4th Qtr 2014 ACA Cheapest to Highest charts MD, DC and VA,7-8

4th QTR 2014 ACA CareFirst Rate Comparison Tool
Baltimore Metro Rates 2014 4th Quarter Rates Cheapest to Highest
1
2
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4
5
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7
8
9
10
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12
13
14
15
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18
19
20
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22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
G
S
S
S
S
G
S
P
P
P
G
P
P
P
P
G
G
P
G
P
P
P
P
P
P
P
Product
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue HMO $500 (Ded $500; In $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
1 of 15
Rates for
40 year old
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$278.26
$311.93
$356.72
$359.41
$361.40
$365.85
$367.63
$367.87
$375.97
$382.71
$383.72
$384.56
$392.20
$448.77
$456.80
$459.04
$463.77
$464.23
$470.23
$476.80
$478.81
$491.57
$499.56
$534.32
$543.88
$546.54
$561.19
$565.63
$572.44
$575.76
$578.57
$582.93
$587.05
$588.11
$594.43
$596.87
$601.12
$603.51
$683.07
$699.85
$705.38
$728.19
Baltimore Metro Rates 2014 4th Quarter
Product
Ranking
Cheapest to
Rates for
40 year old Highest - All 42
Plans
RX
Bronze
B
B
B
B
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
19
20
21
22
23
24
25
26
27
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
HealthyBlue HMO $500 (Ded $500; In $0/$30)
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
1
2
3
4
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
$311.93
$278.26
$384.56
$392.20
2
1
12
13
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$356.72
$375.97
$361.40
$359.41
$365.85
$367.63
$382.71
$367.87
$383.72
$470.23
$478.81
$476.80
$499.56
$464.23
3
9
5
4
6
7
10
8
11
19
21
20
23
18
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$463.77
$448.77
$491.57
$456.80
$459.04
$594.43
$587.05
$582.93
$561.19
17
14
22
15
16
35
33
32
27
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$601.12
$565.63
$534.32
$572.44
$596.87
$575.76
$543.88
$578.57
$546.54
$588.11
$603.51
$699.85
$728.19
$705.38
$683.07
37
28
24
29
36
30
25
31
26
34
38
40
42
41
39
Silver
Gold
Platinum
2 of 15
Eastern Shore Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
G
S
S
S
S
G
S
P
P
P
G
P
P
P
P
G
G
P
G
P
P
P
P
P
P
P
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue HMO $500 (Ded $500; In $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
3 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Rates for
40 year old
$275.35
$308.67
$353.00
$355.66
$357.63
$362.03
$363.79
$364.02
$372.05
$378.71
$379.72
$380.54
$388.11
$444.08
$452.03
$454.24
$458.92
$459.38
$465.32
$471.82
$473.81
$486.44
$494.34
$528.74
$538.20
$540.83
$555.32
$559.72
$566.46
$569.74
$572.53
$576.84
$580.92
$581.97
$588.22
$590.64
$594.85
$597.21
$675.94
$692.54
$698.01
$720.58
Eastern Shore Rates 2014 4th Quarter
Product
Ranking
Rates for 40 Cheapest to
year old Highest - All
42 Plans
RX
Bronze
1
2
3
4
B
B
B
B
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
19
20
21
22
23
24
25
26
27
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
HealthyBlue HMO $500 (Ded $500; In $0/$30)
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
$308.67
$275.35
$380.54
$388.11
2
1
12
13
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$353.00
$372.05
$357.63
$355.66
$362.03
$363.79
$378.71
$364.02
$379.72
$465.32
$473.81
$471.82
$494.34
$459.38
3
9
5
4
6
7
10
8
11
19
21
20
23
18
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$458.92
