Click here to skip navigation
Skip Navigation

In This Section

Healthcare Plan Information

Tribal Premium Rates for the Federal Employees Health Benefits Program

HMO (Regional Plans with Specific Service Areas)

Plan - Option Enrollment Code 2021 Total Monthly Premium 2022 Monthly Premium Rates - Total Premium 2022 Monthly Premium Rates - Tribal Employer Pays 2022 Monthly Premium Rates - Employee Pays 2022 Monthly Premium Rates - Change in Employee Payment
Alabama Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Alabama Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Alabama Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Alabama Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Alabama Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Alabama Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Alabama Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Alabama Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Alabama Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Alaska Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Alaska Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Alaska Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Alaska Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Alaska Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Alaska Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Alaska Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Alaska Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Alaska Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Arizona Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Arizona Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Arizona Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Arizona Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Arizona Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Arizona Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Arizona Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Arizona Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Arizona Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Arizona Aetna Open Access - High Self WQ1 1345.67 1438.67 530.53 908.14 85.89
Arizona Aetna Open Access - High Self & Family WQ2 3267.25 3493.06 1243.95 2249.11 200.07
Arizona Aetna Open Access - High Self Plus One WQ3 3234.86 3458.43 1136.70 2321.73 208.03
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R61 812.24 873.15 530.53 342.62 53.80
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R62 1827.50 1964.56 1243.95 720.61 111.32
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R63 1746.29 1877.24 1136.70 740.54 115.41
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R64 649.22 665.45 499.09 166.36 4.06
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R65 1460.72 1497.23 1122.92 374.31 9.13
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R66 1395.81 1430.72 1073.04 357.68 8.73
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R94 570.96 585.22 438.92 146.30 3.56
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R95 1284.62 1316.73 987.55 329.18 8.03
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R96 1227.55 1258.25 943.69 314.56 7.67
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R91 717.08 763.71 530.53 233.18 39.52
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R92 1613.41 1718.28 1243.95 474.33 70.98
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R93 1541.69 1641.90 1136.70 505.20 84.67
Arizona Humana HDHP - HDHP Self BV1 New Plan 453.16 339.87 113.29 New Plan
Arizona Humana HDHP - HDHP Self & Family BV2 New Plan 1129.01 846.76 282.25 New Plan
Arizona Humana HDHP - HDHP Self Plus One BV3 New Plan 993.85 745.39 248.46 New Plan
Arizona Humana HDHP - HDHP Self BY1 New Plan 397.78 298.34 99.44 New Plan
Arizona Humana HDHP - HDHP Self & Family BY2 New Plan 990.51 742.88 247.63 New Plan
Arizona Humana HDHP - HDHP Self Plus One BY3 New Plan 871.98 653.99 217.99 New Plan
Arizona Humana Health Plan, Inc. - Standard Self C74 893.86 916.20 530.53 385.67 15.23
Arizona Humana Health Plan, Inc. - Standard Self & Family C75 2011.17 2061.45 1243.95 817.50 24.54
Arizona Humana Health Plan, Inc. - Standard Self Plus One C76 1921.73 1969.83 1136.70 833.13 32.56
Arizona Humana Health Plan, Inc. - Standard Self BF4 1246.59 1246.59 530.53 716.06 -7.11
Arizona Humana Health Plan, Inc. - Standard Self & Family BF5 2804.84 2804.86 1243.95 1560.91 -25.72
Arizona Humana Health Plan, Inc. - Standard Self Plus One BF6 2680.21 2680.21 1136.70 1543.51 -15.54
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 622.22 668.46 501.35 167.11 11.56
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1471.54 1580.91 1185.68 395.23 27.35
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1337.77 1437.17 1077.88 359.29 24.85
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 528.17 672.10 504.08 168.02 35.98
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1214.76 1545.85 1159.39 386.46 82.77
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1135.55 1445.04 1083.78 361.26 77.37
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 782.12 864.87 530.53 334.34 75.64
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1955.35 2162.16 1243.95 918.21 181.07
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1681.57 1859.46 1136.70 722.76 162.35
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 621.21 657.65 493.24 164.41 9.11
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1469.13 1555.39 1166.54 388.85 21.57
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1335.58 1413.97 1060.48 353.49 19.60
Arkansas Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Arkansas Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Arkansas Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Arkansas Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Arkansas Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Arkansas Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Arkansas Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Arkansas Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Arkansas QualChoice - High Self DH1 767.26 728.85 530.53 198.32 -45.52
Arkansas QualChoice - High Self & Family DH2 2001.20 1901.10 1243.95 657.15 -125.84
Arkansas QualChoice - High Self Plus One DH3 1490.43 1415.83 1061.87 353.96 -18.65
Arkansas QualChoice - Standard Self DH4 599.00 568.97 426.73 142.24 -7.51
Arkansas QualChoice - Standard Self & Family DH5 1562.43 1484.08 1113.06 371.02 -19.59
Arkansas QualChoice - Standard Self Plus One DH6 1163.63 1105.28 828.96 276.32 -14.59
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
California Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
California Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
California Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
California Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
California Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
California Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
California Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
California Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
California Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
California Aetna Open Access - High Self 2X1 936.67 1039.33 530.53 508.80 95.55
California Aetna Open Access - High Self & Family 2X2 2199.02 2440.04 1243.95 1196.09 215.28
California Aetna Open Access - High Self Plus One 2X3 2155.90 2392.22 1136.70 1255.52 220.78
California Anthem Blue Cross Select HMO - High Self B31 774.13 777.23 530.53 246.70 -4.01
California Anthem Blue Cross Select HMO - High Self & Family B32 1768.91 1783.06 1243.95 539.11 -11.59
California Anthem Blue Cross Select HMO - High Self Plus One B33 1641.16 1646.08 1136.70 509.38 -10.62
California Blue Shield of California - Access + HMO Self SI1 858.87 884.61 530.53 354.08 18.63
California Blue Shield of California - Access + HMO Self & Family SI2 1975.39 2034.65 1243.95 790.70 33.52
California Blue Shield of California - Access + HMO Self Plus One SI3 1889.49 1946.19 1136.70 809.49 41.16
California Health Net of California - Basic Self P61 364.04 405.69 304.27 101.42 10.41
California Health Net of California - Basic Self & Family P62 873.73 973.74 730.31 243.43 25.00
California Health Net of California - Basic Self Plus One P63 800.93 892.56 669.42 223.14 22.91
California Health Net of California - High Self LP1 1012.98 1077.33 530.53 546.80 57.24
California Health Net of California - High Self & Family LP2 2431.17 2585.66 1243.95 1341.71 128.75
California Health Net of California - High Self Plus One LP3 2228.57 2370.18 1136.70 1233.48 126.07
California Health Net of California - High Self LB1 1550.64 1618.70 530.53 1088.17 60.95
California Health Net of California - High Self & Family LB2 3721.49 3884.86 1243.95 2640.91 137.63
California Health Net of California - High Self Plus One LB3 3411.35 3561.13 1136.70 2424.43 134.24
California Health Net of California - Basic Self T41 894.18 953.16 530.53 422.63 51.87
California Health Net of California - Basic Self & Family T42 2146.04 2287.61 1243.95 1043.66 115.83
California Health Net of California - Basic Self Plus One T43 1967.20 2096.94 1136.70 960.24 114.20
California Kaiser Permanente - Fresno California - Standard Self NZ4 590.11 590.11 442.58 147.53 0.00
California Kaiser Permanente - Fresno California - Standard Self & Family NZ5 1363.87 1363.87 1022.90 340.97 0.00
California Kaiser Permanente - Fresno California - Standard Self Plus One NZ6 1363.87 1363.87 1022.90 340.97 0.00
California Kaiser Permanente - Fresno California - High Self NZ1 802.99 813.45 530.53 282.92 3.35
California Kaiser Permanente - Fresno California - High Self & Family NZ2 1855.86 1880.06 1243.95 636.11 -1.54
California Kaiser Permanente - Fresno California - High Self Plus One NZ3 1855.86 1880.06 1136.70 743.36 8.66
California Kaiser Permanente - Northern California - Prosper Self KC1 652.08 658.56 493.92 164.64 1.62
California Kaiser Permanente - Northern California - Prosper Self & Family KC2 1525.85 1541.02 1155.77 385.25 3.79
California Kaiser Permanente - Northern California - Prosper Self Plus One KC3 1525.85 1541.02 1136.70 404.32 -0.37
California Kaiser Permanente - Northern California - High Self 591 1014.54 1002.30 530.53 471.77 -19.35
California Kaiser Permanente - Northern California - High Self & Family 592 2421.86 2392.59 1243.95 1148.64 -55.01
California Kaiser Permanente - Northern California - High Self Plus One 593 2421.86 2392.59 1136.70 1255.89 -44.81
California Kaiser Permanente - Northern California - Standard Self 594 822.68 814.88 530.53 284.35 -14.91
California Kaiser Permanente - Northern California - Standard Self & Family 595 1925.11 1906.80 1243.95 662.85 -44.05
California Kaiser Permanente - Northern California - Standard Self Plus One 596 1925.11 1906.80 1136.70 770.10 -33.85
California Kaiser Permanente - Southern California - Prosper Self FL1 New Plan 365.63 274.22 91.41 New Plan
California Kaiser Permanente - Southern California - Prosper Self & Family FL2 New Plan 1023.75 767.81 255.94 New Plan
California Kaiser Permanente - Southern California - Prosper Self Plus One FL3 New Plan 840.97 630.73 210.24 New Plan
California Kaiser Permanente - Southern California - Standard Self 624 473.44 488.35 366.26 122.09 3.73
California Kaiser Permanente - Southern California - Standard Self & Family 625 1094.21 1128.62 846.47 282.15 8.60
California Kaiser Permanente - Southern California - Standard Self Plus One 626 1094.21 1128.62 846.47 282.15 8.60
California Kaiser Permanente - Southern California - High Self 621 750.19 760.63 530.53 230.10 3.33
California Kaiser Permanente - Southern California - High Self & Family 622 1733.83 1757.97 1243.95 514.02 -1.60
California Kaiser Permanente - Southern California - High Self Plus One 623 1733.83 1757.97 1136.70 621.27 8.60
Colorado Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Colorado Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Colorado Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Colorado Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Colorado Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Colorado Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Colorado Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Colorado Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Colorado Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Colorado BlueAdvantageHMO - High Self WW1 636.35 677.71 508.28 169.43 10.34
Colorado BlueAdvantageHMO - High Self & Family WW2 1549.49 1690.50 1243.95 446.55 59.18
Colorado BlueAdvantageHMO - High Self Plus One WW3 1447.66 1554.78 1136.70 418.08 56.17
Colorado BlueAdvantageHMO - HDHP Self WW4 New Plan 639.75 479.81 159.94 New Plan
Colorado BlueAdvantageHMO - HDHP Self & Family WW5 New Plan 1557.77 1168.33 389.44 New Plan
Colorado BlueAdvantageHMO - HDHP Self Plus One WW6 New Plan 1455.42 1091.57 363.85 New Plan
Colorado Humana Health Plan, Inc. - High Self NR1 961.18 970.80 530.53 440.27 2.51
Colorado Humana Health Plan, Inc. - High Self & Family NR2 2162.64 2184.28 1243.95 940.33 -4.10
Colorado Humana Health Plan, Inc. - High Self Plus One NR3 2066.52 2087.22 1136.70 950.52 5.16
Colorado Humana Health Plan, Inc. - Standard Self NR4 666.08 666.08 499.56 166.52 0.00
Colorado Humana Health Plan, Inc. - Standard Self & Family NR5 1498.73 1498.73 1124.05 374.68 0.00
Colorado Humana Health Plan, Inc. - Standard Self Plus One NR6 1432.08 1432.08 1074.06 358.02 0.00
Colorado Humana Health Plan, Inc. - Basic Self RZ1 532.24 518.94 389.21 129.73 -3.33
Colorado Humana Health Plan, Inc. - Basic Self & Family RZ2 1197.52 1167.57 875.68 291.89 -7.49
Colorado Humana Health Plan, Inc. - Basic Self Plus One RZ3 1144.33 1115.73 836.80 278.93 -7.15
Colorado Humana Health Plan, Inc. - High Self NT1 833.60 875.29 530.53 344.76 34.58
Colorado Humana Health Plan, Inc. - High Self & Family NT2 1875.66 1969.44 1243.95 725.49 68.04
Colorado Humana Health Plan, Inc. - High Self Plus One NT3 1792.27 1881.88 1136.70 745.18 74.07
Colorado Humana Health Plan, Inc. - Standard Self NT4 590.27 590.27 442.70 147.57 0.00
Colorado Humana Health Plan, Inc. - Standard Self & Family NT5 1328.12 1328.12 996.09 332.03 0.00
Colorado Humana Health Plan, Inc. - Standard Self Plus One NT6 1269.13 1269.13 951.85 317.28 0.00
Colorado Humana Health Plan, Inc. - Basic Self R21 621.40 605.89 454.42 151.47 -3.88
Colorado Humana Health Plan, Inc. - Basic Self & Family R22 1398.17 1363.22 1022.42 340.80 -8.74
Colorado Humana Health Plan, Inc. - Basic Self Plus One R23 1336.03 1302.62 976.97 325.65 -8.36
Colorado Kaiser Permanente - Colorado - Standard Self 654 660.83 659.17 494.38 164.79 -0.42
Colorado Kaiser Permanente - Colorado - Standard Self & Family 655 1493.46 1489.71 1117.28 372.43 -0.93
Colorado Kaiser Permanente - Colorado - Standard Self Plus One 656 1493.46 1489.71 1117.28 372.43 -0.93
Colorado Kaiser Permanente - Colorado - High Self 651 772.89 772.89 530.53 242.36 -7.11
Colorado Kaiser Permanente - Colorado - High Self & Family 652 1746.75 1746.75 1243.95 502.80 -25.74
Colorado Kaiser Permanente - Colorado - High Self Plus One 653 1746.75 1746.75 1136.70 610.05 -15.54
Colorado Kaiser Permanente - Colorado - Prosper Self N41 445.51 390.15 292.61 97.54 -13.84
Colorado Kaiser Permanente - Colorado - Prosper Self & Family N42 1095.94 959.77 719.83 239.94 -34.04
Colorado Kaiser Permanente - Colorado - Prosper Self Plus One N43 1006.85 881.73 661.30 220.43 -31.28
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 528.17 672.10 504.08 168.02 35.98
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1214.76 1545.85 1159.39 386.46 82.77
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1135.55 1445.04 1083.78 361.26 77.37
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 782.12 864.87 530.53 334.34 75.64
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1955.35 2162.16 1243.95 918.21 181.07
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1681.57 1859.46 1136.70 722.76 162.35
