Rate/Rule Schedule · 04142016 (Q4) RV With Silver.pdf, 33871khperate_04262 016_ind_sg.pdf, SERFF...
Transcript of Rate/Rule Schedule · 04142016 (Q4) RV With Silver.pdf, 33871khperate_04262 016_ind_sg.pdf, SERFF...
Rate/Rule Schedule
Item
No.
Schedule
Item
Status
Document Name
Affected Form Numbers
(Separated with commas) Rate Action Rate Action Information Attachments
1 Rate Files KE 670 WPR GMC Rev. 1.17,KE 670 SG EXC-ON Rev.1.17, KE 670 SG EXC-ON.TierRev. 1.17, KE 670 SG EXC-ON.Direct Rev. 1.17, KE 670SG EXC-OFF Rev. 1.17, KE670 SG EXC-OFF.Tier Rev.1.17, KE 670 SG EXC-OFF.Direct Rev. 1.17, KE 670SG EXC-OFF.Direct.ADentalRev. 1.17, PREV/SCH-I Rev.1.17
New 33871KHPE v1-104142016 (Q1) RVWith Silver.pdf,33871KHPE v1-104142016 (Q2) RVWith Silver.pdf,33871KHPE v1-104142016 (Q3) RVWith Silver.pdf,33871KHPE v1-104142016 (Q4) RVWith Silver.pdf,33871khperate_04262016_ind_sg.pdf,
SERFF Tracking #: INAC-130539718 State Tracking #: INAC-130539718 Company Tracking #: KHPE SG 1-1-2017
State: Pennsylvania Filing Company: Keystone Health Plan East, Inc.
TOI/Sub-TOI: H15G Group Health - Hospital/Surgical/Medical Expense/H15G.003 Small Group Only
Product Name: KHPE Small Group HMO eff 1-1-2017
Project Name/Number: /
PDF Pipeline for SERFF Tracking Number INAC-130539718 Generated 06/14/2016 09:28 AM
Company On/Off Metal Network Rating
Exchange HIOS Plan ID Level AreaKHPE ON 33871PA0100001 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0100002 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0100003 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0100004 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0100005 Silver Keystone HMO Silver Classic $2,500 $25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0100006 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE ON 33871PA0100007 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100008 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE ON 33871PA0100009 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100020 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE OFF 33871PA0100021 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE OFF 33871PA0100022 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE OFF 33871PA0100023 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE OFF 33871PA0100024 Silver Keystone HMO Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE OFF 33871PA0100025 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100026 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE ON 33871PA0100035 Gold Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0100036 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0100037 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0100044 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8
KHPE OFF 33871PA0100045 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8
KHPE OFF 33871PA0100047 Gold Keystone HMO Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100048 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100049 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE ON 33871PA0110001 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE ON 33871PA0110002 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE ON 33871PA0110003 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE ON 33871PA0110004 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE ON 33871PA0110005 Gold Keystone DPOS Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0110006 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE ON 33871PA0110007 Silver Keystone DPOS Silver Secure $3,500/$40/$80/$600 Keystone Health Plan East Network 8
KHPE ON 33871PA0110008 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0110009 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE ON 33871PA0110010 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110011 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110012 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110013 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110014 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110015 Gold Keystone DPOS Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110016 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110017 Silver Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110018 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110019 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110020 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
Keystone Health Plan East
Plan Design Summary
Plan Design Marketing Name
05/15/2015
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 201733871PA0100001 33871PA0100002
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band Non-Tobacco Tobacco Non-Tobacco Tobacco
0-20 $274.54 $274.54 $262.43 $262.43
21 $432.34 $486.39 $413.28 $464.94
22 $432.34 $486.39 $413.28 $464.94
23 $432.34 $486.39 $413.28 $464.94
24 $432.34 $486.39 $413.28 $464.94
25 $434.07 $488.33 $414.93 $466.80
26 $442.72 $498.06 $423.20 $476.10
27 $453.10 $509.73 $433.12 $487.26
28 $469.96 $528.70 $449.24 $505.39
29 $483.79 $544.27 $462.46 $520.27
30 $490.71 $576.58 $469.07 $551.16
31 $501.09 $588.78 $478.99 $562.82
32 $511.46 $600.97 $488.91 $574.47
33 $517.95 $608.59 $495.11 $581.75
34 $524.86 $616.72 $501.72 $589.52
35 $528.32 $620.78 $505.03 $593.41
36 $531.78 $624.84 $508.34 $597.29
37 $535.24 $628.91 $511.64 $601.18
38 $538.70 $632.97 $514.95 $605.06
39 $545.62 $641.10 $521.56 $612.83
40 $552.53 $676.86 $528.17 $647.01
41 $562.91 $689.57 $538.09 $659.16
42 $572.86 $701.75 $547.60 $670.81
43 $586.69 $718.70 $560.82 $687.01
44 $603.98 $739.88 $577.35 $707.26
45 $624.30 $764.77 $596.78 $731.05
46 $648.52 $794.43 $619.92 $759.40
47 $675.75 $827.80 $645.96 $791.30
48 $706.88 $865.93 $675.71 $827.75
49 $737.58 $903.53 $705.06 $863.69
50 $772.17 $1,061.73 $738.12 $1,014.91
51 $806.32 $1,108.69 $770.77 $1,059.81
52 $843.93 $1,160.41 $806.72 $1,109.25
53 $881.98 $1,212.72 $843.09 $1,159.25
54 $923.05 $1,269.20 $882.35 $1,213.24
55 $964.13 $1,325.67 $921.62 $1,267.22
56 $1,008.66 $1,386.90 $964.18 $1,325.75
57 $1,053.62 $1,448.73 $1,007.17 $1,384.85
58 $1,101.61 $1,514.72 $1,053.04 $1,447.93
59 $1,125.39 $1,547.41 $1,075.77 $1,479.18
60 $1,173.38 $1,613.40 $1,121.64 $1,542.26
61 $1,214.89 $1,670.47 $1,161.32 $1,596.81
62 $1,242.12 $1,707.92 $1,187.36 $1,632.61
63 $1,276.28 $1,754.88 $1,220.00 $1,677.51
64 $1,297.02 $1,783.42 $1,239.84 $1,704.78
65+ $1,297.02 $1,783.42 $1,239.84 $1,704.78
$0
0%
$3,000
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
No
Platinum
$4,000
Platinum
Keystone HMO Platinum Preferred $10/$20/$100
No
33871PA0100001
KE 670 WPR GMC
8
33871PA0100002
8
KE 670 WPR GMC
Keystone Health Plan East Network Keystone Health Plan East Network
$10/$20 $20/$40
Page Number: 2 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100003 33871PA0100004
Non-Tobacco Tobacco Non-Tobacco Tobacco
$216.40 $216.40 $223.43 $223.43
$340.78 $383.38 $351.86 $395.84
$340.78 $383.38 $351.86 $395.84
$340.78 $383.38 $351.86 $395.84
$340.78 $383.38 $351.86 $395.84
$342.14 $384.91 $353.27 $397.43
$348.96 $392.58 $360.31 $405.34
$357.14 $401.78 $368.75 $414.85
$370.43 $416.73 $382.47 $430.28
$381.33 $429.00 $393.73 $442.95
$386.79 $454.47 $399.36 $469.25
$394.96 $464.08 $407.81 $479.17
$403.14 $473.69 $416.25 $489.10
$408.25 $479.70 $421.53 $495.30
$413.71 $486.11 $427.16 $501.91
$416.43 $489.31 $429.98 $505.22
$419.16 $492.51 $432.79 $508.53
$421.89 $495.72 $435.60 $511.84
$424.61 $498.92 $438.42 $515.14
$430.06 $505.33 $444.05 $521.76
$435.52 $533.51 $449.68 $550.86
$443.70 $543.53 $458.12 $561.20
$451.53 $553.13 $466.22 $571.12
$462.44 $566.49 $477.48 $584.91
$476.07 $583.19 $491.55 $602.15
$492.09 $602.81 $508.09 $622.41
$511.17 $626.18 $527.79 $646.55
$532.64 $652.48 $549.96 $673.70
$557.18 $682.54 $575.29 $704.74
$581.37 $712.18 $600.28 $735.34
$608.63 $836.87 $628.43 $864.08
$635.56 $873.89 $656.22 $902.31
$665.20 $914.65 $686.83 $944.40
$695.19 $955.89 $717.80 $986.97
$727.57 $1,000.40 $751.23 $1,032.93
$759.94 $1,044.92 $784.65 $1,078.90
$795.04 $1,093.18 $820.89 $1,128.73
$830.48 $1,141.91 $857.49 $1,179.05
$868.31 $1,193.92 $896.54 $1,232.75
$887.05 $1,219.70 $915.90 $1,259.36
$924.88 $1,271.71 $954.95 $1,313.06
$957.59 $1,316.69 $988.73 $1,359.51
$979.06 $1,346.21 $1,010.90 $1,389.99
$1,005.98 $1,383.23 $1,038.70 $1,428.21
$1,022.34 $1,405.72 $1,055.58 $1,451.43
$1,022.34 $1,405.72 $1,055.58 $1,451.43
Gold
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0100004
Gold
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
No No
33871PA0100003
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 3 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100005 33871PA0100006
Non-Tobacco Tobacco Non-Tobacco Tobacco
$191.32 $191.32 $181.92 $181.92
$301.28 $338.94 $286.49 $322.30
$301.28 $338.94 $286.49 $322.30
$301.28 $338.94 $286.49 $322.30
$301.28 $338.94 $286.49 $322.30
$302.49 $340.30 $287.64 $323.59
$308.51 $347.08 $293.37 $330.04
$315.75 $355.21 $300.24 $337.77
$327.50 $368.43 $311.41 $350.34
$337.14 $379.28 $320.58 $360.66
$341.96 $401.80 $325.17 $382.07
$349.19 $410.30 $332.04 $390.15
$356.42 $418.79 $338.92 $398.23
$360.94 $424.10 $343.22 $403.28
$365.76 $429.77 $347.80 $408.66
$368.17 $432.60 $350.09 $411.36
$370.58 $435.43 $352.38 $414.05
$372.99 $438.26 $354.67 $416.74
$375.40 $441.09 $356.97 $419.44
$380.22 $446.76 $361.55 $424.82
$385.04 $471.67 $366.13 $448.51
$392.27 $480.53 $373.01 $456.94
$399.20 $489.02 $379.60 $465.01
$408.84 $500.83 $388.77 $476.24
$420.89 $515.59 $400.23 $490.28
$435.05 $532.94 $413.69 $506.77
$451.93 $553.61 $429.74 $526.43
$470.91 $576.86 $447.78 $548.54
$492.60 $603.43 $468.41 $573.80
$513.99 $629.64 $488.75 $598.72
$538.09 $739.88 $511.67 $703.55
$561.89 $772.60 $534.30 $734.67
$588.11 $808.65 $559.23 $768.94
$614.62 $845.10 $584.44 $803.60
$643.24 $884.46 $611.66 $841.03
$671.86 $923.81 $638.87 $878.45
$702.89 $966.48 $668.38 $919.02
$734.23 $1,009.56 $698.18 $959.99
$767.67 $1,055.55 $729.98 $1,003.72
$784.24 $1,078.33 $745.73 $1,025.38
$817.68 $1,124.31 $777.53 $1,069.11
$846.61 $1,164.08 $805.04 $1,106.93
$865.59 $1,190.18 $823.09 $1,131.74
$889.39 $1,222.91 $845.72 $1,162.86
$903.84 $1,242.79 $859.47 $1,181.77
$903.84 $1,242.79 $859.47 $1,181.77
33871PA0100005
$2,500
30%
$7,150
No
Silver
Keystone HMO Silver Classic $2,500 $25/$50/70%
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
Silver
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
No
33871PA0100006
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded
Page Number: 4 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100007 33871PA0100008
Non-Tobacco Tobacco Non-Tobacco Tobacco
$135.45 $135.45 $193.47 $193.47
$213.30 $239.96 $304.68 $342.77
$213.30 $239.96 $304.68 $342.77
$213.30 $239.96 $304.68 $342.77
$213.30 $239.96 $304.68 $342.77
$214.15 $240.92 $305.90 $344.14
$218.42 $245.72 $311.99 $350.99
$223.54 $251.48 $319.31 $359.22
$231.86 $260.84 $331.19 $372.59
$238.68 $268.52 $340.94 $383.56
$242.09 $284.46 $345.81 $406.33
$247.21 $290.48 $353.13 $414.92
$252.33 $296.49 $360.44 $423.52
$255.53 $300.25 $365.01 $428.89
$258.95 $304.26 $369.88 $434.61
$260.65 $306.27 $372.32 $437.48
$262.36 $308.27 $374.76 $440.34
$264.06 $310.28 $377.20 $443.21
$265.77 $312.28 $379.63 $446.07
$269.18 $316.29 $384.51 $451.80
$272.60 $333.93 $389.38 $477.00
$277.72 $340.20 $396.70 $485.95
$282.62 $346.21 $403.70 $494.54
$289.45 $354.57 $413.45 $506.48
$297.98 $365.02 $425.64 $521.41
$308.00 $377.31 $439.96 $538.95
$319.95 $391.94 $457.02 $559.85
$333.39 $408.40 $476.22 $583.37
$348.74 $427.21 $498.16 $610.24
$363.89 $445.76 $519.79 $636.74
$380.95 $523.81 $544.16 $748.22
$397.80 $546.98 $568.23 $781.32
$416.36 $572.50 $594.74 $817.77
$435.13 $598.30 $621.55 $854.63
$455.39 $626.17 $650.50 $894.43
$475.66 $654.03 $679.44 $934.23
$497.63 $684.24 $710.82 $977.38
$519.81 $714.74 $742.51 $1,020.95
$543.49 $747.29 $776.33 $1,067.45
$555.22 $763.43 $793.09 $1,090.50
$578.89 $795.98 $826.91 $1,137.00
$599.37 $824.14 $856.16 $1,177.22
$612.81 $842.61 $875.35 $1,203.61
$629.66 $865.78 $899.42 $1,236.71
$639.90 $879.86 $914.04 $1,256.81
$639.90 $879.86 $914.04 $1,256.81
33871PA0100007
Bronze
KE 670 WPR GMC
8
Keystone Health Plan East Network
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
No
$50 no ded/$100 no ded
No
$15/$40, $30/$60, $45/$80
Gold
Keystone HMO Gold Proactive
$0
0%/20%/30%
$7,150
33871PA0100008
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 5 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
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44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100009 33871PA0110001
Non-Tobacco Tobacco Non-Tobacco Tobacco
$153.46 $153.46 $287.26 $287.26
$241.68 $271.88 $452.39 $508.93
$241.68 $271.88 $452.39 $508.93
$241.68 $271.88 $452.39 $508.93
$241.68 $271.88 $452.39 $508.93
$242.64 $272.97 $454.19 $510.97
$247.48 $278.41 $463.24 $521.15
$253.28 $284.94 $474.10 $533.36
$262.70 $295.54 $491.74 $553.21
$270.43 $304.24 $506.22 $569.50
$274.30 $322.30 $513.46 $603.31
$280.10 $329.12 $524.31 $616.07
$285.90 $335.93 $535.17 $628.83
$289.53 $340.19 $541.96 $636.80
$293.39 $344.74 $549.20 $645.30
$295.33 $347.01 $552.81 $649.56
$297.26 $349.28 $556.43 $653.81
$299.19 $351.55 $560.05 $658.06
$301.13 $353.83 $563.67 $662.31
$304.99 $358.37 $570.91 $670.82
$308.86 $378.36 $578.15 $708.23
$314.66 $385.46 $589.01 $721.53
$320.22 $392.27 $599.41 $734.28
$327.95 $401.74 $613.89 $752.01
$337.62 $413.59 $631.98 $774.18
$348.98 $427.50 $653.24 $800.22
$362.51 $444.08 $678.58 $831.26
$377.74 $462.73 $707.08 $866.17
$395.14 $484.05 $739.65 $906.07
$412.30 $505.07 $771.77 $945.42
$431.63 $593.49 $807.96 $1,110.94
$450.72 $619.75 $843.70 $1,160.08
$471.75 $648.66 $883.06 $1,214.20
$493.02 $677.90 $922.87 $1,268.94
$515.98 $709.47 $965.84 $1,328.03
$538.94 $741.04 $1,008.82 $1,387.13
$563.83 $775.26 $1,055.41 $1,451.19
$588.96 $809.82 $1,102.46 $1,515.89
$615.79 $846.71 $1,152.68 $1,584.93
$629.08 $864.99 $1,177.56 $1,619.14
$655.91 $901.87 $1,227.77 $1,688.19
$679.11 $933.77 $1,271.20 $1,747.90
$694.33 $954.71 $1,299.70 $1,787.09
$713.43 $980.96 $1,335.44 $1,836.23
$725.03 $996.91 $1,357.16 $1,866.09
$725.03 $996.91 $1,357.16 $1,866.09
33871PA0100009
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone HMO Silver Proactive
$0/$5500/$5500
0%/5%/10%
$7,150
No
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
No
$10/$20
Platinum
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0110001
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 6 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110002 33871PA0110003
Non-Tobacco Tobacco Non-Tobacco Tobacco
$274.60 $274.60 $226.06 $226.06
$432.44 $486.50 $356.00 $400.49
$432.44 $486.50 $356.00 $400.49
$432.44 $486.50 $356.00 $400.49
$432.44 $486.50 $356.00 $400.49
$434.17 $488.44 $357.42 $402.10
$442.82 $498.17 $364.54 $410.11
$453.20 $509.85 $373.08 $419.72
$470.06 $528.82 $386.97 $435.34
$483.90 $544.39 $398.36 $448.15
$490.82 $576.71 $404.05 $474.76
$501.20 $588.91 $412.60 $484.80
$511.58 $601.10 $421.14 $494.84
$518.06 $608.73 $426.48 $501.12
$524.98 $616.86 $432.18 $507.81
$528.44 $620.92 $435.03 $511.16
$531.90 $624.99 $437.87 $514.50
$535.36 $629.05 $440.72 $517.85
$538.82 $633.11 $443.57 $521.19
$545.74 $641.24 $449.27 $527.89
$552.66 $677.01 $454.96 $557.33
$563.04 $689.72 $463.51 $567.79
$572.98 $701.91 $471.69 $577.82
$586.82 $718.86 $483.09 $591.78
$604.12 $740.05 $497.33 $609.22
$624.44 $764.94 $514.06 $629.72
$648.66 $794.61 $533.99 $654.14
$675.90 $827.98 $556.42 $681.62
$707.04 $866.12 $582.05 $713.01
$737.74 $903.74 $607.33 $743.98
$772.34 $1,061.97 $635.81 $874.24
$806.50 $1,108.94 $663.93 $912.91
$844.12 $1,160.67 $694.90 $955.49
$882.18 $1,213.00 $726.23 $998.57
$923.26 $1,269.48 $760.05 $1,045.07
$964.34 $1,325.97 $793.87 $1,091.57
$1,008.88 $1,387.22 $830.54 $1,141.99
$1,053.86 $1,449.05 $867.56 $1,192.90
$1,101.86 $1,515.06 $907.08 $1,247.23
$1,125.64 $1,547.76 $926.66 $1,274.15
$1,173.64 $1,613.76 $966.17 $1,328.49
$1,215.16 $1,670.84 $1,000.35 $1,375.48
$1,242.40 $1,708.30 $1,022.77 $1,406.31
$1,276.57 $1,755.28 $1,050.90 $1,444.98
$1,297.32 $1,783.82 $1,067.99 $1,468.48
$1,297.32 $1,783.82 $1,067.99 $1,468.48
33871PA0110002
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
No
$20/$40
No
$30/$60
Gold
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0110003
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 7 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110004 33871PA0110005
Non-Tobacco Tobacco Non-Tobacco Tobacco
$232.67 $232.67 $228.93 $228.93
$366.40 $412.20 $360.51 $405.58
$366.40 $412.20 $360.51 $405.58
$366.40 $412.20 $360.51 $405.58
$366.40 $412.20 $360.51 $405.58
$367.87 $413.85 $361.96 $407.20
$375.20 $422.10 $369.17 $415.31
$383.99 $431.99 $377.82 $425.05
$398.28 $448.06 $391.88 $440.86
$410.00 $461.25 $403.42 $453.84
$415.87 $488.64 $409.18 $480.79
$424.66 $498.98 $417.84 $490.96
$433.45 $509.31 $426.49 $501.12
$438.95 $515.77 $431.90 $507.48
$444.81 $522.65 $437.66 $514.26
$447.74 $526.10 $440.55 $517.65
$450.67 $529.54 $443.43 $521.03
$453.61 $532.99 $446.32 $524.42
$456.54 $536.43 $449.20 $527.81
$462.40 $543.32 $454.97 $534.59
$468.26 $573.62 $460.74 $564.40
$477.06 $584.39 $469.39 $575.00
$485.48 $594.72 $477.68 $585.16
$497.21 $609.08 $489.22 $599.29
$511.86 $627.03 $503.64 $616.96
$529.09 $648.13 $520.58 $637.71
$549.60 $673.26 $540.77 $662.45
$572.69 $701.54 $563.48 $690.27
$599.07 $733.86 $589.44 $722.07
$625.08 $765.73 $615.04 $753.42
$654.39 $899.79 $643.88 $885.33
$683.34 $939.59 $672.36 $924.49
$715.22 $983.42 $703.72 $967.62
$747.46 $1,027.76 $735.45 $1,011.24
$782.27 $1,075.62 $769.70 $1,058.34
$817.08 $1,123.48 $803.95 $1,105.43
$854.82 $1,175.37 $841.08 $1,156.49
$892.92 $1,227.77 $878.57 $1,208.04
$933.59 $1,283.69 $918.59 $1,263.06
$953.75 $1,311.40 $938.42 $1,290.33
$994.42 $1,367.32 $978.44 $1,345.35
$1,029.59 $1,415.69 $1,013.05 $1,392.94
$1,052.67 $1,447.43 $1,035.76 $1,424.17
$1,081.62 $1,487.23 $1,064.24 $1,463.33
$1,099.20 $1,511.41 $1,081.53 $1,487.12
$1,099.20 $1,511.41 $1,081.53 $1,487.12
33871PA0110004
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
No
$25 no ded/$50 no ded
No
$40 no ded/$80 no ded
GoldKeystone DPOS Gold Classic
$2,000 $40/$80/100%
$2,000
0%
$3,500
33871PA0110005
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 8 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110006 33871PA0110010
Non-Tobacco Tobacco Non-Tobacco Tobacco
$199.85 $199.85 $141.33 $141.33
$314.73 $354.07 $222.57 $250.39
$314.73 $354.07 $222.57 $250.39
$314.73 $354.07 $222.57 $250.39
$314.73 $354.07 $222.57 $250.39
$315.99 $355.49 $223.46 $251.39
$322.28 $362.57 $227.91 $256.40
$329.84 $371.07 $233.25 $262.41
$342.11 $384.88 $241.93 $272.17
$352.18 $396.21 $249.06 $280.19
$357.22 $419.73 $252.62 $296.82
$364.77 $428.61 $257.96 $303.10
$372.33 $437.48 $263.30 $309.38
$377.05 $443.03 $266.64 $313.30
$382.08 $448.95 $270.20 $317.48
$384.60 $451.91 $271.98 $319.58
$387.12 $454.86 $273.76 $321.67
$389.64 $457.82 $275.54 $323.76
$392.15 $460.78 $277.32 $325.85
$397.19 $466.70 $280.88 $330.04
$402.23 $492.73 $284.44 $348.44
$409.78 $501.98 $289.79 $354.99
$417.02 $510.85 $294.90 $361.26
$427.09 $523.18 $302.03 $369.98
$439.68 $538.61 $310.93 $380.89
$454.47 $556.73 $321.39 $393.70
$472.10 $578.32 $333.85 $408.97
$491.92 $602.61 $347.88 $426.15
$514.58 $630.37 $363.90 $445.78
$536.93 $657.74 $379.70 $465.14
$562.11 $772.90 $397.51 $546.57
$586.97 $807.09 $415.09 $570.75
$614.35 $844.74 $434.46 $597.38
$642.05 $882.82 $454.04 $624.31
$671.95 $923.93 $475.19 $653.38
$701.85 $965.04 $496.33 $682.45
$734.27 $1,009.62 $519.25 $713.97
$767.00 $1,054.62 $542.40 $745.80
$801.93 $1,102.66 $567.11 $779.77
$819.24 $1,126.46 $579.35 $796.60
$854.18 $1,174.50 $604.05 $830.57
$884.39 $1,216.04 $625.42 $859.95
$904.22 $1,243.30 $639.44 $879.23
$929.08 $1,277.49 $657.02 $903.41
$944.19 $1,298.26 $667.71 $918.10
$944.19 $1,298.26 $667.71 $918.10
33871PA0110006
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
No
$25 no ded/$50 no ded
No
$50 no ded/$100 no ded
Bronze
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0110010
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 9 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100020 33871PA0100021
Non-Tobacco Tobacco Non-Tobacco Tobacco
$275.08 $275.08 $262.98 $262.98
$433.20 $487.35 $414.13 $465.90
$433.20 $487.35 $414.13 $465.90
$433.20 $487.35 $414.13 $465.90
$433.20 $487.35 $414.13 $465.90
$434.93 $489.30 $415.79 $467.77
$443.59 $499.04 $424.07 $477.08
$453.99 $510.74 $434.01 $488.26
$470.89 $529.75 $450.16 $506.43
$484.75 $545.34 $463.42 $521.34
$491.68 $577.72 $470.04 $552.30
$502.08 $589.94 $479.98 $563.98
$512.47 $602.16 $489.92 $575.66
$518.97 $609.79 $496.13 $582.96
$525.90 $617.93 $502.76 $590.74
$529.37 $622.01 $506.07 $594.64
$532.83 $626.08 $509.39 $598.53
$536.30 $630.15 $512.70 $602.42
$539.76 $634.22 $516.01 $606.31
$546.69 $642.37 $522.64 $614.10
$553.63 $678.19 $529.26 $648.35
$564.02 $690.93 $539.20 $660.52
$573.99 $703.13 $548.73 $672.19
$587.85 $720.11 $561.98 $688.43
$605.18 $741.34 $578.55 $708.72
$625.54 $766.28 $598.01 $732.56
$649.80 $796.00 $621.20 $760.97
$677.09 $829.43 $647.29 $792.93
$708.28 $867.64 $677.11 $829.46
$739.03 $905.32 $706.51 $865.48
$773.69 $1,063.82 $739.64 $1,017.01
$807.91 $1,110.88 $772.36 $1,062.00
$845.60 $1,162.70 $808.39 $1,111.54
$883.72 $1,215.12 $844.83 $1,161.65
$924.88 $1,271.70 $884.18 $1,215.74
$966.03 $1,328.29 $923.52 $1,269.84
$1,010.65 $1,389.64 $966.18 $1,328.49
$1,055.70 $1,451.59 $1,009.25 $1,387.71
$1,103.79 $1,517.71 $1,055.21 $1,450.92
$1,127.61 $1,550.47 $1,077.99 $1,482.24
$1,175.70 $1,616.58 $1,123.96 $1,545.45
$1,217.28 $1,673.77 $1,163.72 $1,600.11
$1,244.58 $1,711.29 $1,189.81 $1,635.99
$1,278.80 $1,758.35 $1,222.53 $1,680.97
$1,299.59 $1,786.94 $1,242.39 $1,708.31
$1,299.59 $1,786.94 $1,242.39 $1,708.31
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
33871PA0100021
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
$4,000
Yes
Platinum
Keystone HMO Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0100020
$10/$20 $20/$40
Page Number: 10 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100022 33871PA0100023
Non-Tobacco Tobacco Non-Tobacco Tobacco
$216.94 $216.94 $223.97 $223.97
$341.63 $384.34 $352.72 $396.81
$341.63 $384.34 $352.72 $396.81
$341.63 $384.34 $352.72 $396.81
$341.63 $384.34 $352.72 $396.81
$343.00 $385.88 $354.13 $398.39
$349.83 $393.56 $361.18 $406.33
$358.03 $402.79 $369.65 $415.85
$371.36 $417.78 $383.40 $431.33
$382.29 $430.07 $394.69 $444.02
$387.75 $455.61 $400.33 $470.39
$395.95 $465.25 $408.80 $480.34
$404.15 $474.88 $417.26 $490.28
$409.28 $480.90 $422.55 $496.50
$414.74 $487.32 $428.20 $503.13
$417.48 $490.54 $431.02 $506.45
$420.21 $493.75 $433.84 $509.76
$422.94 $496.96 $436.66 $513.08
$425.68 $500.17 $439.48 $516.39
$431.14 $506.59 $445.13 $523.02
$436.61 $534.85 $450.77 $552.19
$444.81 $544.89 $459.24 $562.56
$452.67 $554.51 $467.35 $572.50
$463.60 $567.91 $478.64 $586.33
$477.26 $584.65 $492.74 $603.61
$493.32 $604.32 $509.32 $623.92
$512.45 $627.75 $529.07 $648.11
$533.97 $654.12 $551.29 $675.34
$558.57 $684.25 $576.69 $706.45
$582.83 $713.96 $601.73 $737.12
$610.16 $838.97 $629.95 $866.18
$637.15 $876.08 $657.81 $904.50
$666.87 $916.95 $688.50 $946.69
$696.93 $958.28 $719.54 $989.37
$729.39 $1,002.91 $753.05 $1,035.44
$761.84 $1,047.54 $786.56 $1,081.51
$797.03 $1,095.92 $822.89 $1,131.47
$832.56 $1,144.77 $859.57 $1,181.91
$870.48 $1,196.92 $898.72 $1,235.74
$889.27 $1,222.75 $918.12 $1,262.41
$927.19 $1,274.89 $957.27 $1,316.25
$959.99 $1,319.99 $991.13 $1,362.81
$981.51 $1,349.58 $1,013.35 $1,393.36
$1,008.50 $1,386.69 $1,041.22 $1,431.67
$1,024.89 $1,409.24 $1,058.15 $1,454.95
$1,024.89 $1,409.24 $1,058.15 $1,454.95
Yes
33871PA0100023
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
Yes
Gold
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0100022
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 11 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100024 33871PA0100025
Non-Tobacco Tobacco Non-Tobacco Tobacco
$191.86 $191.86 $182.46 $182.46
$302.14 $339.90 $287.34 $323.26
$302.14 $339.90 $287.34 $323.26
$302.14 $339.90 $287.34 $323.26
$302.14 $339.90 $287.34 $323.26
$303.35 $341.26 $288.49 $324.55
$309.39 $348.06 $294.24 $331.02
$316.64 $356.22 $301.14 $338.78
$328.42 $369.48 $312.34 $351.39
$338.09 $380.35 $321.54 $361.73
$342.93 $402.94 $326.14 $383.21
$350.18 $411.46 $333.03 $391.31
$357.43 $419.98 $339.93 $399.42
$361.96 $425.30 $344.24 $404.48
$366.79 $430.98 $348.84 $409.88
$369.21 $433.82 $351.13 $412.58
$371.63 $436.66 $353.43 $415.28
$374.05 $439.50 $355.73 $417.98
$376.46 $442.34 $358.03 $420.69
$381.30 $448.02 $362.63 $426.09
$386.13 $473.01 $367.23 $449.85
$393.38 $481.89 $374.12 $458.30
$400.33 $490.41 $380.73 $466.40
$410.00 $502.25 $389.93 $477.66
$422.09 $517.06 $401.42 $491.74
$436.29 $534.45 $414.92 $508.28
$453.21 $555.18 $431.02 $527.99
$472.24 $578.49 $449.12 $550.17
$493.99 $605.14 $469.81 $575.51
$515.45 $631.42 $490.21 $600.51
$539.62 $741.97 $513.20 $705.64
$563.49 $774.79 $535.90 $736.86
$589.77 $810.94 $560.90 $771.23
$616.36 $847.50 $586.18 $806.00
$645.06 $886.96 $613.48 $843.53
$673.77 $926.43 $640.78 $881.07
$704.89 $969.22 $670.37 $921.76
$736.31 $1,012.42 $700.26 $962.85
$769.85 $1,058.54 $732.15 $1,006.71
$786.46 $1,081.39 $747.96 $1,028.44
$820.00 $1,127.50 $779.85 $1,072.30
$849.01 $1,167.38 $807.44 $1,110.23
$868.04 $1,193.56 $825.54 $1,135.12
$891.91 $1,226.38 $848.24 $1,166.33
$906.41 $1,246.32 $862.02 $1,185.29
$906.41 $1,246.32 $862.02 $1,185.29
Yes
33871PA0100025
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
Yes
Silver
Keystone HMO Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
33871PA0100024
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded $30 no ded/$60 no ded
Page Number: 12 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100026 33871PA0110011
Non-Tobacco Tobacco Non-Tobacco Tobacco
$135.99 $135.99 $287.81 $287.81
$214.15 $240.92 $453.24 $509.89
$214.15 $240.92 $453.24 $509.89
$214.15 $240.92 $453.24 $509.89
$214.15 $240.92 $453.24 $509.89
$215.01 $241.89 $455.05 $511.93
$219.29 $246.70 $464.12 $522.13
$224.43 $252.49 $474.99 $534.37
$232.78 $261.88 $492.67 $554.25
$239.64 $269.59 $507.17 $570.57
$243.06 $285.60 $514.43 $604.45
$248.20 $291.64 $525.30 $617.23
$253.34 $297.68 $536.18 $630.01
$256.56 $301.45 $542.98 $638.00
$259.98 $305.48 $550.23 $646.52
$261.70 $307.49 $553.86 $650.78
$263.41 $309.51 $557.48 $655.04
$265.12 $311.52 $561.11 $659.30
$266.83 $313.53 $564.74 $663.56
$270.26 $317.56 $571.99 $672.09
$273.69 $335.27 $579.24 $709.57
$278.83 $341.56 $590.12 $722.89
$283.75 $347.60 $600.54 $735.66
$290.61 $355.99 $615.05 $753.43
$299.17 $366.49 $633.17 $775.64
$309.24 $378.82 $654.48 $801.73
$321.23 $393.51 $679.86 $832.83
$334.72 $410.03 $708.41 $867.81
$350.14 $428.92 $741.05 $907.78
$365.35 $447.55 $773.23 $947.20
$382.48 $525.91 $809.48 $1,113.04
$399.40 $549.17 $845.29 $1,162.27
$418.03 $574.79 $884.72 $1,216.49
$436.87 $600.70 $924.61 $1,271.34
$457.22 $628.67 $967.67 $1,330.54
$477.56 $656.65 $1,010.72 $1,389.74
$499.62 $686.98 $1,057.41 $1,453.93
$521.89 $717.60 $1,104.54 $1,518.75
$545.66 $750.29 $1,154.85 $1,587.92
$557.44 $766.48 $1,179.78 $1,622.20
$581.21 $799.17 $1,230.09 $1,691.37
$601.77 $827.43 $1,273.60 $1,751.20
$615.26 $845.99 $1,302.16 $1,790.46
$632.18 $869.25 $1,337.96 $1,839.70
$642.45 $883.38 $1,359.72 $1,869.61
$642.45 $883.38 $1,359.72 $1,869.61
Yes
33871PA0110011
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
Yes
Bronze
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0100026
KE 670 WPR GMC
8
Keystone Health Plan East Network
$10/$20$50 no ded/$100 no ded
Page Number: 13 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110012 33871PA0110013
Non-Tobacco Tobacco Non-Tobacco Tobacco
$275.14 $275.14 $226.60 $226.60
$433.29 $487.46 $356.85 $401.46
$433.29 $487.46 $356.85 $401.46
$433.29 $487.46 $356.85 $401.46
$433.29 $487.46 $356.85 $401.46
$435.03 $489.41 $358.28 $403.06
$443.69 $499.16 $365.41 $411.09
$454.09 $510.85 $373.98 $420.72
$470.99 $529.87 $387.89 $436.38
$484.86 $545.46 $399.31 $449.23
$491.79 $577.85 $405.02 $475.90
$502.19 $590.07 $413.59 $485.97
$512.59 $602.29 $422.15 $496.03
$519.09 $609.93 $427.51 $502.32
$526.02 $618.07 $433.21 $509.03
$529.49 $622.15 $436.07 $512.38
$532.95 $626.22 $438.92 $515.74
$536.42 $630.29 $441.78 $519.09
$539.89 $634.36 $444.63 $522.44
$546.82 $642.51 $450.34 $529.15
$553.75 $678.34 $456.05 $558.66
$564.15 $691.08 $464.62 $569.16
$574.12 $703.29 $472.82 $579.21
$587.98 $720.28 $484.24 $593.20
$605.31 $741.51 $498.52 $610.68
$625.68 $766.45 $515.29 $631.23
$649.94 $796.18 $535.27 $655.71
$677.24 $829.62 $557.76 $683.25
$708.44 $867.83 $583.45 $714.72
$739.20 $905.52 $608.78 $745.76
$773.86 $1,064.06 $637.33 $876.33
$808.09 $1,111.13 $665.52 $915.09
$845.79 $1,162.96 $696.57 $957.78
$883.92 $1,215.39 $727.97 $1,000.96
$925.08 $1,271.99 $761.87 $1,047.57
$966.25 $1,328.59 $795.77 $1,094.19
$1,010.88 $1,389.95 $832.53 $1,144.73
$1,055.94 $1,451.92 $869.64 $1,195.76
$1,104.03 $1,518.05 $909.25 $1,250.22
$1,127.87 $1,550.82 $928.88 $1,277.21
$1,175.96 $1,616.95 $968.49 $1,331.67
$1,217.56 $1,674.14 $1,002.75 $1,378.78
$1,244.86 $1,711.68 $1,025.23 $1,409.69
$1,279.09 $1,758.74 $1,053.42 $1,448.45
$1,299.87 $1,787.34 $1,070.55 $1,472.00
$1,299.87 $1,787.34 $1,070.55 $1,472.00
Yes
33871PA0110013
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
Yes
Platinum
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
33871PA0110012
KE 670 WPR GMC
8
Keystone Health Plan East Network
$20/$40 $30/$60
Page Number: 14 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110014 33871PA0110016
Non-Tobacco Tobacco Non-Tobacco Tobacco
$233.21 $233.21 $200.40 $200.40
$367.26 $413.16 $315.58 $355.03
$367.26 $413.16 $315.58 $355.03
$367.26 $413.16 $315.58 $355.03
$367.26 $413.16 $315.58 $355.03
$368.73 $414.82 $316.85 $356.45
$376.07 $423.08 $323.16 $363.55
$384.88 $433.00 $330.73 $372.07
$399.21 $449.11 $343.04 $385.92
$410.96 $462.33 $353.14 $397.28
$416.84 $489.78 $358.19 $420.87
$425.65 $500.14 $365.76 $429.77
$434.46 $510.50 $373.34 $438.67
$439.97 $516.97 $378.07 $444.23
$445.85 $523.87 $383.12 $450.17
$448.79 $527.32 $385.64 $453.13
$451.73 $530.78 $388.17 $456.10
$454.66 $534.23 $390.69 $459.06
$457.60 $537.68 $393.22 $462.03
$463.48 $544.59 $398.27 $467.96
$469.35 $574.96 $403.32 $494.06
$478.17 $585.76 $410.89 $503.34
$486.61 $596.10 $418.15 $512.23
$498.37 $610.50 $428.25 $524.60
$513.06 $628.49 $440.87 $540.07
$530.32 $649.64 $455.70 $558.24
$550.88 $674.83 $473.38 $579.89
$574.02 $703.18 $493.26 $604.24
$600.46 $735.57 $515.98 $632.08
$626.54 $767.51 $538.39 $659.52
$655.92 $901.89 $563.63 $775.00
$684.93 $941.78 $588.56 $809.28
$716.88 $985.72 $616.02 $847.03
$749.20 $1,030.15 $643.79 $885.21
$784.09 $1,078.13 $673.77 $926.44
$818.98 $1,126.10 $703.75 $967.66
$856.81 $1,178.11 $736.26 $1,012.36
$895.00 $1,230.63 $769.08 $1,057.48
$935.77 $1,286.68 $804.11 $1,105.65
$955.97 $1,314.46 $821.47 $1,129.52
$996.73 $1,370.51 $856.50 $1,177.68
$1,031.99 $1,418.99 $886.79 $1,219.34
$1,055.13 $1,450.80 $906.67 $1,246.68
$1,084.14 $1,490.69 $931.61 $1,280.96
$1,101.77 $1,514.93 $946.74 $1,301.79
$1,101.77 $1,514.93 $946.74 $1,301.79
Yes
33871PA0110016
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
Yes
Gold
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0110014
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded$25 no ded/$50 no ded
Page Number: 15 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110019 33871PA0110020
Non-Tobacco Tobacco Non-Tobacco Tobacco
$190.53 $190.53 $141.87 $141.87
$300.05 $337.56 $223.42 $251.35
$300.05 $337.56 $223.42 $251.35
$300.05 $337.56 $223.42 $251.35
$300.05 $337.56 $223.42 $251.35
$301.25 $338.91 $224.32 $252.36
$307.25 $345.66 $228.79 $257.38
$314.45 $353.76 $234.15 $263.42
$326.16 $366.93 $242.86 $273.22
$335.76 $377.73 $250.01 $281.26
$340.56 $400.16 $253.59 $297.96
$347.76 $408.62 $258.95 $304.26
$354.96 $417.08 $264.31 $310.56
$359.46 $422.37 $267.66 $314.50
$364.26 $428.01 $271.24 $318.70
$366.66 $430.83 $273.02 $320.80
$369.06 $433.65 $274.81 $322.90
$371.46 $436.47 $276.60 $325.00
$373.86 $439.29 $278.39 $327.10
$378.67 $444.93 $281.96 $331.30
$383.47 $469.75 $285.53 $349.78
$390.67 $478.57 $290.90 $356.35
$397.57 $487.02 $296.04 $362.64
$407.17 $498.78 $303.19 $371.40
$419.17 $513.49 $312.12 $382.35
$433.27 $530.76 $322.62 $395.21
$450.08 $551.34 $335.13 $410.54
$468.98 $574.50 $349.21 $427.78
$490.58 $600.97 $365.30 $447.49
$511.89 $627.06 $381.16 $466.92
$535.89 $736.85 $399.03 $548.67
$559.60 $769.44 $416.68 $572.94
$585.70 $805.34 $436.12 $599.67
$612.11 $841.64 $455.78 $626.70
$640.61 $880.84 $477.01 $655.89
$669.11 $920.03 $498.23 $685.07
$700.02 $962.53 $521.25 $716.71
$731.23 $1,005.44 $544.48 $748.66
$764.53 $1,051.23 $569.28 $782.76
$781.03 $1,073.92 $581.57 $799.66
$814.34 $1,119.72 $606.37 $833.76
$843.14 $1,159.32 $627.82 $863.25
$862.05 $1,185.32 $641.89 $882.61
$885.75 $1,217.91 $659.55 $906.87
$900.15 $1,237.71 $670.26 $921.62
$900.15 $1,237.71 $670.26 $921.62
Yes
33871PA0110020
Yes
$6,850
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
50%
Bronze
$7,150
$50 no ded/$100 no ded
8
KE 670 WPR GMC
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
33871PA0110019
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
Page Number: 16 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100044 33871PA0100045
Non-Tobacco Tobacco Non-Tobacco Tobacco
$194.02 $194.02 $154.01 $154.01
$305.54 $343.73 $242.53 $272.85
$305.54 $343.73 $242.53 $272.85
$305.54 $343.73 $242.53 $272.85
$305.54 $343.73 $242.53 $272.85
$306.76 $345.10 $243.50 $273.94
$312.87 $351.98 $248.35 $279.39
$320.20 $360.23 $254.17 $285.94
$332.12 $373.63 $263.63 $296.58
$341.89 $384.63 $271.39 $305.31
$346.78 $407.47 $275.27 $323.44
$354.12 $416.09 $281.09 $330.28
$361.45 $424.70 $286.91 $337.12
$366.03 $430.09 $290.55 $341.40
$370.92 $435.83 $294.43 $345.96
$373.36 $438.70 $296.37 $348.24
$375.81 $441.58 $298.31 $350.52
$378.25 $444.45 $300.25 $352.80
$380.70 $447.32 $302.19 $355.08
$385.59 $453.06 $306.07 $359.63
$390.48 $478.33 $309.95 $379.69
$397.81 $487.31 $315.77 $386.82
$404.84 $495.92 $321.35 $393.66
$414.61 $507.90 $329.11 $403.16
$426.83 $522.87 $338.81 $415.05
$441.19 $540.46 $350.21 $429.01
$458.30 $561.42 $363.79 $445.65
$477.55 $585.00 $379.07 $464.36
$499.55 $611.95 $396.54 $485.76
$521.24 $638.52 $413.75 $506.85
$545.69 $750.32 $433.16 $595.59
$569.82 $783.51 $452.32 $621.94
$596.41 $820.06 $473.42 $650.95
$623.29 $857.03 $494.76 $680.29
$652.32 $896.94 $517.80 $711.98
$681.35 $936.85 $540.84 $743.66
$712.82 $980.12 $565.82 $778.00
$744.59 $1,023.81 $591.04 $812.69
$778.51 $1,070.45 $617.96 $849.70
$795.31 $1,093.55 $631.30 $868.04
$829.22 $1,140.18 $658.22 $905.06
$858.56 $1,180.51 $681.51 $937.07
$877.80 $1,206.98 $696.79 $958.08
$901.94 $1,240.17 $715.95 $984.43
$916.61 $1,260.34 $727.59 $1,000.43
$916.61 $1,260.34 $727.59 $1,000.43
33871PA0100044
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
$0
Keystone HMO Gold Proactive
0%/20%/30%
Gold
$7,150
$15/$40, $30/$60, $45/$80
Yes
$0/$5500/$5500
Keystone HMO Silver Proactive
0%/5%/10%
Silver
33871PA0100045
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
$7,150
Page Number: 17 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100035 33871PA0100037
Non-Tobacco Tobacco Non-Tobacco Tobacco
$222.33 $222.33 $174.66 $174.66
$350.13 $393.90 $275.06 $309.44
$350.13 $393.90 $275.06 $309.44
$350.13 $393.90 $275.06 $309.44
$350.13 $393.90 $275.06 $309.44
$351.53 $395.48 $276.16 $310.68
$358.54 $403.35 $281.66 $316.87
$366.94 $412.81 $288.26 $324.30
$380.59 $428.17 $298.99 $336.37
$391.80 $440.77 $307.79 $346.27
$397.40 $466.95 $312.19 $366.83
$405.80 $476.82 $318.80 $374.59
$414.21 $486.69 $325.40 $382.34
$419.46 $492.86 $329.52 $387.19
$425.06 $499.45 $333.92 $392.36
$427.86 $502.74 $336.12 $394.95
$430.66 $506.03 $338.33 $397.53
$433.46 $509.32 $340.53 $400.12
$436.27 $512.61 $342.73 $402.70
$441.87 $519.19 $347.13 $407.87
$447.47 $548.15 $351.53 $430.62
$455.87 $558.44 $358.13 $438.71
$463.93 $568.31 $364.46 $446.46
$475.13 $582.03 $373.26 $457.24
$489.14 $599.19 $384.26 $470.72
$505.59 $619.35 $397.19 $486.56
$525.20 $643.37 $412.59 $505.42
$547.26 $670.39 $429.92 $526.65
$572.47 $701.27 $449.72 $550.91
$597.33 $731.73 $469.25 $574.84
$625.34 $859.84 $491.26 $675.48
$653.00 $897.87 $512.99 $705.36
$683.46 $939.76 $536.92 $738.26
$714.27 $982.12 $561.12 $771.55
$747.53 $1,027.86 $587.26 $807.48
$780.80 $1,073.60 $613.39 $843.41
$816.86 $1,123.18 $641.72 $882.36
$853.27 $1,173.25 $670.32 $921.70
$892.14 $1,226.69 $700.86 $963.68
$911.40 $1,253.17 $715.98 $984.48
$950.26 $1,306.61 $746.52 $1,026.46
$983.87 $1,352.83 $772.92 $1,062.77
$1,005.93 $1,383.16 $790.25 $1,086.59
$1,033.59 $1,421.19 $811.98 $1,116.47
$1,050.39 $1,444.30 $825.18 $1,134.63
$1,050.39 $1,444.30 $825.18 $1,134.63
33871PA0100035
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
Gold Silver
$2,000 $3,500
$3,500 $7,150
No
0%
$40 no ded/$80 no ded
0%
Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone HMO Silver Secure $3,500 $40/$80/$600
33871PA0100037
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded
Page Number: 18 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
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49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100036 33871PA0110007
Non-Tobacco Tobacco Non-Tobacco Tobacco
$185.04 $185.04 $182.41 $182.41
$291.40 $327.83 $287.26 $323.17
$291.40 $327.83 $287.26 $323.17
$291.40 $327.83 $287.26 $323.17
$291.40 $327.83 $287.26 $323.17
$292.57 $329.14 $288.41 $324.46
$298.40 $335.70 $294.16 $330.93
$305.39 $343.56 $301.05 $338.68
$316.75 $356.35 $312.26 $351.29
$326.08 $366.84 $321.45 $361.63
$330.74 $388.62 $326.04 $383.10
$337.74 $396.84 $332.94 $391.20
$344.73 $405.06 $339.83 $399.30
$349.10 $410.19 $344.14 $404.37
$353.76 $415.67 $348.74 $409.77
$356.09 $418.41 $351.04 $412.47
$358.42 $421.15 $353.33 $415.17
$360.76 $423.89 $355.63 $417.87
$363.09 $426.63 $357.93 $420.57
$367.75 $432.11 $362.53 $425.97
$372.41 $456.20 $367.12 $449.72
$379.41 $464.77 $374.02 $458.17
$386.11 $472.98 $380.62 $466.26
$395.43 $484.41 $389.82 $477.52
$407.09 $498.68 $401.31 $491.60
$420.78 $515.46 $414.81 $508.14
$437.10 $535.45 $430.89 $527.85
$455.46 $557.94 $448.99 $550.02
$476.44 $583.64 $469.68 $575.35
$497.13 $608.99 $490.07 $600.34
$520.44 $715.61 $513.05 $705.45
$543.46 $747.26 $535.75 $736.65
$568.82 $782.12 $560.74 $771.01
$594.46 $817.38 $586.02 $805.77
$622.14 $855.45 $613.31 $843.30
$649.83 $893.51 $640.60 $880.82
$679.84 $934.78 $670.18 $921.50
$710.15 $976.45 $700.06 $962.58
$742.49 $1,020.93 $731.95 $1,006.43
$758.52 $1,042.96 $747.75 $1,028.15
$790.87 $1,087.44 $779.63 $1,071.99
$818.84 $1,125.91 $807.21 $1,109.91
$837.20 $1,151.15 $825.31 $1,134.80
$860.22 $1,182.80 $848.00 $1,166.00
$874.20 $1,202.03 $861.78 $1,184.96
$874.20 $1,202.03 $861.78 $1,184.96
Keystone Health Plan East Network
KE 670 WPR GMC
No
Silver Silver
$4,250 $3,500
$7,150 $7,150
No
Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone DPOS Silver Secure $3,500/$40/$80/$600
0% 0%
33871PA0110007
8
33871PA0100036
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded $40 no ded/$80 no ded
Page Number: 19 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
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55
56
57
58
59
60
61
62
63
64
65+
33871PA0110008 33871PA0110009
Non-Tobacco Tobacco Non-Tobacco Tobacco
$193.25 $193.25 $189.99 $189.99
$304.32 $342.36 $299.20 $336.60
$304.32 $342.36 $299.20 $336.60
$304.32 $342.36 $299.20 $336.60
$304.32 $342.36 $299.20 $336.60
$305.54 $343.73 $300.39 $337.94
$311.63 $350.58 $306.38 $344.68
$318.93 $358.80 $313.56 $352.75
$330.80 $372.15 $325.23 $365.88
$340.54 $383.11 $334.80 $376.65
$345.41 $405.85 $339.59 $399.02
$352.71 $414.44 $346.77 $407.45
$360.02 $423.02 $353.95 $415.89
$364.58 $428.38 $358.44 $421.17
$369.45 $434.10 $363.23 $426.79
$371.88 $436.96 $365.62 $429.60
$374.32 $439.82 $368.01 $432.42
$376.75 $442.69 $370.41 $435.23
$379.19 $445.55 $372.80 $438.04
$384.06 $451.27 $377.59 $443.67
$388.93 $476.43 $382.37 $468.41
$396.23 $485.38 $389.56 $477.21
$403.23 $493.96 $396.44 $485.64
$412.97 $505.89 $406.01 $497.36
$425.14 $520.80 $417.98 $512.02
$439.44 $538.32 $432.04 $529.25
$456.49 $559.20 $448.80 $549.78
$475.66 $582.68 $467.65 $572.87
$497.57 $609.52 $489.19 $599.26
$519.18 $635.99 $510.43 $625.28
$543.52 $747.34 $534.37 $734.75
$567.56 $780.40 $558.00 $767.26
$594.04 $816.81 $584.03 $803.05
$620.82 $853.63 $610.36 $839.25
$649.73 $893.38 $638.79 $878.33
$678.64 $933.13 $667.21 $917.42
$709.99 $976.23 $698.03 $959.79
$741.64 $1,019.75 $729.14 $1,002.57
$775.42 $1,066.20 $762.36 $1,048.24
$792.16 $1,089.21 $778.81 $1,070.87
$825.94 $1,135.66 $812.02 $1,116.53
$855.15 $1,175.83 $840.75 $1,156.03
$874.32 $1,202.19 $859.60 $1,181.94
$898.36 $1,235.25 $883.23 $1,214.44
$912.96 $1,255.34 $897.59 $1,234.19
$912.96 $1,255.34 $897.59 $1,234.19
Keystone Health Plan East Network
8
KE 670 WPR GMC
50%
$30 no ded/$60 no ded
Keystone DPOS Silver Classic $4,250 $40/$80/100%
NoNo
0%
Silver
$4,250 $2,750
Keystone DPOS Silver Classic $2,750/$30/$60/50%
Silver
33871PA0110009
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0110008
8
$7,150
$40 no ded/$80 no ded
$7,150
Page Number: 20 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100047 33871PA0100049
Non-Tobacco Tobacco Non-Tobacco Tobacco
$222.88 $222.88 $175.21 $175.21
$350.99 $394.86 $275.91 $310.40
$350.99 $394.86 $275.91 $310.40
$350.99 $394.86 $275.91 $310.40
$350.99 $394.86 $275.91 $310.40
$352.39 $396.44 $277.02 $311.65
$359.41 $404.34 $282.54 $317.85
$367.83 $413.81 $289.16 $325.30
$381.52 $429.21 $299.92 $337.41
$392.75 $441.85 $308.75 $347.34
$398.37 $468.08 $313.16 $367.97
$406.79 $477.98 $319.79 $375.75
$415.22 $487.88 $326.41 $383.53
$420.48 $494.07 $330.55 $388.39
$426.10 $500.67 $334.96 $393.58
$428.91 $503.96 $337.17 $396.17
$431.71 $507.26 $339.38 $398.77
$434.52 $510.56 $341.58 $401.36
$437.33 $513.86 $343.79 $403.95
$442.95 $520.46 $348.20 $409.14
$448.56 $549.49 $352.62 $431.96
$456.98 $559.81 $359.24 $440.07
$465.06 $569.70 $365.59 $447.84
$476.29 $583.45 $374.42 $458.66
$490.33 $600.65 $385.45 $472.18
$506.82 $620.86 $398.42 $488.07
$526.48 $644.94 $413.87 $506.99
$548.59 $672.03 $431.26 $528.29
$573.86 $702.98 $451.12 $552.62
$598.78 $733.51 $470.71 $576.62
$626.86 $861.94 $492.78 $677.58
$654.59 $900.06 $514.58 $707.55
$685.13 $942.05 $538.59 $740.56
$716.01 $984.52 $562.87 $773.94
$749.36 $1,030.37 $589.08 $809.98
$782.70 $1,076.21 $615.29 $846.02
$818.85 $1,125.92 $643.71 $885.10
$855.35 $1,176.11 $672.40 $924.56
$894.31 $1,229.68 $703.03 $966.67
$913.62 $1,256.23 $718.21 $987.53
$952.58 $1,309.79 $748.83 $1,029.65
$986.27 $1,356.13 $775.32 $1,066.07
$1,008.38 $1,386.53 $792.70 $1,089.97
$1,036.11 $1,424.66 $814.50 $1,119.94
$1,052.96 $1,447.82 $827.73 $1,138.15
$1,052.96 $1,447.82 $827.73 $1,138.15
33871PA0100047
KE 670 WPR GMC
33871PA0100049
KE 670 WPR GMC
Keystone Health Plan East Network
Yes Yes
Gold
$2,000
8
Keystone HMO Gold Classic $2,000 $40/$80/100%
8
Keystone HMO Silver Secure $3,500 $40/$80/$600
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$3,500
Keystone Health Plan East Network
Silver
$3,500 $7,150
Page Number: 21 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100048 33871PA0110015
Non-Tobacco Tobacco Non-Tobacco Tobacco
$185.58 $185.58 $229.47 $229.47
$292.26 $328.79 $361.37 $406.54
$292.26 $328.79 $361.37 $406.54
$292.26 $328.79 $361.37 $406.54
$292.26 $328.79 $361.37 $406.54
$293.42 $330.10 $362.81 $408.17
$299.27 $336.68 $370.04 $416.30
$306.28 $344.57 $378.71 $426.05
$317.68 $357.39 $392.81 $441.91
$327.03 $367.91 $404.37 $454.92
$331.71 $389.76 $410.15 $481.93
$338.72 $398.00 $418.83 $492.12
$345.74 $406.24 $427.50 $502.31
$350.12 $411.39 $432.92 $508.68
$354.80 $416.89 $438.70 $515.47
$357.14 $419.64 $441.59 $518.87
$359.47 $422.38 $444.48 $522.27
$361.81 $425.13 $447.37 $525.66
$364.15 $427.88 $450.27 $529.06
$368.83 $433.37 $456.05 $535.86
$373.50 $457.54 $461.83 $565.74
$380.52 $466.13 $470.50 $576.36
$387.24 $474.37 $478.81 $586.55
$396.59 $485.82 $490.38 $600.71
$408.28 $500.14 $504.83 $618.42
$422.02 $516.97 $521.82 $639.22
$438.38 $537.02 $542.05 $664.01
$456.80 $559.58 $564.82 $691.90
$477.84 $585.35 $590.84 $723.78
$498.59 $610.77 $616.49 $755.21
$521.97 $717.71 $645.40 $887.43
$545.06 $749.45 $673.95 $926.68
$570.48 $784.41 $705.39 $969.91
$596.20 $819.78 $737.19 $1,013.64
$623.97 $857.95 $771.52 $1,060.84
$651.73 $896.13 $805.85 $1,108.05
$681.83 $937.52 $843.07 $1,159.23
$712.23 $979.31 $880.66 $1,210.90
$744.67 $1,023.92 $920.77 $1,266.05
$760.74 $1,046.02 $940.64 $1,293.38
$793.18 $1,090.63 $980.75 $1,348.54
$821.24 $1,129.20 $1,015.45 $1,396.24
$839.65 $1,154.52 $1,038.21 $1,427.54
$862.74 $1,186.27 $1,066.76 $1,466.79
$876.77 $1,205.56 $1,084.11 $1,490.65
$876.77 $1,205.56 $1,084.11 $1,490.65
Yes
33871PA0110015
0%
$40 no ded/$80 no ded
$3,500
Gold
Keystone DPOS Gold Classic $2,000/$40/$80/100%
$2,000
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0100048
8
Keystone HMO Silver Classic $4,250 $40/$80/100%
Silver
$4,250
0%
$40 no ded/$80 no ded
Keystone Health Plan East Network
Yes
$7,150
Page Number: 22 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: January 1, 2017 - March 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110017 33871PA0110018
Non-Tobacco Tobacco Non-Tobacco Tobacco
$182.95 $182.95 $193.79 $193.79
$288.12 $324.13 $305.18 $343.33
$288.12 $324.13 $305.18 $343.33
$288.12 $324.13 $305.18 $343.33
$288.12 $324.13 $305.18 $343.33
$289.27 $325.43 $306.40 $344.70
$295.03 $331.91 $312.50 $351.57
$301.95 $339.69 $319.83 $359.80
$313.18 $352.33 $331.73 $373.19
$322.40 $362.70 $341.49 $384.18
$327.01 $384.24 $346.38 $406.99
$333.93 $392.36 $353.70 $415.60
$340.84 $400.49 $361.03 $424.21
$345.16 $405.57 $365.60 $429.58
$349.77 $410.98 $370.49 $435.32
$352.08 $413.69 $372.93 $438.19
$354.38 $416.40 $375.37 $441.06
$356.69 $419.11 $377.81 $443.93
$358.99 $421.82 $380.25 $446.80
$363.60 $427.23 $385.13 $452.53
$368.21 $451.06 $390.02 $477.77
$375.13 $459.53 $397.34 $486.74
$381.75 $467.65 $404.36 $495.34
$390.97 $478.94 $414.13 $507.30
$402.50 $493.06 $426.33 $522.26
$416.04 $509.65 $440.68 $539.83
$432.18 $529.41 $457.77 $560.76
$450.33 $551.65 $476.99 $584.32
$471.07 $577.06 $498.97 $611.23
$491.53 $602.12 $520.63 $637.78
$514.58 $707.54 $545.05 $749.44
$537.34 $738.84 $569.16 $782.59
$562.40 $773.31 $595.71 $819.10
$587.76 $808.17 $622.56 $856.02
$615.13 $845.80 $651.55 $895.89
$642.50 $883.44 $680.55 $935.75
$672.18 $924.24 $711.98 $978.97
$702.14 $965.44 $743.72 $1,022.61
$734.12 $1,009.42 $777.59 $1,069.19
$749.97 $1,031.21 $794.38 $1,092.27
$781.95 $1,075.18 $828.25 $1,138.85
$809.61 $1,113.21 $857.55 $1,179.13
$827.76 $1,138.17 $876.78 $1,205.57
$850.52 $1,169.47 $900.89 $1,238.72
$864.35 $1,188.48 $915.53 $1,258.86
$864.35 $1,188.48 $915.53 $1,258.86
Yes Yes
33871PA0110017
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$7,150 $7,150
Keystone Health Plan East Network
Silver Silver
Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone DPOS Silver Classic $4,250 $40/$80/100%
KE 670 WPR GMC
$3,500 $4,250
33871PA0110018
KE 670 WPR GMC
8 8
Keystone Health Plan East Network
Page Number: 23 05/05/2016
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100005 301.28
33871PA0100006 286.49
33871PA0100009 241.68
33871PA0100036 291.4
33871PA0100037 275.06
33871PA0110006 314.73
33871PA0110007 287.26
33871PA0110008 304.32
33871PA0110009 299.2
2017 On-Exchange Silver Plan Rates
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100024 302.14
33871PA0100025 287.34
33871PA0100045 242.53
33871PA0100048 292.26
33871PA0100049 275.91
33871PA0110016 315.58
33871PA0110017 288.12
33871PA0110018 305.18
33871PA0110019 300.05
2017 Off-Exchange Silver Plan Rates
Company On/Off Metal Network Rating
Exchange HIOS Plan ID Level AreaKHPE ON 33871PA0100001 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0100002 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0100003 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0100004 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0100005 Silver Keystone HMO Silver Classic $2,500 $25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0100006 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE ON 33871PA0100007 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100008 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE ON 33871PA0100009 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100020 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE OFF 33871PA0100021 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE OFF 33871PA0100022 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE OFF 33871PA0100023 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE OFF 33871PA0100024 Silver Keystone HMO Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE OFF 33871PA0100025 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100026 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE ON 33871PA0100035 Gold Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0100036 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0100037 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0100044 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8
KHPE OFF 33871PA0100045 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8
KHPE OFF 33871PA0100047 Gold Keystone HMO Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100048 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0100049 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE ON 33871PA0110001 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE ON 33871PA0110002 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE ON 33871PA0110003 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE ON 33871PA0110004 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE ON 33871PA0110005 Gold Keystone DPOS Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0110006 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE ON 33871PA0110007 Silver Keystone DPOS Silver Secure $3,500/$40/$80/$600 Keystone Health Plan East Network 8
