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Healthcare

Tribal Premium Rates for the Federal Employees Health Benefits Program

HMO (Regional Plans with Specific Service Areas)

Plan - Option Enrollment Code 2018 Total Monthly Premium 2019 Monthly Premium Rates - Total Premium 2019 Monthly Premium Rates - Tribal Employer Pays 2019 Monthly Premium Rates - Employee Pays 2019 Monthly Premium Rates - Change in Employee Payment
Alabama Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Alabama Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Alabama Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Alabama Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Alabama Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Alabama Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Alabama KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Alabama KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Alabama KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Alabama LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Alabama LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Alabama LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
Alaska Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Alaska Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Alaska Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Alaska Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Alaska Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Alaska Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Arizona Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Arizona Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Arizona Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Arizona Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Arizona Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Arizona Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Arizona BF - High Self BF1 1131.67 1361.43 498.72 862.71 227.75
Arizona BF - High Self & Family BF2 2546.25 3063.15 1138.19 1924.96 508.80
Arizona BF - High Self Plus One BF3 2433.08 2926.99 1066.59 1860.40 491.15
Arizona BF - Standard Self BF4 794.13 916.07 498.72 417.35 119.93
Arizona BF - Standard Self & Family BF5 1786.79 2061.17 1138.19 922.98 266.28
Arizona BF - Standard Self Plus One BF6 1707.36 1969.57 1066.59 902.98 259.45
Arizona C7 - Standard Self C74 676.93 726.57 498.72 227.85 47.63
Arizona C7 - Standard Self & Family C75 1523.06 1634.73 1138.19 496.54 103.57
Arizona C7 - Standard Self Plus One C76 1455.35 1562.06 1066.59 495.47 103.95
Arizona C7 - High Self C71 819.48 862.59 498.72 363.87 41.10
Arizona C7 - High Self & Family C72 1843.81 1940.84 1138.19 802.65 88.93
Arizona C7 - High Self Plus One C73 1761.87 1854.58 1066.59 787.99 89.95
Arizona KT - High Self KT1 610.68 679.19 498.72 180.47 27.80
Arizona KT - High Self & Family KT2 1526.70 1697.95 1138.19 559.76 163.15
Arizona KT - High Self Plus One KT3 1312.96 1460.23 1066.59 393.64 65.40
Arizona LU - HDHP Self LU1 482.91 450.32 337.74 112.58 -8.15
Arizona LU - HDHP Self & Family LU2 1207.25 1035.73 776.80 258.93 -42.88
Arizona LU - HDHP Self Plus One LU3 1038.25 968.20 726.15 242.05 -17.51
Arizona R6 - CDHP Self R61 637.93 678.10 498.72 179.38 19.90
Arizona R6 - CDHP Self & Family R62 1435.37 1525.70 1138.19 387.51 28.67
Arizona R6 - CDHP Self Plus One R63 1371.59 1457.91 1066.59 391.32 48.42
Arizona R6 - Value Self R64 519.70 542.01 406.51 135.50 5.58
Arizona R6 - Value Self & Family R65 1169.31 1219.51 914.63 304.88 12.55
Arizona R6 - Value Self Plus One R66 1117.31 1165.32 873.99 291.33 12.00
Arizona R9 - Value Self R94 492.77 494.15 370.61 123.54 0.35
Arizona R9 - Value Self & Family R95 1108.71 1111.85 833.89 277.96 0.78
Arizona R9 - Value Self Plus One R96 1059.44 1062.45 796.84 265.61 0.75
Arizona R9 - CDHP Self R91 618.89 620.64 465.48 155.16 0.44
Arizona R9 - CDHP Self & Family R92 1392.47 1396.42 1047.32 349.10 0.98
Arizona R9 - CDHP Self Plus One R93 1330.59 1334.34 1000.76 333.58 0.93
Arizona WQ - High Self WQ1 1132.60 1125.02 498.72 626.30 -9.59
Arizona WQ - High Self & Family WQ2 2749.87 2731.52 1138.19 1593.33 -26.45
Arizona WQ - High Self Plus One WQ3 2722.63 2704.46 1066.59 1637.87 -20.93
Arkansas Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Arkansas Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Arkansas Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Arkansas Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Arkansas Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Arkansas DH - High Self DH1 733.59 716.37 498.72 217.65 -19.23
Arkansas DH - High Self & Family DH2 1913.45 1868.49 1138.19 730.30 -53.06
Arkansas DH - High Self Plus One DH3 1425.04 1391.56 1043.67 347.89 -13.32
Arkansas DH - Standard Self DH4 572.11 559.30 419.48 139.82 -3.21
Arkansas DH - Standard Self & Family DH5 1492.21 1458.82 1094.12 364.70 -8.35
Arkansas DH - Standard Self Plus One DH6 1111.33 1086.45 814.84 271.61 -6.22
Arkansas KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Arkansas KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Arkansas KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Arkansas LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Arkansas LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Arkansas LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
California 2X - High Self 2X1 751.40 763.92 498.72 265.20 10.51
California 2X - High Self & Family 2X2 1763.99 1793.44 1138.19 655.25 21.35
California 2X - High Self Plus One 2X3 1729.41 1758.27 1066.59 691.68 26.10
California 59 - High Self 591 920.49 992.49 498.72 493.77 69.99
California 59 - High Self & Family 592 2197.33 2369.14 1138.19 1230.95 163.71
California 59 - High Self Plus One 593 2197.33 2369.14 1066.59 1302.55 169.05
California 59 - Standard Self 594 759.31 797.57 498.72 298.85 36.25
California 59 - Standard Self & Family 595 1776.80 1866.28 1138.19 728.09 81.38
California 59 - Standard Self Plus One 596 1776.80 1866.28 1066.59 799.69 86.72
California 62 - Standard Self 624 415.78 431.36 323.52 107.84 3.90
California 62 - Standard Self & Family 625 961.03 996.93 747.70 249.23 8.97
California 62 - Standard Self Plus One 626 961.03 996.93 747.70 249.23 8.97
California 62 - High Self 621 658.15 687.20 498.72 188.48 23.94
California 62 - High Self & Family 622 1521.15 1588.25 1138.19 450.06 59.00
California 62 - High Self Plus One 623 1521.15 1588.25 1066.59 521.66 64.34
California Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
California Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
California Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
California Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
California Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
California Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
California B3 - High Self B31 778.38 770.29 498.72 271.57 -10.10
California B3 - High Self & Family B32 1704.63 1733.18 1138.19 594.99 20.45
California B3 - High Self Plus One B33 1595.66 1609.94 1066.59 543.35 11.52
California KC - Basic Self KC1 645.39 640.81 480.61 160.20 -1.15
California KC - Basic Self & Family KC2 1510.21 1499.44 1124.58 374.86 -5.26
California KC - Basic Self Plus One KC3 1510.21 1499.44 1066.59 432.85 -13.53
California LB - High Self LB1 1383.57 1361.40 498.72 862.68 -24.18
California LB - High Self & Family LB2 3320.55 3267.38 1138.19 2129.19 -61.27
California LB - High Self Plus One LB3 3043.86 2995.09 1066.59 1928.50 -51.53
California LB - Standard Self LB4 1306.41 1289.41 498.72 790.69 -19.01
California LB - Standard Self & Family LB5 3135.41 3094.59 1138.19 1956.40 -48.92
California LB - Standard Self Plus One LB6 2874.13 2836.71 1066.59 1770.12 -40.18
California LP - Standard Self LP4 875.55 945.64 498.72 446.92 68.08
California LP - Standard Self & Family LP5 2101.36 2269.54 1138.19 1131.35 160.08
California LP - Standard Self Plus One LP6 1926.23 2080.41 1066.59 1013.82 151.42
California LP - High Self LP1 913.55 993.05 498.72 494.33 77.49
California LP - High Self & Family LP2 2192.49 2383.33 1138.19 1245.14 182.74
California LP - High Self Plus One LP3 2009.80 2184.72 1066.59 1118.13 172.16
California NZ - Standard Self NZ4 511.64 534.67 401.00 133.67 5.76
California NZ - Standard Self & Family NZ5 1182.50 1235.72 926.79 308.93 13.31
California NZ - Standard Self Plus One NZ6 1182.50 1235.72 926.79 308.93 13.31
California NZ - High Self NZ1 713.81 731.03 498.72 232.31 15.21
California NZ - High Self & Family NZ2 1649.79 1689.55 1138.19 551.36 31.66
California NZ - High Self Plus One NZ3 1649.79 1689.55 1066.59 622.96 37.00
California P6 - Basic Self P61 306.41 332.37 249.28 83.09 6.49
California P6 - Basic Self & Family P62 735.39 797.70 598.28 199.42 15.57
California P6 - Basic Self Plus One P63 674.14 731.23 548.42 182.81 14.28
California SI - High Self SI1 742.17 779.29 498.72 280.57 35.11
California SI - High Self & Family SI2 1707.03 1792.40 1138.19 654.21 77.27
California SI - High Self Plus One SI3 1632.80 1714.44 1066.59 647.85 78.88
California SI - Standard Self SI4 New Plan 705.08 498.72 206.36 New Plan
California SI - Standard Self & Family SI5 New Plan 1621.69 1138.19 483.50 New Plan
California SI - Standard Self Plus One SI6 New Plan 1551.18 1066.59 484.59 New Plan
California T4 - Basic Self T41 787.17 790.29 498.72 291.57 1.11
California T4 - Basic Self & Family T42 1889.23 1896.70 1138.19 758.51 -0.63
California T4 - Basic Self Plus One T43 1731.77 1738.62 1066.59 672.03 4.09
Colorado 65 - Standard Self 654 511.10 586.67 440.00 146.67 18.90
Colorado 65 - Standard Self & Family 655 1155.09 1325.91 994.43 331.48 42.71
Colorado 65 - Standard Self Plus One 656 1155.09 1325.91 994.43 331.48 42.71
Colorado 65 - High Self 651 704.23 738.94 498.72 240.22 32.70
Colorado 65 - High Self & Family 652 1591.55 1670.05 1138.19 531.86 70.40
Colorado 65 - High Self Plus One 653 1591.55 1670.05 1066.59 603.46 75.74
Colorado Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Colorado Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Colorado Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Colorado Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Colorado Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Colorado Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Colorado KT - High Self KT1 610.68 679.19 498.72 180.47 27.80
Colorado KT - High Self & Family KT2 1526.70 1697.95 1138.19 559.76 163.15
Colorado KT - High Self Plus One KT3 1312.96 1460.23 1066.59 393.64 65.40
Colorado LU - HDHP Self LU1 482.91 450.32 337.74 112.58 -8.15
Colorado LU - HDHP Self & Family LU2 1207.25 1035.73 776.80 258.93 -42.88
Colorado LU - HDHP Self Plus One LU3 1038.25 968.20 726.15 242.05 -17.51
Colorado N4 - Basic Self N41 401.48 429.85 322.39 107.46 7.09
Colorado N4 - Basic Self & Family N42 907.36 971.43 728.57 242.86 16.02
Colorado N4 - Basic Self Plus One N43 907.36 971.43 728.57 242.86 16.02
Colorado NR - High Self NR1 637.13 696.22 498.72 197.50 38.22
Colorado NR - High Self & Family NR2 1433.53 1566.46 1138.19 428.27 69.89
Colorado NR - High Self Plus One NR3 1369.81 1496.84 1066.59 430.25 87.80
Colorado NR - Standard Self NR4 500.96 522.30 391.73 130.57 5.33
Colorado NR - Standard Self & Family NR5 1127.17 1175.20 881.40 293.80 12.01
Colorado NR - Standard Self Plus One NR6 1077.07 1122.94 842.21 280.73 11.46
Colorado NT - High Self NT1 625.32 626.86 470.15 156.71 0.38
Colorado NT - High Self & Family NT2 1406.97 1410.48 1057.86 352.62 0.88
