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SALUD
> PMP PREMIUMS MENSUALES
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PLAN A
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| Edad |
Hombre |
Mujer |
Niños/Dep. |
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| <1
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$200
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$200
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$200
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Other Plans
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| 1-18
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$100
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$100
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$100
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| 19
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$89
|
$107
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$89
male
$101 female |
| 20
|
$89
|
$117
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$89
male
$101 female |
| 21
|
$89
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$119
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$89
male
$101 female |
| 22
|
$89
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$121
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N/A
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| 23
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$90
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$123
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N/A
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| 24
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$92
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$136
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N/A
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| 25
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$95
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$128
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N/A
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| 26
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$97
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$132
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N/A
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| 27
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$99
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$133
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N/A
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| 28
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$102
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$140
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N/A
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| 29
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$105
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$142
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N/A
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| 30
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$107
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$144
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N/A
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| 31
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$110
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$148
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N/A
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| 32
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$113
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$149
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N/A
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| 33
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$117
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$149
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N/A
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| 34
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$120
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$149
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N/A
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| 35
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$120
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$150
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N/A
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| 36
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$121
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$153
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N/A
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| 37
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$126
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$155
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N/A
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| 38
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$128
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$158
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N/A
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| 39
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$129
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$162
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N/A
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| 40
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$134
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$167
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N/A
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| 41
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$138
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$170
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N/A
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| 42
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$143
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$175
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N/A
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| 43
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$148
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$178
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N/A
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| 44
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$156
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$181
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N/A
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| 45
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$160
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$184
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N/A
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| 46
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$166
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$187
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N/A
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| 47
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$172
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$191
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N/A
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| 48
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$176
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$195
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N/A
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| 49
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$185
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$200
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N/A
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| 50
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$194
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$206
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N/A
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| 51
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$202
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$211
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N/A
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| 52
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$208
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$216
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N/A
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| 53
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$210
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$220
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N/A
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| 54
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$225
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$225
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N/A
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| 55
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$234
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$228
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N/A
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| 56
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$241
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$234
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N/A
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| 57
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$249
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$239
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N/A
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| 58
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$259
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$246
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N/A
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| 59
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$271
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$257
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N/A
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| 60
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$298
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$281
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N/A
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| 61
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$309
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$290
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N/A
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| 62
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$319
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$302
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N/A
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| 63
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$331
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$313
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N/A
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| 64
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$343
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$327
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N/A
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Optional Rider
Dental: $ 6.00 por miembro *
Optical: $ 5.00 por miembro
FORM NO: PMP/MK/DADE/ RATEWRKSHTH7 (07/07)
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