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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 2022 Total Monthly Premium 2023 Monthly Premium Rates - Total Premium 2023 Monthly Premium Rates - Tribal Employer Pays 2023 Monthly Premium Rates - Employee Pays 2023 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 628.27 641.42 481.07 160.35 3.28
Alabama Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Alabama Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Alabama Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Alabama Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Alabama Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Alaska Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Alaska Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Alaska Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Alaska Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Alaska Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Arizona Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Arizona Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Arizona Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Arizona Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Arizona Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Arizona Aetna Open Access - High Self WQ1 1438.67 1445.82 562.73 883.09 -25.05
Arizona Aetna Open Access - High Self & Family WQ2 3493.06 3510.39 1324.74 2185.65 -63.46
Arizona Aetna Open Access - High Self Plus One WQ3 3458.43 3475.64 1214.46 2261.18 -60.55
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R61 873.15 894.38 562.73 331.65 -10.97
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R62 1964.56 2012.31 1324.74 687.57 -33.04
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R63 1877.24 1922.87 1214.46 708.41 -32.13
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R64 665.45 684.88 513.66 171.22 4.86
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R65 1497.23 1540.89 1155.67 385.22 10.91
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R66 1430.72 1472.47 1104.35 368.12 10.44
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R94 585.22 608.62 456.47 152.15 5.85
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R95 1316.73 1369.40 1027.05 342.35 13.17
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R96 1258.25 1308.58 981.44 327.14 12.58
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R91 763.71 801.88 562.73 239.15 5.97
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R92 1718.28 1804.21 1324.74 479.47 5.14
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R93 1641.90 1723.97 1214.46 509.51 4.31
Arizona Humana HDHP - HDHP Self BV1 453.16 466.77 350.08 116.69 3.40
Arizona Humana HDHP - HDHP Self & Family BV2 1129.01 1162.87 872.15 290.72 8.47
Arizona Humana HDHP - HDHP Self Plus One BV3 993.85 1023.66 767.75 255.91 7.45
Arizona Humana HDHP - HDHP Self BY1 397.78 409.72 307.29 102.43 2.99
Arizona Humana HDHP - HDHP Self & Family BY2 990.51 1020.24 765.18 255.06 7.43
Arizona Humana HDHP - HDHP Self Plus One BY3 871.98 898.13 673.60 224.53 6.54
Arizona Humana Health Plan, Inc. - Standard Self C74 916.20 996.58 562.73 433.85 48.18
Arizona Humana Health Plan, Inc. - Standard Self & Family C75 2061.45 2242.28 1324.74 917.54 100.04
Arizona Humana Health Plan, Inc. - Standard Self Plus One C76 1969.83 2142.60 1214.46 928.14 95.01
Arizona Humana Health Plan, Inc. - Standard Self BF4 1246.59 1283.99 562.73 721.26 5.20
Arizona Humana Health Plan, Inc. - Standard Self & Family BF5 2804.86 2888.99 1324.74 1564.25 3.34
Arizona Humana Health Plan, Inc. - Standard Self Plus One BF6 2680.21 2760.64 1214.46 1546.18 2.67
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 668.46 709.71 532.28 177.43 10.32
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1580.91 1678.47 1258.85 419.62 24.39
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1437.17 1525.88 1144.41 381.47 22.18
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 672.10 708.63 531.47 177.16 9.14
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1545.85 1629.77 1222.33 407.44 20.98
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1445.04 1523.51 1142.63 380.88 19.62
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 864.87 963.45 562.73 400.72 66.38
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2162.16 2408.62 1324.74 1083.88 165.67
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1859.46 2071.40 1214.46 856.94 134.18
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 657.65 634.34 475.76 158.58 -5.83
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1555.39 1500.18 1125.14 375.04 -13.81
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1413.97 1363.81 1022.86 340.95 -12.54
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 628.27 641.42 481.07 160.35 3.28
Arkansas Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Arkansas Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Arkansas Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Arkansas Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Arkansas QualChoice - High Self DH1 728.85 794.47 562.73 231.74 33.42
Arkansas QualChoice - High Self & Family DH2 1901.10 2072.31 1324.74 747.57 90.42
Arkansas QualChoice - High Self Plus One DH3 1415.83 1543.36 1157.52 385.84 31.88
Arkansas QualChoice - Standard Self DH4 568.97 620.17 465.13 155.04 12.80
Arkansas QualChoice - Standard Self & Family DH5 1484.08 1617.66 1213.25 404.41 33.39
Arkansas QualChoice - Standard Self Plus One DH6 1105.28 1204.78 903.59 301.19 24.87
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
California Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
California Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
California Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
California Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
California Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
California Aetna Open Access - High Self 2X1 1039.33 1098.41 562.73 535.68 26.88
California Aetna Open Access - High Self & Family 2X2 2440.04 2578.72 1324.74 1253.98 57.89
California Aetna Open Access - High Self Plus One 2X3 2392.22 2528.18 1214.46 1313.72 58.20
California Anthem Blue Cross Select HMO - High Self B31 777.23 761.69 562.73 198.96 -47.74
California Anthem Blue Cross Select HMO - High Self & Family B32 1783.06 1765.25 1323.94 441.31 -97.80
California Anthem Blue Cross Select HMO - High Self Plus One B33 1646.08 1616.44 1212.33 404.11 -105.27
California Blue Shield of California - Access + HMO Self SI1 884.61 955.39 562.73 392.66 38.58
California Blue Shield of California - Access + HMO Self & Family SI2 2034.65 2197.43 1324.74 872.69 81.99
California Blue Shield of California - Access + HMO Self Plus One SI3 1946.19 2101.88 1214.46 887.42 77.93
California Health Net of California - Basic Self P61 405.69 405.75 304.31 101.44 0.02
California Health Net of California - Basic Self & Family P62 973.74 973.85 730.39 243.46 0.03
California Health Net of California - Basic Self Plus One P63 892.56 892.69 669.52 223.17 0.03
California Health Net of California - Standard Self P64 New Plan 732.81 549.61 183.20 New Plan
California Health Net of California - Standard Self & Family P65 New Plan 1758.73 1319.05 439.68 New Plan
California Health Net of California - Standard Self Plus One P66 New Plan 1612.17 1209.13 403.04 New Plan
California Health Net of California - High Self LP1 1077.33 1086.43 562.73 523.70 -23.10
California Health Net of California - High Self & Family LP2 2585.66 2607.43 1324.74 1282.69 -59.02
California Health Net of California - High Self Plus One LP3 2370.18 2390.14 1214.46 1175.68 -57.80
California Health Net of California - High Self LB1 1618.70 1688.85 562.73 1126.12 37.95
California Health Net of California - High Self & Family LB2 3884.86 4053.23 1324.74 2728.49 87.58
California Health Net of California - High Self Plus One LB3 3561.13 3715.44 1214.46 2500.98 76.55
California Health Net of California - Basic Self T41 953.16 946.60 562.73 383.87 -38.76
California Health Net of California - Basic Self & Family T42 2287.61 2271.84 1324.74 947.10 -96.56
California Health Net of California - Basic Self Plus One T43 2096.94 2082.51 1214.46 868.05 -92.19
California Kaiser Permanente - Fresno California - Standard Self NZ4 590.11 588.10 441.08 147.02 -0.51
California Kaiser Permanente - Fresno California - Standard Self & Family NZ5 1363.87 1359.22 1019.42 339.80 -1.17
California Kaiser Permanente - Fresno California - Standard Self Plus One NZ6 1363.87 1359.22 1019.42 339.80 -1.17
California Kaiser Permanente - Fresno California - High Self NZ1 813.45 818.74 562.73 256.01 -26.91
California Kaiser Permanente - Fresno California - High Self & Family NZ2 1880.06 1892.26 1324.74 567.52 -68.59
California Kaiser Permanente - Fresno California - High Self Plus One NZ3 1880.06 1892.26 1214.46 677.80 -65.56
California Kaiser Permanente - Northern California - Prosper Self KC1 658.56 650.30 487.73 162.57 -2.07
California Kaiser Permanente - Northern California - Prosper Self & Family KC2 1541.02 1521.67 1141.25 380.42 -4.83
California Kaiser Permanente - Northern California - Prosper Self Plus One KC3 1541.02 1521.67 1141.25 380.42 -23.90
California Kaiser Permanente - Northern California - High Self 591 1002.30 992.81 562.73 430.08 -41.69
California Kaiser Permanente - Northern California - High Self & Family 592 2392.59 2369.94 1324.74 1045.20 -103.44
California Kaiser Permanente - Northern California - High Self Plus One 593 2392.59 2369.94 1214.46 1155.48 -100.41
California Kaiser Permanente - Northern California - Standard Self 594 814.88 806.15 562.73 243.42 -40.93
California Kaiser Permanente - Northern California - Standard Self & Family 595 1906.80 1886.43 1324.74 561.69 -101.16
California Kaiser Permanente - Northern California - Standard Self Plus One 596 1906.80 1886.43 1214.46 671.97 -98.13
California Kaiser Permanente - Southern California - Prosper Self FL1 365.63 365.34 274.01 91.33 -0.08
California Kaiser Permanente - Southern California - Prosper Self & Family FL2 1023.75 1022.95 767.21 255.74 -0.20
California Kaiser Permanente - Southern California - Prosper Self Plus One FL3 840.97 840.30 630.23 210.07 -0.17
California Kaiser Permanente - Southern California - Standard Self 624 488.35 528.02 396.02 132.00 9.91
California Kaiser Permanente - Southern California - Standard Self & Family 625 1128.62 1220.33 915.25 305.08 22.93
California Kaiser Permanente - Southern California - Standard Self Plus One 626 1128.62 1220.33 915.25 305.08 22.93
California Kaiser Permanente - Southern California - High Self 621 760.63 779.24 562.73 216.51 -13.59
California Kaiser Permanente - Southern California - High Self & Family 622 1757.97 1800.98 1324.74 476.24 -37.78
California Kaiser Permanente - Southern California - High Self Plus One 623 1757.97 1800.98 1214.46 586.52 -34.75
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 628.27 641.42 481.07 160.35 3.28
Colorado Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Colorado Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Colorado Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Colorado Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Colorado Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Colorado Humana Health Plan, Inc. - High Self NR1 970.80 1004.79 562.73 442.06 1.79
Colorado Humana Health Plan, Inc. - High Self & Family NR2 2184.28 2260.77 1324.74 936.03 -4.30
Colorado Humana Health Plan, Inc. - High Self Plus One NR3 2087.22 2160.30 1214.46 945.84 -4.68
Colorado Humana Health Plan, Inc. - Standard Self NR4 666.08 750.10 562.58 187.52 21.00
Colorado Humana Health Plan, Inc. - Standard Self & Family NR5 1498.73 1687.73 1265.80 421.93 47.25
Colorado Humana Health Plan, Inc. - Standard Self Plus One NR6 1432.08 1612.69 1209.52 403.17 45.15
Colorado Humana Health Plan, Inc. - Basic Self RZ1 518.94 581.86 436.40 145.46 15.73
Colorado Humana Health Plan, Inc. - Basic Self & Family RZ2 1167.57 1309.10 981.83 327.27 35.38
Colorado Humana Health Plan, Inc. - Basic Self Plus One RZ3 1115.73 1250.97 938.23 312.74 33.81
Colorado Humana Health Plan, Inc. - High Self NT1 875.29 911.00 562.73 348.27 3.51
Colorado Humana Health Plan, Inc. - High Self & Family NT2 1969.44 2049.80 1324.74 725.06 -0.43
Colorado Humana Health Plan, Inc. - High Self Plus One NT3 1881.88 1958.67 1214.46 744.21 -0.97
Colorado Humana Health Plan, Inc. - Standard Self NT4 590.27 640.12 480.09 160.03 12.46
Colorado Humana Health Plan, Inc. - Standard Self & Family NT5 1328.12 1440.34 1080.26 360.08 28.05
Colorado Humana Health Plan, Inc. - Standard Self Plus One NT6 1269.13 1376.35 1032.26 344.09 26.81
Colorado Humana Health Plan, Inc. - Basic Self R21 605.89 682.28 511.71 170.57 19.10
Colorado Humana Health Plan, Inc. - Basic Self & Family R22 1363.22 1535.15 1151.36 383.79 42.99
Colorado Humana Health Plan, Inc. - Basic Self Plus One R23 1302.62 1466.90 1100.18 366.72 41.07
Colorado Kaiser Permanente - Colorado - Standard Self 654 659.17 673.68 505.26 168.42 3.63
Colorado Kaiser Permanente - Colorado - Standard Self & Family 655 1489.71 1522.50 1141.88 380.62 8.19
Colorado Kaiser Permanente - Colorado - Standard Self Plus One 656 1489.71 1522.50 1141.88 380.62 8.19
Colorado Kaiser Permanente - Colorado - High Self 651 772.89 786.39 562.73 223.66 -18.70
Colorado Kaiser Permanente - Colorado - High Self & Family 652 1746.75 1777.27 1324.74 452.53 -50.27
Colorado Kaiser Permanente - Colorado - High Self Plus One 653 1746.75 1777.27 1214.46 562.81 -47.24
Colorado Kaiser Permanente - Colorado - Prosper Self N41 390.15 418.73 314.05 104.68 7.14
Colorado Kaiser Permanente - Colorado - Prosper Self & Family N42 959.77 1030.14 772.61 257.53 17.59
Colorado Kaiser Permanente - Colorado - Prosper Self Plus One N43 881.73 946.38 709.79 236.59 16.16
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 672.10 708.63 531.47 177.16 9.14
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1545.85 1629.77 1222.33 407.44 20.98
