|
Authorized Independent Agent |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$229.93 | $229.93 | $301.69 | $291.99 | $310.32 | $300.33 | $355.08 | $343.66 |
|
|
|
102.19 | 102.19 | 124.62 | 123.07 | 128.18 | 126.59 | 146.67 | 144.85 |
|
|
|
121.08 | 149.65 | 140.65 | 176.66 | 144.67 | 181.71 | 165.54 | 207.92 |
|
|
|
141.18 | 178.23 | 164.14 | 210.41 | 168.83 | 216.43 | 193.19 | 247.65 |
|
|
|
152.20 | 221.46 | 177.22 | 260.77 | 182.28 | 268.22 | 208.58 | 306.91 |
|
|
|
172.05 | 254.39 | 200.29 | 299.58 | 206.01 | 308.15 | 235.73 | 352.60 |
|
|
|
197.72 | 280.06 | 230.10 | 330.95 | 236.68 | 340.41 | 270.82 | 389.52 |
|
|
|
217.58 | 295.31 | 253.45 | 349.52 | 260.70 | 359.50 | 298.30 | 411.37 |
|
|
|
237.56 | 310.69 | 276.80 | 367.94 | 284.71 | 378.46 | 325.78 | 433.05 |
|
|
|
277.76 | 354.04 | 322.65 | 418.29 | 331.87 | 430.25 | 379.75 | 492.32 |
|
|
|
304.52 | 381.64 | 353.73 | 451.06 | 363.85 | 463.96 | 416.33 | 530.89 |
|
|
|
331.27 | 392.90 | 384.54 | 463.58 | 395.53 | 476.83 | 452.59 | 545.62 |
|
|
|
358.03 | 407.43 | 415.48 | 479.90 | 427.36 | 493.61 | 489.01 | 564.82 |
|
|
|
391.57 | 427.41 | 454.30 | 503.53 | 427.36 | 493.61 | 489.01 | 564.82 |
|
|
|
427.41 | 449.33 | 494.95 | 526.87 | 509.09 | 541.93 | 582.54 | 620.11 |
|
|
|
463.25 | 471.24 | 536.30 | 552.47 | 551.63 | 568.26 | 631.20 | 650.24 |
|
|
|
544.25 | 511.56 | 629.83 | 599.87 | 647.83 | 617.02 | 741.29 | 706.03 |
|
|
|
652.14 | 566.65 | 754.59 | 664.43 | 776.15 | 683.42 | 888.12 | 782.01 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$155.83 | $155.83 | $220.63 | $213.54 | $213.02 | $206.17 | $259.50 | $251.15 |
|
|
|
69.26 | 69.26 | 91.13 | 90.00 | 87.99 | 86.90 | 107.19 | 105.86 |
|
|
|
82.06 | 101.43 | 102.86 | 129.19 | 99.31 | 124.73 | 120.98 | 151.95 |
|
|
|
95.68 | 120.79 | 120.04 | 153.88 | 115.89 | 148.57 | 141.18 | 180.99 |
|
|
|
103.15 | 150.09 | 129.60 | 190.70 | 125.13 | 184.12 | 152.43 | 224.30 |
|
|
|
116.61 | 172.41 | 146.47 | 219.09 | 141.42 | 211.53 | 172.28 | 257.69 |
|
|
|
134.00 | 189.80 | 168.28 | 242.03 | 162.47 | 233.68 | 197.92 | 284.67 |
|
|
|
147.46 | 200.14 | 185.35 | 255.61 | 178.96 | 246.79 | 218.01 | 300.64 |
|
|
|
161.00 | 210.57 | 202.43 | 269.08 | 195.44 | 259.79 | 238.09 | 316.48 |
|
|
|
188.25 | 239.94 | 235.96 | 305.91 | 227.82 | 295.35 | 277.53 | 359.79 |
|
|
|