Colorado NT - High Self Plus One NT3 1344.44 1347.75 1010.81 336.94 0.83
Colorado NT - Standard Self NT4 526.50 501.41 376.06 125.35 -6.27
Colorado NT - Standard Self & Family NT5 1184.63 1128.21 846.16 282.05 -14.11
Colorado NT - Standard Self Plus One NT6 1131.95 1078.09 808.57 269.52 -13.47
Colorado R2 - Basic Self R21 471.40 491.77 368.83 122.94 5.09
Colorado R2 - Basic Self & Family R22 1060.65 1106.50 829.88 276.62 11.46
Colorado R2 - Basic Self Plus One R23 1013.50 1057.31 792.98 264.33 10.96
Colorado RZ - Basic Self RZ1 495.41 496.95 372.71 124.24 0.39
Colorado RZ - Basic Self & Family RZ2 1114.71 1118.13 838.60 279.53 0.85
Colorado RZ - Basic Self Plus One RZ3 1065.16 1068.47 801.35 267.12 0.83
Colorado WW - High Self WW1 New Plan 594.71 446.03 148.68 New Plan
Colorado WW - High Self & Family WW2 New Plan 1448.11 1086.08 362.03 New Plan
Colorado WW - High Self Plus One WW3 New Plan 1352.95 1014.71 338.24 New Plan
Connecticut Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Connecticut Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Connecticut Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Connecticut Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Connecticut Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Delaware Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Delaware Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Delaware Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Delaware Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Delaware Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Delaware Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Delaware P3 - Basic Self P34 1348.08 1298.46 498.72 799.74 -51.63
Delaware P3 - Basic Self & Family P35 3128.88 3013.75 1138.19 1875.56 -123.23
Delaware P3 - Basic Self Plus One P36 3097.90 2983.89 1066.59 1917.30 -116.77
Delaware P3 - High Self P31 1572.42 1485.21 498.72 986.49 -89.22
Delaware P3 - High Self & Family P32 3812.34 3600.91 1138.19 2462.72 -219.53
Delaware P3 - High Self Plus One P33 3774.57 3565.25 1066.59 2498.66 -212.08
District Of Columbia 2G - Standard Self 2G4 693.62 797.68 498.72 298.96 102.05
District Of Columbia 2G - Standard Self & Family 2G5 1648.05 1895.25 1138.19 757.06 239.10
District Of Columbia 2G - Standard Self Plus One 2G6 1387.25 1595.34 1066.59 528.75 181.94
District Of Columbia Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
District Of Columbia Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
District Of Columbia Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
District Of Columbia Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
District Of Columbia B6 - HDHP Self B61 609.72 518.27 388.70 129.57 -22.86
District Of Columbia B6 - HDHP Self & Family B62 1448.68 1231.38 923.54 307.84 -54.33
District Of Columbia B6 - HDHP Self Plus One B63 1219.44 1036.51 777.38 259.13 -45.73
District Of Columbia E3 - Standard Self E34 504.96 521.76 391.32 130.44 4.20
District Of Columbia E3 - Standard Self & Family E35 1161.49 1199.99 899.99 300.00 9.63
District Of Columbia E3 - Standard Self Plus One E36 1161.49 1199.99 899.99 300.00 9.63
District Of Columbia E3 - High Self E31 660.36 692.68 498.72 193.96 28.87
District Of Columbia E3 - High Self & Family E32 1518.83 1593.15 1138.19 454.96 66.22
District Of Columbia E3 - High Self Plus One E33 1518.83 1593.15 1066.59 526.56 71.56
District Of Columbia JN - High Self JN1 1103.09 1119.13 498.72 620.41 14.03
District Of Columbia JN - High Self & Family JN2 2479.95 2515.98 1138.19 1377.79 27.93
District Of Columbia JN - High Self Plus One JN3 2455.38 2491.04 1066.59 1424.45 32.90
District Of Columbia JN - Basic Self JN4 662.85 680.46 498.72 181.74 15.60
District Of Columbia JN - Basic Self & Family JN5 1516.95 1557.25 1138.19 419.06 32.20
District Of Columbia JN - Basic Self Plus One JN6 1392.99 1430.00 1066.59 363.41 15.16
District Of Columbia JP - High Self JP1 717.77 790.86 498.72 292.14 71.08
District Of Columbia JP - High Self & Family JP2 2012.66 2217.54 1138.19 1079.35 196.78
District Of Columbia JP - High Self Plus One JP3 1401.81 1544.53 1066.59 477.94 127.49
District Of Columbia L9 - Value Self L91 463.32 437.06 327.80 109.26 -6.57
District Of Columbia L9 - Value Self & Family L92 1299.18 1225.49 919.12 306.37 -18.42
District Of Columbia L9 - Value Self Plus One L93 904.89 853.56 640.17 213.39 -12.83
District Of Columbia LR - High Self LR1 607.99 667.94 498.72 169.22 17.22
District Of Columbia LR - High Self & Family LR2 1520.00 1582.99 1138.19 444.80 54.89
District Of Columbia LR - High Self Plus One LR3 1307.19 1436.05 1066.59 369.46 42.66
District Of Columbia T7 - Basic Self T71 460.03 420.12 315.09 105.03 -9.98
District Of Columbia T7 - Basic Self & Family T72 1104.50 1026.16 769.62 256.54 -19.58
District Of Columbia T7 - Basic Self Plus One T73 1006.22 934.90 701.18 233.72 -17.83
District Of Columbia V4 - HDHP Self V41 566.97 495.69 371.77 123.92 -17.82
District Of Columbia V4 - HDHP Self & Family V42 1417.48 1140.06 855.05 285.01 -69.36
District Of Columbia V4 - HDHP Self Plus One V43 1219.01 1065.72 799.29 266.43 -38.32
Florida Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Florida Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Florida Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Florida Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Florida Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Florida Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Florida E2 - Standard Self E24 579.52 633.64 475.23 158.41 13.53
Florida E2 - Standard Self & Family E25 1303.92 1425.67 1069.25 356.42 30.44
Florida E2 - Standard Self Plus One E26 1245.96 1362.29 1021.72 340.57 29.08
Florida E2 - High Self E21 877.91 985.77 498.72 487.05 105.85
Florida E2 - High Self & Family E22 1975.31 2217.93 1138.19 1079.74 234.52
Florida E2 - High Self Plus One E23 1887.56 2119.35 1066.59 1052.76 229.03
Florida EA - High Self EA1 665.04 690.41 498.72 191.69 23.36
Florida EA - High Self & Family EA2 1795.69 1726.08 1138.19 587.89 -77.71
Florida EA - High Self Plus One EA3 1330.14 1484.41 1066.59 417.82 85.29
Florida EE - High Self EE1 876.70 914.05 498.72 415.33 35.34
Florida EE - High Self & Family EE2 1972.60 2056.62 1138.19 918.43 75.92
Florida EE - High Self Plus One EE3 1884.91 1965.25 1066.59 898.66 77.58
Florida EE - Standard Self EE4 761.48 817.31 498.72 318.59 53.82
Florida EE - Standard Self & Family EE5 1713.29 1838.92 1138.19 700.73 117.53
Florida EE - Standard Self Plus One EE6 1637.16 1757.19 1066.59 690.60 117.27
Florida EX - High Self EX1 687.64 744.51 498.72 245.79 54.86
Florida EX - High Self & Family EX2 1547.13 1675.09 1138.19 536.90 119.86
Florida EX - High Self Plus One EX3 1478.36 1600.63 1066.59 534.04 119.51
Florida EX - Standard Self EX4 603.46 653.77 490.33 163.44 12.58
Florida EX - Standard Self & Family EX5 1357.81 1470.97 1103.23 367.74 28.29
Florida EX - Standard Self Plus One EX6 1297.47 1405.60 1054.20 351.40 27.03
Florida KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Florida KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Florida KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Florida LL - Standard Self LL4 792.85 866.91 498.72 368.19 72.05
Florida LL - Standard Self & Family LL5 1783.90 1950.48 1138.19 812.29 158.48
Florida LL - Standard Self Plus One LL6 1704.63 1863.81 1066.59 797.22 156.42
Florida LL - High Self LL1 1361.69 1610.81 498.72 1112.09 247.11
Florida LL - High Self & Family LL2 3063.80 3624.31 1138.19 2486.12 552.41
Florida LL - High Self Plus One LL3 2927.62 3463.24 1066.59 2396.65 532.86
Florida LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Florida LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Florida LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
Florida LV - Value Self LV1 630.05 662.03 496.52 165.51 8.00
Florida LV - Value Self & Family LV2 1766.72 1986.10 1138.19 847.91 211.28
Florida LV - Value Self Plus One LV3 1230.52 1423.37 1066.59 356.78 49.15
Florida MJ - Value Self MJ4 493.22 504.49 378.37 126.12 2.82
Florida MJ - Value Self & Family MJ5 1109.72 1135.10 851.33 283.77 6.34
Florida MJ - Value Self Plus One MJ6 1060.39 1084.63 813.47 271.16 6.06
Florida MJ - CDHP Self MJ1 803.51 854.10 498.72 355.38 48.58
Florida MJ - CDHP Self & Family MJ2 1807.91 1921.75 1138.19 783.56 105.74
Florida MJ - CDHP Self Plus One MJ3 1727.57 1836.36 1066.59 769.77 106.03
Florida ML - Standard Self ML4 684.71 709.22 498.72 210.50 22.50
Florida ML - Standard Self & Family ML5 1773.63 1837.05 1138.19 698.86 55.32
Florida ML - Standard Self Plus One ML6 1369.46 1418.43 1063.82 354.61 12.25
Florida QP - CDHP Self QP1 682.11 684.02 498.72 185.30 -0.10
Florida QP - CDHP Self & Family QP2 1536.77 1541.09 1138.19 402.90 -3.78
Florida QP - CDHP Self Plus One QP3 1468.48 1472.58 1066.59 405.99 1.34
Florida QP - Value Self QP4 488.56 489.95 367.46 122.49 0.35
Florida QP - Value Self & Family QP5 1099.26 1102.36 826.77 275.59 0.78
Florida QP - Value Self Plus One QP6 1050.42 1053.37 790.03 263.34 0.74
Florida W9 - Value Self W94 New Plan 485.23 363.92 121.31 New Plan
Florida W9 - Value Self & Family W95 New Plan 1091.78 818.84 272.94 New Plan
Florida W9 - Value Self Plus One W96 New Plan 1043.25 782.44 260.81 New Plan
Florida W9 - CDHP Self W91 New Plan 573.58 430.19 143.39 New Plan
Florida W9 - CDHP Self & Family W92 New Plan 1290.58 967.94 322.64 New Plan
Florida W9 - CDHP Self Plus One W93 New Plan 1233.20 924.90 308.30 New Plan
Florida WZ - HDHP Self WZ1 New Plan 813.30 498.72 314.58 New Plan
Florida WZ - HDHP Self & Family WZ2 New Plan 2003.32 1138.19 865.13 New Plan
Florida WZ - HDHP Self Plus One WZ3 New Plan 1561.60 1066.59 495.01 New Plan
Florida X2 - Value Self X24 New Plan 470.30 352.73 117.57 New Plan
Florida X2 - Value Self & Family X25 New Plan 1058.16 793.62 264.54 New Plan
Florida X2 - Value Self Plus One X26 New Plan 1011.14 758.36 252.78 New Plan
Florida X2 - CDHP Self X21 New Plan 555.92 416.94 138.98 New Plan
Florida X2 - CDHP Self & Family X22 New Plan 1250.82 938.12 312.70 New Plan
Florida X2 - CDHP Self Plus One X23 New Plan 1195.24 896.43 298.81 New Plan
Georgia 2U - High Self 2U1 1211.43 1584.29 498.72 1085.57 370.85
Georgia 2U - High Self & Family 2U2 2790.49 3649.36 1138.19 2511.17 850.77
Georgia 2U - High Self Plus One 2U3 2762.85 3613.22 1066.59 2546.63 847.61
Georgia AD - Value Self AD4 547.21 658.52 493.89 164.63 27.83
Georgia AD - Value Self & Family AD5 1231.23 1481.61 1111.21 370.40 62.59
Georgia AD - Value Self Plus One AD6 1176.50 1415.77 1061.83 353.94 59.82
Georgia AD - CDHP Self AD1 716.76 797.83 498.72 299.11 79.06
Georgia AD - CDHP Self & Family AD2 1612.72 1795.13 1138.19 656.94 174.31
Georgia AD - CDHP Self Plus One AD3 1541.06 1715.35 1066.59 648.76 171.53
Georgia Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Georgia Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Georgia Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Georgia Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Georgia Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Georgia Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Georgia CB - Standard Self CB4 834.47 976.91 498.72 478.19 140.43
Georgia CB - Standard Self & Family CB5 1877.57 2198.06 1138.19 1059.87 312.39
Georgia CB - Standard Self Plus One CB6 1794.13 2100.37 1066.59 1033.78 303.48
Georgia CB - High Self CB1 905.39 990.36 498.72 491.64 82.96
