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Regence BlueCross BlueShield - Online
Application
Index | Optional Dental | Exclusions
& Limitations | Provider
Directory | Download
Application
Benefit Schedules:
Evolve Core | Evolve Plus | Evolve HSA 50 | Evolve
HSA 80 | Evolve HSA 100
Rate Schedules:
Evolve Core | Evolve Plus | Evolve HSA 50 | Evolve
HSA 80 | Evolve HSA 100
Evolve Plus Rates
Effective date : 3/1/2010
Valid thru : 2/28/2011
Counties :
Clark
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
| Age |
Deductible : 1000 |
| 0-24 |
260.00 |
300.00 |
| 25-29 |
300.00 |
344.00 |
| 30-34 |
348.00 |
400.00 |
| 35-39 |
411.00 |
472.00 |
| 40-44 |
483.00 |
556.00 |
| 45-49 |
585.00 |
672.00 |
| 50-54 |
696.00 |
800.00 |
| 55-59 |
816.00 |
939.00 |
| 60+ |
957.00 |
1100.00 |
| Child |
260.00 |
300.00 |
| Age |
Deductible : 2500 |
| 0-24 |
204.00 |
235.00 |
| 25-29 |
234.00 |
269.00 |
| 30-34 |
272.00 |
313.00 |
| 35-39 |
321.00 |
369.00 |
| 40-44 |
378.00 |
434.00 |
| 45-49 |
457.00 |
526.00 |
| 50-54 |
544.00 |
626.00 |
| 55-59 |
638.00 |
734.00 |
| 60+ |
748.00 |
860.00 |
| Child |
204.00 |
235.00 |
| Age |
Deductible : 5000 |
| 0-24 |
169.00 |
194.00 |
| 25-29 |
194.00 |
223.00 |
| 30-34 |
225.00 |
259.00 |
| 35-39 |
266.00 |
306.00 |
| 40-44 |
313.00 |
360.00 |
| 45-49 |
379.00 |
436.00 |
| 50-54 |
451.00 |
519.00 |
| 55-59 |
529.00 |
609.00 |
| 60+ |
620.00 |
713.00 |
| Child |
169.00 |
194.00 |
| Age |
Deductible : 7500 |
| 0-24 |
153.00 |
176.00 |
| 25-29 |
176.00 |
202.00 |
| 30-34 |
204.00 |
235.00 |
| 35-39 |
241.00 |
277.00 |
| 40-44 |
283.00 |
326.00 |
| 45-49 |
343.00 |
394.00 |
| 50-54 |
408.00 |
469.00 |
| 55-59 |
479.00 |
551.00 |
| 60+ |
561.00 |
645.00 |
| Child |
153.00 |
176.00 |
* - not all of the zip codes are eligible in this county
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Assurant Health
