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Plan Designs
Monthly Premiums
Qualifying Rates
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Important Notices
Monthly Premiums:
Regular Plan
Medicare Carve Out
Low Income Premium Program
Female
Male
Female
Male
50% Reduction Male
50% Reduction Female
75% Reduction Male
75% Reduction Female
All rates effective July 1, 2008 through December 31, 2008.
MEDICARE CARVEOUT (MC) PLAN
FEMALE
Low Income Premium Program
Female
Medicare Carveout
Federal Poverty Income Range:
Attained Age
$500 Plan
0% to 199%
200% to 399%
75% Premium Reduction
50% Premium Reduction
0 - 18
$81
$20
$41
19
$126
$32
$63
20
$126
$32
$63
21
$126
$32
$63
22
$126
$32
$63
23
$126
$32
$63
24
$126
$32
$63
25
$132
$33
$66
26
$137
$34
$69
27
$143
$36
$72
28
$148
$37
$74
29
$152
$38
$76
30
$157
$39
$79
31
$162
$41
$81
32
$167
$42
$84
33
$173
$43
$87
34
$179
$45
$90
35
$186
$47
$93
36
$193
$48
$97
37
$200
$50
$100
38
$207
$52
$104
39
$214
$54
$107
40
$221
$55
$111
41
$228
$57
$114
42
$236
$59
$118
43
$243
$61
$122
44
$251
$63
$126
45
$259
$65
$130
46
$267
$67
$134
47
$275
$69
$138
48
$279
$70
$140
49
$284
$71
$142
50
$288
$72
$144
51
$293
$73
$147
52
$297
$74
$149
53
$299
$75
$150
54
$300
$75
$150
55
$302
$76
$151
56
$303
$76
$152
57
$305
$76
$153
58
$307
$77
$154
59
$309
$77
$155
60
$311
$78
$156
61
$314
$79
$157
62
$316
$79
$158
63
$326
$82
$163
64
$335
$84
$168
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