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Healthcare Plan Information

Temporary Continuation of Coverage (TCC) Premium Rates and Former Spouse Premiums

HMO (Regional Plans with Specific Service Areas)

Plan - Option Enrollment Code 2022 TCC Premium 2023 TCC Monthly Premiums - Total Premium 2023 TCC Monthly Premiums - Government Pays 2023 TCC Monthly Premiums - Employee Pays 2023 TCC Monthly Premiums - Change in Employee Payment 2022 Former Spouse Premium 2023 Former Spouse Monthly Premiums - Total Premium 2023 Former Spouse Monthly Premiums - Government Pays 2023 Former Spouse Monthly Premiums - Employee Pays 2023 Former Spouse Monthly Premiums - Change in Employee Payment
Alabama Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Alabama Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Alabama Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Alabama Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Alabama Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Alabama Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 888.06 997.77 0.00 997.77 109.71 870.65 978.21 0.00 978.21 107.56
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 2024.80 2275.04 0.00 2275.04 250.24 1985.10 2230.43 0.00 2230.43 245.33
Alabama Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 2004.76 2252.50 0.00 2252.50 247.74 1965.45 2208.33 0.00 2208.33 242.88
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 913.44 1028.45 0.00 1028.45 115.01 895.53 1008.28 0.00 1008.28 112.75
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2091.65 2355.07 0.00 2355.07 263.42 2050.64 2308.89 0.00 2308.89 258.25
Alabama Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2050.66 2308.85 0.00 2308.85 258.19 2010.45 2263.58 0.00 2263.58 253.13
Alabama Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Alabama Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Alabama Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Alabama UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 637.16 672.02 0.00 672.02 34.86 624.67 658.84 0.00 658.84 34.17
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1465.50 1537.32 0.00 1537.32 71.82 1436.76 1507.18 0.00 1507.18 70.42
Alabama UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1369.93 1444.85 0.00 1444.85 74.92 1343.07 1416.52 0.00 1416.52 73.45
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 864.25 959.80 0.00 959.80 95.55 847.30 940.98 0.00 940.98 93.68
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2160.60 2399.57 0.00 2399.57 238.97 2118.24 2352.52 0.00 2352.52 234.28
Alabama UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1858.12 2063.63 0.00 2063.63 205.51 1821.69 2023.17 0.00 2023.17 201.48
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Alabama UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Alaska Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Alaska Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Alaska Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Alaska Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Alaska Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Alaska Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1116.40 1129.11 0.00 1129.11 12.71 1094.51 1106.97 0.00 1106.97 12.46
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2548.61 2577.59 0.00 2577.59 28.98 2498.64 2527.05 0.00 2527.05 28.41
Alaska Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2523.42 2552.11 0.00 2552.11 28.69 2473.94 2502.07 0.00 2502.07 28.13
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1058.09 1189.73 0.00 1189.73 131.64 1037.34 1166.40 0.00 1166.40 129.06
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2411.95 2712.07 0.00 2712.07 300.12 2364.66 2658.89 0.00 2658.89 294.23
Alaska Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2388.06 2685.19 0.00 2685.19 297.13 2341.24 2632.54 0.00 2632.54 291.30
Alaska Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Alaska Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Alaska Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Arizona Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Arizona Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Arizona Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Arizona Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Arizona Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Arizona Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 851.07 891.54 0.00 891.54 40.47 834.38 874.06 0.00 874.06 39.68
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1949.29 2041.98 0.00 2041.98 92.69 1911.07 2001.94 0.00 2001.94 90.87
Arizona Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1911.10 2001.95 0.00 2001.95 90.85 1873.63 1962.70 0.00 1962.70 89.07
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1157.80 1175.46 0.00 1175.46 17.66 1135.10 1152.41 0.00 1152.41 17.31
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2640.99 2681.21 0.00 2681.21 40.22 2589.21 2628.64 0.00 2628.64 39.43
Arizona Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2614.87 2654.69 0.00 2654.69 39.82 2563.60 2602.64 0.00 2602.64 39.04
Arizona Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Arizona Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Arizona Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Arizona Aetna Open Access - High Self WQ1 1467.44 1474.74 0.00 1474.74 7.30 1438.67 1445.82 0.00 1445.82 7.15
Arizona Aetna Open Access - High Self & Family WQ2 3562.92 3580.60 0.00 3580.60 17.68 3493.06 3510.39 0.00 3510.39 17.33
Arizona Aetna Open Access - High Self Plus One WQ3 3527.60 3545.15 0.00 3545.15 17.55 3458.43 3475.64 0.00 3475.64 17.21
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R61 890.61 912.27 0.00 912.27 21.66 873.15 894.38 0.00 894.38 21.23
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R62 2003.85 2052.56 0.00 2052.56 48.71 1964.56 2012.31 0.00 2012.31 47.75
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R63 1914.78 1961.33 0.00 1961.33 46.55 1877.24 1922.87 0.00 1922.87 45.63
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R64 678.76 698.58 0.00 698.58 19.82 665.45 684.88 0.00 684.88 19.43
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R65 1527.17 1571.71 0.00 1571.71 44.54 1497.23 1540.89 0.00 1540.89 43.66
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R66 1459.33 1501.92 0.00 1501.92 42.59 1430.72 1472.47 0.00 1472.47 41.75
Arizona Humana CoverageFirst and Humana Value Plan - Value Self R94 596.92 620.79 0.00 620.79 23.87 585.22 608.62 0.00 608.62 23.40
Arizona Humana CoverageFirst and Humana Value Plan - Value Self & Family R95 1343.06 1396.79 0.00 1396.79 53.73 1316.73 1369.40 0.00 1369.40 52.67
Arizona Humana CoverageFirst and Humana Value Plan - Value Self Plus One R96 1283.42 1334.75 0.00 1334.75 51.33 1258.25 1308.58 0.00 1308.58 50.33
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self R91 778.98 817.92 0.00 817.92 38.94 763.71 801.88 0.00 801.88 38.17
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self & Family R92 1752.65 1840.29 0.00 1840.29 87.64 1718.28 1804.21 0.00 1804.21 85.93
Arizona Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One R93 1674.74 1758.45 0.00 1758.45 83.71 1641.90 1723.97 0.00 1723.97 82.07
Arizona Humana HDHP - HDHP Self BV1 462.22 476.11 0.00 476.11 13.89 453.16 466.77 0.00 466.77 13.61
Arizona Humana HDHP - HDHP Self & Family BV2 1151.59 1186.13 0.00 1186.13 34.54 1129.01 1162.87 0.00 1162.87 33.86
Arizona Humana HDHP - HDHP Self Plus One BV3 1013.73 1044.13 0.00 1044.13 30.40 993.85 1023.66 0.00 1023.66 29.81
Arizona Humana HDHP - HDHP Self BY1 405.74 417.91 0.00 417.91 12.17 397.78 409.72 0.00 409.72 11.94
Arizona Humana HDHP - HDHP Self & Family BY2 1010.32 1040.64 0.00 1040.64 30.32 990.51 1020.24 0.00 1020.24 29.73
Arizona Humana HDHP - HDHP Self Plus One BY3 889.42 916.09 0.00 916.09 26.67 871.98 898.13 0.00 898.13 26.15
Arizona Humana Health Plan, Inc. - Standard Self C74 934.52 1016.51 0.00 1016.51 81.99 916.20 996.58 0.00 996.58 80.38
Arizona Humana Health Plan, Inc. - Standard Self & Family C75 2102.68 2287.13 0.00 2287.13 184.45 2061.45 2242.28 0.00 2242.28 180.83
Arizona Humana Health Plan, Inc. - Standard Self Plus One C76 2009.23 2185.45 0.00 2185.45 176.22 1969.83 2142.60 0.00 2142.60 172.77
Arizona Humana Health Plan, Inc. - Standard Self BF4 1271.52 1309.67 0.00 1309.67 38.15 1246.59 1283.99 0.00 1283.99 37.40
Arizona Humana Health Plan, Inc. - Standard Self & Family BF5 2860.96 2946.77 0.00 2946.77 85.81 2804.86 2888.99 0.00 2888.99 84.13
Arizona Humana Health Plan, Inc. - Standard Self Plus One BF6 2733.81 2815.85 0.00 2815.85 82.04 2680.21 2760.64 0.00 2760.64 80.43
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self WF1 681.83 723.90 0.00 723.90 42.07 668.46 709.71 0.00 709.71 41.25
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family WF2 1612.53 1712.04 0.00 1712.04 99.51 1580.91 1678.47 0.00 1678.47 97.56
Arizona UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One WF3 1465.91 1556.40 0.00 1556.40 90.49 1437.17 1525.88 0.00 1525.88 88.71
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 685.54 722.80 0.00 722.80 37.26 672.10 708.63 0.00 708.63 36.53
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1576.77 1662.37 0.00 1662.37 85.60 1545.85 1629.77 0.00 1629.77 83.92
Arizona UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1473.94 1553.98 0.00 1553.98 80.04 1445.04 1523.51 0.00 1523.51 78.47
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 882.17 982.72 0.00 982.72 100.55 864.87 963.45 0.00 963.45 98.58
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2205.40 2456.79 0.00 2456.79 251.39 2162.16 2408.62 0.00 2408.62 246.46
Arizona UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1896.65 2112.83 0.00 2112.83 216.18 1859.46 2071.40 0.00 2071.40 211.94
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self VD1 670.80 647.03 0.00 647.03 -23.77 657.65 634.34 0.00 634.34 -23.31
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family VD2 1586.50 1530.18 0.00 1530.18 -56.32 1555.39 1500.18 0.00 1500.18 -55.21
Arizona UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One VD3 1442.25 1391.09 0.00 1391.09 -51.16 1413.97 1363.81 0.00 1363.81 -50.16
Arkansas Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Arkansas Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Arkansas Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Arkansas Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Arkansas Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Arkansas Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 888.06 997.77 0.00 997.77 109.71 870.65 978.21 0.00 978.21 107.56