Georgia CB - High Self & Family CB2 2037.14 2228.42 1138.19 1090.23 183.18
Georgia CB - High Self Plus One CB3 1946.62 2129.34 1066.59 1062.75 179.96
Georgia DG - High Self DG1 1207.77 1283.43 498.72 784.71 73.65
Georgia DG - High Self & Family DG2 2717.46 2887.71 1138.19 1749.52 162.15
Georgia DG - High Self Plus One DG3 2596.71 2759.40 1066.59 1692.81 159.93
Georgia DG - Standard Self DG4 834.21 937.91 498.72 439.19 101.69
Georgia DG - Standard Self & Family DG5 1876.92 2110.29 1138.19 972.10 225.27
Georgia DG - Standard Self Plus One DG6 1793.50 2016.50 1066.59 949.91 220.24
Georgia DN - Standard Self DN4 682.80 684.93 498.72 186.21 0.12
Georgia DN - Standard Self & Family DN5 1536.32 1541.06 1138.19 402.87 -3.36
Georgia DN - Standard Self Plus One DN6 1468.03 1472.58 1066.59 405.99 1.79
Georgia DN - High Self DN1 713.18 736.41 498.72 237.69 21.22
Georgia DN - High Self & Family DN2 1604.63 1656.94 1138.19 518.75 44.21
Georgia DN - High Self Plus One DN3 1533.33 1583.31 1066.59 516.72 47.22
Georgia F8 - High Self F81 682.11 696.09 498.72 197.37 11.97
Georgia F8 - High Self & Family F82 1541.61 1573.15 1138.19 434.96 23.44
Georgia F8 - High Self Plus One F83 1541.61 1573.15 1066.59 506.56 28.78
Georgia F8 - Standard Self F84 512.98 526.20 394.65 131.55 3.31
Georgia F8 - Standard Self & Family F85 1159.32 1189.22 891.92 297.30 7.47
Georgia F8 - Standard Self Plus One F86 1159.32 1189.22 891.92 297.30 7.47
Georgia LM - CDHP Self LM1 599.97 631.71 473.78 157.93 7.94
Georgia LM - CDHP Self & Family LM2 1349.92 1421.42 1066.07 355.35 17.87
Georgia LM - CDHP Self Plus One LM3 1289.95 1358.24 1018.68 339.56 17.07
Georgia LM - Value Self LM4 474.63 514.02 385.52 128.50 9.84
Georgia LM - Value Self & Family LM5 1067.91 1156.57 867.43 289.14 22.16
Georgia LM - Value Self Plus One LM6 1020.44 1105.17 828.88 276.29 21.18
Georgia LV - Value Self LV1 630.05 662.03 496.52 165.51 8.00
Georgia LV - Value Self & Family LV2 1766.72 1986.10 1138.19 847.91 211.28
Georgia LV - Value Self Plus One LV3 1230.52 1423.37 1066.59 356.78 49.15
Georgia Q7 - Basic Self Q71 588.81 620.17 465.13 155.04 7.84
Georgia Q7 - Basic Self & Family Q72 1324.85 1395.38 1046.54 348.84 17.63
Georgia Q7 - Basic Self Plus One Q73 1265.96 1333.35 1000.01 333.34 16.85
Georgia QM - High Self QM1 572.50 595.40 446.55 148.85 5.73
Georgia QM - High Self & Family QM2 1531.44 1577.38 1138.19 439.19 37.84
Georgia QM - High Self Plus One QM3 1273.81 1318.40 988.80 329.60 11.15
Georgia RJ - Basic Self RJ1 546.11 564.24 423.18 141.06 4.53
Georgia RJ - Basic Self & Family RJ2 1228.76 1269.56 952.17 317.39 10.20
Georgia RJ - Basic Self Plus One RJ3 1174.14 1213.12 909.84 303.28 9.75
Georgia RM - Basic Self RM1 570.35 594.99 446.24 148.75 6.16
Georgia RM - Basic Self & Family RM2 1283.32 1338.74 1004.06 334.68 13.85
Georgia RM - Basic Self Plus One RM3 1226.29 1279.24 959.43 319.81 13.24
Georgia S9 - Value Self S94 504.08 520.65 390.49 130.16 4.14
Georgia S9 - Value Self & Family S95 1134.16 1171.47 878.60 292.87 9.33
Georgia S9 - Value Self Plus One S96 1083.77 1119.41 839.56 279.85 8.91
Georgia S9 - CDHP Self S91 633.10 653.92 490.44 163.48 5.21
Georgia S9 - CDHP Self & Family S92 1424.48 1471.32 1103.49 367.83 11.71
Georgia S9 - CDHP Self Plus One S93 1361.14 1405.93 1054.45 351.48 11.20
Guam Calvo's SelectCare - Standard Self B44 411.73 403.50 302.63 100.87 -2.06
Guam Calvo's SelectCare - Standard Self & Family B45 1100.82 1172.36 879.27 293.09 17.89
Guam Calvo's SelectCare - Standard Self Plus One B46 803.47 795.43 596.57 198.86 -2.01
Guam Calvo's SelectCare - High Self B41 468.72 518.09 388.57 129.52 12.34
Guam Calvo's SelectCare - High Self & Family B42 1253.18 1372.22 1029.17 343.05 29.76
Guam Calvo's SelectCare - High Self Plus One B43 914.68 1011.03 758.27 252.76 24.09
Guam JK - Standard Self JK4 405.17 389.81 292.36 97.45 -3.84
Guam JK - Standard Self & Family JK5 1147.40 1103.87 827.90 275.97 -10.88
Guam JK - Standard Self Plus One JK6 798.55 768.24 576.18 192.06 -7.58
Guam JK - High Self JK1 584.63 471.86 353.90 117.96 -28.20
Guam JK - High Self & Family JK2 1394.49 1125.52 844.14 281.38 -67.24
Guam JK - High Self Plus One JK3 1155.03 932.23 699.17 233.06 -55.70
Guam KX - HDHP Self KX1 127.92 103.72 77.79 25.93 -6.05
Guam KX - HDHP Self & Family KX2 342.96 278.05 208.54 69.51 -16.23
Guam KX - HDHP Self Plus One KX3 308.75 250.45 187.84 62.61 -14.58
Hawaii 63 - High Self 631 658.58 658.58 493.94 164.64 0.00
Hawaii 63 - High Self & Family 632 1468.63 1468.63 1101.47 367.16 0.00
Hawaii 63 - High Self Plus One 633 1468.63 1468.63 1066.59 402.04 -2.76
Hawaii 63 - Standard Self 634 444.69 444.69 333.52 111.17 0.00
Hawaii 63 - Standard Self & Family 635 991.64 991.64 743.73 247.91 0.00
Hawaii 63 - Standard Self Plus One 636 991.64 991.64 743.73 247.91 0.00
Hawaii 87 - High Self 871 606.95 606.95 455.21 151.74 0.00
Hawaii 87 - High Self & Family 872 1364.44 1364.44 1023.33 341.11 0.00
Hawaii 87 - High Self Plus One 873 1329.88 1329.88 997.41 332.47 0.00
Hawaii Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Hawaii Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Hawaii Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Hawaii Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Hawaii Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Idaho 54 - Standard Self 544 608.99 585.17 438.88 146.29 -5.96
Idaho 54 - Standard Self & Family 545 1400.66 1345.91 1009.43 336.48 -13.68
Idaho 54 - Standard Self Plus One 546 1400.66 1345.91 1009.43 336.48 -13.68
Idaho 54 - High Self 541 825.59 815.40 498.72 316.68 -12.20
Idaho 54 - High Self & Family 542 1816.32 1793.91 1138.19 655.72 -30.51
Idaho 54 - High Self Plus One 543 1816.32 1793.91 1066.59 727.32 -25.17
Idaho 9K - High Self 9K1 848.08 935.24 498.72 436.52 85.15
Idaho 9K - High Self & Family 9K2 1875.47 2068.26 1138.19 930.07 184.69
Idaho 9K - High Self Plus One 9K3 1856.90 2047.78 1066.59 981.19 188.12
Idaho 9K - HDHP Self 9K4 420.70 506.91 380.18 126.73 21.56
Idaho 9K - HDHP Self & Family 9K5 879.23 1059.41 794.56 264.85 45.04
Idaho 9K - HDHP Self Plus One 9K6 861.99 1038.64 778.98 259.66 44.16
Idaho Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Idaho Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Idaho Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Idaho Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Idaho Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Idaho Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Idaho DK - Standard Self DK4 593.60 712.44 498.72 213.72 65.32
Idaho DK - Standard Self & Family DK5 1310.81 1573.30 1138.19 435.11 107.41
Idaho DK - Standard Self Plus One DK6 1297.83 1557.70 1066.59 491.11 166.65
Illinois 75 - Standard Self 754 881.49 855.66 498.72 356.94 -27.84
Illinois 75 - Standard Self & Family 755 1983.35 1925.24 1138.19 787.05 -66.21
Illinois 75 - Standard Self Plus One 756 1895.16 1839.67 1066.59 773.08 -58.25
Illinois 75 - High Self 751 1261.67 1212.06 498.72 713.34 -51.62
Illinois 75 - High Self & Family 752 2838.72 2727.14 1138.19 1588.95 -119.68
Illinois 75 - High Self Plus One 753 2712.56 2605.92 1066.59 1539.33 -109.40
Illinois 76 - High Self 761 671.10 681.74 498.72 183.02 8.63
Illinois 76 - High Self & Family 762 1680.97 1711.71 1138.19 573.52 22.64
Illinois 76 - High Self Plus One 763 1474.16 1511.23 1066.59 444.64 34.31
Illinois 9F - High Self 9F1 1570.38 1700.27 498.72 1201.55 127.88
Illinois 9F - High Self & Family 9F2 3533.38 3825.60 1138.19 2687.41 284.12
Illinois 9F - High Self Plus One 9F3 3376.32 3655.56 1066.59 2588.97 276.48
Illinois 9G - High Self 9G1 733.92 782.36 498.72 283.64 46.43
Illinois 9G - High Self & Family 9G2 1588.93 1681.07 1138.19 542.88 84.04
Illinois 9G - High Self Plus One 9G3 1504.53 1591.81 1066.59 525.22 84.52
Illinois 9G - Standard Self 9G4 532.11 558.72 419.04 139.68 6.65
Illinois 9G - Standard Self & Family 9G5 1529.78 1587.91 1138.19 449.72 50.03
Illinois 9G - Standard Self Plus One 9G6 1383.46 1436.02 1066.59 369.43 23.57
Illinois AB - Standard Self AB4 1020.61 1094.77 498.72 596.05 72.15
Illinois AB - Standard Self & Family AB5 2296.39 2463.28 1138.19 1325.09 158.79
Illinois AB - Standard Self Plus One AB6 2194.31 2353.78 1066.59 1287.19 156.71
Illinois AB - Basic Self AB1 584.07 615.16 461.37 153.79 7.77
Illinois AB - Basic Self & Family AB2 1314.15 1384.15 1038.11 346.04 17.50
Illinois AB - Basic Self Plus One AB3 1255.74 1322.64 991.98 330.66 16.73
Illinois Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Illinois Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Illinois Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Illinois Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Illinois Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Illinois Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Illinois EY - High Self EY1 766.48 764.05 498.72 265.33 -4.44
Illinois EY - High Self & Family EY2 2000.27 1994.01 1138.19 855.82 -14.36
Illinois EY - High Self Plus One EY3 1647.95 1642.81 1066.59 576.22 -7.90
Illinois GB - Value Self GB4 516.51 616.37 462.28 154.09 24.96
Illinois GB - Value Self & Family GB5 1162.14 1386.82 1040.12 346.70 56.17
Illinois GB - Value Self Plus One GB6 1110.53 1325.18 993.89 331.29 53.66
Illinois GB - CDHP Self GB1 873.17 936.91 498.72 438.19 61.73
Illinois GB - CDHP Self & Family GB2 1964.60 2108.04 1138.19 969.85 135.34
Illinois GB - CDHP Self Plus One GB3 1877.29 2014.37 1066.59 947.78 134.32
Illinois K8 - Standard Self K84 626.80 642.44 481.83 160.61 3.91
Illinois K8 - Standard Self & Family K85 1918.61 1734.61 1138.19 596.42 -192.10
Illinois K8 - Standard Self Plus One K86 1451.93 1488.24 1066.59 421.65 33.55
Illinois L9 - Value Self L91 463.32 437.06 327.80 109.26 -6.57
Illinois L9 - Value Self & Family L92 1299.18 1225.49 919.12 306.37 -18.42
Illinois L9 - Value Self Plus One L93 904.89 853.56 640.17 213.39 -12.83
Illinois MW - Value Self MW4 556.99 608.81 456.61 152.20 12.95
Illinois MW - Value Self & Family MW5 1253.18 1369.79 1027.34 342.45 29.16
Illinois MW - Value Self Plus One MW6 1197.50 1308.93 981.70 327.23 27.86
Illinois MW - CDHP Self MW1 712.21 757.06 498.72 258.34 42.84
Illinois MW - CDHP Self & Family MW2 1602.51 1703.41 1138.19 565.22 92.80
Illinois MW - CDHP Self Plus One MW3 1531.27 1627.67 1066.59 561.08 93.64
Illinois RW - Basic Self RW1 592.02 623.55 467.66 155.89 7.89
Illinois RW - Basic Self & Family RW2 1332.05 1402.96 1052.22 350.74 17.73
Illinois RW - Basic Self Plus One RW3 1272.83 1340.63 1005.47 335.16 16.95
Indiana 75 - Standard Self 754 881.49 855.66 498.72 356.94 -27.84
Indiana 75 - Standard Self & Family 755 1983.35 1925.24 1138.19 787.05 -66.21
Indiana 75 - Standard Self Plus One 756 1895.16 1839.67 1066.59 773.08 -58.25
Indiana 75 - High Self 751 1261.67 1212.06 498.72 713.34 -51.62
Indiana 75 - High Self & Family 752 2838.72 2727.14 1138.19 1588.95 -119.68
Indiana 75 - High Self Plus One 753 2712.56 2605.92 1066.59 1539.33 -109.40
Indiana A6 - High Self A61 1044.40 1172.64 498.72 673.92 126.23
Indiana A6 - High Self & Family A62 2349.90 2638.48 1138.19 1500.29 280.48
Indiana A6 - High Self Plus One A63 2245.47 2521.22 1066.59 1454.63 272.99
Indiana A6 - Standard Self A64 835.88 930.28 498.72 431.56 92.39
Indiana A6 - Standard Self & Family A65 1880.73 2093.17 1138.19 954.98 204.34
Indiana A6 - Standard Self Plus One A66 1797.14 2000.16 1066.59 933.57 200.26
