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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
500.02
500.02
375.02
125.00
0.00
Alabama Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Alabama Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Alabama Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Alabama Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Alabama Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Alabama Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Alabama Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Alabama Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Alaska Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Alaska Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Alaska Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Alaska Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Alaska Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Alaska Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Alaska Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Alaska Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Alaska Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Arizona Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Arizona Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Arizona Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Arizona Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Arizona Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Arizona Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Arizona Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Arizona Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Arizona Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Arizona Aetna Open Access - High Self
WQ1
1345.67
1438.67
530.53
908.14
85.89
Arizona Aetna Open Access - High Self & Family
WQ2
3267.25
3493.06
1243.95
2249.11
200.07
Arizona Aetna Open Access - High Self Plus One
WQ3
3234.86
3458.43
1136.70
2321.73
208.03
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R61
812.24
873.15
530.53
342.62
53.80
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R62
1827.50
1964.56
1243.95
720.61
111.32
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R63
1746.29
1877.24
1136.70
740.54
115.41
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R64
649.22
665.45
499.09
166.36
4.06
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R65
1460.72
1497.23
1122.92
374.31
9.13
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R66
1395.81
1430.72
1073.04
357.68
8.73
Arizona Humana CoverageFirst and Humana Value Plan - Value Self
R94
570.96
585.22
438.92
146.30
3.56
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family
R95
1284.62
1316.73
987.55
329.18
8.03
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One
R96
1227.55
1258.25
943.69
314.56
7.67
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self
R91
717.08
763.71
530.53
233.18
39.52
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
R92
1613.41
1718.28
1243.95
474.33
70.98
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
R93
1541.69
1641.90
1136.70
505.20
84.67
Arizona Humana HDHP - HDHP Self
BV1
New Plan
453.16
339.87
113.29
New Plan
Arizona Humana HDHP - HDHP Self & Family
BV2
New Plan
1129.01
846.76
282.25
New Plan
Arizona Humana HDHP - HDHP Self Plus One
BV3
New Plan
993.85
745.39
248.46
New Plan
Arizona Humana HDHP - HDHP Self
BY1
New Plan
397.78
298.34
99.44
New Plan
Arizona Humana HDHP - HDHP Self & Family
BY2
New Plan
990.51
742.88
247.63
New Plan
Arizona Humana HDHP - HDHP Self Plus One
BY3
New Plan
871.98
653.99
217.99
New Plan
Arizona Humana Health Plan, Inc. - Standard Self
C74
893.86
916.20
530.53
385.67
15.23
Arizona Humana Health Plan, Inc. - Standard Self & Family
C75
2011.17
2061.45
1243.95
817.50
24.54
Arizona Humana Health Plan, Inc. - Standard Self Plus One
C76
1921.73
1969.83
1136.70
833.13
32.56
Arizona Humana Health Plan, Inc. - Standard Self
BF4
1246.59
1246.59
530.53
716.06
-7.11
Arizona Humana Health Plan, Inc. - Standard Self & Family
BF5
2804.84
2804.86
1243.95
1560.91
-25.72
Arizona Humana Health Plan, Inc. - Standard Self Plus One
BF6
2680.21
2680.21
1136.70
1543.51
-15.54
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
622.22
668.46
501.35
167.11
11.56
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1471.54
1580.91
1185.68
395.23
27.35
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1337.77
1437.17
1077.88
359.29
24.85
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
528.17
672.10
504.08
168.02
35.98
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1214.76
1545.85
1159.39
386.46
82.77
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
1135.55
1445.04
1083.78
361.26
77.37
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
782.12
864.87
530.53
334.34
75.64
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1955.35
2162.16
1243.95
918.21
181.07
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1681.57
1859.46
1136.70
722.76
162.35
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
621.21
657.65
493.24
164.41
9.11
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1469.13
1555.39
1166.54
388.85
21.57
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1335.58
1413.97
1060.48
353.49
19.60
Arkansas Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Arkansas Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Arkansas Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Arkansas Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Arkansas Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Arkansas Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Arkansas Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Arkansas Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Arkansas QualChoice - High Self
DH1
767.26
728.85
530.53
198.32
-45.52
Arkansas QualChoice - High Self & Family
DH2
2001.20
1901.10
1243.95
657.15
-125.84
Arkansas QualChoice - High Self Plus One
DH3
1490.43
1415.83
1061.87
353.96
-18.65
Arkansas QualChoice - Standard Self
DH4
599.00
568.97
426.73
142.24
-7.51
Arkansas QualChoice - Standard Self & Family
DH5
1562.43
1484.08
1113.06
371.02
-19.59
Arkansas QualChoice - Standard Self Plus One
DH6
1163.63
1105.28
828.96
276.32
-14.59
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
California Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
California Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
California Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
California Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
California Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
California Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
California Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
California Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
California Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
California Aetna Open Access - High Self
2X1
936.67
1039.33
530.53
508.80
95.55
California Aetna Open Access - High Self & Family
2X2
2199.02
2440.04
1243.95
1196.09
215.28
California Aetna Open Access - High Self Plus One
2X3
2155.90
2392.22
1136.70
1255.52
220.78
California Anthem Blue Cross Select HMO - High Self
B31
774.13
777.23
530.53
246.70
-4.01
California Anthem Blue Cross Select HMO - High Self & Family
B32
1768.91
1783.06
1243.95
539.11
-11.59
California Anthem Blue Cross Select HMO - High Self Plus One
B33
1641.16
1646.08
1136.70
509.38
-10.62
California Blue Shield of California - Access + HMO Self
SI1
858.87
884.61
530.53
354.08
18.63
California Blue Shield of California - Access + HMO Self & Family
SI2
1975.39
2034.65
1243.95
790.70
33.52
California Blue Shield of California - Access + HMO Self Plus One
SI3
1889.49
1946.19
1136.70
809.49
41.16
California Health Net of California - Basic Self
P61
364.04
405.69
304.27
101.42
10.41
California Health Net of California - Basic Self & Family
P62
873.73
973.74
730.31
243.43
25.00
California Health Net of California - Basic Self Plus One
P63
800.93
892.56
669.42
223.14
22.91
California Health Net of California - High Self
LP1
1012.98
1077.33
530.53
546.80
57.24
California Health Net of California - High Self & Family
LP2
2431.17
2585.66
1243.95
1341.71
128.75
California Health Net of California - High Self Plus One
LP3
2228.57
2370.18
1136.70
1233.48
126.07
California Health Net of California - High Self
LB1
1550.64
1618.70
530.53
1088.17
60.95
California Health Net of California - High Self & Family
LB2
3721.49
3884.86
1243.95
2640.91
137.63
California Health Net of California - High Self Plus One
LB3
3411.35
3561.13
1136.70
2424.43
134.24
California Health Net of California - Basic Self
T41
894.18
953.16
530.53
422.63
51.87
California Health Net of California - Basic Self & Family
T42
2146.04
2287.61
1243.95
1043.66
115.83
California Health Net of California - Basic Self Plus One
T43
1967.20
2096.94
1136.70
960.24
114.20
California Kaiser Permanente - Fresno California - Standard Self
NZ4
590.11
590.11
442.58
147.53
0.00
California Kaiser Permanente - Fresno California - Standard Self & Family
NZ5
1363.87
1363.87
1022.90
340.97
0.00
California Kaiser Permanente - Fresno California - Standard Self Plus One
NZ6
1363.87
1363.87
1022.90
340.97
0.00
California Kaiser Permanente - Fresno California - High Self
NZ1
802.99
813.45
530.53
282.92
3.35
California Kaiser Permanente - Fresno California - High Self & Family
NZ2
1855.86
1880.06
1243.95
636.11
-1.54
California Kaiser Permanente - Fresno California - High Self Plus One
NZ3
1855.86
1880.06
1136.70
743.36
8.66
California Kaiser Permanente - Northern California - Prosper Self
KC1
652.08
658.56
493.92
164.64
1.62
California Kaiser Permanente - Northern California - Prosper Self & Family
KC2
1525.85
1541.02
1155.77
385.25
3.79
California Kaiser Permanente - Northern California - Prosper Self Plus One
KC3
1525.85
1541.02
1136.70
404.32
-0.37
California Kaiser Permanente - Northern California - High Self
591
1014.54
1002.30
530.53
471.77
-19.35
California Kaiser Permanente - Northern California - High Self & Family
592
2421.86
2392.59
1243.95
1148.64
-55.01
California Kaiser Permanente - Northern California - High Self Plus One
593
2421.86
2392.59
1136.70
1255.89
-44.81
California Kaiser Permanente - Northern California - Standard Self
594
822.68
814.88
530.53
284.35
-14.91
California Kaiser Permanente - Northern California - Standard Self & Family
595
1925.11
1906.80
1243.95
662.85
-44.05
California Kaiser Permanente - Northern California - Standard Self Plus One
596
1925.11
1906.80
1136.70
770.10
-33.85
California Kaiser Permanente - Southern California - Prosper Self
FL1
New Plan
365.63
274.22
91.41
New Plan
California Kaiser Permanente - Southern California - Prosper Self & Family
FL2
New Plan
1023.75
767.81
255.94
New Plan
California Kaiser Permanente - Southern California - Prosper Self Plus One
FL3
New Plan
840.97
630.73
210.24
New Plan
California Kaiser Permanente - Southern California - Standard Self
624
473.44
488.35
366.26
122.09
3.73
California Kaiser Permanente - Southern California - Standard Self & Family
625
1094.21
1128.62
846.47
282.15
8.60
California Kaiser Permanente - Southern California - Standard Self Plus One
626
1094.21
1128.62
846.47
282.15
8.60
California Kaiser Permanente - Southern California - High Self
621
750.19
760.63
530.53
230.10
3.33
California Kaiser Permanente - Southern California - High Self & Family
622
1733.83
1757.97
1243.95
514.02
-1.60
California Kaiser Permanente - Southern California - High Self Plus One
623
1733.83
1757.97
1136.70
621.27
8.60
Colorado Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Colorado Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Colorado Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Colorado Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Colorado Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Colorado Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Colorado Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Colorado Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Colorado Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Colorado BlueAdvantageHMO - High Self
WW1
636.35
677.71
508.28
169.43
10.34
Colorado BlueAdvantageHMO - High Self & Family
WW2
1549.49
1690.50
1243.95
446.55
59.18
Colorado BlueAdvantageHMO - High Self Plus One
WW3
1447.66
1554.78
1136.70
418.08
56.17
Colorado BlueAdvantageHMO - HDHP Self
WW4
New Plan
639.75
479.81
159.94
New Plan
Colorado BlueAdvantageHMO - HDHP Self & Family
WW5
New Plan
1557.77
1168.33
389.44
New Plan
Colorado BlueAdvantageHMO - HDHP Self Plus One
WW6
New Plan
1455.42
1091.57
363.85
New Plan
Colorado Humana Health Plan, Inc. - High Self
NR1
961.18
970.80
530.53
440.27
2.51
Colorado Humana Health Plan, Inc. - High Self & Family
NR2
2162.64
2184.28
1243.95
940.33
-4.10
Colorado Humana Health Plan, Inc. - High Self Plus One
NR3
2066.52
2087.22
1136.70
950.52
5.16
Colorado Humana Health Plan, Inc. - Standard Self
NR4
666.08
666.08
499.56
166.52
0.00
Colorado Humana Health Plan, Inc. - Standard Self & Family
NR5
1498.73
1498.73
1124.05
374.68
0.00
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NR6
1432.08
1432.08
1074.06
358.02
0.00
Colorado Humana Health Plan, Inc. - Basic Self
RZ1
532.24
518.94
389.21
129.73
-3.33
Colorado Humana Health Plan, Inc. - Basic Self & Family
RZ2
1197.52
1167.57
875.68
291.89
-7.49
Colorado Humana Health Plan, Inc. - Basic Self Plus One
RZ3
1144.33
1115.73
836.80
278.93
-7.15
Colorado Humana Health Plan, Inc. - High Self
NT1
833.60
875.29
530.53
344.76
34.58
Colorado Humana Health Plan, Inc. - High Self & Family
NT2
1875.66
1969.44
1243.95
725.49
68.04
Colorado Humana Health Plan, Inc. - High Self Plus One
NT3
1792.27
1881.88
1136.70
745.18
74.07
Colorado Humana Health Plan, Inc. - Standard Self
NT4
590.27
590.27
442.70
147.57
0.00
Colorado Humana Health Plan, Inc. - Standard Self & Family
NT5
1328.12
1328.12
996.09
332.03
0.00
Colorado Humana Health Plan, Inc. - Standard Self Plus One
NT6
1269.13
1269.13
951.85
317.28
0.00
Colorado Humana Health Plan, Inc. - Basic Self
R21
621.40
605.89
454.42
151.47
-3.88
Colorado Humana Health Plan, Inc. - Basic Self & Family
R22
1398.17
1363.22
1022.42
340.80
-8.74
Colorado Humana Health Plan, Inc. - Basic Self Plus One
R23
1336.03
1302.62
976.97
325.65
-8.36
Colorado Kaiser Permanente - Colorado - Standard Self
654
660.83
659.17
494.38
164.79
-0.42
Colorado Kaiser Permanente - Colorado - Standard Self & Family
655
1493.46
1489.71
1117.28
372.43
-0.93
Colorado Kaiser Permanente - Colorado - Standard Self Plus One
656
1493.46
1489.71
1117.28
372.43
-0.93
Colorado Kaiser Permanente - Colorado - High Self
651
772.89
772.89
530.53
242.36
-7.11
Colorado Kaiser Permanente - Colorado - High Self & Family
652
1746.75
1746.75
1243.95
502.80
-25.74
Colorado Kaiser Permanente - Colorado - High Self Plus One
653
1746.75
1746.75
1136.70
610.05
-15.54
Colorado Kaiser Permanente - Colorado - Prosper Self
N41
445.51
390.15
292.61
97.54
-13.84
Colorado Kaiser Permanente - Colorado - Prosper Self & Family
N42
1095.94
959.77
719.83
239.94
-34.04
Colorado Kaiser Permanente - Colorado - Prosper Self Plus One
N43
1006.85
881.73
661.30
220.43
-31.28
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
528.17
672.10
504.08
168.02
35.98
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1214.76
1545.85
1159.39
386.46
82.77
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
1135.55
1445.04
1083.78
361.26
77.37
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
782.12
864.87
530.53
334.34
75.64
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1955.35