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 2024.80 2275.04 0.00 2275.04 250.24 1985.10 2230.43 0.00 2230.43 245.33
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 2004.76 2252.50 0.00 2252.50 247.74 1965.45 2208.33 0.00 2208.33 242.88
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 913.44 1028.45 0.00 1028.45 115.01 895.53 1008.28 0.00 1008.28 112.75
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2091.65 2355.07 0.00 2355.07 263.42 2050.64 2308.89 0.00 2308.89 258.25
Arkansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2050.66 2308.85 0.00 2308.85 258.19 2010.45 2263.58 0.00 2263.58 253.13
Arkansas Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Arkansas Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Arkansas Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Arkansas QualChoice - High Self DH1 743.43 810.36 0.00 810.36 66.93 728.85 794.47 0.00 794.47 65.62
Arkansas QualChoice - High Self & Family DH2 1939.12 2113.76 0.00 2113.76 174.64 1901.10 2072.31 0.00 2072.31 171.21
Arkansas QualChoice - High Self Plus One DH3 1444.15 1574.23 0.00 1574.23 130.08 1415.83 1543.36 0.00 1543.36 127.53
Arkansas QualChoice - Standard Self DH4 580.35 632.57 0.00 632.57 52.22 568.97 620.17 0.00 620.17 51.20
Arkansas QualChoice - Standard Self & Family DH5 1513.76 1650.01 0.00 1650.01 136.25 1484.08 1617.66 0.00 1617.66 133.58
Arkansas QualChoice - Standard Self Plus One DH6 1127.39 1228.88 0.00 1228.88 101.49 1105.28 1204.78 0.00 1204.78 99.50
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Arkansas UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 637.16 672.02 0.00 672.02 34.86 624.67 658.84 0.00 658.84 34.17
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1465.50 1537.32 0.00 1537.32 71.82 1436.76 1507.18 0.00 1507.18 70.42
Arkansas UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1369.93 1444.85 0.00 1444.85 74.92 1343.07 1416.52 0.00 1416.52 73.45
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 864.25 959.80 0.00 959.80 95.55 847.30 940.98 0.00 940.98 93.68
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2160.60 2399.57 0.00 2399.57 238.97 2118.24 2352.52 0.00 2352.52 234.28
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1858.12 2063.63 0.00 2063.63 205.51 1821.69 2023.17 0.00 2023.17 201.48
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Arkansas UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
California Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
California Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
California Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
California Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
California Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
California Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1116.40 1129.11 0.00 1129.11 12.71 1094.51 1106.97 0.00 1106.97 12.46
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2548.61 2577.59 0.00 2577.59 28.98 2498.64 2527.05 0.00 2527.05 28.41
California Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2523.42 2552.11 0.00 2552.11 28.69 2473.94 2502.07 0.00 2502.07 28.13
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1058.09 1189.73 0.00 1189.73 131.64 1037.34 1166.40 0.00 1166.40 129.06
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2411.95 2712.07 0.00 2712.07 300.12 2364.66 2658.89 0.00 2658.89 294.23
California Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2388.06 2685.19 0.00 2685.19 297.13 2341.24 2632.54 0.00 2632.54 291.30
California Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
California Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
California Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
California Aetna Open Access - High Self 2X1 1060.12 1120.38 0.00 1120.38 60.26 1039.33 1098.41 0.00 1098.41 59.08
California Aetna Open Access - High Self & Family 2X2 2488.84 2630.29 0.00 2630.29 141.45 2440.04 2578.72 0.00 2578.72 138.68
California Aetna Open Access - High Self Plus One 2X3 2440.06 2578.74 0.00 2578.74 138.68 2392.22 2528.18 0.00 2528.18 135.96
California Anthem Blue Cross Select HMO - High Self B31 792.77 776.92 0.00 776.92 -15.85 777.23 761.69 0.00 761.69 -15.54
California Anthem Blue Cross Select HMO - High Self & Family B32 1818.72 1800.56 0.00 1800.56 -18.16 1783.06 1765.25 0.00 1765.25 -17.81
California Anthem Blue Cross Select HMO - High Self Plus One B33 1679.00 1648.77 0.00 1648.77 -30.23 1646.08 1616.44 0.00 1616.44 -29.64
California Blue Shield of California - Access + HMO Self SI1 902.30 974.50 0.00 974.50 72.20 884.61 955.39 0.00 955.39 70.78
California Blue Shield of California - Access + HMO Self & Family SI2 2075.34 2241.38 0.00 2241.38 166.04 2034.65 2197.43 0.00 2197.43 162.78
California Blue Shield of California - Access + HMO Self Plus One SI3 1985.11 2143.92 0.00 2143.92 158.81 1946.19 2101.88 0.00 2101.88 155.69
California Health Net of California - Basic Self P61 413.80 413.87 0.00 413.87 0.07 405.69 405.75 0.00 405.75 0.06
California Health Net of California - Basic Self & Family P62 993.21 993.33 0.00 993.33 0.12 973.74 973.85 0.00 973.85 0.11
California Health Net of California - Basic Self Plus One P63 910.41 910.54 0.00 910.54 0.13 892.56 892.69 0.00 892.69 0.13
California Health Net of California - Standard Self P64 New Plan 747.47 0.00 747.47 New Plan New Plan 732.81 0.00 732.81 New Plan
California Health Net of California - Standard Self & Family P65 New Plan 1793.90 0.00 1793.90 New Plan New Plan 1758.73 0.00 1758.73 New Plan
California Health Net of California - Standard Self Plus One P66 New Plan 1644.41 0.00 1644.41 New Plan New Plan 1612.17 0.00 1612.17 New Plan
California Health Net of California - High Self LP1 1098.88 1108.16 0.00 1108.16 9.28 1077.33 1086.43 0.00 1086.43 9.10
California Health Net of California - High Self & Family LP2 2637.37 2659.58 0.00 2659.58 22.21 2585.66 2607.43 0.00 2607.43 21.77
California Health Net of California - High Self Plus One LP3 2417.58 2437.94 0.00 2437.94 20.36 2370.18 2390.14 0.00 2390.14 19.96
California Health Net of California - High Self LB1 1651.07 1722.63 0.00 1722.63 71.56 1618.70 1688.85 0.00 1688.85 70.15
California Health Net of California - High Self & Family LB2 3962.56 4134.29 0.00 4134.29 171.73 3884.86 4053.23 0.00 4053.23 168.37
California Health Net of California - High Self Plus One LB3 3632.35 3789.75 0.00 3789.75 157.40 3561.13 3715.44 0.00 3715.44 154.31
California Health Net of California - Basic Self T41 972.22 965.53 0.00 965.53 -6.69 953.16 946.60 0.00 946.60 -6.56
California Health Net of California - Basic Self & Family T42 2333.36 2317.28 0.00 2317.28 -16.08 2287.61 2271.84 0.00 2271.84 -15.77
California Health Net of California - Basic Self Plus One T43 2138.88 2124.16 0.00 2124.16 -14.72 2096.94 2082.51 0.00 2082.51 -14.43
California Kaiser Permanente - Fresno California - Standard Self NZ4 601.91 599.86 0.00 599.86 -2.05 590.11 588.10 0.00 588.10 -2.01
California Kaiser Permanente - Fresno California - Standard Self & Family NZ5 1391.15 1386.40 0.00 1386.40 -4.75 1363.87 1359.22 0.00 1359.22 -4.65
California Kaiser Permanente - Fresno California - Standard Self Plus One NZ6 1391.15 1386.40 0.00 1386.40 -4.75 1363.87 1359.22 0.00 1359.22 -4.65
California Kaiser Permanente - Fresno California - High Self NZ1 829.72 835.11 0.00 835.11 5.39 813.45 818.74 0.00 818.74 5.29
California Kaiser Permanente - Fresno California - High Self & Family NZ2 1917.66 1930.11 0.00 1930.11 12.45 1880.06 1892.26 0.00 1892.26 12.20
California Kaiser Permanente - Fresno California - High Self Plus One NZ3 1917.66 1930.11 0.00 1930.11 12.45 1880.06 1892.26 0.00 1892.26 12.20
California Kaiser Permanente - Northern California - Prosper Self KC1 671.73 663.31 0.00 663.31 -8.42 658.56 650.30 0.00 650.30 -8.26
California Kaiser Permanente - Northern California - Prosper Self & Family KC2 1571.84 1552.10 0.00 1552.10 -19.74 1541.02 1521.67 0.00 1521.67 -19.35
California Kaiser Permanente - Northern California - Prosper Self Plus One KC3 1571.84 1552.10 0.00 1552.10 -19.74 1541.02 1521.67 0.00 1521.67 -19.35
California Kaiser Permanente - Northern California - High Self 591 1022.35 1012.67 0.00 1012.67 -9.68 1002.30 992.81 0.00 992.81 -9.49
California Kaiser Permanente - Northern California - High Self & Family 592 2440.44 2417.34 0.00 2417.34 -23.10 2392.59 2369.94 0.00 2369.94 -22.65
California Kaiser Permanente - Northern California - High Self Plus One 593 2440.44 2417.34 0.00 2417.34 -23.10 2392.59 2369.94 0.00 2369.94 -22.65
California Kaiser Permanente - Northern California - Standard Self 594 831.18 822.27 0.00 822.27 -8.91 814.88 806.15 0.00 806.15 -8.73
California Kaiser Permanente - Northern California - Standard Self & Family 595 1944.94 1924.16 0.00 1924.16 -20.78 1906.80 1886.43 0.00 1886.43 -20.37
California Kaiser Permanente - Northern California - Standard Self Plus One 596 1944.94 1924.16 0.00 1924.16 -20.78 1906.80 1886.43 0.00 1886.43 -20.37
California Kaiser Permanente - Southern California - Prosper Self FL1 372.94 372.65 0.00 372.65 -0.29 365.63 365.34 0.00 365.34 -0.29
California Kaiser Permanente - Southern California - Prosper Self & Family FL2 1044.23 1043.41 0.00 1043.41 -0.82 1023.75 1022.95 0.00 1022.95 -0.80
California Kaiser Permanente - Southern California - Prosper Self Plus One FL3 857.79 857.11 0.00 857.11 -0.68 840.97 840.30 0.00 840.30 -0.67
California Kaiser Permanente - Southern California - Standard Self 624 498.12 538.58 0.00 538.58 40.46 488.35 528.02 0.00 528.02 39.67
California Kaiser Permanente - Southern California - Standard Self & Family 625 1151.19 1244.74 0.00 1244.74 93.55 1128.62 1220.33 0.00 1220.33 91.71
California Kaiser Permanente - Southern California - Standard Self Plus One 626 1151.19 1244.74 0.00 1244.74 93.55 1128.62 1220.33 0.00 1220.33 91.71
California Kaiser Permanente - Southern California - High Self 621 775.84 794.82 0.00 794.82 18.98 760.63 779.24 0.00 779.24 18.61
California Kaiser Permanente - Southern California - High Self & Family 622 1793.13 1837.00 0.00 1837.00 43.87 1757.97 1800.98 0.00 1800.98 43.01
California Kaiser Permanente - Southern California - High Self Plus One 623 1793.13 1837.00 0.00 1837.00 43.87 1757.97 1800.98 0.00 1800.98 43.01
