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Apply Online Now - Electronic
Application
Index | Plan
Limitations | Locate
Providers | Brochure & Application
Plan Benefits:
Elect Premiere | Elect Preferred | Elect
HSA | Elect Value Option
Plan Rates:
Elect Premiere | Elect Preferred | Elect
HSA | Elect Value Option
Elect Preferred Rates
Effective date : 1/1/2010
Valid thru : 12/31/2010
Counties :
Available in all counties
| Family Status : |
Applicant |
Applicant and Spouse |
Applicant and Family |
Applicant and Child(ren) |
| Age |
Deductible : 500 |
| 0-17 |
144.00 |
N/A |
N/A |
N/A |
| 18-20 |
181.00 |
363.00 |
526.00 |
326.00 |
| 21-24 |
187.00 |
375.00 |
544.00 |
337.00 |
| 25-29 |
218.00 |
435.00 |
653.00 |
392.00 |
| 30-34 |
247.00 |
493.00 |
740.00 |
444.00 |
| 35-39 |
271.00 |
543.00 |
814.00 |
488.00 |
| 40-44 |
343.00 |
686.00 |
960.00 |
617.00 |
| 45-49 |
401.00 |
803.00 |
1124.00 |
723.00 |
| 50-54 |
539.00 |
1077.00 |
1346.00 |
969.00 |
| 55-59 |
659.00 |
1319.00 |
1517.00 |
1187.00 |
| 60-64 |
766.00 |
1532.00 |
1685.00 |
1379.00 |
| 65+ |
766.00 |
1532.00 |
1685.00 |
1379.00 |
| Age |
Deductible : 1000 |
| 0-17 |
123.00 |
N/A |
N/A |
N/A |
| 18-20 |
155.00 |
310.00 |
449.00 |
279.00 |
| 21-24 |
160.00 |
320.00 |
465.00 |
288.00 |
| 25-29 |
186.00 |
372.00 |
558.00 |
335.00 |
| 30-34 |
211.00 |
422.00 |
632.00 |
379.00 |
| 35-39 |
232.00 |
464.00 |
696.00 |
417.00 |
| 40-44 |
293.00 |
586.00 |
820.00 |
527.00 |
| 45-49 |
343.00 |
686.00 |
961.00 |
618.00 |
| 50-54 |
460.00 |
920.00 |
1150.00 |
828.00 |
| 55-59 |
563.00 |
1127.00 |
1296.00 |
1014.00 |
| 60-64 |
654.00 |
1309.00 |
1440.00 |
1178.00 |
| 65+ |
654.00 |
1309.00 |
1440.00 |
1178.00 |
| Age |
Deductible : 2500 |
| 0-17 |
92.00 |
N/A |
N/A |
N/A |
| 18-20 |
117.00 |
233.00 |
338.00 |
210.00 |
| 21-24 |
121.00 |
241.00 |
350.00 |
217.00 |
| 25-29 |
140.00 |
280.00 |
420.00 |
252.00 |
| 30-34 |
159.00 |
317.00 |
476.00 |
286.00 |
| 35-39 |
175.00 |
349.00 |
524.00 |
314.00 |
| 40-44 |
221.00 |
441.00 |
618.00 |
397.00 |
| 45-49 |
258.00 |
516.00 |
723.00 |
465.00 |
| 50-54 |
346.00 |
693.00 |
866.00 |
624.00 |
| 55-59 |
424.00 |
848.00 |
976.00 |
764.00 |
| 60-64 |
493.00 |
985.00 |
1084.00 |
887.00 |
| 65+ |
493.00 |
985.00 |
1084.00 |
887.00 |
| Age |
Deductible : 5000 |
| 0-17 |
67.00 |
N/A |
N/A |
N/A |
| 18-20 |
85.00 |
170.00 |
247.00 |
153.00 |
| 21-24 |
88.00 |
176.00 |
255.00 |
158.00 |
| 25-29 |
102.00 |
204.00 |
306.00 |
184.00 |
| 30-34 |
116.00 |
232.00 |
347.00 |
208.00 |
| 35-39 |
127.00 |
255.00 |
382.00 |
229.00 |
| 40-44 |
161.00 |
322.00 |
451.00 |
290.00 |
| 45-49 |
188.00 |
377.00 |
528.00 |
339.00 |
| 50-54 |
253.00 |
506.00 |
632.00 |
455.00 |
| 55-59 |
310.00 |
619.00 |
712.00 |
557.00 |
| 60-64 |
360.00 |
719.00 |
791.00 |
647.00 |
| 65+ |
360.00 |
719.00 |
791.00 |
647.00 |
| Age |
Deductible : 7500 |
| 0-17 |
52.00 |
N/A |
N/A |
N/A |
| 18-20 |
66.00 |
131.00 |
190.00 |
118.00 |
| 21-24 |
68.00 |
136.00 |
197.00 |
122.00 |
| 25-29 |
79.00 |
157.00 |
236.00 |
142.00 |
| 30-34 |
89.00 |
178.00 |
268.00 |
161.00 |
| 35-39 |
98.00 |
196.00 |
294.00 |
177.00 |
| 40-44 |
124.00 |
248.00 |
347.00 |
223.00 |
| 45-49 |
145.00 |
290.00 |
406.00 |
261.00 |
| 50-54 |
195.00 |
389.00 |
487.00 |
350.00 |
| 55-59 |
238.00 |
477.00 |
548.00 |
429.00 |
| 60-64 |
277.00 |
554.00 |
609.00 |
498.00 |
| 65+ |
277.00 |
554.00 |
609.00 |
498.00 |
| Age |
Deductible : 10000 |
| 0-17 |
48.00 |
N/A |
N/A |
N/A |
| 18-20 |
60.00 |
120.00 |
174.00 |
108.00 |
| 21-24 |
62.00 |
124.00 |
180.00 |
112.00 |
| 25-29 |
72.00 |
144.00 |
216.00 |
130.00 |
| 30-34 |
82.00 |
163.00 |
245.00 |
147.00 |
| 35-39 |
90.00 |
180.00 |
270.00 |
162.00 |
| 40-44 |
114.00 |
227.00 |
318.00 |
204.00 |
| 45-49 |
133.00 |
266.00 |
372.00 |
239.00 |
| 50-54 |
178.00 |
357.00 |
446.00 |
321.00 |
| 55-59 |
218.00 |
437.00 |
502.00 |
393.00 |
| 60-64 |
254.00 |
507.00 |
558.00 |
457.00 |
| 65+ |
254.00 |
507.00 |
558.00 |
457.00 |
* - not all of the zip codes are eligible in this county
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