2162.16
1243.95
918.21
181.07
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1681.57
1859.46
1136.70
722.76
162.35
Connecticut Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Connecticut Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Connecticut Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Connecticut Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Connecticut Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Connecticut Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Connecticut Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Connecticut Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Delaware Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Delaware Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Delaware Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Delaware Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Delaware Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Delaware Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Delaware Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Delaware Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Delaware Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Delaware Aetna Open Access - Basic Self
P34
1505.53
1721.76
530.53
1191.23
209.12
Delaware Aetna Open Access - Basic Self & Family
P35
3494.34
3996.29
1243.95
2752.34
476.21
Delaware Aetna Open Access - Basic Self Plus One
P36
3459.73
3956.70
1136.70
2820.00
481.43
Delaware Aetna Open Access - High Self
P31
1588.23
1762.54
530.53
1232.01
167.20
Delaware Aetna Open Access - High Self & Family
P32
3850.71
4273.27
1243.95
3029.32
396.82
Delaware Aetna Open Access - High Self Plus One
P33
3812.58
4230.98
1136.70
3094.28
402.86
District Of Columbia Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
District Of Columbia Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
District Of Columbia Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
District Of Columbia Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
District Of Columbia Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
District Of Columbia Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
District Of Columbia Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
District Of Columbia Aetna Open Access - High Self
JN1
1176.57
1251.55
530.53
721.02
67.87
District Of Columbia Aetna Open Access - High Self & Family
JN2
2645.05
2813.68
1243.95
1569.73
142.89
District Of Columbia Aetna Open Access - High Self Plus One
JN3
2618.85
2785.79
1136.70
1649.09
151.40
District Of Columbia Aetna Open Access - Basic Self
JN4
714.42
739.46
530.53
208.93
17.93
District Of Columbia Aetna Open Access - Basic Self & Family
JN5
1634.92
1692.23
1243.95
448.28
31.57
District Of Columbia Aetna Open Access - Basic Self Plus One
JN6
1501.33
1553.93
1136.70
417.23
37.06
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
1362.12
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
887.81
905.58
530.53
375.05
10.66
District Of Columbia CareFirst BlueChoice - Standard Self & Family
2G5
2109.42
2151.59
1243.95
907.64
16.43
District Of Columbia CareFirst BlueChoice - Standard Self Plus One
2G6
1775.61
1811.12
1136.70
674.42
19.97
District Of Columbia CareFirst BlueChoice - HDHP Self
B61
570.09
604.31
453.23
151.08
8.56
District Of Columbia CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1435.79
1076.84
358.95
20.32
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1208.57
906.43
302.14
17.10
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self
B64
723.67
723.67
530.53
193.14
-7.11
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1719.38
1719.38
1243.95
475.43
-25.74
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1447.29
1447.29
1085.47
361.82
0.00
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self
T71
427.72
368.90
276.68
92.22
-14.71
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family
T72
1099.52
1051.33
788.50
262.83
-12.05
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One
T73
951.84
866.91
650.18
216.73
-21.23
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
598.28
607.25
455.44
151.81
2.24
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1376.05
1396.63
1047.47
349.16
5.15
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1376.05
1396.63
1047.47
349.16
5.15
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self
E31
746.24
756.60
530.53
226.07
3.25
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1716.35
1740.20
1243.95
496.25
-1.89
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1716.35
1740.20
1136.70
603.50
8.31
District Of Columbia M.D. IPA - High Self
JP1
950.89
1011.99
530.53
481.46
53.99
District Of Columbia M.D. IPA - High Self & Family
JP2
2666.28
2837.66
1243.95
1593.71
145.64
District Of Columbia M.D. IPA - High Self Plus One
JP3
1857.09
1976.43
1136.70
839.73
103.80
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
519.91
661.81
496.36
165.45
35.47
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1195.81
1514.20
1135.65
378.55
79.60
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1117.81
1422.92
1067.19
355.73
76.28
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
770.40
822.16
530.53
291.63
44.65
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1825.83
1948.55
1243.95
704.60
96.98
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1656.33
1767.68
1136.70
630.98
95.81
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
554.62
663.76
497.82
165.94
27.29
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1555.15
1586.41
1189.81
396.60
7.81
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1083.18
1327.54
995.66
331.88
61.09
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Florida Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Florida Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Florida Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Florida Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Florida Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Florida Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Florida Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Florida Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Florida Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Florida AvMed - HDHP Self
WZ1
762.08
742.26
530.53
211.73
-26.93
Florida AvMed - HDHP Self & Family
WZ2
1762.00
1714.01
1243.95
470.06
-73.73
Florida AvMed - HDHP Self Plus One
WZ3
1528.67
1487.24
1115.43
371.81
-35.70
Florida AvMed - Standard Self
ML4
820.97
801.88
530.53
271.35
-26.20
Florida AvMed - Standard Self & Family
ML5
1998.92
1952.45
1243.95
708.50
-72.21
Florida AvMed - Standard Self Plus One
ML6
1724.06
1683.98
1136.70
547.28
-55.62
Florida Capital Health Plan - High Self
EA1
690.47
730.49
530.53
199.96
27.34
Florida Capital Health Plan - High Self & Family
EA2
1600.19
1692.93
1243.95
448.98
48.93
Florida Capital Health Plan - High Self Plus One
EA3
1509.99
1597.55
1136.70
460.85
72.02
Florida Humana CoverageFirst and Humana Value Plan - Value Self
W94
585.48
600.12
450.09
150.03
3.66
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
W95
1317.33
1350.29
1012.72
337.57
8.24
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
W96
1258.79
1290.25
967.69
322.56
7.86
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
W91
692.10
726.70
530.53
196.17
23.15
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
W92
1557.18
1635.03
1226.27
408.76
19.47
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
W93
1487.98
1562.38
1136.70
425.68
53.69
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
QP1
768.56
826.22
530.53
295.69
50.55
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
QP2
1731.56
1861.38
1243.95
617.43
104.08
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
QP3
1654.58
1778.66
1136.70
641.96
108.54
Florida Humana CoverageFirst and Humana Value Plan - Value Self
QP4
550.51
550.51
412.88
137.63
0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
QP5
1238.60
1238.60
928.95
309.65
0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
QP6
1183.56
1183.56
887.67
295.89
0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self
MJ4
561.19
561.19
420.89
140.30
0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
MJ5
1262.67
1346.87
1010.15
336.72
21.05
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MJ6
1206.55
1206.55
904.91
301.64
0.00
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
MJ1
1023.92
1064.87
530.53
534.34
33.84
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MJ2
2303.80
2395.92
1243.95
1151.97
66.38
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MJ3
2201.44
2289.47
1136.70
1152.77
72.49
Florida Humana CoverageFirst and Humana Value Plan - Value Self
X24
512.89
546.26
409.70
136.56
8.34
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family
X25
1154.05
1338.33
1003.75
334.58
46.07
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X26
1102.77
1174.44
880.83
293.61
17.92
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self
X21
606.30
630.54
472.91
157.63
6.06
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X22
1364.22
1418.80
1064.10
354.70
13.65
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X23
1303.58
1355.73
1016.80
338.93
13.04
Florida Humana HDHP - HDHP Self
BR1
New Plan
426.44
319.83
106.61
New Plan
Florida Humana HDHP - HDHP Self & Family
BR2
New Plan
1062.23
796.67
265.56
New Plan
Florida Humana HDHP - HDHP Self Plus One
BR3
New Plan
935.07
701.30
233.77
New Plan
Florida Humana HDHP - HDHP Self
A41
New Plan
478.40
358.80
119.60
New Plan
Florida Humana HDHP - HDHP Self & Family
A42
New Plan
1192.12
894.09
298.03
New Plan
Florida Humana HDHP - HDHP Self Plus One
A43
New Plan
1049.38
787.04
262.34
New Plan
Florida Humana HDHP - HDHP Self
FF1
New Plan
406.51
304.88
101.63
New Plan
Florida Humana HDHP - HDHP Self & Family
FF2
New Plan
1012.33
759.25
253.08
New Plan
Florida Humana HDHP - HDHP Self Plus One
FF3
New Plan
891.17
668.38
222.79
New Plan
Florida Humana HDHP - HDHP Self
AP1
New Plan
483.08
362.31
120.77
New Plan
Florida Humana HDHP - HDHP Self & Family
AP2
New Plan
1203.76
902.82
300.94
New Plan
Florida Humana HDHP - HDHP Self Plus One
AP3
New Plan
1059.63
794.72
264.91
New Plan
Florida Humana Medical Plan, Inc. - Standard Self
LL4
1193.21
1282.69
530.53
752.16
82.37
Florida Humana Medical Plan, Inc. - Standard Self & Family
LL5
2684.65
2886.00
1243.95
1642.05
175.61
Florida Humana Medical Plan, Inc. - Standard Self Plus One
LL6
2565.33
2757.73
1136.70
1621.03
176.86
Florida Humana Medical Plan, Inc. - High Self
LL1
1708.94
1794.37
530.53
1263.84
78.32
Florida Humana Medical Plan, Inc. - High Self & Family
LL2
3845.05
4037.30
1243.95
2793.35
166.51
Florida Humana Medical Plan, Inc. - High Self Plus One
LL3
3674.15
3857.86
1136.70
2721.16
168.17
Florida Humana Medical Plan, Inc. - High Self
EE1
1248.93
1323.88
530.53
793.35
67.84
Florida Humana Medical Plan, Inc. - High Self & Family
EE2
2810.15
2978.78
1243.95
1734.83
142.89
Florida Humana Medical Plan, Inc. - High Self Plus One
EE3
2685.30
2846.44
1136.70
1709.74
145.60
Florida Humana Medical Plan, Inc. - Standard Self
EE4
1116.77
1183.78
530.53
653.25
59.90
Florida Humana Medical Plan, Inc. - Standard Self & Family
EE5
2512.71
2663.48
1243.95
1419.53
125.03
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EE6
2401.04
2545.12
1136.70
1408.42
128.54
Florida Humana Medical Plan, Inc. - Standard Self
E24
766.13
804.44
530.53
273.91
31.20
Florida Humana Medical Plan, Inc. - Standard Self & Family
E25
1723.78
1809.97
1243.95
566.02
60.45
Florida Humana Medical Plan, Inc. - Standard Self Plus One
E26
1647.14
1729.50
1136.70
592.80
66.82
Florida Humana Medical Plan, Inc. - High Self
E21
1286.83
1351.18
530.53
820.65
57.24
Florida Humana Medical Plan, Inc. - High Self & Family
E22
2895.27
3040.05
1243.95
1796.10
119.04
Florida Humana Medical Plan, Inc. - High Self Plus One
E23
2766.60
2904.94
1136.70
1768.24
122.80
Florida Humana Medical Plan, Inc. - High Self
EX1
1018.49
1069.40
530.53
538.87
43.80
Florida Humana Medical Plan, Inc. - High Self & Family
EX2
2291.53
2406.11
1243.95
1162.16
88.84
Florida Humana Medical Plan, Inc. - High Self Plus One
EX3
2189.68
2299.16
1136.70
1162.46
93.94
Florida Humana Medical Plan, Inc. - Standard Self
EX4
834.73
897.33
530.53
366.80
55.49
Florida Humana Medical Plan, Inc. - Standard Self & Family
EX5
1878.15
2019.01
1243.95
775.06
115.12
Florida Humana Medical Plan, Inc. - Standard Self Plus One
EX6
1794.67
1929.27
1136.70
792.57
119.06
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
750.62
897.89
530.53
367.36
140.16
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
2251.90
2693.64
1243.95
1449.69
416.00
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1613.89
1930.46
1136.70
793.76
301.03
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Georgia Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Georgia Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Georgia Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Georgia Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Georgia Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Georgia Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Georgia Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Georgia Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Georgia Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Georgia Aetna Open Access - High Self
2U1
1805.85
1729.63
530.53
1199.10
-83.33
Georgia Aetna Open Access - High Self & Family
2U2
4159.72
3984.13
1243.95
2740.18
-201.33
Georgia Aetna Open Access - High Self Plus One
2U3
4118.53
3944.68
1136.70
2807.98
-189.39
Georgia Blue Open Access POS - High Self
QM1
656.41
701.72
526.29
175.43
11.33
Georgia Blue Open Access POS - High Self & Family
QM2
1689.68
1843.44
1243.95
599.49
128.02
Georgia Blue Open Access POS - High Self Plus One
QM3
1446.62
1585.48
1136.70
448.78
87.13
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
S94
612.60
658.56
493.92
164.64
11.49
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
S95
1378.35
1481.72
1111.29
370.43
25.84
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
S96
1317.10
1415.87
1061.90
353.97
24.70
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
S91
769.41
827.10
530.53
296.57
50.58
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
S92
1731.15
1860.99
1243.95
617.04
104.10
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
S93
1654.21
1778.29
1136.70
641.59
108.54
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
AD4
826.04
826.04
530.53
295.51
-7.11
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
AD5
1858.52
1858.50
1243.95
614.55
-25.76
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
AD6
1775.95
1775.93
1136.70
639.23
-15.56
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
AD1
1090.18
1166.51
530.53
635.98
69.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
AD2
2452.86
2624.61
1243.95
1380.66
146.01
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
AD3
2343.86
2507.98
1136.70
1371.28
148.58
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self
LM1
747.13
784.51
530.53
253.98
30.27
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
LM2
1681.12
1765.14
1243.95
521.19
58.28
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
LM3
1606.41
1686.69
1136.70
549.99
64.74
Georgia Humana CoverageFirst and Humana Value Plan - Value Self
LM4
706.81
742.13
530.53
211.60
28.21
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family
LM5
1590.29
1669.81
1243.95
425.86
28.29
