Page 15 - NextCare Holdings 2021 Annual Benefits Enrollment
P. 15
2021
NextCare Holdings Benefits Enrollment
Amounts below this line require a personal health application and are held for approval.
Coverage Less Than 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70+ Years
30 Years
Amount Old Years Old Years Old Years Old Years Old Years Old Years Old Years Old Years Old Old
$160,000 $5 .83 $7 .31 $9 .01 $11 .08 $15 .80 $24 .66 $42 .02 $57 .97 $104 .71 $187 .94
$170,000 $6 .20 $7 .77 $9 .57 $11 .77 $16 .79 $26 .21 $44 .64 $61 .59 $111 .26 $199 .68
$180,000 $6 .56 $8 .22 $10 .14 $12 .46 $17 .78 $27 .75 $47 .27 $65 .22 $117 .80 $211 .43
$190,000 $6 .93 $8 .68 $10 .70 $13 .15 $18 .77 $29 .29 $49 .90 $68 .84 $124 .35 $223 .18
$200,000 $7 .29 $9 .14 $11 .26 $13 .85 $19 .75 $30 .83 $52 .52 $72 .46 $130 .89 $234 .92
$210,000 $7 .66 $9 .60 $11 .82 $14 .54 $20 .74 $32 .37 $55 .15 $76 .08 $137 .44 $246 .67
$220,000 $8 .02 $10 .05 $12 .39 $15 .23 $21 .73 $33 .91 $57 .78 $79 .71 $143 .98 $258 .42
$230,000 $8 .39 $10 .51 $12 .95 $15 .92 $22 .72 $35 .46 $60 .40 $83 .33 $150 .53 $270 .16
$240,000 $8 .75 $10 .97 $13 .51 $16 .62 $23 .70 $37 .00 $63 .03 $86 .95 $157 .07 $281 .91
$250,000 $9 .12 $11 .42 $14 .08 $17 .31 $24 .69 $38 .54 $65 .65 $90 .58 $163 .62 $293 .65
$260,000 $9 .48 $11 .88 $14 .64 $18 .00 $25 .68 $40 .08 $68 .28 $94 .20 $170 .16 $305 .40
$270,000 $9 .84 $12 .34 $15 .20 $18 .69 $26 .67 $41 .62 $70 .91 $97 .82 $176 .70 $317 .15
$280,000 $10 .21 $12 .79 $15 .77 $19 .38 $27 .66 $43 .16 $73 .53 $101 .45 $183 .25 $328 .89
$290,000 $10 .57 $13 .25 $16 .33 $20 .08 $28 .64 $44 .70 $76 .16 $105 .07 $189 .79 $340 .64
$300,000 $10 .94 $13 .71 $16 .89 $20 .77 $29 .63 $46 .25 $78 .78 $108 .69 $196 .34 $352 .38
$310,000 $11 .30 $14 .16 $17 .46 $21 .46 $30 .62 $47 .79 $81 .41 $112 .32 $202 .88 $364 .13
$320,000 $11 .67 $14 .62 $18 .02 $22 .15 $31 .61 $49 .33 $84 .04 $115 .94 $209 .43 $375 .88
$330,000 $12 .03 $15 .08 $18 .58 $22 .85 $32 .59 $50 .87 $86 .66 $119 .56 $215 .97 $387 .62
$340,000 $12 .40 $15 .54 $19 .14 $23 .54 $33 .58 $52 .41 $89 .29 $123 .18 $222 .52 $399 .37
$350,000 $12 .76 $15 .99 $19 .71 $24 .23 $34 .57 $53 .95 $91 .92 $126 .81 $229 .06 $411 .12
$360,000 $13 .13 $16 .45 $20 .27 $24 .92 $35 .56 $55 .50 $94 .54 $130 .43 $235 .61 $422 .86
$370,000 $13 .49 $16 .91 $20 .83 $25 .62 $36 .54 $57 .04 $97 .17 $134 .05 $242 .15 $434 .61