Colorado Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Colorado Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Colorado Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Colorado Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Colorado Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Colorado Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 851.07 891.54 0.00 891.54 40.47 834.38 874.06 0.00 874.06 39.68
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1949.29 2041.98 0.00 2041.98 92.69 1911.07 2001.94 0.00 2001.94 90.87
Colorado Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1911.10 2001.95 0.00 2001.95 90.85 1873.63 1962.70 0.00 1962.70 89.07
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1157.80 1175.46 0.00 1175.46 17.66 1135.10 1152.41 0.00 1152.41 17.31
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2640.99 2681.21 0.00 2681.21 40.22 2589.21 2628.64 0.00 2628.64 39.43
Colorado Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2614.87 2654.69 0.00 2654.69 39.82 2563.60 2602.64 0.00 2602.64 39.04
Colorado Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Colorado Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Colorado Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Colorado Humana Health Plan, Inc. - High Self NR1 990.22 1024.89 0.00 1024.89 34.67 970.80 1004.79 0.00 1004.79 33.99
Colorado Humana Health Plan, Inc. - High Self & Family NR2 2227.97 2305.99 0.00 2305.99 78.02 2184.28 2260.77 0.00 2260.77 76.49
Colorado Humana Health Plan, Inc. - High Self Plus One NR3 2128.96 2203.51 0.00 2203.51 74.55 2087.22 2160.30 0.00 2160.30 73.08
Colorado Humana Health Plan, Inc. - Standard Self NR4 679.40 765.10 0.00 765.10 85.70 666.08 750.10 0.00 750.10 84.02
Colorado Humana Health Plan, Inc. - Standard Self & Family NR5 1528.70 1721.48 0.00 1721.48 192.78 1498.73 1687.73 0.00 1687.73 189.00
Colorado Humana Health Plan, Inc. - Standard Self Plus One NR6 1460.72 1644.94 0.00 1644.94 184.22 1432.08 1612.69 0.00 1612.69 180.61
Colorado Humana Health Plan, Inc. - Basic Self RZ1 529.32 593.50 0.00 593.50 64.18 518.94 581.86 0.00 581.86 62.92
Colorado Humana Health Plan, Inc. - Basic Self & Family RZ2 1190.92 1335.28 0.00 1335.28 144.36 1167.57 1309.10 0.00 1309.10 141.53
Colorado Humana Health Plan, Inc. - Basic Self Plus One RZ3 1138.04 1275.99 0.00 1275.99 137.95 1115.73 1250.97 0.00 1250.97 135.24
Colorado Humana Health Plan, Inc. - High Self NT1 892.80 929.22 0.00 929.22 36.42 875.29 911.00 0.00 911.00 35.71
Colorado Humana Health Plan, Inc. - High Self & Family NT2 2008.83 2090.80 0.00 2090.80 81.97 1969.44 2049.80 0.00 2049.80 80.36
Colorado Humana Health Plan, Inc. - High Self Plus One NT3 1919.52 1997.84 0.00 1997.84 78.32 1881.88 1958.67 0.00 1958.67 76.79
Colorado Humana Health Plan, Inc. - Standard Self NT4 602.08 652.92 0.00 652.92 50.84 590.27 640.12 0.00 640.12 49.85
Colorado Humana Health Plan, Inc. - Standard Self & Family NT5 1354.68 1469.15 0.00 1469.15 114.47 1328.12 1440.34 0.00 1440.34 112.22
Colorado Humana Health Plan, Inc. - Standard Self Plus One NT6 1294.51 1403.88 0.00 1403.88 109.37 1269.13 1376.35 0.00 1376.35 107.22
Colorado Humana Health Plan, Inc. - Basic Self R21 618.01 695.93 0.00 695.93 77.92 605.89 682.28 0.00 682.28 76.39
Colorado Humana Health Plan, Inc. - Basic Self & Family R22 1390.48 1565.85 0.00 1565.85 175.37 1363.22 1535.15 0.00 1535.15 171.93
Colorado Humana Health Plan, Inc. - Basic Self Plus One R23 1328.67 1496.24 0.00 1496.24 167.57 1302.62 1466.90 0.00 1466.90 164.28
Colorado Kaiser Permanente - Colorado - Standard Self 654 672.35 687.15 0.00 687.15 14.80 659.17 673.68 0.00 673.68 14.51
Colorado Kaiser Permanente - Colorado - Standard Self & Family 655 1519.50 1552.95 0.00 1552.95 33.45 1489.71 1522.50 0.00 1522.50 32.79
Colorado Kaiser Permanente - Colorado - Standard Self Plus One 656 1519.50 1552.95 0.00 1552.95 33.45 1489.71 1522.50 0.00 1522.50 32.79
Colorado Kaiser Permanente - Colorado - High Self 651 788.35 802.12 0.00 802.12 13.77 772.89 786.39 0.00 786.39 13.50
Colorado Kaiser Permanente - Colorado - High Self & Family 652 1781.69 1812.82 0.00 1812.82 31.13 1746.75 1777.27 0.00 1777.27 30.52
Colorado Kaiser Permanente - Colorado - High Self Plus One 653 1781.69 1812.82 0.00 1812.82 31.13 1746.75 1777.27 0.00 1777.27 30.52
Colorado Kaiser Permanente - Colorado - Prosper Self N41 397.95 427.10 0.00 427.10 29.15 390.15 418.73 0.00 418.73 28.58
Colorado Kaiser Permanente - Colorado - Prosper Self & Family N42 978.97 1050.74 0.00 1050.74 71.77 959.77 1030.14 0.00 1030.14 70.37
Colorado Kaiser Permanente - Colorado - Prosper Self Plus One N43 899.36 965.31 0.00 965.31 65.95 881.73 946.38 0.00 946.38 64.65
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LU1 685.54 722.80 0.00 722.80 37.26 672.10 708.63 0.00 708.63 36.53
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LU2 1576.77 1662.37 0.00 1662.37 85.60 1545.85 1629.77 0.00 1629.77 83.92
Colorado UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LU3 1473.94 1553.98 0.00 1553.98 80.04 1445.04 1523.51 0.00 1523.51 78.47
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KT1 882.17 982.72 0.00 982.72 100.55 864.87 963.45 0.00 963.45 98.58
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KT2 2205.40 2456.79 0.00 2456.79 251.39 2162.16 2408.62 0.00 2408.62 246.46
Colorado UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KT3 1896.65 2112.83 0.00 2112.83 216.18 1859.46 2071.40 0.00 2071.40 211.94
Connecticut Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Connecticut Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Connecticut Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Connecticut Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Connecticut Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Connecticut Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 946.33 1115.66 0.00 1115.66 169.33 927.77 1093.78 0.00 1093.78 166.01
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2166.99 2554.69 0.00 2554.69 387.70 2124.50 2504.60 0.00 2504.60 380.10
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2124.50 2504.59 0.00 2504.59 380.09 2082.84 2455.48 0.00 2455.48 372.64
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1179.50 1282.37 0.00 1282.37 102.87 1156.37 1257.23 0.00 1257.23 100.86
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2689.86 2924.51 0.00 2924.51 234.65 2637.12 2867.17 0.00 2867.17 230.05
Connecticut Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2663.23 2895.55 0.00 2895.55 232.32 2611.01 2838.77 0.00 2838.77 227.76
Connecticut Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Connecticut Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Connecticut Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Delaware Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Delaware Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Delaware Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Delaware Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Delaware Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Delaware Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self EP4 946.33 1115.66 0.00 1115.66 169.33 927.77 1093.78 0.00 1093.78 166.01
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family EP5 2166.99 2554.69 0.00 2554.69 387.70 2124.50 2504.60 0.00 2504.60 380.10
Delaware Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One EP6 2124.50 2504.59 0.00 2504.59 380.09 2082.84 2455.48 0.00 2455.48 372.64
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self EP1 1179.50 1282.37 0.00 1282.37 102.87 1156.37 1257.23 0.00 1257.23 100.86
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family EP2 2689.86 2924.51 0.00 2924.51 234.65 2637.12 2867.17 0.00 2867.17 230.05
Delaware Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One EP3 2663.23 2895.55 0.00 2895.55 232.32 2611.01 2838.77 0.00 2838.77 227.76
Delaware Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Delaware Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Delaware Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Delaware Aetna Open Access - Basic Self P34 1756.20 1789.11 0.00 1789.11 32.91 1721.76 1754.03 0.00 1754.03 32.27
Delaware Aetna Open Access - Basic Self & Family P35 4076.22 4152.52 0.00 4152.52 76.30 3996.29 4071.10 0.00 4071.10 74.81
Delaware Aetna Open Access - Basic Self Plus One P36 4035.83 4111.35 0.00 4111.35 75.52 3956.70 4030.74 0.00 4030.74 74.04
Delaware Aetna Open Access - High Self P31 1797.79 1772.73 0.00 1772.73 -25.06 1762.54 1737.97 0.00 1737.97 -24.57
Delaware Aetna Open Access - High Self & Family P32 4358.74 4297.98 0.00 4297.98 -60.76 4273.27 4213.71 0.00 4213.71 -59.56
Delaware Aetna Open Access - High Self Plus One P33 4315.60 4255.44 0.00 4255.44 -60.16 4230.98 4172.00 0.00 4172.00 -58.98
District Of Columbia Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
District Of Columbia Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
District Of Columbia Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
District Of Columbia Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
District Of Columbia Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
District Of Columbia Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 888.06 997.77 0.00 997.77 109.71 870.65 978.21 0.00 978.21 107.56
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 2024.80 2275.04 0.00 2275.04 250.24 1985.10 2230.43 0.00 2230.43 245.33
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 2004.76 2252.50 0.00 2252.50 247.74 1965.45 2208.33 0.00 2208.33 242.88
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 913.44 1028.45 0.00 1028.45 115.01 895.53 1008.28 0.00 1008.28 112.75
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2091.65 2355.07 0.00 2355.07 263.42 2050.64 2308.89 0.00 2308.89 258.25
District Of Columbia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2050.66 2308.85 0.00 2308.85 258.19 2010.45 2263.58 0.00 2263.58 253.13
District Of Columbia Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
District Of Columbia Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
District Of Columbia Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
District Of Columbia Aetna Open Access - High Self JN1 1276.58 1355.42 0.00 1355.42 78.84 1251.55 1328.84 0.00 1328.84 77.29
District Of Columbia Aetna Open Access - High Self & Family JN2 2869.95 3047.15 0.00 3047.15 177.20 2813.68 2987.40 0.00 2987.40 173.72
District Of Columbia Aetna Open Access - High Self Plus One JN3 2841.51 3016.96 0.00 3016.96 175.45 2785.79 2957.80 0.00 2957.80 172.01
District Of Columbia Aetna Open Access - Basic Self JN4 754.25 786.14 0.00 786.14 31.89 739.46 770.73 0.00 770.73 31.27
