View |
View |
Bronze B07E
|
E
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
ded/coins |
50%
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B07E-AI2
|
E
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
ded/coins |
50%
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07S
|
S
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
ded/coins |
50%
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B07S-AI2
|
S
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
ded/coins |
50%
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B15E
|
E
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B15E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B15E-AI2
|
E
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B15S
|
S
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B15S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B15S-AI2
|
S
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B16E
|
E
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
50%
|
$9,200 Individual/
$18,400 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B16E-AI2
|
E
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
50%
|
$9,200 Individual/
$18,400 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16S
|
S
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
50%
|
$9,200 Individual/
$18,400 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B16S-AI2
|
S
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
50%
|
$9,200 Individual/
$18,400 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B17E
|
E
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B17E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B17E-AI2
|
E
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B17S
|
S
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Bronze B17S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B17S-AI2
|
S
|
Yes
|
$9,200 Individual/
$18,400 Family
|
ded/coins |
$0 |
0%
|
$9,200 Individual/
$18,400 Family
|
ded/coins
|
View |
View |
Gold G06E
|
E
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
20%
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G06E-AI2
|
E
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
20%
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06S
|
S
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
20%
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G06S-AI2
|
S
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
20%
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G08E
|
E
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
25%
|
$7,800 Individual/
$15,600 Family
|
$15/$30/$60
|
View |
View |
Gold G08E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G08E-AI2
|
E
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
25%
|
$7,800 Individual/
$15,600 Family
|
$15/$30/$60
|
View |
View |
Gold G08S
|
S
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
25%
|
$7,800 Individual/
$15,600 Family
|
$15/$30/$60
|
View |
View |
Gold G08S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G08S-AI2
|
S
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
25%
|
$7,800 Individual/
$15,600 Family
|
$15/$30/$60
|
View |
View |
Silver S25E
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
50%
|
$8,900 Individual/
$17,800 Family
|
$4500 ded/coins
|
View |
View |
Silver S25E-A
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $20 Copay
Spec: $80 Copay |
$0 |
50%
|
$7,350 Individual/
$14,700 Family
|
$4000 ded/coins
|
View |
View |
Silver S25E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S25E-AI2
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
50%
|
$8,900 Individual/
$17,800 Family
|
$4500 ded/coins
|
View |
View |
Silver S25E-B
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $10 Copay
Spec: $50 Copay |
$0 |
50%
|
$2,350 Individual/
$4,700 Family
|
$600 ded/coins
|
View |
View |
Silver S25E-C
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $25 Copay |
$0 |
50%
|
$750 Individual/
$1,500 Family
|
$300 ded/coins
|
View |
View |
Silver S25S
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
50%
|
$8,900 Individual/
$17,800 Family
|
$4500 ded/coins
|
View |
View |
Silver S25S-A
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $20 Copay
Spec: $80 Copay |
$0 |
50%
|
$7,350 Individual/
$14,700 Family
|
$4000 ded/coins
|
View |
View |
Silver S25S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S25S-AI2
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
50%
|
$8,900 Individual/
$17,800 Family
|
$4500 ded/coins
|
View |
View |
Silver S25S-B
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $10 Copay
Spec: $50 Copay |
$0 |
50%
|
$2,350 Individual/
$4,700 Family
|
$600 ded/coins
|
View |
View |
Silver S25S-C
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $25 Copay |
$0 |
50%
|
$750 Individual/
$1,500 Family
|
$300 ded/coins
|
View |
View |
Silver S26E
|
E
|
Yes
|
$5,000 Individual/
$10,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$8,000 Individual/
$16,000 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-A
|
E
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$6,400 Individual/
$12,800 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S26E-AI2
|
E
|
Yes
|
$5,000 Individual/
$10,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$8,000 Individual/
$16,000 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-B
|
E
|
Yes
|
$500 Individual/
$1,000 Family
|
PCP: $20 Copay
Spec: $40 Copay |
$0 |
30%
|
$3,000 Individual/
$6,000 Family
|
10/20[60 sub to ded]
|
View |
View |
Silver S26E-C
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $10 Copay |
$0 |
25%
|
$2,000 Individual/
$4,000 Family
|
$0/$15/$50
|
View |
View |
Silver S26S
|
S
|
Yes
|
$5,000 Individual/
$10,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$8,000 Individual/
$16,000 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-A
|
S
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$6,400 Individual/
$12,800 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S26S-AI2
|
S
|
Yes
|
$5,000 Individual/
$10,000 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
40%
|
$8,000 Individual/
$16,000 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-B
|
S
|
Yes
|
$500 Individual/
$1,000 Family
|
PCP: $20 Copay
Spec: $40 Copay |
$0 |
30%
|
$3,000 Individual/
$6,000 Family
|
10/20[60 sub to ded]
|
View |
View |
Silver S26S-C
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $10 Copay |
$0 |
25%
|
$2,000 Individual/
$4,000 Family
|
$0/$15/$50
|
View |
View |
Silver S27E
|
E
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S27E-A
|
E
|
Yes
|
$4,100 Individual/
$8,200 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$5,100 Individual/
$10,200 Family
|
ded/coins
|
View |
View |
Silver S27E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S27E-AI2
|
E
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S27E-B
|
E
|
Yes
|
$825 Individual/
$1,650 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$1,825 Individual/
$3,650 Family
|
ded/coins
|
View |
View |
Silver S27E-C
|
E
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$700 Individual/
$1,400 Family
|
ded/coins
|
View |
View |
Silver S27S
|
S
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S27S-A
|
S
|
Yes
|
$4,100 Individual/
$8,200 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$5,100 Individual/
$10,200 Family
|
ded/coins
|
View |
View |
Silver S27S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S27S-AI2
|
S
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S27S-B
|
S
|
Yes
|
$825 Individual/
$1,650 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$1,825 Individual/
$3,650 Family
|
ded/coins
|
View |
View |
Silver S27S-C
|
S
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$700 Individual/
$1,400 Family
|
ded/coins
|
View |
View |
Silver S29E
|
E
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S29E-A
|
E
|
Yes
|
$4,100 Individual/
$8,200 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$5,100 Individual/
$10,200 Family
|
ded/coins
|
View |
View |
Silver S29E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S29E-AI2
|
E
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S29E-B
|
E
|
Yes
|
$825 Individual/
$1,650 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$1,825 Individual/
$3,650 Family
|
ded/coins
|
View |
View |
Silver S29E-C
|
E
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$700 Individual/
$1,400 Family
|
ded/coins
|
View |
View |
Silver S29S
|
S
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S29S-A
|
S
|
Yes
|
$4,100 Individual/
$8,200 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$5,100 Individual/
$10,200 Family
|
ded/coins
|
View |
View |
Silver S29S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0%
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S29S-AI2
|
S
|
Yes
|
$5,300 Individual/
$10,600 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$6,300 Individual/
$12,600 Family
|
ded/coins
|
View |
View |
Silver S29S-B
|
S
|
Yes
|
$825 Individual/
$1,650 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$1,825 Individual/
$3,650 Family
|
ded/coins
|
View |
View |
Silver S29S-C
|
S
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
50%
|
$700 Individual/
$1,400 Family
|
ded/coins
|