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Healthcare Plan Information

Tribal Premium Rates for the Federal Employees Health Benefits Program

HMO (Regional Plans with Specific Service Areas)

Plan - Option Enrollment Code 2020 Total Monthly Premium 2021 Monthly Premium Rates - Total Premium 2021 Monthly Premium Rates - Tribal Employer Pays 2021 Monthly Premium Rates - Employee Pays 2021 Monthly Premium Rates - Change in Employee Payment
Alabama Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Alabama Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Alabama Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Alabama Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Alabama Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Alabama Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Alabama Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Alabama Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Alabama Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 454.74 485.85 364.39 121.46 7.78
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1045.92 1117.50 838.13 279.37 17.89
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 977.71 1044.59 783.44 261.15 16.72
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 713.87 769.04 523.42 245.62 42.59
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1784.71 1922.64 1218.21 704.43 103.74
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1534.87 1653.47 1121.16 532.31 89.70
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Alabama UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Alaska Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Alaska Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Alaska Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Alaska Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Alaska Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Alaska Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1073.48 1094.58 523.42 571.16 8.52
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2450.59 2498.80 1218.21 1280.59 14.02
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2426.32 2474.07 1121.16 1352.91 18.85
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1003.99 1009.93 523.42 486.51 -6.64
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2288.65 2302.15 1218.21 1083.94 -20.69
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2265.99 2279.33 1121.16 1158.17 -15.56
Alaska Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Alaska Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Alaska Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Arizona Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Arizona Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Arizona Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Arizona Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Arizona Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Arizona Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Arizona Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Arizona Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Arizona Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Arizona Aetna Open Access - High Self WQ1 1161.16 1345.67 523.42 822.25 171.93
Arizona Aetna Open Access - High Self & Family WQ2 2819.27 3267.25 1218.21 2049.04 413.79
Arizona Aetna Open Access - High Self Plus One WQ3 2791.34 3234.86 1121.16 2113.70 414.62
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R61 718.79 812.24 523.42 288.82 80.87
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R62 1617.27 1827.50 1218.21 609.29 176.04
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R63 1545.38 1746.29 1121.16 625.13 172.01
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R64 574.54 649.22 486.92 162.30 18.67
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R65 1292.68 1460.72 1095.54 365.18 42.01
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R66 1235.24 1395.81 1046.86 348.95 40.14
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R94 523.81 570.96 428.22 142.74 11.79
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R95 1178.56 1284.62 963.47 321.15 26.51
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R96 1126.19 1227.55 920.66 306.89 25.34
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R91 657.89 717.08 523.42 193.66 29.19
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R92 1480.20 1613.41 1210.06 403.35 33.30
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R93 1414.40 1541.69 1121.16 420.53 66.93
Arizona Humana Health Plan, Inc. - Standard Self C74 784.10 893.86 523.42 370.44 97.18
Arizona Humana Health Plan, Inc. - Standard Self & Family C75 1764.19 2011.17 1218.21 792.96 212.79
Arizona Humana Health Plan, Inc. - Standard Self Plus One C76 1685.73 1921.73 1121.16 800.57 207.10
Arizona Humana Health Plan, Inc. - High Self C71 1017.88 1160.38 523.42 636.96 129.92
Arizona Humana Health Plan, Inc. - High Self & Family C72 2290.19 2610.83 1218.21 1392.62 286.45
Arizona Humana Health Plan, Inc. - High Self Plus One C73 2188.40 2494.79 1121.16 1373.63 277.49
Arizona Humana Health Plan, Inc. - High Self BF1 1429.50 1472.38 523.42 948.96 30.30
Arizona Humana Health Plan, Inc. - High Self & Family BF2 3216.27 3312.77 1218.21 2094.56 62.31
Arizona Humana Health Plan, Inc. - High Self Plus One BF3 3073.35 3165.52 1121.16 2044.36 63.27
Arizona Humana Health Plan, Inc. - Standard Self BF4 1154.25 1246.59 523.42 723.17 79.76
Arizona Humana Health Plan, Inc. - Standard Self & Family BF5 2597.08 2804.84 1218.21 1586.63 173.57
Arizona Humana Health Plan, Inc. - Standard Self Plus One BF6 2481.66 2680.21 1121.16 1559.05 169.65
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 522.86 622.22 466.67 155.55 24.84
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1236.39 1471.54 1103.66 367.88 58.78
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1124.05 1337.77 1003.33 334.44 53.43
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 443.84 528.17 396.13 132.04 21.08
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1020.85 1214.76 911.07 303.69 48.48
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 954.27 1135.55 851.66 283.89 45.32
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 724.77 782.12 523.42 258.70 44.77
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1811.90 1955.35 1218.21 737.14 109.26
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1558.25 1681.57 1121.16 560.41 94.42
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 522.02 621.21 465.91 155.30 24.80
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1234.37 1469.13 1101.85 367.28 58.69
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1122.23 1335.58 1001.69 333.89 53.33
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Arizona UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Arkansas Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Arkansas Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Arkansas Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Arkansas Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Arkansas Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Arkansas Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Arkansas Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Arkansas Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Arkansas QualChoice - High Self DH1 752.20 767.26 523.42 243.84 2.48
Arkansas QualChoice - High Self & Family DH2 1961.96 2001.20 1218.21 782.99 5.05
Arkansas QualChoice - High Self Plus One DH3 1461.18 1490.43 1117.82 372.61 3.69
Arkansas QualChoice - Standard Self DH4 587.25 599.00 449.25 149.75 2.94
Arkansas QualChoice - Standard Self & Family DH5 1531.75 1562.43 1171.82 390.61 7.67
Arkansas QualChoice - Standard Self Plus One DH6 1140.77 1163.63 872.72 290.91 5.72
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 454.74 485.85 364.39 121.46 7.78
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1045.92 1117.50 838.13 279.37 17.89
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 977.71 1044.59 783.44 261.15 16.72
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 713.87 769.04 523.42 245.62 42.59
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1784.71 1922.64 1218.21 704.43 103.74
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1534.87 1653.47 1121.16 532.31 89.70
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Arkansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
California Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
California Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
California Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
California Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
California Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
California Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1073.48 1094.58 523.42 571.16 8.52
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2450.59 2498.80 1218.21 1280.59 14.02
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2426.32 2474.07 1121.16 1352.91 18.85
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1003.99 1009.93 523.42 486.51 -6.64
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2288.65 2302.15 1218.21 1083.94 -20.69
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2265.99 2279.33 1121.16 1158.17 -15.56
California Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
California Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
California Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
California Aetna Open Access - High Self 2X1 880.53 936.67 523.42 413.25 43.56
California Aetna Open Access - High Self & Family 2X2 2067.24 2199.02 1218.21 980.81 97.59
California Aetna Open Access - High Self Plus One 2X3 2026.70 2155.90 1121.16 1034.74 100.30
California Anthem Blue Cross Select HMO - High Self B31 774.13 774.13 523.42 250.71 -12.58
California Anthem Blue Cross Select HMO - High Self & Family B32 1768.91 1768.91 1218.21 550.70 -34.19
California Anthem Blue Cross Select HMO - High Self Plus One B33 1641.16 1641.16 1121.16 520.00 -28.90
California Blue Shield of California - Access + HMO Self SI1 833.84 858.87 523.42 335.45 12.45
California Blue Shield of California - Access + HMO Self & Family SI2 1917.85 1975.39 1218.21 757.18 23.35
California Blue Shield of California - Access + HMO Self Plus One SI3 1834.45 1889.49 1121.16 768.33 26.14
California Health Net of California - Basic Self P61 324.37 364.04 273.03 91.01 9.92
California Health Net of California - Basic Self & Family P62 778.46 873.73 655.30 218.43 23.82