206.38 | 258.65 | 258.69 | 329.87 | 249.76 | 318.49 | 304.26 | 387.98 |
|
|
|
224.52 | 266.28 | 281.22 | 339.03 | 271.51 | 327.33 | 330.76 | 398.75 |
|
|
|
242.65 | 276.13 | 303.85 | 350.96 | 293.36 | 338.85 | 357.37 | 412.78 |
|
|
|
265.38 | 289.67 | 332.24 | 368.24 | 320.77 | 355.53 | 390.77 | 433.11 |
|
|
|
289.67 | 304.52 | 361.96 | 385.31 | 349.47 | 372.02 | 425.73 | 453.19 |
|
|
|
313.96 | 319.38 | 392.21 | 404.03 | 378.67 | 390.09 | 461.30 | 475.21 |
|
|
|
368.86 | 346.70 | 460.61 | 438.70 | 444.71 | 423.56 | 541.75 | 515.98 |
|
|
|
441.98 | 384.04 | 551.84 | 485.91 | 532.80 | 469.14 | 649.06 | 571.51 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$124.90 | $124.90 | $181.42 | $175.59 | $172.48 | $166.93 | $213.32 | $206.46 |
|
|
|
55.51 | 55.51 | 74.94 | 74.01 | 71.24 | 70.36 | 88.77 | 87.02 |
|
|
|
65.77 | 81.29 | 84.58 | 106.23 | 80.41 | 100.99 | 99.45 | 124.91 |
|
|
|
76.69 | 96.81 | 98.70 | 126.53 | 93.84 | 120.29 | 116.06 | 148.78 |
|
|
|
82.67 | 120.29 | 106.57 | 156.81 | 101.32 | 149.08 | 125.31 | 184.38 |
|
|
|
93.46 | 138.18 | 120.44 | 180.16 | 114.50 | 171.27 | 141.62 | 211.83 |
|
|
|
107.40 | 152.13 | 138.37 | 199.02 | 131.55 | 189.20 | 162.70 | 234.01 |
|
|
|
118.19 | 160.41 | 152.41 | 210.18 | 144.90 | 199.82 | 179.21 | 247.13 |
|
|
|
129.04 | 168.77 | 166.45 | 221.26 | 158.25 | 210.35 | 195.72 | 260.16 |
|
|
|
150.88 | 192.31 | 194.03 | 251.54 | 184.46 | 239.14 | 228.14 | 295.76 |
|
|
|
165.41 | 207.31 | 212.72 | 271.25 | 202.23 | 257.87 | 250.12 | 318.94 |
|
|
|
179.95 | 213.42 | 231.24 | 278.78 | 219.84 | 265.03 | 271.90 | 327.79 |
|
|
|
194.48 | 221.32 | 249.85 | 288.859 | 237.53 | 274.36 | 293.78 | 339.32 |
|
|
|
212.70 | 232.17 | 273.19 | 302.80 | 259.72 | 287.87 | 321.22 | 356.03 |
|
|
|
212.70 | 232.17 | 273.19 | 302.80 | 259.72 | 287.87 | 321.22 | 356.03 |
|
|
|
251.64 | 255.98 | 322.50 | 332.23 | 306.60 | 315.85 | 379.20 | 390.64 |
|
|
|
295.64 | 277.88 | 378.75 | 360.73 | 360.08 | 342.95 | 445.34 | 424.15 |
|
|
|
354.24 | 307.80 | 453.77 | 399.56 | 431.40 | 379.86 | 533.55 | 469.80 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$101.25 | $101.25 | $149.61 | $149.61 | $141.16 | $139.62 | $175.74 | $170.99 |
|
|
|
45.00 | 45.00 | 61.80 | 61.03 | 58.31 | 57.58 | 72.59 | 71.69 |
|
|
|
53.32 | 65.90 | 69.75 | 87.61 | 65.81 | 82.66 | 81.93 | 102.90 |
|
|
|