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One
LM6
1519.64
1595.60
1136.70
458.90
60.42
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RM1
719.88
791.87
530.53
261.34
64.88
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RM2
1619.74
1781.72
1243.95
537.77
132.84
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RM3
1547.74
1702.52
1136.70
565.82
139.24
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DN4
813.15
874.16
530.53
343.63
53.90
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DN5
1829.53
1966.77
1243.95
722.82
111.50
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DN6
1748.24
1879.39
1136.70
742.69
115.61
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
RJ1
669.85
703.34
527.51
175.83
8.37
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
RJ2
1507.22
1582.53
1186.90
395.63
18.83
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
RJ3
1440.23
1512.18
1134.14
378.04
17.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self
Q71
846.71
872.11
530.53
341.58
18.29
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family
Q72
1905.11
1962.26
1243.95
718.31
31.41
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One
Q73
1820.43
1875.03
1136.70
738.33
39.06
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
CB4
1137.89
1251.68
530.53
721.15
106.68
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
CB5
2560.31
2816.30
1243.95
1572.35
230.25
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
CB6
2446.51
2691.13
1136.70
1554.43
229.08
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self
DG4
1300.76
1430.85
530.53
900.32
122.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family
DG5
2926.71
3219.43
1243.95
1975.48
266.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One
DG6
2796.71
3076.41
1136.70
1939.71
264.16
Georgia Humana HDHP - HDHP Self
AZ1
New Plan
472.40
354.30
118.10
New Plan
Georgia Humana HDHP - HDHP Self & Family
AZ2
New Plan
1177.06
882.80
294.26
New Plan
Georgia Humana HDHP - HDHP Self Plus One
AZ3
New Plan
1036.14
777.11
259.03
New Plan
Georgia Humana HDHP - HDHP Self
B21
New Plan
487.02
365.27
121.75
New Plan
Georgia Humana HDHP - HDHP Self & Family
B22
New Plan
1213.62
910.22
303.40
New Plan
Georgia Humana HDHP - HDHP Self Plus One
B23
New Plan
1068.30
801.23
267.07
New Plan
Georgia Humana HDHP - HDHP Self
AR1
New Plan
477.45
358.09
119.36
New Plan
Georgia Humana HDHP - HDHP Self & Family
AR2
New Plan
1189.72
892.29
297.43
New Plan
Georgia Humana HDHP - HDHP Self Plus One
AR3
New Plan
1047.26
785.45
261.81
New Plan
Georgia Kaiser Permanente - Georgia - High Self
F81
751.10
769.71
530.53
239.18
11.50
Georgia Kaiser Permanente - Georgia - High Self & Family
F82
1697.50
1739.57
1243.95
495.62
16.33
Georgia Kaiser Permanente - Georgia - High Self Plus One
F83
1697.50
1739.57
1136.70
602.87
26.53
Georgia Kaiser Permanente - Georgia - Standard Self
F84
581.10
600.71
450.53
150.18
4.91
Georgia Kaiser Permanente - Georgia - Standard Self & Family
F85
1313.26
1357.59
1018.19
339.40
11.09
Georgia Kaiser Permanente - Georgia - Standard Self Plus One
F86
1313.26
1357.59
1018.19
339.40
11.09
Georgia Kaiser Permanente - Georgia - Prosper Self
LA1
418.90
398.65
298.99
99.66
-5.06
Georgia Kaiser Permanente - Georgia - Prosper Self & Family
LA2
946.66
1034.97
776.23
258.74
22.08
Georgia Kaiser Permanente - Georgia - Prosper Self Plus One
LA3
946.66
900.92
675.69
225.23
-11.43
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
LV1
750.62
897.89
530.53
367.36
140.16
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
LV2
2251.90
2693.64
1243.95
1449.69
416.00
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
LV3
1613.89
1930.46
1136.70
793.76
301.03
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Guam Calvo's SelectCare - Standard Self
B44
429.78
378.91
284.18
94.73
-12.71
Guam Calvo's SelectCare - Standard Self & Family
B45
1248.72
1100.91
825.68
275.23
-36.95
Guam Calvo's SelectCare - Standard Self Plus One
B46
847.21
746.92
560.19
186.73
-25.07
Guam Calvo's SelectCare - High Self
B41
521.69
535.95
401.96
133.99
3.57
Guam Calvo's SelectCare - High Self & Family
B42
1381.77
1419.54
1064.66
354.88
9.44
Guam Calvo's SelectCare - High Self Plus One
B43
1018.07
1045.89
784.42
261.47
6.95
Guam TakeCare - HDHP Self
KX1
120.53
122.31
91.73
30.58
0.45
Guam TakeCare - HDHP Self & Family
KX2
323.16
327.97
245.98
81.99
1.20
Guam TakeCare - HDHP Self Plus One
KX3
290.94
295.23
221.42
73.81
1.08
Guam TakeCare - Standard Self
JK4
404.45
405.77
304.33
101.44
0.33
Guam TakeCare - Standard Self & Family
JK5
1145.39
1149.18
861.89
287.29
0.94
Guam TakeCare - Standard Self Plus One
JK6
797.14
799.78
599.84
199.94
0.66
Guam TakeCare - High Self
JK1
497.81
515.86
386.90
128.96
4.51
Guam TakeCare - High Self & Family
JK2
1187.38
1230.43
922.82
307.61
10.77
Guam TakeCare - High Self Plus One
JK3
983.49
1019.16
764.37
254.79
8.92
Hawaii Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Hawaii Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Hawaii Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Hawaii Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Hawaii Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Hawaii Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Hawaii Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Hawaii Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
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
453.83
453.83
340.37
113.46
0.00
Hawaii HMSA Plan - Standard Self & Family
875
1020.18
1020.18
765.14
255.04
0.00
Hawaii HMSA Plan - Standard Self Plus One
876
994.28
994.28
745.71
248.57
0.00
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
1129.88
376.63
-8.72
Hawaii Kaiser Permanente - Hawaii - Standard Self
634
505.18
485.38
364.04
121.34
-4.95
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family
635
1126.52
1082.38
811.79
270.59
-11.04
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One
636
1126.52
1082.38
811.79
270.59
-11.04
Idaho Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Idaho Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Idaho Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Idaho Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Idaho Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Idaho Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Idaho Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Idaho Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Idaho Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Idaho Altius Health Plan - High Self
9K1
1048.36
1150.85
530.53
620.32
95.38
Idaho Altius Health Plan - High Self & Family
9K2
2318.46
2545.10
1243.95
1301.15
200.90
Idaho Altius Health Plan - High Self Plus One
9K3
2295.50
2519.92
1136.70
1383.22
208.88
Idaho Altius Health Plan - HDHP Self
9K4
672.49
759.22
530.53
228.69
60.57
Idaho Altius Health Plan - HDHP Self & Family
9K5
1405.43
1586.72
1190.04
396.68
45.32
Idaho Altius Health Plan - HDHP Self Plus One
9K6
1377.85
1555.56
1136.70
418.86
74.40
Idaho Altius Health Plan - Standard Self
DK4
883.11
942.54
530.53
412.01
52.32
Idaho Altius Health Plan - Standard Self & Family
DK5
1950.20
2081.43
1243.95
837.48
105.49
Idaho Altius Health Plan - Standard Self Plus One
DK6
1930.87
2060.80
1136.70
924.10
114.39
Idaho Kaiser Permanente - Washington Core - Standard Self
544
618.02
625.21
468.91
156.30
1.80
Idaho Kaiser Permanente - Washington Core - Standard Self & Family
545
1421.44
1438.00
1078.50
359.50
4.14
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One
546
1421.44
1438.00
1078.50
359.50
4.14
Idaho Kaiser Permanente - Washington Core - High Self
541
863.76
869.53
530.53
339.00
-1.34
Idaho Kaiser Permanente - Washington Core - High Self & Family
542
1900.25
1912.93
1243.95
668.98
-13.06
Idaho Kaiser Permanente - Washington Core - High Self Plus One
543
1900.25
1912.93
1136.70
776.23
-2.86
Idaho Kaiser Permanente - Washington Core - Prosper Self
PT4
390.00
390.00
292.50
97.50
0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family
PT5
1091.98
1091.98
818.99
272.99
0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One
PT6
944.67
944.67
708.50
236.17
0.00
Illinois Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Illinois Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Illinois Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Illinois Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Illinois Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Illinois Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Illinois Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Illinois Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Illinois Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Illinois Blue Preferred - High Self
9G1
874.23
905.71
530.53
375.18
24.37
Illinois Blue Preferred - High Self & Family
9G2
1984.52
2139.32
1243.95
895.37
129.06
Illinois Blue Preferred - High Self Plus One
9G3
1862.12
2005.51
1136.70
868.81
127.85
Illinois Blue Preferred - Standard Self
9G4
633.66
614.01
460.51
153.50
-4.91
Illinois Blue Preferred - Standard Self & Family
9G5
1758.23
1791.62
1243.95
547.67
7.65
Illinois Blue Preferred - Standard Self Plus One
9G6
1574.58
1598.20
1136.70
461.50
8.08
Illinois Health Alliance HMO - Standard Self
K84
683.56
704.08
528.06
176.02
5.13
Illinois Health Alliance HMO - Standard Self & Family
K85
1584.35
1631.89
1223.92
407.97
11.88
Illinois Health Alliance HMO - Standard Self Plus One
K86
1461.61
1505.44
1129.08
376.36
10.96
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
GB4
788.47
827.91
530.53
297.38
32.33
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
GB5
1774.00
1862.71
1243.95
618.76
62.97
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
GB6
1695.16
1779.92
1136.70
643.22
69.22
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
GB1
1227.74
1319.83
530.53
789.30
84.98
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
GB2
2762.39
2969.55
1243.95
1725.60
181.42
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
GB3
2639.65
2837.62
1136.70
1700.92
182.43
Illinois Humana CoverageFirst and Humana Value Plan - Value Self
MW4
807.76
799.70
530.53
269.17
-15.17
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1817.40
1799.27
1243.95
555.32
-43.87
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1736.67
1719.32
1136.70
582.62
-32.89
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
1025.96
1056.75
530.53
526.22
23.68
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
2308.48
2377.81
1243.95
1133.86
43.59
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
2205.86
2272.08
1136.70
1135.38
50.68
Illinois Humana HDHP - HDHP Self
BB1
New Plan
445.29
333.97
111.32
New Plan
Illinois Humana HDHP - HDHP Self & Family
BB2
New Plan
1109.33
832.00
277.33
New Plan
Illinois Humana HDHP - HDHP Self Plus One
BB3
New Plan
976.52
732.39
244.13
New Plan
Illinois Humana HDHP - HDHP Self
AW1
New Plan
420.70
315.53
105.17
New Plan
Illinois Humana HDHP - HDHP Self & Family
AW2
New Plan
1047.82
785.87
261.95
New Plan
Illinois Humana HDHP - HDHP Self Plus One
AW3
New Plan
922.39
691.79
230.60
New Plan
Illinois Humana Health Plan, Inc. - Standard Self
754
1045.35
1055.80
530.53
525.27
3.34
Illinois Humana Health Plan, Inc. - Standard Self & Family
755
2352.03
2375.56
1243.95
1131.61
-2.21
Illinois Humana Health Plan, Inc. - Standard Self Plus One
756
2247.53
2270.00
1136.70
1133.30
6.93
Illinois Humana Health Plan, Inc. - High Self
751
1369.01
1403.24
530.53
872.71
27.12
Illinois Humana Health Plan, Inc. - High Self & Family
752
3080.33
3157.29
1243.95
1913.34
51.22
Illinois Humana Health Plan, Inc. - High Self Plus One
753
2943.42
3016.98
1136.70
1880.28
58.02
Illinois Humana Health Plan, Inc. - High Self
9F1
2015.85
2116.64
530.53
1586.11
93.68
Illinois Humana Health Plan, Inc. - High Self & Family
9F2
4535.64
4762.44
1243.95
3518.49
201.06
Illinois Humana Health Plan, Inc. - High Self Plus One
9F3
4334.03
4550.74
1136.70
3414.04
201.17
Illinois Humana Health Plan, Inc. - Standard Self
AB4
1241.70
1447.46
530.53
916.93
198.65
Illinois Humana Health Plan, Inc. - Standard Self & Family
AB5
2793.90
3256.85
1243.95
2012.90
437.21
Illinois Humana Health Plan, Inc. - Standard Self Plus One
AB6
2669.72
3112.11
1136.70
1975.41
426.85
Illinois Humana Health Plan, Inc. - Basic Self
AB1
786.91
845.93
530.53
315.40
51.91
Illinois Humana Health Plan, Inc. - Basic Self & Family
AB2
1770.60
1903.40
1243.95
659.45
107.06
Illinois Humana Health Plan, Inc. - Basic Self Plus One
AB3
1691.91
1818.81
1136.70
682.11
111.36
Illinois Humana Health Plan, Inc. - Basic Self
RW1
819.04
839.50
530.53
308.97
13.35
Illinois Humana Health Plan, Inc. - Basic Self & Family
RW2
1842.86
1888.88
1243.95
644.93
20.28
Illinois Humana Health Plan, Inc. - Basic Self Plus One
RW3
1760.96
1804.92
1136.70
668.22
28.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
554.62
663.76
497.82
165.94
27.29
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1555.15
1586.41
1189.81
396.60
7.81
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1083.18
1327.54
995.66
331.88
61.09
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Indiana Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Indiana Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Indiana Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Indiana Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Indiana Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Indiana Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Indiana Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Indiana Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Indiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Indiana Health Alliance HMO - Standard Self
K84
683.56
704.08
528.06
176.02
5.13
Indiana Health Alliance HMO - Standard Self & Family
K85
1584.35
1631.89
1223.92
407.97
11.88
Indiana Health Alliance HMO - Standard Self Plus One
K86
1461.61
1505.44
1129.08
376.36
10.96
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
MW4
807.76
799.70
530.53
269.17
-15.17
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
MW5
1817.40
1799.27
1243.95
555.32
-43.87
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
MW6
1736.67
1719.32
1136.70
582.62
-32.89
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
MW1
1025.96
1056.75
530.53
526.22
23.68
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
MW2
2308.48
2377.81
1243.95
1133.86
43.59
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
MW3
2205.86
2272.08
1136.70
1135.38
50.68
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
TC1
738.57
757.06
530.53
226.53
11.38
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TC2
1661.79
1703.33
1243.95
459.38
15.80
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TC3
1587.95
1627.64
1136.70
490.94
24.15
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
TC4
New Plan
579.74
434.81
144.93
New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
TC5
New Plan
1304.42
978.32
326.10
New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TC6
New Plan
1246.44
934.83
311.61
New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self
X34
645.88
694.33
520.75
173.58
12.11
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1453.25
1562.23
1171.67
390.56
27.25
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1388.66
1492.81
1119.61
373.20
26.04
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
839.41
902.37
530.53
371.84
55.85
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1888.71
2030.34
1243.95
786.39
115.89
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1804.77
