COPAY RATES. Health Insurance for Individuals & Families Monthly Rate Guide. PreferredOne.com

COPAY RATES Health Insurance for Individuals & Families 2014 Monthly Rate Guide PreferredOne.com

Monthly Rate Guide Follow these simple steps to find the correct rate table and calculate your 2014 Monthly Rate or visit PreferredOne.com to get a fast and free online rate quote. Step 1: DETERMINE YOUR RATE AREA See the map and list of counties on page 4 to locate the county where you reside and your corresponding Rate Area 2-9. Step 2: ARE YOU A SMOKER OR NON-SMOKER? Do you or any adult covered dependents over age 18 smoke? Use the Rate Table designated for Smokers or Non-Smokers. Step 3: CHOOSE YOUR PREFERREDONE NETWORK Choose the PreferredOne Network. The Select Network is only available in certain counties of Rate Area 7 & 8 (Metro Area) and offers the lowest rate. The Choice Network is available for all other Rate Areas listed on the map. Step 4: FIND THE RIGHT RATE TABLE ON PAGES 5-16 Pick the PreferredOne Coverage Option to find your rate by age. 2

Premium Calculation Worksheet 1. Use the Rate Tables on pages 5-16 to determine your monthly rate. 2. Determine the age of each applicant. 3. Rate up to 3 children under the age of 21. 4. Each dependent adult child (ages 21 through 25) receives an additional rate. 5. Add the rates to get your total monthly premium. 6. Go to PreferredOne.com to enroll online. Calculate your Premium Applicant Rate $ Spouse/Domestic Partner $ Child 1 (age 0-20) $ Child 2 (age 0-20) $ Child 3 (age 0-20) $ Adult Child (21 through 25) $ Adult Child (21 through 25) $ Adult Child (21 through 25) $ Total $ Child Only Policy Child 1 (age 0-20) $ *Only one child is allowed on a Child Only Policy 3

Network Rate Area Guide 9 2 6 7 7 5 8 8 4 3 Choice Network Select Network AREA 2 Carlton, Itasca, Koochiching, Lake of the Woods, St. Louis AREA 3 Le Sueur, Martin, Nicollet, Rice, Watonwan AREA 4 Brown, Cottonwood, Jackson, Lincoln, Murray, Nobles, Pipestone, Redwood, Rock AREA 5 Big Stone, Chippewa, Kandiyohi, Lac Qui Parle, Lyon, McLeod, Meeker, Renville, Sibley, Swift, Yellow Medicine AREA 6 Becker, Clay, Douglas, Grant, Otter Tail, Pope, Stevens, Traverse, Wilkin AREA 7 Aitkin, Beltrami, Cass, Chisago, Crow Wing, Hubbard, Isanti, Kanabec, Mille Lacs, Morrison, Pine, Roseau, Todd, Wadena AREA 8 Anoka, Benton, Carver, Dakota, Hennepin, Ramsey, Scott, Sherburne, Stearns, Washington, Wright AREA 9 Clearwater, Kittson, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake 4

PreferredOne Copay Plans - Choice Network Rate Area 8-9 Non-Smoker 0-17 $148.44 $138.99 $125.03 $119.46 $104.98 $75.48 18 $148.44 $138.99 $125.03 $119.46 $104.98 $75.48 19 $148.44 $138.99 $125.03 $119.46 $104.98 $75.48 20 $148.44 $138.99 $125.03 $119.46 $104.98 $75.48 21 $166.78 $156.17 $140.48 $134.23 $117.95 $84.81 22 $166.78 $156.17 $140.48 $134.23 $117.95 $84.81 23 $166.78 $156.17 $140.48 $134.23 $117.95 $84.81 24 $166.78 $156.17 $140.48 $134.23 $117.95 $84.81 25 $167.45 $156.79 $141.04 $134.77 $118.42 $85.15 26 $170.79 $159.92 $143.85 $137.45 $120.78 $86.84 27 $174.79 $163.66 $147.22 $140.67 $123.61 $88.88 28 $181.29 $169.76 $152.70 $145.91 $128.21 $92.19 29 $186.63 $174.75 $157.20 $150.20 $131.99 $94.90 30 $189.30 $177.25 $159.45 $152.35 $133.88 n/a 31 $193.30 $181.00 $162.82 $155.57 $136.71 n/a 32 $197.31 $184.75 $166.19 $158.79 $139.54 n/a 33 $199.81 $187.09 $168.30 $160.81 $141.31 n/a 34 $202.48 $189.59 $170.54 $162.95 $143.19 n/a 35 $203.81 $190.84 $171.67 $164.03 $144.14 n/a 36 $205.14 $192.09 $172.79 $165.10 $145.08 n/a 37 $206.48 $193.34 $173.92 $166.18 $146.02 n/a 38 $207.81 $194.59 $175.04 $167.25 $146.97 n/a 39 $210.48 $197.08 $177.29 $169.40 $148.86 n/a 40 $213.15 $199.58 $179.53 $171.55 $150.74 n/a 41 $217.15 $203.33 $182.91 $174.77 $153.57 n/a 42 $220.99 $206.92 $186.14 $177.85 $156.29 n/a 43 $226.33 $211.92 $190.63 $182.15 $160.06 n/a 44 $233.00 $218.17 $196.25 $187.52 $164.78 n/a 45 $240.84 $225.51 $202.85 $193.83 $170.32 n/a 46 $250.18 $234.25 $210.72 $201.34 $176.93 n/a 47 $260.68 $244.09 $219.57 $209.80 $184.36 n/a 48 $272.69 $255.34 $229.69 $219.47 $192.85 n/a 49 $284.53 $266.42 $239.66 $229.00 $201.23 n/a 50 $297.88 $278.92 $250.90 $239.73 $210.66 n/a 51 $311.05 $291.25 $262.00 $250.34 $219.98 n/a 52 $325.56 $304.84 $274.22 $262.02 $230.24 n/a 53 $340.24 $318.58 $286.58 $273.83 $240.62 n/a 54 $356.08 $333.42 $299.93 $286.58 $251.83 n/a 55 $371.93 $348.26 $313.27 $299.33 $263.03 n/a 56 $389.11 $364.34 $327.74 $313.16 $275.18 n/a 57 $406.45 $380.58 $342.35 $327.12 $287.45 n/a 58 $424.97 $397.92 $357.95 $342.02 $300.54 n/a 59 $434.14 $406.51 $365.67 $349.40 $307.03 n/a 60 $452.65 $423.84 $381.26 $364.30 $320.12 n/a 61 $468.66 $438.83 $394.75 $377.18 $331.45 n/a 62 $479.17 $448.67 $403.60 $385.64 $338.88 n/a 63 $492.35 $461.01 $414.70 $396.25 $348.19 n/a 64 + $500.35 $468.51 $421.44 $402.69 $353.86 n/a Counties include: Anoka, Benton, Carver, Clearwater, Dakota, Hennepin, Kittson, Mahnomen, Marshall, Norman, Pennington, Polk, Ramsey, Red Lake, Scott, Sherburne, Stearns, Washington, Wright 5

