Authorized Kaiser Agent

Rates are only for Atlanta, Georgia and surrounding areas Questions? Call Chris, Holly or Bob at 770-396-9517

2008 HSA Personal Plans Atlanta Monthly Premiums - Rates effective 9/02/2008 - 12/01/2008

HSA Self-Only Plans
	$3,500 Deductible 100%			$5,000 Deductible 100%			$3,500 Deductible 80%
age*	Male	Female		Male	Female		Male	Female
0-2	$81	$88		$69	$71		$75	$81
3-11	81	88		69	71		75	81
12-19	81	88		69	71		75	81
20-24	93	134		79	114		90	127
25-29	117	171		97	145		109	162
30-34	124	216		103	183		115	204
35-39	144	242		123	205		134	231
40-44	163	238		138	201		153	225
45-49	204	253		173	214		191	240
50-54	236	287		199	242		223	270
55-59	307	330		260	278		289	309
60-64**	403	380		339	319		379	355

 

HSA Family Plan Option 1 (3,500 Ded 100% Coinsurance)
	Subscriber/ Child*		Subscriber/ Children*		Subscriber/ Spouse*	Subscriber/ Spouse/Child*	Subscriber/ Spouse/Children*
age*	Male	Female	Male	Female	M or F	M or F	M or F
12-19	$162	$169	$211	$222	$220	$303	$369
20-24	184	267	243	349	290	386	472
25-29	231	339	303	447	370	488	597
30-34	241	426	318	561	421	550	673
35-39	282	479	371	631	492	638	782
40-44	323	471	422	620	549	708	864
45-49	403	499	529	660	616	810	990
50-54	466	565	613	745	674	900	1101
55-59	605	650	799	854	819	1121	1371
60-64**	795	747	1045	983	1069	1469	1792

HSA Family Plan Option 2 (5,000 Ded 100% Coinsurance)
	Subscriber/ Child*		Subscriber/ Children*		Subscriber/ Spouse*	Subscriber/ Spouse/Child*	Subscriber/ Spouse/Children*
age*	Male	Female	Male	Female	M or F	M or F	M or F
12-19	$125	$129	$163	$171	$171	$236	$290
20-24	142	204	187	268	225	304	371
25-29	177	261	233	342	287	384	469
30-34	186	328	244	433	327	433	528
35-39	217	369	285	485	382	501	612
40-44	247	362	326	476	426	556	677
45-49	308	385	406	506	478	634	776
50-54	358	434	471	570	525	706	864
55-59	466	501	613	656	638	880	1075
60-64**	610	574	802	755	830	1151	1406

HSA Family Plan Option 3 (3,500 Ded 80% Coinsurance)
	Subscriber/ Child*		Subscriber/ Children*		Subscriber/ Spouse*	Subscriber/ Spouse/Child*	Subscriber/ Spouse/Children*
age*	Male	Female	Male	Female	M or F	M or F	M or F
12-19	$142	$150	$186	$197	$196	$268	$327
20-24	163	234	215	309	255	343	418
25-29	202	298	267	394	326	434	529
30-34	213	377	282	495	371	488	596
35-39	250	422	327	557	433	566	692
40-44	285	415	375	549	485	628	765
45-49	357	441	468	583	542	717	880
50-54	412	498	541	657	594	800	976
55-59	535	573	704	751	722	997	1215
60-64**	702	660	921	867	942	1301	1589

HSA Family Plan Option 4 (5,000 Ded 80% Coinsurance)
	Subscriber/ Child*		Subscriber/ Children*		Subscriber/ Spouse*	Subscriber/ Spouse/Child*	Subscriber/ Spouse/Children*
age*	Male	Female	Male	Female	M or F	M or F	M or F
12-19	$109	$114	$144	$151	$151	$209	$255
20-24	126	180	165	236	199	268	327
25-29	156	231	204	303	253	340	415
30-34	164	288	216	381	287	382	467
35-39	192	324	252	430	334	442	540
40-44	218	321	287	420	375	489	601
45-49	273	339	359	445	420	562	685
50-54	315	382	415	503	460	622	754
55-59	411	439	540	578	559	777	952
60-64**	538	506	708	666	731	1016	1242

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Click here to download a Kaiser Application	Click here for HMO rates
Click here to apply online
* Family coverage is based on the age of the oldest family member applying. (The oldest family member applying is the "subscriber.") **If you are 65 or older, please inquire about our coverage for Medicare-eligible members at 404-364-7001.
Fax your completed application to our fax: 770-396-4318

To receive your Personal Plans enrollment kit, call Bob, Holly or Chris at (770) 396-9517 or Email: holly@insurance-now.com