KHPE ON 33871PA0110008 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0110009 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE ON 33871PA0110010 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110011 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110012 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110013 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110014 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110015 Gold Keystone DPOS Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110016 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110017 Silver Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110018 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110019 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110020 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
Keystone Health Plan East
Plan Design Summary
Plan Design Marketing Name
05/15/2015
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 201733871PA0100001 33871PA0100002
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band Non-Tobacco Tobacco Non-Tobacco Tobacco
0-20 $282.50 $282.50 $270.04 $270.04
21 $444.88 $500.49 $425.27 $478.42
22 $444.88 $500.49 $425.27 $478.42
23 $444.88 $500.49 $425.27 $478.42
24 $444.88 $500.49 $425.27 $478.42
25 $446.66 $502.49 $426.97 $480.34
26 $455.56 $512.50 $435.47 $489.91
27 $466.24 $524.52 $445.68 $501.39
28 $483.59 $544.03 $462.26 $520.05
29 $497.82 $560.05 $475.87 $535.36
30 $504.94 $593.30 $482.68 $567.15
31 $515.62 $605.85 $492.88 $579.14
32 $526.29 $618.40 $503.09 $591.13
33 $532.97 $626.24 $509.47 $598.63
34 $540.09 $634.60 $516.27 $606.62
35 $543.65 $638.78 $519.67 $610.62
36 $547.20 $642.96 $523.08 $614.62
37 $550.76 $647.15 $526.48 $618.61
38 $554.32 $651.33 $529.88 $622.61
39 $561.44 $659.69 $536.69 $630.61
40 $568.56 $696.48 $543.49 $665.78
41 $579.24 $709.56 $553.70 $678.28
42 $589.47 $722.10 $563.48 $690.26
43 $603.70 $739.54 $577.09 $706.93
44 $621.50 $761.34 $594.10 $727.77
45 $642.41 $786.95 $614.08 $752.25
46 $667.32 $817.47 $637.90 $781.43
47 $695.35 $851.80 $664.69 $814.25
48 $727.38 $891.04 $695.31 $851.75
49 $758.97 $929.74 $725.50 $888.74
50 $794.56 $1,092.52 $759.52 $1,044.35
51 $829.70 $1,140.84 $793.12 $1,090.54
52 $868.41 $1,194.06 $830.12 $1,141.41
53 $907.56 $1,247.89 $867.54 $1,192.87
54 $949.82 $1,306.01 $907.94 $1,248.42
55 $992.09 $1,364.12 $948.34 $1,303.97
56 $1,037.91 $1,427.12 $992.15 $1,364.20
57 $1,084.18 $1,490.74 $1,036.37 $1,425.01
58 $1,133.56 $1,558.64 $1,083.58 $1,489.92
59 $1,158.03 $1,592.29 $1,106.97 $1,522.08
60 $1,207.41 $1,660.19 $1,154.17 $1,586.99
61 $1,250.12 $1,718.91 $1,195.00 $1,643.12
62 $1,278.14 $1,757.45 $1,221.79 $1,679.96
63 $1,313.29 $1,805.77 $1,255.38 $1,726.15
64 $1,334.64 $1,835.14 $1,275.80 $1,754.22
65+ $1,334.64 $1,835.14 $1,275.80 $1,754.22
$0
0%
$3,000
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
No
Platinum
$4,000
Platinum
Keystone HMO Platinum Preferred $10/$20/$100
No
33871PA0100001
KE 670 WPR GMC
8
33871PA0100002
8
KE 670 WPR GMC
Keystone Health Plan East Network Keystone Health Plan East Network
$10/$20 $20/$40
Page Number: 2 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100003 33871PA0100004
Non-Tobacco Tobacco Non-Tobacco Tobacco
$222.67 $222.67 $229.91 $229.91
$350.66 $394.50 $362.07 $407.32
$350.66 $394.50 $362.07 $407.32
$350.66 $394.50 $362.07 $407.32
$350.66 $394.50 $362.07 $407.32
$352.07 $396.07 $363.51 $408.95
$359.08 $403.96 $370.76 $417.10
$367.49 $413.43 $379.44 $426.88
$381.17 $428.82 $393.57 $442.76
$392.39 $441.44 $405.15 $455.80
$398.00 $467.65 $410.94 $482.86
$406.42 $477.54 $419.63 $493.07
$414.83 $487.43 $428.32 $503.28
$420.09 $493.61 $433.75 $509.66
$425.70 $500.20 $439.55 $516.47
$428.51 $503.50 $442.44 $519.87
$431.32 $506.80 $445.34 $523.28
$434.12 $510.09 $448.24 $526.68
$436.93 $513.39 $451.13 $530.08
$442.54 $519.98 $456.93 $536.89
$448.15 $548.98 $462.72 $566.83
$456.56 $559.29 $471.41 $577.48
$464.63 $569.17 $479.74 $587.68
$475.85 $582.92 $491.32 $601.87
$489.88 $600.10 $505.81 $619.61
$506.36 $620.29 $522.82 $640.46
$525.99 $644.34 $543.10 $665.30
$548.09 $671.41 $565.91 $693.24
$573.33 $702.33 $591.98 $725.17
$598.23 $732.83 $617.68 $756.66
$626.28 $861.14 $646.65 $889.14
$653.99 $899.23 $675.25 $928.47
$684.49 $941.18 $706.75 $971.78
$715.35 $983.61 $738.61 $1,015.59
$748.67 $1,029.41 $773.01 $1,062.89
$781.98 $1,075.22 $807.41 $1,110.18
$818.10 $1,124.88 $844.70 $1,161.46
$854.57 $1,175.03 $882.35 $1,213.24
$893.49 $1,228.55 $922.54 $1,268.50
$912.78 $1,255.07 $942.46 $1,295.88
$951.70 $1,308.59 $982.65 $1,351.14
$985.36 $1,354.87 $1,017.40 $1,398.93
$1,007.45 $1,385.25 $1,040.22 $1,430.30
$1,035.16 $1,423.34 $1,068.82 $1,469.63
$1,051.98 $1,446.48 $1,086.20 $1,493.52
$1,051.98 $1,446.48 $1,086.20 $1,493.52
Gold
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0100004
Gold
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
No No
33871PA0100003
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 3 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100005 33871PA0100006
Non-Tobacco Tobacco Non-Tobacco Tobacco
$196.86 $196.86 $187.20 $187.20
$310.02 $348.77 $294.80 $331.65
$310.02 $348.77 $294.80 $331.65
$310.02 $348.77 $294.80 $331.65
$310.02 $348.77 $294.80 $331.65
$311.26 $350.17 $295.98 $332.97
$317.46 $357.14 $301.87 $339.61
$324.90 $365.51 $308.95 $347.57
$336.99 $379.12 $320.45 $360.50
$346.91 $390.28 $329.88 $371.11
$351.87 $413.45 $334.60 $393.15
$359.31 $422.19 $341.67 $401.46
$366.75 $430.94 $348.75 $409.78
$371.40 $436.40 $353.17 $414.97
$376.37 $442.23 $357.89 $420.52
$378.85 $445.14 $360.24 $423.29
$381.33 $448.06 $362.60 $426.06
$383.81 $450.97 $364.96 $428.83
$386.29 $453.89 $367.32 $431.60
$391.25 $459.71 $372.04 $437.14
$396.21 $485.35 $376.75 $461.52
$403.65 $494.47 $383.83 $470.19
$410.78 $503.20 $390.61 $478.49
$420.70 $515.36 $400.04 $490.05
$433.10 $530.55 $411.83 $504.50
$447.67 $548.40 $425.69 $521.47
$465.03 $569.66 $442.20 $541.69
$484.56 $593.59 $460.77 $564.44
$506.88 $620.93 $482.00 $590.44
$528.90 $647.90 $502.93 $616.08
$553.70 $761.33 $526.51 $723.95
$578.19 $795.01 $549.80 $755.97
$605.16 $832.10 $575.45 $791.24
$632.44 $869.61 $601.39 $826.91
$661.89 $910.10 $629.39 $865.42
$691.35 $950.60 $657.40 $903.93
$723.28 $994.51 $687.76 $945.68
$755.52 $1,038.84 $718.42 $987.83
$789.93 $1,086.16 $751.15 $1,032.83
$806.98 $1,109.60 $767.36 $1,055.12
$841.40 $1,156.92 $800.08 $1,100.11
$871.16 $1,197.84 $828.38 $1,139.03
$890.69 $1,224.70 $846.96 $1,164.56
$915.18 $1,258.37 $870.24 $1,196.59
$930.06 $1,278.84 $884.39 $1,216.04
$930.06 $1,278.84 $884.39 $1,216.04
33871PA0100005
$2,500
30%
$7,150
No
Silver
Keystone HMO Silver Classic $2,500 $25/$50/70%
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
Silver
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
No
33871PA0100006
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded
Page Number: 4 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100007 33871PA0100008
Non-Tobacco Tobacco Non-Tobacco Tobacco
$139.37 $139.37 $199.08 $199.08
$219.49 $246.92 $313.52 $352.71
$219.49 $246.92 $313.52 $352.71
$219.49 $246.92 $313.52 $352.71
$219.49 $246.92 $313.52 $352.71
$220.36 $247.91 $314.77 $354.12
$224.75 $252.85 $321.04 $361.17
$230.02 $258.77 $328.57 $369.64
$238.58 $268.40 $340.79 $383.39
$245.60 $276.30 $350.83 $394.68
$249.12 $292.71 $355.84 $418.12
$254.38 $298.90 $363.37 $426.96
$259.65 $305.09 $370.89 $435.80
$262.94 $308.96 $375.59 $441.32
$266.45 $313.08 $380.61 $447.22
$268.21 $315.15 $383.12 $450.16
$269.97 $317.21 $385.63 $453.11
$271.72 $319.27 $388.14 $456.06
$273.48 $321.34 $390.64 $459.01
$276.99 $325.46 $395.66 $464.90
$280.50 $343.61 $400.68 $490.83
$285.77 $350.07 $408.20 $500.05
$290.82 $356.25 $415.41 $508.88
$297.84 $364.86 $425.44 $521.17
$306.62 $375.61 $437.98 $536.53
$316.94 $388.25 $452.72 $554.58
$329.23 $403.30 $470.28 $576.09
$343.06 $420.24 $490.03 $600.29
$358.86 $439.60 $512.60 $627.94
$374.44 $458.69 $534.86 $655.21
$392.00 $539.00 $559.94 $769.92
$409.34 $562.84 $584.71 $803.98
$428.44 $589.10 $611.99 $841.48
$447.75 $615.66 $639.58 $879.42
$468.60 $644.33 $669.36 $920.37
$489.45 $673.00 $699.15 $961.32
$512.06 $704.08 $731.44 $1,005.73
$534.89 $735.47 $764.04 $1,050.56
$559.25 $768.97 $798.84 $1,098.41
$571.32 $785.56 $816.09 $1,122.12
$595.68 $819.06 $850.89 $1,169.97
$616.75 $848.04 $880.99 $1,211.36
$630.58 $867.05 $900.74 $1,238.51
$647.92 $890.89 $925.51 $1,272.57
$658.46 $905.38 $940.55 $1,293.26
$658.46 $905.38 $940.55 $1,293.26
33871PA0100007
Bronze
KE 670 WPR GMC
8
Keystone Health Plan East Network
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
No
$50 no ded/$100 no ded
No
$15/$40, $30/$60, $45/$80
Gold
Keystone HMO Gold Proactive
$0
0%/20%/30%
$7,150
33871PA0100008
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 5 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100009 33871PA0110001
Non-Tobacco Tobacco Non-Tobacco Tobacco
$157.91 $157.91 $295.60 $295.60
$248.68 $279.77 $465.50 $523.69
$248.68 $279.77 $465.50 $523.69
$248.68 $279.77 $465.50 $523.69
$248.68 $279.77 $465.50 $523.69
$249.68 $280.89 $467.37 $525.79
$254.65 $286.48 $476.68 $536.26
$260.62 $293.20 $487.85 $548.83
$270.32 $304.11 $506.00 $569.25
$278.28 $313.06 $520.90 $586.01
$282.26 $331.65 $528.35 $620.81
$288.22 $338.66 $539.52 $633.94
$294.19 $345.68 $550.69 $647.06
$297.92 $350.06 $557.67 $655.27
$301.90 $354.74 $565.12 $664.02
$303.89 $357.07 $568.85 $668.39
$305.88 $359.41 $572.57 $672.77
$307.87 $361.75 $576.29 $677.15
$309.86 $364.09 $580.02 $681.52
$313.84 $368.76 $587.47 $690.27
$317.82 $389.33 $594.91 $728.77
$323.79 $396.64 $606.09 $742.46
$329.51 $403.65 $616.79 $755.57
$337.46 $413.39 $631.69 $773.82
$347.41 $425.58 $650.31 $796.63
$359.10 $439.90 $672.19 $823.43
$373.03 $456.96 $698.26 $855.36
$388.69 $476.15 $727.58 $891.29
$406.60 $498.08 $761.10 $932.35
$424.26 $519.71 $794.15 $972.83
$444.15 $610.71 $831.39 $1,143.16
$463.80 $637.72 $868.17 $1,193.73
$485.43 $667.47 $908.66 $1,249.41
$507.32 $697.56 $949.63 $1,305.74
$530.94 $730.04 $993.85 $1,366.55
$554.57 $762.53 $1,038.07 $1,427.35
$580.18 $797.75 $1,086.02 $1,493.28
$606.04 $833.31 $1,134.43 $1,559.85
$633.65 $871.26 $1,186.10 $1,630.89
$647.32 $890.07 $1,211.71 $1,666.10
$674.93 $928.03 $1,263.38 $1,737.15
$698.80 $960.85 $1,308.07 $1,798.59
$714.47 $982.40 $1,337.39 $1,838.92
$734.12 $1,009.41 $1,374.17 $1,889.48
$746.04 $1,025.82 $1,396.50 $1,920.21
$746.04 $1,025.82 $1,396.50 $1,920.21
33871PA0100009
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone HMO Silver Proactive
$0/$5500/$5500
0%/5%/10%
$7,150
No
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
No
$10/$20
Platinum
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0110001
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 6 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110002 33871PA0110003
Non-Tobacco Tobacco Non-Tobacco Tobacco
$282.56 $282.56 $232.61 $232.61
$444.98 $500.60 $366.32 $412.11
$444.98 $500.60 $366.32 $412.11
$444.98 $500.60 $366.32 $412.11
$444.98 $500.60 $366.32 $412.11
$446.76 $502.61 $367.78 $413.76
$455.66 $512.62 $375.11 $422.00
$466.34 $524.63 $383.90 $431.89
$483.69 $544.16 $398.19 $447.96
$497.93 $560.18 $409.91 $461.15
$505.05 $593.44 $415.77 $488.53
$515.73 $605.99 $424.56 $498.86
$526.41 $618.54 $433.36 $509.19
$533.09 $626.38 $438.85 $515.65
$540.21 $634.74 $444.71 $522.54
$543.77 $638.93 $447.64 $525.98
$547.33 $643.11 $450.57 $529.42
$550.89 $647.29 $453.50 $532.87
$554.45 $651.48 $456.43 $536.31
$561.57 $659.84 $462.29 $543.20
$568.69 $696.64 $468.16 $573.49
$579.37 $709.72 $476.95 $584.26
$589.60 $722.26 $485.37 $594.58
$603.84 $739.70 $497.09 $608.94
$621.64 $761.51 $511.75 $626.89
$642.55 $787.13 $528.96 $647.98
$667.47 $817.65 $549.48 $673.11
$695.51 $852.00 $572.56 $701.38
$727.54 $891.24 $598.93 $733.69
$759.14 $929.94 $624.94 $765.55
$794.74 $1,092.76 $654.25 $899.59
$829.89 $1,141.10 $683.19 $939.38
$868.60 $1,194.33 $715.05 $983.20
$907.76 $1,248.17 $747.29 $1,027.52
$950.04 $1,306.30 $782.09 $1,075.38
$992.31 $1,364.42 $816.89 $1,123.23
$1,038.14 $1,427.45 $854.62 $1,175.11
$1,084.42 $1,491.08 $892.72 $1,227.49
$1,133.81 $1,558.99 $933.38 $1,283.40
$1,158.29 $1,592.64 $953.53 $1,311.10
$1,207.68 $1,660.56 $994.19 $1,367.01
$1,250.40 $1,719.30 $1,029.36 $1,415.37
$1,278.43 $1,757.84 $1,052.43 $1,447.10
$1,313.59 $1,806.18 $1,081.37 $1,486.89
$1,334.94 $1,835.55 $1,098.96 $1,511.07
$1,334.94 $1,835.55 $1,098.96 $1,511.07
33871PA0110002
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
No
$20/$40
No
$30/$60
Gold
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0110003
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 7 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
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43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110004 33871PA0110005
Non-Tobacco Tobacco Non-Tobacco Tobacco
$239.41 $239.41 $235.57 $235.57
$377.03 $424.16 $370.97 $417.34
$377.03 $424.16 $370.97 $417.34
$377.03 $424.16 $370.97 $417.34
$377.03 $424.16 $370.97 $417.34
$378.54 $425.85 $372.45 $419.01
$386.08 $434.34 $379.87 $427.36
$395.13 $444.52 $388.78 $437.37
$409.83 $461.06 $403.24 $453.65
$421.89 $474.63 $415.12 $467.00
$427.93 $502.81 $421.05 $494.73
$436.98 $513.45 $429.95 $505.20
$446.02 $524.08 $438.86 $515.66
$451.68 $530.72 $444.42 $522.20
$457.71 $537.81 $450.36 $529.17
$460.73 $541.36 $453.32 $532.66
$463.74 $544.90 $456.29 $536.14
$466.76 $548.44 $459.26 $539.63
$469.78 $551.99 $462.23 $543.12
$475.81 $559.08 $468.16 $550.09
$481.84 $590.26 $474.10 $580.77
$490.89 $601.34 $483.00 $591.68
$499.56 $611.96 $491.53 $602.13
$511.63 $626.74 $503.41 $616.67
$526.71 $645.22 $518.24 $634.85
$544.43 $666.92 $535.68 $656.21
$565.54 $692.79 $556.45 $681.66
$589.29 $721.89 $579.83 $710.29
$616.44 $755.14 $606.54 $743.01
$643.21 $787.93 $632.87 $775.27
$673.37 $925.89 $662.55 $911.01
$703.16 $966.84 $691.86 $951.31
$735.96 $1,011.94 $724.13 $995.68
$769.14 $1,057.56 $756.78 $1,040.57
$804.95 $1,106.81 $792.02 $1,089.03
$840.77 $1,156.06 $827.26 $1,137.49
$879.61 $1,209.46 $865.47 $1,190.02
$918.82 $1,263.37 $904.05 $1,243.07
$960.67 $1,320.92 $945.23 $1,299.69
$981.40 $1,349.43 $965.63 $1,327.75
$1,023.25 $1,406.97 $1,006.81 $1,384.37
$1,059.45 $1,456.74 $1,042.42 $1,433.33
$1,083.20 $1,489.40 $1,065.80 $1,465.47
$1,112.99 $1,530.36 $1,095.10 $1,505.77
$1,131.08 $1,555.24 $1,112.91 $1,530.25
$1,131.08 $1,555.24 $1,112.91 $1,530.25
33871PA0110004
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
No
$25 no ded/$50 no ded
No
$40 no ded/$80 no ded
GoldKeystone DPOS Gold Classic
$2,000 $40/$80/100%
$2,000
0%
$3,500
33871PA0110005
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 8 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
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44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110006 33871PA0110010
Non-Tobacco Tobacco Non-Tobacco Tobacco
$205.65 $205.65 $145.43 $145.43
$323.86 $364.34 $229.02 $257.65
$323.86 $364.34 $229.02 $257.65
$323.86 $364.34 $229.02 $257.65
$323.86 $364.34 $229.02 $257.65
$325.15 $365.80 $229.94 $258.68
$331.63 $373.08 $234.52 $263.84
$339.40 $381.83 $240.02 $270.02
$352.03 $396.04 $248.95 $280.07
$362.40 $407.70 $256.28 $288.31
$367.58 $431.90 $259.94 $305.43
$375.35 $441.04 $265.44 $311.89
$383.12 $450.17 $270.94 $318.35
$387.98 $455.88 $274.37 $322.39
$393.16 $461.97 $278.03 $326.69
$395.75 $465.01 $279.87 $328.84
$398.35 $468.06 $281.70 $331.00
$400.94 $471.10 $283.53 $333.15
$403.53 $474.14 $285.36 $335.30
$408.71 $480.23 $289.03 $339.61
$413.89 $507.02 $292.69 $358.55
$421.66 $516.54 $298.19 $365.28
$429.11 $525.66 $303.46 $371.73
$439.47 $538.36 $310.79 $380.71
$452.43 $554.23 $319.95 $391.93
$467.65 $572.87 $330.71 $405.12
$485.79 $595.09 $343.54 $420.83
$506.19 $620.08 $357.96 $438.51
$529.51 $648.65 $374.45 $458.71
$552.50 $676.81 $390.71 $478.63
$578.41 $795.31 $409.04 $562.43
$603.99 $830.49 $427.13 $587.30
$632.17 $869.23 $447.05 $614.70
$660.67 $908.42 $467.21 $642.41
$691.44 $950.72 $488.97 $672.33
$722.20 $993.03 $510.72 $702.24
$755.56 $1,038.90 $534.31 $734.68
$789.24 $1,085.21 $558.13 $767.43
$825.19 $1,134.64 $583.55 $802.39
$843.00 $1,159.13 $596.15 $819.70
$878.95 $1,208.56 $621.57 $854.66
$910.04 $1,251.31 $643.56 $884.89
$930.44 $1,279.36 $657.99 $904.73
$956.03 $1,314.54 $676.08 $929.61
$971.57 $1,335.91 $687.06 $944.72
$971.57 $1,335.91 $687.06 $944.72
33871PA0110006
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
No
$25 no ded/$50 no ded
No
$50 no ded/$100 no ded
Bronze
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0110010
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 9 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100020 33871PA0100021
Non-Tobacco Tobacco Non-Tobacco Tobacco
$283.06 $283.06 $270.60 $270.60
$445.76 $501.48 $426.14 $479.41
$445.76 $501.48 $426.14 $479.41
$445.76 $501.48 $426.14 $479.41
$445.76 $501.48 $426.14 $479.41
$447.54 $503.49 $427.85 $481.33
$456.46 $513.52 $436.37 $490.92
$467.16 $525.55 $446.60 $502.42
$484.54 $545.11 $463.22 $521.12
$498.81 $561.16 $476.86 $536.46
$505.94 $594.48 $483.67 $568.32
$516.64 $607.05 $493.90 $580.33
$527.33 $619.62 $504.13 $592.35
$534.02 $627.47 $510.52 $599.86
$541.15 $635.85 $517.34 $607.87
$544.72 $640.04 $520.75 $611.88
$548.28 $644.23 $524.16 $615.89
$551.85 $648.42 $527.57 $619.89
$555.42 $652.61 $530.98 $623.90
$562.55 $661.00 $537.79 $631.91
$569.68 $697.86 $544.61 $667.15
$580.38 $710.96 $554.84 $679.68
$590.63 $723.52 $564.64 $691.69
$604.90 $741.00 $578.28 $708.39
$622.73 $762.84 $595.32 $729.27
$643.68 $788.50 $615.35 $753.81
$668.64 $819.08 $639.22 $783.04
$696.72 $853.49 $666.06 $815.93
$728.82 $892.80 $696.75 $853.51
$760.47 $931.57 $727.00 $890.58
$796.13 $1,094.68 $761.09 $1,046.50
$831.34 $1,143.10 $794.76 $1,092.79
$870.12 $1,196.42 $831.83 $1,143.77
$909.35 $1,250.36 $869.33 $1,195.34
$951.70 $1,308.58 $909.82 $1,251.00
$994.04 $1,366.81 $950.30 $1,306.67
$1,039.96 $1,429.94 $994.20 $1,367.02
$1,086.32 $1,493.69 $1,038.51 $1,427.96
$1,135.80 $1,561.72 $1,085.82 $1,493.00
$1,160.31 $1,595.43 $1,109.25 $1,525.22
$1,209.79 $1,663.46 $1,156.56 $1,590.26
$1,252.59 $1,722.31 $1,197.47 $1,646.52
$1,280.67 $1,760.92 $1,224.31 $1,683.43
$1,315.88 $1,809.34 $1,257.98 $1,729.72
$1,337.28 $1,838.76 $1,278.42 $1,757.85
$1,337.28 $1,838.76 $1,278.42 $1,757.85
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
33871PA0100021
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
$4,000
Yes
Platinum
Keystone HMO Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0100020
$10/$20 $20/$40
Page Number: 10 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100022 33871PA0100023
Non-Tobacco Tobacco Non-Tobacco Tobacco
$223.23 $223.23 $230.47 $230.47
$351.54 $395.48 $362.94 $408.31
$351.54 $395.48 $362.94 $408.31
$351.54 $395.48 $362.94 $408.31
$351.54 $395.48 $362.94 $408.31
$352.95 $397.07 $364.40 $409.95
$359.98 $404.98 $371.66 $418.11
$368.42 $414.47 $380.37 $427.91
$382.13 $429.89 $394.52 $443.84
$393.37 $442.55 $406.13 $456.90
$399.00 $468.82 $411.94 $484.03
$407.44 $478.74 $420.65 $494.27
$415.87 $488.65 $429.36 $504.50
$421.15 $494.85 $434.81 $510.90
$426.77 $501.46 $440.61 $517.72
$429.58 $504.76 $443.52 $521.13
$432.40 $508.07 $446.42 $524.55
$435.21 $511.37 $449.33 $527.96
$438.02 $514.67 $452.23 $531.37
$443.65 $521.28 $458.04 $538.19
$449.27 $550.36 $463.84 $568.21
$457.71 $560.69 $472.55 $578.88
$465.79 $570.60 $480.90 $589.10
$477.04 $584.38 $492.52 $603.33
$491.10 $601.60 $507.03 $621.12
$507.63 $621.84 $524.09 $642.01
$527.31 $645.96 $544.42 $666.91
$549.46 $673.09 $567.28 $694.92
$574.77 $704.09 $593.41 $726.93
$599.73 $734.67 $619.18 $758.50
$627.85 $863.30 $648.22 $891.30
$655.62 $901.48 $676.89 $930.73
$686.21 $943.54 $708.47 $974.14
$717.14 $986.07 $740.41 $1,018.06
$750.54 $1,031.99 $774.89 $1,065.47
$783.94 $1,077.91 $809.37 $1,112.88
$820.15 $1,127.70 $846.75 $1,164.28
$856.71 $1,177.97 $884.50 $1,216.18
$895.73 $1,231.63 $924.78 $1,271.58
$915.06 $1,258.21 $944.74 $1,299.02
$954.08 $1,311.86 $985.03 $1,354.42
$987.83 $1,358.27 $1,019.87 $1,402.33
$1,009.98 $1,388.72 $1,042.74 $1,433.77
$1,037.75 $1,426.91 $1,071.41 $1,473.19
$1,054.62 $1,450.11 $1,088.82 $1,497.15
$1,054.62 $1,450.11 $1,088.82 $1,497.15
Yes
33871PA0100023
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
Yes
Gold
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0100022
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 11 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100024 33871PA0100025
Non-Tobacco Tobacco Non-Tobacco Tobacco
$197.42 $197.42 $187.75 $187.75
$310.90 $349.76 $295.68 $332.64
$310.90 $349.76 $295.68 $332.64
$310.90 $349.76 $295.68 $332.64
$310.90 $349.76 $295.68 $332.64
$312.14 $351.16 $296.86 $333.97
$318.36 $358.16 $302.77 $340.62
$325.82 $366.55 $309.87 $348.60
$337.95 $380.19 $321.40 $361.58
$347.90 $391.38 $330.86 $372.22
$352.87 $414.62 $335.59 $394.32
$360.33 $423.39 $342.69 $402.66
$367.79 $432.16 $349.79 $411.00
$372.46 $437.64 $354.22 $416.21
$377.43 $443.48 $358.95 $421.77
$379.92 $446.40 $361.32 $424.55
$382.41 $449.33 $363.68 $427.33
$384.89 $452.25 $366.05 $430.11
$387.38 $455.17 $368.41 $432.89
$392.36 $461.02 $373.14 $438.44
$397.33 $486.73 $377.88 $462.90
$404.79 $495.87 $384.97 $471.59
$411.94 $504.63 $391.77 $479.92
$421.89 $516.82 $401.23 $491.51
$434.33 $532.05 $413.06 $506.00
$448.94 $549.95 $426.96 $523.02
$466.35 $571.28 $443.52 $543.31
$485.94 $595.27 $462.14 $566.13
$508.32 $622.69 $483.43 $592.20
$530.39 $649.73 $504.42 $617.92
$555.27 $763.49 $528.08 $726.11
$579.83 $797.26 $551.44 $758.23
$606.88 $834.45 $577.16 $793.60
$634.23 $872.07 $603.18 $829.37
$663.77 $912.68 $631.27 $868.00
$693.31 $953.30 $659.36 $906.62
$725.33 $997.33 $689.81 $948.49
$757.66 $1,041.78 $720.56 $990.78
$792.17 $1,089.24 $753.38 $1,035.90
$809.27 $1,112.75 $769.65 $1,058.26
$843.78 $1,160.20 $802.47 $1,103.39
$873.63 $1,201.24 $830.85 $1,142.42
$893.21 $1,228.17 $849.48 $1,168.03
$917.77 $1,261.94 $872.84 $1,200.15
$932.70 $1,282.46 $887.03 $1,219.67
$932.70 $1,282.46 $887.03 $1,219.67
Yes
33871PA0100025
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
Yes
Silver
Keystone HMO Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
33871PA0100024
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded $30 no ded/$60 no ded
Page Number: 12 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100026 33871PA0110011
Non-Tobacco Tobacco Non-Tobacco Tobacco
$139.93 $139.93 $296.15 $296.15
$220.36 $247.91 $466.38 $524.68
$220.36 $247.91 $466.38 $524.68
$220.36 $247.91 $466.38 $524.68
$220.36 $247.91 $466.38 $524.68
$221.25 $248.90 $468.25 $526.78
$225.65 $253.86 $477.58 $537.27
$230.94 $259.81 $488.77 $549.87
$239.54 $269.48 $506.96 $570.33
$246.59 $277.41 $521.88 $587.12
$250.11 $293.88 $529.34 $621.98
$255.40 $300.10 $540.54 $635.13
$260.69 $306.31 $551.73 $648.28
$264.00 $310.19 $558.73 $656.50
$267.52 $314.34 $566.19 $665.27
$269.28 $316.41 $569.92 $669.66
$271.05 $318.48 $573.65 $674.04
$272.81 $320.55 $577.38 $678.42
$274.57 $322.62 $581.11 $682.81
$278.10 $326.77 $588.58 $691.58
$281.62 $344.99 $596.04 $730.15
$286.91 $351.47 $607.23 $743.86
$291.98 $357.68 $617.96 $757.00
$299.03 $366.32 $632.88 $775.28
$307.85 $377.11 $651.54 $798.13
$318.21 $389.80 $673.46 $824.98
$330.55 $404.92 $699.57 $856.98
$344.43 $421.92 $728.96 $892.97
$360.29 $441.36 $762.54 $934.11
$375.94 $460.53 $795.65 $974.67
$393.57 $541.16 $832.96 $1,145.32
$410.98 $565.10 $869.80 $1,195.98
$430.15 $591.46 $910.38 $1,251.77
$449.54 $618.12 $951.42 $1,308.20
$470.48 $646.91 $995.73 $1,369.13
$491.41 $675.69 $1,040.03 $1,430.05
$514.11 $706.90 $1,088.07 $1,496.10
$537.03 $738.41 $1,136.57 $1,562.79
$561.49 $772.04 $1,188.34 $1,633.97
$573.61 $788.71 $1,213.99 $1,669.24
$598.07 $822.34 $1,265.76 $1,740.42
$619.22 $851.43 $1,310.54 $1,801.99
$633.10 $870.52 $1,339.92 $1,842.39
$650.51 $894.46 $1,376.76 $1,893.05
$661.08 $909.00 $1,399.14 $1,923.83
$661.08 $909.00 $1,399.14 $1,923.83
Yes
33871PA0110011
KE 670 WPR GMC
8
Keystone Health Plan East Network
Platinum
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
Yes
Bronze
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0100026
KE 670 WPR GMC
8
Keystone Health Plan East Network
$10/$20$50 no ded/$100 no ded
Page Number: 13 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110012 33871PA0110013
Non-Tobacco Tobacco Non-Tobacco Tobacco
$283.12 $283.12 $233.17 $233.17
$445.86 $501.59 $367.20 $413.10
$445.86 $501.59 $367.20 $413.10
$445.86 $501.59 $367.20 $413.10
$445.86 $501.59 $367.20 $413.10
$447.64 $503.60 $368.67 $414.75
$456.56 $513.63 $376.01 $423.01
$467.26 $525.67 $384.82 $432.93
$484.65 $545.23 $399.14 $449.04
$498.92 $561.28 $410.89 $462.26
$506.05 $594.61 $416.77 $489.70
$516.75 $607.18 $425.58 $500.06
$527.45 $619.76 $434.39 $510.41
$534.14 $627.62 $439.90 $516.89
$541.27 $636.00 $445.78 $523.79
$544.84 $640.19 $448.72 $527.24
$548.41 $644.38 $451.65 $530.69
$551.97 $648.57 $454.59 $534.14
$555.54 $652.76 $457.53 $537.60
$562.68 $661.14 $463.40 $544.50
$569.81 $698.02 $469.28 $574.87
$580.51 $711.12 $478.09 $585.66
$590.76 $723.69 $486.54 $596.01
$605.03 $741.16 $498.29 $610.40
$622.87 $763.01 $512.98 $628.39
$643.82 $788.68 $530.23 $649.54
$668.79 $819.27 $550.80 $674.73
$696.88 $853.68 $573.93 $703.06
$728.98 $893.00 $600.37 $735.45
$760.64 $931.78 $626.44 $767.39
$796.31 $1,094.92 $655.81 $901.75
$831.53 $1,143.35 $684.82 $941.63
$870.32 $1,196.69 $716.77 $985.56
$909.55 $1,250.64 $749.08 $1,029.99
$951.91 $1,308.88 $783.97 $1,077.95
$994.27 $1,367.12 $818.85 $1,125.92
$1,040.19 $1,430.26 $856.67 $1,177.92
$1,086.56 $1,494.02 $894.86 $1,230.43
$1,136.05 $1,562.07 $935.62 $1,286.48
$1,160.57 $1,595.79 $955.82 $1,314.25
$1,210.06 $1,663.84 $996.57 $1,370.29
$1,252.87 $1,722.69 $1,031.83 $1,418.76
$1,280.96 $1,761.31 $1,054.96 $1,450.57
$1,316.18 $1,809.75 $1,083.97 $1,490.46
$1,337.58 $1,839.17 $1,101.59 $1,514.69
$1,337.58 $1,839.17 $1,101.59 $1,514.69
Yes
33871PA0110013
KE 670 WPR GMC
8
Keystone Health Plan East Network
Gold
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
Yes
Platinum
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
33871PA0110012
KE 670 WPR GMC
8
Keystone Health Plan East Network
$20/$40 $30/$60
Page Number: 14 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110014 33871PA0110016
Non-Tobacco Tobacco Non-Tobacco Tobacco
$239.97 $239.97 $206.21 $206.21
$377.91 $425.14 $324.74 $365.33
$377.91 $425.14 $324.74 $365.33
$377.91 $425.14 $324.74 $365.33
$377.91 $425.14 $324.74 $365.33
$379.42 $426.85 $326.04 $366.79
$386.98 $435.35 $332.53 $374.10
$396.05 $445.55 $340.32 $382.86
$410.78 $462.13 $352.99 $397.11
$422.88 $475.74 $363.38 $408.80
$428.92 $503.99 $368.58 $433.08
$437.99 $514.64 $376.37 $442.23
$447.06 $525.30 $384.16 $451.39
$452.73 $531.96 $389.03 $457.12
$458.78 $539.06 $394.23 $463.22
$461.80 $542.62 $396.83 $466.27
$464.83 $546.17 $399.43 $469.33
$467.85 $549.72 $402.02 $472.38
$470.87 $553.27 $404.62 $475.43
$476.92 $560.38 $409.82 $481.54
$482.96 $591.63 $415.01 $508.39
$492.03 $602.74 $422.81 $517.94
$500.73 $613.39 $430.28 $527.09
$512.82 $628.20 $440.67 $539.82
$527.94 $646.72 $453.66 $555.73
$545.70 $668.48 $468.92 $574.43
$566.86 $694.40 $487.10 $596.70
$590.67 $723.57 $507.56 $621.76
$617.88 $756.90 $530.94 $650.41
$644.71 $789.77 $554.00 $678.65
$674.94 $928.04 $579.98 $797.47
$704.80 $969.09 $605.63 $832.75
$737.67 $1,014.30 $633.89 $871.59
$770.93 $1,060.03 $662.46 $910.89
$806.83 $1,109.39 $693.31 $953.30
$842.73 $1,158.76 $724.16 $995.72
$881.66 $1,212.28 $757.61 $1,041.71
$920.96 $1,266.32 $791.38 $1,088.15
$962.91 $1,324.00 $827.43 $1,137.71
$983.69 $1,352.58 $845.29 $1,162.27
$1,025.64 $1,410.25 $881.33 $1,211.83
$1,061.92 $1,460.14 $912.51 $1,254.70
$1,085.73 $1,492.87 $932.97 $1,282.83
$1,115.58 $1,533.92 $958.62 $1,318.10
$1,133.72 $1,558.86 $974.21 $1,339.54
$1,133.72 $1,558.86 $974.21 $1,339.54
Yes
33871PA0110016
KE 670 WPR GMC
8
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
Yes
Gold
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0110014
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded$25 no ded/$50 no ded
Page Number: 15 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110019 33871PA0110020
Non-Tobacco Tobacco Non-Tobacco Tobacco
$196.06 $196.06 $145.99 $145.99
$308.75 $347.35 $229.90 $258.64
$308.75 $347.35 $229.90 $258.64
$308.75 $347.35 $229.90 $258.64
$308.75 $347.35 $229.90 $258.64
$309.99 $348.74 $230.82 $259.67
$316.16 $355.68 $235.42 $264.85
$323.57 $364.02 $240.94 $271.05
$335.61 $377.57 $249.90 $281.14
$345.49 $388.68 $257.26 $289.42
$350.43 $411.76 $260.94 $306.60
$357.84 $420.47 $266.46 $313.09
$365.25 $429.17 $271.97 $319.57
$369.89 $434.62 $275.42 $323.62
$374.83 $440.42 $279.10 $327.94
$377.30 $443.32 $280.94 $330.11
$379.77 $446.23 $282.78 $332.27
$382.24 $449.13 $284.62 $334.43
$384.71 $452.03 $286.46 $336.59
$389.65 $457.83 $290.14 $340.91
$394.59 $483.37 $293.82 $359.92
$402.00 $492.45 $299.33 $366.68
$409.10 $501.14 $304.62 $373.16
$418.98 $513.25 $311.98 $382.17
$431.33 $528.38 $321.17 $393.44
$445.84 $546.15 $331.98 $406.67
$463.13 $567.33 $344.85 $422.45
$482.58 $591.16 $359.34 $440.19
$504.81 $618.39 $375.89 $460.47
$526.73 $645.25 $392.21 $480.46
$551.43 $758.22 $410.61 $564.58
$575.82 $791.76 $428.77 $589.56
$602.69 $828.69 $448.77 $617.06
$629.86 $866.05 $469.00 $644.88
$659.19 $906.38 $490.84 $674.91
$688.52 $946.71 $512.68 $704.94
$720.32 $990.44 $536.36 $737.50
$752.43 $1,034.59 $560.27 $770.37
$786.70 $1,081.72 $585.79 $805.46
$803.68 $1,105.07 $598.44 $822.85
$837.96 $1,152.19 $623.96 $857.94
$867.60 $1,192.94 $646.03 $888.29
$887.05 $1,219.69 $660.51 $908.20
$911.44 $1,253.23 $678.67 $933.17
$926.25 $1,273.61 $689.70 $948.35
$926.25 $1,273.61 $689.70 $948.35
Yes
33871PA0110020
Yes
$6,850
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
50%
Bronze
$7,150
$50 no ded/$100 no ded
8
KE 670 WPR GMC
Keystone Health Plan East Network
Silver
Keystone DPOS Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
33871PA0110019
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
Page Number: 16 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100044 33871PA0100045
Non-Tobacco Tobacco Non-Tobacco Tobacco
$199.64 $199.64 $158.47 $158.47
$314.40 $353.70 $249.56 $280.76
$314.40 $353.70 $249.56 $280.76
$314.40 $353.70 $249.56 $280.76
$314.40 $353.70 $249.56 $280.76
$315.65 $355.11 $250.56 $281.88
$321.94 $362.18 $255.55 $287.50
$329.49 $370.67 $261.54 $294.23
$341.75 $384.47 $271.27 $305.18
$351.81 $395.79 $279.26 $314.17
$356.84 $419.29 $283.25 $332.82
$364.39 $428.15 $289.24 $339.86
$371.93 $437.02 $295.23 $346.90
$376.65 $442.56 $298.98 $351.30
$381.68 $448.47 $302.97 $355.99
$384.19 $451.43 $304.97 $358.33
$386.71 $454.38 $306.96 $360.68
$389.22 $457.34 $308.96 $363.03
$391.74 $460.29 $310.96 $365.37
$396.77 $466.20 $314.95 $370.06
$401.80 $492.20 $318.94 $390.70
$409.34 $501.45 $324.93 $398.04
$416.58 $510.30 $330.67 $405.07
$426.64 $522.63 $338.66 $414.85
$439.21 $538.03 $348.64 $427.08
$453.99 $556.14 $360.37 $441.45
$471.59 $577.70 $374.34 $458.57
$491.40 $601.97 $390.07 $477.83
$514.04 $629.70 $408.03 $499.84
$536.36 $657.04 $425.75 $521.55
$561.51 $772.08 $445.72 $612.86
$586.35 $806.23 $465.43 $639.97
$613.70 $843.84 $487.15 $669.83
$641.37 $881.88 $509.11 $700.02
$671.24 $922.95 $532.82 $732.62
$701.10 $964.02 $556.52 $765.22
$733.49 $1,008.54 $582.23 $800.57
$766.18 $1,053.50 $608.18 $836.25
$801.08 $1,101.49 $635.89 $874.34
$818.37 $1,125.26 $649.61 $893.22
$853.27 $1,173.25 $677.31 $931.31
$883.45 $1,214.75 $701.27 $964.25
$903.26 $1,241.98 $716.99 $985.87
$928.10 $1,276.14 $736.71 $1,012.97
$943.19 $1,296.89 $748.68 $1,029.45
$943.19 $1,296.89 $748.68 $1,029.45
33871PA0100044
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
$0
Keystone HMO Gold Proactive
0%/20%/30%
Gold
$7,150
$15/$40, $30/$60, $45/$80
Yes
$0/$5500/$5500
Keystone HMO Silver Proactive
0%/5%/10%
Silver
33871PA0100045
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
$7,150
Page Number: 17 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100035 33871PA0100037
Non-Tobacco Tobacco Non-Tobacco Tobacco
$228.78 $228.78 $179.73 $179.73
$360.29 $405.32 $283.04 $318.42
$360.29 $405.32 $283.04 $318.42
$360.29 $405.32 $283.04 $318.42
$360.29 $405.32 $283.04 $318.42
$361.73 $406.94 $284.17 $319.69
$368.93 $415.05 $289.83 $326.06
$377.58 $424.78 $296.62 $333.70
$391.63 $440.59 $307.66 $346.12
$403.16 $453.56 $316.72 $356.31
$408.93 $480.49 $321.25 $377.47
$417.57 $490.65 $328.04 $385.45
$426.22 $500.81 $334.83 $393.43
$431.62 $507.16 $339.08 $398.42
$437.39 $513.93 $343.61 $403.74
$440.27 $517.32 $345.87 $406.40
$443.15 $520.70 $348.14 $409.06
$446.04 $524.09 $350.40 $411.72
$448.92 $527.48 $352.67 $414.38
$454.68 $534.25 $357.19 $419.70
$460.45 $564.05 $361.72 $443.11
$469.09 $574.64 $368.52 $451.43
$477.38 $584.79 $375.03 $459.41
$488.91 $598.91 $384.08 $470.50
$503.32 $616.57 $395.40 $484.37
$520.25 $637.31 $408.71 $500.67
$540.43 $662.03 $424.56 $520.08
$563.13 $689.83 $442.39 $541.93
$589.07 $721.61 $462.77 $566.89
$614.65 $752.95 $482.86 $591.51
$643.47 $884.77 $505.51 $695.07
$671.93 $923.91 $527.87 $725.82
$703.28 $967.01 $552.49 $759.67
$734.99 $1,010.60 $577.40 $793.92
$769.21 $1,057.67 $604.29 $830.89
$803.44 $1,104.73 $631.17 $867.86
$840.55 $1,155.75 $660.33 $907.95
$878.02 $1,207.28 $689.76 $948.42
$918.01 $1,262.26 $721.18 $991.62
$937.83 $1,289.51 $736.75 $1,013.03
$977.82 $1,344.50 $768.16 $1,056.23
$1,012.41 $1,392.06 $795.34 $1,093.59
$1,035.10 $1,423.27 $813.17 $1,118.11
$1,063.57 $1,462.40 $835.53 $1,148.85
$1,080.86 $1,486.18 $849.11 $1,167.53
$1,080.86 $1,486.18 $849.11 $1,167.53
33871PA0100035
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
Gold Silver
$2,000 $3,500
$3,500 $7,150
No
0%
$40 no ded/$80 no ded
0%
Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone HMO Silver Secure $3,500 $40/$80/$600
33871PA0100037
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded
Page Number: 18 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100036 33871PA0110007
Non-Tobacco Tobacco Non-Tobacco Tobacco
$190.41 $190.41 $187.70 $187.70
$299.85 $337.33 $295.59 $332.54
$299.85 $337.33 $295.59 $332.54
$299.85 $337.33 $295.59 $332.54
$299.85 $337.33 $295.59 $332.54
$301.05 $338.68 $296.78 $333.87
$307.05 $345.43 $302.69 $340.52
$314.25 $353.53 $309.78 $348.51
$325.94 $366.68 $321.31 $361.47
$335.54 $377.48 $330.77 $372.12
$340.33 $399.89 $335.50 $394.21
$347.53 $408.35 $342.59 $402.55
$354.73 $416.80 $349.69 $410.88
$359.22 $422.09 $354.12 $416.09
$364.02 $427.73 $358.85 $421.65
$366.42 $430.54 $361.22 $424.43
$368.82 $433.36 $363.58 $427.21
$371.22 $436.18 $365.95 $429.99
$373.62 $439.00 $368.31 $432.76
$378.41 $444.64 $373.04 $438.32
$383.21 $469.43 $377.77 $462.77
$390.41 $478.25 $384.86 $471.46
$397.30 $486.70 $391.66 $479.79
$406.90 $498.45 $401.12 $491.37
$418.89 $513.15 $412.94 $505.86
$432.99 $530.41 $426.84 $522.88
$449.78 $550.98 $443.39 $543.15
$468.67 $574.12 $462.01 $565.97
$490.26 $600.57 $483.30 $592.04
$511.55 $626.65 $504.28 $617.75
$535.54 $736.36 $527.93 $725.90
$559.23 $768.94 $551.28 $758.01
$585.31 $804.80 $577.00 $793.37
$611.70 $841.09 $603.01 $829.14
$640.19 $880.26 $631.09 $867.75
$668.67 $919.42 $659.17 $906.36
$699.56 $961.89 $689.62 $948.23
$730.74 $1,004.77 $720.36 $990.50
$764.02 $1,050.53 $753.17 $1,035.61
$780.52 $1,073.21 $769.43 $1,057.97
$813.80 $1,118.98 $802.24 $1,103.08
$842.59 $1,158.56 $830.62 $1,142.10
$861.48 $1,184.53 $849.24 $1,167.71
$885.17 $1,217.10 $872.59 $1,199.82
$899.55 $1,236.89 $886.77 $1,219.32
$899.55 $1,236.89 $886.77 $1,219.32
Keystone Health Plan East Network
KE 670 WPR GMC
No
Silver Silver
$4,250 $3,500
$7,150 $7,150
No
Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone DPOS Silver Secure $3,500/$40/$80/$600
0% 0%
33871PA0110007
8
33871PA0100036
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded $40 no ded/$80 no ded
Page Number: 19 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
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55
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60
61
62
63
64
65+
33871PA0110008 33871PA0110009
Non-Tobacco Tobacco Non-Tobacco Tobacco
$198.85 $198.85 $195.50 $195.50
$313.15 $352.29 $307.87 $346.36
$313.15 $352.29 $307.87 $346.36
$313.15 $352.29 $307.87 $346.36
$313.15 $352.29 $307.87 $346.36
$314.40 $353.70 $309.11 $347.74
$320.67 $360.75 $315.26 $354.67
$328.18 $369.20 $322.65 $362.98
$340.39 $382.94 $334.66 $376.49
$350.41 $394.22 $344.51 $387.58
$355.42 $417.62 $349.44 $410.59
$362.94 $426.45 $356.83 $419.27
$370.46 $435.29 $364.22 $427.95
$375.15 $440.80 $368.83 $433.38
$380.16 $446.69 $373.76 $439.17
$382.67 $449.64 $376.22 $442.06
$385.17 $452.58 $378.69 $444.96
$387.68 $455.52 $381.15 $447.85
$390.18 $458.47 $383.61 $450.74
$395.19 $464.35 $388.54 $456.53
$400.21 $490.25 $393.46 $481.99
$407.72 $499.46 $400.85 $491.04
$414.92 $508.28 $407.93 $499.72
$424.94 $520.56 $417.79 $511.79
$437.47 $535.90 $430.10 $526.87
$452.19 $553.93 $444.57 $544.60
$469.72 $575.41 $461.81 $565.72
$489.45 $599.58 $481.21 $589.48
$512.00 $627.20 $503.37 $616.63
$534.23 $654.44 $525.23 $643.41
$559.29 $769.02 $549.86 $756.06
$584.02 $803.03 $574.19 $789.51
$611.27 $840.49 $600.97 $826.34
$638.83 $878.38 $628.06 $863.59
$668.57 $919.29 $657.31 $903.80
$698.32 $960.19 $686.56 $944.02
$730.58 $1,004.54 $718.27 $987.62
$763.15 $1,049.33 $750.29 $1,031.65
$797.91 $1,097.12 $784.46 $1,078.64
$815.13 $1,120.80 $801.40 $1,101.92
$849.89 $1,168.60 $835.57 $1,148.91
$879.95 $1,209.93 $865.13 $1,189.55
$899.68 $1,237.06 $884.52 $1,216.22
$924.42 $1,271.07 $908.85 $1,249.66
$939.45 $1,291.74 $923.61 $1,269.98
$939.45 $1,291.74 $923.61 $1,269.98
Keystone Health Plan East Network
8
KE 670 WPR GMC
50%
$30 no ded/$60 no ded
Keystone DPOS Silver Classic $4,250 $40/$80/100%
NoNo
0%
Silver
$4,250 $2,750
Keystone DPOS Silver Classic $2,750/$30/$60/50%
Silver
33871PA0110009
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0110008
8
$7,150
$40 no ded/$80 no ded
$7,150
Page Number: 20 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
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32
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57
58
59
60
61
62
63
64
65+
33871PA0100047 33871PA0100049
Non-Tobacco Tobacco Non-Tobacco Tobacco
$229.34 $229.34 $180.29 $180.29
$361.17 $406.31 $283.92 $319.41
$361.17 $406.31 $283.92 $319.41
$361.17 $406.31 $283.92 $319.41
$361.17 $406.31 $283.92 $319.41
$362.61 $407.94 $285.05 $320.68
$369.83 $416.06 $290.73 $327.07
$378.50 $425.81 $297.54 $334.74
$392.59 $441.66 $308.62 $347.19
$404.14 $454.66 $317.70 $357.42
$409.92 $481.66 $322.25 $378.64
$418.59 $491.84 $329.06 $386.64
$427.26 $502.03 $335.87 $394.65
$432.68 $508.39 $340.13 $399.65
$438.45 $515.18 $344.67 $404.99
$441.34 $518.58 $346.95 $407.66
$444.23 $521.97 $349.22 $410.33
$447.12 $525.37 $351.49 $413.00
$450.01 $528.76 $353.76 $415.67
$455.79 $535.55 $358.30 $421.01
$461.57 $565.42 $362.85 $444.49
$470.24 $576.04 $369.66 $452.83
$478.54 $586.22 $376.19 $460.83
$490.10 $600.37 $385.27 $471.96
$504.55 $618.07 $396.63 $485.87
$521.52 $638.87 $409.98 $502.22
$541.75 $663.64 $425.87 $521.70
$564.50 $691.51 $443.76 $543.61
$590.51 $723.37 $464.20 $568.65
$616.15 $754.78 $484.36 $593.34
$645.04 $886.93 $507.07 $697.23
$673.57 $926.16 $529.50 $728.07
$704.99 $969.37 $554.20 $762.03
$736.78 $1,013.07 $579.19 $796.39
$771.09 $1,060.25 $606.16 $833.47
$805.40 $1,107.42 $633.13 $870.56
$842.60 $1,158.57 $662.38 $910.77
$880.16 $1,210.22 $691.90 $951.37
$920.25 $1,265.34 $723.42 $994.70
$940.11 $1,292.66 $739.03 $1,016.17
$980.20 $1,347.78 $770.55 $1,059.51
$1,014.87 $1,395.45 $797.81 $1,096.98
$1,037.63 $1,426.74 $815.69 $1,121.58
$1,066.16 $1,465.97 $838.12 $1,152.42
$1,083.50 $1,489.81 $851.75 $1,171.16
$1,083.50 $1,489.81 $851.75 $1,171.16
33871PA0100047
KE 670 WPR GMC
33871PA0100049
KE 670 WPR GMC
Keystone Health Plan East Network
Yes Yes
Gold
$2,000
8
Keystone HMO Gold Classic $2,000 $40/$80/100%
8
Keystone HMO Silver Secure $3,500 $40/$80/$600
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$3,500
Keystone Health Plan East Network
Silver
$3,500 $7,150
Page Number: 21 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
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40
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45
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48
49
50
51
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53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100048 33871PA0110015
Non-Tobacco Tobacco Non-Tobacco Tobacco
$190.96 $190.96 $236.12 $236.12
$300.73 $338.32 $371.85 $418.33
$300.73 $338.32 $371.85 $418.33
$300.73 $338.32 $371.85 $418.33
$300.73 $338.32 $371.85 $418.33
$301.93 $339.68 $373.34 $420.00
$307.95 $346.44 $380.77 $428.37
$315.17 $354.56 $389.70 $438.41
$326.89 $367.76 $404.20 $454.72
$336.52 $378.58 $416.10 $468.11
$341.33 $401.06 $422.05 $495.91
$348.55 $409.54 $430.97 $506.39
$355.77 $418.02 $439.90 $516.88
$360.28 $423.32 $445.47 $523.43
$365.09 $428.98 $451.42 $530.42
$367.49 $431.81 $454.40 $533.92
$369.90 $434.63 $457.37 $537.41
$372.31 $437.46 $460.35 $540.91
$374.71 $440.29 $463.32 $544.40
$379.52 $445.94 $469.27 $551.40
$384.33 $470.81 $475.22 $582.15
$391.55 $479.65 $484.15 $593.08
$398.47 $488.12 $492.70 $603.56
$408.09 $499.91 $504.60 $618.13
$420.12 $514.65 $519.47 $636.35
$434.26 $531.96 $536.95 $657.76
$451.10 $552.59 $557.77 $683.27
$470.04 $575.80 $581.20 $711.97
$491.70 $602.33 $607.97 $744.77
$513.05 $628.48 $634.37 $777.11
$537.11 $738.52 $664.12 $913.17
$560.86 $771.19 $693.50 $953.56
$587.03 $807.16 $725.85 $998.04
$613.49 $843.55 $758.57 $1,043.03
$642.06 $882.83 $793.90 $1,091.61
$670.63 $922.12 $829.22 $1,140.18
$701.61 $964.71 $867.52 $1,192.84
$732.88 $1,007.71 $906.19 $1,246.02
$766.26 $1,053.61 $947.47 $1,302.77
$782.80 $1,076.36 $967.92 $1,330.89
$816.18 $1,122.25 $1,009.20 $1,387.64
$845.06 $1,161.95 $1,044.89 $1,436.73
$864.00 $1,188.00 $1,068.32 $1,468.94
$887.76 $1,220.67 $1,097.70 $1,509.33
$902.19 $1,240.52 $1,115.54 $1,533.87
$902.19 $1,240.52 $1,115.54 $1,533.87
Yes
33871PA0110015
0%
$40 no ded/$80 no ded
$3,500
Gold
Keystone DPOS Gold Classic $2,000/$40/$80/100%
$2,000
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0100048
8
Keystone HMO Silver Classic $4,250 $40/$80/100%
Silver
$4,250
0%
$40 no ded/$80 no ded
Keystone Health Plan East Network
Yes
$7,150
Page Number: 22 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: April 1, 2017 - June 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110017 33871PA0110018
Non-Tobacco Tobacco Non-Tobacco Tobacco
$188.26 $188.26 $199.41 $199.41
$296.47 $333.53 $314.03 $353.28
$296.47 $333.53 $314.03 $353.28
$296.47 $333.53 $314.03 $353.28
$296.47 $333.53 $314.03 $353.28
$297.66 $334.87 $315.28 $354.69
$303.59 $341.54 $321.56 $361.76
$310.70 $349.54 $329.10 $370.24
$322.27 $362.55 $341.35 $384.02
$331.75 $373.22 $351.40 $395.32
$336.50 $395.38 $356.42 $418.80
$343.61 $403.74 $363.96 $427.65
$350.73 $412.10 $371.50 $436.51
$355.17 $417.33 $376.21 $442.04
$359.92 $422.90 $381.23 $447.95
$362.29 $425.69 $383.74 $450.90
$364.66 $428.48 $386.25 $453.85
$367.03 $431.26 $388.77 $456.80
$369.40 $434.05 $391.28 $459.75
$374.15 $439.62 $396.30 $465.66
$378.89 $464.14 $401.33 $491.63
$386.01 $472.86 $408.86 $500.86
$392.83 $481.21 $416.09 $509.71
$402.31 $492.83 $426.14 $522.02
$414.17 $507.36 $438.70 $537.40
$428.11 $524.43 $453.46 $555.48
$444.71 $544.77 $471.04 $577.03
$463.39 $567.65 $490.83 $601.26
$484.73 $593.80 $513.44 $628.96
$505.78 $619.58 $535.73 $656.27
$529.50 $728.06 $560.85 $771.17
$552.92 $760.27 $585.66 $805.29
$578.71 $795.73 $612.98 $842.85
$604.80 $831.60 $640.62 $880.85
$632.97 $870.33 $670.45 $921.87
$661.13 $909.06 $700.28 $962.89
$691.67 $951.05 $732.63 $1,007.36
$722.50 $993.44 $765.29 $1,052.27
$755.41 $1,038.69 $800.14 $1,100.20
$771.72 $1,061.11 $817.42 $1,123.95
$804.63 $1,106.36 $852.27 $1,171.87
$833.09 $1,145.50 $882.42 $1,213.33
$851.77 $1,171.18 $902.20 $1,240.53
$875.19 $1,203.38 $927.01 $1,274.64
$889.41 $1,222.95 $942.08 $1,295.37
$889.41 $1,222.95 $942.08 $1,295.37
Yes Yes
33871PA0110017
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$7,150 $7,150
Keystone Health Plan East Network
Silver Silver
Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone DPOS Silver Classic $4,250 $40/$80/100%
KE 670 WPR GMC
$3,500 $4,250
33871PA0110018
KE 670 WPR GMC
8 8
Keystone Health Plan East Network
Page Number: 23 05/05/2016
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100005 310.02
33871PA0100006 294.8
33871PA0100009 248.68
33871PA0100036 299.85
33871PA0100037 283.04
33871PA0110006 323.86
33871PA0110007 295.59
33871PA0110008 313.15
33871PA0110009 307.87
2017 On-Exchange Silver Plan Rates
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100024 310.9
33871PA0100025 295.68
33871PA0100045 249.56
33871PA0100048 300.73
33871PA0100049 283.92
33871PA0110016 324.74
33871PA0110017 296.47
33871PA0110018 314.03
33871PA0110019 308.75
2017 Off-Exchange Silver Plan Rates
Company On/Off Metal Network Rating
Exchange HIOS Plan ID Level AreaKHPE ON 33871PA0100001 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0100002 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0100003 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0100004 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0100005 Silver Keystone HMO Silver Classic $2,500 $25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0100006 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE ON 33871PA0100007 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100008 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE ON 33871PA0100009 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100020 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE OFF 33871PA0100021 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE OFF 33871PA0100022 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE OFF 33871PA0100023 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE OFF 33871PA0100024 Silver Keystone HMO Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE OFF 33871PA0100025 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE OFF 33871PA0100026 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100035 Gold Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0100036 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0100037 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8KHPE OFF 33871PA0100044 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100045 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100047 Gold Keystone HMO Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8KHPE OFF 33871PA0100048 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8KHPE OFF 33871PA0100049 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8KHPE ON 33871PA0110001 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0110002 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0110003 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0110004 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0110005 Gold Keystone DPOS Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0110006 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0110007 Silver Keystone DPOS Silver Secure $3,500/$40/$80/$600 Keystone Health Plan East Network 8KHPE ON 33871PA0110008 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE ON 33871PA0110009 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE ON 33871PA0110010 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110011 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110012 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110013 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110014 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110015 Gold Keystone DPOS Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110016 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110017 Silver Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110018 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110019 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110020 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
Keystone Health Plan East
Plan Design Summary
Plan Design Marketing Name
05/15/2015
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 201733871PA0100001 33871PA0100002
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band Non-Tobacco Tobacco Non-Tobacco Tobacco
0-20 $290.71 $290.71 $277.89 $277.89
21 $457.81 $515.03 $437.62 $492.33
22 $457.81 $515.03 $437.62 $492.33
23 $457.81 $515.03 $437.62 $492.33
24 $457.81 $515.03 $437.62 $492.33
25 $459.64 $517.09 $439.37 $494.30
26 $468.80 $527.40 $448.13 $504.14
27 $479.78 $539.76 $458.63 $515.96
28 $497.64 $559.84 $475.70 $535.16
29 $512.29 $576.32 $489.70 $550.91
30 $519.61 $610.54 $496.70 $583.62
31 $530.60 $623.46 $507.21 $595.97
32 $541.59 $636.37 $517.71 $608.31
33 $548.45 $644.43 $524.27 $616.02
34 $555.78 $653.04 $531.27 $624.25
35 $559.44 $657.34 $534.78 $628.36
36 $563.10 $661.65 $538.28 $632.47
37 $566.77 $665.95 $541.78 $636.59
38 $570.43 $670.25 $545.28 $640.70
39 $577.75 $678.86 $552.28 $648.93
40 $585.08 $716.72 $559.28 $685.12
41 $596.07 $730.18 $569.79 $697.99
42 $606.60 $743.08 $579.85 $710.32
43 $621.25 $761.03 $593.85 $727.47
44 $639.56 $783.46 $611.36 $748.92
45 $661.08 $809.82 $631.93 $774.11
46 $686.71 $841.22 $656.43 $804.13
47 $715.55 $876.55 $684.00 $837.91
48 $748.52 $916.93 $715.51 $876.50
49 $781.02 $956.75 $746.58 $914.57
50 $817.65 $1,124.26 $781.59 $1,074.69
51 $853.81 $1,173.99 $816.17 $1,122.23
52 $893.64 $1,228.76 $854.24 $1,174.58
53 $933.93 $1,284.15 $892.75 $1,227.53
54 $977.42 $1,343.95 $934.33 $1,284.70
55 $1,020.91 $1,403.76 $975.90 $1,341.86
56 $1,068.07 $1,468.59 $1,020.97 $1,403.84
57 $1,115.68 $1,534.06 $1,066.49 $1,466.42
58 $1,166.50 $1,603.93 $1,115.06 $1,533.21
59 $1,191.68 $1,638.55 $1,139.13 $1,566.31
60 $1,242.49 $1,708.43 $1,187.71 $1,633.10
61 $1,286.44 $1,768.86 $1,229.72 $1,690.87
62 $1,315.28 $1,808.52 $1,257.29 $1,728.78
63 $1,351.45 $1,858.24 $1,291.86 $1,776.31
64 $1,373.43 $1,888.46 $1,312.86 $1,805.19
65+ $1,373.43 $1,888.46 $1,312.86 $1,805.19
$0
0%
$3,000
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
No
#NAME?
