Rate Schedule Cost Sharing Reduction Funding · Rate Schedule Without Cost Sharing Reduction (CSR)* Funding *Note: Only rates for silver plans sold inside the Exchange and those sold

Rate Schedule

Without

Cost Sharing Reduction (CSR)* Funding

*Note: Only rates for silver plans sold inside the Exchange and those sold both inside and outside the

Exchange are changing due to CSR funding ending. This is because CSRs only apply to silver Exchange

plans. Rates for silver Exchange plans if CSR funding is restored are at the end of this document.

Coordinated Care Corp.

Plan Information

Plan Name: Ambetter Secure Care 1 (2018) with 3 Free PCP Visits

HIOS Plan ID: 61836WA0100001

Effective Date: 1/1/2018

Market Type: Individual

Exchange Status: In the exchange

Metal Level: Gold

Plan Geographic Availability

Area Number Available in area?

1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age

Band Area 1 Area 2 Area 3 Area 4 Area 5 Area 1 Area 2 Area 3 Area 4 Area 5

0-14 246.05 238.42 N/A 225.14 236.70 246.05 238.42 N/A 225.14 236.70

15 267.92 259.62 N/A 245.15 257.74 267.92 259.62 N/A 245.15 257.74

16 276.28 267.72 N/A 252.80 265.78 276.28 267.72 N/A 252.80 265.78

17 284.65 275.82 N/A 260.45 273.83 284.65 275.82 N/A 260.45 273.83

18 293.65 284.55 N/A 268.69 282.49 337.70 327.23 N/A 309.00 324.87

19 302.66 293.28 N/A 276.93 291.16 348.06 337.27 N/A 318.47 334.83

20 311.98 302.31 N/A 285.47 300.13 358.78 347.66 N/A 328.29 345.15

21 321.64 311.67 N/A 294.31 309.42 369.89 358.42 N/A 338.45 355.83

22 321.64 311.67 N/A 294.31 309.42 369.89 358.42 N/A 338.45 355.83

23 321.64 311.67 N/A 294.31 309.42 369.89 358.42 N/A 338.45 355.83

24 321.64 311.67 N/A 294.31 309.42 369.89 358.42 N/A 338.45 355.83

25 322.92 312.91 N/A 295.47 310.65 371.36 359.85 N/A 339.79 357.25

26 329.35 319.14 N/A 301.36 316.84 378.76 367.01 N/A 346.56 364.36

27 337.07 326.62 N/A 308.42 324.26 387.63 375.62 N/A 354.68 372.90

28 349.62 338.78 N/A 319.90 336.33 402.06 389.59 N/A 367.88 386.78

29 359.91 348.75 N/A 329.32 346.23 413.89 401.06 N/A 378.71 398.17

30 365.05 353.74 N/A 334.02 351.18 419.81 406.80 N/A 384.13 403.86

31 372.77 361.22 N/A 341.09 358.61 428.69 415.40 N/A 392.25 412.40

32 380.49 368.70 N/A 348.15 366.03 437.57 424.00 N/A 400.37 420.94

33 385.32 373.37 N/A 352.57 370.68 443.12 429.38 N/A 405.45 426.28

34 390.46 378.36 N/A 357.27 375.63 449.03 435.11 N/A 410.87 431.97

35 393.04 380.85 N/A 359.63 378.10 451.99 437.98 N/A 413.57 434.82

36 395.61 383.35 N/A 361.98 380.58 454.95 440.85 N/A 416.28 437.66

37 398.18 385.84 N/A 364.34 383.05 457.91 443.71 N/A 418.99 440.51

38 400.76 388.33 N/A 366.69 385.53 460.87 446.58 N/A 421.70 443.36

39 405.90 393.32 N/A 371.40 390.48 466.79 452.32 N/A 427.11 449.05

40 411.05 398.31 N/A 376.11 395.43 472.71 458.05 N/A 432.53 454.74

41 418.77 405.79 N/A 383.17 402.85 481.58 466.65 N/A 440.65 463.28

42 426.16 412.95 N/A 389.94 409.97 490.09 474.90 N/A 448.43 471.47

43 436.46 422.93 N/A 399.36 419.87 501.93 486.37 N/A 459.26 482.85

44 449.32 435.39 N/A 411.13 432.25 516.72 500.70 N/A 472.80 497.09

45 464.44 450.04 N/A 424.96 446.79 534.11 517.55 N/A 488.71 513.81

46 482.45 467.49 N/A 441.44 464.12 554.82 537.62 N/A 507.66 533.74

47 502.71 487.13 N/A 459.98 483.61 578.12 560.20 N/A 528.98 556.15

48 525.87 509.57 N/A 481.17 505.89 604.75 586.00 N/A 553.35 581.77

49 548.71 531.70 N/A 502.07 527.86 631.01 611.45 N/A 577.38 607.04

50 574.44 556.63 N/A 525.61 552.61 660.60 640.13 N/A 604.45 635.50

51 599.85 581.25 N/A 548.86 577.05 689.82 668.44 N/A 631.19 663.61

52 627.83 608.37 N/A 574.46 603.97 722.00 699.62 N/A 660.63 694.57

53 656.13 635.79 N/A 600.36 631.20 754.55 731.16 N/A 690.42 725.88

54 686.69 665.40 N/A 628.32 660.59 789.69 765.21 N/A 722.57 759.68

55 717.24 695.01 N/A 656.28 689.99 824.83 799.26 N/A 754.72 793.49

56 750.37 727.11 N/A 686.59 721.86 862.93 836.18 N/A 789.58 830.14

57 783.82 759.52 N/A 717.20 754.04 901.40 873.45 N/A 824.78 867.14

58 819.52 794.12 N/A 749.86 788.38 942.45 913.24 N/A 862.34 906.64

59 837.21 811.26 N/A 766.05 805.40 962.79 932.95 N/A 880.96 926.21

60 872.91 845.85 N/A 798.72 839.74 1003.85 972.73 N/A 918.52 965.71

61 903.79 875.77 N/A 826.97 869.45 1039.36 1007.14 N/A 951.01 999.86

62 924.05 895.41 N/A 845.51 888.94 1062.66 1029.72 N/A 972.34 1022.28

63 949.46 920.03 N/A 868.76 913.38 1091.88 1058.03 N/A 999.07 1050.39

64 and over 964.89 934.98 N/A 882.88 928.23 1109.63 1075.23 N/A 1015.31 1067.46

Lincoln, Spokane, Stevens

Adams, Benton, Chelan, Columbia, Douglas, Franklin, Grant, Kittitas, Walla Walla, Yakima

Non-Smoker Rates Smoker Rates

Coordinated Care Corporation

RATE SCHEDULE

Counties where this plan is available

King

Jefferson, Lewis, Pierce, Snohomish, Thurston

N/A

Plan Information

Plan Name: Ambetter Balanced Care 2 (2018)





Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 202.73 196.44 N/A 185.49 195.02 202.73 196.44 N/A 185.49 195.02

15 220.75 213.90 N/A 201.98 212.36 220.75 213.90 N/A 201.98 212.36

16 227.64 220.58 N/A 208.29 218.98 227.64 220.58 N/A 208.29 218.98

17 234.53 227.25 N/A 214.59 225.61 234.53 227.25 N/A 214.59 225.61

18 241.95 234.44 N/A 221.38 232.75 278.24 269.61 N/A 254.59 267.66

19 249.37 241.63 N/A 228.17 239.89 286.77 277.88 N/A 262.39 275.87

20 257.05 249.08 N/A 235.20 247.28 295.61 286.44 N/A 270.48 284.37

21 265.01 256.80 N/A 242.49 254.94 304.76 295.31 N/A 278.86 293.18

22 265.01 256.80 N/A 242.49 254.94 304.76 295.31 N/A 278.86 293.18

23 265.01 256.80 N/A 242.49 254.94 304.76 295.31 N/A 278.86 293.18

24 265.01 256.80 N/A 242.49 254.94 304.76 295.31 N/A 278.86 293.18

25 266.06 257.81 N/A 243.44 255.95 305.97 296.48 N/A 279.96 294.34

26 271.36 262.95 N/A 248.29 261.05 312.06 302.39 N/A 285.54 300.21

27 277.72 269.11 N/A 254.11 267.17 319.38 309.48 N/A 292.23 307.24

28 288.06 279.13 N/A 263.57 277.11 331.26 320.99 N/A 303.11 318.68

29 296.54 287.34 N/A 271.33 285.27 341.02 330.44 N/A 312.03 328.06

30 300.78 291.45 N/A 275.21 289.35 345.89 335.17 N/A 316.49 332.75

31 307.14 297.61 N/A 281.03 295.46 353.21 342.26 N/A 323.18 339.78

32 313.50 303.78 N/A 286.85 301.58 360.52 349.34 N/A 329.88 346.82

33 317.47 307.63 N/A 290.49 305.41 365.09 353.77 N/A 334.06 351.22

34 321.71 311.74 N/A 294.36 309.49 369.97 358.50 N/A 338.52 355.91

35 323.83 313.79 N/A 296.30 311.52 372.40 360.86 N/A 340.75 358.25

36 325.95 315.85 N/A 298.24 313.56 374.84 363.22 N/A 342.98 360.60

37 328.07 317.90 N/A 300.18 315.60 377.28 365.58 N/A 345.21 362.94

38 330.19 319.95 N/A 302.12 317.64 379.72 367.95 N/A 347.44 365.29

39 334.43 324.06 N/A 306.00 321.72 384.59 372.67 N/A 351.90 369.98

40 338.67 328.17 N/A 309.88 325.80 389.47 377.40 N/A 356.37 374.67

41 345.03 334.33 N/A 315.70 331.92 396.78 384.48 N/A 363.06 381.71

42 351.13 340.24 N/A 321.28 337.78 403.79 391.28 N/A 369.47 388.45

43 359.61 348.46 N/A 329.04 345.94 413.55 400.73 N/A 378.39 397.83

44 370.21 358.73 N/A 338.74 356.14 425.74 412.54 N/A 389.55 409.56

45 382.66 370.80 N/A 350.13 368.12 440.06 426.42 N/A 402.65 423.34

46 397.50 385.18 N/A 363.71 382.40 457.13 442.95 N/A 418.27 439.75

47 414.20 401.35 N/A 378.99 398.46 476.32 461.56 N/A 435.84 458.22

48 433.28 419.84 N/A 396.45 416.81 498.27 482.82 N/A 455.91 479.33

49 452.09 438.08 N/A 413.66 434.91 519.90 503.79 N/A 475.71 500.15

50 473.29 458.62 N/A 433.06 455.30 544.28 527.41 N/A 498.02 523.60

51 494.23 478.90 N/A 452.22 475.44 568.36 550.74 N/A 520.05 546.76

52 517.28 501.24 N/A 473.31 497.62 594.87 576.43 N/A 544.31 572.27

53 540.60 523.84 N/A 494.65 520.06 621.69 602.42 N/A 568.85 598.07

54 565.78 548.24 N/A 517.68 544.28 650.64 630.47 N/A 595.34 625.92

55 590.95 572.63 N/A 540.72 568.49 679.59 658.53 N/A 621.83 653.77

56 618.25 599.08 N/A 565.69 594.75 710.98 688.94 N/A 650.55 683.96

57 645.81 625.79 N/A 590.91 621.26 742.68 719.65 N/A 679.55 714.45

58 675.22 654.29 N/A 617.83 649.56 776.50 752.43 N/A 710.50 747.00

59 689.80 668.41 N/A 631.16 663.58 793.26 768.67 N/A 725.84 763.12

60 719.21 696.91 N/A 658.08 691.88 827.09 801.45 N/A 756.79 795.66

61 744.65 721.57 N/A 681.35 716.35 856.35 829.80 N/A 783.56 823.81

62 761.35 737.74 N/A 696.63 732.41 875.55 848.40 N/A 801.13 842.28

63 782.28 758.03 N/A 715.79 752.55 899.62 871.73 N/A 823.15 865.44

64 and over 794.99 770.35 N/A 727.42 764.78 914.24 885.90 N/A 836.53 879.50





RATE SCHEDULE WITHOUT CSR FUNDING


King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 205.77 199.39 N/A 188.28 197.95 205.77 199.39 N/A 188.28 197.95

