Monthly Premiums (Education Sector)
*Includes Emergency TravelHealth WiseHealth Wise PlusTotal Health*Ultimate Health*
Direct pay drug coverage maximum of $1,200 per calendar year
Single$81.25$104.00$118.00$140.75
Couple$157.75$203.50$230.75$275.75
Family$187.25$242.25$275.00$329.75
Direct pay drug coverage maximum of $2,000 per calendar year
Single$110.50$133.25$148.25$170.50
Couple$216.25$262.00$291.25$336.00
Family$257.25$312.25$348.00$401.50
Annual Premiums (Education Sector)
Additional days for a single trip (over 92-day base travel included with the Total Health and Ultimate Health options)SingleCoupleFamily
15 (total days: 107)$260$520$575
30 (total days: 122) $556$1,112$1,243
45 (total days: 137) $779$1,558$1,743
60 (total days: 152) $1,020$2,040$2,281
75 (total days: 167) $1,280$2,560$2,856
90 (total days: 182) $1,558$3,116$3,450
105 (total days:197) $1,856$3,712$4,063
120 (total days: 212) $2,175$4,350 $4,695
Monthly Premiums (Education Sector)
Option AOption BOption C
Single $64.50$52.75$39.50
Couple $129.25$105.00$79.00
Family $154.00$121.75$94.50
Annual Premiums
Age of insured personSingleFamily
0 - 29$105$209
30 - 39$109$218
40 - 49$112$224
50 - 59$133$266
60 - 65$174$348
66 - 74$242$484
75 +$349$697

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