$4,000
#NAME?
Keystone HMO Platinum Preferred $10/$20/$100
No
33871PA0100001
KE 670 WPR GMC
8
33871PA0100002
8
KE 670 WPR GMC
Keystone Health Plan East Network Keystone Health Plan East Network
$10/$20 $20/$40
Page Number: 2 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100003 33871PA0100004
Non-Tobacco Tobacco Non-Tobacco Tobacco
$229.14 $229.14 $236.59 $236.59
$360.85 $405.96 $372.59 $419.16
$360.85 $405.96 $372.59 $419.16
$360.85 $405.96 $372.59 $419.16
$360.85 $405.96 $372.59 $419.16
$362.30 $407.58 $374.08 $420.84
$369.51 $415.70 $381.53 $429.22
$378.17 $425.44 $390.47 $439.28
$392.25 $441.28 $405.00 $455.63
$403.79 $454.27 $416.92 $469.04
$409.57 $481.24 $422.89 $496.89
$418.23 $491.42 $431.83 $507.40
$426.89 $501.59 $440.77 $517.90
$432.30 $507.95 $446.36 $524.47
$438.07 $514.74 $452.32 $531.48
$440.96 $518.13 $455.30 $534.98
$443.85 $521.52 $458.28 $538.48
$446.74 $524.91 $461.26 $541.98
$449.62 $528.31 $464.24 $545.49
$455.40 $535.09 $470.20 $552.49
$461.17 $564.93 $476.17 $583.30
$469.83 $575.54 $485.11 $594.26
$478.13 $585.71 $493.68 $604.75
$489.68 $599.85 $505.60 $619.36
$504.11 $617.54 $520.50 $637.62
$521.07 $638.31 $538.01 $659.07
$541.28 $663.07 $558.88 $684.63
$564.01 $690.91 $582.35 $713.38
$589.99 $722.74 $609.18 $746.24
$615.61 $754.13 $635.63 $778.65
$644.48 $886.16 $665.44 $914.98
$672.99 $925.36 $694.87 $955.45
$704.38 $968.53 $727.29 $1,000.02
$736.14 $1,012.19 $760.08 $1,045.11
$770.42 $1,059.33 $795.47 $1,093.77
$804.70 $1,106.46 $830.87 $1,142.44
$841.87 $1,157.57 $869.24 $1,195.21
$879.40 $1,209.17 $907.99 $1,248.49
$919.45 $1,264.25 $949.35 $1,305.36
$939.30 $1,291.54 $969.84 $1,333.53
$979.35 $1,346.61 $1,011.20 $1,390.40
$1,013.99 $1,394.24 $1,046.97 $1,439.58
$1,036.73 $1,425.50 $1,070.44 $1,471.86
$1,065.24 $1,464.70 $1,099.88 $1,512.33
$1,082.55 $1,488.52 $1,117.76 $1,536.92
$1,082.55 $1,488.52 $1,117.76 $1,536.92
#NAME?
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0100004
#NAME?
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
No No
33871PA0100003
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 3 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100005 33871PA0100006
Non-Tobacco Tobacco Non-Tobacco Tobacco
$202.58 $202.58 $192.64 $192.64
$319.03 $358.91 $303.36 $341.28
$319.03 $358.91 $303.36 $341.28
$319.03 $358.91 $303.36 $341.28
$319.03 $358.91 $303.36 $341.28
$320.31 $360.34 $304.58 $342.65
$326.69 $367.52 $310.65 $349.48
$334.34 $376.14 $317.93 $357.67
$346.78 $390.13 $329.76 $370.98
$356.99 $401.62 $339.46 $381.90
$362.10 $425.47 $344.32 $404.57
$369.75 $434.46 $351.60 $413.13
$377.41 $443.46 $358.88 $421.68
$382.20 $449.08 $363.43 $427.03
$387.30 $455.08 $368.28 $432.73
$389.85 $458.08 $370.71 $435.59
$392.41 $461.08 $373.14 $438.44
$394.96 $464.08 $375.57 $441.29
$397.51 $467.07 $377.99 $444.14
$402.61 $473.07 $382.85 $449.84
$407.72 $499.46 $387.70 $474.93
$415.38 $508.84 $394.98 $483.85
$422.71 $517.82 $401.96 $492.40
$432.92 $530.33 $411.67 $504.29
$445.68 $545.96 $423.80 $519.16
$460.68 $564.33 $438.06 $536.62
$478.54 $586.22 $455.05 $557.43
$498.64 $610.84 $474.16 $580.84
$521.61 $638.98 $496.00 $607.60
$544.26 $666.72 $517.54 $633.99
$569.79 $783.46 $541.81 $744.99
$594.99 $818.11 $565.77 $777.94
$622.74 $856.27 $592.17 $814.23
$650.82 $894.88 $618.86 $850.94
$681.13 $936.55 $647.68 $890.56
$711.44 $978.22 $676.50 $930.19
$744.30 $1,023.41 $707.75 $973.16
$777.47 $1,069.03 $739.30 $1,016.54
$812.89 $1,117.72 $772.97 $1,062.84
$830.43 $1,141.85 $789.66 $1,085.78
$865.85 $1,190.54 $823.33 $1,132.08
$896.47 $1,232.65 $852.45 $1,172.12
$916.57 $1,260.28 $871.57 $1,198.40
$941.77 $1,294.94 $895.53 $1,231.36
$957.09 $1,316.00 $910.08 $1,251.38
$957.09 $1,316.00 $910.08 $1,251.38
33871PA0100005
$2,500
30%
$7,150
No
#NAME?
Keystone HMO Silver Classic $2,500 $25/$50/70%
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
#NAME?
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
No
33871PA0100006
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded
Page Number: 4 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100007 33871PA0100008
Non-Tobacco Tobacco Non-Tobacco Tobacco
$143.42 $143.42 $204.87 $204.87
$225.86 $254.10 $322.63 $362.96
$225.86 $254.10 $322.63 $362.96
$225.86 $254.10 $322.63 $362.96
$225.86 $254.10 $322.63 $362.96
$226.77 $255.11 $323.92 $364.41
$231.28 $260.19 $330.37 $371.67
$236.70 $266.29 $338.11 $380.38
$245.51 $276.20 $350.70 $394.53
$252.74 $284.33 $361.02 $406.15
$256.35 $301.22 $366.18 $430.26
$261.77 $307.59 $373.93 $439.36
$267.20 $313.95 $381.67 $448.46
$270.58 $317.94 $386.51 $454.15
$274.20 $322.18 $391.67 $460.21
$276.00 $324.31 $394.25 $463.25
$277.81 $326.43 $396.83 $466.28
$279.62 $328.55 $399.41 $469.31
$281.43 $330.67 $401.99 $472.34
$285.04 $334.92 $407.16 $478.41
$288.65 $353.60 $412.32 $505.09
$294.07 $360.24 $420.06 $514.58
$299.27 $366.60 $427.48 $523.67
$306.50 $375.46 $437.81 $536.31
$315.53 $386.52 $450.71 $552.12
$326.15 $399.53 $465.87 $570.70
$338.79 $415.02 $483.94 $592.83
$353.02 $432.45 $504.27 $617.73
$369.29 $452.37 $527.50 $646.18
$385.32 $472.02 $550.40 $674.24
$403.39 $554.66 $576.21 $792.29
$421.23 $579.20 $601.70 $827.34
$440.88 $606.22 $629.77 $865.93
$460.76 $633.55 $658.16 $904.97
$482.22 $663.05 $688.81 $947.11
$503.67 $692.55 $719.46 $989.26
$526.94 $724.54 $752.69 $1,034.95
$550.43 $756.84 $786.24 $1,081.09
$575.50 $791.31 $822.06 $1,130.33
$587.92 $808.39 $839.80 $1,154.73
$612.99 $842.86 $875.61 $1,203.97
$634.67 $872.68 $906.58 $1,246.55
$648.90 $892.24 $926.91 $1,274.50
$666.75 $916.78 $952.40 $1,309.55
$677.58 $931.68 $967.88 $1,330.84
$677.58 $931.68 $967.88 $1,330.84
33871PA0100007
#NAME?
KE 670 WPR GMC
8
Keystone Health Plan East Network
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
No
$50 no ded/$100 no ded
No
$15/$40, $30/$60, $45/$80
#NAME?
Keystone HMO Gold Proactive
$0
0%/20%/30%
$7,150
33871PA0100008
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 5 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100009 33871PA0110001
Non-Tobacco Tobacco Non-Tobacco Tobacco
$162.50 $162.50 $304.18 $304.18
$255.91 $287.90 $479.03 $538.91
$255.91 $287.90 $479.03 $538.91
$255.91 $287.90 $479.03 $538.91
$255.91 $287.90 $479.03 $538.91
$256.93 $289.05 $480.95 $541.07
$262.05 $294.81 $490.53 $551.84
$268.19 $301.72 $502.02 $564.78
$278.17 $312.95 $520.71 $585.79
$286.36 $322.16 $536.04 $603.04
$290.46 $341.29 $543.70 $638.85
$296.60 $348.50 $555.20 $652.36
$302.74 $355.72 $566.69 $665.86
$306.58 $360.23 $573.88 $674.31
$310.67 $365.04 $581.54 $683.31
$312.72 $367.45 $585.38 $687.82
$314.77 $369.85 $589.21 $692.32
$316.82 $372.26 $593.04 $696.82
$318.86 $374.67 $596.87 $701.32
$322.96 $379.48 $604.54 $710.33
$327.05 $400.64 $612.20 $749.95
$333.20 $408.16 $623.70 $764.03
$339.08 $415.37 $634.72 $777.53
$347.27 $425.41 $650.04 $796.30
$357.51 $437.95 $669.21 $819.78
$369.53 $452.68 $691.72 $847.36
$383.87 $470.23 $718.55 $880.22
$399.99 $489.98 $748.72 $917.19
$418.41 $512.56 $783.21 $959.44
$436.58 $534.81 $817.23 $1,001.10
$457.06 $628.45 $855.55 $1,176.38
$477.27 $656.25 $893.39 $1,228.41
$499.54 $686.86 $935.07 $1,285.72
$522.06 $717.83 $977.22 $1,343.68
$546.37 $751.26 $1,022.73 $1,406.25
$570.68 $784.68 $1,068.24 $1,468.83
$597.04 $820.93 $1,117.58 $1,536.67
$623.65 $857.52 $1,167.40 $1,605.17
$652.06 $896.58 $1,220.57 $1,678.28
$666.13 $915.93 $1,246.92 $1,714.51
$694.54 $954.99 $1,300.09 $1,787.62
$719.11 $988.77 $1,346.08 $1,850.85
$735.23 $1,010.94 $1,376.25 $1,892.35
$755.45 $1,038.74 $1,414.10 $1,944.39
$767.73 $1,055.63 $1,437.09 $1,976.00
$767.73 $1,055.63 $1,437.09 $1,976.00
33871PA0100009
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Silver Proactive
$0/$5500/$5500
0%/5%/10%
$7,150
No
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
No
$10/$20
#NAME?
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0110001
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 6 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110002 33871PA0110003
Non-Tobacco Tobacco Non-Tobacco Tobacco
$290.77 $290.77 $239.37 $239.37
$457.91 $515.15 $376.96 $424.08
$457.91 $515.15 $376.96 $424.08
$457.91 $515.15 $376.96 $424.08
$457.91 $515.15 $376.96 $424.08
$459.74 $517.21 $378.47 $425.78
$468.90 $527.51 $386.01 $434.26
$479.89 $539.88 $395.06 $444.44
$497.75 $559.97 $409.76 $460.98
$512.40 $576.45 $421.82 $474.55
$519.73 $610.68 $427.85 $502.73
$530.72 $623.60 $436.90 $513.36
$541.71 $636.51 $445.95 $523.99
$548.58 $644.58 $451.60 $530.63
$555.90 $653.19 $457.63 $537.72
$559.57 $657.49 $460.65 $541.26
$563.23 $661.80 $463.66 $544.81
$566.89 $666.10 $466.68 $548.35
$570.56 $670.41 $469.70 $551.89
$577.88 $679.01 $475.73 $558.98
$585.21 $716.88 $481.76 $590.15
$596.20 $730.35 $490.81 $601.24
$606.73 $743.25 $499.48 $611.86
$621.39 $761.20 $511.54 $626.64
$639.70 $783.64 $526.62 $645.11
$661.22 $810.00 $544.34 $666.81
$686.87 $841.41 $565.44 $692.67
$715.72 $876.75 $589.19 $721.76
$748.69 $917.14 $616.34 $755.01
$781.20 $956.97 $643.10 $787.80
$817.83 $1,124.52 $673.26 $925.73
$854.01 $1,174.26 $703.04 $966.68
$893.84 $1,229.03 $735.83 $1,011.77
$934.14 $1,284.44 $769.01 $1,057.38
$977.64 $1,344.26 $804.82 $1,106.62
$1,021.14 $1,404.07 $840.63 $1,155.86
$1,068.31 $1,468.92 $879.46 $1,209.25
$1,115.93 $1,534.40 $918.66 $1,263.16
$1,166.76 $1,604.29 $960.50 $1,320.69
$1,191.94 $1,638.92 $981.24 $1,349.20
$1,242.77 $1,708.81 $1,023.08 $1,406.73
$1,286.73 $1,769.26 $1,059.27 $1,456.49
$1,315.58 $1,808.92 $1,083.02 $1,489.15
$1,351.75 $1,858.66 $1,112.80 $1,530.09
$1,373.73 $1,888.89 $1,130.88 $1,554.97
$1,373.73 $1,888.89 $1,130.88 $1,554.97
33871PA0110002
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
No
$20/$40
No
$30/$60
#NAME?
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0110003
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 7 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110004 33871PA0110005
Non-Tobacco Tobacco Non-Tobacco Tobacco
$246.37 $246.37 $242.41 $242.41
$387.98 $436.48 $381.75 $429.47
$387.98 $436.48 $381.75 $429.47
$387.98 $436.48 $381.75 $429.47
$387.98 $436.48 $381.75 $429.47
$389.54 $438.23 $383.28 $431.19
$397.30 $446.96 $390.91 $439.77
$406.61 $457.43 $400.07 $450.08
$421.74 $474.46 $414.96 $466.83
$434.15 $488.42 $427.18 $480.57
$440.36 $517.42 $433.29 $509.11
$449.67 $528.37 $442.45 $519.88
$458.98 $539.31 $451.61 $530.64
$464.80 $546.15 $457.34 $537.37
$471.01 $553.44 $463.44 $544.55
$474.12 $557.09 $466.50 $548.13
$477.22 $560.73 $469.55 $551.72
$480.32 $564.38 $472.61 $555.31
$483.43 $568.03 $475.66 $558.90
$489.64 $575.32 $481.77 $566.08
$495.84 $607.41 $487.88 $597.65
$505.15 $618.81 $497.04 $608.87
$514.08 $629.75 $505.82 $619.63
$526.49 $644.95 $518.03 $634.59
$542.01 $663.97 $533.30 $653.30
$560.25 $686.30 $551.25 $675.28
$581.98 $712.92 $572.62 $701.46
$606.42 $742.86 $596.67 $730.93
$634.35 $777.08 $624.16 $764.60
$661.90 $810.83 $651.26 $797.80
$692.94 $952.79 $681.80 $937.48
$723.59 $994.94 $711.96 $978.95
$757.34 $1,041.35 $745.17 $1,024.61
$791.49 $1,088.29 $778.77 $1,070.81
$828.34 $1,138.97 $815.03 $1,120.67
$865.20 $1,189.65 $851.30 $1,170.54
$905.17 $1,244.60 $890.62 $1,224.60
$945.52 $1,300.08 $930.32 $1,279.19
$988.58 $1,359.30 $972.70 $1,337.46
$1,009.92 $1,388.64 $993.69 $1,366.33
$1,052.99 $1,447.86 $1,036.07 $1,424.59
$1,090.23 $1,499.07 $1,072.71 $1,474.98
$1,114.68 $1,532.68 $1,096.76 $1,508.05
$1,145.33 $1,574.83 $1,126.92 $1,549.52
$1,163.94 $1,600.43 $1,145.25 $1,574.71
$1,163.94 $1,600.43 $1,145.25 $1,574.71
33871PA0110004
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
No
$25 no ded/$50 no ded
No
$40 no ded/$80 no ded
#NAME?Keystone DPOS Gold Classic
$2,000 $40/$80/100%
$2,000
0%
$3,500
33871PA0110005
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 8 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
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43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110006 33871PA0110010
Non-Tobacco Tobacco Non-Tobacco Tobacco
$211.63 $211.63 $149.66 $149.66
$333.27 $374.93 $235.68 $265.14
$333.27 $374.93 $235.68 $265.14
$333.27 $374.93 $235.68 $265.14
$333.27 $374.93 $235.68 $265.14
$334.60 $376.43 $236.62 $266.20
$341.27 $383.92 $241.33 $271.50
$349.27 $392.92 $246.99 $277.87
$362.26 $407.55 $256.18 $288.21
$372.93 $419.54 $263.72 $296.69
$378.26 $444.45 $267.50 $314.31
$386.26 $453.85 $273.15 $320.95
$394.26 $463.25 $278.81 $327.60
$399.26 $469.12 $282.34 $331.75
$404.59 $475.39 $286.11 $336.18
$407.25 $478.52 $288.00 $338.40
$409.92 $481.66 $289.88 $340.61
$412.59 $484.79 $291.77 $342.83
$415.25 $487.92 $293.66 $345.05
$420.58 $494.19 $297.43 $349.48
$425.92 $521.75 $301.20 $368.97
$433.92 $531.55 $306.85 $375.90
$441.58 $540.94 $312.27 $382.54
$452.24 $554.00 $319.82 $391.77
$465.58 $570.33 $329.24 $403.32
$481.24 $589.52 $340.32 $416.89
$499.90 $612.38 $353.52 $433.06
$520.90 $638.10 $368.37 $451.25
$544.89 $667.49 $385.33 $472.03
$568.56 $696.48 $402.07 $492.53
$595.22 $818.42 $420.92 $578.77
$621.55 $854.62 $439.54 $604.37
$650.54 $894.49 $460.04 $632.56
$679.87 $934.82 $480.78 $661.08
$711.53 $978.35 $503.17 $691.86
$743.19 $1,021.88 $525.56 $722.65
$777.51 $1,069.08 $549.84 $756.03
$812.17 $1,116.74 $574.35 $789.73
$849.17 $1,167.61 $600.51 $825.70
$867.50 $1,192.81 $613.47 $843.52
$904.49 $1,243.67 $639.63 $879.49
$936.48 $1,287.66 $662.26 $910.60
$957.48 $1,316.53 $677.10 $931.02
$983.81 $1,352.74 $695.72 $956.62
$999.80 $1,374.73 $707.04 $972.17
$999.80 $1,374.73 $707.04 $972.17
33871PA0110006
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
No
$25 no ded/$50 no ded
No
$50 no ded/$100 no ded
#NAME?
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0110010
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 9 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100020 33871PA0100021
Non-Tobacco Tobacco Non-Tobacco Tobacco
$291.28 $291.28 $278.46 $278.46
$458.71 $516.05 $438.53 $493.34
$458.71 $516.05 $438.53 $493.34
$458.71 $516.05 $438.53 $493.34
$458.71 $516.05 $438.53 $493.34
$460.55 $518.12 $440.28 $495.32
$469.72 $528.44 $449.05 $505.18
$480.73 $540.82 $459.58 $517.02
$498.62 $560.95 $476.68 $536.26
$513.30 $577.46 $490.71 $552.05
$520.64 $611.75 $497.73 $584.83
$531.65 $624.69 $508.25 $597.20
$542.66 $637.62 $518.78 $609.56
$549.54 $645.71 $525.36 $617.29
$556.88 $654.33 $532.37 $625.54
$560.55 $658.64 $535.88 $629.66
$564.22 $662.95 $539.39 $633.78
$567.89 $667.27 $542.90 $637.90
$571.56 $671.58 $546.40 $642.03
$578.90 $680.20 $553.42 $650.27
$586.23 $718.14 $560.44 $686.54
$597.24 $731.62 $570.96 $699.43
$607.79 $744.55 $581.05 $711.78
$622.47 $762.53 $595.08 $728.97
$640.82 $785.01 $612.62 $750.46
$662.38 $811.42 $633.23 $775.71
$688.07 $842.88 $657.79 $805.79
$716.97 $878.29 $685.42 $839.64
$750.00 $918.74 $716.99 $878.31
$782.56 $958.64 $748.13 $916.46
$819.26 $1,126.48 $783.21 $1,076.91
$855.50 $1,176.31 $817.85 $1,124.55
$895.41 $1,231.18 $856.00 $1,177.01
$935.77 $1,286.69 $894.60 $1,230.07
$979.35 $1,346.61 $936.26 $1,287.35
$1,022.93 $1,406.53 $977.92 $1,344.63
$1,070.18 $1,471.49 $1,023.08 $1,406.74
$1,117.88 $1,537.09 $1,068.69 $1,469.45
$1,168.80 $1,607.10 $1,117.37 $1,536.38
$1,194.03 $1,641.79 $1,141.49 $1,569.54
$1,244.95 $1,711.80 $1,190.16 $1,636.47
$1,288.98 $1,772.35 $1,232.26 $1,694.36
$1,317.88 $1,812.09 $1,259.89 $1,732.35
$1,354.12 $1,861.91 $1,294.53 $1,779.98
$1,376.13 $1,892.19 $1,315.58 $1,808.92
$1,376.13 $1,892.19 $1,315.58 $1,808.92
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
33871PA0100021
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
$4,000
Yes
#NAME?
Keystone HMO Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0100020
$10/$20 $20/$40
Page Number: 10 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100022 33871PA0100023
Non-Tobacco Tobacco Non-Tobacco Tobacco
$229.72 $229.72 $237.17 $237.17
$361.76 $406.98 $373.49 $420.18
$361.76 $406.98 $373.49 $420.18
$361.76 $406.98 $373.49 $420.18
$361.76 $406.98 $373.49 $420.18
$363.20 $408.60 $374.98 $421.86
$370.44 $416.74 $382.45 $430.26
$379.12 $426.51 $391.42 $440.35
$393.23 $442.38 $405.98 $456.73
$404.81 $455.41 $417.94 $470.18
$410.59 $482.45 $423.91 $498.10
$419.28 $492.65 $432.88 $508.63
$427.96 $502.85 $441.84 $519.16
$433.38 $509.23 $447.44 $525.74
$439.17 $516.03 $453.42 $532.77
$442.07 $519.43 $456.41 $536.28
$444.96 $522.83 $459.39 $539.79
$447.85 $526.23 $462.38 $543.30
$450.75 $529.63 $465.37 $546.81
$456.54 $536.43 $471.35 $553.83
$462.32 $566.35 $477.32 $584.72
$471.01 $576.98 $486.28 $595.70
$479.33 $587.18 $494.88 $606.22
$490.90 $601.36 $506.83 $620.86
$505.37 $619.08 $521.77 $639.16
$522.38 $639.91 $539.32 $660.67
$542.63 $664.73 $560.24 $686.29
$565.43 $692.65 $583.77 $715.11
$591.47 $724.55 $610.66 $748.05
$617.16 $756.02 $637.17 $780.54
$646.10 $888.38 $667.05 $917.20
$674.68 $927.68 $696.56 $957.77
$706.15 $970.95 $729.05 $1,002.45
$737.98 $1,014.73 $761.92 $1,047.64
$772.35 $1,061.98 $797.40 $1,096.43
$806.72 $1,109.24 $832.88 $1,145.22
$843.98 $1,160.47 $871.35 $1,198.11
$881.60 $1,212.20 $910.20 $1,251.52
$921.76 $1,267.41 $951.65 $1,308.52
$941.65 $1,294.77 $972.20 $1,336.77
$981.81 $1,349.98 $1,013.65 $1,393.77
$1,016.54 $1,397.74 $1,049.51 $1,443.07
$1,039.33 $1,429.07 $1,073.04 $1,475.43
$1,067.90 $1,468.37 $1,102.54 $1,516.00
$1,085.27 $1,492.24 $1,120.47 $1,540.65
$1,085.27 $1,492.24 $1,120.47 $1,540.65
Yes
33871PA0100023
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
Yes
#NAME?
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0100022
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60 $25 no ded/$50 no ded
Page Number: 11 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100024 33871PA0100025
Non-Tobacco Tobacco Non-Tobacco Tobacco
$203.16 $203.16 $193.21 $193.21
$319.93 $359.92 $304.27 $342.30
$319.93 $359.92 $304.27 $342.30
$319.93 $359.92 $304.27 $342.30
$319.93 $359.92 $304.27 $342.30
$321.21 $361.36 $305.49 $343.67
$327.61 $368.56 $311.57 $350.52
$335.29 $377.20 $318.87 $358.73
$347.77 $391.24 $330.74 $372.08
$358.01 $402.76 $340.48 $383.04
$363.12 $426.67 $345.34 $405.78
$370.80 $435.69 $352.65 $414.36
$378.48 $444.72 $359.95 $422.94
$383.28 $450.35 $364.51 $428.30
$388.40 $456.37 $369.38 $434.02
$390.96 $459.38 $371.82 $436.88
$393.52 $462.38 $374.25 $439.74
$396.08 $465.39 $376.68 $442.60
$398.64 $468.40 $379.12 $445.46
$403.76 $474.41 $383.99 $451.18
$408.87 $500.87 $388.86 $476.35
$416.55 $510.28 $396.16 $485.29
$423.91 $519.29 $403.16 $493.87
$434.15 $531.83 $412.89 $505.79
$446.95 $547.51 $425.06 $520.70
$461.98 $565.93 $439.36 $538.22
$479.90 $587.88 $456.40 $559.09
$500.06 $612.57 $475.57 $582.58
$523.09 $640.79 $497.48 $609.41
$545.81 $668.61 $519.08 $635.88
$571.40 $785.68 $543.42 $747.21
$596.68 $820.43 $567.46 $780.26
$624.51 $858.70 $593.93 $816.66
$652.66 $897.41 $620.71 $853.47
$683.06 $939.20 $649.61 $893.22
$713.45 $981.00 $678.52 $932.96
$746.40 $1,026.31 $709.86 $976.06
$779.68 $1,072.06 $741.50 $1,019.57
$815.19 $1,120.89 $775.28 $1,066.00
$832.79 $1,145.08 $792.01 $1,089.01
$868.30 $1,193.91 $825.78 $1,135.45
$899.01 $1,236.14 $854.99 $1,175.62
$919.17 $1,263.86 $874.16 $1,201.97
$944.44 $1,298.61 $898.20 $1,235.03
$959.79 $1,319.72 $912.81 $1,255.11
$959.79 $1,319.72 $912.81 $1,255.11
Yes
33871PA0100025
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
Yes
#NAME?
Keystone HMO Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
33871PA0100024
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded $30 no ded/$60 no ded
Page Number: 12 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100026 33871PA0110011
Non-Tobacco Tobacco Non-Tobacco Tobacco
$144.00 $144.00 $304.76 $304.76
$226.77 $255.11 $479.93 $539.93
$226.77 $255.11 $479.93 $539.93
$226.77 $255.11 $479.93 $539.93
$226.77 $255.11 $479.93 $539.93
$227.67 $256.13 $481.85 $542.09
$232.21 $261.24 $491.45 $552.88
$237.65 $267.36 $502.97 $565.84
$246.50 $277.31 $521.69 $586.90
$253.75 $285.47 $537.05 $604.18
$257.38 $302.42 $544.73 $640.05
$262.82 $308.82 $556.24 $653.59
$268.27 $315.21 $567.76 $667.12
$271.67 $319.21 $574.96 $675.58
$275.30 $323.47 $582.64 $684.60
$277.11 $325.60 $586.48 $689.11
$278.92 $327.73 $590.32 $693.63
$280.74 $329.87 $594.16 $698.14
$282.55 $332.00 $598.00 $702.65
$286.18 $336.26 $605.68 $711.67
$289.81 $355.01 $613.36 $751.36
$295.25 $361.68 $624.87 $765.47
$300.47 $368.07 $635.91 $778.99
$307.72 $376.96 $651.27 $797.81
$316.79 $388.07 $670.47 $821.32
$327.45 $401.13 $693.03 $848.96
$340.15 $416.68 $719.90 $881.88
$354.44 $434.18 $750.14 $918.92
$370.76 $454.19 $784.69 $961.25
$386.86 $473.91 $818.77 $1,002.99
$405.01 $556.88 $857.16 $1,178.60
$422.92 $581.52 $895.08 $1,230.73
$442.65 $608.64 $936.83 $1,288.14
$462.60 $636.08 $979.07 $1,346.22
$484.15 $665.70 $1,024.66 $1,408.91
$505.69 $695.32 $1,070.25 $1,471.60
$529.05 $727.44 $1,119.69 $1,539.57
$552.63 $759.87 $1,169.60 $1,608.20
$577.80 $794.48 $1,222.87 $1,681.45
$590.27 $811.63 $1,249.27 $1,717.75
$615.45 $846.24 $1,302.54 $1,791.00
$637.21 $876.17 $1,348.62 $1,854.35
$651.50 $895.81 $1,378.85 $1,895.92
$669.42 $920.45 $1,416.77 $1,948.05
$680.30 $935.41 $1,439.79 $1,979.73
$680.30 $935.41 $1,439.79 $1,979.73
Yes
33871PA0110011
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
Yes
#NAME?
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0100026
KE 670 WPR GMC
8
Keystone Health Plan East Network
$10/$20$50 no ded/$100 no ded
Page Number: 13 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110012 33871PA0110013
Non-Tobacco Tobacco Non-Tobacco Tobacco
$291.35 $291.35 $239.95 $239.95
$458.82 $516.17 $377.87 $425.10
$458.82 $516.17 $377.87 $425.10
$458.82 $516.17 $377.87 $425.10
$458.82 $516.17 $377.87 $425.10
$460.65 $518.23 $379.38 $426.80
$469.83 $528.56 $386.94 $435.30
$480.84 $540.94 $396.01 $445.51
$498.73 $561.07 $410.74 $462.08
$513.41 $577.59 $422.83 $475.69
$520.76 $611.89 $428.88 $503.93
$531.77 $624.83 $437.95 $514.59
$542.78 $637.77 $447.02 $525.25
$549.66 $645.85 $452.69 $531.91
$557.00 $654.48 $458.73 $539.01
$560.67 $658.79 $461.75 $542.56
$564.34 $663.10 $464.78 $546.11
$568.01 $667.42 $467.80 $549.66
$571.68 $671.73 $470.82 $553.22
$579.03 $680.35 $476.87 $560.32
$586.37 $718.30 $482.91 $591.57
$597.38 $731.79 $491.98 $602.68
$607.93 $744.72 $500.67 $613.33
$622.61 $762.70 $512.77 $628.14
$640.97 $785.18 $527.88 $646.65
$662.53 $811.60 $545.64 $668.41
$688.22 $843.07 $566.80 $694.33
$717.13 $878.48 $590.61 $723.49
$750.16 $918.95 $617.81 $756.82
$782.74 $958.86 $644.64 $789.69
$819.44 $1,126.74 $674.87 $927.95
$855.69 $1,176.58 $704.72 $968.99
$895.61 $1,231.46 $737.60 $1,014.20
$935.98 $1,286.98 $770.85 $1,059.92
$979.57 $1,346.91 $806.75 $1,109.28
$1,023.16 $1,406.84 $842.64 $1,158.64
$1,070.42 $1,471.82 $881.56 $1,212.15
$1,118.13 $1,537.43 $920.86 $1,266.19
$1,169.06 $1,607.46 $962.81 $1,323.86
$1,194.30 $1,642.16 $983.59 $1,352.43
$1,245.23 $1,712.19 $1,025.53 $1,410.11
$1,289.27 $1,772.75 $1,061.81 $1,459.99
$1,318.18 $1,812.49 $1,085.61 $1,492.72
$1,354.42 $1,862.33 $1,115.46 $1,533.76
$1,376.45 $1,892.61 $1,133.60 $1,558.70
$1,376.45 $1,892.61 $1,133.60 $1,558.70
Yes
33871PA0110013
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
Yes
#NAME?
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
33871PA0110012
KE 670 WPR GMC
8
Keystone Health Plan East Network
$20/$40 $30/$60
Page Number: 14 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110014 33871PA0110016
Non-Tobacco Tobacco Non-Tobacco Tobacco
$246.94 $246.94 $212.20 $212.20
$388.89 $437.50 $334.17 $375.94
$388.89 $437.50 $334.17 $375.94
$388.89 $437.50 $334.17 $375.94
$388.89 $437.50 $334.17 $375.94
$390.44 $439.25 $335.51 $377.45
$398.22 $448.00 $342.19 $384.97
$407.55 $458.50 $350.21 $393.99
$422.72 $475.56 $363.25 $408.65
$435.17 $489.56 $373.94 $420.68
$441.39 $518.63 $379.29 $445.66
$450.72 $529.60 $387.31 $455.08
$460.05 $540.56 $395.33 $464.51
$465.89 $547.42 $400.34 $470.40
$472.11 $554.73 $405.69 $476.68
$475.22 $558.38 $408.36 $479.82
$478.33 $562.04 $411.03 $482.96
$481.44 $565.70 $413.71 $486.10
$484.55 $569.35 $416.38 $489.24
$490.78 $576.66 $421.73 $495.53
$497.00 $608.82 $427.07 $523.16
$506.33 $620.26 $435.09 $532.99
$515.28 $631.21 $442.78 $542.40
$527.72 $646.46 $453.47 $555.50
$543.28 $665.51 $466.84 $571.88
$561.55 $687.90 $482.54 $591.12
$583.33 $714.58 $501.26 $614.04
$607.83 $744.59 $522.31 $639.83
$635.83 $778.89 $546.37 $669.31
$663.44 $812.72 $570.10 $698.37
$694.55 $955.01 $596.83 $820.64
$725.28 $997.25 $623.23 $856.94
$759.11 $1,043.77 $652.30 $896.92
$793.33 $1,090.83 $681.71 $937.35
$830.28 $1,141.63 $713.46 $981.00
$867.22 $1,192.43 $745.20 $1,024.66
$907.27 $1,247.50 $779.62 $1,071.98
$947.72 $1,303.11 $814.38 $1,119.77
$990.89 $1,362.47 $851.47 $1,170.77
$1,012.27 $1,391.88 $869.85 $1,196.04
$1,055.44 $1,451.23 $906.94 $1,247.05
$1,092.77 $1,502.56 $939.02 $1,291.16
$1,117.27 $1,536.25 $960.08 $1,320.11
$1,148.00 $1,578.49 $986.48 $1,356.41
$1,166.66 $1,604.16 $1,002.51 $1,378.46
$1,166.66 $1,604.16 $1,002.51 $1,378.46
Yes
33871PA0110016
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
Yes
#NAME?
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0110014
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded$25 no ded/$50 no ded
Page Number: 15 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110019 33871PA0110020
Non-Tobacco Tobacco Non-Tobacco Tobacco
$201.76 $201.76 $150.23 $150.23
$317.72 $357.44 $236.58 $266.16
$317.72 $357.44 $236.58 $266.16
$317.72 $357.44 $236.58 $266.16
$317.72 $357.44 $236.58 $266.16
$319.00 $358.87 $237.53 $267.22
$325.35 $366.02 $242.26 $272.54
$332.98 $374.60 $247.94 $278.93
$345.37 $388.54 $257.17 $289.31
$355.53 $399.98 $264.74 $297.83
$360.62 $423.73 $268.52 $315.51
$368.24 $432.69 $274.20 $322.18
$375.87 $441.65 $279.88 $328.86
$380.63 $447.25 $283.43 $333.03
$385.72 $453.22 $287.21 $337.47
$388.26 $456.20 $289.10 $339.70
$390.80 $459.19 $291.00 $341.92
$393.34 $462.18 $292.89 $344.15
$395.88 $465.16 $294.78 $346.37
$400.97 $471.14 $298.57 $350.82
$406.05 $497.41 $302.35 $370.38
$413.68 $506.75 $308.03 $377.34
$420.99 $515.71 $313.47 $384.00
$431.15 $528.16 $321.04 $393.28
$443.86 $543.73 $330.51 $404.87
$458.79 $562.02 $341.63 $418.49
$476.59 $583.82 $354.87 $434.72
$496.60 $608.34 $369.78 $452.98
$519.48 $636.36 $386.81 $473.85
$542.04 $664.00 $403.61 $494.42
$567.46 $780.25 $422.54 $580.99
$592.56 $814.77 $441.23 $606.69
$620.20 $852.77 $461.81 $634.99
$648.16 $891.22 $482.63 $663.61
$678.34 $932.72 $505.10 $694.52
$708.53 $974.22 $527.58 $725.42
$741.25 $1,019.22 $551.95 $758.93
$774.29 $1,064.66 $576.55 $792.76
$809.56 $1,113.15 $602.81 $828.87
$827.04 $1,137.18 $615.82 $846.76
$862.30 $1,185.67 $642.09 $882.87
$892.81 $1,227.61 $664.80 $914.10
$912.82 $1,255.13 $679.70 $934.59
$937.92 $1,289.64 $698.39 $960.29
$953.16 $1,310.61 $709.74 $975.90
$953.16 $1,310.61 $709.74 $975.90
Yes
33871PA0110020
Yes
$6,850
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
50%
#NAME?
$7,150
$50 no ded/$100 no ded
8
KE 670 WPR GMC
Keystone Health Plan East Network
#NAME?
Keystone DPOS Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
33871PA0110019
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
Page Number: 16 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100044 33871PA0100045
Non-Tobacco Tobacco Non-Tobacco Tobacco
$205.44 $205.44 $163.08 $163.08
$323.53 $363.97 $256.81 $288.92
$323.53 $363.97 $256.81 $288.92
$323.53 $363.97 $256.81 $288.92
$323.53 $363.97 $256.81 $288.92
$324.83 $365.43 $257.84 $290.07
$331.30 $372.71 $262.98 $295.85
$339.06 $381.44 $269.14 $302.78
$351.68 $395.64 $279.16 $314.05
$362.03 $407.29 $287.38 $323.30
$367.21 $431.47 $291.48 $342.49
$374.97 $440.59 $297.65 $349.74
$382.74 $449.72 $303.81 $356.98
$387.59 $455.42 $307.66 $361.50
$392.77 $461.50 $311.77 $366.33
$395.36 $464.54 $313.83 $368.75
$397.94 $467.58 $315.88 $371.16
$400.53 $470.63 $317.94 $373.57
$403.12 $473.67 $319.99 $375.99
$408.30 $479.75 $324.10 $380.82
$413.47 $506.51 $328.21 $402.06
$421.24 $516.02 $334.37 $409.61
$428.68 $525.13 $340.28 $416.84
$439.03 $537.82 $348.50 $426.91
$451.97 $553.67 $358.77 $439.49
$467.18 $572.30 $370.84 $454.28
$485.30 $594.49 $385.22 $471.90
$505.68 $619.46 $401.40 $491.72
$528.97 $647.99 $419.89 $514.37
$551.95 $676.13 $438.13 $536.70
$577.83 $794.51 $458.67 $630.67
$603.39 $829.66 $478.96 $658.57
$631.53 $868.36 $501.30 $689.29
$660.01 $907.51 $523.90 $720.36
$690.74 $949.77 $548.30 $753.91
$721.48 $992.03 $572.70 $787.46
$754.80 $1,037.85 $599.15 $823.83
$788.45 $1,084.12 $625.86 $860.55
$824.36 $1,133.49 $654.36 $899.75
$842.15 $1,157.96 $668.49 $919.17
$878.07 $1,207.34 $696.99 $958.37
$909.13 $1,250.05 $721.65 $992.27
$929.51 $1,278.07 $737.83 $1,014.51
$955.07 $1,313.22 $758.12 $1,042.41
$970.59 $1,334.57 $770.43 $1,059.36
$970.59 $1,334.57 $770.43 $1,059.36
33871PA0100044
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
$0
Keystone HMO Gold Proactive
0%/20%/30%
#NAME?
$7,150
$15/$40, $30/$60, $45/$80
Yes
$0/$5500/$5500
Keystone HMO Silver Proactive
0%/5%/10%
#NAME?
33871PA0100045
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
$7,150
Page Number: 17 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100035 33871PA0100037
Non-Tobacco Tobacco Non-Tobacco Tobacco
$235.43 $235.43 $184.95 $184.95
$370.76 $417.10 $291.26 $327.67
$370.76 $417.10 $291.26 $327.67
$370.76 $417.10 $291.26 $327.67
$370.76 $417.10 $291.26 $327.67
$372.24 $418.77 $292.43 $328.98
$379.65 $427.11 $298.25 $335.53
$388.55 $437.12 $305.24 $343.40
$403.01 $453.39 $316.60 $356.18
$414.88 $466.74 $325.92 $366.66
$420.81 $494.45 $330.58 $388.43
$429.71 $504.90 $337.57 $396.65
$438.60 $515.36 $344.56 $404.86
$444.17 $521.89 $348.93 $410.00
$450.10 $528.86 $353.59 $415.47
$453.06 $532.35 $355.92 $418.21
$456.03 $535.83 $358.25 $420.95
$459.00 $539.32 $360.58 $423.68
$461.96 $542.80 $362.91 $426.42
$467.89 $549.78 $367.57 $431.90
$473.83 $580.44 $372.23 $455.99
$482.72 $591.34 $379.22 $464.55
$491.25 $601.78 $385.92 $472.75
$503.12 $616.32 $395.24 $484.17
$517.95 $634.48 $406.89 $498.44
$535.37 $655.83 $420.58 $515.21
$556.13 $681.26 $436.89 $535.19
$579.49 $709.88 $455.24 $557.67
$606.19 $742.58 $476.21 $583.36
$632.51 $774.82 $496.89 $608.69
$662.17 $910.48 $520.19 $715.27
$691.46 $950.76 $543.20 $746.91
$723.72 $995.11 $568.54 $781.75
$756.34 $1,039.97 $594.17 $816.99
$791.56 $1,088.40 $621.84 $855.04
$826.79 $1,136.83 $649.51 $893.08
$864.97 $1,189.34 $679.51 $934.33
$903.53 $1,242.36 $709.81 $975.98
$944.69 $1,298.94 $742.14 $1,020.44
$965.08 $1,326.98 $758.16 $1,042.46
$1,006.23 $1,383.57 $790.49 $1,086.92
$1,041.82 $1,432.51 $818.45 $1,125.36
$1,065.18 $1,464.62 $836.80 $1,150.59
$1,094.47 $1,504.90 $859.81 $1,182.23
$1,112.27 $1,529.37 $873.78 $1,201.46
$1,112.27 $1,529.37 $873.78 $1,201.46
33871PA0100035
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
#NAME? #NAME?
$2,000 $3,500
$3,500 $7,150
No
0%
$40 no ded/$80 no ded
0%
Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone HMO Silver Secure $3,500 $40/$80/$600
33871PA0100037
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded
Page Number: 18 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100036 33871PA0110007
Non-Tobacco Tobacco Non-Tobacco Tobacco
$195.94 $195.94 $193.16 $193.16
$308.57 $347.14 $304.18 $342.21
$308.57 $347.14 $304.18 $342.21
$308.57 $347.14 $304.18 $342.21
$308.57 $347.14 $304.18 $342.21
$309.80 $348.52 $305.40 $343.57
$315.97 $355.47 $311.48 $350.42
$323.38 $363.80 $318.78 $358.63
$335.41 $377.34 $330.65 $371.98
$345.29 $388.45 $340.38 $382.93
$350.22 $411.51 $345.25 $405.67
$357.63 $420.21 $352.55 $414.24
$365.03 $428.91 $359.85 $422.82
$369.66 $434.35 $364.41 $428.18
$374.60 $440.15 $369.28 $433.90
$377.07 $443.05 $371.71 $436.76
$379.54 $445.95 $374.15 $439.62
$382.00 $448.86 $376.58 $442.48
$384.47 $451.76 $379.01 $445.34
$389.41 $457.56 $383.88 $451.06
$394.35 $483.08 $388.75 $476.21
$401.75 $492.15 $396.05 $485.16
$408.85 $500.84 $403.04 $493.73
$418.72 $512.94 $412.78 $505.65
$431.07 $528.06 $424.94 $520.56
$445.57 $545.82 $439.24 $538.07
$462.85 $566.99 $456.27 $558.94
$482.29 $590.80 $475.44 $582.41
$504.50 $618.02 $497.34 $609.24
$526.41 $644.86 $518.94 $635.70
$551.10 $757.76 $543.27 $747.00
$575.48 $791.28 $567.30 $780.04
$602.32 $828.19 $593.77 $816.43
$629.47 $865.53 $620.53 $853.23
$658.79 $905.83 $649.43 $892.97
$688.10 $946.14 $678.33 $932.70
$719.88 $989.84 $709.66 $975.78
$751.97 $1,033.97 $741.29 $1,019.28
$786.23 $1,081.06 $775.06 $1,065.71
$803.20 $1,104.40 $791.79 $1,088.71
$837.45 $1,151.49 $825.55 $1,135.13
$867.07 $1,192.22 $854.75 $1,175.29
$886.51 $1,218.95 $873.92 $1,201.64
$910.89 $1,252.47 $897.95 $1,234.68
$925.70 $1,272.83 $912.54 $1,254.75
$925.70 $1,272.83 $912.54 $1,254.75
Keystone Health Plan East Network
KE 670 WPR GMC
No
#NAME? #NAME?
$4,250 $3,500
$7,150 $7,150
No
Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone DPOS Silver Secure $3,500/$40/$80/$600
0% 0%
33871PA0110007
8
33871PA0100036
KE 670 WPR GMC
8
Keystone Health Plan East Network
$40 no ded/$80 no ded $40 no ded/$80 no ded
Page Number: 19 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110008 33871PA0110009
Non-Tobacco Tobacco Non-Tobacco Tobacco
$204.63 $204.63 $201.18 $201.18
$322.25 $362.53 $316.82 $356.42
$322.25 $362.53 $316.82 $356.42
$322.25 $362.53 $316.82 $356.42
$322.25 $362.53 $316.82 $356.42
$323.54 $363.98 $318.09 $357.85
$329.98 $371.23 $324.42 $364.98
$337.72 $379.93 $332.03 $373.53
$350.28 $394.07 $344.38 $387.43
$360.60 $405.67 $354.52 $398.84
$365.75 $429.76 $359.59 $422.52
$373.49 $438.85 $367.19 $431.45
$381.22 $447.93 $374.80 $440.39
$386.05 $453.61 $379.55 $445.97
$391.21 $459.67 $384.62 $451.93
$393.79 $462.70 $387.15 $454.91
$396.37 $465.73 $389.69 $457.88
$398.94 $468.76 $392.22 $460.86
$401.52 $471.79 $394.76 $463.84
$406.68 $477.85 $399.83 $469.80
$411.83 $504.50 $404.90 $496.00
$419.57 $513.97 $412.50 $505.31
$426.98 $523.05 $419.79 $514.24
$437.29 $535.68 $429.93 $526.66
$450.18 $551.47 $442.60 $542.18
$465.33 $570.03 $457.49 $560.42
$483.37 $592.13 $475.23 $582.16
$503.67 $617.00 $495.19 $606.61
$526.88 $645.42 $518.00 $634.55
$549.76 $673.45 $540.50 $662.11
$575.54 $791.36 $565.84 $778.03
$600.99 $826.37 $590.87 $812.45
$629.03 $864.92 $618.43 $850.35
$657.39 $903.91 $646.31 $888.68
$688.00 $946.00 $676.41 $930.07
$718.61 $988.10 $706.51 $971.45
$751.81 $1,033.73 $739.14 $1,016.32
$785.32 $1,079.82 $772.09 $1,061.63
$821.09 $1,129.00 $807.26 $1,109.98
$838.81 $1,153.37 $824.68 $1,133.94
$874.58 $1,202.55 $859.85 $1,182.29
$905.52 $1,245.09 $890.27 $1,224.12
$925.82 $1,273.00 $910.23 $1,251.56
$951.28 $1,308.01 $935.25 $1,285.97
$966.75 $1,329.28 $950.46 $1,306.88
$966.75 $1,329.28 $950.46 $1,306.88
Keystone Health Plan East Network
8
KE 670 WPR GMC
50%
$30 no ded/$60 no ded
Keystone DPOS Silver Classic $4,250 $40/$80/100%
NoNo
0%
#NAME?
$4,250 $2,750
Keystone DPOS Silver Classic $2,750/$30/$60/50%
#NAME?
33871PA0110009
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0110008
8
$7,150
$40 no ded/$80 no ded
$7,150
Page Number: 20 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
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45
46
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48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100047 33871PA0100049
Non-Tobacco Tobacco Non-Tobacco Tobacco
$236.00 $236.00 $185.53 $185.53
$371.66 $418.12 $292.17 $328.69
$371.66 $418.12 $292.17 $328.69
$371.66 $418.12 $292.17 $328.69
$371.66 $418.12 $292.17 $328.69
$373.15 $419.79 $293.33 $330.00
$380.58 $428.15 $299.18 $336.58
$389.50 $438.19 $306.19 $344.46
$403.99 $454.49 $317.58 $357.28
$415.89 $467.87 $326.93 $367.80
$421.83 $495.65 $331.61 $389.64
$430.75 $506.14 $338.62 $397.88
$439.67 $516.62 $345.63 $406.12
$445.25 $523.17 $350.02 $411.27
$451.20 $530.15 $354.69 $416.76
$454.17 $533.65 $357.03 $419.51
$457.14 $537.14 $359.36 $422.25
$460.11 $540.64 $361.70 $425.00
$463.09 $544.13 $364.04 $427.75
$469.03 $551.12 $368.71 $433.24
$474.98 $581.85 $373.39 $457.40
$483.90 $592.78 $380.40 $465.99
$492.45 $603.25 $387.12 $474.22
$504.34 $617.82 $396.47 $485.68
$519.21 $636.03 $408.16 $499.99
$536.68 $657.43 $421.89 $516.81
$557.49 $682.93 $438.25 $536.86
$580.90 $711.61 $456.66 $559.40
$607.66 $744.39 $477.69 $585.17
$634.05 $776.71 $498.44 $610.58
$663.78 $912.70 $521.81 $717.49
$693.15 $953.08 $544.89 $749.22
$725.48 $997.54 $570.31 $784.17
$758.19 $1,042.51 $596.02 $819.53
$793.49 $1,091.05 $623.78 $857.69
$828.80 $1,139.60 $651.53 $895.85
$867.08 $1,192.24 $681.62 $937.23
$905.74 $1,245.39 $712.01 $979.01
$946.99 $1,302.11 $744.44 $1,023.60
$967.43 $1,330.22 $760.51 $1,045.70
$1,008.68 $1,386.94 $792.94 $1,090.29
$1,044.36 $1,436.00 $820.99 $1,128.86
$1,067.78 $1,468.20 $839.39 $1,154.17
$1,097.14 $1,508.57 $862.47 $1,185.90
$1,114.98 $1,533.10 $876.50 $1,205.19
$1,114.98 $1,533.10 $876.50 $1,205.19
33871PA0100047
KE 670 WPR GMC
33871PA0100049
KE 670 WPR GMC
Keystone Health Plan East Network
Yes Yes
#NAME?
$2,000
8
Keystone HMO Gold Classic $2,000 $40/$80/100%
8
Keystone HMO Silver Secure $3,500 $40/$80/$600
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$3,500
Keystone Health Plan East Network
#NAME?
$3,500 $7,150
Page Number: 21 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100048 33871PA0110015
Non-Tobacco Tobacco Non-Tobacco Tobacco
$196.51 $196.51 $242.98 $242.98
$309.47 $348.15 $382.65 $430.48
$309.47 $348.15 $382.65 $430.48
$309.47 $348.15 $382.65 $430.48
$309.47 $348.15 $382.65 $430.48
$310.71 $349.55 $384.18 $432.21
$316.90 $356.51 $391.84 $440.82
$324.32 $364.86 $401.02 $451.15
$336.39 $378.44 $415.94 $467.94
$346.30 $389.58 $428.19 $481.71
$351.25 $412.72 $434.31 $510.32
$358.68 $421.44 $443.49 $521.11
$366.10 $430.17 $452.68 $531.90
$370.74 $435.63 $458.42 $538.64
$375.70 $441.44 $464.54 $545.84
$378.17 $444.35 $467.60 $549.43
$380.65 $447.26 $470.66 $553.03
$383.12 $450.17 $473.72 $556.63
$385.60 $453.08 $476.79 $560.22
$390.55 $458.90 $482.91 $567.42
$395.50 $484.49 $489.03 $599.06
$402.93 $493.59 $498.21 $610.31
$410.05 $502.31 $507.02 $621.09
$419.95 $514.44 $519.26 $636.09
$432.33 $529.60 $534.57 $654.84
$446.87 $547.42 $552.55 $676.88
$464.20 $568.65 $573.98 $703.13
$483.70 $592.53 $598.09 $732.66
$505.98 $619.83 $625.64 $766.41
$527.96 $646.75 $652.81 $799.69
$552.71 $759.98 $683.42 $939.70
$577.16 $793.60 $713.65 $981.27
$604.09 $830.62 $746.94 $1,027.04
$631.32 $868.06 $780.61 $1,073.34
$660.72 $908.49 $816.96 $1,123.33
$690.12 $948.91 $853.32 $1,173.31
$721.99 $992.74 $892.73 $1,227.50
$754.18 $1,036.99 $932.53 $1,282.22
$788.53 $1,084.23 $975.00 $1,340.63
$805.55 $1,107.63 $996.05 $1,369.56
$839.90 $1,154.86 $1,038.52 $1,427.97
$869.61 $1,195.71 $1,075.26 $1,478.48
$889.11 $1,222.52 $1,099.36 $1,511.62
$913.55 $1,256.14 $1,129.59 $1,553.19
$928.41 $1,276.56 $1,147.95 $1,578.44
$928.41 $1,276.56 $1,147.95 $1,578.44
Yes
33871PA0110015
0%
$40 no ded/$80 no ded
$3,500
#NAME?
Keystone DPOS Gold Classic $2,000/$40/$80/100%
$2,000
KE 670 WPR GMC
8
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0100048
8
Keystone HMO Silver Classic $4,250 $40/$80/100%
#NAME?