15 224.06 217.11 N/A 205.01 215.54 224.06 217.11 N/A 205.01 215.54

16 231.05 223.89 N/A 211.41 222.27 231.05 223.89 N/A 211.41 222.27

17 238.04 230.66 N/A 217.81 229.00 238.04 230.66 N/A 217.81 229.00

18 245.57 237.96 N/A 224.70 236.24 282.41 273.66 N/A 258.41 271.68

19 253.11 245.26 N/A 231.59 243.49 291.07 282.05 N/A 266.33 280.01

20 260.91 252.82 N/A 238.73 250.99 300.04 290.74 N/A 274.54 288.64

21 268.99 260.65 N/A 246.12 258.76 309.33 299.74 N/A 283.04 297.58

22 268.99 260.65 N/A 246.12 258.76 309.33 299.74 N/A 283.04 297.58

23 268.99 260.65 N/A 246.12 258.76 309.33 299.74 N/A 283.04 297.58

24 268.99 260.65 N/A 246.12 258.76 309.33 299.74 N/A 283.04 297.58

25 270.05 261.68 N/A 247.10 259.79 310.56 300.93 N/A 284.16 298.76

26 275.43 266.89 N/A 252.02 264.96 316.74 306.93 N/A 289.82 304.71

27 281.89 273.15 N/A 257.93 271.17 324.17 314.12 N/A 296.61 311.85

28 292.38 283.31 N/A 267.52 281.27 336.23 325.81 N/A 307.65 323.46

29 300.98 291.65 N/A 275.40 289.55 346.13 335.40 N/A 316.71 332.98

30 305.29 295.82 N/A 279.34 293.69 351.08 340.20 N/A 321.24 337.74

31 311.74 302.08 N/A 285.24 299.90 358.50 347.39 N/A 328.03 344.88

32 318.20 308.33 N/A 291.15 306.11 365.93 354.58 N/A 334.82 352.02

33 322.23 312.24 N/A 294.84 309.99 370.57 359.08 N/A 339.07 356.49

34 326.54 316.41 N/A 298.78 314.13 375.52 363.88 N/A 343.60 361.25

35 328.69 318.50 N/A 300.75 316.20 377.99 366.27 N/A 345.86 363.63

36 330.84 320.58 N/A 302.72 318.27 380.47 368.67 N/A 348.13 366.01

37 332.99 322.67 N/A 304.69 320.34 382.94 371.07 N/A 350.39 368.39

38 335.14 324.75 N/A 306.66 322.41 385.41 373.47 N/A 352.65 370.77

39 339.45 328.92 N/A 310.59 326.55 390.36 378.26 N/A 357.18 375.53

40 343.75 333.09 N/A 314.53 330.69 395.31 383.06 N/A 361.71 380.29

41 350.21 339.35 N/A 320.44 336.90 402.74 390.25 N/A 368.50 387.43

42 356.39 345.34 N/A 326.10 342.85 409.85 397.15 N/A 375.01 394.28

43 365.00 353.68 N/A 333.97 351.13 419.75 406.74 N/A 384.07 403.80

44 375.76 364.11 N/A 343.82 361.48 432.12 418.73 N/A 395.39 415.70

45 388.40 376.36 N/A 355.39 373.64 446.66 432.81 N/A 408.69 429.69

46 403.46 390.96 N/A 369.17 388.13 463.98 449.60 N/A 424.54 446.35

47 420.41 407.38 N/A 384.67 404.43 483.47 468.48 N/A 442.37 465.10

48 439.77 426.14 N/A 402.39 423.06 505.74 490.06 N/A 462.75 486.52

49 458.87 444.65 N/A 419.87 441.43 527.70 511.34 N/A 482.85 507.65

50 480.39 465.50 N/A 439.56 462.13 552.45 535.32 N/A 505.49 531.45

51 501.64 486.09 N/A 459.00 482.58 576.88 559.00 N/A 527.85 554.96

52 525.04 508.76 N/A 480.41 505.09 603.80 585.08 N/A 552.47 580.85

53 548.71 531.70 N/A 502.07 527.86 631.02 611.45 N/A 577.38 607.04

54 574.26 556.46 N/A 525.45 552.44 660.40 639.93 N/A 604.27 635.31

55 599.81 581.22 N/A 548.83 577.02 689.79 668.40 N/A 631.15 663.57

56 627.52 608.07 N/A 574.18 603.67 721.65 699.28 N/A 660.31 694.22

57 655.49 635.17 N/A 599.78 630.58 753.82 730.45 N/A 689.74 725.17

58 685.35 664.10 N/A 627.09 659.31 788.15 763.72 N/A 721.16 758.20

59 700.14 678.44 N/A 640.63 673.54 805.16 780.20 N/A 736.72 774.57

60 730.00 707.37 N/A 667.95 702.26 839.50 813.47 N/A 768.14 807.60

61 755.82 732.39 N/A 691.58 727.10 869.19 842.25 N/A 795.31 836.16

62 772.77 748.81 N/A 707.08 743.40 888.68 861.13 N/A 813.14 854.91

63 794.01 769.40 N/A 726.52 763.84 913.12 884.81 N/A 835.50 878.42

64 and over 806.92 781.90 N/A 738.33 776.25 927.95 899.19 N/A 849.08 892.69







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 217.12 210.39 N/A 198.66 208.87 217.12 210.39 N/A 198.66 208.87

15 236.42 229.09 N/A 216.32 227.43 236.42 229.09 N/A 216.32 227.43

16 243.80 236.24 N/A 223.07 234.53 243.80 236.24 N/A 223.07 234.53

17 251.18 243.39 N/A 229.83 241.63 251.18 243.39 N/A 229.83 241.63

18 259.12 251.09 N/A 237.10 249.28 297.99 288.75 N/A 272.66 286.67

19 267.07 258.79 N/A 244.37 256.92 307.13 297.61 N/A 281.02 295.46

20 275.30 266.77 N/A 251.90 264.84 316.60 306.78 N/A 289.69 304.56

21 283.83 275.03 N/A 259.70 273.04 326.40 316.28 N/A 298.65 313.99

22 283.83 275.03 N/A 259.70 273.04 326.40 316.28 N/A 298.65 313.99

23 283.83 275.03 N/A 259.70 273.04 326.40 316.28 N/A 298.65 313.99

24 283.83 275.03 N/A 259.70 273.04 326.40 316.28 N/A 298.65 313.99

25 284.95 276.12 N/A 260.73 274.12 327.69 317.53 N/A 299.84 315.24

26 290.63 281.62 N/A 265.92 279.58 334.22 323.86 N/A 305.81 321.52

27 297.44 288.22 N/A 272.16 286.14 342.05 331.45 N/A 312.98 329.06

28 308.51 298.94 N/A 282.28 296.78 354.78 343.78 N/A 324.63 341.30

29 317.59 307.74 N/A 290.59 305.52 365.23 353.91 N/A 334.18 351.35

30 322.13 312.14 N/A 294.75 309.89 370.45 358.97 N/A 338.96 356.37

31 328.94 318.74 N/A 300.98 316.44 378.28 366.56 N/A 346.13 363.91

32 335.75 325.34 N/A 307.21 322.99 386.12 374.15 N/A 353.30 371.44

33 340.01 329.47 N/A 311.11 327.09 391.01 378.89 N/A 357.78 376.15

34 344.55 333.87 N/A 315.26 331.46 396.23 383.95 N/A 362.55 381.18

35 346.82 336.07 N/A 317.34 333.64 398.85 386.48 N/A 364.94 383.69

36 349.09 338.27 N/A 319.42 335.83 401.46 389.01 N/A 367.33 386.20

37 351.36 340.47 N/A 321.50 338.01 404.07 391.54 N/A 369.72 388.71

38 353.63 342.67 N/A 323.57 340.20 406.68 394.07 N/A 372.11 391.22

39 358.17 347.07 N/A 327.73 344.56 411.90 399.13 N/A 376.89 396.25

40 362.72 351.47 N/A 331.88 348.93 417.12 404.19 N/A 381.67 401.27

41 369.53 358.07 N/A 338.12 355.49 424.96 411.78 N/A 388.83 408.81

42 376.05 364.40 N/A 344.09 361.76 432.46 419.06 N/A 395.70 416.03

43 385.14 373.20 N/A 352.40 370.50 442.91 429.18 N/A 405.26 426.08

44 396.49 384.20 N/A 362.79 381.42 455.96 441.83 N/A 417.21 438.64

45 409.83 397.12 N/A 374.99 394.26 471.30 456.69 N/A 431.24 453.39

46 425.72 412.53 N/A 389.54 409.55 489.58 474.40 N/A 447.97 470.98

47 443.60 429.85 N/A 405.90 426.75 510.14 494.33 N/A 466.78 490.76

48 464.04 449.65 N/A 424.59 446.40 533.64 517.10 N/A 488.28 513.36

49 484.19 469.18 N/A 443.03 465.79 556.82 539.56 N/A 509.49 535.66

50 506.89 491.18 N/A 463.81 487.63 582.93 564.86 N/A 533.38 560.78

51 529.31 512.91 N/A 484.32 509.20 608.71 589.84 N/A 556.97 585.58

52 554.01 536.83 N/A 506.92 532.95 637.11 617.36 N/A 582.95 612.90

53 578.98 561.03 N/A 529.77 556.98 665.83 645.19 N/A 609.23 640.53

54 605.95 587.16 N/A 554.44 582.92 696.84 675.23 N/A 637.61 670.36

55 632.91 613.29 N/A 579.11 608.86 727.84 705.28 N/A 665.98 700.19

56 662.14 641.61 N/A 605.86 636.98 761.46 737.86 N/A 696.74 732.53

57 691.66 670.22 N/A 632.87 665.37 795.41 770.75 N/A 727.80 765.18

58 723.16 700.74 N/A 661.69 695.68 831.63 805.85 N/A 760.95 800.03

59 738.77 715.87 N/A 675.97 710.70 849.59 823.25 N/A 777.37 817.30

60 770.27 746.40 N/A 704.80 741.00 885.81 858.35 N/A 810.52 852.15

61 797.52 772.80 N/A 729.73 767.21 917.15 888.72 N/A 839.19 882.30

62 815.40 790.12 N/A 746.09 784.42 937.71 908.64 N/A 858.01 902.08

63 837.82 811.85 N/A 766.61 805.98 963.50 933.63 N/A 881.60 926.88

64 and over 851.44 825.04 N/A 779.06 819.08 979.15 948.80 N/A 895.92 941.94







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 196.24 190.15 N/A 179.56 188.78 196.24 190.15 N/A 179.56 188.78

