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Area 3 Rates, Georgia
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Area 3 Rates
Third Quarter 2008 New Business Rates: Effective 7/1/08 - 9/15/08

1) Select the plan and corresponding premium based on each applicant’s county (zip code), age and gender.
2) For applicants who have used tobacco in the previous 12 months, add 20% additional premium.
3) Add each applicant’s premium rate together to determine the total family rate for families with fewer than four members.
4) For a family with four or more members applying, multiply the total family rate by .90 for a 10% discount.
$20 Copayment Point-of-Service Plans
  Coventry 3rd Quarter 2008 Rates     Coventry Plan 2000 Summary

$20/500
$20/1,000
$20/2,000
Most Popluar Plan
$20/3,000
$20/4,000
$20/5,000
$20/10,000
 
Age
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
Male
Female
0-1
325.85
325.85
249.85
249.85
187.15
187.15
146.30
146.30
136.80
136.80
129.20
129.20
87.40
87.40
1-19
148.20
148.20
114.00
114.00
85.50
85.50
66.50
66.50
62.70
62.70
58.90
58.90
40.85
40.85
20-24
148.20
212.80
114.00
162.45
85.50
122.55
66.50
95.00
62.70
89.30
58.90
84.55
40.85
57.00
25-29
161.50
271.70
125.40
209.95
93.10
155.80
72.20
122.55
67.45
114.95
65.55
108.30
43.70
73.15
30-34
199.50
295.45
152.95
228.00
113.05
170.05
88.35
132.05
82.65
123.50
78.85
117.80
53.20
79.80
35-39
231.80
316.35
177.65
242.25
132.05
181.45
102.60
141.55
95.95
133.00
92.15
125.40
62.70
85.50
40-44
266.95
369.55
205.20
284.05
152.95
211.85
118.75
166.25
111.15
155.80
106.40
147.25
71.25
99.75
45-49
369.55
443.65
284.05
342.00
211.85
254.60
166.25
199.50
155.80
187.15
147.25
176.70
99.75
119.70
50-54
503.50
532.95
387.60
411.35
287.85
305.90
225.15
238.45
210.90
223.25
200.45
211.85
135.85
144.40
55-59
651.70
597.55
501.60
459.80
372.40
342.95
291.65
267.90
273.60
250.80
259.35
237.50
176.70
160.55
60-64
887.30
695.40
682.10
534.85
509.20
398.05
397.10
310.65
372.40
290.70
352.45
276.45
239.40
188.10
An optional Mental Health Rider is available with POS Plans shown above. The monthly premium is $24.88 per member. If this Rider is purchased, it must be taken by all family members applying for coverage on the same application. CoventryOne® monthly rates shown are for effective dates of July 1, 2008, through September 15, 2008. Rates are issued for illustrative purposes . All applicants are subject to medical underwriting and approval by Coventry Health Care of Georgia, Inc. Refer to plan documents for a complete list of coverage, limitations and exclusions.

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Qualified High Deductible 100% / 60% Point-of-Service Plans
$1,250/$2,500
$3,000/$5,500
$5,000/$10,000
 
Age
Male
Female
Male
Female
Male
Female
0-1
235.60
235.60
159.60
159.60
124.45
124.45
1-19
107.35
107.35
72.20
72.20
56.05
56.05
20-24
107.35
153.90
72.20
106.40
56.05
82.65
25-29
117.80
196.65
79.80
133.95
61.75
103.55
30-34
144.40
213.75
96.90
146.30
76.00
113.05
35-39
167.20
228.95
113.05
155.80
88.35
120.65
40-44
191.90
266.95
131.10
181.45
101.65
140.60
45-49
266.95
321.10
181.45
217.55
140.60
170.05
50-54
363.85
385.70
247.95
262.20
190.95
204.25
55-59
469.30
432.25
321.10
293.55
248.90
228.95
60-64
641.25
502.55
437.95
342.00
339.15
265.05
CoventryOne® monthly rates shown are for effective dates of January 1, 2008, through March 15, 2008. Rates are issued for illustrative purposes . All applicants are subject to medical underwriting and approval by Coventry Health Care of Georgia, Inc. Refer to plan documents for a complete list of coverage, limitations and exclusions.

Area 3 Counties:    Appling, Bryan, Bulloch, Candler, Chatham, Coffee, Effingham, Emanuel, Evans, Liberty, Long, McIntosh, Screven, and Wayne
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