Indiana Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Indiana Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Indiana Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Indiana Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Indiana Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Indiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Indiana K8 - Standard Self K84 626.80 642.44 481.83 160.61 3.91
Indiana K8 - Standard Self & Family K85 1918.61 1734.61 1138.19 596.42 -192.10
Indiana K8 - Standard Self Plus One K86 1451.93 1488.24 1066.59 421.65 33.55
Indiana MH - High Self MH1 801.62 883.98 498.72 385.26 80.35
Indiana MH - High Self & Family MH2 1803.64 1988.96 1138.19 850.77 177.22
Indiana MH - High Self Plus One MH3 1723.45 1900.56 1066.59 833.97 174.35
Indiana MH - Standard Self MH4 673.05 722.39 498.72 223.67 47.33
Indiana MH - Standard Self & Family MH5 1514.35 1625.37 1138.19 487.18 102.92
Indiana MH - Standard Self Plus One MH6 1447.05 1553.13 1066.59 486.54 103.32
Indiana MW - Value Self MW4 556.99 608.81 456.61 152.20 12.95
Indiana MW - Value Self & Family MW5 1253.18 1369.79 1027.34 342.45 29.16
Indiana MW - Value Self Plus One MW6 1197.50 1308.93 981.70 327.23 27.86
Indiana MW - CDHP Self MW1 712.21 757.06 498.72 258.34 42.84
Indiana MW - CDHP Self & Family MW2 1602.51 1703.41 1138.19 565.22 92.80
Indiana MW - CDHP Self Plus One MW3 1531.27 1627.67 1066.59 561.08 93.64
Indiana TC - CDHP Self TC1 602.31 622.12 466.59 155.53 4.95
Indiana TC - CDHP Self & Family TC2 1355.23 1399.75 1049.81 349.94 11.13
Indiana TC - CDHP Self Plus One TC3 1295.00 1337.55 1003.16 334.39 10.64
Indiana X3 - Value Self X34 New Plan 570.27 427.70 142.57 New Plan
Indiana X3 - Value Self & Family X35 New Plan 1283.12 962.34 320.78 New Plan
Indiana X3 - Value Self Plus One X36 New Plan 1226.07 919.55 306.52 New Plan
Indiana X3 - CDHP Self X31 New Plan 684.65 498.72 185.93 New Plan
Indiana X3 - CDHP Self & Family X32 New Plan 1540.48 1138.19 402.29 New Plan
Indiana X3 - CDHP Self Plus One X33 New Plan 1472.01 1066.59 405.42 New Plan
Iowa Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Iowa Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Iowa Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Iowa Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Iowa Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Iowa Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Iowa K8 - Standard Self K84 626.80 642.44 481.83 160.61 3.91
Iowa K8 - Standard Self & Family K85 1918.61 1734.61 1138.19 596.42 -192.10
Iowa K8 - Standard Self Plus One K86 1451.93 1488.24 1066.59 421.65 33.55
Iowa LJ - High Self LJ1 610.70 671.95 498.72 173.23 20.56
Iowa LJ - High Self & Family LJ2 1526.76 1679.86 1138.19 541.67 145.00
Iowa LJ - High Self Plus One LJ3 1313.02 1444.69 1066.59 378.10 49.85
Iowa N7 - HDHP Self N71 501.80 532.16 399.12 133.04 7.59
Iowa N7 - HDHP Self & Family N72 1254.50 1223.93 917.95 305.98 -7.64
Iowa N7 - HDHP Self Plus One N73 1078.87 1144.11 858.08 286.03 16.31
Iowa V3 - Standard Self V34 457.49 428.09 321.07 107.02 -7.35
Iowa V3 - Standard Self & Family V35 1114.47 1042.82 782.12 260.70 -17.92
Iowa V3 - Standard Self Plus One V36 1011.08 946.08 709.56 236.52 -16.25
Iowa V3 - High Self V31 773.33 790.31 498.72 291.59 14.97
Iowa V3 - High Self & Family V32 1883.83 1925.21 1138.19 787.02 33.28
Iowa V3 - High Self Plus One V33 1709.05 1746.57 1066.59 679.98 34.76
Kansas Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Kansas Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Kansas Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Kansas Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Kansas Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Kansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Kansas HA - High Self HA1 728.35 881.01 498.72 382.29 150.65
Kansas HA - High Self & Family HA2 1720.46 2081.11 1138.19 942.92 352.55
Kansas HA - High Self Plus One HA3 1703.48 2060.54 1066.59 993.95 354.30
Kansas HA - Standard Self HA4 611.22 707.85 498.72 209.13 56.33
Kansas HA - Standard Self & Family HA5 1442.70 1670.78 1138.19 532.59 171.92
Kansas HA - Standard Self Plus One HA6 1428.42 1654.25 1066.59 587.66 223.07
Kansas MS - High Self MS1 1621.58 1625.63 498.72 1126.91 2.04
Kansas MS - High Self & Family MS2 3648.54 3657.66 1138.19 2519.47 1.02
Kansas MS - High Self Plus One MS3 3486.38 3495.09 1066.59 2428.50 5.95
Kansas MS - Standard Self MS4 871.41 952.77 498.72 454.05 79.35
Kansas MS - Standard Self & Family MS5 1960.70 2143.79 1138.19 1005.60 174.99
Kansas MS - Standard Self Plus One MS6 1873.56 2048.50 1066.59 981.91 172.18
Kansas PH - Value Self PH4 418.77 428.35 321.26 107.09 2.40
Kansas PH - Value Self & Family PH5 942.28 963.82 722.87 240.95 5.38
Kansas PH - Value Self Plus One PH6 900.38 920.96 690.72 230.24 5.15
Kansas PH - CDHP Self PH1 576.23 600.95 450.71 150.24 6.18
Kansas PH - CDHP Self & Family PH2 1296.49 1352.13 1014.10 338.03 13.91
Kansas PH - CDHP Self Plus One PH3 1238.88 1292.05 969.04 323.01 13.29
Kentucky 6N - CDHP Self 6N1 585.07 633.64 475.23 158.41 12.14
Kentucky 6N - CDHP Self & Family 6N2 1316.38 1425.69 1069.27 356.42 27.33
Kentucky 6N - CDHP Self Plus One 6N3 1257.88 1362.31 1021.73 340.58 26.11
Kentucky A6 - High Self A61 1044.40 1172.64 498.72 673.92 126.23
Kentucky A6 - High Self & Family A62 2349.90 2638.48 1138.19 1500.29 280.48
Kentucky A6 - High Self Plus One A63 2245.47 2521.22 1066.59 1454.63 272.99
Kentucky A6 - Standard Self A64 835.88 930.28 498.72 431.56 92.39
Kentucky A6 - Standard Self & Family A65 1880.73 2093.17 1138.19 954.98 204.34
Kentucky A6 - Standard Self Plus One A66 1797.14 2000.16 1066.59 933.57 200.26
Kentucky Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Kentucky Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Kentucky Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Kentucky Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Kentucky Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Kentucky LJ - High Self LJ1 610.70 671.95 498.72 173.23 20.56
Kentucky LJ - High Self & Family LJ2 1526.76 1679.86 1138.19 541.67 145.00
Kentucky LJ - High Self Plus One LJ3 1313.02 1444.69 1066.59 378.10 49.85
Kentucky MH - High Self MH1 801.62 883.98 498.72 385.26 80.35
Kentucky MH - High Self & Family MH2 1803.64 1988.96 1138.19 850.77 177.22
Kentucky MH - High Self Plus One MH3 1723.45 1900.56 1066.59 833.97 174.35
Kentucky MH - Standard Self MH4 673.05 722.39 498.72 223.67 47.33
Kentucky MH - Standard Self & Family MH5 1514.35 1625.37 1138.19 487.18 102.92
Kentucky MH - Standard Self Plus One MH6 1447.05 1553.13 1066.59 486.54 103.32
Kentucky MI - High Self MI1 1000.31 1123.14 498.72 624.42 120.82
Kentucky MI - High Self & Family MI2 2250.65 2527.03 1138.19 1388.84 268.28
Kentucky MI - High Self Plus One MI3 2150.63 2414.71 1066.59 1348.12 261.32
Kentucky MI - Standard Self MI4 763.58 811.92 498.72 313.20 46.33
Kentucky MI - Standard Self & Family MI5 1718.08 1826.80 1138.19 688.61 100.62
Kentucky MI - Standard Self Plus One MI6 1641.71 1745.62 1066.59 679.03 101.15
Kentucky N7 - HDHP Self N71 501.80 532.16 399.12 133.04 7.59
Kentucky N7 - HDHP Self & Family N72 1254.50 1223.93 917.95 305.98 -7.64
Kentucky N7 - HDHP Self Plus One N73 1078.87 1144.11 858.08 286.03 16.31
Kentucky TC - CDHP Self TC1 602.31 622.12 466.59 155.53 4.95
Kentucky TC - CDHP Self & Family TC2 1355.23 1399.75 1049.81 349.94 11.13
Kentucky TC - CDHP Self Plus One TC3 1295.00 1337.55 1003.16 334.39 10.64
Kentucky W6 - Basic Self W61 New Plan 585.78 439.34 146.44 New Plan
Kentucky W6 - Basic Self & Family W62 New Plan 1318.01 988.51 329.50 New Plan
Kentucky W6 - Basic Self Plus One W63 New Plan 1259.42 944.57 314.85 New Plan
Kentucky X3 - Value Self X34 New Plan 570.27 427.70 142.57 New Plan
Kentucky X3 - Value Self & Family X35 New Plan 1283.12 962.34 320.78 New Plan
Kentucky X3 - Value Self Plus One X36 New Plan 1226.07 919.55 306.52 New Plan
Kentucky X3 - CDHP Self X31 New Plan 684.65 498.72 185.93 New Plan
Kentucky X3 - CDHP Self & Family X32 New Plan 1540.48 1138.19 402.29 New Plan
Kentucky X3 - CDHP Self Plus One X33 New Plan 1472.01 1066.59 405.42 New Plan
Louisiana AE - High Self AE1 790.73 864.05 498.72 365.33 71.31
Louisiana AE - High Self & Family AE2 1779.09 1944.06 1138.19 805.87 156.87
Louisiana AE - High Self Plus One AE3 1700.03 1857.68 1066.59 791.09 154.89
Louisiana AE - Standard Self AE4 683.91 734.05 498.72 235.33 48.13
Louisiana AE - Standard Self & Family AE5 1538.81 1651.63 1138.19 513.44 104.72
Louisiana AE - Standard Self Plus One AE6 1470.41 1578.22 1066.59 511.63 105.05
Louisiana Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Louisiana Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Louisiana Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Louisiana Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Louisiana Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Louisiana BC - Standard Self BC4 571.85 596.57 447.43 149.14 6.18
Louisiana BC - Standard Self & Family BC5 1286.68 1342.29 1006.72 335.57 13.90
Louisiana BC - Standard Self Plus One BC6 1229.50 1282.62 961.97 320.65 13.28
Louisiana BC - High Self BC1 693.72 751.10 498.72 252.38 55.37
Louisiana BC - High Self & Family BC2 1560.93 1690.02 1138.19 551.83 120.99
Louisiana BC - High Self Plus One BC3 1491.56 1614.90 1066.59 548.31 120.58
Louisiana KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Louisiana KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Louisiana KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Louisiana LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Louisiana LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Louisiana LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
Maine Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Maine Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Maine Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Maine Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Maine Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Maine Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Maryland 2G - Standard Self 2G4 693.62 797.68 498.72 298.96 102.05
Maryland 2G - Standard Self & Family 2G5 1648.05 1895.25 1138.19 757.06 239.10
Maryland 2G - Standard Self Plus One 2G6 1387.25 1595.34 1066.59 528.75 181.94
Maryland Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Maryland Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Maryland Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Maryland Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Maryland Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Maryland Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Maryland B6 - HDHP Self B61 609.72 518.27 388.70 129.57 -22.86
Maryland B6 - HDHP Self & Family B62 1448.68 1231.38 923.54 307.84 -54.33
Maryland B6 - HDHP Self Plus One B63 1219.44 1036.51 777.38 259.13 -45.73
Maryland E3 - Standard Self E34 504.96 521.76 391.32 130.44 4.20
Maryland E3 - Standard Self & Family E35 1161.49 1199.99 899.99 300.00 9.63
Maryland E3 - Standard Self Plus One E36 1161.49 1199.99 899.99 300.00 9.63
Maryland E3 - High Self E31 660.36 692.68 498.72 193.96 28.87
Maryland E3 - High Self & Family E32 1518.83 1593.15 1138.19 454.96 66.22
Maryland E3 - High Self Plus One E33 1518.83 1593.15 1066.59 526.56 71.56
Maryland JN - High Self JN1 1103.09 1119.13 498.72 620.41 14.03
Maryland JN - High Self & Family JN2 2479.95 2515.98 1138.19 1377.79 27.93
Maryland JN - High Self Plus One JN3 2455.38 2491.04 1066.59 1424.45 32.90
Maryland JN - Basic Self JN4 662.85 680.46 498.72 181.74 15.60