1940.12
1136.70
803.42
119.81
Indiana Humana HDHP - HDHP Self
BB1
New Plan
445.29
333.97
111.32
New Plan
Indiana Humana HDHP - HDHP Self & Family
BB2
New Plan
1109.33
832.00
277.33
New Plan
Indiana Humana HDHP - HDHP Self Plus One
BB3
New Plan
976.52
732.39
244.13
New Plan
Indiana Humana HDHP - HDHP Self
DT1
New Plan
495.73
371.80
123.93
New Plan
Indiana Humana HDHP - HDHP Self & Family
DT2
New Plan
1235.41
926.56
308.85
New Plan
Indiana Humana HDHP - HDHP Self Plus One
DT3
New Plan
1087.47
815.60
271.87
New Plan
Indiana Humana Health Plan of Ohio, Inc. - Standard Self
A64
1230.78
1243.08
530.53
712.55
5.19
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2769.30
2796.95
1243.95
1553.00
1.91
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2646.19
2672.63
1136.70
1535.93
10.90
Indiana Humana Health Plan, Inc. - Standard Self
754
1045.35
1055.80
530.53
525.27
3.34
Indiana Humana Health Plan, Inc. - Standard Self & Family
755
2352.03
2375.56
1243.95
1131.61
-2.21
Indiana Humana Health Plan, Inc. - Standard Self Plus One
756
2247.53
2270.00
1136.70
1133.30
6.93
Indiana Humana Health Plan, Inc. - High Self
751
1369.01
1403.24
530.53
872.71
27.12
Indiana Humana Health Plan, Inc. - High Self & Family
752
3080.33
3157.29
1243.95
1913.34
51.22
Indiana Humana Health Plan, Inc. - High Self Plus One
753
2943.42
3016.98
1136.70
1880.28
58.02
Indiana Humana Health Plan, Inc. - Standard Self
MH4
945.62
992.90
530.53
462.37
40.17
Indiana Humana Health Plan, Inc. - Standard Self & Family
MH5
2127.62
2233.96
1243.95
990.01
80.60
Indiana Humana Health Plan, Inc. - Standard Self Plus One
MH6
2033.05
2134.67
1136.70
997.97
86.08
Iowa Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Iowa Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Iowa Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Iowa Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Iowa Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Iowa Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Iowa Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Iowa Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Iowa Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Iowa Health Alliance HMO - Standard Self
K84
683.56
704.08
528.06
176.02
5.13
Iowa Health Alliance HMO - Standard Self & Family
K85
1584.35
1631.89
1223.92
407.97
11.88
Iowa Health Alliance HMO - Standard Self Plus One
K86
1461.61
1505.44
1129.08
376.36
10.96
Iowa HealthPartners - Standard Self
V34
509.41
553.28
414.96
138.32
10.97
Iowa HealthPartners - Standard Self & Family
V35
1240.94
1347.84
1010.88
336.96
26.73
Iowa HealthPartners - Standard Self Plus One
V36
1125.80
1222.78
917.09
305.69
24.24
Iowa HealthPartners - High Self
V31
668.07
692.14
519.11
173.03
6.01
Iowa HealthPartners - High Self & Family
V32
1627.38
1686.01
1243.95
442.06
32.89
Iowa HealthPartners - High Self Plus One
V33
1476.41
1529.58
1136.70
392.88
23.78
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
692.86
744.55
530.53
214.02
40.81
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1593.56
1712.45
1243.95
468.50
70.11
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1489.63
1600.76
1136.70
464.06
91.65
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
776.84
873.95
530.53
343.42
90.00
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1942.11
2184.93
1243.95
940.98
217.08
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1670.22
1879.04
1136.70
742.34
193.28
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Kansas Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Kansas Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Kansas Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Kansas Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Kansas Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Kansas Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Kansas Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Kansas Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Kansas Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Kansas Aetna Open Access - High Self
HA1
1156.52
1188.98
530.53
658.45
25.35
Kansas Aetna Open Access - High Self & Family
HA2
2731.91
2808.54
1243.95
1564.59
50.89
Kansas Aetna Open Access - High Self Plus One
HA3
2704.89
2780.77
1136.70
1644.07
60.34
Kansas Aetna Open Access - Standard Self
HA4
901.36
909.37
530.53
378.84
0.90
Kansas Aetna Open Access - Standard Self & Family
HA5
2127.54
2146.47
1243.95
902.52
-6.81
Kansas Aetna Open Access - Standard Self Plus One
HA6
2106.48
2125.26
1136.70
988.56
3.24
Kansas Humana CoverageFirst and Humana Value Plan - Value Self
PH4
527.61
567.17
425.38
141.79
9.89
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
1187.12
1276.15
957.11
319.04
22.26
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
1134.36
1219.44
914.58
304.86
21.27
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
758.03
758.03
530.53
227.50
-7.11
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1705.58
1705.60
1243.95
461.65
-25.72
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1629.77
1629.79
1136.70
493.09
-15.52
Kansas Humana HDHP - HDHP Self
BK1
New Plan
403.13
302.35
100.78
New Plan
Kansas Humana HDHP - HDHP Self & Family
BK2
New Plan
1003.93
752.95
250.98
New Plan
Kansas Humana HDHP - HDHP Self Plus One
BK3
New Plan
883.78
662.84
220.94
New Plan
Kansas Humana Health Plan, Inc. - Standard Self
MS4
1200.59
1290.64
530.53
760.11
82.94
Kansas Humana Health Plan, Inc. - Standard Self & Family
MS5
2701.34
2903.98
1243.95
1660.03
176.90
Kansas Humana Health Plan, Inc. - Standard Self Plus One
MS6
2581.32
2774.94
1136.70
1638.24
178.08
Kentucky Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Kentucky Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Kentucky Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Kentucky Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Kentucky Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Kentucky Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Kentucky Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Kentucky Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self
TC1
738.57
757.06
530.53
226.53
11.38
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TC2
1661.79
1703.33
1243.95
459.38
15.80
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TC3
1587.95
1627.64
1136.70
490.94
24.15
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self
TC4
New Plan
579.74
434.81
144.93
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family
TC5
New Plan
1304.42
978.32
326.10
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TC6
New Plan
1246.44
934.83
311.61
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self
6N1
828.04
848.75
530.53
318.22
13.60
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
6N2
1863.07
1909.68
1243.95
665.73
20.87
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
6N3
1780.29
1824.81
1136.70
688.11
28.98
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self
6N4
New Plan
633.82
475.37
158.45
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family
6N5
New Plan
1426.06
1069.55
356.51
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One
6N6
New Plan
1362.70
1022.03
340.67
New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self
X34
645.88
694.33
520.75
173.58
12.11
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1453.25
1562.23
1171.67
390.56
27.25
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1388.66
1492.81
1119.61
373.20
26.04
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
839.41
902.37
530.53
371.84
55.85
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1888.71
2030.34
1243.95
786.39
115.89
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1804.77
1940.12
1136.70
803.42
119.81
Kentucky Humana HDHP - HDHP Self
DT1
New Plan
495.73
371.80
123.93
New Plan
Kentucky Humana HDHP - HDHP Self & Family
DT2
New Plan
1235.41
926.56
308.85
New Plan
Kentucky Humana HDHP - HDHP Self Plus One
DT3
New Plan
1087.47
815.60
271.87
New Plan
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self
A64
1230.78
1243.08
530.53
712.55
5.19
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2769.30
2796.95
1243.95
1553.00
1.91
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2646.19
2672.63
1136.70
1535.93
10.90
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self
W61
639.06
671.02
503.27
167.75
7.99
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1437.93
1509.82
1132.37
377.45
17.97
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1374.01
1442.72
1082.04
360.68
17.18
Kentucky Humana Health Plan, Inc. - Standard Self
MI4
920.40
929.59
530.53
399.06
2.08
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MI5
2070.86
2091.55
1243.95
847.60
-5.05
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MI6
1978.84
1998.62
1136.70
861.92
4.24
Kentucky Humana Health Plan, Inc. - Standard Self
MH4
945.62
992.90
530.53
462.37
40.17
Kentucky Humana Health Plan, Inc. - Standard Self & Family
MH5
2127.62
2233.96
1243.95
990.01
80.60
Kentucky Humana Health Plan, Inc. - Standard Self Plus One
MH6
2033.05
2134.67
1136.70
997.97
86.08
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
N71
692.86
744.55
530.53
214.02
40.81
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
N72
1593.56
1712.45
1243.95
468.50
70.11
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
N73
1489.63
1600.76
1136.70
464.06
91.65
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LJ1
776.84
873.95
530.53
343.42
90.00
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LJ2
1942.11
2184.93
1243.95
940.98
217.08
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LJ3
1670.22
1879.04
1136.70
742.34
193.28
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Louisiana Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Louisiana Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Louisiana Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Louisiana Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Louisiana Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Louisiana Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Louisiana Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Louisiana Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
BC4
741.54
760.09
530.53
229.56
11.44
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
BC5
1668.46
1710.22
1243.95
466.27
16.02
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
BC6
1594.30
1634.19
1136.70
497.49
24.35
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
BC1
991.47
1031.12
530.53
500.59
32.54
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
BC2
2230.82
2320.07
1243.95
1076.12
63.51
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
BC3
2131.68
2216.96
1136.70
1080.26
69.74
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self
AE1
1210.69
1271.25
530.53
740.72
53.45
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family
AE2
2724.04
2860.22
1243.95
1616.27
110.44
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One
AE3
2602.99
2733.12
1136.70
1596.42
114.59
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self
AE4
912.43
939.79
530.53
409.26
20.25
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family
AE5
2052.98
2114.58
1243.95
870.63
35.86
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One
AE6
1961.72
2020.59
1136.70
883.89
43.33
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Maine Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Maine Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Maine Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Maine Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Maine Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Maine Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Maine Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Maine Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Maine Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Maryland Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Maryland Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Maryland Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Maryland Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Maryland Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Maryland Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Maryland Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Maryland Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Maryland Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Maryland Aetna Open Access - High Self
JN1
1176.57
1251.55
530.53
721.02
67.87
Maryland Aetna Open Access - High Self & Family
JN2
2645.05
2813.68
1243.95
1569.73
142.89
Maryland Aetna Open Access - High Self Plus One
JN3
2618.85
2785.79
1136.70
1649.09
151.40
Maryland Aetna Open Access - Basic Self
JN4
714.42
739.46
530.53
208.93
17.93
Maryland Aetna Open Access - Basic Self & Family
JN5
1634.92
1692.23
1243.95
448.28
31.57
Maryland Aetna Open Access - Basic Self Plus One
JN6
1501.33
1553.93
1136.70
417.23
37.06
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
1362.12
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
887.81
905.58
530.53
375.05
10.66
Maryland CareFirst BlueChoice - Standard Self & Family
2G5
2109.42
2151.59
1243.95
907.64
16.43
Maryland CareFirst BlueChoice - Standard Self Plus One
2G6
1775.61
1811.12
1136.70
674.42
19.97
Maryland CareFirst BlueChoice - HDHP Self
B61
570.09
604.31
453.23
151.08
8.56
Maryland CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1435.79
1076.84
358.95
20.32
Maryland CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1208.57
906.43
302.14
17.10
Maryland CareFirst BlueChoice - Blue Value Plus Self
B64
723.67
723.67
530.53
193.14
-7.11
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1719.38
1719.38
1243.95
475.43
-25.74
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1447.29
1447.29
1085.47
361.82
0.00
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self
T71
427.72
368.90
276.68
92.22
-14.71
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family
T72
1099.52
1051.33
788.50
262.83
-12.05
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One
T73
951.84
866.91
650.18
216.73
-21.23
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
598.28
607.25
455.44
151.81
2.24
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1376.05
1396.63
1047.47
349.16
5.15
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1376.05
1396.63
1047.47
349.16
5.15
Maryland Kaiser Permanente - Mid-Atlantic States - High Self
E31
746.24
756.60
530.53
226.07
3.25
Maryland Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1716.35
1740.20
1243.95
496.25
-1.89
Maryland Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1716.35
1740.20
1136.70
603.50
8.31
Maryland M.D. IPA - High Self
JP1
950.89
1011.99
530.53
481.46
53.99
Maryland M.D. IPA - High Self & Family
JP2
2666.28
2837.66
1243.95
1593.71
145.64
Maryland M.D. IPA - High Self Plus One
JP3
1857.09
1976.43
1136.70
839.73
103.80
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
519.91
661.81
496.36
165.45
35.47
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1195.81
1514.20
1135.65
378.55
79.60
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1117.81
1422.92
1067.19
355.73
76.28
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
770.40
822.16
530.53
291.63
44.65
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1825.83
1948.55
1243.95
704.60
96.98
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1656.33
1767.68
1136.70
630.98
95.81
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
554.62
