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Calculate Your Premium for Kids Plan

  

Step 1 of 2:   Select Age of Child to be Covered
Birth Date of Child Applicant: Pick the Birth Date

Step 2 of 2:   Calculate Premium

Estimated Monthly Medical Premium

With Office Visit Waiver
150 500 1000
Select Value:   N/A N/A N/A
Select Med Plus:   N/A N/A N/A
Select Care Plus:   N/A N/A N/A

Without Office Visit Waiver
150 500 1000
Select Value:   N/A N/A N/A
Select Med Plus:   N/A N/A N/A
Select Care Plus:   N/A N/A N/A

Estimated Monthly Dental Premium
Annual Max Benefit 750 1000 1500
  N/A N/A N/A

Additional Information About Estimated Monthly Premiums
1. These are only estimated monthly premiums and are subject to change based on underwriting review.
2. Premiums under these plans are subject to adjustment each January 1, if your original effective date is
January 1 through June 30, or each July 1, if your original effective date is July 1 through December 31.
3. Premiums will increase on the first of the month following the birthday on which the Subscriber (policy
holder) moves from one age category to another.