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Summary of Benefits
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Monthly Premiums
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Medicare Carve-Out
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Application/Forms
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Important Notices
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Monthly Premiums: 

Click on one of the plan designs and you will be redirected to the premiums associated with that plan. 

  2010
  Effective January 1, 2010 through June 30, 2010
   
Monthly Premium Rates
 		 [Click Here]
Low Income Premium Program
Federal Income Poverty Level 0% - 199%
(75% Discount)
 		 [Click Here]
Low Income Premium Program
Federal Income Poverty Level 200% - 299%
(50% Discount)
 		 [Click Here]
Low Income Premium Program
Federal Income Poverty Level 300% - 399%
(40% Discount)
Members Effective Prior to January 1, 2009
 		 [Click Here]
Low Income Premium Program
Federal Income Poverty Level 300% - 399%
(25% Discount)
Members Effective On or After January 1, 2009
 		 [Click Here]
Medicare CarveOut Plan

 

 [Click Here]
 
 
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