Rate chart guide. Please save this guide for future reference. Dental Insurance Plan. Grandfathered coverage
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- Leonard Bridges
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1 Grandfathered plans Closed to new membership Rate chart guide Kaiser Permanente for Individuals and Families n January 2016 n California Please save this guide for future reference. Your rate is based on your age or the age of your younger spouse as of. (If you or your younger spouse turns 65 this year, you may find you can get a lower rate through Kaiser Permanente Senior Advantage. For more information, call ) Your rate may increase or decrease if you: n move to a new rate area n n n add or drop a dependent drop dental coverage change plans If any of these changes apply to you, consult this Rate Chart Guide for your new rate. To use the Rate Chart Guide, first determine your rate area by finding your ZIP code in the lists on pages 2 and 3. Then locate the page listing your rate area and family category. Your monthly rate will appear in the box where the subscriber s age and plan intersect. If you have any questions, or would like to confirm your rate area, please call our Member Service Contact Center. Representatives are available 24 hours a day, seven days a week (except holidays), at For TTY for the deaf, hard of hearing, or speech impaired, call 711. Dental Insurance Plan Kaiser Permanente offers an optional Dental Insurance Plan underwritten by Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc., and administered by Delta Dental of California. For more information, call Delta Dental at (if you are already enrolled, call toll free ) monthly rates Enrollee only $27.54 Enrollee and spouse $52.56 Enrollee and child $46.33 Enrollee and children $71.36 Enrollee, spouse, and child(ren) $82.62 Grandfathered coverage Because you were already enrolled in your current Kaiser Permanente plan on March 23, 2010, the day the Affordable Care Act was signed into law, your coverage is considered grandfathered. That means you ll continue to enjoy similar benefits as before, although grandfathered coverage is not guaranteed indefinitely. If you change plans, you may lose your grandfathered coverage _V02 California 2016
2 Service area ZIP codes Rate Area Rate Area Rate Area
3 Rate Area Rate Area Rate Area Rate Area 7 Rate Area 7 applies to members who live outside Rate Areas
