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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 November 1, 2008 through October 31, 2009
Monthly family rates are based on the age of primary applicant
0 - 19 $93 $185 $257 $160
20 - 24 136 270 376 233
25 - 29 148 313 441 273
30 - 34 172 366 504 315
35 - 39 187 396 525 338
40 - 44 232 462 615 383
45 - 49 276 547 671 394
50 - 54 326 647 774 446
55 - 59 386 766 894 501
60 - 64 450 898 963 540
Beneficial Rx - $2,500 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 $77 $152 $212 $132
20 - 24 112 222 310 193
25 - 29 122 258 364 227
30 - 34 142 302 416 260
35 - 39 155 328 433 279
40 - 44 192 381 509 317
45 - 49 228 451 554 326
50 - 54 269 534 640 368
55 - 59 318 633 738 414
60 - 64 371 742 795 445
Beneficial Rx - $5,000 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 $61 $121 $169 $105
20 - 24 88 176 246 152
25 - 29 97 205 289 179
30 - 34 112 238 330 206
35 - 39 123 259 343 221
40 - 44 151 302 403 250
45 - 49 180 357 439 258
50 - 54 212 423 506 292
55 - 59 252 501 585 328
60 - 64 294 587 629 353