Maryland JN - Basic Self & Family JN5 1516.95 1557.25 1138.19 419.06 32.20
Maryland JN - Basic Self Plus One JN6 1392.99 1430.00 1066.59 363.41 15.16
Maryland JP - High Self JP1 717.77 790.86 498.72 292.14 71.08
Maryland JP - High Self & Family JP2 2012.66 2217.54 1138.19 1079.35 196.78
Maryland JP - High Self Plus One JP3 1401.81 1544.53 1066.59 477.94 127.49
Maryland L9 - Value Self L91 463.32 437.06 327.80 109.26 -6.57
Maryland L9 - Value Self & Family L92 1299.18 1225.49 919.12 306.37 -18.42
Maryland L9 - Value Self Plus One L93 904.89 853.56 640.17 213.39 -12.83
Maryland LR - High Self LR1 607.99 667.94 498.72 169.22 17.22
Maryland LR - High Self & Family LR2 1520.00 1582.99 1138.19 444.80 54.89
Maryland LR - High Self Plus One LR3 1307.19 1436.05 1066.59 369.46 42.66
Maryland T7 - Basic Self T71 460.03 420.12 315.09 105.03 -9.98
Maryland T7 - Basic Self & Family T72 1104.50 1026.16 769.62 256.54 -19.58
Maryland T7 - Basic Self Plus One T73 1006.22 934.90 701.18 233.72 -17.83
Maryland V4 - HDHP Self V41 566.97 495.69 371.77 123.92 -17.82
Maryland V4 - HDHP Self & Family V42 1417.48 1140.06 855.05 285.01 -69.36
Maryland V4 - HDHP Self Plus One V43 1219.01 1065.72 799.29 266.43 -38.32
Massachusetts Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Massachusetts Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Massachusetts Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Massachusetts Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Michigan 52 - High Self 521 708.22 763.84 498.72 265.12 53.61
Michigan 52 - High Self & Family 522 1728.05 1863.72 1138.19 725.53 127.57
Michigan 52 - High Self Plus One 523 1628.90 1756.82 1066.59 690.23 125.16
Michigan Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Michigan Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Michigan Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Michigan Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Michigan Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Michigan Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Michigan GY - Standard Self GY4 563.92 598.35 448.76 149.59 8.61
Michigan GY - Standard Self & Family GY5 1375.96 1460.01 1095.01 365.00 21.01
Michigan GY - Standard Self Plus One GY6 1297.01 1376.22 1032.17 344.05 19.80
Michigan K5 - High Self K51 927.81 943.45 498.72 444.73 13.63
Michigan K5 - High Self & Family K52 2263.82 2301.95 1138.19 1163.76 30.03
Michigan K5 - High Self Plus One K53 2133.97 2169.90 1066.59 1103.31 33.17
Michigan LE - High Self LE1 813.80 912.10 498.72 413.38 96.29
Michigan LE - High Self & Family LE2 1912.41 2143.44 1138.19 1005.25 222.93
Michigan LE - High Self Plus One LE3 1790.34 2006.64 1066.59 940.05 213.54
Michigan LE - Standard Self LE4 593.32 504.44 378.33 126.11 -22.22
Michigan LE - Standard Self & Family LE5 1394.32 1185.45 889.09 296.36 -52.22
Michigan LE - Standard Self Plus One LE6 1305.31 1109.79 832.34 277.45 -48.88
Michigan LX - High Self LX1 667.98 734.72 498.72 236.00 64.73
Michigan LX - High Self & Family LX2 1629.83 1792.64 1138.19 654.45 154.71
Michigan LX - High Self Plus One LX3 1536.36 1689.81 1066.59 623.22 150.69
Minnesota Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Minnesota Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Minnesota Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Minnesota Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Minnesota Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Minnesota V3 - Standard Self V34 457.49 428.09 321.07 107.02 -7.35
Minnesota V3 - Standard Self & Family V35 1114.47 1042.82 782.12 260.70 -17.92
Minnesota V3 - Standard Self Plus One V36 1011.08 946.08 709.56 236.52 -16.25
Minnesota V3 - High Self V31 773.33 790.31 498.72 291.59 14.97
Minnesota V3 - High Self & Family V32 1883.83 1925.21 1138.19 787.02 33.28
Minnesota V3 - High Self Plus One V33 1709.05 1746.57 1066.59 679.98 34.76
Mississippi Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Mississippi Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Mississippi Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Mississippi Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Mississippi Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Mississippi KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Mississippi KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Mississippi KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Mississippi LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Mississippi LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Mississippi LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
Missouri 9G - High Self 9G1 733.92 782.36 498.72 283.64 46.43
Missouri 9G - High Self & Family 9G2 1588.93 1681.07 1138.19 542.88 84.04
Missouri 9G - High Self Plus One 9G3 1504.53 1591.81 1066.59 525.22 84.52
Missouri 9G - Standard Self 9G4 532.11 558.72 419.04 139.68 6.65
Missouri 9G - Standard Self & Family 9G5 1529.78 1587.91 1138.19 449.72 50.03
Missouri 9G - Standard Self Plus One 9G6 1383.46 1436.02 1066.59 369.43 23.57
Missouri Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Missouri Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Missouri Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Missouri Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Missouri Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Missouri Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Missouri HA - High Self HA1 728.35 881.01 498.72 382.29 150.65
Missouri HA - High Self & Family HA2 1720.46 2081.11 1138.19 942.92 352.55
Missouri HA - High Self Plus One HA3 1703.48 2060.54 1066.59 993.95 354.30
Missouri HA - Standard Self HA4 611.22 707.85 498.72 209.13 56.33
Missouri HA - Standard Self & Family HA5 1442.70 1670.78 1138.19 532.59 171.92
Missouri HA - Standard Self Plus One HA6 1428.42 1654.25 1066.59 587.66 223.07
Missouri MS - High Self MS1 1621.58 1625.63 498.72 1126.91 2.04
Missouri MS - High Self & Family MS2 3648.54 3657.66 1138.19 2519.47 1.02
Missouri MS - High Self Plus One MS3 3486.38 3495.09 1066.59 2428.50 5.95
Missouri MS - Standard Self MS4 871.41 952.77 498.72 454.05 79.35
Missouri MS - Standard Self & Family MS5 1960.70 2143.79 1138.19 1005.60 174.99
Missouri MS - Standard Self Plus One MS6 1873.56 2048.50 1066.59 981.91 172.18
Missouri PH - Value Self PH4 418.77 428.35 321.26 107.09 2.40
Missouri PH - Value Self & Family PH5 942.28 963.82 722.87 240.95 5.38
Missouri PH - Value Self Plus One PH6 900.38 920.96 690.72 230.24 5.15
Missouri PH - CDHP Self PH1 576.23 600.95 450.71 150.24 6.18
Missouri PH - CDHP Self & Family PH2 1296.49 1352.13 1014.10 338.03 13.91
Missouri PH - CDHP Self Plus One PH3 1238.88 1292.05 969.04 323.01 13.29
Montana Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Montana Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Montana Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Montana Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Montana Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Montana Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Nebraska Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Nebraska Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Nebraska Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Nebraska Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Nebraska Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Nevada Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Nevada Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Nevada Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Nevada Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Nevada Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Nevada Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Nevada KT - High Self KT1 610.68 679.19 498.72 180.47 27.80
Nevada KT - High Self & Family KT2 1526.70 1697.95 1138.19 559.76 163.15
Nevada KT - High Self Plus One KT3 1312.96 1460.23 1066.59 393.64 65.40
Nevada LU - HDHP Self LU1 482.91 450.32 337.74 112.58 -8.15
Nevada LU - HDHP Self & Family LU2 1207.25 1035.73 776.80 258.93 -42.88
Nevada LU - HDHP Self Plus One LU3 1038.25 968.20 726.15 242.05 -17.51
Nevada NM - High Self NM1 607.53 658.54 493.91 164.63 12.75
Nevada NM - High Self & Family NM2 1439.79 1560.67 1138.19 422.48 62.53
Nevada NM - High Self Plus One NM3 1154.31 1251.25 938.44 312.81 24.23
New Hampshire Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
New Hampshire Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
New Hampshire Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
New Hampshire Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
New Jersey 80 - Standard Self 804 710.99 925.97 498.72 427.25 212.97
New Jersey 80 - Standard Self & Family 805 2107.28 2246.47 1138.19 1108.28 131.09
New Jersey 80 - Standard Self Plus One 806 1673.97 2153.84 1066.59 1087.25 477.11
New Jersey Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
New Jersey Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
New Jersey Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
New Jersey Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
New Jersey Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
New Jersey JR - High Self JR1 1444.26 1409.79 498.72 911.07 -36.48
New Jersey JR - High Self & Family JR2 3336.10 3256.46 1138.19 2118.27 -87.74
New Jersey JR - High Self Plus One JR3 3303.06 3224.20 1066.59 2157.61 -81.62
New Jersey JR - Basic Self JR4 1163.83 1163.41 498.72 664.69 -2.43
New Jersey JR - Basic Self & Family JR5 2697.24 2696.33 1138.19 1558.14 -9.01
New Jersey JR - Basic Self Plus One JR6 2670.55 2669.62 1066.59 1603.03 -3.69
New Jersey P3 - Basic Self P34 1348.08 1298.46 498.72 799.74 -51.63
New Jersey P3 - Basic Self & Family P35 3128.88 3013.75 1138.19 1875.56 -123.23
New Jersey P3 - Basic Self Plus One P36 3097.90 2983.89 1066.59 1917.30 -116.77
New Jersey P3 - High Self P31 1572.42 1485.21 498.72 986.49 -89.22
New Jersey P3 - High Self & Family P32 3812.34 3600.91 1138.19 2462.72 -219.53
New Jersey P3 - High Self Plus One P33 3774.57 3565.25 1066.59 2498.66 -212.08
New Mexico Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
New Mexico Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
New Mexico Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
New Mexico Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
New Mexico Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
New Mexico P2 - High Self P21 771.18 740.31 498.72 241.59 -32.88
New Mexico P2 - High Self & Family P22 1812.29 1739.75 1138.19 601.56 -80.64
New Mexico P2 - High Self Plus One P23 1750.62 1680.53 1066.59 613.94 -72.85
New Mexico PS - Standard Self PS4 649.91 622.66 467.00 155.66 -6.82
New Mexico PS - Standard Self & Family PS5 1527.35 1463.28 1097.46 365.82 -31.44
New Mexico PS - Standard Self Plus One PS6 1475.35 1413.45 1060.09 353.36 -58.16
New York 51 - High Self 511 762.75 985.36 498.72 486.64 220.60
New York 51 - High Self & Family 512 2148.25 2821.39 1138.19 1683.20 665.04
New York 51 - High Self Plus One 513 1359.28 1755.46 1066.59 688.87 349.05
New York 80 - Standard Self 804 710.99 925.97 498.72 427.25 212.97
New York 80 - Standard Self & Family 805 2107.28 2246.47 1138.19 1108.28 131.09
New York 80 - Standard Self Plus One 806 1673.97 2153.84 1066.59 1087.25 477.11
New York Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
New York Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
New York Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
