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Temporary Continuation of Coverage (TCC) Premium Rates and Former Spouse Premiums
HMO (Regional Plans with Specific Service Areas)
Alabama Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Alabama Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Alabama Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Alabama Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Alabama Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Alabama Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
F51 |
845.81 |
868.77 |
0.00 |
868.77 |
22.96 |
829.23 |
851.74 |
0.00 |
851.74 |
22.51 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
F52 |
1928.53 |
1980.87 |
0.00 |
1980.87 |
52.34 |
1890.72 |
1942.03 |
0.00 |
1942.03 |
51.31 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
F53 |
1909.44 |
1961.27 |
0.00 |
1961.27 |
51.83 |
1872.00 |
1922.81 |
0.00 |
1922.81 |
50.81 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
F54 |
836.38 |
838.26 |
0.00 |
838.26 |
1.88 |
819.98 |
821.82 |
0.00 |
821.82 |
1.84 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
F55 |
1915.16 |
1919.52 |
0.00 |
1919.52 |
4.36 |
1877.61 |
1881.88 |
0.00 |
1881.88 |
4.27 |
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
F56 |
1877.60 |
1881.86 |
0.00 |
1881.86 |
4.26 |
1840.78 |
1844.96 |
0.00 |
1844.96 |
4.18 |
Alabama Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Alabama Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Alabama Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
LS1 |
463.83 |
495.57 |
0.00 |
495.57 |
31.74 |
454.74 |
485.85 |
0.00 |
485.85 |
31.11 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
LS2 |
1066.84 |
1139.85 |
0.00 |
1139.85 |
73.01 |
1045.92 |
1117.50 |
0.00 |
1117.50 |
71.58 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
LS3 |
997.26 |
1065.48 |
0.00 |
1065.48 |
68.22 |
977.71 |
1044.59 |
0.00 |
1044.59 |
66.88 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
KK1 |
728.15 |
784.42 |
0.00 |
784.42 |
56.27 |
713.87 |
769.04 |
0.00 |
769.04 |
55.17 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
KK2 |
1820.40 |
1961.09 |
0.00 |
1961.09 |
140.69 |
1784.71 |
1922.64 |
0.00 |
1922.64 |
137.93 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
KK3 |
1565.57 |
1686.54 |
0.00 |
1686.54 |
120.97 |
1534.87 |
1653.47 |
0.00 |
1653.47 |
118.60 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Alaska Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Alaska Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Alaska Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Alaska Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Alaska Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Alaska Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
JS4 |
1094.95 |
1116.47 |
0.00 |
1116.47 |
21.52 |
1073.48 |
1094.58 |
0.00 |
1094.58 |
21.10 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
JS5 |
2499.60 |
2548.78 |
0.00 |
2548.78 |
49.18 |
2450.59 |
2498.80 |
0.00 |
2498.80 |
48.21 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
JS6 |
2474.85 |
2523.55 |
0.00 |
2523.55 |
48.70 |
2426.32 |
2474.07 |
0.00 |
2474.07 |
47.75 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
JS1 |
1024.07 |
1030.13 |
0.00 |
1030.13 |
6.06 |
1003.99 |
1009.93 |
0.00 |
1009.93 |
5.94 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
JS2 |
2334.42 |
2348.19 |
0.00 |
2348.19 |
13.77 |
2288.65 |
2302.15 |
0.00 |
2302.15 |
13.50 |
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
JS3 |
2311.31 |
2324.92 |
0.00 |
2324.92 |
13.61 |
2265.99 |
2279.33 |
0.00 |
2279.33 |
13.34 |
Alaska Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Alaska Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Alaska Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Arizona Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Arizona Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Arizona Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Arizona Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Arizona Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Arizona Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
G54 |
726.98 |
731.38 |
0.00 |
731.38 |
4.40 |
712.73 |
717.04 |
0.00 |
717.04 |
4.31 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
G55 |
1665.02 |
1675.12 |
0.00 |
1675.12 |
10.10 |
1632.37 |
1642.27 |
0.00 |
1642.27 |
9.90 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
G56 |
1632.38 |
1642.29 |
0.00 |
1642.29 |
9.91 |
1600.37 |
1610.09 |
0.00 |
1610.09 |
9.72 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
G51 |
922.59 |
1079.94 |
0.00 |
1079.94 |
157.35 |
904.50 |
1058.76 |
0.00 |
1058.76 |
154.26 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
G52 |
2104.36 |
2463.38 |
0.00 |
2463.38 |
359.02 |
2063.10 |
2415.08 |
0.00 |
2415.08 |
351.98 |
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
G53 |
2083.56 |
2439.02 |
0.00 |
2439.02 |
355.46 |
2042.71 |
2391.20 |
0.00 |
2391.20 |
348.49 |
Arizona Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Arizona Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Arizona Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Arizona Aetna Open Access - High Self |
WQ1 |
1184.38 |
1372.58 |
0.00 |
1372.58 |
188.20 |
1161.16 |
1345.67 |
0.00 |
1345.67 |
184.51 |
Arizona Aetna Open Access - High Self & Family |
WQ2 |
2875.66 |
3332.60 |
0.00 |
3332.60 |
456.94 |
2819.27 |
3267.25 |
0.00 |
3267.25 |
447.98 |
Arizona Aetna Open Access - High Self Plus One |
WQ3 |
2847.17 |
3299.56 |
0.00 |
3299.56 |
452.39 |
2791.34 |
3234.86 |
0.00 |
3234.86 |
443.52 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self |
R61 |
733.17 |
828.48 |
0.00 |
828.48 |
95.31 |
718.79 |
812.24 |
0.00 |
812.24 |
93.45 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
R62 |
1649.62 |
1864.05 |
0.00 |
1864.05 |
214.43 |
1617.27 |
1827.50 |
0.00 |
1827.50 |
210.23 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
R63 |
1576.29 |
1781.22 |
0.00 |
1781.22 |
204.93 |
1545.38 |
1746.29 |
0.00 |
1746.29 |
200.91 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self |
R64 |
586.03 |
662.20 |
0.00 |
662.20 |
76.17 |
574.54 |
649.22 |
0.00 |
649.22 |
74.68 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family |
R65 |
1318.53 |
1489.93 |
0.00 |
1489.93 |
171.40 |
1292.68 |
1460.72 |
0.00 |
1460.72 |
168.04 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
R66 |
1259.94 |
1423.73 |
0.00 |
1423.73 |
163.79 |
1235.24 |
1395.81 |
0.00 |
1395.81 |
160.57 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self |
R94 |
534.29 |
582.38 |
0.00 |
582.38 |
48.09 |
523.81 |
570.96 |
0.00 |
570.96 |
47.15 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family |
R95 |
1202.13 |
1310.31 |
0.00 |
1310.31 |
108.18 |
1178.56 |
1284.62 |
0.00 |
1284.62 |
106.06 |
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
R96 |
1148.71 |
1252.10 |
0.00 |
1252.10 |
103.39 |
1126.19 |
1227.55 |
0.00 |
1227.55 |
101.36 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self |
R91 |
671.05 |
731.42 |
0.00 |
731.42 |
60.37 |
657.89 |
717.08 |
0.00 |
717.08 |
59.19 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
R92 |
1509.80 |
1645.68 |
0.00 |
1645.68 |
135.88 |
1480.20 |
1613.41 |
0.00 |
1613.41 |
133.21 |
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
R93 |
1442.69 |
1572.52 |
0.00 |
1572.52 |
129.83 |
1414.40 |
1541.69 |
0.00 |
1541.69 |
127.29 |
Arizona Humana Health Plan, Inc. - Standard Self |
C74 |
799.78 |
911.74 |
0.00 |
911.74 |
111.96 |
784.10 |
893.86 |
0.00 |
893.86 |
109.76 |
Arizona Humana Health Plan, Inc. - Standard Self & Family |
C75 |
1799.47 |
2051.39 |
0.00 |
2051.39 |
251.92 |
1764.19 |
2011.17 |
0.00 |
2011.17 |
246.98 |
Arizona Humana Health Plan, Inc. - Standard Self Plus One |
C76 |
1719.44 |
1960.16 |
0.00 |
1960.16 |
240.72 |
1685.73 |
1921.73 |
0.00 |
1921.73 |
236.00 |
Arizona Humana Health Plan, Inc. - High Self |
C71 |
1038.24 |
1183.59 |
0.00 |
1183.59 |
145.35 |
1017.88 |
1160.38 |
0.00 |
1160.38 |
142.50 |
Arizona Humana Health Plan, Inc. - High Self & Family |
C72 |
2335.99 |
2663.05 |
0.00 |
2663.05 |
327.06 |
2290.19 |
2610.83 |
0.00 |
2610.83 |
320.64 |
Arizona Humana Health Plan, Inc. - High Self Plus One |
C73 |
2232.17 |
2544.69 |
0.00 |
2544.69 |
312.52 |
2188.40 |
2494.79 |
0.00 |
2494.79 |
306.39 |
Arizona Humana Health Plan, Inc. - High Self |
BF1 |
1458.09 |
1501.83 |
0.00 |
1501.83 |
43.74 |
1429.50 |
1472.38 |
0.00 |
1472.38 |
42.88 |
Arizona Humana Health Plan, Inc. - High Self & Family |
BF2 |
3280.60 |
3379.03 |
0.00 |
3379.03 |
98.43 |
3216.27 |
3312.77 |
0.00 |
3312.77 |
96.50 |
Arizona Humana Health Plan, Inc. - High Self Plus One |
BF3 |
3134.82 |
3228.83 |
0.00 |
3228.83 |
94.01 |
3073.35 |
3165.52 |
0.00 |
3165.52 |
92.17 |
Arizona Humana Health Plan, Inc. - Standard Self |
BF4 |
1177.34 |
1271.52 |
0.00 |
1271.52 |
94.18 |
1154.25 |
1246.59 |
0.00 |
1246.59 |
92.34 |
Arizona Humana Health Plan, Inc. - Standard Self & Family |
BF5 |
2649.02 |
2860.94 |
0.00 |
2860.94 |
211.92 |
2597.08 |
2804.84 |
0.00 |
2804.84 |
207.76 |
Arizona Humana Health Plan, Inc. - Standard Self Plus One |
BF6 |
2531.29 |
2733.81 |
0.00 |
2733.81 |
202.52 |
2481.66 |
2680.21 |
0.00 |
2680.21 |
198.55 |
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
WF1 |
533.32 |
634.66 |
0.00 |
634.66 |
101.34 |
522.86 |
622.22 |
0.00 |
622.22 |
99.36 |
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
WF2 |
1261.12 |
1500.97 |
0.00 |
1500.97 |
239.85 |
1236.39 |
1471.54 |
0.00 |
1471.54 |
235.15 |
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
WF3 |
1146.53 |
1364.53 |
0.00 |
1364.53 |
218.00 |
1124.05 |
1337.77 |
0.00 |
1337.77 |
213.72 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
LU1 |
452.72 |
538.73 |
0.00 |
538.73 |
86.01 |
443.84 |
528.17 |
0.00 |
528.17 |
84.33 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
LU2 |
1041.27 |
1239.06 |
0.00 |
1239.06 |
197.79 |
1020.85 |
1214.76 |
0.00 |
1214.76 |
193.91 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
LU3 |
973.36 |
1158.26 |
0.00 |
1158.26 |
184.90 |
954.27 |
1135.55 |
0.00 |
1135.55 |
181.28 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
KT1 |
739.27 |
797.76 |
0.00 |
797.76 |
58.49 |
724.77 |
782.12 |
0.00 |
782.12 |
57.35 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
KT2 |
1848.14 |
1994.46 |
0.00 |
1994.46 |
146.32 |
1811.90 |
1955.35 |
0.00 |
1955.35 |
143.45 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
KT3 |
1589.42 |
1715.20 |
0.00 |
1715.20 |
125.78 |
1558.25 |
1681.57 |
0.00 |
1681.57 |
123.32 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
VD1 |
532.46 |
633.63 |
0.00 |
633.63 |
101.17 |
522.02 |
621.21 |
0.00 |
621.21 |
99.19 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
VD2 |
1259.06 |
1498.51 |
0.00 |
1498.51 |
239.45 |
1234.37 |
1469.13 |
0.00 |
1469.13 |
234.76 |
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
VD3 |
1144.67 |
1362.29 |
0.00 |
1362.29 |
217.62 |
1122.23 |
1335.58 |
0.00 |
1335.58 |
213.35 |
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Arkansas Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Arkansas Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Arkansas Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Arkansas Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Arkansas Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Arkansas Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
F51 |
845.81 |
868.77 |
0.00 |
868.77 |
22.96 |
829.23 |
