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|
*Authorized Independent Agent |
|
|
Blue Cross Blue
Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$214.89 |
$214.89 |
$319.79 |
$319.79 |
$424.69 |
$424.69 |
$429.67 |
$579.83 |
|
$247.08 |
$247.08 |
$367.69 |
$367.69 |
$488.30 |
$488.30 |
$494.03 |
$666.68 |
|
|
95.51 |
95.51 |
200.41 |
200.41 |
305.31 |
305.31 |
191.01 |
341.18 |
|
109.81 |
109.81 |
230.42 |
230.42 |
351.04 |
351.04 |
219.63 |
392.28 |
|
|
113.16 |
139.87 |
218.06 |
244.77 |
322.96 |
349.66 |
250.54 |
400.70 |
|
130.11 |
160.82 |
250.72 |
281.43 |
371.33 |
402.04 |
288.06 |
460.72 |
|
|
131.91 |
166.57 |
236.84 |
271.47 |
359.28 |
397.30 |
292.86 |
473.01 |
|
151.71 |
191.52 |
272.32 |
312.13 |
413.10 |
456.82 |
336.72 |
543.86 |
|
|
142.24 |
206.97 |
247.14 |
311.87 |
384.29 |
450.94 |
333.26 |
545.88 |
|
163.55 |
237.97 |
284.16 |
358.58 |
441.85 |
518.49 |
383.17 |
627.65 |
|
|
160.80 |
237.75 |
265.70 |
342.65 |
402.85 |
481.72 |
378.97 |
591.60 |
|
184.89 |
273.36 |
305.50 |
393.97 |
463.19 |
553.88 |
435.74 |
680.22 |
|
|
184.79 |
261.74 |
289.69 |
366.64 |
448.34 |
512.16 |
425.93 |
660.85 |
|
212.47 |
300.94 |
333.08 |
421.56 |
515.50 |
588.88 |
489.73 |
759.84 |
|
|
203.35 |
276.00 |
308.25 |
380.90 |
472.44 |
535.59 |
461.69 |
697.07 |
|
233.81 |
317.34 |
354.42 |
437.95 |
543.21 |
615.81 |
530.85 |
801.48 |
|
|
222.02 |
290.37 |
326.92 |
395.27 |
491.11 |
549.96 |
494.96 |
730.33 |
|
255.28 |
333.86 |
375.89 |
454.47 |
564.68 |
632.33 |
569.10 |
839.73 |
|
|
259.59 |
330.88 |
364.49 |
435.78 |
524.95 |
573.95 |
550.52 |
768.70 |
|
298.47 |
380.44 |
419.08 |
501.05 |
603.58 |
659.92 |
632.99 |
883.84 |
|
|
284.60 |
356.68 |
389.50 |
461.58 |
549.96 |
599.75 |
599.18 |
817.35 |
|
327.23 |
410.11 |
447.84 |
530.72 |
632.33 |
689.58 |
688.93 |
939.78 |
|
|
309.61 |
367.20 |
414.51 |
472.10 |
571.91 |
609.03 |
639.58 |
842.82 |
|
355.98 |
422.21 |
476.59 |
542.82 |
657.58 |
700.25 |
735.38 |
969.06 |
|
|
334.61 |
380.78 |
439.51 |
485.68 |
593.75 |
621.47 |
681.79 |
870.09 |
|
384.74 |
437.82 |
505.35 |
558.43 |
682.69 |
714.56 |
783.91 |
1000.42 |
|
|
365.96 |
399.45 |
470.86 |
504.35 |
625.10 |
640.15 |
728.18 |
916.48 |
|
420.78 |
459.29 |
541.39 |
579.90 |
718.73 |
736.03 |
837.26 |
1053.76 |
|
|
399.45 |
419.94 |
504.35 |
524.84 |
661.76 |
629.74 |
777.98 |
946.02 |
|
459.29 |
482.84 |
579.90 |
603.45 |
760.88 |
724.06 |
894.51 |
1087.72 |
|
|
432.95 |
440.42 |
537.85 |
545.32 |
695.26 |
650.22 |
828.56 |
996.60 |
|
497.80 |
506.39 |
618.41 |
627.00 |
799.40 |
747.61 |
952.67 |
1145.88 |
|
|
508.65 |
478.10 |
613.55 |
583.00 |
744.71 |
687.90 |
922.25 |
1082.04 |
|
584.84 |
549.71 |
705.46 |
670.33 |
856.25 |
790.94 |
1060.40 |
1244.11 |
|
|
609.48 |
529.59 |
714.38 |
634.49 |
819.28 |
739.39 |
1070.49 |
1222.01 |
|
700.77 |
608.91 |
821.38 |
729.53 |
942.00 |
850.14 |
1230.84 |
1405.06 |
|
|
720.60 |
635.17 |
825.50 |
740.07 |
930.40 |
844.97 |
1238.76 |
1378.63 |
|
828.54 |
730.31 |