$380,000 $13 .86 $17 .36 $21 .40 $26 .31 $37 .53 $58 .58 $99 .79 $137 .68 $248 .70 $446 .35
$390,000 $14 .22 $17 .82 $21 .96 $27 .00 $38 .52 $60 .12 $102 .42 $141 .30 $255 .24 $458 .10
$400,000 $14 .58 $18 .28 $22 .52 $27 .69 $39 .51 $61 .66 $105 .05 $144 .92 $261 .78 $469 .85
$410,000 $14 .95 $18 .73 $23 .09 $28 .38 $40 .50 $63 .20 $107 .67 $148 .55 $268 .33 $481 .59
$420,000 $15 .31 $19 .19 $23 .65 $29 .08 $41 .48 $64 .74 $110 .30 $152 .17 $274 .87 $493 .34
$430,000 $15 .68 $19 .65 $24 .21 $29 .77 $42 .47 $66 .29 $112 .92 $155 .79 $281 .42 $505 .08
$440,000 $16 .04 $20 .10 $24 .78 $30 .46 $43 .46 $67 .83 $115 .55 $159 .42 $287 .96 $516 .83
$450,000 $16 .41 $20 .56 $25 .34 $31 .15 $44 .45 $69 .37 $118 .18 $163 .04 $294 .51 $528 .58
$460,000 $16 .77 $21 .02 $25 .90 $31 .85 $45 .43 $70 .91 $120 .80 $166 .66 $301 .05 $540 .32
$470,000 $17 .14 $21 .48 $26 .46 $32 .54 $46 .42 $72 .45 $123 .43 $170 .28 $307 .60 $552 .07
$480,000 $17 .50 $21 .93 $27 .03 $33 .23 $47 .41 $73 .99 $126 .06 $173 .91 $314 .14 $563 .82
$490,000 $17 .87 $22 .39 $27 .59 $33 .92 $48 .40 $75 .54 $128 .68 $177 .53 $320 .69 $575 .56
$500,000 $18 .23 $22 .85 $28 .15 $34 .62 $49 .38 $77 .08 $131 .31 $181 .15 $327 .23 $587 .31
15
NextCare Holdings Benefits Enrollment
Amounts below this line require a personal health application and are held for approval.
Coverage Less Than 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70+ Years
30 Years
Amount Old Years Old Years Old Years Old Years Old Years Old Years Old Years Old Years Old Old
$160,000 $5 .83 $7 .31 $9 .01 $11 .08 $15 .80 $24 .66 $42 .02 $57 .97 $104 .71 $187 .94
$170,000 $6 .20 $7 .77 $9 .57 $11 .77 $16 .79 $26 .21 $44 .64 $61 .59 $111 .26 $199 .68
$180,000 $6 .56 $8 .22 $10 .14 $12 .46 $17 .78 $27 .75 $47 .27 $65 .22 $117 .80 $211 .43
$190,000 $6 .93 $8 .68 $10 .70 $13 .15 $18 .77 $29 .29 $49 .90 $68 .84 $124 .35 $223 .18
$200,000 $7 .29 $9 .14 $11 .26 $13 .85 $19 .75 $30 .83 $52 .52 $72 .46 $130 .89 $234 .92
$210,000 $7 .66 $9 .60 $11 .82 $14 .54 $20 .74 $32 .37 $55 .15 $76 .08 $137 .44 $246 .67
$220,000 $8 .02 $10 .05 $12 .39 $15 .23 $21 .73 $33 .91 $57 .78 $79 .71 $143 .98 $258 .42
$230,000 $8 .39 $10 .51 $12 .95 $15 .92 $22 .72 $35 .46 $60 .40 $83 .33 $150 .53 $270 .16
$240,000 $8 .75 $10 .97 $13 .51 $16 .62 $23 .70 $37 .00 $63 .03 $86 .95 $157 .07 $281 .91