15 213.68 207.06 N/A 195.52 205.56 213.68 207.06 N/A 195.52 205.56

16 220.35 213.52 N/A 201.62 211.98 220.35 213.52 N/A 201.62 211.98

17 227.02 219.98 N/A 207.72 218.39 227.02 219.98 N/A 207.72 218.39

18 234.20 226.94 N/A 214.30 225.30 269.33 260.98 N/A 246.44 259.10

19 241.39 233.90 N/A 220.87 232.21 277.59 268.99 N/A 254.00 267.04

20 248.82 241.11 N/A 227.67 239.37 286.15 277.28 N/A 261.83 275.27

21 256.53 248.58 N/A 234.73 246.78 295.01 285.86 N/A 269.93 283.80

22 256.53 248.58 N/A 234.73 246.78 295.01 285.86 N/A 269.93 283.80

23 256.53 248.58 N/A 234.73 246.78 295.01 285.86 N/A 269.93 283.80

24 256.53 248.58 N/A 234.73 246.78 295.01 285.86 N/A 269.93 283.80

25 257.55 249.56 N/A 235.65 247.76 296.18 287.00 N/A 271.00 284.92

26 262.68 254.53 N/A 240.35 252.69 302.08 292.71 N/A 276.40 290.60

27 268.83 260.50 N/A 245.98 258.62 309.16 299.57 N/A 282.88 297.41

28 278.84 270.19 N/A 255.14 268.24 320.66 310.72 N/A 293.41 308.48

29 287.05 278.15 N/A 262.65 276.14 330.10 319.87 N/A 302.04 317.56

30 291.15 282.12 N/A 266.40 280.09 334.82 324.44 N/A 306.36 322.10

31 297.31 288.09 N/A 272.04 286.01 341.90 331.30 N/A 312.84 328.91

32 303.46 294.06 N/A 277.67 291.93 348.98 338.16 N/A 319.32 335.72

33 307.31 297.78 N/A 281.19 295.63 353.41 342.45 N/A 323.37 339.98

34 311.42 301.76 N/A 284.94 299.58 358.13 347.03 N/A 327.69 344.52

35 313.47 303.75 N/A 286.82 301.56 360.49 349.31 N/A 329.85 346.79

36 315.52 305.74 N/A 288.70 303.53 362.85 351.60 N/A 332.01 349.06

37 317.57 307.73 N/A 290.58 305.50 365.21 353.89 N/A 334.16 351.33

38 319.62 309.72 N/A 292.46 307.48 367.57 356.17 N/A 336.32 353.60

39 323.73 313.69 N/A 296.21 311.43 372.29 360.75 N/A 340.64 358.14

40 327.83 317.67 N/A 299.97 315.37 377.01 365.32 N/A 344.96 362.68

41 333.99 323.64 N/A 305.60 321.30 384.09 372.18 N/A 351.44 369.49

42 339.89 329.35 N/A 311.00 326.97 390.87 378.76 N/A 357.65 376.02

43 348.10 337.31 N/A 318.51 334.87 400.31 387.90 N/A 366.29 385.10

44 358.36 347.25 N/A 327.90 344.74 412.11 399.34 N/A 377.08 396.45

45 370.41 358.93 N/A 338.93 356.34 425.98 412.77 N/A 389.77 409.79

46 384.78 372.85 N/A 352.07 370.16 442.50 428.78 N/A 404.88 425.68

47 400.94 388.51 N/A 366.86 385.71 461.08 446.79 N/A 421.89 443.56

48 419.41 406.41 N/A 383.76 403.47 482.32 467.37 N/A 441.32 463.99

49 437.62 424.06 N/A 400.43 420.99 503.27 487.67 N/A 460.49 484.14

50 458.14 443.94 N/A 419.20 440.74 526.87 510.53 N/A 482.08 506.85

51 478.41 463.58 N/A 437.74 460.23 550.17 533.12 N/A 503.41 529.26

52 500.73 485.20 N/A 458.17 481.70 575.84 557.99 N/A 526.89 553.95

53 523.30 507.08 N/A 478.82 503.42 601.80 583.14 N/A 550.64 578.93

54 547.67 530.69 N/A 501.12 526.86 629.82 610.30 N/A 576.29 605.89

55 572.04 554.31 N/A 523.42 550.30 657.85 637.45 N/A 601.93 632.85

56 598.46 579.91 N/A 547.59 575.72 688.23 666.90 N/A 629.73 662.08

57 625.14 605.76 N/A 572.00 601.38 718.91 696.62 N/A 657.80 691.59

58 653.61 633.35 N/A 598.06 628.78 751.65 728.35 N/A 687.76 723.09

59 667.72 647.02 N/A 610.97 642.35 767.88 744.08 N/A 702.61 738.70

60 696.20 674.61 N/A 637.02 669.74 800.62 775.81 N/A 732.57 770.20

61 720.82 698.48 N/A 659.55 693.43 828.94 803.25 N/A 758.48 797.44

62 736.98 714.14 N/A 674.34 708.98 847.53 821.26 N/A 775.49 815.32

63 757.25 733.77 N/A 692.88 728.47 870.83 843.84 N/A 796.81 837.74

64 and over 769.55 745.69 N/A 704.14 740.31 884.98 857.55 N/A 809.76 851.35







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 210.43 203.91 N/A 192.54 202.43 210.43 203.91 N/A 192.54 202.43

15 229.13 222.03 N/A 209.66 220.43 229.13 222.03 N/A 209.66 220.43

16 236.29 228.96 N/A 216.20 227.31 236.29 228.96 N/A 216.20 227.31

17 243.44 235.89 N/A 222.74 234.19 243.44 235.89 N/A 222.74 234.19

18 251.14 243.35 N/A 229.79 241.60 288.81 279.86 N/A 264.26 277.83

19 258.84 250.82 N/A 236.84 249.00 297.67 288.44 N/A 272.37 286.36

20 266.82 258.55 N/A 244.14 256.68 306.84 297.33 N/A 280.76 295.18

21 275.08 266.55 N/A 251.70 264.63 316.34 306.53 N/A 289.45 304.32

22 275.08 266.55 N/A 251.70 264.63 316.34 306.53 N/A 289.45 304.32

23 275.08 266.55 N/A 251.70 264.63 316.34 306.53 N/A 289.45 304.32

24 275.08 266.55 N/A 251.70 264.63 316.34 306.53 N/A 289.45 304.32

25 276.17 267.61 N/A 252.70 265.68 317.60 307.75 N/A 290.60 305.53

26 281.67 272.94 N/A 257.73 270.97 323.92 313.88 N/A 296.39 311.61

27 288.27 279.34 N/A 263.77 277.32 331.51 321.24 N/A 303.34 318.92

28 299.00 289.73 N/A 273.59 287.64 343.85 333.19 N/A 314.62 330.78

29 307.80 298.26 N/A 281.64 296.11 353.97 343.00 N/A 323.89 340.52

30 312.20 302.53 N/A 285.67 300.34 359.04 347.91 N/A 328.52 345.39

31 318.81 308.92 N/A 291.71 306.69 366.63 355.26 N/A 335.46 352.70

32 325.41 315.32 N/A 297.75 313.04 374.22 362.62 N/A 342.41 360.00

33 329.53 319.32 N/A 301.52 317.01 378.96 367.22 N/A 346.75 364.56

34 333.93 323.58 N/A 305.55 321.25 384.03 372.12 N/A 351.38 369.43

35 336.14 325.72 N/A 307.56 323.36 386.56 374.57 N/A 353.70 371.87

36 338.34 327.85 N/A 309.58 325.48 389.09 377.02 N/A 356.01 374.30

37 340.54 329.98 N/A 311.59 327.60 391.62 379.48 N/A 358.33 376.74

38 342.74 332.11 N/A 313.60 329.71 394.15 381.93 N/A 360.65 379.17

39 347.14 336.38 N/A 317.63 333.95 399.21 386.83 N/A 365.28 384.04

40 351.54 340.64 N/A 321.66 338.18 404.27 391.74 N/A 369.91 388.91

41 358.14 347.04 N/A 327.70 344.53 411.86 399.09 N/A 376.85 396.21

42 364.47 353.17 N/A 333.49 350.62 419.14 406.14 N/A 383.51 403.21

43 373.27 361.70 N/A 341.54 359.09 429.26 415.95 N/A 392.77 412.95

44 384.27 372.36 N/A 351.61 369.67 441.91 428.21 N/A 404.35 425.12

45 397.20 384.89 N/A 363.44 382.11 456.78 442.62 N/A 417.95 439.42

46 412.61 399.81 N/A 377.53 396.93 474.50 459.79 N/A 434.16 456.46

47 429.93 416.61 N/A 393.39 413.60 494.42 479.10 N/A 452.40 475.64

48 449.74 435.80 N/A 411.51 432.65 517.20 501.17 N/A 473.24 497.55

49 469.27 454.72 N/A 429.38 451.44 539.66 522.93 N/A 493.79 519.15

50 491.28 476.05 N/A 449.52 472.61 564.97 547.45 N/A 516.94 543.50

51 513.01 497.10 N/A 469.40 493.51 589.96 571.67 N/A 539.81 567.54

52 536.94 520.29 N/A 491.30 516.53 617.48 598.34 N/A 564.99 594.01

53 561.14 543.75 N/A 513.45 539.82 645.31 625.31 N/A 590.46 620.79

54 587.27 569.07 N/A 537.36 564.96 675.37 654.43 N/A 617.96 649.70

55 613.41 594.39 N/A 561.27 590.10 705.42 683.55 N/A 645.46 678.61

56 641.74 621.84 N/A 587.19 617.35 738.00 715.12 N/A 675.27 709.96

57 670.35 649.56 N/A 613.37 644.87 770.90 747.00 N/A 705.37 741.60

58 700.88 679.15 N/A 641.30 674.24 806.01 781.02 N/A 737.50 775.38

59 716.01 693.81 N/A 655.15 688.80 823.41 797.88 N/A 753.42 792.12

60 746.54 723.40 N/A 683.08 718.17 858.52 831.91 N/A 785.55 825.90

61 772.95 748.99 N/A 707.25 743.57 888.89 861.33 N/A 813.33 855.11

62 790.28 765.78 N/A 723.10 760.25 908.82 880.64 N/A 831.57 874.28

63 812.01 786.83 N/A 742.99 781.15 933.81 904.86 N/A 854.43 898.32

64 and over 825.20 799.62 N/A 755.06 793.84 948.98 919.56 N/A 868.32 912.92







King


N/A

Plan Information

Plan Name: Ambetter Balanced Care 2 (2018) + Vision





Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 205.73 199.35 N/A 188.24 197.91 205.73 199.35 N/A 188.24 197.91

15 224.02 217.07 N/A 204.98 215.51 224.02 217.07 N/A 204.98 215.51

16 231.01 223.85 N/A 211.37 222.23 231.01 223.85 N/A 211.37 222.23

17 238.00 230.62 N/A 217.77 228.96 238.00 230.62 N/A 217.77 228.96

18 245.53 237.92 N/A 224.66 236.20 282.36 273.61 N/A 258.36 271.63

19 253.06 245.22 N/A 231.55 243.45 291.02 282.00 N/A 266.29 279.96

20 260.86 252.78 N/A 238.69 250.95 299.99 290.69 N/A 274.49 288.59

21 268.94 260.60 N/A 246.08 258.72 309.28 299.69 N/A 282.99 297.53

22 268.94 260.60 N/A 246.08 258.72 309.28 299.69 N/A 282.99 297.53

23 268.94 260.60 N/A 246.08 258.72 309.28 299.69 N/A 282.99 297.53

24 268.94 260.60 N/A 246.08 258.72 309.28 299.69 N/A 282.99 297.53

25 270.01 261.64 N/A 247.06 259.75 310.51 300.88 N/A 284.11 298.71

26 275.38 266.85 N/A 251.98 264.92 316.69 306.87 N/A 289.77 304.66

27 281.84 273.10 N/A 257.88 271.13 324.11 314.07 N/A 296.56 311.80

28 292.33 283.26 N/A 267.48 281.22 336.18 325.75 N/A 307.60 323.40

29 300.93 291.60 N/A 275.35 289.50 346.07 335.34 N/A 316.66 332.92

30 305.24 295.77 N/A 279.29 293.64 351.02 340.14 N/A 321.18 337.68

31 311.69 302.03 N/A 285.20 299.85 358.44 347.33 N/A 327.98 344.82

32 318.14 308.28 N/A 291.10 306.05 365.87 354.52 N/A 334.77 351.96

33 322.18 312.19 N/A 294.79 309.94 370.50 359.02 N/A 339.01 356.43

34 326.48 316.36 N/A 298.73 314.07 375.45 363.81 N/A 343.54 361.19

35 328.63 318.44 N/A 300.70 316.14 377.93 366.21 N/A 345.80 363.57

36 330.78 320.53 N/A 302.67 318.21 380.40 368.61 N/A 348.07 365.95

37 332.94 322.61 N/A 304.64 320.28 382.88 371.01 N/A 350.33 368.33

38 335.09 324.70 N/A 306.60 322.35 385.35 373.40 N/A 352.60 370.71

39 339.39 328.87 N/A 310.54 326.49 390.30 378.20 N/A 357.12 375.47

40 343.69 333.04 N/A 314.48 330.63 395.25 382.99 N/A 361.65 380.23

41 350.15 339.29 N/A 320.38 336.84 402.67 390.19 N/A 368.44 387.37

42 356.33 345.29 N/A 326.04 342.79 409.78 397.08 N/A 374.95 394.21

43 364.94 353.62 N/A 333.92 351.07 419.68 406.67 N/A 384.01 403.73

44 375.70 364.05 N/A 343.76 361.42 432.05 418.66 N/A 395.33 415.63

45 388.33 376.30 N/A 355.33 373.58 446.59 432.74 N/A 408.63 429.61

46 403.40 390.89 N/A 369.11 388.07 463.90 449.52 N/A 424.47 446.28

47 420.34 407.31 N/A 384.61 404.36 483.39 468.40 N/A 442.30 465.02

48 439.70 426.07 N/A 402.33 422.99 505.66 489.98 N/A 462.67 486.44

49 458.79 444.57 N/A 419.80 441.36 527.61 511.26 N/A 482.77 507.56

50 480.31 465.42 N/A 439.48 462.06 552.36 535.23 N/A 505.41 531.37

51 501.55 486.01 N/A 458.92 482.50 576.79 558.91 N/A 527.76 554.87

52 524.95 508.68 N/A 480.33 505.00 603.69 584.98 N/A 552.38 580.75

53 548.62 531.61 N/A 501.98 527.77 630.91 611.35 N/A 577.28 606.94

54 574.17 556.37 N/A 525.36 552.35 660.29 639.82 N/A 604.17 635.20

55 599.71 581.12 N/A 548.74 576.92 689.67 668.29 N/A 631.05 663.46

56 627.41 607.96 N/A 574.08 603.57 721.53 699.16 N/A 660.20 694.11

57 655.38 635.07 N/A 599.67 630.48 753.69 730.33 N/A 689.63 725.05

58 685.23 663.99 N/A 626.99 659.19 788.02 763.59 N/A 721.04 758.07

59 700.02 678.32 N/A 640.52 673.42 805.03 780.07 N/A 736.60 774.44

60 729.88 707.25 N/A 667.84 702.14 839.36 813.34 N/A 768.01 807.46

61 755.69 732.27 N/A 691.46 726.98 869.05 842.11 N/A 795.18 836.02

62 772.64 748.68 N/A 706.96 743.28 888.53 860.99 N/A 813.01 854.77

63 793.88 769.27 N/A 726.40 763.71 912.96 884.66 N/A 835.36 878.27

64 and over 806.78 781.77 N/A 738.20 776.12 927.80 899.04 N/A 848.93 892.54







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 208.82 202.34 N/A 191.07 200.88 208.82 202.34 N/A 191.07 200.88