949.15 |
850.92 |
1069.76 |
971.53 |
1424.31 |
1585.13 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$145.63 |
$145.63 |
$216.73 |
$216.73 |
$287.82 |
$287.82 |
$291.19 |
$392.96 |
|
$178.96 |
$178.96 |
$266.32 |
$266.32 |
$353.68 |
$353.68 |
$357.83 |
$482.89 |
|
|
64.73 |
64.73 |
135.82 |
135.82 |
206.91 |
206.91 |
129.45 |
231.22 |
|
79.54 |
79.54 |
166.90 |
166.90 |
254.26 |
254.26 |
159.08 |
284.13 |
|
|
76.69 |
94.79 |
147.78 |
165.88 |
218.87 |
236.97 |
169.79 |
271.56 |
|
94.24 |
116.48 |
181.60 |
203.84 |
268.96 |
291.20 |
208.65 |
333.70 |
|
|
89.42 |
112.89 |
160.51 |
183.98 |
243.49 |
269.26 |
198.47 |
320.56 |
|
2109.88 |
138.72 |
197.24 |
226.08 |
299.21 |
330.88 |
243.89 |
393.92 |
|
|
96.40 |
140.27 |
167.49 |
211.36 |
260.44 |
305.61 |
225.85 |
369.95 |
|
118.46 |
172.36 |
205.82 |
259.73 |
320.04 |
375.55 |
277.54 |
454.61 |
|
|
108.98 |
161.13 |
180.07 |
232.22 |
273.02 |
326.47 |
256.83 |
400.94 |
|
133.92 |
198.00 |
221.28 |
285.36 |
335.49 |
401.18 |
315.61 |
492.69 |
|
|
125.23 |
177.38 |
196.33 |
248.48 |
303.85 |
347.10 |
288.66 |
447.87 |
|
153.89 |
217.98 |
241.25 |
305.34 |
373.38 |
426.53 |
354.72 |
550.36 |
|
|
137.81 |
187.05 |
208.90 |
258.14 |
320.18 |
362.97 |
312.90 |
472.41 |
|
169.35 |
229.85 |
256.71 |
317.21 |
393.45 |
446.04 |
384.50 |
580.52 |
|
|
150.47 |
196.79 |
221.56 |
267.88 |
332.83 |
372.71 |
335.44 |
494.96 |
|
184.90 |
241.82 |
272.26 |
329.18 |
409.00 |
458.01 |
412.21 |
608.22 |
|
|
175.93 |
224.24 |
247.02 |
295.33 |
355.76 |
388.97 |
373.10 |
520.96 |
|
216.19 |
275.56 |
303.55 |
362.92 |
437.18 |
477.99 |
458.48 |
640.17 |
|
|
192.88 |
241.73 |
263.97 |
312.82 |
372.71 |
406.46 |
406.07 |
553.93 |
|
237.01 |
297.04 |
324.37 |
384.40 |
458.01 |
499.47 |
499.00 |
680.70 |
|
|
209.82 |
248.86 |
280.92 |
319.95 |
387.59 |
412.75 |
433.45 |
571.19 |
|
257.84 |
305.81 |
345.20 |
393.17 |
476.29 |
507.20 |
532.64 |
701.90 |
|
|
226.77 |
258.06 |
297.86 |
329.15 |
402.39 |
421.18 |
462.06 |
589.67 |
|
278.67 |
317.12 |
366.03 |
404.48 |
494.48 |
517.57 |
567.80 |
724.61 |
|
|
248.02 |
270.72 |
319.11 |
341.81 |
423.64 |
433.84 |
493.50 |
621.11 |
|
304.77 |
332.67 |
392.13 |
420.03 |
520.58 |
533.12 |
606.43 |
763.25 |
|
|
270.72 |
284.60 |
341.81 |
355.69 |
448.48 |
426.78 |
527.24 |
641.13 |
|
332.67 |
349.72 |
420.03 |
437.09 |
551.12 |
524.45 |
647.90 |
787.85 |
|
|
293.42 |
298.48 |
364.51 |
369.57 |
471.18 |
440.66 |
561.52 |
675.41 |
|
360.56 |
366.78 |
447.92 |
454.14 |
579.01 |
541.50 |
690.03 |
829.97 |
|
|
344.72 |
324.02 |
415.81 |
395.11 |
504.70 |
466.20 |
625.02 |
733.31 |
|
423.61 |
398.16 |
510.97 |
485.52 |
620.19 |
572.88 |
768.06 |
901.12 |
|
|
413.05 |
358.91 |
484.14 |
430.00 |
555.24 |
501.09 |
725.49 |
828.18 |
|
507.58 |
441.04 |
594.94 |
528.40 |
682.30 |
615.76 |
891.51 |
1017.70 |
|
|
488.36 |
430.46 |
559.45 |
501.55 |
630.55 |
572.64 |
839.53 |
934.31 |
|
600.12 |
528.97 |
687.48 |
616.33 |
774.84 |
703.69 |
1031.65 |
1148.13 |