$444.08
$486.44
$452.03
$454.24
$588.22
$580.92
$576.84
$555.32
17
14
22
15
16
35
33
32
27
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$594.85
$559.72
$528.74
$566.46
$590.64
$569.74
$538.20
$572.53
$540.83
$581.97
$597.21
$692.54
$720.58
$698.01
$675.94
37
28
24
29
36
30
25
31
26
34
38
40
42
41
39
Silver
Gold
Platinum
4 of 15
PG & Montgomery Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
G
S
S
S
S
G
S
P
P
P
G
P
P
P
P
G
G
P
G
P
P
P
P
P
P
P
Rates for 40
year old
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue HMO $500 (Ded $500; In $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
5 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$251.17
$281.56
$321.99
$324.42
$326.21
$330.23
$331.84
$332.05
$339.37
$345.45
$346.36
$347.12
$354.02
$405.08
$412.33
$414.34
$418.61
$419.03
$424.45
$430.37
$432.20
$443.71
$450.92
$482.29
$490.92
$493.32
$506.55
$510.56
$516.71
$519.70
$522.24
$526.17
$529.89
$530.85
$536.55
$538.76
$542.60
$544.75
$616.56
$631.71
$636.70
$657.29
PG & Montgomery Rates 2014 4th Quarter
Product
Ranking
Rates for
Cheapest to
40 year old Highest - All 42
Plans
RX
Bronze
B
B
B
B
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
19
20
21
22
23
24
25
26
27
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
HealthyBlue HMO $500 (Ded $500; In $0/$30)
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
1
2
3
4
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
$281.56
$251.17
$347.12
$354.02
2
1
12
13
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$321.99
$339.37
$326.21
$324.42
$330.23
$331.84
$345.45
$332.05
$346.36
$424.45
$432.20
$430.37
$450.92
$419.03
3
9
5
4
6
7
10
8
11
19
21
20
23
18
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$418.61
$405.08
$443.71
$412.33
$414.34
$536.55
$529.89
$526.17
$506.55
17
14
22
15
16
35
33
32
27
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$542.60
$510.56
$482.29
$516.71
$538.76
$519.70
$490.92
$522.24
$493.32
$530.85
$544.75
$631.71
$657.29
$636.70
$616.56
37
28
24
29
36
30
25
31
26
34
38
40
42
41
39
Silver
Gold
Platinum
6 of 15
Southern Maryland Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
G
S
S
S
S
G
S
P
P
P
G
P
P
P
P
G
G
P
G
P
P
P
P
P
P
P
Rates for 40
year old
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue HMO $500 (Ded $500; In $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
7 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$275.35
$308.67
$353.00
$355.66
$357.63
$362.03
$363.79
$364.02
$372.05
$378.71
$379.72
$380.54
$388.11
$444.08
$452.03
$454.24
$458.92
$459.38
$465.32
$471.82
$473.81
$486.44
$494.34
$528.74
$538.20
$540.83
$555.32
$559.72
$566.46
$569.74
$572.53
$576.84
$580.92
$581.97
$588.22
$590.64
$594.85
$597.21
$675.94
$692.54
$698.01
$720.58
Southern Maryland Rates 2014 4th Quarter
Product
Rates for 40
year old
RX
Ranking
Cheapest to
Highest - All 42
Plans
Bronze
B
B
B
B
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
19
20
21
22
23
24
25
26
27
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
HealthyBlue HMO $500 (Ded $500; In $0/$30)
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
1
2
3
4
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
$308.67
$275.35
$380.54
$388.11
2
1
12
13
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$353.00
$372.05
$357.63
$355.66
$362.03
$363.79
$378.71
$364.02
$379.72
$465.32
$473.81
$471.82
$494.34
$459.38
3
9
5
4
6
7
10
8
11
19
21
20
23
18
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$458.92
$444.08
$486.44
$452.03
$454.24
$588.22
$580.92
