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HSA Choice Rates

HSA Choice - $1,500 Deductible
Age Insured
Only		 Insured &
Spouse		 Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective November 1, 2008 through October 31, 2009
Monthly family rates are based on the age of primary applicant
0 - 19 $69 $138 $192 $119
20 - 24 101 201 280 173
25 - 29 111 233 327 204
30 - 34 128 272 375 234
35 - 39 140 295 390 251
40 - 44 172 344 457 285
45 - 49 205 406 499 294
50 - 54 242 481 576 332
55 - 59 286 569 665 373
60 - 64 335 668 715 401