| Louisiana Health Plan | ||||||||||||||||
| 150% of Average Rates for the Top Five Carriers After Benefit Adjustment | ||||||||||||||||
| Minimum Rates for 1/1/2007 Effective Date | ||||||||||||||||
| Standard Rate | Discounted Rate* | |||||||||||||||
| $1,000 Ded. | $2,000 Ded. | $1,000 Ded. | $2,000 Ded. | |||||||||||||
| Male | Female | Male | Female | Male | Female | Male | Female | |||||||||
| New Orleans Zip Codes: 700, 701 | ||||||||||||||||
| To-24 | 316.95 | 352.73 | 227.75 | 251.08 | 273.99 | 305.88 | 197.03 | 218.64 | ||||||||
| 25-29 | 336.61 | 405.41 | 242.29 | 289.71 | 286.70 | 345.70 | 206.89 | 248.43 | ||||||||
| 30-34 | 391.55 | 501.77 | 281.82 | 360.71 | 322.01 | 412.89 | 231.73 | 296.94 | ||||||||
| 35-39 | 472.70 | 604.87 | 345.46 | 442.69 | 379.33 | 484.88 | 277.69 | 355.13 | ||||||||
| 40-44 | 583.45 | 719.60 | 435.98 | 533.48 | 463.02 | 568.54 | 345.03 | 420.65 | ||||||||
| 45-49 | 731.66 | 846.39 | 548.87 | 632.81 | 575.99 | 662.49 | 430.36 | 493.70 | ||||||||
| 50-54 | 967.52 | 1,030.01 | 722.02 | 777.43 | 742.01 | 785.29 | 551.59 | 588.77 | ||||||||
| 55-59 | 1,302.97 | 1,256.41 | 953.47 | 955.27 | 963.59 | 929.24 | 704.56 | 699.11 | ||||||||
| 60-64 | 1,620.38 | 1,500.05 | 1,173.88 | 1,127.95 | 1,189.55 | 1,099.80 | 862.50 | 821.35 | ||||||||
| Baton Rouge & Shreveport Zip Codes: 707, 708, 710 or 711 | ||||||||||||||||
| To-24 | 275.20 | 305.62 | 197.07 | 217.50 | 237.43 | 265.69 | 170.51 | 189.03 | ||||||||
| 25-29 | 292.90 | 352.57 | 209.29 | 251.03 | 248.63 | 300.76 | 178.76 | 214.82 | ||||||||
| 30-34 | 339.88 | 436.59 | 243.47 | 312.30 | 278.90 | 358.37 | 200.18 | 256.63 | ||||||||
| 35-39 | 410.71 | 526.66 | 299.14 | 384.99 | 329.25 | 422.47 | 239.75 | 307.73 | ||||||||
| 40-44 | 508.68 | 627.29 | 378.52 | 464.15 | 401.79 | 494.30 | 298.54 | 365.02 | ||||||||
| 45-49 | 638.23 | 739.28 | 477.94 | 551.23 | 498.47 | 574.52 | 372.19 | 427.68 | ||||||||
| 50-54 | 842.47 | 900.24 | 627.37 | 676.30 | 641.43 | 681.16 | 475.42 | 509.48 | ||||||||
| 55-59 | 1,136.95 | 1,097.34 | 829.27 | 831.06 | 832.72 | 804.82 | 608.03 | 603.95 | ||||||||
| 60-64 | 1,417.16 | 1,311.29 | 1,022.07 | 983.32 | 1,029.76 | 951.40 | 744.23 | 708.64 | ||||||||
| All Others Zip Codes: Any Other | ||||||||||||||||
| To-24 | 272.05 | 302.37 | 194.55 | 214.27 | 234.85 | 262.57 | 168.27 | 186.57 | ||||||||
| 25-29 | 289.00 | 348.32 | 206.99 | 247.73 | 246.02 | 296.98 | 176.68 | 212.15 | ||||||||
| 30-34 | 335.80 | 431.09 | 240.49 | 308.14 | 275.86 | 354.37 | 197.82 | 253.94 | ||||||||
| 35-39 | 406.01 | 521.37 | 295.50 | 379.59 | 325.34 | 417.36 | 236.89 | 303.83 | ||||||||
| 40-44 | 502.46 | 620.41 | 373.84 | 458.41 | 398.06 | 488.87 | 294.77 | 360.25 | ||||||||
| 45-49 | 631.10 | 730.79 | 471.71 | 544.13 | 494.02 | 568.84 | 368.28 | 422.88 | ||||||||
| 50-54 | 833.26 | 889.66 | 619.88 | 668.07 | 634.93 | 673.96 | 471.08 | 503.27 | ||||||||
| 55-59 | 1,124.90 | 1,085.13 | 818.87 | 821.03 | 824.93 | 796.48 | 601.06 | 597.53 | ||||||||
| 60-64 | 1,402.34 | 1,297.93 | 1,010.50 | 972.27 | 1,020.09 | 943.01 | 736.60 | 702.01 | ||||||||