| Blue Cross Blue Shield of Georgia SmartSense POS 2500 Deductible Plan Rates | SmartSense POS 2500 Deductible Plan Rates With Comprehensive Drug Rider | ||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$144.01 |
$146.01 |
$217.29 |
$217.29 |
$288.57 |
$288.57 |
$291.95 |
$393.98 |
|
$116.73 |
$116.73 |
$173.71 |
$173.71 |
$230.70 |
$230.77 |
$233.40 |
$314.97 |
|
|
64.90 |
64.90 |
136.17 |
136.17 |
207.45 |
207.45 |
129.79 |
231.82 |
|
51.88 |
51.88 |
108.86 |
108.86 |
165.85 |
165.85 |
103.76 |
185.33 |
|
|
76.89 |
95.04 |
148.17 |
166.31 |
219.44 |
237.59 |
170.23 |
272.27 |
|
61.47 |
75.98 |
118.45 |
132.96 |
175.44 |
189.94 |
136.09 |
217.67 |
|
|
89.65 |
113.18 |
160.93 |
184.46 |
244.13 |
269.96 |
198.99 |
321.40 |
|
71.67 |
90.48 |
128.66 |
147.47 |
195.17 |
215.82 |
159.08 |
256.94 |
|
|
96.65 |
140.63 |
167.93 |
211.91 |
261.12 |
306.41 |
226.44 |
370.92 |
|
77.27 |
112.43 |
134.25 |
169.41 |
208.75 |
244.96 |
181.03 |
296.53 |
|
|
109.26 |
161.55 |
180.54 |
232.82 |
273.73 |
327.32 |
257.50 |
401.98 |
|
87.35 |
129.15 |
144.33 |
186.13 |
218.83 |
261.68 |
205.86 |
321.37 |
|
|
125.56 |
177.85 |
196.84 |
249.12 |
304.64 |
348.00 |
289.41 |
449.04 |
|
100.38 |
142.18 |
157.36 |
199.16 |
243.54 |
278.21 |
231.37 |
358.98 |
|
|
138.17 |
187.53 |
209.45 |
258.81 |
321.02 |
363.92 |
313.71 |
473.64 |
|
110.46 |
149.93 |
167.44 |
206.91 |
256.64 |
290.94 |
250.80 |
378.66 |
|
|
150.86 |
197.30 |
222.14 |
268.58 |
333.70 |
373.69 |
336.32 |
496.25 |
|
120.60 |
157.73 |
177.59 |
214.71 |
266.78 |
298.74 |
268.87 |
396.73 |
|
|
176.39 |
224.83 |
247.66 |
296.10 |
356.69 |
389.99 |
374.07 |
522.31 |
|
141.01 |
179.74 |
197.99 |
236.72 |
285.16 |
311.78 |
299.05 |
417.57 |
|
|
193.38 |
242.36 |
264.66 |
313.63 |
373.69 |
407.52 |
407.13 |
555.38 |
|
154.60 |
193.75 |
211.58 |
250.74 |
298.74 |
325.79 |
325.48 |
444.00 |
|
|
210.37 |
249.51 |
281.65 |
320.79 |
388.60 |
413.82 |
434.58 |
572.68 |
|
168.18 |
199.47 |
225.16 |
256.45 |
310.67 |
330.83 |
347.43 |
457.83 |
|
|
227.36 |
258.73 |
298.64 |
330.01 |
403.44 |
422.28 |
463.26 |
591.21 |
|
181.77 |
206.85 |
238.75 |
263.83 |
322.53 |
337.59 |
370.36 |
472.64 |
|
|
248.66 |
271.42 |
319.94 |
342.70 |
424.74 |
434.97 |
494.79 |
622.73 |
|
198.79 |
216.99 |
255.78 |
273.97 |
339.56 |
347.74 |
395.56 |
497.85 |
|
|
271.42 |
285.34 |
342.70 |
356.62 |
449.65 |
427.89 |
528.62 |
642.80 |
|
216.99 |
228.12 |
273.97 |
285.10 |
359.48 |
342.08 |
422.61 |
513.89 |
|
|
294.18 |
299.26 |
365.46 |
370.53 |
472.41 |
441.81 |
562.99 |
677.17 |
|
235.18 |
239.24 |
292.17 |
296.22 |
377.67 |
353.21 |
450.08 |
541.37 |
|
|
345.62 |
324.86 |
416.90 |
396.14 |
506.01 |
467.41 |
626.65 |
735.22 |
|
276.31 |
259.71 |
333.29 |
316.69 |
404.53 |
373.68 |
500.98 |
587.78 |
|
|
414.13 |
39.85 |
485.41 |
431.12 |
556.68 |
502.40 |
727.38 |
830.34 |
|
331.08 |
287.68 |
388.06 |
344.66 |
445.04 |
401.64 |
581.51 |
663.81 |
|
|
489.64 |
431.58 |
560.91 |
502.86 |
632.19 |
574.14 |
841.72 |
936.75 |
