Authorized Kaiser Agent

Rates are only for Atlanta, Georgia and surrounding areas

2008 HSA Personal Plans Atlanta Monthly Premiums - Rates effective 3/02/2008 - 6/01/2008

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	$75	$81		$63	$66		$70	$75
3-11	75	81		63	66		70	75
12-19	75	81		63	66		70	75
20-24	86	124		73	105		83	118
25-29	108	158		89	134		101	150
30-34	114	200		96	170		106	188
35-39	133	224		113	189		124	213
40-44	151	220		128	186		141	208
45-49	188	234		160	198		177	222
50-54	218	265		184	224		206	250
55-59	284	305		240	257		267	286
60-64**	372	352		313	295		350	329

 

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	$150	$156	$196	$205	$204	$280	$341
20-24	171	246	225	322	268	357	437
25-29	213	313	280	413	342	451	552
30-34	223	394	294	519	389	509	622
35-39	261	443	343	583	454	590	723
40-44	298	436	390	573	508	654	799
45-49	372	462	489	610	570	749	915
50-54	431	522	567	688	623	832	1018
55-59	560	601	738	789	757	1037	1268
60-64**	735	691	966	909	988	1358	1657

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	$115	$120	$151	$158	$158	$218	$268
20-24	131	188	173	248	208	281	343
25-29	163	241	215	316	265	355	434
30-34	172	304	226	400	303	400	488
35-39	201	341	263	448	354	463	566
40-44	229	335	302	440	394	514	626
45-49	285	356	375	468	442	587	718
50-54	331	401	436	527	486	653	799
55-59	431	463	567	606	590	813	994
60-64**	564	530	742	698	768	1064	1300

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	$131	$138	$172	$182	$181	$248	$303
20-24	151	216	199	286	236	317	387
25-29	187	276	246	364	302	401	489
30-34	197	348	261	458	343	451	551
35-39	231	390	303	515	400	523	640
40-44	263	384	346	508	448	580	707
45-49	330	408	433	539	501	662	813
50-54	381	461	500	607	549	739	903
55-59	495	529	651	695	668	921	1123
60-64**	649	610	852	802	870	1203	1470

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	$101	$105	$133	$139	$139	$193	$236
20-24	116	166	153	218	184	248	303
25-29	145	213	188	280	234	314	384
30-34	152	266	200	353	265	354	432
35-39	178	300	233	397	309	409	499
40-44	202	296	265	388	346	452	555
45-49	253	313	332	412	388	520	633
50-54	291	354	384	465	425	575	706
55-59	380	406	499	535	517	719	880
60-64**	497	468	654	616	676	939	1148

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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 Rosa at (770) 396-9517 or Email: holly@insurance-now.com