Connecticut Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Connecticut Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Connecticut Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Connecticut Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Connecticut Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Connecticut Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Connecticut Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Connecticut Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Delaware Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Delaware Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Delaware Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Delaware Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Delaware Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Delaware Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Delaware Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Delaware Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Delaware Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Delaware Aetna Open Access - Basic Self P34 1505.53 1721.76 530.53 1191.23 209.12
Delaware Aetna Open Access - Basic Self & Family P35 3494.34 3996.29 1243.95 2752.34 476.21
Delaware Aetna Open Access - Basic Self Plus One P36 3459.73 3956.70 1136.70 2820.00 481.43
Delaware Aetna Open Access - High Self P31 1588.23 1762.54 530.53 1232.01 167.20
Delaware Aetna Open Access - High Self & Family P32 3850.71 4273.27 1243.95 3029.32 396.82
Delaware Aetna Open Access - High Self Plus One P33 3812.58 4230.98 1136.70 3094.28 402.86
District Of Columbia Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
District Of Columbia Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
District Of Columbia Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
District Of Columbia Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
District Of Columbia Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
District Of Columbia Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
District Of Columbia Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
District Of Columbia Aetna Open Access - High Self JN1 1176.57 1251.55 530.53 721.02 67.87
District Of Columbia Aetna Open Access - High Self & Family JN2 2645.05 2813.68 1243.95 1569.73 142.89
District Of Columbia Aetna Open Access - High Self Plus One JN3 2618.85 2785.79 1136.70 1649.09 151.40
District Of Columbia Aetna Open Access - Basic Self JN4 714.42 739.46 530.53 208.93 17.93
District Of Columbia Aetna Open Access - Basic Self & Family JN5 1634.92 1692.23 1243.95 448.28 31.57
District Of Columbia Aetna Open Access - Basic Self Plus One JN6 1501.33 1553.93 1136.70 417.23 37.06
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 1362.12 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 887.81 905.58 530.53 375.05 10.66
District Of Columbia CareFirst BlueChoice - Standard Self & Family 2G5 2109.42 2151.59 1243.95 907.64 16.43
District Of Columbia CareFirst BlueChoice - Standard Self Plus One 2G6 1775.61 1811.12 1136.70 674.42 19.97
District Of Columbia CareFirst BlueChoice - HDHP Self B61 570.09 604.31 453.23 151.08 8.56
District Of Columbia CareFirst BlueChoice - HDHP Self & Family B62 1354.51 1435.79 1076.84 358.95 20.32
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One B63 1140.17 1208.57 906.43 302.14 17.10
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self B64 723.67 723.67 530.53 193.14 -7.11
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1719.38 1243.95 475.43 -25.74
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1447.29 1085.47 361.82 0.00
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 427.72 368.90 276.68 92.22 -14.71
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1099.52 1051.33 788.50 262.83 -12.05
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 951.84 866.91 650.18 216.73 -21.23
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 598.28 607.25 455.44 151.81 2.24
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1376.05 1396.63 1047.47 349.16 5.15
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1376.05 1396.63 1047.47 349.16 5.15
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self E31 746.24 756.60 530.53 226.07 3.25
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1716.35 1740.20 1243.95 496.25 -1.89
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1716.35 1740.20 1136.70 603.50 8.31
District Of Columbia M.D. IPA - High Self JP1 950.89 1011.99 530.53 481.46 53.99
District Of Columbia M.D. IPA - High Self & Family JP2 2666.28 2837.66 1243.95 1593.71 145.64
District Of Columbia M.D. IPA - High Self Plus One JP3 1857.09 1976.43 1136.70 839.73 103.80
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 519.91 661.81 496.36 165.45 35.47
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1195.81 1514.20 1135.65 378.55 79.60
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1117.81 1422.92 1067.19 355.73 76.28
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 770.40 822.16 530.53 291.63 44.65
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1825.83 1948.55 1243.95 704.60 96.98
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1656.33 1767.68 1136.70 630.98 95.81
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 554.62 663.76 497.82 165.94 27.29
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1555.15 1586.41 1189.81 396.60 7.81
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1083.18 1327.54 995.66 331.88 61.09
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Florida Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Florida Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Florida Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Florida Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Florida Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Florida Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Florida Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Florida Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Florida Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Florida AvMed - HDHP Self WZ1 762.08 742.26 530.53 211.73 -26.93
Florida AvMed - HDHP Self & Family WZ2 1762.00 1714.01 1243.95 470.06 -73.73
Florida AvMed - HDHP Self Plus One WZ3 1528.67 1487.24 1115.43 371.81 -35.70
Florida AvMed - Standard Self ML4 820.97 801.88 530.53 271.35 -26.20
Florida AvMed - Standard Self & Family ML5 1998.92 1952.45 1243.95 708.50 -72.21
Florida AvMed - Standard Self Plus One ML6 1724.06 1683.98 1136.70 547.28 -55.62
Florida Capital Health Plan - High Self EA1 690.47 730.49 530.53 199.96 27.34
Florida Capital Health Plan - High Self & Family EA2 1600.19 1692.93 1243.95 448.98 48.93
Florida Capital Health Plan - High Self Plus One EA3 1509.99 1597.55 1136.70 460.85 72.02
Florida Humana CoverageFirst and Humana Value Plan - Value Self W94 585.48 600.12 450.09 150.03 3.66
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family W95 1317.33 1350.29 1012.72 337.57 8.24
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One W96 1258.79 1290.25 967.69 322.56 7.86
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self W91 692.10 726.70 530.53 196.17 23.15
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family W92 1557.18 1635.03 1226.27 408.76 19.47
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One W93 1487.98 1562.38 1136.70 425.68 53.69
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self QP1 768.56 826.22 530.53 295.69 50.55
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family QP2 1731.56 1861.38 1243.95 617.43 104.08
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One QP3 1654.58 1778.66 1136.70 641.96 108.54
Florida Humana CoverageFirst and Humana Value Plan - Value Self QP4 550.51 550.51 412.88 137.63 0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family QP5 1238.60 1238.60 928.95 309.65 0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One QP6 1183.56 1183.56 887.67 295.89 0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self MJ4 561.19 561.19 420.89 140.30 0.00
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family MJ5 1262.67 1346.87 1010.15 336.72 21.05
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One MJ6 1206.55 1206.55 904.91 301.64 0.00
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self MJ1 1023.92 1064.87 530.53 534.34 33.84
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MJ2 2303.80 2395.92 1243.95 1151.97 66.38
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MJ3 2201.44 2289.47 1136.70 1152.77 72.49
Florida Humana CoverageFirst and Humana Value Plan - Value Self X24 512.89 546.26 409.70 136.56 8.34
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family X25 1154.05 1338.33 1003.75 334.58 46.07
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One X26 1102.77 1174.44 880.83 293.61 17.92
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self X21 606.30 630.54 472.91 157.63 6.06
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X22 1364.22 1418.80 1064.10 354.70 13.65
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X23 1303.58 1355.73 1016.80 338.93 13.04
Florida Humana HDHP - HDHP Self BR1 New Plan 426.44 319.83 106.61 New Plan
Florida Humana HDHP - HDHP Self & Family BR2 New Plan 1062.23 796.67 265.56 New Plan
Florida Humana HDHP - HDHP Self Plus One BR3 New Plan 935.07 701.30 233.77 New Plan
Florida Humana HDHP - HDHP Self A41 New Plan 478.40 358.80 119.60 New Plan
Florida Humana HDHP - HDHP Self & Family A42 New Plan 1192.12 894.09 298.03 New Plan
Florida Humana HDHP - HDHP Self Plus One A43 New Plan 1049.38 787.04 262.34 New Plan
Florida Humana HDHP - HDHP Self FF1 New Plan 406.51 304.88 101.63 New Plan
Florida Humana HDHP - HDHP Self & Family FF2 New Plan 1012.33 759.25 253.08 New Plan
Florida Humana HDHP - HDHP Self Plus One FF3 New Plan 891.17 668.38 222.79 New Plan
Florida Humana HDHP - HDHP Self AP1 New Plan 483.08 362.31 120.77 New Plan
Florida Humana HDHP - HDHP Self & Family AP2 New Plan 1203.76 902.82 300.94 New Plan
Florida Humana HDHP - HDHP Self Plus One AP3 New Plan 1059.63 794.72 264.91 New Plan
Florida Humana Medical Plan, Inc. - Standard Self LL4 1193.21 1282.69 530.53 752.16 82.37
Florida Humana Medical Plan, Inc. - Standard Self & Family LL5 2684.65 2886.00 1243.95 1642.05 175.61
Florida Humana Medical Plan, Inc. - Standard Self Plus One LL6 2565.33 2757.73 1136.70 1621.03 176.86
Florida Humana Medical Plan, Inc. - High Self LL1 1708.94 1794.37 530.53 1263.84 78.32
Florida Humana Medical Plan, Inc. - High Self & Family LL2 3845.05 4037.30 1243.95 2793.35 166.51
Florida Humana Medical Plan, Inc. - High Self Plus One LL3 3674.15 3857.86 1136.70 2721.16 168.17
Florida Humana Medical Plan, Inc. - High Self EE1 1248.93 1323.88 530.53 793.35 67.84
Florida Humana Medical Plan, Inc. - High Self & Family EE2 2810.15 2978.78 1243.95 1734.83 142.89
Florida Humana Medical Plan, Inc. - High Self Plus One EE3 2685.30 2846.44 1136.70 1709.74 145.60
Florida Humana Medical Plan, Inc. - Standard Self EE4 1116.77 1183.78 530.53 653.25 59.90
Florida Humana Medical Plan, Inc. - Standard Self & Family EE5 2512.71 2663.48 1243.95 1419.53 125.03
Florida Humana Medical Plan, Inc. - Standard Self Plus One EE6 2401.04 2545.12 1136.70 1408.42 128.54
Florida Humana Medical Plan, Inc. - Standard Self E24 766.13 804.44 530.53 273.91 31.20
Florida Humana Medical Plan, Inc. - Standard Self & Family E25 1723.78 1809.97 1243.95 566.02 60.45
Florida Humana Medical Plan, Inc. - Standard Self Plus One E26 1647.14 1729.50 1136.70 592.80 66.82
Florida Humana Medical Plan, Inc. - High Self E21 1286.83 1351.18 530.53 820.65 57.24
Florida Humana Medical Plan, Inc. - High Self & Family E22 2895.27 3040.05 1243.95 1796.10 119.04
Florida Humana Medical Plan, Inc. - High Self Plus One E23 2766.60 2904.94 1136.70 1768.24 122.80
Florida Humana Medical Plan, Inc. - High Self EX1 1018.49 1069.40 530.53 538.87 43.80
Florida Humana Medical Plan, Inc. - High Self & Family EX2 2291.53 2406.11 1243.95 1162.16 88.84
Florida Humana Medical Plan, Inc. - High Self Plus One EX3 2189.68 2299.16 1136.70 1162.46 93.94
Florida Humana Medical Plan, Inc. - Standard Self EX4 834.73 897.33 530.53 366.80 55.49
Florida Humana Medical Plan, Inc. - Standard Self & Family EX5 1878.15 2019.01 1243.95 775.06 115.12
Florida Humana Medical Plan, Inc. - Standard Self Plus One EX6 1794.67 1929.27 1136.70 792.57 119.06
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 750.62 897.89 530.53 367.36 140.16
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2251.90 2693.64 1243.95 1449.69 416.00
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1613.89 1930.46 1136.70 793.76 301.03
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Georgia Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Georgia Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Georgia Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Georgia Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Georgia Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Georgia Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Georgia Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Georgia Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Georgia Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Georgia Aetna Open Access - High Self 2U1 1805.85 1729.63 530.53 1199.10 -83.33
Georgia Aetna Open Access - High Self & Family 2U2 4159.72 3984.13 1243.95 2740.18 -201.33
Georgia Aetna Open Access - High Self Plus One 2U3 4118.53 3944.68 1136.70 2807.98 -189.39
Georgia Blue Open Access POS - High Self QM1 656.41 701.72 526.29 175.43 11.33
Georgia Blue Open Access POS - High Self & Family QM2 1689.68 1843.44 1243.95 599.49 128.02
Georgia Blue Open Access POS - High Self Plus One QM3 1446.62 1585.48 1136.70 448.78 87.13
Georgia Humana CoverageFirst and Humana Value Plan - Value Self S94 612.60 658.56 493.92 164.64 11.49
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family S95 1378.35 1481.72 1111.29 370.43 25.84
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One S96 1317.10 1415.87 1061.90 353.97 24.70
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self S91 769.41 827.10 530.53 296.57 50.58
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family S92 1731.15 1860.99 1243.95 617.04 104.10
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One S93 1654.21 1778.29 1136.70 641.59 108.54
Georgia Humana CoverageFirst and Humana Value Plan - Value Self AD4 826.04 826.04 530.53 295.51 -7.11
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family AD5 1858.52 1858.50 1243.95 614.55 -25.76
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One AD6 1775.95 1775.93 1136.70 639.23 -15.56
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self AD1 1090.18 1166.51 530.53 635.98 69.22
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family AD2 2452.86 2624.61 1243.95 1380.66 146.01
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One AD3 2343.86 2507.98 1136.70 1371.28 148.58
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self LM1 747.13 784.51 530.53 253.98 30.27
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family LM2 1681.12 1765.14 1243.95 521.19 58.28
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One LM3 1606.41 1686.69 1136.70 549.99 64.74
Georgia Humana CoverageFirst and Humana Value Plan - Value Self LM4 706.81 742.13 530.53 211.60 28.21
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family LM5 1590.29 1669.81 1243.95 425.86 28.29
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One LM6 1519.64 1595.60 1136.70 458.90 60.42
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RM1 719.88 791.87 530.53 261.34 64.88
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RM2 1619.74 1781.72 1243.95 537.77 132.84
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RM3 1547.74 1702.52 1136.70 565.82 139.24
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DN4 813.15 874.16 530.53 343.63 53.90
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DN5 1829.53 1966.77 1243.95 722.82 111.50
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DN6 1748.24 1879.39 1136.70 742.69 115.61
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RJ1 669.85 703.34 527.51 175.83 8.37
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RJ2 1507.22 1582.53 1186.90 395.63 18.83
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RJ3 1440.23 1512.18 1134.14 378.04 17.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Q71 846.71 872.11 530.53 341.58 18.29
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family Q72 1905.11 1962.26 1243.95 718.31 31.41
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One Q73 1820.43 1875.03 1136.70 738.33 39.06
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self CB4 1137.89 1251.68 530.53 721.15 106.68