$250,000 $9 .12 $11 .42 $14 .08 $17 .31 $24 .69 $38 .54 $65 .65 $90 .58 $163 .62 $293 .65
$260,000 $9 .48 $11 .88 $14 .64 $18 .00 $25 .68 $40 .08 $68 .28 $94 .20 $170 .16 $305 .40
$270,000 $9 .84 $12 .34 $15 .20 $18 .69 $26 .67 $41 .62 $70 .91 $97 .82 $176 .70 $317 .15
$280,000 $10 .21 $12 .79 $15 .77 $19 .38 $27 .66 $43 .16 $73 .53 $101 .45 $183 .25 $328 .89
$290,000 $10 .57 $13 .25 $16 .33 $20 .08 $28 .64 $44 .70 $76 .16 $105 .07 $189 .79 $340 .64
$300,000 $10 .94 $13 .71 $16 .89 $20 .77 $29 .63 $46 .25 $78 .78 $108 .69 $196 .34 $352 .38
$310,000 $11 .30 $14 .16 $17 .46 $21 .46 $30 .62 $47 .79 $81 .41 $112 .32 $202 .88 $364 .13
$320,000 $11 .67 $14 .62 $18 .02 $22 .15 $31 .61 $49 .33 $84 .04 $115 .94 $209 .43 $375 .88
$330,000 $12 .03 $15 .08 $18 .58 $22 .85 $32 .59 $50 .87 $86 .66 $119 .56 $215 .97 $387 .62
$340,000 $12 .40 $15 .54 $19 .14 $23 .54 $33 .58 $52 .41 $89 .29 $123 .18 $222 .52 $399 .37
$350,000 $12 .76 $15 .99 $19 .71 $24 .23 $34 .57 $53 .95 $91 .92 $126 .81 $229 .06 $411 .12
$360,000 $13 .13 $16 .45 $20 .27 $24 .92 $35 .56 $55 .50 $94 .54 $130 .43 $235 .61 $422 .86
$370,000 $13 .49 $16 .91 $20 .83 $25 .62 $36 .54 $57 .04 $97 .17 $134 .05 $242 .15 $434 .61
$380,000 $13 .86 $17 .36 $21 .40 $26 .31 $37 .53 $58 .58 $99 .79 $137 .68 $248 .70 $446 .35
$390,000 $14 .22 $17 .82 $21 .96 $27 .00 $38 .52 $60 .12 $102 .42 $141 .30 $255 .24 $458 .10
$400,000 $14 .58 $18 .28 $22 .52 $27 .69 $39 .51 $61 .66 $105 .05 $144 .92 $261 .78 $469 .85
$410,000 $14 .95 $18 .73 $23 .09 $28 .38 $40 .50 $63 .20 $107 .67 $148 .55 $268 .33 $481 .59
$420,000 $15 .31 $19 .19 $23 .65 $29 .08 $41 .48 $64 .74 $110 .30 $152 .17 $274 .87 $493 .34
$430,000 $15 .68 $19 .65 $24 .21 $29 .77 $42 .47 $66 .29 $112 .92 $155 .79 $281 .42 $505 .08
$440,000 $16 .04 $20 .10 $24 .78 $30 .46 $43 .46 $67 .83 $115 .55 $159 .42 $287 .96 $516 .83
$450,000 $16 .41 $20 .56 $25 .34 $31 .15 $44 .45 $69 .37 $118 .18 $163 .04 $294 .51 $528 .58
$460,000 $16 .77 $21 .02 $25 .90 $31 .85 $45 .43 $70 .91 $120 .80 $166 .66 $301 .05 $540 .32
$470,000 $17 .14 $21 .48 $26 .46 $32 .54 $46 .42 $72 .45 $123 .43 $170 .28 $307 .60 $552 .07
$480,000 $17 .50 $21 .93 $27 .03 $33 .23 $47 .41 $73 .99 $126 .06 $173 .91 $314 .14 $563 .82
$490,000 $17 .87 $22 .39 $27 .59 $33 .92 $48 .40 $75 .54 $128 .68 $177 .53 $320 .69 $575 .56
$500,000 $18 .23 $22 .85 $28 .15 $34 .62 $49 .38 $77 .08 $131 .31 $181 .15 $327 .23 $587 .31
15