District Of Columbia Aetna Open Access - Basic Self & Family JN5 1726.07 1799.10 0.00 1799.10 73.03 1692.23 1763.82 0.00 1763.82 71.59
District Of Columbia Aetna Open Access - Basic Self Plus One JN6 1585.01 1652.06 0.00 1652.06 67.05 1553.93 1619.67 0.00 1619.67 65.74
District Of Columbia Aetna Saver (Open Access) - Saver Self QQ4 607.11 625.83 0.00 625.83 18.72 595.21 613.56 0.00 613.56 18.35
District Of Columbia Aetna Saver (Open Access) - Saver Self & Family QQ5 1389.36 1432.28 0.00 1432.28 42.92 1362.12 1404.20 0.00 1404.20 42.08
District Of Columbia Aetna Saver (Open Access) - Saver Self Plus One QQ6 1275.84 1315.24 0.00 1315.24 39.40 1250.82 1289.45 0.00 1289.45 38.63
District Of Columbia CareFirst BlueChoice - Standard Self 2G4 923.69 1043.74 0.00 1043.74 120.05 905.58 1023.27 0.00 1023.27 117.69
District Of Columbia CareFirst BlueChoice - Standard Self & Family 2G5 2194.62 2479.93 0.00 2479.93 285.31 2151.59 2431.30 0.00 2431.30 279.71
District Of Columbia CareFirst BlueChoice - Standard Self Plus One 2G6 1847.34 2087.50 0.00 2087.50 240.16 1811.12 2046.57 0.00 2046.57 235.45
District Of Columbia CareFirst BlueChoice - HDHP Self B61 616.40 705.74 0.00 705.74 89.34 604.31 691.90 0.00 691.90 87.59
District Of Columbia CareFirst BlueChoice - HDHP Self & Family B62 1464.51 1676.84 0.00 1676.84 212.33 1435.79 1643.96 0.00 1643.96 208.17
District Of Columbia CareFirst BlueChoice - HDHP Self Plus One B63 1232.74 1411.53 0.00 1411.53 178.79 1208.57 1383.85 0.00 1383.85 175.28
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self B64 738.14 775.03 0.00 775.03 36.89 723.67 759.83 0.00 759.83 36.16
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self & Family B65 1753.77 1841.46 0.00 1841.46 87.69 1719.38 1805.35 0.00 1805.35 85.97
District Of Columbia CareFirst BlueChoice - Blue Value Plus Self Plus One B66 1476.24 1550.07 0.00 1550.07 73.83 1447.29 1519.68 0.00 1519.68 72.39
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self T71 376.28 387.32 0.00 387.32 11.04 368.90 379.73 0.00 379.73 10.83
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self & Family T72 1072.36 1089.71 0.00 1089.71 17.35 1051.33 1068.34 0.00 1068.34 17.01
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Prosper Self Plus One T73 884.25 925.32 0.00 925.32 41.07 866.91 907.18 0.00 907.18 40.27
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self E34 619.40 647.98 0.00 647.98 28.58 607.25 635.27 0.00 635.27 28.02
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self & Family E35 1424.56 1490.31 0.00 1490.31 65.75 1396.63 1461.09 0.00 1461.09 64.46
District Of Columbia Kaiser Permanente - Mid-Atlantic States - Standard Self Plus One E36 1424.56 1490.31 0.00 1490.31 65.75 1396.63 1461.09 0.00 1461.09 64.46
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self E31 771.73 806.72 0.00 806.72 34.99 756.60 790.90 0.00 790.90 34.30
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self & Family E32 1775.00 1855.41 0.00 1855.41 80.41 1740.20 1819.03 0.00 1819.03 78.83
District Of Columbia Kaiser Permanente - Mid-Atlantic States - High Self Plus One E33 1775.00 1855.41 0.00 1855.41 80.41 1740.20 1819.03 0.00 1819.03 78.83
District Of Columbia M.D. IPA - High Self JP1 1032.23 1087.10 0.00 1087.10 54.87 1011.99 1065.78 0.00 1065.78 53.79
District Of Columbia M.D. IPA - High Self & Family JP2 2894.41 3048.21 0.00 3048.21 153.80 2837.66 2988.44 0.00 2988.44 150.78
District Of Columbia M.D. IPA - High Self Plus One JP3 2015.96 2123.08 0.00 2123.08 107.12 1976.43 2081.45 0.00 2081.45 105.02
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
District Of Columbia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self V41 675.05 678.49 0.00 678.49 3.44 661.81 665.19 0.00 665.19 3.38
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family V42 1544.48 1560.46 0.00 1560.46 15.98 1514.20 1529.86 0.00 1529.86 15.66
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One V43 1451.38 1458.73 0.00 1458.73 7.35 1422.92 1430.13 0.00 1430.13 7.21
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LR1 838.60 926.17 0.00 926.17 87.57 822.16 908.01 0.00 908.01 85.85
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LR2 1987.52 2194.97 0.00 2194.97 207.45 1948.55 2151.93 0.00 2151.93 203.38
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LR3 1803.03 1991.21 0.00 1991.21 188.18 1767.68 1952.17 0.00 1952.17 184.49
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 677.04 710.94 0.00 710.94 33.90 663.76 697.00 0.00 697.00 33.24
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1618.14 1706.26 0.00 1706.26 88.12 1586.41 1672.80 0.00 1672.80 86.39
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1354.09 1510.78 0.00 1510.78 156.69 1327.54 1481.16 0.00 1481.16 153.62
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
District Of Columbia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Florida Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Florida Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Florida Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Florida Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Florida Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Florida Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 888.06 997.77 0.00 997.77 109.71 870.65 978.21 0.00 978.21 107.56
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 2024.80 2275.04 0.00 2275.04 250.24 1985.10 2230.43 0.00 2230.43 245.33
Florida Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 2004.76 2252.50 0.00 2252.50 247.74 1965.45 2208.33 0.00 2208.33 242.88
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 913.44 1028.45 0.00 1028.45 115.01 895.53 1008.28 0.00 1008.28 112.75
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2091.65 2355.07 0.00 2355.07 263.42 2050.64 2308.89 0.00 2308.89 258.25
Florida Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2050.66 2308.85 0.00 2308.85 258.19 2010.45 2263.58 0.00 2263.58 253.13
Florida Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Florida Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Florida Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Florida AvMed - HDHP Self WZ1 757.11 883.53 0.00 883.53 126.42 742.26 866.21 0.00 866.21 123.95
Florida AvMed - HDHP Self & Family WZ2 1748.29 2056.30 0.00 2056.30 308.01 1714.01 2015.98 0.00 2015.98 301.97
Florida AvMed - HDHP Self Plus One WZ3 1516.98 1782.61 0.00 1782.61 265.63 1487.24 1747.66 0.00 1747.66 260.42
Florida AvMed - Standard Self ML4 817.92 965.24 0.00 965.24 147.32 801.88 946.31 0.00 946.31 144.43
Florida AvMed - Standard Self & Family ML5 1991.50 2350.18 0.00 2350.18 358.68 1952.45 2304.10 0.00 2304.10 351.65
Florida AvMed - Standard Self Plus One ML6 1717.66 2027.04 0.00 2027.04 309.38 1683.98 1987.29 0.00 1987.29 303.31
Florida Capital Health Plan - High Self EA1 745.10 769.12 0.00 769.12 24.02 730.49 754.04 0.00 754.04 23.55
Florida Capital Health Plan - High Self & Family EA2 1726.79 1782.41 0.00 1782.41 55.62 1692.93 1747.46 0.00 1747.46 54.53
Florida Capital Health Plan - High Self Plus One EA3 1629.50 1681.99 0.00 1681.99 52.49 1597.55 1649.01 0.00 1649.01 51.46
Florida Humana CoverageFirst and Humana Value Plan - Value Self W94 612.12 668.88 0.00 668.88 56.76 600.12 655.76 0.00 655.76 55.64
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family W95 1377.30 1504.97 0.00 1504.97 127.67 1350.29 1475.46 0.00 1475.46 125.17
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One W96 1316.06 1438.07 0.00 1438.07 122.01 1290.25 1409.87 0.00 1409.87 119.62
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self W91 741.23 777.39 0.00 777.39 36.16 726.70 762.15 0.00 762.15 35.45
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family W92 1667.73 1749.07 0.00 1749.07 81.34 1635.03 1714.77 0.00 1714.77 79.74
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One W93 1593.63 1671.38 0.00 1671.38 77.75 1562.38 1638.61 0.00 1638.61 76.23
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self QP1 842.74 890.37 0.00 890.37 47.63 826.22 872.91 0.00 872.91 46.69
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family QP2 1898.61 2005.91 0.00 2005.91 107.30 1861.38 1966.58 0.00 1966.58 105.20
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One QP3 1814.23 1916.73 0.00 1916.73 102.50 1778.66 1879.15 0.00 1879.15 100.49
Florida Humana CoverageFirst and Humana Value Plan - Value Self QP4 561.52 584.77 0.00 584.77 23.25 550.51 573.30 0.00 573.30 22.79
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family QP5 1263.37 1315.64 0.00 1315.64 52.27 1238.60 1289.84 0.00 1289.84 51.24
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One QP6 1207.23 1257.18 0.00 1257.18 49.95 1183.56 1232.53 0.00 1232.53 48.97
Florida Humana CoverageFirst and Humana Value Plan - Value Self MJ4 572.41 603.90 0.00 603.90 31.49 561.19 592.06 0.00 592.06 30.87
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family MJ5 1373.81 1449.34 0.00 1449.34 75.53 1346.87 1420.92 0.00 1420.92 74.05
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One MJ6 1230.68 1298.38 0.00 1298.38 67.70 1206.55 1272.92 0.00 1272.92 66.37
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self MJ1 1086.17 1134.39 0.00 1134.39 48.22 1064.87 1112.15 0.00 1112.15 47.28
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MJ2 2443.84 2552.33 0.00 2552.33 108.49 2395.92 2502.28 0.00 2502.28 106.36
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MJ3 2335.26 2438.93 0.00 2438.93 103.67 2289.47 2391.11 0.00 2391.11 101.64
Florida Humana CoverageFirst and Humana Value Plan - Value Self X24 557.19 587.55 0.00 587.55 30.36 546.26 576.03 0.00 576.03 29.77
Florida Humana CoverageFirst and Humana Value Plan - Value Self & Family X25 1365.10 1439.46 0.00 1439.46 74.36 1338.33 1411.24 0.00 1411.24 72.91
Florida Humana CoverageFirst and Humana Value Plan - Value Self Plus One X26 1197.93 1263.19 0.00 1263.19 65.26 1174.44 1238.42 0.00 1238.42 63.98
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self X21 643.15 688.19 0.00 688.19 45.04 630.54 674.70 0.00 674.70 44.16
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X22 1447.18 1548.46 0.00 1548.46 101.28 1418.80 1518.10 0.00 1518.10 99.30
Florida Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X23 1382.84 1479.64 0.00 1479.64 96.80 1355.73 1450.63 0.00 1450.63 94.90
Florida Humana HDHP - HDHP Self BR1 434.97 448.04 0.00 448.04 13.07 426.44 439.25 0.00 439.25 12.81
Florida Humana HDHP - HDHP Self & Family BR2 1083.47 1115.96 0.00 1115.96 32.49 1062.23 1094.08 0.00 1094.08 31.85