PreferredOne Copay Plans - Choice Network Rate Area 8-9 Smoker 0-17 $148.44 $138.99 $125.03 $119.46 $104.98 $75.48 18 $169.22 $158.45 $142.53 $136.19 $119.67 $86.05 19 $169.22 $158.45 $142.53 $136.19 $119.67 $86.05 20 $169.22 $158.45 $142.53 $136.19 $119.67 $86.05 21 $190.13 $178.03 $160.15 $153.02 $134.47 $96.68 22 $190.13 $178.03 $160.15 $153.02 $134.47 $96.68 23 $190.13 $178.03 $160.15 $153.02 $134.47 $96.68 24 $190.13 $178.03 $160.15 $153.02 $134.47 $96.68 25 $190.89 $178.74 $160.79 $153.63 $135.00 $97.07 26 $194.70 $182.30 $163.99 $156.69 $137.69 $99.00 27 $199.26 $186.58 $167.84 $160.37 $140.92 $101.32 28 $206.68 $193.52 $174.08 $166.33 $146.16 $105.09 29 $212.76 $199.22 $179.21 $171.23 $150.47 $108.19 30 $215.80 $202.07 $181.77 $173.68 $152.62 n/a 31 $220.37 $206.34 $185.61 $177.35 $155.85 n/a 32 $224.93 $210.61 $189.46 $181.02 $159.07 n/a 33 $227.78 $213.28 $191.86 $183.32 $161.09 n/a 34 $230.82 $216.13 $194.42 $185.77 $163.24 n/a 35 $232.34 $217.56 $195.70 $186.99 $164.32 n/a 36 $233.86 $218.98 $196.98 $188.22 $165.39 n/a 37 $235.39 $220.40 $198.26 $189.44 $166.47 n/a 38 $236.91 $221.83 $199.54 $190.66 $167.54 n/a 39 $239.95 $224.68 $202.11 $193.11 $169.70 n/a 40 $242.99 $227.52 $204.67 $195.56 $171.85 n/a 41 $247.55 $231.80 $208.51 $199.23 $175.07 n/a 42 $251.93 $235.89 $212.20 $202.75 $178.17 n/a 43 $258.01 $241.59 $217.32 $207.65 $182.47 n/a 44 $265.62 $248.71 $223.73 $213.77 $187.85 n/a 45 $274.55 $257.08 $231.25 $220.96 $194.17 n/a 46 $285.20 $267.05 $240.22 $229.53 $201.70 n/a 47 $297.18 $278.26 $250.31 $239.17 $210.17 n/a 48 $310.87 $291.08 $261.84 $250.19 $219.85 n/a 49 $324.37 $303.72 $273.21 $261.05 $229.40 n/a 50 $339.58 $317.97 $286.02 $273.30 $240.15 n/a 51 $354.60 $332.03 $298.68 $285.39 $250.78 n/a 52 $371.14 $347.52 $312.61 $298.70 $262.48 n/a 53 $387.87 $363.19 $326.70 $312.16 $274.31 n/a 54 $405.94 $380.10 $341.92 $326.70 $287.08 n/a 55 $424.00 $397.01 $357.13 $341.24 $299.86 n/a 56 $443.58 $415.35 $373.63 $357.00 $313.71 n/a 57 $463.36 $433.86 $390.28 $372.91 $327.69 n/a 58 $484.46 $453.63 $408.06 $389.90 $342.62 n/a 59 $494.92 $463.42 $416.87 $398.31 $350.01 n/a 60 $516.02 $483.18 $434.64 $415.30 $364.94 n/a 61 $534.28 $500.27 $450.02 $429.99 $377.85 n/a 62 $546.25 $511.49 $460.11 $439.63 $386.32 n/a 63 $561.28 $525.55 $472.76 $451.72 $396.94 n/a 64 + $570.40 $534.10 $480.44 $459.06 $403.40 n/a Counties include: Anoka, Benton, Carver, Clearwater, Dakota, Hennepin, Kittson, Mahnomen, Marshall, Norman, Pennington, Polk, Ramsey, Red Lake, Scott, Sherburne, Stearns, Washington, Wright 6

