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DENTAL/VISION MONTHLY PREMIUMS**
| Value Plan Monthly Rates |
| Single Only |
$20.00
|
| Insured & One (Spouse or Child) |
$37.00
|
| Insured & 2 or more |
$55.00
|
| Standard Plan Monthly Rates |
| Single Only |
$28.60
|
| Insured & One (Spouse or Child) |
$52.50
|
| Insured & 2 or more |
$76.65
|
| Royal Plan Monthly Rates |
| Single Only |
$36.37
|
| Insured & One (Spouse or Child) |
$66.86
|
| Insured & 2 or more |
$98.15
|
100/70/50 Monthly Rates
| Region One - NE, KS, SC, SD, TN, OH, ND, OK, KY, LA, MO, MS, WV, AL |
| Single Only |
$34.76
|
| Insured & One (Spouse or Child) |
$73.94
|
| Insured & 2 or more |
$127.96
|
| Region Two - WY, NM, FL, PA, IL, DE, NC, VA, GA, IN, TX, IA |
| Single Only |
$38.03
|
| Insured & One (Spouse or Child) |
$80.73
|
| Insured & 2 or more |
$139.40
|
| Region Three - MD, MT, VT, MI, UT, ID, MN, WI, ME |
| Single Only |
$43.53
|
| Insured & One (Spouse or Child) |
$92.39
|
| Insured & 2 or more |
$159.71
|
| Region Four - OR, MA, NV, NJ, RI, CO |
| Single Only |
$49.45
|
| Insured & One (Spouse or Child) |
$104.90
|
| Insured & 2 or more |
$181.52
|
| Region Five - AK, WA, HI, CA, DC, CT |
| Single Only |
$54.14
|
| Insured & One (Spouse or Child) |
$114.90
|
| Insured & 2 or more |
$199.21
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*Above rates include appropriate fees. The Group Policy is governed by the laws of the state of VA.
**As this is an association, plan coverage is not available in NY and NH due to state laws.
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