663.76
497.82
165.94
27.29
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1555.15
1586.41
1189.81
396.60
7.81
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1083.18
1327.54
995.66
331.88
61.09
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Massachusetts Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Massachusetts Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Massachusetts Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Massachusetts Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Massachusetts Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Massachusetts Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Massachusetts Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Michigan Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Michigan Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Michigan Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Michigan Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Michigan Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Michigan Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Michigan Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Michigan Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Michigan Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Michigan Blue Care Network of Michigan - High Self
LX1
765.81
790.44
530.53
259.91
17.52
Michigan Blue Care Network of Michigan - High Self & Family
LX2
1868.58
1928.70
1243.95
684.75
34.38
Michigan Blue Care Network of Michigan - High Self Plus One
LX3
1761.39
1818.03
1136.70
681.33
41.10
Michigan Blue Care Network of Michigan - High Self
K51
996.49
1042.12
530.53
511.59
38.52
Michigan Blue Care Network of Michigan - High Self & Family
K52
2431.46
2542.76
1243.95
1298.81
85.56
Michigan Blue Care Network of Michigan - High Self Plus One
K53
2291.97
2396.85
1136.70
1260.15
89.34
Michigan Health Alliance Plan - High Self
521
842.18
910.11
530.53
379.58
60.82
Michigan Health Alliance Plan - High Self & Family
522
2054.93
2220.62
1243.95
976.67
139.95
Michigan Health Alliance Plan - High Self Plus One
523
1937.00
2093.22
1136.70
956.52
140.68
Michigan Health Alliance Plan - Standard Self
GY4
557.55
530.16
397.62
132.54
-6.85
Michigan Health Alliance Plan - Standard Self & Family
GY5
1360.41
1293.57
970.18
323.39
-16.71
Michigan Health Alliance Plan - Standard Self Plus One
GY6
1282.34
1219.38
914.54
304.84
-15.74
Michigan Priority Health - High Self
LE1
1037.29
1106.71
530.53
576.18
62.31
Michigan Priority Health - High Self & Family
LE2
2437.63
2600.74
1243.95
1356.79
137.37
Michigan Priority Health - High Self Plus One
LE3
2282.04
2434.73
1136.70
1298.03
137.15
Michigan Priority Health - Standard Self
LE4
587.38
617.22
462.92
154.30
7.46
Michigan Priority Health - Standard Self & Family
LE5
1380.32
1450.45
1087.84
362.61
17.53
Michigan Priority Health - Standard Self Plus One
LE6
1292.22
1357.85
1018.39
339.46
16.41
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
Minnesota Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Minnesota Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Minnesota Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Minnesota Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Minnesota Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Minnesota Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Minnesota Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Minnesota Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Minnesota HealthPartners - Standard Self
V34
509.41
553.28
414.96
138.32
10.97
Minnesota HealthPartners - Standard Self & Family
V35
1240.94
1347.84
1010.88
336.96
26.73
Minnesota HealthPartners - Standard Self Plus One
V36
1125.80
1222.78
917.09
305.69
24.24
Minnesota HealthPartners - High Self
V31
668.07
692.14
519.11
173.03
6.01
Minnesota HealthPartners - High Self & Family
V32
1627.38
1686.01
1243.95
442.06
32.89
Minnesota HealthPartners - High Self Plus One
V33
1476.41
1529.58
1136.70
392.88
23.78
Mississippi Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Mississippi Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Mississippi Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Mississippi Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Mississippi Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Mississippi Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Mississippi Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Mississippi Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Missouri Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Missouri Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Missouri Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Missouri Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Missouri Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Missouri Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Missouri Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Missouri Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Missouri Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Missouri Aetna Open Access - High Self
HA1
1156.52
1188.98
530.53
658.45
25.35
Missouri Aetna Open Access - High Self & Family
HA2
2731.91
2808.54
1243.95
1564.59
50.89
Missouri Aetna Open Access - High Self Plus One
HA3
2704.89
2780.77
1136.70
1644.07
60.34
Missouri Aetna Open Access - Standard Self
HA4
901.36
909.37
530.53
378.84
0.90
Missouri Aetna Open Access - Standard Self & Family
HA5
2127.54
2146.47
1243.95
902.52
-6.81
Missouri Aetna Open Access - Standard Self Plus One
HA6
2106.48
2125.26
1136.70
988.56
3.24
Missouri Blue Preferred - High Self
9G1
874.23
905.71
530.53
375.18
24.37
Missouri Blue Preferred - High Self & Family
9G2
1984.52
2139.32
1243.95
895.37
129.06
Missouri Blue Preferred - High Self Plus One
9G3
1862.12
2005.51
1136.70
868.81
127.85
Missouri Blue Preferred - Standard Self
9G4
633.66
614.01
460.51
153.50
-4.91
Missouri Blue Preferred - Standard Self & Family
9G5
1758.23
1791.62
1243.95
547.67
7.65
Missouri Blue Preferred - Standard Self Plus One
9G6
1574.58
1598.20
1136.70
461.50
8.08
Missouri Humana CoverageFirst and Humana Value Plan - Value Self
PH4
527.61
567.17
425.38
141.79
9.89
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family
PH5
1187.12
1276.15
957.11
319.04
22.26
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One
PH6
1134.36
1219.44
914.58
304.86
21.27
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self
PH1
758.03
758.03
530.53
227.50
-7.11
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
PH2
1705.58
1705.60
1243.95
461.65
-25.72
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
PH3
1629.77
1629.79
1136.70
493.09
-15.52
Missouri Humana HDHP - HDHP Self
BK1
New Plan
403.13
302.35
100.78
New Plan
Missouri Humana HDHP - HDHP Self & Family
BK2
New Plan
1003.93
752.95
250.98
New Plan
Missouri Humana HDHP - HDHP Self Plus One
BK3
New Plan
883.78
662.84
220.94
New Plan
Missouri Humana Health Plan, Inc. - Standard Self
MS4
1200.59
1290.64
530.53
760.11
82.94
Missouri Humana Health Plan, Inc. - Standard Self & Family
MS5
2701.34
2903.98
1243.95
1660.03
176.90
Missouri Humana Health Plan, Inc. - Standard Self Plus One
MS6
2581.32
2774.94
1136.70
1638.24
178.08
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Montana Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Montana Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Montana Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Montana Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Montana Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Montana Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Montana Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Montana Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Montana Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Nebraska Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Nebraska Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Nebraska Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Nebraska Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Nebraska Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Nebraska Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Nebraska Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Nebraska Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Nevada Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Nevada Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Nevada Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Nevada Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Nevada Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Nevada Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Nevada Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Nevada Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Nevada Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Nevada Health Plan of Nevada, Inc. - High Self
NM1
741.17
830.16
530.53
299.63
81.88
Nevada Health Plan of Nevada, Inc. - High Self & Family
NM2
1756.50
1967.40
1243.95
723.45
185.16
Nevada Health Plan of Nevada, Inc. - High Self Plus One
NM3
1408.23
1577.31
1136.70
440.61
88.55
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
622.22
668.46
501.35
167.11
11.56
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1471.54
1580.91
1185.68
395.23
27.35
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1337.77
1437.17
1077.88
359.29
24.85
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
528.17
672.10
504.08
168.02
35.98
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1214.76
1545.85
1159.39
386.46
82.77
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
1135.55
1445.04
1083.78
361.26
77.37
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
782.12
864.87
530.53
334.34
75.64
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1955.35
2162.16
1243.95
918.21
181.07
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1681.57
1859.46
1136.70
722.76
162.35
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
621.21
657.65
493.24
164.41
9.11
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1469.13
1555.39
1166.54
388.85
21.57
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1335.58
1413.97
1060.48
353.49
19.60
New Hampshire Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
New Hampshire Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
New Hampshire Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
New Hampshire Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
New Hampshire Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
New Hampshire Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
New Hampshire Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
New Jersey Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
New Jersey Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
New Jersey Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
New Jersey Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
New Jersey Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
New Jersey Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
New Jersey Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
New Jersey Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
New Jersey Aetna Open Access - High Self
JR1
1656.81
1655.18
530.53
1124.65
-8.74
New Jersey Aetna Open Access - High Self & Family
JR2
3827.03
3823.24
1243.95
2579.29
-29.53
New Jersey Aetna Open Access - High Self Plus One
JR3
3789.11
3785.41
1136.70
2648.71
-19.24
New Jersey Aetna Open Access - Basic Self
JR4
1429.35
1428.27
530.53
897.74
-8.19
New Jersey Aetna Open Access - Basic Self & Family
JR5
3312.70
3310.19
1243.95
2066.24
-28.25
New Jersey Aetna Open Access - Basic Self Plus One
JR6
3279.88
3277.41
1136.70
2140.71
-18.01
New Jersey Aetna Open Access - Basic Self
P34
1505.53
1721.76
530.53
1191.23
209.12
New Jersey Aetna Open Access - Basic Self & Family
P35
3494.34
3996.29
1243.95
2752.34
476.21
New Jersey Aetna Open Access - Basic Self Plus One
P36
3459.73
3956.70
1136.70
2820.00
481.43
New Jersey Aetna Open Access - High Self
P31
1588.23
1762.54
530.53
1232.01
167.20
New Jersey Aetna Open Access - High Self & Family
P32
3850.71
4273.27
1243.95
3029.32
396.82
New Jersey Aetna Open Access - High Self Plus One
P33
3812.58
4230.98
1136.70
3094.28
402.86
New Jersey Emblemhealth Plan, Inc. - Standard Self
804
1039.85
1039.85
530.53
509.32
-7.11
New Jersey Emblemhealth Plan, Inc. - Standard Self & Family
805
2522.72
2522.72
1243.95
1278.77
-25.74
New Jersey Emblemhealth Plan, Inc. - Standard Self Plus One
806
2418.74
2418.74
1136.70
1282.04
-15.54
New Mexico Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
New Mexico Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
New Mexico Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
New Mexico Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
New Mexico Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
New Mexico Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
New Mexico Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
New Mexico Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
New Mexico Presbyterian Health Plan - High Self
P21
846.93
874.47
530.53
343.94
20.43
New Mexico Presbyterian Health Plan - High Self & Family
P22
1990.34
2055.08
1243.95
811.13
39.00
New Mexico Presbyterian Health Plan - High Self Plus One
P23
1922.59
1985.12
1136.70
848.42
46.99
New Mexico Presbyterian Health Plan - Standard Self
PS4
706.31
725.23
530.53
194.70
11.81
New Mexico Presbyterian Health Plan - Standard Self & Family
PS5
1659.84
1704.34
1243.95
460.39
18.76
New Mexico Presbyterian Health Plan - Standard Self Plus One
PS6
1603.38
1646.36
1136.70
509.66
27.44
New Mexico Presbyterian Health Plan - Wellness Self
PS1
632.06
653.81
490.36
163.45
5.44
New Mexico Presbyterian Health Plan - Wellness Self & Family
PS2
1485.36
1536.43
1152.32
384.11
12.77
New Mexico Presbyterian Health Plan - Wellness Self Plus One
PS3
1434.79
1484.17
1113.13
371.04
12.34
New York Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
New York Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
New York Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
New York Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
New York Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
New York Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
New York Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
New York Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
New York Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
New York Aetna Open Access - High Self
JC1
1459.58
1728.91
530.53
1198.38
262.22
New York Aetna Open Access - High Self & Family
JC2
3606.57
4272.13
1243.95
3028.18
639.82
New York Aetna Open Access - High Self Plus One
JC3
3570.88
4229.83
1136.70
3093.13
643.41
New York Aetna Open Access - Basic Self
JC4
1219.86
1462.83
530.53
932.30
235.86
New York Aetna Open Access - Basic Self & Family
JC5
2975.51
3568.09
1243.95
2324.14
566.84
New York Aetna Open Access - Basic Self Plus One
JC6
2946.06
3532.77
1136.70
2396.07
571.17
New York CDPHP - Standard Self
SG4
704.56
773.76
530.53
243.23
62.09
New York CDPHP - Standard Self & Family
SG5
1690.87
1857.01
1243.95
613.06
140.40
New York CDPHP - Standard Self Plus One
SG6
1564.12
1717.73
1136.70
581.03
138.07
New York Emblemhealth Plan, Inc. - Standard Self
804
1039.85
1039.85
530.53
509.32
-7.11
New York Emblemhealth Plan, Inc. - Standard Self & Family
805
2522.72
2522.72
1243.95
1278.77
-25.74
New York Emblemhealth Plan, Inc. - Standard Self Plus One
806
2418.74
2418.74
1136.70
1282.04
-15.54
New York HIP of Greater NY - Standard Self