PreferredOne Copay Plans - Choice Network Rate Area 5, 6, 7 Non-Smoker 0-17 $156.25 $146.31 $131.61 $125.75 $110.50 $79.45 18 $156.25 $146.31 $131.61 $125.75 $110.50 $79.45 19 $156.25 $146.31 $131.61 $125.75 $110.50 $79.45 20 $156.25 $146.31 $131.61 $125.75 $110.50 $79.45 21 $175.56 $164.39 $147.87 $141.29 $124.16 $89.27 22 $175.56 $164.39 $147.87 $141.29 $124.16 $89.27 23 $175.56 $164.39 $147.87 $141.29 $124.16 $89.27 24 $175.56 $164.39 $147.87 $141.29 $124.16 $89.27 25 $176.26 $165.05 $148.47 $141.86 $124.66 $89.63 26 $179.78 $168.33 $151.42 $144.69 $127.14 $91.41 27 $183.99 $172.28 $154.97 $148.08 $130.12 $93.56 28 $190.84 $178.69 $160.74 $153.59 $134.96 $97.04 29 $196.45 $183.95 $165.47 $158.11 $138.94 $99.89 30 $199.26 $186.58 $167.84 $160.37 $140.92 n/a 31 $203.48 $190.53 $171.39 $163.76 $143.90 n/a 32 $207.69 $194.47 $174.94 $167.15 $146.88 n/a 33 $210.32 $196.94 $177.15 $169.27 $148.74 n/a 34 $213.13 $199.57 $179.52 $171.53 $150.73 n/a 35 $214.54 $200.88 $180.70 $172.66 $151.72 n/a 36 $215.94 $202.20 $181.89 $173.79 $152.72 n/a 37 $217.35 $203.51 $183.07 $174.92 $153.71 n/a 38 $218.75 $204.83 $184.25 $176.05 $154.70 n/a 39 $221.56 $207.46 $186.62 $178.31 $156.69 n/a 40 $224.37 $210.09 $188.98 $180.57 $158.68 n/a 41 $228.58 $214.03 $192.53 $183.96 $161.66 n/a 42 $232.62 $217.81 $195.93 $187.21 $164.51 n/a 43 $238.24 $223.07 $200.67 $191.74 $168.49 n/a 44 $245.26 $229.65 $206.58 $197.39 $173.45 n/a 45 $253.51 $237.38 $213.53 $204.03 $179.29 n/a 46 $263.34 $246.58 $221.81 $211.94 $186.24 n/a 47 $274.40 $256.94 $231.13 $220.84 $194.06 n/a 48 $287.04 $268.77 $241.77 $231.02 $203.00 n/a 49 $299.51 $280.45 $252.27 $241.05 $211.82 n/a 50 $313.55 $293.60 $264.10 $252.35 $221.75 n/a 51 $327.42 $306.58 $275.79 $263.51 $231.56 n/a 52 $342.70 $320.89 $288.65 $275.81 $242.36 n/a 53 $358.15 $335.35 $301.66 $288.24 $253.29 n/a 54 $374.83 $350.97 $315.71 $301.66 $265.08 n/a 55 $391.50 $366.58 $329.76 $315.09 $276.88 n/a 56 $409.59 $383.52 $344.99 $329.64 $289.67 n/a 57 $427.85 $400.61 $360.37 $344.33 $302.58 n/a 58 $447.33 $418.86 $376.78 $360.02 $316.36 n/a 59 $456.99 $427.90 $384.92 $367.79 $323.19 n/a 60 $476.48 $446.15 $401.33 $383.47 $336.97 n/a 61 $493.33 $461.93 $415.53 $397.04 $348.89 n/a 62 $504.39 $472.29 $424.84 $405.94 $356.71 n/a 63 $518.26 $485.27 $436.53 $417.10 $366.52 n/a 64 + $526.69 $493.16 $443.62 $423.88 $372.48 n/a Counties include: Aitkin, Becker, Beltrami, Big Stone, Cass, Chippewa, Chisago, Clay, Crow Wing, Douglas, Grant, Hubbard, Isanti, Kanabec, Kandiyohi, Lac Qui Parle. Lyon, McLeod, Meeker, Mille Lacs, Morrison, Otter Tail, Pine, Pope, Renwille, Roseau, Sibley, Stevens, Swift, Todd, Traverse, Wadena, Wilkin, Yellow Medicine 7

PreferredOne Copay Plans - Choice Network Rate Area 5, 6, 7 Smoker 0-17 $156.25 $146.31 $131.61 $125.75 $110.50 $79.45 18 $178.13 $166.79 $150.03 $143.36 $125.97 $90.57 19 $178.13 $166.79 $150.03 $143.36 $125.97 $90.57 20 $178.13 $166.79 $150.03 $143.36 $125.97 $90.57 21 $200.14 $187.40 $168.58 $161.08 $141.54 $101.77 22 $200.14 $187.40 $168.58 $161.08 $141.54 $101.77 23 $200.14 $187.40 $168.58 $161.08 $141.54 $101.77 24 $200.14 $187.40 $168.58 $161.08 $141.54 $101.77 25 $200.94 $188.15 $169.25 $161.72 $142.11 $102.18 26 $204.94 $191.90 $172.62 $164.94 $144.94 $104.21 27 $209.75 $196.40 $176.67 $168.81 $148.34 $106.65 28 $217.55 $203.71 $183.24 $175.09 $153.86 $110.62 29 $223.96 $209.70 $188.64 $180.24 $158.39 $113.88 30 $227.16 $212.70 $191.33 $182.82 $160.65 n/a 31 $231.96 $217.20 $195.38 $186.69 $164.05 n/a 32 $236.77 $221.70 $199.43 $190.55 $167.44 n/a 33 $239.77 $224.51 $201.96 $192.97 $169.57 n/a 34 $242.97 $227.51 $204.65 $195.55 $171.83 n/a 35 $244.57 $229.01 $206.00 $196.83 $172.96 n/a 36 $246.17 $230.50 $207.35 $198.12 $174.10 n/a 37 $247.77 $232.00 $208.70 $199.41 $175.23 n/a 38 $249.38 $233.50 $210.05 $200.70 $176.36 n/a 39 $252.58 $236.50 $212.74 $203.28 $178.63 n/a 40 $255.78 $239.50 $215.44 $205.85 $180.89 n/a 41 $260.58 $244.00 $219.49 $209.72 $184.29 n/a 42 $265.19 $248.31 $223.36 $213.42 $187.54 n/a 43 $271.59 $254.30 $228.76 $218.58 $192.07 n/a 44 $279.60 $261.80 $235.50 $225.02 $197.73 n/a 45 $289.00 $270.61 $243.43 $232.59 $204.39 n/a 46 $300.21 $281.10 $252.87 $241.61 $212.31 n/a 47 $312.82 $292.91 $263.49 $251.76 $221.23 n/a 48 $327.23 $306.40 $275.62 $263.36 $231.42 n/a 49 $341.44 $319.71 $287.59 $274.79 $241.47 n/a 50 $357.45 $334.70 $301.08 $287.68 $252.79 n/a 51 $373.26 $349.50 $314.40 $300.41 $263.98 n/a 52 $390.68 $365.81 $329.06 $314.42 $276.29 n/a 53 $408.29 $382.30 $343.90 $328.59 $288.75 n/a 54 $427.30 $400.10 $359.91 $343.90 $302.19 n/a 55 $446.31 $417.91 $375.93 $359.20 $315.64 n/a 56 $466.93 $437.21 $393.29 $375.79 $330.22 n/a 57 $487.74 $456.70 $410.82 $392.54 $344.94 n/a 58 $509.96 $477.50 $429.53 $410.42 $360.65 n/a 59 $520.97 $487.81 $438.81 $419.28 $368.43 n/a 60 $543.18 $508.61 $457.52 $437.16 $384.15 n/a 61 $562.40 $526.60 $473.70 $452.62 $397.73 n/a 62 $575.00 $538.41 $484.32 $462.77 $406.65 n/a 63 $590.82 $553.21 $497.64 $475.49 $417.83 n/a 64 + $600.42 $562.21 $505.73 $483.23 $424.63 n/a Counties include: Aitkin, Becker, Beltrami, Big Stone, Cass, Chippewa, Chisago, Clay, Crow Wing, Douglas, Grant, Hubbard, Isanti, Kanabec, Kandiyohi, Lac Qui Parle. Lyon, McLeod, Meeker, Mille Lacs, Morrison, Otter Tail, Pine, Pope, Renwille, Roseau, Sibley, Stevens, Swift, Todd, Traverse, Wadena, Wilkin, Yellow Medicine 8