851.74 |
0.00 |
851.74 |
22.51 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
F52 |
1928.53 |
1980.87 |
0.00 |
1980.87 |
52.34 |
1890.72 |
1942.03 |
0.00 |
1942.03 |
51.31 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
F53 |
1909.44 |
1961.27 |
0.00 |
1961.27 |
51.83 |
1872.00 |
1922.81 |
0.00 |
1922.81 |
50.81 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
F54 |
836.38 |
838.26 |
0.00 |
838.26 |
1.88 |
819.98 |
821.82 |
0.00 |
821.82 |
1.84 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
F55 |
1915.16 |
1919.52 |
0.00 |
1919.52 |
4.36 |
1877.61 |
1881.88 |
0.00 |
1881.88 |
4.27 |
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
F56 |
1877.60 |
1881.86 |
0.00 |
1881.86 |
4.26 |
1840.78 |
1844.96 |
0.00 |
1844.96 |
4.18 |
Arkansas Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Arkansas Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Arkansas QualChoice - High Self |
DH1 |
767.24 |
782.61 |
0.00 |
782.61 |
15.37 |
752.20 |
767.26 |
0.00 |
767.26 |
15.06 |
Arkansas QualChoice - High Self & Family |
DH2 |
2001.20 |
2041.22 |
0.00 |
2041.22 |
40.02 |
1961.96 |
2001.20 |
0.00 |
2001.20 |
39.24 |
Arkansas QualChoice - High Self Plus One |
DH3 |
1490.40 |
1520.24 |
0.00 |
1520.24 |
29.84 |
1461.18 |
1490.43 |
0.00 |
1490.43 |
29.25 |
Arkansas QualChoice - Standard Self |
DH4 |
599.00 |
610.98 |
0.00 |
610.98 |
11.98 |
587.25 |
599.00 |
0.00 |
599.00 |
11.75 |
Arkansas QualChoice - Standard Self & Family |
DH5 |
1562.39 |
1593.68 |
0.00 |
1593.68 |
31.29 |
1531.75 |
1562.43 |
0.00 |
1562.43 |
30.68 |
Arkansas QualChoice - Standard Self Plus One |
DH6 |
1163.59 |
1186.90 |
0.00 |
1186.90 |
23.31 |
1140.77 |
1163.63 |
0.00 |
1163.63 |
22.86 |
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
LS1 |
463.83 |
495.57 |
0.00 |
495.57 |
31.74 |
454.74 |
485.85 |
0.00 |
485.85 |
31.11 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
LS2 |
1066.84 |
1139.85 |
0.00 |
1139.85 |
73.01 |
1045.92 |
1117.50 |
0.00 |
1117.50 |
71.58 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
LS3 |
997.26 |
1065.48 |
0.00 |
1065.48 |
68.22 |
977.71 |
1044.59 |
0.00 |
1044.59 |
66.88 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
KK1 |
728.15 |
784.42 |
0.00 |
784.42 |
56.27 |
713.87 |
769.04 |
0.00 |
769.04 |
55.17 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
KK2 |
1820.40 |
1961.09 |
0.00 |
1961.09 |
140.69 |
1784.71 |
1922.64 |
0.00 |
1922.64 |
137.93 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
KK3 |
1565.57 |
1686.54 |
0.00 |
1686.54 |
120.97 |
1534.87 |
1653.47 |
0.00 |
1653.47 |
118.60 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
California Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
California Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
California Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
California Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
California Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
California Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
JS4 |
1094.95 |
1116.47 |
0.00 |
1116.47 |
21.52 |
1073.48 |
1094.58 |
0.00 |
1094.58 |
21.10 |
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
JS5 |
2499.60 |
2548.78 |
0.00 |
2548.78 |
49.18 |
2450.59 |
2498.80 |
0.00 |
2498.80 |
48.21 |
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
JS6 |
2474.85 |
2523.55 |
0.00 |
2523.55 |
48.70 |
2426.32 |
2474.07 |
0.00 |
2474.07 |
47.75 |
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
JS1 |
1024.07 |
1030.13 |
0.00 |
1030.13 |
6.06 |
1003.99 |
1009.93 |
0.00 |
1009.93 |
5.94 |
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
JS2 |
2334.42 |
2348.19 |
0.00 |
2348.19 |
13.77 |
2288.65 |
2302.15 |
0.00 |
2302.15 |
13.50 |
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
JS3 |
2311.31 |
2324.92 |
0.00 |
2324.92 |
13.61 |
2265.99 |
2279.33 |
0.00 |
2279.33 |
13.34 |
California Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
California Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
California Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
California Aetna Open Access - High Self |
2X1 |
898.14 |
955.40 |
0.00 |
955.40 |
57.26 |
880.53 |
936.67 |
0.00 |
936.67 |
56.14 |
California Aetna Open Access - High Self & Family |
2X2 |
2108.58 |
2243.00 |
0.00 |
2243.00 |
134.42 |
2067.24 |
2199.02 |
0.00 |
2199.02 |
131.78 |
California Aetna Open Access - High Self Plus One |
2X3 |
2067.23 |
2199.02 |
0.00 |
2199.02 |
131.79 |
2026.70 |
2155.90 |
0.00 |
2155.90 |
129.20 |
California Anthem Blue Cross Select HMO - High Self |
B31 |
789.61 |
789.61 |
0.00 |
789.61 |
0.00 |
774.13 |
774.13 |
0.00 |
774.13 |
0.00 |
California Anthem Blue Cross Select HMO - High Self & Family |
B32 |
1804.29 |
1804.29 |
0.00 |
1804.29 |
0.00 |
1768.91 |
1768.91 |
0.00 |
1768.91 |
0.00 |
California Anthem Blue Cross Select HMO - High Self Plus One |
B33 |
1673.98 |
1673.98 |
0.00 |
1673.98 |
0.00 |
1641.16 |
1641.16 |
0.00 |
1641.16 |
0.00 |
California Blue Shield of California - Access + HMO Self |
SI1 |
850.52 |
876.05 |
0.00 |
876.05 |
25.53 |
833.84 |
858.87 |
0.00 |
858.87 |
25.03 |
California Blue Shield of California - Access + HMO Self & Family |
SI2 |
1956.21 |
2014.90 |
0.00 |
2014.90 |
58.69 |
1917.85 |
1975.39 |
0.00 |
1975.39 |
57.54 |
California Blue Shield of California - Access + HMO Self Plus One |
SI3 |
1871.14 |
1927.28 |
0.00 |
1927.28 |
56.14 |
1834.45 |
1889.49 |
0.00 |
1889.49 |
55.04 |
California Health Net of California - Basic Self |
P61 |
330.86 |
371.32 |
0.00 |
371.32 |
40.46 |
324.37 |
364.04 |
0.00 |
364.04 |
39.67 |
California Health Net of California - Basic Self & Family |
P62 |
794.03 |
891.20 |
0.00 |
891.20 |
97.17 |
778.46 |
873.73 |
0.00 |
873.73 |
95.27 |
California Health Net of California - Basic Self Plus One |
P63 |
727.86 |
816.95 |
0.00 |
816.95 |
89.09 |
713.59 |
800.93 |
0.00 |
800.93 |
87.34 |
California Health Net of California - High Self |
LP1 |
1069.33 |
1033.24 |
0.00 |
1033.24 |
-36.09 |
1048.36 |
1012.98 |
0.00 |
1012.98 |
-35.38 |
California Health Net of California - High Self & Family |
LP2 |
2566.38 |
2479.79 |
0.00 |
2479.79 |
-86.59 |
2516.06 |
2431.17 |
0.00 |
2431.17 |
-84.89 |
California Health Net of California - High Self Plus One |
LP3 |
2352.53 |
2273.14 |
0.00 |
2273.14 |
-79.39 |
2306.40 |
2228.57 |
0.00 |
2228.57 |
-77.83 |
California Health Net of California - High Self |
LB1 |
1540.77 |
1581.65 |
0.00 |
1581.65 |
40.88 |
1510.56 |
1550.64 |
0.00 |
1550.64 |
40.08 |
California Health Net of California - High Self & Family |
LB2 |
3697.89 |
3795.92 |
0.00 |
3795.92 |
98.03 |
3625.38 |
3721.49 |
0.00 |
3721.49 |
96.11 |
California Health Net of California - High Self Plus One |
LB3 |
3389.73 |
3479.58 |
0.00 |
3479.58 |
89.85 |
3323.26 |
3411.35 |
0.00 |
3411.35 |
88.09 |
California Health Net of California - Standard Self |
LB4 |
1367.35 |
1495.46 |
0.00 |
1495.46 |
128.11 |
1340.54 |
1466.14 |
0.00 |
1466.14 |
125.60 |
California Health Net of California - Standard Self & Family |
LB5 |
3281.63 |
3589.08 |
0.00 |
3589.08 |
307.45 |
3217.28 |
3518.71 |
0.00 |
3518.71 |
301.43 |
California Health Net of California - Standard Self Plus One |
LB6 |
3008.16 |
3290.01 |
0.00 |
3290.01 |
281.85 |
2949.18 |
3225.50 |
0.00 |
3225.50 |
276.32 |
California Health Net of California - Basic Self |
T41 |
899.47 |
912.06 |
0.00 |
912.06 |
12.59 |
881.83 |
894.18 |
0.00 |
894.18 |
12.35 |
California Health Net of California - Basic Self & Family |
T42 |
2158.73 |
2188.96 |
0.00 |
2188.96 |
30.23 |
2116.40 |
2146.04 |
0.00 |
2146.04 |
29.64 |
California Health Net of California - Basic Self Plus One |
T43 |
1978.86 |
2006.54 |
0.00 |
2006.54 |
27.68 |
1940.06 |
1967.20 |
0.00 |
1967.20 |
27.14 |
California Kaiser Permanente - Fresno California - Standard Self |
NZ4 |
578.14 |
601.91 |
0.00 |
601.91 |
23.77 |
566.80 |
590.11 |
0.00 |
590.11 |
23.31 |
California Kaiser Permanente - Fresno California - Standard Self & Family |
NZ5 |
1336.15 |
1391.15 |
0.00 |
1391.15 |
55.00 |
1309.95 |
1363.87 |
0.00 |
1363.87 |
53.92 |
California Kaiser Permanente - Fresno California - Standard Self Plus One |
NZ6 |
1336.15 |
1391.15 |
0.00 |
1391.15 |
55.00 |
1309.95 |
1363.87 |
0.00 |
1363.87 |
53.92 |
California Kaiser Permanente - Fresno California - High Self |
NZ1 |
792.46 |
819.05 |
0.00 |
819.05 |
26.59 |
776.92 |
802.99 |
0.00 |
802.99 |
26.07 |
California Kaiser Permanente - Fresno California - High Self & Family |
NZ2 |
1831.58 |
1892.98 |
0.00 |
1892.98 |
61.40 |
1795.67 |
1855.86 |
0.00 |
1855.86 |
60.19 |
California Kaiser Permanente - Fresno California - High Self Plus One |
NZ3 |
1831.58 |
1892.98 |
0.00 |
1892.98 |
61.40 |
1795.67 |
1855.86 |
0.00 |
1855.86 |
60.19 |
California Kaiser Permanente - Northern California - Basic Self |
KC1 |
665.12 |
665.12 |
0.00 |
665.12 |
0.00 |
652.08 |
652.08 |
0.00 |
652.08 |
0.00 |
California Kaiser Permanente - Northern California - Basic Self & Family |
KC2 |
1556.37 |
1556.37 |
0.00 |
1556.37 |
0.00 |
1525.85 |
1525.85 |
0.00 |
1525.85 |
0.00 |
California Kaiser Permanente - Northern California - Basic Self Plus One |
KC3 |
1556.37 |
1556.37 |
0.00 |
1556.37 |
0.00 |
1525.85 |
1525.85 |
0.00 |
1525.85 |
0.00 |
California Kaiser Permanente - Northern California - High Self |
591 |
1020.47 |
1034.83 |
0.00 |
1034.83 |
14.36 |
1000.46 |
1014.54 |
0.00 |
1014.54 |
14.08 |
California Kaiser Permanente - Northern California - High Self & Family |
592 |
2435.97 |
2470.30 |
0.00 |
2470.30 |
34.33 |
2388.21 |
2421.86 |
0.00 |
2421.86 |
33.65 |
California Kaiser Permanente - Northern California - High Self Plus One |
593 |
2435.97 |
2470.30 |
0.00 |
2470.30 |
34.33 |
2388.21 |
2421.86 |
0.00 |
2421.86 |
33.65 |
California Kaiser Permanente - Northern California - Standard Self |
594 |
826.08 |
839.13 |
0.00 |
839.13 |
13.05 |
809.88 |
822.68 |
0.00 |
822.68 |
12.80 |
California Kaiser Permanente - Northern California - Standard Self & Family |
595 |
1932.98 |
1963.61 |
0.00 |
1963.61 |
30.63 |
1895.08 |
1925.11 |
0.00 |
1925.11 |
30.03 |
California Kaiser Permanente - Northern California - Standard Self Plus One |
596 |
1932.98 |
1963.61 |
0.00 |
1963.61 |
30.63 |
1895.08 |
1925.11 |
0.00 |
1925.11 |
30.03 |
California Kaiser Permanente - Southern California - Standard Self |
624 |
475.64 |
482.91 |
0.00 |
482.91 |
7.27 |
466.31 |
473.44 |
0.00 |
473.44 |
7.13 |
California Kaiser Permanente - Southern California - Standard Self & Family |
625 |
1099.25 |
1116.09 |
0.00 |
1116.09 |
16.84 |
1077.70 |
1094.21 |
0.00 |
1094.21 |
16.51 |
California Kaiser Permanente - Southern California - Standard Self Plus One |
626 |
1099.25 |
1116.09 |
0.00 |
1116.09 |
16.84 |
1077.70 |
1094.21 |
0.00 |
1094.21 |
16.51 |
California Kaiser Permanente - Southern California - High Self |
621 |
750.12 |
765.19 |
0.00 |
765.19 |
15.07 |
735.41 |
750.19 |
0.00 |
750.19 |
14.78 |
California Kaiser Permanente - Southern California - High Self & Family |
622 |
1733.65 |
1768.51 |
0.00 |
1768.51 |
34.86 |
1699.66 |
1733.83 |
0.00 |
1733.83 |
34.17 |
California Kaiser Permanente - Southern California - High Self Plus One |
623 |
1733.65 |
1768.51 |
0.00 |
1768.51 |
34.86 |
1699.66 |
1733.83 |
0.00 |
1733.83 |
34.17 |
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Colorado Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Colorado Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Colorado Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Colorado Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Colorado Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Colorado Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