4 Rate Area 1 /1000 Subscriber only 30/10 /2000 0/ $294 $288 $280 $271 $228 $177 $169 $169 $136 $ ,576 1,576 1,576 1,576 1,383 1,576 1,576 1,576 1,576 1,383 4
5 Rate Area 1 /1000 Subscriber + spouse 30/10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $646 $6 $619 $597 $1 $383 $365 $367 $294 $ , ,017 1, ,028 1, ,038 1, ,051 1,038 1, ,063 1,051 1, ,085 1,072 1,0 1, ,108 1,096 1,063 1, ,129 1,119 1,085 1, ,154 1,141 1,108 1, ,177 1,166 1,130 1, ,205 1,194 1,158 1, ,234 1,223 1,187 1, ,263 1,2 1,214 1, ,295 1,283 1,244 1,197 1,010 1, ,327 1,314 1,273 1,229 1,035 1,053 1,000 1, ,363 1,349 1,307 1,261 1,062 1,078 1,024 1, ,399 1,385 1,344 1,296 1,090 1,102 1,048 1, ,437 1,423 1,379 1,331 1,121 1,129 1,073 1, ,475 1,462 1,417 1,366 1,149 1,155 1,099 1, ,515 1,1 1,454 1,4 1,180 1,183 1,1 1, ,545 1,531 1,484 1,431 1,204 1,208 1,149 1, ,576 1,560 1,514 1,458 1,229 1,234 1,173 1, ,608 1,593 1,544 1,488 1,4 1,261 1,197 1, ,6 1,624 1,575 1,517 1,278 1,289 1,224 1, ,674 1,658 1,607 1,547 1,304 1,315 1,249 1,8 1, ,707 1,691 1,639 1,576 1,331 1,344 1,276 1,285 1, ,742 1,7 1,673 1,608 1,357 1,372 1,304 1,313 1, ,149 3,149 3,149 3,149 2,762 3,149 3,149 3,149 3,149 2,762 5
6 Rate Area 1 /1000 Subscriber + child 30/10 /2000 0/ $586 $579 $560 $5 $455 $353 $339 $339 $274 $ , ,030 1, ,051 1,0 1, ,073 1,062 1, ,086 1,075 1,043 1, ,099 1,089 1,056 1, ,112 1,102 1,068 1, ,126 1,117 1,082 1, ,1 1,131 1,096 1, ,154 1,145 1,108 1, ,169 1,161 1,123 1, ,164 2,164 2,164 2,164 1,915 2,164 2,164 2,164 2,164 1,915 6
7 Rate Area 1 /1000 Subscriber + children 30/10 /2000 0/ $1,014 $1,003 $972 $935 $788 $563 $537 $539 $432 $ ,043 1, ,058 1,046 1, ,073 1,062 1, ,088 1,077 1,044 1, ,099 1,088 1,054 1, ,110 1,100 1,065 1, ,124 1,111 1,077 1, ,136 1,124 1,089 1, ,148 1,136 1,102 1, ,159 1,148 1,112 1, ,171 1,161 1,126 1, ,185 1,173 1,138 1, ,197 1,187 1,151 1, ,210 1,201 1,164 1, ,218 1,207 1,170 1, ,230 1,217 1,180 1, ,239 1,228 1,189 1, ,247 1,235 1,197 1, ,7 1,245 1,205 1, ,9 1,246 1,208 1, ,260 1,247 1,210 1, ,262 1,248 1,212 1, ,263 1,249 1,214 1, ,268 1,0 1,216 1, ,273 1,8 1,223 1, ,279 1,263 1,229 1, ,285 1,271 1,234 1,189 1, ,293 1,278 1,2 1,194 1, ,299 1,284 1,246 1,202 1, ,307 1,295 1,6 1,208 1, ,318 1,304 1,263 1,217 1, ,327 1,314 1,274 1,228 1,034 1, ,337 1,3 1,283 1,235 1,0 1, ,347 1,335 1,293 1,245 1,0 1,066 1,012 1, ,374 1,360 1,318 1,270 1,069 1,085 1,031 1, ,0 1,385 1,344 1,295 1,090 1,102 1,046 1, ,427 1,411 1,368 1,318 1,110 1,122 1,065 1, ,454 1,439 1,397 