$576.84
$555.32
17
14
22
15
16
35
33
32
27
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$594.85
$559.72
$528.74
$566.46
$590.64
$569.74
$538.20
$572.53
$540.83
$581.97
$597.21
$692.54
$720.58
$698.01
$675.94
37
28
24
29
36
30
25
31
26
34
38
40
42
41
39
Silver
Gold
Platinum
8 of 15
Western Maryland Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
G
S
S
S
S
G
S
P
P
P
G
P
P
P
P
G
G
P
G
P
P
P
P
P
P
P
Rates for 40
year old
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%) HRA or HDHP
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue HMO $500 (Ded $500; In $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
9 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$268.16
$300.60
$343.77
$346.36
$348.28
$352.57
$354.29
$354.51
$362.33
$368.81
$369.79
$370.60
$377.97
$432.48
$440.22
$442.37
$446.93
$447.38
$453.16
$459.49
$461.43
$473.73
$481.42
$514.92
$524.13
$526.70
$540.81
$545.10
$551.66
$554.86
$557.57
$561.77
$565.74
$566.76
$572.85
$575.20
$579.30
$581.61
$658.27
$674.45
$679.77
$701.75
Western Maryland Rates 2014 4th Quarter
Product
Rates for 40
year old
RX
Ranking
Cheapest to
Highest - All
42 Plans
Bronze
1
2
3
4
B
B
B
B
BlueChoice HMO HSA/HRA $3,000 (Ded $3000; IN $30/$40)
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%/OON 50%)
BluePreferred PPO HSA/HRA $4000 (Ded $4000; IN 20%/OON 40%)
5
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $20/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN $20/$30)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
Healthy Blue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $20/$30, OON 20%)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN $20/$30, OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 40%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN no Charge, OON 20%)
BluePreferred PPO HSA/HRA $1600 - (Ded $1600; IN 10%, OON 30%)
BluePreferred PPO $2000 (Ded $2000; IN 20%, OON 40%)HRA or HDHP
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
19
20
21
22
23
24
25
26
27
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1000 - SE (Ded $1000; IN 20%) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PPO $1000 (Ded $1000; IN 20%, OON 40%) HRA or HDHP
BluePreferred PPO $1400 (Ded $1400; IN $20, OON 20%) HRA or HDHP
HealthyBlue PPO $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO $20/$30 (Ded $0; $20/$30)
HealthyBlue HMO $500 (Ded $500; In $0/$30)
HealthyBlue HMO $1000 (Ded $1000; IN $0/$30) HRA or HDHP
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
HealthyBlue Plus $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Plus $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue Advantage $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO $250 (Ded $250; IN $10, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $500 (Ded $500; IN $0/$30, OON $50)
HealthyBlue PPO $1000 (Ded $1000; IN $0/$30, OON $50) HRA or HDHP
$10/$45/$65/50%
$10/20%/40%/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
$300.60
$268.16
$370.60
$377.97
2
1
12
13
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$343.77
$362.33
$348.28
$346.36
$352.57
$354.29
$368.81
$354.51
$369.79
$453.16
$461.43
$459.49
$481.42
$447.38
3
9
5
4
6
7
10
8
11
19
21
20
23
18
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$446.93
$432.48
$473.73
$440.22
$442.37
$572.85
$565.74
$561.77
$540.81
17
14
22
15
16
35
33
32
27
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$579.30
$545.10
$514.92
$551.66
$575.20
$554.86
$524.13
$557.57
$526.70
$566.76
$581.61
$674.45
$701.75
$679.77
$658.27
37