|
391.44 |
345.03 |
448.42 |
402.01 |
505.41 |
459.00 |
672.91 |
748.89 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense POS |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$94.63 |
$94.63 |
$140.82 |
$140.82 |
$187.01 |
$187.01 |
$189.20 |
$255.33 |
|
$119.28 |
$119.28 |
$177.50 |
$177.50 |
$235.73 |
$235.73 |
$238.49 |
$321.84 |
|
|
42.06 |
42.06 |
88.25 |
88.25 |
134.44 |
134.44 |
84.11 |
150.24 |
|
53.01 |
53.01 |
111.24 |
111.24 |
169.46 |
169.46 |
106.02 |
189.37 |
|
|
49.83 |
61.59 |
96.02 |
107.78 |
142.21 |
153.97 |
110.32 |
176.45 |
|
62.81 |
77.63 |
121.03 |
135.86 |
179.26 |
194.08 |
139.06 |
222.41 |
|
|
58.10 |
73.35 |
104.29 |
119.54 |
158.21 |
174.95 |
128.96 |
208.29 |
|
73.24 |
92.46 |
131.46 |
150.68 |
199.42 |
220.53 |
162.55 |
262.55 |
|
|
62.64 |
91.14 |
108.83 |
137.33 |
169.22 |
198.57 |
146.75 |
240.38 |
|
78.95 |
114.88 |
137.18 |
173.10 |
213.30 |
250.30 |
184.98 |
303.00 |
|
|
70.81 |
104.69 |
117.00 |
150.89 |
177.39 |
212.13 |
166.88 |
260.51 |
|
89.25 |
131.96 |
147.48 |
190.19 |
223.60 |
267.38 |
210.35 |
328.37 |
|
|
81.37 |
115.26 |
127.56 |
161.45 |
197.43 |
225.53 |
187.56 |
291.01 |
|
102.57 |
145.28 |
160.79 |
203.50 |
248.85 |
284.28 |
236.42 |
366.81 |
|
|
89.54 |
121.54 |
135.74 |
167.73 |
208.04 |
235.85 |
203.31 |
306.95 |
|
112.87 |
153.19 |
171.09 |
211.42 |
262.23 |
297.28 |
256.26 |
386.91 |
|
|
97.77 |
127.86 |
143.96 |
174.06 |
216.26 |
242.17 |
217.96 |
321.60 |
|
123.23 |
161.17 |
181.46 |
219.40 |
272.60 |
305.26 |
274.73 |
405.38 |
|
|
114.31 |
145.70 |
160.50 |
191.90 |
231.16 |
252.74 |
242.42 |
338.50 |
|
144.09 |
183.66 |
202.31 |
241.88 |
291.38 |
318.57 |
305.57 |
426.67 |
|
|
125.32 |
157.06 |
171.51 |
203.26 |
242.17 |
264.10 |
263.85 |
359.92 |
|
157.97 |
197.98 |
216.19 |
256.20 |
305.26 |
332.89 |
332.58 |
453.68 |
|
|
136.33 |
161.70 |
182.53 |
207.89 |
251.84 |
268.19 |
281.64 |
371.13 |
|
171.85 |
203.82 |
230.07 |
262.04 |
317.44 |
338.04 |
355.00 |
467.81 |
|
|
147.35 |
167.68 |
193.54 |
213.87 |
261.46 |
273.67 |
300.23 |
383.14 |
|
185.73 |
211.36 |
243.95 |
269.58 |
329.56 |
344.95 |
378.43 |
482.95 |
|
|
161.15 |
175.90 |
207.34 |
222.09 |
275.26 |
281.89 |
320.66 |
403.57 |
|
203.13 |
221.72 |
261.35 |
279.94 |
346.96 |
355.32 |
404.18 |
508.70 |
|
|
175.90 |
184.92 |
222.09 |
231.11 |
291.41 |
277.30 |
342.58 |
416.58 |
|
221.72 |
233.09 |
279.94 |
291.31 |
367.31 |
349.54 |
431.82 |
525.09 |
|
|
190.65 |
193.94 |
236.84 |
240.13 |
306.16 |
286.32 |
364.86 |
438.85 |
|
240.31 |
244.46 |
298.54 |
302.68 |
385.90 |
360.91 |
459.89 |
553.17 |
|
|
223.99 |
210.53 |
270.18 |
256.72 |
327.93 |
302.92 |
406.11 |
476.47 |
|
282.33 |
265.37 |
340.56 |
323.60 |
413.35 |
381.82 |
511.90 |
600.59 |
|
|
268.38 |
233.20 |
314.58 |
279.40 |
360.77 |
325.59 |
471.39 |
538.11 |
|
338.29 |
293.95 |
396.52 |
352.18 |
454.74 |
410.40 |
594.18 |
678.29 |
|
|
317.32 |
279.70 |
363.51 |
325.89 |
409.70 |
372.08 |
545.49 |
607.08 |
|
399.97 |
352.55 |