Florida Humana HDHP - HDHP Self Plus One BR3 953.77 982.39 0.00 982.39 28.62 935.07 963.13 0.00 963.13 28.06
Florida Humana HDHP - HDHP Self A41 487.97 502.63 0.00 502.63 14.66 478.40 492.77 0.00 492.77 14.37
Florida Humana HDHP - HDHP Self & Family A42 1215.96 1252.45 0.00 1252.45 36.49 1192.12 1227.89 0.00 1227.89 35.77
Florida Humana HDHP - HDHP Self Plus One A43 1070.37 1102.48 0.00 1102.48 32.11 1049.38 1080.86 0.00 1080.86 31.48
Florida Humana HDHP - HDHP Self FF1 414.64 427.06 0.00 427.06 12.42 406.51 418.69 0.00 418.69 12.18
Florida Humana HDHP - HDHP Self & Family FF2 1032.58 1063.56 0.00 1063.56 30.98 1012.33 1042.71 0.00 1042.71 30.38
Florida Humana HDHP - HDHP Self Plus One FF3 908.99 936.25 0.00 936.25 27.26 891.17 917.89 0.00 917.89 26.72
Florida Humana HDHP - HDHP Self AP1 492.74 507.50 0.00 507.50 14.76 483.08 497.55 0.00 497.55 14.47
Florida Humana HDHP - HDHP Self & Family AP2 1227.84 1264.68 0.00 1264.68 36.84 1203.76 1239.88 0.00 1239.88 36.12
Florida Humana HDHP - HDHP Self Plus One AP3 1080.82 1113.25 0.00 1113.25 32.43 1059.63 1091.42 0.00 1091.42 31.79
Florida Humana Medical Plan, Inc. - Standard Self LL4 1308.34 1449.26 0.00 1449.26 140.92 1282.69 1420.84 0.00 1420.84 138.15
Florida Humana Medical Plan, Inc. - Standard Self & Family LL5 2943.72 3260.77 0.00 3260.77 317.05 2886.00 3196.83 0.00 3196.83 310.83
Florida Humana Medical Plan, Inc. - Standard Self Plus One LL6 2812.88 3115.86 0.00 3115.86 302.98 2757.73 3054.76 0.00 3054.76 297.03
Florida Humana Medical Plan, Inc. - High Self LL1 1830.26 2061.44 0.00 2061.44 231.18 1794.37 2021.02 0.00 2021.02 226.65
Florida Humana Medical Plan, Inc. - High Self & Family LL2 4118.05 4638.17 0.00 4638.17 520.12 4037.30 4547.23 0.00 4547.23 509.93
Florida Humana Medical Plan, Inc. - High Self Plus One LL3 3935.02 4432.04 0.00 4432.04 497.02 3857.86 4345.14 0.00 4345.14 487.28
Florida Humana Medical Plan, Inc. - High Self EE1 1350.36 1515.33 0.00 1515.33 164.97 1323.88 1485.62 0.00 1485.62 161.74
Florida Humana Medical Plan, Inc. - High Self & Family EE2 3038.36 3409.56 0.00 3409.56 371.20 2978.78 3342.71 0.00 3342.71 363.93
Florida Humana Medical Plan, Inc. - High Self Plus One EE3 2903.37 3258.09 0.00 3258.09 354.72 2846.44 3194.21 0.00 3194.21 347.77
Florida Humana Medical Plan, Inc. - Standard Self EE4 1207.46 1364.45 0.00 1364.45 156.99 1183.78 1337.70 0.00 1337.70 153.92
Florida Humana Medical Plan, Inc. - Standard Self & Family EE5 2716.75 3069.98 0.00 3069.98 353.23 2663.48 3009.78 0.00 3009.78 346.30
Florida Humana Medical Plan, Inc. - Standard Self Plus One EE6 2596.02 2933.51 0.00 2933.51 337.49 2545.12 2875.99 0.00 2875.99 330.87
Florida Humana Medical Plan, Inc. - Standard Self E24 820.53 880.75 0.00 880.75 60.22 804.44 863.48 0.00 863.48 59.04
Florida Humana Medical Plan, Inc. - Standard Self & Family E25 1846.17 1981.67 0.00 1981.67 135.50 1809.97 1942.81 0.00 1942.81 132.84
Florida Humana Medical Plan, Inc. - Standard Self Plus One E26 1764.09 1893.55 0.00 1893.55 129.46 1729.50 1856.42 0.00 1856.42 126.92
Florida Humana Medical Plan, Inc. - High Self E21 1378.20 1437.16 0.00 1437.16 58.96 1351.18 1408.98 0.00 1408.98 57.80
Florida Humana Medical Plan, Inc. - High Self & Family E22 3100.85 3233.52 0.00 3233.52 132.67 3040.05 3170.12 0.00 3170.12 130.07
Florida Humana Medical Plan, Inc. - High Self Plus One E23 2963.04 3089.80 0.00 3089.80 126.76 2904.94 3029.22 0.00 3029.22 124.28
Florida Humana Medical Plan, Inc. - High Self EX1 1090.79 1123.41 0.00 1123.41 32.62 1069.40 1101.38 0.00 1101.38 31.98
Florida Humana Medical Plan, Inc. - High Self & Family EX2 2454.23 2527.60 0.00 2527.60 73.37 2406.11 2478.04 0.00 2478.04 71.93
Florida Humana Medical Plan, Inc. - High Self Plus One EX3 2345.14 2415.25 0.00 2415.25 70.11 2299.16 2367.89 0.00 2367.89 68.73
Florida Humana Medical Plan, Inc. - Standard Self EX4 915.28 956.65 0.00 956.65 41.37 897.33 937.89 0.00 937.89 40.56
Florida Humana Medical Plan, Inc. - Standard Self & Family EX5 2059.39 2152.50 0.00 2152.50 93.11 2019.01 2110.29 0.00 2110.29 91.28
Florida Humana Medical Plan, Inc. - Standard Self Plus One EX6 1967.86 2056.83 0.00 2056.83 88.97 1929.27 2016.50 0.00 2016.50 87.23
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Florida UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self LS1 637.16 672.02 0.00 672.02 34.86 624.67 658.84 0.00 658.84 34.17
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family LS2 1465.50 1537.32 0.00 1537.32 71.82 1436.76 1507.18 0.00 1507.18 70.42
Florida UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One LS3 1369.93 1444.85 0.00 1444.85 74.92 1343.07 1416.52 0.00 1416.52 73.45
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self KK1 864.25 959.80 0.00 959.80 95.55 847.30 940.98 0.00 940.98 93.68
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family KK2 2160.60 2399.57 0.00 2399.57 238.97 2118.24 2352.52 0.00 2352.52 234.28
Florida UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One KK3 1858.12 2063.63 0.00 2063.63 205.51 1821.69 2023.17 0.00 2023.17 201.48
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 915.85 1025.55 0.00 1025.55 109.70 897.89 1005.44 0.00 1005.44 107.55
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2747.51 3076.63 0.00 3076.63 329.12 2693.64 3016.30 0.00 3016.30 322.66
Florida UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1969.07 2204.91 0.00 2204.91 235.84 1930.46 2161.68 0.00 2161.68 231.22
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Florida UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Georgia Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Georgia Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Georgia Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Georgia Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Georgia Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Georgia Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self F51 888.06 997.77 0.00 997.77 109.71 870.65 978.21 0.00 978.21 107.56
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family F52 2024.80 2275.04 0.00 2275.04 250.24 1985.10 2230.43 0.00 2230.43 245.33
Georgia Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One F53 2004.76 2252.50 0.00 2252.50 247.74 1965.45 2208.33 0.00 2208.33 242.88
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self F54 913.44 1028.45 0.00 1028.45 115.01 895.53 1008.28 0.00 1008.28 112.75
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family F55 2091.65 2355.07 0.00 2355.07 263.42 2050.64 2308.89 0.00 2308.89 258.25
Georgia Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One F56 2050.66 2308.85 0.00 2308.85 258.19 2010.45 2263.58 0.00 2263.58 253.13
Georgia Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Georgia Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Georgia Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Georgia Aetna Open Access - High Self 2U1 1764.22 1818.30 0.00 1818.30 54.08 1729.63 1782.65 0.00 1782.65 53.02
Georgia Aetna Open Access - High Self & Family 2U2 4063.81 4188.40 0.00 4188.40 124.59 3984.13 4106.27 0.00 4106.27 122.14
Georgia Aetna Open Access - High Self Plus One 2U3 4023.57 4146.93 0.00 4146.93 123.36 3944.68 4065.62 0.00 4065.62 120.94
Georgia Humana CoverageFirst and Humana Value Plan - Value Self S94 671.73 722.12 0.00 722.12 50.39 658.56 707.96 0.00 707.96 49.40
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family S95 1511.35 1624.73 0.00 1624.73 113.38 1481.72 1592.87 0.00 1592.87 111.15
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One S96 1444.19 1552.52 0.00 1552.52 108.33 1415.87 1522.08 0.00 1522.08 106.21
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self S91 843.64 852.09 0.00 852.09 8.45 827.10 835.38 0.00 835.38 8.28
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family S92 1898.21 1917.20 0.00 1917.20 18.99 1860.99 1879.61 0.00 1879.61 18.62
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One S93 1813.86 1831.98 0.00 1831.98 18.12 1778.29 1796.06 0.00 1796.06 17.77
Georgia Humana CoverageFirst and Humana Value Plan - Value Self AD4 842.56 893.13 0.00 893.13 50.57 826.04 875.62 0.00 875.62 49.58
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family AD5 1895.67 2009.44 0.00 2009.44 113.77 1858.50 1970.04 0.00 1970.04 111.54
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One AD6 1811.45 1920.14 0.00 1920.14 108.69 1775.93 1882.49 0.00 1882.49 106.56
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self AD1 1189.84 1273.13 0.00 1273.13 83.29 1166.51 1248.17 0.00 1248.17 81.66
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family AD2 2677.10 2864.52 0.00 2864.52 187.42 2624.61 2808.35 0.00 2808.35 183.74
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One AD3 2558.14 2737.20 0.00 2737.20 179.06 2507.98 2683.53 0.00 2683.53 175.55
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self LM1 800.20 856.07 0.00 856.07 55.87 784.51 839.28 0.00 839.28 54.77
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self & Family LM2 1800.44 1926.17 0.00 1926.17 125.73 1765.14 1888.40 0.00 1888.40 123.26
Georgia Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One LM3 1720.42 1840.56 0.00 1840.56 120.14 1686.69 1804.47 0.00 1804.47 117.78
Georgia Humana CoverageFirst and Humana Value Plan - Value Self LM4 756.97 801.94 0.00 801.94 44.97 742.13 786.22 0.00 786.22 44.09
Georgia Humana CoverageFirst and Humana Value Plan - Value Self & Family LM5 1703.21 1804.38 0.00 1804.38 101.17 1669.81 1769.00 0.00 1769.00 99.19
Georgia Humana CoverageFirst and Humana Value Plan - Value Self Plus One LM6 1627.51 1724.22 0.00 1724.22 96.71 1595.60 1690.41 0.00 1690.41 94.81
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RM1 807.71 910.19 0.00 910.19 102.48 791.87 892.34 0.00 892.34 100.47
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RM2 1817.35 2047.95 0.00 2047.95 230.60 1781.72 2007.79 0.00 2007.79 226.07
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RM3 1736.57 1956.93 0.00 1956.93 220.36 1702.52 1918.56 0.00 1918.56 216.04
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DN4 891.64 1006.04 0.00 1006.04 114.40 874.16 986.31 0.00 986.31 112.15
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DN5 2006.11 2263.48 0.00 2263.48 257.37 1966.77 2219.10 0.00 2219.10 252.33
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DN6 1916.98 2162.91 0.00 2162.91 245.93 1879.39 2120.50 0.00 2120.50 241.11
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self RJ1 717.41 812.35 0.00 812.35 94.94 703.34 796.42 0.00 796.42 93.08