California Health Net of California - Basic Self Plus One P63 713.59 800.93 600.70 200.23 21.83
California Health Net of California - High Self LP1 1048.36 1012.98 523.42 489.56 -47.96
California Health Net of California - High Self & Family LP2 2516.06 2431.17 1218.21 1212.96 -119.08
California Health Net of California - High Self Plus One LP3 2306.40 2228.57 1121.16 1107.41 -106.73
California Health Net of California - High Self LB1 1510.56 1550.64 523.42 1027.22 27.50
California Health Net of California - High Self & Family LB2 3625.38 3721.49 1218.21 2503.28 61.92
California Health Net of California - High Self Plus One LB3 3323.26 3411.35 1121.16 2290.19 59.19
California Health Net of California - Standard Self LB4 1340.54 1466.14 523.42 942.72 113.02
California Health Net of California - Standard Self & Family LB5 3217.28 3518.71 1218.21 2300.50 267.24
California Health Net of California - Standard Self Plus One LB6 2949.18 3225.50 1121.16 2104.34 247.42
California Health Net of California - Basic Self T41 881.83 894.18 523.42 370.76 -0.23
California Health Net of California - Basic Self & Family T42 2116.40 2146.04 1218.21 927.83 -4.55
California Health Net of California - Basic Self Plus One T43 1940.06 1967.20 1121.16 846.04 -1.76
California Kaiser Permanente - Fresno California - Standard Self NZ4 566.80 590.11 442.58 147.53 5.83
California Kaiser Permanente - Fresno California - Standard Self & Family NZ5 1309.95 1363.87 1022.90 340.97 13.48
California Kaiser Permanente - Fresno California - Standard Self Plus One NZ6 1309.95 1363.87 1022.90 340.97 13.48
California Kaiser Permanente - Fresno California - High Self NZ1 776.92 802.99 523.42 279.57 13.49
California Kaiser Permanente - Fresno California - High Self & Family NZ2 1795.67 1855.86 1218.21 637.65 26.00
California Kaiser Permanente - Fresno California - High Self Plus One NZ3 1795.67 1855.86 1121.16 734.70 31.29
California Kaiser Permanente - Northern California - Basic Self KC1 652.08 652.08 489.06 163.02 0.00
California Kaiser Permanente - Northern California - Basic Self & Family KC2 1525.85 1525.85 1144.39 381.46 0.00
California Kaiser Permanente - Northern California - Basic Self Plus One KC3 1525.85 1525.85 1121.16 404.69 -28.90
California Kaiser Permanente - Northern California - High Self 591 1000.46 1014.54 523.42 491.12 1.50
California Kaiser Permanente - Northern California - High Self & Family 592 2388.21 2421.86 1218.21 1203.65 -0.54
California Kaiser Permanente - Northern California - High Self Plus One 593 2388.21 2421.86 1121.16 1300.70 4.75
California Kaiser Permanente - Northern California - Standard Self 594 809.88 822.68 523.42 299.26 0.22
California Kaiser Permanente - Northern California - Standard Self & Family 595 1895.08 1925.11 1218.21 706.90 -4.16
California Kaiser Permanente - Northern California - Standard Self Plus One 596 1895.08 1925.11 1121.16 803.95 1.13
California Kaiser Permanente - Southern California - Standard Self 624 466.31 473.44 355.08 118.36 1.78
California Kaiser Permanente - Southern California - Standard Self & Family 625 1077.70 1094.21 820.66 273.55 4.13
California Kaiser Permanente - Southern California - Standard Self Plus One 626 1077.70 1094.21 820.66 273.55 4.13
California Kaiser Permanente - Southern California - High Self 621 735.41 750.19 523.42 226.77 2.20
California Kaiser Permanente - Southern California - High Self & Family 622 1699.66 1733.83 1218.21 515.62 -0.02
California Kaiser Permanente - Southern California - High Self Plus One 623 1699.66 1733.83 1121.16 612.67 5.27
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
California UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Colorado Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Colorado Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Colorado Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Colorado Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Colorado Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Colorado Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Colorado Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Colorado Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Colorado Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self WW1 636.35 636.35 477.26 159.09 0.00
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self & Family WW2 1549.49 1549.49 1162.12 387.37 0.00
Colorado BlueAdvantageHMO on the Pathway HMO Network - High Self Plus One WW3 1447.66 1447.66 1085.75 361.91 0.00
Colorado Humana Health Plan, Inc. - High Self NR1 821.51 961.18 523.42 437.76 127.09
Colorado Humana Health Plan, Inc. - High Self & Family NR2 1848.41 2162.64 1218.21 944.43 280.04
Colorado Humana Health Plan, Inc. - High Self Plus One NR3 1766.27 2066.52 1121.16 945.36 271.35
Colorado Humana Health Plan, Inc. - Standard Self NR4 569.31 666.08 499.56 166.52 24.19
Colorado Humana Health Plan, Inc. - Standard Self & Family NR5 1280.98 1498.73 1124.05 374.68 54.44
Colorado Humana Health Plan, Inc. - Standard Self Plus One NR6 1224.02 1432.08 1074.06 358.02 52.02
Colorado Humana Health Plan, Inc. - Basic Self RZ1 521.80 532.24 399.18 133.06 2.61
Colorado Humana Health Plan, Inc. - Basic Self & Family RZ2 1174.03 1197.52 898.14 299.38 5.87
Colorado Humana Health Plan, Inc. - Basic Self Plus One RZ3 1121.90 1144.33 858.25 286.08 5.61
Colorado Humana Health Plan, Inc. - High Self NT1 764.77 833.60 523.42 310.18 56.25
Colorado Humana Health Plan, Inc. - High Self & Family NT2 1720.79 1875.66 1218.21 657.45 120.68
Colorado Humana Health Plan, Inc. - High Self Plus One NT3 1644.28 1792.27 1121.16 671.11 119.09
Colorado Humana Health Plan, Inc. - Standard Self NT4 541.52 590.27 442.70 147.57 12.19
Colorado Humana Health Plan, Inc. - Standard Self & Family NT5 1218.45 1328.12 996.09 332.03 27.42
Colorado Humana Health Plan, Inc. - Standard Self Plus One NT6 1164.35 1269.13 951.85 317.28 26.19
Colorado Humana Health Plan, Inc. - Basic Self R21 531.12 621.40 466.05 155.35 22.57
Colorado Humana Health Plan, Inc. - Basic Self & Family R22 1195.00 1398.17 1048.63 349.54 50.79
Colorado Humana Health Plan, Inc. - Basic Self Plus One R23 1141.90 1336.03 1002.02 334.01 48.54
Colorado Kaiser Permanente - Colorado - Standard Self 654 671.30 660.83 495.62 165.21 -2.61
Colorado Kaiser Permanente - Colorado - Standard Self & Family 655 1517.12 1493.46 1120.10 373.36 -5.92
Colorado Kaiser Permanente - Colorado - Standard Self Plus One 656 1517.12 1493.46 1120.10 373.36 -51.50
Colorado Kaiser Permanente - Colorado - High Self 651 789.17 772.89 523.42 249.47 -28.86
Colorado Kaiser Permanente - Colorado - High Self & Family 652 1783.51 1746.75 1218.21 528.54 -70.95
Colorado Kaiser Permanente - Colorado - High Self Plus One 653 1783.51 1746.75 1121.16 625.59 -65.66
Colorado Kaiser Permanente - Colorado - Basic Self N41 484.77 445.51 334.13 111.38 -9.81
Colorado Kaiser Permanente - Colorado - Basic Self & Family N42 1095.60 1095.94 821.96 273.98 0.08
Colorado Kaiser Permanente - Colorado - Basic Self Plus One N43 1095.60 1006.85 755.14 251.71 -22.19
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 443.84 528.17 396.13 132.04 21.08
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1020.85 1214.76 911.07 303.69 48.48
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 954.27 1135.55 851.66 283.89 45.32
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 724.77 782.12 523.42 258.70 44.77
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1811.90 1955.35 1218.21 737.14 109.26
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1558.25 1681.57 1121.16 560.41 94.42
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Colorado UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Connecticut Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Connecticut Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Connecticut Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Connecticut Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Connecticut Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Connecticut Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 759.61 839.63 523.42 316.21 67.44
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1739.51 1922.68 1218.21 704.47 148.98
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1705.38 1884.96 1121.16 763.80 150.68
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1075.75 1124.65 523.42 601.23 36.32
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2453.32 2564.88 1218.21 1346.67 77.37
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2429.03 2539.46 1121.16 1418.30 81.53
Connecticut Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Connecticut Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Connecticut UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Delaware Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Delaware Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Delaware Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Delaware Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Delaware Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Delaware Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 759.61 839.63 523.42 316.21 67.44
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1739.51 1922.68 1218.21 704.47 148.98
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1705.38 1884.96 1121.16 763.80 150.68
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1075.75 1124.65 523.42 601.23 36.32
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2453.32 2564.88 1218.21 1346.67 77.37
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2429.03 2539.46 1121.16 1418.30 81.53
Delaware Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Delaware Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Delaware Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Delaware Aetna Open Access - Basic Self P34 1310.08 1505.53 523.42 982.11 182.87
Delaware Aetna Open Access - Basic Self & Family P35 3040.68 3494.34 1218.21 2276.13 419.47
Delaware Aetna Open Access - Basic Self Plus One P36 3010.54 3459.73 1121.16 2338.57 420.29
Delaware Aetna Open Access - High Self P31 1456.61 1588.23 523.42 1064.81 119.04
Delaware Aetna Open Access - High Self & Family P32 3531.54 3850.71 1218.21 2632.50 284.98
Delaware Aetna Open Access - High Self Plus One P33 3496.55 3812.58 1121.16 2691.42 287.13
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Delaware UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
District Of Columbia Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