62.17 | 78.49 | 81.40 | 104.35 | 76.80 | 98.45 | 95.61 | 122.57 |
|
|
|
67.02 | 97.52 | 87.89 | 129.32 | 82.92 | 122.01 | 103.23 | 151.90 |
|
|
|
75.77 | 112.03 | 99.32 | 148.57 | 93.71 | 140.18 | 116.67 | 174.51 |
|
|
|
87.07 | 123.33 | 114.11 | 164.12 | 107.67 | 154.85 | 134.04 | 192.78 |
|
|
|
95.82 | 130.05 | 125.69 | 173.33 | 118.59 | 163.54 | 147.64 | 203.60 |
|
|
|
104.61 | 136.82 | 137.27 | 182.47 | 129.51 | 172.16 | 161.24 | 214.33 |
|
|
|
122.32 | 155.91 | 160.01 | 207.44 | 150.97 | 195.72 | 187.95 | 243.66 |
|
|
|
134.10 | 168.06 | 175.42 | 223.69 | 165.51 | 211.05 | 206.05 | 262.75 |
|
|
|
145.88 | 173.02 | 190.70 | 229.90 | 179.92 | 216.91 | 224.00 | 270.04 |
|
|
|
157.67 | 179.42 | 206.04 | 237.99 | 194.40 | 224.54 | 242.02 | 279.55 |
|
|
|
172.44 | 188.22 | 225.29 | 249.71 | 212.57 | 235.60 | 264.63 | 293.31 |
|
|
|
188.22 | 197.87 | 245.45 | 261.28 | 231.59 | 246.52 | 288.31 | 306.91 |
|
|
|
204.00 | 207.52 | 265.96 | 273.98 | 250.93 | 258.50 | 312.40 | 321.82 |
|
|
|
239.67 | 225.28 | 312.34 | 297.48 | 294.70 | 280.68 | 366.88 | 349.43 |
|
|
|
287.18 | 249.54 | 374.21 | 329.50 | 353.07 | 310.89 | 439.55 | 387.04 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$91.49 | $91.49 | $137.69 | $133.26 | $128.74 | $124.60 | $161.82 | $156.61 |
|
|
|
40.66 | 40.66 | 56.87 | 56.17 | 53.18 | 52.52 | 66.84 | 66.01 |
|
|
|
48.18 | 59.55 | 64.19 | 80.62 | 60.02 | 75.39 | 75.44 | 94.75 |
|
|
|
56.18 | 70.92 | 74.91 | 96.03 | 70.04 | 89.79 | 88.04 | 112.86 |
|
|
|
60.56 | 88.12 | 80.88 | 119.01 | 75.63 | 111.28 | 95.05 | 139.87 |
|
|
|
68.46 | 101.23 | 91.41 | 136.72 | 85.47 | 127.84 | 107.43 | 160.69 |
|
|
|
78.68 | 111.44 | 105.01 | 151.04 | 98.19 | 141.23 | 123.42 | 177.51 |
|
|
|
86.58 | 117.51 | 115.67 | 159.51 | 108.16 | 149.15 | 135.94 | 187.47 |
|
|
|
94.53 | 123.63 | 126.33 | 167.92 | 118.12 | 157.01 | 148.47 | 197.35 |
|
|
|
110.52 | 140.88 | 147.25 | 190.90 | 137.69 | 178.50 | 173.06 | 224.36 |
|
|
|
121.17 | 151.86 | 161.44 | 205.86 | 150.95 | 192.48 | 189.73 | 241.94 |
|
|
|
131.82 | 156.34 | 175.50 | 211.57 | 164.09 | 197.83 | 206.25 | 248.65 |
|
|
|
142.47 | 162.13 | 189.62 | 219.02 | 177.30 | 204.79 | 222.85 | 257.40 |
|
|
|
155.81 | 170.08 | 207.33 | 229.80 | 193.86 | 214.87 | 243.67 | 270.08 |
|
|
|
170.08 | 178.80 | 225.88 | 240.46 | 211.21 | 224.83 | 265.47 | 282.60 |
|
|
|