28
24
29
36
30
25
31
26
34
38
40
42
41
39
Silver
Gold
Platinum
10 of 15
DC Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
B
B
B
B
S
S
S
S
S
S
B
S
S
S
G
S
S
G
S
G
S
G
G
G
G
G
G
G
G
G
G
G
G
G
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
Rates for 40
Year Old
RX
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice Plus HSA/HRA $3500 (Ded $3500; IN None, OON 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%, OON 50%)
BluePreferred PPO HSA/HRA $4500 (Ded $4,500; IN None, OON 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $2000 - (Ded $2000; IN NONE)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
HealthyBlue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN None, OON 20%)
BluePreferred PPO $4500 (Ded $4,500, IN $30, OON 20%) HRA or HDHP
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 30%)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $15/$25, OON 20%)
BlueChoice Plus $2000 (Ded $2000; IN None; OON 20%) HRA or HDHP
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $15/$25) HRA or HDHP
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice HMO $1800 (Ded $1800; IN $15/$25) HRA or HDHP
BluePreferred PPO HSA/HRA $2000 100%/80% (Ded $2000; IN None; OON 20%)
BlueChoice HMO $1000-SE (Ded $1000; IN 20%) HRA or HDHP
BluePreferred PPO HSA/HRA $1800 (Ded $1800; IN 10%, OON 30%)
BlueChoice HMO Referral $500 (Ded $500; IN $30/$40)
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Advantage $1000 (Ded $1000; IN $30, OON 30%) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice HMO $250 (Ded $250; IN $20/$30)
BluePreferred PPO $2000 (Ded $2000; IN $20, OON 20%) HRA or HDHP
BluePreferred PPO HSA/HRA $1400 (Ded $1400; IN None, OON 20%)
BluePreferred PPO $1200 (Ded $1200; IN $20; OON 20%) HRA or HDHP
BluePreferred PPO $1000 80%/60% (Ded $1000; IN $20,OON 40%) HRA or HDHP
HealthyBlue PP0 $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PP0 $1000 100%/80% (Ded $1000; IN None, OON 20%) HRA or HDHP
BluePreferred PP0 $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
HealthyBlue HMO $600 (Ded $600; IN $0/$30)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue HMO $300 (Ded $300; IN $0/$30)
HealthyBlue Plus $600 (Ded $600; IN $0/$30, OON $50)
BlueChoice HMO Referral $10/$20 (Ded $0; IN $10/$20)
HealthyBlue Advantage $600 (Ded $600; IN $0/$30, OON $50)
BlueChoice Plus 100%/60%, $20/30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice HMO $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $300 (Ded $300; IN $0/$30, OON $50)
HealthyBlue Advantage $300 (Ded $300; IN $0/$30, OON $50)
BlueChoice Plus 100%/80%, $20/30 (Ded $0; IN $20/$30, OON 20%)
BlueChoice Advantage 90%/70%- SE (Ded $0; IN 10%, OON 30%)
Bluechoice Advantage 100%/70% (Ded $0; IN $30, OON 30%)
BlueChoice Plus 100%/80%, $10/20 (Ded $0; IN $10/$20, OON 20%)
BlueChoice Advantage 80%/50% (Ded $0; IN $20, OON 50%)
BluePreferred PPO $500 (Ded $500, IN $10, OON 20%)
HealthyBlue PPO $600 (Ded $600, IN $0/$30, OON $50)
HealthyBlue PPO $300 (Ded $300, IN $0/$30, OON $50)
BluePreferred PPO 100%/80%- SE (Ded $0, IN $20/$30, OON 20%)
BluePreferred PPO 100%/80% (Ded $0, IN $20/$30, OON 20%)
11 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$205.86
$240.51
$258.39
$264.27
$264.98
$268.93
$271.02
$273.41
$276.31
$280.99
$290.92
$291.03
$294.00
$295.70
$322.96
$324.29
$324.97
$326.26
$330.10
$332.76
$333.32
$337.19
$341.05
$351.89
$354.66
$355.62
$365.81
$379.67
$385.38
$398.27
$399.86
$403.81
$406.19
$406.52
$414.13
$415.96
$423.76
$427.30
$427.97
$431.83
$432.17