458.20 |
410.78 |
516.42 |
469.00 |
687.58 |
765.21 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$85.81 |
$85.51 |
$127.25 |
$127.25 |
$169.00 |
$169.00 |
$170.98 |
$230.73 |
|
$109.25 |
$109.25 |
$162.58 |
$162.58 |
$215.91 |
$215.91 |
$218.44 |
$294.78 |
|
|
38.01 |
38.01 |
79.75 |
79.75 |
121.49 |
121.49 |
76.01 |
135.77 |
|
48.56 |
48.56 |
101.89 |
101.89 |
155.22 |
155.22 |
97.11 |
173.45 |
|
|
45.03 |
55.66 |
86.77 |
97.40 |
128.52 |
139.14 |
99.70 |
159.45 |
|
57.53 |
71.11 |
110.86 |
124.44 |
164.19 |
177.77 |
127.37 |
203.71 |
|
|
52.50 |
66.28 |
94.25 |
108.03 |
142.97 |
158.10 |
116.54 |
188.23 |
|
67.08 |
84.68 |
120.41 |
138.01 |
182.66 |
201.99 |
148.89 |
240.48 |
|
|
56.60 |
82.36 |
98.35 |
124.10 |
152.92 |
179.44 |
132.61 |
217.22 |
|
72.32 |
105.22 |
125.65 |
158.55 |
195.37 |
229.26 |
169.43 |
277.52 |
|
|
63.99 |
94.61 |
105.73 |
136.35 |
160.31 |
191.69 |
150.81 |
235.42 |
|
81.75 |
120.87 |
135.08 |
174.20 |
204.81 |
244.91 |
192.67 |
300.77 |
|
|
73.53 |
104.15 |
115.28 |
145.90 |
178.41 |
203.81 |
169.49 |
262.98 |
|
93.95 |
133.07 |
147.28 |
186.40 |
227.93 |
260.38 |
216.54 |
335.98 |
|
|
80.92 |
109.83 |
122.66 |
151.57 |
188.00 |
213.13 |
183.72 |
277.38 |
|
103.38 |
140.32 |
156.71 |
193.65 |
240.19 |
272.29 |
234.72 |
354.38 |
|
|
88.35 |
115.55 |
130.09 |
157.29 |
195.43 |
218.85 |
196.96 |
290.62 |
|
112.87 |
147.62 |
166.20 |
200.95 |
249.68 |
279.60 |
251.64 |
371.30 |
|
|
103.30 |
131.67 |
145.04 |
173.41 |
208.89 |
228.39 |
219.07 |
305.89 |
|
131.97 |
168.22 |
185.30 |
221.55 |
266.88 |
291.79 |
279.88 |
390.80 |
|
|
113.25 |
141.93 |
154.99 |
183.68 |
218.85 |
238.66 |
238.43 |
325.25 |
|
14.69 |
181.33 |
198.02 |
234.66 |
279.60 |
304.91 |
304.62 |
415.54 |
|
|
123.20 |
146.12 |
164.94 |
187.87 |
227.58 |
242.35 |
254.51 |
335.38 |
|
157.40 |
186.68 |
210.73 |
240.02 |
290.76 |
309.63 |
325.16 |
428.48 |
|
|
133.15 |
151.53 |
174.90 |
193.27 |
236.27 |
247.30 |
271.31 |
364.24 |
|
170.12 |
193.59 |
223.45 |
246.92 |
301.86 |
315.95 |
346.62 |
442.35 |
|
|
145.63 |
158.96 |
187.37 |
200.70 |
248.75 |
254.73 |
289.77 |
364.70 |
|
186.05 |
203.08 |
239.38 |
256.41 |
317.80 |
325.45 |
370.21 |
465.94 |
|
|
158.96 |
167.11 |
200.70 |
208.85 |
263.34 |
250.59 |
309.58 |
376.45 |
|
203.08 |
213.49 |
256.41 |
266.82 |
336.44 |
320.15 |
395.52 |
480.95 |
|
|
172.28 |
175.26 |
214.03 |
217.00 |
276.66 |
258.74 |
329.71 |
396.58 |
|
220.11 |
223.91 |
273.44 |
277.24 |
353.46 |
330.57 |
421.23 |
506.67 |
|
|
202.41 |
190.25 |
244.15 |
231.99 |
296.34 |
273.74 |
366.99 |
430.58 |
|
258.60 |
243.06 |
311.93 |
296.39 |
378.60 |
349.72 |
468.87 |
550.10 |
|
|
242.53 |
210.74 |
284.27 |
252.48 |
326.02 |
294.23 |
425.98 |
486.28 |
|
309.86 |
269.24 |
363.19 |
322.57 |
416.52 |
375.90 |
544.23 |
621.27 |
|
|
286.75 |
252.75 |
328.49 |
294.50 |
370.24 |
336.24 |
492.94 |
548.60 |
|
366.35 |
322.92 |
419.68 |
376.25 |
473.01 |
429.58 |
629.78 |
700.89 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$78.66 |