$4,250
0%
$40 no ded/$80 no ded
Keystone Health Plan East Network
Yes
$7,150
Page Number: 22 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: July 1, 2017 - September 30, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
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46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110017 33871PA0110018
Non-Tobacco Tobacco Non-Tobacco Tobacco
$193.73 $193.73 $205.20 $205.20
$305.09 $343.22 $323.15 $363.55
$305.09 $343.22 $323.15 $363.55
$305.09 $343.22 $323.15 $363.55
$305.09 $343.22 $323.15 $363.55
$306.31 $344.60 $324.45 $365.00
$312.41 $351.46 $330.91 $372.27
$319.73 $359.70 $338.66 $381.00
$331.63 $373.08 $351.27 $395.18
$341.39 $384.07 $361.61 $406.81
$346.27 $406.87 $366.78 $430.96
$353.60 $415.48 $374.53 $440.08
$360.92 $424.08 $382.29 $449.19
$365.49 $429.46 $387.14 $454.89
$370.38 $435.19 $392.31 $460.96
$372.82 $438.06 $394.89 $464.00
$375.26 $440.93 $397.48 $467.04
$377.70 $443.79 $400.06 $470.07
$380.14 $446.66 $402.65 $473.11
$385.02 $452.40 $407.82 $479.19
$389.90 $477.63 $412.99 $505.91
$397.22 $486.60 $420.75 $515.41
$404.24 $495.19 $428.18 $524.52
$414.00 $507.15 $438.52 $537.19
$426.21 $522.10 $451.44 $553.02
$440.55 $539.67 $466.63 $571.63
$457.63 $560.60 $484.73 $593.79
$476.85 $584.14 $505.09 $618.73
$498.82 $611.05 $528.36 $647.23
$520.48 $637.59 $551.30 $675.34
$544.89 $749.22 $577.15 $793.58
$568.99 $782.36 $602.68 $828.69
$595.53 $818.85 $630.79 $867.34
$622.38 $855.77 $659.23 $906.44
$651.36 $895.62 $689.93 $948.66
$680.34 $935.47 $720.63 $990.87
$711.77 $978.68 $753.92 $1,036.63
$743.50 $1,022.31 $787.52 $1,082.85
$777.36 $1,068.87 $823.39 $1,132.17
$794.14 $1,091.94 $841.17 $1,156.60
$828.01 $1,138.51 $877.04 $1,205.93
$857.29 $1,178.78 $908.06 $1,248.58
$876.52 $1,205.21 $928.42 $1,276.58
$900.62 $1,238.35 $953.95 $1,311.68
$915.26 $1,258.48 $969.45 $1,333.01
$915.26 $1,258.48 $969.45 $1,333.01
Yes Yes
33871PA0110017
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$7,150 $7,150
Keystone Health Plan East Network
#NAME? #NAME?
Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone DPOS Silver Classic $4,250 $40/$80/100%
KE 670 WPR GMC
$3,500 $4,250
33871PA0110018
KE 670 WPR GMC
8 8
Keystone Health Plan East Network
Page Number: 23 05/05/2016
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100005 319.03
33871PA0100006 303.36
33871PA0100009 255.91
33871PA0100036 308.57
33871PA0100037 291.26
33871PA0110006 333.27
33871PA0110007 304.18
33871PA0110008 322.25
33871PA0110009 316.82
2017 On-Exchange Silver Plan Rates
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100024 319.93
33871PA0100025 304.27
33871PA0100045 256.81
33871PA0100048 309.47
33871PA0100049 292.17
33871PA0110016 334.17
33871PA0110017 305.09
33871PA0110018 323.15
33871PA0110019 317.72
2017 Off-Exchange Silver Plan Rates
Company On/Off Metal Network Rating
Exchange HIOS Plan ID Level AreaKHPE ON 33871PA0100001 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0100002 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0100003 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0100004 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0100005 Silver Keystone HMO Silver Classic $2,500 $25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0100006 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE ON 33871PA0100007 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100008 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE ON 33871PA0100009 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100020 Platinum Keystone HMO Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE OFF 33871PA0100021 Platinum Keystone HMO Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE OFF 33871PA0100022 Gold Keystone HMO Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE OFF 33871PA0100023 Gold Keystone HMO Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE OFF 33871PA0100024 Silver Keystone HMO Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE OFF 33871PA0100025 Silver Keystone HMO Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE OFF 33871PA0100026 Bronze Keystone HMO Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8KHPE ON 33871PA0100035 Gold Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0100036 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0100037 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8KHPE OFF 33871PA0100044 Gold Keystone HMO Gold Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100045 Silver Keystone HMO Silver Proactive Keystone Health Plan East Network 8KHPE OFF 33871PA0100047 Gold Keystone HMO Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8KHPE OFF 33871PA0100048 Silver Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8KHPE OFF 33871PA0100049 Silver Keystone HMO Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8KHPE ON 33871PA0110001 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8KHPE ON 33871PA0110002 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8KHPE ON 33871PA0110003 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8KHPE ON 33871PA0110004 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8KHPE ON 33871PA0110005 Gold Keystone DPOS Gold Classic $2,000 $40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0110006 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8KHPE ON 33871PA0110007 Silver Keystone DPOS Silver Secure $3,500/$40/$80/$600 Keystone Health Plan East Network 8KHPE ON 33871PA0110008 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8KHPE ON 33871PA0110009 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8KHPE ON 33871PA0110010 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110011 Platinum Keystone DPOS Platinum Preferred $10/$20/$100 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110012 Platinum Keystone DPOS Platinum Preferred $20/$40/$150 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110013 Gold Keystone DPOS Gold Preferred $30/$60/$650 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110014 Gold Keystone DPOS Gold Classic $1,000 $25/$50/90% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110015 Gold Keystone DPOS Gold Classic $2,000/$40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110016 Silver Keystone DPOS Silver Classic $2,500/$25/$50/70% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110017 Silver Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone Health Plan East Network 8
KHPE OFF 33871PA0110018 Silver Keystone DPOS Silver Classic $4,250 $40/$80/100% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110019 Silver Keystone DPOS Silver Classic $2,750/$30/$60/50% Keystone Health Plan East Network 8
KHPE OFF 33871PA0110020 Bronze Keystone DPOS Bronze Essential $6,850/$50/$100/$700 Keystone Health Plan East Network 8
Keystone Health Plan East
Plan Design Summary
Plan Design Marketing Name
05/15/2015
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 201733871PA0100001 33871PA0100002
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band Non-Tobacco Tobacco Non-Tobacco Tobacco
0-20 $299.14 $299.14 $285.95 $285.95
21 $471.08 $529.97 $450.31 $506.60
22 $471.08 $529.97 $450.31 $506.60
23 $471.08 $529.97 $450.31 $506.60
24 $471.08 $529.97 $450.31 $506.60
25 $472.97 $532.09 $452.11 $508.63
26 $482.39 $542.69 $461.12 $518.76
27 $493.69 $555.41 $471.93 $530.92
28 $512.07 $576.07 $489.49 $550.67
29 $527.14 $593.03 $503.90 $566.88
30 $534.68 $628.25 $511.10 $600.55
31 $545.98 $641.53 $521.91 $613.24
32 $557.29 $654.81 $532.72 $625.94
33 $564.36 $663.12 $539.47 $633.88
34 $571.89 $671.97 $546.68 $642.35
35 $575.66 $676.40 $550.28 $646.58
36 $579.43 $680.83 $553.88 $650.81
37 $583.20 $685.26 $557.48 $655.04
38 $586.97 $689.69 $561.09 $659.28
39 $594.50 $698.54 $568.29 $667.74
40 $602.04 $737.50 $575.50 $704.98
41 $613.35 $751.35 $586.30 $718.22
42 $624.18 $764.62 $596.66 $730.91
43 $639.26 $783.09 $611.07 $748.56
44 $658.10 $806.17 $629.08 $770.63
45 $680.24 $833.30 $650.25 $796.55
46 $706.62 $865.61 $675.47 $827.45
47 $736.30 $901.97 $703.84 $862.20
48 $770.22 $943.52 $736.26 $901.92
49 $803.66 $984.49 $768.23 $941.08
50 $841.35 $1,156.86 $804.25 $1,105.85
51 $878.57 $1,208.03 $839.83 $1,154.77
52 $919.55 $1,264.38 $879.01 $1,208.63
53 $961.01 $1,321.38 $918.63 $1,263.12
54 $1,005.76 $1,382.92 $961.41 $1,321.94
55 $1,050.51 $1,444.45 $1,004.19 $1,380.77
56 $1,099.03 $1,511.17 $1,050.57 $1,444.54
57 $1,148.03 $1,578.54 $1,097.41 $1,508.93
58 $1,200.32 $1,650.43 $1,147.39 $1,577.66
59 $1,226.22 $1,686.06 $1,172.16 $1,611.72
60 $1,278.52 $1,757.96 $1,222.14 $1,680.45
61 $1,323.74 $1,820.14 $1,265.37 $1,739.89
62 $1,353.42 $1,860.95 $1,293.74 $1,778.90
63 $1,390.63 $1,912.12 $1,329.32 $1,827.81
64 $1,413.24 $1,943.21 $1,350.93 $1,857.53
65+ $1,413.24 $1,943.21 $1,350.93 $1,857.53
$10/$20 $20/$40
Keystone Health Plan East Network
33871PA0100001
KE 670 WPR GMC
8
33871PA0100002
8
KE 670 WPR GMC
Keystone Health Plan East Network
$0
0%
$3,000
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
No
#NAME?
$4,000
#NAME?
Keystone HMO Platinum Preferred $10/$20/$100
No
Page Number: 2 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100003 33871PA0100004
Non-Tobacco Tobacco Non-Tobacco Tobacco
$235.78 $235.78 $243.45 $243.45
$371.31 $417.73 $383.39 $431.31
$371.31 $417.73 $383.39 $431.31
$371.31 $417.73 $383.39 $431.31
$371.31 $417.73 $383.39 $431.31
$372.80 $419.40 $384.92 $433.04
$380.23 $427.75 $392.59 $441.66
$389.14 $437.78 $401.79 $452.02
$403.62 $454.07 $416.74 $468.84
$415.50 $467.44 $429.01 $482.64
$421.44 $495.19 $435.15 $511.30
$430.35 $505.66 $444.35 $522.11
$439.26 $516.14 $453.55 $532.92
$444.83 $522.68 $459.30 $539.68
$450.78 $529.66 $465.43 $546.88
$453.75 $533.15 $468.50 $550.49
$456.72 $536.64 $471.57 $554.09
$459.69 $540.13 $474.64 $557.70
$462.66 $543.62 $477.70 $561.30
$468.60 $550.60 $483.84 $568.51
$474.54 $581.31 $489.97 $600.21
$483.45 $592.23 $499.17 $611.49
$491.99 $602.69 $507.99 $622.29
$503.87 $617.24 $520.26 $637.32
$518.73 $635.44 $535.59 $656.10
$536.18 $656.82 $553.61 $678.18
$556.97 $682.29 $575.08 $704.48
$580.36 $710.95 $599.24 $734.06
$607.10 $743.70 $626.84 $767.88
$633.46 $775.99 $654.06 $801.22
$663.17 $911.85 $684.73 $941.51
$692.50 $952.19 $715.02 $983.15
$724.81 $996.61 $748.37 $1,029.02
$757.48 $1,041.54 $782.11 $1,075.41
$792.76 $1,090.04 $818.53 $1,125.49
$828.03 $1,138.54 $854.96 $1,175.57
$866.28 $1,191.13 $894.45 $1,229.86
$904.89 $1,244.23 $934.32 $1,284.69
$946.11 $1,300.90 $976.87 $1,343.20
$966.53 $1,328.98 $997.96 $1,372.20
$1,007.75 $1,385.65 $1,040.52 $1,430.71
$1,043.39 $1,434.67 $1,077.32 $1,481.32
$1,066.79 $1,466.83 $1,101.48 $1,514.53
$1,096.12 $1,507.16 $1,131.76 $1,556.17
$1,113.93 $1,531.67 $1,150.17 $1,581.48
$1,113.93 $1,531.67 $1,150.17 $1,581.48
$30/$60 $25 no ded/$50 no ded
KE 670 WPR GMC
8
Keystone Health Plan East Network
33871PA0100003
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
No No
#NAME?
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0100004
Page Number: 3 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100005 33871PA0100006
Non-Tobacco Tobacco Non-Tobacco Tobacco
$208.46 $208.46 $198.22 $198.22
$328.28 $369.31 $312.16 $351.18
$328.28 $369.31 $312.16 $351.18
$328.28 $369.31 $312.16 $351.18
$328.28 $369.31 $312.16 $351.18
$329.59 $370.79 $313.41 $352.58
$336.16 $378.18 $319.65 $359.61
$344.04 $387.04 $327.14 $368.04
$356.84 $401.44 $339.32 $381.73
$367.34 $413.26 $349.31 $392.97
$372.60 $437.80 $354.30 $416.30
$380.47 $447.06 $361.79 $425.11
$388.35 $456.32 $369.28 $433.91
$393.28 $462.10 $373.97 $439.41
$398.53 $468.27 $378.96 $445.28
$401.16 $471.36 $381.46 $448.21
$403.78 $474.44 $383.96 $451.15
$406.41 $477.53 $386.45 $454.08
$409.04 $480.62 $388.95 $457.02
$414.29 $486.79 $393.95 $462.89
$419.54 $513.94 $398.94 $488.70
$427.42 $523.59 $406.43 $497.88
$434.97 $532.84 $413.61 $506.67
$445.47 $545.71 $423.60 $518.91
$458.61 $561.79 $436.09 $534.21
$474.03 $580.69 $450.76 $552.18
$492.42 $603.21 $468.24 $573.59
$513.10 $628.55 $487.91 $597.68
$536.74 $657.50 $510.38 $625.22
$560.04 $686.05 $532.54 $652.37
$586.31 $806.17 $557.52 $766.59
$612.24 $841.83 $582.18 $800.49
$640.80 $881.10 $609.34 $837.84
$669.69 $920.82 $636.81 $875.61
$700.87 $963.70 $666.46 $916.38
$732.06 $1,006.58 $696.12 $957.16
$765.87 $1,053.08 $728.27 $1,001.37
$800.01 $1,100.02 $760.73 $1,046.01
$836.45 $1,150.12 $795.38 $1,093.65
$854.51 $1,174.95 $812.55 $1,117.26
$890.95 $1,225.05 $847.20 $1,164.90
$922.46 $1,268.39 $877.17 $1,206.11
$943.14 $1,296.82 $896.83 $1,233.15
$969.08 $1,332.48 $921.50 $1,267.06
$984.84 $1,354.15 $936.48 $1,287.66
$984.84 $1,354.15 $936.48 $1,287.66
$25 no ded/$50 no ded
33871PA0100006
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
#NAME?
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
No
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Silver Classic $2,500 $25/$50/70%
33871PA0100005
$2,500
30%
$7,150
No
Page Number: 4 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100007 33871PA0100008
Non-Tobacco Tobacco Non-Tobacco Tobacco
$147.58 $147.58 $210.81 $210.81
$232.41 $261.46 $331.98 $373.48
$232.41 $261.46 $331.98 $373.48
$232.41 $261.46 $331.98 $373.48
$232.41 $261.46 $331.98 $373.48
$233.34 $262.51 $333.31 $374.97
$237.99 $267.74 $339.95 $382.44
$243.57 $274.01 $347.92 $391.41
$252.63 $284.21 $360.86 $405.97
$260.07 $292.58 $371.49 $417.92
$263.79 $309.95 $376.80 $442.74
$269.36 $316.50 $384.77 $452.10
$274.94 $323.06 $392.73 $461.46
$278.43 $327.15 $397.71 $467.31
$282.15 $331.52 $403.03 $473.56
$284.01 $333.71 $405.68 $476.68
$285.87 $335.89 $408.34 $479.80
$287.72 $338.08 $410.99 $482.92
$289.58 $340.26 $413.65 $486.04
$293.30 $344.63 $418.96 $492.28
$297.02 $363.85 $424.27 $519.73
$302.60 $370.68 $432.24 $529.49
$307.94 $377.23 $439.88 $538.85
$315.38 $386.34 $450.50 $551.86
$324.68 $397.73 $463.78 $568.13
$335.60 $411.11 $479.38 $587.24
$348.62 $427.06 $497.97 $610.02
$363.26 $444.99 $518.89 $635.64
$379.99 $465.49 $542.79 $664.92
$396.49 $485.70 $566.36 $693.79
$415.09 $570.74 $592.92 $815.26
$433.45 $595.99 $619.15 $851.33
$453.67 $623.79 $648.03 $891.04
$474.12 $651.91 $677.24 $931.21
$496.20 $682.27 $708.78 $974.57
$518.28 $712.63 $740.32 $1,017.94
$542.22 $745.55 $774.51 $1,064.96
$566.39 $778.78 $809.04 $1,112.43
$592.18 $814.25 $845.89 $1,163.10
$604.97 $831.83 $864.15 $1,188.20
$630.76 $867.30 $901.00 $1,238.87
$653.08 $897.98 $932.87 $1,282.69
$667.72 $918.11 $953.78 $1,311.45
$686.08 $943.36 $980.01 $1,347.51
$697.23 $958.70 $995.94 $1,369.42
$697.23 $958.70 $995.94 $1,369.42
33871PA0100008
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
$15/$40, $30/$60, $45/$80
#NAME?
Keystone HMO Gold Proactive
$0
0%/20%/30%
$7,150
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
No
$50 no ded/$100 no ded
KE 670 WPR GMC
8
Keystone Health Plan East Network
33871PA0100007
#NAME?
Page Number: 5 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100009 33871PA0110001
Non-Tobacco Tobacco Non-Tobacco Tobacco
$167.21 $167.21 $313.00 $313.00
$263.33 $296.25 $492.92 $554.53
$263.33 $296.25 $492.92 $554.53
$263.33 $296.25 $492.92 $554.53
$263.33 $296.25 $492.92 $554.53
$264.38 $297.43 $494.89 $556.75
$269.65 $303.36 $504.75 $567.84
$275.97 $310.47 $516.58 $581.15
$286.24 $322.02 $535.80 $602.78
$294.67 $331.50 $551.58 $620.52
$298.88 $351.18 $559.46 $657.37
$305.20 $358.61 $571.29 $671.27
$311.52 $366.03 $583.12 $685.17
$315.47 $370.68 $590.52 $693.86
$319.68 $375.63 $598.40 $703.12
$321.79 $378.10 $602.35 $707.76
$323.90 $380.58 $606.29 $712.39
$326.00 $383.05 $610.23 $717.02
$328.11 $385.53 $614.18 $721.66
$332.32 $390.48 $622.06 $730.92
$336.54 $412.26 $629.95 $771.69
$342.86 $420.00 $641.78 $786.18
$348.91 $427.42 $653.12 $800.07
$357.34 $437.74 $668.89 $819.39
$367.87 $450.64 $688.61 $843.54
$380.25 $465.80 $711.77 $871.92
$394.99 $483.87 $739.38 $905.74
$411.58 $504.19 $770.43 $943.78
$430.54 $527.42 $805.92 $987.25
$449.24 $550.32 $840.92 $1,030.13
$470.31 $646.67 $880.35 $1,210.49
$491.11 $675.28 $919.29 $1,264.03
$514.02 $706.78 $962.18 $1,322.99
$537.19 $738.64 $1,005.55 $1,382.64
$562.21 $773.04 $1,052.38 $1,447.02
$587.23 $807.43 $1,099.21 $1,511.41
$614.35 $844.73 $1,149.98 $1,581.22
$641.73 $882.38 $1,201.24 $1,651.71
$670.96 $922.58 $1,255.96 $1,726.94
$685.45 $942.49 $1,283.07 $1,764.22
$714.68 $982.68 $1,337.78 $1,839.45
$739.96 $1,017.44 $1,385.10 $1,904.51
$756.55 $1,040.25 $1,416.16 $1,947.21
$777.35 $1,068.85 $1,455.10 $2,000.76
$789.99 $1,086.23 $1,478.76 $2,033.29
$789.99 $1,086.23 $1,478.76 $2,033.29
33871PA0110001
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
$10/$20
#NAME?
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0100009
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Silver Proactive
$0/$5500/$5500
0%/5%/10%
$7,150
No
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
Page Number: 6 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110002 33871PA0110003
Non-Tobacco Tobacco Non-Tobacco Tobacco
$299.20 $299.20 $246.31 $246.31
$471.19 $530.09 $387.89 $436.38
$471.19 $530.09 $387.89 $436.38
$471.19 $530.09 $387.89 $436.38
$471.19 $530.09 $387.89 $436.38
$473.07 $532.21 $389.44 $438.12
$482.50 $542.81 $397.20 $446.85
$493.80 $555.53 $406.51 $457.33
$512.18 $576.20 $421.64 $474.34
$527.26 $593.17 $434.05 $488.31
$534.80 $628.39 $440.26 $517.30
$546.11 $641.67 $449.57 $528.24
$557.41 $654.96 $458.88 $539.18
$564.48 $663.27 $464.70 $546.02
$572.02 $672.13 $470.90 $553.31
$575.79 $676.55 $474.00 $556.96
$579.56 $680.98 $477.11 $560.60
$583.33 $685.41 $480.21 $564.25
$587.10 $689.84 $483.31 $567.89
$594.64 $698.70 $489.52 $575.19
$602.18 $737.67 $495.73 $607.26
$613.49 $751.52 $505.04 $618.67
$624.32 $764.80 $513.96 $629.60
$639.40 $783.27 $526.37 $644.80
$658.25 $806.35 $541.89 $663.81
$680.39 $833.48 $560.12 $686.14
$706.78 $865.81 $581.84 $712.75
$736.47 $902.17 $606.28 $742.69
$770.39 $943.73 $634.20 $776.90
$803.85 $984.71 $661.74 $810.64
$841.54 $1,157.12 $692.78 $952.57
$878.76 $1,208.30 $723.42 $994.70
$919.76 $1,264.67 $757.17 $1,041.10
$961.22 $1,321.68 $791.30 $1,088.04
$1,005.99 $1,383.23 $828.15 $1,138.71
$1,050.75 $1,444.78 $865.00 $1,189.38
$1,099.28 $1,511.51 $904.95 $1,244.31
$1,148.28 $1,578.89 $945.29 $1,299.78
$1,200.59 $1,650.81 $988.35 $1,358.98
$1,226.50 $1,686.44 $1,009.68 $1,388.32
$1,278.80 $1,758.35 $1,052.74 $1,447.52
$1,324.04 $1,820.55 $1,089.98 $1,498.72
$1,353.72 $1,861.37 $1,114.41 $1,532.32
$1,390.95 $1,912.55 $1,145.06 $1,574.46
$1,413.56 $1,943.65 $1,163.67 $1,600.06
$1,413.56 $1,943.65 $1,163.67 $1,600.06
33871PA0110003
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
$30/$60
#NAME?
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0110002
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
No
$20/$40
Page Number: 7 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110004 33871PA0110005
Non-Tobacco Tobacco Non-Tobacco Tobacco
$253.51 $253.51 $249.44 $249.44
$399.23 $449.14 $392.82 $441.92
$399.23 $449.14 $392.82 $441.92
$399.23 $449.14 $392.82 $441.92
$399.23 $449.14 $392.82 $441.92
$400.83 $450.93 $394.39 $443.69
$408.81 $459.92 $402.24 $452.53
$418.40 $470.69 $411.67 $463.13
$433.97 $488.21 $426.99 $480.37
$446.74 $502.58 $439.56 $494.51
$453.13 $532.43 $445.85 $523.87
$462.71 $543.68 $455.27 $534.95
$472.29 $554.94 $464.70 $546.03
$478.28 $561.98 $470.59 $552.95
$484.67 $569.48 $476.88 $560.33
$487.86 $573.24 $480.02 $564.03
$491.06 $576.99 $483.16 $567.72
$494.25 $580.74 $486.31 $571.41
$497.44 $584.50 $489.45 $575.10
$503.83 $592.00 $495.73 $582.49
$510.22 $625.02 $502.02 $614.97
$519.80 $636.76 $511.45 $626.52
$528.98 $648.00 $520.48 $637.59
$541.76 $663.65 $533.05 $652.99
$557.73 $683.22 $548.77 $672.24
$576.49 $706.20 $567.23 $694.85
$598.85 $733.59 $589.23 $721.80
$624.00 $764.40 $613.97 $752.12
$652.74 $799.61 $642.26 $786.76
$681.09 $834.34 $670.15 $820.93
$713.03 $980.41 $701.57 $964.66
$744.57 $1,023.78 $732.60 $1,007.33
$779.30 $1,071.54 $766.78 $1,054.32
$814.43 $1,119.85 $801.35 $1,101.85
$852.36 $1,172.00 $838.66 $1,153.16
$890.29 $1,224.15 $875.98 $1,204.47
$931.41 $1,280.69 $916.44 $1,260.11
$972.93 $1,337.78 $957.29 $1,316.28
$1,017.24 $1,398.71 $1,000.90 $1,376.23
$1,039.20 $1,428.90 $1,022.50 $1,405.94
$1,083.52 $1,489.83 $1,066.10 $1,465.89
$1,121.84 $1,542.53 $1,103.82 $1,517.75
$1,146.99 $1,577.12 $1,128.56 $1,551.77
$1,178.53 $1,620.48 $1,159.60 $1,594.44
$1,197.69 $1,646.83 $1,178.45 $1,620.37
$1,197.69 $1,646.83 $1,178.45 $1,620.37
33871PA0110005
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
$40 no ded/$80 no ded
#NAME?Keystone DPOS Gold Classic
$2,000 $40/$80/100%
$2,000
0%
$3,500
33871PA0110004
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
No
$25 no ded/$50 no ded
Page Number: 8 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110006 33871PA0110010
Non-Tobacco Tobacco Non-Tobacco Tobacco
$217.76 $217.76 $153.99 $153.99
$342.93 $385.80 $242.51 $272.83
$342.93 $385.80 $242.51 $272.83
$342.93 $385.80 $242.51 $272.83
$342.93 $385.80 $242.51 $272.83
$344.30 $387.34 $243.48 $273.92
$351.16 $395.06 $248.33 $279.37
$359.39 $404.31 $254.15 $285.92
$372.77 $419.36 $263.61 $296.56
$383.74 $431.71 $271.37 $305.29
$389.23 $457.34 $275.25 $323.42
$397.46 $467.01 $281.07 $330.26
$405.69 $476.68 $286.89 $337.10
$410.83 $482.73 $290.53 $341.37
$416.32 $489.17 $294.41 $345.93
$419.06 $492.40 $296.35 $348.21
$421.80 $495.62 $298.29 $350.49
$424.55 $498.84 $300.23 $352.77
$427.29 $502.07 $302.17 $355.05
$432.78 $508.51 $306.05 $359.61
$438.27 $536.87 $309.93 $379.66
$446.50 $546.96 $315.75 $386.79
$454.38 $556.62 $321.33 $393.63
$465.36 $570.06 $329.09 $403.13
$479.07 $586.87 $338.79 $415.02
$495.19 $606.61 $350.19 $428.98
$514.40 $630.13 $363.77 $445.61
$536.00 $656.60 $379.05 $464.33
$560.69 $686.85 $396.51 $485.72
$585.04 $716.67 $413.72 $506.81
$612.47 $842.15 $433.13 $595.55
$639.57 $879.40 $452.28 $621.89
$669.40 $920.43 $473.38 $650.90
$699.58 $961.92 $494.72 $680.24
$732.16 $1,006.72 $517.76 $711.92
$764.73 $1,051.51 $540.80 $743.60
$800.06 $1,100.08 $565.78 $777.95
$835.72 $1,149.12 $591.00 $812.63
$873.79 $1,201.46 $617.92 $849.64
$892.65 $1,227.39 $631.26 $867.98
$930.71 $1,279.73 $658.18 $904.99
$963.63 $1,325.00 $681.46 $937.00
$985.24 $1,354.70 $696.74 $958.01
$1,012.33 $1,391.95 $715.89 $984.35
$1,028.79 $1,414.59 $727.53 $1,000.36
$1,028.79 $1,414.59 $727.53 $1,000.36
No
$50 no ded/$100 no ded
#NAME?
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0110010
KE 670 WPR GMC
8
Keystone Health Plan East Network
33871PA0110006
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
No
$25 no ded/$50 no ded
Page Number: 9 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100020 33871PA0100021
Non-Tobacco Tobacco Non-Tobacco Tobacco
$299.73 $299.73 $286.54 $286.54
$472.01 $531.01 $451.24 $507.65
$472.01 $531.01 $451.24 $507.65
$472.01 $531.01 $451.24 $507.65
$472.01 $531.01 $451.24 $507.65
$473.90 $533.14 $453.05 $509.68
$483.34 $543.76 $462.07 $519.83
$494.67 $556.50 $472.90 $532.01
$513.08 $577.21 $490.50 $551.81
$528.18 $594.20 $504.94 $568.06
$535.73 $629.49 $512.16 $601.79
$547.06 $642.80 $522.99 $614.51
$558.39 $656.11 $533.82 $627.24
$565.47 $664.43 $540.59 $635.19
$573.02 $673.30 $547.81 $643.67
$576.80 $677.74 $551.42 $647.91
$580.57 $682.17 $555.03 $652.16
$584.35 $686.61 $558.64 $656.40
$588.13 $691.05 $562.25 $660.64
$595.68 $699.92 $569.47 $669.12
$603.23 $738.96 $576.69 $706.44
$614.56 $752.84 $587.52 $719.71
$625.42 $766.13 $597.89 $732.42
$640.52 $784.64 $612.33 $750.11
$659.40 $807.77 $630.38 $772.22
$681.58 $834.94 $651.59 $798.20
$708.02 $867.32 $676.86 $829.16
$737.75 $903.75 $705.29 $863.98
$771.74 $945.38 $737.78 $903.78
$805.25 $986.43 $769.82 $943.03
$843.01 $1,159.14 $805.92 $1,108.14
$880.30 $1,210.42 $841.56 $1,157.15
$921.37 $1,266.88 $880.82 $1,211.13
$962.90 $1,323.99 $920.53 $1,265.73
$1,007.75 $1,385.65 $963.40 $1,324.67
$1,052.59 $1,447.31 $1,006.27 $1,383.62
$1,101.20 $1,514.15 $1,052.75 $1,447.52
$1,150.29 $1,581.65 $1,099.67 $1,512.05
$1,202.69 $1,653.69 $1,149.76 $1,580.92
$1,228.65 $1,689.39 $1,174.58 $1,615.05
$1,281.04 $1,761.43 $1,224.67 $1,683.92
$1,326.35 $1,823.74 $1,267.99 $1,743.48
$1,356.09 $1,864.62 $1,296.42 $1,782.57
$1,393.38 $1,915.90 $1,332.06 $1,831.59
$1,416.03 $1,947.05 $1,353.72 $1,861.37
$1,416.03 $1,947.05 $1,353.72 $1,861.37
$10/$20 $20/$40
Yes
33871PA0100021
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Platinum Preferred $20/$40/$150
$0
0%
$4,000
Yes
#NAME?
Keystone HMO Platinum Preferred $10/$20/$100
$0
0%
$3,000
33871PA0100020
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 10 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100022 33871PA0100023
Non-Tobacco Tobacco Non-Tobacco Tobacco
$236.38 $236.38 $244.04 $244.04
$372.24 $418.78 $384.32 $432.36
$372.24 $418.78 $384.32 $432.36
$372.24 $418.78 $384.32 $432.36
$372.24 $418.78 $384.32 $432.36
$373.73 $420.45 $385.86 $434.09
$381.18 $428.83 $393.54 $442.74
$390.11 $438.88 $402.77 $453.11
$404.63 $455.21 $417.75 $469.97
$416.54 $468.61 $430.05 $483.81
$422.50 $496.43 $436.20 $512.54
$431.43 $506.93 $445.43 $523.38
$440.37 $517.43 $454.65 $534.21
$445.95 $523.99 $460.41 $540.99
$451.90 $530.99 $466.56 $548.21
$454.88 $534.49 $469.64 $551.82
$457.86 $537.99 $472.71 $555.44
$460.84 $541.49 $475.79 $559.05
$463.82 $544.98 $478.86 $562.66
$469.77 $551.98 $485.01 $569.89
$475.73 $582.77 $491.16 $601.67
$484.66 $593.71 $500.38 $612.97
$493.22 $604.20 $509.22 $623.80
$505.14 $618.79 $521.52 $638.86
$520.03 $637.03 $536.89 $657.69
$537.52 $658.46 $554.96 $679.82
$558.37 $684.00 $576.48 $706.19
$581.82 $712.73 $600.69 $735.85
$608.62 $745.56 $628.36 $769.74
$635.05 $777.94 $655.65 $803.17
$664.83 $914.14 $686.39 $943.79
$694.24 $954.57 $716.75 $985.54
$726.62 $999.10 $750.19 $1,031.51
$759.38 $1,044.15 $784.01 $1,078.01
$794.74 $1,092.77 $820.52 $1,128.22
$830.11 $1,141.39 $857.03 $1,178.42
$868.45 $1,194.11 $896.62 $1,232.85
$907.16 $1,247.34 $936.59 $1,287.80
$948.48 $1,304.16 $979.24 $1,346.46
$968.95 $1,332.31 $1,000.38 $1,375.53
$1,010.27 $1,389.12 $1,043.04 $1,434.18
$1,046.01 $1,438.26 $1,079.94 $1,484.91
$1,069.46 $1,470.51 $1,104.15 $1,518.20
$1,098.87 $1,510.94 $1,134.51 $1,559.95
$1,116.72 $1,535.51 $1,152.96 $1,585.32
$1,116.72 $1,535.51 $1,152.96 $1,585.32
$30/$60 $25 no ded/$50 no ded
Yes
33871PA0100023
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
Yes
#NAME?
Keystone HMO Gold Preferred $30/$60/$650
$0
0%
$7,150
33871PA0100022
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 11 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100024 33871PA0100025
Non-Tobacco Tobacco Non-Tobacco Tobacco
$209.05 $209.05 $198.81 $198.81
$329.21 $370.36 $313.09 $352.23
$329.21 $370.36 $313.09 $352.23
$329.21 $370.36 $313.09 $352.23
$329.21 $370.36 $313.09 $352.23
$330.53 $371.84 $314.34 $353.64
$337.11 $379.25 $320.60 $360.68
$345.01 $388.14 $328.12 $369.13
$357.85 $402.58 $340.33 $382.87
$368.38 $414.43 $350.35 $394.14
$373.65 $439.04 $355.36 $417.54
$381.55 $448.32 $362.87 $426.37
$389.45 $457.61 $370.39 $435.20
$394.39 $463.41 $375.08 $440.72
$399.66 $469.60 $380.09 $446.61
$402.29 $472.69 $382.60 $449.55
$404.93 $475.79 $385.10 $452.49
$407.56 $478.88 $387.61 $455.44
$410.19 $481.98 $390.11 $458.38
$415.46 $488.17 $395.12 $464.27
$420.73 $515.39 $400.13 $490.16
$428.63 $525.07 $407.64 $499.36
$436.20 $534.35 $414.84 $508.18
$446.74 $547.25 $424.86 $520.46
$459.90 $563.38 $437.39 $535.80
$475.38 $582.34 $452.10 $553.82
$493.81 $604.92 $469.63 $575.30
$514.55 $630.33 $489.36 $599.47
$538.26 $659.36 $511.90 $627.08
$561.63 $688.00 $534.13 $654.31
$587.97 $808.45 $559.18 $768.87
$613.97 $844.22 $583.91 $802.88
$642.62 $883.60 $611.15 $840.33
$671.59 $923.43 $638.70 $878.22
$702.86 $966.43 $668.45 $919.11
$734.14 $1,009.44 $698.19 $960.01
$768.04 $1,056.06 $730.44 $1,004.35
$802.28 $1,103.14 $763.00 $1,049.13
$838.82 $1,153.38 $797.75 $1,096.91
$856.93 $1,178.28 $814.97 $1,120.59
$893.47 $1,228.53 $849.73 $1,168.37
$925.08 $1,271.98 $879.78 $1,209.70
$945.82 $1,300.50 $899.51 $1,236.82
$971.82 $1,336.26 $924.24 $1,270.83
$987.63 $1,357.99 $939.27 $1,291.50
$987.63 $1,357.99 $939.27 $1,291.50
$25 no ded/$50 no ded $30 no ded/$60 no ded
Yes
33871PA0100025
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone HMO Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
Yes
#NAME?
Keystone HMO Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
33871PA0100024
KE 670 WPR GMC
8
Keystone Health Plan East Network
Page Number: 12 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100026 33871PA0110011
Non-Tobacco Tobacco Non-Tobacco Tobacco
$148.17 $148.17 $313.59 $313.59
$233.34 $262.51 $493.85 $555.58
$233.34 $262.51 $493.85 $555.58
$233.34 $262.51 $493.85 $555.58
$233.34 $262.51 $493.85 $555.58
$234.27 $263.56 $495.82 $557.80
$238.94 $268.81 $505.70 $568.91
$244.54 $275.11 $517.55 $582.25
$253.64 $285.35 $536.81 $603.92
$261.11 $293.75 $552.62 $621.69
$264.84 $311.19 $560.52 $658.61
$270.44 $317.77 $572.37 $672.54
$276.04 $324.35 $584.22 $686.46
$279.54 $328.46 $591.63 $695.17
$283.28 $332.85 $599.53 $704.45
$285.14 $335.04 $603.48 $709.09
$287.01 $337.24 $607.43 $713.74
$288.88 $339.43 $611.39 $718.38
$290.74 $341.62 $615.34 $723.02
$294.48 $346.01 $623.24 $732.30
$298.21 $365.31 $631.14 $773.15
$303.81 $372.17 $642.99 $787.66
$309.18 $378.74 $654.35 $801.58
$316.64 $387.89 $670.15 $820.94
$325.98 $399.32 $689.91 $845.14
$336.94 $412.76 $713.12 $873.57
$350.01 $428.76 $740.77 $907.45
$364.71 $446.77 $771.89 $945.56
$381.51 $467.35 $807.44 $989.12
$398.08 $487.65 $842.51 $1,032.07
$416.75 $573.03 $882.01 $1,212.77
$435.18 $598.37 $921.03 $1,266.41
$455.48 $626.29 $963.99 $1,325.49
$476.02 $654.52 $1,007.45 $1,385.25
$498.18 $685.00 $1,054.37 $1,449.76
$520.35 $715.48 $1,101.28 $1,514.26
$544.39 $748.53 $1,152.15 $1,584.21
$568.65 $781.90 $1,203.51 $1,654.83
$594.55 $817.51 $1,258.33 $1,730.20
$607.39 $835.16 $1,285.49 $1,767.55
$633.29 $870.77 $1,340.31 $1,842.92
$655.69 $901.57 $1,387.72 $1,908.11
$670.39 $921.79 $1,418.83 $1,950.89
$688.82 $947.13 $1,457.84 $2,004.53
$700.02 $962.53 $1,481.55 $2,037.13
$700.02 $962.53 $1,481.55 $2,037.13
$50 no ded/$100 no ded
Yes
33871PA0110011
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Platinum Preferred $10/$20/$100
$0
0%
$3,000
Yes
#NAME?
Keystone HMO Bronze Essential $6,850/$50/$100/$700
$6,850
50%
$7,150
33871PA0100026
KE 670 WPR GMC
8
Keystone Health Plan East Network
$10/$20
Page Number: 13 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110012 33871PA0110013
Non-Tobacco Tobacco Non-Tobacco Tobacco
$299.79 $299.79 $246.90 $246.90
$472.12 $531.13 $388.82 $437.43
$472.12 $531.13 $388.82 $437.43
$472.12 $531.13 $388.82 $437.43
$472.12 $531.13 $388.82 $437.43
$474.01 $533.26 $390.38 $439.18
$483.45 $543.88 $398.15 $447.92
$494.78 $556.63 $407.49 $458.42
$513.19 $577.34 $422.65 $475.48
$528.30 $594.34 $435.09 $489.48
$535.85 $629.63 $441.31 $518.54
$547.18 $642.94 $450.65 $529.51
$558.52 $656.26 $459.98 $540.47
$565.60 $664.58 $465.81 $547.33
$573.15 $673.45 $472.03 $554.64
$576.93 $677.89 $475.14 $558.29
$580.70 $682.33 $478.25 $561.95
$584.48 $686.77 $481.36 $565.60
$588.26 $691.20 $484.47 $569.26
$595.81 $700.08 $490.69 $576.57
$603.37 $739.12 $496.92 $608.72
$614.70 $753.00 $506.25 $620.15
$625.56 $766.31 $515.19 $631.11
$640.66 $784.81 $527.63 $646.35
$659.55 $807.95 $543.19 $665.40
$681.74 $835.13 $561.46 $687.79
$708.18 $867.52 $583.23 $714.46
$737.92 $903.95 $607.73 $744.47
$771.91 $945.59 $635.73 $778.76
$805.43 $986.66 $663.33 $812.58
$843.20 $1,159.40 $694.44 $954.85
$880.50 $1,210.69 $725.15 $997.09
$921.57 $1,267.16 $758.98 $1,043.60
$963.12 $1,324.29 $793.20 $1,090.65
$1,007.97 $1,385.96 $830.14 $1,141.44
$1,052.82 $1,447.63 $867.07 $1,192.23
$1,101.45 $1,514.49 $907.12 $1,247.29
$1,150.55 $1,582.01 $947.56 $1,302.90
$1,202.96 $1,654.06 $990.72 $1,362.24
$1,228.92 $1,689.77 $1,012.11 $1,391.65
$1,281.33 $1,761.83 $1,055.26 $1,450.99
$1,326.65 $1,824.15 $1,092.59 $1,502.31
$1,356.39 $1,865.04 $1,117.09 $1,536.00
$1,393.69 $1,916.33 $1,147.80 $1,578.23
$1,416.35 $1,947.49 $1,166.46 $1,603.89
$1,416.35 $1,947.49 $1,166.46 $1,603.89
$30/$60
Yes
33871PA0110013
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Gold Preferred $30/$60/$650
$0
0%
$7,150
Yes
#NAME?
Keystone DPOS Platinum Preferred $20/$40/$150
$0
0%
$4,000
33871PA0110012
KE 670 WPR GMC
8
Keystone Health Plan East Network
$20/$40
Page Number: 14 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110014 33871PA0110016
Non-Tobacco Tobacco Non-Tobacco Tobacco
$254.10 $254.10 $218.35 $218.35
$400.16 $450.18 $343.86 $386.84
$400.16 $450.18 $343.86 $386.84
$400.16 $450.18 $343.86 $386.84
$400.16 $450.18 $343.86 $386.84
$401.76 $451.98 $345.24 $388.39
$409.77 $460.99 $352.11 $396.13
$419.37 $471.79 $360.37 $405.41
$434.98 $489.35 $373.78 $420.50
$447.78 $503.75 $384.78 $432.88
$454.18 $533.67 $390.28 $458.58
$463.79 $544.95 $398.53 $468.28
$473.39 $556.24 $406.79 $477.98
$479.39 $563.29 $411.95 $484.04
$485.80 $570.81 $417.45 $490.50
$489.00 $574.57 $420.20 $493.73
$492.20 $578.33 $422.95 $496.96
$495.40 $582.10 $425.70 $500.20
$498.60 $585.86 $428.45 $503.43
$505.00 $593.38 $433.95 $509.89
$511.41 $626.47 $439.45 $538.33
$521.01 $638.24 $447.71 $548.44
$530.22 $649.51 $455.62 $558.13
$543.02 $665.20 $466.62 $571.61
$559.03 $684.81 $480.37 $588.46
$577.83 $707.85 $496.53 $608.26
$600.24 $735.30 $515.79 $631.84
$625.45 $766.18 $537.45 $658.38
$654.27 $801.48 $562.21 $688.71
$682.68 $836.28 $586.63 $718.62
$714.69 $982.70 $614.14 $844.44
$746.30 $1,026.17 $641.30 $881.79
$781.12 $1,074.04 $671.22 $922.92
$816.33 $1,122.46 $701.48 $964.53
$854.35 $1,174.73 $734.14 $1,009.45
$892.36 $1,227.00 $766.81 $1,054.36
$933.58 $1,283.67 $802.23 $1,103.06
$975.20 $1,340.89 $837.99 $1,152.23
$1,019.61 $1,401.97 $876.16 $1,204.72
$1,041.62 $1,432.23 $895.07 $1,230.72
$1,086.04 $1,493.31 $933.24 $1,283.20
$1,124.46 $1,546.13 $966.25 $1,328.59
$1,149.67 $1,580.79 $987.91 $1,358.38
$1,181.28 $1,624.26 $1,015.08 $1,395.73
$1,200.48 $1,650.67 $1,031.58 $1,418.43
$1,200.48 $1,650.67 $1,031.58 $1,418.43
$25 no ded/$50 no ded
Yes
33871PA0110016
KE 670 WPR GMC
8
Keystone Health Plan East Network
#NAME?
Keystone DPOS Silver Classic $2,500/$25/$50/70%
$2,500
30%
$7,150
Yes
#NAME?
Keystone DPOS Gold Classic $1,000 $25/$50/90%
$1,000
10%
$5,500
33871PA0110014
KE 670 WPR GMC
8
Keystone Health Plan East Network
$25 no ded/$50 no ded
Page Number: 15 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110019 33871PA0110020
Non-Tobacco Tobacco Non-Tobacco Tobacco
$207.60 $207.60 $154.59 $154.59
$326.94 $367.80 $243.44 $273.87
$326.94 $367.80 $243.44 $273.87
$326.94 $367.80 $243.44 $273.87
$326.94 $367.80 $243.44 $273.87
$328.24 $369.27 $244.42 $274.97
$334.78 $376.63 $249.28 $280.45
$342.63 $385.46 $255.13 $287.02
$355.38 $399.80 $264.62 $297.70
$365.84 $411.57 $272.41 $306.46
$371.07 $436.01 $276.31 $324.66
$378.92 $445.23 $282.15 $331.53
$386.77 $454.45 $287.99 $338.39
$391.67 $460.21 $291.64 $342.68
$396.90 $466.36 $295.54 $347.26
$399.52 $469.43 $297.49 $349.55
$402.13 $472.50 $299.43 $351.83
$404.75 $475.58 $301.38 $354.12
$407.36 $478.65 $303.33 $356.41
$412.59 $484.80 $307.22 $360.99
$417.82 $511.83 $311.12 $381.12
$425.67 $521.45 $316.96 $388.28
$433.19 $530.66 $322.56 $395.14
$443.65 $543.47 $330.35 $404.68
$456.73 $559.49 $340.09 $416.61
$472.10 $578.32 $351.53 $430.62
$490.40 $600.75 $365.16 $447.32
$511.00 $625.98 $380.50 $466.11
$534.54 $654.81 $398.03 $487.58
$557.75 $683.25 $415.31 $508.76
$583.91 $802.87 $434.79 $597.83
$609.74 $838.39 $454.02 $624.28
$638.18 $877.50 $475.20 $653.40
$666.95 $917.06 $496.62 $682.85
$698.01 $959.76 $519.75 $714.65
$729.07 $1,002.47 $542.88 $746.45
$762.74 $1,048.77 $567.95 $780.93
$796.74 $1,095.52 $593.27 $815.74
$833.03 $1,145.42 $620.29 $852.90
$851.01 $1,170.15 $633.68 $871.31
$887.30 $1,220.04 $660.70 $908.46
$918.69 $1,263.20 $684.07 $940.60
$939.29 $1,291.52 $699.41 $961.69
$965.12 $1,327.03 $718.64 $988.13
$980.81 $1,348.61 $730.32 $1,004.20
$980.81 $1,348.61 $730.32 $1,004.20
#NAME?
Keystone DPOS Silver Classic $2,750/$30/$60/50%
$2,750
50%
$7,150
33871PA0110019
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30 no ded/$60 no ded
$6,850
Keystone DPOS Bronze Essential $6,850/$50/$100/$700
50%
#NAME?
$7,150
$50 no ded/$100 no ded
8
KE 670 WPR GMC
Keystone Health Plan East Network
Yes
33871PA0110020
Yes
Page Number: 16 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100044 33871PA0100045
Non-Tobacco Tobacco Non-Tobacco Tobacco
$211.40 $211.40 $167.81 $167.81
$332.91 $374.53 $264.26 $297.29
$332.91 $374.53 $264.26 $297.29
$332.91 $374.53 $264.26 $297.29
$332.91 $374.53 $264.26 $297.29
$334.24 $376.02 $265.32 $298.48
$340.90 $383.51 $270.60 $304.43
$348.89 $392.50 $276.94 $311.56
$361.88 $407.11 $287.25 $323.16
$372.53 $419.09 $295.71 $332.67
$377.86 $443.98 $299.94 $352.42
$385.85 $453.37 $306.28 $359.88
$393.83 $462.76 $312.62 $367.33
$398.83 $468.62 $316.58 $371.99
$404.16 $474.88 $320.81 $376.95
$406.82 $478.01 $322.93 $379.44
$409.48 $481.14 $325.04 $381.92
$412.15 $484.27 $327.15 $384.41
$414.81 $487.40 $329.27 $386.89
$420.13 $493.66 $333.50 $391.86
$425.46 $521.19 $337.72 $413.71
$433.45 $530.98 $344.07 $421.48
$441.11 $540.36 $350.14 $428.93
$451.76 $553.41 $358.60 $439.29
$465.08 $569.72 $369.17 $452.23
$480.72 $588.89 $381.59 $467.45
$499.37 $611.73 $396.39 $485.58
$520.34 $637.42 $413.04 $505.97
$544.31 $666.78 $432.06 $529.28
$567.95 $695.74 $450.83 $552.26
$594.58 $817.55 $471.97 $648.96
$620.88 $853.71 $492.84 $677.66
$649.84 $893.54 $515.84 $709.27
$679.14 $933.82 $539.09 $741.25
$710.77 $977.30 $564.19 $775.77
$742.39 $1,020.79 $589.30 $810.29
$776.68 $1,067.94 $616.52 $847.71
$811.31 $1,115.55 $644.00 $885.50
$848.26 $1,166.36 $673.33 $925.83
$866.57 $1,191.53 $687.87 $945.82
$903.52 $1,242.34 $717.20 $986.15
$935.48 $1,286.29 $742.57 $1,021.03
$956.46 $1,315.13 $759.22 $1,043.93
$982.76 $1,351.29 $780.10 $1,072.63
$998.73 $1,373.26 $792.78 $1,090.07
$998.73 $1,373.26 $792.78 $1,090.07
Yes
$0/$5500/$5500
Keystone HMO Silver Proactive
0%/5%/10%
#NAME?
33871PA0100045
KE 670 WPR GMC
8
Keystone Health Plan East Network
$30/$60, $40 no ded/$80 no ded, $50 no ded/$100 no ded
$7,150
KE 670 WPR GMC
8
Keystone Health Plan East Network
Yes
$0
Keystone HMO Gold Proactive
0%/20%/30%
#NAME?
$7,150
$15/$40, $30/$60, $45/$80
33871PA0100044
Page Number: 17 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100035 33871PA0100037
Non-Tobacco Tobacco Non-Tobacco Tobacco
$242.26 $242.26 $190.31 $190.31
$381.50 $429.19 $299.71 $337.17
$381.50 $429.19 $299.71 $337.17
$381.50 $429.19 $299.71 $337.17
$381.50 $429.19 $299.71 $337.17
$383.03 $430.91 $300.91 $338.52
$390.66 $439.49 $306.90 $345.26
$399.82 $449.79 $314.09 $353.35
$414.70 $466.53 $325.78 $366.50
$426.90 $480.27 $335.37 $377.29
$433.01 $508.78 $340.17 $399.70
$442.16 $519.54 $347.36 $408.15
$451.32 $530.30 $354.55 $416.60
$457.04 $537.03 $359.05 $421.88
$463.15 $544.20 $363.84 $427.52
$466.20 $547.78 $366.24 $430.33
$469.25 $551.37 $368.64 $433.15
$472.30 $554.96 $371.04 $435.97
$475.36 $558.54 $373.43 $438.79
$481.46 $565.71 $378.23 $444.42
$487.56 $597.26 $383.03 $469.21
$496.72 $608.48 $390.22 $478.02
$505.49 $619.23 $397.11 $486.46
$517.70 $634.19 $406.70 $498.21
$532.96 $652.88 $418.69 $512.90
$550.89 $674.84 $432.78 $530.15
$572.26 $701.02 $449.56 $550.71
$596.29 $730.46 $468.44 $573.84
$623.76 $764.11 $490.02 $600.27
$650.85 $797.29 $511.30 $626.34
$681.37 $936.88 $535.28 $736.00
$711.51 $978.32 $558.95 $768.56
$744.70 $1,023.96 $585.03 $804.41
$778.27 $1,070.12 $611.40 $840.68
$814.51 $1,119.96 $639.87 $879.83
$850.76 $1,169.79 $668.35 $918.98
$890.05 $1,223.82 $699.22 $961.42
$929.73 $1,278.38 $730.38 $1,004.28
$972.07 $1,336.60 $763.65 $1,050.02
$993.06 $1,365.45 $780.14 $1,072.69
$1,035.40 $1,423.68 $813.40 $1,118.43
$1,072.03 $1,474.04 $842.18 $1,157.99
$1,096.06 $1,507.09 $861.06 $1,183.95
$1,126.20 $1,548.53 $884.73 $1,216.51
$1,144.50 $1,573.71 $899.12 $1,236.29
$1,144.50 $1,573.71 $899.12 $1,236.29
$40 no ded/$80 no ded
Keystone HMO Gold Classic $2,000/$40/$80/100% Keystone HMO Silver Secure $3,500 $40/$80/$600
33871PA0100037
KE 670 WPR GMC
8
Keystone Health Plan East Network
0%
#NAME? #NAME?
$2,000 $3,500
$3,500 $7,150
No
0%
$40 no ded/$80 no ded
33871PA0100035
KE 670 WPR GMC
8
Keystone Health Plan East Network
No
Page Number: 18 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100036 33871PA0110007
Non-Tobacco Tobacco Non-Tobacco Tobacco
$201.62 $201.62 $198.76 $198.76
$317.51 $357.20 $313.00 $352.13
$317.51 $357.20 $313.00 $352.13
$317.51 $357.20 $313.00 $352.13
$317.51 $357.20 $313.00 $352.13
$318.78 $358.63 $314.25 $353.54
$325.13 $365.77 $320.51 $360.58
$332.75 $374.35 $328.03 $369.03
$345.14 $388.28 $340.23 $382.76
$355.30 $399.71 $350.25 $394.03
$360.38 $423.44 $355.26 $417.43
$368.00 $432.40 $362.77 $426.25
$375.62 $441.35 $370.28 $435.08
$380.38 $446.95 $374.98 $440.60
$385.46 $452.91 $379.98 $446.48
$388.00 $455.90 $382.49 $449.42
$390.54 $458.88 $384.99 $452.37
$393.08 $461.87 $387.50 $455.31
$395.62 $464.85 $390.00 $458.25
$400.70 $470.82 $395.01 $464.13
$405.78 $497.08 $400.02 $490.02
$413.40 $506.42 $407.53 $499.22
$420.70 $515.36 $414.73 $508.04
$430.86 $527.81 $424.74 $520.31
$443.56 $543.37 $437.26 $535.65
$458.49 $561.65 $451.97 $553.67
$476.27 $583.43 $469.50 $575.14
$496.27 $607.93 $489.22 $599.30
$519.13 $635.94 $511.76 $626.90
$541.68 $663.55 $533.98 $654.13
$567.08 $779.73 $559.02 $768.65
$592.16 $814.22 $583.75 $802.65
$619.78 $852.20 $610.98 $840.10
$647.72 $890.62 $638.52 $877.97
$677.89 $932.10 $668.26 $918.86
$708.05 $973.57 $697.99 $959.74
$740.75 $1,018.54 $730.23 $1,004.07
$773.78 $1,063.94 $762.79 $1,048.83
$809.02 $1,112.40 $797.53 $1,096.60
$826.48 $1,136.41 $814.74 $1,120.27
$861.73 $1,184.87 $849.49 $1,168.05
$892.21 $1,226.79 $879.54 $1,209.36
$912.21 $1,254.29 $899.25 $1,236.48
$937.29 $1,288.78 $923.98 $1,270.47
$952.53 $1,309.74 $939.00 $1,291.13
$952.53 $1,309.74 $939.00 $1,291.13
$40 no ded/$80 no ded $40 no ded/$80 no ded
33871PA0110007
8
33871PA0100036
KE 670 WPR GMC
8
Keystone Health Plan East Network
0% 0%
No
#NAME? #NAME?
$4,250 $3,500
$7,150 $7,150
No
Keystone HMO Silver Classic $4,250 $40/$80/100% Keystone DPOS Silver Secure $3,500/$40/$80/$600
KE 670 WPR GMC
Keystone Health Plan East Network
Page Number: 19 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110008 33871PA0110009
Non-Tobacco Tobacco Non-Tobacco Tobacco
$210.56 $210.56 $207.01 $207.01
$331.59 $373.04 $326.01 $366.76
$331.59 $373.04 $326.01 $366.76
$331.59 $373.04 $326.01 $366.76
$331.59 $373.04 $326.01 $366.76
$332.92 $374.53 $327.31 $368.22
$339.55 $381.99 $333.83 $375.56
$347.51 $390.95 $341.65 $384.36
$360.44 $405.50 $354.37 $398.66
$371.05 $417.43 $364.80 $410.40
$376.36 $442.22 $370.02 $434.77
$384.31 $451.57 $377.84 $443.96
$392.27 $460.92 $385.66 $453.16
$397.25 $466.76 $390.56 $458.90
$402.55 $473.00 $395.77 $465.03
$405.20 $476.12 $398.38 $468.10
$407.86 $479.23 $400.99 $471.16
$410.51 $482.35 $403.60 $474.22
$413.16 $485.47 $406.20 $477.29
$418.47 $491.70 $411.42 $483.42
$423.77 $519.12 $416.64 $510.38
$431.73 $528.87 $424.46 $519.96
$439.36 $538.21 $431.96 $529.15
$449.97 $551.21 $442.39 $541.93
$463.23 $567.46 $455.43 $557.90
$478.82 $586.55 $470.75 $576.67
$497.39 $609.30 $489.01 $599.04
$518.28 $634.89 $509.55 $624.20
$542.15 $664.14 $533.02 $652.95
$565.70 $692.98 $556.17 $681.30
$592.22 $814.31 $582.25 $800.59
$618.42 $850.33 $608.00 $836.00
$647.27 $889.99 $636.36 $875.00
$676.45 $930.11 $665.05 $914.45
$707.95 $973.43 $696.02 $957.03
$739.45 $1,016.74 $726.99 $999.62
$773.60 $1,063.70 $760.57 $1,045.79
$808.09 $1,111.12 $794.48 $1,092.40
$844.90 $1,161.73 $830.66 $1,142.16
$863.13 $1,186.81 $848.59 $1,166.82
$899.94 $1,237.42 $884.78 $1,216.57
$931.77 $1,281.19 $916.08 $1,259.61
$952.66 $1,309.91 $936.61 $1,287.85
$978.86 $1,345.93 $962.37 $1,323.26
$994.77 $1,367.82 $978.02 $1,344.77
$994.77 $1,367.82 $978.02 $1,344.77
$7,150
$40 no ded/$80 no ded
$7,150
#NAME?
$4,250 $2,750
Keystone DPOS Silver Classic $2,750/$30/$60/50%
#NAME?
33871PA0110009
Keystone Health Plan East Network
KE 670 WPR GMC
33871PA0110008
8
0% 50%
$30 no ded/$60 no ded
Keystone DPOS Silver Classic $4,250 $40/$80/100%
NoNo
8
KE 670 WPR GMC
Keystone Health Plan East Network
Page Number: 20 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
OFF
33871PA0100047 33871PA0100049
Non-Tobacco Tobacco Non-Tobacco Tobacco
$242.85 $242.85 $190.90 $190.90
$382.44 $430.24 $300.64 $338.22
$382.44 $430.24 $300.64 $338.22
$382.44 $430.24 $300.64 $338.22
$382.44 $430.24 $300.64 $338.22
$383.96 $431.96 $301.84 $339.57
$391.61 $440.57 $307.85 $346.33
$400.79 $450.89 $315.07 $354.45
$415.71 $467.67 $326.79 $367.64
$427.94 $481.44 $336.41 $378.46
$434.06 $510.03 $341.22 $400.94
$443.24 $520.81 $348.44 $409.41
$452.42 $531.59 $355.65 $417.89
$458.16 $538.33 $360.16 $423.19
$464.28 $545.52 $364.97 $428.84
$467.34 $549.12 $367.38 $431.67
$470.40 $552.71 $369.78 $434.50
$473.45 $556.31 $372.19 $437.32
$476.51 $559.90 $374.59 $440.15
$482.63 $567.09 $379.40 $445.80
$488.75 $598.72 $384.21 $470.66
$497.93 $609.96 $391.43 $479.50
$506.73 $620.74 $398.34 $487.97
$518.96 $635.73 $407.96 $499.76
$534.26 $654.47 $419.99 $514.49
$552.24 $676.49 $434.12 $531.80
$573.65 $702.72 $450.96 $552.42
$597.75 $732.24 $469.90 $575.62
$625.28 $765.97 $491.54 $602.14
$652.43 $799.23 $512.89 $628.29
$683.03 $939.17 $536.94 $738.29
$713.24 $980.71 $560.69 $770.95
$746.51 $1,026.46 $586.84 $806.91
$780.17 $1,072.73 $613.30 $843.29
$816.50 $1,122.69 $641.86 $882.56
$852.83 $1,172.64 $670.42 $921.83
$892.22 $1,226.80 $701.39 $964.41
$931.99 $1,281.49 $732.65 $1,007.40
$974.44 $1,339.86 $766.02 $1,053.28
$995.48 $1,368.78 $782.56 $1,076.02
$1,037.93 $1,427.15 $815.93 $1,121.90
$1,074.64 $1,477.63 $844.79 $1,161.59
$1,098.74 $1,510.76 $863.73 $1,187.63
$1,128.95 $1,552.30 $887.48 $1,220.29
$1,147.31 $1,577.55 $901.91 $1,240.13
$1,147.31 $1,577.55 $901.91 $1,240.13
$3,500 $7,150
Yes
#NAME?