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family CB5 2560.31 2816.30 1243.95 1572.35 230.25
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One CB6 2446.51 2691.13 1136.70 1554.43 229.08
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DG4 1300.76 1430.85 530.53 900.32 122.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DG5 2926.71 3219.43 1243.95 1975.48 266.98
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DG6 2796.71 3076.41 1136.70 1939.71 264.16
Georgia Humana HDHP - HDHP Self AZ1 New Plan 472.40 354.30 118.10 New Plan
Georgia Humana HDHP - HDHP Self & Family AZ2 New Plan 1177.06 882.80 294.26 New Plan
Georgia Humana HDHP - HDHP Self Plus One AZ3 New Plan 1036.14 777.11 259.03 New Plan
Georgia Humana HDHP - HDHP Self B21 New Plan 487.02 365.27 121.75 New Plan
Georgia Humana HDHP - HDHP Self & Family B22 New Plan 1213.62 910.22 303.40 New Plan
Georgia Humana HDHP - HDHP Self Plus One B23 New Plan 1068.30 801.23 267.07 New Plan
Georgia Humana HDHP - HDHP Self AR1 New Plan 477.45 358.09 119.36 New Plan
Georgia Humana HDHP - HDHP Self & Family AR2 New Plan 1189.72 892.29 297.43 New Plan
Georgia Humana HDHP - HDHP Self Plus One AR3 New Plan 1047.26 785.45 261.81 New Plan
Georgia Kaiser Permanente - Georgia - High Self F81 751.10 769.71 530.53 239.18 11.50
Georgia Kaiser Permanente - Georgia - High Self & Family F82 1697.50 1739.57 1243.95 495.62 16.33
Georgia Kaiser Permanente - Georgia - High Self Plus One F83 1697.50 1739.57 1136.70 602.87 26.53
Georgia Kaiser Permanente - Georgia - Standard Self F84 581.10 600.71 450.53 150.18 4.91
Georgia Kaiser Permanente - Georgia - Standard Self & Family F85 1313.26 1357.59 1018.19 339.40 11.09
Georgia Kaiser Permanente - Georgia - Standard Self Plus One F86 1313.26 1357.59 1018.19 339.40 11.09
Georgia Kaiser Permanente - Georgia - Prosper Self LA1 418.90 398.65 298.99 99.66 -5.06
Georgia Kaiser Permanente - Georgia - Prosper Self & Family LA2 946.66 1034.97 776.23 258.74 22.08
Georgia Kaiser Permanente - Georgia - Prosper Self Plus One LA3 946.66 900.92 675.69 225.23 -11.43
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 750.62 897.89 530.53 367.36 140.16
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2251.90 2693.64 1243.95 1449.69 416.00
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1613.89 1930.46 1136.70 793.76 301.03
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Guam Calvo's SelectCare - Standard Self B44 429.78 378.91 284.18 94.73 -12.71
Guam Calvo's SelectCare - Standard Self & Family B45 1248.72 1100.91 825.68 275.23 -36.95
Guam Calvo's SelectCare - Standard Self Plus One B46 847.21 746.92 560.19 186.73 -25.07
Guam Calvo's SelectCare - High Self B41 521.69 535.95 401.96 133.99 3.57
Guam Calvo's SelectCare - High Self & Family B42 1381.77 1419.54 1064.66 354.88 9.44
Guam Calvo's SelectCare - High Self Plus One B43 1018.07 1045.89 784.42 261.47 6.95
Guam TakeCare - HDHP Self KX1 120.53 122.31 91.73 30.58 0.45
Guam TakeCare - HDHP Self & Family KX2 323.16 327.97 245.98 81.99 1.20
Guam TakeCare - HDHP Self Plus One KX3 290.94 295.23 221.42 73.81 1.08
Guam TakeCare - Standard Self JK4 404.45 405.77 304.33 101.44 0.33
Guam TakeCare - Standard Self & Family JK5 1145.39 1149.18 861.89 287.29 0.94
Guam TakeCare - Standard Self Plus One JK6 797.14 799.78 599.84 199.94 0.66
Guam TakeCare - High Self JK1 497.81 515.86 386.90 128.96 4.51
Guam TakeCare - High Self & Family JK2 1187.38 1230.43 922.82 307.61 10.77
Guam TakeCare - High Self Plus One JK3 983.49 1019.16 764.37 254.79 8.92
Hawaii Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Hawaii Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Hawaii Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Hawaii Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Hawaii Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Hawaii Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Hawaii Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Hawaii Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Hawaii HMSA Plan - High Self 871 631.24 631.24 473.43 157.81 0.00
Hawaii HMSA Plan - High Self & Family 872 1419.02 1419.02 1064.27 354.75 0.00
Hawaii HMSA Plan - High Self Plus One 873 1383.07 1383.07 1037.30 345.77 0.00
Hawaii HMSA Plan - Standard Self 874 453.83 453.83 340.37 113.46 0.00
Hawaii HMSA Plan - Standard Self & Family 875 1020.18 1020.18 765.14 255.04 0.00
Hawaii HMSA Plan - Standard Self Plus One 876 994.28 994.28 745.71 248.57 0.00
Hawaii Kaiser Permanente - Hawaii - High Self 631 675.55 675.55 506.66 168.89 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 1129.88 376.63 -8.72
Hawaii Kaiser Permanente - Hawaii - Standard Self 634 505.18 485.38 364.04 121.34 -4.95
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family 635 1126.52 1082.38 811.79 270.59 -11.04
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One 636 1126.52 1082.38 811.79 270.59 -11.04
Idaho Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Idaho Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Idaho Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Idaho Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Idaho Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Idaho Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Idaho Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Idaho Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Idaho Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Idaho Altius Health Plan - High Self 9K1 1048.36 1150.85 530.53 620.32 95.38
Idaho Altius Health Plan - High Self & Family 9K2 2318.46 2545.10 1243.95 1301.15 200.90
Idaho Altius Health Plan - High Self Plus One 9K3 2295.50 2519.92 1136.70 1383.22 208.88
Idaho Altius Health Plan - HDHP Self 9K4 672.49 759.22 530.53 228.69 60.57
Idaho Altius Health Plan - HDHP Self & Family 9K5 1405.43 1586.72 1190.04 396.68 45.32
Idaho Altius Health Plan - HDHP Self Plus One 9K6 1377.85 1555.56 1136.70 418.86 74.40
Idaho Altius Health Plan - Standard Self DK4 883.11 942.54 530.53 412.01 52.32
Idaho Altius Health Plan - Standard Self & Family DK5 1950.20 2081.43 1243.95 837.48 105.49
Idaho Altius Health Plan - Standard Self Plus One DK6 1930.87 2060.80 1136.70 924.10 114.39
Idaho Kaiser Permanente - Washington Core - Standard Self 544 618.02 625.21 468.91 156.30 1.80
Idaho Kaiser Permanente - Washington Core - Standard Self & Family 545 1421.44 1438.00 1078.50 359.50 4.14
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One 546 1421.44 1438.00 1078.50 359.50 4.14
Idaho Kaiser Permanente - Washington Core - High Self 541 863.76 869.53 530.53 339.00 -1.34
Idaho Kaiser Permanente - Washington Core - High Self & Family 542 1900.25 1912.93 1243.95 668.98 -13.06
Idaho Kaiser Permanente - Washington Core - High Self Plus One 543 1900.25 1912.93 1136.70 776.23 -2.86
Idaho Kaiser Permanente - Washington Core - Prosper Self PT4 390.00 390.00 292.50 97.50 0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family PT5 1091.98 1091.98 818.99 272.99 0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One PT6 944.67 944.67 708.50 236.17 0.00
Illinois Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Illinois Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Illinois Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Illinois Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Illinois Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Illinois Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Illinois Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Illinois Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Illinois Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Illinois Blue Preferred - High Self 9G1 874.23 905.71 530.53 375.18 24.37
Illinois Blue Preferred - High Self & Family 9G2 1984.52 2139.32 1243.95 895.37 129.06
Illinois Blue Preferred - High Self Plus One 9G3 1862.12 2005.51 1136.70 868.81 127.85
Illinois Blue Preferred - Standard Self 9G4 633.66 614.01 460.51 153.50 -4.91
Illinois Blue Preferred - Standard Self & Family 9G5 1758.23 1791.62 1243.95 547.67 7.65
Illinois Blue Preferred - Standard Self Plus One 9G6 1574.58 1598.20 1136.70 461.50 8.08
Illinois Health Alliance HMO - Standard Self K84 683.56 704.08 528.06 176.02 5.13
Illinois Health Alliance HMO - Standard Self & Family K85 1584.35 1631.89 1223.92 407.97 11.88
Illinois Health Alliance HMO - Standard Self Plus One K86 1461.61 1505.44 1129.08 376.36 10.96
Illinois Humana CoverageFirst and Humana Value Plan - Value Self GB4 788.47 827.91 530.53 297.38 32.33
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family GB5 1774.00 1862.71 1243.95 618.76 62.97
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One GB6 1695.16 1779.92 1136.70 643.22 69.22
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self GB1 1227.74 1319.83 530.53 789.30 84.98
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family GB2 2762.39 2969.55 1243.95 1725.60 181.42
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One GB3 2639.65 2837.62 1136.70 1700.92 182.43
Illinois Humana CoverageFirst and Humana Value Plan - Value Self MW4 807.76 799.70 530.53 269.17 -15.17
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1817.40 1799.27 1243.95 555.32 -43.87
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1736.67 1719.32 1136.70 582.62 -32.89
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1025.96 1056.75 530.53 526.22 23.68
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2308.48 2377.81 1243.95 1133.86 43.59
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2205.86 2272.08 1136.70 1135.38 50.68
Illinois Humana HDHP - HDHP Self BB1 New Plan 445.29 333.97 111.32 New Plan
Illinois Humana HDHP - HDHP Self & Family BB2 New Plan 1109.33 832.00 277.33 New Plan
Illinois Humana HDHP - HDHP Self Plus One BB3 New Plan 976.52 732.39 244.13 New Plan
Illinois Humana HDHP - HDHP Self AW1 New Plan 420.70 315.53 105.17 New Plan
Illinois Humana HDHP - HDHP Self & Family AW2 New Plan 1047.82 785.87 261.95 New Plan
Illinois Humana HDHP - HDHP Self Plus One AW3 New Plan 922.39 691.79 230.60 New Plan
Illinois Humana Health Plan, Inc. - Standard Self 754 1045.35 1055.80 530.53 525.27 3.34
Illinois Humana Health Plan, Inc. - Standard Self & Family 755 2352.03 2375.56 1243.95 1131.61 -2.21
Illinois Humana Health Plan, Inc. - Standard Self Plus One 756 2247.53 2270.00 1136.70 1133.30 6.93
Illinois Humana Health Plan, Inc. - High Self 751 1369.01 1403.24 530.53 872.71 27.12
Illinois Humana Health Plan, Inc. - High Self & Family 752 3080.33 3157.29 1243.95 1913.34 51.22
Illinois Humana Health Plan, Inc. - High Self Plus One 753 2943.42 3016.98 1136.70 1880.28 58.02
Illinois Humana Health Plan, Inc. - High Self 9F1 2015.85 2116.64 530.53 1586.11 93.68
Illinois Humana Health Plan, Inc. - High Self & Family 9F2 4535.64 4762.44 1243.95 3518.49 201.06
Illinois Humana Health Plan, Inc. - High Self Plus One 9F3 4334.03 4550.74 1136.70 3414.04 201.17
Illinois Humana Health Plan, Inc. - Standard Self AB4 1241.70 1447.46 530.53 916.93 198.65
Illinois Humana Health Plan, Inc. - Standard Self & Family AB5 2793.90 3256.85 1243.95 2012.90 437.21
Illinois Humana Health Plan, Inc. - Standard Self Plus One AB6 2669.72 3112.11 1136.70 1975.41 426.85
Illinois Humana Health Plan, Inc. - Basic Self AB1 786.91 845.93 530.53 315.40 51.91
Illinois Humana Health Plan, Inc. - Basic Self & Family AB2 1770.60 1903.40 1243.95 659.45 107.06
Illinois Humana Health Plan, Inc. - Basic Self Plus One AB3 1691.91 1818.81 1136.70 682.11 111.36
Illinois Humana Health Plan, Inc. - Basic Self RW1 819.04 839.50 530.53 308.97 13.35
Illinois Humana Health Plan, Inc. - Basic Self & Family RW2 1842.86 1888.88 1243.95 644.93 20.28
Illinois Humana Health Plan, Inc. - Basic Self Plus One RW3 1760.96 1804.92 1136.70 668.22 28.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 554.62 663.76 497.82 165.94 27.29
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1555.15 1586.41 1189.81 396.60 7.81
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1083.18 1327.54 995.66 331.88 61.09
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Indiana Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Indiana Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Indiana Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Indiana Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Indiana Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Indiana Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Indiana Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Indiana Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Indiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Indiana Health Alliance HMO - Standard Self K84 683.56 704.08 528.06 176.02 5.13
Indiana Health Alliance HMO - Standard Self & Family K85 1584.35 1631.89 1223.92 407.97 11.88
Indiana Health Alliance HMO - Standard Self Plus One K86 1461.61 1505.44 1129.08 376.36 10.96
Indiana Humana CoverageFirst and Humana Value Plan - Value Self MW4 807.76 799.70 530.53 269.17 -15.17
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1817.40 1799.27 1243.95 555.32 -43.87
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1736.67 1719.32 1136.70 582.62 -32.89
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1025.96 1056.75 530.53 526.22 23.68
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2308.48 2377.81 1243.95 1133.86 43.59
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2205.86 2272.08 1136.70 1135.38 50.68
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self TC1 738.57 757.06 530.53 226.53 11.38
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TC2 1661.79 1703.33 1243.95 459.38 15.80
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TC3 1587.95 1627.64 1136.70 490.94 24.15
Indiana Humana CoverageFirst and Humana Value Plan - Value Self TC4 New Plan 579.74 434.81 144.93 New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family TC5 New Plan 1304.42 978.32 326.10 New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One TC6 New Plan 1246.44 934.83 311.61 New Plan
Indiana Humana CoverageFirst and Humana Value Plan - Value Self X34 645.88 694.33 520.75 173.58 12.11
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1453.25 1562.23 1171.67 390.56 27.25
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1388.66 1492.81 1119.61 373.20 26.04
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self X31 839.41 902.37 530.53 371.84 55.85
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 1888.71 2030.34 1243.95 786.39 115.89
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1804.77 1940.12 1136.70 803.42 119.81
Indiana Humana HDHP - HDHP Self BB1 New Plan 445.29 333.97 111.32 New Plan
Indiana Humana HDHP - HDHP Self & Family BB2 New Plan 1109.33 832.00 277.33 New Plan
Indiana Humana HDHP - HDHP Self Plus One BB3 New Plan 976.52 732.39 244.13 New Plan
Indiana Humana HDHP - HDHP Self DT1 New Plan 495.73 371.80 123.93 New Plan
Indiana Humana HDHP - HDHP Self & Family DT2 New Plan 1235.41 926.56 308.85 New Plan
Indiana Humana HDHP - HDHP Self Plus One DT3 New Plan 1087.47 815.60 271.87 New Plan
Indiana Humana Health Plan of Ohio, Inc. - Standard Self A64 1230.78 1243.08 530.53 712.55 5.19
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2769.30 2796.95 1243.95 1553.00 1.91
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2646.19 2672.63 1136.70 1535.93 10.90
Indiana Humana Health Plan, Inc. - Standard Self 754 1045.35 1055.80 530.53 525.27 3.34
Indiana Humana Health Plan, Inc. - Standard Self & Family 755 2352.03 2375.56 1243.95 1131.61 -2.21
Indiana Humana Health Plan, Inc. - Standard Self Plus One 756 2247.53 2270.00 1136.70 1133.30 6.93
Indiana Humana Health Plan, Inc. - High Self 751 1369.01 1403.24 530.53 872.71 27.12
Indiana Humana Health Plan, Inc. - High Self & Family 752 3080.33 3157.29 1243.95 1913.34 51.22
Indiana Humana Health Plan, Inc. - High Self Plus One 753 2943.42 3016.98 1136.70 1880.28 58.02
Indiana Humana Health Plan, Inc. - Standard Self MH4 945.62 992.90 530.53 462.37 40.17
Indiana Humana Health Plan, Inc. - Standard Self & Family MH5 2127.62 2233.96 1243.95 990.01 80.60
Indiana Humana Health Plan, Inc. - Standard Self Plus One MH6 2033.05 2134.67 1136.70 997.97 86.08