1,344 1,132 1,1 1,084 1, ,483 1,466 1,423 1,370 1,154 1,159 1,101 1, ,4 1,488 1,443 1,389 1,170 1,179 1,122 1, ,5 1,9 1,465 1,410 1,188 1,202 1,141 1, ,547 1,532 1,485 1,430 1,204 1,223 1,163 1, ,571 1,554 1,6 1,4 1,223 1,245 1,182 1, ,592 1,576 1,529 1,471 1,2 1,268 1,204 1, ,615 1,599 1,549 1,492 1,8 1,290 1,226 1, ,638 1,623 1,573 1,514 1,275 1,313 1,247 1,8 1, ,026 3,026 3,026 3,026 2,656 3,026 3,026 3,026 3,026 2,656 7
8 Rate Area 1 Subscriber, spouse + child(ren) / /10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $1,109 $1,099 $1,064 $1,0 $864 $624 $593 $597 $477 $ ,161 1,149 1,112 1, ,214 1,203 1,166 1, ,271 1,9 1,218 1, ,306 1,295 1,5 1,208 1, ,344 1,332 1,290 1,242 1, ,381 1,368 1,327 1,276 1, ,422 1,7 1,365 1,313 1, ,464 1,448 1,4 1,3 1, ,494 1,478 1,435 1,379 1, ,527 1,511 1,466 1,410 1, ,558 1,543 1,497 1,4 1, ,593 1,576 1,530 1,471 1, ,627 1,610 1,561 1,4 1, ,645 1,626 1,579 1,519 1, ,661 1,643 1,595 1,535 1, ,679 1,662 1,610 1,553 1, ,696 1,679 1,628 1,570 1, ,713 1,696 1,646 1,585 1, ,717 1,700 1,648 1,587 1,337 1, ,721 1,703 1,6 1,590 1,339 1,069 1,017 1, ,724 1,706 1,653 1,594 1,343 1,111 1,057 1, ,727 1,708 1,658 1,597 1,345 1,155 1,098 1, ,729 1,712 1,661 1,599 1,346 1,202 1,141 1, ,7 1,721 1,669 1,608 1,353 1,217 1,156 1, ,7 1,730 1,679 1,615 1,361 1,234 1,173 1, ,757 1,739 1,688 1,624 1,367 1,249 1,189 1, ,769 1,748 1,696 1,634 1,376 1,268 1,204 1, ,778 1,757 1,706 1,641 1,381 1,284 1,220 1, ,790 1,770 1,717 1,652 1,392 1,318 1,2 1,261 1, ,801 1,782 1,728 1,664 1,3 1,354 1,285 1,295 1, ,815 1,793 1,742 1,677 1,411 1,391 1,321 1,328 1, ,828 1,807 1,753 1,688 1,422 1,428 1,357 1,364 1, ,839 1,818 1,765 1,700 1,432 1,467 1,393 1,0 1, ,859 1,839 1,783 1,717 1,448 1,478 1,4 1,411 1, ,878 1,858 1,803 1,737 1,464 1,490 1,415 1,423 1, ,899 1,879 1,823 1,755 1,478 1,2 1,426 1,435 1, ,920 1,899 1,843 1,774 1,494 1,512 1,437 1,446 1,155 1, ,939 1,921 1,862 1,793 1,9 1,523 1,449 1,458 1,165 1, ,956 1,936 1,878 1,810 1,521 1,543 1,466 1,476 1,179 1, ,972 1,952 1,894 1,823 1,535 1,560 1,484 1,492 1,193 1, ,989 1,967 1,909 1,839 1,548 1,581 1,2 1,511 1,207 1, ,005 1,986 1,9 1,855 1,560 1,600 1,518 1,529 1,223 1, ,021 2,001 1,942 1,869 1,575 1,617 1,536 1,545 1,236 1, ,039 2,017 1,958 1,885 1,587 1,639 1,556 1,563 1,2 1, ,056 2,033 1,973 1,901 1,602 1,658 1,574 1,582 1,269 1, ,852 3,852 3,852 3,852 3,380 3,852 3,852 3,852 3,852 3,380 8
