HI 01005: Premium Health Insurance
TN 21 (10-04)
|
INCLUSIVE PERIOD |
REDUCED PREMIUM AMOUNT |
SURCHARGE AMOUNT |
|---|---|---|
01/18–12/18 |
232.00 |
255.20 |
|
01/17–12/17 |
227.00 |
249.70 |
|
01/16–12/16 |
226.00 |
248.60 |
|
01/15-12/15 |
224.00 |
246.40 |
|
01/14–12/14 |
234.00 |
$257.40 |
|
01/13-12/13 |
243.00 |
267.30 |
|
01/12-12/12 |
248.00 |
272.80 |
|
01/11-12/11 |
248.00 |
272.80 |
|
01/10-12/10 |
254.00 |
279.40 |
|
01/09-12/09 |
244.00 |
268.40 |
|
01/08-12/08 |
233.00 |
256.30 |
|
01/07-12/07 |
226.00 |
248.60 |
|
01/06-12/06 |
216.00 |
237.60 |
|
01/05-12/05 |
206.00 |
226.60 |
|
01/04-12/04 |
189.00 |
207.90 |
|
01/03-12/03 |
174.00 |
191.40 |
|
01/02-12/02 |
175.00 |
192.50 |
|
01/01-12/01 |
165.00 |
181.50 |
|
01/00-12/00 |
166.00 |
182.60 |
|
01/98-12/99 |
170.00 |
187.00 |
|
01/97-12/97 |
187.00 |
205.70 |
|
01/96-12/96 |
188.00 |
206.80 |
|
01/95-12/95 |
183.00 |
201.30 |
|
01/94-12/94 |
184.00 |
202.40 |