Iowa Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Iowa Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Iowa Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Iowa Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Iowa Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Iowa Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Iowa Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Iowa Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Iowa Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Iowa Health Alliance HMO - Standard Self K84 683.56 704.08 528.06 176.02 5.13
Iowa Health Alliance HMO - Standard Self & Family K85 1584.35 1631.89 1223.92 407.97 11.88
Iowa Health Alliance HMO - Standard Self Plus One K86 1461.61 1505.44 1129.08 376.36 10.96
Iowa HealthPartners - Standard Self V34 509.41 553.28 414.96 138.32 10.97
Iowa HealthPartners - Standard Self & Family V35 1240.94 1347.84 1010.88 336.96 26.73
Iowa HealthPartners - Standard Self Plus One V36 1125.80 1222.78 917.09 305.69 24.24
Iowa HealthPartners - High Self V31 668.07 692.14 519.11 173.03 6.01
Iowa HealthPartners - High Self & Family V32 1627.38 1686.01 1243.95 442.06 32.89
Iowa HealthPartners - High Self Plus One V33 1476.41 1529.58 1136.70 392.88 23.78
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 692.86 744.55 530.53 214.02 40.81
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1593.56 1712.45 1243.95 468.50 70.11
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1489.63 1600.76 1136.70 464.06 91.65
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 776.84 873.95 530.53 343.42 90.00
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 1942.11 2184.93 1243.95 940.98 217.08
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1670.22 1879.04 1136.70 742.34 193.28
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Kansas Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Kansas Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Kansas Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Kansas Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Kansas Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Kansas Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Kansas Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Kansas Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Kansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Kansas Aetna Open Access - High Self HA1 1156.52 1188.98 530.53 658.45 25.35
Kansas Aetna Open Access - High Self & Family HA2 2731.91 2808.54 1243.95 1564.59 50.89
Kansas Aetna Open Access - High Self Plus One HA3 2704.89 2780.77 1136.70 1644.07 60.34
Kansas Aetna Open Access - Standard Self HA4 901.36 909.37 530.53 378.84 0.90
Kansas Aetna Open Access - Standard Self & Family HA5 2127.54 2146.47 1243.95 902.52 -6.81
Kansas Aetna Open Access - Standard Self Plus One HA6 2106.48 2125.26 1136.70 988.56 3.24
Kansas Humana CoverageFirst and Humana Value Plan - Value Self PH4 527.61 567.17 425.38 141.79 9.89
Kansas Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1187.12 1276.15 957.11 319.04 22.26
Kansas Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1134.36 1219.44 914.58 304.86 21.27
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 758.03 758.03 530.53 227.50 -7.11
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1705.58 1705.60 1243.95 461.65 -25.72
Kansas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1629.77 1629.79 1136.70 493.09 -15.52
Kansas Humana HDHP - HDHP Self BK1 New Plan 403.13 302.35 100.78 New Plan
Kansas Humana HDHP - HDHP Self & Family BK2 New Plan 1003.93 752.95 250.98 New Plan
Kansas Humana HDHP - HDHP Self Plus One BK3 New Plan 883.78 662.84 220.94 New Plan
Kansas Humana Health Plan, Inc. - Standard Self MS4 1200.59 1290.64 530.53 760.11 82.94
Kansas Humana Health Plan, Inc. - Standard Self & Family MS5 2701.34 2903.98 1243.95 1660.03 176.90
Kansas Humana Health Plan, Inc. - Standard Self Plus One MS6 2581.32 2774.94 1136.70 1638.24 178.08
Kentucky Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Kentucky Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Kentucky Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Kentucky Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Kentucky Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Kentucky Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Kentucky Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Kentucky Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Kentucky Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Kentucky Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self TC1 738.57 757.06 530.53 226.53 11.38
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TC2 1661.79 1703.33 1243.95 459.38 15.80
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TC3 1587.95 1627.64 1136.70 490.94 24.15
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self TC4 New Plan 579.74 434.81 144.93 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family TC5 New Plan 1304.42 978.32 326.10 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One TC6 New Plan 1246.44 934.83 311.61 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self 6N1 828.04 848.75 530.53 318.22 13.60
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family 6N2 1863.07 1909.68 1243.95 665.73 20.87
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One 6N3 1780.29 1824.81 1136.70 688.11 28.98
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self 6N4 New Plan 633.82 475.37 158.45 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family 6N5 New Plan 1426.06 1069.55 356.51 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One 6N6 New Plan 1362.70 1022.03 340.67 New Plan
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self X34 645.88 694.33 520.75 173.58 12.11
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1453.25 1562.23 1171.67 390.56 27.25
Kentucky Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1388.66 1492.81 1119.61 373.20 26.04
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self X31 839.41 902.37 530.53 371.84 55.85
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 1888.71 2030.34 1243.95 786.39 115.89
Kentucky Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1804.77 1940.12 1136.70 803.42 119.81
Kentucky Humana HDHP - HDHP Self DT1 New Plan 495.73 371.80 123.93 New Plan
Kentucky Humana HDHP - HDHP Self & Family DT2 New Plan 1235.41 926.56 308.85 New Plan
Kentucky Humana HDHP - HDHP Self Plus One DT3 New Plan 1087.47 815.60 271.87 New Plan
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self A64 1230.78 1243.08 530.53 712.55 5.19
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2769.30 2796.95 1243.95 1553.00 1.91
Kentucky Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2646.19 2672.63 1136.70 1535.93 10.90
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self W61 639.06 671.02 503.27 167.75 7.99
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self & Family W62 1437.93 1509.82 1132.37 377.45 17.97
Kentucky Humana Health Plan of Ohio, Inc. - Basic Self Plus One W63 1374.01 1442.72 1082.04 360.68 17.18
Kentucky Humana Health Plan, Inc. - Standard Self MI4 920.40 929.59 530.53 399.06 2.08
Kentucky Humana Health Plan, Inc. - Standard Self & Family MI5 2070.86 2091.55 1243.95 847.60 -5.05
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MI6 1978.84 1998.62 1136.70 861.92 4.24
Kentucky Humana Health Plan, Inc. - Standard Self MH4 945.62 992.90 530.53 462.37 40.17
Kentucky Humana Health Plan, Inc. - Standard Self & Family MH5 2127.62 2233.96 1243.95 990.01 80.60
Kentucky Humana Health Plan, Inc. - Standard Self Plus One MH6 2033.05 2134.67 1136.70 997.97 86.08
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Kentucky UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 692.86 744.55 530.53 214.02 40.81
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1593.56 1712.45 1243.95 468.50 70.11
Kentucky UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1489.63 1600.76 1136.70 464.06 91.65
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 776.84 873.95 530.53 343.42 90.00
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 1942.11 2184.93 1243.95 940.98 217.08
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1670.22 1879.04 1136.70 742.34 193.28
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Kentucky UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Louisiana Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Louisiana Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Louisiana Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Louisiana Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Louisiana Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Louisiana Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Louisiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Louisiana Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Louisiana Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Louisiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self BC4 741.54 760.09 530.53 229.56 11.44
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family BC5 1668.46 1710.22 1243.95 466.27 16.02
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One BC6 1594.30 1634.19 1136.70 497.49 24.35
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self BC1 991.47 1031.12 530.53 500.59 32.54
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family BC2 2230.82 2320.07 1243.95 1076.12 63.51
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One BC3 2131.68 2216.96 1136.70 1080.26 69.74
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self AE1 1210.69 1271.25 530.53 740.72 53.45
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self & Family AE2 2724.04 2860.22 1243.95 1616.27 110.44
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - High Self Plus One AE3 2602.99 2733.12 1136.70 1596.42 114.59
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self AE4 912.43 939.79 530.53 409.26 20.25
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self & Family AE5 2052.98 2114.58 1243.95 870.63 35.86
Louisiana Humana Health Benefit Plan of Louisiana, Inc. - Standard Self Plus One AE6 1961.72 2020.59 1136.70 883.89 43.33
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Louisiana UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Louisiana UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Louisiana UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Maine Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Maine Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Maine Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Maine Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Maine Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Maine Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Maine Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Maine Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Maine Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Maine Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Maine Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Maryland Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Maryland Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Maryland Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Maryland Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Maryland Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Maryland Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Maryland Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Maryland Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Maryland Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Maryland Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Maryland Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Maryland Aetna Open Access - High Self JN1 1176.57 1251.55 530.53 721.02 67.87
Maryland Aetna Open Access - High Self & Family JN2 2645.05 2813.68 1243.95 1569.73 142.89
Maryland Aetna Open Access - High Self Plus One JN3 2618.85 2785.79 1136.70 1649.09 151.40
Maryland Aetna Open Access - Basic Self JN4 714.42 739.46 530.53 208.93 17.93
Maryland Aetna Open Access - Basic Self & Family JN5 1634.92 1692.23 1243.95 448.28 31.57
Maryland Aetna Open Access - Basic Self Plus One JN6 1501.33 1553.93 1136.70 417.23 37.06
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 1362.12 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 887.81 905.58 530.53 375.05 10.66
Maryland CareFirst BlueChoice - Standard Self & Family 2G5 2109.42 2151.59 1243.95 907.64 16.43
Maryland CareFirst BlueChoice - Standard Self Plus One 2G6 1775.61 1811.12 1136.70 674.42 19.97
Maryland CareFirst BlueChoice - HDHP Self B61 570.09 604.31 453.23 151.08 8.56
Maryland CareFirst BlueChoice - HDHP Self & Family B62 1354.51 1435.79 1076.84 358.95 20.32
Maryland CareFirst BlueChoice - HDHP Self Plus One B63 1140.17 1208.57 906.43 302.14 17.10
Maryland CareFirst BlueChoice - Blue Value Plus Self B64 723.67 723.67 530.53 193.14 -7.11
Maryland CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1719.38 1243.95 475.43 -25.74
Maryland CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1447.29 1085.47 361.82 0.00
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 427.72 368.90 276.68 92.22 -14.71
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1099.52 1051.33 788.50 262.83 -12.05
Maryland Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 951.84 866.91 650.18 216.73 -21.23
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self E34 598.28 607.25 455.44 151.81 2.24
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1376.05 1396.63 1047.47 349.16 5.15
Maryland Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1376.05 1396.63 1047.47 349.16 5.15
Maryland Kaiser Permanente - Mid-Atlantic States - High Self E31 746.24 756.60 530.53 226.07 3.25
Maryland Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1716.35 1740.20 1243.95 496.25 -1.89
Maryland Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1716.35 1740.20 1136.70 603.50 8.31
Maryland M.D. IPA - High Self JP1 950.89 1011.99 530.53 481.46 53.99
Maryland M.D. IPA - High Self & Family JP2 2666.28 2837.66 1243.95 1593.71 145.64
Maryland M.D. IPA - High Self Plus One JP3 1857.09 1976.43 1136.70 839.73 103.80
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Maryland UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 519.91 661.81 496.36 165.45 35.47
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1195.81 1514.20 1135.65 378.55 79.60
Maryland UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1117.81 1422.92 1067.19 355.73 76.28
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 770.40 822.16 530.53 291.63 44.65
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1825.83 1948.55 1243.95 704.60 96.98
Maryland UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1656.33 1767.68 1136.70 630.98 95.81
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 554.62 663.76 497.82 165.94 27.29
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1555.15 1586.41 1189.81 396.60 7.81
Maryland UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1083.18 1327.54 995.66 331.88 61.09
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Maryland UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Massachusetts Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Massachusetts Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Massachusetts Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Massachusetts Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Massachusetts Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Massachusetts Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Massachusetts Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Massachusetts Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Massachusetts Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Massachusetts Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Michigan Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Michigan Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Michigan Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Michigan Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Michigan Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Michigan Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Michigan Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Michigan Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Michigan Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Michigan Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Michigan Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Michigan Blue Care Network of Michigan - High Self LX1 765.81 790.44 530.53 259.91 17.52