9 Rate Area 2 /1000 Subscriber only 30/10 /2000 0/ $269 $268 $9 $249 $212 $163 $154 $154 $123 $ ,620 1,620 1,620 1,620 1,447 1,620 1,620 1,620 1,620 1,447 9
10 Rate Area 2 /1000 Subscriber + spouse 30/10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $603 $601 $581 $562 $475 $352 $334 $336 $271 $ ,004 1, ,020 1, ,034 1, ,049 1,044 1, ,064 1,058 1, ,080 1,073 1,036 1, ,095 1,089 1,052 1, ,122 1,116 1,079 1, ,1 1,142 1,105 1, ,177 1,170 1,131 1, ,206 1,199 1,158 1, ,237 1,229 1,188 1, ,266 1,8 1,215 1, ,296 1,286 1,244 1,201 1,020 1, ,327 1,317 1,274 1,231 1,045 1, ,358 1,3 1,304 1,261 1,069 1,058 1,005 1, ,391 1,381 1,337 1,290 1,093 1,084 1,031 1, ,424 1,412 1,366 1,321 1,118 1,108 1,052 1, ,456 1,446 1,398 1,3 1,145 1,133 1,078 1, ,490 1,478 1,430 1,381 1,173 1,160 1,103 1, ,523 1,513 1,463 1,411 1,199 1,185 1,127 1, ,557 1,549 1,496 1,444 1,226 1,212 1,153 1, ,595 1,584 1,531 1,475 1,6 1,239 1,178 1, ,631 1,621 1,566 1,510 1,285 1,268 1,204 1, ,237 3,237 3,237 3,237 2,894 3,237 3,237 3,237 3,237 2,894 10
11 Rate Area 2 /1000 Subscriber + child 30/10 /2000 0/ $537 $537 $518 $498 $424 $324 $308 $308 $248 $ , ,015 1, ,030 1, ,041 1,034 1, ,055 1,048 1, ,069 1,061 1, ,082 1,074 1,037 1, ,220 2,220 2,220 2,220 1,987 2,220 2,220 2,220 2,220 1,987 11
12 Rate Area 2 /1000 Subscriber + children 30/10 /2000 0/ $935 $929 $897 $868 $737 $2 $476 $479 $387 $ ,011 1, ,031 1, ,044 1,035 1, ,055 1,048 1, ,066 1,059 1, ,078 1,072 1,035 1, ,091 1,084 1,047 1, ,103 1,094 1,059 1, ,115 1,107 1,070 1, ,127 1,118 1,080 1, ,137 1,131 1,093 1, ,1 1,142 1,104 1, ,157 1,149 1,111 1, ,162 1,155 1,116 1, ,168 1,161 1,120 1, ,175 1,168 1,129 1, ,180 1,173 1,133 1, ,184 1,177 1,137 1, ,190 1,181 1,142 1, ,195 1,185 1,146 1, ,198 1,189 1,1 1, ,201 1,192 1,154 1, ,204 1,196 1,157 1, ,208 1,199 1,160 1, ,211 1,201 1,162 1, ,213 1,204 1,163 1, ,215 1,208 1,167 1, ,226 1,217 1,176 1, ,237 1,227 1,188 1, ,246 1,238 1,197 1, ,8 1,248 1,206 1, ,267 1,9 1,216 1, ,287 1,280 1,237 1,195 1, ,307 1,298 1,6 1,213 1,030 1, ,327 1,318 1,274 1,231 1,046 1, ,346 1,3 1,294 1,2 1,062 1,052 1,001 1, ,369 1,360 1,314 1,271 1,078 1,074 1,020 1, ,387 1,380 1,330 1,286 1,093 1,092 1,036 1, ,7 1,398 1,351 1,306 1,108 1,111 1,055 1, ,4 1,415 1,369 1,322 1,120 1,131 1,074 1, ,444 1,436 1,388 1,3 1,137 1,1 1,092 1, ,466 1,455 1,8 1,357 1,153 1,169 1,111 1, ,484 1,475 1,426 1,377 1,168 1,190 1,131 1, ,5 1,495 1,448 1,395 1,184 1,210 1,1 1, ,112 3,112 3,112 3,112 2,779 3,112 3,112 3,112 3,112 2,779 12