PreferredOne Copay Plans - Choice Network Rate Area 3-4 Non-Smoker 0-17 $171.88 $160.94 $144.77 $138.33 $121.55 $87.40 18 $171.88 $160.94 $144.77 $138.33 $121.55 $87.40 19 $171.88 $160.94 $144.77 $138.33 $121.55 $87.40 20 $171.88 $160.94 $144.77 $138.33 $121.55 $87.40 21 $193.12 $180.83 $162.66 $155.42 $136.58 $98.20 22 $193.12 $180.83 $162.66 $155.42 $136.58 $98.20 23 $193.12 $180.83 $162.66 $155.42 $136.58 $98.20 24 $193.12 $180.83 $162.66 $155.42 $136.58 $98.20 25 $193.89 $181.55 $163.31 $156.05 $137.12 $98.59 26 $197.75 $185.17 $166.57 $159.15 $139.85 $100.55 27 $202.39 $189.51 $170.47 $162.88 $143.13 $102.91 28 $209.92 $196.56 $176.81 $168.95 $148.46 $106.74 29 $216.10 $202.34 $182.02 $173.92 $152.83 $109.88 30 $219.19 $205.24 $184.62 $176.41 $155.01 n/a 31 $223.82 $209.58 $188.53 $180.14 $158.29 n/a 32 $228.46 $213.92 $192.43 $183.87 $161.57 n/a 33 $231.36 $216.63 $194.87 $186.20 $163.62 n/a 34 $234.45 $219.52 $197.47 $188.68 $165.80 n/a 35 $235.99 $220.97 $198.77 $189.93 $166.90 n/a 36 $237.54 $222.42 $200.07 $191.17 $167.99 n/a 37 $239.08 $223.86 $201.38 $192.41 $169.08 n/a 38 $240.63 $225.31 $202.68 $193.66 $170.17 n/a 39 $243.72 $228.20 $205.28 $196.14 $172.36 n/a 40 $246.81 $231.10 $207.88 $198.63 $174.54 n/a 41 $251.44 $235.44 $211.79 $202.36 $177.82 n/a 42 $255.88 $239.60 $215.53 $205.94 $180.96 n/a 43 $262.06 $245.38 $220.73 $210.91 $185.33 n/a 44 $269.79 $252.61 $227.24 $217.13 $190.80 n/a 45 $278.86 $261.11 $234.88 $224.43 $197.22 n/a 46 $289.68 $271.24 $243.99 $233.14 $204.86 n/a 47 $301.84 $282.63 $254.24 $242.93 $213.47 n/a 48 $315.75 $295.65 $265.95 $254.12 $223.30 n/a 49 $329.46 $308.49 $277.50 $265.15 $233.00 n/a 50 $344.91 $322.96 $290.51 $277.59 $243.92 n/a 51 $360.17 $337.24 $303.36 $289.86 $254.71 n/a 52 $376.97 $352.97 $317.52 $303.39 $266.60 n/a 53 $393.96 $368.89 $331.83 $317.06 $278.62 n/a 54 $412.31 $386.06 $347.28 $331.83 $291.59 n/a 55 $430.65 $403.24 $362.74 $346.59 $304.56 n/a 56 $450.55 $421.87 $379.49 $362.60 $318.63 n/a 57 $470.63 $440.67 $396.41 $378.77 $332.84 n/a 58 $492.07 $460.75 $414.46 $396.02 $348.00 n/a 59 $502.69 $470.69 $423.41 $404.57 $355.51 n/a 60 $524.12 $490.76 $441.46 $421.82 $370.67 n/a 61 $542.66 $508.12 $457.08 $436.74 $383.78 n/a 62 $554.83 $519.51 $467.33 $446.53 $392.38 n/a 63 $570.09 $533.80 $480.18 $458.81 $403.17 n/a 64 + $579.36 $542.48 $487.99 $466.27 $409.73 n/a Counties include: Brown, Cottonwood, Jackson, Le Sueur, Lincoln, Martin, Murray, Nicollet, Nobles, Pipestone, Redwood, Rice, Rock, Watonwan 9