15 227.38 220.33 N/A 208.05 218.74 227.38 220.33 N/A 208.05 218.74

16 234.48 227.21 N/A 214.55 225.57 234.48 227.21 N/A 214.55 225.57

17 241.57 234.08 N/A 221.04 232.39 241.57 234.08 N/A 221.04 232.39

18 249.22 241.49 N/A 228.03 239.75 286.60 277.71 N/A 262.24 275.71

19 256.86 248.90 N/A 235.03 247.10 295.39 286.23 N/A 270.28 284.16

20 264.78 256.57 N/A 242.27 254.71 304.49 295.05 N/A 278.61 292.92

21 272.97 264.51 N/A 249.77 262.60 313.92 304.19 N/A 287.24 301.99

22 272.97 264.51 N/A 249.77 262.60 313.92 304.19 N/A 287.24 301.99

23 272.97 264.51 N/A 249.77 262.60 313.92 304.19 N/A 287.24 301.99

24 272.97 264.51 N/A 249.77 262.60 313.92 304.19 N/A 287.24 301.99

25 274.06 265.56 N/A 250.76 263.64 315.16 305.39 N/A 288.38 303.19

26 279.52 270.85 N/A 255.76 268.89 321.44 311.48 N/A 294.12 309.23

27 286.07 277.20 N/A 261.75 275.20 328.98 318.78 N/A 301.01 316.48

28 296.71 287.51 N/A 271.49 285.44 341.22 330.64 N/A 312.22 328.25

29 305.45 295.98 N/A 279.48 293.84 351.26 340.37 N/A 321.41 337.92

30 309.81 300.21 N/A 283.48 298.04 356.29 345.24 N/A 326.00 342.75

31 316.37 306.56 N/A 289.47 304.34 363.82 352.54 N/A 332.90 349.99

32 322.92 312.91 N/A 295.47 310.65 371.35 359.84 N/A 339.79 357.24

33 327.01 316.87 N/A 299.21 314.58 376.06 364.40 N/A 344.10 361.77

34 331.38 321.11 N/A 303.21 318.79 381.08 369.27 N/A 348.69 366.60

35 333.56 323.22 N/A 305.21 320.89 383.60 371.70 N/A 350.99 369.02

36 335.75 325.34 N/A 307.21 322.99 386.11 374.14 N/A 353.29 371.44

37 337.93 327.45 N/A 309.21 325.09 388.62 376.57 N/A 355.59 373.85

38 340.11 329.57 N/A 311.20 327.19 391.13 379.01 N/A 357.88 376.27

39 344.48 333.80 N/A 315.20 331.39 396.15 383.87 N/A 362.48 381.10

40 348.85 338.03 N/A 319.20 335.59 401.18 388.74 N/A 367.08 385.93

41 355.40 344.38 N/A 325.19 341.89 408.71 396.04 N/A 373.97 393.18

42 361.68 350.47 N/A 330.93 347.93 415.93 403.04 N/A 380.57 400.12

43 370.41 358.93 N/A 338.93 356.34 425.97 412.77 N/A 389.77 409.79

44 381.33 369.51 N/A 348.92 366.84 438.53 424.94 N/A 401.26 421.87

45 394.16 381.94 N/A 360.66 379.18 453.28 439.23 N/A 414.75 436.06

46 409.45 396.75 N/A 374.64 393.89 470.86 456.27 N/A 430.84 452.97

47 426.64 413.42 N/A 390.38 410.43 490.64 475.43 N/A 448.93 471.99

48 446.30 432.46 N/A 408.36 429.34 513.24 497.33 N/A 469.62 493.74

49 465.68 451.24 N/A 426.09 447.98 535.53 518.93 N/A 490.01 515.18

50 487.51 472.40 N/A 446.07 468.99 560.64 543.26 N/A 512.99 539.34

51 509.08 493.30 N/A 465.81 489.73 585.44 567.29 N/A 535.68 563.19

52 532.83 516.31 N/A 487.54 512.58 612.75 593.75 N/A 560.67 589.46

53 556.85 539.58 N/A 509.51 535.69 640.37 620.52 N/A 585.94 616.04

54 582.78 564.71 N/A 533.24 560.63 670.19 649.42 N/A 613.23 644.73

55 608.71 589.84 N/A 556.97 585.58 700.02 678.32 N/A 640.51 673.42

56 636.82 617.08 N/A 582.69 612.63 732.35 709.65 N/A 670.10 704.52

57 665.21 644.59 N/A 608.67 639.94 765.00 741.28 N/A 699.97 735.93

58 695.51 673.95 N/A 636.39 669.08 799.84 775.04 N/A 731.85 769.45

59 710.53 688.50 N/A 650.13 683.53 817.10 791.77 N/A 747.65 786.05

60 740.82 717.86 N/A 677.85 712.67 851.95 825.54 N/A 779.53 819.57

61 767.03 743.25 N/A 701.83 737.88 882.08 854.74 N/A 807.11 848.56

62 784.23 759.91 N/A 717.57 754.42 901.86 873.90 N/A 825.20 867.59

63 805.79 780.81 N/A 737.30 775.17 926.66 897.93 N/A 847.89 891.45

64 and over 818.88 793.50 N/A 749.28 787.76 941.72 912.52 N/A 861.67 905.93







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 220.34 213.51 N/A 201.61 211.97 220.34 213.51 N/A 201.61 211.97

15 239.92 232.49 N/A 219.53 230.81 239.92 232.49 N/A 219.53 230.81

16 247.41 239.74 N/A 226.38 238.01 247.41 239.74 N/A 226.38 238.01

17 254.90 247.00 N/A 233.23 245.22 254.90 247.00 N/A 233.23 245.22

18 262.97 254.81 N/A 240.61 252.97 302.41 293.04 N/A 276.71 290.92

19 271.03 262.63 N/A 247.99 260.73 311.69 302.02 N/A 285.19 299.84

20 279.38 270.72 N/A 255.64 268.77 321.29 311.33 N/A 293.98 309.08

21 288.03 279.11 N/A 263.55 277.09 331.24 320.97 N/A 303.08 318.65

22 288.03 279.11 N/A 263.55 277.09 331.24 320.97 N/A 303.08 318.65

23 288.03 279.11 N/A 263.55 277.09 331.24 320.97 N/A 303.08 318.65

24 288.03 279.11 N/A 263.55 277.09 331.24 320.97 N/A 303.08 318.65

25 289.18 280.21 N/A 264.60 278.19 332.55 322.24 N/A 304.29 319.92

26 294.94 285.79 N/A 269.87 283.73 339.18 328.66 N/A 310.35 326.29

27 301.85 292.49 N/A 276.19 290.38 347.13 336.37 N/A 317.62 333.94

28 313.08 303.38 N/A 286.47 301.19 360.04 348.88 N/A 329.44 346.36

29 322.30 312.31 N/A 294.90 310.05 370.64 359.15 N/A 339.14 356.56

30 326.91 316.77 N/A 299.12 314.48 375.94 364.29 N/A 343.99 361.66

31 333.82 323.47 N/A 305.45 321.13 383.89 371.99 N/A 351.26 369.30

32 340.73 330.17 N/A 311.77 327.78 391.84 379.70 N/A 358.54 376.95

33 345.05 334.36 N/A 315.72 331.94 396.81 384.51 N/A 363.08 381.73

34 349.66 338.82 N/A 319.94 336.37 402.11 389.64 N/A 367.93 386.83

35 351.97 341.05 N/A 322.05 338.59 404.76 392.21 N/A 370.36 389.38

36 354.27 343.29 N/A 324.16 340.81 407.41 394.78 N/A 372.78 391.93

37 356.57 345.52 N/A 326.26 343.02 410.06 397.35 N/A 375.20 394.48

38 358.88 347.75 N/A 328.37 345.24 412.71 399.92 N/A 377.63 397.03

39 363.49 352.22 N/A 332.59 349.67 418.01 405.05 N/A 382.48 402.12

40 368.09 356.68 N/A 336.81 354.11 423.31 410.19 N/A 387.33 407.22

41 375.01 363.38 N/A 343.13 360.76 431.26 417.89 N/A 394.60 414.87

42 381.63 369.80 N/A 349.19 367.13 438.88 425.27 N/A 401.57 422.20

43 390.85 378.73 N/A 357.63 376.00 449.48 435.54 N/A 411.27 432.40

44 402.37 389.90 N/A 368.17 387.08 462.73 448.38 N/A 423.39 445.14

45 415.91 403.01 N/A 380.55 400.10 478.29 463.47 N/A 437.64 460.12

46 432.04 418.64 N/A 395.31 415.62 496.84 481.44 N/A 454.61 477.96

47 450.18 436.23 N/A 411.92 433.07 517.71 501.66 N/A 473.70 498.04

48 470.92 456.32 N/A 430.89 453.02 541.56 524.77 N/A 495.52 520.98

49 491.37 476.14 N/A 449.60 472.70 565.07 547.56 N/A 517.04 543.60

50 514.41 498.46 N/A 470.69 494.86 591.57 573.23 N/A 541.29 569.09

51 537.16 520.51 N/A 491.51 516.75 617.74 598.59 N/A 565.23 594.27

52 562.22 544.79 N/A 514.43 540.86 646.56 626.51 N/A 591.60 621.99

53 587.57 569.35 N/A 537.63 565.24 675.70 654.76 N/A 618.27 650.03

54 614.93 595.87 N/A 562.66 591.56 707.17 685.25 N/A 647.06 680.30

55 642.29 622.38 N/A 587.70 617.89 738.64 715.74 N/A 675.85 710.57

56 671.96 651.13 N/A 614.84 646.43 772.75 748.80 N/A 707.07 743.39

57 701.91 680.16 N/A 642.25 675.24 807.20 782.18 N/A 738.59 776.53

58 733.89 711.13 N/A 671.50 706.00 843.97 817.81 N/A 772.23 811.90

59 749.73 726.49 N/A 686.00 721.24 862.19 835.46 N/A 788.90 829.42

60 781.70 757.46 N/A 715.25 751.99 898.95 871.08 N/A 822.54 864.79

61 809.35 784.26 N/A 740.55 778.59 930.75 901.90 N/A 851.64 895.38

62 827.49 801.84 N/A 757.16 796.05 951.62 922.12 N/A 870.73 915.46

63 850.25 823.89 N/A 777.98 817.94 977.78 947.47 N/A 894.67 940.63

64 and over 864.06 837.28 N/A 790.62 831.23 993.67 962.87 N/A 909.21 955.91







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 213.55 206.93 N/A 195.40 205.43 213.55 206.93 N/A 195.40 205.43