G54 |
726.98 |
731.38 |
0.00 |
731.38 |
4.40 |
712.73 |
717.04 |
0.00 |
717.04 |
4.31 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
G55 |
1665.02 |
1675.12 |
0.00 |
1675.12 |
10.10 |
1632.37 |
1642.27 |
0.00 |
1642.27 |
9.90 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
G56 |
1632.38 |
1642.29 |
0.00 |
1642.29 |
9.91 |
1600.37 |
1610.09 |
0.00 |
1610.09 |
9.72 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
G51 |
922.59 |
1079.94 |
0.00 |
1079.94 |
157.35 |
904.50 |
1058.76 |
0.00 |
1058.76 |
154.26 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
G52 |
2104.36 |
2463.38 |
0.00 |
2463.38 |
359.02 |
2063.10 |
2415.08 |
0.00 |
2415.08 |
351.98 |
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
G53 |
2083.56 |
2439.02 |
0.00 |
2439.02 |
355.46 |
2042.71 |
2391.20 |
0.00 |
2391.20 |
348.49 |
Colorado Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Colorado Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Colorado Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self |
WW1 |
649.08 |
649.08 |
0.00 |
649.08 |
0.00 |
636.35 |
636.35 |
0.00 |
636.35 |
0.00 |
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self & Family |
WW2 |
1580.48 |
1580.48 |
0.00 |
1580.48 |
0.00 |
1549.49 |
1549.49 |
0.00 |
1549.49 |
0.00 |
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self Plus One |
WW3 |
1476.61 |
1476.61 |
0.00 |
1476.61 |
0.00 |
1447.66 |
1447.66 |
0.00 |
1447.66 |
0.00 |
Colorado Humana Health Plan, Inc. - High Self |
NR1 |
837.94 |
980.40 |
0.00 |
980.40 |
142.46 |
821.51 |
961.18 |
0.00 |
961.18 |
139.67 |
Colorado Humana Health Plan, Inc. - High Self & Family |
NR2 |
1885.38 |
2205.89 |
0.00 |
2205.89 |
320.51 |
1848.41 |
2162.64 |
0.00 |
2162.64 |
314.23 |
Colorado Humana Health Plan, Inc. - High Self Plus One |
NR3 |
1801.60 |
2107.85 |
0.00 |
2107.85 |
306.25 |
1766.27 |
2066.52 |
0.00 |
2066.52 |
300.25 |
Colorado Humana Health Plan, Inc. - Standard Self |
NR4 |
580.70 |
679.40 |
0.00 |
679.40 |
98.70 |
569.31 |
666.08 |
0.00 |
666.08 |
96.77 |
Colorado Humana Health Plan, Inc. - Standard Self & Family |
NR5 |
1306.60 |
1528.70 |
0.00 |
1528.70 |
222.10 |
1280.98 |
1498.73 |
0.00 |
1498.73 |
217.75 |
Colorado Humana Health Plan, Inc. - Standard Self Plus One |
NR6 |
1248.50 |
1460.72 |
0.00 |
1460.72 |
212.22 |
1224.02 |
1432.08 |
0.00 |
1432.08 |
208.06 |
Colorado Humana Health Plan, Inc. - Basic Self |
RZ1 |
532.24 |
542.88 |
0.00 |
542.88 |
10.64 |
521.80 |
532.24 |
0.00 |
532.24 |
10.44 |
Colorado Humana Health Plan, Inc. - Basic Self & Family |
RZ2 |
1197.51 |
1221.47 |
0.00 |
1221.47 |
23.96 |
1174.03 |
1197.52 |
0.00 |
1197.52 |
23.49 |
Colorado Humana Health Plan, Inc. - Basic Self Plus One |
RZ3 |
1144.34 |
1167.22 |
0.00 |
1167.22 |
22.88 |
1121.90 |
1144.33 |
0.00 |
1144.33 |
22.43 |
Colorado Humana Health Plan, Inc. - High Self |
NT1 |
780.07 |
850.27 |
0.00 |
850.27 |
70.20 |
764.77 |
833.60 |
0.00 |
833.60 |
68.83 |
Colorado Humana Health Plan, Inc. - High Self & Family |
NT2 |
1755.21 |
1913.17 |
0.00 |
1913.17 |
157.96 |
1720.79 |
1875.66 |
0.00 |
1875.66 |
154.87 |
Colorado Humana Health Plan, Inc. - High Self Plus One |
NT3 |
1677.17 |
1828.12 |
0.00 |
1828.12 |
150.95 |
1644.28 |
1792.27 |
0.00 |
1792.27 |
147.99 |
Colorado Humana Health Plan, Inc. - Standard Self |
NT4 |
552.35 |
602.08 |
0.00 |
602.08 |
49.73 |
541.52 |
590.27 |
0.00 |
590.27 |
48.75 |
Colorado Humana Health Plan, Inc. - Standard Self & Family |
NT5 |
1242.82 |
1354.68 |
0.00 |
1354.68 |
111.86 |
1218.45 |
1328.12 |
0.00 |
1328.12 |
109.67 |
Colorado Humana Health Plan, Inc. - Standard Self Plus One |
NT6 |
1187.64 |
1294.51 |
0.00 |
1294.51 |
106.87 |
1164.35 |
1269.13 |
0.00 |
1269.13 |
104.78 |
Colorado Humana Health Plan, Inc. - Basic Self |
R21 |
541.74 |
633.83 |
0.00 |
633.83 |
92.09 |
531.12 |
621.40 |
0.00 |
621.40 |
90.28 |
Colorado Humana Health Plan, Inc. - Basic Self & Family |
R22 |
1218.90 |
1426.13 |
0.00 |
1426.13 |
207.23 |
1195.00 |
1398.17 |
0.00 |
1398.17 |
203.17 |
Colorado Humana Health Plan, Inc. - Basic Self Plus One |
R23 |
1164.74 |
1362.75 |
0.00 |
1362.75 |
198.01 |
1141.90 |
1336.03 |
0.00 |
1336.03 |
194.13 |
Colorado Kaiser Permanente - Colorado - Standard Self |
654 |
684.73 |
674.05 |
0.00 |
674.05 |
-10.68 |
671.30 |
660.83 |
0.00 |
660.83 |
-10.47 |
Colorado Kaiser Permanente - Colorado - Standard Self & Family |
655 |
1547.46 |
1523.33 |
0.00 |
1523.33 |
-24.13 |
1517.12 |
1493.46 |
0.00 |
1493.46 |
-23.66 |
Colorado Kaiser Permanente - Colorado - Standard Self Plus One |
656 |
1547.46 |
1523.33 |
0.00 |
1523.33 |
-24.13 |
1517.12 |
1493.46 |
0.00 |
1493.46 |
-23.66 |
Colorado Kaiser Permanente - Colorado - High Self |
651 |
804.95 |
788.35 |
0.00 |
788.35 |
-16.60 |
789.17 |
772.89 |
0.00 |
772.89 |
-16.28 |
Colorado Kaiser Permanente - Colorado - High Self & Family |
652 |
1819.18 |
1781.69 |
0.00 |
1781.69 |
-37.49 |
1783.51 |
1746.75 |
0.00 |
1746.75 |
-36.76 |
Colorado Kaiser Permanente - Colorado - High Self Plus One |
653 |
1819.18 |
1781.69 |
0.00 |
1781.69 |
-37.49 |
1783.51 |
1746.75 |
0.00 |
1746.75 |
-36.76 |
Colorado Kaiser Permanente - Colorado - Basic Self |
N41 |
494.47 |
454.42 |
0.00 |
454.42 |
-40.05 |
484.77 |
445.51 |
0.00 |
445.51 |
-39.26 |
Colorado Kaiser Permanente - Colorado - Basic Self & Family |
N42 |
1117.51 |
1117.86 |
0.00 |
1117.86 |
0.35 |
1095.60 |
1095.94 |
0.00 |
1095.94 |
0.34 |
Colorado Kaiser Permanente - Colorado - Basic Self Plus One |
N43 |
1117.51 |
1026.99 |
0.00 |
1026.99 |
-90.52 |
1095.60 |
1006.85 |
0.00 |
1006.85 |
-88.75 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
LU1 |
452.72 |
538.73 |
0.00 |
538.73 |
86.01 |
443.84 |
528.17 |
0.00 |
528.17 |
84.33 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
LU2 |
1041.27 |
1239.06 |
0.00 |
1239.06 |
197.79 |
1020.85 |
1214.76 |
0.00 |
1214.76 |
193.91 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
LU3 |
973.36 |
1158.26 |
0.00 |
1158.26 |
184.90 |
954.27 |
1135.55 |
0.00 |
1135.55 |
181.28 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
KT1 |
739.27 |
797.76 |
0.00 |
797.76 |
58.49 |
724.77 |
782.12 |
0.00 |
782.12 |
57.35 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
KT2 |
1848.14 |
1994.46 |
0.00 |
1994.46 |
146.32 |
1811.90 |
1955.35 |
0.00 |
1955.35 |
143.45 |
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
KT3 |
1589.42 |
1715.20 |
0.00 |
1715.20 |
125.78 |
1558.25 |
1681.57 |
0.00 |
1681.57 |
123.32 |
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Connecticut Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Connecticut Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Connecticut Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Connecticut Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Connecticut Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Connecticut Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
EP4 |
774.80 |
856.42 |
0.00 |
856.42 |
81.62 |
759.61 |
839.63 |
0.00 |
839.63 |
80.02 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
EP5 |
1774.30 |
1961.13 |
0.00 |
1961.13 |
186.83 |
1739.51 |
1922.68 |
0.00 |
1922.68 |
183.17 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
EP6 |
1739.49 |
1922.66 |
0.00 |
1922.66 |
183.17 |
1705.38 |
1884.96 |
0.00 |
1884.96 |
179.58 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
EP1 |
1097.27 |
1147.14 |
0.00 |
1147.14 |
49.87 |
1075.75 |
1124.65 |
0.00 |
1124.65 |
48.90 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
EP2 |
2502.39 |
2616.18 |
0.00 |
2616.18 |
113.79 |
2453.32 |
2564.88 |
0.00 |
2564.88 |
111.56 |
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
EP3 |
2477.61 |
2590.25 |
0.00 |
2590.25 |
112.64 |
2429.03 |
2539.46 |
0.00 |
2539.46 |
110.43 |
Connecticut Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Connecticut Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Delaware Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Delaware Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Delaware Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Delaware Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Delaware Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Delaware Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
EP4 |
774.80 |
856.42 |
0.00 |
856.42 |
81.62 |
759.61 |
839.63 |
0.00 |
839.63 |
80.02 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
EP5 |
1774.30 |
1961.13 |
0.00 |
1961.13 |
186.83 |
1739.51 |
1922.68 |
0.00 |
1922.68 |
183.17 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
EP6 |
1739.49 |
1922.66 |
0.00 |
1922.66 |
183.17 |
1705.38 |
1884.96 |
0.00 |
1884.96 |
179.58 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
EP1 |
1097.27 |
1147.14 |
0.00 |
1147.14 |
49.87 |
1075.75 |
1124.65 |
0.00 |
1124.65 |
48.90 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
EP2 |
2502.39 |
2616.18 |
0.00 |
2616.18 |
113.79 |
2453.32 |
2564.88 |
0.00 |
2564.88 |
111.56 |
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
EP3 |
2477.61 |
2590.25 |
0.00 |
2590.25 |
112.64 |
2429.03 |
2539.46 |
0.00 |
2539.46 |
110.43 |
Delaware Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Delaware Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Delaware Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Delaware Aetna Open Access - Basic Self |
P34 |
1336.28 |
1535.64 |
0.00 |
1535.64 |
199.36 |
1310.08 |
1505.53 |
0.00 |
1505.53 |
195.45 |
Delaware Aetna Open Access - Basic Self & Family |
P35 |
3101.49 |
3564.23 |
0.00 |
3564.23 |
462.74 |
3040.68 |
3494.34 |
0.00 |
3494.34 |
453.66 |
Delaware Aetna Open Access - Basic Self Plus One |
P36 |
3070.75 |
3528.92 |
0.00 |
3528.92 |
458.17 |
3010.54 |
3459.73 |
0.00 |
3459.73 |
449.19 |
Delaware Aetna Open Access - High Self |
P31 |
1485.74 |
1619.99 |
0.00 |
1619.99 |
134.25 |
1456.61 |
1588.23 |
0.00 |
1588.23 |
131.62 |
Delaware Aetna Open Access - High Self & Family |
P32 |
3602.17 |
3927.72 |
0.00 |
3927.72 |
325.55 |
3531.54 |
3850.71 |
0.00 |
3850.71 |
319.17 |
Delaware Aetna Open Access - High Self Plus One |
P33 |
3566.48 |
3888.83 |
0.00 |
3888.83 |
322.35 |
3496.55 |
3812.58 |
0.00 |
3812.58 |
316.03 |
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
District Of Columbia Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
District Of Columbia Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
District Of Columbia Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
District Of Columbia Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
District Of Columbia Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
District Of Columbia Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
F51 |
845.81 |
868.77 |
0.00 |
868.77 |
22.96 |
829.23 |
851.74 |
0.00 |
851.74 |
22.51 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
F52 |
1928.53 |
1980.87 |
0.00 |
1980.87 |
52.34 |
1890.72 |
1942.03 |
0.00 |
1942.03 |
51.31 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
F53 |
1909.44 |
1961.27 |
0.00 |
1961.27 |
51.83 |
1872.00 |
1922.81 |
0.00 |
1922.81 |
50.81 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
F54 |
836.38 |
838.26 |
0.00 |
838.26 |
1.88 |
819.98 |
821.82 |
0.00 |
821.82 |
1.84 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
F55 |
1915.16 |
1919.52 |
0.00 |
1919.52 |
4.36 |
1877.61 |
1881.88 |
0.00 |
1881.88 |
4.27 |
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
F56 |
1877.60 |
1881.86 |