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family RJ2 1614.18 1827.83 0.00 1827.83 213.65 1582.53 1791.99 0.00 1791.99 209.46
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One RJ3 1542.42 1746.59 0.00 1746.59 204.17 1512.18 1712.34 0.00 1712.34 200.16
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Q71 889.55 1064.58 0.00 1064.58 175.03 872.11 1043.71 0.00 1043.71 171.60
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self & Family Q72 2001.51 2395.31 0.00 2395.31 393.80 1962.26 2348.34 0.00 2348.34 386.08
Georgia Humana Employers Health Plan of Georgia, Inc. - Basic Self Plus One Q73 1912.53 2288.81 0.00 2288.81 376.28 1875.03 2243.93 0.00 2243.93 368.90
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self CB4 1276.71 1404.39 0.00 1404.39 127.68 1251.68 1376.85 0.00 1376.85 125.17
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family CB5 2872.63 3159.86 0.00 3159.86 287.23 2816.30 3097.90 0.00 3097.90 281.60
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One CB6 2744.95 3019.43 0.00 3019.43 274.48 2691.13 2960.23 0.00 2960.23 269.10
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self DG4 1459.47 1525.12 0.00 1525.12 65.65 1430.85 1495.22 0.00 1495.22 64.37
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self & Family DG5 3283.82 3431.58 0.00 3431.58 147.76 3219.43 3364.29 0.00 3364.29 144.86
Georgia Humana Employers Health Plan of Georgia, Inc. - Standard Self Plus One DG6 3137.94 3279.16 0.00 3279.16 141.22 3076.41 3214.86 0.00 3214.86 138.45
Georgia Humana HDHP - HDHP Self AZ1 481.85 496.30 0.00 496.30 14.45 472.40 486.57 0.00 486.57 14.17
Georgia Humana HDHP - HDHP Self & Family AZ2 1200.60 1236.63 0.00 1236.63 36.03 1177.06 1212.38 0.00 1212.38 35.32
Georgia Humana HDHP - HDHP Self Plus One AZ3 1056.86 1088.55 0.00 1088.55 31.69 1036.14 1067.21 0.00 1067.21 31.07
Georgia Humana HDHP - HDHP Self B21 496.76 511.64 0.00 511.64 14.88 487.02 501.61 0.00 501.61 14.59
Georgia Humana HDHP - HDHP Self & Family B22 1237.89 1275.04 0.00 1275.04 37.15 1213.62 1250.04 0.00 1250.04 36.42
Georgia Humana HDHP - HDHP Self Plus One B23 1089.67 1122.35 0.00 1122.35 32.68 1068.30 1100.34 0.00 1100.34 32.04
Georgia Humana HDHP - HDHP Self AR1 487.00 501.61 0.00 501.61 14.61 477.45 491.77 0.00 491.77 14.32
Georgia Humana HDHP - HDHP Self & Family AR2 1213.51 1249.91 0.00 1249.91 36.40 1189.72 1225.40 0.00 1225.40 35.68
Georgia Humana HDHP - HDHP Self Plus One AR3 1068.21 1100.25 0.00 1100.25 32.04 1047.26 1078.68 0.00 1078.68 31.42
Georgia Kaiser Permanente - Georgia - High Self F81 785.10 823.80 0.00 823.80 38.70 769.71 807.65 0.00 807.65 37.94
Georgia Kaiser Permanente - Georgia - High Self & Family F82 1774.36 1861.78 0.00 1861.78 87.42 1739.57 1825.27 0.00 1825.27 85.70
Georgia Kaiser Permanente - Georgia - High Self Plus One F83 1774.36 1861.78 0.00 1861.78 87.42 1739.57 1825.27 0.00 1825.27 85.70
Georgia Kaiser Permanente - Georgia - Standard Self F84 612.72 644.72 0.00 644.72 32.00 600.71 632.08 0.00 632.08 31.37
Georgia Kaiser Permanente - Georgia - Standard Self & Family F85 1384.74 1457.10 0.00 1457.10 72.36 1357.59 1428.53 0.00 1428.53 70.94
Georgia Kaiser Permanente - Georgia - Standard Self Plus One F86 1384.74 1457.10 0.00 1457.10 72.36 1357.59 1428.53 0.00 1428.53 70.94
Georgia Kaiser Permanente - Georgia - Prosper Self LA1 406.62 443.17 0.00 443.17 36.55 398.65 434.48 0.00 434.48 35.83
Georgia Kaiser Permanente - Georgia - Prosper Self & Family LA2 1055.67 1150.66 0.00 1150.66 94.99 1034.97 1128.10 0.00 1128.10 93.13
Georgia Kaiser Permanente - Georgia - Prosper Self Plus One LA3 918.94 1001.62 0.00 1001.62 82.68 900.92 981.98 0.00 981.98 81.06
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Georgia UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self LV1 915.85 1025.55 0.00 1025.55 109.70 897.89 1005.44 0.00 1005.44 107.55
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family LV2 2747.51 3076.63 0.00 3076.63 329.12 2693.64 3016.30 0.00 3016.30 322.66
Georgia UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One LV3 1969.07 2204.91 0.00 2204.91 235.84 1930.46 2161.68 0.00 2161.68 231.22
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Georgia UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Guam Calvo's SelectCare - Standard Self B44 386.49 412.72 0.00 412.72 26.23 378.91 404.63 0.00 404.63 25.72
Guam Calvo's SelectCare - Standard Self & Family B45 1122.93 1199.17 0.00 1199.17 76.24 1100.91 1175.66 0.00 1175.66 74.75
Guam Calvo's SelectCare - Standard Self Plus One B46 761.86 813.59 0.00 813.59 51.73 746.92 797.64 0.00 797.64 50.72
Guam Calvo's SelectCare - High Self B41 546.67 562.51 0.00 562.51 15.84 535.95 551.48 0.00 551.48 15.53
Guam Calvo's SelectCare - High Self & Family B42 1447.93 1489.91 0.00 1489.91 41.98 1419.54 1460.70 0.00 1460.70 41.16
Guam Calvo's SelectCare - High Self Plus One B43 1066.81 1097.80 0.00 1097.80 30.99 1045.89 1076.27 0.00 1076.27 30.38
Guam TakeCare - HDHP Self KX1 124.76 122.35 0.00 122.35 -2.41 122.31 119.95 0.00 119.95 -2.36
Guam TakeCare - HDHP Self & Family KX2 334.53 327.96 0.00 327.96 -6.57 327.97 321.53 0.00 321.53 -6.44
Guam TakeCare - HDHP Self Plus One KX3 301.13 295.30 0.00 295.30 -5.83 295.23 289.51 0.00 289.51 -5.72
Guam TakeCare - Standard Self JK4 413.89 450.09 0.00 450.09 36.20 405.77 441.26 0.00 441.26 35.49
Guam TakeCare - Standard Self & Family JK5 1172.16 1274.68 0.00 1274.68 102.52 1149.18 1249.69 0.00 1249.69 100.51
Guam TakeCare - Standard Self Plus One JK6 815.78 887.13 0.00 887.13 71.35 799.78 869.74 0.00 869.74 69.96
Guam TakeCare - High Self JK1 526.18 576.09 0.00 576.09 49.91 515.86 564.79 0.00 564.79 48.93
Guam TakeCare - High Self & Family JK2 1255.04 1374.02 0.00 1374.02 118.98 1230.43 1347.08 0.00 1347.08 116.65
Guam TakeCare - High Self Plus One JK3 1039.54 1138.11 0.00 1138.11 98.57 1019.16 1115.79 0.00 1115.79 96.63
Hawaii Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Hawaii Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Hawaii Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Hawaii Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Hawaii Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Hawaii Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1116.40 1129.11 0.00 1129.11 12.71 1094.51 1106.97 0.00 1106.97 12.46
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2548.61 2577.59 0.00 2577.59 28.98 2498.64 2527.05 0.00 2527.05 28.41
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2523.42 2552.11 0.00 2552.11 28.69 2473.94 2502.07 0.00 2502.07 28.13
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1058.09 1189.73 0.00 1189.73 131.64 1037.34 1166.40 0.00 1166.40 129.06
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2411.95 2712.07 0.00 2712.07 300.12 2364.66 2658.89 0.00 2658.89 294.23
Hawaii Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2388.06 2685.19 0.00 2685.19 297.13 2341.24 2632.54 0.00 2632.54 291.30
Hawaii Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Hawaii Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Hawaii Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Hawaii HMSA Plan - High Self 871 643.86 643.86 0.00 643.86 0.00 631.24 631.24 0.00 631.24 0.00
Hawaii HMSA Plan - High Self & Family 872 1447.40 1447.40 0.00 1447.40 0.00 1419.02 1419.02 0.00 1419.02 0.00
Hawaii HMSA Plan - High Self Plus One 873 1410.73 1410.73 0.00 1410.73 0.00 1383.07 1383.07 0.00 1383.07 0.00
Hawaii HMSA Plan - Standard Self 874 462.91 462.91 0.00 462.91 0.00 453.83 453.83 0.00 453.83 0.00
Hawaii HMSA Plan - Standard Self & Family 875 1040.58 1040.58 0.00 1040.58 0.00 1020.18 1020.18 0.00 1020.18 0.00
Hawaii HMSA Plan - Standard Self Plus One 876 1014.17 1014.17 0.00 1014.17 0.00 994.28 994.28 0.00 994.28 0.00
Hawaii Kaiser Permanente - Hawaii - High Self 631 689.06 708.71 0.00 708.71 19.65 675.55 694.81 0.00 694.81 19.26
Hawaii Kaiser Permanente - Hawaii - High Self & Family 632 1536.64 1580.46 0.00 1580.46 43.82 1506.51 1549.47 0.00 1549.47 42.96
Hawaii Kaiser Permanente - Hawaii - High Self Plus One 633 1536.64 1580.46 0.00 1580.46 43.82 1506.51 1549.47 0.00 1549.47 42.96
Hawaii Kaiser Permanente - Hawaii - Standard Self 634 495.09 495.09 0.00 495.09 0.00 485.38 485.38 0.00 485.38 0.00
Hawaii Kaiser Permanente - Hawaii - Standard Self & Family 635 1104.03 1104.03 0.00 1104.03 0.00 1082.38 1082.38 0.00 1082.38 0.00
Hawaii Kaiser Permanente - Hawaii - Standard Self Plus One 636 1104.03 1104.03 0.00 1104.03 0.00 1082.38 1082.38 0.00 1082.38 0.00
Idaho Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Idaho Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Idaho Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Idaho Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Idaho Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Idaho Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 842.71 882.23 0.00 882.23 39.52 826.19 864.93 0.00 864.93 38.74
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1920.88 2010.95 0.00 2010.95 90.07 1883.22 1971.52 0.00 1971.52 88.30
Idaho Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1902.26 1991.46 0.00 1991.46 89.20 1864.96 1952.41 0.00 1952.41 87.45
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 850.40 919.18 0.00 919.18 68.78 833.73 901.16 0.00 901.16 67.43
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1951.72 2109.47 0.00 2109.47 157.75 1913.45 2068.11 0.00 2068.11 154.66
Idaho Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1913.46 2068.14 0.00 2068.14 154.68 1875.94 2027.59 0.00 2027.59 151.65
Idaho Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Idaho Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Idaho Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Idaho Altius Health Plan - High Self 9K1 1173.87 1239.01 0.00 1239.01 65.14 1150.85 1214.72 0.00 1214.72 63.87
Idaho Altius Health Plan - High Self & Family 9K2 2596.00 2740.12 0.00 2740.12 144.12 2545.10 2686.39 0.00 2686.39 141.29
Idaho Altius Health Plan - High Self Plus One 9K3 2570.32 2713.02 0.00 2713.02 142.70 2519.92 2659.82 0.00 2659.82 139.90
Idaho Altius Health Plan - HDHP Self 9K4 774.40 810.79 0.00 810.79 36.39 759.22 794.89 0.00 794.89 35.67
Idaho Altius Health Plan - HDHP Self & Family 9K5 1618.45 1694.48 0.00 1694.48 76.03 1586.72 1661.25 0.00 1661.25 74.53
Idaho Altius Health Plan - HDHP Self Plus One 9K6 1586.67 1661.19 0.00 1661.19 74.52 1555.56 1628.62 0.00 1628.62 73.06
Idaho Altius Health Plan - Standard Self DK4 961.39 1013.22 0.00 1013.22 51.83 942.54 993.35 0.00 993.35 50.81
Idaho Altius Health Plan - Standard Self & Family DK5 2123.06 2237.56 0.00 2237.56 114.50 2081.43 2193.69 0.00 2193.69 112.26
