|
Individual
Conversion
Portability
TAA
|
|
 |
|
2006 HRA PLAN RATES
Monthly Premium Rates per Individual
Special Low Income - Portability Plan
|
Attained Age |
Male |
Female |
One Child |
Children |
<30 |
$158.76 |
$308.97 |
$154.60 |
$310.14 |
30-39 |
$201.66 |
$322.30 |
|
|
40-49 |
$279.17 |
$347.52 |
|
|
50-59 |
$468.36 |
$449.88 |
|
|
60-64 |
$689.55 |
$584.13 |
|
|
65+ Medicare Primary |
$396.49 |
$335.87 |
|
|
Special Non Low Income - Portability Plan
|
Attained Age |
Male |
Female |
One Child |
Children |
<30 |
$416.74 |
$811.04 |
$405.83 |
$814.14 |
30-39 |
$529.35 |
$846.04 |
|
|
40-49 |
$732.83 |
$912.26 |
|
|
50-59 |
$1,229.45 |
$1,180.94 |
|
|
60-64 |
$1,810.08 |
$1,533.35 |
|
|
65+ Medicare Primary |
$1,040.80 |
$881.67 |
|
|
Please note: When you or any covered
family member has a birthday that moves you to the next age bracket, the
rate will change the month after the birthday occurs.
How to figure out your
cost of coverage
1.
Go
to the above rate chart and get a rate for your coverage based on your
age and gender.
2.
Get
rates for other family members to be covered based on their ages and genders.
3.
Add
together all the rates for your family members. This your total monthly
cost of coverage
Low Income Guidelines
|
Family Members
|
1
|
2
|
3
|
4
|
|
Adjusted Gross Income
|
$19,600
|
$26,400
|
$33,200
|
$40,000
|
|
(On last Federal Tax Return)
|
|
|
|
Family Members
|
5
|
6
|
7
|
8
|
|
Adjusted Gross Income
|
$46,800
|
$53,600
|
$60,400
|
$67,200
|
|
(On last Federal Tax Return)
|
**If you did not file a Federal Tax Return,
please call the Treasury Dept. at 1-800-829-1040 and request letter #1722(ICP)
to verify income.
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