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Apply Online Now - Electronic Application
Index | HSA Benefits | HSA
Rates
Provider
Directory | Download Application
The Healthy Investor HSA Rates
Effective date : 5/1/2010
Valid thru : 4/30/2011
Counties :
Clallam,
Clark,
Cowlitz,
Grays Harbor,
Island,
Jefferson,
King,
Kitsap,
Lewis,
Mason,
Pacific,
Pierce,
San Juan,
Skagit,
Skamania,
Snohomish,
Thurston,
Wahkiakum,
Whatcom
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
Family
Non-Smoker |
Family
Smoker |
| Age |
Deductible : 2000 |
| 0-24 |
178.00 |
212.00 |
N/A |
N/A |
| 25-29 |
220.00 |
257.00 |
N/A |
N/A |
| 30-34 |
233.00 |
274.00 |
N/A |
N/A |
| 35-39 |
235.00 |
279.00 |
N/A |
N/A |
| 40-44 |
247.00 |
293.00 |
N/A |
N/A |
| 45-49 |
263.00 |
311.00 |
N/A |
N/A |
| 50-54 |
330.00 |
390.00 |
N/A |
N/A |
| 55-59 |
438.00 |
516.00 |
N/A |
N/A |
| 60+ |
554.00 |
654.00 |
N/A |
N/A |
| Child |
N/A |
N/A |
N/A |
N/A |
| Age |
Deductible : 3000 |
| 0-24 |
159.00 |
189.00 |
N/A |
N/A |
| 25-29 |
197.00 |
230.00 |
N/A |
N/A |
| 30-34 |
208.00 |
244.00 |
N/A |
N/A |
| 35-39 |
210.00 |
250.00 |
N/A |
N/A |
| 40-44 |
221.00 |
262.00 |
N/A |
N/A |
| 45-49 |
235.00 |
278.00 |
N/A |
N/A |
| 50-54 |
294.00 |
349.00 |
N/A |
N/A |
| 55-59 |
391.00 |
461.00 |
N/A |
N/A |
| 60+ |
495.00 |
585.00 |
N/A |
N/A |
| Child |
N/A |
N/A |
N/A |
N/A |
| Age |
Deductible : 4000 |
| 0-24 |
N/A |
N/A |
177.00 |
210.00 |
| 25-29 |
N/A |
N/A |
218.00 |
255.00 |
| 30-34 |
N/A |
N/A |
231.00 |
270.00 |
| 35-39 |
N/A |
N/A |
233.00 |
275.00 |
| 40-44 |
N/A |
N/A |
245.00 |
290.00 |
| 45-49 |
N/A |
N/A |
261.00 |
309.00 |
| 50-54 |
N/A |
N/A |
327.00 |
387.00 |
| 55-59 |
N/A |
N/A |
432.00 |
509.00 |
| 60+ |
N/A |
N/A |
550.00 |
647.00 |
| Child |
N/A |
N/A |
122.00 |
122.00 |
| Age |
Deductible : 6000 |
| 0-24 |
N/A |
N/A |
158.00 |
187.00 |
| 25-29 |
N/A |
N/A |
195.00 |
228.00 |
| 30-34 |
N/A |
N/A |
206.00 |
241.00 |
| 35-39 |
N/A |
N/A |
208.00 |
246.00 |
| 40-44 |
N/A |
N/A |
218.00 |
259.00 |
| 45-49 |
N/A |
N/A |
233.00 |
276.00 |
| 50-54 |
N/A |
N/A |
292.00 |
345.00 |
| 55-59 |
N/A |
N/A |
386.00 |
455.00 |
| 60+ |
N/A |
N/A |
491.00 |
578.00 |
| Child |
N/A |
N/A |
109.00 |
109.00 |
Counties :
Adams,
Asotin,
Benton,
Chelan,
Columbia,
Douglas,
Ferry,
Franklin,
Garfield,
Grant,
Kittitas,
Klickitat,
Lincoln,
Okanogan,
Pend Oreille,
Spokane,
Stevens,
Walla Walla,
Whitman,
Yakima
| Family Status : |
Applicant
Non-Smoker |
Applicant
Smoker |
Family
Non-Smoker |
Family
Smoker |
| Age |
Deductible : 2000 |
| 0-24 |
189.00 |
225.00 |
N/A |
N/A |
| 25-29 |
233.00 |
272.00 |
N/A |
N/A |
| 30-34 |
247.00 |
290.00 |
N/A |
N/A |
| 35-39 |
249.00 |
296.00 |
N/A |
N/A |
| 40-44 |
262.00 |
311.00 |
N/A |
N/A |
| 45-49 |
279.00 |
330.00 |
N/A |
N/A |
| 50-54 |
350.00 |
413.00 |
N/A |
N/A |
| 55-59 |
464.00 |
547.00 |
N/A |
N/A |
| 60+ |
587.00 |
693.00 |
N/A |
N/A |
| Child |
N/A |
N/A |
N/A |
N/A |
| Age |
Deductible : 3000 |
| 0-24 |
169.00 |
200.00 |
N/A |
N/A |
| 25-29 |
209.00 |
244.00 |
N/A |
N/A |
| 30-34 |
220.00 |
259.00 |
N/A |
N/A |
| 35-39 |
223.00 |
265.00 |
N/A |
N/A |
| 40-44 |
234.00 |
278.00 |
N/A |
N/A |
| 45-49 |
249.00 |
295.00 |
N/A |
N/A |
| 50-54 |
312.00 |
370.00 |
N/A |
N/A |
| 55-59 |
414.00 |
489.00 |
N/A |
N/A |
| 60+ |
525.00 |
620.00 |
N/A |
N/A |
| Child |
N/A |
N/A |
N/A |
N/A |
| Age |
Deductible : 4000 |
| 0-24 |
N/A |
N/A |
188.00 |
223.00 |
| 25-29 |
N/A |
N/A |
231.00 |
270.00 |
| 30-34 |
N/A |
N/A |
245.00 |
286.00 |
| 35-39 |
N/A |
N/A |
247.00 |
292.00 |
| 40-44 |
N/A |
N/A |
260.00 |
307.00 |
| 45-49 |
N/A |
N/A |
277.00 |
328.00 |
| 50-54 |
N/A |
N/A |
347.00 |
410.00 |
| 55-59 |
N/A |
N/A |
458.00 |
540.00 |
| 60+ |
N/A |
N/A |
583.00 |
686.00 |
| Child |
N/A |
N/A |
129.00 |
129.00 |
| Age |
Deductible : 6000 |
| 0-24 |
N/A |
N/A |
167.00 |
198.00 |
| 25-29 |
N/A |
N/A |
207.00 |
242.00 |
| 30-34 |
N/A |
N/A |
218.00 |
255.00 |
| 35-39 |
N/A |
N/A |
220.00 |
261.00 |
| 40-44 |
N/A |
N/A |
231.00 |
275.00 |
| 45-49 |
N/A |
N/A |
247.00 |
293.00 |
| 50-54 |
N/A |
N/A |
310.00 |
366.00 |
| 55-59 |
N/A |
N/A |
409.00 |
482.00 |
| 60+ |
N/A |
N/A |
520.00 |
613.00 |
| Child |
N/A |
N/A |
116.00 |
116.00 |
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Asuris NW Health 