Idaho Altius Health Plan - Standard Self Plus One DK6 2102.02 2215.39 0.00 2215.39 113.37 2060.80 2171.95 0.00 2171.95 111.15
Idaho Kaiser Permanente - Washington Core - Standard Self 544 637.71 653.68 0.00 653.68 15.97 625.21 640.86 0.00 640.86 15.65
Idaho Kaiser Permanente - Washington Core - Standard Self & Family 545 1466.76 1503.42 0.00 1503.42 36.66 1438.00 1473.94 0.00 1473.94 35.94
Idaho Kaiser Permanente - Washington Core - Standard Self Plus One 546 1466.76 1503.42 0.00 1503.42 36.66 1438.00 1473.94 0.00 1473.94 35.94
Idaho Kaiser Permanente - Washington Core - High Self 541 886.92 920.85 0.00 920.85 33.93 869.53 902.79 0.00 902.79 33.26
Idaho Kaiser Permanente - Washington Core - High Self & Family 542 1951.19 2025.84 0.00 2025.84 74.65 1912.93 1986.12 0.00 1986.12 73.19
Idaho Kaiser Permanente - Washington Core - High Self Plus One 543 1951.19 2025.84 0.00 2025.84 74.65 1912.93 1986.12 0.00 1986.12 73.19
Idaho Kaiser Permanente - Washington Core - Prosper Self PT4 397.80 397.80 0.00 397.80 0.00 390.00 390.00 0.00 390.00 0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self & Family PT5 1113.82 1113.82 0.00 1113.82 0.00 1091.98 1091.98 0.00 1091.98 0.00
Idaho Kaiser Permanente - Washington Core - Prosper Self Plus One PT6 963.56 963.56 0.00 963.56 0.00 944.67 944.67 0.00 944.67 0.00
Illinois Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Illinois Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Illinois Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Illinois Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Illinois Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Illinois Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 842.71 882.23 0.00 882.23 39.52 826.19 864.93 0.00 864.93 38.74
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1920.88 2010.95 0.00 2010.95 90.07 1883.22 1971.52 0.00 1971.52 88.30
Illinois Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1902.26 1991.46 0.00 1991.46 89.20 1864.96 1952.41 0.00 1952.41 87.45
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 850.40 919.18 0.00 919.18 68.78 833.73 901.16 0.00 901.16 67.43
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1951.72 2109.47 0.00 2109.47 157.75 1913.45 2068.11 0.00 2068.11 154.66
Illinois Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1913.46 2068.14 0.00 2068.14 154.68 1875.94 2027.59 0.00 2027.59 151.65
Illinois Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Illinois Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Illinois Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Illinois Health Alliance HMO - Standard Self K84 718.16 804.35 0.00 804.35 86.19 704.08 788.58 0.00 788.58 84.50
Illinois Health Alliance HMO - Standard Self & Family K85 1664.53 1885.95 0.00 1885.95 221.42 1631.89 1848.97 0.00 1848.97 217.08
Illinois Health Alliance HMO - Standard Self Plus One K86 1535.55 1723.34 0.00 1723.34 187.79 1505.44 1689.55 0.00 1689.55 184.11
Illinois Humana CoverageFirst and Humana Value Plan - Value Self GB4 844.47 852.88 0.00 852.88 8.41 827.91 836.16 0.00 836.16 8.25
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family GB5 1899.96 1918.95 0.00 1918.95 18.99 1862.71 1881.32 0.00 1881.32 18.61
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One GB6 1815.52 1833.61 0.00 1833.61 18.09 1779.92 1797.66 0.00 1797.66 17.74
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self GB1 1346.23 1359.68 0.00 1359.68 13.45 1319.83 1333.02 0.00 1333.02 13.19
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family GB2 3028.94 3059.21 0.00 3059.21 30.27 2969.55 2999.23 0.00 2999.23 29.68
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One GB3 2894.37 2923.32 0.00 2923.32 28.95 2837.62 2866.00 0.00 2866.00 28.38
Illinois Humana CoverageFirst and Humana Value Plan - Value Self MW4 815.69 832.00 0.00 832.00 16.31 799.70 815.69 0.00 815.69 15.99
Illinois Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1835.26 1871.99 0.00 1871.99 36.73 1799.27 1835.28 0.00 1835.28 36.01
Illinois Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1753.71 1788.81 0.00 1788.81 35.10 1719.32 1753.74 0.00 1753.74 34.42
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1077.89 1119.45 0.00 1119.45 41.56 1056.75 1097.50 0.00 1097.50 40.75
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2425.37 2518.94 0.00 2518.94 93.57 2377.81 2469.55 0.00 2469.55 91.74
Illinois Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2317.52 2406.93 0.00 2406.93 89.41 2272.08 2359.74 0.00 2359.74 87.66
Illinois Humana HDHP - HDHP Self BB1 454.20 467.83 0.00 467.83 13.63 445.29 458.66 0.00 458.66 13.37
Illinois Humana HDHP - HDHP Self & Family BB2 1131.52 1165.46 0.00 1165.46 33.94 1109.33 1142.61 0.00 1142.61 33.28
Illinois Humana HDHP - HDHP Self Plus One BB3 996.05 1025.93 0.00 1025.93 29.88 976.52 1005.81 0.00 1005.81 29.29
Illinois Humana HDHP - HDHP Self AW1 429.11 441.98 0.00 441.98 12.87 420.70 433.31 0.00 433.31 12.61
Illinois Humana HDHP - HDHP Self & Family AW2 1068.78 1100.85 0.00 1100.85 32.07 1047.82 1079.26 0.00 1079.26 31.44
Illinois Humana HDHP - HDHP Self Plus One AW3 940.84 969.08 0.00 969.08 28.24 922.39 950.08 0.00 950.08 27.69
Illinois Humana Health Plan, Inc. - Standard Self 754 1076.92 1183.63 0.00 1183.63 106.71 1055.80 1160.42 0.00 1160.42 104.62
Illinois Humana Health Plan, Inc. - Standard Self & Family 755 2423.07 2663.21 0.00 2663.21 240.14 2375.56 2610.99 0.00 2610.99 235.43
Illinois Humana Health Plan, Inc. - Standard Self Plus One 756 2315.40 2544.84 0.00 2544.84 229.44 2270.00 2494.94 0.00 2494.94 224.94
Illinois Humana Health Plan, Inc. - High Self 751 1431.30 1474.25 0.00 1474.25 42.95 1403.24 1445.34 0.00 1445.34 42.10
Illinois Humana Health Plan, Inc. - High Self & Family 752 3220.44 3317.03 0.00 3317.03 96.59 3157.29 3251.99 0.00 3251.99 94.70
Illinois Humana Health Plan, Inc. - High Self Plus One 753 3077.32 3169.61 0.00 3169.61 92.29 3016.98 3107.46 0.00 3107.46 90.48
Illinois Humana Health Plan, Inc. - High Self 9F1 2158.97 2745.57 0.00 2745.57 586.60 2116.64 2691.74 0.00 2691.74 575.10
Illinois Humana Health Plan, Inc. - High Self & Family 9F2 4857.69 6177.53 0.00 6177.53 1319.84 4762.44 6056.40 0.00 6056.40 1293.96
Illinois Humana Health Plan, Inc. - High Self Plus One 9F3 4641.75 5902.91 0.00 5902.91 1261.16 4550.74 5787.17 0.00 5787.17 1236.43
Illinois Humana Health Plan, Inc. - Standard Self AB4 1476.41 1545.06 0.00 1545.06 68.65 1447.46 1514.76 0.00 1514.76 67.30
Illinois Humana Health Plan, Inc. - Standard Self & Family AB5 3321.99 3476.45 0.00 3476.45 154.46 3256.85 3408.28 0.00 3408.28 151.43
Illinois Humana Health Plan, Inc. - Standard Self Plus One AB6 3174.35 3321.94 0.00 3321.94 147.59 3112.11 3256.80 0.00 3256.80 144.69
Illinois Humana Health Plan, Inc. - Basic Self AB1 862.85 967.47 0.00 967.47 104.62 845.93 948.50 0.00 948.50 102.57
Illinois Humana Health Plan, Inc. - Basic Self & Family AB2 1941.47 2176.85 0.00 2176.85 235.38 1903.40 2134.17 0.00 2134.17 230.77
Illinois Humana Health Plan, Inc. - Basic Self Plus One AB3 1855.19 2080.12 0.00 2080.12 224.93 1818.81 2039.33 0.00 2039.33 220.52
Illinois Humana Health Plan, Inc. - Basic Self RW1 856.29 953.49 0.00 953.49 97.20 839.50 934.79 0.00 934.79 95.29
Illinois Humana Health Plan, Inc. - Basic Self & Family RW2 1926.66 2145.34 0.00 2145.34 218.68 1888.88 2103.27 0.00 2103.27 214.39
Illinois Humana Health Plan, Inc. - Basic Self Plus One RW3 1841.02 2049.98 0.00 2049.98 208.96 1804.92 2009.78 0.00 2009.78 204.86
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Illinois UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self L91 677.04 710.94 0.00 710.94 33.90 663.76 697.00 0.00 697.00 33.24
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self & Family L92 1618.14 1706.26 0.00 1706.26 88.12 1586.41 1672.80 0.00 1672.80 86.39
Illinois UnitedHealthcare Insurance Company, Inc. Choice Plus Advanced - Value Self Plus One L93 1354.09 1510.78 0.00 1510.78 156.69 1327.54 1481.16 0.00 1481.16 153.62
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Illinois UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Indiana Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Indiana Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Indiana Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Indiana Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Indiana Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Indiana Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self JS4 1116.40 1129.11 0.00 1129.11 12.71 1094.51 1106.97 0.00 1106.97 12.46
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family JS5 2548.61 2577.59 0.00 2577.59 28.98 2498.64 2527.05 0.00 2527.05 28.41
Indiana Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One JS6 2523.42 2552.11 0.00 2552.11 28.69 2473.94 2502.07 0.00 2502.07 28.13
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self JS1 1058.09 1189.73 0.00 1189.73 131.64 1037.34 1166.40 0.00 1166.40 129.06
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family JS2 2411.95 2712.07 0.00 2712.07 300.12 2364.66 2658.89 0.00 2658.89 294.23
Indiana Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One JS3 2388.06 2685.19 0.00 2685.19 297.13 2341.24 2632.54 0.00 2632.54 291.30
Indiana Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Indiana Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Indiana Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Indiana Health Alliance HMO - Standard Self K84 718.16 804.35 0.00 804.35 86.19 704.08 788.58 0.00 788.58 84.50
Indiana Health Alliance HMO - Standard Self & Family K85 1664.53 1885.95 0.00 1885.95 221.42 1631.89 1848.97 0.00 1848.97 217.08
Indiana Health Alliance HMO - Standard Self Plus One K86 1535.55 1723.34 0.00 1723.34 187.79 1505.44 1689.55 0.00 1689.55 184.11
Indiana Humana CoverageFirst and Humana Value Plan - Value Self MW4 815.69 832.00 0.00 832.00 16.31 799.70 815.69 0.00 815.69 15.99
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family MW5 1835.26 1871.99 0.00 1871.99 36.73 1799.27 1835.28 0.00 1835.28 36.01
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One MW6 1753.71 1788.81 0.00 1788.81 35.10 1719.32 1753.74 0.00 1753.74 34.42
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self MW1 1077.89 1119.45 0.00 1119.45 41.56 1056.75 1097.50 0.00 1097.50 40.75
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family MW2 2425.37 2518.94 0.00 2518.94 93.57 2377.81 2469.55 0.00 2469.55 91.74