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1445.04 1523.51 1142.63 380.88 19.62
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 864.87 963.45 562.73 400.72 66.38
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2162.16 2408.62 1324.74 1083.88 165.67
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1859.46 2071.40 1214.46 856.94 134.18
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 628.27 641.42 481.07 160.35 3.28
Connecticut Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Connecticut Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Connecticut Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Connecticut Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Delaware Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Delaware Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Delaware Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Delaware Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Delaware Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Delaware Aetna Open Access - Basic Self P34 1721.76 1754.03 562.73 1191.30 0.07
Delaware Aetna Open Access - Basic Self & Family P35 3996.29 4071.10 1324.74 2746.36 -5.98
Delaware Aetna Open Access - Basic Self Plus One P36 3956.70 4030.74 1214.46 2816.28 -3.72
Delaware Aetna Open Access - High Self P31 1762.54 1737.97 562.73 1175.24 -56.77
Delaware Aetna Open Access - High Self & Family P32 4273.27 4213.71 1324.74 2888.97 -140.35
Delaware Aetna Open Access - High Self Plus One P33 4230.98 4172.00 1214.46 2957.54 -136.74
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 628.27 641.42 481.07 160.35 3.28
District Of Columbia Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
District Of Columbia Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
District Of Columbia Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
District Of Columbia Aetna Open Access - High Self JN1 1251.55 1328.84 562.73 766.11 45.09
District Of Columbia Aetna Open Access - High Self & Family JN2 2813.68 2987.40 1324.74 1662.66 92.93
District Of Columbia Aetna Open Access - High Self Plus One JN3 2785.79 2957.80 1214.46 1743.34 94.25
District Of Columbia Aetna Open Access - Basic Self JN4 739.46 770.73 562.73 208.00 -0.93
District Of Columbia Aetna Open Access - Basic Self & Family JN5 1692.23 1763.82 1322.87 440.95 -7.33
District Of Columbia Aetna Open Access - Basic Self Plus One JN6 1553.93 1619.67 1214.46 405.21 -12.02
District Of Columbia Aetna Saver (Open Access) - Saver Self QQ4 595.21 613.56 460.17 153.39 4.59
District Of Columbia Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.12 1404.20 1053.15 351.05 10.52
District Of Columbia Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1289.45 967.09 322.36 9.66
District Of Columbia CareFirst BlueChoice - Standard Self 2G4 905.58 1023.27 562.73 460.54 85.49
District Of Columbia CareFirst BlueChoice - Standard Self & Family 2G5 2151.59 2431.30 1324.74 1106.56 198.92
District Of Columbia CareFirst BlueChoice - Standard Self Plus One 2G6 1811.12 2046.57 1214.46 832.11 157.69
District Of Columbia CareFirst BlueChoice - HDHP Self B61 604.31 691.90 518.93 172.97 21.89
District Of Columbia CareFirst BlueChoice - HDHP Self & Family B62 1435.79 1643.96 1232.97 410.99 52.04
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One B63 1208.57 1383.85 1037.89 345.96 43.82
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self B64 723.67 759.83 562.73 197.10 3.96
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1805.35 1324.74 480.61 5.18
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1519.68 1139.76 379.92 18.10
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 368.90 379.73 284.80 94.93 2.71
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1051.33 1068.34 801.26 267.08 4.25
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 866.91 907.18 680.39 226.79 10.06
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 607.25 635.27 476.45 158.82 7.01
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1396.63 1461.09 1095.82 365.27 16.11
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1396.63 1461.09 1095.82 365.27 16.11
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self E31 756.60 790.90 562.73 228.17 2.10
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1740.20 1819.03 1324.74 494.29 -1.96
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1740.20 1819.03 1214.46 604.57 1.07
District Of Columbia M.D. IPA - High Self JP1 1011.99 1065.78 562.73 503.05 21.59
District Of Columbia M.D. IPA - High Self & Family JP2 2837.66 2988.44 1324.74 1663.70 69.99
District Of Columbia M.D. IPA - High Self Plus One JP3 1976.43 2081.45 1214.46 866.99 27.26
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 661.81 665.19 498.89 166.30 0.85
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1514.20 1529.86 1147.40 382.46 3.91
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1422.92 1430.13 1072.60 357.53 1.80
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 822.16 908.01 562.73 345.28 53.65
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1948.55 2151.93 1324.74 827.19 122.59
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1767.68 1952.17 1214.46 737.71 106.73
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 663.76 697.00 522.75 174.25 8.31
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1586.41 1672.80 1254.60 418.20 21.60
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1327.54 1481.16 1110.87 370.29 38.41
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Florida Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Florida Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Florida Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Florida Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Florida Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Florida AvMed - HDHP Self WZ1 742.26 866.21 562.73 303.48 91.75
Florida AvMed - HDHP Self & Family WZ2 1714.01 2015.98 1324.74 691.24 221.18
Florida AvMed - HDHP Self Plus One WZ3 1487.24 1747.66 1214.46 533.20 161.39
Florida AvMed - Standard Self ML4 801.88 946.31 562.73 383.58 112.23
Florida AvMed - Standard Self & Family ML5 1952.45 2304.10 1324.74 979.36 270.86
Florida AvMed - Standard Self Plus One ML6 1683.98 1987.29 1214.46 772.83 225.55
Florida Capital Health Plan - High Self EA1 730.49 754.04 562.73 191.31 -8.65
Florida Capital Health Plan - High Self & Family EA2 1692.93 1747.46 1310.60 436.86 -12.12
Florida Capital Health Plan - High Self Plus One EA3 1597.55 1649.01 1214.46 434.55 -26.30
Florida Humana CoverageFirst and Humana Value Plan - Value Self W94 600.12 655.76 491.82 163.94 13.91
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family W95 1350.29 1475.46 1106.60 368.86 31.29
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One W96 1290.25 1409.87 1057.40 352.47 29.91
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self W91 726.70 762.15 562.73 199.42 3.25
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family W92 1635.03 1714.77 1286.08 428.69 19.93
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One W93 1562.38 1638.61 1214.46 424.15 -1.53
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self QP1 826.22 872.91 562.73 310.18 14.49
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family QP2 1861.38 1966.58 1324.74 641.84 24.41
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One QP3 1778.66 1879.15 1214.46 664.69 22.73
Florida Humana CoverageFirst and Humana Value Plan - Value Self QP4 550.51 573.30 429.98 143.32 5.69
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family QP5 1238.60 1289.84 967.38 322.46 12.81
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One QP6 1183.56 1232.53 924.40 308.13 12.24
Florida Humana CoverageFirst and Humana Value Plan - Value Self MJ4 561.19 592.06 444.05 148.01 7.71
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family MJ5 1346.87 1420.92 1065.69 355.23 18.51
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One MJ6 1206.55 1272.92 954.69 318.23 16.59
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self MJ1 1064.87 1112.15 562.73 549.42 15.08
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MJ2 2395.92 2502.28 1324.74 1177.54 25.57
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MJ3 2289.47 2391.11 1214.46 1176.65 23.88
Florida Humana CoverageFirst and Humana Value Plan - Value Self X24 546.26 576.03 432.02 144.01 7.45
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family X25 1338.33 1411.24 1058.43 352.81 18.23
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One X26 1174.44 1238.42 928.82 309.60 15.99
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self X21 630.54 674.70 506.03 168.67 11.04
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X22 1418.80 1518.10 1138.58 379.52 24.82
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X23 1355.73 1450.63 1087.97 362.66 23.73
Florida Humana HDHP - HDHP Self BR1 426.44 439.25 329.44 109.81 3.20
Florida Humana HDHP - HDHP Self & Family BR2 1062.23 1094.08 820.56 273.52 7.96
Florida Humana HDHP - HDHP Self Plus One BR3 935.07 963.13 722.35 240.78 7.01
Florida Humana HDHP - HDHP Self A41 478.40 492.77 369.58 123.19 3.59
Florida Humana HDHP - HDHP Self & Family A42 1192.12 1227.89 920.92 306.97 8.94
Florida Humana HDHP - HDHP Self Plus One A43 1049.38 1080.86 810.65 270.21 7.87
Florida Humana HDHP - HDHP Self FF1 406.51 418.69 314.02 104.67 3.04
Florida Humana HDHP - HDHP Self & Family FF2 1012.33 1042.71 782.03 260.68 7.60
Florida Humana HDHP - HDHP Self Plus One FF3 891.17 917.89 688.42 229.47 6.68
Florida Humana HDHP - HDHP Self AP1 483.08 497.55 373.16 124.39 3.62
Florida Humana HDHP - HDHP Self & Family AP2 1203.76 1239.88 929.91 309.97 9.03
Florida Humana HDHP - HDHP Self Plus One AP3 1059.63 1091.42 818.57 272.85 7.94
Florida Humana Medical Plan, Inc. - Standard Self LL4 1282.69 1420.84 562.73 858.11 105.95
Florida Humana Medical Plan, Inc. - Standard Self & Family LL5 2886.00 3196.83 1324.74 1872.09 230.04
Florida Humana Medical Plan, Inc. - Standard Self Plus One LL6 2757.73 3054.76 1214.46 1840.30 219.27
Florida Humana Medical Plan, Inc. - High Self LL1 1794.37 2021.02 562.73 1458.29 194.45
Florida Humana Medical Plan, Inc. - High Self & Family LL2 4037.30 4547.23 1324.74 3222.49 429.14
Florida Humana Medical Plan, Inc. - High Self Plus One LL3 3857.86 4345.14 1214.46 3130.68 409.52
Florida Humana Medical Plan, Inc. - High Self EE1 1323.88 1485.62 562.73 922.89 129.54
Florida Humana Medical Plan, Inc. - High Self & Family EE2 2978.78 3342.71 1324.74 2017.97 283.14
Florida Humana Medical Plan, Inc. - High Self Plus One EE3 2846.44 3194.21 1214.46 1979.75 270.01
Florida Humana Medical Plan, Inc. - Standard Self EE4 1183.78 1337.70 562.73 774.97 121.72
Florida Humana Medical Plan, Inc. - Standard Self & Family EE5 2663.48 3009.78 1324.74 1685.04 265.51
Florida Humana Medical Plan, Inc. - Standard Self Plus One EE6 2545.12 2875.99 1214.46 1661.53 253.11
Florida Humana Medical Plan, Inc. - Standard Self E24 804.44 863.48 562.73 300.75 26.84
Florida Humana Medical Plan, Inc. - Standard Self & Family E25 1809.97 1942.81 1324.74 618.07 52.05
Florida Humana Medical Plan, Inc. - Standard Self Plus One E26 1729.50 1856.42 1214.46 641.96 49.16
Florida Humana Medical Plan, Inc. - High Self E21 1351.18 1408.98 562.73 846.25 25.60
Florida Humana Medical Plan, Inc. - High Self & Family E22 3040.05 3170.12 1324.74 1845.38 49.28
Florida Humana Medical Plan, Inc. - High Self Plus One E23 2904.94 3029.22 1214.46 1814.76 46.52
Florida Humana Medical Plan, Inc. - High Self EX1 1069.40 1101.38 562.73 538.65 -0.22
Florida Humana Medical Plan, Inc. - High Self & Family EX2 2406.11 2478.04 1324.74 1153.30 -8.86
Florida Humana Medical Plan, Inc. - High Self Plus One EX3 2299.16 2367.89 1214.46 1153.43 -9.03
Florida Humana Medical Plan, Inc. - Standard Self EX4 897.33 937.89 562.73 375.16 8.36
Florida Humana Medical Plan, Inc. - Standard Self & Family EX5 2019.01 2110.29 1324.74 785.55 10.49
Florida Humana Medical Plan, Inc. - Standard Self Plus One EX6 1929.27 2016.50 1214.46 802.04 9.47
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 897.89 1005.44 562.73 442.71 75.35
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2693.64 3016.30 1324.74 1691.56 241.87
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1930.46 2161.68 1214.46 947.22 153.46
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Georgia Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Georgia Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Georgia Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Georgia Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Georgia Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Georgia Aetna Open Access - High Self 2U1 1729.63 1782.65 562.73 1219.92 20.82
Georgia Aetna Open Access - High Self & Family 2U2 3984.13 4106.27 1324.74 2781.53 41.35
Georgia Aetna Open Access - High Self Plus One 2U3 3944.68 4065.62 1214.46 2851.16 43.18
Georgia Humana CoverageFirst and Humana Value Plan - Value Self S94 658.56 707.96 530.97 176.99 12.35
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family S95 1481.72 1592.87 1194.65 398.22 27.79
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One S96 1415.87 1522.08 1141.56 380.52 26.55
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self S91 827.10 835.38 562.73 272.65 -23.92
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family S92 1860.99 1879.61 1324.74 554.87 -62.17
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One S93 1778.29 1796.06 1214.46 581.60 -59.99
Georgia Humana CoverageFirst and Humana Value Plan - Value Self AD4 826.04 875.62 562.73 312.89 17.38
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family AD5 1858.50 1970.04 1324.74 645.30 30.75
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One AD6 1775.93 1882.49 1214.46 668.03 28.80
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self AD1 1166.51 1248.17 562.73 685.44 49.46
