|
Asuris Northwest Health - Online
Application
Index | Optional Dental | Exclusions
& Limitations | Provider
Directory | Download Application
Benefit Schedules:
Emerge Core | Emerge Plus | Emerge HSA 50 | Emerge
HSA 80 | Emerge HSA 100
Rate Schedules:
Emerge Core | Emerge Plus | Emerge HSA 50 | Emerge HSA 80 | Emerge HSA 100
Emerge Plus Rates
Effective date : 10/1/2010
Valid thru : 6/30/2011
Counties :
Adams,
Benton,
Chelan,
Douglas,
Ferry,
Franklin,
Grant,
Kittitas,
Lincoln,
Okanogan,
Pend Oreille,
Spokane,
Stevens,
Whitman
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
| Age |
Deductible : 1000 |
| 0-24 |
229.00 |
263.00 |
| 25-29 |
263.00 |
302.00 |
| 30-34 |
305.00 |
351.00 |
| 35-39 |
360.00 |
414.00 |
| 40-44 |
424.00 |
487.00 |
| 45-49 |
512.00 |
589.00 |
| 50-54 |
610.00 |
701.00 |
| 55-59 |
716.00 |
823.00 |
| 60+ |
839.00 |
964.00 |
| Child |
229.00 |
229.00 |
| Age |
Deductible : 2500 |
| 0-24 |
173.00 |
199.00 |
| 25-29 |
199.00 |
228.00 |
| 30-34 |
231.00 |
265.00 |
| 35-39 |
272.00 |
313.00 |
| 40-44 |
320.00 |
368.00 |
| 45-49 |
387.00 |
446.00 |
| 50-54 |
461.00 |
530.00 |
| 55-59 |
541.00 |
622.00 |
| 60+ |
634.00 |
729.00 |
| Child |
173.00 |
173.00 |
| Age |
Deductible : 5000 |
| 0-24 |
143.00 |
165.00 |
| 25-29 |
165.00 |
189.00 |
| 30-34 |
191.00 |
220.00 |
| 35-39 |
226.00 |
259.00 |
| 40-44 |
265.00 |
305.00 |
| 45-49 |
321.00 |
369.00 |
| 50-54 |
382.00 |
440.00 |
| 55-59 |
449.00 |
516.00 |
| 60+ |
526.00 |
604.00 |
| Child |
143.00 |
143.00 |
| Age |
Deductible : 7500 |
| 0-24 |
130.00 |
149.00 |
| 25-29 |
149.00 |
171.00 |
| 30-34 |
173.00 |
199.00 |
| 35-39 |
204.00 |
235.00 |
| 40-44 |
240.00 |
276.00 |
| 45-49 |
291.00 |
334.00 |
| 50-54 |
346.00 |
398.00 |
| 55-59 |
406.00 |
467.00 |
| 60+ |
475.00 |
547.00 |
| Child |
130.00 |
130.00 |
* - not all of the zip codes are eligible in this county
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Assurant Health