Michigan Blue Care Network of Michigan - High Self & Family LX2 1868.58 1928.70 1243.95 684.75 34.38
Michigan Blue Care Network of Michigan - High Self Plus One LX3 1761.39 1818.03 1136.70 681.33 41.10
Michigan Blue Care Network of Michigan - High Self K51 996.49 1042.12 530.53 511.59 38.52
Michigan Blue Care Network of Michigan - High Self & Family K52 2431.46 2542.76 1243.95 1298.81 85.56
Michigan Blue Care Network of Michigan - High Self Plus One K53 2291.97 2396.85 1136.70 1260.15 89.34
Michigan Health Alliance Plan - High Self 521 842.18 910.11 530.53 379.58 60.82
Michigan Health Alliance Plan - High Self & Family 522 2054.93 2220.62 1243.95 976.67 139.95
Michigan Health Alliance Plan - High Self Plus One 523 1937.00 2093.22 1136.70 956.52 140.68
Michigan Health Alliance Plan - Standard Self GY4 557.55 530.16 397.62 132.54 -6.85
Michigan Health Alliance Plan - Standard Self & Family GY5 1360.41 1293.57 970.18 323.39 -16.71
Michigan Health Alliance Plan - Standard Self Plus One GY6 1282.34 1219.38 914.54 304.84 -15.74
Michigan Priority Health - High Self LE1 1037.29 1106.71 530.53 576.18 62.31
Michigan Priority Health - High Self & Family LE2 2437.63 2600.74 1243.95 1356.79 137.37
Michigan Priority Health - High Self Plus One LE3 2282.04 2434.73 1136.70 1298.03 137.15
Michigan Priority Health - Standard Self LE4 587.38 617.22 462.92 154.30 7.46
Michigan Priority Health - Standard Self & Family LE5 1380.32 1450.45 1087.84 362.61 17.53
Michigan Priority Health - Standard Self Plus One LE6 1292.22 1357.85 1018.39 339.46 16.41
Michigan Priority Health - Value Self Y41 473.24 473.24 354.93 118.31 0.00
Michigan Priority Health - Value Self & Family Y42 1112.13 1112.13 834.10 278.03 0.00
Michigan Priority Health - Value Self Plus One Y43 1041.13 1041.13 780.85 260.28 0.00
Minnesota Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Minnesota Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Minnesota Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Minnesota Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Minnesota Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Minnesota Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Minnesota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Minnesota Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Minnesota Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Minnesota Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Minnesota HealthPartners - Standard Self V34 509.41 553.28 414.96 138.32 10.97
Minnesota HealthPartners - Standard Self & Family V35 1240.94 1347.84 1010.88 336.96 26.73
Minnesota HealthPartners - Standard Self Plus One V36 1125.80 1222.78 917.09 305.69 24.24
Minnesota HealthPartners - High Self V31 668.07 692.14 519.11 173.03 6.01
Minnesota HealthPartners - High Self & Family V32 1627.38 1686.01 1243.95 442.06 32.89
Minnesota HealthPartners - High Self Plus One V33 1476.41 1529.58 1136.70 392.88 23.78
Mississippi Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Mississippi Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Mississippi Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Mississippi Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Mississippi Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Mississippi Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Mississippi Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Mississippi Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Mississippi Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Mississippi Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Mississippi UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Mississippi UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Mississippi UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Missouri Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Missouri Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Missouri Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Missouri Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Missouri Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Missouri Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Missouri Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Missouri Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Missouri Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Missouri Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Missouri Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Missouri Aetna Open Access - High Self HA1 1156.52 1188.98 530.53 658.45 25.35
Missouri Aetna Open Access - High Self & Family HA2 2731.91 2808.54 1243.95 1564.59 50.89
Missouri Aetna Open Access - High Self Plus One HA3 2704.89 2780.77 1136.70 1644.07 60.34
Missouri Aetna Open Access - Standard Self HA4 901.36 909.37 530.53 378.84 0.90
Missouri Aetna Open Access - Standard Self & Family HA5 2127.54 2146.47 1243.95 902.52 -6.81
Missouri Aetna Open Access - Standard Self Plus One HA6 2106.48 2125.26 1136.70 988.56 3.24
Missouri Blue Preferred - High Self 9G1 874.23 905.71 530.53 375.18 24.37
Missouri Blue Preferred - High Self & Family 9G2 1984.52 2139.32 1243.95 895.37 129.06
Missouri Blue Preferred - High Self Plus One 9G3 1862.12 2005.51 1136.70 868.81 127.85
Missouri Blue Preferred - Standard Self 9G4 633.66 614.01 460.51 153.50 -4.91
Missouri Blue Preferred - Standard Self & Family 9G5 1758.23 1791.62 1243.95 547.67 7.65
Missouri Blue Preferred - Standard Self Plus One 9G6 1574.58 1598.20 1136.70 461.50 8.08
Missouri Humana CoverageFirst and Humana Value Plan - Value Self PH4 527.61 567.17 425.38 141.79 9.89
Missouri Humana CoverageFirst and Humana Value Plan - Value Self & Family PH5 1187.12 1276.15 957.11 319.04 22.26
Missouri Humana CoverageFirst and Humana Value Plan - Value Self Plus One PH6 1134.36 1219.44 914.58 304.86 21.27
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self PH1 758.03 758.03 530.53 227.50 -7.11
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self & Family PH2 1705.58 1705.60 1243.95 461.65 -25.72
Missouri Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One PH3 1629.77 1629.79 1136.70 493.09 -15.52
Missouri Humana HDHP - HDHP Self BK1 New Plan 403.13 302.35 100.78 New Plan
Missouri Humana HDHP - HDHP Self & Family BK2 New Plan 1003.93 752.95 250.98 New Plan
Missouri Humana HDHP - HDHP Self Plus One BK3 New Plan 883.78 662.84 220.94 New Plan
Missouri Humana Health Plan, Inc. - Standard Self MS4 1200.59 1290.64 530.53 760.11 82.94
Missouri Humana Health Plan, Inc. - Standard Self & Family MS5 2701.34 2903.98 1243.95 1660.03 176.90
Missouri Humana Health Plan, Inc. - Standard Self Plus One MS6 2581.32 2774.94 1136.70 1638.24 178.08
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Missouri UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Missouri UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Montana Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Montana Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Montana Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Montana Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Montana Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Montana Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Montana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Montana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Montana Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Montana Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Montana Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Nebraska Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Nebraska Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Nebraska Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Nebraska Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Nebraska Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Nebraska Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Nebraska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Nebraska Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Nebraska Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Nebraska Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Nevada Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Nevada Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Nevada Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Nevada Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Nevada Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Nevada Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Nevada Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Nevada Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Nevada Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Nevada Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Nevada Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Nevada Health Plan of Nevada, Inc. - High Self NM1 741.17 830.16 530.53 299.63 81.88
Nevada Health Plan of Nevada, Inc. - High Self & Family NM2 1756.50 1967.40 1243.95 723.45 185.16
Nevada Health Plan of Nevada, Inc. - High Self Plus One NM3 1408.23 1577.31 1136.70 440.61 88.55
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 622.22 668.46 501.35 167.11 11.56
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1471.54 1580.91 1185.68 395.23 27.35
Nevada UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1337.77 1437.17 1077.88 359.29 24.85
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 528.17 672.10 504.08 168.02 35.98
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1214.76 1545.85 1159.39 386.46 82.77
Nevada UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1135.55 1445.04 1083.78 361.26 77.37
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 782.12 864.87 530.53 334.34 75.64
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1955.35 2162.16 1243.95 918.21 181.07
Nevada UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1681.57 1859.46 1136.70 722.76 162.35
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 621.21 657.65 493.24 164.41 9.11
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1469.13 1555.39 1166.54 388.85 21.57
Nevada UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1335.58 1413.97 1060.48 353.49 19.60
New Hampshire Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
New Hampshire Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
New Hampshire Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
New Hampshire Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
New Hampshire Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
New Hampshire Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
New Hampshire Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
New Hampshire Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
New Hampshire Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
New Hampshire Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
New Jersey Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
New Jersey Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
New Jersey Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
New Jersey Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
New Jersey Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
New Jersey Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
New Jersey Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
New Jersey Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
New Jersey Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
New Jersey Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
New Jersey Aetna Open Access - High Self JR1 1656.81 1655.18 530.53 1124.65 -8.74
New Jersey Aetna Open Access - High Self & Family JR2 3827.03 3823.24 1243.95 2579.29 -29.53
New Jersey Aetna Open Access - High Self Plus One JR3 3789.11 3785.41 1136.70 2648.71 -19.24
New Jersey Aetna Open Access - Basic Self JR4 1429.35 1428.27 530.53 897.74 -8.19
New Jersey Aetna Open Access - Basic Self & Family JR5 3312.70 3310.19 1243.95 2066.24 -28.25
New Jersey Aetna Open Access - Basic Self Plus One JR6 3279.88 3277.41 1136.70 2140.71 -18.01
New Jersey Aetna Open Access - Basic Self P34 1505.53 1721.76 530.53 1191.23 209.12
New Jersey Aetna Open Access - Basic Self & Family P35 3494.34 3996.29 1243.95 2752.34 476.21
New Jersey Aetna Open Access - Basic Self Plus One P36 3459.73 3956.70 1136.70 2820.00 481.43
New Jersey Aetna Open Access - High Self P31 1588.23 1762.54 530.53 1232.01 167.20
New Jersey Aetna Open Access - High Self & Family P32 3850.71 4273.27 1243.95 3029.32 396.82
New Jersey Aetna Open Access - High Self Plus One P33 3812.58 4230.98 1136.70 3094.28 402.86
New Jersey Emblemhealth Plan, Inc. - Standard Self 804 1039.85 1039.85 530.53 509.32 -7.11
New Jersey Emblemhealth Plan, Inc. - Standard Self & Family 805 2522.72 2522.72 1243.95 1278.77 -25.74
New Jersey Emblemhealth Plan, Inc. - Standard Self Plus One 806 2418.74 2418.74 1136.70 1282.04 -15.54
New Mexico Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
New Mexico Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
New Mexico Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
New Mexico Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
New Mexico Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
New Mexico Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
New Mexico Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
New Mexico Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
New Mexico Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
New Mexico Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
New Mexico Presbyterian Health Plan - High Self P21 846.93 874.47 530.53 343.94 20.43
New Mexico Presbyterian Health Plan - High Self & Family P22 1990.34 2055.08 1243.95 811.13 39.00
New Mexico Presbyterian Health Plan - High Self Plus One P23 1922.59 1985.12 1136.70 848.42 46.99
New Mexico Presbyterian Health Plan - Standard Self PS4 706.31 725.23 530.53 194.70 11.81
New Mexico Presbyterian Health Plan - Standard Self & Family PS5 1659.84 1704.34 1243.95 460.39 18.76
New Mexico Presbyterian Health Plan - Standard Self Plus One PS6 1603.38 1646.36 1136.70 509.66 27.44
New Mexico Presbyterian Health Plan - Wellness Self PS1 632.06 653.81 490.36 163.45 5.44
New Mexico Presbyterian Health Plan - Wellness Self & Family PS2 1485.36 1536.43 1152.32 384.11 12.77
New Mexico Presbyterian Health Plan - Wellness Self Plus One PS3 1434.79 1484.17 1113.13 371.04 12.34
New York Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
New York Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
New York Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
New York Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
New York Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
New York Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
New York Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
New York Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
New York Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
New York Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
New York Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
New York Aetna Open Access - High Self JC1 1459.58 1728.91 530.53 1198.38 262.22
New York Aetna Open Access - High Self & Family JC2 3606.57 4272.13 1243.95 3028.18 639.82
New York Aetna Open Access - High Self Plus One JC3 3570.88 4229.83 1136.70 3093.13 643.41
New York Aetna Open Access - Basic Self JC4 1219.86 1462.83 530.53 932.30 235.86
New York Aetna Open Access - Basic Self & Family JC5 2975.51 3568.09 1243.95 2324.14 566.84
New York Aetna Open Access - Basic Self Plus One JC6 2946.06 3532.77 1136.70 2396.07 571.17
New York CDPHP - Standard Self SG4 704.56 773.76 530.53 243.23 62.09
New York CDPHP - Standard Self & Family SG5 1690.87 1857.01 1243.95 613.06 140.40
New York CDPHP - Standard Self Plus One SG6 1564.12 1717.73 1136.70 581.03 138.07
New York Emblemhealth Plan, Inc. - Standard Self 804 1039.85 1039.85 530.53 509.32 -7.11
New York Emblemhealth Plan, Inc. - Standard Self & Family 805 2522.72 2522.72 1243.95 1278.77 -25.74
New York Emblemhealth Plan, Inc. - Standard Self Plus One 806 2418.74 2418.74 1136.70 1282.04 -15.54
New York HIP of Greater NY - Standard Self YL4 900.68 975.30 530.53 444.77 67.51
New York HIP of Greater NY - Standard Self & Family YL5 2618.24 2835.13 1243.95 1591.18 191.15
New York HIP of Greater NY - Standard Self Plus One YL6 1644.59 1780.87 1136.70 644.17 120.74
