Master Plan Monthly Premiums

wdt_ID wdt_created_by wdt_created_at wdt_last_edited_by wdt_last_edited_at Plan Name Line of Business County Web ID 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64
733 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Active Choice PPO Individual and Family SF 2024-active-choice-ppo-silver-ifp-sf 336.77 366.70 378.15 389.59 401.92 414.25 427.01 440.22 440.22 440.22 440.22 441.98 450.78 461.35 478.52 492.60 499.65 510.21 520.78 527.38 534.43 537.95 541.47 544.99 548.51 555.56 562.60 573.16 583.29 597.38 614.99 635.68 660.33 688.06 719.76 751.01 786.23 821.01 859.31 898.05 939.87 981.69 1,027.03 1,072.81 1,121.68 1,145.89 1,194.75 1,237.01 1,264.75 1,299.52 1,320.65
734 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Active Choice PPO Individual and Family SM 2024-active-choice-ppo-silver-ifp-sm 363.72 396.06 408.42 420.78 434.09 447.41 461.19 475.46 475.46 475.46 475.46 477.36 486.87 498.28 516.82 532.04 539.64 551.06 562.47 569.60 577.21 581.01 584.81 588.62 592.42 600.03 607.63 619.05 629.98 645.20 664.21 686.56 713.19 743.14 777.37 811.13 849.17 886.73 928.09 969.93 1,015.10 1,060.27 1,109.24 1,158.69 1,211.47 1,237.62 1,290.39 1,336.04 1,365.99 1,403.55 1,426.36
735 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Amber 50 HMO Silver Individual and Family SF 2024-amber-50-hmo-silver-ifp-sf 348.79 379.80 391.65 403.51 416.27 429.04 442.26 455.94 455.94 455.94 455.94 457.76 466.88 477.83 495.61 510.20 517.49 528.44 539.38 546.22 553.51 557.16 560.81 564.45 568.10 575.40 582.69 593.63 604.12 618.71 636.95 658.38 683.91 712.64 745.46 777.83 814.31 850.33 890.00 930.12 973.43 1,016.75 1,063.71 1,111.13 1,161.74 1,186.81 1,237.42 1,281.19 1,309.92 1,345.94 1,367.81
736 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Amber 50 HMO Silver Individual and Family SM 2024-amber-50-hmo-silver-ifp-sm 376.72 410.20 423.00 435.81 449.60 463.38 477.66 492.44 492.44 492.44 492.44 494.41 504.26 516.08 535.28 551.04 558.92 570.74 582.55 589.94 597.82 601.76 605.70 609.64 613.58 621.46 629.34 641.15 652.48 668.24 687.94 711.08 738.66 769.68 805.14 840.10 879.49 918.40 961.24 1,004.57 1,051.36 1,098.14 1,148.86 1,200.07 1,254.73 1,281.82 1,336.48 1,383.75 1,414.77 1,453.68 1,477.30
737 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM American Indian / Alaskan Native HMO Individual and Family SF 2024-american-indian-alaskan-native-hmo-ifp-sf 295.70 321.99 332.04 342.09 352.91 363.73 374.94 386.54 386.54 386.54 386.54 388.09 395.82 405.09 420.17 432.54 438.72 448.00 457.28 463.07 469.26 472.35 475.44 478.54 481.63 487.81 494.00 503.27 512.16 524.53 540.00 558.16 579.81 604.16 631.99 659.44 690.36 720.90 754.52 788.54 825.26 861.98 901.80 942.00 984.90 1,006.16 1,049.07 1,086.18 1,110.53 1,141.06 1,159.61
738 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM American Indian / Alaskan Native HMO Individual and Family SM 2024-american-indian-alaskan-native-hmo-ifp-sm 319.36 347.75 358.60 369.45 381.14 392.83 404.94 417.46 417.46 417.46 417.46 419.13 427.48 437.50 453.78 467.14 473.82 483.84 493.86 500.12 506.80 510.14 513.48 516.82 520.16 526.84 533.52 543.54 553.14 566.50 583.20 602.82 626.19 652.49 682.55 712.19 745.59 778.57 814.89 851.62 891.28 930.94 973.94 1,017.36 1,063.69 1,086.65 1,132.99 1,173.07 1,199.37 1,232.35 1,252.38
739 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Bronze 60 HDHP HMO Employer Group SF 2024-bronze-60-hdhp-hmo-egp-sf 241.84 263.34 271.56 279.78 288.63 297.48 306.65 316.14 316.14 316.14 316.14 317.40 323.72 331.31 343.64 353.76 358.81 366.40 373.99 378.73 383.79 386.32 388.85 391.38 393.91 398.96 404.02 411.61 418.88 429.00 441.64 456.50 474.20 494.12 516.88 539.33 564.62 589.59 617.10 644.92 674.95 704.98 737.55 770.42 805.52 822.90 857.99 888.34 908.26 933.23 948.40
740 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Bronze 60 HDHP HMO Employer Group SM 2024-bronze-60-hdhp-hmo-egp-sm 261.20 284.42 293.30 302.18 311.74 321.30 331.20 341.44 341.44 341.44 341.44 342.81 349.64 357.83 371.15 382.08 387.54 395.73 403.93 409.05 414.51 417.24 419.98 422.71 425.44 430.90 436.37 444.56 452.41 463.34 477.00 493.05 512.17 533.68 558.26 582.50 609.82 636.79 666.50 696.55 728.98 761.42 796.59 832.10 870.00 888.78 926.68 959.46 980.97 1,007.94 1,024.32
741 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Bronze 60 HDHP HMO Individual and Family SF 2024-bronze-60-hdhp-hmo-ifp-sf 295.70 321.99 332.04 342.09 352.91 363.73 374.94 386.54 386.54 386.54 386.54 388.09 395.82 405.09 420.17 432.54 438.72 448.00 457.28 463.07 469.26 472.35 475.44 478.54 481.63 487.81 494.00 503.27 512.16 524.53 540.00 558.16 579.81 604.16 631.99 659.44 690.36 720.90 754.52 788.54 825.26 861.98 901.80 942.00 984.90 1,006.16 1,049.07 1,086.18 1,110.53 1,141.06 1,159.61
742 imLana 05/12/2025 02:25 PM imLana 05/12/2025 02:25 PM Bronze 60 HDHP HMO Individual and Family SM 2024-bronze-60-hdhp-hmo-ifp-sm 319.36 347.75 358.60 369.45 381.14 392.83 404.94 417.46 417.46 417.46 417.46 419.13 427.48 437.50 453.78 467.14 473.82 483.84 493.86 500.12 506.80 510.14 513.48 516.82 520.16 526.84 533.52 543.54 553.14 566.50 583.20 602.82 626.19 652.49 682.55 712.19 745.59 778.57 814.89 851.62 891.28 930.94 973.94 1,017.36 1,063.69 1,086.65 1,132.99 1,173.07 1,199.37 1,232.35 1,252.38
Plan Name Line of Business County Web ID 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64