District Of Columbia Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
District Of Columbia Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
District Of Columbia Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
District Of Columbia Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
District Of Columbia Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
District Of Columbia Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
District Of Columbia Aetna Open Access - High Self JN1 1137.57 1176.57 523.42 653.15 26.42
District Of Columbia Aetna Open Access - High Self & Family JN2 2557.43 2645.05 1218.21 1426.84 53.43
District Of Columbia Aetna Open Access - High Self Plus One JN3 2532.10 2618.85 1121.16 1497.69 57.85
District Of Columbia Aetna Open Access - Basic Self JN4 697.10 714.42 523.42 191.00 4.74
District Of Columbia Aetna Open Access - Basic Self & Family JN5 1595.34 1634.92 1218.21 416.71 5.39
District Of Columbia Aetna Open Access - Basic Self Plus One JN6 1464.99 1501.33 1121.16 380.17 7.44
District Of Columbia Aetna Saver (Open Access) - Saver Self QQ4 595.21 595.21 446.41 148.80 0.00
District Of Columbia Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.14 1362.12 1021.59 340.53 0.00
District Of Columbia Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1250.82 938.12 312.70 0.00
District Of Columbia CareFirst BlueChoice - Standard Self 2G4 845.54 887.81 523.42 364.39 29.69
District Of Columbia CareFirst BlueChoice - Standard Self & Family 2G5 2008.96 2109.42 1218.21 891.21 66.27
District Of Columbia CareFirst BlueChoice - Standard Self Plus One 2G6 1691.06 1775.61 1121.16 654.45 55.65
District Of Columbia CareFirst BlueChoice - HDHP Self B61 570.09 570.09 427.57 142.52 0.00
District Of Columbia CareFirst BlueChoice - HDHP Self & Family B62 1354.51 1354.51 1015.88 338.63 0.00
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One B63 1140.17 1140.17 855.13 285.04 0.00
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self B64 705.99 723.67 523.42 200.25 5.10
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1677.46 1719.38 1218.21 501.17 7.73
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1412.02 1447.29 1085.47 361.82 8.82
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self T71 420.12 427.72 320.79 106.93 1.90
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self & Family T72 1026.16 1099.52 824.64 274.88 18.34
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One T73 934.90 951.84 713.88 237.96 4.24
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 571.55 598.28 448.71 149.57 6.68
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1314.50 1376.05 1032.04 344.01 15.39
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1314.50 1376.05 1032.04 344.01 15.39
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self E31 722.82 746.24 523.42 222.82 10.84
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1662.53 1716.35 1218.21 498.14 19.63
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1662.53 1716.35 1121.16 595.19 24.92
District Of Columbia M.D. IPA - High Self JP1 876.61 950.89 523.42 427.47 61.70
District Of Columbia M.D. IPA - High Self & Family JP2 2458.04 2666.28 1218.21 1448.07 174.05
District Of Columbia M.D. IPA - High Self Plus One JP3 1712.04 1857.09 1121.16 735.93 116.15
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 486.57 519.91 389.93 129.98 8.34
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1119.11 1195.81 896.86 298.95 19.17
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1046.13 1117.81 838.36 279.45 17.92
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 714.89 770.40 523.42 246.98 42.93
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1694.29 1825.83 1218.21 607.62 97.35
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1536.99 1656.33 1121.16 535.17 90.44
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 521.50 554.62 415.97 138.65 8.28
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1462.26 1555.15 1166.36 388.79 23.23
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1018.46 1083.18 812.39 270.79 16.18
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
District Of Columbia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Florida Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Florida Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Florida Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Florida Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Florida Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Florida Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Florida Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Florida Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Florida Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Florida AvMed - HDHP Self WZ1 805.16 762.08 523.42 238.66 -55.66
Florida AvMed - HDHP Self & Family WZ2 1871.35 1762.00 1218.21 543.79 -143.54
Florida AvMed - HDHP Self Plus One WZ3 1622.34 1528.67 1121.16 407.51 -122.57
Florida AvMed - Standard Self ML4 709.24 820.97 523.42 297.55 99.15
Florida AvMed - Standard Self & Family ML5 1726.81 1998.92 1218.21 780.71 237.92
Florida AvMed - Standard Self Plus One ML6 1489.37 1724.06 1121.16 602.90 205.79
Florida Capital Health Plan - High Self EA1 680.62 690.47 517.85 172.62 2.47
Florida Capital Health Plan - High Self & Family EA2 1577.33 1600.19 1200.14 400.05 5.72
Florida Capital Health Plan - High Self Plus One EA3 1488.41 1509.99 1121.16 388.83 -7.32
Florida Humana CoverageFirst and Humana Value Plan - Value Self W94 513.59 585.48 439.11 146.37 17.97
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family W95 1155.57 1317.33 988.00 329.33 40.44
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One W96 1104.20 1258.79 944.09 314.70 38.65
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self W91 607.10 692.10 519.08 173.02 21.25
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family W92 1365.95 1557.18 1167.89 389.29 47.80
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One W93 1305.27 1487.98 1115.99 371.99 45.67
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self QP1 725.05 768.56 523.42 245.14 30.93
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family QP2 1633.54 1731.56 1218.21 513.35 63.83
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One QP3 1560.93 1654.58 1121.16 533.42 64.75
Florida Humana CoverageFirst and Humana Value Plan - Value Self QP4 519.35 550.51 412.88 137.63 7.79
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family QP5 1168.48 1238.60 928.95 309.65 17.53
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One QP6 1116.57 1183.56 887.67 295.89 16.75
Florida Humana CoverageFirst and Humana Value Plan - Value Self MJ4 519.61 561.19 420.89 140.30 10.40
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family MJ5 1169.13 1262.67 947.00 315.67 23.39
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One MJ6 1117.18 1206.55 904.91 301.64 22.35
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self MJ1 948.07 1023.92 523.42 500.50 63.27
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MJ2 2133.15 2303.80 1218.21 1085.59 136.46
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MJ3 2038.36 2201.44 1121.16 1080.28 134.18
Florida Humana CoverageFirst and Humana Value Plan - Value Self X24 493.18 512.89 384.67 128.22 4.93
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family X25 1109.66 1154.05 865.54 288.51 11.10
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One X26 1060.35 1102.77 827.08 275.69 10.60
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self X21 582.99 606.30 454.73 151.57 5.82
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X22 1311.74 1364.22 1023.17 341.05 13.12
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X23 1253.44 1303.58 977.69 325.89 12.53
Florida Humana Medical Plan, Inc. - Standard Self LL4 1074.95 1193.21 523.42 669.79 105.68
Florida Humana Medical Plan, Inc. - Standard Self & Family LL5 2418.61 2684.65 1218.21 1466.44 231.85
Florida Humana Medical Plan, Inc. - Standard Self Plus One LL6 2311.12 2565.33 1121.16 1444.17 225.31
Florida Humana Medical Plan, Inc. - High Self LL1 1659.15 1708.94 523.42 1185.52 37.21
Florida Humana Medical Plan, Inc. - High Self & Family LL2 3733.06 3845.05 1218.21 2626.84 77.80
Florida Humana Medical Plan, Inc. - High Self Plus One LL3 3567.14 3674.15 1121.16 2552.99 78.11
Florida Humana Medical Plan, Inc. - High Self EE1 1115.14 1248.93 523.42 725.51 121.21
Florida Humana Medical Plan, Inc. - High Self & Family EE2 2509.07 2810.15 1218.21 1591.94 266.89
Florida Humana Medical Plan, Inc. - High Self Plus One EE3 2397.59 2685.30 1121.16 1564.14 258.81
Florida Humana Medical Plan, Inc. - Standard Self EE4 997.12 1116.77 523.42 593.35 107.07
Florida Humana Medical Plan, Inc. - Standard Self & Family EE5 2243.50 2512.71 1218.21 1294.50 235.02
Florida Humana Medical Plan, Inc. - Standard Self Plus One EE6 2143.79 2401.04 1121.16 1279.88 228.35
Florida Humana Medical Plan, Inc. - Standard Self E24 716.02 766.13 523.42 242.71 37.53
Florida Humana Medical Plan, Inc. - Standard Self & Family E25 1611.00 1723.78 1218.21 505.57 78.59
Florida Humana Medical Plan, Inc. - Standard Self Plus One E26 1539.40 1647.14 1121.16 525.98 78.84
Florida Humana Medical Plan, Inc. - High Self E21 1202.65 1286.83 523.42 763.41 71.60
Florida Humana Medical Plan, Inc. - High Self & Family E22 2705.86 2895.27 1218.21 1677.06 155.22
Florida Humana Medical Plan, Inc. - High Self Plus One E23 2585.61 2766.60 1121.16 1645.44 152.09
Florida Humana Medical Plan, Inc. - High Self EX1 893.40 1018.49 523.42 495.07 112.51
Florida Humana Medical Plan, Inc. - High Self & Family EX2 2010.10 2291.53 1218.21 1073.32 247.24
Florida Humana Medical Plan, Inc. - High Self Plus One EX3 1920.77 2189.68 1121.16 1068.52 240.01
Florida Humana Medical Plan, Inc. - Standard Self EX4 732.23 834.73 523.42 311.31 89.92
Florida Humana Medical Plan, Inc. - Standard Self & Family EX5 1647.51 1878.15 1218.21 659.94 196.45
Florida Humana Medical Plan, Inc. - Standard Self Plus One EX6 1574.28 1794.67 1121.16 673.51 191.49
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 454.74 485.85 364.39 121.46 7.78
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1045.92 1117.50 838.13 279.37 17.89
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 977.71 1044.59 783.44 261.15 16.72
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 713.87 769.04 523.42 245.62 42.59
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1784.71 1922.64 1218.21 704.43 103.74