$78.66 |
$117.05 |
$117.05 |
$155.45 |
$155.45 |
$157.27 |
$212.24 |
|
$100.51 |
$100.51 |
$149.58 |
$149.58 |
$198.65 |
$198.65 |
$200.98 |
$271.21 |
|
|
34.96 |
34.96 |
73.35 |
73.35 |
111.75 |
111.75 |
69.92 |
124.88 |
|
44.67 |
44.67 |
93.74 |
93.74 |
142.81 |
142.81 |
89.35 |
159.58 |
|
|
41.42 |
51.20 |
79.82 |
89.59 |
118.21 |
127.99 |
91.70 |
146.67 |
|
52.93 |
65.42 |
102.00 |
114.49 |
151.06 |
163.55 |
117.19 |
187.43 |
|
|
48.30 |
60.97 |
86.69 |
99.37 |
131.51 |
145.43 |
107.19 |
173.14 |
|
61.72 |
77.91 |
110.78 |
126.98 |
168.05 |
185.84 |
126.98 |
221.25 |
|
|
52.06 |
75.76 |
90.46 |
114.15 |
140.66 |
165.06 |
121.98 |
199.81 |
|
66.53 |
96.81 |
115.60 |
145.88 |
179.75 |
210.93 |
155.88 |
255.33 |
|
|
58.86 |
87.02 |
97.25 |
125.42 |
147.46 |
176.32 |
138.72 |
216.54 |
|
72.21 |
111.21 |
124.28 |
160.27 |
188.43 |
225.32 |
177.26 |
276.72 |
|
|
67.64 |
95.80 |
106.04 |
134.20 |
164.11 |
187.47 |
155.90 |
241.89 |
|
86.43 |
122.43 |
135.50 |
171.49 |
209.71 |
239.56 |
199.23 |
309.11 |
|
|
74.43 |
101.02 |
112.83 |
139.42 |
172.93 |
196.04 |
168.99 |
255.15 |
|
95.12 |
129.10 |
144.18 |
178.16 |
220.98 |
250.52 |
215.95 |
326.05 |
|
|
81.27 |
106.28 |
119.66 |
144.68 |
179.76 |
201.30 |
181.17 |
267.32 |
|
103.85 |
135.82 |
152.91 |
184.88 |
229.72 |
257.24 |
231.52 |
341.61 |
|
|
95.02 |
121.11 |
133.41 |
159.51 |
192.15 |
210.08 |
201.51 |
281.37 |
|
121.42 |
154.77 |
170.49 |
203.83 |
245.54 |
268.46 |
257.50 |
359.55 |
|
|
104.17 |
130.56 |
142.57 |
168.95 |
201.30 |
219.53 |
219.32 |
299.18 |
|
133.12 |
166.84 |
182.19 |
215.90 |
257.24 |
280.53 |
280.26 |
382.31 |
|
|
113.33 |
134.41 |
151.72 |
172.80 |
209.34 |
222.92 |
234.11 |
308.50 |
|
144.82 |
171.76 |
193.88 |
220.82 |
267.51 |
284.87 |
299.16 |
394.22 |
|
|
122.48 |
139.38 |
160.88 |
177.77 |
219.33 |
227.48 |
249.56 |
318.48 |
|
156.51 |
178.11 |
205.58 |
227.18 |
277.72 |
290.69 |
318.90 |
406.98 |
|
|
133.95 |
146.21 |
172.35 |
184.61 |
228.80 |
234.31 |
266.54 |
355.46 |
|
171.18 |
186.84 |
220.24 |
235.91 |
292.39 |
299.43 |
340.60 |
428.68 |
|
|
146.21 |
153.71 |
184.61 |
192.11 |
242.22 |
230.50 |
284.76 |
346.27 |
|
186.84 |
196.42 |
235.91 |
245.49 |
309.53 |
294.56 |
363.89 |
442.49 |
|
|
158.47 |
161.21 |
196.87 |
199.60 |
254.48 |
238.00 |
303.28 |
364.79 |
|
202.51 |
206.00 |
251.58 |
255.07 |
325.20 |
304.14 |
387.55 |
466.15 |
|
|
186.18 |
175.00 |
224.58 |
213.40 |
272.59 |
251.79 |
337.57 |
396.06 |
|
237.92 |
223.63 |
286.99 |
272.70 |
348.33 |
321.76 |
431.38 |
506.12 |
|
|
223.09 |
193.85 |
261.48 |
232.24 |
299.88 |
270.64 |
391.83 |
447.29 |
|
285.08 |
247.71 |
334.15 |
296.78 |
383.21 |
345.84 |
500.72 |
571.59 |
|
|
263.76 |
232.49 |
302.16 |
270.89 |
340.56 |
309.28 |
453.42 |
504.62 |
|
337.06 |
297.10 |
386.12 |
346.16 |
435.19 |
395.23 |
579.42 |
644.85 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$70.17 |
$70.17 |
$104.42 |
$104.42 |
$138.67 |
$138.67 |
$140.30 |
$189.33 |
|
$92.03 |
$92.03 |
