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Beneficial Rx Rates

Beneficial Rx - $1,000 Deductible
Age Insured
Only		 Insured &
Spouse		 Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective December 1, 2009 through October 31, 2010
Monthly family rates are based on the age of primary applicant
0 - 19 109 218 302 188
20 - 24 160 318 442 274
25 - 29 174 368 519 322
30 - 34 202 431 593 370
35 - 39 220 466 618 397
40 - 44 273 543 724 451
45 - 49 324 643 789 464
50 - 54 383 761 911 525
55 - 59 454 901 1052 589
60 - 64 529 1057 1133 636
Beneficial Rx - $2,500 Deductible
Age Insured
Only		 Insured &
Spouse		 Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective December 1, 2009 through October 31, 2010
Monthly family rates are based on the age of primary applicant
0 - 19 $91 $179 $250 $155
20 - 24 132 261 365 227
25 - 29 144 304 428 267
30 - 34 167 355 490 306
35 - 39 182 386 510 328
40 - 44 226 449 598 373
45 - 49 268 531 652 383
50 - 54 317 628 753 433
55 - 59 374 745 869 487
60 - 64 437 873 935 524
Beneficial Rx - $5,000 Deductible
Age Insured
Only		 Insured &
Spouse		 Insured & Spouse & Child (ren) Insured & Child (ren)

Monthly rates effective December 1, 2009 through October 31, 2010
Monthly family rates are based on the age of primary applicant
0 - 19 $72 $142 $199 $123
20 - 24 104 208 290 179
25 - 29 114 241 340 210
30 - 34 132 281 388 242
35 - 39 145 305 404 260
40 - 44 178 355 474 295
45 - 49 211 420 516 304
50 - 54 250 497 596 343
55 - 59 296 589 688 386
60 - 64 346 691 741 415