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Healthcare

Tribal Premium Rates for the Federal Employees Health Benefits Program

HMO (Regional Plans with Specific Service Areas)

Plan - Option Enrollment Code 2021 Total Monthly Premium 2022 Monthly Premium Rates - Total Premium 2022 Monthly Premium Rates - Tribal Employer Pays 2022 Monthly Premium Rates - Employee Pays 2022 Monthly Premium Rates - Change in Employee Payment
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
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