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One MW3 2317.52 2406.93 0.00 2406.93 89.41 2272.08 2359.74 0.00 2359.74 87.66
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self TC1 772.20 822.39 0.00 822.39 50.19 757.06 806.26 0.00 806.26 49.20
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family TC2 1737.40 1850.30 0.00 1850.30 112.90 1703.33 1814.02 0.00 1814.02 110.69
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One TC3 1660.19 1768.11 0.00 1768.11 107.92 1627.64 1733.44 0.00 1733.44 105.80
Indiana Humana CoverageFirst and Humana Value Plan - Value Self TC4 591.33 638.62 0.00 638.62 47.29 579.74 626.10 0.00 626.10 46.36
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family TC5 1330.51 1436.95 0.00 1436.95 106.44 1304.42 1408.77 0.00 1408.77 104.35
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One TC6 1271.37 1373.07 0.00 1373.07 101.70 1246.44 1346.15 0.00 1346.15 99.71
Indiana Humana CoverageFirst and Humana Value Plan - Value Self X34 708.22 747.16 0.00 747.16 38.94 694.33 732.51 0.00 732.51 38.18
Indiana Humana CoverageFirst and Humana Value Plan - Value Self & Family X35 1593.47 1681.12 0.00 1681.12 87.65 1562.23 1648.16 0.00 1648.16 85.93
Indiana Humana CoverageFirst and Humana Value Plan - Value Self Plus One X36 1522.67 1606.43 0.00 1606.43 83.76 1492.81 1574.93 0.00 1574.93 82.12
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self X31 920.42 971.05 0.00 971.05 50.63 902.37 952.01 0.00 952.01 49.64
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self & Family X32 2070.95 2184.85 0.00 2184.85 113.90 2030.34 2142.01 0.00 2142.01 111.67
Indiana Humana CoverageFirst and Humana Value Plan - CDHP Self Plus One X33 1978.92 2087.77 0.00 2087.77 108.85 1940.12 2046.83 0.00 2046.83 106.71
Indiana Humana HDHP - HDHP Self BB1 454.20 467.83 0.00 467.83 13.63 445.29 458.66 0.00 458.66 13.37
Indiana Humana HDHP - HDHP Self & Family BB2 1131.52 1165.46 0.00 1165.46 33.94 1109.33 1142.61 0.00 1142.61 33.28
Indiana Humana HDHP - HDHP Self Plus One BB3 996.05 1025.93 0.00 1025.93 29.88 976.52 1005.81 0.00 1005.81 29.29
Indiana Humana HDHP - HDHP Self DT1 505.64 520.81 0.00 520.81 15.17 495.73 510.60 0.00 510.60 14.87
Indiana Humana HDHP - HDHP Self & Family DT2 1260.12 1297.93 0.00 1297.93 37.81 1235.41 1272.48 0.00 1272.48 37.07
Indiana Humana HDHP - HDHP Self Plus One DT3 1109.22 1142.50 0.00 1142.50 33.28 1087.47 1120.10 0.00 1120.10 32.63
Indiana Humana HDHP - HDHP Self FZ1 New Plan 421.95 0.00 421.95 New Plan New Plan 413.68 0.00 413.68 New Plan
Indiana Humana HDHP - HDHP Self & Family FZ2 New Plan 1050.76 0.00 1050.76 New Plan New Plan 1030.16 0.00 1030.16 New Plan
Indiana Humana HDHP - HDHP Self Plus One FZ3 New Plan 925.00 0.00 925.00 New Plan New Plan 906.86 0.00 906.86 New Plan
Indiana Humana Health Plan of Ohio, Inc. - Standard Self A64 1267.94 1330.55 0.00 1330.55 62.61 1243.08 1304.46 0.00 1304.46 61.38
Indiana Humana Health Plan of Ohio, Inc. - Standard Self & Family A65 2852.89 2993.75 0.00 2993.75 140.86 2796.95 2935.05 0.00 2935.05 138.10
Indiana Humana Health Plan of Ohio, Inc. - Standard Self Plus One A66 2726.08 2860.71 0.00 2860.71 134.63 2672.63 2804.62 0.00 2804.62 131.99
Indiana Humana Health Plan, Inc. - Standard Self 754 1076.92 1183.63 0.00 1183.63 106.71 1055.80 1160.42 0.00 1160.42 104.62
Indiana Humana Health Plan, Inc. - Standard Self & Family 755 2423.07 2663.21 0.00 2663.21 240.14 2375.56 2610.99 0.00 2610.99 235.43
Indiana Humana Health Plan, Inc. - Standard Self Plus One 756 2315.40 2544.84 0.00 2544.84 229.44 2270.00 2494.94 0.00 2494.94 224.94
Indiana Humana Health Plan, Inc. - High Self 751 1431.30 1474.25 0.00 1474.25 42.95 1403.24 1445.34 0.00 1445.34 42.10
Indiana Humana Health Plan, Inc. - High Self & Family 752 3220.44 3317.03 0.00 3317.03 96.59 3157.29 3251.99 0.00 3251.99 94.70
Indiana Humana Health Plan, Inc. - High Self Plus One 753 3077.32 3169.61 0.00 3169.61 92.29 3016.98 3107.46 0.00 3107.46 90.48
Indiana Humana Health Plan, Inc. - Standard Self MH4 1012.76 1120.69 0.00 1120.69 107.93 992.90 1098.72 0.00 1098.72 105.82
Indiana Humana Health Plan, Inc. - Standard Self & Family MH5 2278.64 2521.54 0.00 2521.54 242.90 2233.96 2472.10 0.00 2472.10 238.14
Indiana Humana Health Plan, Inc. - Standard Self Plus One MH6 2177.36 2409.45 0.00 2409.45 232.09 2134.67 2362.21 0.00 2362.21 227.54
Indiana Indiana University Health Plans Select - High Self FS1 New Plan 618.35 0.00 618.35 New Plan New Plan 606.23 0.00 606.23 New Plan
Indiana Indiana University Health Plans Select - High Self & Family FS2 New Plan 1731.40 0.00 1731.40 New Plan New Plan 1697.45 0.00 1697.45 New Plan
Indiana Indiana University Health Plans Select - High Self Plus One FS3 New Plan 1360.41 0.00 1360.41 New Plan New Plan 1333.74 0.00 1333.74 New Plan
Iowa Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Iowa Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Iowa Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Iowa Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Iowa Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Iowa Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self H41 842.71 882.23 0.00 882.23 39.52 826.19 864.93 0.00 864.93 38.74
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family H42 1920.88 2010.95 0.00 2010.95 90.07 1883.22 1971.52 0.00 1971.52 88.30
Iowa Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One H43 1902.26 1991.46 0.00 1991.46 89.20 1864.96 1952.41 0.00 1952.41 87.45
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self H44 850.40 919.18 0.00 919.18 68.78 833.73 901.16 0.00 901.16 67.43
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family H45 1951.72 2109.47 0.00 2109.47 157.75 1913.45 2068.11 0.00 2068.11 154.66
Iowa Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One H46 1913.46 2068.14 0.00 2068.14 154.68 1875.94 2027.59 0.00 2027.59 151.65
Iowa Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Iowa Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66 18.41
Iowa Aetna HealthFund HDHP - HDHP Self Plus One 226 1818.28 1836.73 0.00 1836.73 18.45 1782.63 1800.72 0.00 1800.72 18.09
Iowa Health Alliance HMO - Standard Self K84 718.16 804.35 0.00 804.35 86.19 704.08 788.58 0.00 788.58 84.50
Iowa Health Alliance HMO - Standard Self & Family K85 1664.53 1885.95 0.00 1885.95 221.42 1631.89 1848.97 0.00 1848.97 217.08
Iowa Health Alliance HMO - Standard Self Plus One K86 1535.55 1723.34 0.00 1723.34 187.79 1505.44 1689.55 0.00 1689.55 184.11
Iowa HealthPartners - Standard Self V34 564.35 564.35 0.00 564.35 0.00 553.28 553.28 0.00 553.28 0.00
Iowa HealthPartners - Standard Self & Family V35 1374.80 1374.80 0.00 1374.80 0.00 1347.84 1347.84 0.00 1347.84 0.00
Iowa HealthPartners - Standard Self Plus One V36 1247.24 1247.24 0.00 1247.24 0.00 1222.78 1222.78 0.00 1222.78 0.00
Iowa HealthPartners - High Self V31 705.98 751.91 0.00 751.91 45.93 692.14 737.17 0.00 737.17 45.03
Iowa HealthPartners - High Self & Family V32 1719.73 1831.64 0.00 1831.64 111.91 1686.01 1795.73 0.00 1795.73 109.72
Iowa HealthPartners - High Self Plus One V33 1560.17 1661.70 0.00 1661.70 101.53 1529.58 1629.12 0.00 1629.12 99.54
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self AS1 663.93 726.03 0.00 726.03 62.10 650.91 711.79 0.00 711.79 60.88
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self & Family AS2 1570.25 1717.04 0.00 1717.04 146.79 1539.46 1683.37 0.00 1683.37 143.91
Iowa UnitedHealthcare Insurance Company, Inc. - Choice Plus Primary - High Self Plus One AS3 1427.48 1560.95 0.00 1560.95 133.47 1399.49 1530.34 0.00 1530.34 130.85
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self N71 759.44 773.00 0.00 773.00 13.56 744.55 757.84 0.00 757.84 13.29
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self & Family N72 1746.70 1777.92 0.00 1777.92 31.22 1712.45 1743.06 0.00 1743.06 30.61
Iowa UnitedHealthcare Insurance Company, Inc. Choice HDHP - HDHP Self Plus One N73 1632.78 1661.99 0.00 1661.99 29.21 1600.76 1629.40 0.00 1629.40 28.64
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self LJ1 891.43 994.97 0.00 994.97 103.54 873.95 975.46 0.00 975.46 101.51
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self & Family LJ2 2228.63 2487.40 0.00 2487.40 258.77 2184.93 2438.63 0.00 2438.63 253.70
Iowa UnitedHealthcare Insurance Company, Inc. Choice Open Access HMO - High Self Plus One LJ3 1916.62 2139.14 0.00 2139.14 222.52 1879.04 2097.20 0.00 2097.20 218.16
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Y81 592.88 688.93 0.00 688.93 96.05 581.25 675.42 0.00 675.42 94.17
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self & Family Y82 1402.18 1629.30 0.00 1629.30 227.12 1374.69 1597.35 0.00 1597.35 222.66
Iowa UnitedHealthcare Insurance Company, Inc. Choice Primary - High Self Plus One Y83 1274.70 1481.18 0.00 1481.18 206.48 1249.71 1452.14 0.00 1452.14 202.43
Kansas Aetna Advantage - Advantage Self Z24 510.02 510.02 0.00 510.02 0.00 500.02 500.02 0.00 500.02 0.00
Kansas Aetna Advantage - Advantage Self & Family Z25 1351.50 1351.50 0.00 1351.50 0.00 1325.00 1325.00 0.00 1325.00 0.00
Kansas Aetna Advantage - Advantage Self Plus One Z26 1122.02 1122.02 0.00 1122.02 0.00 1100.02 1100.02 0.00 1100.02 0.00
Kansas Aetna Direct - CDHP Self N61 640.84 654.25 0.00 654.25 13.41 628.27 641.42 0.00 641.42 13.15
Kansas Aetna Direct - CDHP Self & Family N62 1616.17 1649.92 0.00 1649.92 33.75 1584.48 1617.57 0.00 1617.57 33.09
Kansas Aetna Direct - CDHP Self Plus One N63 1405.43 1434.80 0.00 1434.80 29.37 1377.87 1406.67 0.00 1406.67 28.80
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self G54 851.07 891.54 0.00 891.54 40.47 834.38 874.06 0.00 874.06 39.68
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self & Family G55 1949.29 2041.98 0.00 2041.98 92.69 1911.07 2001.94 0.00 2001.94 90.87
Kansas Aetna HealthFund CDHP and Aetna Value Plan - Value Self Plus One G56 1911.10 2001.95 0.00 2001.95 90.85 1873.63 1962.70 0.00 1962.70 89.07
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self G51 1157.80 1175.46 0.00 1175.46 17.66 1135.10 1152.41 0.00 1152.41 17.31
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self & Family G52 2640.99 2681.21 0.00 2681.21 40.22 2589.21 2628.64 0.00 2628.64 39.43
Kansas Aetna HealthFund CDHP and Aetna Value Plan - CDHP Self Plus One G53 2614.87 2654.69 0.00 2654.69 39.82 2563.60 2602.64 0.00 2602.64 39.04
Kansas Aetna HealthFund HDHP - HDHP Self 224 840.80 849.30 0.00 849.30 8.50 824.31 832.65 0.00 832.65 8.34
Kansas Aetna HealthFund HDHP - HDHP Self & Family 225 1854.62 1873.39 0.00 1873.39 18.77 1818.25 1836.66 0.00 1836.66