$436.35
$437.25
$441.88
$443.33
$451.08
$451.36
$456.52
$457.33
$489.60
$491.09
$501.70
$513.17
$526.01
DC Rates 2014 4th Quarter
Product
Ranking
Rates for 40 Cheapest to
year old Most ExpensiveAll 54 Plans
RX
Bronze
1
2
3
4
5
B
B
B
B
B
BlueChoice HMO Referral HSA/HRA $4000 - SE (Ded $4000; IN 20%)
BlueChoice Plus HSA/HRA $3500 (Ded $3500; IN None, OON 20%)
BluePreferred PPO HSA/HRA $4000 - SE (Ded $4000; IN 30%, OON 50%)
BluePreferred PPO HSA/HRA $4500 (Ded $4,500; IN None, OON 20%)
BluePreferred PPO $4500 (Ded $4,500, IN $30, OON 20%) HRA or HDHP
6
7
8
9
10
11
12
13
14
15
16
17
18
S
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - (Ded $2000; IN NONE)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice Plus $2000 (Ded $2000; IN None; OON 20%) HRA or HDHP
BlueChoice Plus HSA/HRA $2000 (Ded $2000; IN None, OON 20%)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $15/$25, OON 20%)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
HealthyBlue Advantage HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 30%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 100%/80% (Ded $2000; IN None; OON 20%)
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $1800 (Ded $1800; IN 10%, OON 30%)
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1800 (Ded $1800; IN $15/$25) HRA or HDHP
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $15/$25) HRA or HDHP
HealthyBlue HMO $1500 (Ded $1500; IN $0/$30)
BlueChoice HMO $1000-SE (Ded $1000; IN 20%) HRA or HDHP
BlueChoice HMO Referral $500 (Ded $500; IN $30/$40)
BlueChoice HMO $250 (Ded $250; IN $20/$30)
HealthyBlue Plus $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
HealthyBlue Advantage $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BlueChoice Advantage $1000 (Ded $1000; IN $30, OON 30%) HRA or HDHP
BluePreferred PPO $2000 (Ded $2000; IN $20, OON 20%) HRA or HDHP
HealthyBlue PP0 $1500 (Ded $1500; IN $0/$30, OON $50) HRA or HDHP
BluePreferred PPO HSA/HRA $1400 (Ded $1400; IN None, OON 20%)
BluePreferred PPO $1200 (Ded $1200; IN $20; OON 20%) HRA or HDHP
BluePreferred PP0 $1000 - SE (Ded $1000; IN 10%, OON 30%) HRA or HDHP
BluePreferred PP0 $1000 100%/80% (Ded $1000; IN None, OON 20%) HRA or HDHP
BluePreferred PPO $1000 80%/60% (Ded $1000; IN $20,OON 40%) HRA or HDHP
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
HealthyBlue HMO $600 (Ded $600; IN $0/$30)
HealthyBlue HMO $300 (Ded $300; IN $0/$30)
BlueChoice HMO $30/$40 (Ded $0; IN $30/$40)
BlueChoice HMO Referral $10/$20 (Ded $0; IN $10/$20)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $600 (Ded $600; IN $0/$30, OON $50)
HealthyBlue Plus $300 (Ded $300; IN $0/$30, OON $50)
BlueChoice Plus 100%/80%, $20/30 (Ded $0; IN $20/$30, OON 20%)
BlueChoice Plus 100%/60%, $20/30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Plus 100%/80%, $10/20 (Ded $0; IN $10/$20, OON 20%)
HealthyBlue Advantage $600 (Ded $600; IN $0/$30, OON $50)
HealthyBlue Advantage $300 (Ded $300; IN $0/$30, OON $50)
BlueChoice Advantage 90%/70%- SE (Ded $0; IN 10%, OON 30%)
BlueChoice Advantage 80%/50% (Ded $0; IN 20%, OON 50%)
Bluechoice Advantage 100%/70% (Ded $0; IN $30, OON 30%)
HealthyBlue PPO $600 (Ded $600, IN $0/$30, OON $50)
BluePreferred PPO $500 (Ded $500, IN $10, OON 20%)
HealthyBlue PPO $300 (Ded $300, IN $0/$30, OON $50)
BluePreferred PPO 100%/80% (Ded $0, IN $20/$30, OON 20%)
BluePreferred PPO 100%/80%- SE (Ded $0, IN $20/$30, OON 20%)
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Non-Integrated
$205.86
$240.51
$258.39
$264.27
$290.92
1
2
3
4
11