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family AD2 2624.61 2808.35 1324.74 1483.61 102.95
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One AD3 2507.98 2683.53 1214.46 1469.07 97.79
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self LM1 784.51 839.28 562.73 276.55 22.57
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family LM2 1765.14 1888.40 1324.74 563.66 42.47
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One LM3 1686.69 1804.47 1214.46 590.01 40.02
Georgia Humana CoverageFirst and Humana Value Plan - Value Self LM4 742.13 786.22 562.73 223.49 11.89
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family LM5 1669.81 1769.00 1324.74 444.26 18.40
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One LM6 1595.60 1690.41 1214.46 475.95 17.05
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RM1 791.87 892.34 562.73 329.61 68.27
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RM2 1781.72 2007.79 1324.74 683.05 145.28
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RM3 1702.52 1918.56 1214.46 704.10 138.28
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DN4 874.16 986.31 562.73 423.58 79.95
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DN5 1966.77 2219.10 1324.74 894.36 171.54
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DN6 1879.39 2120.50 1214.46 906.04 163.35
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RJ1 703.34 796.42 562.73 233.69 57.86
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RJ2 1582.53 1791.99 1324.74 467.25 71.62
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RJ3 1512.18 1712.34 1214.46 497.88 119.84
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Q71 872.11 1043.71 562.73 480.98 139.40
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family Q72 1962.26 2348.34 1324.74 1023.60 305.29
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One Q73 1875.03 2243.93 1214.46 1029.47 291.14
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self CB4 1251.68 1376.85 562.73 814.12 92.97
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family CB5 2816.30 3097.90 1324.74 1773.16 200.81
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One CB6 2691.13 2960.23 1214.46 1745.77 191.34
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DG4 1430.85 1495.22 562.73 932.49 32.17
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DG5 3219.43 3364.29 1324.74 2039.55 64.07
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DG6 3076.41 3214.86 1214.46 2000.40 60.69
Georgia Humana HDHP - HDHP Self AZ1 472.40 486.57 364.93 121.64 3.54
Georgia Humana HDHP - HDHP Self & Family AZ2 1177.06 1212.38 909.29 303.09 8.83
Georgia Humana HDHP - HDHP Self Plus One AZ3 1036.14 1067.21 800.41 266.80 7.77
Georgia Humana HDHP - HDHP Self B21 487.02 501.61 376.21 125.40 3.65
Georgia Humana HDHP - HDHP Self & Family B22 1213.62 1250.04 937.53 312.51 9.11
Georgia Humana HDHP - HDHP Self Plus One B23 1068.30 1100.34 825.26 275.08 8.01
Georgia Humana HDHP - HDHP Self AR1 477.45 491.77 368.83 122.94 3.58
Georgia Humana HDHP - HDHP Self & Family AR2 1189.72 1225.40 919.05 306.35 8.92
Georgia Humana HDHP - HDHP Self Plus One AR3 1047.26 1078.68 809.01 269.67 7.86
Georgia Kaiser Permanente - Georgia - High Self F81 769.71 807.65 562.73 244.92 5.74
Georgia Kaiser Permanente - Georgia - High Self & Family F82 1739.57 1825.27 1324.74 500.53 4.91
Georgia Kaiser Permanente - Georgia - High Self Plus One F83 1739.57 1825.27 1214.46 610.81 7.94
Georgia Kaiser Permanente - Georgia - Standard Self F84 600.71 632.08 474.06 158.02 7.84
Georgia Kaiser Permanente - Georgia - Standard Self & Family F85 1357.59 1428.53 1071.40 357.13 17.73
Georgia Kaiser Permanente - Georgia - Standard Self Plus One F86 1357.59 1428.53 1071.40 357.13 17.73
Georgia Kaiser Permanente - Georgia - Prosper Self LA1 398.65 434.48 325.86 108.62 8.96
Georgia Kaiser Permanente - Georgia - Prosper Self & Family LA2 1034.97 1128.10 846.08 282.02 23.28
Georgia Kaiser Permanente - Georgia - Prosper Self Plus One LA3 900.92 981.98 736.49 245.49 20.26
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 897.89 1005.44 562.73 442.71 75.35
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2693.64 3016.30 1324.74 1691.56 241.87
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1930.46 2161.68 1214.46 947.22 153.46
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
Guam Calvo's SelectCare - Standard Self B44 378.91 404.63 303.47 101.16 6.43
Guam Calvo's SelectCare - Standard Self & Family B45 1100.91 1175.66 881.75 293.91 18.68
Guam Calvo's SelectCare - Standard Self Plus One B46 746.92 797.64 598.23 199.41 12.68
Guam Calvo's SelectCare - High Self B41 535.95 551.48 413.61 137.87 3.88
Guam Calvo's SelectCare - High Self & Family B42 1419.54 1460.70 1095.53 365.17 10.29
Guam Calvo's SelectCare - High Self Plus One B43 1045.89 1076.27 807.20 269.07 7.60
Guam TakeCare - HDHP Self KX1 122.31 119.95 89.96 29.99 -0.59
Guam TakeCare - HDHP Self & Family KX2 327.97 321.53 241.15 80.38 -1.61
Guam TakeCare - HDHP Self Plus One KX3 295.23 289.51 217.13 72.38 -1.43
Guam TakeCare - Standard Self JK4 405.77 441.26 330.95 110.31 8.87
Guam TakeCare - Standard Self & Family JK5 1149.18 1249.69 937.27 312.42 25.13
Guam TakeCare - Standard Self Plus One JK6 799.78 869.74 652.31 217.43 17.49
Guam TakeCare - High Self JK1 515.86 564.79 423.59 141.20 12.24
Guam TakeCare - High Self & Family JK2 1230.43 1347.08 1010.31 336.77 29.16
Guam TakeCare - High Self Plus One JK3 1019.16 1115.79 836.84 278.95 24.16
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 628.27 641.42 481.07 160.35 3.28
Hawaii Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Hawaii Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Hawaii Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Hawaii Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 631 675.55 694.81 521.11 173.70 4.81
Hawaii Kaiser Permanente - Hawaii - High Self & Family 632 1506.51 1549.47 1162.10 387.37 10.74
Hawaii Kaiser Permanente - Hawaii - High Self Plus One 633 1506.51 1549.47 1162.10 387.37 10.74
Hawaii Kaiser Permanente - Hawaii - Standard Self 634 485.38 485.38 364.04 121.34 0.00
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family 635 1082.38 1082.38 811.79 270.59 0.00
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One 636 1082.38 1082.38 811.79 270.59 0.00
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 628.27 641.42 481.07 160.35 3.28
Idaho Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Idaho Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Idaho Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Idaho Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Idaho Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Idaho Altius Health Plan - High Self 9K1 1150.85 1214.72 562.73 651.99 31.67
Idaho Altius Health Plan - High Self & Family 9K2 2545.10 2686.39 1324.74 1361.65 60.50
Idaho Altius Health Plan - High Self Plus One 9K3 2519.92 2659.82 1214.46 1445.36 62.14
Idaho Altius Health Plan - HDHP Self 9K4 759.22 794.89 562.73 232.16 3.47
Idaho Altius Health Plan - HDHP Self & Family 9K5 1586.72 1661.25 1245.94 415.31 18.63
Idaho Altius Health Plan - HDHP Self Plus One 9K6 1555.56 1628.62 1214.46 414.16 -4.70
Idaho Altius Health Plan - Standard Self DK4 942.54 993.35 562.73 430.62 18.61
Idaho Altius Health Plan - Standard Self & Family DK5 2081.43 2193.69 1324.74 868.95 31.47
Idaho Altius Health Plan - Standard Self Plus One DK6 2060.80 2171.95 1214.46 957.49 33.39
Idaho Kaiser Permanente - Washington Core - Standard Self 544 625.21 640.86 480.65 160.21 3.91
Idaho Kaiser Permanente - Washington Core - Standard Self & Family 545 1438.00 1473.94 1105.46 368.48 8.98
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One 546 1438.00 1473.94 1105.46 368.48 8.98
Idaho Kaiser Permanente - Washington Core - High Self 541 869.53 902.79 562.73 340.06 1.06
Idaho Kaiser Permanente - Washington Core - High Self & Family 542 1912.93 1986.12 1324.74 661.38 -7.60
Idaho Kaiser Permanente - Washington Core - High Self Plus One 543 1912.93 1986.12 1214.46 771.66 -4.57
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 628.27 641.42 481.07 160.35 3.28
Illinois Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Illinois Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Illinois Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Illinois Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Illinois Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Illinois Health Alliance HMO - Standard Self K84 704.08 788.58 562.73 225.85 49.83
Illinois Health Alliance HMO - Standard Self & Family K85 1631.89 1848.97 1324.74 524.23 116.26
Illinois Health Alliance HMO - Standard Self Plus One K86 1505.44 1689.55 1214.46 475.09 98.73
Illinois Humana CoverageFirst and Humana Value Plan - Value Self GB4 827.91 836.16 562.73 273.43 -23.95
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family GB5 1862.71 1881.32 1324.74 556.58 -62.18
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One GB6 1779.92 1797.66 1214.46 583.20 -60.02
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self GB1 1319.83 1333.02 562.73 770.29 -19.01
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family GB2 2969.55 2999.23 1324.74 1674.49 -51.11
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One GB3 2837.62 2866.00 1214.46 1651.54 -49.38
Illinois Humana CoverageFirst and Humana Value Plan - Value Self MW4 799.70 815.69 562.73 252.96 -16.21
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1799.27 1835.28 1324.74 510.54 -44.78
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1719.32 1753.74 1214.46 539.28 -43.34
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1056.75 1097.50 562.73 534.77 8.55
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2377.81 2469.55 1324.74 1144.81 10.95
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2272.08 2359.74 1214.46 1145.28 9.90
Illinois Humana HDHP - HDHP Self BB1 445.29 458.66 344.00 114.66 3.34
Illinois Humana HDHP - HDHP Self & Family BB2 1109.33 1142.61 856.96 285.65 8.32
Illinois Humana HDHP - HDHP Self Plus One BB3 976.52 1005.81 754.36 251.45 7.32
Illinois Humana HDHP - HDHP Self AW1 420.70 433.31 324.98 108.33 3.16
Illinois Humana HDHP - HDHP Self & Family AW2 1047.82 1079.26 809.45 269.81 7.86
Illinois Humana HDHP - HDHP Self Plus One AW3 922.39 950.08 712.56 237.52 6.92
Illinois Humana Health Plan, Inc. - Standard Self 754 1055.80 1160.42 562.73 597.69 72.42
Illinois Humana Health Plan, Inc. - Standard Self & Family 755 2375.56 2610.99 1324.74 1286.25 154.64
Illinois Humana Health Plan, Inc. - Standard Self Plus One 756 2270.00 2494.94 1214.46 1280.48 147.18
Illinois Humana Health Plan, Inc. - High Self 751 1403.24 1445.34 562.73 882.61 9.90
Illinois Humana Health Plan, Inc. - High Self & Family 752 3157.29 3251.99 1324.74 1927.25 13.91
Illinois Humana Health Plan, Inc. - High Self Plus One 753 3016.98 3107.46 1214.46 1893.00 12.72
Illinois Humana Health Plan, Inc. - High Self 9F1 2116.64 2691.74 562.73 2129.01 542.90
Illinois Humana Health Plan, Inc. - High Self & Family 9F2 4762.44 6056.40 1324.74 4731.66 1213.17
Illinois Humana Health Plan, Inc. - High Self Plus One 9F3 4550.74 5787.17 1214.46 4572.71 1158.67
Illinois Humana Health Plan, Inc. - Standard Self AB4 1447.46 1514.76 562.73 952.03 35.10
Illinois Humana Health Plan, Inc. - Standard Self & Family AB5 3256.85 3408.28 1324.74 2083.54 70.64
Illinois Humana Health Plan, Inc. - Standard Self Plus One AB6 3112.11 3256.80 1214.46 2042.34 66.93
Illinois Humana Health Plan, Inc. - Basic Self AB1 845.93 948.50 562.73 385.77 70.37
Illinois Humana Health Plan, Inc. - Basic Self & Family AB2 1903.40 2134.17 1324.74 809.43 149.98
Illinois Humana Health Plan, Inc. - Basic Self Plus One AB3 1818.81 2039.33 1214.46 824.87 142.76
Illinois Humana Health Plan, Inc. - Basic Self RW1 839.50 934.79 562.73 372.06 63.09
Illinois Humana Health Plan, Inc. - Basic Self & Family RW2 1888.88 2103.27 1324.74 778.53 133.60
Illinois Humana Health Plan, Inc. - Basic Self Plus One RW3 1804.92 2009.78 1214.46 795.32 127.10
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 663.76 697.00 522.75 174.25 8.31
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1586.41 1672.80 1254.60 418.20 21.60
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1327.54 1481.16 1110.87 370.29 38.41
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Indiana Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Indiana Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Indiana Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Indiana Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Indiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Indiana Health Alliance HMO - Standard Self K84 704.08 788.58 562.73 225.85 49.83
Indiana Health Alliance HMO - Standard Self & Family K85 1631.89 1848.97 1324.74 524.23 116.26
Indiana Health Alliance HMO - Standard Self Plus One K86 1505.44 1689.55 1214.46 475.09 98.73
Indiana Humana CoverageFirst and Humana Value Plan - Value Self MW4 799.70 815.69 562.73 252.96 -16.21
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1799.27 1835.28 1324.74 510.54 -44.78
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1719.32 1753.74 1214.46 539.28 -43.34
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1056.75 1097.50 562.73 534.77 8.55
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2377.81 2469.55 1324.74 1144.81 10.95
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2272.08 2359.74 1214.46 1145.28 9.90
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self TC1 757.06 806.26 562.73 243.53 17.00
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TC2 1703.33 1814.02 1324.74 489.28 29.90
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TC3 1627.64 1733.44 1214.46 518.98 28.04
Indiana Humana CoverageFirst and Humana Value Plan - Value Self TC4 579.74 626.10 469.58 156.52 11.59
