|

HSA Qualified Rates
Effective date : 9/1/2010
Valid thru : 8/31/2011
Counties :
Baker,
Clatsop,
Columbia,
Coos,
Crook,
Curry,
Deschutes,
Gilliam,
Grant,
Harney,
Hood River,
Jefferson,
Klamath,
Lake,
Lincoln,
Malheur,
Morrow,
Sherman,
Tillamook,
Umatilla,
Union,
Wallowa,
Wasco,
Wheeler
| Family Status : |
Applicant |
Applicant and Family |
| Age |
Deductible : 3000 |
| 0-19 |
106.00 |
N/A |
| 20-24 |
106.00 |
N/A |
| 25-29 |
160.00 |
N/A |
| 30-34 |
213.00 |
N/A |
| 35-39 |
213.00 |
N/A |
| 40-44 |
224.00 |
N/A |
| 45-49 |
244.00 |
N/A |
| 50-54 |
361.00 |
N/A |
| 55-59 |
424.00 |
N/A |
| 60-64 |
532.00 |
N/A |
| 65+ |
532.00 |
N/A |
| Child |
102.00 |
N/A |
| Age |
Deductible : 6000 |
| 0-19 |
N/A |
106.00 |
| 20-24 |
N/A |
106.00 |
| 25-29 |
N/A |
160.00 |
| 30-34 |
N/A |
213.00 |
| 35-39 |
N/A |
213.00 |
| 40-44 |
N/A |
224.00 |
| 45-49 |
N/A |
244.00 |
| 50-54 |
N/A |
361.00 |
| 55-59 |
N/A |
424.00 |
| 60-64 |
N/A |
532.00 |
| 65+ |
N/A |
532.00 |
| Child |
N/A |
102.00 |
Counties :
Benton,
Clackamas,
Douglas,
Jackson,
Josephine,
Lane,
Linn,
Marion,
Multnomah,
Polk,
Washington,
Yamhill
| Family Status : |
Applicant |
Applicant and Family |
| Age |
Deductible : 3000 |
| 0-19 |
88.00 |
N/A |
| 20-24 |
88.00 |
N/A |
| 25-29 |
132.00 |
N/A |
| 30-34 |
176.00 |
N/A |
| 35-39 |
176.00 |
N/A |
| 40-44 |
185.00 |
N/A |
| 45-49 |
202.00 |
N/A |
| 50-54 |
299.00 |
N/A |
| 55-59 |
351.00 |
N/A |
| 60-64 |
440.00 |
N/A |
| 65+ |
440.00 |
N/A |
| Child |
84.00 |
N/A |
| Age |
Deductible : 6000 |
| 0-19 |
N/A |
88.00 |
| 20-24 |
N/A |
88.00 |
| 25-29 |
N/A |
132.00 |
| 30-34 |
N/A |
176.00 |
| 35-39 |
N/A |
176.00 |
| 40-44 |
N/A |
185.00 |
| 45-49 |
N/A |
202.00 |
| 50-54 |
N/A |
299.00 |
| 55-59 |
N/A |
351.00 |
| 60-64 |
N/A |
440.00 |
| 65+ |
N/A |
440.00 |
| Child |
N/A |
84.00 |
|
|