$136.95 |
$136.95 |
$181.87 |
$181.87 |
$184.00 |
$248.31 |
|
|
31.19 |
31.19 |
65.44 |
65.44 |
99.69 |
99.69 |
62.37 |
111.40 |
|
40.90 |
40.90 |
85.82 |
85.82 |
130.75 |
130.75 |
81.80 |
146.11 |
|
|
36.95 |
45.67 |
71.20 |
79.92 |
105.46 |
114.18 |
81.81 |
130.84 |
|
48.46 |
59.90 |
93.38 |
104.82 |
138.30 |
149.74 |
107.29 |
171.60 |
|
|
43.08 |
54.39 |
77.34 |
88.64 |
117.32 |
129.73 |
95.63 |
154.45 |
|
56.50 |
71.33 |
101.43 |
116.26 |
153.86 |
170.14 |
125.41 |
202.56 |
|
|
46.45 |
67.58 |
80.70 |
101.83 |
125.48 |
147.25 |
108.82 |
178.25 |
|
60.91 |
88.63 |
105.84 |
133.56 |
164.57 |
193.11 |
142.71 |
233.77 |
|
|
52.51 |
77.63 |
86.76 |
111.88 |
131.54 |
157.30 |
123.75 |
193.17 |
|
68.86 |
101.81 |
113.78 |
146.74 |
172.52 |
206.29 |
162.29 |
253.35 |
|
|
60.34 |
85.47 |
94.59 |
119.72 |
146.40 |
167.24 |
139.08 |
215.79 |
|
79.14 |
112.09 |
124.06 |
157.01 |
192.00 |
219.33 |
182.40 |
283.01 |
|
|
66.40 |
90.12 |
100.65 |
124.37 |
154.27 |
174.88 |
150.76 |
227.61 |
|
87.08 |
118.19 |
132.01 |
163.12 |
202.32 |
229.36 |
197.72 |
298.51 |
|
|
72.50 |
94.81 |
106.75 |
129.07 |
160.36 |
179.58 |
161.62 |
238.48 |
|
95.08 |
124.35 |
140.00 |
169.27 |
210.32 |
235.52 |
211.96 |
312.76 |
|
|
84.76 |
108.04 |
119.02 |
142.29 |
171.41 |
187.41 |
179.76 |
251.00 |
|
111.17 |
141.70 |
156.09 |
186.62 |
224.81 |
245.79 |
235.76 |
329.19 |
|
|
92.93 |
116.47 |
127.18 |
150.72 |
179.58 |
195.84 |
195.65 |
266.89 |
|
121.88 |
152.75 |
166.80 |
197.67 |
235.52 |
256.84 |
256.60 |
350.03 |
|
|
101.10 |
119.90 |
135.35 |
154.16 |
186.75 |
198.86 |
208.84 |
275.20 |
|
132.59 |
157.25 |
177.51 |
202.18 |
244.92 |
260.81 |
273.90 |
360.93 |
|
|
109.26 |
124.34 |
143.51 |
158.59 |
193.88 |
202.93 |
222.62 |
284.11 |
|
143.30 |
163.07 |
188.22 |
207.99 |
254.27 |
266.14 |
291.97 |
372.61 |
|
|
119.50 |
130.43 |
153.75 |
164.69 |
204.11 |
209.03 |
237.77 |
299.26 |
|
156.72 |
171.06 |
201.64 |
215.99 |
267.69 |
274.14 |
311.84 |
392.48 |
|
|
130.43 |
137.12 |
164.69 |
171.37 |
216.08 |
205.63 |
254.03 |
308.90 |
|
171.06 |
179.84 |
215.99 |
224.76 |
283.39 |
269.68 |
333.16 |
405.13 |
|
|
141.37 |
143.61 |
175.62 |
178.06 |
227.02 |
212.31 |
270.55 |
325.42 |
|
185.41 |
188.61 |
230.33 |
233.53 |
297.74 |
278.45 |
354.82 |
426.79 |
|
|
166.09 |
156.11 |
200.34 |
190.37 |
243.17 |
224.62 |
301.14 |
353.32 |
|
217.83 |
204.74 |
262.75 |
249.67 |
318.92 |
294.59 |
394.95 |
463.37 |
|
|
199.01 |
172.93 |
233.27 |
207.18 |
267.52 |
241.43 |
349.55 |
399.02 |
|
261.01 |
226.79 |
305.93 |
271.72 |
350.85 |
316.64 |
458.43 |
523.32 |
|
|
235.30 |
207.40 |
269.55 |
241.65 |
303.80 |
275.91 |
404.49 |
450.16 |
|
308.59 |
272.01 |
353.52 |
316.93 |
398.44 |
361.85 |
530.49 |
590.39 |
|
Blue Cross
Blue Shield of Georgia SmartSense |
SmartSense |
||||||||||||||||
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
Male |
Female |
+ Child |
+ Child |
Children |
|
Couple |
|
|
|
$60.60 |
$60.60 |
$90.18 |
$90.18 |
$119.76 |
$119.76 |
$121.16 |