PreferredOne Copay Plans - Choice Network Rate Area 3-4 Smoker 0-17 $171.88 $160.94 $144.77 $138.33 $121.55 $87.40 18 $195.94 $183.47 $165.04 $157.69 $138.57 $99.63 19 $195.94 $183.47 $165.04 $157.69 $138.57 $99.63 20 $195.94 $183.47 $165.04 $157.69 $138.57 $99.63 21 $220.16 $206.14 $185.43 $177.18 $155.70 $111.95 22 $220.16 $206.14 $185.43 $177.18 $155.70 $111.95 23 $220.16 $206.14 $185.43 $177.18 $155.70 $111.95 24 $220.16 $206.14 $185.43 $177.18 $155.70 $111.95 25 $221.04 $206.97 $186.18 $177.89 $156.32 $112.39 26 $225.44 $211.09 $189.89 $181.44 $159.43 $114.63 27 $230.72 $216.04 $194.34 $185.69 $163.17 $117.32 28 $239.31 $224.08 $201.57 $192.60 $169.24 $121.69 29 $246.35 $230.67 $207.50 $198.27 $174.22 $125.27 30 $249.88 $233.97 $210.47 $201.10 $176.72 n/a 31 $255.16 $238.92 $214.92 $205.35 $180.45 n/a 32 $260.44 $243.87 $219.37 $209.61 $184.19 n/a 33 $263.75 $246.96 $222.15 $212.26 $186.52 n/a 34 $267.27 $250.26 $225.12 $215.10 $189.02 n/a 35 $269.03 $251.91 $226.60 $216.52 $190.26 n/a 36 $270.79 $253.56 $228.08 $217.93 $191.51 n/a 37 $272.55 $255.20 $229.57 $219.35 $192.75 n/a 38 $274.31 $256.85 $231.05 $220.77 $194.00 n/a 39 $277.84 $260.15 $234.02 $223.60 $196.49 n/a 40 $281.36 $263.45 $236.99 $226.44 $198.98 n/a 41 $286.64 $268.40 $241.44 $230.69 $202.72 n/a 42 $291.71 $273.14 $245.70 $234.77 $206.30 n/a 43 $298.75 $279.74 $251.63 $240.44 $211.28 n/a 44 $307.56 $287.98 $259.05 $247.52 $217.51 n/a 45 $317.90 $297.67 $267.77 $255.85 $224.83 n/a 46 $330.23 $309.21 $278.15 $265.77 $233.54 n/a 47 $344.10 $322.20 $289.83 $276.94 $243.35 n/a 48 $359.95 $337.04 $303.19 $289.69 $254.56 n/a 49 $375.58 $351.68 $316.35 $302.27 $265.62 n/a 50 $393.20 $368.17 $331.19 $316.45 $278.07 n/a 51 $410.59 $384.46 $345.84 $330.45 $290.37 n/a 52 $429.74 $402.39 $361.97 $345.86 $303.92 n/a 53 $449.12 $420.53 $378.29 $361.45 $317.62 n/a 54 $470.03 $440.11 $395.90 $378.29 $332.41 n/a 55 $490.95 $459.70 $413.52 $395.12 $347.20 n/a 56 $513.62 $480.93 $432.62 $413.37 $363.24 n/a 57 $536.52 $502.37 $451.90 $431.79 $379.43 n/a 58 $560.96 $525.25 $472.49 $451.46 $396.72 n/a 59 $573.06 $536.59 $482.69 $461.21 $405.28 n/a 60 $597.50 $559.47 $503.27 $480.87 $422.56 n/a 61 $618.64 $579.26 $521.07 $497.88 $437.51 n/a 62 $632.51 $592.25 $532.75 $509.05 $447.32 n/a 63 $649.90 $608.53 $547.40 $523.04 $459.62 n/a 64 + $660.47 $618.43 $556.30 $531.55 $467.09 n/a Counties include: Brown, Cottonwood, Jackson, Le Sueur, Lincoln, Martin, Murray, Nicollet, Nobles, Pipestone, Redwood, Rice, Rock, Watonwan 10

PreferredOne Copay Plans - Choice Network Rate Area 2 Non-Smoker 0-17 $179.69 $168.25 $151.35 $144.61 $127.08 $91.37 18 $179.69 $168.25 $151.35 $144.61 $127.08 $91.37 19 $179.69 $168.25 $151.35 $144.61 $127.08 $91.37 20 $179.69 $168.25 $151.35 $144.61 $127.08 $91.37 21 $201.90 $189.05 $170.06 $162.49 $142.78 $102.66 22 $201.90 $189.05 $170.06 $162.49 $142.78 $102.66 23 $201.90 $189.05 $170.06 $162.49 $142.78 $102.66 24 $201.90 $189.05 $170.06 $162.49 $142.78 $102.66 25 $202.70 $189.80 $170.74 $163.14 $143.36 $103.07 26 $206.74 $193.58 $174.14 $166.39 $146.21 $105.13 27 $211.59 $198.12 $178.22 $170.29 $149.64 $107.59 28 $219.46 $205.49 $184.85 $176.62 $155.21 $111.59 29 $225.92 $211.54 $190.29 $181.82 $159.78 $114.88 30 $229.15 $214.57 $193.01 $184.42 $162.06 n/a 31 $234.00 $219.10 $197.09 $188.32 $165.49 n/a 32 $238.84 $223.64 $201.18 $192.22 $168.91 n/a 33 $241.87 $226.48 $203.73 $194.66 $171.06 n/a 34 $245.10 $229.50 $206.45 $197.26 $173.34 n/a 35 $246.72 $231.01 $207.81 $198.56 $174.48 n/a 36 $248.33 $232.53 $209.17 $199.86 $175.62 n/a 37 $249.95 $234.04 $210.53 $201.16 $176.77 n/a 38 $251.56 $235.55 $211.89 $202.46 $177.91 n/a 39 $254.79 $238.58 $214.61 $205.06 $180.19 n/a 40 $258.02 $241.60 $217.33 $207.66 $182.48 n/a 41 $262.87 $246.14 $221.41 $211.56 $185.90 n/a 42 $267.51 $250.49 $225.32 $215.30 $189.19 n/a 43 $273.97 $256.54 $230.77 $220.50 $193.76 n/a 44 $282.05 $264.10 $237.57 $227.00 $199.47 n/a 45 $291.54 $272.98 $245.56 $234.63 $206.18 n/a 46 $302.84 $283.57 $255.08 $243.73 $214.18 n/a 47 $315.56 $295.48 $265.80 $253.97 $223.17 n/a 48 $330.10 $309.09 $278.04 $265.67 $233.45 n/a 49 $344.44 $322.51 $290.12 $277.20 $243.59 n/a 50 $360.59 $337.64 $303.72 $290.20 $255.01 n/a 51 $376.54 $352.57 $317.15 $303.04 $266.29 n/a 52 $394.10 $369.02 $331.95 $317.18 $278.71 n/a 53 $411.87 $385.65 $346.91 $331.48 $291.28 n/a 54 $431.05 $403.61 $363.07 $346.91 $304.84 n/a 55 $450.23 $421.57 $379.22 $362.35 $318.41 n/a 56 $471.02 $441.04 $396.74 $379.08 $333.12 n/a 57 $492.02 $460.71 $414.43 $395.98 $347.96 n/a 58 $514.43 $481.69 $433.30 $414.02 $363.81 n/a 59 $525.54 $492.09 $442.66 $422.96 $371.67 n/a 60 $547.95 $513.07 $461.53 $440.99 $387.52 n/a 61 $567.33 $531.22 $477.86 $456.59 $401.22 n/a 62 $580.05 $543.13 $488.57 $466.83 $410.22 n/a 63 $596.00 $558.06 $502.00 $479.67 $421.50 n/a 64 + $605.69 $567.14 $510.17 $487.46 $428.35 n/a Counties include: Carlton, Itasca, Koochiching, Lake of the Woods, St. Louis 11