YL4
900.68
975.30
530.53
444.77
67.51
New York HIP of Greater NY - Standard Self & Family
YL5
2618.24
2835.13
1243.95
1591.18
191.15
New York HIP of Greater NY - Standard Self Plus One
YL6
1644.59
1780.87
1136.70
644.17
120.74
New York HIP of Greater NY - High Self
511
1050.75
1050.75
530.53
520.22
-7.11
New York HIP of Greater NY - High Self & Family
512
3054.39
3054.59
1243.95
1810.64
-25.54
New York HIP of Greater NY - High Self Plus One
513
1918.63
1918.74
1136.70
782.04
-15.43
New York Independent Health - Standard Self
C54
722.15
737.77
530.53
207.24
8.51
New York Independent Health - Standard Self & Family
C55
1949.81
1991.99
1243.95
748.04
16.44
New York Independent Health - Standard Self Plus One
C56
1841.49
1881.36
1136.70
744.66
24.33
New York Independent Health - High Self
QA1
790.94
800.65
530.53
270.12
2.60
New York Independent Health - High Self & Family
QA2
2135.55
2161.75
1243.95
917.80
0.46
New York Independent Health - High Self Plus One
QA3
2016.91
2041.65
1136.70
904.95
9.20
New York Independent Health - HDHP Self
QA4
599.30
601.19
450.89
150.30
0.48
New York Independent Health - HDHP Self & Family
QA5
1551.36
1552.76
1164.57
388.19
0.35
New York Independent Health - HDHP Self Plus One
QA6
1475.76
1477.36
1108.02
369.34
0.40
North Carolina Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
North Carolina Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
North Carolina Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
North Carolina Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
North Carolina Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
North Carolina Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
North Carolina Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
North Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
North Dakota Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
North Dakota Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
North Dakota Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
North Dakota Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
North Dakota Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
North Dakota Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
North Dakota Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
North Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
North Dakota HealthPartners - Standard Self
V34
509.41
553.28
414.96
138.32
10.97
North Dakota HealthPartners - Standard Self & Family
V35
1240.94
1347.84
1010.88
336.96
26.73
North Dakota HealthPartners - Standard Self Plus One
V36
1125.80
1222.78
917.09
305.69
24.24
North Dakota HealthPartners - High Self
V31
668.07
692.14
519.11
173.03
6.01
North Dakota HealthPartners - High Self & Family
V32
1627.38
1686.01
1243.95
442.06
32.89
North Dakota HealthPartners - High Self Plus One
V33
1476.41
1529.58
1136.70
392.88
23.78
Northern Mariana Islands Calvo's SelectCare - Standard Self
B44
429.78
378.91
284.18
94.73
-12.71
Northern Mariana Islands Calvo's SelectCare - Standard Self & Family
B45
1248.72
1100.91
825.68
275.23
-36.95
Northern Mariana Islands Calvo's SelectCare - Standard Self Plus One
B46
847.21
746.92
560.19
186.73
-25.07
Northern Mariana Islands Calvo's SelectCare - High Self
B41
521.69
535.95
401.96
133.99
3.57
Northern Mariana Islands Calvo's SelectCare - High Self & Family
B42
1381.77
1419.54
1064.66
354.88
9.44
Northern Mariana Islands Calvo's SelectCare - High Self Plus One
B43
1018.07
1045.89
784.42
261.47
6.95
Northern Mariana Islands TakeCare - HDHP Self
KX1
120.53
122.31
91.73
30.58
0.45
Northern Mariana Islands TakeCare - HDHP Self & Family
KX2
323.16
327.97
245.98
81.99
1.20
Northern Mariana Islands TakeCare - HDHP Self Plus One
KX3
290.94
295.23
221.42
73.81
1.08
Northern Mariana Islands TakeCare - Standard Self
JK4
404.45
405.77
304.33
101.44
0.33
Northern Mariana Islands TakeCare - Standard Self & Family
JK5
1145.39
1149.18
861.89
287.29
0.94
Northern Mariana Islands TakeCare - Standard Self Plus One
JK6
797.14
799.78
599.84
199.94
0.66
Northern Mariana Islands TakeCare - High Self
JK1
497.81
515.86
386.90
128.96
4.51
Northern Mariana Islands TakeCare - High Self & Family
JK2
1187.38
1230.43
922.82
307.61
10.77
Northern Mariana Islands TakeCare - High Self Plus One
JK3
983.49
1019.16
764.37
254.79
8.92
Ohio Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Ohio Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Ohio Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Ohio Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Ohio Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Ohio Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Ohio Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Ohio Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Ohio Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Ohio AultCare Insurance Company - High Self
3A1
875.88
930.26
530.53
399.73
47.27
Ohio AultCare Insurance Company - High Self & Family
3A2
2163.29
2297.82
1243.95
1053.87
108.79
Ohio AultCare Insurance Company - High Self Plus One
3A3
1839.24
1953.62
1136.70
816.92
98.84
Ohio AultCare Insurance Company - HDHP Self
3A4
465.88
442.82
332.12
110.70
-5.77
Ohio AultCare Insurance Company - HDHP Self & Family
3A5
1491.77
1417.93
1063.45
354.48
-18.46
Ohio AultCare Insurance Company - HDHP Self Plus One
3A6
885.69
841.84
631.38
210.46
-10.96
Ohio Humana CoverageFirst and Humana Value Plan - Value Self
X34
645.88
694.33
520.75
173.58
12.11
Ohio Humana CoverageFirst and Humana Value Plan - Value Self & Family
X35
1453.25
1562.23
1171.67
390.56
27.25
Ohio Humana CoverageFirst and Humana Value Plan - Value Self Plus One
X36
1388.66
1492.81
1119.61
373.20
26.04
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self
X31
839.41
902.37
530.53
371.84
55.85
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
X32
1888.71
2030.34
1243.95
786.39
115.89
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
X33
1804.77
1940.12
1136.70
803.42
119.81
Ohio Humana HDHP - HDHP Self
DT1
New Plan
495.73
371.80
123.93
New Plan
Ohio Humana HDHP - HDHP Self & Family
DT2
New Plan
1235.41
926.56
308.85
New Plan
Ohio Humana HDHP - HDHP Self Plus One
DT3
New Plan
1087.47
815.60
271.87
New Plan
Ohio Humana Health Plan of Ohio, Inc. - Standard Self
A64
1230.78
1243.08
530.53
712.55
5.19
Ohio Humana Health Plan of Ohio, Inc. - Standard Self & Family
A65
2769.30
2796.95
1243.95
1553.00
1.91
Ohio Humana Health Plan of Ohio, Inc. - Standard Self Plus One
A66
2646.19
2672.63
1136.70
1535.93
10.90
Ohio Humana Health Plan of Ohio, Inc. - Basic Self
W61
639.06
671.02
503.27
167.75
7.99
Ohio Humana Health Plan of Ohio, Inc. - Basic Self & Family
W62
1437.93
1509.82
1132.37
377.45
17.97
Ohio Humana Health Plan of Ohio, Inc. - Basic Self Plus One
W63
1374.01
1442.72
1082.04
360.68
17.18
Ohio Medical Mutual of Ohio - Basic Self
YF1
415.05
416.74
312.56
104.18
0.42
Ohio Medical Mutual of Ohio - Basic Self & Family
YF2
996.10
1000.16
750.12
250.04
1.02
Ohio Medical Mutual of Ohio - Basic Self Plus One
YF3
913.10
916.80
687.60
229.20
0.93
Ohio Medical Mutual of Ohio - Standard Self
YF4
985.86
1193.60
530.53
663.07
200.63
Ohio Medical Mutual of Ohio - Standard Self & Family
YF5
2366.04
2864.62
1243.95
1620.67
472.84
Ohio Medical Mutual of Ohio - Standard Self Plus One
YF6
2168.88
2625.89
1136.70
1489.19
441.47
Ohio Medical Mutual of Ohio - Standard Self
644
940.96
1047.84
530.53
517.31
99.77
Ohio Medical Mutual of Ohio - Standard Self & Family
645
2258.32
2514.79
1243.95
1270.84
230.73
Ohio Medical Mutual of Ohio - Standard Self Plus One
646
2070.12
2305.23
1136.70
1168.53
219.57
Ohio Medical Mutual of Ohio - Standard Self
X64
861.34
1109.98
530.53
579.45
241.53
Ohio Medical Mutual of Ohio - Standard Self & Family
X65
2067.22
2663.98
1243.95
1420.03
571.02
Ohio Medical Mutual of Ohio - Standard Self Plus One
X66
1894.95
2441.99
1136.70
1305.29
531.50
Ohio Medical Mutual of Ohio - Basic Self
X61
405.28
406.94
305.21
101.73
0.41
Ohio Medical Mutual of Ohio - Basic Self & Family
X62
972.68
976.69
732.52
244.17
1.00
Ohio Medical Mutual of Ohio - Basic Self Plus One
X63
891.63
895.29
671.47
223.82
0.91
Ohio Medical Mutual of Ohio - Basic Self
UX1
411.21
412.90
309.68
103.22
0.42
Ohio Medical Mutual of Ohio - Basic Self & Family
UX2
986.92
990.97
743.23
247.74
1.01
Ohio Medical Mutual of Ohio - Basic Self Plus One
UX3
904.67
908.40
681.30
227.10
0.93
Oklahoma Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Oklahoma Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Oklahoma Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Oklahoma Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Oklahoma Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Oklahoma Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Oklahoma Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Oregon Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Oregon Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Oregon Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Oregon Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Oregon Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Oregon Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Oregon Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Oregon Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Oregon Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Oregon Kaiser Permanente - Northwest - Standard Self
574
688.35
668.89
501.67
167.22
-4.87
Oregon Kaiser Permanente - Northwest - Standard Self & Family
575
1581.34
1536.64
1152.48
384.16
-11.17
Oregon Kaiser Permanente - Northwest - Standard Self Plus One
576
1581.34
1536.64
1136.70
399.94
-60.24
Oregon Kaiser Permanente - Northwest - High Self
571
751.68
757.66
530.53
227.13
-1.13
Oregon Kaiser Permanente - Northwest - High Self & Family
572
1697.82
1711.34
1243.95
467.39
-12.22
Oregon Kaiser Permanente - Northwest - High Self Plus One
573
1697.82
1711.34
1136.70
574.64
-2.02
Oregon Kaiser Permanente - Northwest - Prosper Self
AM1
391.78
391.78
293.84
97.94
0.00
Oregon Kaiser Permanente - Northwest - Prosper Self & Family
AM2
926.47
971.66
728.75
242.91
11.29
Oregon Kaiser Permanente - Northwest - Prosper Self Plus One
AM3
842.29
842.29
631.72
210.57
0.00
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
622.22
668.46
501.35
167.11
11.56
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1471.54
1580.91
1185.68
395.23
27.35
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1337.77
1437.17
1077.88
359.29
24.85
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
528.17
672.10
504.08
168.02
35.98
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1214.76
1545.85
1159.39
386.46
82.77
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
1135.55
1445.04
1083.78
361.26
77.37
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
782.12
864.87
530.53
334.34
75.64
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1955.35
2162.16
1243.95
918.21
181.07
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1681.57
1859.46
1136.70
722.76
162.35
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
621.21
657.65
493.24
164.41
9.11
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1469.13
1555.39
1166.54
388.85
21.57
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1335.58
1413.97
1060.48
353.49
19.60
Palau Calvo's SelectCare - Standard Self
B44
429.78
378.91
284.18
94.73
-12.71
Palau Calvo's SelectCare - Standard Self & Family
B45
1248.72
1100.91
825.68
275.23
-36.95
Palau Calvo's SelectCare - Standard Self Plus One
B46
847.21
746.92
560.19
186.73
-25.07
Palau Calvo's SelectCare - High Self
B41
521.69
535.95
401.96
133.99
3.57
Palau Calvo's SelectCare - High Self & Family
B42
1381.77
1419.54
1064.66
354.88
9.44
Palau Calvo's SelectCare - High Self Plus One
B43
1018.07
1045.89
784.42
261.47
6.95
Palau TakeCare - HDHP Self
KX1
120.53
122.31
91.73
30.58
0.45
Palau TakeCare - HDHP Self & Family
KX2
323.16
327.97
245.98
81.99
1.20
Palau TakeCare - HDHP Self Plus One
KX3
290.94
295.23
221.42
73.81
1.08
Palau TakeCare - Standard Self
JK4
404.45
405.77
304.33
101.44
0.33
Palau TakeCare - Standard Self & Family
JK5
1145.39
1149.18
861.89
287.29
0.94
Palau TakeCare - Standard Self Plus One
JK6
797.14
799.78
599.84
199.94
0.66
Palau TakeCare - High Self
JK1
497.81
515.86
386.90
128.96
4.51
Palau TakeCare - High Self & Family
JK2
1187.38
1230.43
922.82
307.61
10.77
Palau TakeCare - High Self Plus One
JK3
983.49
1019.16
764.37
254.79
8.92
Pennsylvania Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Pennsylvania Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Pennsylvania Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Pennsylvania Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Pennsylvania Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Pennsylvania Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Pennsylvania Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Pennsylvania Aetna Open Access - High Self
YE1
1206.55
1181.68
530.53
651.15
-31.98
Pennsylvania Aetna Open Access - High Self & Family
YE2
3029.63
2967.19
1243.95
1723.24
-88.18
Pennsylvania Aetna Open Access - High Self Plus One
YE3
2999.64
2937.83
1136.70
1801.13
-77.35
Pennsylvania Aetna Open Access - Basic Self
P34
1505.53
1721.76
530.53
1191.23
209.12
Pennsylvania Aetna Open Access - Basic Self & Family
P35
3494.34
3996.29
1243.95
2752.34
476.21
Pennsylvania Aetna Open Access - Basic Self Plus One
P36
3459.73
3956.70
1136.70
2820.00
481.43
Pennsylvania Aetna Open Access - High Self
P31
1588.23
1762.54
530.53
1232.01
167.20
Pennsylvania Aetna Open Access - High Self & Family
P32
3850.71
4273.27
1243.95
3029.32
396.82
Pennsylvania Aetna Open Access - High Self Plus One
P33
3812.58
4230.98
1136.70
3094.28
402.86
Pennsylvania Geisinger Health Plan - Standard Self
GG4
912.69
992.53
530.53
462.00
72.73
Pennsylvania Geisinger Health Plan - Standard Self & Family
GG5
2089.62
2272.42
1243.95
1028.47
157.06
Pennsylvania Geisinger Health Plan - Standard Self Plus One
GG6
1972.08
2144.57
1136.70
1007.87
156.95
Pennsylvania Geisinger Health Plan - Basic Self
AJ1
802.06
891.00
530.53
360.47
81.83
Pennsylvania Geisinger Health Plan - Basic Self & Family
AJ2
1836.32
2039.96
1243.95
796.01
177.90
Pennsylvania Geisinger Health Plan - Basic Self Plus One
AJ3
1732.99
1925.21
1136.70
788.51
176.68
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
519.91
661.81
496.36
165.45
35.47
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1195.81
1514.20
1135.65
378.55
79.60
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1117.81
1422.92
1067.19
355.73
76.28
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
770.40
822.16
530.53
291.63
44.65
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1825.83
1948.55
1243.95
704.60
96.98
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1656.33
1767.68
1136.70
630.98
95.81
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Pennsylvania UPMC Health Plan - HDHP Self
8W4
641.66
667.98
500.99
166.99
6.58
Pennsylvania UPMC Health Plan - HDHP Self & Family
8W5
1476.87
1539.20
1154.40
384.80
15.58
Pennsylvania UPMC Health Plan - HDHP Self Plus One
8W6
1420.71
1479.49
1109.62
369.87
14.69
Pennsylvania UPMC Health Plan - Standard Self
UW4
682.22
723.21
530.53
192.68
22.13
Pennsylvania UPMC Health Plan - Standard Self & Family
UW5
1601.25
1698.91
1243.95
454.96
54.65
Pennsylvania UPMC Health Plan - Standard Self Plus One
UW6
1533.74
1626.19
1136.70
489.49
76.91
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self
ZJ1
457.88
480.76
360.57
120.19
5.72