15 232.53 225.32 N/A 212.77 223.70 232.53 225.32 N/A 212.77 223.70

16 239.79 232.36 N/A 219.41 230.68 239.79 232.36 N/A 219.41 230.68

17 247.05 239.39 N/A 226.05 237.66 247.05 239.39 N/A 226.05 237.66

18 254.86 246.96 N/A 233.20 245.18 293.09 284.01 N/A 268.18 281.96

19 262.68 254.54 N/A 240.35 252.70 302.08 292.72 N/A 276.40 290.60

20 270.77 262.38 N/A 247.76 260.49 311.39 301.74 N/A 284.92 299.56

21 279.16 270.51 N/A 255.43 268.55 321.03 311.08 N/A 293.74 308.83

22 279.16 270.51 N/A 255.43 268.55 321.03 311.08 N/A 293.74 308.83

23 279.16 270.51 N/A 255.43 268.55 321.03 311.08 N/A 293.74 308.83

24 279.16 270.51 N/A 255.43 268.55 321.03 311.08 N/A 293.74 308.83

25 280.27 271.58 N/A 256.44 269.62 322.31 312.31 N/A 294.91 310.06

26 285.85 276.99 N/A 261.55 274.99 328.73 318.54 N/A 300.78 316.23

27 292.55 283.48 N/A 267.68 281.43 336.43 326.00 N/A 307.83 323.65

28 303.44 294.03 N/A 277.64 291.90 348.95 338.13 N/A 319.29 335.69

29 312.37 302.68 N/A 285.82 300.50 359.22 348.09 N/A 328.69 345.57

30 316.83 307.01 N/A 289.90 304.79 364.36 353.06 N/A 333.39 350.51

31 323.53 313.50 N/A 296.03 311.24 372.06 360.53 N/A 340.44 357.93

32 330.23 320.00 N/A 302.16 317.68 379.77 368.00 N/A 347.49 365.34

33 334.42 324.05 N/A 306.00 321.71 384.58 372.66 N/A 351.89 369.97

34 338.89 328.38 N/A 310.08 326.01 389.72 377.64 N/A 356.59 374.91

35 341.12 330.55 N/A 312.13 328.16 392.29 380.13 N/A 358.94 377.38

36 343.35 332.71 N/A 314.17 330.31 394.86 382.62 N/A 361.29 379.85

37 345.59 334.87 N/A 316.21 332.45 397.42 385.10 N/A 363.64 382.32

38 347.82 337.04 N/A 318.26 334.60 399.99 387.59 N/A 365.99 384.79

39 352.29 341.37 N/A 322.34 338.90 405.13 392.57 N/A 370.69 389.73

40 356.75 345.69 N/A 326.43 343.20 410.27 397.55 N/A 375.39 394.68

41 363.45 352.19 N/A 332.56 349.64 417.97 405.01 N/A 382.44 402.09

42 369.87 358.41 N/A 338.43 355.82 425.35 412.17 N/A 389.20 409.19

43 378.81 367.06 N/A 346.61 364.41 435.63 422.12 N/A 398.60 419.07

44 389.97 377.88 N/A 356.82 375.15 448.47 434.56 N/A 410.35 431.43

45 403.09 390.60 N/A 368.83 387.77 463.56 449.19 N/A 424.15 445.94

46 418.72 405.74 N/A 383.13 402.81 481.53 466.61 N/A 440.60 463.23

47 436.31 422.78 N/A 399.22 419.73 501.76 486.20 N/A 459.11 482.69

48 456.41 442.26 N/A 417.61 439.07 524.87 508.60 N/A 480.26 504.93

49 476.23 461.47 N/A 435.75 458.13 547.66 530.69 N/A 501.11 526.85

50 498.56 483.11 N/A 456.18 479.62 573.34 555.57 N/A 524.61 551.56

51 520.61 504.47 N/A 476.36 500.83 598.71 580.15 N/A 547.82 575.95

52 544.90 528.01 N/A 498.58 524.19 626.63 607.21 N/A 573.37 602.82

53 569.46 551.81 N/A 521.06 547.82 654.88 634.58 N/A 599.22 630.00

54 595.98 577.51 N/A 545.33 573.34 685.38 664.13 N/A 627.12 659.34

55 622.50 603.21 N/A 569.59 598.85 715.88 693.69 N/A 655.03 688.68

56 651.26 631.07 N/A 595.90 626.51 748.94 725.73 N/A 685.28 720.48

57 680.29 659.20 N/A 622.46 654.44 782.33 758.08 N/A 715.83 752.60

58 711.27 689.22 N/A 650.81 684.24 817.96 792.61 N/A 748.44 786.88

59 726.63 704.10 N/A 664.86 699.01 835.62 809.72 N/A 764.59 803.87

60 757.61 734.13 N/A 693.21 728.82 871.25 844.24 N/A 797.20 838.15

61 784.41 760.09 N/A 717.73 754.60 902.07 874.11 N/A 825.40 867.79

62 802.00 777.13 N/A 733.83 771.52 922.30 893.70 N/A 843.90 887.25

63 824.05 798.50 N/A 754.00 792.73 947.66 918.28 N/A 867.11 911.65

64 and over 837.44 811.48 N/A 766.25 805.61 963.06 933.20 N/A 881.19 926.46







King


N/A

Rate Schedule

With

Cost Share Reduction (CSR) Funding (For silver plans sold only inside the exchange or inside and outside the Exchange)

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 185.00 179.26 N/A 169.27 177.97 185.00 179.26 N/A 169.27 177.97

15 201.44 195.20 N/A 184.32 193.79 201.44 195.20 N/A 184.32 193.79

16 207.73 201.29 N/A 190.07 199.84 207.73 201.29 N/A 190.07 199.84

17 214.02 207.38 N/A 195.83 205.89 214.02 207.38 N/A 195.83 205.89

18 220.79 213.95 N/A 202.02 212.40 253.91 246.04 N/A 232.33 244.26

19 227.56 220.51 N/A 208.22 218.91 261.70 253.58 N/A 239.45 251.75

20 234.58 227.30 N/A 214.64 225.66 269.76 261.40 N/A 246.83 259.51

21 241.84 234.34 N/A 221.28 232.65 278.11 269.49 N/A 254.48 267.55

22 241.84 234.34 N/A 221.28 232.65 278.11 269.49 N/A 254.48 267.55

23 241.84 234.34 N/A 221.28 232.65 278.11 269.49 N/A 254.48 267.55

24 241.84 234.34 N/A 221.28 232.65 278.11 269.49 N/A 254.48 267.55

25 242.80 235.27 N/A 222.16 233.57 279.22 270.56 N/A 255.48 268.61

26 247.63 239.96 N/A 226.59 238.22 284.78 275.95 N/A 260.57 273.96

27 253.44 245.58 N/A 231.90 243.81 291.45 282.42 N/A 266.68 280.38

28 262.87 254.72 N/A 240.53 252.88 302.30 292.93 N/A 276.60 290.81

29 270.61 262.22 N/A 247.61 260.32 311.20 301.55 N/A 284.75 299.37

30 274.48 265.97 N/A 251.15 264.05 315.65 305.86 N/A 288.82 303.65

31 280.28 271.59 N/A 256.46 269.63 322.32 312.33 N/A 294.93 310.07

32 286.08 277.22 N/A 261.77 275.21 329.00 318.80 N/A 301.03 316.50

33 289.71 280.73 N/A 265.09 278.70 333.17 322.84 N/A 304.85 320.51

34 293.58 284.48 N/A 268.63 282.43 337.62 327.15 N/A 308.92 324.79

35 295.52 286.36 N/A 270.40 284.29 339.84 329.31 N/A 310.96 326.93

36 297.45 288.23 N/A 272.17 286.15 342.07 331.46 N/A 312.99 329.07

37 299.39 290.10 N/A 273.94 288.01 344.29 333.62 N/A 315.03 331.21

38 301.32 291.98 N/A 275.71 289.87 346.52 335.78 N/A 317.06 333.35

39 305.19 295.73 N/A 279.25 293.59 350.97 340.09 N/A 321.14 337.63

40 309.06 299.48 N/A 282.79 297.31 355.42 344.40 N/A 325.21 341.91

41 314.86 305.10 N/A 288.10 302.90 362.09 350.87 N/A 331.31 348.33

42 320.42 310.49 N/A 293.19 308.25 368.49 357.07 N/A 337.17 354.49

43 328.16 317.99 N/A 300.27 315.69 377.39 365.69 N/A 345.31 363.05

44 337.84 327.36 N/A 309.12 325.00 388.51 376.47 N/A 355.49 373.75

45 349.20 338.38 N/A 319.52 335.93 401.58 389.13 N/A 367.45 386.32

46 362.75 351.50 N/A 331.91 348.96 417.16 404.22 N/A 381.70 401.30

47 377.98 366.26 N/A 345.85 363.62 434.68 421.20 N/A 397.73 418.16

48 395.39 383.13 N/A 361.78 380.37 454.70 440.61 N/A 416.05 437.42

49 412.56 399.77 N/A 377.49 396.88 474.45 459.74 N/A 434.12 456.42

50 431.91 418.52 N/A 395.20 415.50 496.69 481.30 N/A 454.48 477.82

51 451.01 437.03 N/A 412.68 433.87 518.66 502.59 N/A 474.58 498.96

52 472.05 457.42 N/A 431.93 454.11 542.86 526.03 N/A 496.72 522.23

53 493.33 478.04 N/A 451.40 474.59 567.33 549.75 N/A 519.11 545.77

54 516.31 500.30 N/A 472.42 496.69 593.75 575.35 N/A 543.28 571.19

55 539.28 522.56 N/A 493.44 518.79 620.17 600.95 N/A 567.46 596.61

56 564.19 546.70 N/A 516.23 542.75 648.82 628.70 N/A 593.67 624.16

57 589.34 571.07 N/A 539.25 566.94 677.74 656.73 N/A 620.13 651.99

58 616.18 597.08 N/A 563.81 592.77 708.61 686.64 N/A 648.38 681.68

59 629.48 609.97 N/A 575.98 605.56 723.91 701.46 N/A 662.37 696.40

60 656.33 635.98 N/A 600.54 631.39 754.78 731.38 N/A 690.62 726.09

61 679.54 658.48 N/A 621.78 653.72 781.47 757.25 N/A 715.05 751.78

62 694.78 673.24 N/A 635.72 668.38 798.99 774.23 N/A 731.08 768.63

63 713.88 691.75 N/A 653.20 686.75 820.96 795.51 N/A 751.18 789.77

64 and over 725.48 702.99 N/A 663.81 697.91 834.30 808.44 N/A 763.39 802.60





RATE SCHEDULE WITH CSR FUNDING


King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 187.77 181.95 N/A 171.81 180.64 187.77 181.95 N/A 171.81 180.64

15 204.47 198.13 N/A 187.09 196.70 204.47 198.13 N/A 187.09 196.70

16 210.85 204.31 N/A 192.93 202.84 210.85 204.31 N/A 192.93 202.84

17 217.23 210.50 N/A 198.77 208.98 217.23 210.50 N/A 198.77 208.98

18 224.10 217.16 N/A 205.05 215.59 257.72 249.73 N/A 235.81 247.92

19 230.98 223.82 N/A 211.34 222.20 265.62 257.39 N/A 243.04 255.53

20 238.09 230.71 N/A 217.86 229.05 273.81 265.32 N/A 250.53 263.40

21 245.47 237.86 N/A 224.60 236.14 282.29 273.54 N/A 258.29 271.56

22 245.47 237.86 N/A 224.60 236.14 282.29 273.54 N/A 258.29 271.56

23 245.47 237.86 N/A 224.60 236.14 282.29 273.54 N/A 258.29 271.56

24 245.47 237.86 N/A 224.60 236.14 282.29 273.54 N/A 258.29 271.56

25 246.44 238.80 N/A 225.49 237.07 283.41 274.62 N/A 259.32 272.64

26 251.35 243.56 N/A 229.98 241.80 289.05 280.09 N/A 264.48 278.07

27 257.24 249.26 N/A 235.37 247.46 295.83 286.65 N/A 270.68 284.58

28 266.81 258.54 N/A 244.13 256.67 306.83 297.32 N/A 280.75 295.17

29 274.67 266.15 N/A 251.32 264.23 315.87 306.08 N/A 289.02 303.86

30 278.59 269.96 N/A 254.91 268.01 320.38 310.45 N/A 293.15 308.21

31 284.49 275.67 N/A 260.30 273.67 327.16 317.02 N/A 299.35 314.73

32 290.38 281.37 N/A 265.69 279.34 333.93 323.58 N/A 305.55 321.24

33 294.06 284.94 N/A 269.06 282.88 338.17 327.68 N/A 309.42 325.32

34 297.99 288.75 N/A 272.66 286.66 342.68 332.06 N/A 313.56 329.66

35 299.95 290.65 N/A 274.45 288.55 344.94 334.25 N/A 315.62 331.83

36 301.91 292.55 N/A 276.25 290.44 347.20 336.44 N/A 317.69 334.01

37 303.88 294.46 N/A 278.05 292.33 349.46 338.62 N/A 319.75 336.18

38 305.84 296.36 N/A 279.84 294.22 351.72 340.81 N/A 321.82 338.35

39 309.77 300.16 N/A 283.44 298.00 356.23 345.19 N/A 325.95 342.70

40 313.69 303.97 N/A 287.03 301.77 360.75 349.57 N/A 330.09 347.04

41 319.59 309.68 N/A 292.42 307.44 367.52 356.13 N/A 336.28 353.56

42 325.23 315.15 N/A 297.59 312.87 374.02 362.42 N/A 342.22 359.80

43 333.09 322.76 N/A 304.77 320.43 383.05 371.17 N/A 350.49 368.49

44 342.90 332.27 N/A 313.76 329.87 394.34 382.12 N/A 360.82 379.35

45 354.44 343.45 N/A 324.31 340.97 407.61 394.97 N/A 372.96 392.12

46 368.19 356.77 N/A 336.89 354.20 423.41 410.29 N/A 387.42 407.32

47 383.65 371.76 N/A 351.04 369.07 441.20 427.52 N/A 403.70 424.43

48 401.32 388.88 N/A 367.21 386.07 461.52 447.21 N/A 422.29 443.98

49 418.75 405.77 N/A 383.16 402.84 481.56 466.63 N/A 440.63 463.26

50 438.39 424.80 N/A 401.12 421.73 504.15 488.52 N/A 461.29 484.99

51 457.78 443.59 N/A 418.87 440.38 526.44 510.13 N/A 481.70 506.44

52 479.13 464.28 N/A 438.41 460.93 551.00 533.92 N/A 504.17 530.06

53 500.73 485.21 N/A 458.17 481.71 575.84 557.99 N/A 526.90 553.96

54 524.05 507.81 N/A 479.51 504.14 602.66 583.98 N/A 551.43 579.76

55 547.37 530.40 N/A 500.84 526.57 629.48 609.96 N/A 575.97 605.56

56 572.65 554.90 N/A 523.98 550.89 658.55 638.14 N/A 602.57 633.53

57 598.18 579.64 N/A 547.33 575.45 687.91 666.58 N/A 629.43 661.77

58 625.43 606.04 N/A 572.26 601.66 719.24 696.94 N/A 658.10 691.91

59 638.93 619.12 N/A 584.62 614.65 734.76 711.99 N/A 672.31 706.84

60 666.17 645.52 N/A 609.55 640.86 766.10 742.35 N/A 700.98 736.99

61 689.74 668.35 N/A 631.11 663.53 793.20 768.61 N/A 725.77 763.05

62 705.20 683.34 N/A 645.26 678.40 810.98 785.84 N/A 742.05 780.16

63 724.59 702.13 N/A 663.00 697.06 833.28 807.45 N/A 762.45 801.61

64 and over 736.36 713.53 N/A 673.77 708.38 846.82 820.57 N/A 774.84 814.64







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 198.13 191.99 N/A 181.29 190.61 198.13 191.99 N/A 181.29 190.61