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1534.87 1653.47 1121.16 532.31 89.70
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 701.44 750.62 523.42 227.20 36.60
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2104.29 2251.90 1218.21 1033.69 113.42
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1508.07 1613.89 1121.16 492.73 76.92
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Florida UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Georgia Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Georgia Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Georgia Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Georgia Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Georgia Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Georgia Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Georgia Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Georgia Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Georgia Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Georgia Aetna Open Access - High Self 2U1 1733.36 1805.85 523.42 1282.43 59.91
Georgia Aetna Open Access - High Self & Family 2U2 3992.69 4159.72 1218.21 2941.51 132.84
Georgia Aetna Open Access - High Self Plus One 2U3 3953.15 4118.53 1121.16 2997.37 136.48
Georgia Blue Open Access POS - High Self QM1 625.17 656.41 492.31 164.10 7.81
Georgia Blue Open Access POS - High Self & Family QM2 1640.47 1689.68 1218.21 471.47 15.02
Georgia Blue Open Access POS - High Self Plus One QM3 1377.74 1446.62 1084.97 361.65 17.22
Georgia Humana CoverageFirst and Humana Value Plan - Value Self S94 551.89 612.60 459.45 153.15 15.18
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family S95 1241.74 1378.35 1033.76 344.59 34.16
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One S96 1186.58 1317.10 987.83 329.27 32.63
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self S91 693.14 769.41 523.42 245.99 63.69
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family S92 1559.61 1731.15 1218.21 512.94 123.04
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One S93 1490.28 1654.21 1121.16 533.05 135.03
Georgia Humana CoverageFirst and Humana Value Plan - Value Self AD4 737.53 826.04 523.42 302.62 75.93
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family AD5 1659.41 1858.52 1218.21 640.31 164.92
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One AD6 1585.68 1775.95 1121.16 654.79 161.37
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self AD1 973.38 1090.18 523.42 566.76 104.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family AD2 2190.07 2452.86 1218.21 1234.65 228.60
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One AD3 2092.74 2343.86 1121.16 1222.70 222.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self LM1 679.23 747.13 523.42 223.71 53.90
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family LM2 1528.30 1681.12 1218.21 462.91 80.84
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One LM3 1460.36 1606.41 1121.16 485.25 117.15
Georgia Humana CoverageFirst and Humana Value Plan - Value Self LM4 642.55 706.81 523.42 183.39 22.75
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family LM5 1445.71 1590.29 1192.72 397.57 36.14
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One LM6 1381.47 1519.64 1121.16 398.48 53.11
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RM1 648.53 719.88 523.42 196.46 34.33
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RM2 1459.23 1619.74 1214.81 404.93 40.12
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RM3 1394.36 1547.74 1121.16 426.58 77.99
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DN4 726.03 813.15 523.42 289.73 74.54
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DN5 1633.52 1829.53 1218.21 611.32 161.82
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DN6 1560.93 1748.24 1121.16 627.08 158.41
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self DN1 780.61 874.27 523.42 350.85 81.08
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family DN2 1756.37 1967.12 1218.21 748.91 176.56
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One DN3 1678.30 1879.71 1121.16 758.55 172.51
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RJ1 598.09 669.85 502.39 167.46 17.94
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RJ2 1345.72 1507.22 1130.42 376.80 40.37
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RJ3 1285.92 1440.23 1080.17 360.06 38.58
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Q71 762.80 846.71 523.42 323.29 71.33
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family Q72 1716.33 1905.11 1218.21 686.90 154.59
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One Q73 1640.02 1820.43 1121.16 699.27 151.51
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self CB4 1250.45 1137.89 523.42 614.47 -125.14
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family CB5 2813.50 2560.31 1218.21 1342.10 -287.38
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One CB6 2688.47 2446.51 1121.16 1325.35 -270.86
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self CB1 1148.57 1274.89 523.42 751.47 113.74
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family CB2 2584.40 2868.67 1218.21 1650.46 250.08
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One CB3 2469.61 2741.27 1121.16 1620.11 242.76
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self DG1 1321.93 1388.03 523.42 864.61 53.52
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self & Family DG2 2974.34 3123.06 1218.21 1904.85 114.53
Georgia Humana Employers Health Plan of Georgia, Inc. - High Self Plus One DG3 2842.19 2984.30 1121.16 1863.14 113.21
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DG4 1171.84 1300.76 523.42 777.34 116.34
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DG5 2636.70 2926.71 1218.21 1708.50 255.82
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DG6 2519.57 2796.71 1121.16 1675.55 248.24
Georgia Kaiser Permanente - Georgia - High Self F81 730.04 751.10 523.42 227.68 8.48
Georgia Kaiser Permanente - Georgia - High Self & Family F82 1649.87 1697.50 1218.21 479.29 13.44
Georgia Kaiser Permanente - Georgia - High Self Plus One F83 1649.87 1697.50 1121.16 576.34 18.73
Georgia Kaiser Permanente - Georgia - Standard Self F84 552.33 581.10 435.83 145.27 7.19
Georgia Kaiser Permanente - Georgia - Standard Self & Family F85 1248.26 1313.26 984.95 328.31 16.25
Georgia Kaiser Permanente - Georgia - Standard Self Plus One F86 1248.26 1313.26 984.95 328.31 16.25
Georgia Kaiser Permanente - Georgia - Basic Self LA1 393.36 418.90 314.18 104.72 6.38
Georgia Kaiser Permanente - Georgia - Basic Self & Family LA2 888.98 946.66 710.00 236.66 14.42
Georgia Kaiser Permanente - Georgia - Basic Self Plus One LA3 888.98 946.66 710.00 236.66 14.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 701.44 750.62 523.42 227.20 36.60
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2104.29 2251.90 1218.21 1033.69 113.42
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1508.07 1613.89 1121.16 492.73 76.92
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Georgia UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Guam Calvo's SelectCare - Standard Self B44 396.74 429.78 322.34 107.44 8.26
Guam Calvo's SelectCare - Standard Self & Family B45 1152.73 1248.72 936.54 312.18 24.00
Guam Calvo's SelectCare - Standard Self Plus One B46 782.10 847.21 635.41 211.80 16.28
Guam Calvo's SelectCare - High Self B41 491.55 521.69 391.27 130.42 7.53
Guam Calvo's SelectCare - High Self & Family B42 1301.89 1381.77 1036.33 345.44 19.97
Guam Calvo's SelectCare - High Self Plus One B43 959.23 1018.07 763.55 254.52 14.71
Guam TakeCare - HDHP Self KX1 124.24 120.53 90.40 30.13 -0.93
Guam TakeCare - HDHP Self & Family KX2 339.32 323.16 242.37 80.79 -4.04
Guam TakeCare - HDHP Self Plus One KX3 306.11 290.94 218.21 72.73 -3.80
Guam TakeCare - Standard Self JK4 389.24 404.45 303.34 101.11 3.80
Guam TakeCare - Standard Self & Family JK5 1102.31 1145.39 859.04 286.35 10.77
Guam TakeCare - Standard Self Plus One JK6 767.15 797.14 597.86 199.28 7.49
Guam TakeCare - High Self JK1 492.35 497.81 373.36 124.45 1.36
Guam TakeCare - High Self & Family JK2 1174.40 1187.38 890.54 296.84 3.24
Guam TakeCare - High Self Plus One JK3 972.73 983.49 737.62 245.87 2.69
Hawaii Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Hawaii Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Hawaii Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Hawaii Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Hawaii Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Hawaii Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1073.48 1094.58 523.42 571.16 8.52
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2450.59 2498.80 1218.21 1280.59 14.02
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2426.32 2474.07 1121.16 1352.91 18.85
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1003.99 1009.93 523.42 486.51 -6.64
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2288.65 2302.15 1218.21 1083.94 -20.69
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2265.99 2279.33 1121.16 1158.17 -15.56
Hawaii Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Hawaii Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Hawaii HMSA Plan - High Self 871 631.24 631.24 473.43 157.81 0.00
Hawaii HMSA Plan - High Self & Family 872 1419.02 1419.02 1064.27 354.75 0.00
Hawaii HMSA Plan - High Self Plus One 873 1383.07 1383.07 1037.30 345.77 0.00
Hawaii HMSA Plan - Standard Self 874 430.97 453.83 340.37 113.46 5.72
Hawaii HMSA Plan - Standard Self & Family 875 968.83 1020.18 765.14 255.04 12.83
Hawaii HMSA Plan - Standard Self Plus One 876 944.23 994.28 745.71 248.57 12.51
Hawaii Kaiser Permanente - Hawaii - High Self 631 675.55 675.55 506.66 168.89 0.00
Hawaii Kaiser Permanente - Hawaii - High Self & Family 632 1506.51 1506.51 1129.88 376.63 0.00
Hawaii Kaiser Permanente - Hawaii - High Self Plus One 633 1506.51 1506.51 1121.16 385.35 -28.90
Hawaii Kaiser Permanente - Hawaii - Standard Self 634 481.15 505.18 378.89 126.29 6.00
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family 635 1072.98 1126.52 844.89 281.63 13.39
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One 636 1072.98 1126.52 844.89 281.63 13.39
