MSA Washington: Health Savings Accounts in Washington

Use the online e-Enrollment Application

Evolve HSA 80 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	124.00	142.00	N/A	N/A
25-29	142.00	163.00	N/A	N/A
30-34	165.00	190.00	N/A	N/A
35-39	195.00	224.00	N/A	N/A
40-44	229.00	264.00	N/A	N/A
45-49	277.00	319.00	N/A	N/A
50-54	330.00	379.00	N/A	N/A
55-59	387.00	445.00	N/A	N/A
60+	454.00	522.00	N/A	N/A
Child	124.00	124.00	N/A	N/A
Age	Deductible : 3500
0-24	99.00	113.00	N/A	N/A
25-29	113.00	130.00	N/A	N/A
30-34	132.00	151.00	N/A	N/A
35-39	155.00	179.00	N/A	N/A
40-44	183.00	210.00	N/A	N/A
45-49	221.00	254.00	N/A	N/A
50-54	263.00	303.00	N/A	N/A
55-59	309.00	355.00	N/A	N/A
60+	362.00	416.00	N/A	N/A
Child	99.00	99.00	N/A	N/A
Age	Deductible : 4000
0-24	N/A	N/A	124.00	142.00
25-29	N/A	N/A	142.00	163.00
30-34	N/A	N/A	165.00	190.00
35-39	N/A	N/A	195.00	224.00
40-44	N/A	N/A	229.00	264.00
45-49	N/A	N/A	277.00	319.00
50-54	N/A	N/A	330.00	379.00
55-59	N/A	N/A	387.00	445.00
60+	N/A	N/A	454.00	522.00
Child	N/A	N/A	124.00	124.00
Age	Deductible : 7000
0-24	N/A	N/A	99.00	113.00
25-29	N/A	N/A	113.00	130.00
30-34	N/A	N/A	132.00	151.00
35-39	N/A	N/A	155.00	179.00
40-44	N/A	N/A	183.00	210.00
45-49	N/A	N/A	221.00	254.00
50-54	N/A	N/A	263.00	303.00
55-59	N/A	N/A	309.00	355.00
60+	N/A	N/A	362.00	416.00
Child	N/A	N/A	99.00	99.00