69O-149.207. Health Maintenance Organization Standard Risk Rates

(1) The table below provides the standard annual risk rates for HMO plans for the Standard Benefit Plan. The 200% standard risk rate referenced in Section 627.6675(3)(a), F.S., is determined by multiplying each value in the table by the factor 2.0.

(2) To determine the rate for a particular county, multiply the rate schedule below by the appropriate area factor.

(3) Standard risk rates for coverage providing benefits coordinating with or otherwise considering coverage under Medicare, parts A and B, shall be determined by multiplying the standard risk rates identified herein by .278.

 

STANDARD HEALTH BENEFIT PLAN
	Age	Male	Female		County	Area Factor
	0	$5,258.45	$5,250.04		Alachua	1.04
	1	$2,968.48	$2,960.07		Baker	1.06
	2-6	$2,909.90	$2,901.49		Bay	0.90
	7-12	$2,822.45	$2,814.04		Bradford	1.04
	13-17	$2,972.73	$2,964.33		Brevard	0.94
	18	$2,549.95	$4,120.85		Broward	1.00
	19	$2,570.16	$4,301.90		Calhoun	0.90
	20	$2,610.13	$4,382.36		Charlotte	0.99
	21	$2,630.36	$4,472.30		Citrus	0.92
	22	$2,670.38	$4,539.11		Clay	1.06
	23	$2,729.45	$4,663.20		Collier	0.90
	24	$2,776.56	$4,759.79		Columbia	1.04
	25	$2,819.35	$4,883.42		Dade	1.00
	26	$2,899.75	$5,051.05		De Soto	0.90
	27	$2,983.75	$5,227.91		Dixie	1.04
	28	$3,047.19	$5,290.86		Duval	1.06
	29	$3,150.59	$5,242.98		Escambia	1.08
	30	$3,236.87	$5,247.52		Flagler	0.90
	31	$3,279.13	$5,177.31		Franklin	0.90
	32	$3,340.11	$5,172.07		Gadsden	0.90
	33	$3,402.20	$5,136.91		Gilchrist	1.05
	34	$3,444.91	$5,106.34		Glades	0.90
	35	$3,532.78	$5,128.20		Gulf	0.90
	36	$3,580.77	$5,108.61		Hamilton	0.90
	37	$3,649.52	$5,085.24		Hardee	0.84
	38	$3,748.38	$5,099.53		Hendry	0.96
	39	$3,815.47	$5,111.88		Hernando	1.03
	40	$3,923.62	$5,139.24		Highlands	0.84
	41	$4,003.19	$5,186.08		Hillsborough	1.01
	42	$4,102.20	$5,276.71		Holmes	0.90
	43	$4,235.88	$5,400.47		Indian River	0.90
	44	$4,359.59	$5,523.74		Jackson	0.90
	45	$4,486.17	$5,621.99		Jefferson	0.90
	46	$4,682.63	$5,747.05		Lafayette	0.90
	47	$4,872.08	$5,874.81		Lake	0.94
	48	$5,109.97	$5,986.94		Lee	1.01
	49	$5,341.56	$6,117.55		Leon	0.90
	50	$5,598.42	$6,278.89		Levy	1.04
	51	$5,909.83	$6,447.58		Liberty	0.90
	52	$6,253.14	$6,612.37		Madison	0.90
	53	$6,590.04	$6,778.15		Manatee	1.06
	54	$6,966.54	$6,965.19		Marion	0.97
	55	$7,360.26	$7,102.09		Martin	1.02
	56	$7,730.02	$7,258.77		Monroe	0.90
	57	$8,099.29	$7,390.68		Nassau	1.06
	58	$8,615.15	$7,721.59		Okaloosa	1.05
	59	$9,149.91	$8,070.04		Okeechobee	0.94
	60	$9,714.17	$8,467.78		Orange	0.94
	61	$10,192.09	$8,914.29		Osceola	0.96
	62	$10,667.92	$9,373.20		Palm Beach	1.06
	63	$11,239.30	$9,927.57		Pasco	1.01
	64	$11,819.57	$10,475.54		Pinellas	1.01
	65	$14,318.73	$12,839.86		Polk	1.15
	66	$14,377.66	$12,885.56		Putnam	1.01
	67	$14,436.21	$12,930.98		St. Johns	1.06
	68	$14,494.23	$12,975.97		St. Lucie	1.01
	69	$14,551.64	$13,020.50		Santa Rosa	1.08
	70	$14,608.25	$13,064.41		Sarasota	1.07
	71	$14,663.96	$13,107.62		Seminole	0.97
	72	$14,718.64	$13,150.03		Sumter	0.97
	73	$14,772.15	$13,191.51		Suwannee	0.94
	74	$14,824.35	$13,232.00		Taylor	0.90
	75	$14,875.09	$13,271.34		Union	0.90
	76	$14,924.27	$13,309.50		Volusia	1.00
	77	$14,971.75	$13,346.31		Wakulla	0.90
	78	$15,017.41	$13,381.72		Walton	1.07
	79	$15,061.10	$13,415.60		Washington	0.90

 

Specific Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS. History–New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.207, Amended 5-18-04, 5-22-05, 6-1-06, 8-23-07, 10-29-08.