MSA Washington: Health Savings Accounts in Washington

Use the online e-Enrollment Application

Evolve HSA 50 Rates
Effective date : 10/1/2010
Valid thru : 6/30/2011
Counties : Clallam, Columbia, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima

Family Status :	Applicant Non-Smoker	Applicant Smoker	Family Non-Smoker	Family Smoker
Age	Deductible : 2000
0-24	85.00	98.00	N/A	N/A
25-29	98.00	113.00	N/A	N/A
30-34	114.00	131.00	N/A	N/A
35-39	134.00	154.00	N/A	N/A
40-44	158.00	182.00	N/A	N/A
45-49	191.00	220.00	N/A	N/A
50-54	227.00	261.00	N/A	N/A
55-59	267.00	307.00	N/A	N/A
60+	313.00	359.00	N/A	N/A
Child	85.00	85.00	N/A	N/A
Age	Deductible : 3500
0-24	68.00	78.00	N/A	N/A
25-29	78.00	90.00	N/A	N/A
30-34	91.00	104.00	N/A	N/A
35-39	107.00	123.00	N/A	N/A
40-44	126.00	145.00	N/A	N/A
45-49	152.00	175.00	N/A	N/A
50-54	181.00	208.00	N/A	N/A
55-59	213.00	245.00	N/A	N/A
60+	249.00	287.00	N/A	N/A
Child	68.00	68.00	N/A	N/A
Age	Deductible : 4000
0-24	N/A	N/A	85.00	98.00
25-29	N/A	N/A	98.00	113.00
30-34	N/A	N/A	114.00	131.00
35-39	N/A	N/A	134.00	154.00
40-44	N/A	N/A	158.00	182.00
45-49	N/A	N/A	191.00	220.00
50-54	N/A	N/A	227.00	261.00
55-59	N/A	N/A	267.00	307.00
60+	N/A	N/A	313.00	359.00
Child	N/A	N/A	85.00	85.00
Age	Deductible : 7000
0-24	N/A	N/A	68.00	78.00
25-29	N/A	N/A	78.00	90.00
30-34	N/A	N/A	91.00	104.00
35-39	N/A	N/A	107.00	123.00
40-44	N/A	N/A	126.00	145.00
45-49	N/A	N/A	152.00	175.00
50-54	N/A	N/A	181.00	208.00
55-59	N/A	N/A	213.00	245.00
60+	N/A	N/A	249.00	287.00
Child	N/A	N/A	68.00	68.00