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
$271.02
$268.93
$264.98
$295.70
$280.99
$294.00
$273.41
$276.31
$291.03
$324.29
$330.10
$324.97
$333.32
7
6
5
14
10
13
8
9
12
16
19
17
21
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
Non-Integrated
Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
$326.26
$322.96
$341.05
$332.76
$337.19
$365.81
$351.89
$355.62
$354.66
$379.67
$403.81
$385.38
$398.27
$406.52
$406.19
$399.86
18
15
23
20
22
27
24
26
25
28
32
29
30
34
33
31
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$427.30
$423.76
$436.35
$427.97
$415.96
$427.30
$437.25
$443.33
$432.17
$456.52
$431.83
$441.88
$451.08
$457.33
$451.36
$491.09
$489.60
$501.70
$526.01
$513.17
35
37
42
39
36
38
43
45
41
48
40
44
46
49
47
51
50
52
54
53
Silver
Gold
Platinum
12 of 15
Virginia Rates 2014 4th Quarter Cheapest to Highest
Product
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
41
41
42
43
44
45
46
47
48
49
50
B
B
S
S
S
S
S
S
S
S
S
B
B
G
G
G
B
G
G
G
S
S
S
P
P
P
P
P
P
P
P
G
P
P
G
P
P
P
P
P
G
P
P
G
G
G
G
P
P
P
P
P
RX
BlueChoice HMO Referral HSA/HRA $4000- SE (Ded $4000; IN 20%)
BlueChoice Plus HSA/HRA $3500 (Ded $3500; IN No Charge, OON 20%)
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN No Charge)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
HealthyBlue Advantage HSA/HRA $2000 (Ded $2000; IN No Charge/$30, OON $50)
BlueChoice Plus HSA/HRA $2000; IN No Charge/ OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 30%)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $15/$25, OON 20%)
BlueChoice Plus $2000 (Ded $2000; IN No Charge, OON 20%)
BluePreferred PPO HSA/HRA $4000- SE (Ded $4000; IN 30%, OON 50%)
BluePreferred PPO HSA/HRA $4500 (Ded $4500; IN No Charge, OON 20%)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $15/$25)
BlueChoice HMO $1800 (Ded $1800; IN $15/$25)
BlueChoice HMO $1000- SE (Ded $1000; IN 20%)
BluePreferred PPO $4500 (Ded $4500; IN $30, OON 20%
Healthy Blue HMO $1500 (Ded $1500; IN $0/$30)
Healthy Blue Plus $1500 (Ded $1500; $0/$30, OON $50)
Healthy Blue Advantage $1500 (Ded $1500; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN No Charge, OON 20%)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
HealthyBlue HMO $600 (Ded $600; IN $0/$30)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
HealthyBlue Plus $600 (Ded $600; IN $0/$30, OON $50)
HealthyBlue HMO $300 (Ded $300; In $0/$30)
BlueChoice HMO Referral $10/$20 (Ded $0; IN $10/$20)
HealthyBlue Advantage $600 (Ded $600; IN $0/$30, OON $50)
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BluePreferred PPO $2000 (Ded $2000; IN $20, OON 20%)
BlueChoice HMO $30/$40 (Ded $0; IN $30/$40)
HealthyBlue Plus $300 (Ded $300; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $1400 (Ded $1400; IN No Charge, OON 20%)
HealthyBlue Advantage $300 (Ded $300; IN $0/$30, OON $50)
BlueChoice HMO $20/$30 (Ded $0; IN $20/$30)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BlueChoice Advantage 100%/70% (Ded $0; IN $30, OON 30%)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BluePreferred PPO $1200 (Ded $1200; IN $20, OON 20%)
BlueChoice Plus 100%/80%, $10/$20 (Ded $0; IN $10/$20, OON 20%)
BlueChoice Advantage 80%/50% (Ded $0; IN $20, OON 50%)
BluePreferred PPO $1000 80%/60% (Ded $1000; IN $20, OON 40%)
BluePreferred PPO $1000 100%/80% (Ded $1000; IN No Charge, OON 20%)
BluePreferred $1000- SE (Ded $1000; IN 10%, OON 30%)
Healthy Blue PPO $1500 (Ded $1500; IN $0/$30, OON $50)
BluePreferred PPO $500 (Ded $500; IN $10, OON 20%)
HealthyBlue PPO $600 (Ded $600; IN $0/$30, OON $50)