15 215.75 209.06 N/A 197.41 207.55 215.75 209.06 N/A 197.41 207.55

16 222.48 215.58 N/A 203.57 214.03 222.48 215.58 N/A 203.57 214.03

17 229.21 222.11 N/A 209.73 220.50 229.21 222.11 N/A 209.73 220.50

18 236.47 229.14 N/A 216.37 227.48 271.94 263.51 N/A 248.82 261.60

19 243.72 236.16 N/A 223.00 234.46 280.28 271.59 N/A 256.45 269.63

20 251.23 243.44 N/A 229.88 241.68 288.91 279.96 N/A 264.36 277.94

21 259.01 250.98 N/A 236.99 249.17 297.86 288.63 N/A 272.54 286.54

22 259.01 250.98 N/A 236.99 249.17 297.86 288.63 N/A 272.54 286.54

23 259.01 250.98 N/A 236.99 249.17 297.86 288.63 N/A 272.54 286.54

24 259.01 250.98 N/A 236.99 249.17 297.86 288.63 N/A 272.54 286.54

25 260.04 251.97 N/A 237.93 250.15 299.04 289.77 N/A 273.62 287.68

26 265.22 256.99 N/A 242.67 255.14 305.00 295.54 N/A 279.07 293.41

27 271.43 263.02 N/A 248.36 261.12 312.15 302.47 N/A 285.61 300.29

28 281.53 272.81 N/A 257.60 270.83 323.76 313.73 N/A 296.24 311.46

29 289.82 280.84 N/A 265.19 278.81 333.29 322.96 N/A 304.96 320.63

30 293.96 284.85 N/A 268.98 282.79 338.06 327.58 N/A 309.32 325.21

31 300.18 290.88 N/A 274.67 288.77 345.21 334.51 N/A 315.87 332.09

32 306.40 296.90 N/A 280.35 294.75 352.36 341.43 N/A 322.41 338.97

33 310.28 300.66 N/A 283.91 298.49 356.82 345.76 N/A 326.49 343.26

34 314.43 304.68 N/A 287.70 302.48 361.59 350.38 N/A 330.85 347.85

35 316.50 306.69 N/A 289.60 304.47 363.97 352.69 N/A 333.03 350.14

36 318.57 308.69 N/A 291.49 306.46 366.36 355.00 N/A 335.22 352.43

37 320.64 310.70 N/A 293.39 308.46 368.74 357.31 N/A 337.40 354.73

38 322.71 312.71 N/A 295.28 310.45 371.12 359.62 N/A 339.58 357.02

39 326.86 316.73 N/A 299.07 314.44 375.89 364.23 N/A 343.94 361.60

40 331.00 320.74 N/A 302.87 318.42 380.65 368.85 N/A 348.30 366.19

41 337.22 326.76 N/A 308.55 324.40 387.80 375.78 N/A 354.84 373.06

42 343.17 332.54 N/A 314.01 330.13 394.65 382.42 N/A 361.11 379.65

43 351.46 340.57 N/A 321.59 338.11 404.18 391.65 N/A 369.83 388.82

44 361.82 350.61 N/A 331.07 348.07 416.10 403.20 N/A 380.73 400.28

45 374.00 362.40 N/A 342.21 359.78 430.10 416.76 N/A 393.54 413.75

46 388.50 376.46 N/A 355.48 373.74 446.77 432.92 N/A 408.80 429.80

47 404.82 392.27 N/A 370.41 389.43 465.54 451.11 N/A 425.97 447.85

48 423.46 410.34 N/A 387.47 407.37 486.98 471.89 N/A 445.59 468.48

49 441.85 428.16 N/A 404.30 425.06 508.13 492.38 N/A 464.94 488.82

50 462.57 448.23 N/A 423.26 445.00 531.96 515.47 N/A 486.74 511.75

51 483.03 468.06 N/A 441.98 464.68 555.49 538.27 N/A 508.27 534.38

52 505.57 489.90 N/A 462.59 486.36 581.40 563.38 N/A 531.98 559.31

53 528.36 511.98 N/A 483.45 508.28 607.61 588.78 N/A 555.97 584.52

54 552.96 535.82 N/A 505.96 531.95 635.91 616.20 N/A 581.86 611.75

55 577.57 559.67 N/A 528.48 555.62 664.21 643.61 N/A 607.75 638.97

56 604.25 585.52 N/A 552.89 581.29 694.88 673.34 N/A 635.82 668.48

57 631.18 611.62 N/A 577.53 607.20 725.86 703.36 N/A 664.16 698.28

58 659.93 639.47 N/A 603.84 634.85 758.92 735.40 N/A 694.41 730.08

59 674.18 653.28 N/A 616.87 648.56 775.30 751.27 N/A 709.40 745.84

60 702.93 681.14 N/A 643.18 676.21 808.36 783.31 N/A 739.65 777.65

61 727.79 705.23 N/A 665.93 700.13 836.96 811.01 N/A 765.82 805.15

62 744.11 721.04 N/A 680.86 715.83 855.72 829.20 N/A 782.99 823.21

63 764.57 740.87 N/A 699.58 735.51 879.25 852.00 N/A 804.52 845.84

64 and over 776.99 752.90 N/A 710.94 747.46 893.54 865.84 N/A 817.59 859.58







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 179.08 173.53 N/A 163.86 172.27 179.08 173.53 N/A 163.86 172.27

15 195.00 188.95 N/A 178.42 187.59 195.00 188.95 N/A 178.42 187.59

16 201.08 194.85 N/A 183.99 193.44 201.08 194.85 N/A 183.99 193.44

17 207.17 200.75 N/A 189.56 199.30 207.17 200.75 N/A 189.56 199.30

18 213.73 207.10 N/A 195.56 205.60 245.78 238.16 N/A 224.89 236.44

19 220.28 213.45 N/A 201.56 211.91 253.32 245.47 N/A 231.79 243.70

20 227.07 220.03 N/A 207.77 218.44 261.13 253.03 N/A 238.93 251.21

21 234.10 226.84 N/A 214.20 225.21 269.22 260.87 N/A 246.33 258.99

22 234.10 226.84 N/A 214.20 225.21 269.22 260.87 N/A 246.33 258.99

23 234.10 226.84 N/A 214.20 225.21 269.22 260.87 N/A 246.33 258.99

24 234.10 226.84 N/A 214.20 225.21 269.22 260.87 N/A 246.33 258.99

25 235.03 227.74 N/A 215.05 226.10 270.28 261.90 N/A 247.31 260.01

26 239.71 232.28 N/A 219.33 230.60 275.67 267.12 N/A 252.23 265.19

27 245.33 237.72 N/A 224.47 236.01 282.13 273.38 N/A 258.15 271.41

28 254.46 246.57 N/A 232.83 244.79 292.63 283.55 N/A 267.75 281.51

29 261.95 253.83 N/A 239.68 251.99 301.24 291.90 N/A 275.64 289.79

30 265.69 257.46 N/A 243.11 255.60 305.55 296.08 N/A 279.58 293.94

31 271.31 262.90 N/A 248.25 261.00 312.01 302.34 N/A 285.49 300.15

32 276.93 268.35 N/A 253.39 266.41 318.47 308.60 N/A 291.40 306.37

33 280.44 271.75 N/A 256.60 269.78 322.51 312.51 N/A 295.09 310.25

34 284.19 275.38 N/A 260.03 273.39 326.82 316.68 N/A 299.04 314.40

35 286.06 277.19 N/A 261.74 275.19 328.97 318.77 N/A 301.01 316.47

36 287.93 279.01 N/A 263.46 276.99 331.12 320.86 N/A 302.98 318.54

37 289.81 280.82 N/A 265.17 278.79 333.28 322.94 N/A 304.95 320.61

38 291.68 282.64 N/A 266.89 280.59 335.43 325.03 N/A 306.92 322.68

39 295.42 286.27 N/A 270.31 284.20 339.74 329.21 N/A 310.86 326.83

40 299.17 289.89 N/A 273.74 287.80 344.04 333.38 N/A 314.80 330.97

41 304.79 295.34 N/A 278.88 293.21 350.51 339.64 N/A 320.71 337.19

42 310.17 300.56 N/A 283.81 298.38 356.70 345.64 N/A 326.38 343.14

43 317.66 307.81 N/A 290.66 305.59 365.31 353.99 N/A 334.26 351.43

44 327.03 316.89 N/A 299.23 314.60 376.08 364.42 N/A 344.11 361.79

45 338.03 327.55 N/A 309.30 325.18 388.73 376.68 N/A 355.69 373.96

46 351.14 340.25 N/A 321.29 337.79 403.81 391.29 N/A 369.48 388.46

47 365.88 354.54 N/A 334.78 351.98 420.77 407.72 N/A 385.00 404.78

48 382.74 370.87 N/A 350.21 368.20 440.15 426.51 N/A 402.74 423.42

49 399.36 386.98 N/A 365.41 384.18 459.26 445.03 N/A 420.23 441.81

50 418.09 405.13 N/A 382.55 402.20 480.80 465.90 N/A 439.93 462.53

51 436.58 423.05 N/A 399.47 419.99 502.07 486.50 N/A 459.39 482.99

52 456.95 442.78 N/A 418.11 439.58 525.49 509.20 N/A 480.82 505.52

53 477.55 462.74 N/A 436.96 459.40 549.18 532.15 N/A 502.50 528.31

54 499.79 484.29 N/A 457.30 480.79 574.75 556.94 N/A 525.90 552.91

55 522.02 505.84 N/A 477.65 502.19 600.33 581.72 N/A 549.30 577.52

56 546.14 529.21 N/A 499.71 525.38 628.06 608.59 N/A 574.67 604.19

57 570.48 552.80 N/A 521.99 548.80 656.05 635.72 N/A 600.29 631.12

58 596.46 577.97 N/A 545.77 573.80 685.93 664.67 N/A 627.63 659.87

59 609.34 590.45 N/A 557.55 586.19 700.74 679.02 N/A 641.18 674.11

60 635.32 615.63 N/A 581.32 611.18 730.62 707.97 N/A 668.52 702.86

61 657.80 637.41 N/A 601.88 632.80 756.47 733.02 N/A 692.17 727.72

62 672.54 651.70 N/A 615.38 646.99 773.43 749.45 N/A 707.69 744.04

63 691.04 669.62 N/A 632.30 664.78 794.69 770.06 N/A 727.14 764.50

64 and over 702.26 680.49 N/A 642.57 675.58 807.61 782.57 N/A 738.96 776.92







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 192.03 186.08 N/A 175.71 184.73 192.03 186.08 N/A 175.71 184.73