13 Rate Area 2 Subscriber, spouse + child(ren) / /10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $1,041 $1,032 $1,000 $963 $820 $560 $530 $533 $428 $ ,098 1,087 1,055 1, ,160 1,145 1,114 1, ,224 1,206 1,175 1, ,5 1,238 1,203 1, ,285 1,271 1,233 1,187 1, ,317 1,303 1,265 1,217 1, ,3 1,339 1,296 1,248 1, ,384 1,373 1,328 1,282 1, ,413 1,4 1,357 1,309 1, ,443 1,434 1,387 1,339 1, ,474 1,466 1,419 1,367 1, ,7 1,496 1,448 1,398 1, ,539 1,530 1,479 1,427 1, ,552 1,541 1,491 1,439 1, ,565 1,554 1,3 1,451 1, ,577 1,566 1,514 1,462 1, ,589 1,578 1,527 1,474 1, ,601 1,591 1,537 1,486 1, ,609 1,597 1,545 1,492 1, ,614 1,603 1,5 1,497 1,271 1, ,620 1,609 1,554 1,4 1,274 1, ,6 1,615 1,561 1,510 1,280 1,051 1, ,633 1,620 1,566 1,516 1,285 1,078 1,0 1, ,636 1,623 1,569 1,519 1,287 1,103 1,048 1, ,642 1,629 1,574 1,521 1,290 1,127 1,072 1, ,645 1,633 1,578 1,527 1,294 1,151 1,093 1, ,649 1,636 1,581 1,531 1,296 1,176 1,118 1, ,652 1,642 1,587 1,533 1,301 1,201 1,141 1, ,663 1,651 1,597 1,545 1,309 1,227 1,167 1, ,678 1,663 1,610 1,555 1,320 1,6 1,192 1, ,691 1,676 1,621 1,566 1,328 1,282 1,219 1, ,702 1,689 1,633 1,577 1,339 1,310 1,244 1,1 1, ,715 1,702 1,645 1,589 1,346 1,339 1,272 1,279 1, ,728 1,716 1,659 1,601 1,358 1,352 1,284 1,293 1, ,742 1,729 1,671 1,615 1,369 1,366 1,298 1,306 1, ,756 1,743 1,684 1,628 1,380 1,381 1,313 1,318 1, ,769 1,757 1,698 1,642 1,391 1,395 1,326 1,331 1, ,784 1,772 1,713 1,656 1,2 1,9 1,339 1,345 1, ,799 1,785 1,726 1,667 1,413 1,426 1,356 1,364 1, ,813 1,801 1,741 1,681 1,4 1,444 1,372 1,380 1, ,828 1,815 1,755 1,695 1,437 1,462 1,388 1,395 1, ,844 1,831 1,769 1,708 1,449 1,481 1,8 1,412 1, ,859 1,846 1,784 1,722 1,461 1,497 1,424 1,428 1, ,873 1,861 1,799 1,738 1,472 1,517 1,442 1,446 1,162 1, ,890 1,875 1,813 1,751 1,485 1,536 1,458 1,463 1,176 1, ,956 3,956 3,956 3,956 3,539 3,956 3,956 3,956 3,956 3,539 13
14 Rate Area 3 /1000 Subscriber only 30/10 /2000 0/ $284 $281 $271 $263 $2 $171 $163 $163 $130 $ ,703 1,703 1,703 1,703 1,523 1,703 1,703 1,703 1,703 1,523 14
15 Rate Area 3 /1000 Subscriber + spouse 30/10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $634 $631 $611 $589 $1 $369 $352 $353 $285 $ , ,014 1, ,028 1, ,044 1,035 1, ,057 1,049 1, ,072 1,064 1, ,089 1,079 1,046 1, ,104 1,095 1,061 1, ,119 1,113 1,077 1, ,137 1,129 1,092 1, ,154 1,146 1,108 1, ,181 1,173 1,134 1, ,212 1,201 1,162 1, ,2 1,233 1,191 1, ,271 1,262 1,220 1,178 1, ,302 1,295 1,248 1,206 1,023 1, ,332 1,3 1,280 1,235 1,048 1, ,364 1,356 1,309 1,266 1,072 