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Regence 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 Core Rates
Effective date : 10/1/2010
Valid thru : 6/30/2011
Counties :
Clallam,
Columbia,
Cowlitz,
Grays Harbor,
Island,
Jefferson,
King,
Kitsap,
Klickitat,
Lewis,
Mason,
Pacific,
Pierce,
San Juan,
Skagit,
Skamania,
Snohomish,
Thurston,
Wahkiakum,
Walla Walla,
Whatcom,
Yakima
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
| Age |
Deductible : 2500 |
| 0-24 |
97.00 |
112.00 |
| 25-29 |
112.00 |
129.00 |
| 30-34 |
130.00 |
149.00 |
| 35-39 |
153.00 |
176.00 |
| 40-44 |
180.00 |
207.00 |
| 45-49 |
218.00 |
251.00 |
| 50-54 |
260.00 |
298.00 |
| 55-59 |
305.00 |
350.00 |
| 60+ |
357.00 |
410.00 |
| Child |
97.00 |
97.00 |
| Age |
Deductible : 5000 |
| 0-24 |
80.00 |
92.00 |
| 25-29 |
92.00 |
106.00 |
| 30-34 |
107.00 |
123.00 |
| 35-39 |
126.00 |
145.00 |
| 40-44 |
148.00 |
170.00 |
| 45-49 |
179.00 |
206.00 |
| 50-54 |
213.00 |
245.00 |
| 55-59 |
250.00 |
288.00 |
| 60+ |
293.00 |
337.00 |
| Child |
80.00 |
80.00 |
| Age |
Deductible : 7500 |
| 0-24 |
69.00 |
80.00 |
| 25-29 |
79.00 |
91.00 |
| 30-34 |
92.00 |
106.00 |
| 35-39 |
109.00 |
125.00 |
| 40-44 |
128.00 |
147.00 |
| 45-49 |
155.00 |
178.00 |
| 50-54 |
185.00 |
212.00 |
| 55-59 |
217.00 |
249.00 |
| 60+ |
254.00 |
292.00 |
| Child |
69.00 |
69.00 |
| Age |
Deductible : 10000 |
| 0-24 |
62.00 |
71.00 |
| 25-29 |
71.00 |
82.00 |
| 30-34 |
83.00 |
95.00 |
| 35-39 |
98.00 |
113.00 |
| 40-44 |
115.00 |
132.00 |
| 45-49 |
139.00 |
160.00 |
| 50-54 |
166.00 |
191.00 |
| 55-59 |
195.00 |
224.00 |
| 60+ |
228.00 |
262.00 |
| Child |
62.00 |
62.00 |
* - not all of the zip codes are eligible in this county
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Assurant Health