Idaho Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Idaho Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Idaho Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Idaho Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Idaho Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Idaho Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Idaho Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Idaho Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Idaho Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Idaho Altius Health Plan - High Self 9K1 1009.06 1048.36 523.42 524.94 26.72
Idaho Altius Health Plan - High Self & Family 9K2 2231.52 2318.46 1218.21 1100.25 52.75
Idaho Altius Health Plan - High Self Plus One 9K3 2209.42 2295.50 1121.16 1174.34 57.18
Idaho Altius Health Plan - HDHP Self 9K4 529.23 672.49 504.37 168.12 35.81
Idaho Altius Health Plan - HDHP Self & Family 9K5 1106.04 1405.43 1054.07 351.36 74.85
Idaho Altius Health Plan - HDHP Self Plus One 9K6 1084.37 1377.85 1033.39 344.46 73.37
Idaho Altius Health Plan - Standard Self DK4 761.30 883.11 523.42 359.69 109.23
Idaho Altius Health Plan - Standard Self & Family DK5 1681.23 1950.20 1218.21 731.99 234.78
Idaho Altius Health Plan - Standard Self Plus One DK6 1664.56 1930.87 1121.16 809.71 237.41
Idaho Kaiser Permanente - Washington Core - Standard Self 544 604.13 618.02 463.52 154.50 3.47
Idaho Kaiser Permanente - Washington Core - Standard Self & Family 545 1389.53 1421.44 1066.08 355.36 7.98
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One 546 1389.53 1421.44 1066.08 355.36 7.98
Idaho Kaiser Permanente - Washington Core - High Self 541 845.74 863.76 523.42 340.34 5.44
Idaho Kaiser Permanente - Washington Core - High Self & Family 542 1860.65 1900.25 1218.21 682.04 5.41
Idaho Kaiser Permanente - Washington Core - High Self Plus One 543 1860.65 1900.25 1121.16 779.09 10.70
Idaho Kaiser Permanente - Washington Core - Prosper Self PT4 New Plan 390.00 292.50 97.50 New Plan
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family PT5 New Plan 1091.98 818.99 272.99 New Plan
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One PT6 New Plan 944.67 708.50 236.17 New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Idaho UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Illinois Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Illinois Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Illinois Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Illinois Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Illinois Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Illinois Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Illinois Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Illinois Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Illinois Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Illinois Blue Preferred - High Self 9G1 833.21 874.23 523.42 350.81 28.44
Illinois Blue Preferred - High Self & Family 9G2 1858.87 1984.52 1218.21 766.31 91.46
Illinois Blue Preferred - High Self Plus One 9G3 1760.59 1862.12 1121.16 740.96 72.63
Illinois Blue Preferred - Standard Self 9G4 600.62 633.66 475.25 158.41 8.26
Illinois Blue Preferred - Standard Self & Family 9G5 1707.01 1758.23 1218.21 540.02 17.03
Illinois Blue Preferred - Standard Self Plus One 9G6 1543.71 1574.58 1121.16 453.42 1.97
Illinois Health Alliance HMO - Standard Self K84 668.14 683.56 512.67 170.89 3.86
Illinois Health Alliance HMO - Standard Self & Family K85 1803.99 1584.35 1188.26 396.09 -223.88
Illinois Health Alliance HMO - Standard Self Plus One K86 1547.78 1461.61 1096.21 365.40 -90.12
Illinois Humana CoverageFirst and Humana Value Plan - Value Self GB4 758.14 788.47 523.42 265.05 17.75
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family GB5 1705.77 1774.00 1218.21 555.79 34.04
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One GB6 1629.96 1695.16 1121.16 574.00 36.30
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self GB1 1180.53 1227.74 523.42 704.32 34.63
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family GB2 2656.14 2762.39 1218.21 1544.18 72.06
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One GB3 2538.12 2639.65 1121.16 1518.49 72.63
Illinois Humana CoverageFirst and Humana Value Plan - Value Self MW4 754.91 807.76 523.42 284.34 40.27
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1698.52 1817.40 1218.21 599.19 84.69
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1623.05 1736.67 1121.16 615.51 84.72
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 916.02 1025.96 523.42 502.54 97.36
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2061.15 2308.48 1218.21 1090.27 213.14
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 1969.50 2205.86 1121.16 1084.70 207.46
Illinois Humana Health Plan, Inc. - Standard Self 754 951.90 1045.35 523.42 521.93 80.87
Illinois Humana Health Plan, Inc. - Standard Self & Family 755 2141.77 2352.03 1218.21 1133.82 176.07
Illinois Humana Health Plan, Inc. - Standard Self Plus One 756 2046.59 2247.53 1121.16 1126.37 172.04
Illinois Humana Health Plan, Inc. - High Self 751 1238.94 1369.01 523.42 845.59 117.49
Illinois Humana Health Plan, Inc. - High Self & Family 752 2787.61 3080.33 1218.21 1862.12 258.53
Illinois Humana Health Plan, Inc. - High Self Plus One 753 2663.74 2943.42 1121.16 1822.26 250.78
Illinois Humana Health Plan, Inc. - High Self 9F1 1938.32 2015.85 523.42 1492.43 64.95
Illinois Humana Health Plan, Inc. - High Self & Family 9F2 4361.20 4535.64 1218.21 3317.43 140.25
Illinois Humana Health Plan, Inc. - High Self Plus One 9F3 4167.35 4334.03 1121.16 3212.87 137.78
Illinois Humana Health Plan, Inc. - Standard Self AB4 1149.53 1241.70 523.42 718.28 79.59
Illinois Humana Health Plan, Inc. - Standard Self & Family AB5 2586.44 2793.90 1218.21 1575.69 173.27
Illinois Humana Health Plan, Inc. - Standard Self Plus One AB6 2471.50 2669.72 1121.16 1548.56 169.32
Illinois Humana Health Plan, Inc. - Basic Self AB1 756.64 786.91 523.42 263.49 17.69
Illinois Humana Health Plan, Inc. - Basic Self & Family AB2 1702.50 1770.60 1218.21 552.39 33.91
Illinois Humana Health Plan, Inc. - Basic Self Plus One AB3 1626.84 1691.91 1121.16 570.75 36.17
Illinois Humana Health Plan, Inc. - Basic Self RW1 748.24 819.04 523.42 295.62 58.22
Illinois Humana Health Plan, Inc. - Basic Self & Family RW2 1683.54 1842.86 1218.21 624.65 125.13
Illinois Humana Health Plan, Inc. - Basic Self Plus One RW3 1608.73 1760.96 1121.16 639.80 123.33
Illinois Union Health Service - High Self 761 744.08 782.06 523.42 258.64 25.40
Illinois Union Health Service - High Self & Family 762 1901.64 1962.91 1218.21 744.70 27.08
Illinois Union Health Service - High Self Plus One 763 1668.33 1732.34 1121.16 611.18 35.11
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 521.50 554.62 415.97 138.65 8.28
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1462.26 1555.15 1166.36 388.79 23.23
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1018.46 1083.18 812.39 270.79 16.18
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Illinois UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Indiana Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Indiana Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Indiana Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Indiana Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Indiana Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Indiana Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1073.48 1094.58 523.42 571.16 8.52
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2450.59 2498.80 1218.21 1280.59 14.02
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2426.32 2474.07 1121.16 1352.91 18.85
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1003.99 1009.93 523.42 486.51 -6.64
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2288.65 2302.15 1218.21 1083.94 -20.69
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2265.99 2279.33 1121.16 1158.17 -15.56
Indiana Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Indiana Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Indiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Indiana Health Alliance HMO - Standard Self K84 668.14 683.56 512.67 170.89 3.86
Indiana Health Alliance HMO - Standard Self & Family K85 1803.99 1584.35 1188.26 396.09 -223.88
Indiana Health Alliance HMO - Standard Self Plus One K86 1547.78 1461.61 1096.21 365.40 -90.12
Indiana Humana CoverageFirst - CDHP Self TC1 659.47 738.57 523.42 215.15 50.28
Indiana Humana CoverageFirst - CDHP Self & Family TC2 1483.73 1661.79 1218.21 443.58 72.65
Indiana Humana CoverageFirst - CDHP Self Plus One TC3 1417.82 1587.95 1121.16 466.79 112.34
Indiana Humana CoverageFirst and Humana Value Plan - Value Self MW4 754.91 807.76 523.42 284.34 40.27
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1698.52 1817.40 1218.21 599.19 84.69
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1623.05 1736.67 1121.16 615.51 84.72
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 916.02 1025.96 523.42 502.54 97.36
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2061.15 2308.48 1218.21 1090.27 213.14
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 1969.50 2205.86 1121.16 1084.70 207.46
Indiana Humana CoverageFirst and Humana Value Plan - Value Self X34 615.12 645.88 484.41 161.47 7.69
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1384.05 1453.25 1089.94 363.31 17.30
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1322.53 1388.66 1041.50 347.16 16.53
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self X31 799.44 839.41 523.42 315.99 27.39
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 1798.77 1888.71 1218.21 670.50 55.75
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1718.82 1804.77 1121.16 683.61 57.05
Indiana Humana Health Plan of Ohio, Inc. - High Self A61 1500.98 1576.03 523.42 1052.61 62.47
Indiana Humana Health Plan of Ohio, Inc. - High Self & Family A62 3377.23 3546.10 1218.21 2327.89 134.68
Indiana Humana Health Plan of Ohio, Inc. - High Self Plus One A63 3227.14 3388.49 1121.16 2267.33 132.45
Indiana Humana Health Plan of Ohio, Inc. - Standard Self A64 1172.17 1230.78 523.42 707.36 46.03
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2637.42 2769.30 1218.21 1551.09 97.69
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2520.20 2646.19 1121.16 1525.03 97.09
Indiana Humana Health Plan, Inc. - Standard Self 754 951.90 1045.35 523.42 521.93 80.87
Indiana Humana Health Plan, Inc. - Standard Self & Family 755 2141.77 2352.03 1218.21 1133.82 176.07
Indiana Humana Health Plan, Inc. - Standard Self Plus One 756 2046.59 2247.53 1121.16 1126.37 172.04
Indiana Humana Health Plan, Inc. - High Self 751 1238.94 1369.01 523.42 845.59 117.49
Indiana Humana Health Plan, Inc. - High Self & Family 752 2787.61 3080.33 1218.21 1862.12 258.53