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family TC5 1304.42 1408.77 1056.58 352.19 26.09
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One TC6 1246.44 1346.15 1009.61 336.54 24.93
Indiana Humana CoverageFirst and Humana Value Plan - Value Self X34 694.33 732.51 549.38 183.13 9.55
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1562.23 1648.16 1236.12 412.04 21.48
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1492.81 1574.93 1181.20 393.73 20.53
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self X31 902.37 952.01 562.73 389.28 17.44
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 2030.34 2142.01 1324.74 817.27 30.88
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1940.12 2046.83 1214.46 832.37 28.95
Indiana Humana HDHP - HDHP Self BB1 445.29 458.66 344.00 114.66 3.34
Indiana Humana HDHP - HDHP Self & Family BB2 1109.33 1142.61 856.96 285.65 8.32
Indiana Humana HDHP - HDHP Self Plus One BB3 976.52 1005.81 754.36 251.45 7.32
Indiana Humana HDHP - HDHP Self DT1 495.73 510.60 382.95 127.65 3.72
Indiana Humana HDHP - HDHP Self & Family DT2 1235.41 1272.48 954.36 318.12 9.27
Indiana Humana HDHP - HDHP Self Plus One DT3 1087.47 1120.10 840.08 280.02 8.15
Indiana Humana HDHP - HDHP Self FZ1 New Plan 413.68 310.26 103.42 New Plan
Indiana Humana HDHP - HDHP Self & Family FZ2 New Plan 1030.16 772.62 257.54 New Plan
Indiana Humana HDHP - HDHP Self Plus One FZ3 New Plan 906.86 680.15 226.71 New Plan
Indiana Humana Health Plan of Ohio, Inc. - Standard Self A64 1243.08 1304.46 562.73 741.73 29.18
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2796.95 2935.05 1324.74 1610.31 57.31
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2672.63 2804.62 1214.46 1590.16 54.23
Indiana Humana Health Plan, Inc. - Standard Self 754 1055.80 1160.42 562.73 597.69 72.42
Indiana Humana Health Plan, Inc. - Standard Self & Family 755 2375.56 2610.99 1324.74 1286.25 154.64
Indiana Humana Health Plan, Inc. - Standard Self Plus One 756 2270.00 2494.94 1214.46 1280.48 147.18
Indiana Humana Health Plan, Inc. - High Self 751 1403.24 1445.34 562.73 882.61 9.90
Indiana Humana Health Plan, Inc. - High Self & Family 752 3157.29 3251.99 1324.74 1927.25 13.91
Indiana Humana Health Plan, Inc. - High Self Plus One 753 3016.98 3107.46 1214.46 1893.00 12.72
Indiana Humana Health Plan, Inc. - Standard Self MH4 992.90 1098.72 562.73 535.99 73.62
Indiana Humana Health Plan, Inc. - Standard Self & Family MH5 2233.96 2472.10 1324.74 1147.36 157.35
Indiana Humana Health Plan, Inc. - Standard Self Plus One MH6 2134.67 2362.21 1214.46 1147.75 149.78
Indiana Indiana University Health Plans Select - High Self FS1 New Plan 606.23 454.67 151.56 New Plan
Indiana Indiana University Health Plans Select - High Self & Family FS2 New Plan 1697.45 1273.09 424.36 New Plan
Indiana Indiana University Health Plans Select - High Self Plus One FS3 New Plan 1333.74 1000.31 333.43 New Plan
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 628.27 641.42 481.07 160.35 3.28
Iowa Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Iowa Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Iowa Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Iowa Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Iowa Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Iowa Health Alliance HMO - Standard Self K84 704.08 788.58 562.73 225.85 49.83
Iowa Health Alliance HMO - Standard Self & Family K85 1631.89 1848.97 1324.74 524.23 116.26
Iowa Health Alliance HMO - Standard Self Plus One K86 1505.44 1689.55 1214.46 475.09 98.73
Iowa HealthPartners - Standard Self V34 553.28 553.28 414.96 138.32 0.00
Iowa HealthPartners - Standard Self & Family V35 1347.84 1347.84 1010.88 336.96 0.00
Iowa HealthPartners - Standard Self Plus One V36 1222.78 1222.78 917.09 305.69 0.00
Iowa HealthPartners - High Self V31 692.14 737.17 552.88 184.29 11.26
Iowa HealthPartners - High Self & Family V32 1686.01 1795.73 1324.74 470.99 28.93
Iowa HealthPartners - High Self Plus One V33 1529.58 1629.12 1214.46 414.66 21.78
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 744.55 757.84 562.73 195.11 -18.91
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1712.45 1743.06 1307.30 435.76 -32.74
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1600.76 1629.40 1214.46 414.94 -49.12
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 873.95 975.46 562.73 412.73 69.31
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 2184.93 2438.63 1324.74 1113.89 172.91
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1879.04 2097.20 1214.46 882.74 140.40
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Kansas Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Kansas Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Kansas Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Kansas Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Kansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Kansas Aetna Open Access - Standard Self HA4 909.37 895.01 562.73 332.28 -46.56
Kansas Aetna Open Access - Standard Self & Family HA5 2146.47 2112.54 1324.74 787.80 -114.72
Kansas Aetna Open Access - Standard Self Plus One HA6 2125.26 2091.64 1214.46 877.18 -111.38
Kansas Aetna Open Access - High Self HA1 1188.98 1196.91 562.73 634.18 -24.27
Kansas Aetna Open Access - High Self & Family HA2 2808.54 2827.31 1324.74 1502.57 -62.02
Kansas Aetna Open Access - High Self Plus One HA3 2780.77 2799.33 1214.46 1584.87 -59.20
Kansas Humana CoverageFirst and Humana Value Plan - Value Self PH4 567.17 587.58 440.69 146.89 5.10
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1276.15 1322.10 991.58 330.52 11.48
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1219.44 1263.36 947.52 315.84 10.98
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 758.03 750.21 562.66 187.55 -39.95
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1705.60 1687.96 1265.97 421.99 -39.66
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1629.79 1612.95 1209.71 403.24 -89.85
Kansas Humana HDHP - HDHP Self BK1 403.13 415.22 311.42 103.80 3.02
Kansas Humana HDHP - HDHP Self & Family BK2 1003.93 1034.06 775.55 258.51 7.53
Kansas Humana HDHP - HDHP Self Plus One BK3 883.78 910.30 682.73 227.57 6.63
Kansas Humana Health Plan, Inc. - Standard Self MS4 1290.64 1362.75 562.73 800.02 39.91
Kansas Humana Health Plan, Inc. - Standard Self & Family MS5 2903.98 3066.20 1324.74 1741.46 81.43
Kansas Humana Health Plan, Inc. - Standard Self Plus One MS6 2774.94 2929.96 1214.46 1715.50 77.26
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 628.27 641.42 481.07 160.35 3.28
Kentucky Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Kentucky Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Kentucky Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Kentucky Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self TC1 757.06 806.26 562.73 243.53 17.00
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TC2 1703.33 1814.02 1324.74 489.28 29.90
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TC3 1627.64 1733.44 1214.46 518.98 28.04
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self TC4 579.74 626.10 469.58 156.52 11.59
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family TC5 1304.42 1408.77 1056.58 352.19 26.09
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One TC6 1246.44 1346.15 1009.61 336.54 24.93
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self 6N1 848.75 900.08 562.73 337.35 19.13
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family 6N2 1909.68 2025.16 1324.74 700.42 34.69
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One 6N3 1824.81 1935.14 1214.46 720.68 32.57
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self 6N4 633.82 678.19 508.64 169.55 11.10
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family 6N5 1426.06 1525.90 1144.43 381.47 24.96
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One 6N6 1362.70 1458.08 1093.56 364.52 23.85
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self X34 694.33 732.51 549.38 183.13 9.55
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1562.23 1648.16 1236.12 412.04 21.48
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1492.81 1574.93 1181.20 393.73 20.53
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self X31 902.37 952.01 562.73 389.28 17.44
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 2030.34 2142.01 1324.74 817.27 30.88
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1940.12 2046.83 1214.46 832.37 28.95
Kentucky Humana HDHP - HDHP Self DT1 495.73 510.60 382.95 127.65 3.72
Kentucky Humana HDHP - HDHP Self & Family DT2 1235.41 1272.48 954.36 318.12 9.27
Kentucky Humana HDHP - HDHP Self Plus One DT3 1087.47 1120.10 840.08 280.02 8.15
Kentucky Humana HDHP - HDHP Self FZ1 New Plan 413.68 310.26 103.42 New Plan
Kentucky Humana HDHP - HDHP Self & Family FZ2 New Plan 1030.16 772.62 257.54 New Plan
Kentucky Humana HDHP - HDHP Self Plus One FZ3 New Plan 906.86 680.15 226.71 New Plan
Kentucky Humana HDHP - HDHP Self FW1 New Plan 413.68 310.26 103.42 New Plan
Kentucky Humana HDHP - HDHP Self & Family FW2 New Plan 1030.16 772.62 257.54 New Plan
Kentucky Humana HDHP - HDHP Self Plus One FW3 New Plan 906.86 680.15 226.71 New Plan
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self A64 1243.08 1304.46 562.73 741.73 29.18
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2796.95 2935.05 1324.74 1610.31 57.31
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2672.63 2804.62 1214.46 1590.16 54.23
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self W61 671.02 758.25 562.73 195.52 27.77
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family W62 1509.82 1706.10 1279.58 426.52 49.07
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One W63 1442.72 1630.24 1214.46 415.78 55.10
Kentucky Humana Health Plan, Inc. - Standard Self MI4 929.59 1040.63 562.73 477.90 78.84
Kentucky Humana Health Plan, Inc. - Standard Self & Family MI5 2091.55 2341.41 1324.74 1016.67 169.07
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MI6 1998.62 2237.41 1214.46 1022.95 161.03
Kentucky Humana Health Plan, Inc. - Standard Self MH4 992.90 1098.72 562.73 535.99 73.62
Kentucky Humana Health Plan, Inc. - Standard Self & Family MH5 2233.96 2472.10 1324.74 1147.36 157.35
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MH6 2134.67 2362.21 1214.46 1147.75 149.78
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 744.55 757.84 562.73 195.11 -18.91
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1712.45 1743.06 1307.30 435.76 -32.74
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1600.76 1629.40 1214.46 414.94 -49.12
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 873.95 975.46 562.73 412.73 69.31
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 2184.93 2438.63 1324.74 1113.89 172.91
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1879.04 2097.20 1214.46 882.74 140.40
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Louisiana Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Louisiana Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Louisiana Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Louisiana Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self BC4 760.09 848.29 562.73 285.56 56.00
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family BC5 1710.22 1908.64 1324.74 583.90 117.63
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One BC6 1634.19 1823.81 1214.46 609.35 111.86
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self BC1 1031.12 1109.46 562.73 546.73 46.14
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family BC2 2320.07 2496.37 1324.74 1171.63 95.51
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One BC3 2216.96 2385.41 1214.46 1170.95 90.69
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self AE1 1271.25 1366.58 562.73 803.85 63.13
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family AE2 2860.22 3074.74 1324.74 1750.00 133.73
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One AE3 2733.12 2938.11 1214.46 1723.65 127.23
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self AE4 939.79 979.03 562.73 416.30 7.04
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family AE5 2114.58 2202.85 1324.74 878.11 7.48
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One AE6 2020.59 2104.96 1214.46 890.50 6.61
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Maine Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Maine Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Maine Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Maine Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Maine Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Maryland Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Maryland Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Maryland Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Maryland Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Maryland Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Maryland Aetna Open Access - High Self JN1 1251.55 1328.84 562.73 766.11 45.09
Maryland Aetna Open Access - High Self & Family JN2 2813.68 2987.40 1324.74 1662.66 92.93
Maryland Aetna Open Access - High Self Plus One JN3 2785.79 2957.80 1214.46 1743.34 94.25
Maryland Aetna Open Access - Basic Self JN4 739.46 770.73 562.73 208.00 -0.93
Maryland Aetna Open Access - Basic Self & Family JN5 1692.23 1763.82 1322.87 440.95 -7.33
Maryland Aetna Open Access - Basic Self Plus One JN6 1553.93 1619.67 1214.46 405.21 -12.02
Maryland Aetna Saver (Open Access) - Saver Self QQ4 595.21 613.56 460.17 153.39 4.59
Maryland Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.12 1404.20 1053.15 351.05 10.52
Maryland Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1289.45 967.09 322.36 9.66
Maryland CareFirst BlueChoice - Standard Self 2G4 905.58 1023.27 562.73 460.54 85.49
Maryland CareFirst BlueChoice - Standard Self & Family 2G5 2151.59 2431.30 1324.74 1106.56 198.92