New York HIP of Greater NY - High Self 511 1050.75 1050.75 530.53 520.22 -7.11
New York HIP of Greater NY - High Self & Family 512 3054.39 3054.59 1243.95 1810.64 -25.54
New York HIP of Greater NY - High Self Plus One 513 1918.63 1918.74 1136.70 782.04 -15.43
New York Independent Health - Standard Self C54 722.15 737.77 530.53 207.24 8.51
New York Independent Health - Standard Self & Family C55 1949.81 1991.99 1243.95 748.04 16.44
New York Independent Health - Standard Self Plus One C56 1841.49 1881.36 1136.70 744.66 24.33
New York Independent Health - High Self QA1 790.94 800.65 530.53 270.12 2.60
New York Independent Health - High Self & Family QA2 2135.55 2161.75 1243.95 917.80 0.46
New York Independent Health - High Self Plus One QA3 2016.91 2041.65 1136.70 904.95 9.20
New York Independent Health - HDHP Self QA4 599.30 601.19 450.89 150.30 0.48
New York Independent Health - HDHP Self & Family QA5 1551.36 1552.76 1164.57 388.19 0.35
New York Independent Health - HDHP Self Plus One QA6 1475.76 1477.36 1108.02 369.34 0.40
North Carolina Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
North Carolina Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
North Carolina Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
North Carolina Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
North Carolina Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
North Carolina Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
North Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
North Carolina Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
North Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
North Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
North Carolina UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
North Carolina UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
North Carolina UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
North Dakota Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
North Dakota Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
North Dakota Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
North Dakota Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
North Dakota Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
North Dakota Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
North Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
North Dakota Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
North Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
North Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
North Dakota HealthPartners - Standard Self V34 509.41 553.28 414.96 138.32 10.97
North Dakota HealthPartners - Standard Self & Family V35 1240.94 1347.84 1010.88 336.96 26.73
North Dakota HealthPartners - Standard Self Plus One V36 1125.80 1222.78 917.09 305.69 24.24
North Dakota HealthPartners - High Self V31 668.07 692.14 519.11 173.03 6.01
North Dakota HealthPartners - High Self & Family V32 1627.38 1686.01 1243.95 442.06 32.89
North Dakota HealthPartners - High Self Plus One V33 1476.41 1529.58 1136.70 392.88 23.78
Northern Mariana Islands Calvo's SelectCare - Standard Self B44 429.78 378.91 284.18 94.73 -12.71
Northern Mariana Islands Calvo's SelectCare - Standard Self & Family B45 1248.72 1100.91 825.68 275.23 -36.95
Northern Mariana Islands Calvo's SelectCare - Standard Self Plus One B46 847.21 746.92 560.19 186.73 -25.07
Northern Mariana Islands Calvo's SelectCare - High Self B41 521.69 535.95 401.96 133.99 3.57
Northern Mariana Islands Calvo's SelectCare - High Self & Family B42 1381.77 1419.54 1064.66 354.88 9.44
Northern Mariana Islands Calvo's SelectCare - High Self Plus One B43 1018.07 1045.89 784.42 261.47 6.95
Northern Mariana Islands TakeCare - HDHP Self KX1 120.53 122.31 91.73 30.58 0.45
Northern Mariana Islands TakeCare - HDHP Self & Family KX2 323.16 327.97 245.98 81.99 1.20
Northern Mariana Islands TakeCare - HDHP Self Plus One KX3 290.94 295.23 221.42 73.81 1.08
Northern Mariana Islands TakeCare - Standard Self JK4 404.45 405.77 304.33 101.44 0.33
Northern Mariana Islands TakeCare - Standard Self & Family JK5 1145.39 1149.18 861.89 287.29 0.94
Northern Mariana Islands TakeCare - Standard Self Plus One JK6 797.14 799.78 599.84 199.94 0.66
Northern Mariana Islands TakeCare - High Self JK1 497.81 515.86 386.90 128.96 4.51
Northern Mariana Islands TakeCare - High Self & Family JK2 1187.38 1230.43 922.82 307.61 10.77
Northern Mariana Islands TakeCare - High Self Plus One JK3 983.49 1019.16 764.37 254.79 8.92
Ohio Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Ohio Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Ohio Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Ohio Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Ohio Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Ohio Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Ohio Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Ohio Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Ohio Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Ohio Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Ohio Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Ohio AultCare Insurance Company - High Self 3A1 875.88 930.26 530.53 399.73 47.27
Ohio AultCare Insurance Company - High Self & Family 3A2 2163.29 2297.82 1243.95 1053.87 108.79
Ohio AultCare Insurance Company - High Self Plus One 3A3 1839.24 1953.62 1136.70 816.92 98.84
Ohio AultCare Insurance Company - HDHP Self 3A4 465.88 442.82 332.12 110.70 -5.77
Ohio AultCare Insurance Company - HDHP Self & Family 3A5 1491.77 1417.93 1063.45 354.48 -18.46
Ohio AultCare Insurance Company - HDHP Self Plus One 3A6 885.69 841.84 631.38 210.46 -10.96
Ohio Humana CoverageFirst and Humana Value Plan - Value Self X34 645.88 694.33 520.75 173.58 12.11
Ohio Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1453.25 1562.23 1171.67 390.56 27.25
Ohio Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1388.66 1492.81 1119.61 373.20 26.04
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self X31 839.41 902.37 530.53 371.84 55.85
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 1888.71 2030.34 1243.95 786.39 115.89
Ohio Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1804.77 1940.12 1136.70 803.42 119.81
Ohio Humana HDHP - HDHP Self DT1 New Plan 495.73 371.80 123.93 New Plan
Ohio Humana HDHP - HDHP Self & Family DT2 New Plan 1235.41 926.56 308.85 New Plan
Ohio Humana HDHP - HDHP Self Plus One DT3 New Plan 1087.47 815.60 271.87 New Plan
Ohio Humana Health Plan of Ohio, Inc. - Standard Self A64 1230.78 1243.08 530.53 712.55 5.19
Ohio Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2769.30 2796.95 1243.95 1553.00 1.91
Ohio Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2646.19 2672.63 1136.70 1535.93 10.90
Ohio Humana Health Plan of Ohio, Inc. - Basic Self W61 639.06 671.02 503.27 167.75 7.99
Ohio Humana Health Plan of Ohio, Inc. - Basic Self & Family W62 1437.93 1509.82 1132.37 377.45 17.97
Ohio Humana Health Plan of Ohio, Inc. - Basic Self Plus One W63 1374.01 1442.72 1082.04 360.68 17.18
Ohio Medical Mutual of Ohio - Basic Self YF1 415.05 416.74 312.56 104.18 0.42
Ohio Medical Mutual of Ohio - Basic Self & Family YF2 996.10 1000.16 750.12 250.04 1.02
Ohio Medical Mutual of Ohio - Basic Self Plus One YF3 913.10 916.80 687.60 229.20 0.93
Ohio Medical Mutual of Ohio - Standard Self YF4 985.86 1193.60 530.53 663.07 200.63
Ohio Medical Mutual of Ohio - Standard Self & Family YF5 2366.04 2864.62 1243.95 1620.67 472.84
Ohio Medical Mutual of Ohio - Standard Self Plus One YF6 2168.88 2625.89 1136.70 1489.19 441.47
Ohio Medical Mutual of Ohio - Standard Self 644 940.96 1047.84 530.53 517.31 99.77
Ohio Medical Mutual of Ohio - Standard Self & Family 645 2258.32 2514.79 1243.95 1270.84 230.73
Ohio Medical Mutual of Ohio - Standard Self Plus One 646 2070.12 2305.23 1136.70 1168.53 219.57
Ohio Medical Mutual of Ohio - Standard Self X64 861.34 1109.98 530.53 579.45 241.53
Ohio Medical Mutual of Ohio - Standard Self & Family X65 2067.22 2663.98 1243.95 1420.03 571.02
Ohio Medical Mutual of Ohio - Standard Self Plus One X66 1894.95 2441.99 1136.70 1305.29 531.50
Ohio Medical Mutual of Ohio - Basic Self X61 405.28 406.94 305.21 101.73 0.41
Ohio Medical Mutual of Ohio - Basic Self & Family X62 972.68 976.69 732.52 244.17 1.00
Ohio Medical Mutual of Ohio - Basic Self Plus One X63 891.63 895.29 671.47 223.82 0.91
Ohio Medical Mutual of Ohio - Basic Self UX1 411.21 412.90 309.68 103.22 0.42
Ohio Medical Mutual of Ohio - Basic Self & Family UX2 986.92 990.97 743.23 247.74 1.01
Ohio Medical Mutual of Ohio - Basic Self Plus One UX3 904.67 908.40 681.30 227.10 0.93
Oklahoma Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Oklahoma Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Oklahoma Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Oklahoma Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Oklahoma Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Oklahoma Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Oklahoma Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Oklahoma Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Oklahoma Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Oklahoma Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Oregon Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Oregon Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Oregon Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Oregon Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Oregon Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Oregon Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Oregon Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Oregon Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Oregon Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Oregon Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Oregon Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Oregon Kaiser Permanente - Northwest - Standard Self 574 688.35 668.89 501.67 167.22 -4.87
Oregon Kaiser Permanente - Northwest - Standard Self & Family 575 1581.34 1536.64 1152.48 384.16 -11.17
Oregon Kaiser Permanente - Northwest - Standard Self Plus One 576 1581.34 1536.64 1136.70 399.94 -60.24
Oregon Kaiser Permanente - Northwest - High Self 571 751.68 757.66 530.53 227.13 -1.13
Oregon Kaiser Permanente - Northwest - High Self & Family 572 1697.82 1711.34 1243.95 467.39 -12.22
Oregon Kaiser Permanente - Northwest - High Self Plus One 573 1697.82 1711.34 1136.70 574.64 -2.02
Oregon Kaiser Permanente - Northwest - Prosper Self AM1 391.78 391.78 293.84 97.94 0.00
Oregon Kaiser Permanente - Northwest - Prosper Self & Family AM2 926.47 971.66 728.75 242.91 11.29
Oregon Kaiser Permanente - Northwest - Prosper Self Plus One AM3 842.29 842.29 631.72 210.57 0.00
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 622.22 668.46 501.35 167.11 11.56
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1471.54 1580.91 1185.68 395.23 27.35
Oregon UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1337.77 1437.17 1077.88 359.29 24.85
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 528.17 672.10 504.08 168.02 35.98
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1214.76 1545.85 1159.39 386.46 82.77
Oregon UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1135.55 1445.04 1083.78 361.26 77.37
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 782.12 864.87 530.53 334.34 75.64
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1955.35 2162.16 1243.95 918.21 181.07
Oregon UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1681.57 1859.46 1136.70 722.76 162.35
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 621.21 657.65 493.24 164.41 9.11
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1469.13 1555.39 1166.54 388.85 21.57
Oregon UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1335.58 1413.97 1060.48 353.49 19.60
Palau Calvo's SelectCare - Standard Self B44 429.78 378.91 284.18 94.73 -12.71
Palau Calvo's SelectCare - Standard Self & Family B45 1248.72 1100.91 825.68 275.23 -36.95
Palau Calvo's SelectCare - Standard Self Plus One B46 847.21 746.92 560.19 186.73 -25.07
Palau Calvo's SelectCare - High Self B41 521.69 535.95 401.96 133.99 3.57
Palau Calvo's SelectCare - High Self & Family B42 1381.77 1419.54 1064.66 354.88 9.44
Palau Calvo's SelectCare - High Self Plus One B43 1018.07 1045.89 784.42 261.47 6.95
Palau TakeCare - HDHP Self KX1 120.53 122.31 91.73 30.58 0.45
Palau TakeCare - HDHP Self & Family KX2 323.16 327.97 245.98 81.99 1.20
Palau TakeCare - HDHP Self Plus One KX3 290.94 295.23 221.42 73.81 1.08
Palau TakeCare - Standard Self JK4 404.45 405.77 304.33 101.44 0.33
Palau TakeCare - Standard Self & Family JK5 1145.39 1149.18 861.89 287.29 0.94
Palau TakeCare - Standard Self Plus One JK6 797.14 799.78 599.84 199.94 0.66
Palau TakeCare - High Self JK1 497.81 515.86 386.90 128.96 4.51
Palau TakeCare - High Self & Family JK2 1187.38 1230.43 922.82 307.61 10.77
Palau TakeCare - High Self Plus One JK3 983.49 1019.16 764.37 254.79 8.92
Pennsylvania Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Pennsylvania Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Pennsylvania Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Pennsylvania Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Pennsylvania Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Pennsylvania Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Pennsylvania Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Pennsylvania Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Pennsylvania Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Pennsylvania Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Pennsylvania Aetna Open Access - High Self YE1 1206.55 1181.68 530.53 651.15 -31.98
Pennsylvania Aetna Open Access - High Self & Family YE2 3029.63 2967.19 1243.95 1723.24 -88.18
Pennsylvania Aetna Open Access - High Self Plus One YE3 2999.64 2937.83 1136.70 1801.13 -77.35
Pennsylvania Aetna Open Access - Basic Self P34 1505.53 1721.76 530.53 1191.23 209.12
Pennsylvania Aetna Open Access - Basic Self & Family P35 3494.34 3996.29 1243.95 2752.34 476.21
Pennsylvania Aetna Open Access - Basic Self Plus One P36 3459.73 3956.70 1136.70 2820.00 481.43
Pennsylvania Aetna Open Access - High Self P31 1588.23 1762.54 530.53 1232.01 167.20
Pennsylvania Aetna Open Access - High Self & Family P32 3850.71 4273.27 1243.95 3029.32 396.82
Pennsylvania Aetna Open Access - High Self Plus One P33 3812.58 4230.98 1136.70 3094.28 402.86
Pennsylvania Geisinger Health Plan - Standard Self GG4 912.69 992.53 530.53 462.00 72.73
Pennsylvania Geisinger Health Plan - Standard Self & Family GG5 2089.62 2272.42 1243.95 1028.47 157.06
Pennsylvania Geisinger Health Plan - Standard Self Plus One GG6 1972.08 2144.57 1136.70 1007.87 156.95
Pennsylvania Geisinger Health Plan - Basic Self AJ1 802.06 891.00 530.53 360.47 81.83
Pennsylvania Geisinger Health Plan - Basic Self & Family AJ2 1836.32 2039.96 1243.95 796.01 177.90
Pennsylvania Geisinger Health Plan - Basic Self Plus One AJ3 1732.99 1925.21 1136.70 788.51 176.68
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Pennsylvania UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 519.91 661.81 496.36 165.45 35.47
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1195.81 1514.20 1135.65 378.55 79.60
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1117.81 1422.92 1067.19 355.73 76.28
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 770.40 822.16 530.53 291.63 44.65
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1825.83 1948.55 1243.95 704.60 96.98
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1656.33 1767.68 1136.70 630.98 95.81
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Pennsylvania UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Pennsylvania UPMC Health Plan - HDHP Self 8W4 641.66 667.98 500.99 166.99 6.58
Pennsylvania UPMC Health Plan - HDHP Self & Family 8W5 1476.87 1539.20 1154.40 384.80 15.58
Pennsylvania UPMC Health Plan - HDHP Self Plus One 8W6 1420.71 1479.49 1109.62 369.87 14.69
Pennsylvania UPMC Health Plan - Standard Self UW4 682.22 723.21 530.53 192.68 22.13
Pennsylvania UPMC Health Plan - Standard Self & Family UW5 1601.25 1698.91 1243.95 454.96 54.65
Pennsylvania UPMC Health Plan - Standard Self Plus One UW6 1533.74 1626.19 1136.70 489.49 76.91
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self ZJ1 457.88 480.76 360.57 120.19 5.72
