Authorized CoventryOne Agent

CoventryOne POS Individual Health Plan Monthly Rates - Effective 06/16/08 - 8/15/08
(coverage and rates are subject to Coventry medical underwriting and approval. If approved CoventryOne rates are guaranteed for 12 months
from the effective date of coverage)

NOTE: FOR ALL PLANS, CALCULATE THE PREMIUM FOR THE AGE OF EACH FAMILY MEMBER
- IF THERE ARE 4 OR MORE MEMBERS TO BE COVERED IN YOUR FAMILY, A 10% FAMILY DISCOUNT
WILL BE GIVEN (for tobacco users, add 20% to the total rate)

RATES - AREA 1 - Use these rates if your zip code is in Banks, Barrow, Bartow, Butts, Carroll, Cherokee, Clarke,
Clayton, Cobb, Coweta, Dawson, Dekalb, Douglas, Fayette, Forsyth, Fulton, Gordon, Greene, Gwinnett, Haralson, Heard,
Henry, Jackson, Jasper, Madison, Meriwether, Morgan, Newton, Oconee, Oglethorpe, Paulding, Pike, Rockdale, Spalding,
Troup, Walton or Wilkes County in Georgia

These rates are available for applicants with effective dates from March 16, 2008 through June 15, 2008.

$500
DEDUCTIBLE

$1,000 DEDUCTIBLE

$2,000 DEDUCTIBLE

 $3,000 DEDUCTIBLE

$4,000 DEDUCTIBLE

$5,000 DEDUCTIBLE

 $10,000 DEDUCTIBLE

Age

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

> 1

$343

$343

$263

$263

$197

$197

$154

$154

$144

$144

$136

$136

$92

$92

1-19

156

156

120

120

90

90

70

70

66

66

62

62

43

43

20-24

156

224

120

171

90

129

70

100

66

94

62

89

43

60

25-29

170

286

132

221

98

164

76

129

71

121

69

114

46

77

30-34

210

311

161

240

119

179

93

139

87

130

83

124

56

84

35-39

244

333

187

255

139

191

108

149

101

140

97

132

66

90

40-44

281

389

216

299

161

223

125

175

117

164

112

155

75

105

45-49

389

467

299

360

223

268

175

210

164

197

155

186

105

126

50-54

530

561

408

433

303

322

237

251

222

235

211

223

143

152

55-59

686

629

528

484

392

361

307

282

288

264

273

250

186

169

60-64

934

732

718

563

536

419

418

327

392

306

371

291

252

198

RATES - AREA 2 - Use these rates if your zip code is in Aiken, Atkinson, Baldwin, Bibb, Bleckley, Brantley, Burke, Chattooga, Columbia, Crawford, Dooly, Floyd, Gilmer, Habersham, Hall, Houston, Jones, Lamar, Lincoln, Lumpkin, Macon, McDuffie, Monroe, Peach, Pickens, Pierce, Polk, Richmond, Taylor, Twiggs, Union, Upson, Ware, White or Wilkinson County

These rates are available for applicants with effective dates from March 16, 2008 through June 15, 2008.

$500
DEDUCTIBLE

$1,000 DEDUCTIBLE

$2,000 DEDUCTIBLE

 $3,000 DEDUCTIBLE

$4,000 DEDUCTIBLE

$5,000 DEDUCTIBLE

 $10,000 DEDUCTIBLE

Age

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

> 1

$377.30

$377.30

$289.30

$289.30

$216.70

$216.70

$169.40

$169.40

$158.40

$158.40

$149.60

$149.60

$101.20

$101.20

1-19

171.60

171.60

132.00

132.00

99.00

99.00

77.00

77.00

72.60

72.60

68.20

68.20

47.30

47.30

20-24

171.60

246.40

132.00

188.10

99.00

141.90

77.00

110.00

72.60

103.40

68.20

97.90

47.30

66.00

25-29

187.00

314.60

145.20

243.10

107.80

180.40

83.60

141.90

78.10

133.10

75.90

125.40

50.60

84.70

30-34

231.00

342.10

177.10

264.00

130.90

196.90

102.30

152.90

95.70

143.00

91.30

136.40

61.60

92.40

35-39

268.40

366.30

205.70

280.50

152.90

210.10

118.80

163.90

111.10

154.00

106.70

145.20

72.60

99.00

40-44

309.10

427.90

237.60

328.90

177.10

245.30

137.50

192.50

128.70

180.40

123.20

170.50

82.50

115.50

45-49

427.90

513.70

328.90

396.00

245.30

294.80

192.50

231.00

180.40

216.70

170.50

204.60

115.50

138.60

50-54

583.00

617.10

448.80

476.30

333.30

354.20

260.70

2276.10

244.20

258.50

232.10

245.30

157.30

167.20

55-59

754.60

691.90

580.80

532.40

431.20

397.10

337.70

310.20

316.80

290.40

300.30

275.00

204.60

185.90

60-64

1027.40

805.20

789.80

619.30

589.60

460.90

459.80

359.70

431.20

336.60

408.10

320.10

277.20

217.80

RATES - AREA 3 - Use these rates if your zip code is in Appling, Bryan, Bulloch, Candler, Chatham, Coffee, Effingham, Emanuel, Evans, Liberty, Long, McIntosh, Screven or Wayne County.

These rates are available for applicants with effective dates from March 16, 2008 through June 15, 2008 .

$500
DEDUCTIBLE

$1,000 DEDUCTIBLE

$2,000 DEDUCTIBLE

 $3,000 DEDUCTIBLE

$4,000 DEDUCTIBLE

$5,000 DEDUCTIBLE

 $10,000 DEDUCTIBLE

Age

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

Male

Female

> 1

$325.85

$325.85

$249.85

$249.85

$187.15

$187.15

$146.30

$146.30

$136.80

$136.80

$129.20

$129.20

$87.40

$87.40

1-19

148.20

148.20

114.00

114.00

85.50

85.50

66.50

66.50

62.70

62.70

58.90

58.90

40.85

40.85

20-24

148.20

212.80

114.00

162.45

85.50

122.55

66.50

95.00

62.70

89.30

58.90

84.55

40.85

57.00

25-29

161.50

271.70

125.40

209.95

93.10

155.80

72.20

122.55

67.45

114.95

65.55

108.30

43.70

73.15

30-34

199.50

295.45

152.95

228.00

113.05

170.05

88.35

132.05

82.65

123.50

78.85

117.80

53.20

79.80

35-39

231.80

316.35

177.65

242.25

132.05

181.45

102.60

141.55

95.95

133.00

92.15

125.40

62.70

85.50

40-44

266.95

369.55

205.20

284.05

152.95

211.85

118.75

166.25

111.15

155.80

106.40

147.25

71.25

99.75

45-49

369.55

443.65

284.05

342.00

211.85

254.60

166.25

199.50

155.80

187.15

147.25

176.70

99.75

119.70

50-54

503.50

532.95

387.60

411.35

287.85

305.90

225.15

238.45

210.90

223.25

200.45

211.85

135.85

144.40

55-59

651.70

597.55

501.60

459.80

372.40

342.95

291.65

267.90

273.60

250.80

259.35

237.50

176.70

160.55

60-64

887.30

695.40

682.10

534.85

509.20

398.05

397.10

310.65

372.40

290.70

352.45

276.45

239.40

188.10

Click here to view the CoventryOne Individual Plan Benefits
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9 Dunwoody Park, Suite 136
Atlanta, GA 30338
Authorized Coventry Agent

Call Holly, Chris or Bob at
(770) 396-9517

Outside of the Atlanta area,
call toll-free:
1-877-711-8376.
Email: holly@insurance-now.com