1,059 1,007 1, ,398 1,387 1,341 1,296 1,098 1,087 1,032 1, ,432 1,421 1,373 1,326 1,126 1,113 1,058 1, ,466 1,454 1,7 1,358 1,151 1,1 1,084 1, ,497 1,489 1,439 1,388 1,177 1,167 1,108 1, ,532 1,521 1,471 1,421 1,204 1,192 1,133 1, ,567 1,557 1,5 1,454 1,233 1,220 1,160 1, ,602 1,592 1,539 1,486 1,261 1,247 1,185 1, ,639 1,631 1,574 1,519 1,290 1,276 1,212 1, ,678 1,666 1,611 1,554 1,321 1,306 1,239 1,244 1, ,716 1,705 1,647 1,590 1,352 1,337 1,268 1,272 1, ,5 3,5 3,5 3,5 3,047 3,5 3,5 3,5 3,5 3,047 15
16 Rate Area 3 /1000 Subscriber + child 30/10 /2000 0/ $567 $564 $543 $526 $449 $3 $324 $324 $261 $ , ,023 1, ,045 1,035 1, ,056 1,049 1, ,070 1,062 1, ,084 1,075 1,037 1, ,097 1,090 1,051 1, ,111 1,104 1,066 1, ,126 1,117 1,078 1, ,137 1,131 1,092 1, ,336 2,336 2,336 2,336 2,086 2,336 2,336 2,336 2,336 2,086 16
17 Rate Area 3 /1000 Subscriber + children 30/10 /2000 0/ $982 $977 $944 $914 $774 $528 $2 $4 $5 $ ,022 1, ,044 1,036 1, ,063 1,058 1, ,085 1,078 1,041 1, ,097 1,091 1,052 1, ,109 1,104 1,066 1, ,122 1,116 1,078 1, ,134 1,128 1,091 1, ,148 1,1 1,103 1, ,160 1,153 1,114 1, ,174 1,164 1,127 1, ,185 1,177 1,137 1, ,198 1,191 1,1 1, ,211 1,203 1,162 1, ,216 1,211 1,169 1, ,224 1,215 1,175 1, ,231 1,223 1,181 1, ,238 1,229 1,189 1, ,244 1,235 1,195 1, ,247 1,239 1,198 1, ,4 1,243 1,201 1, ,7 1,247 1,206 1, ,261 1,2 1,212 1, ,266 1,6 1,215 1, ,269 1,8 1,217 1,176 1, ,272 1,262 1,220 1,178 1, ,274 1,266 1,223 1,181 1, ,276 1,268 1,2 1,184 1, ,280 1,271 1,227 1,187 1, ,290 1,282 1,239 1,197 1, ,302 1,294 1,248 1,206 1, ,313 1,303 1,9 1,217 1, ,324 1,315 1,271 1,226 1,041 1, ,335 1,326 1,281 1,237 1,049 1, ,355 1,345 1,302 1,6 1,066 1, ,377 1,367 1,321 1,276 1,082 1,067 1,014 1, ,399 1,388 1,341 1,296 1,099 1,089 1,034 1, ,420 1,410 1,361 1,316 1,116 1,109 1,052 1, ,442 1,432 1,384 1,337 1,133 1,131 1,074 1, ,461 1,451 1,2 1,355 1,149 1,151 1,092 1, ,482 1,471 1,422 1,372 1,164 1,170 1,111 1, ,3 1,491 1,4 1,391 1,181 1,190 1,131 1, ,521 1,511 1,461 1,411 1,198 1,211 1,1 1, ,544 1,532 1,481 1,430 1,214 1,231 1,169 1, ,563 1,553 1,499 1,449 1,231 1,2 1,190 1, ,584 1,575 1,521 1,470 1,246 1,273 1,210 1, ,277 3,277 3,277 3,277 2,928 3,277 3,277 3,277 3,277 2,928 17