New York Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
New York Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
New York Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
New York C5 - Standard Self C54 676.09 701.83 498.72 203.11 23.73
New York C5 - Standard Self & Family C55 1825.42 1894.95 1138.19 756.76 61.43
New York C5 - Standard Self Plus One C56 1724.00 1789.65 1066.59 723.06 62.89
New York JC - High Self JC1 1165.02 1303.06 498.72 804.34 136.03
New York JC - High Self & Family JC2 2878.72 3219.84 1138.19 2081.65 333.02
New York JC - High Self Plus One JC3 2850.27 3187.99 1066.59 2121.40 334.96
New York JC - Basic Self JC4 884.50 1063.21 498.72 564.49 176.70
New York JC - Basic Self & Family JC5 2157.46 2593.37 1138.19 1455.18 427.81
New York JC - Basic Self Plus One JC6 2136.12 2567.72 1066.59 1501.13 428.84
New York MVP Health Care - Standard Self GA4 750.84 741.87 498.72 243.15 -10.98
New York MVP Health Care - Standard Self & Family GA5 1839.50 1817.55 1138.19 679.36 -30.05
New York MVP Health Care - Standard Self Plus One GA6 1726.88 1706.27 1066.59 639.68 -23.37
New York MVP Health Care - Standard Self MF4 966.83 981.37 498.72 482.65 12.53
New York MVP Health Care - Standard Self & Family MF5 2368.73 2404.35 1138.19 1266.16 27.52
New York MVP Health Care - Standard Self Plus One MF6 2223.69 2257.17 1066.59 1190.58 30.72
New York MVP Health Care - Standard Self GV4 703.65 629.35 472.01 157.34 -49.60
New York MVP Health Care - Standard Self & Family GV5 1723.89 1541.91 1138.19 403.72 -190.08
New York MVP Health Care - Standard Self Plus One GV6 1618.35 1447.53 1066.59 380.94 -173.58
New York MVP Health Care - Standard Self MX4 848.97 878.45 498.72 379.73 27.47
New York MVP Health Care - Standard Self & Family MX5 2079.98 2152.19 1138.19 1014.00 64.11
New York MVP Health Care - Standard Self Plus One MX6 1952.64 2020.46 1066.59 953.87 65.06
New York MVP Health Care - Standard Self M94 703.39 723.26 498.72 224.54 17.86
New York MVP Health Care - Standard Self & Family M95 1723.30 1772.01 1138.19 633.82 40.61
New York MVP Health Care - Standard Self Plus One M96 1617.79 1663.48 1066.59 596.89 42.93
New York QA - High Self QA1 709.91 727.63 498.72 228.91 15.71
New York QA - High Self & Family QA2 1916.79 1964.56 1138.19 826.37 39.67
New York QA - High Self Plus One QA3 1810.29 1855.43 1066.59 788.84 42.38
New York QA - HDHP Self QA4 523.90 590.57 442.93 147.64 16.67
New York QA - HDHP Self & Family QA5 1344.68 1524.84 1138.19 386.65 50.48
New York QA - HDHP Self Plus One QA6 1251.10 1421.20 1065.90 355.30 42.53
New York SG - Standard Self SG4 577.57 577.57 433.18 144.39 0.00
New York SG - Standard Self & Family SG5 1732.66 1732.66 1138.19 594.47 -8.10
New York SG - Standard Self Plus One SG6 1155.14 1155.14 866.36 288.78 0.00
New York SG - High Self SG1 805.78 870.29 498.72 371.57 62.50
New York SG - High Self & Family SG2 2417.26 2610.55 1138.19 1472.36 185.19
New York SG - High Self Plus One SG3 1611.61 1740.55 1066.59 673.96 126.18
New York YL - Standard Self YL4 New Plan 658.60 493.95 164.65 New Plan
New York YL - Standard Self & Family YL5 New Plan 1884.68 1138.19 746.49 New Plan
New York YL - Standard Self Plus One YL6 New Plan 1169.22 876.92 292.30 New Plan
North Carolina Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
North Carolina Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
North Carolina Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
North Carolina Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
North Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
North Carolina KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
North Carolina KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
North Carolina KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
North Carolina LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
North Carolina LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
North Carolina LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
North Dakota Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
North Dakota Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
North Dakota Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
North Dakota Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
North Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
North Dakota V3 - Standard Self V34 457.49 428.09 321.07 107.02 -7.35
North Dakota V3 - Standard Self & Family V35 1114.47 1042.82 782.12 260.70 -17.92
North Dakota V3 - Standard Self Plus One V36 1011.08 946.08 709.56 236.52 -16.25
North Dakota V3 - High Self V31 773.33 790.31 498.72 291.59 14.97
North Dakota V3 - High Self & Family V32 1883.83 1925.21 1138.19 787.02 33.28
North Dakota V3 - High Self Plus One V33 1709.05 1746.57 1066.59 679.98 34.76
Ohio 3A - High Self 3A1 749.32 769.49 498.72 270.77 18.16
Ohio 3A - High Self & Family 3A2 1850.85 1900.67 1138.19 762.48 41.72
Ohio 3A - High Self Plus One 3A3 1573.56 1615.94 1066.59 549.35 39.62
Ohio 3A - HDHP Self 3A4 359.67 373.25 279.94 93.31 3.39
Ohio 3A - HDHP Self & Family 3A5 1156.70 1194.33 895.75 298.58 9.41
Ohio 3A - HDHP Self Plus One 3A6 681.72 709.13 531.85 177.28 6.85
Ohio 64 - Standard Self 644 761.45 857.76 498.72 359.04 94.30
Ohio 64 - Standard Self & Family 645 1827.50 2058.62 1138.19 920.43 223.02
Ohio 64 - Standard Self Plus One 646 1675.25 1887.04 1066.59 820.45 209.03
Ohio A6 - High Self A61 1044.40 1172.64 498.72 673.92 126.23
Ohio A6 - High Self & Family A62 2349.90 2638.48 1138.19 1500.29 280.48
Ohio A6 - High Self Plus One A63 2245.47 2521.22 1066.59 1454.63 272.99
Ohio A6 - Standard Self A64 835.88 930.28 498.72 431.56 92.39
Ohio A6 - Standard Self & Family A65 1880.73 2093.17 1138.19 954.98 204.34
Ohio A6 - Standard Self Plus One A66 1797.14 2000.16 1066.59 933.57 200.26
Ohio Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Ohio Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Ohio Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Ohio Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Ohio Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Ohio Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Ohio UX - Basic Self UX1 593.58 482.56 361.92 120.64 -27.75
Ohio UX - Basic Self & Family UX2 1424.63 1158.15 868.61 289.54 -66.62
Ohio UX - Basic Self Plus One UX3 1305.92 1061.65 796.24 265.41 -61.07
Ohio W6 - Basic Self W61 New Plan 585.78 439.34 146.44 New Plan
Ohio W6 - Basic Self & Family W62 New Plan 1318.01 988.51 329.50 New Plan
Ohio W6 - Basic Self Plus One W63 New Plan 1259.42 944.57 314.85 New Plan
Ohio X3 - Value Self X34 New Plan 570.27 427.70 142.57 New Plan
Ohio X3 - Value Self & Family X35 New Plan 1283.12 962.34 320.78 New Plan
Ohio X3 - Value Self Plus One X36 New Plan 1226.07 919.55 306.52 New Plan
Ohio X3 - CDHP Self X31 New Plan 684.65 498.72 185.93 New Plan
Ohio X3 - CDHP Self & Family X32 New Plan 1540.48 1138.19 402.29 New Plan
Ohio X3 - CDHP Self Plus One X33 New Plan 1472.01 1066.59 405.42 New Plan
Ohio X6 - Standard Self X64 New Plan 805.96 498.72 307.24 New Plan
Ohio X6 - Standard Self & Family X65 New Plan 1934.29 1138.19 796.10 New Plan
Ohio X6 - Standard Self Plus One X66 New Plan 1773.07 1066.59 706.48 New Plan
Ohio X6 - Basic Self X61 New Plan 461.72 346.29 115.43 New Plan
Ohio X6 - Basic Self & Family X62 New Plan 1108.12 831.09 277.03 New Plan
Ohio X6 - Basic Self Plus One X63 New Plan 1015.78 761.84 253.94 New Plan
Ohio YF - Basic Self YF1 New Plan 490.56 367.92 122.64 New Plan
Ohio YF - Basic Self & Family YF2 New Plan 1177.37 883.03 294.34 New Plan
Ohio YF - Basic Self Plus One YF3 New Plan 1079.26 809.45 269.81 New Plan
Ohio YF - Standard Self YF4 New Plan 919.84 498.72 421.12 New Plan
Ohio YF - Standard Self & Family YF5 New Plan 2207.60 1138.19 1069.41 New Plan
Ohio YF - Standard Self Plus One YF6 New Plan 2023.60 1066.59 957.01 New Plan
Oklahoma Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Oklahoma Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Oklahoma Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Oklahoma Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Oklahoma IM - Standard Self IM4 525.29 602.16 451.62 150.54 19.22
Oklahoma IM - Standard Self & Family IM5 1313.22 1505.40 1129.05 376.35 48.05
Oklahoma IM - Standard Self Plus One IM6 1050.57 1204.32 903.24 301.08 38.44
Oklahoma IM - High Self IM1 567.91 619.00 464.25 154.75 12.77
Oklahoma IM - High Self & Family IM2 1419.73 1547.52 1138.19 409.33 54.40
Oklahoma IM - High Self Plus One IM3 1135.79 1238.01 928.51 309.50 25.55
Oregon 57 - Standard Self 574 600.25 620.30 465.23 155.07 5.01
Oregon 57 - Standard Self & Family 575 1378.98 1425.00 1068.75 356.25 11.51
Oregon 57 - Standard Self Plus One 576 1378.98 1425.00 1066.59 358.41 13.67
Oregon 57 - High Self 571 692.08 706.68 498.72 207.96 12.59
Oregon 57 - High Self & Family 572 1563.14 1596.16 1138.19 457.97 24.92
Oregon 57 - High Self Plus One 573 1563.14 1596.16 1066.59 529.57 30.26
Oregon Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Oregon Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Oregon Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Oregon Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Oregon Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Oregon Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Oregon KT - High Self KT1 610.68 679.19 498.72 180.47 27.80
Oregon KT - High Self & Family KT2 1526.70 1697.95 1138.19 559.76 163.15
Oregon KT - High Self Plus One KT3 1312.96 1460.23 1066.59 393.64 65.40
Oregon LU - HDHP Self LU1 482.91 450.32 337.74 112.58 -8.15
Oregon LU - HDHP Self & Family LU2 1207.25 1035.73 776.80 258.93 -42.88
Oregon LU - HDHP Self Plus One LU3 1038.25 968.20 726.15 242.05 -17.51
Pennsylvania 8W - HDHP Self 8W4 539.61 573.58 430.19 143.39 8.49
Pennsylvania 8W - HDHP Self & Family 8W5 1237.58 1317.59 988.19 329.40 20.01
Pennsylvania 8W - HDHP Self Plus One 8W6 1191.45 1268.04 951.03 317.01 19.15
Pennsylvania 8W - High Self 8W1 864.39 872.78 498.72 374.06 6.38
Pennsylvania 8W - High Self & Family 8W2 2031.32 2051.31 1138.19 913.12 11.89
Pennsylvania 8W - High Self Plus One 8W3 1944.95 1964.13 1066.59 897.54 16.42
Pennsylvania Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Pennsylvania Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Pennsylvania Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Pennsylvania Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Pennsylvania GG - Standard Self GG4 684.08 729.17 498.72 230.45 43.08
Pennsylvania GG - Standard Self & Family GG5 1566.20 1669.46 1138.19 531.27 95.16
Pennsylvania GG - Standard Self Plus One GG6 1478.10 1575.54 1066.59 508.95 94.68
Pennsylvania Highmark Choice Company - High Self NP1 689.76 777.73 498.72 279.01 85.96
Pennsylvania Highmark Choice Company - High Self & Family NP2 1568.19 1767.78 1138.19 629.59 191.49
Pennsylvania Highmark Choice Company - High Self Plus One NP3 1389.18 1563.99 1066.59 497.40 150.11
Pennsylvania LR - High Self LR1 607.99 667.94 498.72 169.22 17.22
Pennsylvania LR - High Self & Family LR2 1520.00 1582.99 1138.19 444.80 54.89
Pennsylvania LR - High Self Plus One LR3 1307.19 1436.05 1066.59 369.46 42.66
Pennsylvania P3 - Basic Self P34 1348.08 1298.46 498.72 799.74 -51.63
Pennsylvania P3 - Basic Self & Family P35 3128.88 3013.75 1138.19 1875.56 -123.23
Pennsylvania P3 - Basic Self Plus One P36 3097.90 2983.89 1066.59 1917.30 -116.77
Pennsylvania P3 - High Self P31 1572.42 1485.21 498.72 986.49 -89.22