0.00 |
1881.86 |
4.26 |
1840.78 |
1844.96 |
0.00 |
1844.96 |
4.18 |
District Of Columbia Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
District Of Columbia Aetna Open Access - High Self |
JN1 |
1160.32 |
1200.10 |
0.00 |
1200.10 |
39.78 |
1137.57 |
1176.57 |
0.00 |
1176.57 |
39.00 |
District Of Columbia Aetna Open Access - High Self & Family |
JN2 |
2608.58 |
2697.95 |
0.00 |
2697.95 |
89.37 |
2557.43 |
2645.05 |
0.00 |
2645.05 |
87.62 |
District Of Columbia Aetna Open Access - High Self Plus One |
JN3 |
2582.74 |
2671.23 |
0.00 |
2671.23 |
88.49 |
2532.10 |
2618.85 |
0.00 |
2618.85 |
86.75 |
District Of Columbia Aetna Open Access - Basic Self |
JN4 |
711.04 |
728.71 |
0.00 |
728.71 |
17.67 |
697.10 |
714.42 |
0.00 |
714.42 |
17.32 |
District Of Columbia Aetna Open Access - Basic Self & Family |
JN5 |
1627.25 |
1667.62 |
0.00 |
1667.62 |
40.37 |
1595.34 |
1634.92 |
0.00 |
1634.92 |
39.58 |
District Of Columbia Aetna Open Access - Basic Self Plus One |
JN6 |
1494.29 |
1531.36 |
0.00 |
1531.36 |
37.07 |
1464.99 |
1501.33 |
0.00 |
1501.33 |
36.34 |
District Of Columbia Aetna Saver (Open Access) - Saver Self |
QQ4 |
607.11 |
607.11 |
0.00 |
607.11 |
0.00 |
595.21 |
595.21 |
0.00 |
595.21 |
0.00 |
District Of Columbia Aetna Saver (Open Access) - Saver Self & Family |
QQ5 |
1389.38 |
1389.36 |
0.00 |
1389.36 |
-0.02 |
1362.14 |
1362.12 |
0.00 |
1362.12 |
-0.02 |
District Of Columbia Aetna Saver (Open Access) - Saver Self Plus One |
QQ6 |
1275.84 |
1275.84 |
0.00 |
1275.84 |
0.00 |
1250.82 |
1250.82 |
0.00 |
1250.82 |
0.00 |
District Of Columbia CareFirst BlueChoice - Standard Self |
2G4 |
862.45 |
905.57 |
0.00 |
905.57 |
43.12 |
845.54 |
887.81 |
0.00 |
887.81 |
42.27 |
District Of Columbia CareFirst BlueChoice - Standard Self & Family |
2G5 |
2049.14 |
2151.61 |
0.00 |
2151.61 |
102.47 |
2008.96 |
2109.42 |
0.00 |
2109.42 |
100.46 |
District Of Columbia CareFirst BlueChoice - Standard Self Plus One |
2G6 |
1724.88 |
1811.12 |
0.00 |
1811.12 |
86.24 |
1691.06 |
1775.61 |
0.00 |
1775.61 |
84.55 |
District Of Columbia CareFirst BlueChoice - HDHP Self |
B61 |
581.49 |
581.49 |
0.00 |
581.49 |
0.00 |
570.09 |
570.09 |
0.00 |
570.09 |
0.00 |
District Of Columbia CareFirst BlueChoice - HDHP Self & Family |
B62 |
1381.60 |
1381.60 |
0.00 |
1381.60 |
0.00 |
1354.51 |
1354.51 |
0.00 |
1354.51 |
0.00 |
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One |
B63 |
1162.97 |
1162.97 |
0.00 |
1162.97 |
0.00 |
1140.17 |
1140.17 |
0.00 |
1140.17 |
0.00 |
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self |
B64 |
720.11 |
738.14 |
0.00 |
738.14 |
18.03 |
705.99 |
723.67 |
0.00 |
723.67 |
17.68 |
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family |
B65 |
1711.01 |
1753.77 |
0.00 |
1753.77 |
42.76 |
1677.46 |
1719.38 |
0.00 |
1719.38 |
41.92 |
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One |
B66 |
1440.26 |
1476.24 |
0.00 |
1476.24 |
35.98 |
1412.02 |
1447.29 |
0.00 |
1447.29 |
35.27 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self |
T71 |
428.52 |
436.27 |
0.00 |
436.27 |
7.75 |
420.12 |
427.72 |
0.00 |
427.72 |
7.60 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self & Family |
T72 |
1046.68 |
1121.51 |
0.00 |
1121.51 |
74.83 |
1026.16 |
1099.52 |
0.00 |
1099.52 |
73.36 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One |
T73 |
953.60 |
970.88 |
0.00 |
970.88 |
17.28 |
934.90 |
951.84 |
0.00 |
951.84 |
16.94 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self |
E34 |
582.98 |
610.25 |
0.00 |
610.25 |
27.27 |
571.55 |
598.28 |
0.00 |
598.28 |
26.73 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family |
E35 |
1340.79 |
1403.57 |
0.00 |
1403.57 |
62.78 |
1314.50 |
1376.05 |
0.00 |
1376.05 |
61.55 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One |
E36 |
1340.79 |
1403.57 |
0.00 |
1403.57 |
62.78 |
1314.50 |
1376.05 |
0.00 |
1376.05 |
61.55 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self |
E31 |
737.28 |
761.16 |
0.00 |
761.16 |
23.88 |
722.82 |
746.24 |
0.00 |
746.24 |
23.42 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family |
E32 |
1695.78 |
1750.68 |
0.00 |
1750.68 |
54.90 |
1662.53 |
1716.35 |
0.00 |
1716.35 |
53.82 |
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One |
E33 |
1695.78 |
1750.68 |
0.00 |
1750.68 |
54.90 |
1662.53 |
1716.35 |
0.00 |
1716.35 |
53.82 |
District Of Columbia M.D. IPA - High Self |
JP1 |
894.14 |
969.91 |
0.00 |
969.91 |
75.77 |
876.61 |
950.89 |
0.00 |
950.89 |
74.28 |
District Of Columbia M.D. IPA - High Self & Family |
JP2 |
2507.20 |
2719.61 |
0.00 |
2719.61 |
212.41 |
2458.04 |
2666.28 |
0.00 |
2666.28 |
208.24 |
District Of Columbia M.D. IPA - High Self Plus One |
JP3 |
1746.28 |
1894.23 |
0.00 |
1894.23 |
147.95 |
1712.04 |
1857.09 |
0.00 |
1857.09 |
145.05 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
V41 |
496.30 |
530.31 |
0.00 |
530.31 |
34.01 |
486.57 |
519.91 |
0.00 |
519.91 |
33.34 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
V42 |
1141.49 |
1219.73 |
0.00 |
1219.73 |
78.24 |
1119.11 |
1195.81 |
0.00 |
1195.81 |
76.70 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
V43 |
1067.05 |
1140.17 |
0.00 |
1140.17 |
73.12 |
1046.13 |
1117.81 |
0.00 |
1117.81 |
71.68 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
LR1 |
729.19 |
785.81 |
0.00 |
785.81 |
56.62 |
714.89 |
770.40 |
0.00 |
770.40 |
55.51 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
LR2 |
1728.18 |
1862.35 |
0.00 |
1862.35 |
134.17 |
1694.29 |
1825.83 |
0.00 |
1825.83 |
131.54 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
LR3 |
1567.73 |
1689.46 |
0.00 |
1689.46 |
121.73 |
1536.99 |
1656.33 |
0.00 |
1656.33 |
119.34 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self |
L91 |
531.93 |
565.71 |
0.00 |
565.71 |
33.78 |
521.50 |
554.62 |
0.00 |
554.62 |
33.12 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family |
L92 |
1491.51 |
1586.25 |
0.00 |
1586.25 |
94.74 |
1462.26 |
1555.15 |
0.00 |
1555.15 |
92.89 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One |
L93 |
1038.83 |
1104.84 |
0.00 |
1104.84 |
66.01 |
1018.46 |
1083.18 |
0.00 |
1083.18 |
64.72 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Florida Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Florida Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Florida Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Florida Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Florida Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Florida Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
F51 |
845.81 |
868.77 |
0.00 |
868.77 |
22.96 |
829.23 |
851.74 |
0.00 |
851.74 |
22.51 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
F52 |
1928.53 |
1980.87 |
0.00 |
1980.87 |
52.34 |
1890.72 |
1942.03 |
0.00 |
1942.03 |
51.31 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
F53 |
1909.44 |
1961.27 |
0.00 |
1961.27 |
51.83 |
1872.00 |
1922.81 |
0.00 |
1922.81 |
50.81 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
F54 |
836.38 |
838.26 |
0.00 |
838.26 |
1.88 |
819.98 |
821.82 |
0.00 |
821.82 |
1.84 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
F55 |
1915.16 |
1919.52 |
0.00 |
1919.52 |
4.36 |
1877.61 |
1881.88 |
0.00 |
1881.88 |
4.27 |
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
F56 |
1877.60 |
1881.86 |
0.00 |
1881.86 |
4.26 |
1840.78 |
1844.96 |
0.00 |
1844.96 |
4.18 |
Florida Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Florida Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Florida Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Florida AvMed - HDHP Self |
WZ1 |
821.26 |
777.32 |
0.00 |
777.32 |
-43.94 |
805.16 |
762.08 |
0.00 |
762.08 |
-43.08 |
Florida AvMed - HDHP Self & Family |
WZ2 |
1908.78 |
1797.24 |
0.00 |
1797.24 |
-111.54 |
1871.35 |
1762.00 |
0.00 |
1762.00 |
-109.35 |
Florida AvMed - HDHP Self Plus One |
WZ3 |
1654.79 |
1559.24 |
0.00 |
1559.24 |
-95.55 |
1622.34 |
1528.67 |
0.00 |
1528.67 |
-93.67 |
Florida AvMed - Standard Self |
ML4 |
723.42 |
837.39 |
0.00 |
837.39 |
113.97 |
709.24 |
820.97 |
0.00 |
820.97 |
111.73 |
Florida AvMed - Standard Self & Family |
ML5 |
1761.35 |
2038.90 |
0.00 |
2038.90 |
277.55 |
1726.81 |
1998.92 |
0.00 |
1998.92 |
272.11 |
Florida AvMed - Standard Self Plus One |
ML6 |
1519.16 |
1758.54 |
0.00 |
1758.54 |
239.38 |
1489.37 |
1724.06 |
0.00 |
1724.06 |
234.69 |
Florida Capital Health Plan - High Self |
EA1 |
694.23 |
704.28 |
0.00 |
704.28 |
10.05 |
680.62 |
690.47 |
0.00 |
690.47 |
9.85 |
Florida Capital Health Plan - High Self & Family |
EA2 |
1608.88 |
1632.19 |
0.00 |
1632.19 |
23.31 |
1577.33 |
1600.19 |
0.00 |
1600.19 |
22.86 |
Florida Capital Health Plan - High Self Plus One |
EA3 |
1518.18 |
1540.19 |
0.00 |
1540.19 |
22.01 |
1488.41 |
1509.99 |
0.00 |
1509.99 |
21.58 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self |
W94 |
523.86 |
597.19 |
0.00 |
597.19 |
73.33 |
513.59 |
585.48 |
0.00 |
585.48 |
71.89 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family |
W95 |
1178.68 |
1343.68 |
0.00 |
1343.68 |
165.00 |
1155.57 |
1317.33 |
0.00 |
1317.33 |
161.76 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
W96 |
1126.28 |
1283.97 |
0.00 |
1283.97 |
157.69 |
1104.20 |
1258.79 |
0.00 |
1258.79 |
154.59 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self |
W91 |
619.24 |
705.94 |
0.00 |
705.94 |
86.70 |
607.10 |
692.10 |
0.00 |
692.10 |
85.00 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
W92 |
1393.27 |
1588.32 |
0.00 |
1588.32 |
195.05 |
1365.95 |
1557.18 |
0.00 |
1557.18 |
191.23 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
W93 |
1331.38 |
1517.74 |
0.00 |
1517.74 |
186.36 |
1305.27 |
1487.98 |
0.00 |
1487.98 |
182.71 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self |
QP1 |
739.55 |
783.93 |
0.00 |
783.93 |
44.38 |
725.05 |
768.56 |
0.00 |
768.56 |
43.51 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
QP2 |
1666.21 |
1766.19 |
0.00 |
1766.19 |
99.98 |
1633.54 |
1731.56 |
0.00 |
1731.56 |
98.02 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
QP3 |
1592.15 |
1687.67 |
0.00 |
1687.67 |
95.52 |
1560.93 |
1654.58 |
0.00 |
1654.58 |
93.65 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self |
QP4 |
529.74 |
561.52 |
0.00 |
561.52 |
31.78 |
519.35 |
550.51 |
0.00 |
550.51 |
31.16 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family |
QP5 |
1191.85 |
1263.37 |
0.00 |
1263.37 |
71.52 |
1168.48 |
1238.60 |
0.00 |
1238.60 |
70.12 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
QP6 |
1138.90 |
1207.23 |
0.00 |
1207.23 |
68.33 |
1116.57 |
1183.56 |
0.00 |
1183.56 |
66.99 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self |
MJ4 |
530.00 |
572.41 |
0.00 |
572.41 |
42.41 |
519.61 |
561.19 |
0.00 |
561.19 |
41.58 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family |
MJ5 |
1192.51 |
1287.92 |
0.00 |
1287.92 |
95.41 |
1169.13 |
1262.67 |
0.00 |
1262.67 |
93.54 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
MJ6 |
1139.52 |
1230.68 |
0.00 |
1230.68 |
91.16 |
1117.18 |
1206.55 |
0.00 |
1206.55 |
89.37 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self |
MJ1 |
967.03 |
1044.40 |
0.00 |
1044.40 |
77.37 |
948.07 |
1023.92 |
0.00 |
1023.92 |
75.85 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
MJ2 |
2175.81 |
2349.88 |
0.00 |
2349.88 |
174.07 |
2133.15 |
2303.80 |
0.00 |
2303.80 |
170.65 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
MJ3 |
2079.13 |
2245.47 |
0.00 |
2245.47 |
166.34 |
2038.36 |
2201.44 |
0.00 |
2201.44 |
163.08 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self |