Indiana Humana Health Plan, Inc. - High Self Plus One 753 2663.74 2943.42 1121.16 1822.26 250.78
Indiana Humana Health Plan, Inc. - High Self MH1 1104.96 1215.48 523.42 692.06 97.94
Indiana Humana Health Plan, Inc. - High Self & Family MH2 2486.19 2734.83 1218.21 1516.62 214.45
Indiana Humana Health Plan, Inc. - High Self Plus One MH3 2375.69 2613.26 1121.16 1492.10 208.67
Indiana Humana Health Plan, Inc. - Standard Self MH4 859.65 945.62 523.42 422.20 73.39
Indiana Humana Health Plan, Inc. - Standard Self & Family MH5 1934.18 2127.62 1218.21 909.41 159.25
Indiana Humana Health Plan, Inc. - Standard Self Plus One MH6 1848.23 2033.05 1121.16 911.89 155.92
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Indiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Iowa Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Iowa Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Iowa Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Iowa Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Iowa Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Iowa Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Iowa Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Iowa Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Iowa Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Iowa Health Alliance HMO - Standard Self K84 668.14 683.56 512.67 170.89 3.86
Iowa Health Alliance HMO - Standard Self & Family K85 1803.99 1584.35 1188.26 396.09 -223.88
Iowa Health Alliance HMO - Standard Self Plus One K86 1547.78 1461.61 1096.21 365.40 -90.12
Iowa HealthPartners - Standard Self V34 459.92 509.41 382.06 127.35 12.37
Iowa HealthPartners - Standard Self & Family V35 1120.41 1240.94 930.71 310.23 30.13
Iowa HealthPartners - Standard Self Plus One V36 1016.45 1125.80 844.35 281.45 27.34
Iowa HealthPartners - High Self V31 712.31 668.07 501.05 167.02 -34.45
Iowa HealthPartners - High Self & Family V32 1735.20 1627.38 1218.21 409.17 -142.01
Iowa HealthPartners - High Self Plus One V33 1574.21 1476.41 1107.31 369.10 -112.85
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 610.42 692.86 519.65 173.21 20.61
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1403.98 1593.56 1195.17 398.39 47.40
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1312.42 1489.63 1117.22 372.41 44.31
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 720.18 776.84 523.42 253.42 44.08
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 1800.48 1942.11 1218.21 723.90 107.44
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1548.41 1670.22 1121.16 549.06 92.91
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Iowa UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Kansas Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Kansas Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Kansas Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Kansas Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Kansas Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Kansas Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Kansas Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Kansas Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Kansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Kansas Aetna Open Access - High Self HA1 1099.93 1156.52 523.42 633.10 44.01
Kansas Aetna Open Access - High Self & Family HA2 2598.18 2731.91 1218.21 1513.70 99.54
Kansas Aetna Open Access - High Self Plus One HA3 2572.53 2704.89 1121.16 1583.73 103.46
Kansas Aetna Open Access - Standard Self HA4 716.37 901.36 523.42 377.94 172.41
Kansas Aetna Open Access - Standard Self & Family HA5 1690.89 2127.54 1218.21 909.33 402.46
Kansas Aetna Open Access - Standard Self Plus One HA6 1674.16 2106.48 1121.16 985.32 403.42
Kansas Humana CoverageFirst and Humana Value Plan - Value Self PH4 484.03 527.61 395.71 131.90 10.89
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1089.10 1187.12 890.34 296.78 24.51
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1040.67 1134.36 850.77 283.59 23.42
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 715.11 758.03 523.42 234.61 30.34
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1609.03 1705.58 1218.21 487.37 62.36
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1537.51 1629.77 1121.16 508.61 63.36
Kansas Humana Health Plan, Inc. - High Self MS1 1723.17 1796.84 523.42 1273.42 61.09
Kansas Humana Health Plan, Inc. - High Self & Family MS2 3877.12 4042.89 1218.21 2824.68 131.58
Kansas Humana Health Plan, Inc. - High Self Plus One MS3 3704.81 3863.17 1121.16 2742.01 129.46
Kansas Humana Health Plan, Inc. - Standard Self MS4 1067.00 1200.59 523.42 677.17 121.01
Kansas Humana Health Plan, Inc. - Standard Self & Family MS5 2400.78 2701.34 1218.21 1483.13 266.37
Kansas Humana Health Plan, Inc. - Standard Self Plus One MS6 2294.09 2581.32 1121.16 1460.16 258.33
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Kansas UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Kentucky Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Kentucky Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Kentucky Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Kentucky Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Kentucky Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Kentucky Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Kentucky Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Kentucky Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Kentucky Humana CoverageFirst - CDHP Self TC1 659.47 738.57 523.42 215.15 50.28
Kentucky Humana CoverageFirst - CDHP Self & Family TC2 1483.73 1661.79 1218.21 443.58 72.65
Kentucky Humana CoverageFirst - CDHP Self Plus One TC3 1417.82 1587.95 1121.16 466.79 112.34
Kentucky Humana CoverageFirst - CDHP Self 6N1 766.70 828.04 523.42 304.62 48.76
Kentucky Humana CoverageFirst - CDHP Self & Family 6N2 1725.08 1863.07 1218.21 644.86 103.80
Kentucky Humana CoverageFirst - CDHP Self Plus One 6N3 1648.40 1780.29 1121.16 659.13 102.99
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self X34 615.12 645.88 484.41 161.47 7.69
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1384.05 1453.25 1089.94 363.31 17.30
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1322.53 1388.66 1041.50 347.16 16.53
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self X31 799.44 839.41 523.42 315.99 27.39
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 1798.77 1888.71 1218.21 670.50 55.75
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1718.82 1804.77 1121.16 683.61 57.05
Kentucky Humana Health Plan of Ohio, Inc. - High Self A61 1500.98 1576.03 523.42 1052.61 62.47
Kentucky Humana Health Plan of Ohio, Inc. - High Self & Family A62 3377.23 3546.10 1218.21 2327.89 134.68
Kentucky Humana Health Plan of Ohio, Inc. - High Self Plus One A63 3227.14 3388.49 1121.16 2267.33 132.45
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self A64 1172.17 1230.78 523.42 707.36 46.03
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2637.42 2769.30 1218.21 1551.09 97.69
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2520.20 2646.19 1121.16 1525.03 97.09
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self W61 608.62 639.06 479.30 159.76 7.61
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family W62 1369.44 1437.93 1078.45 359.48 17.12
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One W63 1308.58 1374.01 1030.51 343.50 16.36
Kentucky Humana Health Plan, Inc. - High Self MI1 1381.45 1436.72 523.42 913.30 42.69
Kentucky Humana Health Plan, Inc. - High Self & Family MI2 3108.24 3232.54 1218.21 2014.33 90.11
Kentucky Humana Health Plan, Inc. - High Self Plus One MI3 2970.09 3088.91 1121.16 1967.75 89.92
Kentucky Humana Health Plan, Inc. - Standard Self MI4 885.00 920.40 523.42 396.98 22.82
Kentucky Humana Health Plan, Inc. - Standard Self & Family MI5 1991.21 2070.86 1218.21 852.65 45.46
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MI6 1902.75 1978.84 1121.16 857.68 47.19
Kentucky Humana Health Plan, Inc. - High Self MH1 1104.96 1215.48 523.42 692.06 97.94
Kentucky Humana Health Plan, Inc. - High Self & Family MH2 2486.19 2734.83 1218.21 1516.62 214.45
Kentucky Humana Health Plan, Inc. - High Self Plus One MH3 2375.69 2613.26 1121.16 1492.10 208.67
Kentucky Humana Health Plan, Inc. - Standard Self MH4 859.65 945.62 523.42 422.20 73.39
Kentucky Humana Health Plan, Inc. - Standard Self & Family MH5 1934.18 2127.62 1218.21 909.41 159.25
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MH6 1848.23 2033.05 1121.16 911.89 155.92
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 610.42 692.86 519.65 173.21 20.61
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1403.98 1593.56 1195.17 398.39 47.40
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1312.42 1489.63 1117.22 372.41 44.31
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 720.18 776.84 523.42 253.42 44.08
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 1800.48 1942.11 1218.21 723.90 107.44
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1548.41 1670.22 1121.16 549.06 92.91
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Kentucky UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Louisiana Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Louisiana Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Louisiana Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Louisiana Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Louisiana Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Louisiana Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Louisiana Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Louisiana Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self BC4 674.14 741.54 523.42 218.12 49.59
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family BC5 1516.80 1668.46 1218.21 450.25 71.05
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One BC6 1449.37 1594.30 1121.16 473.14 110.80
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self BC1 901.33 991.47 523.42 468.05 77.56
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family BC2 2028.02 2230.82 1218.21 1012.61 168.61
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One BC3 1937.89 2131.68 1121.16 1010.52 164.89
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self AE1 1071.42 1210.69 523.42 687.27 126.69
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family AE2 2410.63 2724.04 1218.21 1505.83 279.22
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One AE3 2303.51 2602.99 1121.16 1481.83 270.58
