0949 Plan Rates 2018-2019(2).xlsx - Read-Only

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2018 Rates Plan Name Anthem BCBS BlueCard PPO 70 Anthem BCBS BlueCard PPO 80 Anthem BCBS BlueCard PPO 90 Anthem BCBS CDHP-20 H S A Anthem BCBS CDHP-40/H S A Cigna CDHP-20 H S A Anthem BCBS Blue Card MSP PPO 70 Anthem BCBS Blue Card MSP PPO 80 Anthem BCBS Blue Card MSP PPO 90 Preventive Dental Basic Dent-50/150 Dent&Ortho-25/75

Plan Code Single Plus Sps Plus Child Family MPP4 775 1550 1395 2325 MPP3 851 1702 1532 2553 MPP2 937 1874 1687 2811 MHDE 559 1118 1006 1677 MHBR 494 988 889 1482 MHDC 559 1118 1006 1677 Medicare Secondary Payer Plans for age 65+ MS12 619 1238 1114 1857 MS11 679 1358 1222 2037 MS10 749 1498 1348 2247 Dental DDPV 33 66 59 99 DD50 53 106 95 159 DD25 71 142 128 213

2019 Rates Single Plus Sps Plus Child 825 1650 1485 902 1804 1624 993 1986 1787 609 1218 1096 538 1076 968 609 1218 1096

Family 2475 2706 2979 1827 1614 1827

656 720 794

1312 1440 1588

1181 1296 1429

1968 2160 2382

35 54 73

70 108 146

63 97 131

105 162 219