X24 |
503.04 |
523.15 |
0.00 |
523.15 |
20.11 |
493.18 |
512.89 |
0.00 |
512.89 |
19.71 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family |
X25 |
1131.85 |
1177.13 |
0.00 |
1177.13 |
45.28 |
1109.66 |
1154.05 |
0.00 |
1154.05 |
44.39 |
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
X26 |
1081.56 |
1124.83 |
0.00 |
1124.83 |
43.27 |
1060.35 |
1102.77 |
0.00 |
1102.77 |
42.42 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self |
X21 |
594.65 |
618.43 |
0.00 |
618.43 |
23.78 |
582.99 |
606.30 |
0.00 |
606.30 |
23.31 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
X22 |
1337.97 |
1391.50 |
0.00 |
1391.50 |
53.53 |
1311.74 |
1364.22 |
0.00 |
1364.22 |
52.48 |
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
X23 |
1278.51 |
1329.65 |
0.00 |
1329.65 |
51.14 |
1253.44 |
1303.58 |
0.00 |
1303.58 |
50.14 |
Florida Humana Medical Plan, Inc. - Standard Self |
LL4 |
1096.45 |
1217.07 |
0.00 |
1217.07 |
120.62 |
1074.95 |
1193.21 |
0.00 |
1193.21 |
118.26 |
Florida Humana Medical Plan, Inc. - Standard Self & Family |
LL5 |
2466.98 |
2738.34 |
0.00 |
2738.34 |
271.36 |
2418.61 |
2684.65 |
0.00 |
2684.65 |
266.04 |
Florida Humana Medical Plan, Inc. - Standard Self Plus One |
LL6 |
2357.34 |
2616.64 |
0.00 |
2616.64 |
259.30 |
2311.12 |
2565.33 |
0.00 |
2565.33 |
254.21 |
Florida Humana Medical Plan, Inc. - High Self |
LL1 |
1692.33 |
1743.12 |
0.00 |
1743.12 |
50.79 |
1659.15 |
1708.94 |
0.00 |
1708.94 |
49.79 |
Florida Humana Medical Plan, Inc. - High Self & Family |
LL2 |
3807.72 |
3921.95 |
0.00 |
3921.95 |
114.23 |
3733.06 |
3845.05 |
0.00 |
3845.05 |
111.99 |
Florida Humana Medical Plan, Inc. - High Self Plus One |
LL3 |
3638.48 |
3747.63 |
0.00 |
3747.63 |
109.15 |
3567.14 |
3674.15 |
0.00 |
3674.15 |
107.01 |
Florida Humana Medical Plan, Inc. - High Self |
EE1 |
1137.44 |
1273.91 |
0.00 |
1273.91 |
136.47 |
1115.14 |
1248.93 |
0.00 |
1248.93 |
133.79 |
Florida Humana Medical Plan, Inc. - High Self & Family |
EE2 |
2559.25 |
2866.35 |
0.00 |
2866.35 |
307.10 |
2509.07 |
2810.15 |
0.00 |
2810.15 |
301.08 |
Florida Humana Medical Plan, Inc. - High Self Plus One |
EE3 |
2445.54 |
2739.01 |
0.00 |
2739.01 |
293.47 |
2397.59 |
2685.30 |
0.00 |
2685.30 |
287.71 |
Florida Humana Medical Plan, Inc. - Standard Self |
EE4 |
1017.06 |
1139.11 |
0.00 |
1139.11 |
122.05 |
997.12 |
1116.77 |
0.00 |
1116.77 |
119.65 |
Florida Humana Medical Plan, Inc. - Standard Self & Family |
EE5 |
2288.37 |
2562.96 |
0.00 |
2562.96 |
274.59 |
2243.50 |
2512.71 |
0.00 |
2512.71 |
269.21 |
Florida Humana Medical Plan, Inc. - Standard Self Plus One |
EE6 |
2186.67 |
2449.06 |
0.00 |
2449.06 |
262.39 |
2143.79 |
2401.04 |
0.00 |
2401.04 |
257.25 |
Florida Humana Medical Plan, Inc. - Standard Self |
E24 |
730.34 |
781.45 |
0.00 |
781.45 |
51.11 |
716.02 |
766.13 |
0.00 |
766.13 |
50.11 |
Florida Humana Medical Plan, Inc. - Standard Self & Family |
E25 |
1643.22 |
1758.26 |
0.00 |
1758.26 |
115.04 |
1611.00 |
1723.78 |
0.00 |
1723.78 |
112.78 |
Florida Humana Medical Plan, Inc. - Standard Self Plus One |
E26 |
1570.19 |
1680.08 |
0.00 |
1680.08 |
109.89 |
1539.40 |
1647.14 |
0.00 |
1647.14 |
107.74 |
Florida Humana Medical Plan, Inc. - High Self |
E21 |
1226.70 |
1312.57 |
0.00 |
1312.57 |
85.87 |
1202.65 |
1286.83 |
0.00 |
1286.83 |
84.18 |
Florida Humana Medical Plan, Inc. - High Self & Family |
E22 |
2759.98 |
2953.18 |
0.00 |
2953.18 |
193.20 |
2705.86 |
2895.27 |
0.00 |
2895.27 |
189.41 |
Florida Humana Medical Plan, Inc. - High Self Plus One |
E23 |
2637.32 |
2821.93 |
0.00 |
2821.93 |
184.61 |
2585.61 |
2766.60 |
0.00 |
2766.60 |
180.99 |
Florida Humana Medical Plan, Inc. - High Self |
EX1 |
911.27 |
1038.86 |
0.00 |
1038.86 |
127.59 |
893.40 |
1018.49 |
0.00 |
1018.49 |
125.09 |
Florida Humana Medical Plan, Inc. - High Self & Family |
EX2 |
2050.30 |
2337.36 |
0.00 |
2337.36 |
287.06 |
2010.10 |
2291.53 |
0.00 |
2291.53 |
281.43 |
Florida Humana Medical Plan, Inc. - High Self Plus One |
EX3 |
1959.19 |
2233.47 |
0.00 |
2233.47 |
274.28 |
1920.77 |
2189.68 |
0.00 |
2189.68 |
268.91 |
Florida Humana Medical Plan, Inc. - Standard Self |
EX4 |
746.87 |
851.42 |
0.00 |
851.42 |
104.55 |
732.23 |
834.73 |
0.00 |
834.73 |
102.50 |
Florida Humana Medical Plan, Inc. - Standard Self & Family |
EX5 |
1680.46 |
1915.71 |
0.00 |
1915.71 |
235.25 |
1647.51 |
1878.15 |
0.00 |
1878.15 |
230.64 |
Florida Humana Medical Plan, Inc. - Standard Self Plus One |
EX6 |
1605.77 |
1830.56 |
0.00 |
1830.56 |
224.79 |
1574.28 |
1794.67 |
0.00 |
1794.67 |
220.39 |
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self |
LS1 |
463.83 |
495.57 |
0.00 |
495.57 |
31.74 |
454.74 |
485.85 |
0.00 |
485.85 |
31.11 |
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family |
LS2 |
1066.84 |
1139.85 |
0.00 |
1139.85 |
73.01 |
1045.92 |
1117.50 |
0.00 |
1117.50 |
71.58 |
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One |
LS3 |
997.26 |
1065.48 |
0.00 |
1065.48 |
68.22 |
977.71 |
1044.59 |
0.00 |
1044.59 |
66.88 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self |
KK1 |
728.15 |
784.42 |
0.00 |
784.42 |
56.27 |
713.87 |
769.04 |
0.00 |
769.04 |
55.17 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family |
KK2 |
1820.40 |
1961.09 |
0.00 |
1961.09 |
140.69 |
1784.71 |
1922.64 |
0.00 |
1922.64 |
137.93 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One |
KK3 |
1565.57 |
1686.54 |
0.00 |
1686.54 |
120.97 |
1534.87 |
1653.47 |
0.00 |
1653.47 |
118.60 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self |
LV1 |
715.47 |
765.63 |
0.00 |
765.63 |
50.16 |
701.44 |
750.62 |
0.00 |
750.62 |
49.18 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family |
LV2 |
2146.38 |
2296.94 |
0.00 |
2296.94 |
150.56 |
2104.29 |
2251.90 |
0.00 |
2251.90 |
147.61 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One |
LV3 |
1538.23 |
1646.17 |
0.00 |
1646.17 |
107.94 |
1508.07 |
1613.89 |
0.00 |
1613.89 |
105.82 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Georgia Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Georgia Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Georgia Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Georgia Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Georgia Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Georgia Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
F51 |
845.81 |
868.77 |
0.00 |
868.77 |
22.96 |
829.23 |
851.74 |
0.00 |
851.74 |
22.51 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
F52 |
1928.53 |
1980.87 |
0.00 |
1980.87 |
52.34 |
1890.72 |
1942.03 |
0.00 |
1942.03 |
51.31 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
F53 |
1909.44 |
1961.27 |
0.00 |
1961.27 |
51.83 |
1872.00 |
1922.81 |
0.00 |
1922.81 |
50.81 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
F54 |
836.38 |
838.26 |
0.00 |
838.26 |
1.88 |
819.98 |
821.82 |
0.00 |
821.82 |
1.84 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
F55 |
1915.16 |
1919.52 |
0.00 |
1919.52 |
4.36 |
1877.61 |
1881.88 |
0.00 |
1881.88 |
4.27 |
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
F56 |
1877.60 |
1881.86 |
0.00 |
1881.86 |
4.26 |
1840.78 |
1844.96 |
0.00 |
1844.96 |
4.18 |
Georgia Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Georgia Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Georgia Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Georgia Aetna Open Access - High Self |
2U1 |
1768.03 |
1841.97 |
0.00 |
1841.97 |
73.94 |
1733.36 |
1805.85 |
0.00 |
1805.85 |
72.49 |
Georgia Aetna Open Access - High Self & Family |
2U2 |
4072.54 |
4242.91 |
0.00 |
4242.91 |
170.37 |
3992.69 |
4159.72 |
0.00 |
4159.72 |
167.03 |
Georgia Aetna Open Access - High Self Plus One |
2U3 |
4032.21 |
4200.90 |
0.00 |
4200.90 |
168.69 |
3953.15 |
4118.53 |
0.00 |
4118.53 |
165.38 |
Georgia Blue Open Access POS - High Self |
QM1 |
637.67 |
669.54 |
0.00 |
669.54 |
31.87 |
625.17 |
656.41 |
0.00 |
656.41 |
31.24 |
Georgia Blue Open Access POS - High Self & Family |
QM2 |
1673.28 |
1723.47 |
0.00 |
1723.47 |
50.19 |
1640.47 |
1689.68 |
0.00 |
1689.68 |
49.21 |
Georgia Blue Open Access POS - High Self Plus One |
QM3 |
1405.29 |
1475.55 |
0.00 |
1475.55 |
70.26 |
1377.74 |
1446.62 |
0.00 |
1446.62 |
68.88 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self |
S94 |
562.93 |
624.85 |
0.00 |
624.85 |
61.92 |
551.89 |
612.60 |
0.00 |
612.60 |
60.71 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family |
S95 |
1266.57 |
1405.92 |
0.00 |
1405.92 |
139.35 |
1241.74 |
1378.35 |
0.00 |
1378.35 |
136.61 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
S96 |
1210.31 |
1343.44 |
0.00 |
1343.44 |
133.13 |
1186.58 |
1317.10 |
0.00 |
1317.10 |
130.52 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self |
S91 |
707.00 |
784.80 |
0.00 |
784.80 |
77.80 |
693.14 |
769.41 |
0.00 |
769.41 |
76.27 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
S92 |
1590.80 |
1765.77 |
0.00 |
1765.77 |
174.97 |
1559.61 |
1731.15 |
0.00 |
1731.15 |
171.54 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
S93 |
1520.09 |
1687.29 |
0.00 |
1687.29 |
167.20 |
1490.28 |
1654.21 |
0.00 |
1654.21 |
163.93 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self |
AD4 |
752.28 |
842.56 |
0.00 |
842.56 |
90.28 |
737.53 |
826.04 |
0.00 |
826.04 |
88.51 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family |
AD5 |
1692.60 |
1895.69 |
0.00 |
1895.69 |
203.09 |
1659.41 |
1858.52 |
0.00 |
1858.52 |
199.11 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
AD6 |
1617.39 |
1811.47 |
0.00 |
1811.47 |
194.08 |
1585.68 |
1775.95 |
0.00 |
1775.95 |
190.27 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self |
AD1 |
992.85 |
1111.98 |
0.00 |
1111.98 |
119.13 |
973.38 |
1090.18 |
0.00 |
1090.18 |
116.80 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
AD2 |
2233.87 |
2501.92 |
0.00 |
2501.92 |
268.05 |
2190.07 |
2452.86 |
0.00 |
2452.86 |
262.79 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
AD3 |
2134.59 |
2390.74 |
0.00 |
2390.74 |
256.15 |
2092.74 |
2343.86 |
0.00 |
2343.86 |
251.12 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self |
LM1 |
692.81 |
762.07 |
0.00 |
762.07 |
69.26 |
679.23 |
747.13 |
0.00 |
747.13 |
67.90 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
LM2 |
1558.87 |
1714.74 |
0.00 |
1714.74 |
155.87 |
1528.30 |
1681.12 |
0.00 |
1681.12 |
152.82 |
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
LM3 |
1489.57 |
1638.54 |
0.00 |
1638.54 |
148.97 |
1460.36 |
1606.41 |
0.00 |
1606.41 |
146.05 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self |
LM4 |
655.40 |
720.95 |
0.00 |
720.95 |
65.55 |
642.55 |
706.81 |
0.00 |
706.81 |
64.26 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family |
LM5 |
1474.62 |
1622.10 |
0.00 |
1622.10 |
147.48 |
1445.71 |
1590.29 |
0.00 |
1590.29 |
144.58 |
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
LM6 |
1409.10 |
1550.03 |
0.00 |
1550.03 |
140.93 |
1381.47 |
1519.64 |
0.00 |
1519.64 |
138.17 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self |
RM1 |
661.50 |
734.28 |
0.00 |
734.28 |
72.78 |
648.53 |
719.88 |
0.00 |
719.88 |
71.35 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family |
RM2 |
1488.41 |
1652.13 |
0.00 |
1652.13 |
163.72 |
1459.23 |
1619.74 |
0.00 |
1619.74 |
160.51 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One |
RM3 |
1422.25 |
1578.69 |
0.00 |
1578.69 |
156.44 |
1394.36 |
1547.74 |
0.00 |
1547.74 |
153.38 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self |
DN4 |
740.55 |
829.41 |
0.00 |
829.41 |
88.86 |
726.03 |
813.15 |