$2,000
8
Keystone HMO Gold Classic $2,000 $40/$80/100%
8
Keystone HMO Silver Secure $3,500 $40/$80/$600
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$3,500
Keystone Health Plan East Network
#NAME?
Keystone Health Plan East Network
Yes
33871PA0100047
KE 670 WPR GMC
33871PA0100049
KE 670 WPR GMC
Page Number: 21 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0100048 33871PA0110015
Non-Tobacco Tobacco Non-Tobacco Tobacco
$202.21 $202.21 $250.03 $250.03
$318.44 $358.25 $393.75 $442.97
$318.44 $358.25 $393.75 $442.97
$318.44 $358.25 $393.75 $442.97
$318.44 $358.25 $393.75 $442.97
$319.72 $359.68 $395.32 $444.74
$326.08 $366.85 $403.20 $453.60
$333.73 $375.44 $412.65 $464.23
$346.15 $389.41 $428.00 $481.50
$356.34 $400.88 $440.60 $495.68
$361.43 $424.68 $446.90 $525.11
$369.07 $433.66 $456.35 $536.21
$376.72 $442.64 $465.80 $547.32
$381.49 $448.25 $471.71 $554.26
$386.59 $454.24 $478.01 $561.66
$389.14 $457.24 $481.16 $565.36
$391.68 $460.23 $484.31 $569.06
$394.23 $463.22 $487.46 $572.76
$396.78 $466.22 $490.61 $576.47
$401.87 $472.20 $496.91 $583.87
$406.97 $498.54 $503.21 $616.43
$414.61 $507.90 $512.66 $628.01
$421.94 $516.87 $521.71 $639.10
$432.13 $529.35 $534.31 $654.54
$444.86 $544.96 $550.06 $673.83
$459.83 $563.29 $568.57 $696.50
$477.66 $585.14 $590.62 $723.51
$497.72 $609.71 $615.43 $753.90
$520.65 $637.80 $643.78 $788.63
$543.26 $665.50 $671.73 $822.87
$568.74 $782.01 $703.23 $966.94
$593.89 $816.60 $734.34 $1,009.72
$621.60 $854.70 $768.59 $1,056.82
$649.62 $893.23 $803.24 $1,104.46
$679.87 $934.83 $840.65 $1,155.89
$710.13 $976.42 $878.06 $1,207.33
$742.93 $1,021.52 $918.61 $1,263.09
$776.04 $1,067.06 $959.56 $1,319.40
$811.39 $1,115.66 $1,003.27 $1,379.49
$828.90 $1,139.74 $1,024.92 $1,409.27
$864.25 $1,188.35 $1,068.63 $1,469.37
$894.82 $1,230.38 $1,106.43 $1,521.34
$914.88 $1,257.97 $1,131.24 $1,555.45
$940.04 $1,292.56 $1,162.34 $1,598.22
$955.32 $1,313.57 $1,181.24 $1,624.21
$955.32 $1,313.57 $1,181.24 $1,624.21
Keystone HMO Silver Classic $4,250 $40/$80/100%
#NAME?
$4,250
0%
$40 no ded/$80 no ded
Keystone Health Plan East Network
Yes
$7,150
33871PA0100048
8 8
Keystone Health Plan East Network
KE 670 WPR GMC
Yes
33871PA0110015
0%
$40 no ded/$80 no ded
$3,500
#NAME?
Keystone DPOS Gold Classic $2,000/$40/$80/100%
$2,000
KE 670 WPR GMC
Page Number: 22 05/05/2016
RATE PAGES
Company Name: Keystone Health Plan East
Product: HMO
Effective Date of Rates: October 1, 2017 - December 31, 2017
Plan ID (On Exchange)=>
Plan ID (Off Exchange)=>
Form # =>
Rating Area =>
Network =>
Metal =>
Plan Name =>
Deductible =>
Coinsurance =>
Copays =>
OOP Maximum =>
Dental (Yes/No)Age Band
0-20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65+
33871PA0110017 33871PA0110018
Non-Tobacco Tobacco Non-Tobacco Tobacco
$199.35 $199.35 $211.15 $211.15
$313.93 $353.17 $332.52 $374.09
$313.93 $353.17 $332.52 $374.09
$313.93 $353.17 $332.52 $374.09
$313.93 $353.17 $332.52 $374.09
$315.19 $354.59 $333.85 $375.58
$321.47 $361.65 $340.50 $383.07
$329.00 $370.13 $348.48 $392.04
$341.24 $383.90 $361.45 $406.63
$351.29 $395.20 $372.09 $418.60
$356.31 $418.67 $377.41 $443.46
$363.85 $427.52 $385.39 $452.84
$371.38 $436.37 $393.37 $462.21
$376.09 $441.91 $398.36 $468.07
$381.11 $447.81 $403.68 $474.33
$383.63 $450.76 $406.34 $477.45
$386.14 $453.71 $409.00 $480.58
$388.65 $456.66 $411.66 $483.70
$391.16 $459.61 $414.32 $486.83
$396.18 $465.51 $419.64 $493.08
$401.21 $491.48 $424.96 $520.58
$408.74 $500.71 $432.94 $530.36
$415.96 $509.55 $440.59 $539.72
$426.01 $521.86 $451.23 $552.76
$438.56 $537.24 $464.53 $569.05
$453.32 $555.31 $480.16 $588.20
$470.90 $576.85 $498.78 $611.01
$490.68 $601.08 $519.73 $636.67
$513.28 $628.77 $543.67 $666.00
$535.57 $656.07 $567.28 $694.92
$560.68 $770.94 $593.88 $816.59
$585.48 $805.04 $620.15 $852.71
$612.80 $842.59 $649.08 $892.49
$640.42 $880.58 $678.34 $932.72
$670.25 $921.59 $709.93 $976.16
$700.07 $962.59 $741.52 $1,019.60
$732.40 $1,007.06 $775.77 $1,066.69
$765.05 $1,051.95 $810.36 $1,114.24
$799.90 $1,099.86 $847.27 $1,164.99
$817.17 $1,123.60 $865.55 $1,190.14
$852.01 $1,171.52 $902.46 $1,240.89
$882.15 $1,212.96 $934.39 $1,284.78
$901.93 $1,240.15 $955.34 $1,313.59
$926.73 $1,274.25 $981.60 $1,349.71
$941.79 $1,294.97 $997.56 $1,371.65
$941.79 $1,294.97 $997.56 $1,371.65
$3,500 $4,250
33871PA0110018
KE 670 WPR GMC
8 8
Keystone Health Plan East Network
Yes Yes
33871PA0110017
0% 0%
$40 no ded/$80 no ded $40 no ded/$80 no ded
$7,150 $7,150
Keystone Health Plan East Network
#NAME? #NAME?
Keystone DPOS Silver Secure $3,500 $40/$80/$600 Keystone DPOS Silver Classic $4,250 $40/$80/100%
KE 670 WPR GMC
Page Number: 23 05/05/2016
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100005 328.28
33871PA0100006 312.16
33871PA0100009 263.33
33871PA0100036 317.51
33871PA0100037 299.71
33871PA0110006 342.93
33871PA0110007 313
33871PA0110008 331.59
33871PA0110009 326.01
2017 On-Exchange Silver Plan Rates
Silver Plan Rates for Age 21 Non-Smoker, by Geographic Area and Exchange Status
HIOS Plan ID # Rating Area 1 Rating Area 2 Rating Area 3 Rating Area 4 Rating Area 5 Rating Area 6 Rating Area 7 Rating Area 8 Rating Area 9
33871PA0100024 329.21
33871PA0100025 313.09
33871PA0100045 264.26
33871PA0100048 318.44
33871PA0100049 300.64
33871PA0110016 343.86
33871PA0110017 313.93
33871PA0110018 332.52
33871PA0110019 326.94
2017 Off-Exchange Silver Plan Rates
2017 Rates Table Template v6.0 All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If macros are disabled, press and hold the ALT key and press the F, then I, and then N key. After that, select the Enable All Content option by pressing enter. (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5.If you are a community rating state, select Family Option under Age and fill in all columns.
If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band.
If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use.
To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet.
HIOS Issuer ID* 33871
Federal TIN* 23-2405376
Rate Effective Date* 1/1/2017
Rate Expiration Date* 3/31/2017
Plan ID* Rating Area ID* Tobacco* Age* Individual Rate* Individual Tobacco Rate*
Required:
Enter the 14-character Plan ID
Required:
Select the Rating Area ID
Require:
Select if Tobacco use of subscriber is used to
determine if a person is eligible for a rate from a
plan
Required:
Select the age of a subscriber eligible for the
rate
Required:
Enter the rate of an Individual Non-Tobacco or
No Preference enrollee on a plan
Required:
Enter the rate of an Individual tobacco enrollee
on a plan
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
274.54 274.54
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User21
432.34 486.39
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User22
432.34 486.39
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User23
432.34 486.39
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User24
432.34 486.39
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User25
434.07 488.33
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User26
442.72 498.06
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User27
453.10 509.73
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User28
469.96 528.70
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User29
483.79 544.27
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User30
490.71 576.58
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User31
501.09 588.78
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User32
511.46 600.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User33
517.95 608.59
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User34
524.86 616.72
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User35
528.32 620.78
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User36
531.78 624.84
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User37
535.24 628.91
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User38
538.70 632.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User39
545.62 641.10
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User40
552.53 676.86
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User41
562.91 689.57
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User42
572.86 701.75
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User43
586.69 718.70
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User44
603.98 739.88
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User45
624.30 764.77
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User46
648.52 794.43
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User47
675.75 827.80
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User48
706.88 865.93
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User49
737.58 903.53
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User50
772.17 1061.73
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User51
806.32 1108.69
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User52
843.93 1160.41
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User53
881.98 1212.72
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User54
923.05 1269.20
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User55
964.13 1325.67
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User56
1008.66 1386.90
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User57
1053.62 1448.73
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User58
1101.61 1514.72
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User59
1125.39 1547.41
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User60
1173.38 1613.40
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User61
1214.89 1670.47
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User62
1242.12 1707.92
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User63
1276.28 1754.88
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User64
1297.02 1783.42
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1297.02 1783.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
262.43 262.43
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User21
413.28 464.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User22
413.28 464.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User23
413.28 464.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User24
413.28 464.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User25
414.93 466.80
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User26
423.20 476.10
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User27
433.12 487.26
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User28
449.24 505.39
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User29
462.46 520.27
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User30
469.07 551.16
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User31
478.99 562.82
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User32
488.91 574.47
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User33
495.11 581.75
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User34
501.72 589.52
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User35
505.03 593.41
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User36
508.34 597.29
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User37
511.64 601.18
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User38
514.95 605.06
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User39
521.56 612.83
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User40
528.17 647.01
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User41
538.09 659.16
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User42
547.60 670.81
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User43
560.82 687.01
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User44
577.35 707.26
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User45
596.78 731.05
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User46
619.92 759.40
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User47
645.96 791.30
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User48
675.71 827.75
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User49
705.06 863.69
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User50
738.12 1014.91
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User51
770.77 1059.81
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User52
806.72 1109.25
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User53
843.09 1159.25
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User54
882.35 1213.24
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User55
921.62 1267.22
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User56
964.18 1325.75
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User57
1007.17 1384.85
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User58
1053.04 1447.93
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User59
1075.77 1479.18
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User60
1121.64 1542.26
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User61
1161.32 1596.81
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User62
1187.36 1632.61
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User63
1220.00 1677.51
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User64
1239.84 1704.78
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1239.84 1704.78
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
216.40 216.40
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User21
340.78 383.38
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User22
340.78 383.38
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User23
340.78 383.38
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User24
340.78 383.38
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User25
342.14 384.91
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User26
348.96 392.58
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User27
357.14 401.78
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User28
370.43 416.73
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User29
381.33 429.00
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User30
386.79 454.47
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User31
394.96 464.08
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User32
403.14 473.69
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User33
408.25 479.70
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User34
413.71 486.11
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User35
416.43 489.31
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User36
419.16 492.51
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User37
421.89 495.72
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User38
424.61 498.92
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User39
430.06 505.33
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User40
435.52 533.51
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User41
443.70 543.53
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User42
451.53 553.13
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User43
462.44 566.49
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User44
476.07 583.19
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User45
492.09 602.81
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User46
511.17 626.18
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User47
532.64 652.48
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User48
557.18 682.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User49
581.37 712.18
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User50
608.63 836.87
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User51
635.56 873.89
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User52
665.20 914.65
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User53
695.19 955.89
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User54
727.57 1000.40
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User55
759.94 1044.92
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User56
795.04 1093.18
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User57
830.48 1141.91
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User58
868.31 1193.92
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User59
887.05 1219.70
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User60
924.88 1271.71
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User61
957.59 1316.69
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User62
979.06 1346.21
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User63
1005.98 1383.23
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User64
1022.34 1405.72
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1022.34 1405.72
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
223.43 223.43
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User21
351.86 395.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User22
351.86 395.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User23
351.86 395.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User24
351.86 395.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User25
353.27 397.43
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User26
360.31 405.34
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User27
368.75 414.85
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User28
382.47 430.28
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User29
393.73 442.95
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User30
399.36 469.25
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User31
407.81 479.17
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User32
416.25 489.10
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User33
421.53 495.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User34
427.16 501.91
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User35
429.98 505.22
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User36
432.79 508.53
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User37
435.60 511.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User38
438.42 515.14
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User39
444.05 521.76
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User40
449.68 550.86
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User41
458.12 561.20
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User42
466.22 571.12
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User43
477.48 584.91
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User44
491.55 602.15
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User45
508.09 622.41
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User46
527.79 646.55
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User47
549.96 673.70
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User48
575.29 704.74
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User49
600.28 735.34
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User50
628.43 864.08
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User51
656.22 902.31
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User52
686.83 944.40
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User53
717.80 986.97
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User54
751.23 1032.93
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User55
784.65 1078.90
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User56
820.89 1128.73
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User57
857.49 1179.05
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User58
896.54 1232.75
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User59
915.90 1259.36
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User60
954.95 1313.06
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User61
988.73 1359.51
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User62
1010.90 1389.99
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User63
1038.70 1428.21
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User64
1055.58 1451.43
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1055.58 1451.43
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
191.32 191.32
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User21
301.28 338.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User22
301.28 338.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User23
301.28 338.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User24
301.28 338.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User25
302.49 340.30
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User26
308.51 347.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User27
315.75 355.21
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User28
327.50 368.43
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User29
337.14 379.28
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User30
341.96 401.80
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User31
349.19 410.30
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User32
356.42 418.79
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User33
360.94 424.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User34
365.76 429.77
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User35
368.17 432.60
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User36
370.58 435.43
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User37
372.99 438.26
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User38
375.40 441.09
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User39
380.22 446.76
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User40
385.04 471.67
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User41
392.27 480.53
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User42
399.20 489.02
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User43
408.84 500.83
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User44
420.89 515.59
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User45
435.05 532.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User46
451.93 553.61
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User47
470.91 576.86
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User48
492.60 603.43
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User49
513.99 629.64
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User50
538.09 739.88
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User51
561.89 772.60
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User52
588.11 808.65
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User53
614.62 845.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User54
643.24 884.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User55
671.86 923.81
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User56
702.89 966.48
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User57
734.23 1009.56
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User58
767.67 1055.55
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User59
784.24 1078.33
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User60
817.68 1124.31
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User61
846.61 1164.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User62
865.59 1190.18
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User63
889.39 1222.91
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User64
903.84 1242.79
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
903.84 1242.79
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
181.92 181.92
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User21
286.49 322.30
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User22
286.49 322.30
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User23
286.49 322.30
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User24
286.49 322.30
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User25
287.64 323.59
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User26
293.37 330.04
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User27
300.24 337.77
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User28
311.41 350.34
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User29
320.58 360.66
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User30
325.17 382.07
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User31
332.04 390.15
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User32
338.92 398.23
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User33
343.22 403.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User34
347.80 408.66
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User35
350.09 411.36
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User36
352.38 414.05
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User37
354.67 416.74
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User38
356.97 419.44
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User39
361.55 424.82
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User40
366.13 448.51
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User41
373.01 456.94
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User42
379.60 465.01
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User43
388.77 476.24
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User44
400.23 490.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User45
413.69 506.77
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User46
429.74 526.43
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User47
447.78 548.54
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User48
468.41 573.80
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User49
488.75 598.72
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User50
511.67 703.55
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User51
534.30 734.67
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User52
559.23 768.94
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User53
584.44 803.60
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User54
611.66 841.03
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User55
638.87 878.45
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User56
668.38 919.02
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User57
698.18 959.99
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User58
729.98 1003.72
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User59
745.73 1025.38
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User60
777.53 1069.11
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User61
805.04 1106.93
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User62
823.09 1131.74
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User63
845.72 1162.86
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User64
859.47 1181.77
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
859.47 1181.77
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
135.45 135.45
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User21
213.30 239.96
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User22
213.30 239.96
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User23
213.30 239.96
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User24
213.30 239.96
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User25
214.15 240.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User26
218.42 245.72
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User27
223.54 251.48
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User28
231.86 260.84
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User29
238.68 268.52
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User30
242.09 284.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User31
247.21 290.48
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User32
252.33 296.49
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User33
255.53 300.25
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User34
258.95 304.26
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User35
260.65 306.27
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User36
262.36 308.27
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User37
264.06 310.28
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User38
265.77 312.28
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User39
269.18 316.29
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User40
272.60 333.93
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User41
277.72 340.20
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User42
282.62 346.21
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User43
289.45 354.57
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User44
297.98 365.02
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User45
308.00 377.31
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User46
319.95 391.94
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User47
333.39 408.40
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User48
348.74 427.21
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User49
363.89 445.76
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User50
380.95 523.81
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User51
397.80 546.98
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User52
416.36 572.50
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User53
435.13 598.30
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User54
455.39 626.17
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User55
475.66 654.03
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User56
497.63 684.24
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User57
519.81 714.74
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User58
543.49 747.29
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User59
555.22 763.43
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User60
578.89 795.98
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User61
599.37 824.14
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User62
612.81 842.61
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User63
629.66 865.78
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User64
639.90 879.86
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
639.90 879.86
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
193.47 193.47
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User21
304.68 342.77
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User22
304.68 342.77
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User23
304.68 342.77
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User24
304.68 342.77
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User25
305.90 344.14
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User26
311.99 350.99
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User27
319.31 359.22
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User28
331.19 372.59
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User29
340.94 383.56
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User30
345.81 406.33
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User31
353.13 414.92
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User32
360.44 423.52
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User33
365.01 428.89
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User34
369.88 434.61
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User35
372.32 437.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User36
374.76 440.34
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User37
377.20 443.21
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User38
379.63 446.07
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User39
384.51 451.80
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User40
389.38 477.00
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User41
396.70 485.95
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User42
403.70 494.54
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User43
413.45 506.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User44
425.64 521.41
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User45
439.96 538.95
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User46
457.02 559.85
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User47
476.22 583.37
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User48
498.16 610.24
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User49
519.79 636.74
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User50
544.16 748.22
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User51
568.23 781.32
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User52
594.74 817.77
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User53
621.55 854.63
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User54
650.50 894.43
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User55
679.44 934.23
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User56
710.82 977.38
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User57
742.51 1020.95
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User58
776.33 1067.45
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User59
793.09 1090.50
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User60
826.91 1137.00
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User61
856.16 1177.22
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User62
875.35 1203.61
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User63
899.42 1236.71
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User64
914.04 1256.81
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
914.04 1256.81
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
153.46 153.46
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User21
241.68 271.88
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User22
241.68 271.88
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User23
241.68 271.88
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User24
241.68 271.88
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User25
242.64 272.97
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User26
247.48 278.41
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User27
253.28 284.94
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User28
262.70 295.54
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User29
270.43 304.24
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User30
274.30 322.30
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User31
280.10 329.12
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User32
285.90 335.93
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User33
289.53 340.19
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User34
293.39 344.74
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User35
295.33 347.01
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User36
297.26 349.28
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User37
299.19 351.55
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User38
301.13 353.83
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User39
304.99 358.37
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User40
308.86 378.36
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User41
314.66 385.46
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User42
320.22 392.27
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User43
327.95 401.74
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User44
337.62 413.59
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User45
348.98 427.50
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User46
362.51 444.08
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User47
377.74 462.73
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User48
395.14 484.05
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User49
412.30 505.07
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User50
431.63 593.49
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User51
450.72 619.75
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User52
471.75 648.66
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User53
493.02 677.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User54
515.98 709.47
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User55
538.94 741.04
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User56
563.83 775.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User57
588.96 809.82
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User58
615.79 846.71
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User59
629.08 864.99
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User60
655.91 901.87
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User61
679.11 933.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User62
694.33 954.71
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User63
713.43 980.96
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User64
725.03 996.91
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
725.03 996.91
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User0-20
222.33 222.33
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User21
350.13 393.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User22
350.13 393.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User23
350.13 393.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User24
350.13 393.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User25
351.53 395.48
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User26
358.54 403.35
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User27
366.94 412.81
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User28
380.59 428.17
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User29
391.80 440.77
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User30
397.40 466.95
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User31
405.80 476.82
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User32
414.21 486.69
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User33
419.46 492.86
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User34
425.06 499.45
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User35
427.86 502.74
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User36
430.66 506.03
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User37
433.46 509.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User38
436.27 512.61
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User39
441.87 519.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User40
447.47 548.15
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User41
455.87 558.44
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User42
463.93 568.31
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User43
475.13 582.03
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User44
489.14 599.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User45
505.59 619.35
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User46
525.20 643.37
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User47
547.26 670.39
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User48
572.47 701.27
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User49
597.33 731.73
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User50
625.34 859.84
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User51
653.00 897.87
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User52
683.46 939.76
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User53
714.27 982.12
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User54
747.53 1027.86
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User55
780.80 1073.60
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User56
816.86 1123.18
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User57
853.27 1173.25
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User58
892.14 1226.69
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User59
911.40 1253.17
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User60
950.26 1306.61
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User61
983.87 1352.83
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User62
1005.93 1383.16
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User63
1033.59 1421.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User64
1050.39 1444.30
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1050.39 1444.30
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User0-20
185.04 185.04
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User21
291.40 327.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User22
291.40 327.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User23
291.40 327.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User24
291.40 327.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User25
292.57 329.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User26
298.40 335.70
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User27
305.39 343.56
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User28
316.75 356.35
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User29
326.08 366.84
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User30
330.74 388.62
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User31
337.74 396.84
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User32
344.73 405.06
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User33
349.10 410.19
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User34
353.76 415.67
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User35
356.09 418.41
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User36
358.42 421.15
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User37
360.76 423.89
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User38
363.09 426.63
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User39
367.75 432.11
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User40
372.41 456.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User41
379.41 464.77
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User42
386.11 472.98
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User43
395.43 484.41
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User44
407.09 498.68
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User45
420.78 515.46
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User46
437.10 535.45
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User47
455.46 557.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User48
476.44 583.64
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User49
497.13 608.99
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User50
520.44 715.61
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User51
543.46 747.26
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User52
568.82 782.12
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User53
594.46 817.38
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User54
622.14 855.45
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User55
649.83 893.51
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User56
679.84 934.78
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User57
710.15 976.45
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User58
742.49 1020.93
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User59
758.52 1042.96
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User60
790.87 1087.44
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User61
818.84 1125.91
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User62
837.20 1151.15
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User63
860.22 1182.80
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User64
874.20 1202.03
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
874.20 1202.03
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User0-20
174.66 174.66
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User21
275.06 309.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User22
275.06 309.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User23
275.06 309.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User24
275.06 309.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User25
276.16 310.68
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User26
281.66 316.87
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User27
288.26 324.30
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User28
298.99 336.37
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User29
307.79 346.27
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User30
312.19 366.83
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User31
318.80 374.59
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User32
325.40 382.34
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User33
329.52 387.19
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User34
333.92 392.36
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User35
336.12 394.95
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User36
338.33 397.53
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User37
340.53 400.12
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User38
342.73 402.70
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User39
347.13 407.87
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User40
351.53 430.62
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User41
358.13 438.71
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User42
364.46 446.46
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User43
373.26 457.24
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User44
384.26 470.72
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User45
397.19 486.56
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User46
412.59 505.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User47
429.92 526.65
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User48
449.72 550.91
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User49
469.25 574.84
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User50
491.26 675.48
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User51
512.99 705.36
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User52
536.92 738.26
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User53
561.12 771.55
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User54
587.26 807.48
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User55
613.39 843.41
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User56
641.72 882.36
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User57
670.32 921.70
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User58
700.86 963.68
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User59
715.98 984.48
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User60
746.52 1026.46
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User61
772.92 1062.77
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User62
790.25 1086.59
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User63
811.98 1116.47
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User64
825.18 1134.63
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
825.18 1134.63
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
287.26 287.26
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User21
452.39 508.93
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User22
452.39 508.93
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User23
452.39 508.93
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User24
452.39 508.93
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User25
454.19 510.97
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User26
463.24 521.15
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User27
474.10 533.36
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User28
491.74 553.21
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User29
506.22 569.50
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User30
513.46 603.31
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User31
524.31 616.07
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User32
535.17 628.83
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User33
541.96 636.80
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User34
549.20 645.30
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User35
552.81 649.56
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User36
556.43 653.81
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User37
560.05 658.06
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User38
563.67 662.31
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User39
570.91 670.82
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User40
578.15 708.23
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User41
589.01 721.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User42
599.41 734.28
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User43
613.89 752.01
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User44
631.98 774.18
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User45
653.24 800.22
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User46
678.58 831.26
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User47
707.08 866.17
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User48
739.65 906.07
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User49
771.77 945.42
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User50
807.96 1110.94
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User51
843.70 1160.08
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User52
883.06 1214.20
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User53
922.87 1268.94
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User54
965.84 1328.03
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User55
1008.82 1387.13
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User56
1055.41 1451.19
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User57
1102.46 1515.89
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User58
1152.68 1584.93
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User59
1177.56 1619.14
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User60
1227.77 1688.19
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User61
1271.20 1747.90
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User62
1299.70 1787.09
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User63
1335.44 1836.23
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User64
1357.16 1866.09
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1357.16 1866.09
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
274.60 274.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User21
432.44 486.50
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User22
432.44 486.50
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User23
432.44 486.50
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User24
432.44 486.50
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User25
434.17 488.44
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User26
442.82 498.17
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User27
453.20 509.85
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User28
470.06 528.82
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User29
483.90 544.39
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User30
490.82 576.71
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User31
501.20 588.91
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User32
511.58 601.10
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User33
518.06 608.73
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User34
524.98 616.86
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User35
528.44 620.92
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User36
531.90 624.99
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User37
535.36 629.05
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User38
538.82 633.11
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User39
545.74 641.24
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User40
552.66 677.01
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User41
563.04 689.72
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User42
572.98 701.91
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User43
586.82 718.86
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User44
604.12 740.05
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User45
624.44 764.94
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User46
648.66 794.61
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User47
675.90 827.98
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User48
707.04 866.12
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User49
737.74 903.74
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User50
772.34 1061.97
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User51
806.50 1108.94
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User52
844.12 1160.67
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User53
882.18 1213.00
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User54
923.26 1269.48
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User55
964.34 1325.97
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User56
1008.88 1387.22
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User57
1053.86 1449.05
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User58
1101.86 1515.06
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User59
1125.64 1547.76
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User60
1173.64 1613.76
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User61
1215.16 1670.84
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User62
1242.40 1708.30
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User63
1276.57 1755.28
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User64
1297.32 1783.82
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1297.32 1783.82
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
226.06 226.06
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User21
356.00 400.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User22
356.00 400.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User23
356.00 400.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User24
356.00 400.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User25
357.42 402.10
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User26
364.54 410.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User27
373.08 419.72
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User28
386.97 435.34
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User29
398.36 448.15
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User30
404.05 474.76
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User31
412.60 484.80
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User32
421.14 494.84
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User33
426.48 501.12
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User34
432.18 507.81
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User35
435.03 511.16
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User36
437.87 514.50
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User37
440.72 517.85
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User38
443.57 521.19
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User39
449.27 527.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User40
454.96 557.33
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User41
463.51 567.79
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User42
471.69 577.82
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User43
483.09 591.78
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User44
497.33 609.22
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User45
514.06 629.72
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User46
533.99 654.14
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User47
556.42 681.62
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User48
582.05 713.01
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User49
607.33 743.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User50
635.81 874.24
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User51
663.93 912.91
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User52
694.90 955.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User53
726.23 998.57
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User54
760.05 1045.07
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User55
793.87 1091.57
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User56
830.54 1141.99
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User57
867.56 1192.90
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User58
907.08 1247.23
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User59
926.66 1274.15
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User60
966.17 1328.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User61
1000.35 1375.48
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User62
1022.77 1406.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User63
1050.90 1444.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User64
1067.99 1468.48
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1067.99 1468.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
232.67 232.67
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User21
366.40 412.20
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User22
366.40 412.20
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User23
366.40 412.20
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User24
366.40 412.20
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User25
367.87 413.85
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User26
375.20 422.10
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User27
383.99 431.99
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User28
398.28 448.06
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User29
410.00 461.25
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User30
415.87 488.64
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User31
424.66 498.98
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User32
433.45 509.31
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User33
438.95 515.77
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User34
444.81 522.65
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User35
447.74 526.10
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User36
450.67 529.54
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User37
453.61 532.99
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User38
456.54 536.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User39
462.40 543.32
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User40
468.26 573.62
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User41
477.06 584.39
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User42
485.48 594.72
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User43
497.21 609.08
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User44
511.86 627.03
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User45
529.09 648.13
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User46
549.60 673.26
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User47
572.69 701.54
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User48
599.07 733.86
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User49
625.08 765.73
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User50
654.39 899.79
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User51
683.34 939.59
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User52
715.22 983.42
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User53
747.46 1027.76
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User54
782.27 1075.62
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User55
817.08 1123.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User56
854.82 1175.37
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User57
892.92 1227.77
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User58
933.59 1283.69
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User59
953.75 1311.40
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User60
994.42 1367.32
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User61
1029.59 1415.69
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User62
1052.67 1447.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User63
1081.62 1487.23
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User64
1099.20 1511.41
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1099.20 1511.41
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
228.93 228.93
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User21
360.51 405.58
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User22
360.51 405.58
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User23
360.51 405.58
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User24
360.51 405.58
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User25
361.96 407.20
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User26
369.17 415.31
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User27
377.82 425.05
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User28
391.88 440.86
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User29
403.42 453.84
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User30
409.18 480.79
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User31
417.84 490.96
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User32
426.49 501.12
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User33
431.90 507.48
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User34
437.66 514.26
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User35
440.55 517.65
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User36
443.43 521.03
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User37
446.32 524.42
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User38
449.20 527.81
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User39
454.97 534.59
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User40
460.74 564.40
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User41
469.39 575.00
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User42
477.68 585.16
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User43
489.22 599.29
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User44
503.64 616.96
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User45
520.58 637.71
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User46
540.77 662.45
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User47
563.48 690.27
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User48
589.44 722.07
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User49
615.04 753.42
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User50
643.88 885.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User51
672.36 924.49
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User52
703.72 967.62
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User53
735.45 1011.24
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User54
769.70 1058.34
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User55
803.95 1105.43
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User56
841.08 1156.49
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User57
878.57 1208.04
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User58
918.59 1263.06
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User59
938.42 1290.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User60
978.44 1345.35
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User61
1013.05 1392.94
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User62
1035.76 1424.17
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User63
1064.24 1463.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User64
1081.53 1487.12
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1081.53 1487.12
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
199.85 199.85
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User21
314.73 354.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User22
314.73 354.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User23
314.73 354.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User24
314.73 354.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User25
315.99 355.49
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User26
322.28 362.57
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User27
329.84 371.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User28
342.11 384.88
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User29
352.18 396.21
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User30
357.22 419.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User31
364.77 428.61
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User32
372.33 437.48
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User33
377.05 443.03
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User34
382.08 448.95
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User35
384.60 451.91
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User36
387.12 454.86
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User37
389.64 457.82
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User38
392.15 460.78
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User39
397.19 466.70
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User40
402.23 492.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User41
409.78 501.98
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User42
417.02 510.85
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User43
427.09 523.18
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User44
439.68 538.61
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User45
454.47 556.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User46
472.10 578.32
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User47
491.92 602.61
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User48
514.58 630.37
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User49
536.93 657.74
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User50
562.11 772.90
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User51
586.97 807.09
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User52
614.35 844.74
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User53
642.05 882.82
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User54
671.95 923.93
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User55
701.85 965.04
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User56
734.27 1009.62
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User57
767.00 1054.62
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User58
801.93 1102.66
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User59
819.24 1126.46
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User60
854.18 1174.50
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User61
884.39 1216.04
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User62
904.22 1243.30
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User63
929.08 1277.49
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User64
944.19 1298.26
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
944.19 1298.26
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
182.41 182.41
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User21
287.26 323.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User22
287.26 323.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User23
287.26 323.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User24
287.26 323.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User25
288.41 324.46
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User26
294.16 330.93
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User27
301.05 338.68
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User28
312.26 351.29
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User29
321.45 361.63
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User30
326.04 383.10
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User31
332.94 391.20
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User32
339.83 399.30
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User33
344.14 404.37
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User34
348.74 409.77
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User35
351.04 412.47
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User36
353.33 415.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User37
355.63 417.87
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User38
357.93 420.57
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User39
362.53 425.97
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User40
367.12 449.72
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User41
374.02 458.17
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User42
380.62 466.26
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User43
389.82 477.52
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User44
401.31 491.60
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User45
414.81 508.14
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User46
430.89 527.85
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User47
448.99 550.02
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User48
469.68 575.35
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User49
490.07 600.34
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User50
513.05 705.45
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User51
535.75 736.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User52
560.74 771.01
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User53
586.02 805.77
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User54
613.31 843.30
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User55
640.60 880.82
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User56
670.18 921.50
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User57
700.06 962.58
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User58
731.95 1006.43
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User59
747.75 1028.15
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User60
779.63 1071.99
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User61
807.21 1109.91
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User62
825.31 1134.80
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User63
848.00 1166.00
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User64
861.78 1184.96
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
861.78 1184.96
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
193.25 193.25
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User21
304.32 342.36
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User22
304.32 342.36
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User23
304.32 342.36
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User24
304.32 342.36
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User25
305.54 343.73
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User26
311.63 350.58
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User27
318.93 358.80
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User28
330.80 372.15
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User29
340.54 383.11
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User30
345.41 405.85
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User31
352.71 414.44
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User32
360.02 423.02
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User33
364.58 428.38
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User34
369.45 434.10
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User35
371.88 436.96
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User36
374.32 439.82
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User37
376.75 442.69
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User38
379.19 445.55
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User39
384.06 451.27
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User40
388.93 476.43
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User41
396.23 485.38
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User42
403.23 493.96
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User43
412.97 505.89
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User44
425.14 520.80
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User45
439.44 538.32
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User46
456.49 559.20
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User47
475.66 582.68
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User48
497.57 609.52
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User49
519.18 635.99
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User50
543.52 747.34
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User51
567.56 780.40
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User52
594.04 816.81
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User53
620.82 853.63
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User54
649.73 893.38
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User55
678.64 933.13
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User56
709.99 976.23
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User57
741.64 1019.75
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User58
775.42 1066.20
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User59
792.16 1089.21
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User60
825.94 1135.66
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User61
855.15 1175.83
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User62
874.32 1202.19
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User63
898.36 1235.25
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User64
912.96 1255.34
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
912.96 1255.34
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
189.99 189.99
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User21
299.20 336.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User22
299.20 336.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User23
299.20 336.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User24
299.20 336.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User25
300.39 337.94
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User26
306.38 344.68
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User27
313.56 352.75
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User28
325.23 365.88
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User29
334.80 376.65
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User30
339.59 399.02
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User31
346.77 407.45
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User32
353.95 415.89
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User33
358.44 421.17
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User34
363.23 426.79
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User35
365.62 429.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User36
368.01 432.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User37
370.41 435.23
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User38
372.80 438.04
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User39
377.59 443.67
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User40
382.37 468.41
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User41
389.56 477.21
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User42
396.44 485.64
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User43
406.01 497.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User44
417.98 512.02
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User45
432.04 529.25
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User46
448.80 549.78
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User47
467.65 572.87
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User48
489.19 599.26
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User49
510.43 625.28
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User50
534.37 734.75
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User51
558.00 767.26
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User52
584.03 803.05
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User53
610.36 839.25
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User54
638.79 878.33
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User55
667.21 917.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User56
698.03 959.79
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User57
729.14 1002.57
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User58
762.36 1048.24
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User59
778.81 1070.87
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User60
812.02 1116.53
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User61
840.75 1156.03
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User62
859.60 1181.94
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User63
883.23 1214.44
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User64
897.59 1234.19
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
897.59 1234.19
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User0-20
141.33 141.33
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User21
222.57 250.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User22
222.57 250.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User23
222.57 250.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User24
222.57 250.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User25
223.46 251.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User26
227.91 256.40
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User27
233.25 262.41
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User28
241.93 272.17
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User29
249.06 280.19
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User30
252.62 296.82
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User31
257.96 303.10
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User32
263.30 309.38
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User33
266.64 313.30
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User34
270.20 317.48
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User35
271.98 319.58
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User36
273.76 321.67
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User37
275.54 323.76
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User38
277.32 325.85
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User39
280.88 330.04
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User40
284.44 348.44
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User41
289.79 354.99
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User42
294.90 361.26
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User43
302.03 369.98
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User44
310.93 380.89
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User45
321.39 393.70
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User46
333.85 408.97
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User47
347.88 426.15
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User48
363.90 445.78
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User49
379.70 465.14
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User50
397.51 546.57
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User51
415.09 570.75
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User52
434.46 597.38
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User53
454.04 624.31
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User54
475.19 653.38
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User55
496.33 682.45
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User56
519.25 713.97
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User57
542.40 745.80
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User58
567.11 779.77
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User59
579.35 796.60
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User60
604.05 830.57
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User61
625.42 859.95
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User62
639.44 879.23
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User63
657.02 903.41
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User64
667.71 918.10
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
667.71 918.10
2017 Rates Table Template v6.0 All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If macros are disabled, press and hold the ALT key and press the F, then I, and then N key. After that, select the Enable All Content option by pressing enter. (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5.If you are a community rating state, select Family Option under Age and fill in all columns.
If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band.
If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use.
To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet.
HIOS Issuer ID* 33871
Federal TIN* 23-2405376
Rate Effective Date* 4/1/2017
Rate Expiration Date* 6/30/2017
Plan ID* Rating Area ID* Tobacco* Age* Individual Rate* Individual Tobacco Rate*
Required:
Enter the 14-character Plan ID
Required:
Select the Rating Area ID
Require:
Select if Tobacco use of subscriber is used to
determine if a person is eligible for a rate from a
plan
Required:
Select the age of a subscriber eligible for the
rate
Required:
Enter the rate of an Individual Non-Tobacco or
No Preference enrollee on a plan
Required:
Enter the rate of an Individual tobacco enrollee
on a plan
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
282.50 282.50
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User21
444.88 500.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User22
444.88 500.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User23
444.88 500.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User24
444.88 500.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User25
446.66 502.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User26
455.56 512.50
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User27
466.24 524.52
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User28
483.59 544.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User29
497.82 560.05
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User30
504.94 593.30
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User31
515.62 605.85
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User32
526.29 618.40
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User33
532.97 626.24
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User34
540.09 634.60
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User35
543.65 638.78
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User36
547.20 642.96
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User37
550.76 647.15
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User38
554.32 651.33
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User39
561.44 659.69
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User40
568.56 696.48
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User41
579.24 709.56
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User42
589.47 722.10
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User43
603.70 739.54
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User44
621.50 761.34
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User45
642.41 786.95
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User46
667.32 817.47
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User47
695.35 851.80
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User48
727.38 891.04
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User49
758.97 929.74
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User50
794.56 1092.52
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User51
829.70 1140.84
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User52
868.41 1194.06
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User53
907.56 1247.89
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User54
949.82 1306.01
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User55
992.09 1364.12
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User56
1037.91 1427.12
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User57
1084.18 1490.74
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User58
1133.56 1558.64
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User59
1158.03 1592.29
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User60
1207.41 1660.19
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User61
1250.12 1718.91
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User62
1278.14 1757.45
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User63
1313.29 1805.77
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User64
1334.64 1835.14
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1334.64 1835.14
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
270.04 270.04
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User21
425.27 478.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User22
425.27 478.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User23
425.27 478.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User24
425.27 478.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User25
426.97 480.34
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User26
435.47 489.91
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User27
445.68 501.39
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User28
462.26 520.05
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User29
475.87 535.36
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User30
482.68 567.15
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User31
492.88 579.14
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User32
503.09 591.13
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User33
509.47 598.63
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User34
516.27 606.62
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User35
519.67 610.62
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User36
523.08 614.62
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User37
526.48 618.61
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User38
529.88 622.61
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User39
536.69 630.61
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User40
543.49 665.78
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User41
553.70 678.28
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User42
563.48 690.26
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User43
577.09 706.93
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User44
594.10 727.77
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User45
614.08 752.25
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User46
637.90 781.43
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User47
664.69 814.25
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User48
695.31 851.75
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User49
725.50 888.74
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User50
759.52 1044.35
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User51
793.12 1090.54
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User52
830.12 1141.41
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User53
867.54 1192.87
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User54
907.94 1248.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User55
948.34 1303.97
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User56
992.15 1364.20
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User57
1036.37 1425.01
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User58
1083.58 1489.92
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User59
1106.97 1522.08
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User60
1154.17 1586.99
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User61
1195.00 1643.12
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User62
1221.79 1679.96
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User63
1255.38 1726.15
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User64
1275.80 1754.22
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1275.80 1754.22
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
222.67 222.67
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User21
350.66 394.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User22
350.66 394.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User23
350.66 394.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User24
350.66 394.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User25
352.07 396.07
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User26
359.08 403.96
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User27
367.49 413.43
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User28
381.17 428.82
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User29
392.39 441.44
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User30
398.00 467.65
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User31
406.42 477.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User32
414.83 487.43
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User33
420.09 493.61
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User34
425.70 500.20
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User35
428.51 503.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User36
431.32 506.80
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User37
434.12 510.09
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User38
436.93 513.39
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User39
442.54 519.98
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User40
448.15 548.98
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User41
456.56 559.29
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User42
464.63 569.17
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User43
475.85 582.92
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User44
489.88 600.10
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User45
506.36 620.29
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User46
525.99 644.34
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User47
548.09 671.41
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User48
573.33 702.33
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User49
598.23 732.83
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User50
626.28 861.14
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User51
653.99 899.23
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User52
684.49 941.18
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User53
715.35 983.61
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User54
748.67 1029.41
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User55
781.98 1075.22
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User56
818.10 1124.88
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User57
854.57 1175.03
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User58
893.49 1228.55
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User59
912.78 1255.07
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User60
951.70 1308.59
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User61
985.36 1354.87
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User62
1007.45 1385.25
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User63
1035.16 1423.34
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User64
1051.98 1446.48
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1051.98 1446.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
229.91 229.91
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User21
362.07 407.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User22
362.07 407.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User23
362.07 407.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User24
362.07 407.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User25
363.51 408.95
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User26
370.76 417.10
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User27
379.44 426.88
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User28
393.57 442.76
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User29
405.15 455.80
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User30
410.94 482.86
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User31
419.63 493.07
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User32
428.32 503.28
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User33
433.75 509.66
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User34
439.55 516.47
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User35
442.44 519.87
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User36
445.34 523.28
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User37
448.24 526.68
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User38
451.13 530.08
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User39
456.93 536.89
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User40
462.72 566.83
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User41
471.41 577.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User42
479.74 587.68
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User43
491.32 601.87
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User44
505.81 619.61
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User45
522.82 640.46
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User46
543.10 665.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User47
565.91 693.24
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User48
591.98 725.17
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User49
617.68 756.66
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User50
646.65 889.14
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User51
675.25 928.47
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User52
706.75 971.78
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User53
738.61 1015.59
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User54
773.01 1062.89
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User55
807.41 1110.18
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User56
844.70 1161.46
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User57
882.35 1213.24
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User58
922.54 1268.50
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User59
942.46 1295.88
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User60
982.65 1351.14
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User61
1017.40 1398.93
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User62
1040.22 1430.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User63
1068.82 1469.63
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User64
1086.20 1493.52
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1086.20 1493.52
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
196.86 196.86
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User21
310.02 348.77
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User22
310.02 348.77
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User23
310.02 348.77
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User24
310.02 348.77
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User25
311.26 350.17
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User26
317.46 357.14
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User27
324.90 365.51
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User28
336.99 379.12
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User29
346.91 390.28
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User30
351.87 413.45
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User31
359.31 422.19
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User32
366.75 430.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User33
371.40 436.40
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User34
376.37 442.23
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User35
378.85 445.14
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User36
381.33 448.06
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User37
383.81 450.97
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User38
386.29 453.89
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User39
391.25 459.71
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User40
396.21 485.35
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User41
403.65 494.47
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User42
410.78 503.20
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User43
420.70 515.36
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User44
433.10 530.55
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User45
447.67 548.40
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User46
465.03 569.66
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User47
484.56 593.59
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User48
506.88 620.93
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User49
528.90 647.90
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User50
553.70 761.33
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User51
578.19 795.01
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User52
605.16 832.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User53
632.44 869.61
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User54
661.89 910.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User55
691.35 950.60
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User56
723.28 994.51
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User57
755.52 1038.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User58
789.93 1086.16
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User59
806.98 1109.60
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User60
841.40 1156.92
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User61
871.16 1197.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User62
890.69 1224.70
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User63
915.18 1258.37
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User64
930.06 1278.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
930.06 1278.84
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
187.20 187.20
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User21
294.80 331.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User22
294.80 331.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User23
294.80 331.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User24
294.80 331.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User25
295.98 332.97
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User26
301.87 339.61
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User27
308.95 347.57
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User28
320.45 360.50
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User29
329.88 371.11
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User30
334.60 393.15
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User31
341.67 401.46
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User32
348.75 409.78
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User33
353.17 414.97
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User34
357.89 420.52
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User35
360.24 423.29
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User36
362.60 426.06
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User37
364.96 428.83
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User38
367.32 431.60
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User39
372.04 437.14
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User40
376.75 461.52
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User41
383.83 470.19
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User42
390.61 478.49
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User43
400.04 490.05
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User44
411.83 504.50
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User45
425.69 521.47
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User46
442.20 541.69
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User47
460.77 564.44
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User48
482.00 590.44
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User49
502.93 616.08
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User50
526.51 723.95
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User51
549.80 755.97
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User52
575.45 791.24
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User53
601.39 826.91
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User54
629.39 865.42
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User55
657.40 903.93
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User56
687.76 945.68
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User57
718.42 987.83
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User58
751.15 1032.83
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User59
767.36 1055.12
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User60
800.08 1100.11
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User61
828.38 1139.03
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User62
846.96 1164.56
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User63
870.24 1196.59
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User64
884.39 1216.04
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
884.39 1216.04
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
139.37 139.37
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User21
219.49 246.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User22
219.49 246.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User23
219.49 246.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User24
219.49 246.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User25
220.36 247.91
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User26
224.75 252.85
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User27
230.02 258.77
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User28
238.58 268.40
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User29
245.60 276.30
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User30
249.12 292.71
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User31
254.38 298.90
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User32
259.65 305.09
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User33
262.94 308.96
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User34
266.45 313.08
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User35
268.21 315.15
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User36
269.97 317.21
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User37
271.72 319.27
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User38
273.48 321.34
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User39
276.99 325.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User40
280.50 343.61
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User41
285.77 350.07
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User42
290.82 356.25
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User43
297.84 364.86
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User44
306.62 375.61
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User45
316.94 388.25
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User46
329.23 403.30
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User47
343.06 420.24
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User48
358.86 439.60
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User49
374.44 458.69
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User50
392.00 539.00
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User51
409.34 562.84
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User52
428.44 589.10
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User53
447.75 615.66
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User54
468.60 644.33
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User55
489.45 673.00
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User56
512.06 704.08
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User57
534.89 735.47
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User58
559.25 768.97
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User59
571.32 785.56
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User60
595.68 819.06
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User61
616.75 848.04
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User62
630.58 867.05
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User63
647.92 890.89
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User64
658.46 905.38
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
658.46 905.38
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
199.08 199.08
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User21
313.52 352.71
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User22
313.52 352.71
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User23
313.52 352.71
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User24
313.52 352.71
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User25
314.77 354.12
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User26
321.04 361.17
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User27
328.57 369.64
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User28
340.79 383.39
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User29
350.83 394.68
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User30
355.84 418.12
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User31
363.37 426.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User32
370.89 435.80
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User33
375.59 441.32
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User34
380.61 447.22
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User35
383.12 450.16
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User36
385.63 453.11
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User37
388.14 456.06
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User38
390.64 459.01
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User39
395.66 464.90
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User40
400.68 490.83
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User41
408.20 500.05
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User42
415.41 508.88
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User43
425.44 521.17
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User44
437.98 536.53
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User45
452.72 554.58
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User46
470.28 576.09
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User47
490.03 600.29
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User48
512.60 627.94
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User49
534.86 655.21
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User50
559.94 769.92
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User51
584.71 803.98
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User52
611.99 841.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User53
639.58 879.42
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User54
669.36 920.37
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User55
699.15 961.32
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User56
731.44 1005.73
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User57
764.04 1050.56
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User58
798.84 1098.41
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User59
816.09 1122.12
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User60
850.89 1169.97
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User61
880.99 1211.36
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User62
900.74 1238.51
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User63
925.51 1272.57
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User64
940.55 1293.26
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
940.55 1293.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
157.91 157.91
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User21
248.68 279.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User22
248.68 279.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User23
248.68 279.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User24
248.68 279.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User25
249.68 280.89
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User26
254.65 286.48
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User27
260.62 293.20
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User28
270.32 304.11
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User29
278.28 313.06
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User30
282.26 331.65
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User31
288.22 338.66
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User32
294.19 345.68
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User33
297.92 350.06
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User34
301.90 354.74
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User35
303.89 357.07
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User36
305.88 359.41
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User37
307.87 361.75
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User38
309.86 364.09
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User39
313.84 368.76
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User40
317.82 389.33
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User41
323.79 396.64
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User42
329.51 403.65
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User43
337.46 413.39
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User44
347.41 425.58
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User45
359.10 439.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User46
373.03 456.96
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User47
388.69 476.15
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User48
406.60 498.08
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User49
424.26 519.71
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User50
444.15 610.71
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User51
463.80 637.72
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User52
485.43 667.47
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User53
507.32 697.56
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User54
530.94 730.04
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User55
554.57 762.53
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User56
580.18 797.75
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User57
606.04 833.31
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User58
633.65 871.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User59
647.32 890.07
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User60
674.93 928.03
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User61
698.80 960.85
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User62
714.47 982.40
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User63
734.12 1009.41
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User64
746.04 1025.82
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
746.04 1025.82
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User0-20
228.78 228.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User21
360.29 405.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User22
360.29 405.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User23
360.29 405.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User24
360.29 405.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User25
361.73 406.94
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User26
368.93 415.05
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User27
377.58 424.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User28
391.63 440.59
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User29
403.16 453.56
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User30
408.93 480.49
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User31
417.57 490.65
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User32
426.22 500.81
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User33
431.62 507.16
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User34
437.39 513.93
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User35
440.27 517.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User36
443.15 520.70
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User37
446.04 524.09
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User38
448.92 527.48
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User39
454.68 534.25
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User40
460.45 564.05
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User41
469.09 574.64
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User42
477.38 584.79
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User43
488.91 598.91
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User44
503.32 616.57
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User45
520.25 637.31
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User46
540.43 662.03
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User47
563.13 689.83
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User48
589.07 721.61
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User49
614.65 752.95
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User50
643.47 884.77
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User51
671.93 923.91
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User52
703.28 967.01
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User53
734.99 1010.60
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User54
769.21 1057.67
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User55
803.44 1104.73
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User56
840.55 1155.75
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User57
878.02 1207.28
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User58
918.01 1262.26
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User59
937.83 1289.51
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User60
977.82 1344.50
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User61
1012.41 1392.06
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User62
1035.10 1423.27
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User63
1063.57 1462.40
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User64
1080.86 1486.18
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1080.86 1486.18
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User0-20
190.41 190.41
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User21
299.85 337.33
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User22
299.85 337.33
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User23
299.85 337.33
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User24
299.85 337.33
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User25
301.05 338.68
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User26
307.05 345.43
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User27
314.25 353.53
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User28
325.94 366.68
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User29
335.54 377.48
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User30
340.33 399.89
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User31
347.53 408.35
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User32
354.73 416.80
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User33
359.22 422.09
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User34
364.02 427.73
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User35
366.42 430.54
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User36
368.82 433.36
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User37
371.22 436.18
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User38
373.62 439.00
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User39
378.41 444.64
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User40
383.21 469.43
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User41
390.41 478.25
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User42
397.30 486.70
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User43
406.90 498.45
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User44
418.89 513.15
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User45
432.99 530.41
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User46
449.78 550.98
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User47
468.67 574.12
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User48
490.26 600.57
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User49
511.55 626.65
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User50
535.54 736.36
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User51
559.23 768.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User52
585.31 804.80
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User53
611.70 841.09
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User54
640.19 880.26
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User55
668.67 919.42
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User56
699.56 961.89
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User57
730.74 1004.77
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User58
764.02 1050.53
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User59
780.52 1073.21
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User60
813.80 1118.98
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User61
842.59 1158.56
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User62
861.48 1184.53
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User63
885.17 1217.10
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User64
899.55 1236.89
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
899.55 1236.89
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User0-20
179.73 179.73
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User21
283.04 318.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User22
283.04 318.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User23
283.04 318.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User24
283.04 318.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User25
284.17 319.69
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User26
289.83 326.06
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User27
296.62 333.70
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User28
307.66 346.12
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User29
316.72 356.31
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User30
321.25 377.47
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User31
328.04 385.45
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User32
334.83 393.43
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User33
339.08 398.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User34
343.61 403.74
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User35
345.87 406.40
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User36
348.14 409.06
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User37
350.40 411.72
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User38
352.67 414.38
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User39
357.19 419.70
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User40
361.72 443.11
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User41
368.52 451.43
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User42
375.03 459.41
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User43
384.08 470.50
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User44
395.40 484.37
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User45
408.71 500.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User46
424.56 520.08
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User47
442.39 541.93
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User48
462.77 566.89
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User49
482.86 591.51
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User50
505.51 695.07
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User51
527.87 725.82
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User52
552.49 759.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User53
577.40 793.92
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User54
604.29 830.89
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User55
631.17 867.86
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User56
660.33 907.95
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User57
689.76 948.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User58
721.18 991.62
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User59
736.75 1013.03
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User60
768.16 1056.23
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User61
795.34 1093.59
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User62
813.17 1118.11
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User63
835.53 1148.85
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User64
849.11 1167.53
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
849.11 1167.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
295.60 295.60
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User21
465.50 523.69
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User22
465.50 523.69
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User23
465.50 523.69
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User24
465.50 523.69
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User25
467.37 525.79
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User26
476.68 536.26
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User27
487.85 548.83
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User28
506.00 569.25
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User29
520.90 586.01
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User30
528.35 620.81
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User31
539.52 633.94
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User32
550.69 647.06
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User33
557.67 655.27
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User34
565.12 664.02
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User35
568.85 668.39
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User36
572.57 672.77
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User37
576.29 677.15
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User38
580.02 681.52
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User39
587.47 690.27
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User40
594.91 728.77
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User41
606.09 742.46
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User42
616.79 755.57
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User43
631.69 773.82
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User44
650.31 796.63
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User45
672.19 823.43
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User46
698.26 855.36
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User47
727.58 891.29
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User48
761.10 932.35
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User49
794.15 972.83
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User50
831.39 1143.16
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User51
868.17 1193.73
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User52
908.66 1249.41
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User53
949.63 1305.74
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User54
993.85 1366.55
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User55
1038.07 1427.35
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User56
1086.02 1493.28
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User57
1134.43 1559.85
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User58
1186.10 1630.89
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User59
1211.71 1666.10
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User60
1263.38 1737.15
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User61
1308.07 1798.59
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User62
1337.39 1838.92
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User63
1374.17 1889.48
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User64
1396.50 1920.21
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1396.50 1920.21
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
282.56 282.56
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User21
444.98 500.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User22
444.98 500.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User23
444.98 500.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User24
444.98 500.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User25
446.76 502.61
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User26
455.66 512.62
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User27
466.34 524.63
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User28
483.69 544.16
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User29
497.93 560.18
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User30
505.05 593.44
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User31
515.73 605.99
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User32
526.41 618.54
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User33
533.09 626.38
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User34
540.21 634.74
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User35
543.77 638.93
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User36
547.33 643.11
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User37
550.89 647.29
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User38
554.45 651.48
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User39
561.57 659.84
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User40
568.69 696.64
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User41
579.37 709.72
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User42
589.60 722.26
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User43
603.84 739.70
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User44
621.64 761.51
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User45
642.55 787.13
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User46
667.47 817.65
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User47
695.51 852.00
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User48
727.54 891.24
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User49
759.14 929.94
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User50
794.74 1092.76
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User51
829.89 1141.10
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User52
868.60 1194.33
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User53
907.76 1248.17
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User54
950.04 1306.30
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User55
992.31 1364.42
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User56
1038.14 1427.45
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User57
1084.42 1491.08
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User58
1133.81 1558.99
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User59
1158.29 1592.64
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User60
1207.68 1660.56
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User61
1250.40 1719.30
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User62
1278.43 1757.84
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User63
1313.59 1806.18
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User64
1334.94 1835.55
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1334.94 1835.55
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
232.61 232.61
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User21
366.32 412.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User22
366.32 412.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User23
366.32 412.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User24
366.32 412.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User25
367.78 413.76
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User26
375.11 422.00
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User27
383.90 431.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User28
398.19 447.96
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User29
409.91 461.15
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User30
415.77 488.53
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User31
424.56 498.86
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User32
433.36 509.19
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User33
438.85 515.65
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User34
444.71 522.54
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User35
447.64 525.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User36
450.57 529.42
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User37
453.50 532.87
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User38
456.43 536.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User39
462.29 543.20
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User40
468.16 573.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User41
476.95 584.26
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User42
485.37 594.58
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User43
497.09 608.94
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User44
511.75 626.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User45
528.96 647.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User46
549.48 673.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User47
572.56 701.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User48
598.93 733.69
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User49
624.94 765.55
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User50
654.25 899.59
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User51
683.19 939.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User52
715.05 983.20
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User53
747.29 1027.52
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User54
782.09 1075.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User55
816.89 1123.23
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User56
854.62 1175.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User57
892.72 1227.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User58
933.38 1283.40
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User59
953.53 1311.10
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User60
994.19 1367.01
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User61
1029.36 1415.37
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User62
1052.43 1447.10
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User63
1081.37 1486.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User64
1098.96 1511.07
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1098.96 1511.07
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
239.41 239.41
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User21
377.03 424.16
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User22
377.03 424.16
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User23
377.03 424.16
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User24
377.03 424.16
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User25
378.54 425.85
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User26
386.08 434.34
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User27
395.13 444.52
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User28
409.83 461.06
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User29
421.89 474.63
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User30
427.93 502.81
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User31
436.98 513.45
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User32
446.02 524.08
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User33
451.68 530.72
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User34
457.71 537.81
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User35
460.73 541.36
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User36
463.74 544.90
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User37
466.76 548.44
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User38
469.78 551.99
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User39
475.81 559.08
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User40
481.84 590.26
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User41
490.89 601.34
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User42
499.56 611.96
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User43
511.63 626.74
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User44
526.71 645.22
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User45
544.43 666.92
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User46
565.54 692.79
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User47
589.29 721.89
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User48
616.44 755.14
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User49
643.21 787.93
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User50
673.37 925.89
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User51
703.16 966.84
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User52
735.96 1011.94
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User53
769.14 1057.56
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User54
804.95 1106.81
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User55
840.77 1156.06
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User56
879.61 1209.46
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User57
918.82 1263.37
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User58
960.67 1320.92
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User59
981.40 1349.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User60
1023.25 1406.97
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User61
1059.45 1456.74
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User62
1083.20 1489.40
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User63
1112.99 1530.36
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User64
1131.08 1555.24
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1131.08 1555.24
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
235.57 235.57
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User21
370.97 417.34
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User22
370.97 417.34
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User23
370.97 417.34
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User24
370.97 417.34
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User25
372.45 419.01
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User26
379.87 427.36
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User27
388.78 437.37
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User28
403.24 453.65
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User29
415.12 467.00
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User30
421.05 494.73
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User31
429.95 505.20
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User32
438.86 515.66
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User33
444.42 522.20
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User34
450.36 529.17
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User35
453.32 532.66
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User36
456.29 536.14
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User37
459.26 539.63
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User38
462.23 543.12
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User39
468.16 550.09
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User40
474.10 580.77
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User41
483.00 591.68
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User42
491.53 602.13
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User43
503.41 616.67
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User44
518.24 634.85
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User45
535.68 656.21
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User46
556.45 681.66
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User47
579.83 710.29
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User48
606.54 743.01
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User49
632.87 775.27
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User50
662.55 911.01
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User51
691.86 951.31
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User52
724.13 995.68
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User53
756.78 1040.57
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User54
792.02 1089.03
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User55
827.26 1137.49
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User56
865.47 1190.02
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User57
904.05 1243.07
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User58
945.23 1299.69
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User59
965.63 1327.75
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User60
1006.81 1384.37
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User61
1042.42 1433.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User62
1065.80 1465.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User63
1095.10 1505.77
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User64
1112.91 1530.25
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1112.91 1530.25
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
205.65 205.65
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User21
323.86 364.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User22
323.86 364.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User23
323.86 364.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User24
323.86 364.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User25
325.15 365.80
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User26
331.63 373.08
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User27
339.40 381.83
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User28
352.03 396.04
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User29
362.40 407.70
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User30
367.58 431.90
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User31
375.35 441.04
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User32
383.12 450.17
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User33
387.98 455.88
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User34
393.16 461.97
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User35
395.75 465.01
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User36
398.35 468.06
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User37
400.94 471.10
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User38
403.53 474.14
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User39
408.71 480.23
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User40
413.89 507.02
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User41
421.66 516.54
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User42
429.11 525.66
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User43
439.47 538.36
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User44
452.43 554.23
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User45
467.65 572.87
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User46
485.79 595.09
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User47
506.19 620.08
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User48
529.51 648.65
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User49
552.50 676.81
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User50
578.41 795.31
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User51
603.99 830.49
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User52
632.17 869.23
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User53
660.67 908.42
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User54
691.44 950.72
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User55
722.20 993.03
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User56
755.56 1038.90
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User57
789.24 1085.21
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User58
825.19 1134.64
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User59
843.00 1159.13
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User60
878.95 1208.56
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User61
910.04 1251.31
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User62
930.44 1279.36
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User63
956.03 1314.54
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User64
971.57 1335.91
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
971.57 1335.91
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
187.70 187.70
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User21
295.59 332.54
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User22
295.59 332.54
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User23
295.59 332.54
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User24
295.59 332.54
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User25
296.78 333.87
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User26
302.69 340.52
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User27
309.78 348.51
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User28
321.31 361.47
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User29
330.77 372.12
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User30
335.50 394.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User31
342.59 402.55
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User32
349.69 410.88
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User33
354.12 416.09
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User34
358.85 421.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User35
361.22 424.43
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User36
363.58 427.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User37
365.95 429.99
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User38
368.31 432.76
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User39
373.04 438.32
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User40
377.77 462.77
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User41
384.86 471.46
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User42
391.66 479.79
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User43
401.12 491.37
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User44
412.94 505.86
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User45
426.84 522.88
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User46
443.39 543.15
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User47
462.01 565.97
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User48
483.30 592.04
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User49
504.28 617.75
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User50
527.93 725.90
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User51
551.28 758.01
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User52
577.00 793.37
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User53
603.01 829.14
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User54
631.09 867.75
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User55
659.17 906.36
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User56
689.62 948.23
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User57
720.36 990.50
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User58
753.17 1035.61
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User59
769.43 1057.97
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User60
802.24 1103.08
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User61
830.62 1142.10
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User62
849.24 1167.71
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User63
872.59 1199.82
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User64
886.77 1219.32
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
886.77 1219.32
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
198.85 198.85
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User21
313.15 352.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User22
313.15 352.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User23
313.15 352.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User24
313.15 352.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User25
314.40 353.70
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User26
320.67 360.75
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User27
328.18 369.20
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User28
340.39 382.94
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User29
350.41 394.22
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User30
355.42 417.62
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User31
362.94 426.45
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User32
370.46 435.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User33
375.15 440.80
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User34
380.16 446.69
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User35
382.67 449.64
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User36
385.17 452.58
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User37
387.68 455.52
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User38
390.18 458.47
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User39
395.19 464.35
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User40
400.21 490.25
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User41
407.72 499.46
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User42
414.92 508.28
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User43
424.94 520.56
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User44
437.47 535.90
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User45
452.19 553.93
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User46
469.72 575.41
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User47
489.45 599.58
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User48
512.00 627.20
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User49
534.23 654.44
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User50
559.29 769.02
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User51
584.02 803.03
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User52
611.27 840.49
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User53
638.83 878.38
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User54
668.57 919.29
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User55
698.32 960.19
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User56
730.58 1004.54
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User57
763.15 1049.33
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User58
797.91 1097.12
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User59
815.13 1120.80
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User60
849.89 1168.60
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User61
879.95 1209.93
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User62
899.68 1237.06
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User63
924.42 1271.07
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User64
939.45 1291.74
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
939.45 1291.74
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
195.50 195.50
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User21
307.87 346.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User22
307.87 346.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User23
307.87 346.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User24
307.87 346.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User25
309.11 347.74
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User26
315.26 354.67
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User27
322.65 362.98
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User28
334.66 376.49
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User29
344.51 387.58
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User30
349.44 410.59
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User31
356.83 419.27
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User32
364.22 427.95
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User33
368.83 433.38
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User34
373.76 439.17
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User35
376.22 442.06
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User36
378.69 444.96
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User37
381.15 447.85
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User38
383.61 450.74
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User39
388.54 456.53
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User40
393.46 481.99
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User41
400.85 491.04
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User42
407.93 499.72
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User43
417.79 511.79
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User44
430.10 526.87
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User45
444.57 544.60
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User46
461.81 565.72
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User47
481.21 589.48
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User48
503.37 616.63
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User49
525.23 643.41
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User50
549.86 756.06
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User51
574.19 789.51
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User52
600.97 826.34
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User53
628.06 863.59
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User54
657.31 903.80
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User55
686.56 944.02
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User56
718.27 987.62
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User57
750.29 1031.65
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User58
784.46 1078.64
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User59
801.40 1101.92
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User60
835.57 1148.91
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User61
865.13 1189.55
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User62
884.52 1216.22
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User63
908.85 1249.66
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User64
923.61 1269.98
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
923.61 1269.98
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User0-20
145.43 145.43
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User21
229.02 257.65
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User22
229.02 257.65
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User23
229.02 257.65
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User24
229.02 257.65
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User25
229.94 258.68
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User26
234.52 263.84
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User27
240.02 270.02
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User28
248.95 280.07
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User29
256.28 288.31
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User30
259.94 305.43
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User31
265.44 311.89
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User32
270.94 318.35
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User33
274.37 322.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User34
278.03 326.69
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User35
279.87 328.84
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User36
281.70 331.00
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User37
283.53 333.15
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User38
285.36 335.30
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User39
289.03 339.61
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User40
292.69 358.55
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User41
298.19 365.28
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User42
303.46 371.73
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User43
310.79 380.71
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User44
319.95 391.93
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User45
330.71 405.12
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User46
343.54 420.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User47
357.96 438.51
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User48
374.45 458.71
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User49
390.71 478.63
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User50
409.04 562.43
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User51
427.13 587.30
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User52
447.05 614.70
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User53
467.21 642.41
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User54
488.97 672.33
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User55
510.72 702.24
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User56
534.31 734.68
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User57
558.13 767.43
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User58
583.55 802.39
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User59
596.15 819.70
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User60
621.57 854.66
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User61
643.56 884.89
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User62
657.99 904.73
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User63
676.08 929.61
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User64
687.06 944.72
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
687.06 944.72
2017 Rates Table Template v6.0 All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If macros are disabled, press and hold the ALT key and press the F, then I, and then N key. After that, select the Enable All Content option by pressing enter. (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5.If you are a community rating state, select Family Option under Age and fill in all columns.