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self & Family
ZJ2
1030.23
1081.73
811.30
270.43
12.87
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self Plus One
ZJ3
984.45
1033.65
775.24
258.41
12.30
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
500.02
500.02
375.02
125.00
0.00
Rhode Island Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Rhode Island Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Rhode Island Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Rhode Island Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Rhode Island Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Rhode Island Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
South Carolina Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
South Carolina Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
South Carolina Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
South Carolina Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
South Carolina Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
South Carolina Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
South Carolina Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
South Carolina Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
South Dakota Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
South Dakota Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
South Dakota Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
South Dakota Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
South Dakota Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
South Dakota Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
South Dakota Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
South Dakota Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
South Dakota HealthPartners - Standard Self
V34
509.41
553.28
414.96
138.32
10.97
South Dakota HealthPartners - Standard Self & Family
V35
1240.94
1347.84
1010.88
336.96
26.73
South Dakota HealthPartners - Standard Self Plus One
V36
1125.80
1222.78
917.09
305.69
24.24
South Dakota HealthPartners - High Self
V31
668.07
692.14
519.11
173.03
6.01
South Dakota HealthPartners - High Self & Family
V32
1627.38
1686.01
1243.95
442.06
32.89
South Dakota HealthPartners - High Self Plus One
V33
1476.41
1529.58
1136.70
392.88
23.78
Tennessee Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Tennessee Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Tennessee Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Tennessee Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Tennessee Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Tennessee Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Tennessee Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Tennessee Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self
TT1
790.01
849.29
530.53
318.76
52.17
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TT2
1777.58
1910.91
1243.95
666.96
107.59
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TT3
1698.58
1825.98
1136.70
689.28
111.86
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self
TT4
723.93
742.02
530.53
211.49
10.98
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self & Family
TT5
1628.79
1669.53
1243.95
425.58
15.00
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TT6
1556.43
1595.34
1136.70
458.64
23.37
Tennessee Humana HDHP - HDHP Self
ER1
New Plan
397.78
298.34
99.44
New Plan
Tennessee Humana HDHP - HDHP Self & Family
ER2
New Plan
990.51
742.88
247.63
New Plan
Tennessee Humana HDHP - HDHP Self Plus One
ER3
New Plan
871.98
653.99
217.99
New Plan
Tennessee Humana Health Plan, Inc. - Standard Self
GJ4
904.91
927.55
530.53
397.02
15.53
Tennessee Humana Health Plan, Inc. - Standard Self & Family
GJ5
2036.08
2086.98
1243.95
843.03
25.16
Tennessee Humana Health Plan, Inc. - Standard Self Plus One
GJ6
1945.60
1994.20
1136.70
857.50
33.06
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LS1
485.85
624.67
468.50
156.17
34.71
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LS2
1117.50
1436.76
1077.57
359.19
79.82
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LS3
1044.59
1343.07
1007.30
335.77
74.62
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KK1
769.04
847.30
530.53
316.77
71.15
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KK2
1922.64
2118.24
1243.95
874.29
169.86
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KK3
1653.47
1821.69
1136.70
684.99
152.68
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Texas Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Texas Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Texas Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Texas Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Texas Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Texas Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Texas Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Texas Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Texas Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Texas Baylor Scott and White Health Plan - Basic Self
A81
585.89
553.71
415.28
138.43
-8.04
Texas Baylor Scott and White Health Plan - Basic Self & Family
A82
1374.53
1298.90
974.18
324.72
-18.91
Texas Baylor Scott and White Health Plan - Basic Self Plus One
A83
1298.59
1227.14
920.36
306.78
-17.87
Texas Baylor Scott and White Health Plan - Standard Self
A84
861.23
1012.68
530.53
482.15
144.34
Texas Baylor Scott and White Health Plan - Standard Self & Family
A85
2021.78
2377.44
1243.95
1133.49
329.92
Texas Baylor Scott and White Health Plan - Standard Self Plus One
A86
1910.05
2246.03
1136.70
1109.33
320.44
Texas Baylor Scott and White Health Plan - Basic Self
P81
603.94
570.74
428.06
142.68
-8.30
Texas Baylor Scott and White Health Plan - Basic Self & Family
P82
1416.96
1339.00
1004.25
334.75
-19.49
Texas Baylor Scott and White Health Plan - Basic Self Plus One
P83
1338.68
1265.01
948.76
316.25
-18.42
Texas Baylor Scott and White Health Plan - Standard Self
P84
966.68
1041.17
530.53
510.64
67.38
Texas Baylor Scott and White Health Plan - Standard Self & Family
P85
2269.43
2444.46
1243.95
1200.51
149.29
Texas Baylor Scott and White Health Plan - Standard Self Plus One
P86
2143.96
2309.30
1136.70
1172.60
149.80
Texas Humana CoverageFirst and Humana Value Plan - Value Self
T34
565.11
593.36
445.02
148.34
7.06
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
T35
1271.53
1424.09
1068.07
356.02
38.14
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
T36
1215.02
1275.78
956.84
318.94
15.19
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
T31
811.87
872.76
530.53
342.23
53.78
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
T32
1826.67
1963.67
1243.95
719.72
111.26
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
T33
1745.51
1876.42
1136.70
739.72
115.37
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TV1
909.39
909.39
530.53
378.86
-7.11
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TV2
2046.16
2046.18
1243.95
802.23
-25.72
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TV3
1955.24
1955.24
1136.70
818.54
-15.54
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TV4
719.27
719.27
530.53
188.74
-7.11
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TV5
1618.39
1618.39
1213.79
404.60
0.00
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TV6
1546.48
1546.48
1136.70
409.78
-15.54
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TU4
600.62
615.64
461.73
153.91
3.76
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TU5
1351.42
1385.19
1038.89
346.30
8.45
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TU6
1291.38
1323.68
992.76
330.92
8.08
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TU1
729.73
773.52
530.53
242.99
36.68
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TU2
1641.92
1740.46
1243.95
496.51
72.80
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TU3
1568.93
1663.11
1136.70
526.41
78.64
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self
TP1
772.14
772.14
530.53
241.61
-7.11
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family
TP2
1737.28
1737.28
1243.95
493.33
-25.74
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One
TP3
1660.08
1660.10
1136.70
523.40
-15.52
Texas Humana CoverageFirst and Humana Value Plan - Value Self
TP4
452.47
486.40
364.80
121.60
8.48
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family
TP5
1018.05
1167.36
875.52
291.84
37.33
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One
TP6
972.81
1045.76
784.32
261.44
18.24
Texas Humana HDHP - HDHP Self
FD1
New Plan
397.78
298.34
99.44
New Plan
Texas Humana HDHP - HDHP Self & Family
FD2
New Plan
990.51
742.88
247.63
New Plan
Texas Humana HDHP - HDHP Self Plus One
FD3
New Plan
871.98
653.99
217.99
New Plan
Texas Humana HDHP - HDHP Self
AN1
New Plan
458.62
343.97
114.65
New Plan
Texas Humana HDHP - HDHP Self & Family
AN2
New Plan
1142.64
856.98
285.66
New Plan
Texas Humana HDHP - HDHP Self Plus One
AN3
New Plan
1005.85
754.39
251.46
New Plan
Texas Humana HDHP - HDHP Self
DX1
New Plan
404.56
303.42
101.14
New Plan
Texas Humana HDHP - HDHP Self & Family
DX2
New Plan
1007.50
755.63
251.87
New Plan
Texas Humana HDHP - HDHP Self Plus One
DX3
New Plan
886.93
665.20
221.73
New Plan
Texas Humana HDHP - HDHP Self
CG1
New Plan
512.55
384.41
128.14
New Plan
Texas Humana HDHP - HDHP Self & Family
CG2
New Plan
1277.45
958.09
319.36
New Plan
Texas Humana HDHP - HDHP Self Plus One
CG3
New Plan
1124.46
843.35
281.11
New Plan
Texas Humana Health Plan of Texas - Standard Self
UC4
898.65
898.65
530.53
368.12
-7.11
Texas Humana Health Plan of Texas - Standard Self & Family
UC5
2021.96
2021.96
1243.95
778.01
-25.74
Texas Humana Health Plan of Texas - Standard Self Plus One
UC6
1932.08
1932.08
1136.70
795.38
-15.54
Texas Humana Health Plan of Texas - Basic Self
QX1
817.38
869.70
530.53
339.17
45.21
Texas Humana Health Plan of Texas - Basic Self & Family
QX2
1839.09
1956.80
1243.95
712.85
91.97
Texas Humana Health Plan of Texas - Basic Self Plus One
QX3
1757.36
1869.83
1136.70
733.13
96.93
Texas Humana Health Plan of Texas - Standard Self
EW4
936.24
950.28
530.53
419.75
6.93
Texas Humana Health Plan of Texas - Standard Self & Family
EW5
2106.50
2138.07
1243.95
894.12
5.83
Texas Humana Health Plan of Texas - Standard Self Plus One
EW6
2012.88
2043.06
1136.70
906.36
14.64
Texas Humana Health Plan of Texas - Basic Self
QY1
844.65
844.65
530.53
314.12
-7.11
Texas Humana Health Plan of Texas - Basic Self & Family
QY2
1900.47
1900.49
1243.95
656.54
-25.72
Texas Humana Health Plan of Texas - Basic Self Plus One
QY3
1816.04
1816.06
1136.70
679.36
-15.52
Texas Humana Health Plan of Texas - Basic Self
Q21
786.37
825.70
530.53
295.17
32.22
Texas Humana Health Plan of Texas - Basic Self & Family
Q22
1769.32
1857.81
1243.95
613.86
62.75
Texas Humana Health Plan of Texas - Basic Self Plus One
Q23
1690.63
1775.17
1136.70
638.47
69.00
Texas Humana Health Plan of Texas - Basic Self
Q61
699.16
716.65
530.53
186.12
10.38
Texas Humana Health Plan of Texas - Basic Self & Family
Q62
1573.17
1612.48
1209.36
403.12
9.83
Texas Humana Health Plan of Texas - Basic Self Plus One
Q63
1503.23
1540.83
1136.70
404.13
22.06
Texas Humana Health Plan of Texas - Standard Self
UU4
1608.19
1608.19
530.53
1077.66
-7.11
Texas Humana Health Plan of Texas - Standard Self & Family
UU5
3618.40
3618.36
1243.95
2374.41
-25.78
Texas Humana Health Plan of Texas - Standard Self Plus One
UU6
3457.57
3457.55
1136.70
2320.85
-15.56
Texas Humana Health Plan of Texas - Standard Self
UR4
1069.55
1069.55
530.53
539.02
-7.11
Texas Humana Health Plan of Texas - Standard Self & Family
UR5
2406.45
2406.47
1243.95
1162.52
-25.72
Texas Humana Health Plan of Texas - Standard Self Plus One
UR6
2299.48
2299.51
1136.70
1162.81
-15.51
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
554.62
663.76
497.82
165.94
27.29
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1555.15
1586.41
1189.81
396.60
7.81
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1083.18
1327.54
995.66
331.88
61.09
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Utah Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Utah Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Utah Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Utah Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Utah Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Utah Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Utah Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Utah Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Utah Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Utah Altius Health Plan - High Self
9K1
1048.36
1150.85
530.53
620.32
95.38
Utah Altius Health Plan - High Self & Family
9K2
2318.46
2545.10
1243.95
1301.15
200.90
Utah Altius Health Plan - High Self Plus One
9K3
2295.50
2519.92
1136.70
1383.22
208.88
Utah Altius Health Plan - HDHP Self
9K4
672.49
759.22
530.53
228.69
60.57
Utah Altius Health Plan - HDHP Self & Family
9K5
1405.43
1586.72
1190.04
396.68
45.32
Utah Altius Health Plan - HDHP Self Plus One
9K6
1377.85
1555.56
1136.70
418.86
74.40
Utah Altius Health Plan - Standard Self
DK4
883.11
942.54
530.53
412.01
52.32
Utah Altius Health Plan - Standard Self & Family
DK5
1950.20
2081.43
1243.95
837.48
105.49
Utah Altius Health Plan - Standard Self Plus One
DK6
1930.87
2060.80
1136.70
924.10
114.39
Utah SelectHealth Plan - Standard Self
SF4
628.62
643.09
482.32
160.77
3.62
Utah SelectHealth Plan - Standard Self & Family
SF5
1571.55
1607.71
1205.78
401.93
9.04
Utah SelectHealth Plan - Standard Self Plus One
SF6
1382.96
1414.77
1061.08
353.69
7.95
Utah SelectHealth Plan - HDHP Self
WX1
539.48
572.37
429.28
143.09
8.22
Utah SelectHealth Plan - HDHP Self & Family
WX2
1348.69
1430.93
1073.20
357.73
20.56
Utah SelectHealth Plan - HDHP Self Plus One
WX3
1186.84
1259.20
944.40
314.80
18.09
Vermont Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Vermont Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Vermont Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Vermont Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Vermont Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Vermont Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self
EP4
839.63
927.77
530.53
397.24
81.03
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
EP5
1922.68
2124.50
1243.95
880.55
176.08
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
EP6
1884.96
2082.84
1136.70
946.14
182.34
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
EP1
1124.65
1156.37
530.53
625.84
24.61
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
EP2
2564.88
2637.12
1243.95
1393.17
46.50
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
EP3
2539.46
2611.01
1136.70
1474.31
56.01
Vermont Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Vermont Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Vermont Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
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
1136.70
387.98
-15.54
Virginia Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Virginia Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Virginia Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Virginia Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Virginia Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Virginia Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
Virginia Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Virginia Aetna Open Access - High Self
JN1
1176.57
1251.55
530.53
721.02
67.87
Virginia Aetna Open Access - High Self & Family
JN2
2645.05
2813.68
1243.95
