| Monthly Premium for $10,000 of Coverage | ||||
| Attained Age | Member Only | Member + Spouse/Domestic Partner | Member + Children | Member + Spouse/ Domestic Partner + Children |
| <25 | $5.30 | $10.40 | $8.00 | $13.10 |
| 25–29 | $5.60 | $11.10 | $8.20 | $13.80 |
| 30–34 | $6.90 | $13.50 | $9.50 | $16.20 |
| 35–39 | $7.50 | $15.10 | $10.20 | $17.80 |
| 40–44 | $9.00 | $18.40 | $11.70 | $21.10 |
| 45–49 | $13.00 | $27.10 | $15.70 | $29.70 |
| 50–54 | $18.40 | $39.20 | $21.00 | $41.80 |
| 55–59 | $25.50 | $55.20 | $28.20 | $57.80 |
| 60–64 | $34.10 | $74.60 | $36.70 | $77.10 |
| 65–69 | $45.80 | $102.00 | $48.50 | $104.70 |