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kaiser permanente plans Georgia

Kaiser Permanente
2009 HMO Rates

Rates for plans effective through 12/1/2009

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HMO Premier Plan

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$203	$213	$415	$411	$418	$699	$911		$621	$915
20-24	233	334	567	440	540	730	934		774	1,065
25-29	287	424	715	493	632	786	994		920	1,209
30-34	304	534	842	511	744	801	1,005		1,045	1,337
35-39	354	601	957	561	809	851	1,058		1,163	1,451
40-44	405	591	1,063	612	778	901	999		1,270	1,558
45-49	505	626	1,167	692	807	953	1,078		1,357	1,620
50-54	584	709	1,295	759	884	1,008	1,184		1,471	1,716
55-59	759	819	1,530	938	1,000	1,184	1,440		1,705	1953
60-64	996	938	1,988	1,183	1,113	1,445	1,540		2,175	2,436

HMO Plan 500

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$159	$168	$326	$322	$333	$553	$690		$491	$720
20-24	184	253	449	347	429	576	714		612	844
25-29	229	336	563	391	503	621	754		726	958
30-34	238	424	663	403	588	634	767		828	1,057
35-39	280	475	755	443	640	675	805		920	1,149
40-44	320	467	842	484	615	715	759		1,001	1,233
45-49	399	496	925	547	636	754	817		1,071	1,278
50-54	463	561	1,024	601	699	795	902		1,159	1,357
55-59	601	645	1,209	742	792	938	1,096		1,349	1,544
60-64	788	742	1,217	934	880	1,144	1,170		1,721	1,927

HMO Plan 1000

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$134	$143	$279	$275	$282	$471	$609		$417	$613
20-24	155	226	382	296	363	490	630		518	716
25-29	193	284	479	333	424	528	666		617	813
30-34	205	361	566	343	499	538	678		704	896
35-39	237	405	642	378	545	571	713		782	974
40-44	272	396	715	411	524	607	671		853	1,046
45-49	340	420	787	463	541	642	722		911	1,087
50-54	395	476	871	511	595	678	794		988	1,154
55-59	511	547	1,028	630	672	794	969		1,147	1,313
60-64	670	630	1,337	796	747	971	1,034		1,463	1,637

HMO Plan 2000

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$105	$109	$214	$211	$216	$362	$470		$321	$471
20-24	118	172	293	228	280	378	486		400	550
25-29	149	218	368	255	326	407	513		475	628
30-34	157	276	434	265	384	415	522		543	691
35-39	184	312	492	292	418	440	547		601	751
40-44	209	305	549	317	403	467	515		655	808
45-49	262	326	605	358	416	492	557		701	837
50-54	303	366	668	395	457	521	612		759	887
55-59	395	421	791	484	517	612	745		883	1,009
60-64	515	484	1,029	612	576	746	795		1,125	1,261

HMO Plan 3000

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$95	$103	$195	$193	$199	$332	$430		$295	$432
20-24	111	157	270	208	255	346	443		367	505
25-29	137	200	337	236	299	372	471		437	572
30-34	145	254	399	242	353	379	478		493	634
35-39	168	284	451	265	383	403	504		550	687
40-44	192	280	504	290	367	429	472		601	738
45-49	238	296	553	326	382	453	509		643	765
50-54	276	336	612	261	418	476	561		696	813
55-59	361	387	724	445	474	561	683		809	924
60-64	472	445	940	562	526	684	728		1,030	1,153

HMO Plan 5000

	Member only		Member + Spouse *	Member + 1 Child		Member + 2 or more Children			Member + Sp + 1 Child *	Member + Sp + 2 or more Children *
Age	Male	Female	Male or Female	Male	Female	Male	Female		Male or Female	Male or Female
0-19	$84	$88	$176	$172	$178	$296	$384		$263	$386
20-24	100	143	239	187	229	311	399		326	450
25-29	122	179	304	209	270	333	421		390	512
30-34	128	228	357	216	316	340	429		443	567
35-39	150	254	405	237	343	361	449		492	616
40-44	171	251	450	259	330	383	424		538	662
45-49	213	266	495	292	340	404	455		575	686
50-54	247	301	547	322	375	428	503		624	726
55-59	322	346	649	397	424	503	611		722	828
60-64	422	397	841	501	472	612	654		924	1,033

* Kaiser rates are based on the oldest spouse.

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