Maryland CareFirst BlueChoice - Standard Self Plus One 2G6 1811.12 2046.57 1214.46 832.11 157.69
Maryland CareFirst BlueChoice - HDHP Self B61 604.31 691.90 518.93 172.97 21.89
Maryland CareFirst BlueChoice - HDHP Self & Family B62 1435.79 1643.96 1232.97 410.99 52.04
Maryland CareFirst BlueChoice - HDHP Self Plus One B63 1208.57 1383.85 1037.89 345.96 43.82
Maryland CareFirst BlueChoice - Blue Value Plus Self B64 723.67 759.83 562.73 197.10 3.96
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1805.35 1324.74 480.61 5.18
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1519.68 1139.76 379.92 18.10
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 368.90 379.73 284.80 94.93 2.71
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1051.33 1068.34 801.26 267.08 4.25
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 866.91 907.18 680.39 226.79 10.06
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self E34 607.25 635.27 476.45 158.82 7.01
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1396.63 1461.09 1095.82 365.27 16.11
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1396.63 1461.09 1095.82 365.27 16.11
Maryland Kaiser Permanente - Mid-Atlantic States - High Self E31 756.60 790.90 562.73 228.17 2.10
Maryland Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1740.20 1819.03 1324.74 494.29 -1.96
Maryland Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1740.20 1819.03 1214.46 604.57 1.07
Maryland M.D. IPA - High Self JP1 1011.99 1065.78 562.73 503.05 21.59
Maryland M.D. IPA - High Self & Family JP2 2837.66 2988.44 1324.74 1663.70 69.99
Maryland M.D. IPA - High Self Plus One JP3 1976.43 2081.45 1214.46 866.99 27.26
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 661.81 665.19 498.89 166.30 0.85
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1514.20 1529.86 1147.40 382.46 3.91
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1422.92 1430.13 1072.60 357.53 1.80
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 822.16 908.01 562.73 345.28 53.65
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1948.55 2151.93 1324.74 827.19 122.59
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1767.68 1952.17 1214.46 737.71 106.73
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 663.76 697.00 522.75 174.25 8.31
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1586.41 1672.80 1254.60 418.20 21.60
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1327.54 1481.16 1110.87 370.29 38.41
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Massachusetts Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Massachusetts Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Massachusetts Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Michigan Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Michigan Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Michigan Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Michigan Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Michigan Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Michigan Blue Care Network of Michigan - High Self LX1 790.44 850.05 562.73 287.32 27.41
Michigan Blue Care Network of Michigan - High Self & Family LX2 1928.70 2074.19 1324.74 749.45 64.70
Michigan Blue Care Network of Michigan - High Self Plus One LX3 1818.03 1955.20 1214.46 740.74 59.41
Michigan Blue Care Network of Michigan - High Self K51 1042.12 1042.28 562.73 479.55 -32.04
Michigan Blue Care Network of Michigan - High Self & Family K52 2542.76 2543.08 1324.74 1218.34 -80.47
Michigan Blue Care Network of Michigan - High Self Plus One K53 2396.85 2397.14 1214.46 1182.68 -77.47
Michigan Health Alliance Plan - High Self 521 910.11 915.09 562.73 352.36 -27.22
Michigan Health Alliance Plan - High Self & Family 522 2220.62 2232.86 1324.74 908.12 -68.55
Michigan Health Alliance Plan - High Self Plus One 523 2093.22 2104.72 1214.46 890.26 -66.26
Michigan Health Alliance Plan - Standard Self GY4 530.16 533.15 399.86 133.29 0.75
Michigan Health Alliance Plan - Standard Self & Family GY5 1293.57 1300.89 975.67 325.22 1.83
Michigan Health Alliance Plan - Standard Self Plus One GY6 1219.38 1226.27 919.70 306.57 1.73
Michigan Priority Health - High Self LE1 1106.71 1110.87 562.73 548.14 -28.04
Michigan Priority Health - High Self & Family LE2 2600.74 2610.53 1324.74 1285.79 -71.00
Michigan Priority Health - High Self Plus One LE3 2434.73 2443.89 1214.46 1229.43 -68.60
Michigan Priority Health - Standard Self LE4 617.22 671.04 503.28 167.76 13.46
Michigan Priority Health - Standard Self & Family LE5 1450.45 1576.94 1182.71 394.23 31.62
Michigan Priority Health - Standard Self Plus One LE6 1357.85 1476.30 1107.23 369.07 29.61
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 628.27 641.42 481.07 160.35 3.28
Minnesota Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Minnesota Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Minnesota Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Minnesota Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Minnesota HealthPartners - Standard Self V34 553.28 553.28 414.96 138.32 0.00
Minnesota HealthPartners - Standard Self & Family V35 1347.84 1347.84 1010.88 336.96 0.00
Minnesota HealthPartners - Standard Self Plus One V36 1222.78 1222.78 917.09 305.69 0.00
Minnesota HealthPartners - High Self V31 692.14 737.17 552.88 184.29 11.26
Minnesota HealthPartners - High Self & Family V32 1686.01 1795.73 1324.74 470.99 28.93
Minnesota HealthPartners - High Self Plus One V33 1529.58 1629.12 1214.46 414.66 21.78
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 628.27 641.42 481.07 160.35 3.28
Mississippi Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Mississippi Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Mississippi Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Mississippi Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Missouri Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Missouri Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Missouri Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Missouri Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Missouri Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Missouri Aetna Open Access - Standard Self HA4 909.37 895.01 562.73 332.28 -46.56
Missouri Aetna Open Access - Standard Self & Family HA5 2146.47 2112.54 1324.74 787.80 -114.72
Missouri Aetna Open Access - Standard Self Plus One HA6 2125.26 2091.64 1214.46 877.18 -111.38
Missouri Aetna Open Access - High Self HA1 1188.98 1196.91 562.73 634.18 -24.27
Missouri Aetna Open Access - High Self & Family HA2 2808.54 2827.31 1324.74 1502.57 -62.02
Missouri Aetna Open Access - High Self Plus One HA3 2780.77 2799.33 1214.46 1584.87 -59.20
Missouri Humana CoverageFirst and Humana Value Plan - Value Self PH4 567.17 587.58 440.69 146.89 5.10
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1276.15 1322.10 991.58 330.52 11.48
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1219.44 1263.36 947.52 315.84 10.98
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 758.03 750.21 562.66 187.55 -39.95
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1705.60 1687.96 1265.97 421.99 -39.66
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1629.79 1612.95 1209.71 403.24 -89.85
Missouri Humana HDHP - HDHP Self BK1 403.13 415.22 311.42 103.80 3.02
Missouri Humana HDHP - HDHP Self & Family BK2 1003.93 1034.06 775.55 258.51 7.53
Missouri Humana HDHP - HDHP Self Plus One BK3 883.78 910.30 682.73 227.57 6.63
Missouri Humana Health Plan, Inc. - Standard Self MS4 1290.64 1362.75 562.73 800.02 39.91
Missouri Humana Health Plan, Inc. - Standard Self & Family MS5 2903.98 3066.20 1324.74 1741.46 81.43
Missouri Humana Health Plan, Inc. - Standard Self Plus One MS6 2774.94 2929.96 1214.46 1715.50 77.26
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Montana Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Montana Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Montana Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Montana Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Montana Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Nebraska Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Nebraska Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Nebraska Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Nebraska Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Nevada Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Nevada Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Nevada Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Nevada Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Nevada Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Nevada Health Plan of Nevada, Inc. - High Self NM1 830.16 752.98 562.73 190.25 -109.38
Nevada Health Plan of Nevada, Inc. - High Self & Family NM2 1967.40 1784.47 1324.74 459.73 -263.72
Nevada Health Plan of Nevada, Inc. - High Self Plus One NM3 1577.31 1430.67 1073.00 357.67 -82.94
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 668.46 709.71 532.28 177.43 10.32
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1580.91 1678.47 1258.85 419.62 24.39
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1437.17 1525.88 1144.41 381.47 22.18
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 672.10 708.63 531.47 177.16 9.14
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1545.85 1629.77 1222.33 407.44 20.98
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1445.04 1523.51 1142.63 380.88 19.62
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 864.87 963.45 562.73 400.72 66.38
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2162.16 2408.62 1324.74 1083.88 165.67
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1859.46 2071.40 1214.46 856.94 134.18
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 657.65 634.34 475.76 158.58 -5.83
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1555.39 1500.18 1125.14 375.04 -13.81
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1413.97 1363.81 1022.86 340.95 -12.54
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 628.27 641.42 481.07 160.35 3.28
New Hampshire Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
New Hampshire Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
New Hampshire Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
New Jersey Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
New Jersey Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
New Jersey Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
New Jersey Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
New Jersey Aetna Open Access - High Self JR1 1655.18 1682.03 562.73 1119.30 -5.35
New Jersey Aetna Open Access - High Self & Family JR2 3823.24 3885.25 1324.74 2560.51 -18.78
New Jersey Aetna Open Access - High Self Plus One JR3 3785.41 3846.79 1214.46 2632.33 -16.38
New Jersey Aetna Open Access - Basic Self JR4 1428.27 1446.40 562.73 883.67 -14.07
New Jersey Aetna Open Access - Basic Self & Family JR5 3310.19 3352.14 1324.74 2027.40 -38.84
New Jersey Aetna Open Access - Basic Self Plus One JR6 3277.41 3318.94 1214.46 2104.48 -36.23
New Jersey Aetna Open Access - Basic Self P34 1721.76 1754.03 562.73 1191.30 0.07
New Jersey Aetna Open Access - Basic Self & Family P35 3996.29 4071.10 1324.74 2746.36 -5.98
New Jersey Aetna Open Access - Basic Self Plus One P36 3956.70 4030.74 1214.46 2816.28 -3.72
New Jersey Aetna Open Access - High Self P31 1762.54 1737.97 562.73 1175.24 -56.77
New Jersey Aetna Open Access - High Self & Family P32 4273.27 4213.71 1324.74 2888.97 -140.35
New Jersey Aetna Open Access - High Self Plus One P33 4230.98 4172.00 1214.46 2957.54 -136.74
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 628.27 641.42 481.07 160.35 3.28
New Mexico Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
New Mexico Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
New Mexico Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
New Mexico Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
New Mexico Presbyterian Health Plan - High Self P21 874.47 1018.20 562.73 455.47 111.53
New Mexico Presbyterian Health Plan - High Self & Family P22 2055.08 2392.85 1324.74 1068.11 256.98
New Mexico Presbyterian Health Plan - High Self Plus One P23 1985.12 2311.38 1214.46 1096.92 248.50
New Mexico Presbyterian Health Plan - Standard Self PS4 725.23 853.75 562.73 291.02 96.32
New Mexico Presbyterian Health Plan - Standard Self & Family PS5 1704.34 2006.38 1324.74 681.64 221.25
New Mexico Presbyterian Health Plan - Standard Self Plus One PS6 1646.36 1938.06 1214.46 723.60 213.94
New Mexico Presbyterian Health Plan - Wellness Self PS1 653.81 756.54 562.73 193.81 30.36
New Mexico Presbyterian Health Plan - Wellness Self & Family PS2 1536.43 1777.88 1324.74 453.14 69.03
New Mexico Presbyterian Health Plan - Wellness Self Plus One PS3 1484.17 1717.34 1214.46 502.88 131.84
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 628.27 641.42 481.07 160.35 3.28
New York Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
New York Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
New York Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
New York Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
New York Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
New York Aetna Open Access - High Self JC1 1728.91 1704.13 562.73 1141.40 -56.98
New York Aetna Open Access - High Self & Family JC2 4272.13 4210.87 1324.74 2886.13 -142.05
New York Aetna Open Access - High Self Plus One JC3 4229.83 4169.19 1214.46 2954.73 -138.40
New York Aetna Open Access - Basic Self JC4 1462.83 1496.69 562.73 933.96 1.66
New York Aetna Open Access - Basic Self & Family JC5 3568.09 3650.70 1324.74 2325.96 1.82
New York Aetna Open Access - Basic Self Plus One JC6 3532.77 3614.59 1214.46 2400.13 4.06
New York CDPHP - Standard Self SG4 773.76 879.95 562.73 317.22 73.99
New York CDPHP - Standard Self & Family SG5 1857.01 2111.89 1324.74 787.15 174.09
New York CDPHP - Standard Self Plus One SG6 1717.73 1953.49 1214.46 739.03 158.00
