|
HDHP 2600 without Rx Rates
Effective date : 10/1/2008
Valid thru : 9/30/2009
Counties :
Columbia,
Multnomah,
Polk,
Washington,
Yamhill,
Benton*,
Clackamas*,
Hood River*,
Linn*,
Marion*
| Family Status : |
Applicant |
Applicant and Spouse |
Applicant and Child(ren) |
Applicant and Family |
| Age |
Deductible : 2600 |
| 0-19 |
92.00 |
N/A |
N/A |
N/A |
| 20-25 |
110.00 |
N/A |
N/A |
N/A |
| 26-29 |
133.00 |
N/A |
N/A |
N/A |
| 30-34 |
170.00 |
N/A |
N/A |
N/A |
| 35-39 |
186.00 |
N/A |
N/A |
N/A |
| 40-44 |
231.00 |
N/A |
N/A |
N/A |
| 45-49 |
248.00 |
N/A |
N/A |
N/A |
| 50-54 |
322.00 |
N/A |
N/A |
N/A |
| 55-59 |
400.00 |
N/A |
N/A |
N/A |
| 60-64 |
437.00 |
N/A |
N/A |
N/A |
| 65 |
515.00 |
N/A |
N/A |
N/A |
| Age |
Deductible : 5200 |
| 0-19 |
N/A |
N/A |
N/A |
N/A |
| 20-25 |
N/A |
220.00 |
198.00 |
330.00 |
| 26-29 |
N/A |
266.00 |
239.00 |
399.00 |
| 30-34 |
N/A |
340.00 |
306.00 |
510.00 |
| 35-39 |
N/A |
372.00 |
335.00 |
558.00 |
| 40-44 |
N/A |
462.00 |
416.00 |
693.00 |
| 45-49 |
N/A |
496.00 |
446.00 |
744.00 |
| 50-54 |
N/A |
644.00 |
580.00 |
966.00 |
| 55-59 |
N/A |
800.00 |
720.00 |
1200.00 |
| 60-64 |
N/A |
874.00 |
787.00 |
1311.00 |
| 65 |
N/A |
N/A |
N/A |
N/A |
|
|
LifeWise
HSA Plans