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self & Family ZJ2 1030.23 1081.73 811.30 270.43 12.87
Puerto Rico Humana Health Plans of Puerto Rico, Inc. - High Self Plus One ZJ3 984.45 1033.65 775.24 258.41 12.30
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self 891 390.04 390.04 292.53 97.51 0.00
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self & Family 892 893.21 893.21 669.91 223.30 0.00
Puerto Rico Triple-S Salud Inc. Puerto Rico - High Self Plus One 893 875.79 875.79 656.84 218.95 0.00
Rhode Island Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Rhode Island Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Rhode Island Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Rhode Island Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Rhode Island Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Rhode Island Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Rhode Island Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Rhode Island Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Rhode Island Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Rhode Island Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
South Carolina Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
South Carolina Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
South Carolina Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
South Carolina Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
South Carolina Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
South Carolina Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
South Carolina Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
South Carolina Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
South Carolina Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
South Carolina Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
South Dakota Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
South Dakota Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
South Dakota Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
South Dakota Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
South Dakota Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
South Dakota Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
South Dakota Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
South Dakota Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
South Dakota Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
South Dakota Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
South Dakota HealthPartners - Standard Self V34 509.41 553.28 414.96 138.32 10.97
South Dakota HealthPartners - Standard Self & Family V35 1240.94 1347.84 1010.88 336.96 26.73
South Dakota HealthPartners - Standard Self Plus One V36 1125.80 1222.78 917.09 305.69 24.24
South Dakota HealthPartners - High Self V31 668.07 692.14 519.11 173.03 6.01
South Dakota HealthPartners - High Self & Family V32 1627.38 1686.01 1243.95 442.06 32.89
South Dakota HealthPartners - High Self Plus One V33 1476.41 1529.58 1136.70 392.88 23.78
Tennessee Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Tennessee Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Tennessee Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Tennessee Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Tennessee Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Tennessee Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Tennessee Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Tennessee Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Tennessee Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Tennessee Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self TT1 790.01 849.29 530.53 318.76 52.17
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TT2 1777.58 1910.91 1243.95 666.96 107.59
Tennessee Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TT3 1698.58 1825.98 1136.70 689.28 111.86
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self TT4 723.93 742.02 530.53 211.49 10.98
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self & Family TT5 1628.79 1669.53 1243.95 425.58 15.00
Tennessee Humana CoverageFirst and Humana Value Plan - Value Self Plus One TT6 1556.43 1595.34 1136.70 458.64 23.37
Tennessee Humana HDHP - HDHP Self ER1 New Plan 397.78 298.34 99.44 New Plan
Tennessee Humana HDHP - HDHP Self & Family ER2 New Plan 990.51 742.88 247.63 New Plan
Tennessee Humana HDHP - HDHP Self Plus One ER3 New Plan 871.98 653.99 217.99 New Plan
Tennessee Humana Health Plan, Inc. - Standard Self GJ4 904.91 927.55 530.53 397.02 15.53
Tennessee Humana Health Plan, Inc. - Standard Self & Family GJ5 2036.08 2086.98 1243.95 843.03 25.16
Tennessee Humana Health Plan, Inc. - Standard Self Plus One GJ6 1945.60 1994.20 1136.70 857.50 33.06
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Tennessee UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 485.85 624.67 468.50 156.17 34.71
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1117.50 1436.76 1077.57 359.19 79.82
Tennessee UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1044.59 1343.07 1007.30 335.77 74.62
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 769.04 847.30 530.53 316.77 71.15
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 1922.64 2118.24 1243.95 874.29 169.86
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1653.47 1821.69 1136.70 684.99 152.68
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Tennessee UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Texas Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Texas Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Texas Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Texas Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Texas Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Texas Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Texas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Texas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Texas Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Texas Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Texas Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Texas Baylor Scott and White Health Plan - Basic Self A81 585.89 553.71 415.28 138.43 -8.04
Texas Baylor Scott and White Health Plan - Basic Self & Family A82 1374.53 1298.90 974.18 324.72 -18.91
Texas Baylor Scott and White Health Plan - Basic Self Plus One A83 1298.59 1227.14 920.36 306.78 -17.87
Texas Baylor Scott and White Health Plan - Standard Self A84 861.23 1012.68 530.53 482.15 144.34
Texas Baylor Scott and White Health Plan - Standard Self & Family A85 2021.78 2377.44 1243.95 1133.49 329.92
Texas Baylor Scott and White Health Plan - Standard Self Plus One A86 1910.05 2246.03 1136.70 1109.33 320.44
Texas Baylor Scott and White Health Plan - Basic Self P81 603.94 570.74 428.06 142.68 -8.30
Texas Baylor Scott and White Health Plan - Basic Self & Family P82 1416.96 1339.00 1004.25 334.75 -19.49
Texas Baylor Scott and White Health Plan - Basic Self Plus One P83 1338.68 1265.01 948.76 316.25 -18.42
Texas Baylor Scott and White Health Plan - Standard Self P84 966.68 1041.17 530.53 510.64 67.38
Texas Baylor Scott and White Health Plan - Standard Self & Family P85 2269.43 2444.46 1243.95 1200.51 149.29
Texas Baylor Scott and White Health Plan - Standard Self Plus One P86 2143.96 2309.30 1136.70 1172.60 149.80
Texas Humana CoverageFirst and Humana Value Plan - Value Self T34 565.11 593.36 445.02 148.34 7.06
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family T35 1271.53 1424.09 1068.07 356.02 38.14
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One T36 1215.02 1275.78 956.84 318.94 15.19
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self T31 811.87 872.76 530.53 342.23 53.78
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family T32 1826.67 1963.67 1243.95 719.72 111.26
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One T33 1745.51 1876.42 1136.70 739.72 115.37
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TV1 909.39 909.39 530.53 378.86 -7.11
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TV2 2046.16 2046.18 1243.95 802.23 -25.72
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TV3 1955.24 1955.24 1136.70 818.54 -15.54
Texas Humana CoverageFirst and Humana Value Plan - Value Self TV4 719.27 719.27 530.53 188.74 -7.11
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TV5 1618.39 1618.39 1213.79 404.60 0.00
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TV6 1546.48 1546.48 1136.70 409.78 -15.54
Texas Humana CoverageFirst and Humana Value Plan - Value Self TU4 600.62 615.64 461.73 153.91 3.76
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TU5 1351.42 1385.19 1038.89 346.30 8.45
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TU6 1291.38 1323.68 992.76 330.92 8.08
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TU1 729.73 773.52 530.53 242.99 36.68
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TU2 1641.92 1740.46 1243.95 496.51 72.80
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TU3 1568.93 1663.11 1136.70 526.41 78.64
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self TP1 772.14 772.14 530.53 241.61 -7.11
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TP2 1737.28 1737.28 1243.95 493.33 -25.74
Texas Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TP3 1660.08 1660.10 1136.70 523.40 -15.52
Texas Humana CoverageFirst and Humana Value Plan - Value Self TP4 452.47 486.40 364.80 121.60 8.48
Texas Humana CoverageFirst and Humana Value Plan - Value Self & Family TP5 1018.05 1167.36 875.52 291.84 37.33
Texas Humana CoverageFirst and Humana Value Plan - Value Self Plus One TP6 972.81 1045.76 784.32 261.44 18.24
Texas Humana HDHP - HDHP Self FD1 New Plan 397.78 298.34 99.44 New Plan
Texas Humana HDHP - HDHP Self & Family FD2 New Plan 990.51 742.88 247.63 New Plan
Texas Humana HDHP - HDHP Self Plus One FD3 New Plan 871.98 653.99 217.99 New Plan
Texas Humana HDHP - HDHP Self AN1 New Plan 458.62 343.97 114.65 New Plan
Texas Humana HDHP - HDHP Self & Family AN2 New Plan 1142.64 856.98 285.66 New Plan
Texas Humana HDHP - HDHP Self Plus One AN3 New Plan 1005.85 754.39 251.46 New Plan
Texas Humana HDHP - HDHP Self DX1 New Plan 404.56 303.42 101.14 New Plan
Texas Humana HDHP - HDHP Self & Family DX2 New Plan 1007.50 755.63 251.87 New Plan
Texas Humana HDHP - HDHP Self Plus One DX3 New Plan 886.93 665.20 221.73 New Plan
Texas Humana HDHP - HDHP Self CG1 New Plan 512.55 384.41 128.14 New Plan
Texas Humana HDHP - HDHP Self & Family CG2 New Plan 1277.45 958.09 319.36 New Plan
Texas Humana HDHP - HDHP Self Plus One CG3 New Plan 1124.46 843.35 281.11 New Plan
Texas Humana Health Plan of Texas - Standard Self UC4 898.65 898.65 530.53 368.12 -7.11
Texas Humana Health Plan of Texas - Standard Self & Family UC5 2021.96 2021.96 1243.95 778.01 -25.74
Texas Humana Health Plan of Texas - Standard Self Plus One UC6 1932.08 1932.08 1136.70 795.38 -15.54
Texas Humana Health Plan of Texas - Basic Self QX1 817.38 869.70 530.53 339.17 45.21
Texas Humana Health Plan of Texas - Basic Self & Family QX2 1839.09 1956.80 1243.95 712.85 91.97
Texas Humana Health Plan of Texas - Basic Self Plus One QX3 1757.36 1869.83 1136.70 733.13 96.93
Texas Humana Health Plan of Texas - Standard Self EW4 936.24 950.28 530.53 419.75 6.93
Texas Humana Health Plan of Texas - Standard Self & Family EW5 2106.50 2138.07 1243.95 894.12 5.83
Texas Humana Health Plan of Texas - Standard Self Plus One EW6 2012.88 2043.06 1136.70 906.36 14.64
Texas Humana Health Plan of Texas - Basic Self QY1 844.65 844.65 530.53 314.12 -7.11
Texas Humana Health Plan of Texas - Basic Self & Family QY2 1900.47 1900.49 1243.95 656.54 -25.72
Texas Humana Health Plan of Texas - Basic Self Plus One QY3 1816.04 1816.06 1136.70 679.36 -15.52
Texas Humana Health Plan of Texas - Basic Self Q21 786.37 825.70 530.53 295.17 32.22
Texas Humana Health Plan of Texas - Basic Self & Family Q22 1769.32 1857.81 1243.95 613.86 62.75
Texas Humana Health Plan of Texas - Basic Self Plus One Q23 1690.63 1775.17 1136.70 638.47 69.00
Texas Humana Health Plan of Texas - Basic Self Q61 699.16 716.65 530.53 186.12 10.38
Texas Humana Health Plan of Texas - Basic Self & Family Q62 1573.17 1612.48 1209.36 403.12 9.83
Texas Humana Health Plan of Texas - Basic Self Plus One Q63 1503.23 1540.83 1136.70 404.13 22.06
Texas Humana Health Plan of Texas - Standard Self UU4 1608.19 1608.19 530.53 1077.66 -7.11
Texas Humana Health Plan of Texas - Standard Self & Family UU5 3618.40 3618.36 1243.95 2374.41 -25.78
Texas Humana Health Plan of Texas - Standard Self Plus One UU6 3457.57 3457.55 1136.70 2320.85 -15.56
Texas Humana Health Plan of Texas - Standard Self UR4 1069.55 1069.55 530.53 539.02 -7.11
Texas Humana Health Plan of Texas - Standard Self & Family UR5 2406.45 2406.47 1243.95 1162.52 -25.72
Texas Humana Health Plan of Texas - Standard Self Plus One UR6 2299.48 2299.51 1136.70 1162.81 -15.51
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Texas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 554.62 663.76 497.82 165.94 27.29
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1555.15 1586.41 1189.81 396.60 7.81
Texas UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1083.18 1327.54 995.66 331.88 61.09
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Texas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Utah Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Utah Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Utah Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Utah Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Utah Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Utah Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Utah Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Utah Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Utah Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Utah Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Utah Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Utah Altius Health Plan - High Self 9K1 1048.36 1150.85 530.53 620.32 95.38
Utah Altius Health Plan - High Self & Family 9K2 2318.46 2545.10 1243.95 1301.15 200.90
Utah Altius Health Plan - High Self Plus One 9K3 2295.50 2519.92 1136.70 1383.22 208.88
Utah Altius Health Plan - HDHP Self 9K4 672.49 759.22 530.53 228.69 60.57
Utah Altius Health Plan - HDHP Self & Family 9K5 1405.43 1586.72 1190.04 396.68 45.32
Utah Altius Health Plan - HDHP Self Plus One 9K6 1377.85 1555.56 1136.70 418.86 74.40
Utah Altius Health Plan - Standard Self DK4 883.11 942.54 530.53 412.01 52.32
Utah Altius Health Plan - Standard Self & Family DK5 1950.20 2081.43 1243.95 837.48 105.49
Utah Altius Health Plan - Standard Self Plus One DK6 1930.87 2060.80 1136.70 924.10 114.39
Utah SelectHealth Plan - Standard Self SF4 628.62 643.09 482.32 160.77 3.62
Utah SelectHealth Plan - Standard Self & Family SF5 1571.55 1607.71 1205.78 401.93 9.04
Utah SelectHealth Plan - Standard Self Plus One SF6 1382.96 1414.77 1061.08 353.69 7.95
Utah SelectHealth Plan - HDHP Self WX1 539.48 572.37 429.28 143.09 8.22
Utah SelectHealth Plan - HDHP Self & Family WX2 1348.69 1430.93 1073.20 357.73 20.56
Utah SelectHealth Plan - HDHP Self Plus One WX3 1186.84 1259.20 944.40 314.80 18.09
Vermont Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Vermont Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Vermont Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Vermont Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Vermont Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Vermont Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 839.63 927.77 530.53 397.24 81.03
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 1922.68 2124.50 1243.95 880.55 176.08
Vermont Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 1884.96 2082.84 1136.70 946.14 182.34
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1124.65 1156.37 530.53 625.84 24.61
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2564.88 2637.12 1243.95 1393.17 46.50
Vermont Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2539.46 2611.01 1136.70 1474.31 56.01
Vermont Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Vermont Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Vermont Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self 851 679.03 679.03 509.27 169.76 0.00
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self & Family 852 1555.02 1555.02 1166.27 388.75 0.00