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self AE4 807.45 912.43 523.42 389.01 92.40
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family AE5 1816.79 2052.98 1218.21 834.77 202.00
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One AE6 1736.04 1961.72 1121.16 840.56 196.78
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 454.74 485.85 364.39 121.46 7.78
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1045.92 1117.50 838.13 279.37 17.89
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 977.71 1044.59 783.44 261.15 16.72
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 713.87 769.04 523.42 245.62 42.59
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1784.71 1922.64 1218.21 704.43 103.74
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1534.87 1653.47 1121.16 532.31 89.70
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Louisiana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Maine Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Maine Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Maine Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Maine Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Maine Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Maine Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 759.61 839.63 523.42 316.21 67.44
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1739.51 1922.68 1218.21 704.47 148.98
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1705.38 1884.96 1121.16 763.80 150.68
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1075.75 1124.65 523.42 601.23 36.32
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2453.32 2564.88 1218.21 1346.67 77.37
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2429.03 2539.46 1121.16 1418.30 81.53
Maine Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Maine Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Maine Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Maine UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Maryland Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Maryland Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Maryland Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Maryland Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Maryland Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Maryland Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 829.23 851.74 523.42 328.32 9.93
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1890.72 1942.03 1218.21 723.82 17.12
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1872.00 1922.81 1121.16 801.65 21.91
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 819.98 821.82 523.42 298.40 -10.74
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1877.61 1881.88 1218.21 663.67 -29.92
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1840.78 1844.96 1121.16 723.80 -24.72
Maryland Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Maryland Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Maryland Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Maryland Aetna Open Access - High Self JN1 1137.57 1176.57 523.42 653.15 26.42
Maryland Aetna Open Access - High Self & Family JN2 2557.43 2645.05 1218.21 1426.84 53.43
Maryland Aetna Open Access - High Self Plus One JN3 2532.10 2618.85 1121.16 1497.69 57.85
Maryland Aetna Open Access - Basic Self JN4 697.10 714.42 523.42 191.00 4.74
Maryland Aetna Open Access - Basic Self & Family JN5 1595.34 1634.92 1218.21 416.71 5.39
Maryland Aetna Open Access - Basic Self Plus One JN6 1464.99 1501.33 1121.16 380.17 7.44
Maryland Aetna Saver (Open Access) - Saver Self QQ4 595.21 595.21 446.41 148.80 0.00
Maryland Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.14 1362.12 1021.59 340.53 0.00
Maryland Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1250.82 938.12 312.70 0.00
Maryland CareFirst BlueChoice - Standard Self 2G4 845.54 887.81 523.42 364.39 29.69
Maryland CareFirst BlueChoice - Standard Self & Family 2G5 2008.96 2109.42 1218.21 891.21 66.27
Maryland CareFirst BlueChoice - Standard Self Plus One 2G6 1691.06 1775.61 1121.16 654.45 55.65
Maryland CareFirst BlueChoice - HDHP Self B61 570.09 570.09 427.57 142.52 0.00
Maryland CareFirst BlueChoice - HDHP Self & Family B62 1354.51 1354.51 1015.88 338.63 0.00
Maryland CareFirst BlueChoice - HDHP Self Plus One B63 1140.17 1140.17 855.13 285.04 0.00
Maryland CareFirst BlueChoice - Blue Value Plus Self B64 705.99 723.67 523.42 200.25 5.10
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family B65 1677.46 1719.38 1218.21 501.17 7.73
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1412.02 1447.29 1085.47 361.82 8.82
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self T71 420.12 427.72 320.79 106.93 1.90
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self & Family T72 1026.16 1099.52 824.64 274.88 18.34
Maryland Kaiser Permanente - Mid-Atlantic States - Basic Self Plus One T73 934.90 951.84 713.88 237.96 4.24
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self E34 571.55 598.28 448.71 149.57 6.68
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1314.50 1376.05 1032.04 344.01 15.39
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1314.50 1376.05 1032.04 344.01 15.39
Maryland Kaiser Permanente - Mid-Atlantic States - High Self E31 722.82 746.24 523.42 222.82 10.84
Maryland Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1662.53 1716.35 1218.21 498.14 19.63
Maryland Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1662.53 1716.35 1121.16 595.19 24.92
Maryland M.D. IPA - High Self JP1 876.61 950.89 523.42 427.47 61.70
Maryland M.D. IPA - High Self & Family JP2 2458.04 2666.28 1218.21 1448.07 174.05
Maryland M.D. IPA - High Self Plus One JP3 1712.04 1857.09 1121.16 735.93 116.15
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 486.57 519.91 389.93 129.98 8.34
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1119.11 1195.81 896.86 298.95 19.17
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1046.13 1117.81 838.36 279.45 17.92
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 714.89 770.40 523.42 246.98 42.93
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1694.29 1825.83 1218.21 607.62 97.35
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1536.99 1656.33 1121.16 535.17 90.44
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 521.50 554.62 415.97 138.65 8.28
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1462.26 1555.15 1166.36 388.79 23.23
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1018.46 1083.18 812.39 270.79 16.18
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Maryland UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Massachusetts Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Massachusetts Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Massachusetts Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Massachusetts Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Massachusetts Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Massachusetts Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 759.61 839.63 523.42 316.21 67.44
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1739.51 1922.68 1218.21 704.47 148.98
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1705.38 1884.96 1121.16 763.80 150.68
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1075.75 1124.65 523.42 601.23 36.32
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2453.32 2564.88 1218.21 1346.67 77.37
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2429.03 2539.46 1121.16 1418.30 81.53
Massachusetts Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Massachusetts UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Michigan Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Michigan Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Michigan Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Michigan Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Michigan Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Michigan Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Michigan Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Michigan Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Michigan Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Michigan Blue Care Network of Michigan - High Self LX1 742.86 765.81 523.42 242.39 10.37
Michigan Blue Care Network of Michigan - High Self & Family LX2 1812.59 1868.58 1218.21 650.37 21.80
Michigan Blue Care Network of Michigan - High Self Plus One LX3 1708.57 1761.39 1121.16 640.23 23.92
Michigan Blue Care Network of Michigan - High Self K51 957.73 996.49 523.42 473.07 26.18
Michigan Blue Care Network of Michigan - High Self & Family K52 2336.82 2431.46 1218.21 1213.25 60.45
Michigan Blue Care Network of Michigan - High Self Plus One K53 2202.72 2291.97 1121.16 1170.81 60.35
Michigan Health Alliance Plan - High Self 521 787.89 842.18 523.42 318.76 41.71
Michigan Health Alliance Plan - High Self & Family 522 1922.44 2054.93 1218.21 836.72 98.30
Michigan Health Alliance Plan - High Self Plus One 523 1812.14 1937.00 1121.16 815.84 95.96
Michigan Health Alliance Plan - Standard Self GY4 614.23 557.55 418.16 139.39 -14.17
Michigan Health Alliance Plan - Standard Self & Family GY5 1498.77 1360.41 1020.31 340.10 -34.59
Michigan Health Alliance Plan - Standard Self Plus One GY6 1412.78 1282.34 961.76 320.58 -32.61
Michigan Priority Health - High Self LE1 919.58 1037.29 523.42 513.87 105.13
Michigan Priority Health - High Self & Family LE2 2161.01 2437.63 1218.21 1219.42 242.43
Michigan Priority Health - High Self Plus One LE3 2023.06 2282.04 1121.16 1160.88 230.08
Michigan Priority Health - Standard Self LE4 539.33 587.38 440.54 146.84 12.01
Michigan Priority Health - Standard Self & Family LE5 1267.44 1380.32 1035.24 345.08 28.22
Michigan Priority Health - Standard Self Plus One LE6 1186.53 1292.22 969.17 323.05 26.42
Michigan Priority Health - Value Self Y41 473.24 473.24 354.93 118.31 0.00
Michigan Priority Health - Value Self & Family Y42 1112.13 1112.13 834.10 278.03 0.00
Michigan Priority Health - Value Self Plus One Y43 1041.13 1041.13 780.85 260.28 0.00
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Michigan UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Minnesota Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Minnesota Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Minnesota Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Minnesota Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Minnesota Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Minnesota Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Minnesota Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Minnesota Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Minnesota HealthPartners - Standard Self V34 459.92 509.41 382.06 127.35 12.37