HealthyBlue PPO $300 (Ded $300; IN $0/$30, OON $50)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO 100%/80% (Ded $0; IN $20/$30, OON 20%)
13 of 15
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
Integration
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Integrated
Non-integrated
Integrated
Non-Integrated
Non-integrated
Non-integrated
Non-integrated
Integrated
Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-integrated
Non-Integrated
Non-Integrated
Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-integrated
Non-Integrated
Non-Integrated
Non-integrated
Non-integrated
Integrated
Non-integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Rates for
40 year
old
$202.61
$237.09
$267.05
$268.64
$271.41
$275.28
$277.68
$279.69
$289.49
$291.72
$293.95
$300.92
$308.39
$321.75
$324.80
$332.60
$336.82
$348.95
$357.58
$360.70
$374.12
$376.24
$379.51
$419.07
$419.12
$424.13
$429.50
$430.20
$432.25
$433.23
$435.41
$436.51
$439.98
$440.85
$442.14
$444.68
$445.29
$447.30
$451.53
$451.89
$458.11
$458.11
$458.11
$458.27
$465.88
$467.52
$469.59
$560.40
$561.36
$573.96
$586.45
$600.78
Virginia Rates 2014 4th Quarter
Product
RX
Integration
Ranking
Rates for 40 Cheapest to
year old
Highest-all
52
Bronze
1
2
3
4
5
B
B
B
B
B
BlueChoice HMO Referral HSA/HRA $4000- SE (Ded $4000; IN 20%)
BlueChoice Plus HSA/HRA $3500 (Ded $3500; IN No Charge, OON 20%)
BluePreferred PPO HSA/HRA $4000- SE (Ded $4000; IN 30%, OON 50%)
BluePreferred PPO $4500 (Ded $4500; IN $30, OON 20%
BluePreferred PPO HSA/HRA $4500 (Ded $4500; IN No Charge, OON 20%)
6
7
8
9
10
11
12
13
14
15
16
17
S
S
S
S
S
S
S
S
S
S
S
S
BlueChoice HMO HSA/HRA $2000 - SE (Ded $2000; IN 20%)
BlueChoice HMO HSA/HRA $2000 (Ded $2000; IN No Charge)
HealthyBlue HMO HSA/HRA $2000 (Ded $2000; IN $0/$30)
HealthyBlue Plus HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
HealthyBlue Advantage HSA/HRA $2000 (Ded $2000; IN No Charge/$30, OON $50)
BlueChoice Plus HSA/HRA $1500 (Ded $1500; IN $15/$25, OON 20%)
BlueChoice Plus $2000 (Ded $2000; IN No Charge, OON 20%)
BlueChoice Plus HSA/HRA $2000; IN No Charge/ OON 20%)
BlueChoice Advantage HSA/HRA $1500 (Ded $1500; IN $30, OON 30%)
BluePreferred PPO HSA/HRA $2000 - SE (Ded $2000; IN 20%, OON 40%)
BluePreferred PPO HSA/HRA $2000 (Ded $2000; IN No Charge, OON 20%)
HealthyBlue PPO HSA/HRA $2000 (Ded $2000; IN $0/$30, OON $50)
18
19
20
21
22
23
24
25
26
27
28
29
30
G
G
G
G
G
G
G
G
G
G
G
G
G
BlueChoice HMO $1800 (Ded $1800; IN $15/$25)
BlueChoice HMO HSA/HRA $1500 (Ded $1500; IN $15/$25)
Healthy Blue HMO $1500 (Ded $1500; IN $0/$30)
BlueChoice HMO $1000- SE (Ded $1000; IN 20%)
Healthy Blue Plus $1500 (Ded $1500; $0/$30, OON $50)
Healthy Blue Advantage $1500 (Ded $1500; IN $0/$30, OON $50)
BluePreferred PPO $2000 (Ded $2000; IN $20, OON 20%)
Healthy Blue PPO $1500 (Ded $1500; IN $0/$30, OON $50)
BluePreferred PPO HSA/HRA $1400 (Ded $1400; IN No Charge, OON 20%)
BluePreferred PPO $1200 (Ded $1200; IN $20, OON 20%)
BluePreferred $1000- SE (Ded $1000; IN 10%, OON 30%)
BluePreferred PPO $1000 100%/80% (Ded $1000; IN No Charge, OON 20%)
BluePreferred PPO $1000 80%/60% (Ded $1000; IN $20, OON 40%)
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
P
BlueChoice HMO Referral $10/$20 (Ded $0; IN $10/$20)
BlueChoice HMO Referral $20/$30 (Ded $0; IN $20/$30)
BlueChoice HMO Referral $30/$40 (Ded $0; IN $30/$40)
BlueChoice HMO $20/$30 (Ded $0; IN $20/$30)
BlueChoice HMO $30/$40 (Ded $0; IN $30/$40)
BlueChoice Plus 100%/80%, $10/$20 (Ded $0; IN $10/$20, OON 20%)