1569.73
142.89
Virginia Aetna Open Access - High Self Plus One
JN3
2618.85
2785.79
1136.70
1649.09
151.40
Virginia Aetna Open Access - Basic Self
JN4
714.42
739.46
530.53
208.93
17.93
Virginia Aetna Open Access - Basic Self & Family
JN5
1634.92
1692.23
1243.95
448.28
31.57
Virginia Aetna Open Access - Basic Self Plus One
JN6
1501.33
1553.93
1136.70
417.23
37.06
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
1362.12
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
887.81
905.58
530.53
375.05
10.66
Virginia CareFirst BlueChoice - Standard Self & Family
2G5
2109.42
2151.59
1243.95
907.64
16.43
Virginia CareFirst BlueChoice - Standard Self Plus One
2G6
1775.61
1811.12
1136.70
674.42
19.97
Virginia CareFirst BlueChoice - HDHP Self
B61
570.09
604.31
453.23
151.08
8.56
Virginia CareFirst BlueChoice - HDHP Self & Family
B62
1354.51
1435.79
1076.84
358.95
20.32
Virginia CareFirst BlueChoice - HDHP Self Plus One
B63
1140.17
1208.57
906.43
302.14
17.10
Virginia CareFirst BlueChoice - Blue Value Plus Self
B64
723.67
723.67
530.53
193.14
-7.11
Virginia CareFirst BlueChoice - Blue Value Plus Self & Family
B65
1719.38
1719.38
1243.95
475.43
-25.74
Virginia CareFirst BlueChoice - Blue Value Plus Self Plus One
B66
1447.29
1447.29
1085.47
361.82
0.00
Virginia Healthkeepers, Inc. HDHP - HDHP Self
9V1
New Plan
537.20
402.90
134.30
New Plan
Virginia Healthkeepers, Inc. HDHP - HDHP Self & Family
9V2
New Plan
1308.06
981.05
327.01
New Plan
Virginia Healthkeepers, Inc. HDHP - HDHP Self Plus One
9V3
New Plan
1222.09
916.57
305.52
New Plan
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self
T71
427.72
368.90
276.68
92.22
-14.71
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family
T72
1099.52
1051.33
788.50
262.83
-12.05
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One
T73
951.84
866.91
650.18
216.73
-21.23
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self
E34
598.28
607.25
455.44
151.81
2.24
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family
E35
1376.05
1396.63
1047.47
349.16
5.15
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One
E36
1376.05
1396.63
1047.47
349.16
5.15
Virginia Kaiser Permanente - Mid-Atlantic States - High Self
E31
746.24
756.60
530.53
226.07
3.25
Virginia Kaiser Permanente - Mid-Atlantic States - High Self & Family
E32
1716.35
1740.20
1243.95
496.25
-1.89
Virginia Kaiser Permanente - Mid-Atlantic States - High Self Plus One
E33
1716.35
1740.20
1136.70
603.50
8.31
Virginia M.D. IPA - High Self
JP1
950.89
1011.99
530.53
481.46
53.99
Virginia M.D. IPA - High Self & Family
JP2
2666.28
2837.66
1243.95
1593.71
145.64
Virginia M.D. IPA - High Self Plus One
JP3
1857.09
1976.43
1136.70
839.73
103.80
Virginia Optima Health - HDHP Self
PG4
605.09
568.79
426.59
142.20
-9.07
Virginia Optima Health - HDHP Self & Family
PG5
1334.78
1254.67
941.00
313.67
-20.02
Virginia Optima Health - HDHP Self Plus One
PG6
1308.60
1230.10
922.58
307.52
-19.63
Virginia Optima Health - High Self
PG1
719.55
719.55
530.53
189.02
-7.11
Virginia Optima Health - High Self & Family
PG2
1738.69
1738.69
1243.95
494.74
-25.74
Virginia Optima Health - High Self Plus One
PG3
1738.56
1738.56
1136.70
601.86
-15.54
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
AS1
599.47
650.91
488.18
162.73
12.86
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
AS2
1417.76
1539.46
1154.60
384.86
30.42
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
AS3
1288.89
1399.49
1049.62
349.87
27.65
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
V41
519.91
661.81
496.36
165.45
35.47
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
V42
1195.81
1514.20
1135.65
378.55
79.60
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
V43
1117.81
1422.92
1067.19
355.73
76.28
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
LR1
770.40
822.16
530.53
291.63
44.65
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
LR2
1825.83
1948.55
1243.95
704.60
96.98
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
LR3
1656.33
1767.68
1136.70
630.98
95.81
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self
L91
554.62
663.76
497.82
165.94
27.29
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family
L92
1555.15
1586.41
1189.81
396.60
7.81
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One
L93
1083.18
1327.54
995.66
331.88
61.09
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
Y81
576.72
581.25
435.94
145.31
1.13
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
Y82
1363.94
1374.69
1031.02
343.67
2.69
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
Y83
1239.94
1249.71
937.28
312.43
2.45
Washington Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Washington Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Washington Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Washington Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Washington Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Washington Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self
G54
717.04
834.38
530.53
303.85
110.23
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
G55
1642.27
1911.07
1243.95
667.12
243.06
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
G56
1610.09
1873.63
1136.70
736.93
248.00
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
G51
1058.76
1135.10
530.53
604.57
69.23
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
G52
2415.08
2589.21
1243.95
1345.26
148.39
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
G53
2391.20
2563.60
1136.70
1426.90
156.86
Washington Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Washington Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Washington Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Washington Kaiser Permanente - Northwest - Standard Self
574
688.35
668.89
501.67
167.22
-4.87
Washington Kaiser Permanente - Northwest - Standard Self & Family
575
1581.34
1536.64
1152.48
384.16
-11.17
Washington Kaiser Permanente - Northwest - Standard Self Plus One
576
1581.34
1536.64
1136.70
399.94
-60.24
Washington Kaiser Permanente - Northwest - High Self
571
751.68
757.66
530.53
227.13
-1.13
Washington Kaiser Permanente - Northwest - High Self & Family
572
1697.82
1711.34
1243.95
467.39
-12.22
Washington Kaiser Permanente - Northwest - High Self Plus One
573
1697.82
1711.34
1136.70
574.64
-2.02
Washington Kaiser Permanente - Northwest - Prosper Self
AM1
391.78
391.78
293.84
97.94
0.00
Washington Kaiser Permanente - Northwest - Prosper Self & Family
AM2
926.47
971.66
728.75
242.91
11.29
Washington Kaiser Permanente - Northwest - Prosper Self Plus One
AM3
842.29
842.29
631.72
210.57
0.00
Washington Kaiser Permanente - Washington Core - Standard Self
544
618.02
625.21
468.91
156.30
1.80
Washington Kaiser Permanente - Washington Core - Standard Self & Family
545
1421.44
1438.00
1078.50
359.50
4.14
Washington Kaiser Permanente - Washington Core - Standard Self Plus One
546
1421.44
1438.00
1078.50
359.50
4.14
Washington Kaiser Permanente - Washington Core - High Self
541
863.76
869.53
530.53
339.00
-1.34
Washington Kaiser Permanente - Washington Core - High Self & Family
542
1900.25
1912.93
1243.95
668.98
-13.06
Washington Kaiser Permanente - Washington Core - High Self Plus One
543
1900.25
1912.93
1136.70
776.23
-2.86
Washington Kaiser Permanente - Washington Core - Prosper Self
PT4
390.00
390.00
292.50
97.50
0.00
Washington Kaiser Permanente - Washington Core - Prosper Self & Family
PT5
1091.98
1091.98
818.99
272.99
0.00
Washington Kaiser Permanente - Washington Core - Prosper Self Plus One
PT6
944.67
944.67
708.50
236.17
0.00
Washington Kaiser Permanente Washington Options Federal - Standard Self
L11
743.17
758.05
530.53
227.52
7.77
Washington Kaiser Permanente Washington Options Federal - Standard Self & Family
L12
1649.83
1682.83
1243.95
438.88
7.26
Washington Kaiser Permanente Washington Options Federal - Standard Self Plus One
L13
1649.83
1682.83
1136.70
546.13
17.46
Washington Kaiser Permanente Washington Options Federal - HDHP Self
L14
661.72
675.18
506.39
168.79
3.36
Washington Kaiser Permanente Washington Options Federal - HDHP Self & Family
L15
1468.98
1498.84
1124.13
374.71
7.47
Washington Kaiser Permanente Washington Options Federal - HDHP Self Plus One
L16
1468.98
1498.84
1124.13
374.71
7.47
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self
WF1
622.22
668.46
501.35
167.11
11.56
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family
WF2
1471.54
1580.91
1185.68
395.23
27.35
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One
WF3
1337.77
1437.17
1077.88
359.29
24.85
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self
LU1
528.17
672.10
504.08
168.02
35.98
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family
LU2
1214.76
1545.85
1159.39
386.46
82.77
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One
LU3
1135.55
1445.04
1083.78
361.26
77.37
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self
KT1
782.12
864.87
530.53
334.34
75.64
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family
KT2
1955.35
2162.16
1243.95
918.21
181.07
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One
KT3
1681.57
1859.46
1136.70
722.76
162.35
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self
VD1
621.21
657.65
493.24
164.41
9.11
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family
VD2
1469.13
1555.39
1166.54
388.85
21.57
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One
VD3
1335.58
1413.97
1060.48
353.49
19.60
West Virginia Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
West Virginia Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
West Virginia Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
West Virginia Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
West Virginia Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
West Virginia Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
F51
851.74
870.65
530.53
340.12
11.80
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
F52
1942.03
1985.10
1243.95
741.15
17.33
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
F53
1922.81
1965.45
1136.70
828.75
27.10
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self
F54
821.82
895.53
530.53
365.00
66.60
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
F55
1881.88
2050.64
1243.95
806.69
143.02
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
F56
1844.96
2010.45
1136.70
873.75
149.95
West Virginia Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
West Virginia Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Wisconsin Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Wisconsin Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Wisconsin Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Wisconsin Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Wisconsin Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Wisconsin Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self
JS4
1094.58
1094.51
530.53
563.98
-7.18
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
JS5
2498.80
2498.64
1243.95
1254.69
-25.90
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
JS6
2474.07
2473.94
1136.70
1337.24
-15.67
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
JS1
1009.93
1037.34
530.53
506.81
20.30
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
JS2
2302.15
2364.66
1243.95
1120.71
36.77
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
JS3
2279.33
2341.24
1136.70
1204.54
46.37
Wisconsin Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Wisconsin Dean Health Plan, Inc. - High Self
WD1
1260.87
1284.57
530.53
754.04
16.59
Wisconsin Dean Health Plan, Inc. - High Self & Family
WD2
2900.04
2954.53
1243.95
1710.58
28.75
Wisconsin Dean Health Plan, Inc. - High Self Plus One
WD3
2647.86
2697.61
1136.70
1560.91
34.21
Wisconsin Dean Health Plan, Inc. - Standard Self
WD4
685.12
712.42
530.53
181.89
10.61
Wisconsin Dean Health Plan, Inc. - Standard Self & Family
WD5
1644.26
1709.80
1243.95
465.85
39.80
Wisconsin Dean Health Plan, Inc. - Standard Self Plus One
WD6
1507.26
1567.32
1136.70
430.62
44.52
Wisconsin Dean Health Plan, Inc. - Basic Self
AG1
455.07
455.07
341.30
113.77
0.00
Wisconsin Dean Health Plan, Inc. - Basic Self & Family
AG2
1023.90
1023.90
767.93
255.97
0.00
Wisconsin Dean Health Plan, Inc. - Basic Self Plus One
AG3
955.63
955.63
716.72
238.91
0.00
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self
WJ1
889.03
1089.03
530.53
558.50
192.89
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self & Family
WJ2
2311.51
2831.62
1243.95
1587.67
494.37
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self Plus One
WJ3
1955.89
2395.94
1136.70
1259.24
424.51
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self
WJ4
618.84
587.45
440.59
146.86
-7.85
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self & Family
WJ5
1609.01
1527.44
1145.58
381.86
-20.39
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self Plus One
WJ6
1361.47
1292.44
969.33
323.11
-17.26
Wisconsin HealthPartners - Standard Self
V34
509.41
553.28
414.96
138.32
10.97
Wisconsin HealthPartners - Standard Self & Family
V35
1240.94
1347.84
1010.88
336.96
26.73
Wisconsin HealthPartners - Standard Self Plus One
V36
1125.80
1222.78
917.09
305.69
24.24
Wisconsin HealthPartners - High Self
V31
668.07
692.14
519.11
173.03
6.01
Wisconsin HealthPartners - High Self & Family
V32
1627.38
1686.01
1243.95
442.06
32.89
Wisconsin HealthPartners - High Self Plus One
V33
1476.41
1529.58
1136.70
392.88
23.78
Wyoming Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Wyoming Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Wyoming Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Wyoming Aetna Direct - CDHP Self
N61
615.83
628.27
471.20
157.07
3.11
Wyoming Aetna Direct - CDHP Self & Family
N62
1553.07
1584.48
1188.36
396.12
7.85
Wyoming Aetna Direct - CDHP Self Plus One
N63
1350.55
1377.87
1033.40
344.47
6.83
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self
H41
826.84
826.19
530.53
295.66
-7.76
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family
H42
1884.74
1883.22
1243.95
639.27
-27.26
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One
H43
1866.43
1864.96
1136.70
728.26
-17.01
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self
H44
817.48
833.73
530.53
303.20
9.14
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family
H45
1876.16
1913.45
1243.95
669.50
11.55
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One
H46
1839.39
1875.94
1136.70
739.24
21.01
Wyoming Aetna HealthFund HDHP - HDHP Self
224
786.02
824.31
530.53
293.78
31.18
Wyoming Aetna HealthFund HDHP - HDHP Self & Family
225
1733.83
1818.25
1243.95
574.30
58.68
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One
226
1699.88
1782.63
1136.70
645.93
67.21
Wyoming Altius Health Plan - High Self
9K1
1048.36
1150.85
530.53
620.32
95.38
Wyoming Altius Health Plan - High Self & Family
9K2
2318.46
2545.10
1243.95
1301.15
200.90
Wyoming Altius Health Plan - High Self Plus One
9K3
2295.50
2519.92
1136.70
1383.22
208.88
Wyoming Altius Health Plan - HDHP Self
9K4
672.49
759.22
530.53
228.69
60.57
Wyoming Altius Health Plan - HDHP Self & Family
9K5
1405.43
1586.72
1190.04
396.68
45.32
Wyoming Altius Health Plan - HDHP Self Plus One
9K6
1377.85
1555.56
1136.70
418.86
74.40
Wyoming Altius Health Plan - Standard Self
DK4
883.11
942.54
530.53
412.01
52.32
Wyoming Altius Health Plan - Standard Self & Family
DK5
1950.20
2081.43
1243.95
837.48
105.49
Wyoming Altius Health Plan - Standard Self Plus One
DK6
1930.87
2060.80
1136.70
924.10
114.39
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service