New York HIP of Greater NY - Standard Self YL4 975.30 1005.98 562.73 443.25 -1.52
New York HIP of Greater NY - Standard Self & Family YL5 2835.13 2924.26 1324.74 1599.52 8.34
New York HIP of Greater NY - Standard Self Plus One YL6 1780.87 1836.90 1214.46 622.44 -21.73
New York HIP of Greater NY - High Self 511 1050.75 1050.75 562.73 488.02 -32.20
New York HIP of Greater NY - High Self & Family 512 3054.59 3054.50 1324.74 1729.76 -80.88
New York HIP of Greater NY - High Self Plus One 513 1918.74 1918.71 1214.46 704.25 -77.79
New York Independent Health - Standard Self C54 737.77 751.88 562.73 189.15 -18.09
New York Independent Health - Standard Self & Family C55 1991.99 2030.08 1324.74 705.34 -42.70
New York Independent Health - Standard Self Plus One C56 1881.36 1917.28 1214.46 702.82 -41.84
New York Independent Health - High Self QA1 800.65 822.86 562.73 260.13 -9.99
New York Independent Health - High Self & Family QA2 2161.75 2221.72 1324.74 896.98 -20.82
New York Independent Health - High Self Plus One QA3 2041.65 2098.31 1214.46 883.85 -21.10
New York Independent Health - HDHP Self QA4 601.19 631.09 473.32 157.77 7.47
New York Independent Health - HDHP Self & Family QA5 1552.76 1638.93 1229.20 409.73 21.54
New York Independent Health - HDHP Self Plus One QA6 1477.36 1558.03 1168.52 389.51 20.17
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 628.27 641.42 481.07 160.35 3.28
North Carolina Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
North Carolina Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
North Carolina Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
North Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
North Dakota Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
North Dakota Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
North Dakota Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
North Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
North Dakota HealthPartners - Standard Self V34 553.28 553.28 414.96 138.32 0.00
North Dakota HealthPartners - Standard Self & Family V35 1347.84 1347.84 1010.88 336.96 0.00
North Dakota HealthPartners - Standard Self Plus One V36 1222.78 1222.78 917.09 305.69 0.00
North Dakota HealthPartners - High Self V31 692.14 737.17 552.88 184.29 11.26
North Dakota HealthPartners - High Self & Family V32 1686.01 1795.73 1324.74 470.99 28.93
North Dakota HealthPartners - High Self Plus One V33 1529.58 1629.12 1214.46 414.66 21.78
Northern Mariana Islands Calvo's SelectCare - Standard Self B44 378.91 404.63 303.47 101.16 6.43
Northern Mariana Islands Calvo's SelectCare - Standard Self & Family B45 1100.91 1175.66 881.75 293.91 18.68
Northern Mariana Islands Calvo's SelectCare - Standard Self Plus One B46 746.92 797.64 598.23 199.41 12.68
Northern Mariana Islands Calvo's SelectCare - High Self B41 535.95 551.48 413.61 137.87 3.88
Northern Mariana Islands Calvo's SelectCare - High Self & Family B42 1419.54 1460.70 1095.53 365.17 10.29
Northern Mariana Islands Calvo's SelectCare - High Self Plus One B43 1045.89 1076.27 807.20 269.07 7.60
Northern Mariana Islands TakeCare - HDHP Self KX1 122.31 119.95 89.96 29.99 -0.59
Northern Mariana Islands TakeCare - HDHP Self & Family KX2 327.97 321.53 241.15 80.38 -1.61
Northern Mariana Islands TakeCare - HDHP Self Plus One KX3 295.23 289.51 217.13 72.38 -1.43
Northern Mariana Islands TakeCare - Standard Self JK4 405.77 441.26 330.95 110.31 8.87
Northern Mariana Islands TakeCare - Standard Self & Family JK5 1149.18 1249.69 937.27 312.42 25.13
Northern Mariana Islands TakeCare - Standard Self Plus One JK6 799.78 869.74 652.31 217.43 17.49
Northern Mariana Islands TakeCare - High Self JK1 515.86 564.79 423.59 141.20 12.24
Northern Mariana Islands TakeCare - High Self & Family JK2 1230.43 1347.08 1010.31 336.77 29.16
Northern Mariana Islands TakeCare - High Self Plus One JK3 1019.16 1115.79 836.84 278.95 24.16
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 628.27 641.42 481.07 160.35 3.28
Ohio Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Ohio Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Ohio Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Ohio Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Ohio Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Ohio AultCare Insurance Company - High Self 3A1 930.26 933.99 562.73 371.26 -28.47
Ohio AultCare Insurance Company - High Self & Family 3A2 2297.82 2148.23 1324.74 823.49 -230.38
Ohio AultCare Insurance Company - High Self Plus One 3A3 1953.62 1961.35 1214.46 746.89 -70.03
Ohio AultCare Insurance Company - HDHP Self 3A4 442.82 438.38 328.79 109.59 -1.11
Ohio AultCare Insurance Company - HDHP Self & Family 3A5 1417.93 1403.74 1052.81 350.93 -3.55
Ohio AultCare Insurance Company - HDHP Self Plus One 3A6 841.84 833.43 625.07 208.36 -2.10
Ohio Humana CoverageFirst and Humana Value Plan - Value Self X34 694.33 732.51 549.38 183.13 9.55
Ohio Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1562.23 1648.16 1236.12 412.04 21.48
Ohio Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1492.81 1574.93 1181.20 393.73 20.53
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self X31 902.37 952.01 562.73 389.28 17.44
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 2030.34 2142.01 1324.74 817.27 30.88
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1940.12 2046.83 1214.46 832.37 28.95
Ohio Humana HDHP - HDHP Self DT1 495.73 510.60 382.95 127.65 3.72
Ohio Humana HDHP - HDHP Self & Family DT2 1235.41 1272.48 954.36 318.12 9.27
Ohio Humana HDHP - HDHP Self Plus One DT3 1087.47 1120.10 840.08 280.02 8.15
Ohio Humana Health Plan of Ohio, Inc. - Standard Self A64 1243.08 1304.46 562.73 741.73 29.18
Ohio Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2796.95 2935.05 1324.74 1610.31 57.31
Ohio Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2672.63 2804.62 1214.46 1590.16 54.23
Ohio Humana Health Plan of Ohio, Inc. - Basic Self W61 671.02 758.25 562.73 195.52 27.77
Ohio Humana Health Plan of Ohio, Inc. - Basic Self & Family W62 1509.82 1706.10 1279.58 426.52 49.07
Ohio Humana Health Plan of Ohio, Inc. - Basic Self Plus One W63 1442.72 1630.24 1214.46 415.78 55.10
Ohio Medical Mutual of Ohio - Standard Self 644 1047.84 1188.59 562.73 625.86 108.55
Ohio Medical Mutual of Ohio - Standard Self & Family 645 2514.79 2852.63 1324.74 1527.89 257.05
Ohio Medical Mutual of Ohio - Standard Self Plus One 646 2305.23 2614.91 1214.46 1400.45 231.92
Ohio Medical Mutual of Ohio - Basic Self UX1 412.90 412.90 309.68 103.22 0.00
Ohio Medical Mutual of Ohio - Basic Self & Family UX2 990.97 990.97 743.23 247.74 0.00
Ohio Medical Mutual of Ohio - Basic Self Plus One UX3 908.40 908.40 681.30 227.10 0.00
Ohio Medical Mutual of Ohio - Basic Self YF1 416.74 406.14 304.61 101.53 -2.65
Ohio Medical Mutual of Ohio - Basic Self & Family YF2 1000.16 974.74 731.06 243.68 -6.36
Ohio Medical Mutual of Ohio - Basic Self Plus One YF3 916.80 893.51 670.13 223.38 -5.82
Ohio Medical Mutual of Ohio - Standard Self YF4 1193.60 1209.00 562.73 646.27 -16.80
Ohio Medical Mutual of Ohio - Standard Self & Family YF5 2864.62 2901.62 1324.74 1576.88 -43.79
Ohio Medical Mutual of Ohio - Standard Self Plus One YF6 2625.89 2659.82 1214.46 1445.36 -43.83
Ohio Medical Mutual of Ohio - WellFlex Self F11 New Plan 721.44 541.08 180.36 New Plan
Ohio Medical Mutual of Ohio - WellFlex Self & Family F12 New Plan 1731.43 1298.57 432.86 New Plan
Ohio Medical Mutual of Ohio - WellFlex Self Plus One F13 New Plan 1587.13 1190.35 396.78 New Plan
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 628.27 641.42 481.07 160.35 3.28
Oklahoma Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Oklahoma Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Oklahoma Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Oregon Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Oregon Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Oregon Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Oregon Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Oregon Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Oregon Kaiser Permanente - Northwest - Standard Self 574 668.89 695.35 521.51 173.84 6.62
Oregon Kaiser Permanente - Northwest - Standard Self & Family 575 1536.64 1597.48 1198.11 399.37 15.21
Oregon Kaiser Permanente - Northwest - Standard Self Plus One 576 1536.64 1597.48 1198.11 399.37 -0.57
Oregon Kaiser Permanente - Northwest - High Self 571 757.66 798.22 562.73 235.49 8.36
Oregon Kaiser Permanente - Northwest - High Self & Family 572 1711.34 1802.91 1324.74 478.17 10.78
Oregon Kaiser Permanente - Northwest - High Self Plus One 573 1711.34 1802.91 1214.46 588.45 13.81
Oregon Kaiser Permanente - Northwest - Prosper Self AM1 391.78 410.63 307.97 102.66 4.72
Oregon Kaiser Permanente - Northwest - Prosper Self & Family AM2 971.66 1018.38 763.79 254.59 11.68
Oregon Kaiser Permanente - Northwest - Prosper Self Plus One AM3 842.29 882.81 662.11 220.70 10.13
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 668.46 709.71 532.28 177.43 10.32
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1580.91 1678.47 1258.85 419.62 24.39
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1437.17 1525.88 1144.41 381.47 22.18
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 672.10 708.63 531.47 177.16 9.14
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1545.85 1629.77 1222.33 407.44 20.98
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1445.04 1523.51 1142.63 380.88 19.62
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 864.87 963.45 562.73 400.72 66.38
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2162.16 2408.62 1324.74 1083.88 165.67
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1859.46 2071.40 1214.46 856.94 134.18
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 657.65 634.34 475.76 158.58 -5.83
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1555.39 1500.18 1125.14 375.04 -13.81
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1413.97 1363.81 1022.86 340.95 -12.54
Palau Calvo's SelectCare - Standard Self B44 378.91 404.63 303.47 101.16 6.43
Palau Calvo's SelectCare - Standard Self & Family B45 1100.91 1175.66 881.75 293.91 18.68
Palau Calvo's SelectCare - Standard Self Plus One B46 746.92 797.64 598.23 199.41 12.68
Palau Calvo's SelectCare - High Self B41 535.95 551.48 413.61 137.87 3.88
Palau Calvo's SelectCare - High Self & Family B42 1419.54 1460.70 1095.53 365.17 10.29
Palau Calvo's SelectCare - High Self Plus One B43 1045.89 1076.27 807.20 269.07 7.60
Palau TakeCare - HDHP Self KX1 122.31 119.95 89.96 29.99 -0.59
Palau TakeCare - HDHP Self & Family KX2 327.97 321.53 241.15 80.38 -1.61
Palau TakeCare - HDHP Self Plus One KX3 295.23 289.51 217.13 72.38 -1.43
Palau TakeCare - Standard Self JK4 405.77 441.26 330.95 110.31 8.87
Palau TakeCare - Standard Self & Family JK5 1149.18 1249.69 937.27 312.42 25.13
Palau TakeCare - Standard Self Plus One JK6 799.78 869.74 652.31 217.43 17.49
Palau TakeCare - High Self JK1 515.86 564.79 423.59 141.20 12.24
Palau TakeCare - High Self & Family JK2 1230.43 1347.08 1010.31 336.77 29.16
Palau TakeCare - High Self Plus One JK3 1019.16 1115.79 836.84 278.95 24.16
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 628.27 641.42 481.07 160.35 3.28
Pennsylvania Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Pennsylvania Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Pennsylvania Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Pennsylvania Aetna Open Access - High Self YE1 1181.68 1203.69 562.73 640.96 -10.19
Pennsylvania Aetna Open Access - High Self & Family YE2 2967.19 3022.48 1324.74 1697.74 -25.50
Pennsylvania Aetna Open Access - High Self Plus One YE3 2937.83 2992.56 1214.46 1778.10 -23.03
Pennsylvania Aetna Open Access - Basic Self P34 1721.76 1754.03 562.73 1191.30 0.07
Pennsylvania Aetna Open Access - Basic Self & Family P35 3996.29 4071.10 1324.74 2746.36 -5.98
Pennsylvania Aetna Open Access - Basic Self Plus One P36 3956.70 4030.74 1214.46 2816.28 -3.72
Pennsylvania Aetna Open Access - High Self P31 1762.54 1737.97 562.73 1175.24 -56.77
Pennsylvania Aetna Open Access - High Self & Family P32 4273.27 4213.71 1324.74 2888.97 -140.35
Pennsylvania Aetna Open Access - High Self Plus One P33 4230.98 4172.00 1214.46 2957.54 -136.74
Pennsylvania Geisinger Health Plan - Standard Self GG4 992.53 956.97 562.73 394.24 -67.76
Pennsylvania Geisinger Health Plan - Standard Self & Family GG5 2272.42 2190.98 1324.74 866.24 -162.23
Pennsylvania Geisinger Health Plan - Standard Self Plus One GG6 2144.57 2067.74 1214.46 853.28 -154.59
Pennsylvania Geisinger Health Plan - Basic Self AJ1 891.00 865.54 562.73 302.81 -57.66
Pennsylvania Geisinger Health Plan - Basic Self & Family AJ2 2039.96 1981.70 1324.74 656.96 -139.05
Pennsylvania Geisinger Health Plan - Basic Self Plus One AJ3 1925.21 1870.22 1214.46 655.76 -132.75
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 661.81 665.19 498.89 166.30 0.85
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1514.20 1529.86 1147.40 382.46 3.91
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1422.92 1430.13 1072.60 357.53 1.80
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 822.16 908.01 562.73 345.28 53.65
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1948.55 2151.93 1324.74 827.19 122.59
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1767.68 1952.17 1214.46 737.71 106.73
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
Pennsylvania UPMC Health Plan - HDHP Self 8W4 667.98 704.75 528.56 176.19 9.20
Pennsylvania UPMC Health Plan - HDHP Self & Family 8W5 1539.20 1625.78 1219.34 406.44 21.64
Pennsylvania UPMC Health Plan - HDHP Self Plus One 8W6 1479.49 1561.93 1171.45 390.48 20.61
Pennsylvania UPMC Health Plan - Standard Self UW4 723.21 732.33 549.25 183.08 -9.60
Pennsylvania UPMC Health Plan - Standard Self & Family UW5 1698.91 1725.60 1294.20 431.40 -23.56
Pennsylvania UPMC Health Plan - Standard Self Plus One UW6 1626.19 1646.58 1214.46 432.12 -57.37