15 209.10 202.62 N/A 191.33 201.15 209.10 202.62 N/A 191.33 201.15

16 215.63 208.94 N/A 197.30 207.43 215.63 208.94 N/A 197.30 207.43

17 222.15 215.27 N/A 203.27 213.71 222.15 215.27 N/A 203.27 213.71

18 229.18 222.08 N/A 209.70 220.47 263.56 255.39 N/A 241.16 253.54

19 236.21 228.89 N/A 216.13 227.23 271.64 263.22 N/A 248.55 261.32

20 243.49 235.94 N/A 222.79 234.24 280.01 271.33 N/A 256.21 269.37

21 251.03 243.25 N/A 229.69 241.49 288.68 279.73 N/A 264.15 277.71

22 251.03 243.25 N/A 229.69 241.49 288.68 279.73 N/A 264.15 277.71

23 251.03 243.25 N/A 229.69 241.49 288.68 279.73 N/A 264.15 277.71

24 251.03 243.25 N/A 229.69 241.49 288.68 279.73 N/A 264.15 277.71

25 252.02 244.21 N/A 230.60 242.45 289.83 280.84 N/A 265.19 278.81

26 257.04 249.08 N/A 235.20 247.28 295.60 286.44 N/A 270.47 284.37

27 263.07 254.91 N/A 240.71 253.07 302.53 293.15 N/A 276.81 291.03

28 272.86 264.40 N/A 249.67 262.49 313.79 304.06 N/A 287.12 301.86

29 280.89 272.18 N/A 257.02 270.22 323.02 313.01 N/A 295.57 310.75

30 284.91 276.08 N/A 260.69 274.08 327.64 317.49 N/A 299.79 315.19

31 290.93 281.91 N/A 266.20 279.88 334.57 324.20 N/A 306.13 321.86

32 296.96 287.75 N/A 271.71 285.67 341.50 330.91 N/A 312.47 328.52

33 300.72 291.40 N/A 275.16 289.29 345.83 335.11 N/A 316.43 332.69

34 304.74 295.29 N/A 278.84 293.16 350.45 339.58 N/A 320.66 337.13

35 306.75 297.24 N/A 280.67 295.09 352.76 341.82 N/A 322.77 339.35

36 308.75 299.18 N/A 282.51 297.02 355.07 344.06 N/A 324.89 341.57

37 310.76 301.13 N/A 284.35 298.95 357.38 346.30 N/A 327.00 343.80

38 312.77 303.07 N/A 286.18 300.89 359.69 348.54 N/A 329.11 346.02

39 316.79 306.97 N/A 289.86 304.75 364.30 353.01 N/A 333.34 350.46

40 320.80 310.86 N/A 293.53 308.61 368.92 357.49 N/A 337.56 354.90

41 326.83 316.70 N/A 299.05 314.41 375.85 364.20 N/A 343.90 361.57

42 332.60 322.29 N/A 304.33 319.96 382.49 370.63 N/A 349.98 367.96

43 340.63 330.07 N/A 311.68 327.69 391.73 379.58 N/A 358.43 376.84

44 350.67 339.80 N/A 320.87 337.35 403.28 390.77 N/A 369.00 387.95

45 362.47 351.24 N/A 331.66 348.70 416.84 403.92 N/A 381.41 401.00

46 376.53 364.86 N/A 344.52 362.22 433.01 419.59 N/A 396.20 416.55

47 392.34 380.18 N/A 358.99 377.43 451.20 437.21 N/A 412.84 434.05

48 410.42 397.69 N/A 375.53 394.82 471.98 457.35 N/A 431.86 454.04

49 428.24 414.96 N/A 391.84 411.97 492.48 477.21 N/A 450.61 473.76

50 448.32 434.42 N/A 410.21 431.28 515.57 499.59 N/A 471.75 495.98

51 468.15 453.64 N/A 428.36 450.36 538.37 521.68 N/A 492.61 517.92

52 489.99 474.80 N/A 448.34 471.37 563.49 546.02 N/A 515.59 542.08

53 512.08 496.21 N/A 468.55 492.62 588.89 570.64 N/A 538.84 566.51

54 535.93 519.31 N/A 490.37 515.56 616.32 597.21 N/A 563.93 592.90

55 559.77 542.42 N/A 512.19 538.50 643.74 623.78 N/A 589.02 619.28

56 585.63 567.47 N/A 535.85 563.37 673.47 652.60 N/A 616.23 647.88

57 611.73 592.77 N/A 559.74 588.49 703.49 681.69 N/A 643.70 676.76

58 639.60 619.77 N/A 585.23 615.29 735.54 712.74 N/A 673.02 707.59

59 653.40 633.15 N/A 597.86 628.57 751.41 728.12 N/A 687.54 722.86

60 681.27 660.15 N/A 623.36 655.38 783.46 759.17 N/A 716.86 753.69

61 705.36 683.50 N/A 645.41 678.56 811.17 786.02 N/A 742.22 780.35

62 721.18 698.82 N/A 659.88 693.77 829.36 803.65 N/A 758.86 797.84

63 741.01 718.04 N/A 678.02 712.85 852.16 825.74 N/A 779.73 819.78

64 and over 753.05 729.70 N/A 689.04 724.43 866.01 839.16 N/A 792.40 833.10







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 188.01 182.18 N/A 172.03 180.86 188.01 182.18 N/A 172.03 180.86

15 204.72 198.37 N/A 187.32 196.94 204.72 198.37 N/A 187.32 196.94

16 211.11 204.56 N/A 193.16 203.09 211.11 204.56 N/A 193.16 203.09

17 217.50 210.76 N/A 199.01 209.23 217.50 210.76 N/A 199.01 209.23

18 224.38 217.42 N/A 205.31 215.85 258.04 250.04 N/A 236.10 248.23

19 231.26 224.09 N/A 211.60 222.47 265.95 257.70 N/A 243.34 255.84

20 238.39 231.00 N/A 218.12 229.33 274.15 265.65 N/A 250.84 263.73

21 245.77 238.15 N/A 224.88 236.43 282.63 273.87 N/A 258.61 271.89

22 245.77 238.15 N/A 224.88 236.43 282.63 273.87 N/A 258.61 271.89

23 245.77 238.15 N/A 224.88 236.43 282.63 273.87 N/A 258.61 271.89

24 245.77 238.15 N/A 224.88 236.43 282.63 273.87 N/A 258.61 271.89

25 246.74 239.09 N/A 225.77 237.37 283.75 274.96 N/A 259.64 272.97

26 251.66 243.86 N/A 230.27 242.10 289.41 280.44 N/A 264.81 278.41

27 257.56 249.57 N/A 235.66 247.77 296.19 287.01 N/A 271.01 284.93

28 267.14 258.86 N/A 244.43 256.99 307.21 297.69 N/A 281.10 295.54

29 275.01 266.48 N/A 251.63 264.56 316.26 306.45 N/A 289.37 304.24

30 278.94 270.29 N/A 255.23 268.34 320.78 310.83 N/A 293.51 308.59

31 284.84 276.01 N/A 260.62 274.01 327.56 317.41 N/A 299.72 315.11

32 290.73 281.72 N/A 266.02 279.69 334.34 323.98 N/A 305.92 321.64

33 294.42 285.29 N/A 269.39 283.23 338.58 328.09 N/A 309.80 325.72

34 298.35 289.10 N/A 272.99 287.02 343.11 332.47 N/A 313.94 330.07

35 300.32 291.01 N/A 274.79 288.91 345.37 334.66 N/A 316.01 332.24

36 302.28 292.91 N/A 276.59 290.80 347.63 336.85 N/A 318.08 334.42

37 304.25 294.82 N/A 278.39 292.69 349.89 339.04 N/A 320.15 336.59

38 306.22 296.72 N/A 280.19 294.58 352.15 341.23 N/A 322.22 338.77

39 310.15 300.53 N/A 283.79 298.36 356.67 345.61 N/A 326.35 343.12

40 314.08 304.34 N/A 287.38 302.15 361.19 350.00 N/A 330.49 347.47

41 319.98 310.06 N/A 292.78 307.82 367.98 356.57 N/A 336.70 353.99

42 325.63 315.54 N/A 297.95 313.26 374.48 362.87 N/A 342.65 360.25

43 333.50 323.16 N/A 305.15 320.82 383.52 371.63 N/A 350.92 368.95

44 343.33 332.68 N/A 314.14 330.28 394.83 382.59 N/A 361.27 379.82

45 354.88 343.88 N/A 324.71 341.39 408.11 395.46 N/A 373.42 392.60

46 368.64 357.21 N/A 337.31 354.63 423.94 410.79 N/A 387.90 407.83

47 384.12 372.22 N/A 351.47 369.53 441.74 428.05 N/A 404.19 424.96

48 401.82 389.36 N/A 367.66 386.55 462.09 447.77 N/A 422.81 444.53

49 419.27 406.27 N/A 383.63 403.33 482.16 467.21 N/A 441.17 463.83

50 438.93 425.32 N/A 401.62 422.25 504.77 489.12 N/A 461.86 485.59

51 458.34 444.13 N/A 419.38 440.93 527.09 510.75 N/A 482.29 507.06

52 479.72 464.85 N/A 438.95 461.49 551.68 534.58 N/A 504.79 530.72

53 501.35 485.81 N/A 458.74 482.30 576.55 558.68 N/A 527.55 554.64

54 524.70 508.43 N/A 480.10 504.76 603.40 584.70 N/A 552.11 580.47

55 548.04 531.06 N/A 501.46 527.22 630.25 610.71 N/A 576.68 606.30

56 573.36 555.58 N/A 524.62 551.57 659.36 638.92 N/A 603.32 634.31

57 598.92 580.35 N/A 548.01 576.16 688.75 667.40 N/A 630.21 662.58

58 626.20 606.78 N/A 572.97 602.40 720.13 697.80 N/A 658.92 692.76

59 639.71 619.88 N/A 585.34 615.40 735.67 712.86 N/A 673.14 707.71

60 666.99 646.32 N/A 610.30 641.65 767.04 743.26 N/A 701.84 737.89

61 690.59 669.18 N/A 631.89 664.34 794.17 769.55 N/A 726.67 763.99

62 706.07 684.18 N/A 646.05 679.24 811.98 786.81 N/A 742.96 781.12

63 725.48 702.99 N/A 663.82 697.92 834.31 808.44 N/A 763.39 802.60

64 and over 737.27 714.41 N/A 674.60 709.25 847.86 821.58 N/A 775.79 815.64







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 190.83 184.91 N/A 174.61 183.58 190.83 184.91 N/A 174.61 183.58