0.00 |
813.15 |
87.12 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family |
DN5 |
1666.19 |
1866.12 |
0.00 |
1866.12 |
199.93 |
1633.52 |
1829.53 |
0.00 |
1829.53 |
196.01 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One |
DN6 |
1592.15 |
1783.20 |
0.00 |
1783.20 |
191.05 |
1560.93 |
1748.24 |
0.00 |
1748.24 |
187.31 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self |
DN1 |
796.22 |
891.76 |
0.00 |
891.76 |
95.54 |
780.61 |
874.27 |
0.00 |
874.27 |
93.66 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family |
DN2 |
1791.50 |
2006.46 |
0.00 |
2006.46 |
214.96 |
1756.37 |
1967.12 |
0.00 |
1967.12 |
210.75 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One |
DN3 |
1711.87 |
1917.30 |
0.00 |
1917.30 |
205.43 |
1678.30 |
1879.71 |
0.00 |
1879.71 |
201.41 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self |
RJ1 |
610.05 |
683.25 |
0.00 |
683.25 |
73.20 |
598.09 |
669.85 |
0.00 |
669.85 |
71.76 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family |
RJ2 |
1372.63 |
1537.36 |
0.00 |
1537.36 |
164.73 |
1345.72 |
1507.22 |
0.00 |
1507.22 |
161.50 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One |
RJ3 |
1311.64 |
1469.03 |
0.00 |
1469.03 |
157.39 |
1285.92 |
1440.23 |
0.00 |
1440.23 |
154.31 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self |
Q71 |
778.06 |
863.64 |
0.00 |
863.64 |
85.58 |
762.80 |
846.71 |
0.00 |
846.71 |
83.91 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family |
Q72 |
1750.66 |
1943.21 |
0.00 |
1943.21 |
192.55 |
1716.33 |
1905.11 |
0.00 |
1905.11 |
188.78 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One |
Q73 |
1672.82 |
1856.84 |
0.00 |
1856.84 |
184.02 |
1640.02 |
1820.43 |
0.00 |
1820.43 |
180.41 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self |
CB4 |
1275.46 |
1160.65 |
0.00 |
1160.65 |
-114.81 |
1250.45 |
1137.89 |
0.00 |
1137.89 |
-112.56 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family |
CB5 |
2869.77 |
2611.52 |
0.00 |
2611.52 |
-258.25 |
2813.50 |
2560.31 |
0.00 |
2560.31 |
-253.19 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One |
CB6 |
2742.24 |
2495.44 |
0.00 |
2495.44 |
-246.80 |
2688.47 |
2446.51 |
0.00 |
2446.51 |
-241.96 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self |
CB1 |
1171.54 |
1300.39 |
0.00 |
1300.39 |
128.85 |
1148.57 |
1274.89 |
0.00 |
1274.89 |
126.32 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family |
CB2 |
2636.09 |
2926.04 |
0.00 |
2926.04 |
289.95 |
2584.40 |
2868.67 |
0.00 |
2868.67 |
284.27 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One |
CB3 |
2519.00 |
2796.10 |
0.00 |
2796.10 |
277.10 |
2469.61 |
2741.27 |
0.00 |
2741.27 |
271.66 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self |
DG1 |
1348.37 |
1415.79 |
0.00 |
1415.79 |
67.42 |
1321.93 |
1388.03 |
0.00 |
1388.03 |
66.10 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family |
DG2 |
3033.83 |
3185.52 |
0.00 |
3185.52 |
151.69 |
2974.34 |
3123.06 |
0.00 |
3123.06 |
148.72 |
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One |
DG3 |
2899.03 |
3043.99 |
0.00 |
3043.99 |
144.96 |
2842.19 |
2984.30 |
0.00 |
2984.30 |
142.11 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self |
DG4 |
1195.28 |
1326.78 |
0.00 |
1326.78 |
131.50 |
1171.84 |
1300.76 |
0.00 |
1300.76 |
128.92 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family |
DG5 |
2689.43 |
2985.24 |
0.00 |
2985.24 |
295.81 |
2636.70 |
2926.71 |
0.00 |
2926.71 |
290.01 |
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One |
DG6 |
2569.96 |
2852.64 |
0.00 |
2852.64 |
282.68 |
2519.57 |
2796.71 |
0.00 |
2796.71 |
277.14 |
Georgia Kaiser Permanente - Georgia - High Self |
F81 |
744.64 |
766.12 |
0.00 |
766.12 |
21.48 |
730.04 |
751.10 |
0.00 |
751.10 |
21.06 |
Georgia Kaiser Permanente - Georgia - High Self & Family |
F82 |
1682.87 |
1731.45 |
0.00 |
1731.45 |
48.58 |
1649.87 |
1697.50 |
0.00 |
1697.50 |
47.63 |
Georgia Kaiser Permanente - Georgia - High Self Plus One |
F83 |
1682.87 |
1731.45 |
0.00 |
1731.45 |
48.58 |
1649.87 |
1697.50 |
0.00 |
1697.50 |
47.63 |
Georgia Kaiser Permanente - Georgia - Standard Self |
F84 |
563.38 |
592.72 |
0.00 |
592.72 |
29.34 |
552.33 |
581.10 |
0.00 |
581.10 |
28.77 |
Georgia Kaiser Permanente - Georgia - Standard Self & Family |
F85 |
1273.23 |
1339.53 |
0.00 |
1339.53 |
66.30 |
1248.26 |
1313.26 |
0.00 |
1313.26 |
65.00 |
Georgia Kaiser Permanente - Georgia - Standard Self Plus One |
F86 |
1273.23 |
1339.53 |
0.00 |
1339.53 |
66.30 |
1248.26 |
1313.26 |
0.00 |
1313.26 |
65.00 |
Georgia Kaiser Permanente - Georgia - Basic Self |
LA1 |
401.23 |
427.28 |
0.00 |
427.28 |
26.05 |
393.36 |
418.90 |
0.00 |
418.90 |
25.54 |
Georgia Kaiser Permanente - Georgia - Basic Self & Family |
LA2 |
906.76 |
965.59 |
0.00 |
965.59 |
58.83 |
888.98 |
946.66 |
0.00 |
946.66 |
57.68 |
Georgia Kaiser Permanente - Georgia - Basic Self Plus One |
LA3 |
906.76 |
965.59 |
0.00 |
965.59 |
58.83 |
888.98 |
946.66 |
0.00 |
946.66 |
57.68 |
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self |
LV1 |
715.47 |
765.63 |
0.00 |
765.63 |
50.16 |
701.44 |
750.62 |
0.00 |
750.62 |
49.18 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family |
LV2 |
2146.38 |
2296.94 |
0.00 |
2296.94 |
150.56 |
2104.29 |
2251.90 |
0.00 |
2251.90 |
147.61 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One |
LV3 |
1538.23 |
1646.17 |
0.00 |
1646.17 |
107.94 |
1508.07 |
1613.89 |
0.00 |
1613.89 |
105.82 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Guam Calvo's SelectCare - Standard Self |
B44 |
404.67 |
438.38 |
0.00 |
438.38 |
33.71 |
396.74 |
429.78 |
0.00 |
429.78 |
33.04 |
Guam Calvo's SelectCare - Standard Self & Family |
B45 |
1175.78 |
1273.69 |
0.00 |
1273.69 |
97.91 |
1152.73 |
1248.72 |
0.00 |
1248.72 |
95.99 |
Guam Calvo's SelectCare - Standard Self Plus One |
B46 |
797.74 |
864.15 |
0.00 |
864.15 |
66.41 |
782.10 |
847.21 |
0.00 |
847.21 |
65.11 |
Guam Calvo's SelectCare - High Self |
B41 |
501.38 |
532.12 |
0.00 |
532.12 |
30.74 |
491.55 |
521.69 |
0.00 |
521.69 |
30.14 |
Guam Calvo's SelectCare - High Self & Family |
B42 |
1327.93 |
1409.41 |
0.00 |
1409.41 |
81.48 |
1301.89 |
1381.77 |
0.00 |
1381.77 |
79.88 |
Guam Calvo's SelectCare - High Self Plus One |
B43 |
978.41 |
1038.43 |
0.00 |
1038.43 |
60.02 |
959.23 |
1018.07 |
0.00 |
1018.07 |
58.84 |
Guam TakeCare - HDHP Self |
KX1 |
126.72 |
122.94 |
0.00 |
122.94 |
-3.78 |
124.24 |
120.53 |
0.00 |
120.53 |
-3.71 |
Guam TakeCare - HDHP Self & Family |
KX2 |
346.11 |
329.62 |
0.00 |
329.62 |
-16.49 |
339.32 |
323.16 |
0.00 |
323.16 |
-16.16 |
Guam TakeCare - HDHP Self Plus One |
KX3 |
312.23 |
296.76 |
0.00 |
296.76 |
-15.47 |
306.11 |
290.94 |
0.00 |
290.94 |
-15.17 |
Guam TakeCare - Standard Self |
JK4 |
397.02 |
412.54 |
0.00 |
412.54 |
15.52 |
389.24 |
404.45 |
0.00 |
404.45 |
15.21 |
Guam TakeCare - Standard Self & Family |
JK5 |
1124.36 |
1168.30 |
0.00 |
1168.30 |
43.94 |
1102.31 |
1145.39 |
0.00 |
1145.39 |
43.08 |
Guam TakeCare - Standard Self Plus One |
JK6 |
782.49 |
813.08 |
0.00 |
813.08 |
30.59 |
767.15 |
797.14 |
0.00 |
797.14 |
29.99 |
Guam TakeCare - High Self |
JK1 |
502.20 |
507.77 |
0.00 |
507.77 |
5.57 |
492.35 |
497.81 |
0.00 |
497.81 |
5.46 |
Guam TakeCare - High Self & Family |
JK2 |
1197.89 |
1211.13 |
0.00 |
1211.13 |
13.24 |
1174.40 |
1187.38 |
0.00 |
1187.38 |
12.98 |
Guam TakeCare - High Self Plus One |
JK3 |
992.18 |
1003.16 |
0.00 |
1003.16 |
10.98 |
972.73 |
983.49 |
0.00 |
983.49 |
10.76 |
Hawaii Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Hawaii Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Hawaii Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Hawaii Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Hawaii Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Hawaii Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
JS4 |
1094.95 |
1116.47 |
0.00 |
1116.47 |
21.52 |
1073.48 |
1094.58 |
0.00 |
1094.58 |
21.10 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
JS5 |
2499.60 |
2548.78 |
0.00 |
2548.78 |
49.18 |
2450.59 |
2498.80 |
0.00 |
2498.80 |
48.21 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
JS6 |
2474.85 |
2523.55 |
0.00 |
2523.55 |
48.70 |
2426.32 |
2474.07 |
0.00 |
2474.07 |
47.75 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
JS1 |
1024.07 |
1030.13 |
0.00 |
1030.13 |
6.06 |
1003.99 |
1009.93 |
0.00 |
1009.93 |
5.94 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
JS2 |
2334.42 |
2348.19 |
0.00 |
2348.19 |
13.77 |
2288.65 |
2302.15 |
0.00 |
2302.15 |
13.50 |
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
JS3 |
2311.31 |
2324.92 |
0.00 |
2324.92 |
13.61 |
2265.99 |
2279.33 |
0.00 |
2279.33 |
13.34 |
Hawaii Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Hawaii Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Hawaii HMSA Plan - High Self |
871 |
643.86 |
643.86 |
0.00 |
643.86 |
0.00 |
631.24 |
631.24 |
0.00 |
631.24 |
0.00 |
Hawaii HMSA Plan - High Self & Family |
872 |
1447.40 |
1447.40 |
0.00 |
1447.40 |
0.00 |
1419.02 |
1419.02 |
0.00 |
1419.02 |
0.00 |
Hawaii HMSA Plan - High Self Plus One |
873 |
1410.73 |
1410.73 |
0.00 |
1410.73 |
0.00 |
1383.07 |
1383.07 |
0.00 |
1383.07 |
0.00 |
Hawaii HMSA Plan - Standard Self |
874 |
439.59 |
462.91 |
0.00 |
462.91 |
23.32 |
430.97 |
453.83 |
0.00 |
453.83 |
22.86 |
Hawaii HMSA Plan - Standard Self & Family |
875 |
988.21 |
1040.58 |
0.00 |
1040.58 |
52.37 |
968.83 |
1020.18 |
0.00 |
1020.18 |
51.35 |
Hawaii HMSA Plan - Standard Self Plus One |
876 |
963.11 |
1014.17 |
0.00 |
1014.17 |
51.06 |
944.23 |
994.28 |
0.00 |
994.28 |
50.05 |
Hawaii Kaiser Permanente - Hawaii - High Self |
631 |
689.06 |
689.06 |
0.00 |
689.06 |
0.00 |
675.55 |
675.55 |
0.00 |
675.55 |
0.00 |
Hawaii Kaiser Permanente - Hawaii - High Self & Family |
632 |
1536.64 |
1536.64 |
0.00 |
1536.64 |
0.00 |
1506.51 |
1506.51 |
0.00 |
1506.51 |
0.00 |
Hawaii Kaiser Permanente - Hawaii - High Self Plus One |
633 |
1536.64 |
1536.64 |
0.00 |
1536.64 |
0.00 |
1506.51 |
1506.51 |
0.00 |
1506.51 |
0.00 |
Hawaii Kaiser Permanente - Hawaii - Standard Self |
634 |
490.77 |
515.28 |
0.00 |
515.28 |
24.51 |
481.15 |
505.18 |
0.00 |
505.18 |
24.03 |
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family |
635 |
1094.44 |
1149.05 |
0.00 |
1149.05 |
54.61 |
1072.98 |
1126.52 |
0.00 |
1126.52 |
53.54 |
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One |
636 |
1094.44 |
1149.05 |
0.00 |
1149.05 |
54.61 |
1072.98 |
1126.52 |
0.00 |
1126.52 |
53.54 |
Idaho Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Idaho Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Idaho Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Idaho Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Idaho Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Idaho Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
H41 |
845.04 |
843.38 |
0.00 |
843.38 |
-1.66 |
828.47 |
826.84 |
0.00 |
826.84 |
-1.63 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
H42 |
1926.22 |
1922.43 |
0.00 |
1922.43 |
-3.79 |
1888.45 |
1884.74 |
0.00 |
1884.74 |
-3.71 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
H43 |
1907.32 |
1903.76 |
0.00 |
1903.76 |
-3.56 |
1869.92 |
1866.43 |
0.00 |
1866.43 |
-3.49 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
H44 |
823.18 |
833.83 |
0.00 |
833.83 |
10.65 |
807.04 |
817.48 |
0.00 |
817.48 |
10.44 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
H45 |
1889.22 |
1913.68 |
0.00 |
1913.68 |
24.46 |
1852.18 |
1876.16 |
0.00 |
1876.16 |
23.98 |