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self ZJ1 480.76 492.79 369.59 123.20 3.01
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self & Family ZJ2 1081.73 1108.75 831.56 277.19 6.76
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self Plus One ZJ3 1033.65 1059.50 794.63 264.87 6.46
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self 891 390.04 415.16 311.37 103.79 6.28
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self & Family 892 893.21 950.71 713.03 237.68 14.38
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self Plus One 893 875.79 932.19 699.14 233.05 14.10
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 628.27 641.42 481.07 160.35 3.28
Rhode Island Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Rhode Island Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Rhode Island Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
South Carolina Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
South Carolina Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
South Carolina Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
South Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
South Dakota Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
South Dakota Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
South Dakota Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
South Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
South Dakota HealthPartners - Standard Self V34 553.28 553.28 414.96 138.32 0.00
South Dakota HealthPartners - Standard Self & Family V35 1347.84 1347.84 1010.88 336.96 0.00
South Dakota HealthPartners - Standard Self Plus One V36 1222.78 1222.78 917.09 305.69 0.00
South Dakota HealthPartners - High Self V31 692.14 737.17 552.88 184.29 11.26
South Dakota HealthPartners - High Self & Family V32 1686.01 1795.73 1324.74 470.99 28.93
South Dakota HealthPartners - High Self Plus One V33 1529.58 1629.12 1214.46 414.66 21.78
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 628.27 641.42 481.07 160.35 3.28
Tennessee Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Tennessee Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Tennessee Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Tennessee Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self TT1 849.29 925.71 562.73 362.98 44.22
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TT2 1910.91 2082.88 1324.74 758.14 91.18
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TT3 1825.98 1990.32 1214.46 775.86 86.58
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self TT4 742.02 805.09 562.73 242.36 30.87
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self & Family TT5 1669.53 1811.44 1324.74 486.70 61.12
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self Plus One TT6 1595.34 1730.95 1214.46 516.49 57.85
Tennessee Humana HDHP - HDHP Self ER1 397.78 409.72 307.29 102.43 2.99
Tennessee Humana HDHP - HDHP Self & Family ER2 990.51 1020.24 765.18 255.06 7.43
Tennessee Humana HDHP - HDHP Self Plus One ER3 871.98 898.13 673.60 224.53 6.54
Tennessee Humana Health Plan, Inc. - Standard Self GJ4 927.55 986.92 562.73 424.19 27.17
Tennessee Humana Health Plan, Inc. - Standard Self & Family GJ5 2086.98 2220.55 1324.74 895.81 52.78
Tennessee Humana Health Plan, Inc. - Standard Self Plus One GJ6 1994.20 2121.86 1214.46 907.40 49.90
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 624.67 658.84 494.13 164.71 8.54
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1436.76 1507.18 1130.39 376.79 17.60
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1343.07 1416.52 1062.39 354.13 18.36
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 847.30 940.98 562.73 378.25 61.48
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2118.24 2352.52 1324.74 1027.78 153.49
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1821.69 2023.17 1214.46 808.71 123.72
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Texas Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Texas Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Texas Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Texas Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Texas Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Texas Baylor Scott & White Health Plan - Basic Self A81 553.71 591.07 443.30 147.77 9.34
Texas Baylor Scott & White Health Plan - Basic Self & Family A82 1298.90 1386.71 1040.03 346.68 21.96
Texas Baylor Scott & White Health Plan - Basic Self Plus One A83 1227.14 1310.10 982.58 327.52 20.74
Texas Baylor Scott & White Health Plan - Standard Self A84 1012.68 919.88 562.73 357.15 -125.00
Texas Baylor Scott & White Health Plan - Standard Self & Family A85 2377.44 2159.39 1324.74 834.65 -298.84
Texas Baylor Scott & White Health Plan - Standard Self Plus One A86 2246.03 2040.03 1214.46 825.57 -283.76
Texas Baylor Scott & White Health Plan - Basic Self P81 570.74 609.27 456.95 152.32 9.64
Texas Baylor Scott & White Health Plan - Basic Self & Family P82 1339.00 1429.50 1072.13 357.37 22.62
Texas Baylor Scott & White Health Plan - Basic Self Plus One P83 1265.01 1350.51 1012.88 337.63 21.38
Texas Baylor Scott & White Health Plan - Standard Self P84 1041.17 945.77 562.73 383.04 -127.60
Texas Baylor Scott & White Health Plan - Standard Self & Family P85 2444.46 2220.25 1324.74 895.51 -305.00
Texas Baylor Scott & White Health Plan - Standard Self Plus One P86 2309.30 2097.51 1214.46 883.05 -289.55
Texas Humana CoverageFirst and Humana Value Plan - Value Self T34 593.36 658.65 493.99 164.66 16.32
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family T35 1424.09 1580.74 1185.56 395.18 39.16
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One T36 1275.78 1416.11 1062.08 354.03 35.09
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self T31 872.76 964.41 562.73 401.68 59.45
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family T32 1963.67 2169.85 1324.74 845.11 125.39
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One T33 1876.42 2073.46 1214.46 859.00 119.28
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TV1 909.39 934.68 562.73 371.95 -6.91
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TV2 2046.18 2103.05 1324.74 778.31 -23.92
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TV3 1955.24 2009.58 1214.46 795.12 -23.42
Texas Humana CoverageFirst and Humana Value Plan - Value Self TV4 719.27 719.27 539.45 179.82 -8.92
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TV5 1618.39 1618.41 1213.81 404.60 0.00
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TV6 1546.48 1546.50 1159.88 386.62 -23.16
Texas Humana CoverageFirst and Humana Value Plan - Value Self TU4 615.64 624.61 468.46 156.15 2.24
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TU5 1385.19 1405.37 1054.03 351.34 5.04
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TU6 1323.68 1342.94 1007.21 335.73 4.81
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TU1 773.52 870.85 562.73 308.12 65.13
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TU2 1740.46 1959.43 1324.74 634.69 138.18
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TU3 1663.11 1872.37 1214.46 657.91 131.50
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TP1 772.14 866.43 562.73 303.70 62.09
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TP2 1737.28 1949.46 1324.74 624.72 131.39
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TP3 1660.10 1862.86 1214.46 648.40 125.00
Texas Humana CoverageFirst and Humana Value Plan - Value Self TP4 486.40 534.56 400.92 133.64 12.04
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TP5 1167.36 1282.95 962.21 320.74 28.90
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TP6 1045.76 1149.31 861.98 287.33 25.89
Texas Humana HDHP - HDHP Self FD1 397.78 409.72 307.29 102.43 2.99
Texas Humana HDHP - HDHP Self & Family FD2 990.51 1020.24 765.18 255.06 7.43
Texas Humana HDHP - HDHP Self Plus One FD3 871.98 898.13 673.60 224.53 6.54
Texas Humana HDHP - HDHP Self AN1 458.62 472.40 354.30 118.10 3.45
Texas Humana HDHP - HDHP Self & Family AN2 1142.64 1176.91 882.68 294.23 8.57
Texas Humana HDHP - HDHP Self Plus One AN3 1005.85 1036.01 777.01 259.00 7.54
Texas Humana HDHP - HDHP Self DX1 404.56 416.72 312.54 104.18 3.04
Texas Humana HDHP - HDHP Self & Family DX2 1007.50 1037.73 778.30 259.43 7.56
Texas Humana HDHP - HDHP Self Plus One DX3 886.93 913.55 685.16 228.39 6.66
Texas Humana HDHP - HDHP Self CG1 512.55 527.91 395.93 131.98 3.84
Texas Humana HDHP - HDHP Self & Family CG2 1277.45 1315.77 986.83 328.94 9.58
Texas Humana HDHP - HDHP Self Plus One CG3 1124.46 1158.19 868.64 289.55 8.44
Texas Humana Health Plan of Texas - Standard Self UC4 898.65 993.03 562.73 430.30 62.18
Texas Humana Health Plan of Texas - Standard Self & Family UC5 2021.96 2234.29 1324.74 909.55 131.54
Texas Humana Health Plan of Texas - Standard Self Plus One UC6 1932.08 2134.97 1214.46 920.51 125.13
Texas Humana Health Plan of Texas - Basic Self QX1 869.70 962.41 562.73 399.68 60.51
Texas Humana Health Plan of Texas - Basic Self & Family QX2 1956.80 2165.43 1324.74 840.69 127.84
Texas Humana Health Plan of Texas - Basic Self Plus One QX3 1869.83 2069.19 1214.46 854.73 121.60
Texas Humana Health Plan of Texas - Standard Self EW4 950.28 1004.94 562.73 442.21 22.46
Texas Humana Health Plan of Texas - Standard Self & Family EW5 2138.07 2261.09 1324.74 936.35 42.23
Texas Humana Health Plan of Texas - Standard Self Plus One EW6 2043.06 2160.58 1214.46 946.12 39.76
Texas Humana Health Plan of Texas - Basic Self QY1 844.65 1015.39 562.73 452.66 138.54
Texas Humana Health Plan of Texas - Basic Self & Family QY2 1900.49 2284.62 1324.74 959.88 303.34
Texas Humana Health Plan of Texas - Basic Self Plus One QY3 1816.06 2183.09 1214.46 968.63 289.27
Texas Humana Health Plan of Texas - Basic Self Q21 825.70 931.39 562.73 368.66 73.49
Texas Humana Health Plan of Texas - Basic Self & Family Q22 1857.81 2095.62 1324.74 770.88 157.02
Texas Humana Health Plan of Texas - Basic Self Plus One Q23 1775.17 2002.43 1214.46 787.97 149.50
Texas Humana Health Plan of Texas - Basic Self Q61 716.65 792.05 562.73 229.32 43.20
Texas Humana Health Plan of Texas - Basic Self & Family Q62 1612.48 1782.13 1324.74 457.39 54.27
Texas Humana Health Plan of Texas - Basic Self Plus One Q63 1540.83 1702.91 1214.46 488.45 84.32
Texas Humana Health Plan of Texas - Standard Self UU4 1608.19 1688.57 562.73 1125.84 48.18
Texas Humana Health Plan of Texas - Standard Self & Family UU5 3618.36 3799.27 1324.74 2474.53 100.12
Texas Humana Health Plan of Texas - Standard Self Plus One UU6 3457.55 3630.42 1214.46 2415.96 95.11
Texas Humana Health Plan of Texas - Standard Self UR4 1069.55 1152.75 562.73 590.02 51.00
Texas Humana Health Plan of Texas - Standard Self & Family UR5 2406.47 2593.70 1324.74 1268.96 106.44
Texas Humana Health Plan of Texas - Standard Self Plus One UR6 2299.51 2478.41 1214.46 1263.95 101.14
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 663.76 697.00 522.75 174.25 8.31
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1586.41 1672.80 1254.60 418.20 21.60
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1327.54 1481.16 1110.87 370.29 38.41
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Utah Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Utah Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Utah Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Utah Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Utah Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Utah Altius Health Plan - High Self 9K1 1150.85 1214.72 562.73 651.99 31.67
Utah Altius Health Plan - High Self & Family 9K2 2545.10 2686.39 1324.74 1361.65 60.50
Utah Altius Health Plan - High Self Plus One 9K3 2519.92 2659.82 1214.46 1445.36 62.14
Utah Altius Health Plan - HDHP Self 9K4 759.22 794.89 562.73 232.16 3.47
Utah Altius Health Plan - HDHP Self & Family 9K5 1586.72 1661.25 1245.94 415.31 18.63
Utah Altius Health Plan - HDHP Self Plus One 9K6 1555.56 1628.62 1214.46 414.16 -4.70
Utah Altius Health Plan - Standard Self DK4 942.54 993.35 562.73 430.62 18.61
Utah Altius Health Plan - Standard Self & Family DK5 2081.43 2193.69 1324.74 868.95 31.47
Utah Altius Health Plan - Standard Self Plus One DK6 2060.80 2171.95 1214.46 957.49 33.39
Utah SelectHealth Plan - Standard Self SF4 643.09 701.59 526.19 175.40 14.63
Utah SelectHealth Plan - Standard Self & Family SF5 1607.71 1754.03 1315.52 438.51 36.58
Utah SelectHealth Plan - Standard Self Plus One SF6 1414.77 1543.51 1157.63 385.88 32.19
Utah SelectHealth Plan - HDHP Self WX1 572.37 653.64 490.23 163.41 20.32
Utah SelectHealth Plan - HDHP Self & Family WX2 1430.93 1634.12 1225.59 408.53 50.80
Utah SelectHealth Plan - HDHP Self Plus One WX3 1259.20 1438.04 1078.53 359.51 44.71
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 628.27 641.42 481.07 160.35 3.28
Vermont Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Vermont Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 927.77 1093.78 562.73 531.05 133.81
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2124.50 2504.60 1324.74 1179.86 299.31
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2082.84 2455.48 1214.46 1241.02 294.88
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1156.37 1257.23 562.73 694.50 68.66
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2637.12 2867.17 1324.74 1542.43 149.26
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2611.01 2838.77 1214.46 1624.31 150.00
Vermont Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Vermont Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Vermont Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self 851 679.03 665.45 499.09 166.36 -3.40
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self & Family 852 1555.02 1523.90 1142.93 380.97 -7.78
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self Plus One 853 1524.68 1494.16 1120.62 373.54 -14.44
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 628.27 641.42 481.07 160.35 3.28