18 Rate Area 3 Subscriber, spouse + child(ren) / /10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $1,095 $1,085 $1,051 $1,014 $861 $588 $560 $562 $452 $ ,157 1,142 1,109 1, ,221 1,204 1,173 1, ,289 1,269 1,237 1,187 1, ,321 1,302 1,267 1,217 1, ,353 1,338 1,298 1,248 1, ,387 1,372 1,329 1,282 1, ,422 1,9 1,364 1,315 1, ,456 1,446 1,399 1,346 1, ,489 1,477 1,427 1,379 1, ,519 1,9 1,458 1,9 1, ,553 1,541 1,491 1,439 1, ,587 1,575 1,523 1,471 1, ,620 1,608 1,555 1,4 1, ,634 1,621 1,568 1,516 1, ,646 1,635 1,580 1,528 1, ,660 1,647 1,593 1,539 1, ,673 1,661 1,607 1,551 1, ,685 1,675 1,619 1,563 1,327 1, ,693 1,680 1,6 1,572 1,330 1, ,699 1,687 1,632 1,576 1,338 1,055 1,002 1, ,705 1,693 1,636 1,583 1,342 1,080 1,0 1, ,713 1,701 1,644 1,589 1,346 1,108 1,051 1, ,718 1,705 1,649 1,593 1,352 1,136 1,078 1, ,722 1,708 1,652 1,598 1,356 1,161 1,103 1, ,727 1,715 1,658 1,602 1,358 1,185 1,127 1, ,730 1,718 1,661 1,607 1,361 1,212 1,151 1, ,734 1,722 1,665 1,611 1,364 1,239 1,176 1, ,7 1,728 1,670 1,615 1,367 1,266 1,201 1, ,7 1,7 1,681 1,6 1,378 1,295 1,227 1, ,763 1,751 1,694 1,636 1,387 1,322 1,6 1,9 1, ,777 1,764 1,706 1,649 1,399 1,351 1,282 1,286 1, ,790 1,778 1,720 1,660 1,8 1,380 1,310 1,316 1, ,803 1,790 1,731 1,673 1,420 1,410 1,339 1,344 1, ,819 1,805 1,745 1,686 1,430 1,4 1,352 1,358 1, ,833 1,820 1,760 1,701 1,442 1,439 1,366 1,372 1, ,846 1,834 1,773 1,715 1,452 1,454 1,381 1,387 1, ,861 1,848 1,788 1,728 1,466 1,468 1,395 1,1 1, ,875 1,863 1,802 1,741 1,475 1,483 1,9 1,415 1, ,893 1,881 1,815 1,755 1,489 1,3 1,426 1,433 1, ,908 1,895 1,831 1,769 1,499 1,519 1,444 1,451 1,168 1, ,9 1,911 1,847 1,785 1,513 1,539 1,462 1,468 1,181 1, ,939 1,927 1,862 1,801 1,5 1,558 1,481 1,485 1,196 1, ,955 1,943 1,880 1,815 1,537 1,577 1,497 1,4 1,210 1, ,972 1,959 1,894 1,831 1,551 1,597 1,517 1,520 1,223 1, ,988 1,975 1,910 1,846 1,563 1,617 1,536 1,539 1,237 1, ,165 4,165 4,165 4,165 3,726 4,165 4,165 4,165 4,165 3,726 18
19 Rate Area 4 /1000 Subscriber only 30/10 /2000 0/ $296 $296 $285 $277 $235 $180 $171 $171 $138 $ ,789 1,789 1,789 1,789 1,598 1,789 1,789 1,789 1,789 1,598 19
20 Rate Area 4 /1000 Subscriber + spouse 30/10 /2000 0/ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 19 $668 $662 $641 $621 $5 $389 $369 $372 $297 $ , ,019 1, ,034 1, ,0 1,045 1, ,064 1,058 1, ,079 1,073 1,035 1, ,095 1,089 1,0 1, ,111 1,104 1,066 1, ,127 1,118 1,082 1, ,142 1,134 1,097 1, ,160 1,151 1,114 1, ,177 1,168 1,130 1, ,195 1,185 1,146 1, ,212 1,201 1,162 1, ,242 1,233 1,191 1, ,272 1,262 1,221 1,180 1, ,302 1,295 1,248 1,210 1,024 1, ,332 1,326 1,281 1,238 1,049 1, ,366 1,358 1,310 1,268 1,075 1,061 1,008 1, ,399 1,390 1,343 1,298 1,101 1,087 1,033 1, ,432 1,424 1,374 1,329 1,128 1,114 