Minnesota HealthPartners - Standard Self & Family V35 1120.41 1240.94 930.71 310.23 30.13
Minnesota HealthPartners - Standard Self Plus One V36 1016.45 1125.80 844.35 281.45 27.34
Minnesota HealthPartners - High Self V31 712.31 668.07 501.05 167.02 -34.45
Minnesota HealthPartners - High Self & Family V32 1735.20 1627.38 1218.21 409.17 -142.01
Minnesota HealthPartners - High Self Plus One V33 1574.21 1476.41 1107.31 369.10 -112.85
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Minnesota UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Mississippi Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Mississippi Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Mississippi Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Mississippi Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Mississippi Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Mississippi Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Mississippi Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Mississippi Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 454.74 485.85 364.39 121.46 7.78
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1045.92 1117.50 838.13 279.37 17.89
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 977.71 1044.59 783.44 261.15 16.72
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 713.87 769.04 523.42 245.62 42.59
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1784.71 1922.64 1218.21 704.43 103.74
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1534.87 1653.47 1121.16 532.31 89.70
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Mississippi UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Missouri Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Missouri Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Missouri Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Missouri Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Missouri Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Missouri Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Missouri Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Missouri Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Missouri Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Missouri Aetna Open Access - High Self HA1 1099.93 1156.52 523.42 633.10 44.01
Missouri Aetna Open Access - High Self & Family HA2 2598.18 2731.91 1218.21 1513.70 99.54
Missouri Aetna Open Access - High Self Plus One HA3 2572.53 2704.89 1121.16 1583.73 103.46
Missouri Aetna Open Access - Standard Self HA4 716.37 901.36 523.42 377.94 172.41
Missouri Aetna Open Access - Standard Self & Family HA5 1690.89 2127.54 1218.21 909.33 402.46
Missouri Aetna Open Access - Standard Self Plus One HA6 1674.16 2106.48 1121.16 985.32 403.42
Missouri Blue Preferred - High Self 9G1 833.21 874.23 523.42 350.81 28.44
Missouri Blue Preferred - High Self & Family 9G2 1858.87 1984.52 1218.21 766.31 91.46
Missouri Blue Preferred - High Self Plus One 9G3 1760.59 1862.12 1121.16 740.96 72.63
Missouri Blue Preferred - Standard Self 9G4 600.62 633.66 475.25 158.41 8.26
Missouri Blue Preferred - Standard Self & Family 9G5 1707.01 1758.23 1218.21 540.02 17.03
Missouri Blue Preferred - Standard Self Plus One 9G6 1543.71 1574.58 1121.16 453.42 1.97
Missouri Humana CoverageFirst and Humana Value Plan - Value Self PH4 484.03 527.61 395.71 131.90 10.89
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1089.10 1187.12 890.34 296.78 24.51
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1040.67 1134.36 850.77 283.59 23.42
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 715.11 758.03 523.42 234.61 30.34
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1609.03 1705.58 1218.21 487.37 62.36
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1537.51 1629.77 1121.16 508.61 63.36
Missouri Humana Health Plan, Inc. - High Self MS1 1723.17 1796.84 523.42 1273.42 61.09
Missouri Humana Health Plan, Inc. - High Self & Family MS2 3877.12 4042.89 1218.21 2824.68 131.58
Missouri Humana Health Plan, Inc. - High Self Plus One MS3 3704.81 3863.17 1121.16 2742.01 129.46
Missouri Humana Health Plan, Inc. - Standard Self MS4 1067.00 1200.59 523.42 677.17 121.01
Missouri Humana Health Plan, Inc. - Standard Self & Family MS5 2400.78 2701.34 1218.21 1483.13 266.37
Missouri Humana Health Plan, Inc. - Standard Self Plus One MS6 2294.09 2581.32 1121.16 1460.16 258.33
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 525.81 599.47 449.60 149.87 18.42
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1243.36 1417.76 1063.32 354.44 43.60
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1130.42 1288.89 966.67 322.22 39.62
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 506.74 576.72 432.54 144.18 17.50
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1198.23 1363.94 1022.96 340.98 41.42
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1089.38 1239.94 929.96 309.98 37.64
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Missouri UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Montana Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Montana Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Montana Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Montana Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Montana Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Montana Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Montana Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Montana Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Montana Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Montana UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Nebraska Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Nebraska Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Nebraska Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Nebraska Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Nebraska Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Nebraska Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 828.47 826.84 523.42 303.42 -14.21
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1888.45 1884.74 1218.21 666.53 -37.90
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1869.92 1866.43 1121.16 745.27 -32.39
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 807.04 817.48 523.42 294.06 -2.14
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1852.18 1876.16 1218.21 657.95 -10.21
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1815.86 1839.39 1121.16 718.23 -5.37
Nebraska Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Nebraska Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Nebraska UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
Nevada Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
Nevada Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
Nevada Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
Nevada Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
Nevada Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
Nevada Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 712.73 717.04 523.42 193.62 -8.27
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1632.37 1642.27 1218.21 424.06 -24.29
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1600.37 1610.09 1121.16 488.93 -19.18
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 904.50 1058.76 523.42 535.34 141.68
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2063.10 2415.08 1218.21 1196.87 317.79
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2042.71 2391.20 1121.16 1270.04 319.59
Nevada Aetna HealthFund HDHP - HDHP Self 224 728.80 786.02 523.42 262.60 44.64
Nevada Aetna HealthFund HDHP - HDHP Self & Family 225 1607.60 1733.83 1218.21 515.62 92.04
Nevada Aetna HealthFund HDHP - HDHP Self Plus One 226 1576.10 1699.88 1121.16 578.72 94.88
Nevada Health Plan of Nevada, Inc. - High Self NM1 706.98 741.17 523.42 217.75 21.61
Nevada Health Plan of Nevada, Inc. - High Self & Family NM2 1675.48 1756.50 1218.21 538.29 46.83
Nevada Health Plan of Nevada, Inc. - High Self Plus One NM3 1343.29 1408.23 1056.17 352.06 16.24
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 522.86 622.22 466.67 155.55 24.84
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1236.39 1471.54 1103.66 367.88 58.78
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1124.05 1337.77 1003.33 334.44 53.43
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 443.84 528.17 396.13 132.04 21.08
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1020.85 1214.76 911.07 303.69 48.48
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 954.27 1135.55 851.66 283.89 45.32
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 724.77 782.12 523.42 258.70 44.77
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1811.90 1955.35 1218.21 737.14 109.26
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1558.25 1681.57 1121.16 560.41 94.42
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 522.02 621.21 465.91 155.30 24.80
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1234.37 1469.13 1101.85 367.28 58.69
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1122.23 1335.58 1001.69 333.89 53.33
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Y51 New Plan 411.73 308.80 102.93 New Plan
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self & Family Y52 New Plan 1091.07 818.30 272.77 New Plan
Nevada UnitedHealthcare Insurance Company, Inc. UnitedHealthcare Advantage Plan - High Self Plus One Y53 New Plan 905.80 679.35 226.45 New Plan
New Hampshire Aetna Advantage - Advantage Self Z24 463.84 500.02 375.02 125.00 9.04
New Hampshire Aetna Advantage - Advantage Self & Family Z25 1229.17 1325.00 993.75 331.25 23.96
New Hampshire Aetna Advantage - Advantage Self Plus One Z26 1020.44 1100.02 825.02 275.00 19.89
New Hampshire Aetna Direct - CDHP Self N61 612.65 615.83 461.87 153.96 0.80
New Hampshire Aetna Direct - CDHP Self & Family N62 1545.01 1553.07 1164.80 388.27 2.02
New Hampshire Aetna Direct - CDHP Self Plus One N63 1343.55 1350.55 1012.91 337.64 1.75
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 759.61 839.63 523.42 316.21 67.44
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1739.51 1922.68 1218.21 704.47 148.98
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1705.38 1884.96 1121.16 763.80 150.68
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self