Pennsylvania P3 - High Self & Family P32 3812.34 3600.91 1138.19 2462.72 -219.53
Pennsylvania P3 - High Self Plus One P33 3774.57 3565.25 1066.59 2498.66 -212.08
Pennsylvania UW - Standard Self UW4 624.50 651.86 488.90 162.96 6.84
Pennsylvania UW - Standard Self & Family UW5 1467.51 1523.80 1138.19 385.61 18.73
Pennsylvania UW - Standard Self Plus One UW6 1405.11 1459.27 1066.59 392.68 41.40
Pennsylvania V4 - HDHP Self V41 566.97 495.69 371.77 123.92 -17.82
Pennsylvania V4 - HDHP Self & Family V42 1417.48 1140.06 855.05 285.01 -69.36
Pennsylvania V4 - HDHP Self Plus One V43 1219.01 1065.72 799.29 266.43 -38.32
Pennsylvania YE - High Self YE1 920.10 938.12 498.72 439.40 16.01
Pennsylvania YE - High Self & Family YE2 2310.38 2355.62 1138.19 1217.43 37.14
Pennsylvania YE - High Self Plus One YE3 2287.50 2332.29 1066.59 1265.70 42.03
Puerto Rico 89 - High Self 891 407.38 407.38 305.54 101.84 0.00
Puerto Rico 89 - High Self & Family 892 932.88 932.88 699.66 233.22 0.00
Puerto Rico 89 - High Self Plus One 893 914.70 914.70 686.03 228.67 0.00
Puerto Rico ZJ - High Self ZJ1 367.71 365.11 273.83 91.28 -0.65
Puerto Rico ZJ - High Self & Family ZJ2 827.30 821.49 616.12 205.37 -1.45
Puerto Rico ZJ - High Self Plus One ZJ3 790.53 784.98 588.74 196.24 -1.39
Rhode Island Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Rhode Island Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Rhode Island Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Rhode Island Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
South Carolina Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
South Carolina Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
South Carolina Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
South Carolina Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
South Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
South Dakota Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
South Dakota Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
South Dakota Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
South Dakota Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
South Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
South Dakota V3 - Standard Self V34 457.49 428.09 321.07 107.02 -7.35
South Dakota V3 - Standard Self & Family V35 1114.47 1042.82 782.12 260.70 -17.92
South Dakota V3 - Standard Self Plus One V36 1011.08 946.08 709.56 236.52 -16.25
South Dakota V3 - High Self V31 773.33 790.31 498.72 291.59 14.97
South Dakota V3 - High Self & Family V32 1883.83 1925.21 1138.19 787.02 33.28
South Dakota V3 - High Self Plus One V33 1709.05 1746.57 1066.59 679.98 34.76
Tennessee Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Tennessee Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Tennessee Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Tennessee Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Tennessee Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Tennessee GJ - High Self GJ1 858.35 963.76 498.72 465.04 103.40
Tennessee GJ - High Self & Family GJ2 1931.24 2168.38 1138.19 1030.19 229.04
Tennessee GJ - High Self Plus One GJ3 1845.39 2072.01 1066.59 1005.42 223.86
Tennessee GJ - Standard Self GJ4 781.91 815.62 498.72 316.90 31.70
Tennessee GJ - Standard Self & Family GJ5 1759.29 1835.12 1138.19 696.93 67.73
Tennessee GJ - Standard Self Plus One GJ6 1681.10 1753.55 1066.59 686.96 69.69
Tennessee KK - High Self KK1 595.34 679.03 498.72 180.31 31.48
Tennessee KK - High Self & Family KK2 1488.31 1697.63 1138.19 559.44 187.36
Tennessee KK - High Self Plus One KK3 1279.94 1459.94 1066.59 393.35 73.37
Tennessee LS - HDHP Self LS1 438.25 418.71 314.03 104.68 -4.88
Tennessee LS - HDHP Self & Family LS2 1095.62 963.08 722.31 240.77 -33.13
Tennessee LS - HDHP Self Plus One LS3 942.24 900.25 675.19 225.06 -10.50
Tennessee TT - CDHP Self TT1 638.08 665.45 498.72 166.73 7.21
Tennessee TT - CDHP Self & Family TT2 1435.68 1497.30 1122.98 374.32 15.40
Tennessee TT - CDHP Self Plus One TT3 1371.87 1430.76 1066.59 364.17 21.20
Tennessee TT - Value Self TT4 515.62 537.77 403.33 134.44 5.54
Tennessee TT - Value Self & Family TT5 1160.16 1209.93 907.45 302.48 12.44
Tennessee TT - Value Self Plus One TT6 1108.60 1156.16 867.12 289.04 11.89
Tennessee UB - High Self UB1 1053.02 994.83 498.72 496.11 -60.20
Tennessee UB - High Self & Family UB2 2698.41 2549.26 1138.19 1411.07 -157.25
Tennessee UB - High Self Plus One UB3 2671.72 2524.06 1066.59 1457.47 -150.42
Texas A8 - Basic Self A81 659.79 605.89 454.42 151.47 -13.48
Texas A8 - Basic Self & Family A82 1546.05 1421.53 1066.15 355.38 -60.58
Texas A8 - Basic Self Plus One A83 1293.26 1343.01 1007.26 335.75 12.44
Texas A8 - Standard Self A84 781.15 738.68 498.72 239.96 -44.48
Texas A8 - Standard Self & Family A85 1830.79 1733.64 1138.19 595.45 -105.25
Texas A8 - Standard Self Plus One A86 1531.38 1637.83 1066.59 571.24 103.69
Texas Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Texas Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Texas Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Texas Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Texas Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Texas Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Texas EW - Standard Self EW4 741.93 774.00 498.72 275.28 30.06
Texas EW - Standard Self & Family EW5 1669.33 1741.48 1138.19 603.29 64.05
Texas EW - Standard Self Plus One EW6 1595.14 1664.09 1066.59 597.50 66.19
Texas EW - High Self EW1 924.78 1029.06 498.72 530.34 102.27
Texas EW - High Self & Family EW2 2080.76 2315.41 1138.19 1177.22 226.55
Texas EW - High Self Plus One EW3 1988.26 2212.51 1066.59 1145.92 221.49
Texas L9 - Value Self L91 463.32 437.06 327.80 109.26 -6.57
Texas L9 - Value Self & Family L92 1299.18 1225.49 919.12 306.37 -18.42
Texas L9 - Value Self Plus One L93 904.89 853.56 640.17 213.39 -12.83
Texas P8 - Basic Self P81 738.77 679.94 498.72 181.22 -60.84
Texas P8 - Basic Self & Family P82 1731.36 1595.60 1138.19 457.41 -143.86
Texas P8 - Basic Self Plus One P83 1448.24 1507.42 1066.59 440.83 56.42
Texas P8 - Standard Self P84 874.68 826.87 498.72 328.15 -49.82
Texas P8 - Standard Self & Family P85 2050.30 1940.84 1138.19 802.65 -117.56
Texas P8 - Standard Self Plus One P86 1714.94 1833.59 1066.59 767.00 115.89
Texas Q2 - Basic Self Q21 567.28 597.50 448.13 149.37 7.55
Texas Q2 - Basic Self & Family Q22 1276.38 1344.35 1008.26 336.09 17.00
Texas Q2 - Basic Self Plus One Q23 1219.64 1284.57 963.43 321.14 16.23
Texas Q6 - Basic Self Q61 564.53 588.92 441.69 147.23 6.10
Texas Q6 - Basic Self & Family Q62 1270.19 1325.11 993.83 331.28 13.73
Texas Q6 - Basic Self Plus One Q63 1213.75 1266.20 949.65 316.55 13.11
Texas QX - Basic Self QX1 587.90 619.21 464.41 154.80 7.83
Texas QX - Basic Self & Family QX2 1322.77 1393.21 1044.91 348.30 17.61
Texas QX - Basic Self Plus One QX3 1263.99 1331.29 998.47 332.82 16.82
Texas QY - Basic Self QY1 582.64 613.67 460.25 153.42 7.76
Texas QY - Basic Self & Family QY2 1310.94 1380.75 1035.56 345.19 17.46
Texas QY - Basic Self Plus One QY3 1252.70 1319.39 989.54 329.85 16.68
Texas T3 - Value Self T34 482.39 498.25 373.69 124.56 3.96
Texas T3 - Value Self & Family T35 1085.39 1121.08 840.81 280.27 8.92
Texas T3 - Value Self Plus One T36 1037.14 1071.27 803.45 267.82 8.54
Texas T3 - CDHP Self T31 633.27 654.10 490.58 163.52 5.20
Texas T3 - CDHP Self & Family T32 1424.87 1471.69 1103.77 367.92 11.70
Texas T3 - CDHP Self Plus One T33 1361.56 1406.30 1054.73 351.57 11.18
Texas TP - CDHP Self TP1 589.83 591.48 443.61 147.87 0.41
Texas TP - CDHP Self & Family TP2 1327.13 1330.83 998.12 332.71 0.93
Texas TP - CDHP Self Plus One TP3 1268.15 1271.70 953.78 317.92 0.88
Texas TP - Value Self TP4 418.75 398.93 299.20 99.73 -4.96
Texas TP - Value Self & Family TP5 942.22 897.59 673.19 224.40 -11.15
Texas TP - Value Self Plus One TP6 900.34 857.72 643.29 214.43 -10.65
Texas TU - Value Self TU4 507.20 508.63 381.47 127.16 0.36
Texas TU - Value Self & Family TU5 1141.21 1144.39 858.29 286.10 0.80
Texas TU - Value Self Plus One TU6 1090.51 1093.56 820.17 273.39 0.76
Texas TU - CDHP Self TU1 637.61 639.38 479.54 159.84 0.44
Texas TU - CDHP Self & Family TU2 1434.64 1438.65 1078.99 359.66 1.00
Texas TU - CDHP Self Plus One TU3 1370.85 1374.69 1031.02 343.67 0.96
Texas TV - CDHP Self TV1 665.69 707.59 498.72 208.87 39.89
Texas TV - CDHP Self & Family TV2 1497.80 1592.09 1138.19 453.90 79.45
Texas TV - CDHP Self Plus One TV3 1431.24 1521.35 1066.59 454.76 87.35
Texas TV - Value Self TV4 539.74 579.13 434.35 144.78 9.85
Texas TV - Value Self & Family TV5 1214.42 1303.06 977.30 325.76 22.16
Texas TV - Value Self Plus One TV6 1160.45 1245.14 933.86 311.28 21.17
Texas UC - Standard Self UC4 745.23 799.87 498.72 301.15 52.63
Texas UC - Standard Self & Family UC5 1676.74 1799.70 1138.19 661.51 114.86
Texas UC - Standard Self Plus One UC6 1602.23 1719.71 1066.59 653.12 114.72
Texas UC - High Self UC1 929.05 977.93 498.72 479.21 46.87
Texas UC - High Self & Family UC2 2090.36 2200.36 1138.19 1062.17 101.90
Texas UC - High Self Plus One UC3 1997.45 2102.56 1066.59 1035.97 102.35
Texas UR - Standard Self UR4 888.16 890.89 498.72 392.17 0.72
Texas UR - Standard Self & Family UR5 1998.34 2004.54 1138.19 866.35 -1.90
Texas UR - Standard Self Plus One UR6 1909.53 1915.44 1066.59 848.85 3.15
Texas UR - High Self UR1 1370.89 1291.83 498.72 793.11 -81.07
Texas UR - High Self & Family UR2 3084.49 2906.65 1138.19 1768.46 -185.94
Texas UR - High Self Plus One UR3 2947.43 2777.45 1066.59 1710.86 -172.74
Texas UU - Standard Self UU4 1186.64 1297.47 498.72 798.75 108.82
Texas UU - Standard Self & Family UU5 2670.01 2919.32 1138.19 1781.13 241.21
Texas UU - Standard Self Plus One UU6 2551.34 2789.56 1066.59 1722.97 235.46
Texas UU - High Self UU1 1452.97 1471.21 498.72 972.49 16.23
Texas UU - High Self & Family UU2 3269.20 3310.15 1138.19 2171.96 32.85
Texas UU - High Self Plus One UU3 3123.90 3163.05 1066.59 2096.46 36.39
Utah 9K - High Self 9K1 848.08 935.24 498.72 436.52 85.15
Utah 9K - High Self & Family 9K2 1875.47 2068.26 1138.19 930.07 184.69
Utah 9K - High Self Plus One 9K3 1856.90 2047.78 1066.59 981.19 188.12
Utah 9K - HDHP Self 9K4 420.70 506.91 380.18 126.73 21.56
Utah 9K - HDHP Self & Family 9K5 879.23 1059.41 794.56 264.85 45.04
Utah 9K - HDHP Self Plus One 9K6 861.99 1038.64 778.98 259.66 44.16
Utah Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Utah Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Utah Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Utah Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Utah Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Utah Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Utah DK - Standard Self DK4 593.60 712.44 498.72 213.72 65.32
Utah DK - Standard Self & Family DK5 1310.81 1573.30 1138.19 435.11 107.41
Utah DK - Standard Self Plus One DK6 1297.83 1557.70 1066.59 491.11 166.65
Utah SelectHealth Plan - Standard Self SF4 595.42 619.21 464.41 154.80 5.95
Utah SelectHealth Plan - Standard Self & Family SF5 1357.05 1411.26 1058.45 352.81 13.55
Utah SelectHealth Plan - Standard Self Plus One SF6 1357.05 1411.26 1058.45 352.81 13.55
Utah SelectHealth Plan - High Self SF1 973.68 1044.46 498.72 545.74 68.77
Utah SelectHealth Plan - High Self & Family SF2 2219.21 2380.54 1138.19 1242.35 153.23
Utah SelectHealth Plan - High Self Plus One SF3 2219.21 2380.54 1066.59 1313.95 158.57
Utah WX - HDHP Self WX1 New Plan 506.91 380.18 126.73 New Plan
