plan
1023.90
767.93
255.97
New Plan
Wisconsin Dean Health Plan, Inc. - Basic Self Plus One
AG3
New Plan
955.63
716.72
238.91
New Plan
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self
WJ1
857.96
889.03
523.42
365.61
18.49
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self & Family
WJ2
2230.76
2311.51
1218.21
1093.30
46.56
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self Plus One
WJ3
1887.56
1955.89
1121.16
834.73
39.43
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self
WJ4
New Plan
618.84
464.13
154.71
New Plan
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self & Family
WJ5
New Plan
1609.01
1206.76
402.25
New Plan
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self Plus One
WJ6
New Plan
1361.47
1021.10
340.37
New Plan
Wisconsin HealthPartners - Standard Self
V34
459.92
509.41
382.06
127.35
12.37
Wisconsin HealthPartners - Standard Self & Family
V35
1120.41
1240.94
930.71
310.23
30.13
Wisconsin HealthPartners - Standard Self Plus One
V36
1016.45
1125.80
844.35
281.45
27.34
Wisconsin HealthPartners - High Self
V31
712.31
668.07
501.05
167.02
-34.45
Wisconsin HealthPartners - High Self & Family
V32
1735.20
1627.38
1218.21
409.17
-142.01
Wisconsin HealthPartners - High Self Plus One
V33
1574.21
1476.41
1107.31
369.10
-112.85
Wisconsin Quartz Health Benefit Plans Corporation - High Self
TF1
1010.36
1103.81
523.42
580.39
80.87
Wisconsin Quartz Health Benefit Plans Corporation - High Self & Family
TF2
2424.89
2649.18
1218.21
1430.97
190.10
Wisconsin Quartz Health Benefit Plans Corporation - High Self Plus One
TF3
2273.35
2483.63
1121.16
1362.47
181.38
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self
TF4
614.27
640.40
480.30
160.10
6.53
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self & Family
TF5
1474.29
1536.95
1152.71
384.24
15.67
Wisconsin Quartz Health Benefit Plans Corporation - Standard Self Plus One
TF6
1351.44
1408.85
1056.64
352.21
14.35
Wisconsin UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Wisconsin UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Wisconsin UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
Wyoming Aetna Advantage - Advantage Self
Z24
463.84
500.02
375.02
125.00
9.04
Wyoming Aetna Advantage - Advantage Self & Family
Z25
1229.17
1325.00
993.75
331.25
23.96
Wyoming Aetna Advantage - Advantage Self Plus One
Z26
1020.44
1100.02
825.02
275.00
19.89
Wyoming Aetna Direct - CDHP Self
N61
612.65
615.83
461.87
153.96
0.80
Wyoming Aetna Direct - CDHP Self & Family
N62
1545.01
1553.07
1164.80
388.27
2.02
Wyoming Aetna Direct - CDHP Self Plus One
N63
1343.55
1350.55
1012.91
337.64
1.75
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
828.47
826.84
523.42
303.42
-14.21
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1888.45
1884.74
1218.21
666.53
-37.90
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1869.92
1866.43
1121.16
745.27
-32.39
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
807.04
817.48
523.42
294.06
-2.14
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1852.18
1876.16
1218.21
657.95
-10.21
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1815.86
1839.39
1121.16
718.23
-5.37
Wyoming Aetna HealthFund HDHP - HDHP Self
224
728.80
786.02
523.42
262.60
44.64
Wyoming Aetna HealthFund HDHP - HDHP Self & Family
225
1607.60
1733.83
1218.21
515.62
92.04
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One
226
1576.10
1699.88
1121.16
578.72
94.88
Wyoming Altius Health Plan - High Self
9K1
1009.06
1048.36
523.42
524.94
26.72
Wyoming Altius Health Plan - High Self & Family
9K2
2231.52
2318.46
1218.21
1100.25
52.75
Wyoming Altius Health Plan - High Self Plus One
9K3
2209.42
2295.50
1121.16
1174.34
57.18
Wyoming Altius Health Plan - HDHP Self
9K4
529.23
672.49
504.37
168.12
35.81
Wyoming Altius Health Plan - HDHP Self & Family
9K5
1106.04
1405.43
1054.07
351.36
74.85
Wyoming Altius Health Plan - HDHP Self Plus One
9K6
1084.37
1377.85
1033.39
344.46
73.37
Wyoming Altius Health Plan - Standard Self
DK4
761.30
883.11
523.42
359.69
109.23
Wyoming Altius Health Plan - Standard Self & Family
DK5
1681.23
1950.20
1218.21
731.99
234.78
Wyoming Altius Health Plan - Standard Self Plus One
DK6
1664.56
1930.87
1121.16
809.71
237.41
Wyoming UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self
Y51
New Plan
411.73
308.80
102.93
New Plan
Wyoming UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family
Y52
New Plan
1091.07
818.30
272.77
New Plan
Wyoming UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One
Y53
New Plan
905.80
679.35
226.45
New Plan
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service