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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 Plus 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 : 1000 |
| 0-24 |
215.00 |
247.00 |
| 25-29 |
247.00 |
284.00 |
| 30-34 |
287.00 |
330.00 |
| 35-39 |
339.00 |
390.00 |
| 40-44 |
399.00 |
458.00 |
| 45-49 |
482.00 |
555.00 |
| 50-54 |
574.00 |
660.00 |
| 55-59 |
673.00 |
775.00 |
| 60+ |
789.00 |
907.00 |
| Child |
215.00 |
215.00 |
| Age |
Deductible : 2500 |
| 0-24 |
163.00 |
187.00 |
| 25-29 |
187.00 |
215.00 |
| 30-34 |
217.00 |
249.00 |
| 35-39 |
256.00 |
295.00 |
| 40-44 |
301.00 |
347.00 |
| 45-49 |
365.00 |
419.00 |
| 50-54 |
434.00 |
499.00 |
| 55-59 |
509.00 |
586.00 |
| 60+ |
597.00 |
686.00 |
| Child |
163.00 |
163.00 |
| Age |
Deductible : 5000 |
| 0-24 |
135.00 |
155.00 |
| 25-29 |
155.00 |
178.00 |
| 30-34 |
180.00 |
207.00 |
| 35-39 |
212.00 |
244.00 |
| 40-44 |
250.00 |
287.00 |
| 45-49 |
302.00 |
348.00 |
| 50-54 |
360.00 |
414.00 |
| 55-59 |
422.00 |
485.00 |
| 60+ |
495.00 |
569.00 |
| Child |
135.00 |
135.00 |
| Age |
Deductible : 7500 |
| 0-24 |
122.00 |
140.00 |
| 25-29 |
140.00 |
161.00 |
| 30-34 |
163.00 |
187.00 |
| 35-39 |
192.00 |
221.00 |
| 40-44 |
226.00 |
260.00 |
| 45-49 |
273.00 |
314.00 |
| 50-54 |
325.00 |
374.00 |
| 55-59 |
382.00 |
439.00 |
| 60+ |
447.00 |
515.00 |
| Child |
122.00 |
122.00 |
* - not all of the zip codes are eligible in this county
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Assurant Health
