| Single/Family | Deductible | Cost per month | Cost per year |
| Single | $200 | $385.71 | $4,628.52 |
| Single | $500 | $347.37 | $4,168.44 |
| Single | $2,000 | $281.29 | $3,375.48 |
| Family | $200/$600 | $799.96 | $9,599.52 |
| Family | $500/$1,000 | $720.45 | $8,645.40 |
| Family | $2,000/$4,000 | $582.26 | $6,987.12 |