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EMERGENCY
MEDICAL |
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PLAN A | Coverage | 0-25 | 26-34 | 35-39 | 40-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-79 | 80-85 |
SINGLE-TRIP
premium
per day
| $15,000 | $2.21 | $2.25 | $2.35 | $2.70 | $3.05 | $3.50 | $3.95 | $5.60 | $6.67 | $8.95 |
$25,000 | $2.28 | $2.44 | $2.57 | $2.95 | $3.10 | $3.90 | $4.76 | $6.67 | $8.47 | $10.56 |
$50,000 | $2.63 | $2.82 | $2.95 | $3.26 | $3.68 | $4.57 | $5.24 | $7.90 | $10.14 | $11.43 |
$100,000 | $3.35 | $3.62 | $3.79 | $4.76 | $5.14 | $6.00 | $6.82 | $9.92 | $12.87 | $13.10 |
$150,000 | $4.62 | $4.93 | $5.71 | $6.67 | $7.14 | $7.62 | $9.52 | | |  |
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PLAN B | Coverage | 0-25 | 26-34 | 35-39 | 40-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-79 | 80-85 |
SINGLE-TRIP
premium
per day
| $15,000 | $2.43 | $2.48 | $2.59 | $2.97 | $3.36 | $3.85 | $4.35 | $6.16 | $7.34 | $9.85 |
$25,000 | $2.51 | $2.68 | $2.83 | $3.25 | $3.41 | $4.29 | $5.24 | $7.34 | $9.32 | $11.62 |
$50,000 | $2.97 | $3.10 | $3.25 | $3.59 | $4.05 | $5.03 | $5.76 | $8.69 | $11.15 | $12.57 |
$100,000 | $3.69 | $3.98 | $4.17 | $5.24 | $5.65 | $6.60 | $7.50 | $10.91 | $14.16 | $14.41 |
$150,000 | $5.08 | $5.42 | $6.28 | $7.34 | $7.85 | $8.38 | $10.47 |  |  |  |
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OPTIONAL INSURANCE
SINGLE-TRIP ONLY |
Premium per day | Coverage | 0-25 | 26-34 | 35-39 | 40-54 | 55-59 | 60-64 | 65-69 | 70-74 | 75-79 | 80-85 |
TRIP INTERRUPTION | $1,500 | $0.57 | $0.59 | $0.61 | $0.63 | $0.64 | $0.66 | $0.68 | $0.70 | $0.72 | $0.74 |
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