If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band.
If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use.
To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet.
HIOS Issuer ID* 33871
Federal TIN* 23-2405376
Rate Effective Date* 7/1/2017
Rate Expiration Date* 9/30/2017
Plan ID* Rating Area ID* Tobacco* Age* Individual Rate* Individual Tobacco Rate*
Required:
Enter the 14-character Plan ID
Required:
Select the Rating Area ID
Require:
Select if Tobacco use of subscriber is used to
determine if a person is eligible for a rate from a
plan
Required:
Select the age of a subscriber eligible for the
rate
Required:
Enter the rate of an Individual Non-Tobacco or
No Preference enrollee on a plan
Required:
Enter the rate of an Individual tobacco enrollee
on a plan
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
290.71 290.71
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User21
457.81 515.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User22
457.81 515.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User23
457.81 515.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User24
457.81 515.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User25
459.64 517.09
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User26
468.80 527.40
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User27
479.78 539.76
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User28
497.64 559.84
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User29
512.29 576.32
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User30
519.61 610.54
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User31
530.60 623.46
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User32
541.59 636.37
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User33
548.45 644.43
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User34
555.78 653.04
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User35
559.44 657.34
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User36
563.10 661.65
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User37
566.77 665.95
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User38
570.43 670.25
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User39
577.75 678.86
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User40
585.08 716.72
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User41
596.07 730.18
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User42
606.60 743.08
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User43
621.25 761.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User44
639.56 783.46
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User45
661.08 809.82
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User46
686.71 841.22
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User47
715.55 876.55
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User48
748.52 916.93
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User49
781.02 956.75
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User50
817.65 1124.26
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User51
853.81 1173.99
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User52
893.64 1228.76
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User53
933.93 1284.15
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User54
977.42 1343.95
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User55
1020.91 1403.76
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User56
1068.07 1468.59
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User57
1115.68 1534.06
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User58
1166.50 1603.93
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User59
1191.68 1638.55
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User60
1242.49 1708.43
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User61
1286.44 1768.86
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User62
1315.28 1808.52
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User63
1351.45 1858.24
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User64
1373.43 1888.46
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1373.43 1888.46
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
277.89 277.89
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User21
437.62 492.33
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User22
437.62 492.33
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User23
437.62 492.33
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User24
437.62 492.33
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User25
439.37 494.30
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User26
448.13 504.14
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User27
458.63 515.96
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User28
475.70 535.16
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User29
489.70 550.91
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User30
496.70 583.62
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User31
507.21 595.97
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User32
517.71 608.31
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User33
524.27 616.02
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User34
531.27 624.25
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User35
534.78 628.36
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User36
538.28 632.47
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User37
541.78 636.59
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User38
545.28 640.70
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User39
552.28 648.93
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User40
559.28 685.12
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User41
569.79 697.99
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User42
579.85 710.32
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User43
593.85 727.47
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User44
611.36 748.92
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User45
631.93 774.11
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User46
656.43 804.13
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User47
684.00 837.91
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User48
715.51 876.50
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User49
746.58 914.57
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User50
781.59 1074.69
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User51
816.17 1122.23
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User52
854.24 1174.58
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User53
892.75 1227.53
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User54
934.33 1284.70
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User55
975.90 1341.86
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User56
1020.97 1403.84
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User57
1066.49 1466.42
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User58
1115.06 1533.21
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User59
1139.13 1566.31
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User60
1187.71 1633.10
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User61
1229.72 1690.87
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User62
1257.29 1728.78
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User63
1291.86 1776.31
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User64
1312.86 1805.19
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1312.86 1805.19
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
229.14 229.14
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User21
360.85 405.96
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User22
360.85 405.96
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User23
360.85 405.96
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User24
360.85 405.96
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User25
362.30 407.58
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User26
369.51 415.70
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User27
378.17 425.44
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User28
392.25 441.28
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User29
403.79 454.27
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User30
409.57 481.24
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User31
418.23 491.42
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User32
426.89 501.59
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User33
432.30 507.95
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User34
438.07 514.74
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User35
440.96 518.13
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User36
443.85 521.52
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User37
446.74 524.91
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User38
449.62 528.31
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User39
455.40 535.09
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User40
461.17 564.93
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User41
469.83 575.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User42
478.13 585.71
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User43
489.68 599.85
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User44
504.11 617.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User45
521.07 638.31
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User46
541.28 663.07
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User47
564.01 690.91
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User48
589.99 722.74
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User49
615.61 754.13
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User50
644.48 886.16
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User51
672.99 925.36
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User52
704.38 968.53
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User53
736.14 1012.19
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User54
770.42 1059.33
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User55
804.70 1106.46
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User56
841.87 1157.57
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User57
879.40 1209.17
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User58
919.45 1264.25
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User59
939.30 1291.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User60
979.35 1346.61
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User61
1013.99 1394.24
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User62
1036.73 1425.50
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User63
1065.24 1464.70
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User64
1082.55 1488.52
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1082.55 1488.52
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
236.59 236.59
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User21
372.59 419.16
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User22
372.59 419.16
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User23
372.59 419.16
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User24
372.59 419.16
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User25
374.08 420.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User26
381.53 429.22
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User27
390.47 439.28
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User28
405.00 455.63
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User29
416.92 469.04
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User30
422.89 496.89
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User31
431.83 507.40
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User32
440.77 517.90
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User33
446.36 524.47
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User34
452.32 531.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User35
455.30 534.98
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User36
458.28 538.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User37
461.26 541.98
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User38
464.24 545.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User39
470.20 552.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User40
476.17 583.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User41
485.11 594.26
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User42
493.68 604.75
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User43
505.60 619.36
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User44
520.50 637.62
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User45
538.01 659.07
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User46
558.88 684.63
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User47
582.35 713.38
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User48
609.18 746.24
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User49
635.63 778.65
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User50
665.44 914.98
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User51
694.87 955.45
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User52
727.29 1000.02
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User53
760.08 1045.11
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User54
795.47 1093.77
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User55
830.87 1142.44
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User56
869.24 1195.21
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User57
907.99 1248.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User58
949.35 1305.36
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User59
969.84 1333.53
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User60
1011.20 1390.40
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User61
1046.97 1439.58
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User62
1070.44 1471.86
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User63
1099.88 1512.33
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User64
1117.76 1536.92
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1117.76 1536.92
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
202.58 202.58
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User21
319.03 358.91
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User22
319.03 358.91
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User23
319.03 358.91
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User24
319.03 358.91
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User25
320.31 360.34
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User26
326.69 367.52
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User27
334.34 376.14
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User28
346.78 390.13
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User29
356.99 401.62
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User30
362.10 425.47
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User31
369.75 434.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User32
377.41 443.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User33
382.20 449.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User34
387.30 455.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User35
389.85 458.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User36
392.41 461.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User37
394.96 464.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User38
397.51 467.07
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User39
402.61 473.07
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User40
407.72 499.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User41
415.38 508.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User42
422.71 517.82
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User43
432.92 530.33
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User44
445.68 545.96
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User45
460.68 564.33
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User46
478.54 586.22
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User47
498.64 610.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User48
521.61 638.98
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User49
544.26 666.72
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User50
569.79 783.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User51
594.99 818.11
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User52
622.74 856.27
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User53
650.82 894.88
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User54
681.13 936.55
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User55
711.44 978.22
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User56
744.30 1023.41
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User57
777.47 1069.03
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User58
812.89 1117.72
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User59
830.43 1141.85
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User60
865.85 1190.54
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User61
896.47 1232.65
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User62
916.57 1260.28
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User63
941.77 1294.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User64
957.09 1316.00
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
957.09 1316.00
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
192.64 192.64
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User21
303.36 341.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User22
303.36 341.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User23
303.36 341.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User24
303.36 341.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User25
304.58 342.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User26
310.65 349.48
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User27
317.93 357.67
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User28
329.76 370.98
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User29
339.46 381.90
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User30
344.32 404.57
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User31
351.60 413.13
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User32
358.88 421.68
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User33
363.43 427.03
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User34
368.28 432.73
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User35
370.71 435.59
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User36
373.14 438.44
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User37
375.57 441.29
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User38
377.99 444.14
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User39
382.85 449.84
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User40
387.70 474.93
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User41
394.98 483.85
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User42
401.96 492.40
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User43
411.67 504.29
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User44
423.80 519.16
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User45
438.06 536.62
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User46
455.05 557.43
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User47
474.16 580.84
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User48
496.00 607.60
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User49
517.54 633.99
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User50
541.81 744.99
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User51
565.77 777.94
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User52
592.17 814.23
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User53
618.86 850.94
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User54
647.68 890.56
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User55
676.50 930.19
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User56
707.75 973.16
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User57
739.30 1016.54
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User58
772.97 1062.84
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User59
789.66 1085.78
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User60
823.33 1132.08
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User61
852.45 1172.12
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User62
871.57 1198.40
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User63
895.53 1231.36
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User64
910.08 1251.38
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
910.08 1251.38
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
143.42 143.42
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User21
225.86 254.10
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User22
225.86 254.10
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User23
225.86 254.10
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User24
225.86 254.10
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User25
226.77 255.11
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User26
231.28 260.19
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User27
236.70 266.29
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User28
245.51 276.20
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User29
252.74 284.33
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User30
256.35 301.22
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User31
261.77 307.59
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User32
267.20 313.95
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User33
270.58 317.94
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User34
274.20 322.18
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User35
276.00 324.31
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User36
277.81 326.43
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User37
279.62 328.55
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User38
281.43 330.67
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User39
285.04 334.92
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User40
288.65 353.60
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User41
294.07 360.24
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User42
299.27 366.60
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User43
306.50 375.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User44
315.53 386.52
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User45
326.15 399.53
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User46
338.79 415.02
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User47
353.02 432.45
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User48
369.29 452.37
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User49
385.32 472.02
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User50
403.39 554.66
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User51
421.23 579.20
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User52
440.88 606.22
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User53
460.76 633.55
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User54
482.22 663.05
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User55
503.67 692.55
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User56
526.94 724.54
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User57
550.43 756.84
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User58
575.50 791.31
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User59
587.92 808.39
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User60
612.99 842.86
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User61
634.67 872.68
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User62
648.90 892.24
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User63
666.75 916.78
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User64
677.58 931.68
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
677.58 931.68
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
204.87 204.87
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User21
322.63 362.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User22
322.63 362.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User23
322.63 362.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User24
322.63 362.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User25
323.92 364.41
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User26
330.37 371.67
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User27
338.11 380.38
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User28
350.70 394.53
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User29
361.02 406.15
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User30
366.18 430.26
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User31
373.93 439.36
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User32
381.67 448.46
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User33
386.51 454.15
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User34
391.67 460.21
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User35
394.25 463.25
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User36
396.83 466.28
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User37
399.41 469.31
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User38
401.99 472.34
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User39
407.16 478.41
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User40
412.32 505.09
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User41
420.06 514.58
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User42
427.48 523.67
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User43
437.81 536.31
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User44
450.71 552.12
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User45
465.87 570.70
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User46
483.94 592.83
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User47
504.27 617.73
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User48
527.50 646.18
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User49
550.40 674.24
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User50
576.21 792.29
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User51
601.70 827.34
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User52
629.77 865.93
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User53
658.16 904.97
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User54
688.81 947.11
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User55
719.46 989.26
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User56
752.69 1034.95
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User57
786.24 1081.09
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User58
822.06 1130.33
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User59
839.80 1154.73
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User60
875.61 1203.97
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User61
906.58 1246.55
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User62
926.91 1274.50
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User63
952.40 1309.55
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User64
967.88 1330.84
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
967.88 1330.84
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
162.50 162.50
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User21
255.91 287.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User22
255.91 287.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User23
255.91 287.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User24
255.91 287.90
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User25
256.93 289.05
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User26
262.05 294.81
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User27
268.19 301.72
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User28
278.17 312.95
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User29
286.36 322.16
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User30
290.46 341.29
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User31
296.60 348.50
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User32
302.74 355.72
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User33
306.58 360.23
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User34
310.67 365.04
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User35
312.72 367.45
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User36
314.77 369.85
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User37
316.82 372.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User38
318.86 374.67
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User39
322.96 379.48
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User40
327.05 400.64
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User41
333.20 408.16
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User42
339.08 415.37
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User43
347.27 425.41
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User44
357.51 437.95
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User45
369.53 452.68
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User46
383.87 470.23
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User47
399.99 489.98
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User48
418.41 512.56
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User49
436.58 534.81
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User50
457.06 628.45
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User51
477.27 656.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User52
499.54 686.86
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User53
522.06 717.83
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User54
546.37 751.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User55
570.68 784.68
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User56
597.04 820.93
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User57
623.65 857.52
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User58
652.06 896.58
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User59
666.13 915.93
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User60
694.54 954.99
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User61
719.11 988.77
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User62
735.23 1010.94
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User63
755.45 1038.74
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User64
767.73 1055.63
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
767.73 1055.63
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User0-20
235.43 235.43
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User21
370.76 417.10
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User22
370.76 417.10
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User23
370.76 417.10
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User24
370.76 417.10
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User25
372.24 418.77
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User26
379.65 427.11
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User27
388.55 437.12
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User28
403.01 453.39
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User29
414.88 466.74
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User30
420.81 494.45
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User31
429.71 504.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User32
438.60 515.36
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User33
444.17 521.89
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User34
450.10 528.86
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User35
453.06 532.35
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User36
456.03 535.83
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User37
459.00 539.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User38
461.96 542.80
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User39
467.89 549.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User40
473.83 580.44
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User41
482.72 591.34
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User42
491.25 601.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User43
503.12 616.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User44
517.95 634.48
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User45
535.37 655.83
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User46
556.13 681.26
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User47
579.49 709.88
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User48
606.19 742.58
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User49
632.51 774.82
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User50
662.17 910.48
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User51
691.46 950.76
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User52
723.72 995.11
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User53
756.34 1039.97
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User54
791.56 1088.40
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User55
826.79 1136.83
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User56
864.97 1189.34
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User57
903.53 1242.36
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User58
944.69 1298.94
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User59
965.08 1326.98
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User60
1006.23 1383.57
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User61
1041.82 1432.51
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User62
1065.18 1464.62
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User63
1094.47 1504.90
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User64
1112.27 1529.37
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1112.27 1529.37
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User0-20
195.94 195.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User21
308.57 347.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User22
308.57 347.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User23
308.57 347.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User24
308.57 347.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User25
309.80 348.52
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User26
315.97 355.47
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User27
323.38 363.80
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User28
335.41 377.34
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User29
345.29 388.45
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User30
350.22 411.51
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User31
357.63 420.21
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User32
365.03 428.91
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User33
369.66 434.35
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User34
374.60 440.15
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User35
377.07 443.05
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User36
379.54 445.95
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User37
382.00 448.86
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User38
384.47 451.76
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User39
389.41 457.56
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User40
394.35 483.08
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User41
401.75 492.15
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User42
408.85 500.84
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User43
418.72 512.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User44
431.07 528.06
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User45
445.57 545.82
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User46
462.85 566.99
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User47
482.29 590.80
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User48
504.50 618.02
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User49
526.41 644.86
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User50
551.10 757.76
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User51
575.48 791.28
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User52
602.32 828.19
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User53
629.47 865.53
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User54
658.79 905.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User55
688.10 946.14
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User56
719.88 989.84
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User57
751.97 1033.97
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User58
786.23 1081.06
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User59
803.20 1104.40
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User60
837.45 1151.49
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User61
867.07 1192.22
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User62
886.51 1218.95
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User63
910.89 1252.47
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User64
925.70 1272.83
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
925.70 1272.83
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User0-20
184.95 184.95
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User21
291.26 327.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User22
291.26 327.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User23
291.26 327.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User24
291.26 327.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User25
292.43 328.98
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User26
298.25 335.53
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User27
305.24 343.40
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User28
316.60 356.18
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User29
325.92 366.66
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User30
330.58 388.43
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User31
337.57 396.65
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User32
344.56 404.86
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User33
348.93 410.00
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User34
353.59 415.47
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User35
355.92 418.21
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User36
358.25 420.95
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User37
360.58 423.68
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User38
362.91 426.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User39
367.57 431.90
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User40
372.23 455.99
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User41
379.22 464.55
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User42
385.92 472.75
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User43
395.24 484.17
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User44
406.89 498.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User45
420.58 515.21
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User46
436.89 535.19
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User47
455.24 557.67
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User48
476.21 583.36
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User49
496.89 608.69
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User50
520.19 715.27
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User51
543.20 746.91
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User52
568.54 781.75
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User53
594.17 816.99
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User54
621.84 855.04
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User55
649.51 893.08
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User56
679.51 934.33
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User57
709.81 975.98
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User58
742.14 1020.44
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User59
758.16 1042.46
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User60
790.49 1086.92
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User61
818.45 1125.36
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User62
836.80 1150.59
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User63
859.81 1182.23
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User64
873.78 1201.46
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
873.78 1201.46
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
304.18 304.18
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User21
479.03 538.91
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User22
479.03 538.91
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User23
479.03 538.91
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User24
479.03 538.91
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User25
480.95 541.07
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User26
490.53 551.84
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User27
502.02 564.78
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User28
520.71 585.79
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User29
536.04 603.04
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User30
543.70 638.85
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User31
555.20 652.36
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User32
566.69 665.86
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User33
573.88 674.31
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User34
581.54 683.31
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User35
585.38 687.82
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User36
589.21 692.32
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User37
593.04 696.82
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User38
596.87 701.32
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User39
604.54 710.33
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User40
612.20 749.95
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User41
623.70 764.03
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User42
634.72 777.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User43
650.04 796.30
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User44
669.21 819.78
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User45
691.72 847.36
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User46
718.55 880.22
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User47
748.72 917.19
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User48
783.21 959.44
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User49
817.23 1001.10
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User50
855.55 1176.38
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User51
893.39 1228.41
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User52
935.07 1285.72
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User53
977.22 1343.68
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User54
1022.73 1406.25
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User55
1068.24 1468.83
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User56
1117.58 1536.67
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User57
1167.40 1605.17
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User58
1220.57 1678.28
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User59
1246.92 1714.51
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User60
1300.09 1787.62
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User61
1346.08 1850.85
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User62
1376.25 1892.35
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User63
1414.10 1944.39
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User64
1437.09 1976.00
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1437.09 1976.00
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
290.77 290.77
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User21
457.91 515.15
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User22
457.91 515.15
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User23
457.91 515.15
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User24
457.91 515.15
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User25
459.74 517.21
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User26
468.90 527.51
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User27
479.89 539.88
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User28
497.75 559.97
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User29
512.40 576.45
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User30
519.73 610.68
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User31
530.72 623.60
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User32
541.71 636.51
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User33
548.58 644.58
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User34
555.90 653.19
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User35
559.57 657.49
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User36
563.23 661.80
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User37
566.89 666.10
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User38
570.56 670.41
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User39
577.88 679.01
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User40
585.21 716.88
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User41
596.20 730.35
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User42
606.73 743.25
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User43
621.39 761.20
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User44
639.70 783.64
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User45
661.22 810.00
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User46
686.87 841.41
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User47
715.72 876.75
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User48
748.69 917.14
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User49
781.20 956.97
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User50
817.83 1124.52
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User51
854.01 1174.26
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User52
893.84 1229.03
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User53
934.14 1284.44
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User54
977.64 1344.26
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User55
1021.14 1404.07
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User56
1068.31 1468.92
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User57
1115.93 1534.40
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User58
1166.76 1604.29
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User59
1191.94 1638.92
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User60
1242.77 1708.81
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User61
1286.73 1769.26
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User62
1315.58 1808.92
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User63
1351.75 1858.66
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User64
1373.73 1888.89
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1373.73 1888.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
239.37 239.37
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User21
376.96 424.08
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User22
376.96 424.08
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User23
376.96 424.08
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User24
376.96 424.08
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User25
378.47 425.78
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User26
386.01 434.26
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User27
395.06 444.44
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User28
409.76 460.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User29
421.82 474.55
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User30
427.85 502.73
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User31
436.90 513.36
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User32
445.95 523.99
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User33
451.60 530.63
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User34
457.63 537.72
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User35
460.65 541.26
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User36
463.66 544.81
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User37
466.68 548.35
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User38
469.70 551.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User39
475.73 558.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User40
481.76 590.15
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User41
490.81 601.24
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User42
499.48 611.86
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User43
511.54 626.64
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User44
526.62 645.11
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User45
544.34 666.81
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User46
565.44 692.67
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User47
589.19 721.76
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User48
616.34 755.01
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User49
643.10 787.80
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User50
673.26 925.73
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User51
703.04 966.68
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User52
735.83 1011.77
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User53
769.01 1057.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User54
804.82 1106.62
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User55
840.63 1155.86
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User56
879.46 1209.25
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User57
918.66 1263.16
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User58
960.50 1320.69
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User59
981.24 1349.20
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User60
1023.08 1406.73
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User61
1059.27 1456.49
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User62
1083.02 1489.15
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User63
1112.80 1530.09
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User64
1130.88 1554.97
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1130.88 1554.97
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
246.37 246.37
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User21
387.98 436.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User22
387.98 436.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User23
387.98 436.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User24
387.98 436.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User25
389.54 438.23
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User26
397.30 446.96
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User27
406.61 457.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User28
421.74 474.46
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User29
434.15 488.42
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User30
440.36 517.42
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User31
449.67 528.37
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User32
458.98 539.31
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User33
464.80 546.15
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User34
471.01 553.44
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User35
474.12 557.09
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User36
477.22 560.73
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User37
480.32 564.38
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User38
483.43 568.03
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User39
489.64 575.32
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User40
495.84 607.41
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User41
505.15 618.81
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User42
514.08 629.75
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User43
526.49 644.95
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User44
542.01 663.97
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User45
560.25 686.30
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User46
581.98 712.92
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User47
606.42 742.86
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User48
634.35 777.08
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User49
661.90 810.83
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User50
692.94 952.79
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User51
723.59 994.94
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User52
757.34 1041.35
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User53
791.49 1088.29
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User54
828.34 1138.97
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User55
865.20 1189.65
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User56
905.17 1244.60
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User57
945.52 1300.08
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User58
988.58 1359.30
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User59
1009.92 1388.64
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User60
1052.99 1447.86
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User61
1090.23 1499.07
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User62
1114.68 1532.68
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User63
1145.33 1574.83
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User64
1163.94 1600.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1163.94 1600.43
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
242.41 242.41
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User21
381.75 429.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User22
381.75 429.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User23
381.75 429.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User24
381.75 429.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User25
383.28 431.19
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User26
390.91 439.77
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User27
400.07 450.08
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User28
414.96 466.83
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User29
427.18 480.57
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User30
433.29 509.11
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User31
442.45 519.88
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User32
451.61 530.64
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User33
457.34 537.37
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User34
463.44 544.55
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User35
466.50 548.13
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User36
469.55 551.72
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User37
472.61 555.31
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User38
475.66 558.90
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User39
481.77 566.08
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User40
487.88 597.65
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User41
497.04 608.87
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User42
505.82 619.63
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User43
518.03 634.59
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User44
533.30 653.30
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User45
551.25 675.28
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User46
572.62 701.46
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User47
596.67 730.93
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User48
624.16 764.60
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User49
651.26 797.80
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User50
681.80 937.48
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User51
711.96 978.95
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User52
745.17 1024.61
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User53
778.77 1070.81
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User54
815.03 1120.67
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User55
851.30 1170.54
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User56
890.62 1224.60
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User57
930.32 1279.19
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User58
972.70 1337.46
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User59
993.69 1366.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User60
1036.07 1424.59
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User61
1072.71 1474.98
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User62
1096.76 1508.05
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User63
1126.92 1549.52
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User64
1145.25 1574.71
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1145.25 1574.71
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
211.63 211.63
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User21
333.27 374.93
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User22
333.27 374.93
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User23
333.27 374.93
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User24
333.27 374.93
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User25
334.60 376.43
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User26
341.27 383.92
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User27
349.27 392.92
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User28
362.26 407.55
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User29
372.93 419.54
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User30
378.26 444.45
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User31
386.26 453.85
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User32
394.26 463.25
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User33
399.26 469.12
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User34
404.59 475.39
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User35
407.25 478.52
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User36
409.92 481.66
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User37
412.59 484.79
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User38
415.25 487.92
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User39
420.58 494.19
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User40
425.92 521.75
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User41
433.92 531.55
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User42
441.58 540.94
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User43
452.24 554.00
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User44
465.58 570.33
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User45
481.24 589.52
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User46
499.90 612.38
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User47
520.90 638.10
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User48
544.89 667.49
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User49
568.56 696.48
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User50
595.22 818.42
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User51
621.55 854.62
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User52
650.54 894.49
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User53
679.87 934.82
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User54
711.53 978.35
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User55
743.19 1021.88
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User56
777.51 1069.08
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User57
812.17 1116.74
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User58
849.17 1167.61
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User59
867.50 1192.81
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User60
904.49 1243.67
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User61
936.48 1287.66
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User62
957.48 1316.53
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User63
983.81 1352.74
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User64
999.80 1374.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
999.80 1374.73
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
193.16 193.16
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User21
304.18 342.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User22
304.18 342.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User23
304.18 342.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User24
304.18 342.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User25
305.40 343.57
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User26
311.48 350.42
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User27
318.78 358.63
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User28
330.65 371.98
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User29
340.38 382.93
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User30
345.25 405.67
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User31
352.55 414.24
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User32
359.85 422.82
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User33
364.41 428.18
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User34
369.28 433.90
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User35
371.71 436.76
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User36
374.15 439.62
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User37
376.58 442.48
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User38
379.01 445.34
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User39
383.88 451.06
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User40
388.75 476.21
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User41
396.05 485.16
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User42
403.04 493.73
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User43
412.78 505.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User44
424.94 520.56
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User45
439.24 538.07
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User46
456.27 558.94
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User47
475.44 582.41
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User48
497.34 609.24
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User49
518.94 635.70
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User50
543.27 747.00
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User51
567.30 780.04
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User52
593.77 816.43
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User53
620.53 853.23
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User54
649.43 892.97
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User55
678.33 932.70
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User56
709.66 975.78
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User57
741.29 1019.28
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User58
775.06 1065.71
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User59
791.79 1088.71
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User60
825.55 1135.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User61
854.75 1175.29
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User62
873.92 1201.64
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User63
897.95 1234.68
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User64
912.54 1254.75
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
912.54 1254.75
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
204.63 204.63
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User21
322.25 362.53
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User22
322.25 362.53
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User23
322.25 362.53
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User24
322.25 362.53
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User25
323.54 363.98
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User26
329.98 371.23
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User27
337.72 379.93
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User28
350.28 394.07
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User29
360.60 405.67
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User30
365.75 429.76
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User31
373.49 438.85
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User32
381.22 447.93
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User33
386.05 453.61
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User34
391.21 459.67
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User35
393.79 462.70
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User36
396.37 465.73
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User37
398.94 468.76
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User38
401.52 471.79
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User39
406.68 477.85
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User40
411.83 504.50
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User41
419.57 513.97
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User42
426.98 523.05
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User43
437.29 535.68
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User44
450.18 551.47
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User45
465.33 570.03
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User46
483.37 592.13
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User47
503.67 617.00
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User48
526.88 645.42
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User49
549.76 673.45
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User50
575.54 791.36
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User51
600.99 826.37
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User52
629.03 864.92
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User53
657.39 903.91
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User54
688.00 946.00
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User55
718.61 988.10
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User56
751.81 1033.73
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User57
785.32 1079.82
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User58
821.09 1129.00
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User59
838.81 1153.37
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User60
874.58 1202.55
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User61
905.52 1245.09
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User62
925.82 1273.00
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User63
951.28 1308.01
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User64
966.75 1329.28
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
966.75 1329.28
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
201.18 201.18
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User21
316.82 356.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User22
316.82 356.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User23
316.82 356.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User24
316.82 356.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User25
318.09 357.85
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User26
324.42 364.98
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User27
332.03 373.53
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User28
344.38 387.43
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User29
354.52 398.84
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User30
359.59 422.52
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User31
367.19 431.45
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User32
374.80 440.39
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User33
379.55 445.97
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User34
384.62 451.93
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User35
387.15 454.91
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User36
389.69 457.88
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User37
392.22 460.86
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User38
394.76 463.84
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User39
399.83 469.80
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User40
404.90 496.00
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User41
412.50 505.31
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User42
419.79 514.24
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User43
429.93 526.66
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User44
442.60 542.18
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User45
457.49 560.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User46
475.23 582.16
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User47
495.19 606.61
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User48
518.00 634.55
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User49
540.50 662.11
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User50
565.84 778.03
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User51
590.87 812.45
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User52
618.43 850.35
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User53
646.31 888.68
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User54
676.41 930.07
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User55
706.51 971.45
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User56
739.14 1016.32
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User57
772.09 1061.63
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User58
807.26 1109.98
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User59
824.68 1133.94
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User60
859.85 1182.29
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User61
890.27 1224.12
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User62
910.23 1251.56
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User63
935.25 1285.97
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User64
950.46 1306.88
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
950.46 1306.88
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User0-20
149.66 149.66
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User21
235.68 265.14
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User22
235.68 265.14
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User23
235.68 265.14
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User24
235.68 265.14
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User25
236.62 266.20
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User26
241.33 271.50
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User27
246.99 277.87
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User28
256.18 288.21
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User29
263.72 296.69
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User30
267.50 314.31
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User31
273.15 320.95
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User32
278.81 327.60
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User33
282.34 331.75
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User34
286.11 336.18
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User35
288.00 338.40
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User36
289.88 340.61
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User37
291.77 342.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User38
293.66 345.05
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User39
297.43 349.48
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User40
301.20 368.97
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User41
306.85 375.90
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User42
312.27 382.54
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User43
319.82 391.77
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User44
329.24 403.32
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User45
340.32 416.89
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User46
353.52 433.06
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User47
368.37 451.25
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User48
385.33 472.03
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User49
402.07 492.53
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User50
420.92 578.77
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User51
439.54 604.37
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User52
460.04 632.56
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User53
480.78 661.08
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User54
503.17 691.86
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User55
525.56 722.65
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User56
549.84 756.03
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User57
574.35 789.73
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User58
600.51 825.70
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User59
613.47 843.52
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User60
639.63 879.49
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User61
662.26 910.60
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User62
677.10 931.02
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User63
695.72 956.62
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User64
707.04 972.17
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
707.04 972.17
2017 Rates Table Template v6.0 All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If macros are disabled, press and hold the ALT key and press the F, then I, and then N key. After that, select the Enable All Content option by pressing enter. (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5.If you are a community rating state, select Family Option under Age and fill in all columns.
If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band.
If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use.
To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet.
HIOS Issuer ID* 33871
Federal TIN* 23-2405376
Rate Effective Date* 10/1/2017
Rate Expiration Date* 12/31/2017
Plan ID* Rating Area ID* Tobacco* Age* Individual Rate* Individual Tobacco Rate*
Required:
Enter the 14-character Plan ID
Required:
Select the Rating Area ID
Require:
Select if Tobacco use of subscriber is used to
determine if a person is eligible for a rate from a
plan
Required:
Select the age of a subscriber eligible for the
rate
Required:
Enter the rate of an Individual Non-Tobacco or
No Preference enrollee on a plan
Required:
Enter the rate of an Individual tobacco enrollee
on a plan
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
299.14 299.14
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User21
471.08 529.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User22
471.08 529.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User23
471.08 529.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User24
471.08 529.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User25
472.97 532.09
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User26
482.39 542.69
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User27
493.69 555.41
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User28
512.07 576.07
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User29
527.14 593.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User30
534.68 628.25
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User31
545.98 641.53
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User32
557.29 654.81
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User33
564.36 663.12
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User34
571.89 671.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User35
575.66 676.40
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User36
579.43 680.83
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User37
583.20 685.26
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User38
586.97 689.69
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User39
594.50 698.54
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User40
602.04 737.50
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User41
613.35 751.35
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User42
624.18 764.62
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User43
639.26 783.09
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User44
658.10 806.17
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User45
680.24 833.30
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User46
706.62 865.61
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User47
736.30 901.97
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User48
770.22 943.52
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User49
803.66 984.49
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User50
841.35 1156.86
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User51
878.57 1208.03
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User52
919.55 1264.38
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User53
961.01 1321.38
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User54
1005.76 1382.92
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User55
1050.51 1444.45
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User56
1099.03 1511.17
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User57
1148.03 1578.54
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User58
1200.32 1650.43
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User59
1226.22 1686.06
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User60
1278.52 1757.96
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User61
1323.74 1820.14
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User62
1353.42 1860.95
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User63
1390.63 1912.12
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User64
1413.24 1943.21
33871PA0100001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1413.24 1943.21
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
285.95 285.95
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User21
450.31 506.60
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User22
450.31 506.60
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User23
450.31 506.60
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User24
450.31 506.60
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User25
452.11 508.63
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User26
461.12 518.76
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User27
471.93 530.92
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User28
489.49 550.67
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User29
503.90 566.88
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User30
511.10 600.55
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User31
521.91 613.24
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User32
532.72 625.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User33
539.47 633.88
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User34
546.68 642.35
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User35
550.28 646.58
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User36
553.88 650.81
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User37
557.48 655.04
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User38
561.09 659.28
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User39
568.29 667.74
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User40
575.50 704.98
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User41
586.30 718.22
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User42
596.66 730.91
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User43
611.07 748.56
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User44
629.08 770.63
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User45
650.25 796.55
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User46
675.47 827.45
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User47
703.84 862.20
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User48
736.26 901.92
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User49
768.23 941.08
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User50
804.25 1105.85
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User51
839.83 1154.77
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User52
879.01 1208.63
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User53
918.63 1263.12
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User54
961.41 1321.94
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User55
1004.19 1380.77
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User56
1050.57 1444.54
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User57
1097.41 1508.93
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User58
1147.39 1577.66
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User59
1172.16 1611.72
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User60
1222.14 1680.45
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User61
1265.37 1739.89
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User62
1293.74 1778.90
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User63
1329.32 1827.81
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User64
1350.93 1857.53
33871PA0100002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1350.93 1857.53
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
235.78 235.78
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User21
371.31 417.73
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User22
371.31 417.73
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User23
371.31 417.73
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User24
371.31 417.73
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User25
372.80 419.40
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User26
380.23 427.75
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User27
389.14 437.78
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User28
403.62 454.07
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User29
415.50 467.44
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User30
421.44 495.19
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User31
430.35 505.66
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User32
439.26 516.14
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User33
444.83 522.68
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User34
450.78 529.66
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User35
453.75 533.15
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User36
456.72 536.64
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User37
459.69 540.13
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User38
462.66 543.62
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User39
468.60 550.60
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User40
474.54 581.31
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User41
483.45 592.23
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User42
491.99 602.69
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User43
503.87 617.24
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User44
518.73 635.44
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User45
536.18 656.82
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User46
556.97 682.29
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User47
580.36 710.95
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User48
607.10 743.70
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User49
633.46 775.99
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User50
663.17 911.85
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User51
692.50 952.19
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User52
724.81 996.61
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User53
757.48 1041.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User54
792.76 1090.04
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User55
828.03 1138.54
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User56
866.28 1191.13
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User57
904.89 1244.23
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User58
946.11 1300.90
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User59
966.53 1328.98
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User60
1007.75 1385.65
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User61
1043.39 1434.67
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User62
1066.79 1466.83
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User63
1096.12 1507.16
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User64
1113.93 1531.67
33871PA0100003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1113.93 1531.67
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
243.45 243.45
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User21
383.39 431.31
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User22
383.39 431.31
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User23
383.39 431.31
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User24
383.39 431.31
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User25
384.92 433.04
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User26
392.59 441.66
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User27
401.79 452.02
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User28
416.74 468.84
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User29
429.01 482.64
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User30
435.15 511.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User31
444.35 522.11
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User32
453.55 532.92
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User33
459.30 539.68
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User34
465.43 546.88
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User35
468.50 550.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User36
471.57 554.09
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User37
474.64 557.70
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User38
477.70 561.30
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User39
483.84 568.51
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User40
489.97 600.21
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User41
499.17 611.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User42
507.99 622.29
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User43
520.26 637.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User44
535.59 656.10
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User45
553.61 678.18
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User46
575.08 704.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User47
599.24 734.06
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User48
626.84 767.88
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User49
654.06 801.22
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User50
684.73 941.51
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User51
715.02 983.15
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User52
748.37 1029.02
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User53
782.11 1075.41
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User54
818.53 1125.49
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User55
854.96 1175.57
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User56
894.45 1229.86
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User57
934.32 1284.69
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User58
976.87 1343.20
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User59
997.96 1372.20
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User60
1040.52 1430.71
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User61
1077.32 1481.32
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User62
1101.48 1514.53
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User63
1131.76 1556.17
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User64
1150.17 1581.48
33871PA0100004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1150.17 1581.48
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
208.46 208.46
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User21
328.28 369.31
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User22
328.28 369.31
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User23
328.28 369.31
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User24
328.28 369.31
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User25
329.59 370.79
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User26
336.16 378.18
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User27
344.04 387.04
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User28
356.84 401.44
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User29
367.34 413.26
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User30
372.60 437.80
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User31
380.47 447.06
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User32
388.35 456.32
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User33
393.28 462.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User34
398.53 468.27
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User35
401.16 471.36
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User36
403.78 474.44
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User37
406.41 477.53
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User38
409.04 480.62
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User39
414.29 486.79
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User40
419.54 513.94
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User41
427.42 523.59
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User42
434.97 532.84
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User43
445.47 545.71
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User44
458.61 561.79
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User45
474.03 580.69
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User46
492.42 603.21
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User47
513.10 628.55
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User48
536.74 657.50
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User49
560.04 686.05
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User50
586.31 806.17
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User51
612.24 841.83
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User52
640.80 881.10
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User53
669.69 920.82
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User54
700.87 963.70
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User55
732.06 1006.58
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User56
765.87 1053.08
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User57
800.01 1100.02
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User58
836.45 1150.12
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User59
854.51 1174.95
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User60
890.95 1225.05
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User61
922.46 1268.39
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User62
943.14 1296.82
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User63
969.08 1332.48
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User64
984.84 1354.15
33871PA0100005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
984.84 1354.15
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
198.22 198.22
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User21
312.16 351.18
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User22
312.16 351.18
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User23
312.16 351.18
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User24
312.16 351.18
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User25
313.41 352.58
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User26
319.65 359.61
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User27
327.14 368.04
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User28
339.32 381.73
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User29
349.31 392.97
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User30
354.30 416.30
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User31
361.79 425.11
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User32
369.28 433.91
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User33
373.97 439.41
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User34
378.96 445.28
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User35
381.46 448.21
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User36
383.96 451.15
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User37
386.45 454.08
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User38
388.95 457.02
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User39
393.95 462.89
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User40
398.94 488.70
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User41
406.43 497.88
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User42
413.61 506.67
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User43
423.60 518.91
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User44
436.09 534.21
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User45
450.76 552.18
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User46
468.24 573.59
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User47
487.91 597.68
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User48
510.38 625.22
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User49
532.54 652.37
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User50
557.52 766.59
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User51
582.18 800.49
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User52
609.34 837.84
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User53
636.81 875.61
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User54
666.46 916.38
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User55
696.12 957.16
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User56
728.27 1001.37
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User57
760.73 1046.01
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User58
795.38 1093.65
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User59
812.55 1117.26
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User60
847.20 1164.90
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User61
877.17 1206.11
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User62
896.83 1233.15
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User63
921.50 1267.06
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User64
936.48 1287.66
33871PA0100006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
936.48 1287.66
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
147.58 147.58
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User21
232.41 261.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User22
232.41 261.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User23
232.41 261.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User24
232.41 261.46
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User25
233.34 262.51
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User26
237.99 267.74
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User27
243.57 274.01
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User28
252.63 284.21
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User29
260.07 292.58
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User30
263.79 309.95
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User31
269.36 316.50
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User32
274.94 323.06
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User33
278.43 327.15
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User34
282.15 331.52
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User35
284.01 333.71
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User36
285.87 335.89
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User37
287.72 338.08
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User38
289.58 340.26
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User39
293.30 344.63
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User40
297.02 363.85
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User41
302.60 370.68
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User42
307.94 377.23
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User43
315.38 386.34
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User44
324.68 397.73
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User45
335.60 411.11
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User46
348.62 427.06
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User47
363.26 444.99
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User48
379.99 465.49
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User49
396.49 485.70
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User50
415.09 570.74
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User51
433.45 595.99
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User52
453.67 623.79
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User53
474.12 651.91
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User54
496.20 682.27
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User55
518.28 712.63
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User56
542.22 745.55
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User57
566.39 778.78
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User58
592.18 814.25
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User59
604.97 831.83
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User60
630.76 867.30
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User61
653.08 897.98
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User62
667.72 918.11
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User63
686.08 943.36
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User64
697.23 958.70
33871PA0100007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
697.23 958.70
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
210.81 210.81
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User21
331.98 373.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User22
331.98 373.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User23
331.98 373.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User24
331.98 373.48
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User25
333.31 374.97
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User26
339.95 382.44
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User27
347.92 391.41
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User28
360.86 405.97
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User29
371.49 417.92
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User30
376.80 442.74
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User31
384.77 452.10
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User32
392.73 461.46
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User33
397.71 467.31
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User34
403.03 473.56
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User35
405.68 476.68
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User36
408.34 479.80
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User37
410.99 482.92
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User38
413.65 486.04
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User39
418.96 492.28
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User40
424.27 519.73
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User41
432.24 529.49
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User42
439.88 538.85
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User43
450.50 551.86
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User44
463.78 568.13
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User45
479.38 587.24
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User46
497.97 610.02
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User47
518.89 635.64
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User48
542.79 664.92
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User49
566.36 693.79
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User50
592.92 815.26
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User51
619.15 851.33
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User52
648.03 891.04
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User53
677.24 931.21
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User54
708.78 974.57
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User55
740.32 1017.94
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User56
774.51 1064.96
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User57
809.04 1112.43
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User58
845.89 1163.10
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User59
864.15 1188.20
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User60
901.00 1238.87
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User61
932.87 1282.69
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User62
953.78 1311.45
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User63
980.01 1347.51
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User64
995.94 1369.42
33871PA0100008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
995.94 1369.42
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
167.21 167.21
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User21
263.33 296.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User22
263.33 296.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User23
263.33 296.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User24
263.33 296.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User25
264.38 297.43
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User26
269.65 303.36
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User27
275.97 310.47
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User28
286.24 322.02
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User29
294.67 331.50
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User30
298.88 351.18
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User31
305.20 358.61
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User32
311.52 366.03
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User33
315.47 370.68
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User34
319.68 375.63
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User35
321.79 378.10
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User36
323.90 380.58
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User37
326.00 383.05
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User38
328.11 385.53
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User39
332.32 390.48
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User40
336.54 412.26
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User41
342.86 420.00
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User42
348.91 427.42
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User43
357.34 437.74
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User44
367.87 450.64
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User45
380.25 465.80
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User46
394.99 483.87
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User47
411.58 504.19
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User48
430.54 527.42
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User49
449.24 550.32
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User50
470.31 646.67
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User51
491.11 675.28
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User52
514.02 706.78
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User53
537.19 738.64
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User54
562.21 773.04
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User55
587.23 807.43
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User56
614.35 844.73
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User57
641.73 882.38
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User58
670.96 922.58
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User59
685.45 942.49
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User60
714.68 982.68
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User61
739.96 1017.44
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User62
756.55 1040.25
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User63
777.35 1068.85
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User64
789.99 1086.23
33871PA0100009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
789.99 1086.23
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User0-20
242.26 242.26
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User21
381.50 429.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User22
381.50 429.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User23
381.50 429.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User24
381.50 429.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User25
383.03 430.91
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User26
390.66 439.49
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User27
399.82 449.79
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User28
414.70 466.53
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User29
426.90 480.27
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User30
433.01 508.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User31
442.16 519.54
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User32
451.32 530.30
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User33
457.04 537.03
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User34
463.15 544.20
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User35
466.20 547.78
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User36
469.25 551.37
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User37
472.30 554.96
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User38
475.36 558.54
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User39
481.46 565.71
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User40
487.56 597.26
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User41
496.72 608.48
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User42
505.49 619.23
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User43
517.70 634.19
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User44
532.96 652.88
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User45
550.89 674.84
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User46
572.26 701.02
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User47
596.29 730.46
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User48
623.76 764.11
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User49
650.85 797.29
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User50
681.37 936.88
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User51
711.51 978.32
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User52
744.70 1023.96
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User53
778.27 1070.12
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User54
814.51 1119.96
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User55
850.76 1169.79
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User56
890.05 1223.82
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User57
929.73 1278.38
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User58
972.07 1336.60
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User59
993.06 1365.45
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User60
1035.40 1423.68
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User61
1072.03 1474.04
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User62
1096.06 1507.09
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User63
1126.20 1548.53
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User64
1144.50 1573.71
33871PA0100035 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1144.50 1573.71
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User0-20
201.62 201.62
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User21
317.51 357.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User22
317.51 357.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User23
317.51 357.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User24
317.51 357.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User25
318.78 358.63
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User26
325.13 365.77
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User27
332.75 374.35
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User28
345.14 388.28
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User29
355.30 399.71
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User30
360.38 423.44
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User31
368.00 432.40
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User32
375.62 441.35
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User33
380.38 446.95
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User34
385.46 452.91
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User35
388.00 455.90
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User36
390.54 458.88
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User37
393.08 461.87
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User38
395.62 464.85
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User39
400.70 470.82
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User40
405.78 497.08
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User41
413.40 506.42
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User42
420.70 515.36
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User43
430.86 527.81
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User44
443.56 543.37
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User45
458.49 561.65
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User46
476.27 583.43
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User47
496.27 607.93
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User48
519.13 635.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User49
541.68 663.55
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User50
567.08 779.73
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User51
592.16 814.22
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User52
619.78 852.20
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User53
647.72 890.62
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User54
677.89 932.10
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User55
708.05 973.57
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User56
740.75 1018.54
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User57
773.78 1063.94
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User58
809.02 1112.40
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User59
826.48 1136.41
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User60
861.73 1184.87
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User61
892.21 1226.79
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User62
912.21 1254.29
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User63
937.29 1288.78
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User64
952.53 1309.74
33871PA0100036 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
952.53 1309.74
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User0-20
190.31 190.31
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User21
299.71 337.17
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User22
299.71 337.17
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User23
299.71 337.17
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User24
299.71 337.17
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User25
300.91 338.52
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User26
306.90 345.26
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User27
314.09 353.35
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User28
325.78 366.50
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User29
335.37 377.29
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User30
340.17 399.70
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User31
347.36 408.15
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User32
354.55 416.60
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User33
359.05 421.88
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User34
363.84 427.52
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User35
366.24 430.33
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User36
368.64 433.15
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User37
371.04 435.97
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User38
373.43 438.79
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User39
378.23 444.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User40
383.03 469.21
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User41
390.22 478.02
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User42
397.11 486.46
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User43
406.70 498.21
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User44
418.69 512.90
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User45
432.78 530.15
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User46
449.56 550.71
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User47
468.44 573.84
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User48
490.02 600.27
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User49
511.30 626.34
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User50
535.28 736.00
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User51
558.95 768.56
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User52
585.03 804.41
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User53
611.40 840.68
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User54
639.87 879.83
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User55
668.35 918.98
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User56
699.22 961.42
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User57
730.38 1004.28
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User58
763.65 1050.02
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User59
780.14 1072.69
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User60
813.40 1118.43
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User61
842.18 1157.99
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User62
861.06 1183.95
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User63
884.73 1216.51
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User64
899.12 1236.29
33871PA0100037 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
899.12 1236.29
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
313.00 313.00
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User21
492.92 554.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User22
492.92 554.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User23
492.92 554.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User24
492.92 554.53
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User25
494.89 556.75
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User26
504.75 567.84
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User27
516.58 581.15
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User28
535.80 602.78
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User29
551.58 620.52
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User30
559.46 657.37
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User31
571.29 671.27
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User32
583.12 685.17
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User33
590.52 693.86
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User34
598.40 703.12
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User35
602.35 707.76
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User36
606.29 712.39
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User37
610.23 717.02
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User38
614.18 721.66
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User39
622.06 730.92
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User40
629.95 771.69
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User41
641.78 786.18
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User42
653.12 800.07
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User43
668.89 819.39
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User44
688.61 843.54
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User45
711.77 871.92
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User46
739.38 905.74
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User47
770.43 943.78
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User48
805.92 987.25
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User49
840.92 1030.13
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User50
880.35 1210.49
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User51
919.29 1264.03
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User52
962.18 1322.99
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User53
1005.55 1382.64
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User54
1052.38 1447.02
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User55
1099.21 1511.41
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User56
1149.98 1581.22
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User57
1201.24 1651.71
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User58
1255.96 1726.94
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User59
1283.07 1764.22
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User60
1337.78 1839.45
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User61
1385.10 1904.51
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User62
1416.16 1947.21
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User63
1455.10 2000.76
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User64
1478.76 2033.29
33871PA0110001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1478.76 2033.29
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
299.20 299.20
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User21
471.19 530.09
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User22
471.19 530.09
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User23
471.19 530.09
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User24
471.19 530.09
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User25
473.07 532.21
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User26
482.50 542.81
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User27
493.80 555.53
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User28
512.18 576.20
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User29
527.26 593.17
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User30
534.80 628.39
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User31
546.11 641.67
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User32
557.41 654.96
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User33
564.48 663.27
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User34
572.02 672.13
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User35
575.79 676.55
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User36
579.56 680.98
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User37
583.33 685.41
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User38
587.10 689.84
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User39
594.64 698.70
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User40
602.18 737.67
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User41
613.49 751.52
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User42
624.32 764.80
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User43
639.40 783.27
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User44
658.25 806.35
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User45
680.39 833.48
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User46
706.78 865.81
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User47
736.47 902.17
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User48
770.39 943.73
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User49
803.85 984.71
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User50
841.54 1157.12
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User51
878.76 1208.30
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User52
919.76 1264.67
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User53
961.22 1321.68
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User54
1005.99 1383.23
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User55
1050.75 1444.78
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User56
1099.28 1511.51
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User57
1148.28 1578.89
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User58
1200.59 1650.81
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User59
1226.50 1686.44
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User60
1278.80 1758.35
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User61
1324.04 1820.55
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User62
1353.72 1861.37
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User63
1390.95 1912.55
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User64
1413.56 1943.65
33871PA0110002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1413.56 1943.65
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
246.31 246.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User21
387.89 436.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User22
387.89 436.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User23
387.89 436.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User24
387.89 436.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User25
389.44 438.12
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User26
397.20 446.85
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User27
406.51 457.33
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User28
421.64 474.34
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User29
434.05 488.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User30
440.26 517.30
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User31
449.57 528.24
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User32
458.88 539.18
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User33
464.70 546.02
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User34
470.90 553.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User35
474.00 556.96
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User36
477.11 560.60
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User37
480.21 564.25
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User38
483.31 567.89
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User39
489.52 575.19
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User40
495.73 607.26
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User41
505.04 618.67
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User42
513.96 629.60
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User43
526.37 644.80
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User44
541.89 663.81
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User45
560.12 686.14
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User46
581.84 712.75
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User47
606.28 742.69
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User48
634.20 776.90
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User49
661.74 810.64
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User50
692.78 952.57
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User51
723.42 994.70
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User52
757.17 1041.10
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User53
791.30 1088.04
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User54
828.15 1138.71
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User55
865.00 1189.38
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User56
904.95 1244.31
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User57
945.29 1299.78
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User58
988.35 1358.98
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User59
1009.68 1388.32
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User60
1052.74 1447.52
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User61
1089.98 1498.72
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User62
1114.41 1532.32
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User63
1145.06 1574.46
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User64
1163.67 1600.06
33871PA0110003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1163.67 1600.06
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
253.51 253.51
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User21
399.23 449.14
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User22
399.23 449.14
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User23
399.23 449.14
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User24
399.23 449.14
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User25
400.83 450.93
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User26
408.81 459.92
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User27
418.40 470.69
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User28
433.97 488.21
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User29
446.74 502.58
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User30
453.13 532.43
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User31
462.71 543.68
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User32
472.29 554.94
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User33
478.28 561.98
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User34
484.67 569.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User35
487.86 573.24
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User36
491.06 576.99
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User37
494.25 580.74
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User38
497.44 584.50
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User39
503.83 592.00
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User40
510.22 625.02
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User41
519.80 636.76
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User42
528.98 648.00
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User43
541.76 663.65
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User44
557.73 683.22
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User45
576.49 706.20
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User46
598.85 733.59
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User47
624.00 764.40
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User48
652.74 799.61
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User49
681.09 834.34
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User50
713.03 980.41
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User51
744.57 1023.78
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User52
779.30 1071.54
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User53
814.43 1119.85
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User54
852.36 1172.00
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User55
890.29 1224.15
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User56
931.41 1280.69
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User57
972.93 1337.78
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User58
1017.24 1398.71
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User59
1039.20 1428.90
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User60
1083.52 1489.83
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User61
1121.84 1542.53
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User62
1146.99 1577.12
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User63
1178.53 1620.48
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User64
1197.69 1646.83
33871PA0110004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1197.69 1646.83
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
249.44 249.44
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User21
392.82 441.92
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User22
392.82 441.92
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User23
392.82 441.92
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User24
392.82 441.92
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User25
394.39 443.69
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User26
402.24 452.53
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User27
411.67 463.13
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User28
426.99 480.37
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User29
439.56 494.51
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User30
445.85 523.87
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User31
455.27 534.95
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User32
464.70 546.03
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User33
470.59 552.95
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User34
476.88 560.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User35
480.02 564.03
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User36
483.16 567.72
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User37
486.31 571.41
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User38
489.45 575.10
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User39
495.73 582.49
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User40
502.02 614.97
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User41
511.45 626.52
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User42
520.48 637.59
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User43
533.05 652.99
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User44
548.77 672.24
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User45
567.23 694.85
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User46
589.23 721.80
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User47
613.97 752.12
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User48
642.26 786.76
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User49
670.15 820.93
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User50
701.57 964.66
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User51
732.60 1007.33
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User52
766.78 1054.32
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User53
801.35 1101.85
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User54
838.66 1153.16
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User55
875.98 1204.47
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User56
916.44 1260.11
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User57
957.29 1316.28
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User58
1000.90 1376.23
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User59
1022.50 1405.94
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User60
1066.10 1465.89
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User61
1103.82 1517.75
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User62
1128.56 1551.77
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User63
1159.60 1594.44
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User64
1178.45 1620.37
33871PA0110005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1178.45 1620.37
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
217.76 217.76
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User21
342.93 385.80
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User22
342.93 385.80
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User23
342.93 385.80
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User24
342.93 385.80
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User25
344.30 387.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User26
351.16 395.06
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User27
359.39 404.31
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User28
372.77 419.36
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User29
383.74 431.71
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User30
389.23 457.34
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User31
397.46 467.01
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User32
405.69 476.68
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User33
410.83 482.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User34
416.32 489.17
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User35
419.06 492.40
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User36
421.80 495.62
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User37
424.55 498.84
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User38
427.29 502.07
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User39
432.78 508.51
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User40
438.27 536.87
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User41
446.50 546.96
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User42
454.38 556.62
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User43
465.36 570.06
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User44
479.07 586.87
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User45
495.19 606.61
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User46
514.40 630.13
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User47
536.00 656.60
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User48
560.69 686.85
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User49
585.04 716.67
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User50
612.47 842.15
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User51
639.57 879.40
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User52
669.40 920.43
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User53
699.58 961.92
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User54
732.16 1006.72
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User55
764.73 1051.51
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User56
800.06 1100.08
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User57
835.72 1149.12
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User58
873.79 1201.46
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User59
892.65 1227.39
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User60
930.71 1279.73
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User61
963.63 1325.00
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User62
985.24 1354.70
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User63
1012.33 1391.95
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User64
1028.79 1414.59
33871PA0110006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1028.79 1414.59
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
198.76 198.76
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User21
313.00 352.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User22
313.00 352.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User23
313.00 352.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User24
313.00 352.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User25
314.25 353.54
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User26
320.51 360.58
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User27
328.03 369.03
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User28
340.23 382.76
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User29
350.25 394.03
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User30
355.26 417.43
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User31
362.77 426.25
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User32
370.28 435.08
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User33
374.98 440.60
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User34
379.98 446.48
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User35
382.49 449.42
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User36
384.99 452.37
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User37
387.50 455.31
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User38
390.00 458.25
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User39
395.01 464.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User40
400.02 490.02
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User41
407.53 499.22
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User42
414.73 508.04
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User43
424.74 520.31
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User44
437.26 535.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User45
451.97 553.67
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User46
469.50 575.14
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User47
489.22 599.30
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User48
511.76 626.90
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User49
533.98 654.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User50
559.02 768.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User51
583.75 802.65
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User52
610.98 840.10
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User53
638.52 877.97
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User54
668.26 918.86
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User55
697.99 959.74
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User56
730.23 1004.07
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User57
762.79 1048.83
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User58
797.53 1096.60
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User59
814.74 1120.27
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User60
849.49 1168.05
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User61
879.54 1209.36
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User62
899.25 1236.48
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User63
923.98 1270.47
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User64
939.00 1291.13
33871PA0110007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
939.00 1291.13
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User0-20
210.56 210.56
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User21
331.59 373.04
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User22
331.59 373.04
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User23
331.59 373.04
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User24
331.59 373.04
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User25
332.92 374.53
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User26
339.55 381.99
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User27
347.51 390.95
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User28
360.44 405.50
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User29
371.05 417.43
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User30
376.36 442.22
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User31
384.31 451.57
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User32
392.27 460.92
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User33
397.25 466.76
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User34
402.55 473.00
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User35
405.20 476.12
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User36
407.86 479.23
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User37
410.51 482.35
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User38
413.16 485.47
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User39
418.47 491.70
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User40
423.77 519.12
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User41
431.73 528.87
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User42
439.36 538.21
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User43
449.97 551.21
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User44
463.23 567.46
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User45
478.82 586.55
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User46
497.39 609.30
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User47
518.28 634.89
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User48
542.15 664.14
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User49
565.70 692.98
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User50
592.22 814.31
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User51
618.42 850.33
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User52
647.27 889.99
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User53
676.45 930.11
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User54
707.95 973.43
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User55
739.45 1016.74
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User56
773.60 1063.70
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User57
808.09 1111.12
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User58
844.90 1161.73
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User59
863.13 1186.81
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User60
899.94 1237.42
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User61
931.77 1281.19
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User62
952.66 1309.91
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User63
978.86 1345.93
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User64
994.77 1367.82
33871PA0110008 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
994.77 1367.82
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User0-20
207.01 207.01
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User21
326.01 366.76
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User22
326.01 366.76
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User23
326.01 366.76
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User24
326.01 366.76
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User25
327.31 368.22
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User26
333.83 375.56
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User27
341.65 384.36
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User28
354.37 398.66
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User29
364.80 410.40
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User30
370.02 434.77
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User31
377.84 443.96
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User32
385.66 453.16
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User33
390.56 458.90
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User34
395.77 465.03
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User35
398.38 468.10
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User36
400.99 471.16
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User37
403.60 474.22
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User38
406.20 477.29
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User39
411.42 483.42
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User40
416.64 510.38
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User41
424.46 519.96
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User42
431.96 529.15
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User43
442.39 541.93
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User44
455.43 557.90
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User45
470.75 576.67
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User46
489.01 599.04
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User47
509.55 624.20
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User48
533.02 652.95
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User49
556.17 681.30
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User50
582.25 800.59
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User51
608.00 836.00
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User52
636.36 875.00
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User53
665.05 914.45
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User54
696.02 957.03
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User55
726.99 999.62
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User56
760.57 1045.79
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User57
794.48 1092.40
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User58
830.66 1142.16
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User59
848.59 1166.82
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User60
884.78 1216.57
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User61
916.08 1259.61
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User62
936.61 1287.85
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User63
962.37 1323.26
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User64
978.02 1344.77
33871PA0110009 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
978.02 1344.77
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User0-20
153.99 153.99
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User21
242.51 272.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User22
242.51 272.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User23
242.51 272.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User24
242.51 272.83
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User25
243.48 273.92
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User26
248.33 279.37
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User27
254.15 285.92
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User28
263.61 296.56
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User29
271.37 305.29
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User30
275.25 323.42
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User31
281.07 330.26
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User32
286.89 337.10
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User33
290.53 341.37
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User34
294.41 345.93
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User35
296.35 348.21
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User36
298.29 350.49
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User37
300.23 352.77
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User38
302.17 355.05
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User39
306.05 359.61
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User40
309.93 379.66
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User41
315.75 386.79
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User42
321.33 393.63
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User43
329.09 403.13
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User44
338.79 415.02
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User45
350.19 428.98
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User46
363.77 445.61
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User47
379.05 464.33
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User48
396.51 485.72
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User49
413.72 506.81
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User50
433.13 595.55
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User51
452.28 621.89
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User52
473.38 650.90
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User53
494.72 680.24
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User54
517.76 711.92
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User55
540.80 743.60
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User56
565.78 777.95
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User57
591.00 812.63
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User58
617.92 849.64
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User59
631.26 867.98
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User60
658.18 904.99
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User61
681.46 937.00
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User62
696.74 958.01
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User63
715.89 984.35
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User64
727.53 1000.36
33871PA0110010 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
727.53 1000.36
2017 Rates Table Template v6.0 All fields with an asterisk ( * ) are required. To validate press Validate button or Ctrl + Shift + I. To finalize, press Finalize button or Ctrl + Shift + F.