1,058 1, ,467 1,456 1,8 1,361 1,154 1,141 1,084 1, ,3 1,491 1,442 1,393 1,181 1,169 1,111 1, ,537 1,527 1,475 1,427 1,210 1,198 1,139 1, ,573 1,561 1,510 1,458 1,238 1,2 1,164 1, ,609 1,597 1,546 1,492 1,266 1,4 1,191 1, ,645 1,634 1,580 1,527 1,296 1,282 1,217 1, ,683 1,673 1,616 1,561 1,326 1,310 1,244 1,248 1, ,721 1,709 1,652 1,597 1,356 1,341 1,273 1,279 1, ,761 1,749 1,692 1,633 1,387 1,371 1,302 1,307 1, ,802 1,790 1,729 1,671 1,421 1,1 1,330 1,338 1, ,578 3,578 3,578 3,578 3,198 3,578 3,578 3,578 3,578 3,198 20
21 Rate Area 4 /1000 Subscriber + child 30/10 /2000 0/ $595 $595 $569 $553 $469 $361 $3 $3 $275 $ ,013 1, ,033 1, ,052 1,046 1, ,074 1,066 1, ,095 1,089 1,0 1, ,109 1,103 1,064 1, ,122 1,116 1,078 1, ,136 1,129 1,092 1, ,151 1,142 1,105 1, ,164 1,156 1,118 1, ,180 1,172 1,133 1, ,195 1,185 1,149 1, ,455 2,455 2,455 2,455 2,192 2,455 2,455 2,455 2,455 2,192 21
22 Rate Area 4 /1000 Subscriber + children 30/10 /2000 0/ $1,033 $1,0 $991 $960 $812 $554 $527 $528 $427 $ ,074 1,067 1, ,095 1,090 1,051 1, ,117 1,109 1,072 1, ,1 1,133 1,094 1, ,151 1,146 1,107 1, ,164 1,157 1,118 1, ,178 1,172 1,131 1, ,192 1,184 1,145 1, ,206 1,198 1,157 1, ,217 1,211 1,169 1, ,232 1,223 1,183 1, ,244 1,237 1,196 1, ,8 1,1 1,210 1, ,272 1,262 1,221 1,181 1, ,279 1,269 1,227 1,187 1, ,285 1,276 1,233 1,195 1, ,293 1,283 1,2 1,199 1, ,298 1,290 1,246 1,204 1, ,306 1,297 1,4 1,212 1, ,310 1,301 1,8 1,215 1, ,315 1,307 1,261 1,220 1, ,320 1,310 1,266 1,224 1, ,3 1,315 1,272 1,227 1, ,328 1,318 1,275 1,233 1, ,330 1,322 1,279 1,235 1, ,335 1,326 1,281 1,238 1, ,339 1,328 1,283 1,2 1, ,341 1,330 1,286 1,243 1, ,343 1,335 1,289 1,245 1, ,355 1,345 1,301 1,7 1,066 1, ,366 1,357 1,310 1,267 1,075 1, ,378 1,368 1,324 1,279 1,084 1, ,388 1,381 1,335 1,287 1,093 1,058 1,005 1, ,1 1,391 1,344 1,299 1,103 1,078 1,024 1, ,423 1,413 1,366 1,318 1,118 1,098 1,046 1, ,444 1,436 1,387 1,3 1,136 1,120 1,064 1, ,467 1,457 1,8 1,360 1,154 1,142 1,085 1, ,490 1,481 1,430 1,383 1,174 1,164 1,107 1, ,513 1,4 1,451 1,2 1,191 1,187 1,128 1, ,533 1,5 1,471 1,423 1,208 1,208 1,148 1, ,553 1,545 1,492 1,442 1,224 1,227 1,168 1, ,576 1,566 1,513 1,462 1,2 1,248 1,187 1, ,597 1,588 1,533 1,482 1,7 1,271 1,208 1, ,619 1,609 1,554 1,3 1,274 1,294 1,227 1, ,643 1,632 1,576 1,521 1,293 1,315 1,248 1,5 1, ,663 1,652 1,597 1,544 1,308 1,338 1,271 1,274 1, ,439 3,439 3,439 3,439 3,073 3,439 3,439 3,439 3,439 3,073 22
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