| *Discounted rates are available to persons who have not smoked cigarettes, cigars, pipe or utilized other tabacco products in the last year | ||||||||||||||||
| Louisiana Health Plan | ||||||||||||||||
| 150% of Average Rates for the Top Five Carriers After Benefit Adjustment | ||||||||||||||||
| Minimum Rates for 1/1/2007 Effective Date | ||||||||||||||||
| Standard Rate | Discounted Rate* | |||||||||||||||
| $3,500 Ded. | $5,000 Ded. | $3,500 Ded. | $5,000 Ded. | |||||||||||||
| Male | Female | Male | Female | Male | Female | Male | Female | |||||||||
| New Orleans Zip Codes: 700, 701 | ||||||||||||||||
| To-24 | 189.55 | 208.96 | 145.77 | 167.37 | 163.98 | 181.96 | 127.21 | 146.55 | ||||||||
| 25-29 | 201.66 | 241.11 | 156.14 | 194.38 | 172.19 | 206.76 | 134.61 | 166.65 | ||||||||
| 30-34 | 234.55 | 300.21 | 182.20 | 242.69 | 192.86 | 247.13 | 152.06 | 201.70 | ||||||||
| 35-39 | 287.51 | 368.44 | 224.34 | 299.12 | 231.11 | 295.56 | 182.09 | 241.11 | ||||||||
| 40-44 | 362.86 | 444.00 | 286.61 | 361.39 | 287.15 | 350.10 | 230.14 | 287.52 | ||||||||
| 45-49 | 456.81 | 526.66 | 368.07 | 423.49 | 358.17 | 410.89 | 292.48 | 333.64 | ||||||||
| 50-54 | 600.91 | 647.04 | 484.20 | 521.77 | 459.08 | 490.02 | 374.70 | 400.84 | ||||||||
| 55-59 | 793.55 | 795.05 | 635.58 | 644.81 | 586.39 | 581.85 | 476.60 | 478.51 | ||||||||
| 60-64 | 977.00 | 938.76 | 778.01 | 761.72 | 717.84 | 683.59 | 582.21 | 561.91 | ||||||||
| Baton Rouge & Shrevepor Zip Codes: 707, 708, 710 or 711 | ||||||||||||||||
| To-24 | 164.02 | 181.02 | 125.38 | 143.75 | 141.91 | 157.33 | 109.67 | 126.01 | ||||||||
| 25-29 | 174.19 | 208.92 | 133.85 | 166.78 | 148.78 | 178.79 | 115.63 | 143.88 | ||||||||
| 30-34 | 202.63 | 259.92 | 156.52 | 209.23 | 166.60 | 213.58 | 130.07 | 172.83 | ||||||||
| 35-39 | 248.96 | 320.41 | 192.36 | 257.84 | 199.54 | 256.12 | 156.64 | 207.54 | ||||||||
| 40-44 | 315.03 | 386.30 | 246.57 | 312.33 | 248.46 | 303.79 | 196.98 | 247.35 | ||||||||
| 45-49 | 397.77 | 458.78 | 317.21 | 365.82 | 309.77 | 355.95 | 250.44 | 287.26 | ||||||||
| 50-54 | 522.14 | 562.86 | 416.95 | 450.58 | 395.68 | 424.02 | 320.51 | 343.73 | ||||||||
| 55-59 | 690.18 | 691.66 | 547.65 | 556.61 | 506.04 | 502.64 | 408.41 | 410.85 | ||||||||
| 60-64 | 850.64 | 818.39 | 671.62 | 657.83 | 619.41 | 589.78 | 498.15 | 481.80 | ||||||||
| All Others Zip Codes: Any Other | ||||||||||||||||
| To-24 | 161.93 | 178.33 | 123.67 | 141.72 | 140.04 | 155.28 | 108.12 | 124.30 | ||||||||
| 25-29 | 172.27 | 206.18 | 132.23 | 164.93 | 147.05 | 176.57 | 114.05 | 141.68 | ||||||||
| 30-34 | 200.15 | 256.45 | 154.36 | 205.80 | 164.64 | 211.34 | 128.70 | 170.93 | ||||||||
| 35-39 | 245.94 | 315.93 | 189.92 | 254.24 | 197.16 | 252.87 | 154.42 | 204.90 | ||||||||
| 40-44 | 311.14 | 381.52 | 243.30 | 307.91 | 245.32 | 299.82 | 194.83 | 244.40 | ||||||||
| 45-49 | 392.59 | 452.87 | 313.05 | 360.93 | 306.50 | 351.96 | 247.55 | 283.56 | ||||||||
| 50-54 | 515.91 | 556.01 | 411.95 | 444.51 | 392.06 | 418.86 | 316.78 | 339.77 | ||||||||
| 55-59 | 681.52 | 683.32 | 540.83 | 549.80 | ||||||||||||