MSA Washington: Health Savings Accounts in Washington

Asuris Northwest Health - Online Application

Emerge HSA 50 Rates
Effective date : 10/1/2010
Valid thru : 6/30/2011
Counties : Adams, Benton, Chelan, Douglas, Ferry, Franklin, Grant, Kittitas, Lincoln, Okanogan, Pend Oreille, Spokane, Stevens, Whitman

Family Status :	Applicant Non-Smoker	Applicant Smoker	Family Non-Smoker	Family Smoker
Age	Deductible : 2000
0-24	91.00	104.00	N/A	N/A
25-29	104.00	120.00	N/A	N/A
30-34	121.00	139.00	N/A	N/A
35-39	143.00	164.00	N/A	N/A
40-44	168.00	193.00	N/A	N/A
45-49	203.00	233.00	N/A	N/A
50-54	242.00	278.00	N/A	N/A
55-59	283.00	326.00	N/A	N/A
60+	332.00	382.00	N/A	N/A
Child	91.00	91.00	N/A	N/A
Age	Deductible : 3500
0-24	72.00	83.00	N/A	N/A
25-29	83.00	95.00	N/A	N/A
30-34	96.00	111.00	N/A	N/A
35-39	114.00	131.00	N/A	N/A
40-44	134.00	154.00	N/A	N/A
45-49	162.00	186.00	N/A	N/A
50-54	193.00	222.00	N/A	N/A
55-59	226.00	260.00	N/A	N/A
60+	265.00	305.00	N/A	N/A
Child	72.00	72.00	N/A	N/A
Age	Deductible : 4000
0-24	N/A	N/A	91.00	104.00
25-29	N/A	N/A	104.00	120.00
30-34	N/A	N/A	121.00	139.00
35-39	N/A	N/A	143.00	164.00
40-44	N/A	N/A	168.00	193.00
45-49	N/A	N/A	203.00	233.00
50-54	N/A	N/A	242.00	278.00
55-59	N/A	N/A	283.00	326.00
60+	N/A	N/A	332.00	382.00
Child	N/A	N/A	91.00	91.00
Age	Deductible : 7000
0-24	N/A	N/A	72.00	83.00
25-29	N/A	N/A	83.00	95.00
30-34	N/A	N/A	96.00	111.00
35-39	N/A	N/A	114.00	131.00
40-44	N/A	N/A	134.00	154.00
45-49	N/A	N/A	162.00	186.00
50-54	N/A	N/A	193.00	222.00
55-59	N/A	N/A	226.00	260.00
60+	N/A	N/A	265.00	305.00
Child	N/A	N/A	72.00	72.00