PreferredOne Copay Plans - Choice Network Rate Area 2 Smoker 0-17 $179.69 $168.25 $151.35 $144.61 $127.08 $91.37 18 $204.84 $191.81 $172.54 $164.86 $144.87 $104.16 19 $204.84 $191.81 $172.54 $164.86 $144.87 $104.16 20 $204.84 $191.81 $172.54 $164.86 $144.87 $104.16 21 $230.16 $215.51 $193.86 $185.24 $162.77 $117.03 22 $230.16 $215.51 $193.86 $185.24 $162.77 $117.03 23 $230.16 $215.51 $193.86 $185.24 $162.77 $117.03 24 $230.16 $215.51 $193.86 $185.24 $162.77 $117.03 25 $231.08 $216.37 $194.64 $185.98 $163.42 $117.50 26 $235.69 $220.68 $198.52 $189.68 $166.68 $119.84 27 $241.21 $225.86 $203.17 $194.13 $170.59 $122.65 28 $250.19 $234.26 $210.73 $201.35 $176.94 $127.22 29 $257.55 $241.16 $216.93 $207.28 $182.14 $130.96 30 $261.23 $244.61 $220.04 $210.24 $184.75 n/a 31 $266.76 $249.78 $224.69 $214.69 $188.65 n/a 32 $272.28 $254.95 $229.34 $219.13 $192.56 n/a 33 $275.73 $258.18 $232.25 $221.91 $195.00 n/a 34 $279.42 $261.63 $235.35 $224.88 $197.61 n/a 35 $281.26 $263.36 $236.90 $226.36 $198.91 n/a 36 $283.10 $265.08 $238.45 $227.84 $200.21 n/a 37 $284.94 $266.80 $240.00 $229.32 $201.51 n/a 38 $286.78 $268.53 $241.55 $230.80 $202.82 n/a 39 $290.46 $271.98 $244.66 $233.77 $205.42 n/a 40 $294.15 $275.42 $247.76 $236.73 $208.02 n/a 41 $299.67 $280.60 $252.41 $241.18 $211.93 n/a 42 $304.96 $285.55 $256.87 $245.44 $215.68 n/a 43 $312.33 $292.45 $263.07 $251.37 $220.88 n/a 44 $321.54 $301.07 $270.83 $258.78 $227.39 n/a 45 $332.35 $311.20 $279.94 $267.48 $235.05 n/a 46 $345.24 $323.27 $290.80 $277.85 $244.16 n/a 47 $359.74 $336.85 $303.01 $289.52 $254.42 n/a 48 $376.32 $352.36 $316.97 $302.86 $266.14 n/a 49 $392.66 $367.66 $330.73 $316.01 $277.69 n/a 50 $411.07 $384.91 $346.24 $330.83 $290.71 n/a 51 $429.25 $401.93 $361.56 $345.47 $303.57 n/a 52 $449.28 $420.68 $378.42 $361.58 $317.73 n/a 53 $469.53 $439.65 $395.48 $377.88 $332.06 n/a 54 $491.40 $460.12 $413.90 $395.48 $347.52 n/a 55 $513.26 $480.59 $432.32 $413.08 $362.99 n/a 56 $536.97 $502.79 $452.28 $432.16 $379.75 n/a 57 $560.91 $525.20 $472.45 $451.42 $396.68 n/a 58 $586.45 $549.13 $493.96 $471.98 $414.75 n/a 59 $599.11 $560.98 $504.63 $482.17 $423.70 n/a 60 $624.66 $584.90 $526.15 $502.73 $441.77 n/a 61 $646.76 $605.59 $544.76 $520.51 $457.39 n/a 62 $661.26 $619.17 $556.97 $532.18 $467.65 n/a 63 $679.44 $636.19 $572.29 $546.82 $480.51 n/a 64 + $690.49 $646.54 $581.59 $555.71 $488.32 n/a Counties include: Carlton, Itasca, Koochiching, Lake of the Woods, St. Louis 12

PreferredOne Copay Plans - Select Network Rate Area 7 Non-Smoker 0-17 $140.67 $131.72 $118.46 $113.15 $99.45 $71.50 18 $140.67 $131.72 $118.46 $113.15 $99.45 $71.50 19 $140.67 $131.72 $118.46 $113.15 $99.45 $71.50 20 $140.67 $131.72 $118.46 $113.15 $99.45 $71.50 21 $158.06 $148.00 $133.10 $127.14 $111.74 $80.33 22 $158.06 $148.00 $133.10 $127.14 $111.74 $80.33 23 $158.06 $148.00 $133.10 $127.14 $111.74 $80.33 24 $158.06 $148.00 $133.10 $127.14 $111.74 $80.33 25 $158.69 $148.59 $133.63 $127.65 $112.19 $80.65 26 $161.85 $151.55 $136.29 $130.19 $114.43 $82.26 27 $165.64 $155.10 $139.49 $133.24 $117.11 $84.19 28 $171.81 $160.87 $144.68 $138.20 $121.47 $87.32 29 $176.86 $165.61 $148.94 $142.27 $125.04 $89.89 30 $179.39 $167.98 $151.07 $144.30 $126.83 n/a 31 $183.19 $171.53 $154.26 $147.36 $129.51 n/a 32 $186.98 $175.08 $157.46 $150.41 $132.19 n/a 33 $189.35 $177.30 $159.45 $152.31 $133.87 n/a 34 $191.88 $179.67 $161.58 $154.35 $135.66 n/a 35 $193.14 $180.85 $162.65 $155.36 $136.55 n/a 36 $194.41 $182.04 $163.71 $156.38 $137.45 n/a 37 $195.67 $183.22 $164.78 $157.40 $138.34 n/a 38 $196.94 $184.41 $165.84 $158.42 $139.23 n/a 39 $199.47 $186.77 $167.97 $160.45 $141.02 n/a 40 $202.00 $189.14 $170.10 $162.48 $142.81 n/a 41 $205.79 $192.69 $173.30 $165.54 $145.49 n/a 42 $209.42 $196.10 $176.36 $168.46 $148.06 n/a 43 $214.48 $200.83 $180.62 $172.53 $151.64 n/a 44 $220.80 $206.75 $185.94 $177.61 $156.11 n/a 45 $228.23 $213.71 $192.20 $183.59 $161.36 n/a 46 $237.08 $222.00 $199.65 $190.71 $167.62 n/a 47 $247.04 $231.32 $208.03 $198.72 $174.66 n/a 48 $258.42 $241.98 $217.62 $207.87 $182.70 n/a 49 $269.64 $252.49 $227.07 $216.90 $190.64 n/a 50 $282.29 $264.33 $237.72 $227.07 $199.57 n/a 51 $294.77 $276.02 $248.23 $237.12 $208.40 n/a 52 $308.52 $288.89 $259.81 $248.18 $218.12 n/a 53 $322.43 $301.92 $271.52 $259.37 $227.96 n/a 54 $337.45 $315.98 $284.17 $271.44 $238.57 n/a 55 $352.46 $330.04 $296.81 $283.52 $249.19 n/a 56 $368.74 $345.28 $310.52 $296.62 $260.70 n/a 57 $385.18 $360.67 $324.36 $309.84 $272.32 n/a 58 $402.73 $377.10 $339.14 $323.95 $284.72 n/a 59 $411.42 $385.24 $346.46 $330.95 $290.87 n/a 60 $428.96 $401.67 $361.23 $345.06 $303.27 n/a 61 $444.14 $415.88 $374.01 $357.26 $314.00 n/a 62 $454.09 $425.20 $382.39 $365.27 $321.04 n/a 63 $466.58 $436.89 $392.91 $375.32 $329.87 n/a 64 + $474.17 $444.00 $399.30 $381.42 $335.23 n/a Counties include: Chisago 13

