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Premera Blue Cross - Online application
Index | Exclusions
& Limitations | Provider
List | Download Application
Benefit Schedules:
Protector Plus 20 | Value
Plus 30 | Preferred Plus
30 | Preferred Plus 20
Rate Schedules:
Protector Plus 20 | Value
Plus 30 | Preferred Plus 30 | Preferred
Plus 20
Heritage Preferred Plus 20 Rates
Effective date : 10/1/2010
Valid thru : 9/30/2011
Counties :
Not available in
Clark
| Family Status : |
Applicant Non-Smoker |
Applicant Smoker |
| Age |
Deductible : 1000 |
| 0-24 |
425.00 |
494.00 |
| 25-29 |
505.00 |
587.00 |
| 30-34 |
525.00 |
612.00 |
| 35-39 |
587.00 |
684.00 |
| 40-44 |
776.00 |
902.00 |
| 45-49 |
902.00 |
1048.00 |
| 50-54 |
1037.00 |
1204.00 |
| 55-59 |
1256.00 |
1459.00 |
| 60-64 |
1465.00 |
1703.00 |
| 65+ |
1570.00 |
1827.00 |
| Child |
322.00 |
322.00 |
* - not all of the zip codes are eligible in this county
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