Virgin Islands Triple-S Salud Inc. U.S. Virgin Islands - High Self Plus One 853 1524.68 1524.68 1136.70 387.98 -15.54
Virginia Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Virginia Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Virginia Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Virginia Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Virginia Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Virginia Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
Virginia Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Virginia Aetna Open Access - High Self JN1 1176.57 1251.55 530.53 721.02 67.87
Virginia Aetna Open Access - High Self & Family JN2 2645.05 2813.68 1243.95 1569.73 142.89
Virginia Aetna Open Access - High Self Plus One JN3 2618.85 2785.79 1136.70 1649.09 151.40
Virginia Aetna Open Access - Basic Self JN4 714.42 739.46 530.53 208.93 17.93
Virginia Aetna Open Access - Basic Self & Family JN5 1634.92 1692.23 1243.95 448.28 31.57
Virginia Aetna Open Access - Basic Self Plus One JN6 1501.33 1553.93 1136.70 417.23 37.06
Virginia Aetna Saver (Open Access) - Saver Self QQ4 595.21 595.21 446.41 148.80 0.00
Virginia Aetna Saver (Open Access) - Saver Self & Family QQ5 1362.12 1362.12 1021.59 340.53 0.00
Virginia Aetna Saver (Open Access) - Saver Self Plus One QQ6 1250.82 1250.82 938.12 312.70 0.00
Virginia CareFirst BlueChoice - Standard Self 2G4 887.81 905.58 530.53 375.05 10.66
Virginia CareFirst BlueChoice - Standard Self & Family 2G5 2109.42 2151.59 1243.95 907.64 16.43
Virginia CareFirst BlueChoice - Standard Self Plus One 2G6 1775.61 1811.12 1136.70 674.42 19.97
Virginia CareFirst BlueChoice - HDHP Self B61 570.09 604.31 453.23 151.08 8.56
Virginia CareFirst BlueChoice - HDHP Self & Family B62 1354.51 1435.79 1076.84 358.95 20.32
Virginia CareFirst BlueChoice - HDHP Self Plus One B63 1140.17 1208.57 906.43 302.14 17.10
Virginia CareFirst BlueChoice - Blue Value Plus Self B64 723.67 723.67 530.53 193.14 -7.11
Virginia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1719.38 1719.38 1243.95 475.43 -25.74
Virginia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1447.29 1447.29 1085.47 361.82 0.00
Virginia Healthkeepers, Inc. HDHP - HDHP Self 9V1 New Plan 537.20 402.90 134.30 New Plan
Virginia Healthkeepers, Inc. HDHP - HDHP Self & Family 9V2 New Plan 1308.06 981.05 327.01 New Plan
Virginia Healthkeepers, Inc. HDHP - HDHP Self Plus One 9V3 New Plan 1222.09 916.57 305.52 New Plan
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 427.72 368.90 276.68 92.22 -14.71
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1099.52 1051.33 788.50 262.83 -12.05
Virginia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 951.84 866.91 650.18 216.73 -21.23
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 598.28 607.25 455.44 151.81 2.24
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1376.05 1396.63 1047.47 349.16 5.15
Virginia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1376.05 1396.63 1047.47 349.16 5.15
Virginia Kaiser Permanente - Mid-Atlantic States - High Self E31 746.24 756.60 530.53 226.07 3.25
Virginia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1716.35 1740.20 1243.95 496.25 -1.89
Virginia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1716.35 1740.20 1136.70 603.50 8.31
Virginia M.D. IPA - High Self JP1 950.89 1011.99 530.53 481.46 53.99
Virginia M.D. IPA - High Self & Family JP2 2666.28 2837.66 1243.95 1593.71 145.64
Virginia M.D. IPA - High Self Plus One JP3 1857.09 1976.43 1136.70 839.73 103.80
Virginia Optima Health - HDHP Self PG4 605.09 568.79 426.59 142.20 -9.07
Virginia Optima Health - HDHP Self & Family PG5 1334.78 1254.67 941.00 313.67 -20.02
Virginia Optima Health - HDHP Self Plus One PG6 1308.60 1230.10 922.58 307.52 -19.63
Virginia Optima Health - High Self PG1 719.55 719.55 530.53 189.02 -7.11
Virginia Optima Health - High Self & Family PG2 1738.69 1738.69 1243.95 494.74 -25.74
Virginia Optima Health - High Self Plus One PG3 1738.56 1738.56 1136.70 601.86 -15.54
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 599.47 650.91 488.18 162.73 12.86
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1417.76 1539.46 1154.60 384.86 30.42
Virginia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1288.89 1399.49 1049.62 349.87 27.65
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 519.91 661.81 496.36 165.45 35.47
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1195.81 1514.20 1135.65 378.55 79.60
Virginia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1117.81 1422.92 1067.19 355.73 76.28
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 770.40 822.16 530.53 291.63 44.65
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1825.83 1948.55 1243.95 704.60 96.98
Virginia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1656.33 1767.68 1136.70 630.98 95.81
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 554.62 663.76 497.82 165.94 27.29
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1555.15 1586.41 1189.81 396.60 7.81
Virginia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1083.18 1327.54 995.66 331.88 61.09
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 576.72 581.25 435.94 145.31 1.13
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1363.94 1374.69 1031.02 343.67 2.69
Virginia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1239.94 1249.71 937.28 312.43 2.45
Washington Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Washington Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Washington Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Washington Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Washington Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Washington Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 717.04 834.38 530.53 303.85 110.23
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1642.27 1911.07 1243.95 667.12 243.06
Washington Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1610.09 1873.63 1136.70 736.93 248.00
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1058.76 1135.10 530.53 604.57 69.23
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2415.08 2589.21 1243.95 1345.26 148.39
Washington Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2391.20 2563.60 1136.70 1426.90 156.86
Washington Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Washington Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Washington Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Washington Kaiser Permanente - Northwest - Standard Self 574 688.35 668.89 501.67 167.22 -4.87
Washington Kaiser Permanente - Northwest - Standard Self & Family 575 1581.34 1536.64 1152.48 384.16 -11.17
Washington Kaiser Permanente - Northwest - Standard Self Plus One 576 1581.34 1536.64 1136.70 399.94 -60.24
Washington Kaiser Permanente - Northwest - High Self 571 751.68 757.66 530.53 227.13 -1.13
Washington Kaiser Permanente - Northwest - High Self & Family 572 1697.82 1711.34 1243.95 467.39 -12.22
Washington Kaiser Permanente - Northwest - High Self Plus One 573 1697.82 1711.34 1136.70 574.64 -2.02
Washington Kaiser Permanente - Northwest - Prosper Self AM1 391.78 391.78 293.84 97.94 0.00
Washington Kaiser Permanente - Northwest - Prosper Self & Family AM2 926.47 971.66 728.75 242.91 11.29
Washington Kaiser Permanente - Northwest - Prosper Self Plus One AM3 842.29 842.29 631.72 210.57 0.00
Washington Kaiser Permanente - Washington Core - Standard Self 544 618.02 625.21 468.91 156.30 1.80
Washington Kaiser Permanente - Washington Core - Standard Self & Family 545 1421.44 1438.00 1078.50 359.50 4.14
Washington Kaiser Permanente - Washington Core - Standard Self Plus One 546 1421.44 1438.00 1078.50 359.50 4.14
Washington Kaiser Permanente - Washington Core - High Self 541 863.76 869.53 530.53 339.00 -1.34
Washington Kaiser Permanente - Washington Core - High Self & Family 542 1900.25 1912.93 1243.95 668.98 -13.06
Washington Kaiser Permanente - Washington Core - High Self Plus One 543 1900.25 1912.93 1136.70 776.23 -2.86
Washington Kaiser Permanente - Washington Core - Prosper Self PT4 390.00 390.00 292.50 97.50 0.00
Washington Kaiser Permanente - Washington Core - Prosper Self & Family PT5 1091.98 1091.98 818.99 272.99 0.00
Washington Kaiser Permanente - Washington Core - Prosper Self Plus One PT6 944.67 944.67 708.50 236.17 0.00
Washington Kaiser Permanente Washington Options Federal - Standard Self L11 743.17 758.05 530.53 227.52 7.77
Washington Kaiser Permanente Washington Options Federal - Standard Self & Family L12 1649.83 1682.83 1243.95 438.88 7.26
Washington Kaiser Permanente Washington Options Federal - Standard Self Plus One L13 1649.83 1682.83 1136.70 546.13 17.46
Washington Kaiser Permanente Washington Options Federal - HDHP Self L14 661.72 675.18 506.39 168.79 3.36
Washington Kaiser Permanente Washington Options Federal - HDHP Self & Family L15 1468.98 1498.84 1124.13 374.71 7.47
Washington Kaiser Permanente Washington Options Federal - HDHP Self Plus One L16 1468.98 1498.84 1124.13 374.71 7.47
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 622.22 668.46 501.35 167.11 11.56
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1471.54 1580.91 1185.68 395.23 27.35
Washington UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1337.77 1437.17 1077.88 359.29 24.85
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 528.17 672.10 504.08 168.02 35.98
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1214.76 1545.85 1159.39 386.46 82.77
Washington UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1135.55 1445.04 1083.78 361.26 77.37
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 782.12 864.87 530.53 334.34 75.64
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 1955.35 2162.16 1243.95 918.21 181.07
Washington UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1681.57 1859.46 1136.70 722.76 162.35
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 621.21 657.65 493.24 164.41 9.11
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1469.13 1555.39 1166.54 388.85 21.57
Washington UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1335.58 1413.97 1060.48 353.49 19.60
West Virginia Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
West Virginia Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
West Virginia Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
West Virginia Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
West Virginia Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
West Virginia Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 851.74 870.65 530.53 340.12 11.80
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 1942.03 1985.10 1243.95 741.15 17.33
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 1922.81 1965.45 1136.70 828.75 27.10
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 821.82 895.53 530.53 365.00 66.60
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 1881.88 2050.64 1243.95 806.69 143.02
West Virginia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 1844.96 2010.45 1136.70 873.75 149.95
West Virginia Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
West Virginia Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
West Virginia Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Wisconsin Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Wisconsin Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Wisconsin Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Wisconsin Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Wisconsin Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Wisconsin Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1094.58 1094.51 530.53 563.98 -7.18
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2498.80 2498.64 1243.95 1254.69 -25.90
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2474.07 2473.94 1136.70 1337.24 -15.67
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1009.93 1037.34 530.53 506.81 20.30
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2302.15 2364.66 1243.95 1120.71 36.77
Wisconsin Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2279.33 2341.24 1136.70 1204.54 46.37
Wisconsin Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Wisconsin Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Wisconsin Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Wisconsin Dean Health Plan, Inc. - High Self WD1 1260.87 1284.57 530.53 754.04 16.59
Wisconsin Dean Health Plan, Inc. - High Self & Family WD2 2900.04 2954.53 1243.95 1710.58 28.75
Wisconsin Dean Health Plan, Inc. - High Self Plus One WD3 2647.86 2697.61 1136.70 1560.91 34.21
Wisconsin Dean Health Plan, Inc. - Standard Self WD4 685.12 712.42 530.53 181.89 10.61
Wisconsin Dean Health Plan, Inc. - Standard Self & Family WD5 1644.26 1709.80 1243.95 465.85 39.80
Wisconsin Dean Health Plan, Inc. - Standard Self Plus One WD6 1507.26 1567.32 1136.70 430.62 44.52
Wisconsin Dean Health Plan, Inc. - Basic Self AG1 455.07 455.07 341.30 113.77 0.00
Wisconsin Dean Health Plan, Inc. - Basic Self & Family AG2 1023.90 1023.90 767.93 255.97 0.00
Wisconsin Dean Health Plan, Inc. - Basic Self Plus One AG3 955.63 955.63 716.72 238.91 0.00
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self WJ1 889.03 1089.03 530.53 558.50 192.89
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self & Family WJ2 2311.51 2831.62 1243.95 1587.67 494.37
Wisconsin Group Health Cooperative of South Central Wisconsin - High Self Plus One WJ3 1955.89 2395.94 1136.70 1259.24 424.51
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self WJ4 618.84 587.45 440.59 146.86 -7.85
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self & Family WJ5 1609.01 1527.44 1145.58 381.86 -20.39
Wisconsin Group Health Cooperative of South Central Wisconsin - Standard Self Plus One WJ6 1361.47 1292.44 969.33 323.11 -17.26
Wisconsin HealthPartners - Standard Self V34 509.41 553.28 414.96 138.32 10.97
Wisconsin HealthPartners - Standard Self & Family V35 1240.94 1347.84 1010.88 336.96 26.73
Wisconsin HealthPartners - Standard Self Plus One V36 1125.80 1222.78 917.09 305.69 24.24
Wisconsin HealthPartners - High Self V31 668.07 692.14 519.11 173.03 6.01
Wisconsin HealthPartners - High Self & Family V32 1627.38 1686.01 1243.95 442.06 32.89
Wisconsin HealthPartners - High Self Plus One V33 1476.41 1529.58 1136.70 392.88 23.78
Wyoming Aetna Advantage - Advantage Self Z24 500.02 500.02 375.02 125.00 0.00
Wyoming Aetna Advantage - Advantage Self & Family Z25 1325.00 1325.00 993.75 331.25 0.00
Wyoming Aetna Advantage - Advantage Self Plus One Z26 1100.02 1100.02 825.02 275.00 0.00
Wyoming Aetna Direct - CDHP Self N61 615.83 628.27 471.20 157.07 3.11
Wyoming Aetna Direct - CDHP Self & Family N62 1553.07 1584.48 1188.36 396.12 7.85
Wyoming Aetna Direct - CDHP Self Plus One N63 1350.55 1377.87 1033.40 344.47 6.83
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 826.84 826.19 530.53 295.66 -7.76
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1884.74 1883.22 1243.95 639.27 -27.26
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1866.43 1864.96 1136.70 728.26 -17.01
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 817.48 833.73 530.53 303.20 9.14
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1876.16 1913.45 1243.95 669.50 11.55
Wyoming Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1839.39 1875.94 1136.70 739.24 21.01
Wyoming Aetna HealthFund HDHP - HDHP Self 224 786.02 824.31 530.53 293.78 31.18
Wyoming Aetna HealthFund HDHP - HDHP Self & Family 225 1733.83 1818.25 1243.95 574.30 58.68
Wyoming Aetna HealthFund HDHP - HDHP Self Plus One 226 1699.88 1782.63 1136.70 645.93 67.21
Wyoming Altius Health Plan - High Self 9K1 1048.36 1150.85 530.53 620.32 95.38
Wyoming Altius Health Plan - High Self & Family 9K2 2318.46 2545.10 1243.95 1301.15 200.90
Wyoming Altius Health Plan - High Self Plus One 9K3 2295.50 2519.92 1136.70 1383.22 208.88
Wyoming Altius Health Plan - HDHP Self 9K4 672.49 759.22 530.53 228.69 60.57
Wyoming Altius Health Plan - HDHP Self & Family 9K5 1405.43 1586.72 1190.04 396.68 45.32
Wyoming Altius Health Plan - HDHP Self Plus One 9K6 1377.85 1555.56 1136.70 418.86 74.40
Wyoming Altius Health Plan - Standard Self DK4 883.11 942.54 530.53 412.01 52.32
Wyoming Altius Health Plan - Standard Self & Family DK5 1950.20 2081.43 1243.95 837.48 105.49
Wyoming Altius Health Plan - Standard Self Plus One DK6 1930.87 2060.80 1136.70 924.10 114.39
Control Panel