184.34 | 187.52 | 244.76 | 252.14 | 228.86 | 235.76 | 287.65 | 296.33 |
|
|
|
216.57 | 203.56 | 287.44 | 273.77 | 268.77 | 255.99 | 337.82 | 321.75 |
|
|
|
259.50 | 225.48 | 344.38 | 303.23 | 322.01 | 283.53 | 404.74 | 356.38 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$84.16 | $84.16 | $127.31 | $123.21 | $116.86 | $113.10 | $148.50 | $143.72 |
|
|
|
37.41 | 37.41 | 52.58 | 51.93 | 48.27 | 47.67 | 61.34 | 60.58 |
|
|
|
44.32 | 54.78 | 59.35 | 74.54 | 54.48 | 68.43 | 69.23 | 86.95 |
|
|
|
51.68 | 65.24 | 69.26 | 88.79 | 63.58 | 81.50 | 80.79 | 103.57 |
|
|
|
55.71 | 81.06 | 74.78 | 110.03 | 68.64 | 101.01 | 87.23 | 128.35 |
|
|
|
62.98 | 93.12 | 84.51 | 126.42 | 77.58 | 116.04 | 98.58 | 147.46 |
|
|
|
72.37 | 102.51 | 97.10 | 139.65 | 89.13 | 128.19 | 113.26 | 162.90 |
|
|
|
79.64 | 108.10 | 106.95 | 147.48 | 98.17 | 135.38 | 124.75 | 172.04 |
|
|
|
86.96 | 113.73 | 116.80 | 155.26 | 107.22 | 142.52 | 136.24 | 181.11 |
|
|
|
101.67 | 129.59 | 136.15 | 176.51 | 124.98 | 162.02 | 158.81 | 205.89 |
|
|
|
111.46 | 139.70 | 149.27 | 190.34 | 137.02 | 174.72 | 174.11 | 222.02 |
|
|
|
121.26 | 143.82 | 162.26 | 195.62 | 148.95 | 179.57 | 189.27 | 228.18 |
|
|
|
131.05 | 149.14 | 175.32 | 202.50 | 160.93 | 185.89 | 204.51 | 236.21 |
|
|
|
143.33 | 156.45 | 191.70 | 212.47 | 175.97 | 195.04 | 223.61 | 247.84 |
|
|
|
156.45 | 164.47 | 208.85 | 222.33 | 191.72 | 204.08 | 243.62 | 259.34 |
|
|
|
169.57 | 172.49 | 226.30 | 233.13 | 207.73 | 214.00 | 263.97 | 271.94 |
|
|
|
199.22 | 187.25 | 265.77 | 253.13 | 243.96 | 232.36 | 310.01 | 295.27 |
|
|
|
238.71 | 207.42 | 318.41 | 280.37 | 292.29 | 257.36 | 371.42 | 327.04 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$75.09 | $75.09 | $117.18 | $113.41 | $107.21 | $103.76 | $137.67 | $133.24 |
|
|
|
33.37 | 33.37 | 48.40 | 47.80 | 44.28 | 43.73 | 56.86 | 56.16 |
|
|
|
39.54 | 48.87 | 54.63 | 68.62 | 49.98 | 62.77 | 64.18 | 80.61 |
|
|
|
46.10 | 58.20 | 63.75 | 81.73 | 58.33 | 74.77 | 74.90 | 96.01 |
|
|
|
49.70 | 72.32 | 68.83 | 101.28 | 62.97 | 92.66 | 80.87 | 118.99 |
|
|
|
56.19 | 83.07 | 77.79 | 116.36 | 71.17 | 106.46 | 91.39 | 136.70 |
|
|
|
64.57 | 91.46 | 89.37 | 128.54 | 81.77 | 117.60 | 105.00 | 151.02 |
|
|
|
71.05 | 96.44 | 98.44 | 135.76 | 90.06 | 124.20 | 115.65 | 159.49 |
|
|
|
77.58 | 101.46 | 107.51 | 142.91 | 98.36 | 130.75 | 126.31 | 167.89 |
|
|
|
