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 Rulemaking 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.