Virginia Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Virginia Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
Virginia Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Virginia Aetna Open Access - High Self JN1 1251.55 1328.84 562.73 766.11 45.09
Virginia Aetna Open Access - High Self & Family JN2 2813.68 2987.40 1324.74 1662.66 92.93
Virginia Aetna Open Access - High Self Plus One JN3 2785.79 2957.80 1214.46 1743.34 94.25
Virginia Aetna Open Access - Basic Self JN4 739.46 770.73 562.73 208.00 -0.93
Virginia Aetna Open Access - Basic Self & Family JN5 1692.23 1763.82 1322.87 440.95 -7.33
Virginia Aetna Open Access - Basic Self Plus One JN6 1553.93 1619.67 1214.46 405.21 -12.02
Virginia Aetna Saver (Open Access) - Saver Self QQ4 595.21 613.56 460.17 153.39 4.59
Virginia Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.12 1404.20 1053.15 351.05 10.52
Virginia Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1289.45 967.09 322.36 9.66
Virginia CareFirst BlueChoice - Standard Self 2G4 905.58 1023.27 562.73 460.54 85.49
Virginia CareFirst BlueChoice - Standard Self & Family 2G5 2151.59 2431.30 1324.74 1106.56 198.92
Virginia CareFirst BlueChoice - Standard Self Plus One 2G6 1811.12 2046.57 1214.46 832.11 157.69
Virginia CareFirst BlueChoice - HDHP Self B61 604.31 691.90 518.93 172.97 21.89
Virginia CareFirst BlueChoice - HDHP Self & Family B62 1435.79 1643.96 1232.97 410.99 52.04
Virginia CareFirst BlueChoice - HDHP Self Plus One B63 1208.57 1383.85 1037.89 345.96 43.82
Virginia CareFirst BlueChoice - Blue Value Plus Self B64 723.67 759.83 562.73 197.10 3.96
Virginia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1805.35 1324.74 480.61 5.18
Virginia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1519.68 1139.76 379.92 18.10
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 368.90 379.73 284.80 94.93 2.71
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1051.33 1068.34 801.26 267.08 4.25
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 866.91 907.18 680.39 226.79 10.06
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 607.25 635.27 476.45 158.82 7.01
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1396.63 1461.09 1095.82 365.27 16.11
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1396.63 1461.09 1095.82 365.27 16.11
Virginia Kaiser Permanente - Mid-Atlantic States - High Self E31 756.60 790.90 562.73 228.17 2.10
Virginia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1740.20 1819.03 1324.74 494.29 -1.96
Virginia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1740.20 1819.03 1214.46 604.57 1.07
Virginia M.D. IPA - High Self JP1 1011.99 1065.78 562.73 503.05 21.59
Virginia M.D. IPA - High Self & Family JP2 2837.66 2988.44 1324.74 1663.70 69.99
Virginia M.D. IPA - High Self Plus One JP3 1976.43 2081.45 1214.46 866.99 27.26
Virginia Optima Health - HDHP Self PG4 568.79 585.87 439.40 146.47 4.27
Virginia Optima Health - HDHP Self & Family PG5 1254.67 1292.31 969.23 323.08 9.41
Virginia Optima Health - HDHP Self Plus One PG6 1230.10 1267.00 950.25 316.75 9.23
Virginia Optima Health - High Self PG1 719.55 805.91 562.73 243.18 54.16
Virginia Optima Health - High Self & Family PG2 1738.69 1947.34 1324.74 622.60 127.86
Virginia Optima Health - High Self Plus One PG3 1738.56 1947.18 1214.46 732.72 130.86
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 650.91 711.79 533.84 177.95 15.22
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1539.46 1683.37 1262.53 420.84 35.98
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1399.49 1530.34 1147.76 382.58 32.71
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 661.81 665.19 498.89 166.30 0.85
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1514.20 1529.86 1147.40 382.46 3.91
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1422.92 1430.13 1072.60 357.53 1.80
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 822.16 908.01 562.73 345.28 53.65
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1948.55 2151.93 1324.74 827.19 122.59
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1767.68 1952.17 1214.46 737.71 106.73
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 663.76 697.00 522.75 174.25 8.31
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1586.41 1672.80 1254.60 418.20 21.60
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1327.54 1481.16 1110.87 370.29 38.41
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 581.25 675.42 506.57 168.85 23.54
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1374.69 1597.35 1198.01 399.34 55.67
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1249.71 1452.14 1089.11 363.03 50.60
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 628.27 641.42 481.07 160.35 3.28
Washington Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Washington Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 834.38 874.06 562.73 311.33 7.48
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1911.07 2001.94 1324.74 677.20 10.08
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1873.63 1962.70 1214.46 748.24 11.31
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1135.10 1152.41 562.73 589.68 -14.89
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2589.21 2628.64 1324.74 1303.90 -41.36
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2563.60 2602.64 1214.46 1388.18 -38.72
Washington Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Washington Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Washington Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Washington Kaiser Permanente - Northwest - Standard Self 574 668.89 695.35 521.51 173.84 6.62
Washington Kaiser Permanente - Northwest - Standard Self & Family 575 1536.64 1597.48 1198.11 399.37 15.21
Washington Kaiser Permanente - Northwest - Standard Self Plus One 576 1536.64 1597.48 1198.11 399.37 -0.57
Washington Kaiser Permanente - Northwest - High Self 571 757.66 798.22 562.73 235.49 8.36
Washington Kaiser Permanente - Northwest - High Self & Family 572 1711.34 1802.91 1324.74 478.17 10.78
Washington Kaiser Permanente - Northwest - High Self Plus One 573 1711.34 1802.91 1214.46 588.45 13.81
Washington Kaiser Permanente - Northwest - Prosper Self AM1 391.78 410.63 307.97 102.66 4.72
Washington Kaiser Permanente - Northwest - Prosper Self & Family AM2 971.66 1018.38 763.79 254.59 11.68
Washington Kaiser Permanente - Northwest - Prosper Self Plus One AM3 842.29 882.81 662.11 220.70 10.13
Washington Kaiser Permanente - Washington Core - Standard Self 544 625.21 640.86 480.65 160.21 3.91
Washington Kaiser Permanente - Washington Core - Standard Self & Family 545 1438.00 1473.94 1105.46 368.48 8.98
Washington Kaiser Permanente - Washington Core - Standard Self Plus One 546 1438.00 1473.94 1105.46 368.48 8.98
Washington Kaiser Permanente - Washington Core - High Self 541 869.53 902.79 562.73 340.06 1.06
Washington Kaiser Permanente - Washington Core - High Self & Family 542 1912.93 1986.12 1324.74 661.38 -7.60
Washington Kaiser Permanente - Washington Core - High Self Plus One 543 1912.93 1986.12 1214.46 771.66 -4.57
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 758.05 676.00 507.00 169.00 -58.52
Washington Kaiser Permanente Washington Options Federal - Standard Self & Family L12 1682.83 1500.70 1125.53 375.17 -63.71
Washington Kaiser Permanente Washington Options Federal - Standard Self Plus One L13 1682.83 1500.70 1125.53 375.17 -170.96
Washington Kaiser Permanente Washington Options Federal - HDHP Self L14 675.18 719.98 539.99 179.99 11.20
Washington Kaiser Permanente Washington Options Federal - HDHP Self & Family L15 1498.84 1598.26 1198.70 399.56 24.85
Washington Kaiser Permanente Washington Options Federal - HDHP Self Plus One L16 1498.84 1598.26 1198.70 399.56 24.85
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 668.46 709.71 532.28 177.43 10.32
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1580.91 1678.47 1258.85 419.62 24.39
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1437.17 1525.88 1144.41 381.47 22.18
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 672.10 708.63 531.47 177.16 9.14
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1545.85 1629.77 1222.33 407.44 20.98
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1445.04 1523.51 1142.63 380.88 19.62
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 864.87 963.45 562.73 400.72 66.38
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2162.16 2408.62 1324.74 1083.88 165.67
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1859.46 2071.40 1214.46 856.94 134.18
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 657.65 634.34 475.76 158.58 -5.83
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1555.39 1500.18 1125.14 375.04 -13.81
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1413.97 1363.81 1022.86 340.95 -12.54
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 628.27 641.42 481.07 160.35 3.28
West Virginia Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
West Virginia Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 870.65 978.21 562.73 415.48 75.36
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1985.10 2230.43 1324.74 905.69 164.54
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1965.45 2208.33 1214.46 993.87 165.12
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 895.53 1008.28 562.73 445.55 80.55
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2050.64 2308.89 1324.74 984.15 177.46
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2010.45 2263.58 1214.46 1049.12 175.37
West Virginia Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
West Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
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 628.27 641.42 481.07 160.35 3.28
Wisconsin Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Wisconsin Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.51 1106.97 562.73 544.24 -19.74
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.64 2527.05 1324.74 1202.31 -52.38
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2473.94 2502.07 1214.46 1287.61 -49.63
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1037.34 1166.40 562.73 603.67 96.86
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2364.66 2658.89 1324.74 1334.15 213.44
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2341.24 2632.54 1214.46 1418.08 213.54
Wisconsin Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Wisconsin Dean Health Plan, Inc. - High Self WD1 1284.57 1367.71 562.73 804.98 50.94
Wisconsin Dean Health Plan, Inc. - High Self & Family WD2 2954.53 3145.76 1324.74 1821.02 110.44
Wisconsin Dean Health Plan, Inc. - High Self Plus One WD3 2697.61 2872.22 1214.46 1657.76 96.85
Wisconsin Dean Health Plan, Inc. - Standard Self WD4 712.42 738.51 553.88 184.63 2.74
Wisconsin Dean Health Plan, Inc. - Standard Self & Family WD5 1709.80 1772.44 1324.74 447.70 -18.15
Wisconsin Dean Health Plan, Inc. - Standard Self Plus One WD6 1567.32 1624.74 1214.46 410.28 -20.34
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 1089.03 1113.47 562.73 550.74 -7.76
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self & Family WJ2 2831.62 2895.14 1324.74 1570.40 -17.27
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self Plus One WJ3 2395.94 2449.72 1214.46 1235.26 -23.98
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self WJ4 587.45 641.03 480.77 160.26 13.40
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self & Family WJ5 1527.44 1666.75 1250.06 416.69 34.83
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self Plus One WJ6 1292.44 1410.33 1057.75 352.58 29.47
Wisconsin HealthPartners - Standard Self V34 553.28 553.28 414.96 138.32 0.00
Wisconsin HealthPartners - Standard Self & Family V35 1347.84 1347.84 1010.88 336.96 0.00
Wisconsin HealthPartners - Standard Self Plus One V36 1222.78 1222.78 917.09 305.69 0.00
Wisconsin HealthPartners - High Self V31 692.14 737.17 552.88 184.29 11.26
Wisconsin HealthPartners - High Self & Family V32 1686.01 1795.73 1324.74 470.99 28.93
Wisconsin HealthPartners - High Self Plus One V33 1529.58 1629.12 1214.46 414.66 21.78
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 628.27 641.42 481.07 160.35 3.28
Wyoming Aetna Direct - CDHP Self & Family N62 1584.48 1617.57 1213.18 404.39 8.27
Wyoming Aetna Direct - CDHP Self Plus One N63 1377.87 1406.67 1055.00 351.67 7.20
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.19 864.93 562.73 302.20 6.54
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1883.22 1971.52 1324.74 646.78 7.51
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1864.96 1952.41 1214.46 737.95 9.69
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 833.73 901.16 562.73 338.43 35.23
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1913.45 2068.11 1324.74 743.37 73.87
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1875.94 2027.59 1214.46 813.13 73.89
Wyoming Aetna HealthFund HDHP - HDHP Self 224 824.31 832.65 562.73 269.92 -23.86
Wyoming Aetna HealthFund HDHP - HDHP Self & Family 225 1818.25 1836.66 1324.74 511.92 -62.38
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One 226 1782.63 1800.72 1214.46 586.26 -59.67
Wyoming Altius Health Plan - High Self 9K1 1150.85 1214.72 562.73 651.99 31.67
Wyoming Altius Health Plan - High Self & Family 9K2 2545.10 2686.39 1324.74 1361.65 60.50
Wyoming Altius Health Plan - High Self Plus One 9K3 2519.92 2659.82 1214.46 1445.36 62.14
Wyoming Altius Health Plan - HDHP Self 9K4 759.22 794.89 562.73 232.16 3.47
Wyoming Altius Health Plan - HDHP Self & Family 9K5 1586.72 1661.25 1245.94 415.31 18.63
Wyoming Altius Health Plan - HDHP Self Plus One 9K6 1555.56 1628.62 1214.46 414.16 -4.70
Wyoming Altius Health Plan - Standard Self DK4 942.54 993.35 562.73 430.62 18.61
Wyoming Altius Health Plan - Standard Self & Family DK5 2081.43 2193.69 1324.74 868.95 31.47
Wyoming Altius Health Plan - Standard Self Plus One DK6 2060.80 2171.95 1214.46 957.49 33.39
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