PreferredOne Copay Plans - Select Network Rate Area 7 Smoker 0-17 $140.67 $131.72 $118.46 $113.15 $99.45 $71.50 18 $160.36 $150.16 $135.04 $129.00 $113.38 $81.50 19 $160.36 $150.16 $135.04 $129.00 $113.38 $81.50 20 $160.36 $150.16 $135.04 $129.00 $113.38 $81.50 21 $180.18 $168.72 $151.73 $144.94 $127.39 $91.58 22 $180.18 $168.72 $151.73 $144.94 $127.39 $91.58 23 $180.18 $168.72 $151.73 $144.94 $127.39 $91.58 24 $180.18 $168.72 $151.73 $144.94 $127.39 $91.58 25 $180.90 $169.39 $152.34 $145.52 $127.90 $91.94 26 $184.51 $172.77 $155.38 $148.42 $130.45 $93.78 27 $188.83 $176.82 $159.02 $151.90 $133.50 $95.97 28 $195.86 $183.40 $164.93 $157.55 $138.47 $99.55 29 $201.63 $188.80 $169.79 $162.19 $142.55 $102.48 30 $204.51 $191.50 $172.22 $164.51 $144.59 n/a 31 $208.83 $195.54 $175.86 $167.98 $147.64 n/a 32 $213.16 $199.59 $179.50 $171.46 $150.70 n/a 33 $215.86 $202.12 $181.78 $173.64 $152.61 n/a 34 $218.74 $204.82 $184.20 $175.96 $154.65 n/a 35 $220.18 $206.17 $185.42 $177.12 $155.67 n/a 36 $221.63 $207.52 $186.63 $178.28 $156.69 n/a 37 $223.07 $208.87 $187.85 $179.43 $157.71 n/a 38 $224.51 $210.22 $189.06 $180.59 $158.73 n/a 39 $227.39 $212.92 $191.49 $182.91 $160.76 n/a 40 $230.27 $215.62 $193.92 $185.23 $162.80 n/a 41 $234.60 $219.67 $197.56 $188.71 $165.86 n/a 42 $238.74 $223.55 $201.05 $192.04 $168.79 n/a 43 $244.51 $228.95 $205.90 $196.68 $172.87 n/a 44 $251.72 $235.70 $211.97 $202.48 $177.96 n/a 45 $260.18 $243.63 $219.10 $209.29 $183.95 n/a 46 $270.28 $253.08 $227.60 $217.41 $191.08 n/a 47 $281.63 $263.71 $237.16 $226.54 $199.11 n/a 48 $294.60 $275.85 $248.08 $236.98 $208.28 n/a 49 $307.39 $287.83 $258.86 $247.27 $217.32 n/a 50 $321.81 $301.33 $271.00 $258.86 $227.52 n/a 51 $336.04 $314.66 $282.98 $270.31 $237.58 n/a 52 $351.72 $329.34 $296.18 $282.92 $248.66 n/a 53 $367.57 $344.19 $309.54 $295.68 $259.87 n/a 54 $384.69 $360.21 $323.95 $309.45 $271.97 n/a 55 $401.81 $376.24 $338.37 $323.21 $284.08 n/a 56 $420.37 $393.62 $353.99 $338.14 $297.20 n/a 57 $439.11 $411.17 $369.77 $353.22 $310.44 n/a 58 $459.11 $429.89 $386.62 $369.31 $324.59 n/a 59 $469.02 $439.17 $394.96 $377.28 $331.59 n/a 60 $489.02 $457.90 $411.80 $393.37 $345.73 n/a 61 $506.32 $474.10 $426.37 $407.28 $357.96 n/a 62 $517.67 $484.73 $435.93 $416.41 $365.99 n/a 63 $531.90 $498.06 $447.92 $427.86 $376.05 n/a 64 + $540.55 $506.16 $455.20 $434.82 $382.16 n/a Counties include: Chisago 14