$163.51 |
|
$77.75 |
$77.75 |
$115.70 |
$115.70 |
$153.65 |
$153.65 |
$155.45 |
$209.78 |
|
|
26.93 |
26.93 |
56.51 |
56.51 |
86.09 |
86.09 |
53.86 |
96.21 |
|
34.55 |
34.55 |
72.50 |
72.50 |
110.46 |
110.46 |
69.11 |
123.43 |
|
|
31.91 |
39.44 |
61.49 |
69.02 |
91.07 |
98.60 |
70.65 |
112.99 |
|
40.94 |
50.60 |
78.89 |
88.55 |
116.84 |
126.50 |
90.64 |
144.97 |
|
|
37.21 |
46.97 |
66.79 |
76.55 |
101.31 |
112.04 |
82.58 |
133.38 |
|
47.74 |
60.26 |
85.69 |
98.22 |
129.98 |
143.74 |
105.95 |
171.13 |
|
|
40.11 |
58.36 |
69.69 |
87.94 |
108.37 |
127.16 |
93.97 |
153.93 |
|
51.46 |
74.88 |
89.41 |
112.83 |
139.03 |
163.15 |
120.57 |
197.49 |
|
|
45.34 |
67.04 |
74.92 |
96.62 |
113.60 |
135.84 |
106.87 |
166.83 |
|
58.18 |
86.01 |
96.13 |
123.97 |
145.75 |
174.28 |
137.11 |
214.03 |
|
|
52.11 |
73.81 |
81.69 |
103.39 |
126.43 |
144.42 |
120.11 |
186.35 |
|
66.86 |
94.69 |
104.81 |
132.65 |
162.20 |
185.29 |
154.10 |
239.09 |
|
|
57.34 |
77.83 |
86.92 |
107.41 |
133.22 |
151.03 |
130.19 |
196.57 |
|
73.57 |
99.85 |
111.52 |
137.80 |
170.92 |
193.77 |
167.04 |
252.19 |
|
|
62.61 |
81.88 |
92.19 |
111.46 |
138.49 |
155.08 |
139.57 |
205.95 |
|
80.32 |
105.05 |
118.28 |
143.00 |
177.68 |
198.97 |
179.07 |
264.23 |
|
|
73.20 |
93.30 |
102.78 |
122.89 |
148.03 |
161.85 |
155.24 |
216.76 |
|
93.92 |
119.71 |
131.87 |
157.66 |
189.92 |
207.65 |
199.17 |
278.11 |
|
|
80.25 |
100.58 |
109.83 |
130.16 |
155.08 |
169.12 |
168.96 |
230.49 |
|
102.96 |
129.04 |
140.92 |
166.99 |
198.97 |
216.98 |
216.78 |
295.71 |
|
|
87.31 |
103.55 |
166.89 |
133.13 |
161.27 |
171.74 |
180.36 |
237.67 |
|
112.01 |
132.85 |
149.96 |
170.80 |
206.91 |
220.34 |
231.39 |
304.92 |
|
|
94.36 |
107.38 |
123.94 |
136.96 |
167.43 |
175.25 |
192.26 |
245.36 |
|
121.06 |
137.76 |
159.01 |
175.71 |
214.81 |
224.84 |
246.66 |
314.79 |
|
|
103.20 |
112.64 |
132.78 |
142.22 |
176.27 |
180.51 |
205.34 |
258.44 |
|
132.40 |
144.52 |
170.35 |
182.47 |
226.15 |
231.60 |
263.45 |
331.57 |
|
|
112.64 |
118.42 |
142.22 |
148.00 |
186.61 |
177.58 |
219.38 |
266.77 |
|
144.52 |
151.93 |
182.47 |
189.88 |
239.42 |
227.83 |
281.46 |
342.26 |
|
|
122.09 |
124.19 |
151.67 |
153.77 |
196.06 |
183.35 |
233.65 |
281.03 |
|
156.64 |
159.34 |
194.59 |
197.29 |
251.54 |
235.24 |
299.76 |
360.56 |
|
|
143.44 |
134.82 |
173.02 |
164.40 |
210.00 |
193.98 |
260.07 |
305.12 |
|
184.03 |
172.97 |
221.98 |
210.92 |
269.43 |
248.87 |
333.66 |
391.47 |
|
|
171.87 |
149.34 |
201.48 |
178.92 |
231.03 |
208.50 |
301.87 |
344.60 |
|
220.50 |
191.60 |
258.45 |
229.55 |
296.41 |
267.50 |
387.29 |
442.11 |
|
|
203.20 |
179.11 |
232.78 |
208.69 |
262.36 |
238.27 |
349.32 |
388.76 |
|
260.71 |
229.80 |
298.66 |
267.75 |
336.61 |
305.70 |
448.17 |
498.77 |
|
|
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Blue Cross and Blue Shield of GeorgiaI nc. and Greater Georgia Life Insurance Company are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
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