BluePreferred Underwritten -- District of Columbia

Monthly Premium Rates Effective: January 1, 2007

* To Include a Maternity Benefit Add $126 To the Monthly Premium Rate

Click on the desired link to go directly to the rates for that plan or scroll down. Links below indicate member's In-Network/Out-of-Network deductibles and Insurance Carrier's share of coinsurance.

100/300 Deductible with 90/70 Coinsurance
300/600 Deductible with 80/60 Coinsurance
500/1000 Deductible with 80/60 Coinsurance
750/1500 Deductible with 80/60 Coinsurance

*In Network: $100 Deductible, 90%/10% Coinsurance, $2,500 Out of Pocket*
*Out of Network: $300 Deductible, 70%/30% Coinsurance, $5,000 Out of Pocket*
*Prescription: $10/$25/$45 Copays, $100 Deductible, $1,500 Annual Max*
AGE AT EFFECTIVE DATE	INDIVIDUAL	INDIVIDUAL & CHILDREN	INDIVIDUAL & ADULT	FAMILY
1-5	$130
6-17	$116	$221	$232	$313
18-20	$168	$320	$337	$454
21	$171	$326	$343	$463
22	$174	$331	$348	$468
23	$180	$343	$360	$485
24	$182	$348	$364	$493
25	$186	$351	$370	$499
26	$190	$362	$381	$516
27	$194	$368	$387	$521
28	$196	$373	$393	$529
29	$202	$384	$403	$543
30	$205	$389	$409	$551
31	$211	$401	$420	$568
32	$213	$403	$426	$574
33	$219	$414	$437	$591
34	$221	$420	$443	$596
35	$227	$432	$453	$613
36	$230	$437	$459	$618
37	$235	$448	$470	$634
38	$240	$457	$482	$649
39	$244	$462	$486	$657
40	$249	$473	$498	$671
41	$260	$495	$520	$702
42	$274	$520	$548	$740
43	$285	$542	$570	$768
44	$298	$567	$598	$807
45	$313	$595	$625	$843
46	$327	$620	$654	$882
47	$341	$648	$681	$918
48	$358	$678	$714	$965
49	$374	$712	$747	$1,009
50	$391	$742	$781	$1,054
51	$407	$772	$815	$1,098
52	$426	$811	$853	$1,151
53	$446	$848	$892	$1,203
54	$465	$884	$931	$1,257
55	$488	$928	$975	$1,317
56	$509	$970	$1,020	$1,376
57	$534	$1,017	$1,070	$1,443
58	$557	$1,059	$1,114	$1,503
59	$585	$1,111	$1,169	$1,578
60	$610	$1,158	$1,219	$1,645
61	$637	$1,211	$1,275	$1,720
62	$668	$1,270	$1,336	$1,803
63	$699	$1,328	$1,397	$1,886
64	$729	$1,386	$1,458	$1,967
65	$762	$1,450	$1,525	$2,058
66 and over	$799	$1,516	$1,597	$2,155
* To Include a Maternity Benefit Add $126 To the Monthly Premium Rate

*In Network: $300 Deductible, 80%/20% Coinsurance, $2,500 Out of Pocket*
*Out of Network: $600 Deductible, 60%/40% Coinsurance, $5,000 Out of Pocket*
*Prescription: $10/$25/$45 Copays, $100 Deductible, $1,500 Annual Max*
AGE AT EFFECTIVE DATE	INDIVIDUAL	INDIVIDUAL & CHILDREN	INDIVIDUAL & ADULT	FAMILY
1-5	$96
6-17	$85	$162	$170	$230
18-20	$123	$235	$247	$333
21	$126	$239	$252	$339
22	$127	$243	$255	$343
23	$132	$252	$264	$356
24	$134	$255	$267	$362
25	$136	$258	$271	$366
26	$140	$265	$279	$378
27	$142	$270	$284	$381
28	$144	$273	$288	$387
29	$148	$282	$296	$398
30	$150	$285	$300	$404
31	$154	$294	$308	$416
32	$156	$296	$312	$420
33	$160	$303	$320	$433
34	$162	$308	$324	$437
35	$166	$316	$332	$449
36	$168	$320	$336	$452
37	$173	$329	$344	$464
38	$176	$335	$353	$475
39	$179	$338	$356	$481
40	$182	$347	$365	$491
41	$191	$362	$380	$514
42	$200	$380	$401	$542
43	$209	$397	$418	$562
44	$218	$415	$438	$591
45	$229	$436	$457	$617
46	$239	$454	$478	$645
47	$250	$474	$498	$671
48	$262	$496	$522	$706
49