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
H46 |
1852.18 |
1876.18 |
0.00 |
1876.18 |
24.00 |
1815.86 |
1839.39 |
0.00 |
1839.39 |
23.53 |
Idaho Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Idaho Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Idaho Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Idaho Altius Health Plan - High Self |
9K1 |
1029.24 |
1069.33 |
0.00 |
1069.33 |
40.09 |
1009.06 |
1048.36 |
0.00 |
1048.36 |
39.30 |
Idaho Altius Health Plan - High Self & Family |
9K2 |
2276.15 |
2364.83 |
0.00 |
2364.83 |
88.68 |
2231.52 |
2318.46 |
0.00 |
2318.46 |
86.94 |
Idaho Altius Health Plan - High Self Plus One |
9K3 |
2253.61 |
2341.41 |
0.00 |
2341.41 |
87.80 |
2209.42 |
2295.50 |
0.00 |
2295.50 |
86.08 |
Idaho Altius Health Plan - HDHP Self |
9K4 |
539.81 |
685.94 |
0.00 |
685.94 |
146.13 |
529.23 |
672.49 |
0.00 |
672.49 |
143.26 |
Idaho Altius Health Plan - HDHP Self & Family |
9K5 |
1128.16 |
1433.54 |
0.00 |
1433.54 |
305.38 |
1106.04 |
1405.43 |
0.00 |
1405.43 |
299.39 |
Idaho Altius Health Plan - HDHP Self Plus One |
9K6 |
1106.06 |
1405.41 |
0.00 |
1405.41 |
299.35 |
1084.37 |
1377.85 |
0.00 |
1377.85 |
293.48 |
Idaho Altius Health Plan - Standard Self |
DK4 |
776.53 |
900.77 |
0.00 |
900.77 |
124.24 |
761.30 |
883.11 |
0.00 |
883.11 |
121.81 |
Idaho Altius Health Plan - Standard Self & Family |
DK5 |
1714.85 |
1989.20 |
0.00 |
1989.20 |
274.35 |
1681.23 |
1950.20 |
0.00 |
1950.20 |
268.97 |
Idaho Altius Health Plan - Standard Self Plus One |
DK6 |
1697.85 |
1969.49 |
0.00 |
1969.49 |
271.64 |
1664.56 |
1930.87 |
0.00 |
1930.87 |
266.31 |
Idaho Kaiser Permanente - Washington Core - Standard Self |
544 |
616.21 |
630.38 |
0.00 |
630.38 |
14.17 |
604.13 |
618.02 |
0.00 |
618.02 |
13.89 |
Idaho Kaiser Permanente - Washington Core - Standard Self & Family |
545 |
1417.32 |
1449.87 |
0.00 |
1449.87 |
32.55 |
1389.53 |
1421.44 |
0.00 |
1421.44 |
31.91 |
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One |
546 |
1417.32 |
1449.87 |
0.00 |
1449.87 |
32.55 |
1389.53 |
1421.44 |
0.00 |
1421.44 |
31.91 |
Idaho Kaiser Permanente - Washington Core - High Self |
541 |
862.65 |
881.04 |
0.00 |
881.04 |
18.39 |
845.74 |
863.76 |
0.00 |
863.76 |
18.02 |
Idaho Kaiser Permanente - Washington Core - High Self & Family |
542 |
1897.86 |
1938.26 |
0.00 |
1938.26 |
40.40 |
1860.65 |
1900.25 |
0.00 |
1900.25 |
39.60 |
Idaho Kaiser Permanente - Washington Core - High Self Plus One |
543 |
1897.86 |
1938.26 |
0.00 |
1938.26 |
40.40 |
1860.65 |
1900.25 |
0.00 |
1900.25 |
39.60 |
Idaho Kaiser Permanente - Washington Core - Prosper Self |
PT4 |
New Plan |
397.80 |
0.00 |
397.80 |
New Plan |
New Plan |
390.00 |
0.00 |
390.00 |
New Plan |
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family |
PT5 |
New Plan |
1113.82 |
0.00 |
1113.82 |
New Plan |
New Plan |
1091.98 |
0.00 |
1091.98 |
New Plan |
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One |
PT6 |
New Plan |
963.56 |
0.00 |
963.56 |
New Plan |
New Plan |
944.67 |
0.00 |
944.67 |
New Plan |
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Illinois Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Illinois Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Illinois Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Illinois Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Illinois Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Illinois Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
H41 |
845.04 |
843.38 |
0.00 |
843.38 |
-1.66 |
828.47 |
826.84 |
0.00 |
826.84 |
-1.63 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
H42 |
1926.22 |
1922.43 |
0.00 |
1922.43 |
-3.79 |
1888.45 |
1884.74 |
0.00 |
1884.74 |
-3.71 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
H43 |
1907.32 |
1903.76 |
0.00 |
1903.76 |
-3.56 |
1869.92 |
1866.43 |
0.00 |
1866.43 |
-3.49 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
H44 |
823.18 |
833.83 |
0.00 |
833.83 |
10.65 |
807.04 |
817.48 |
0.00 |
817.48 |
10.44 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
H45 |
1889.22 |
1913.68 |
0.00 |
1913.68 |
24.46 |
1852.18 |
1876.16 |
0.00 |
1876.16 |
23.98 |
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
H46 |
1852.18 |
1876.18 |
0.00 |
1876.18 |
24.00 |
1815.86 |
1839.39 |
0.00 |
1839.39 |
23.53 |
Illinois Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Illinois Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Illinois Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Illinois Blue Preferred - High Self |
9G1 |
849.87 |
891.71 |
0.00 |
891.71 |
41.84 |
833.21 |
874.23 |
0.00 |
874.23 |
41.02 |
Illinois Blue Preferred - High Self & Family |
9G2 |
1896.05 |
2024.21 |
0.00 |
2024.21 |
128.16 |
1858.87 |
1984.52 |
0.00 |
1984.52 |
125.65 |
Illinois Blue Preferred - High Self Plus One |
9G3 |
1795.80 |
1899.36 |
0.00 |
1899.36 |
103.56 |
1760.59 |
1862.12 |
0.00 |
1862.12 |
101.53 |
Illinois Blue Preferred - Standard Self |
9G4 |
612.63 |
646.33 |
0.00 |
646.33 |
33.70 |
600.62 |
633.66 |
0.00 |
633.66 |
33.04 |
Illinois Blue Preferred - Standard Self & Family |
9G5 |
1741.15 |
1793.39 |
0.00 |
1793.39 |
52.24 |
1707.01 |
1758.23 |
0.00 |
1758.23 |
51.22 |
Illinois Blue Preferred - Standard Self Plus One |
9G6 |
1574.58 |
1606.07 |
0.00 |
1606.07 |
31.49 |
1543.71 |
1574.58 |
0.00 |
1574.58 |
30.87 |
Illinois Health Alliance HMO - Standard Self |
K84 |
681.50 |
697.23 |
0.00 |
697.23 |
15.73 |
668.14 |
683.56 |
0.00 |
683.56 |
15.42 |
Illinois Health Alliance HMO - Standard Self & Family |
K85 |
1840.07 |
1616.04 |
0.00 |
1616.04 |
-224.03 |
1803.99 |
1584.35 |
0.00 |
1584.35 |
-219.64 |
Illinois Health Alliance HMO - Standard Self Plus One |
K86 |
1578.74 |
1490.84 |
0.00 |
1490.84 |
-87.90 |
1547.78 |
1461.61 |
0.00 |
1461.61 |
-86.17 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self |
GB4 |
773.30 |
804.24 |
0.00 |
804.24 |
30.94 |
758.14 |
788.47 |
0.00 |
788.47 |
30.33 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family |
GB5 |
1739.89 |
1809.48 |
0.00 |
1809.48 |
69.59 |
1705.77 |
1774.00 |
0.00 |
1774.00 |
68.23 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
GB6 |
1662.56 |
1729.06 |
0.00 |
1729.06 |
66.50 |
1629.96 |
1695.16 |
0.00 |
1695.16 |
65.20 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self |
GB1 |
1204.14 |
1252.29 |
0.00 |
1252.29 |
48.15 |
1180.53 |
1227.74 |
0.00 |
1227.74 |
47.21 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
GB2 |
2709.26 |
2817.64 |
0.00 |
2817.64 |
108.38 |
2656.14 |
2762.39 |
0.00 |
2762.39 |
106.25 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
GB3 |
2588.88 |
2692.44 |
0.00 |
2692.44 |
103.56 |
2538.12 |
2639.65 |
0.00 |
2639.65 |
101.53 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self |
MW4 |
770.01 |
823.92 |
0.00 |
823.92 |
53.91 |
754.91 |
807.76 |
0.00 |
807.76 |
52.85 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family |
MW5 |
1732.49 |
1853.75 |
0.00 |
1853.75 |
121.26 |
1698.52 |
1817.40 |
0.00 |
1817.40 |
118.88 |
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
MW6 |
1655.51 |
1771.40 |
0.00 |
1771.40 |
115.89 |
1623.05 |
1736.67 |
0.00 |
1736.67 |
113.62 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self |
MW1 |
934.34 |
1046.48 |
0.00 |
1046.48 |
112.14 |
916.02 |
1025.96 |
0.00 |
1025.96 |
109.94 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
MW2 |
2102.37 |
2354.65 |
0.00 |
2354.65 |
252.28 |
2061.15 |
2308.48 |
0.00 |
2308.48 |
247.33 |
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
MW3 |
2008.89 |
2249.98 |
0.00 |
2249.98 |
241.09 |
1969.50 |
2205.86 |
0.00 |
2205.86 |
236.36 |
Illinois Humana Health Plan, Inc. - Standard Self |
754 |
970.94 |
1066.26 |
0.00 |
1066.26 |
95.32 |
951.90 |
1045.35 |
0.00 |
1045.35 |
93.45 |
Illinois Humana Health Plan, Inc. - Standard Self & Family |
755 |
2184.61 |
2399.07 |
0.00 |
2399.07 |
214.46 |
2141.77 |
2352.03 |
0.00 |
2352.03 |
210.26 |
Illinois Humana Health Plan, Inc. - Standard Self Plus One |
756 |
2087.52 |
2292.48 |
0.00 |
2292.48 |
204.96 |
2046.59 |
2247.53 |
0.00 |
2247.53 |
200.94 |
Illinois Humana Health Plan, Inc. - High Self |
751 |
1263.72 |
1396.39 |
0.00 |
1396.39 |
132.67 |
1238.94 |
1369.01 |
0.00 |
1369.01 |
130.07 |
Illinois Humana Health Plan, Inc. - High Self & Family |
752 |
2843.36 |
3141.94 |
0.00 |
3141.94 |
298.58 |
2787.61 |
3080.33 |
0.00 |
3080.33 |
292.72 |
Illinois Humana Health Plan, Inc. - High Self Plus One |
753 |
2717.01 |
3002.29 |
0.00 |
3002.29 |
285.28 |
2663.74 |
2943.42 |
0.00 |
2943.42 |
279.68 |
Illinois Humana Health Plan, Inc. - High Self |
9F1 |
1977.09 |
2056.17 |
0.00 |
2056.17 |
79.08 |
1938.32 |
2015.85 |
0.00 |
2015.85 |
77.53 |
Illinois Humana Health Plan, Inc. - High Self & Family |
9F2 |
4448.42 |
4626.35 |
0.00 |
4626.35 |
177.93 |
4361.20 |
4535.64 |
0.00 |
4535.64 |
174.44 |
Illinois Humana Health Plan, Inc. - High Self Plus One |
9F3 |
4250.70 |
4420.71 |
0.00 |
4420.71 |
170.01 |
4167.35 |
4334.03 |
0.00 |
4334.03 |
166.68 |
Illinois Humana Health Plan, Inc. - Standard Self |
AB4 |
1172.52 |
1266.53 |
0.00 |
1266.53 |
94.01 |
1149.53 |
1241.70 |
0.00 |
1241.70 |
92.17 |
Illinois Humana Health Plan, Inc. - Standard Self & Family |
AB5 |
2638.17 |
2849.78 |
0.00 |
2849.78 |
211.61 |
2586.44 |
2793.90 |
0.00 |
2793.90 |
207.46 |
Illinois Humana Health Plan, Inc. - Standard Self Plus One |
AB6 |
2520.93 |
2723.11 |
0.00 |
2723.11 |
202.18 |
2471.50 |
2669.72 |
0.00 |
2669.72 |
198.22 |
Illinois Humana Health Plan, Inc. - Basic Self |
AB1 |
771.77 |
802.65 |
0.00 |
802.65 |
30.88 |
756.64 |
786.91 |
0.00 |
786.91 |
30.27 |
Illinois Humana Health Plan, Inc. - Basic Self & Family |
AB2 |
1736.55 |
1806.01 |
0.00 |
1806.01 |
69.46 |
1702.50 |
1770.60 |
0.00 |
1770.60 |
68.10 |
Illinois Humana Health Plan, Inc. - Basic Self Plus One |
AB3 |
1659.38 |
1725.75 |
0.00 |
1725.75 |
66.37 |
1626.84 |
1691.91 |
0.00 |
1691.91 |
65.07 |
Illinois Humana Health Plan, Inc. - Basic Self |
RW1 |
763.20 |
835.42 |
0.00 |
835.42 |
72.22 |
748.24 |
819.04 |
0.00 |
819.04 |
70.80 |
Illinois Humana Health Plan, Inc. - Basic Self & Family |
RW2 |
1717.21 |
1879.72 |
0.00 |
1879.72 |
162.51 |
1683.54 |
1842.86 |
0.00 |
1842.86 |
159.32 |
Illinois Humana Health Plan, Inc. - Basic Self Plus One |
RW3 |
1640.90 |
1796.18 |
0.00 |
1796.18 |
155.28 |
1608.73 |
1760.96 |
0.00 |
1760.96 |
152.23 |
Illinois Union Health Service - High Self |
761 |
758.96 |
797.70 |
0.00 |
797.70 |
38.74 |
744.08 |
782.06 |
0.00 |
782.06 |
37.98 |
Illinois Union Health Service - High Self & Family |
762 |
1939.67 |
2002.17 |
0.00 |
2002.17 |
62.50 |
1901.64 |
1962.91 |
0.00 |
1962.91 |
61.27 |
Illinois Union Health Service - High Self Plus One |
763 |
1701.70 |
1766.99 |
0.00 |
1766.99 |
65.29 |
1668.33 |
1732.34 |
0.00 |
1732.34 |
64.01 |
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |
AS1 |
536.33 |
611.46 |
0.00 |
611.46 |
75.13 |
525.81 |
599.47 |
0.00 |
599.47 |
73.66 |
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family |
AS2 |
1268.23 |
1446.12 |
0.00 |
1446.12 |
177.89 |
1243.36 |
1417.76 |
0.00 |
1417.76 |
174.40 |
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One |
AS3 |
1153.03 |
1314.67 |
0.00 |
1314.67 |
161.64 |
1130.42 |
1288.89 |
0.00 |
1288.89 |
158.47 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self |
L91 |
531.93 |
565.71 |
0.00 |
565.71 |
33.78 |
521.50 |
554.62 |
0.00 |
554.62 |
33.12 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family |
L92 |
1491.51 |
1586.25 |
0.00 |
1586.25 |
94.74 |
1462.26 |
1555.15 |
0.00 |
1555.15 |