PreferredOne Copay Plans - Select Network Rate Area 8 Non-Smoker 0-17 $133.64 $125.13 $112.54 $107.50 $94.48 $67.92 18 $133.64 $125.13 $112.54 $107.50 $94.48 $67.92 19 $133.64 $125.13 $112.54 $107.50 $94.48 $67.92 20 $133.64 $125.13 $112.54 $107.50 $94.48 $67.92 21 $150.15 $140.60 $126.44 $120.78 $106.16 $76.31 22 $150.15 $140.60 $126.44 $120.78 $106.16 $76.31 23 $150.15 $140.60 $126.44 $120.78 $106.16 $76.31 24 $150.15 $140.60 $126.44 $120.78 $106.16 $76.31 25 $150.75 $141.16 $126.95 $121.27 $106.58 $76.62 26 $153.76 $143.97 $129.48 $123.68 $108.70 $78.15 27 $157.36 $147.35 $132.51 $126.58 $111.25 $79.98 28 $163.22 $152.83 $137.45 $131.29 $115.39 $82.95 29 $168.02 $157.33 $141.49 $135.16 $118.79 $85.40 30 $170.42 $159.58 $143.51 $137.09 $120.49 n/a 31 $174.03 $162.95 $146.55 $139.99 $123.04 n/a 32 $177.63 $166.33 $149.58 $142.89 $125.58 n/a 33 $179.88 $168.44 $151.48 $144.70 $127.18 n/a 34 $182.29 $170.69 $153.50 $146.63 $128.87 n/a 35 $183.49 $171.81 $154.52 $147.60 $129.72 n/a 36 $184.69 $172.94 $155.53 $148.56 $130.57 n/a 37 $185.89 $174.06 $156.54 $149.53 $131.42 n/a 38 $187.09 $175.19 $157.55 $150.50 $132.27 n/a 39 $189.49 $177.44 $159.57 $152.43 $133.97 n/a 40 $191.90 $179.69 $161.60 $154.36 $135.67 n/a 41 $195.50 $183.06 $164.63 $157.26 $138.22 n/a 42 $198.95 $186.29 $167.54 $160.04 $140.66 n/a 43 $203.76 $190.79 $171.59 $163.90 $144.05 n/a 44 $209.76 $196.42 $176.64 $168.73 $148.30 n/a 45 $216.82 $203.02 $182.59 $174.41 $153.29 n/a 46 $225.23 $210.90 $189.67 $181.17 $159.24 n/a 47 $234.69 $219.76 $197.63 $188.78 $165.92 n/a 48 $245.50 $229.88 $206.74 $197.48 $173.57 n/a 49 $256.16 $239.86 $215.71 $206.06 $181.10 n/a 50 $268.17 $251.11 $225.83 $215.72 $189.60 n/a 51 $280.04 $262.22 $235.82 $225.26 $197.98 n/a 52 $293.10 $274.45 $246.82 $235.77 $207.22 n/a 53 $306.31 $286.82 $257.95 $246.40 $216.56 n/a 54 $320.58 $300.18 $269.96 $257.87 $226.64 n/a 55 $334.84 $313.54 $281.97 $269.35 $236.73 n/a 56 $350.31 $328.02 $295.00 $281.79 $247.66 n/a 57 $365.92 $342.64 $308.15 $294.35 $258.70 n/a 58 $382.59 $358.25 $322.18 $307.75 $270.49 n/a 59 $390.85 $365.98 $329.14 $314.40 $276.33 n/a 60 $407.51 $381.59 $343.17 $327.80 $288.11 n/a 61 $421.93 $395.08 $355.31 $339.40 $298.30 n/a 62 $431.39 $403.94 $363.28 $347.01 $304.99 n/a 63 $443.25 $415.05 $373.26 $356.55 $313.37 n/a 64 + $450.46 $421.80 $379.33 $362.35 $318.47 n/a Counties include: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Sherburne, Washington 15

PreferredOne Copay Plans - Select Network Rate Area 8 Smoker 0-17 $133.64 $125.13 $112.54 $107.50 $94.48 $67.92 18 $152.35 $142.65 $128.29 $122.55 $107.71 $77.43 19 $152.35 $142.65 $128.29 $122.55 $107.71 $77.43 20 $152.35 $142.65 $128.29 $122.55 $107.71 $77.43 21 $171.17 $160.28 $144.15 $137.69 $121.02 $87.00 22 $171.17 $160.28 $144.15 $137.69 $121.02 $87.00 23 $171.17 $160.28 $144.15 $137.69 $121.02 $87.00 24 $171.17 $160.28 $144.15 $137.69 $121.02 $87.00 25 $171.86 $160.92 $144.72 $138.24 $121.50 $87.35 26 $175.28 $164.13 $147.61 $141.00 $123.92 $89.09 27 $179.39 $167.98 $151.07 $144.30 $126.83 $91.17 28 $186.07 $174.23 $156.69 $149.67 $131.55 $94.57 29 $191.54 $179.36 $161.30 $154.08 $135.42 $97.35 30 $194.28 $181.92 $163.61 $156.28 $137.36 n/a 31 $198.39 $185.77 $167.07 $159.59 $140.26 n/a 32 $202.50 $189.61 $170.53 $162.89 $143.17 n/a 33 $205.07 $192.02 $172.69 $164.96 $144.98 n/a 34 $207.81 $194.58 $174.99 $167.16 $146.92 n/a 35 $209.17 $195.87 $176.15 $168.26 $147.88 n/a 36 $210.54 $197.15 $177.30 $169.36 $148.85 n/a 37 $211.91 $198.43 $178.45 $170.46 $149.82 n/a 38 $213.28 $199.71 $179.61 $171.56 $150.79 n/a 39 $216.02 $202.28 $181.91 $173.77 $152.73 n/a 40 $218.76 $204.84 $184.22 $175.97 $154.66 n/a 41 $222.87 $208.69 $187.68 $179.28 $157.57 n/a 42 $226.81 $212.37 $190.99 $182.44 $160.35 n/a 43 $232.28 $217.50 $195.61 $186.85 $164.22 n/a 44 $239.13 $223.91 $201.37 $192.36 $169.06 n/a 45 $247.18 $231.45 $208.15 $198.83 $174.75 n/a 46 $256.76 $240.42 $216.22 $206.54 $181.53 n/a 47 $267.55 $250.52 $225.30 $215.21 $189.15 n/a 48 $279.87 $262.06 $235.68 $225.13 $197.87 n/a 49 $292.02 $273.44 $245.91 $234.90 $206.46 n/a 50 $305.72 $286.26 $257.45 $245.92 $216.14 n/a 51 $319.24 $298.93 $268.83 $256.80 $225.70 n/a 52 $334.13 $312.87 $281.37 $268.78 $236.23 n/a 53 $349.20 $326.98 $294.06 $280.89 $246.88 n/a 54 $365.46 $342.20 $307.75 $293.97 $258.38 n/a 55 $381.72 $357.43 $321.45 $307.05 $269.87 n/a 56 $399.35 $373.94 $336.29 $321.24 $282.34 n/a 57 $417.15 $390.61 $351.29 $335.56 $294.92 n/a 58 $436.15 $408.40 $367.29 $350.84 $308.36 n/a 59 $445.57 $417.22 $375.21 $358.41 $315.01 n/a 60 $464.57 $435.01 $391.21 $373.70 $328.44 n/a 61 $481.00 $450.39 $405.05 $386.92 $340.06 n/a 62 $491.78 $460.49 $414.13 $395.59 $347.69 n/a 63 $505.31 $473.15 $425.52 $406.47 $357.25 n/a 64 + $513.52 $480.85 $432.44 $413.08 $363.06 n/a Counties include: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Sherburne, Washington 16 1/2014