90.70 | 115.61 | 125.32 | 162.47 | 114.65 | 148.64 | 147.23 | 190.87 |
|
|
|
99.44 | 124.63 | 137.39 | 175.20 | 125.70 | 160.29 | 161.41 | 205.83 |
|
|
|
108.18 | 128.31 | 149.36 | 180.06 | 136.65 | 164.73 | 175.47 | 211.54 |
|
|
|
116.92 | 133.05 | 161.38 | 186.40 | 147.64 | 170.53 | 189.59 | 218.98 |
|
|
|
127.87 | 139.58 | 176.45 | 195.58 | 161.44 | 178.93 | 207.30 | 229.76 |
|
|
|
139.58 | 146.73 | 192.24 | 204.64 | 175.88 | 187.23 | 225.85 | 240.42 |
|
|
|
151.28 | 153.89 | 208.30 | 214.59 | 190.57 | 196.32 | 244.72 | 252.10 |
|
|
|
177.73 | 167.06 | 244.63 | 233.00 | 223.81 | 213.16 | 287.40 | 273.73 |
|
|
|
212.96 | 185.05 | 293.09 | 258.07 | 268.14 | 236.11 | 344.33 | 303.19 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
|
$64.83 | $64.83 | $100.19 | $96.97 | $93.87 | $90.85 | $117.63 | $113.85 |
|
|
|
28.81 | 28.81 | 41.39 | 40.87 | 38.77 | 38.29 | 48.59 | 47.99 |
|
|
|
34.14 | 42.20 | 46.71 | 58.67 | 43.76 | 54.96 | 54.84 | 68.88 |
|
|
|
39.81 | 50.25 | 54.51 | 69.88 | 51.07 | 65.46 | 64.00 | 82.04 |
|
|
|
42.91 | 62.44 | 58.85 | 86.60 | 55.14 | 81.13 | 69.10 | 101.67 |
|
|
|
48.51 | 71.73 | 66.52 | 99.49 | 62.31 | 93.21 | 78.09 | 116.81 |
|
|
|
55.75 | 78.97 | 76.42 | 109.91 | 71.59 | 102.97 | 89.74 | 129.04 |
|
|
|
61.35 | 83.27 | 84.17 | 116.07 | 78.86 | 108.74 | 98.82 | 136.28 |
|
|
|
66.98 | 87.60 | 91.93 | 122.19 | 86.12 | 114.48 | 107.93 | 143.46 |
|
|
|
78.32 | 99.83 | 107.15 | 138.92 | 100.39 | 130.14 | 125.80 | 163.09 |
|
|
|
85.86 | 107.61 | 117.48 | 149.80 | 110.06 | 140.34 | 137.92 | 175.87 |
|
|
|
93.41 | 110.78 | 127.71 | 153.96 | 119.64 | 144.23 | 149.93 | 180.75 |
|
|
|
100.95 | 114.88 | 137.98 | 159.37 | 129.27 | 149.31 | 162.00 | 187.11 |
|
|
|
110.41 | 120.51 | 150.87 | 167.22 | 141.34 | 156.66 | 177.13 | 196.33 |
|
|
|
120.51 | 126.69 | 164.37 | 174.98 | 153.99 | 163.92 | 192.98 | 205.43 |
|
|
|
130.62 | 132.87 | 178.11 | 183.48 | 166.86 | 171.89 | 209.10 | 215.41 |
|
|
|
153.46 | 144.24 | 209.17 | 199.22 | 195.96 | 186.64 | 245.57 | 233.89 |
|
|
|
183.88 | 159.78 | 250.60 | 220.66 | 234.77 | 206.72 | 294.22 | 259.06 |
|
|
|
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
Single Male |
Single Female |
|
|
Plan Rates |
with Enhanced Drug Plan |
Plan Rates |
with Enhanced Drug Plan |
||||||
|
|
||||
|
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.
|
||||