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Tribal Premium Rates for the Federal Employees Health Benefits Program
HMO (Regional Plans with Specific Service Areas)
Alabama Aetna Advantage - Advantage Self
Z24
500.02
500.02
375.02
125.00
0.00
Alabama Aetna Advantage - Advantage Self & Family
Z25
1325.00
1325.00
993.75
331.25
0.00
Alabama Aetna Advantage - Advantage Self Plus One
Z26
1100.02
1100.02
825.02
275.00
0.00
Alabama Aetna Direct - CDHP Self
N61
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
U.S. Office of Personnel Management
1900 E Street, NW, Washington, DC 20415
202-606-1800
Federal Relay Service