15 207.79 201.35 N/A 190.13 199.89 207.79 201.35 N/A 190.13 199.89

16 214.27 207.63 N/A 196.06 206.13 214.27 207.63 N/A 196.06 206.13

17 220.76 213.92 N/A 202.00 212.37 220.76 213.92 N/A 202.00 212.37

18 227.74 220.68 N/A 208.39 219.09 261.91 253.79 N/A 239.64 251.95

19 234.73 227.45 N/A 214.78 225.81 269.94 261.57 N/A 246.99 259.68

20 241.96 234.46 N/A 221.40 232.77 278.26 269.63 N/A 254.61 267.68

21 249.46 241.72 N/A 228.25 239.98 286.87 277.98 N/A 262.49 275.97

22 249.46 241.72 N/A 228.25 239.98 286.87 277.98 N/A 262.49 275.97

23 249.46 241.72 N/A 228.25 239.98 286.87 277.98 N/A 262.49 275.97

24 249.46 241.72 N/A 228.25 239.98 286.87 277.98 N/A 262.49 275.97

25 250.44 242.68 N/A 229.16 240.93 288.01 279.08 N/A 263.53 277.07

26 255.43 247.51 N/A 233.72 245.73 293.75 284.64 N/A 268.78 282.59

27 261.42 253.32 N/A 239.20 251.49 300.63 291.31 N/A 275.08 289.21

28 271.15 262.74 N/A 248.10 260.84 311.82 302.15 N/A 285.32 299.97

29 279.13 270.48 N/A 255.40 268.52 321.00 311.05 N/A 293.72 308.80

30 283.12 274.34 N/A 259.06 272.36 325.59 315.50 N/A 297.91 313.22

31 289.11 280.15 N/A 264.53 278.12 332.47 322.17 N/A 304.21 319.84

32 295.10 285.95 N/A 270.01 283.88 339.36 328.84 N/A 310.51 326.46

33 298.84 289.57 N/A 273.44 287.48 343.66 333.01 N/A 314.45 330.60

34 302.83 293.44 N/A 277.09 291.32 348.25 337.46 N/A 318.65 335.02

35 304.82 295.37 N/A 278.91 293.24 350.55 339.68 N/A 320.75 337.23

36 306.82 297.31 N/A 280.74 295.16 352.84 341.90 N/A 322.85 339.43

37 308.81 299.24 N/A 282.57 297.08 355.14 344.13 N/A 324.95 341.64

38 310.81 301.18 N/A 284.39 299.00 357.43 346.35 N/A 327.05 343.85

39 314.80 305.04 N/A 288.04 302.84 362.02 350.80 N/A 331.25 348.26

40 318.79 308.91 N/A 291.70 306.68 366.61 355.25 N/A 335.45 352.68

41 324.78 314.71 N/A 297.17 312.44 373.50 361.92 N/A 341.75 359.30

42 330.52 320.27 N/A 302.42 317.96 380.09 368.31 N/A 347.79 365.65

43 338.50 328.01 N/A 309.73 325.64 389.27 377.21 N/A 356.19 374.48

44 348.48 337.67 N/A 318.86 335.23 400.75 388.32 N/A 366.68 385.52

45 360.20 349.03 N/A 329.58 346.51 414.23 401.39 N/A 379.02 398.49

46 374.17 362.57 N/A 342.37 359.95 430.30 416.96 N/A 393.72 413.94

47 389.88 377.80 N/A 356.74 375.07 448.37 434.47 N/A 410.26 431.33

48 407.84 395.20 N/A 373.18 392.35 469.02 454.48 N/A 429.15 451.20

49 425.56 412.36 N/A 389.38 409.38 489.39 474.22 N/A 447.79 470.79

50 445.51 431.70 N/A 407.64 428.58 512.34 496.46 N/A 468.79 492.87

51 465.22 450.80 N/A 425.67 447.54 535.00 518.42 N/A 489.53 514.67

52 486.92 471.82 N/A 445.53 468.42 559.96 542.60 N/A 512.36 538.68

53 508.87 493.10 N/A 465.62 489.53 585.20 567.06 N/A 535.46 562.96

54 532.57 516.06 N/A 487.30 512.33 612.45 593.47 N/A 560.39 589.18

55 556.27 539.02 N/A 508.98 535.13 639.71 619.87 N/A 585.33 615.40

56 581.96 563.92 N/A 532.49 559.84 669.25 648.51 N/A 612.37 643.82

57 607.90 589.06 N/A 556.23 584.80 699.09 677.41 N/A 639.66 672.52

58 635.59 615.89 N/A 581.56 611.44 730.93 708.27 N/A 668.80 703.15

59 649.31 629.18 N/A 594.12 624.64 746.71 723.56 N/A 683.24 718.33

60 677.00 656.01 N/A 619.45 651.27 778.55 754.41 N/A 712.37 748.96

61 700.94 679.22 N/A 641.36 674.31 806.09 781.10 N/A 737.57 775.45

62 716.66 694.44 N/A 655.74 689.43 824.16 798.61 N/A 754.10 792.84

63 736.37 713.54 N/A 673.77 708.38 846.82 820.57 N/A 774.84 814.64

64 and over 748.33 725.13 N/A 684.72 719.89 860.58 833.90 N/A 787.43 827.88







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 201.35 195.11 N/A 184.24 193.70 201.35 195.11 N/A 184.24 193.70

15 219.25 212.46 N/A 200.62 210.92 219.25 212.46 N/A 200.62 210.92

16 226.10 219.09 N/A 206.88 217.50 226.10 219.09 N/A 206.88 217.50

17 232.94 225.72 N/A 213.14 224.09 232.94 225.72 N/A 213.14 224.09

18 240.31 232.86 N/A 219.88 231.18 276.36 267.79 N/A 252.87 265.85

19 247.68 240.00 N/A 226.63 238.27 284.83 276.00 N/A 260.62 274.01

20 255.31 247.40 N/A 233.61 245.61 293.61 284.51 N/A 268.65 282.45

21 263.22 255.06 N/A 240.85 253.22 302.70 293.32 N/A 276.97 291.20

22 263.22 255.06 N/A 240.85 253.22 302.70 293.32 N/A 276.97 291.20

23 263.22 255.06 N/A 240.85 253.22 302.70 293.32 N/A 276.97 291.20

24 263.22 255.06 N/A 240.85 253.22 302.70 293.32 N/A 276.97 291.20

25 264.26 256.07 N/A 241.80 254.22 303.90 294.48 N/A 278.07 292.35

26 269.53 261.17 N/A 246.62 259.28 309.95 300.35 N/A 283.61 298.18

27 275.84 267.29 N/A 252.40 265.36 317.22 307.39 N/A 290.26 305.17

28 286.11 277.24 N/A 261.79 275.24 329.02 318.82 N/A 301.06 316.52

29 294.53 285.40 N/A 269.50 283.34 338.71 328.21 N/A 309.92 325.84

30 298.74 289.48 N/A 273.35 287.39 343.55 332.90 N/A 314.35 330.50

31 305.06 295.60 N/A 279.13 293.47 350.82 339.94 N/A 321.00 337.49

32 311.38 301.72 N/A 284.91 299.54 358.08 346.98 N/A 327.65 344.48

33 315.32 305.55 N/A 288.52 303.34 362.62 351.38 N/A 331.80 348.84

34 319.54 309.63 N/A 292.38 307.39 367.47 356.07 N/A 336.23 353.50

35 321.64 311.67 N/A 294.30 309.42 369.89 358.42 N/A 338.45 355.83

36 323.75 313.71 N/A 296.23 311.44 372.31 360.77 N/A 340.66 358.16

37 325.85 315.75 N/A 298.16 313.47 374.73 363.11 N/A 342.88 360.49

38 327.96 317.79 N/A 300.08 315.50 377.15 365.46 N/A 345.09 362.82

39 332.17 321.87 N/A 303.94 319.55 382.00 370.15 N/A 349.53 367.48

40 336.38 325.95 N/A 307.79 323.60 386.84 374.85 N/A 353.96 372.14

41 342.70 332.07 N/A 313.57 329.68 394.10 381.89 N/A 360.60 379.13

42 348.75 337.94 N/A 319.11 335.50 401.06 388.63 N/A 366.97 385.82

43 357.17 346.10 N/A 326.81 343.60 410.75 398.02 N/A 375.84 395.14

44 367.70 356.30 N/A 336.45 353.73 422.86 409.75 N/A 386.92 406.79

45 380.07 368.29 N/A 347.77 365.63 437.08 423.54 N/A 399.93 420.48

46 394.81 382.57 N/A 361.25 379.81 454.04 439.96 N/A 415.44 436.78

47 411.40 398.64 N/A 376.43 395.76 473.10 458.44 N/A 432.89 455.13

48 430.35 417.01 N/A 393.77 413.99 494.90 479.56 N/A 452.83 476.09

49 449.03 435.11 N/A 410.87 431.97 516.39 500.38 N/A 472.50 496.77

50 470.09 455.52 N/A 430.13 452.23 540.60 523.85 N/A 494.65 520.06

51 490.88 475.67 N/A 449.16 472.23 564.52 547.02 N/A 516.53 543.07

52 513.78 497.86 N/A 470.11 494.26 590.85 572.54 N/A 540.63 568.40

53 536.95 520.30 N/A 491.31 516.54 617.49 598.35 N/A 565.00 594.02

54 561.95 544.53 N/A 514.19 540.60 646.24 626.21 N/A 591.31 621.69

55 586.96 568.76 N/A 537.06 564.65 675.00 654.07 N/A 617.62 649.35

56 614.07 595.03 N/A 561.87 590.73 706.18 684.29 N/A 646.15 679.34

57 641.44 621.56 N/A 586.92 617.07 737.66 714.79 N/A 674.96 709.63

58 670.66 649.87 N/A 613.65 645.17 771.25 747.35 N/A 705.70 741.95

59 685.13 663.89 N/A 626.90 659.10 787.90 763.48 N/A 720.93 757.96

60 714.35 692.20 N/A 653.63 687.20 821.50 796.03 N/A 751.67 790.28

61 739.62 716.69 N/A 676.75 711.51 850.56 824.19 N/A 778.26 818.24

62 756.20 732.76 N/A 691.92 727.46 869.63 842.67 N/A 795.71 836.58

63 776.99 752.91 N/A 710.95 747.47 893.54 865.84 N/A 817.59 859.59

64 and over 789.62 765.14 N/A 722.50 759.61 908.06 879.91 N/A 830.87 873.55







King


N/A

Plan Information






Metal Level: Silver



1 Yes

2 Yes

3 No

4 Yes

5 Yes

Plan Rates

Age


0-14 195.15 189.10 N/A 178.56 187.73 195.15 189.10 N/A 178.56 187.73

15 212.50 205.91 N/A 194.44 204.42 212.50 205.91 N/A 194.44 204.42

16 219.13 212.34 N/A 200.50 210.80 219.13 212.34 N/A 200.50 210.80

17 225.76 218.76 N/A 206.57 217.18 225.76 218.76 N/A 206.57 217.18

18 232.91 225.69 N/A 213.11 224.05 267.84 259.54 N/A 245.07 257.66

19 240.05 232.61 N/A 219.64 230.93 276.06 267.50 N/A 252.59 265.57

20 247.45 239.78 N/A 226.41 238.04 284.56 275.74 N/A 260.37 273.75

21 255.11 247.20 N/A 233.43 245.42 293.37 284.28 N/A 268.44 282.23

22 255.11 247.20 N/A 233.43 245.42 293.37 284.28 N/A 268.44 282.23

23 255.11 247.20 N/A 233.43 245.42 293.37 284.28 N/A 268.44 282.23

24 255.11 247.20 N/A 233.43 245.42 293.37 284.28 N/A 268.44 282.23

25 256.12 248.18 N/A 234.35 246.39 294.54 285.41 N/A 269.50 283.34

26 261.22 253.12 N/A 239.02 251.29 300.40 291.09 N/A 274.87 288.99

27 267.34 259.06 N/A 244.62 257.18 307.45 297.91 N/A 281.31 295.76

28 277.29 268.70 N/A 253.72 266.76 318.89 309.00 N/A 291.78 306.77

29 285.46 276.61 N/A 261.19 274.61 328.27 318.10 N/A 300.37 315.80

30 289.54 280.56 N/A 264.93 278.53 332.97 322.65 N/A 304.67 320.32

31 295.66 286.49 N/A 270.53 284.42 340.01 329.47 N/A 311.11 327.09

32 301.78 292.43 N/A 276.13 290.31 347.05 336.29 N/A 317.55 333.86

33 305.61 296.13 N/A 279.63 294.00 351.45 340.55 N/A 321.58 338.09

34 309.69 300.09 N/A 283.37 297.92 356.14 345.10 N/A 325.87 342.61

35 311.73 302.07 N/A 285.23 299.89 358.49 347.38 N/A 328.02 344.87

36 313.77 304.04 N/A 287.10 301.85 360.84 349.65 N/A 330.17 347.13

37 315.81 306.02 N/A 288.97 303.81 363.18 351.93 N/A 332.31 349.38

38 317.85 308.00 N/A 290.84 305.77 365.53 354.20 N/A 334.46 351.64

39 321.93 311.95 N/A 294.57 309.70 370.23 358.75 N/A 338.76 356.16

40 326.02 315.91 N/A 298.30 313.63 374.92 363.30 N/A 343.05 360.67

41 332.14 321.84 N/A 303.91 319.52 381.96 370.12 N/A 349.49 367.45

42 338.01 327.53 N/A 309.28 325.16 388.71 376.66 N/A 355.67 373.94

43 346.17 335.44 N/A 316.74 333.01 398.09 385.75 N/A 364.26 382.97

44 356.37 345.33 N/A 326.08 342.83 409.83 397.12 N/A 374.99 394.26

45 368.36 356.94 N/A 337.05 354.36 423.62 410.49 N/A 387.61 407.52

46 382.65 370.79 N/A 350.12 368.11 440.05 426.40 N/A 402.64 423.32

47 398.72 386.36 N/A 364.83 383.57 458.53 444.31 N/A 419.55 441.10

48 417.09 404.16 N/A 381.63 401.24 479.65 464.78 N/A 438.88 461.42

49 435.20 421.71 N/A 398.21 418.66 500.48 484.96 N/A 457.94 481.46

50 455.61 441.48 N/A 416.88 438.29 523.95 507.71 N/A 479.41 504.04

51 475.76 461.01 N/A 435.32 457.68 547.12 530.16 N/A 500.62 526.33

52 497.95 482.52 N/A 455.63 479.03 572.65 554.89 N/A 523.97 550.89

53 520.40 504.27 N/A 476.17 500.63 598.46 579.91 N/A 547.59 575.72

54 544.64 527.75 N/A 498.34 523.94 626.33 606.92 N/A 573.09 602.53

55 568.87 551.24 N/A 520.52 547.25 654.20 633.92 N/A 598.59 629.34

56 595.15 576.70 N/A 544.56 572.53 684.42 663.20 N/A 626.24 658.41

57 621.68 602.40 N/A 568.83 598.05 714.93 692.76 N/A 654.16 687.76

58 649.99 629.84 N/A 594.74 625.29 747.49 724.32 N/A 683.95 719.09

59 664.02 643.44 N/A 607.58 638.79 763.63 739.95 N/A 698.72 734.61

60 692.34 670.88 N/A 633.49 666.03 796.19 771.51 N/A 728.51 765.93

61 716.83 694.61 N/A 655.90 689.59 824.35 798.80 N/A 754.28 793.03

62 732.90 710.18 N/A 670.60 705.05 842.83 816.71 N/A 771.19 810.81

63 753.05 729.71 N/A 689.04 724.44 866.01 839.16 N/A 792.40 833.10

64 and over 765.29 741.56 N/A 700.24 736.21 880.08 852.80 N/A 805.27 846.64







King


N/A

Rate Schedule Cost Sharing Reduction Funding · Rate Schedule Without Cost Sharing Reduction (CSR)* Funding *Note: Only rates for silver plans sold inside the Exchange and those sold

Documents