If macros are disabled, press and hold the ALT key and press the F, then I, and then N key. After that, select the Enable All Content option by pressing enter. (note that you can also press the C key to select "Enable All Content") Instructions can be found in cells B1 through B5.If you are a community rating state, select Family Option under Age and fill in all columns.
If you are not community rating state, select 0-20 under Age and provide an Individual Rate for every age band.
If Tobacco is Tobacco User/Non-Tobacco User, you must give a rate for Tobacco Use and Non-Tobacco Use.
To add a new sheet, press the Add Sheet button, or Ctrl + Shift + H. All plans must have the same dates on a sheet.
HIOS Issuer ID* 33871
Federal TIN* 23-2405376
Rate Effective Date* 1/1/2017
Rate Expiration Date* 12/31/2017
Plan ID* Rating Area ID* Tobacco* Age* Individual Rate* Individual Tobacco Rate*
Required:
Enter the 14-character Plan ID
Required:
Select the Rating Area ID
Require:
Select if Tobacco use of subscriber is used to
determine if a person is eligible for a rate from a
plan
Required:
Select the age of a subscriber eligible for the
rate
Required:
Enter the rate of an Individual Non-Tobacco or
No Preference enrollee on a plan
Required:
Enter the rate of an Individual tobacco enrollee
on a plan
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User0-20
361.72 361.72
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User21
569.63 640.83
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User22
569.63 640.83
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User23
569.63 640.83
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User24
569.63 640.83
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User25
571.91 643.40
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User26
583.30 656.21
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User27
596.97 671.59
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User28
619.19 696.59
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User29
637.42 717.09
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User30
646.53 759.67
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User31
660.20 775.74
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User32
673.87 791.80
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User33
682.42 801.84
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User34
691.53 812.55
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User35
696.09 817.90
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User36
700.64 823.26
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User37
705.20 828.61
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User38
709.76 833.97
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User39
718.87 844.68
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User40
727.99 891.78
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User41
741.66 908.53
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User42
754.76 924.58
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User43
772.99 946.91
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User44
795.77 974.82
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User45
822.55 1007.62
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User46
854.45 1046.70
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User47
890.33 1090.66
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User48
931.35 1140.90
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User49
971.79 1190.44
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User50
1017.36 1398.87
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User51
1062.36 1460.74
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User52
1111.92 1528.89
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User53
1162.05 1597.81
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User54
1216.16 1672.22
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User55
1270.27 1746.63
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User56
1328.95 1827.30
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User57
1388.19 1908.76
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User58
1451.42 1995.70
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User59
1482.75 2038.78
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User60
1545.98 2125.72
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User61
1600.66 2200.91
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User62
1636.55 2250.25
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User63
1681.55 2312.13
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User64
1708.89 2349.72
33871PA0040001 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1708.89 2349.72
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User0-20
247.91 247.91
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User21
390.41 439.21
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User22
390.41 439.21
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User23
390.41 439.21
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User24
390.41 439.21
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User25
391.97 440.97
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User26
399.78 449.75
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User27
409.15 460.29
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User28
424.38 477.42
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User29
436.87 491.48
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User30
443.12 520.66
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User31
452.49 531.67
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User32
461.86 542.68
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User33
467.71 549.56
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User34
473.96 556.90
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User35
477.08 560.57
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User36
480.20 564.24
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User37
483.33 567.91
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User38
486.45 571.58
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User39
492.70 578.92
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User40
498.94 611.21
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User41
508.31 622.68
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User42
517.29 633.68
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User43
529.79 648.99
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User44
545.40 668.12
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User45
563.75 690.60
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User46
585.62 717.38
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User47
610.21 747.51
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User48
638.32 781.94
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User49
666.04 815.90
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User50
697.27 958.75
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User51
728.11 1001.16
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User52
762.08 1047.86
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User53
796.44 1095.10
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User54
833.53 1146.10
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User55
870.61 1197.09
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User56
910.83 1252.39
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User57
951.43 1308.22
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User58
994.76 1367.80
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User59
1016.24 1397.33
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User60
1059.57 1456.91
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User61
1097.05 1508.45
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User62
1121.65 1542.27
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User63
1152.49 1584.67
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User64
1171.23 1610.44
33871PA0040002 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1171.23 1610.44
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User0-20
193.05 193.05
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User21
304.01 342.01
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User22
304.01 342.01
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User23
304.01 342.01
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User24
304.01 342.01
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User25
305.23 343.38
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User26
311.31 350.22
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User27
318.60 358.43
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User28
330.46 371.77
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User29
340.19 382.71
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User30
345.05 405.44
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User31
352.35 414.01
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User32
359.64 422.58
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User33
364.20 427.94
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User34
369.07 433.66
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User35
371.50 436.51
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User36
373.93 439.37
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User37
376.36 442.23
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User38
378.80 445.09
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User39
383.66 450.80
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User40
388.52 475.94
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User41
395.82 484.88
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User42
402.81 493.45
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User43
412.54 505.36
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User44
424.70 520.26
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User45
438.99 537.76
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User46
456.02 558.62
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User47
475.17 582.08
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User48
497.06 608.89
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User49
518.64 635.34
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User50
542.96 746.57
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User51
566.98 779.60
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User52
593.43 815.96
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User53
620.18 852.75
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User54
649.06 892.46
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User55
677.94 932.17
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User56
709.26 975.23
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User57
740.87 1018.70
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User58
774.62 1065.10
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User59
791.34 1088.09
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User60
825.08 1134.49
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User61
854.27 1174.62
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User62
873.42 1200.95
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User63
897.44 1233.98
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User64
912.03 1254.04
33871PA0040003 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
912.03 1254.04
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User0-20
116.59 116.59
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User21
183.61 206.56
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User22
183.61 206.56
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User23
183.61 206.56
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User24
183.61 206.56
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User25
184.34 207.39
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User26
188.02 211.52
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User27
192.42 216.48
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User28
199.58 224.53
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User29
205.46 231.14
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User30
208.40 244.87
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User31
212.80 250.04
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User32
217.21 255.22
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User33
219.96 258.46
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User34
222.90 261.91
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User35
224.37 263.64
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User36
225.84 265.36
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User37
227.31 267.09
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User38
228.78 268.81
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User39
231.72 272.27
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User40
234.65 287.45
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User41
239.06 292.85
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User42
243.28 298.02
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User43
249.16 305.22
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User44
256.50 314.22
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User45
265.13 324.79
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User46
275.42 337.38
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User47
286.98 351.55
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User48
300.20 367.75
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User49
313.24 383.72
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User50
327.93 450.90
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User51
342.43 470.84
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User52
358.41 492.81
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User53
374.56 515.03
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User54
392.01 539.01
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User55
409.45 562.99
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User56
428.36 589.00
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User57
447.46 615.25
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User58
467.84 643.28
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User59
477.94 657.16
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User60
498.32 685.19
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User61
515.94 709.42
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User62
527.51 725.33
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User63
542.02 745.27
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User64
550.83 757.39
33871PA0040004 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
550.83 757.39
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User0-20
225.13 225.13
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User21
354.53 398.85
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User22
354.53 398.85
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User23
354.53 398.85
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User24
354.53 398.85
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User25
355.95 400.44
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User26
363.04 408.42
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User27
371.55 417.99
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User28
385.37 433.55
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User29
396.72 446.31
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User30
402.39 472.81
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User31
410.90 482.81
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User32
419.41 492.81
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User33
424.73 499.05
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User34
430.40 505.72
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User35
433.24 509.05
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User36
436.07 512.38
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User37
438.91 515.72
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User38
441.74 519.05
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User39
447.42 525.71
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User40
453.09 555.03
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User41
461.60 565.46
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User42
469.75 575.45
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User43
481.10 589.34
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User44
495.28 606.72
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User45
511.94 627.13
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User46
531.80 651.45
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User47
554.13 678.81
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User48
579.66 710.08
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User49
604.83 740.91
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User50
633.19 870.64
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User51
661.20 909.15
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User52
692.04 951.56
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User53
723.24 994.46
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User54
756.92 1040.77
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User55
790.60 1087.08
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User56
827.12 1137.29
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User57
863.99 1187.99
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User58
903.34 1242.10
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User59
922.84 1268.91
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User60
962.19 1323.02
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User61
996.23 1369.82
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User62
1018.56 1400.53
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User63
1046.57 1439.04
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User64
1063.59 1462.44
33871PA0040005 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
1063.59 1462.44
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User0-20
175.99 175.99
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User21
277.15 311.79
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User22
277.15 311.79
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User23
277.15 311.79
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User24
277.15 311.79
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User25
278.26 313.04
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User26
283.80 319.28
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User27
290.45 326.76
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User28
301.26 338.92
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User29
310.13 348.90
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User30
314.57 369.61
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User31
321.22 377.43
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User32
327.87 385.25
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User33
332.03 390.13
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User34
336.46 395.34
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User35
338.68 397.95
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User36
340.89 400.55
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User37
343.11 403.16
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User38
345.33 405.76
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User39
349.76 410.97
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User40
354.20 433.89
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User41
360.85 442.04
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User42
367.22 449.85
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User43
376.09 460.71
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User44
387.18 474.29
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User45
400.20 490.25
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User46
415.73 509.26
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User47
433.19 530.65
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User48
453.14 555.10
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User49
472.82 579.20
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User50
494.99 680.61
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User51
516.88 710.72
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User52
541.00 743.87
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User53
565.39 777.41
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User54
591.72 813.61
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User55
618.04 849.81
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User56
646.59 889.06
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User57
675.41 928.70
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User58
706.18 971.00
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User59
721.42 991.95
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User60
752.19 1034.25
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User61
778.79 1070.84
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User62
796.25 1094.85
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User63
818.15 1124.95
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User64
831.45 1143.24
33871PA0040006 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
831.45 1143.24
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User0-20
155.40 155.40
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User21
244.73 275.32
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User22
244.73 275.32
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User23
244.73 275.32
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User24
244.73 275.32
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User25
245.71 276.42
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User26
250.60 281.93
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User27
256.48 288.54
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User28
266.02 299.27
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User29
273.85 308.08
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User30
277.77 326.38
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User31
283.64 333.28
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User32
289.52 340.18
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User33
293.19 344.49
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User34
297.10 349.10
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User35
299.06 351.40
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User36
301.02 353.70
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User37
302.98 356.00
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User38
304.93 358.30
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User39
308.85 362.90
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User40
312.76 383.14
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User41
318.64 390.33
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User42
324.27 397.23
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User43
332.10 406.82
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User44
341.89 418.81
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User45
353.39 432.90
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User46
367.10 449.69
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User47
382.51 468.58
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User48
400.13 490.16
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User49
417.51 511.45
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User50
437.09 601.00
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User51
456.42 627.58
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User52
477.71 656.86
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User53
499.25 686.47
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User54
522.50 718.44
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User55
545.75 750.40
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User56
570.96 785.06
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User57
596.41 820.06
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User58
623.57 857.41
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User59
637.03 875.92
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User60
664.20 913.27
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User61
687.69 945.58
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User62
703.11 966.78
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User63
722.44 993.36
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User64
734.19 1009.51
33871PA0040007 Rating Area 8 Tobacco User/Non-Tobacco User65 and over
734.19 1009.51
Supporting Document Schedules Satisfied - Item: REDACTED FILING DOCUMENTSComments:
Attachment(s): R-PA-KHPE Small Group Federal Actuarial Memorandum 2017.pdfR-PA-KHPE Small Group Pennsylvania Actuarial Memorandum 2017.pdf
Item Status:Status Date:
Satisfied - Item: Non-Confidential PDF FilesComments:
Attachment(s):
2017 PA SG Actuarial Memorandum Rate Exhibits KHPE (Entity-Specific Gross Premium) FINAL RV.pdfKHPE Small Group Rate Change Request Summary 2017.pdfKHPE PA Small Group Bulletin Information.pdfKHPE Small Group URRT_Part2.pdf33871khpeurrtpt1_SG_5172016.pdfR-KHPE cover letter SG_Redacted.pdf
Item Status:Status Date:
SERFF Tracking #: INAC-130539718 State Tracking #: INAC-130539718 Company Tracking #: KHPE SG 1-1-2017
State: Pennsylvania Filing Company: Keystone Health Plan East, Inc.
TOI/Sub-TOI: H15G Group Health - Hospital/Surgical/Medical Expense/H15G.003 Small Group Only
Product Name: KHPE Small Group HMO eff 1-1-2017
Project Name/Number: /
PDF Pipeline for SERFF Tracking Number INAC-130539718 Generated 06/14/2016 09:28 AM
GENERAL OVERVIEW
PURPOSES
This Actuarial Memorandum is provided along with the Unified Rate Review Template (URRT) to provide
certain information to support the gross premium for the single risk pool for small group market health
care insurance underwritten by Keystone Health Plan East in the Commonwealth of Pennsylvania. It is
provided as a component of an application for certification as a Qualified Health Plan and a state rate
filing. This submission may not be appropriate for other purposes.
GENERAL INFORMATION
COMPANY IDENTIFYING INFORMATION
Company Legal Name: Keystone Health Plan East (“KHPE”)
State: Pennsylvania
HIOS Issuer ID (5-digit): 33871
Market: Small Group
Effective Date(s): 1/1/2017-3/31/2017, 4/1/2017 – 6/30/2017, 7/1/2017 – 9/30/2017,
10/1/2017 – 12/31/2017
Worksheet 1 of the accompanying URRT contains experience period data and development of the
projected Single Risk Pool Gross Premium Average Rate PMPM for the small group market for KHPE.
Worksheet 2 contains experience period data and projections by product for the single risk pool for the
same entities. This memorandum pertains only to plans denoted in Worksheet 2 by Plan IDs starting
with the sequence 33871.
COMPANY CONTACT INFORMATION
Primary Contact Name: xxxxxxxxxxxx
Primary Contact Telephone Number: xxxxxxxxxxxx
Primary Contact Email Address: xxxxxxxxxxxxxxxxxxxxxx
PROPOSED RATE INCREASE
The changes to the single risk pool gross premium average rate per member per month (PMPM) from
calendar year 2015 to calendar year 2017 were incorporated into the pricing and reflected in the Unified
Rate Review Template. The changes are driven by factors including: changes in market-wide population
risk morbidity and covered services, increasing unit costs for medical services, increasing utilization of
medical services, increasing fees and taxes imposed by the federal government, anticipated costs to
administer the plan, anticipated revenue or payments due to market-wide risk adjustment, and the
discontinuance of net reinsurance payments from the Federal Transitional Reinsurance Program.
The weighted average increase across KHPE plans based on projected membership, inclusive of the
impact of benefit and cost sharing changes, is 3.7%. The minimum increase is 1.2% and the maximum
increase is 5.8%.
WORKSHEET 1: DATA COLLECTION TEMPLATE
SECTION I: EXPERIENCE PERIOD PREMIUM AND CLAIMS
PAID THROUGH DATE
Experience period premium, claims, and member months are obtained from the company’s internal
data warehouse. The claims data is collected for incurred dates from January through December 2015
and paid through January 2016. Earned premiums and member months are for January through
December 2015. The data are for all direct-written small group business of KHPE in the Commonwealth
of Pennsylvania
PREMIUMS (NET OF MLR REBATE) IN EXPERIENCE PERIOD
Earned Premiums (net of MLR Rebate) in Experience Period are developed by summing the earned
premium reported in the company’s internal data warehouse and adjusting for MLR rebates, if any, for
the period. Although 2015 federal MLR rebate calculations are not final as of the writing of this
memorandum, no federal MLR rebates are expected for calendar year 2015, so no adjustment to earned
premium for MLR rebates is needed.
The calculation for federal minimum loss ratio rebates is based on 2013, 2014, and 2015 experience of
earned premium, incurred claims, quality improvement expenses, and taxes. The three years of
experience is blended for all segments.
ALLOWED AND INCURRED CLAIMS INCURRED DURING THE EXPERIENCE PERIOD
Paid-to-Date and Incurred Claims, and Member Months
Insurer fee-for-service claims expenses and member liabilities for dates of service in January 2015
through December 2015 and paid through January 2016 are sourced from the IBCFOC’s internal data
warehouse. The claims and member liabilities are completed with incurred but not reported (IBNR)
adjustments to develop ultimate incurred insurer fee-for-service claims expenses and member liabilities
for the January through December 2015 period. Capitation amounts are also sourced from the internal
data warehouse for the January through December 2015 period but they are not adjusted for IBNR.
Allowed Claims
Allowed claims are determined by separately obtaining paid-to-date fee-for-service claims and member
cost-sharing amounts, applying claim lag factors to those amounts to estimate ultimate incurred fee-for-
service claims and member-sharing amounts and adding them together with capitation amounts.
Allowed claims do not include ineligible claims, payments for services other than medical care provided,
recovery payments related to internal large claim pooling mechanisms, or active live reserves.
IBNR Development
Medical fee for service incurred but not reported (IBNR) claims are modeled through the use of standard
claim lag methodologies. A range of results is developed, and a provision for adverse deviation is
applied. The provision for adverse deviation is dependent on many factors such as stability, size, product
mix, etc.
The completion factors are developed annually in the 2Q – 3Q period. We do not believe our IBNR is
unusually high or unusually low for incurred 2015 paid through January 2016.
Experience Period Index Rate
The Index Rate of Experience Period is estimated by removing cost and utilization trend from the Index
Rate for Projection Period.
SECTION II: ALLOWED CLAIMS, PMPM BASIS
BENEFIT CATEGORIES
Utilization and Unit Cost data for allowed claims in the experience period are provided in Section II. The
data is provided by benefit category using a standardized indicator from the internal data warehouse
that assigns each claim line to a category based on the type of provider and the location of the service.
The utilization and unit cost data are provided for the following categories: Inpatient Hospital admits,
Outpatient Hospital visits, Professional visits, Other Medical visits, Capitation per member per month
(PMPM), and Prescription Drug scripts.
Experience Period capitation is reported as a per member per month (PMPM) value. In order to
complete the URRT, the Utilization per 1,000 statistics for capitated services only is reported as 1,000 so
that the appropriate capitation PMPM is reported.
PROJECTION FACTORS
The estimated incurred claims experience on an allowed basis for January 2015 through December 2015
is projected to the future rating period by several factors. Factors were calculated from the combined
experience of QCC and KHPE.
Changes in Population Risk Morbidity
Experience period allowed claims are adjusted to account for differences in the average morbidity of
the single risk pool population underlying the experience and the anticipated population in the
projection period. This adjustment reflects changes in the small group market-wide morbidity due to
one or more of the following: guarantee issue, the individual mandate, Medicaid and CHIP migration,
take-up of insurance by the previously uninsured, health status of the newly insured, enrollment from
prior high risk pools, subsidy effects, dumping of enrollment from group markets to the individual
market, and market-wide impact of transitional products/plans.
Changes in Other Factors
Experience period allowed claims are adjusted to account for differences in the single risk pool
population underlying the experience and the anticipated population in the projection period pertaining
to several factors not due to changes in morbidity or the costs and utilization of medical care. This
adjustment reflects: additional benefits required to be covered as essential health benefits; recently
mandated benefits required by state law that are not reflected in the experience period data; benefits in
the experience that are removed for the projection period; anticipated changes in the average
utilization of services due to differences in average cost sharing requirements during the experience
period and average cost sharing requirements in the projection period; changes in demographic
characteristics of the single risk pool experience period population and the projection period population
(including age, gender, region, and tobacco use); changes in the provider network (adding or removing a
provider system or introducing a limited network option); and anticipated changes in pharmacy rebates.
Trend Factors
a. Annualized Cost Trend
Annual cost trend reflects changes in costs of medical treatment due to medical inflation and changes in
the distribution of services across network providers. The trend value is developed by reviewing
historical medical costs for the single risk pool and adjusting them for anticipated future provider
contracting reimbursement levels. The data is normalized for changes in age, benefit changes during the
experience period, changes to provider contracts, and prescription drug formulary, and new drugs
brought to market.
b. Annualized Utilization Trend
Annual utilization trend reflects the change in the number of units per 1,000 members for a fixed level
of illness burden and includes changes due to the mix and intensity of services provided and changes
related to shifts in product mix. It also includes effects of selection, if any, since this cannot be reflected
in the relative cost of the various products and plans offered.
CREDIBILITY MANUAL RATE DEVELOPMENT
The experience period claims for the single risk pool are determined to be fully credible; therefore no
credibility adjustment is required.
SECTION III: PROJECTED EXPERIENCE
PAID TO ALLOWED RATIO
The Projected Allowed Experience Claims PMPM shown in Worksheet 1 represents projected allowed
claims experience PMPM for the projected portfolio of plans. The Paid to Allowed Average Factor in
Projection Period adjusts the allowed down to Projected Incurred Claims before ACA reinsurance and
risk adjustment for the population anticipated to be covered in the projection period. The Projected
Incurred Claims before ACA reinsurance and risk adjustment represents the net amount of incurred
insurer claim liability expected in the projection period, net of member cost sharing and cost sharing
paid by HHS on behalf of low-income members. It reflects the average benefit level anticipated during
the projection period. The ratio was calculated using incurred (before ACA reinsurance and risk
adjustment) and allowed PMPMs from worksheet two of the URRT.
RISK ADJUSTMENT AND REINSURANCE
Projected Risk Adjustment PMPM
Projected Risk Adjustment is accounted for in Projected Incurred Claims before ACA Reinsurance and
Risk Adjustment to reflect anticipated risk adjustment transfer amounts for the projection period. The
amount reflects the projected morbidity for the single risk pool for IBCFOC in the projection period.
The estimated risk adjustment revenue for all of the plans in the risk pool is developed using the
following methodology. We recognize that the HHS payment transfer formula implies that the projected
incurred claims based solely on the experience period single risk pool claims need to be adjusted by the
ratio of the current statewide market’s risk relative to allowable rating factor (ARF) for age compared to
the single risk pool’s risk relative to ARF presented during the experience period. This adjustment,
together with the assumed future changes in population risk morbidity, results in the issuer’s pricing
being consistent with the anticipated morbidity level of the future statewide market.
Estimating the current statewide market’s risk and ARF is difficult, because we do not have access to the
relevant data from other carriers operating in this market. In order to gain insight, we participated in
the Wakely Consulting Group’s risk adjustment reporting project for this market. Our assumptions are
the result of a combination of measurements based on Wakely’s reports and our own actuarial
judgment.
The anticipated risk adjustment transfer revenue is allocated proportionally based on plan premium.
The Projected Risk Adjustment is subtracted from Projected Incurred Claims before ACA Reinsurance
and Risk Adjustment to reflect anticipated receipt of risk adjustment transfer amounts for the projection
period.
When the projected risk adjustment amounts for KHPE and QCC are combined, the result is consistent
with the projection made in our initial submission, and is comparable to the Wakely projection. We also
considered 2014 risk transfer results.
Projected ACA Reinsurance Recoveries Net of Reinsurance Premium (Individual Market Only)
With the expiration of the reinsurance program at the end of the 2016 benefit year, there is no
reinsurance premium assumed in the rates.
NON-BENEFIT EXPENSES AND PROFIT & RISK
Administrative Expense Load
An Administrative Expense Load is applied to Projected Incurred Claims to reflect expenses related to
quality improvement and fraud detection/recovery and other expenses of operating a business, broker
commissions, and premium payment processing fees.
Profit & Risk Load/Contribution to Surplus
A Profit & Risk Load/Contribution to Surplus for the single risk pool is applied to Projected Incurred
Claims for the projection period, if applicable.
Taxes and Fees
A Taxes & Fees load is applied to Projected Incurred Claims to pass through the fees and taxes levied by
the federal and state governments.
PROJECTED LOSS RATIO
The projected loss ratio for the single risk pool is estimated to exceed 80% reflecting premium
adjustments permitted by the federal MLR calculation.
SINGLE RISK POOL
The single risk pool reflects all covered lives for every small group non-grandfathered product and plan combination for KHPE in the state of Pennsylvania. It is established according to the Single Risk Pool requirements in 45 CFR § 156.80(d).
INDEX RATE
The Index Rate is defined as the EHB portion of projected allowed claims divided by all projected single risk pool lives. The Index Rate is the same value for all non-grandfathered plans for KHPE small group Plans in Pennsylvania. The Index Rate reflects the twelve month projection for calendar year 2017. It has been developed following the specifications of 45 CFR § 156.80(d)(1).
MARKET ADJUSTED INDEX RATE
The Market Adjusted Index rate is calculated as the Index Rate adjusted for all allowable market-wide
modifiers defined in the market rating rules: federal reinsurance program adjustment, risk adjustment
and exchange user fees. The Market Adjusted Index Rate reflects the average demographic
characteristics of the single risk pool.
PLAN ADJUSTED INDEX RATE
The Plan Adjusted Index Rate is calculated as the issuer Market Adjusted Index Rate adjusted for all
allowable plan level modifiers defined in the market rating rule. These include actuarial value and cost
sharing adjustment, provider network, delivery system and utilization management adjustment,
adjustment for benefits in addition to the EHBs, impact of specific eligibility categories for the
catastrophic plan and administrative costs.
CALIBRATION
The plan adjusted index rate is projected for all products using the same anticipated age distribution
and the mandated age curve. Therefore the consumer adjusted premium rate is the plan adjusted index
rate divided by the average age, geographic and tobacco factors for the expected distribution. The
average age of the combined small group risk pool population is 46.
The Average Age factor is the weighted average age factor based on the projected membership. The
Tobacco Factor is calculated as the projected average factor for tobacco users multiplied by the
projected tobacco use prevalence.
There is only one geographic rating area for this filing. The geographic rating area factor for this filing is
1.0.
WORKSHEET 2: PRODUCT-PLAN DATA COLLECTION
AV METAL VALUES
The AV Metal Values included in Worksheet 2 of the URRT were valued using the AV Calculator, where
possible, otherwise the AV Metal Values were developed under an alternate methodology. Actuarial
certifications required by 45 CFR Part 156, §156.135 are provided in a separate document.
AV PRICING VALUES
The AV Pricing Value represents the cumulative effect of adjustments made by plan to move from the
Market Adjusted Index Rate to the Plan Adjusted Index Rate.
MEMBERSHIP PROJECTIONS
Enrollment is projected based on current and anticipated enrollment by plan. Items impacting these
projections include changes in the size of the market due to introduction of guarantee issue
requirements and the individual mandate.
TERMINATED PLANS
The following plans are terminated:
HIOS ID Plan Name
33871PA0100017 Keystone HMO Bronze Basic
33871PA0100046 Keystone HMO Bronze Basic
HIOS ID CHANGES
Pursuant to guidance from CMS, the following plans were reclassified from HMO to POS. HIOS IDs for
the following plans are changed effective January 1, 2017. They are shown in the Experience Period
section of the URRT Worksheet 2 using the 2017 HIOS ID numbers.
2016 HIOS ID 2017 HIOS ID Plan Name
33871PA0100010 33871PA0110001 Keystone DPOS Platinum Preferred $10/$20/$100
33871PA0100011 33871PA0110002 Keystone DPOS Platinum Preferred $20/$40/$150
33871PA0100012 33871PA0110003 Keystone DPOS Gold Preferred $30/$60/$650
33871PA0100013 33871PA0110004 Keystone DPOS Gold Classic $1,000 $25/$50/90%
33871PA0100018 33871PA0110005 Keystone DPOS Gold Classic $2,000 $40/$80/100%
33871PA0100014 33871PA0110006 Keystone DPOS Silver Classic $2,500 $25/$50/70%
33871PA0100034 33871PA0110007 Keystone DPOS Silver Secure $3,500/$40/$80/$600
33871PA0100019 33871PA0110008 Keystone DPOS Silver Classic $4,250/$40/$80/100%
33871PA0100015 33871PA0110009 Keystone DPOS Silver Classic $2,750 $30/$60/50%
33871PA0100016 33871PA0110010 Keystone DPOS Bronze Essential $6,850 $50/$100/$700
33871PA0100027 33871PA0110011 Keystone DPOS Platinum Preferred $10/$20/$100
33871PA0100028 33871PA0110012 Keystone DPOS Platinum Preferred $20/$40/$150
33871PA0100029 33871PA0110013 Keystone DPOS Gold Preferred $30/$60/$650
33871PA0100030 33871PA0110014 Keystone DPOS Gold Classic $1,000 $25/$50/90%
33871PA0100031 33871PA0110016 Keystone DPOS Silver Classic $2,500 $25/$50/70%
33871PA0100032 33871PA0110019 Keystone DPOS Silver Classic $2,750 $30/$60/50%
33871PA0100033 33871PA0110020 Keystone DPOS Bronze Essential $6,850 $50/$100/$700
33871PA0100041 33871PA0110015 Keystone DPOS Gold Classic $2,000 $40/$80/100%
33871PA0100042 33871PA0110018 Keystone DPOS Silver Classic $4,250/$40/$80/100%
33871PA0100043 33871PA0110017 Keystone DPOS Silver Secure $3,500/$40/$80/$600
WARNING ALERTS
There are no warning alerts in URRT Part 1.
ACTUARIAL CERTIFICATION
I, xxxxxxxxxxxxxx, am Director & Actuary of Commercial Markets for the Independence Blue Cross Family of Companies. I am a member of the Society of Actuaries and the American Academy of Actuaries with the education and experience necessary to perform the work necessary and meet the Qualification Standards of the American Academy of Actuaries to render the qualified actuarial opinion contained herein. The developed rates and memorandum have been prepared in conformity with appropriate Actuarial Standards of Practice and the Academy’s Code of Professional Conduct.
The Part I Unified Rate Review Template does not demonstrate the process used by the issuer to develop the premium rates and allowable rating factors. Rather, it represents information required by Federal regulation to be provided in support of the review of gross premium rate increases, for certification of qualified health plans for Federally facilitated exchanges, and for certification that the index rate is developed in accordance with Federal regulation and used consistently and only adjusted by the allowable modifiers. I hereby certify that, to the best of my knowledge and judgment, the following:
The projected index rate is:
—In compliance with all applicable State and Federal Statutes and Regulations (45 CFR 156.08(d)(1) and 147.102);
—Developed in compliance with applicable Actuarial Standards of Practice;
—Reasonable in relation to the benefits provided and the population anticipated to be covered; and
—Neither excessive nor deficient.
The index rate and only the allowable modifiers as described in 45 CFR 156.80(d)(1) and 45 CFR 156.80(d)(2) were used to generate plan level rates.
The percent of total premium that represents essential health benefits included in Worksheet 2, Sections III and IV were calculated in accordance with actuarial standards of practice.
Geographic rating factors reflect only differences in the costs of delivery of and do not include differences for population morbidity by geographic area.
The AV Calculator was used to determine the AV Metal Values shown in Worksheet 2 of the
Part I Unified Rate Review Template for all plans, unless an alternate methodology was
required. If an alternate methodology was used to calculate the AV Metal Value for at least
one plan offered, a copy of the actuarial certification required by 45 CFR Part 156, §156.135
will be included.
xxxxxxxxxxxxxx xxxxxxxxxxxxxx May 11, 2016
PENNSYLVANIA ACTUARIAL MEMORANDUM
PURPOSES
This Actuarial Memorandum is provided along with the Unified Rate Review Template (URRT) and PA
Actuarial Memorandum Rate Exhibits to provide certain information to support the gross premium for
the single risk pool for small group market health care insurance underwritten by Keystone Health Plan
East in the Commonwealth of Pennsylvania. It is provided as a component of a state rate filing. This
submission may not be appropriate for other purposes.
1. BASIC INFORMATION AND DATA
A. COMPANY INFORMATION
Company Legal Name: Keystone Health Plan East (“KHPE”)
State: Pennsylvania
NAIC #: 95056
Market: Small Group
Marketplace: On and Off Exchange
Effective Date(s): 1/1/2017-3/31/2017, 4/1/2017 – 6/30/2017, 7/1/2017 – 9/30/2017,
10/1/2017 – 12/31/2017
Average Rate Change: 3.7%
Range of Rate Changes: 1.2% - 5.8%
Products: HMO
Rating Areas: Rating Area 8
Metal Levels: Platinum, Gold, Silver, Bronze
Current Members: 125,640
Current Policyholders: 73,044
Number of 2017 Plans: 44
HIOS Issuer ID (5-digit): 33871
Worksheet 1 of the accompanying URRT contains experience period data and development of the
projected Single Risk Pool Gross Premium Average Rate PMPM for the small group market for KHPE.
Worksheet 2 contains experience period data and projections by product for the single risk pool for the
same entities. This memorandum pertains only to plans denoted in Worksheet 2 by Plan IDs starting
with the sequence 33871.
COMPANY CONTACT INFORMATION
Primary Contact Name: xxxxxxxxxxxx
Primary Contact Telephone Number: xxxxxxxxxxxx
Primary Contact Email Address: xxxxxxxxxxxxxxxx xxxxxxxx
B. RATE HISTORY AND PROPOSED VARIATIONS IN RATE CHANGES
January 1, 2014 Initial Filing INAC- 128999672
January 1, 2015 8.40% INAC- 129626509
October 1, 2015 -0.30% INAC- 130111004
January 1, 2016 6.88% INAC- 129955625
The historical rate changes varied by metallic tier based on plan benefits as illustrated via the Pricing AV.
Proposed rate changes vary by metallic tier and plan based on projected experience and plan benefit
changes.
C. AVERAGE RATE CHANGE
The average proposed rate change is 3.7%. The changes to the single risk pool gross premium average
rate per member per month (PMPM) from calendar year 2015 to calendar year 2017 are incorporated
into the pricing and reflected in the Unified Rate Review Template.
The change in 21-year-old Non-Tobacco Premium PMPM calculated in Table 11, Cell AZ13 is 3.7%.
D. MEMBERSHIP COUNT
Table 1 illustrates the Experience Period member-months, Current Period members as of February 1,
2016, and Projected Rating Period Member-months by ages.
E. BENEFIT CHANGES
Benefit changes were made to the following plans to assure compliance with Actuarial Value
requirements.
F. EXPERIENCE PERIOD CLAIMS AND PREMIUMS
Table 2 illustrates the experience period claims and premiums using calendar year data. The data is
consistent with the data reported in Section 1 of Worksheet I of the URRT.
Experience period premium, claims, and member months are obtained from the company’s internal
data warehouse. The claims data is collected for incurred dates from January through December 2015
and paid through January 2016. Earned premiums and member months are for January through
December 2015. The data are for all direct-written individual business of KHPE in the Commonwealth of
Pennsylvania, including out-of-network claims written by KHPE but paid by QCC for POS plans. No
private reinsurance was applicable.
Projected Risk Adjustment PMPM
Non-EHB benefits are illustrated separately in cell H26. Capitation is uniform by age for the experience
period. Net pharmacy rebates are illustrated in cell J26.
Projected Risk Adjustment is accounted for in Projected Incurred Claims before ACA Reinsurance and
Risk Adjustment to reflect anticipated risk adjustment transfer amounts for the projection period. The
amount reflects the projected morbidity for the single risk pool for IBCFOC in the projection period.
The estimated risk adjustment revenue for all of the plans in the risk pool is developed using the
following methodology. We recognize that the HHS payment transfer formula implies that the projected
incurred claims based solely on the experience period single risk pool claims need to be adjusted by the
ratio of the current statewide market’s risk relative to allowable rating factor (ARF) for age compared to
the single risk pool’s risk relative to ARF presented during the experience period. This adjustment,
together with the assumed future changes in population risk morbidity, results in the issuer’s pricing
being consistent with the anticipated morbidity level of the future statewide market.
Estimating the current statewide market’s risk and ARF is difficult, because we do not have access to the
relevant data from other carriers operating in this market. In order to gain insight, we participated in
the Wakely Consulting Group’s risk adjustment reporting project for this market. Our assumptions are
the result of a combination of measurements based on Wakely’s reports and our own actuarial
judgment.
The anticipated risk adjustment transfer revenue is allocated proportionally based on plan premium.
The Projected Risk Adjustment is subtracted from Projected Incurred Claims before ACA Reinsurance
and Risk Adjustment to reflect anticipated receipt of risk adjustment transfer amounts for the projection
period.
When the projected risk adjustment amounts for KHPE and Independence Blue Cross (QCC) are
combined, the result is consistent with the projection made in our initial submission, and is comparable
to the Wakely projection. We also considered 2014 risk transfer results.
Projected ACA Reinsurance Recoveries Net of Reinsurance Premium (Individual Market Only)
The Federal Transitional Reinsurance Program is not applicable for 2017.
G. CREDIBILITY OF DATA
The experience period data is considered 100% credible.
H. TREND IDENTIFICATION
Table 3 identifies the proposed annual medical and prescription drug allowed claims cost and utilization
trends. These data match the data illustrated in Section 2 of Worksheet I of the URRT. Additional
discussion is provided in Section I, Historical Experience.
I. HISTORICAL EXPERIENCE
Table 4 illustrates historical experience from 2014 through 2015 for the product line.
a. Annualized Cost Trend
Annual cost trend reflects changes in costs of medical treatment due to medical inflation and changes in
the distribution of services across network providers. The trend value is developed by reviewing
historical medical costs for the single risk pool and adjusting them for anticipated future provider
contracting reimbursement levels. The data is normalized for changes in age, benefit changes during the
experience period, changes to provider contracts, and prescription drug formulary, and new drugs
brought to market.
b. Annualized Utilization Trend
Annual utilization trend reflects the change in the number of units per 1,000 members for a fixed level
of illness burden and includes changes due to the mix and intensity of services provided and changes
related to shifts in product mix. It also includes effects of selection, if any, since this cannot be reflected
in the relative cost of the various products and plans offered.
J. TERMINATED PLANS
The following plans are terminated:
HIOS ID Plan Name
33871PA0100017 Keystone HMO Bronze Basic
33871PA0100046 Keystone HMO Bronze Basic
K. HIOS ID CHANGES
Pursuant to guidance from CMS, the following plans were reclassified from HMO to POS. HIOS IDs for
the following plans are changed effective January 1, 2017. They are shown in the Experience Period
section of the URRT Worksheet 2 using the 2017 HIOS ID numbers.
2016 HIOS ID 2017 HIOS ID Plan Name
33871PA0100010 33871PA0110001 Keystone DPOS Platinum Preferred $10/$20/$100
33871PA0100011 33871PA0110002 Keystone DPOS Platinum Preferred $20/$40/$150
33871PA0100012 33871PA0110003 Keystone DPOS Gold Preferred $30/$60/$650
33871PA0100013 33871PA0110004 Keystone DPOS Gold Classic $1,000 $25/$50/90%
33871PA0100018 33871PA0110005 Keystone DPOS Gold Classic $2,000 $40/$80/100%
33871PA0100014 33871PA0110006 Keystone DPOS Silver Classic $2,500 $25/$50/70%
33871PA0100034 33871PA0110007 Keystone DPOS Silver Secure $3,500/$40/$80/$600
33871PA0100019 33871PA0110008 Keystone DPOS Silver Classic $4,250/$40/$80/100%
33871PA0100015 33871PA0110009 Keystone DPOS Silver Classic $2,750 $30/$60/50%
33871PA0100016 33871PA0110010 Keystone DPOS Bronze Essential $6,850 $50/$100/$700
33871PA0100027 33871PA0110011 Keystone DPOS Platinum Preferred $10/$20/$100
33871PA0100028 33871PA0110012 Keystone DPOS Platinum Preferred $20/$40/$150
33871PA0100029 33871PA0110013 Keystone DPOS Gold Preferred $30/$60/$650
33871PA0100030 33871PA0110014 Keystone DPOS Gold Classic $1,000 $25/$50/90%
33871PA0100031 33871PA0110016 Keystone DPOS Silver Classic $2,500 $25/$50/70%
33871PA0100032 33871PA0110019 Keystone DPOS Silver Classic $2,750 $30/$60/50%
33871PA0100033 33871PA0110020 Keystone DPOS Bronze Essential $6,850 $50/$100/$700
33871PA0100041 33871PA0110015 Keystone DPOS Gold Classic $2,000 $40/$80/100%
33871PA0100042 33871PA0110018 Keystone DPOS Silver Classic $4,250/$40/$80/100%
33871PA0100043 33871PA0110017 Keystone DPOS Silver Secure $3,500/$40/$80/$600
2. RATE DEVELOPMENT AND CHANGE
A. DEVELOPMENT OF PROJECTED INDEX RATE, MARKET-ADJUSTED INDEX RATE, & TOTAL
ALLOWED CLAIMS
Table 5 illustrates the development of the Projected Index Rate and Market-Adjusted Index Rate
beginning with the Experience Period Index Rate.
Changes in Population Risk Morbidity
Experience period allowed claims are adjusted to account for differences in the average morbidity of the
single risk pool population underlying the experience and the anticipated population in the projection
period. This adjustment reflects changes in the small group market-wide morbidity due to one or more
of the following: guarantee issue, the individual mandate, Medicaid and CHIP migration, take-up of
insurance by the previously uninsured, health status of the newly insured, enrollment from prior high
risk pools, subsidy effects, dumping of enrollment from group markets to the individual market, and
market-wide impact of transitional products/plans.
Changes in Other Factors
Experience period allowed claims are adjusted to account for differences in the single risk pool
population underlying the experience and the anticipated population in the projection period pertaining
to several factors not due to changes in morbidity or the costs and utilization of medical care. This
adjustment reflects: additional benefits required to be covered as essential health benefits; recently
mandated benefits required by state law that are not reflected in the experience period data; benefits in
the experience that are removed for the projection period; anticipated changes in the average
utilization of services due to differences in average cost sharing requirements during the experience
period and average cost sharing requirements in the projection period; changes in demographic
characteristics of the single risk pool experience period population and the projection period population
(including age, gender, region, and tobacco use); changes in the provider network (adding or removing a
provider system or introducing a limited network option); and anticipated changes in pharmacy rebates.
B. RETENTION ITEMS
Table 6 illustrates the retention items, expressed as percentages of premium. Administrative expenses
are calculated and applied on a PMPM basis. When expressed as a percentage of premium, these will
vary by premium size. Consistent with conversations with our State regulator, no Pricing load was
applied for the Managed Care Assessment levied pursuant to Article VIII-I of the Pennsylvania Code, as it
will be separately reimbursed.
Administrative Expenses 9.89%
General and Claims 3.68%
Agent/Broker Fees and Commissions 5.74%
Quality Improvement Initiatives 0.47%
Taxes and Fees 4.12%
PCORI Fees 0.05%
PA Premium Tax 0.00%
Federal Income Tax 2.47%
Health Insurance Providers Fee 1.60%
Profit/Contingency 2.00%
Total Retention 16.01%
C. NORMALIZED MARKET-ADJUSTED PROJECTED ALLOWED TOTAL CLAIMS
Table 7 compares the normalization factors used in this filing to those used in the 2016 filing. The
changes in the factors reflect small differences from the projected populations in 2016 and 2017.
D. COMPONENTS OF RATE CHANGE
Table 8 illustrates the components of rate change, based on inputs form other sections of the Rate
Exhibits. The results in Row H are similar to the values in Row A of Table 8.
Data in Table 9 was taken from the 2016 URRT with the exceptions of Risk Adjustment and Reinsurance
which were revised to project company-specific values.
3. PLAN RATE DEVELOPMENT
Table 10 is populated with plan information consistent with entries in the 2017 URRT. Plan mappings,
where applicable, are illustrated in Column F of Table 10.
Attached to this actuarial memorandum are exhibits providing actuarial certifications for the use of
alternate methods of calculating the Actuarial Value, where applicable, as well as required support for
the calculations.
4. PLAN PREMIUM DEVELOPMENT FOR 21-YEAR OLD NON-TOBACCO USER
Table 11 is populated from other sections of the Rate Exhibits, along with the population by age and
rating area for the Projection Period.
5. PLAN FACTORS
Tables 12, 13, and 14 illustrate the factors used in pricing for age, tobacco, geographic rating area, and
network. To be consistent with our Consumer rating, we are proposing to use the tobacco factors
approved for 2016 in 2017 rating in consideration of the additional premium required for Individual
Plans by the terminating of the federal reinsurance program.
6. ACTUARIAL CERTIFICATION
I, xxxxxxxxxxxxxxxxxx, am Director & Actuary of Commercial Markets for the Independence Blue Cross Family of Companies. I am a member of the Society of Actuaries and the American Academy of Actuaries with the education and experience necessary to perform the work necessary and meet the Qualification Standards of the American Academy of Actuaries to render the qualified actuarial opinion contained herein. The developed rates and memorandum have been prepared in conformity with appropriate Actuarial Standards of Practice and the Academy’s Code of Professional Conduct. The Part I Unified Rate Review Template does not demonstrate the process used by the issuer to develop the premium rates and allowable rating factors. Rather, it represents information required by Federal regulation to be provided in support of the review of gross premium rate increases, for certification of qualified health plans for Federally facilitated exchanges, and for certification that the index rate is developed in accordance with Federal regulation and used consistently and only adjusted by the allowable modifiers. I hereby certify that, to the best of my knowledge and judgment, the following:
The projected index rate is:
—In compliance with all applicable State and Federal Statutes and Regulations (45 CFR 156.08(d)(1) and 147.106);
—Developed in compliance with applicable Actuarial Standards of Practice;
—Reasonable in relation to the benefits provided and the population anticipated to be covered; and
—Neither excessive nor deficient.
The index rate and only the allowable modifiers as described in 45 CFR 156.80(d)(1) and 45 CFR 156.80(d)(2) were used to generate plan level rates.
The percent of total premium that represents essential health benefits included in Worksheet 2, Sections III and IV were calculated in accordance with actuarial standards of practice.
The AV Calculator was used to determine the AV Metal Values illustrated in Worksheet 2 of
the Part I Unified Rate Review Template for all plans, unless an alternate methodology was
required. If an alternate methodology was used to calculate the AV Metal Value for at least
one plan offered, a copy of the actuarial certification required by 45 CFR Part 156, §156.135
will be included.
All factor, benefit, and other changes from the prior approved filing have been disclosed in
the actuarial memorandum.
New plans cannot be considered modifications of existing plans under the uniform
modification standards in 45 CFR 147.106.
The information presented in the PA Actuarial Memorandum and PA Actuarial
Memorandum Rate Exhibits is consistent with the information presented in the 2017 Rate
Filing Justification.
xxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxx May 11, 2016
PA Rate Template Part I
Data Relevant to the Rate Filing
Table 1. Number of Members
Member-months Members Member-months
Experience PeriodCurrent Period
(as of Feb. 1, 2016)
Projected Rating
Period
Total 1,494,855 125,640 1,508,556
<18 288,407 23,045 276,697
18-24 146,476 12,023 144,356
25-29 128,636 11,072 132,945
30-34 128,955 11,279 135,432
35-39 115,241 10,136 121,703
40-44 118,421 9,531 114,434
45-49 140,785 11,668 140,093
50-54 156,581 12,994 156,020
55-59 147,479 12,408 148,980
60-63 92,249 8,158 97,952
64+ 31,626 3,327 39,944
Table 2. Experience Period Claims and Premiums
Earned Premium Paid ClaimsUltimate Incurred
ClaimsMember Months
Estimated Cost
Sharing
(Member & HHS)
Allowed Claims
(Non-Capitated)
Non-EHB
portion of
Allowed Claims
Total Prescription
Drug Rebates*
Total EHB
CapitationTotal Non-EHB Capitation
Estimated Risk
Adjustment
Estimated
Reinsurance
Recoveries
$671,931,345 $ 508,712,286.58 $550,417,515 1,494,855 $22,793,366 $573,210,881 $ 6,356,088.10 $ (209,279.70) ############## $ - 37,933,070.43$ (3,172,524.16)$
2015 Total Allowed EHB Claims + EHB Capitation PMPM (net of prescription drug rebates) 396.44$
Loss Ratio 81.61%
*Express Prescription Drug Rebates as a negative number
Table 3. Trend Components
Cost* Utilization* Composite Weight*
3.83% 2.40% 6.32% 18.93% <- Annualized Trend Factors on URRT
3.00% 2.40% 5.47% 24.00%
1.65% 2.40% 4.09% 30.85%
1.32% 2.00% 3.35% 0.00%
1.50% 0.23%
4.50% 4.50% 9.20% 25.99%
6.17% 100.00%
1.127
* Express Cost, Utilization, and Weight as percentages
Table 4. Historical Experience
Month-Year Total Annual Premium Incurred Claims Completion Factors*Ultimate Incurred
ClaimsMembers
Ultimate
Incurred PMPM
Estimated Annual
Cost Sharing
(Member + HHS)
Prescription
Drug Rebates**
Allowed Claims (Net of
Prescription Drug Rebates)Allowed PMPM
Jan-13 #DIV/0! #DIV/0! #DIV/0!
Feb-13 #DIV/0! #DIV/0! #DIV/0!
Mar-13 #DIV/0! #DIV/0! #DIV/0!
Apr-13 #DIV/0! #DIV/0! #DIV/0!
May-13 #DIV/0! #DIV/0! #DIV/0!
Jun-13 #DIV/0! #DIV/0! #DIV/0!
Jul-13 #DIV/0! #DIV/0! #DIV/0!
Aug-13 #DIV/0! #DIV/0! #DIV/0!
Sep-13 #DIV/0! #DIV/0! #DIV/0!
Oct-13 #DIV/0! #DIV/0! #DIV/0!
Nov-13 #DIV/0! #DIV/0! #DIV/0!
Dec-13 #DIV/0! #DIV/0! #DIV/0!