BlueChoice Plus 100%/80%, $20/$30 (Ded $0; IN $20/$30, OON 20%)
BlueChoice Plus 100%/60%, $20/$30 (Ded $0; IN $20/$30, OON 40%)
BlueChoice Advantage 100%/70% (Ded $0; IN $30, OON 30%)
BlueChoice Advantage 90%/70% - SE (Ded $0; IN 10%, OON 30%)
BlueChoice Advantage 80%/50% (Ded $0; IN $20, OON 50%)
HealthyBlue HMO $300 (Ded $300; In $0/$30)
HealthyBlue HMO $600 (Ded $600; IN $0/$30)
HealthyBlue Plus $300 (Ded $300; IN $0/$30, OON $50)
HealthyBlue Plus $600 (Ded $600; IN $0/$30, OON $50)
HealthyBlue Advantage $300 (Ded $300; IN $0/$30, OON $50)
HealthyBlue Advantage $600 (Ded $600; IN $0/$30, OON $50)
BluePreferred PPO $500 (Ded $500; IN $10, OON 20%)
BluePreferred PPO 100%/80% (Ded $0; IN $20/$30, OON 20%)
BluePreferred PPO 100%/80% - SE (Ded $0; IN $20/$30, OON 20%)
HealthyBlue PPO $300 (Ded $300; IN $0/$30, OON $50)
HealthyBlue PPO $600 (Ded $600; IN $0/$30, OON $50)
$10/20%/40%/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
Integrated
Integrated
Integrated
Non-Integrated
Integrated
$202.61
$237.09
$300.92
$336.82
$308.39
1
2
12
17
13
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
Non-Integrated
Integrated
Integrated
Integrated
Integrated
Integrated
$267.05
$271.41
$268.64
$275.28
$277.68
$291.72
$293.95
$279.69
$289.49
$374.12
$379.51
$376.24
3
5
4
6
7
10
11
8
9
21
23
22
$10/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$0/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$10/$45/$65/50%
Non-integrated
Integrated
Non-integrated
Integrated
Non-integrated
Non-integrated
Non-integrated
Non-integrated
Integrated
Non-integrated
Integrated
Non-integrated
Non-integrated
$324.80
$321.75
$348.95
$332.60
$357.58
$360.70
$436.51
$469.59
$442.14
$458.11
$467.52
$465.88
$458.27
15
14
18
16
19
20
32
45
35
41
44
43
42
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/$45/$65/50%
$10/20%/40%/50%
$10/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$0/$45/$65/50%
$10/20%/40%/50%
$0/$45/$65/50%
$0/$45/$65/50%
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
Non-Integrated
$432.25
$424.13
$419.07
$445.29
439.98
$458.11
$447.30
$435.41
$451.53
$451.89
$458.11
$430.20
$419.12
$440.85
$429.50
$444.68
$433.23
$560.40
$600.78
$586.45
$573.96
$561.36
29
26
24
37
33
41
38
31
39
40
41
28
25
34
27
36
30
46
50
49
48
47
Silver
Gold
Platinum
14 of 15
NOTES
* In the Maryland market, all jurisdictions have the same order of plans (cheapest to highest) for all
jurisdictions.
MD State Defined Geographic Regions
The State has divided Maryland into defined regions for purposes of rating:
Baltimore Metro - Anne Arundel County, Baltimore City, Baltimore County, Harford County, and Howard
County
DC Metro- Montgomery County, and Prince George’s County
Western MD- Allegany County, Carroll County, Frederick County, Garrett County, and Washington
County
Eastern & Southern MD - Calvert County, Caroline County, Cecil County, Charles County, Dorchester
County, Kent County, Queen Anne’s County, Somerset County, St Mary’s County, Talbot County,
Wicomico County, and Worcester County
* VA jurisidiction has 3 different plans that are priced exactly the same.
VA Territory- the cities of Alexandria and Falls Church, the counties of Arlington and the portion of
Fairfax east of Route 123, including incorporated limits of Fairfax City and the town of Vienna in their
entirety.
Zip codes split by Route 123 are:
Fairfax County: 22030, 22039, 22079, 22101, 22102, 22124, 22180, 22181, 22182, 22191, 22192
Prince William County: 22125, 22191, 22192
15 of 15

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