Utah WX - HDHP Self & Family WX2 New Plan 1155.31 866.48 288.83 New Plan
Utah WX - HDHP Self Plus One WX3 New Plan 1155.31 866.48 288.83 New Plan
Vermont Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Vermont Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Vermont Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 565.39 619.08 464.31 154.77 13.42
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1294.71 1417.65 1063.24 354.41 30.73
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1269.32 1389.85 1042.39 347.46 30.13
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 898.60 916.80 498.72 418.08 16.19
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2049.32 2090.83 1138.19 952.64 33.41
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2029.04 2070.12 1066.59 1003.53 38.32
Vermont Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Vermont Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Vermont Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Virgin Islands 85 - High Self 851 627.88 659.25 494.44 164.81 7.84
Virgin Islands 85 - High Self & Family 852 1437.82 1509.71 1132.28 377.43 17.98
Virgin Islands 85 - High Self Plus One 853 1409.79 1480.27 1066.59 413.68 61.23
Virginia 2G - Standard Self 2G4 693.62 797.68 498.72 298.96 102.05
Virginia 2G - Standard Self & Family 2G5 1648.05 1895.25 1138.19 757.06 239.10
Virginia 2G - Standard Self Plus One 2G6 1387.25 1595.34 1066.59 528.75 181.94
Virginia Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Virginia Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Virginia Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
Virginia Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Virginia B6 - HDHP Self B61 609.72 518.27 388.70 129.57 -22.86
Virginia B6 - HDHP Self & Family B62 1448.68 1231.38 923.54 307.84 -54.33
Virginia B6 - HDHP Self Plus One B63 1219.44 1036.51 777.38 259.13 -45.73
Virginia E3 - Standard Self E34 504.96 521.76 391.32 130.44 4.20
Virginia E3 - Standard Self & Family E35 1161.49 1199.99 899.99 300.00 9.63
Virginia E3 - Standard Self Plus One E36 1161.49 1199.99 899.99 300.00 9.63
Virginia E3 - High Self E31 660.36 692.68 498.72 193.96 28.87
Virginia E3 - High Self & Family E32 1518.83 1593.15 1138.19 454.96 66.22
Virginia E3 - High Self Plus One E33 1518.83 1593.15 1066.59 526.56 71.56
Virginia JN - High Self JN1 1103.09 1119.13 498.72 620.41 14.03
Virginia JN - High Self & Family JN2 2479.95 2515.98 1138.19 1377.79 27.93
Virginia JN - High Self Plus One JN3 2455.38 2491.04 1066.59 1424.45 32.90
Virginia JN - Basic Self JN4 662.85 680.46 498.72 181.74 15.60
Virginia JN - Basic Self & Family JN5 1516.95 1557.25 1138.19 419.06 32.20
Virginia JN - Basic Self Plus One JN6 1392.99 1430.00 1066.59 363.41 15.16
Virginia JP - High Self JP1 717.77 790.86 498.72 292.14 71.08
Virginia JP - High Self & Family JP2 2012.66 2217.54 1138.19 1079.35 196.78
Virginia JP - High Self Plus One JP3 1401.81 1544.53 1066.59 477.94 127.49
Virginia L9 - Value Self L91 463.32 437.06 327.80 109.26 -6.57
Virginia L9 - Value Self & Family L92 1299.18 1225.49 919.12 306.37 -18.42
Virginia L9 - Value Self Plus One L93 904.89 853.56 640.17 213.39 -12.83
Virginia LR - High Self LR1 607.99 667.94 498.72 169.22 17.22
Virginia LR - High Self & Family LR2 1520.00 1582.99 1138.19 444.80 54.89
Virginia LR - High Self Plus One LR3 1307.19 1436.05 1066.59 369.46 42.66
Virginia PG - HDHP Self PG4 New Plan 605.19 453.89 151.30 New Plan
Virginia PG - HDHP Self & Family PG5 New Plan 1334.99 1001.24 333.75 New Plan
Virginia PG - HDHP Self Plus One PG6 New Plan 1308.80 981.60 327.20 New Plan
Virginia PG - High Self PG1 651.28 678.47 498.72 179.75 16.93
Virginia PG - High Self & Family PG2 1573.80 1639.47 1138.19 501.28 57.57
Virginia PG - High Self Plus One PG3 1573.69 1639.37 1066.59 572.78 62.92
Virginia T7 - Basic Self T71 460.03 420.12 315.09 105.03 -9.98
Virginia T7 - Basic Self & Family T72 1104.50 1026.16 769.62 256.54 -19.58
Virginia T7 - Basic Self Plus One T73 1006.22 934.90 701.18 233.72 -17.83
Virginia V4 - HDHP Self V41 566.97 495.69 371.77 123.92 -17.82
Virginia V4 - HDHP Self & Family V42 1417.48 1140.06 855.05 285.01 -69.36
Virginia V4 - HDHP Self Plus One V43 1219.01 1065.72 799.29 266.43 -38.32
Washington 54 - Standard Self 544 608.99 585.17 438.88 146.29 -5.96
Washington 54 - Standard Self & Family 545 1400.66 1345.91 1009.43 336.48 -13.68
Washington 54 - Standard Self Plus One 546 1400.66 1345.91 1009.43 336.48 -13.68
Washington 54 - High Self 541 825.59 815.40 498.72 316.68 -12.20
Washington 54 - High Self & Family 542 1816.32 1793.91 1138.19 655.72 -30.51
Washington 54 - High Self Plus One 543 1816.32 1793.91 1066.59 727.32 -25.17
Washington 57 - Standard Self 574 600.25 620.30 465.23 155.07 5.01
Washington 57 - Standard Self & Family 575 1378.98 1425.00 1068.75 356.25 11.51
Washington 57 - Standard Self Plus One 576 1378.98 1425.00 1066.59 358.41 13.67
Washington 57 - High Self 571 692.08 706.68 498.72 207.96 12.59
Washington 57 - High Self & Family 572 1563.14 1596.16 1138.19 457.97 24.92
Washington 57 - High Self Plus One 573 1563.14 1596.16 1066.59 529.57 30.26
Washington Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Washington Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Washington Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 549.60 670.58 498.72 171.86 34.46
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1258.73 1535.86 1138.19 397.67 82.99
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1234.07 1505.77 1066.59 439.18 130.66
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 750.27 785.14 498.72 286.42 32.86
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 1711.34 1790.88 1138.19 652.69 71.44
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 1694.42 1773.18 1066.59 706.59 76.00
Washington Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Washington Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Washington Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Washington KT - High Self KT1 610.68 679.19 498.72 180.47 27.80
Washington KT - High Self & Family KT2 1526.70 1697.95 1138.19 559.76 163.15
Washington KT - High Self Plus One KT3 1312.96 1460.23 1066.59 393.64 65.40
Washington L1 - Standard Self L11 664.56 697.82 498.72 199.10 31.25
Washington L1 - Standard Self & Family L12 1475.31 1549.12 1138.19 410.93 42.10
Washington L1 - Standard Self Plus One L13 1475.31 1549.12 1066.59 482.53 71.05
Washington L1 - HDHP Self L14 525.79 587.17 440.38 146.79 15.34
Washington L1 - HDHP Self & Family L15 1167.25 1303.49 977.62 325.87 34.06
Washington L1 - HDHP Self Plus One L16 1167.25 1303.49 977.62 325.87 34.06
Washington LU - HDHP Self LU1 482.91 450.32 337.74 112.58 -8.15
Washington LU - HDHP Self & Family LU2 1207.25 1035.73 776.80 258.93 -42.88
Washington LU - HDHP Self Plus One LU3 1038.25 968.20 726.15 242.05 -17.51
West Virginia Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
West Virginia Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
West Virginia Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 805.96 810.79 498.72 312.07 2.82
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1837.66 1848.71 1138.19 710.52 2.95
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1819.46 1830.40 1066.59 763.81 8.18
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 582.99 708.44 498.72 209.72 63.97
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1334.99 1622.25 1138.19 484.06 150.31
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1308.80 1590.42 1066.59 523.83 196.63
West Virginia Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
West Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Wisconsin Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Wisconsin Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Wisconsin Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 764.34 803.99 498.72 305.27 37.64
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 1744.88 1835.41 1138.19 697.22 82.43
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 1727.61 1817.25 1066.59 750.66 86.88
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1042.95 1049.04 498.72 550.32 4.08
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2377.46 2391.35 1138.19 1253.16 5.79
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2353.95 2367.69 1066.59 1301.10 10.98
Wisconsin Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Wisconsin EY - High Self EY1 766.48 764.05 498.72 265.33 -4.44
Wisconsin EY - High Self & Family EY2 2000.27 1994.01 1138.19 855.82 -14.36
Wisconsin EY - High Self Plus One EY3 1647.95 1642.81 1066.59 576.22 -7.90
Wisconsin V3 - Standard Self V34 457.49 428.09 321.07 107.02 -7.35
Wisconsin V3 - Standard Self & Family V35 1114.47 1042.82 782.12 260.70 -17.92
Wisconsin V3 - Standard Self Plus One V36 1011.08 946.08 709.56 236.52 -16.25
Wisconsin V3 - High Self V31 773.33 790.31 498.72 291.59 14.97
Wisconsin V3 - High Self & Family V32 1883.83 1925.21 1138.19 787.02 33.28
Wisconsin V3 - High Self Plus One V33 1709.05 1746.57 1066.59 679.98 34.76
Wisconsin WD - High Self WD1 1067.43 1097.14 498.72 598.42 27.70
Wisconsin WD - High Self & Family WD2 2455.05 2523.39 1138.19 1385.20 60.24
Wisconsin WD - High Self Plus One WD3 2241.57 2303.97 1066.59 1237.38 59.64
Wisconsin WD - Standard Self WD4 643.00 645.67 484.25 161.42 0.67
Wisconsin WD - Standard Self & Family WD5 1543.21 1549.62 1138.19 411.43 -1.69
Wisconsin WD - Standard Self Plus One WD6 1414.62 1420.51 1065.38 355.13 1.48
Wisconsin WJ - High Self WJ1 697.17 731.03 498.72 232.31 31.85
Wisconsin WJ - High Self & Family WJ2 2077.55 1900.69 1138.19 762.50 -184.96
Wisconsin WJ - High Self Plus One WJ3 1380.38 1608.27 1066.59 541.68 196.59
Wyoming 9K - High Self 9K1 848.08 935.24 498.72 436.52 85.15
Wyoming 9K - High Self & Family 9K2 1875.47 2068.26 1138.19 930.07 184.69
Wyoming 9K - High Self Plus One 9K3 1856.90 2047.78 1066.59 981.19 188.12
Wyoming 9K - HDHP Self 9K4 420.70 506.91 380.18 126.73 21.56
Wyoming 9K - HDHP Self & Family 9K5 879.23 1059.41 794.56 264.85 45.04
Wyoming 9K - HDHP Self Plus One 9K6 861.99 1038.64 778.98 259.66 44.16
Wyoming Aetna Direct - CDHP Self N61 527.67 557.33 418.00 139.33 7.41
Wyoming Aetna Direct - CDHP Self & Family N62 1330.70 1405.54 1054.16 351.38 18.71
Wyoming Aetna Direct - CDHP Self Plus One N63 1157.17 1222.26 916.70 305.56 16.27
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 822.84 828.86 498.72 330.14 4.01
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1875.64 1889.38 1138.19 751.19 5.64
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1857.07 1870.68 1066.59 804.09 10.85
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 575.73 616.53 462.40 154.13 10.20
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1321.36 1414.99 1061.24 353.75 23.41
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1295.45 1387.25 1040.44 346.81 22.95
Wyoming Aetna HealthFund HDHP - HDHP Self 224 607.43 659.71 494.78 164.93 13.07
Wyoming Aetna HealthFund HDHP - HDHP Self & Family 225 1339.91 1455.20 1091.40 363.80 28.82
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One 226 1313.63 1426.69 1066.59 360.10 31.69
Wyoming DK - Standard Self DK4 593.60 712.44 498.72 213.72 65.32
Wyoming DK - Standard Self & Family DK5 1310.81 1573.30 1138.19 435.11 107.41
Wyoming DK - Standard Self Plus One DK6 1297.83 1557.70 1066.59 491.11 166.65
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