Jan-14 $ 40,604,302.32 1.0000 $ 40,604,302.32 316,387 $ 128.34 $ (44,294.18) $ 43,270,404.49 $ 136.76
Feb-14 $ 34,166,292.36 1.0000 $ 34,166,292.36 301,899 $ 113.17 $ (42,265.86) $ 36,832,394.53 $ 122.00
Mar-14 $ 39,338,046.68 1.0000 $ 39,338,046.68 282,712 $ 139.15 $ (39,579.68) $ 42,004,148.85 $ 148.58
Apr-14 $ 41,450,398.48 1.0000 $ 41,450,398.48 257,248 $ 161.13 $ (36,014.72) $ 44,116,500.65 $ 171.49
May-14 $ 40,797,001.60 1.0000 $ 40,797,001.60 242,959 $ 167.92 $ (34,014.26) $ 43,463,103.77 $ 178.89
Jun-14 $ 38,230,510.58 1.0000 $ 38,230,510.58 225,177 $ 169.78 $ (31,524.78) $ 40,896,612.75 $ 181.62
Jul-14 $ 42,003,525.81 1.0000 $ 42,003,525.81 208,509 $ 201.45 $ (29,191.26) $ 44,669,627.98 $ 214.23
Aug-14 $ 38,398,241.23 1.0000 $ 38,398,241.23 195,609 $ 196.30 $ (27,385.26) $ 41,064,343.40 $ 209.93
Sep-14 $ 40,788,043.11 1.0000 $ 40,788,043.11 179,173 $ 227.65 $ (25,084.22) $ 43,454,145.28 $ 242.53
Oct-14 $ 41,520,340.29 1.0000 $ 41,520,340.29 165,793 $ 250.43 $ (23,211.02) $ 44,186,442.46 $ 266.52
Nov-14 $ 35,480,336.72 1.0000 $ 35,480,336.72 153,360 $ 231.35 $ (21,470.40) $ 38,146,438.89 $ 248.74
Dec-14 $ 40,242,044.94 0.9996 $ 40,256,875.96 126,131 $ 319.17 $ (17,658.34) $ 42,908,147.11 $ 340.19
Jan-15 $47,920,822.35 0.9994 $ 47,947,678.83 125,009 $ 383.55 $ (17,501.26) $ 49,820,269.55 $ 398.53
Feb-15 $ 44,150,845.02 0.9990 $ 44,193,848.22 124,735 $ 354.30 $ (17,462.90) $ 46,050,292.23 $ 369.19
Mar-15 $ 47,088,110.55 0.9986 $ 47,152,770.65 124,684 $ 378.18 $ (17,455.76) $ 48,987,557.76 $ 392.89
Apr-15 $ 46,649,913.22 0.9978 $ 46,751,217.97 124,297 $ 376.13 $ (17,401.58) $ 48,549,360.42 $ 390.59
May-15 $ 43,834,781.73 0.9968 $ 43,974,492.82 123,986 $ 354.67 $ (17,358.04) $ 45,734,228.94 $ 368.87
Jun-15 $ 45,917,347.66 0.9944 $ 46,174,635.54 123,538 $ 373.77 $ (17,295.32) $ 47,816,794.87 $ 387.06
Jul-15 $ 46,642,687.61 0.9913 $ 47,053,128.66 123,094 $ 382.25 $ (17,233.16) $ 48,542,134.82 $ 394.35
Aug-15 $ 45,159,671.28 0.9845 $ 45,872,902.32 122,749 $ 373.71 $ (17,184.86) $ 47,059,118.49 $ 383.38
Sep-15 $ 44,059,138.00 0.9777 $ 45,063,479.53 122,919 $ 366.61 $ (17,208.66) $ 45,958,585.21 $ 373.89
Oct-15 $ 46,775,969.09 0.9628 $ 48,581,819.84 122,974 $ 395.06 $ (17,216.36) $ 48,675,416.30 $ 395.82
Nov-15 $ 45,433,595.81 0.9219 $ 49,283,273.13 123,067 $ 400.46 $ (17,229.38) $ 47,333,043.01 $ 384.61
Dec-15 $ 46,784,632.69 0.8534 $ 54,822,664.27 124,688 $ 439.68 $ (17,456.32) $ 48,684,079.90 $ 390.45
* Express Completion Factor as a percentage
**Express Prescription Drug Rebates as a negative number
2 Year Trend Projection Factor
Service Category
Other Medical
Capitation
Prescription Drugs
Total Annual Trend
Inpatient Hospital
Outpatient Hospital
Professional
$31,993,226
$22,793,366
$632,859,798
$671,931,345
PA Rate Template Part IIRate Development and Change
Table 5. Development of the Projected Index Rate, Market-Adjusted Index Rate, and Total Allowed Claims
2015 Total Allowed EHB Claims PMPM + EHB Capitation PMPM (net of prescription drug rebates) $401.00 <- Index Rate of Experience Period on URRT Table 5A. Small Group Projected Index Rate with Quarterly Trend 2 Year Trend Projection Factor 1.105
Unadjusted Projected Allowed EHB Claims PMPM 443.06$ January April July October Total Single Risk Pool
Single Risk Pool Adjustment Factors <- Adj't. from Experience to Projection Period - Pop'l risk Morbidity on URRT # of Member Months Renewing in Quarter 545,005 342,971 234,694 372,185 1,494,855.00
Change in Morbidity 1.000 <- Adj't. from Experience to Projection Period - Other on URRT Percent of Members Months Renewing in Quarter 36% 23% 16% 25% 100%
Change in Other 1.060 Base Allowed Claims 469.65$ 469.65$ 469.65$ 469.65$ 469.65$
Change in Demographics 1.037 Months of Trend - 3 6 9 4
Change in Network 0.989 Annual Trend 6.17% 6.17% 6.17% 6.17% 6.17%
Change in Benefits 0.996 Single Risk Pool Projected Allowed Claims 469.65$ 476.73$ 483.91$ 491.20$ 478.88$
Change in Other 1.038
Adjusted Projected Allowed EHB Claims PMPM 469.65$ <- Index Rate for Projection Period on URRT - Individual (Small Group 1rst Qtr)
Adjusted Projected Allowed EHB Claims PMPM [will only populate for small group filings] 478.88$ <- Index Rate for Projection Period on URRT - Small Group
Projected Paid to Allowed Ratio 0.879956329 <- Paid to Allowed Average Factor in Projection Period on URRT
Projected Paid EHB Claims PMPM 421.3909711
Market-wide Adjustments
Projected Paid Net Risk Adjustment PMPM 16.87$
Projected Paid Exchange User Fees PMPM 0.92$
Market-Adjusted Projected Paid EHB Claims PMPM 439.18$
Market-Adjusted Projected Allowed EHB Claims PMPM 499.10$ <- Market-Adjusted Index Rate
Projected Allowed Non-EHB Claims PMPM 5.89$
Market-Adjusted Projected Paid Total Claims PMPM 444.37$
Market-Adjusted Projected Allowed Total Claims PMPM 504.99$
Table 6. Retention Table 7. Normalized Market-Adjusted Projected Allowed Total Claims
Retention Items - Express in percentages Normalization Factors 2016 2017
Administrative Expenses 10% Average Age Factor 1.457 1.472
General and Claims 3.68% Average Geographic Factor 1.000 1.000
Agent/Broker Fees and Commissions 5.74% Average Tobacco Factor 1.015 1.011
Quality Improvement Initiatives 0.47% Average Benefit Richness (induced demand) 0.979 0.947
Taxes and Fees 4.12% Average Network Factor 1.044 1.011
PCORI Fees (Enter $ amount here: $______________ ) 0.05%
Pa Premium Tax (if applicable) 0.00% Market-Adjusted Projected Allowed Total Claims PMPM 490.48$ 504.99$
Federal Income Tax 2.47%
Health Insurance Providers Fee (only for small group market, prorated for coverage in 2018) 1.60% Normalized Market-Adjusted Projected Allowed Total Claims PMPM 324.30$ 354.35$
Profit/Contingency 2%
Total Retention 16%
<- Single Pool Gross Premium Avg. Rate, PMPM on URRT
Projected Required Revenue PMPM 529.10$
Table 8. Components of Rate Change Table 9. Year-over-Year Data to Support Table 8
Rate Components 2016 2017 Difference Percent Change 2016 2017
A. Calibrated Plan Adjusted Index Rate (PMPM) 339.6419632 352.1416905 $12.50 3.7% Paid-to-Allowed 0.87 0.879956329
B. Base period allowed claims before normalization $374.00 401.00$ $27.00 8% URRT Trend (2-Year Trend Factor) 1.165652009 1.13 <- URRT W1, S2
C. Normalization factor component of change (126.72)$ -119.6165634 $7.10 $0.02 URRT Morbidity 1.016 1.000 <- URRT W1, S2
URRT "Other" 1.009530314 1.060 <- URRT W1, S2
D. Change in Normalized Allowed Claims Adjustment Components D1. Base period allowed claims after normalization 247.28$ 281.38$ 34.10$ 10% Risk Adjustment 58.14$ 16.87$ <- URRT W1, S3
D2. URRT Trend 40.96$ 35.77$ (5.19)$ -2% Reinsurance 2.25$ -$ <- URRT W1, S3
D3. URRT Morbidity 4.61$ -$ (4.61)$ -1% Exchange User Fee 0.88$ 0.92$ <- URRT W1, S3
D4. URRT Other 2.79$ 19.03$ 16.24$ 5% Capitation 19.75$ 19.23$ <- URRT W1, S2
D5. Normalized URRT RA/RI on an allowed basis 45.89$ 13.45$ (32.44)$ -10% D6. Normalized Exchange User Fee on an allowed basis 0.67$ 0.74$ 0.07$ 0% Network 1.000 1 D7. Subtotal - Sum(D1:D6) 342.21$ 350.37$ 8.16$ 2% Pricing AV 0.851 0.845790942
E. Change in Allowable Plan Adjusted Level Components Benefit Richness 1.000 1 E1. Network -$ 0 -$ 0% Catastrophic Eligibility 1.000 1 E2. Pricing AV (51.06)$ (54.03)$ (2.97)$ -1% E3. Benefit Richness -$ -$ -$ 0% Administrative Expenses 9.99% 9.89% E4. Catastrophic Eligibility -$ -$ -$ 0% Taxes and Fees 4.29% 4.12% E5. Subtotal - Sum(E1:E4) (51.06)$ (54.03)$ (2.97)$ -1% Profit and/or Contingency 0.00% 2.00%F. Change in Retention Components
F1. Administrative Expenses 33.92$ 34.84$ 0.93$ 0% F2. Taxes and Fees 14.57$ 14.52$ (0.05)$ 0% F3. Profit and/or Contingency -$ 7.04$ 7.04$ 2% F4. Subtotal - Sum(F1:F3) 48.49$ 56.41$ 7.92$ 2%
G. Change in Miscellaneous Items -$ 0%
H. Sum of Components of Rate Change (should approximate the change shown in line A) 339.64$ 352.75$ 13.11$ 4%
PA Rate Template Part IIITable 10. Plan Rates
Carrier Name: KHPE
Plan Type(s): HMO
Market Segment: Small Group
Rate Effective Date: 1/1/2017
Market Adjusted Index Rate 499.10$
Plan Number HIOS Plan ID (Standard Component)
Plan Type
(HMO, POS, PPO, EPO,
Indemnity, Other)
Totals
Plan 1 33871PA0100001 HMO
Plan 2 33871PA0100002 HMO
Plan 3 33871PA0100003 HMO
Plan 4 33871PA0100004 HMO
Plan 5 33871PA0100005 HMO
Plan 6 33871PA0100006 HMO
Plan 7 33871PA0100007 HMO
Plan 8 33871PA0100008 HMO
Plan 9 33871PA0100009 HMO
Plan 10 33871PA0110001 POS
Plan 11 33871PA0110002 POS
Plan 12 33871PA0110003 POS
Plan 13 33871PA0110004 POS
Plan 14 33871PA0110006 POS
Plan 15 33871PA0110009 POS
Plan 16 33871PA0110010 POS
Plan 17 33871PA0100017 HMO
Plan 18 33871PA0110005 POS
Plan 19 33871PA0110008 POS
Plan 20 33871PA0100020 HMO
Plan 21 33871PA0100021 HMO
Plan 22 33871PA0100022 HMO
Plan 23 33871PA0100023 HMO
Plan 24 33871PA0100024 HMO
Plan 25 33871PA0100025 HMO
Plan 26 33871PA0100026 HMO
Plan 27 33871PA0110011 POS
Plan 28 33871PA0110012 POS
Plan 29 33871PA0110013 POS
Plan 30 33871PA0110014 POS
Plan 31 33871PA0110016 POS
Plan 32 33871PA0110019 POS
Plan 33 33871PA0110020 POS
Plan 34 33871PA0110007 POS
Plan 35 33871PA0100035 HMO
Plan 36 33871PA0100036 HMO
Plan 37 33871PA0100037 HMO
Plan 38 33871PA0110015 POS
Plan 39 33871PA0110018 POS
Plan 40 33871PA0110017 POS
Plan 41 33871PA0100044 HMO
Plan 42 33871PA0100045 HMO
Plan 43 33871PA0100046 HMO
Plan 44 33871PA0100047 HMO
Plan 45 33871PA0100048 HMO
Plan 46 33871PA0100049 HMO
Plan 47
Plan 48
Plan 49
Plan 50
Plan 51
Plan 52
Plan 53
Plan 54
Plan 55
Plan 56
Plan 57
Plan 58
Plan 59
Plan 60
Plan 61
Plan 62
Plan 63
Plan 64
Plan 65
Plan 66
Plan 67
Plan 68
Plan 69
Plan 70
Plan 71
Plan 72
Plan 73
Plan 74
Plan 75
Plan 76
Plan 77
Plan 78
Plan 79
Plan 80
Plan 81
Plan 82
Plan 83
Plan 84
Plan 85
Plan 86
Plan 87
Plan 88
Plan 89
Plan 90
Plan 91
Plan 92
Plan 93
Plan 94
Plan 95
Plan 96
Plan 97
Plan 98
Plan 99
Plan 100
1/1/16 Plan
Marketing Name
Discontinued, New,
Modified, Existing
(D,N,M,E) for 2017
1/1/17 Plan
Marketing Name
(If 1/1/16 Plan
Discontinued) Metallic Tier
Metallic Tier
Actuarial
Value
0.814
Keystone HMO Platinum Preferred $10/$20/$100E Keystone HMO Platinum Preferred $10/$20/$100Platinum 0.915
Keystone HMO Platinum Preferred $20/$40/$150E Keystone HMO Platinum Preferred $20/$40/$150Platinum 0.883
Keystone HMO Gold Preferred $30/$60/$600E Keystone HMO Gold Preferred $30/$60/$600Gold 0.819
Keystone HMO Gold Classic $1,000 $25/$50/90%E Keystone HMO Gold Classic $1,000 $25/$50/90%Gold 0.785
Keystone HMO Silver Classic $2,000 $25/$50/70%E Keystone HMO Silver Classic $2,000 $25/$50/70%Silver 0.708
Keystone HMO Silver Classic $2,500 $30/$60/50%E Keystone HMO Silver Classic $2,500 $30/$60/50%Silver 0.704
Keystone HMO Bronze Essential $6,000 $50/$100/$700E Keystone HMO Bronze Essential $6,000 $50/$100/$700Bronze 0.62
Keystone HMO Gold ProactiveE Keystone HMO Gold ProactiveGold 0.79
Keystone HMO Silver ProactiveE Keystone HMO Silver ProactiveSilver 0.719
Keystone DPOS Platinum Preferred $10/$20/$100E Keystone DPOS Platinum Preferred $10/$20/$100Platinum 0.915
Keystone DPOS Platinum Preferred $20/$40/$150E Keystone DPOS Platinum Preferred $20/$40/$150Platinum 0.883
Keystone DPOS Gold Preferred $30/$60/$600E Keystone DPOS Gold Preferred $30/$60/$600Gold 0.819
Keystone DPOS Gold Classic $1,000 $25/$50/90%E Keystone DPOS Gold Classic $1,000 $25/$50/90%Gold 0.785
Keystone DPOS Silver Classic $2,000 $25/$50/70%E Keystone DPOS Silver Classic $2,000 $25/$50/70%Silver 0.708
Keystone DPOS Silver Classic $2,500 $30/$60/50%E Keystone DPOS Silver Classic $2,500 $30/$60/50%Silver 0.704
Keystone DPOS Bronze Essential $6,000 $50/$100/$700E Keystone DPOS Bronze Essential $6,000 $50/$100/$700Bronze 0.62
Keystone HMO Bronze Basic D Keystone HMO Bronze Basic Bronze 0
Keystone DPOS Gold Classic $2,000 $40/$80/100%E Keystone DPOS Gold Classic $2,000 $40/$80/100%Gold 0.782
Keystone DPOS Silver Classic $4,250 $40/$80/100%E Keystone DPOS Silver Classic $4,250 $40/$80/100%Silver 0.688
Keystone HMO Platinum Preferred $10/$20/$100E Keystone HMO Platinum Preferred $10/$20/$100Platinum 0.915
Keystone HMO Platinum Preferred $20/$40/$150E Keystone HMO Platinum Preferred $20/$40/$150Platinum 0.883
Keystone HMO Gold Preferred $30/$60/$600E Keystone HMO Gold Preferred $30/$60/$600Gold 0.819
Keystone HMO Gold Classic $1,000 $25/$50/90%E Keystone HMO Gold Classic $1,000 $25/$50/90%Gold 0.785
Keystone HMO Silver Classic $2,000 $25/$50/70%E Keystone HMO Silver Classic $2,000 $25/$50/70%Silver 0.708
Keystone HMO Silver Classic $2,500 $30/$60/50%E Keystone HMO Silver Classic $2,500 $30/$60/50%Silver 0.704
Keystone HMO Bronze Essential $6,000 $50/$100/$700E Keystone HMO Bronze Essential $6,000 $50/$100/$700Bronze 0.62
Keystone DPOS Platinum Preferred $10/$20/$100E Keystone DPOS Platinum Preferred $10/$20/$100Platinum 0.915
Keystone DPOS Platinum Preferred $20/$40/$150E Keystone DPOS Platinum Preferred $20/$40/$150Platinum 0.883
Keystone DPOS Gold Preferred $30/$60/$600E Keystone DPOS Gold Preferred $30/$60/$600Gold 0.819
Keystone DPOS Gold Classic $1,000 $25/$50/90%E Keystone DPOS Gold Classic $1,000 $25/$50/90%Gold 0.785
Keystone DPOS Silver Classic $2,000 $25/$50/70%E Keystone DPOS Silver Classic $2,000 $25/$50/70%Silver 0.708
Keystone DPOS Silver Classic $2,500 $30/$60/50%E Keystone DPOS Silver Classic $2,500 $30/$60/50%Silver 0.704
Keystone DPOS Bronze Essential $6,000 $50/$100/$700E Keystone DPOS Bronze Essential $6,000 $50/$100/$700Bronze 0.62
Keystone DPOS Silver Secure $3,500 $40/$80/$600E Keystone DPOS Silver Secure $3,500 $40/$80/$600Silver 0.693
Keystone HMO Gold Classic $2,000 $40/$80/100%E Keystone HMO Gold Classic $2,000 $40/$80/100%Gold 0.782
Keystone HMO Silver Classic $4,250 $40/$80/100%E Keystone HMO Silver Classic $4,250 $40/$80/100%Silver 0.688
Keystone HMO Silver Secure $3,500 $40/$80/$600E Keystone HMO Silver Secure $3,500 $40/$80/$600Silver 0.693
Keystone DPOS Gold Classic $2,000 $40/$80/100%E Keystone DPOS Gold Classic $2,000 $40/$80/100%Gold 0.782
Keystone DPOS Silver Classic $4,250 $40/$80/100%E Keystone DPOS Silver Classic $4,250 $40/$80/100%Silver 0.688
Keystone DPOS Silver Secure $3,500 $40/$80/$600E Keystone DPOS Silver Secure $3,500 $40/$80/$600Silver 0.693
Keystone HMO Gold ProactiveE Keystone HMO Gold ProactiveGold 0.79
Keystone HMO Silver ProactiveE Keystone HMO Silver ProactiveSilver 0.719
HMO Bronze Basic D HMO Bronze Basic Bronze 0
Keystone HMO Gold Classic $2,000 $40/$80/100%E Keystone HMO Gold Classic $2,000 $40/$80/100%Gold 0.782
Keystone HMO Silver Classic $4,250 $40/$80/100%E Keystone HMO Silver Classic $4,250 $40/$80/100%Silver 0.688
Keystone HMO Silver Secure $3,500 $40/$80/$600E Keystone HMO Silver Secure $3,500 $40/$80/$600Silver 0.693
Standard AV,
Approach (1),
Approach (2)
Exchange
On/Off or
Off
Pricing AV
(company-
determined
AV)
Benefit
Richness
(induced
demand)
Benefits in
addition to
EHB
Provider
Network
0.846 1.056 1.000 0.989
Approach 1 ON/OFF 1.066 1.056 1.000 1.000
Approach 1 ON/OFF 0.998 1.056 1.000 1.000
Approach 1 ON/OFF 0.819 1.045 1.000 1.000
Approach 1 ON/OFF 0.836 1.060 1.000 1.000
Approach 1 ON/OFF 0.733 1.018 1.000 1.000
Standard AV ON/OFF 0.665 1.062 1.000 1.000
Approach 2 ON/OFF 0.472 1.069 1.000 1.000
Approach 2 ON/OFF 0.737 1.077 1.000 0.952
Approach 2 ON/OFF 0.580 1.056 1.000 0.952
Approach 1 ON/OFF 1.100 1.056 1.000 1.000
Approach 1 ON/OFF 1.048 1.056 1.000 1.000
Approach 1 ON/OFF 0.859 1.044 1.000 1.000
Approach 1 ON/OFF 0.875 1.056 1.000 1.000
Approach 1 ON/OFF 0.769 1.019 1.000 1.000
Standard AV ON/OFF 0.698 1.061 1.000 1.000
Approach 2 ON/OFF 0.000 1.068 1.000 1.000
Standard AV ON/OFF 0.000 1.000 1.000 1.000
Approach 1 ON/OFF 0.847 1.072 1.000 1.000
Approach 1 ON/OFF 0.715 1.055 1.000 1.000
Standard AV OFF 1.047 1.058 1.000 1.000
Standard AV OFF 0.998 1.058 1.000 1.000
Standard AV OFF 0.818 1.046 1.000 1.000
Standard AV OFF 0.835 1.061 1.000 1.000
Standard AV OFF 0.733 1.021 1.000 1.000
Standard AV OFF 0.665 1.064 1.000 1.000
Standard AV OFF 0.472 1.072 1.000 1.000
Standard AV OFF 1.099 1.058 1.000 1.000
Standard AV OFF 1.047 1.058 1.000 1.000
45 CFR Part 156.8 (d) (2) Allowable Factors
Standard AV OFF 0.858 1.046 1.000 1.000
Standard AV OFF 0.874 1.060 1.000 1.000
Standard AV OFF 0.769 1.021 1.000 1.000
Standard AV OFF 0.697 1.064 1.000 1.000
Standard AV OFF 0.496 1.071 1.000 1.000
Approach 1 ON/OFF 0.653 1.083 1.000 1.000
Approach 1 ON/OFF 0.812 1.083 1.000 1.000
Approach 1 ON/OFF 0.681 1.055 1.000 1.000
Approach 1 ON/OFF 0.622 1.083 1.000 1.000
Standard AV OFF 0.846 1.076 1.000 1.000
Standard AV OFF 0.714 1.059 1.000 1.000
Standard AV OFF 0.652 1.087 1.000 1.000
Standard AV OFF 0.737 1.079 1.000 0.952
Standard AV OFF 0.579 1.059 1.000 0.952
Standard AV OFF 0.000 1.000 1.000 1.000
Standard AV OFF 0.811 1.087 1.000 1.000
Standard AV OFF 0.680 1.059 1.000 1.000
Standard AV OFF 0.621 1.088 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
0.000 1.000 1.000 1.000
Age Calibration Factor 1.472
Geographic Calibration Factor 1.000
Aggregate Calibration Factor 1.472
Catastrophic
Eligibility
Tobacco
Surcharge
Adjustment
Pure
Premium Admin Costs
Taxes & Fees (not
including Exchange
fees)
Profit or
Contingency
1.000 0.989 436.95$ 9.9% 4.1% 2.0%
1.000 0.989 $555.94 6.6% 4.1% 2.0%
1.000 0.989 $520.51 8.4% 4.1% 2.0%
1.000 0.989 $422.15 9.8% 4.1% 2.0%
1.000 0.989 $437.19 9.6% 4.1% 2.0%
1.000 0.989 $368.57 10.9% 4.1% 2.0%
1.000 0.989 $348.50 11.4% 4.1% 2.0%
1.000 0.989 $249.22 14.6% 4.2% 2.0%
1.000 0.989 $373.19 10.8% 4.1% 2.0%
1.000 0.989 $287.71 13.1% 4.1% 2.0%
1.000 0.989 $573.57 7.9% 4.1% 2.0%
1.000 0.989 $546.51 8.1% 4.1% 2.0%
1.000 0.989 $442.80 9.5% 4.1% 2.0%
1.000 0.989 $456.29 9.3% 4.1% 2.0%
1.000 0.989 $386.81 10.5% 4.1% 2.0%
1.000 0.989 $365.74 11.0% 4.1% 2.0%
1.000 0.989 $0.00 0.0% 4.1% 2.0%
1.000 0.989 $0.00 0.0% 4.1% 0.0%
1.000 0.989 $448.30 9.4% 4.1% 2.0%
1.000 0.989 $372.06 10.8% 4.1% 2.0%
1.000 0.989 $546.92 8.1% 4.1% 2.0%
1.000 0.989 $521.05 8.4% 4.1% 2.0%
1.000 0.989 $422.68 9.8% 4.1% 2.0%
1.000 0.989 $437.73 9.6% 4.1% 2.0%
1.000 0.989 $369.10 10.9% 4.1% 2.0%
1.000 0.989 $349.02 11.4% 4.1% 2.0%
1.000 0.989 $249.71 14.6% 4.2% 2.0%
1.000 0.989 $574.11 7.9% 4.1% 2.0%
1.000 0.989 $547.04 8.1% 4.1% 2.0%
Calibration
45 CFR Part 156.8 (d) (2) Allowable Factors
1.000 0.989 $443.33 9.5% 4.1% 2.0%
1.000 0.989 $457.45 9.3% 4.1% 2.0%
1.000 0.989 $387.33 10.5% 4.1% 2.0%
1.000 0.989 $366.26 11.0% 4.1% 2.0%
1.000 0.989 $262.29 14.1% 4.1% 2.0%
1.000 0.989 $348.91 11.4% 4.1% 2.0%
1.000 0.989 $434.21 9.6% 4.1% 2.0%
1.000 0.989 $354.53 11.2% 4.1% 2.0%
1.000 0.989 $332.36 11.8% 4.1% 2.0%
1.000 0.989 $449.46 9.4% 4.1% 2.0%
1.000 0.989 $373.22 10.8% 4.1% 2.0%
1.000 0.989 $350.08 11.3% 4.1% 2.0%
1.000 0.989 $373.71 10.8% 4.1% 2.0%
1.000 0.989 $288.22 13.1% 4.1% 2.0%
1.000 0.989 $0.00 0.0% 4.1% 0.0%
1.000 0.989 $435.38 9.6% 4.1% 2.0%
1.000 0.989 $355.69 11.2% 4.1% 2.0%
1.000 0.989 $333.51 11.8% 4.1% 2.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
1.000 1.000 $0.00 0.0% 0.0% 0.0%
Total
Covered Lives @
2/1/2016
Total Policyholders
@ 2/1/2016
2016
Calibrated Plan
Adjusted Index
Rate PMPM
2017 Calibrated
Plan Adjusted
Index Rate
PMPM
Proposed Rate
Change
Compared to
Prior 12
months
125,640 73,044 339.64$ 352.14$ 3.68%
10 10 417.32$ $432.77 3.7%
142 114 398.92$ $413.71 3.7%
160 100 331.47$ $341.21 2.9%
16 14 338.99$ $352.29 3.9%
28 22 298.10$ $301.71 1.2%
24 42 275.72$ $286.92 4.1%
24 10 204.48$ $213.73 4.5%
68 60 290.45$ $305.11 5.0%
470 354 233.48$ $242.11 3.7%
28 6 436.62$ $452.82 3.7%
72 42 417.35$ $432.87 3.7%
84 52 346.27$ $356.43 2.9%
1 - 353.34$ $366.40 3.7%
2 - 311.30$ $315.16 1.2%
16 14 287.95$ $299.63 4.1%
32 12 213.47$ $0.00 -100.0%
2 14 -$ $0.00 #DIV/0!
1 - 344.19$ $360.51 4.7%
1 - 293.73$ $304.32 3.6%
3,405 1,908 417.32$ $433.20 3.8%
15,920 5,925 398.92$ $414.13 3.8%
27,424 19,472 331.47$ $341.63 3.1%
1,538 936 338.99$ $352.72 4.1%
4,644 3,033 298.10$ $302.14 1.4%
1,950 1,215 275.72$ $287.34 4.2%
2,125 1,445 204.48$ $214.15 4.7%
5,364 2,841 436.62$ $453.24 3.8%
18,047 6,455 417.35$ $433.29 3.8%
6,489 6,416 346.27$ $356.85 3.1%
3,703 2,058 353.34$ $367.26 3.9%
2,111 1,332 311.30$ $315.58 1.4%
1,245 765 287.95$ $300.05 4.2%
778 489 213.47$ $223.42 4.7%
1 - 272.43$ $287.26 5.4%
1 - 331.97$ $350.13 5.5%
1 - 281.26$ $291.40 3.6%
3 3 260.86$ $275.06 5.4%
85 40 344.19$ $361.37 5.0%
27 11 293.73$ $305.18 3.9%
49 31 272.43$ $288.12 5.8%
17,593 6,939 290.45$ $305.54 5.2%
11,669 10,532 233.48$ $242.53 3.9%
1 144 -$ $0.00 #DIV/0!
89 52 331.97$ $350.99 5.7%
59 38 281.26$ $292.26 3.9%
138 98 260.86$ $275.91 5.8%
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
- $0.00 #DIV/0!
% of Total
Covered Lives
0.0%
0.1%
0.1%
0.0%
0.0%
0.0%
0.0%
0.1%
0.4%
0.0%
0.1%
0.1%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
2.7%
12.7%
21.8%
1.2%
3.7%
1.6%
1.7%
4.3%
14.4%
5.2%
2.9%
1.7%
1.0%
0.6%
0.0%
0.0%
0.0%
0.0%
0.1%
0.0%
0.0%
14.0%
9.3%
0.0%
0.1%
0.0%
0.1%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
PA Rate Template Part IVTable 11. Plan Premium Development for 21-Year-Old Non-Tobacco User
Carrier Name: KHPE
Plan Type(s): HMO
Market Segment: Small Group
Rate Effective Date: 1/1/2017
Plan Number HIOS Plan ID (Standard Component)
1/1/16 Plan
Marketing Name
Discontinued,
New, Modified,
Existing
(D,N,M,E) for
2017
Totals
Plan 1 33871PA0100001 Keystone HMO Platinum Preferred $10/$20/$100E
Plan 2 33871PA0100002 Keystone HMO Platinum Preferred $20/$40/$150E
Plan 3 33871PA0100003 Keystone HMO Gold Preferred $30/$60/$600E
Plan 4 33871PA0100004 Keystone HMO Gold Classic $1,000 $25/$50/90%E
Plan 5 33871PA0100005 Keystone HMO Silver Classic $2,000 $25/$50/70%E
Plan 6 33871PA0100006 Keystone HMO Silver Classic $2,500 $30/$60/50%E
Plan 7 33871PA0100007 Keystone HMO Bronze Essential $6,000 $50/$100/$700E
Plan 8 33871PA0100008 Keystone HMO Gold Proactive E
Plan 9 33871PA0100009 Keystone HMO Silver Proactive E
Plan 10 33871PA0110001 Keystone DPOS Platinum Preferred $10/$20/$100E
Plan 11 33871PA0110002 Keystone DPOS Platinum Preferred $20/$40/$150E
Plan 12 33871PA0110003 Keystone DPOS Gold Preferred $30/$60/$600E
Plan 13 33871PA0110004 Keystone DPOS Gold Classic $1,000 $25/$50/90%E
Plan 14 33871PA0110006 Keystone DPOS Silver Classic $2,000 $25/$50/70%E
Plan 15 33871PA0110009 Keystone DPOS Silver Classic $2,500 $30/$60/50%E
Plan 16 33871PA0110010 Keystone DPOS Bronze Essential $6,000 $50/$100/$700E
Plan 17 33871PA0100017 Keystone HMO Bronze Basic D
Plan 18 33871PA0110005 Keystone DPOS Gold Classic $2,000 $40/$80/100%E
Plan 19 33871PA0110008 Keystone DPOS Silver Classic $4,250 $40/$80/100%E
Plan 20 33871PA0100020 Keystone HMO Platinum Preferred $10/$20/$100E
Plan 21 33871PA0100021 Keystone HMO Platinum Preferred $20/$40/$150E
Plan 22 33871PA0100022 Keystone HMO Gold Preferred $30/$60/$600E
Plan 23 33871PA0100023 Keystone HMO Gold Classic $1,000 $25/$50/90%E
Plan 24 33871PA0100024 Keystone HMO Silver Classic $2,000 $25/$50/70%E
Plan 25 33871PA0100025 Keystone HMO Silver Classic $2,500 $30/$60/50%E
Plan 26 33871PA0100026 Keystone HMO Bronze Essential $6,000 $50/$100/$700E
Plan 27 33871PA0110011 Keystone DPOS Platinum Preferred $10/$20/$100E
These cells auto-fill using the data entered in Table 9.
Plan 28 33871PA0110012 Keystone DPOS Platinum Preferred $20/$40/$150E
Plan 29 33871PA0110013 Keystone DPOS Gold Preferred $30/$60/$600E
Plan 30 33871PA0110014 Keystone DPOS Gold Classic $1,000 $25/$50/90%E
Plan 31 33871PA0110016 Keystone DPOS Silver Classic $2,000 $25/$50/70%E
Plan 32 33871PA0110019 Keystone DPOS Silver Classic $2,500 $30/$60/50%E
Plan 33 33871PA0110020 Keystone DPOS Bronze Essential $6,000 $50/$100/$700E
Plan 34 33871PA0110007 Keystone DPOS Silver Secure $3,500 $40/$80/$600E
Plan 35 33871PA0100035 Keystone HMO Gold Classic $2,000 $40/$80/100%E
Plan 36 33871PA0100036 Keystone HMO Silver Classic $4,250 $40/$80/100%E
Plan 37 33871PA0100037 Keystone HMO Silver Secure $3,500 $40/$80/$600E
Plan 38 33871PA0110015 Keystone DPOS Gold Classic $2,000 $40/$80/100%E
Plan 39 33871PA0110018 Keystone DPOS Silver Classic $4,250 $40/$80/100%E
Plan 40 33871PA0110017 Keystone DPOS Silver Secure $3,500 $40/$80/$600E
Plan 41 33871PA0100044 Keystone HMO Gold Proactive E
Plan 42 33871PA0100045 Keystone HMO Silver Proactive E
Plan 43 33871PA0100046 HMO Bronze Basic D
Plan 44 33871PA0100047 Keystone HMO Gold Classic $2,000 $40/$80/100%E
Plan 45 33871PA0100048 Keystone HMO Silver Classic $4,250 $40/$80/100%E
Plan 46 33871PA0100049 Keystone HMO Silver Secure $3,500 $40/$80/$600E
Plan 47 0 0 0
Plan 48 0 0 0
Plan 49 0 0 0
Plan 50 0 0 0
Plan 51 0 0 0
Plan 52 0 0 0
Plan 53 0 0 0
Plan 54 0 0 0
Plan 55 0 0 0
Plan 56 0 0 0
Plan 57 0 0 0
Plan 58 0 0 0
Plan 59 0 0 0
Plan 60 0 0 0
Plan 61 0 0 0
Plan 62 0 0 0
Plan 63 0 0 0
Plan 64 0 0 0
Plan 65 0 0 0
Plan 66 0 0 0
Plan 67 0 0 0
Plan 68 0 0 0
Plan 69 0 0 0
Plan 70 0 0 0
Plan 71 0 0 0
Plan 72 0 0 0
Plan 73 0 0 0
Plan 74 0 0 0
Plan 75 0 0 0
Plan 76 0 0 0
Plan 77 0 0 0
Plan 78 0 0 0
Plan 79 0 0 0
Plan 80 0 0 0
Plan 81 0 0 0
Plan 82 0 0 0
Plan 83 0 0 0
Plan 84 0 0 0
Plan 85 0 0 0
Plan 86 0 0 0
Plan 87 0 0 0
Plan 88 0 0 0
Plan 89 0 0 0
Plan 90 0 0 0
Plan 91 0 0 0
Plan 92 0 0 0
Plan 93 0 0 0
Plan 94 0 0 0
Plan 95 0 0 0
Plan 96 0 0 0
Plan 97 0 0 0
Plan 98 0 0 0
Plan 99 0 0 0
Plan 100 0 0 0
Table 11. Plan Premium Development for 21-Year-Old Non-Tobacco User
1/1/17 Plan
Marketing Name
(If 1/1/16 Plan
Discontinued) Metallic Tier
Exchange
On/Off or
Off 1 2 3 4
- - - -
Keystone HMO Platinum Preferred $10/$20/$100Platinum ON/OFF
Keystone HMO Platinum Preferred $20/$40/$150Platinum ON/OFF
Keystone HMO Gold Preferred $30/$60/$600Gold ON/OFF
Keystone HMO Gold Classic $1,000 $25/$50/90%Gold ON/OFF
Keystone HMO Silver Classic $2,000 $25/$50/70%Silver ON/OFF
Keystone HMO Silver Classic $2,500 $30/$60/50%Silver ON/OFF
Keystone HMO Bronze Essential $6,000 $50/$100/$700Bronze ON/OFF
Keystone HMO Gold ProactiveGold ON/OFF
Keystone HMO Silver ProactiveSilver ON/OFF
Keystone DPOS Platinum Preferred $10/$20/$100Platinum ON/OFF
Keystone DPOS Platinum Preferred $20/$40/$150Platinum ON/OFF
Keystone DPOS Gold Preferred $30/$60/$600Gold ON/OFF
Keystone DPOS Gold Classic $1,000 $25/$50/90%Gold ON/OFF
Keystone DPOS Silver Classic $2,000 $25/$50/70%Silver ON/OFF
Keystone DPOS Silver Classic $2,500 $30/$60/50%Silver ON/OFF
Keystone DPOS Bronze Essential $6,000 $50/$100/$700Bronze ON/OFF
Keystone HMO Bronze Basic Bronze ON/OFF
Keystone DPOS Gold Classic $2,000 $40/$80/100%Gold ON/OFF
Keystone DPOS Silver Classic $4,250 $40/$80/100%Silver ON/OFF
Keystone HMO Platinum Preferred $10/$20/$100Platinum OFF
Keystone HMO Platinum Preferred $20/$40/$150Platinum OFF
Keystone HMO Gold Preferred $30/$60/$600Gold OFF
Keystone HMO Gold Classic $1,000 $25/$50/90%Gold OFF
Keystone HMO Silver Classic $2,000 $25/$50/70%Silver OFF
Keystone HMO Silver Classic $2,500 $30/$60/50%Silver OFF
Keystone HMO Bronze Essential $6,000 $50/$100/$700Bronze OFF
Keystone DPOS Platinum Preferred $10/$20/$100Platinum OFF
These cells auto-fill using the data entered in Table 9.
2/1/16 Number of Covered Lives
Keystone DPOS Platinum Preferred $20/$40/$150Platinum OFF
Keystone DPOS Gold Preferred $30/$60/$600Gold OFF
Keystone DPOS Gold Classic $1,000 $25/$50/90%Gold OFF
Keystone DPOS Silver Classic $2,000 $25/$50/70%Silver OFF
Keystone DPOS Silver Classic $2,500 $30/$60/50%Silver OFF
Keystone DPOS Bronze Essential $6,000 $50/$100/$700Bronze OFF
Keystone DPOS Silver Secure $3,500 $40/$80/$600Silver ON/OFF
Keystone HMO Gold Classic $2,000 $40/$80/100%Gold ON/OFF
Keystone HMO Silver Classic $4,250 $40/$80/100%Silver ON/OFF
Keystone HMO Silver Secure $3,500 $40/$80/$600Silver ON/OFF
Keystone DPOS Gold Classic $2,000 $40/$80/100%Gold OFF
Keystone DPOS Silver Classic $4,250 $40/$80/100%Silver OFF
Keystone DPOS Silver Secure $3,500 $40/$80/$600Silver OFF
Keystone HMO Gold ProactiveGold OFF
Keystone HMO Silver ProactiveSilver OFF
HMO Bronze Basic Bronze OFF
Keystone HMO Gold Classic $2,000 $40/$80/100%Gold OFF
Keystone HMO Silver Classic $4,250 $40/$80/100%Silver OFF
Keystone HMO Silver Secure $3,500 $40/$80/$600Silver OFF
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
5 6 7 8 9 Total 1 2
- - - 125,640 - 125,640 -$ -$
10 10 -$ -$
142 142 -$ -$
160 160 -$ -$
16 16 -$ -$
28 28 -$ -$
24 24 -$ -$
24 24 -$ -$
68 68 -$ -$
470 470 -$ -$
28 28 -$ -$
72 72 -$ -$
84 84 -$ -$
1 1 -$ -$
2 2 -$ -$
16 16 -$ -$
32 32 -$ -$
2 2 -$ -$
1 1 -$ -$
1 1 -$ -$
3,405 3,405 -$ -$
15,920 15,920 -$ -$
27,424 27,424 -$ -$
1,538 1,538 -$ -$
4,644 4,644 -$ -$
1,950 1,950 -$ -$
2,125 2,125 -$ -$
5,364 5,364 -$ -$
2/1/16 Number of Covered Lives 2016 21-year-old Non-Tobacco Premium PMPM
(in small group market, average monthly premium weighted for quarterly trend)
18,047 18,047 -$ -$
6,489 6,489 -$ -$
3,703 3,703 -$ -$
2,111 2,111 -$ -$
1,245 1,245 -$ -$
778 778 -$ -$
1 1 -$ -$
1 1 -$ -$
1 1 -$ -$
3 3 -$ -$
85 85 -$ -$
27 27 -$ -$
49 49 -$ -$
17,593 17,593 -$ -$
11,669 11,669 -$ -$
1 1 -$ -$
89 89 -$ -$
59 59 -$ -$
138 138 -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
- -$ -$
3 4 5 6 7 8 9
-$ -$ -$ -$ -$ 339.64$ -$
-$ -$ -$ -$ -$ 417.32$ -$
-$ -$ -$ -$ -$ 398.92$ -$
-$ -$ -$ -$ -$ 331.47$ -$
-$ -$ -$ -$ -$ 338.99$ -$
-$ -$ -$ -$ -$ 298.10$ -$
-$ -$ -$ -$ -$ 275.72$ -$
-$ -$ -$ -$ -$ 204.48$ -$
-$ -$ -$ -$ -$ 290.45$ -$
-$ -$ -$ -$ -$ 233.48$ -$
-$ -$ -$ -$ -$ 436.62$ -$
-$ -$ -$ -$ -$ 417.35$ -$
-$ -$ -$ -$ -$ 346.27$ -$
-$ -$ -$ -$ -$ 353.34$ -$
-$ -$ -$ -$ -$ 311.30$ -$
-$ -$ -$ -$ -$ 287.95$ -$
-$ -$ -$ -$ -$ 213.47$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ 344.19$ -$
-$ -$ -$ -$ -$ 293.73$ -$
-$ -$ -$ -$ -$ 417.32$ -$
-$ -$ -$ -$ -$ 398.92$ -$
-$ -$ -$ -$ -$ 331.47$ -$
-$ -$ -$ -$ -$ 338.99$ -$
-$ -$ -$ -$ -$ 298.10$ -$
-$ -$ -$ -$ -$ 275.72$ -$
-$ -$ -$ -$ -$ 204.48$ -$
-$ -$ -$ -$ -$ 436.62$ -$
2016 21-year-old Non-Tobacco Premium PMPM
(in small group market, average monthly premium weighted for quarterly trend)
-$ -$ -$ -$ -$ 417.35$ -$
-$ -$ -$ -$ -$ 346.27$ -$
-$ -$ -$ -$ -$ 353.34$ -$
-$ -$ -$ -$ -$ 311.30$ -$
-$ -$ -$ -$ -$ 287.95$ -$
-$ -$ -$ -$ -$ 213.47$ -$
-$ -$ -$ -$ -$ 272.43$ -$
-$ -$ -$ -$ -$ 331.97$ -$
-$ -$ -$ -$ -$ 281.26$ -$
-$ -$ -$ -$ -$ 260.86$ -$
-$ -$ -$ -$ -$ 344.19$ -$
-$ -$ -$ -$ -$ 293.73$ -$
-$ -$ -$ -$ -$ 272.43$ -$
-$ -$ -$ -$ -$ 290.45$ -$
-$ -$ -$ -$ -$ 233.48$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ 331.97$ -$
-$ -$ -$ -$ -$ 281.26$ -$
-$ -$ -$ -$ -$ 260.86$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
Average
(weighted by
enrollment by
rating area) 1 2 3 4 5 6
339.64$ -$ -$ -$ -$ -$ -$
417.32$ -$ -$ -$ -$ -$ -$
398.92$ -$ -$ -$ -$ -$ -$
331.47$ -$ -$ -$ -$ -$ -$
338.99$ -$ -$ -$ -$ -$ -$
298.10$ -$ -$ -$ -$ -$ -$
275.72$ -$ -$ -$ -$ -$ -$
204.48$ -$ -$ -$ -$ -$ -$
290.45$ -$ -$ -$ -$ -$ -$
233.48$ -$ -$ -$ -$ -$ -$
436.62$ -$ -$ -$ -$ -$ -$
417.35$ -$ -$ -$ -$ -$ -$
346.27$ -$ -$ -$ -$ -$ -$
353.34$ -$ -$ -$ -$ -$ -$
311.30$ -$ -$ -$ -$ -$ -$
287.95$ -$ -$ -$ -$ -$ -$
213.47$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
344.19$ -$ -$ -$ -$ -$ -$
293.73$ -$ -$ -$ -$ -$ -$
417.32$ -$ -$ -$ -$ -$ -$
398.92$ -$ -$ -$ -$ -$ -$
331.47$ -$ -$ -$ -$ -$ -$
338.99$ -$ -$ -$ -$ -$ -$
298.10$ -$ -$ -$ -$ -$ -$
275.72$ -$ -$ -$ -$ -$ -$
204.48$ -$ -$ -$ -$ -$ -$
436.62$ -$ -$ -$ -$ -$ -$
2016 21-year-old Non-Tobacco Premium PMPM
(in small group market, average monthly premium weighted for quarterly trend)
2017 21-year-old Non-Tobacco Premium PMPM
(in small group market, average monthly premium weighted for quarterly trend)
417.35$ -$ -$ -$ -$ -$ -$
346.27$ -$ -$ -$ -$ -$ -$
353.34$ -$ -$ -$ -$ -$ -$
311.30$ -$ -$ -$ -$ -$ -$
287.95$ -$ -$ -$ -$ -$ -$
213.47$ -$ -$ -$ -$ -$ -$
272.43$ -$ -$ -$ -$ -$ -$
331.97$ -$ -$ -$ -$ -$ -$
281.26$ -$ -$ -$ -$ -$ -$
260.86$ -$ -$ -$ -$ -$ -$
344.19$ -$ -$ -$ -$ -$ -$
293.73$ -$ -$ -$ -$ -$ -$
272.43$ -$ -$ -$ -$ -$ -$
290.45$ -$ -$ -$ -$ -$ -$
233.48$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
331.97$ -$ -$ -$ -$ -$ -$
281.26$ -$ -$ -$ -$ -$ -$
260.86$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
-$ -$ -$ -$ -$ -$ -$
7 8 9
Average
(weighted by
enrollment by
rating area) 1 2 3 4
-$ 352.14$ -$ 352.14$ 0.0% 0.0% 0.0% 0.0%
-$ 432.77$ -$ 432.77$ 0.0% 0.0% 0.0% 0.0%
-$ 413.71$ -$ 413.71$ 0.0% 0.0% 0.0% 0.0%
-$ 341.21$ -$ 341.21$ 0.0% 0.0% 0.0% 0.0%
-$ 352.29$ -$ 352.29$ 0.0% 0.0% 0.0% 0.0%
-$ 301.71$ -$ 301.71$ 0.0% 0.0% 0.0% 0.0%
-$ 286.92$ -$ 286.92$ 0.0% 0.0% 0.0% 0.0%
-$ 213.73$ -$ 213.73$ 0.0% 0.0% 0.0% 0.0%
-$ 305.11$ -$ 305.11$ 0.0% 0.0% 0.0% 0.0%
-$ 242.11$ -$ 242.11$ 0.0% 0.0% 0.0% 0.0%
-$ 452.82$ -$ 452.82$ 0.0% 0.0% 0.0% 0.0%
-$ 432.87$ -$ 432.87$ 0.0% 0.0% 0.0% 0.0%
-$ 356.43$ -$ 356.43$ 0.0% 0.0% 0.0% 0.0%
-$ 366.40$ -$ 366.40$ 0.0% 0.0% 0.0% 0.0%
-$ 315.16$ -$ 315.16$ 0.0% 0.0% 0.0% 0.0%
-$ 299.63$ -$ 299.63$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ 360.51$ -$ 360.51$ 0.0% 0.0% 0.0% 0.0%
-$ 304.32$ -$ 304.32$ 0.0% 0.0% 0.0% 0.0%
-$ 433.20$ -$ 433.20$ 0.0% 0.0% 0.0% 0.0%
-$ 414.13$ -$ 414.13$ 0.0% 0.0% 0.0% 0.0%
-$ 341.63$ -$ 341.63$ 0.0% 0.0% 0.0% 0.0%
-$ 352.72$ -$ 352.72$ 0.0% 0.0% 0.0% 0.0%
-$ 302.14$ -$ 302.14$ 0.0% 0.0% 0.0% 0.0%
-$ 287.34$ -$ 287.34$ 0.0% 0.0% 0.0% 0.0%
-$ 214.15$ -$ 214.15$ 0.0% 0.0% 0.0% 0.0%
-$ 453.24$ -$ 453.24$ 0.0% 0.0% 0.0% 0.0%
Change in 21-year-old Non-Tobacco Premium PMPM 2017 21-year-old Non-Tobacco Premium PMPM
(in small group market, average monthly premium weighted for quarterly trend)
-$ 433.29$ -$ 433.29$ 0.0% 0.0% 0.0% 0.0%
-$ 356.85$ -$ 356.85$ 0.0% 0.0% 0.0% 0.0%
-$ 367.26$ -$ 367.26$ 0.0% 0.0% 0.0% 0.0%
-$ 315.58$ -$ 315.58$ 0.0% 0.0% 0.0% 0.0%
-$ 300.05$ -$ 300.05$ 0.0% 0.0% 0.0% 0.0%
-$ 223.42$ -$ 223.42$ 0.0% 0.0% 0.0% 0.0%
-$ 287.26$ -$ 287.26$ 0.0% 0.0% 0.0% 0.0%
-$ 350.13$ -$ 350.13$ 0.0% 0.0% 0.0% 0.0%
-$ 291.40$ -$ 291.40$ 0.0% 0.0% 0.0% 0.0%
-$ 275.06$ -$ 275.06$ 0.0% 0.0% 0.0% 0.0%
-$ 361.37$ -$ 361.37$ 0.0% 0.0% 0.0% 0.0%
-$ 305.18$ -$ 305.18$ 0.0% 0.0% 0.0% 0.0%
-$ 288.12$ -$ 288.12$ 0.0% 0.0% 0.0% 0.0%
-$ 305.54$ -$ 305.54$ 0.0% 0.0% 0.0% 0.0%
-$ 242.53$ -$ 242.53$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ 350.99$ -$ 350.99$ 0.0% 0.0% 0.0% 0.0%
-$ 292.26$ -$ 292.26$ 0.0% 0.0% 0.0% 0.0%
-$ 275.91$ -$ 275.91$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
-$ -$ -$ -$ 0.0% 0.0% 0.0% 0.0%
5 6 7 8 9
Average
(weighted by
enrollment by
rating area)
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 2.9% 0.0% 2.9%
0.0% 0.0% 0.0% 3.9% 0.0% 3.9%
0.0% 0.0% 0.0% 1.2% 0.0% 1.2%
0.0% 0.0% 0.0% 4.1% 0.0% 4.1%
0.0% 0.0% 0.0% 4.5% 0.0% 4.5%
0.0% 0.0% 0.0% 5.0% 0.0% 5.0%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 2.9% 0.0% 2.9%
0.0% 0.0% 0.0% 3.7% 0.0% 3.7%
0.0% 0.0% 0.0% 1.2% 0.0% 1.2%
0.0% 0.0% 0.0% 4.1% 0.0% 4.1%
0.0% 0.0% 0.0% ###### 0.0% -100.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 4.7% 0.0% 4.7%
0.0% 0.0% 0.0% 3.6% 0.0% 3.6%
0.0% 0.0% 0.0% 3.8% 0.0% 3.8%
0.0% 0.0% 0.0% 3.8% 0.0% 3.8%
0.0% 0.0% 0.0% 3.1% 0.0% 3.1%
0.0% 0.0% 0.0% 4.1% 0.0% 4.1%
0.0% 0.0% 0.0% 1.4% 0.0% 1.4%
0.0% 0.0% 0.0% 4.2% 0.0% 4.2%
0.0% 0.0% 0.0% 4.7% 0.0% 4.7%
0.0% 0.0% 0.0% 3.8% 0.0% 3.8%
Change in 21-year-old Non-Tobacco Premium PMPM
0.0% 0.0% 0.0% 3.8% 0.0% 3.8%
0.0% 0.0% 0.0% 3.1% 0.0% 3.1%
0.0% 0.0% 0.0% 3.9% 0.0% 3.9%
0.0% 0.0% 0.0% 1.4% 0.0% 1.4%
0.0% 0.0% 0.0% 4.2% 0.0% 4.2%
0.0% 0.0% 0.0% 4.7% 0.0% 4.7%
0.0% 0.0% 0.0% 5.4% 0.0% 5.4%
0.0% 0.0% 0.0% 5.5% 0.0% 5.5%
0.0% 0.0% 0.0% 3.6% 0.0% 3.6%
0.0% 0.0% 0.0% 5.4% 0.0% 5.4%
0.0% 0.0% 0.0% 5.0% 0.0% 5.0%
0.0% 0.0% 0.0% 3.9% 0.0% 3.9%
0.0% 0.0% 0.0% 5.8% 0.0% 5.8%
0.0% 0.0% 0.0% 5.2% 0.0% 5.2%
0.0% 0.0% 0.0% 3.9% 0.0% 3.9%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 5.7% 0.0% 5.7%
0.0% 0.0% 0.0% 3.9% 0.0% 3.9%
0.0% 0.0% 0.0% 5.8% 0.0% 5.8%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
0.0% 0.0% 0.0% 0.0% 0.0% 0.0%
PA Rate Template Part VConsumer Factors
Table 12. Age and Tobacco Factors Table 13. Geographic Factors
Age
Band
Age
Factor
Tobacco
Factor
Age
Band
Age
Factor
Tobacco
FactorArea Counties
Current
Factor
Proposed
Factor
0-20 0.635 43 1.357 1.225 Rating Area 1
21 1.000 1.125 44 1.397 1.225 Rating Area 2
22 1.000 1.125 45 1.444 1.225 Rating Area 3
23 1.000 1.125 46 1.500 1.225 Rating Area 4
24 1.000 1.125 47 1.563 1.225 Rating Area 5
25 1.004 1.125 48 1.635 1.225 Rating Area 6
26 1.024 1.125 49 1.706 1.225 Rating Area 7
27 1.048 1.125 50 1.786 1.375 Rating Area 8Bucks, Chester, Delaware, Philadelphia,
Montgomery1.000 1.000
28 1.087 1.125 51 1.865 1.375 Rating Area 9
29 1.119 1.125 52 1.952 1.375
30 1.135 1.175 53 2.040 1.375
31 1.159 1.175 54 2.135 1.375 Table 14. Network Factors32 1.183 1.175 55 2.230 1.375
33 1.198 1.175 56 2.333 1.375
34 1.214 1.175 57 2.437 1.375 Network Name Rating AreaCurrent
Factor
Proposed
Factor
DOH
Approval
Date
35 1.222 1.175 58 2.548 1.375 Proactive Rating Area 8 0.989 0.989
36 1.230 1.175 59 2.603 1.375 Keystone Rating Area 8 1.000 1.000
37 1.238 1.175 60 2.714 1.375
38 1.246 1.175 61 2.810 1.375
39 1.262 1.175 62 2.873 1.375
40 1.278 1.225 63 2.952 1.375
41 1.302 1.225 64+ 3.000 1.375
42 1.325 1.225*PA follows the federal default age curve.
Geographic Area Factors2017 Age and Tobacco Factors
2017 Network Factors
Rate Change Request Summary - 2017 Pennsylvania Insurance Department | www.insurance.pa.gov
1
Keystone Health Plan East – Small Group Plans Rate request filing ID # INAC-130539718 - This document is prepared by the insurance company submitting the rate filing as a consumer tool to help explain the rate filing. It is not intended to describe or include all factors or information considered in the review process. For more information, see the filing at http://www.insurance.pa.gov/Consumers/ACARelatedFilings/
Overview
Requested average rate change: 3.7% Range of requested rate change: 1.2% - 5.8% Effective date: January 1, 2017 People impacted: 125,640 Available in: Rating Area 8
Key information Jan. 2015-Dec. 2015 financial experience
Premiums $616,774,973 Claims $528,572,585 Administrative expenses $85,205,678
Company made (before taxes) $2,996,710
The company expects its annual medical costs to increase 6.2%.
Explanation of requested rate change
Scope and Range of the Rate Increase: Keystone Health Plan East ("KHPE”) is increasing premium rates for the Pennsylvania Consumer ACA compliant products by an average of 3.7%. This rate action is effective from January 1, 2017. About 126,000 members will be affected. The actual impact to premium for a specific customer may be different. Financial Experience of the Product: KHPE is required by federal law to pay out a minimum of 80% percent of premium dollars for medical claims—this is referred to as the minimum Medical Loss Ratio (MLR). The rate action proposed in this filing is expected to achieve a Medical Loss Ratio of greater than 80%. Changes in Medical Service Costs: Premium rates for health care insurance are increasing as the cost of health care service rise. Health care service costs increase as health care providers increase their fees, members use more health care services and supplies, and the types of health care services and supplies change, among other factors. Nearly half of the change in health care service costs is driven by changes to health care provider fees.
How it plans to spend your premium This is how the insurance company plans to spend the premium it collects in 2017:
Claims: 84% Administrative: 10% Taxes & fees: 4% Profit: 2%
Changes in Benefits: Some plan benefits are mandated by federal and state law. Benefit changes for some plans were also made. All changes in benefits are in compliance with the uniform modifications rules stipulated by the Federal government. Administrative Costs: The premium rates presented in this filing include a 2% contribution to surplus. Furthermore, the Affordable Care Act (ACA) imposes taxes and other levies.
Information for Pennsylvania Bulletin
1. Company Legal Name: Keystone Health Plan East (“KHPE”)
NAIC # 95056
2. Market: Small Group
3. Products: HMO
4. Average Rate Change: 3.7%; $18.64 PMPM
5. Current Members: 125,640
6. Experience Period Revenue $616,774,973
7. Additional Revenue from Increase $22,820,674
URRT Part II – Consumer Friendly Justification
Scope and Range of the Rate Increase:
Keystone Health Plan East ("KHPE) is increasing premium rates for the Pennsylvania Small Group ACA compliant products by an average of 3.7%. This rate action is effective from January 1, 2017. About 126,000 members will be affected. The actual impact to premium for a specific customer may be different.
Financial Experience of the Product:
KHPE is required by federal law to pay out a minimum of 80% percent of premium dollars for medical claims—this is referred to as the minimum Medical Loss Ratio (MLR). The rate action proposed in this filing is expected to achieve a Medical Loss Ratio of greater than 80%.
Changes in Medical Service Costs:
Premium rates for health care insurance are increasing as the cost of health care service rise. Health care service costs increase as health care providers increase their fees, members use more health care services and supplies, and the types of health care services and supplies change, among other factors. Nearly half of the change in health care service costs is driven by changes to health care provider fees.
Changes in Benefits:
Some plan benefits are mandated by federal and state law. Benefit changes for some plans were also made. All changes in benefits are in compliance with the uniform modifications rules stipulated by the Federal government.
Administrative Costs:
The premium rates presented in this filing include a 2% contribution to reserves. Furthermore, the Affordable Care Act (ACA) imposes taxes and other levies.
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A B C D E F G H I J K L M N O P Q R S T U V W X Y
Ac
tioUnified Rate Review v3.3
Company Legal Name: KHPE State: PA
HIOS Issuer ID: 33871 Market: Small Group
Effective Date of Rate Change(s): 1/1/2017
Market Level Calculations (Same for all Plans)
Section I: Experience period data
Experience Period: 1/1/2015 to 12/31/2015
Experience Period
Aggregate Amount PMPM % of Prem
Premiums (net of MLR Rebate) in Experience Period: $671,931,345 $449.50 100.00%
Incurred Claims in Experience Period $550,417,515 368.21 81.92%
Allowed Claims: $599,185,808 400.83 89.17%
Index Rate of Experience Period $401.00
Experience Period Member Months 1,494,855
Section II: Allowed Claims, PMPM basis
Experience Period Projection Period: 1/1/2017 to 12/31/2017 Mid-point to Mid-point, Experience to Projection: 24 months
on Actual Experience Allowed
Adj't. from Experience to
Projection Period Projections, before credibility Adjustment Credibility Manual
Benefit Category
Utilization
Description
Utilization per
1,000
Average
Cost/Service PMPM
Pop'l risk
Morbidity Other Cost Util
Utilization per
1,000
Average
Cost/Service PMPM
Utilization
per 1,000
Average
Cost/Service PMPM
Inpatient Hospital Admits 68.91 $15,618.44 $89.69 1.000 1.060 1.041 1.017 71.32 $17,940.93 $106.63 0.00 $0.00 $0.00
Outpatient Hospital Services 1,924.28 $515.59 82.68 1.000 1.060 1.038 1.017 1,991.60 588.85 97.73 0.00 $0.00 0.00
Professional Services 9,452.57 $135.41 106.67 1.000 1.060 1.017 1.017 9,783.26 148.46 121.04 0.00 $0.00 0.00
Other Medical Services 0.01 $82.00 0.00 1.000 1.060 1.017 1.030 0.01 89.90 0.00 0.00 $0.00 0.00
Capitation Services 12,000.00 17.41 17.41 1.000 1.060 1.021 1.000 12,000.00 19.23 19.23 0.00 $0.00 0.00
Prescription Drug Prescriptions 11,766.31 106.46 104.39 1.000 1.060 1.045 1.045 12,849.10 123.23 131.95 0.00 $0.00 0.00
Total $400.83 $476.59 $0.00
After Credibility Projected Period Totals
Section III: Projected Experience: Projected Allowed Experience Claims PMPM (w/applied credibility if applicable) 100.00% 0.00% $476.59 $718,539,496
Paid to Allowed Average Factor in Projection Period 0.880
Projected Incurred Claims, before ACA rein & Risk Adj't, PMPM $419.38 $632,283,377
Projected Risk Adjustments PMPM -16.87 (25,437,372)
Projected Incurred Claims, before reinsurance recoveries, net of rein prem, PMPM $436.25 $657,720,750
Projected ACA reinsurance recoveries, net of rein prem, PMPM 0.00 0
Projected Incurred Claims $436.25 $657,720,750
Administrative Expense Load 9.89% 51.51 77,653,792
Profit & Risk Load 2.00% 10.41 15,696,290
Taxes & Fees 4.30% 22.38 33,743,652
Single Risk Pool Gross Premium Avg. Rate, PMPM $520.54 $784,814,483
Index Rate for Projection Period 499.10$
% increase over Experience Period 15.81%
% Increase, annualized: 7.61%
Projected Member Months 1,507,680
Information Not Releasable to the Public Unless Authorized by Law: This information has not been publically disclosed and may be privileged and confidential. It is for internal government use only and must not be
disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.
Annualized Trend
Factors
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May 11, 2016
Ms. Johanna Fabian-Marks, Special Deputy & Acting Director
Bureau of Accident and Health Insurance
Pennsylvania Insurance Department
1311 Strawberry Square
Harrisburg, PA 17120
SUBMITTED VIA SERFF
RE: Keystone Health Plan East
Small Group HMO Rate Filing effective 1/1/2016
INAC-130539718
Dear Ms. Fabian-Marks:
Attached is the rating methodology for HMO plans of Keystone Health Plan East
(KHPE), and Direct Point-of-Service (DPOS) plans, of which a large majority of benefit
expenses is attributed to KHPE and the remainder to QCC Insurance Company (QCC),
and offered to small employer groups in the Commonwealth of Pennsylvania. New and
renewing plans are being filed to satisfy market reform requirements of the Affordable
Care Act (ACA)—some plans are included in a concurrent application for certification as
a Qualified Health Plan. This rate filing includes rates for these plans and specifies
compliance with rating requirements of the ACA. The enclosed rating methodology is
for rating periods effective from January 1, 2017 through December 31, 2017.
This rate filing is being submitted along with concurrent form filing(s) and SERFF Plan
Management binder(s):
INLG-130546269
INBC- 130545507
INLG-PA17-125061998
INBC-PA17-125061995
Please contact with any
questions regarding this filing.
Sincerely,
Director and Actuary, Commercial Pricing
cc: