MSA Washington: Health Savings Accounts in Washington

Asuris Northwest Health - Online Application

Emerge HSA 100 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 : 5000
0-24	135.00	156.00	N/A	N/A
25-29	156.00	179.00	N/A	N/A
30-34	181.00	208.00	N/A	N/A
35-39	213.00	245.00	N/A	N/A
40-44	251.00	288.00	N/A	N/A
45-49	304.00	349.00	N/A	N/A
50-54	361.00	415.00	N/A	N/A
55-59	424.00	487.00	N/A	N/A
60+	497.00	571.00	N/A	N/A
Child	135.00	135.00	N/A	N/A
Age	Deductible : 10000
0-24	N/A	N/A	135.00	156.00
25-29	N/A	N/A	156.00	179.00
30-34	N/A	N/A	181.00	208.00
35-39	N/A	N/A	213.00	245.00
40-44	N/A	N/A	251.00	288.00
45-49	N/A	N/A	304.00	349.00
50-54	N/A	N/A	361.00	415.00
55-59	N/A	N/A	424.00	487.00
60+	N/A	N/A	497.00	571.00
Child	N/A	N/A	135.00	135.00