92.89 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One |
L93 |
1038.83 |
1104.84 |
0.00 |
1104.84 |
66.01 |
1018.46 |
1083.18 |
0.00 |
1083.18 |
64.72 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self |
Y81 |
516.87 |
588.25 |
0.00 |
588.25 |
71.38 |
506.74 |
576.72 |
0.00 |
576.72 |
69.98 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family |
Y82 |
1222.19 |
1391.22 |
0.00 |
1391.22 |
169.03 |
1198.23 |
1363.94 |
0.00 |
1363.94 |
165.71 |
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One |
Y83 |
1111.17 |
1264.74 |
0.00 |
1264.74 |
153.57 |
1089.38 |
1239.94 |
0.00 |
1239.94 |
150.56 |
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Indiana Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Indiana Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Indiana Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Indiana Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Indiana Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Indiana Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
JS4 |
1094.95 |
1116.47 |
0.00 |
1116.47 |
21.52 |
1073.48 |
1094.58 |
0.00 |
1094.58 |
21.10 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
JS5 |
2499.60 |
2548.78 |
0.00 |
2548.78 |
49.18 |
2450.59 |
2498.80 |
0.00 |
2498.80 |
48.21 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
JS6 |
2474.85 |
2523.55 |
0.00 |
2523.55 |
48.70 |
2426.32 |
2474.07 |
0.00 |
2474.07 |
47.75 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
JS1 |
1024.07 |
1030.13 |
0.00 |
1030.13 |
6.06 |
1003.99 |
1009.93 |
0.00 |
1009.93 |
5.94 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
JS2 |
2334.42 |
2348.19 |
0.00 |
2348.19 |
13.77 |
2288.65 |
2302.15 |
0.00 |
2302.15 |
13.50 |
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
JS3 |
2311.31 |
2324.92 |
0.00 |
2324.92 |
13.61 |
2265.99 |
2279.33 |
0.00 |
2279.33 |
13.34 |
Indiana Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Indiana Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Indiana Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Indiana Health Alliance HMO - Standard Self |
K84 |
681.50 |
697.23 |
0.00 |
697.23 |
15.73 |
668.14 |
683.56 |
0.00 |
683.56 |
15.42 |
Indiana Health Alliance HMO - Standard Self & Family |
K85 |
1840.07 |
1616.04 |
0.00 |
1616.04 |
-224.03 |
1803.99 |
1584.35 |
0.00 |
1584.35 |
-219.64 |
Indiana Health Alliance HMO - Standard Self Plus One |
K86 |
1578.74 |
1490.84 |
0.00 |
1490.84 |
-87.90 |
1547.78 |
1461.61 |
0.00 |
1461.61 |
-86.17 |
Indiana Humana CoverageFirst - CDHP Self |
TC1 |
672.66 |
753.34 |
0.00 |
753.34 |
80.68 |
659.47 |
738.57 |
0.00 |
738.57 |
79.10 |
Indiana Humana CoverageFirst - CDHP Self & Family |
TC2 |
1513.40 |
1695.03 |
0.00 |
1695.03 |
181.63 |
1483.73 |
1661.79 |
0.00 |
1661.79 |
178.06 |
Indiana Humana CoverageFirst - CDHP Self Plus One |
TC3 |
1446.18 |
1619.71 |
0.00 |
1619.71 |
173.53 |
1417.82 |
1587.95 |
0.00 |
1587.95 |
170.13 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self |
MW4 |
770.01 |
823.92 |
0.00 |
823.92 |
53.91 |
754.91 |
807.76 |
0.00 |
807.76 |
52.85 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family |
MW5 |
1732.49 |
1853.75 |
0.00 |
1853.75 |
121.26 |
1698.52 |
1817.40 |
0.00 |
1817.40 |
118.88 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
MW6 |
1655.51 |
1771.40 |
0.00 |
1771.40 |
115.89 |
1623.05 |
1736.67 |
0.00 |
1736.67 |
113.62 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self |
MW1 |
934.34 |
1046.48 |
0.00 |
1046.48 |
112.14 |
916.02 |
1025.96 |
0.00 |
1025.96 |
109.94 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
MW2 |
2102.37 |
2354.65 |
0.00 |
2354.65 |
252.28 |
2061.15 |
2308.48 |
0.00 |
2308.48 |
247.33 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
MW3 |
2008.89 |
2249.98 |
0.00 |
2249.98 |
241.09 |
1969.50 |
2205.86 |
0.00 |
2205.86 |
236.36 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self |
X34 |
627.42 |
658.80 |
0.00 |
658.80 |
31.38 |
615.12 |
645.88 |
0.00 |
645.88 |
30.76 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family |
X35 |
1411.73 |
1482.32 |
0.00 |
1482.32 |
70.59 |
1384.05 |
1453.25 |
0.00 |
1453.25 |
69.20 |
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One |
X36 |
1348.98 |
1416.43 |
0.00 |
1416.43 |
67.45 |
1322.53 |
1388.66 |
0.00 |
1388.66 |
66.13 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self |
X31 |
815.43 |
856.20 |
0.00 |
856.20 |
40.77 |
799.44 |
839.41 |
0.00 |
839.41 |
39.97 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family |
X32 |
1834.75 |
1926.48 |
0.00 |
1926.48 |
91.73 |
1798.77 |
1888.71 |
0.00 |
1888.71 |
89.94 |
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One |
X33 |
1753.20 |
1840.87 |
0.00 |
1840.87 |
87.67 |
1718.82 |
1804.77 |
0.00 |
1804.77 |
85.95 |
Indiana Humana Health Plan of Ohio, Inc. - High Self |
A61 |
1531.00 |
1607.55 |
0.00 |
1607.55 |
76.55 |
1500.98 |
1576.03 |
0.00 |
1576.03 |
75.05 |
Indiana Humana Health Plan of Ohio, Inc. - High Self & Family |
A62 |
3444.77 |
3617.02 |
0.00 |
3617.02 |
172.25 |
3377.23 |
3546.10 |
0.00 |
3546.10 |
168.87 |
Indiana Humana Health Plan of Ohio, Inc. - High Self Plus One |
A63 |
3291.68 |
3456.26 |
0.00 |
3456.26 |
164.58 |
3227.14 |
3388.49 |
0.00 |
3388.49 |
161.35 |
Indiana Humana Health Plan of Ohio, Inc. - Standard Self |
A64 |
1195.61 |
1255.40 |
0.00 |
1255.40 |
59.79 |
1172.17 |
1230.78 |
0.00 |
1230.78 |
58.61 |
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family |
A65 |
2690.17 |
2824.69 |
0.00 |
2824.69 |
134.52 |
2637.42 |
2769.30 |
0.00 |
2769.30 |
131.88 |
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One |
A66 |
2570.60 |
2699.11 |
0.00 |
2699.11 |
128.51 |
2520.20 |
2646.19 |
0.00 |
2646.19 |
125.99 |
Indiana Humana Health Plan, Inc. - Standard Self |
754 |
970.94 |
1066.26 |
0.00 |
1066.26 |
95.32 |
951.90 |
1045.35 |
0.00 |
1045.35 |
93.45 |
Indiana Humana Health Plan, Inc. - Standard Self & Family |
755 |
2184.61 |
2399.07 |
0.00 |
2399.07 |
214.46 |
2141.77 |
2352.03 |
0.00 |
2352.03 |
210.26 |
Indiana Humana Health Plan, Inc. - Standard Self Plus One |
756 |
2087.52 |
2292.48 |
0.00 |
2292.48 |
204.96 |
2046.59 |
2247.53 |
0.00 |
2247.53 |
200.94 |
Indiana Humana Health Plan, Inc. - High Self |
751 |
1263.72 |
1396.39 |
0.00 |
1396.39 |
132.67 |
1238.94 |
1369.01 |
0.00 |
1369.01 |
130.07 |
Indiana Humana Health Plan, Inc. - High Self & Family |
752 |
2843.36 |
3141.94 |
0.00 |
3141.94 |
298.58 |
2787.61 |
3080.33 |
0.00 |
3080.33 |
292.72 |
Indiana Humana Health Plan, Inc. - High Self Plus One |
753 |
2717.01 |
3002.29 |
0.00 |
3002.29 |
285.28 |
2663.74 |
2943.42 |
0.00 |
2943.42 |
279.68 |
Indiana Humana Health Plan, Inc. - High Self |
MH1 |
1127.06 |
1239.79 |
0.00 |
1239.79 |
112.73 |
1104.96 |
1215.48 |
0.00 |
1215.48 |
110.52 |
Indiana Humana Health Plan, Inc. - High Self & Family |
MH2 |
2535.91 |
2789.53 |
0.00 |
2789.53 |
253.62 |
2486.19 |
2734.83 |
0.00 |
2734.83 |
248.64 |
Indiana Humana Health Plan, Inc. - High Self Plus One |
MH3 |
2423.20 |
2665.53 |
0.00 |
2665.53 |
242.33 |
2375.69 |
2613.26 |
0.00 |
2613.26 |
237.57 |
Indiana Humana Health Plan, Inc. - Standard Self |
MH4 |
876.84 |
964.53 |
0.00 |
964.53 |
87.69 |
859.65 |
945.62 |
0.00 |
945.62 |
85.97 |
Indiana Humana Health Plan, Inc. - Standard Self & Family |
MH5 |
1972.86 |
2170.17 |
0.00 |
2170.17 |
197.31 |
1934.18 |
2127.62 |
0.00 |
2127.62 |
193.44 |
Indiana Humana Health Plan, Inc. - Standard Self Plus One |
MH6 |
1885.19 |
2073.71 |
0.00 |
2073.71 |
188.52 |
1848.23 |
2033.05 |
0.00 |
2033.05 |
184.82 |
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self |
Y51 |
New Plan |
419.96 |
0.00 |
419.96 |
New Plan |
New Plan |
411.73 |
0.00 |
411.73 |
New Plan |
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family |
Y52 |
New Plan |
1112.89 |
0.00 |
1112.89 |
New Plan |
New Plan |
1091.07 |
0.00 |
1091.07 |
New Plan |
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One |
Y53 |
New Plan |
923.92 |
0.00 |
923.92 |
New Plan |
New Plan |
905.80 |
0.00 |
905.80 |
New Plan |
Iowa Aetna Advantage - Advantage Self |
Z24 |
473.12 |
510.02 |
0.00 |
510.02 |
36.90 |
463.84 |
500.02 |
0.00 |
500.02 |
36.18 |
Iowa Aetna Advantage - Advantage Self & Family |
Z25 |
1253.75 |
1351.50 |
0.00 |
1351.50 |
97.75 |
1229.17 |
1325.00 |
0.00 |
1325.00 |
95.83 |
Iowa Aetna Advantage - Advantage Self Plus One |
Z26 |
1040.85 |
1122.02 |
0.00 |
1122.02 |
81.17 |
1020.44 |
1100.02 |
0.00 |
1100.02 |
79.58 |
Iowa Aetna Direct - CDHP Self |
N61 |
624.90 |
628.15 |
0.00 |
628.15 |
3.25 |
612.65 |
615.83 |
0.00 |
615.83 |
3.18 |
Iowa Aetna Direct - CDHP Self & Family |
N62 |
1575.91 |
1584.13 |
0.00 |
1584.13 |
8.22 |
1545.01 |
1553.07 |
0.00 |
1553.07 |
8.06 |
Iowa Aetna Direct - CDHP Self Plus One |
N63 |
1370.42 |
1377.56 |
0.00 |
1377.56 |
7.14 |
1343.55 |
1350.55 |
0.00 |
1350.55 |
7.00 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self |
H41 |
845.04 |
843.38 |
0.00 |
843.38 |
-1.66 |
828.47 |
826.84 |
0.00 |
826.84 |
-1.63 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family |
H42 |
1926.22 |
1922.43 |
0.00 |
1922.43 |
-3.79 |
1888.45 |
1884.74 |
0.00 |
1884.74 |
-3.71 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One |
H43 |
1907.32 |
1903.76 |
0.00 |
1903.76 |
-3.56 |
1869.92 |
1866.43 |
0.00 |
1866.43 |
-3.49 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self |
H44 |
823.18 |
833.83 |
0.00 |
833.83 |
10.65 |
807.04 |
817.48 |
0.00 |
817.48 |
10.44 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family |
H45 |
1889.22 |
1913.68 |
0.00 |
1913.68 |
24.46 |
1852.18 |
1876.16 |
0.00 |
1876.16 |
23.98 |
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One |
H46 |
1852.18 |
1876.18 |
0.00 |
1876.18 |
24.00 |
1815.86 |
1839.39 |
0.00 |
1839.39 |
23.53 |
Iowa Aetna HealthFund HDHP - HDHP Self |
224 |
743.38 |
801.74 |
0.00 |
801.74 |
58.36 |
728.80 |
786.02 |
0.00 |
786.02 |
57.22 |
Iowa Aetna HealthFund HDHP - HDHP Self & Family |
225 |
1639.75 |
1768.51 |
0.00 |
1768.51 |
128.76 |
1607.60 |
1733.83 |
0.00 |
1733.83 |
126.23 |
Iowa Aetna HealthFund HDHP - HDHP Self Plus One |
226 |
1607.62 |
1733.88 |
0.00 |
1733.88 |
126.26 |
1576.10 |
1699.88 |
0.00 |
1699.88 |
123.78 |
Iowa Health Alliance HMO - Standard Self |
K84 |
681.50 |
697.23 |
0.00 |
697.23 |
15.73 |
668.14 |
683.56 |
0.00 |
683.56 |
15.42 |
Iowa Health Alliance HMO - Standard Self & Family |
K85 |
1840.07 |
1616.04 |
0.00 |
1616.04 |
-224.03 |
1803.99 |
1584.35 |
0.00 |
1584.35 |
-219.64 |
Iowa Health Alliance HMO - Standard Self Plus One |
K86 |
1578.74 |
1490.84 |
0.00 |
1490.84 |
-87.90 |
1547.78 |
1461.61 |
0.00 |
1461.61 |
-86.17 |
Iowa HealthPartners - Standard Self |
V34 |
469.12 |
519.60 |
0.00 |
519.60 |
50.48 |
459.92 |
509.41 |
0.00 |
509.41 |
49.49 |
Iowa HealthPartners - Standard Self & Family |
V35 |
1142.82 |
1265.76 |
0.00 |
1265.76 |
122.94 |
1120.41 |
1240.94 |
0.00 |
1240.94 |
120.53 |
Iowa HealthPartners - Standard Self Plus One |
V36 |
1036.78 |
1148.32 |
0.00 |
1148.32 |
111.54 |
1016.45 |
1125.80 |
0.00 |
1125.80 |
109.35 |
Iowa HealthPartners - High Self |
V31 |
726.56 |
681.43 |
0.00 |
681.43 |
-45.13 |
712.31 |
668.07 |
0.00 |
668.07 |
-44.24 |
Iowa HealthPartners - High Self & Family |
V32 |
1769.90 |
1659.93 |
0.00 |
1659.93 |
-109.97 |
1735.20 |
1627.38 |
0.00 |
1627.38 |
-107.82 |
Iowa HealthPartners - High Self Plus One |
V33 |
1605.69 |
1505.94 |
0.00 |
1505.94 |
-99.75 |
1574.21 |
1476.41 |
0.00 |
1476.41 |
-97.80 |
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self |