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2024 Plan Documents

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Individual Plans

Small Group Plans

Primary Care Physician (PCP) referrals are not required for any of our plans.

Individual Plans

Small Group Plans

Gold Plans

Gold PPO 90 4500 BSW Plus PPO
Gold PPO 100 4000 BSW Plus PPO
Gold PPO 100 3500 BSW Plus PPO
Gold PPO HSA 3700 BSW Plus PPO
Gold PPO 100 3000 BSW Plus PPO
Gold PPO 80 3000 BSW Plus PPO
Gold PPO HSA 3300 BSW Plus PPO
Gold PPO 100 2300 BSW Plus PPO
Gold PPO 90 2000 BSW Plus PPO
Gold PPO 90 1900 BSW Plus PPO
Gold PPO 80 1500 BSW Plus PPO
Gold PPO 80 1000 BSW Plus PPO
Gold PPO 80 750 BSW Plus PPO
Gold PPO copayment 0 7000 BSW Plus PPO
Gold HMO 90 4500 BSW Premier HMO
Gold HMO 100 4000 BSW Premier HMO
Gold HMO 100 3500 BSW Premier HMO
Gold HMO HSA 3700 BSW Premier HMO
Gold HMO 100 3000 BSW Premier HMO
Gold HMO HSA 3300 BSW Premier HMO
Gold HMO 100 2300 BSW Premier HMO
Gold HMO 90 2000 BSW Premier HMO
Gold HMO 90 1900 BSW Premier HMO
Gold HMO 80 3000 BSW Premier HMO
Gold HMO 80 1500 BSW Premier HMO
Gold HMO 80 1000 BSW Premier HMO
Gold HMO 80 750 BSW Premier HMO
Gold HMO copayment 0 7000 BSW Premier HMO
Gold HMO SM 0 9200 BSW Premier HMO
Gold HMO 90 4500 BSW Plus HMO
Gold HMO 100 4000 BSW Plus HMO
Gold HMO 100 3500 BSW Plus HMO
Gold HMO HSA 3700 BSW Plus HMO
Gold HMO 100 3000 BSW Plus HMO
Gold HMO 80 3000 BSW Plus HMO
Gold HMO HSA 3300 BSW Plus HMO
Gold HMO 100 2300 BSW Plus HMO
Gold HMO 90 2000 BSW Plus HMO
Gold HMO 90 1900 BSW Plus HMO
Gold HMO 80 1500 BSW Plus HMO
Gold HMO 80 1000 BSW Plus HMO
Gold HMO 80 750 BSW Plus HMO
Gold HMO copayment 0 7000 BSW Plus HMO
Gold HMO SM 0 9200 BSW Plus HMO
Gold PPO 90 4500 BSW Access PPO
Gold PPO 100 4000 BSW Access PPO
Gold PPO HSA 3700 BSW Access PPO
Gold PPO 100 3500 BSW Access PPO
Gold PPO HSA 3300 BSW Access PPO
Gold PPO 100 3000 BSW Access PPO
Gold PPO 80 3000 BSW Access PPO
Gold PPO 100 2300 BSW Access PPO
Gold PPO 90 2000 BSW Access PPO
Gold PPO 90 1900 BSW Access PPO
Gold PPO 80 1500 BSW Access PPO
Gold PPO 80 1000 BSW Access PPO
Gold PPO 80 750 BSW Access PPO
Gold PPO copayment 0 7000 BSW Access PPO

Gold PPO 90 4500 BSW Plus PPO
Gold PPO 100 4000 BSW Plus PPO
Gold PPO 100 3500 BSW Plus PPO
Gold PPO HSA 3700 BSW Plus PPO
Gold PPO 100 3000 BSW Plus PPO
Gold PPO 80 3000 BSW Plus PPO
Gold PPO HSA 3300 BSW Plus PPO
Gold PPO 100 2300 BSW Plus PPO
Gold PPO 90 2000 BSW Plus PPO
Gold PPO 90 1900 BSW Plus PPO
Gold PPO 80 1500 BSW Plus PPO
Gold PPO 80 750 BSW Plus PPO
Gold PPO copayment 0 7000 BSW Plus PPO
Gold HMO 90 4500 BSW Premier HMO
Gold HMO 100 4000 BSW Premier HMO
Gold HMO 100 3500 BSW Premier HMO
Gold HMO HSA 3700 BSW Premier HMO
Gold HMO 100 3000 BSW Premier HMO
Gold HMO HSA 3300 BSW Premier HMO
Gold HMO 100 2300 BSW Premier HMO
Gold HMO 90 2000 BSW Premier HMO
Gold HMO 90 1900 BSW Premier HMO
Gold HMO 80 3000 BSW Premier HMO
Gold HMO 80 1500 BSW Premier HMO
Gold HMO 80 1000 BSW Premier HMO
Gold HMO 80 750 BSW Premier HMO
Gold HMO copayment 0 7000 BSW Premier HMO
Gold HMO SM 0 9200 BSW Premier HMO
Gold HMO 90 4500 BSW Plus HMO
Gold HMO 100 4000 BSW Plus HMO
Gold HMO 100 3500 BSW Plus HMO
Gold HMO HSA 3700 BSW Plus HMO
Gold HMO 100 3000 BSW Plus HMO
Gold HMO 80 3000 BSW Plus HMO
Gold HMO HSA 3300 BSW Plus HMO
Gold HMO 100 2300 BSW Plus HMO
Gold HMO 90 2000 BSW Plus HMO
Gold HMO 90 1900 BSW Plus HMO
Gold HMO 80 1500 BSW Plus HMO
Gold HMO 80 1000 BSW Plus HMO
Gold HMO 80 750 BSW Plus HMO
Gold HMO copayment 0 7000 BSW Plus HMO
Gold HMO SM 0 9450 BSW Plus HMO
Gold PPO 90 4500 BSW Access PPO
Gold PPO 100 4000 BSW Access PPO
Gold PPO 100 3500 BSW Access PPO
Gold PPO HSA 3700 BSW Access PPO
Gold PPO 100 3000 BSW Access PPO
Gold PPO HSA 3300 BSW Access PPO
Gold PPO 100 2300 BSW Access PPO
Gold PPO 90 2000 BSW Access PPO
Gold PPO 90 1900 BSW Access PPO
Gold PPO 80 1500 BSW Access PPO
Gold PPO 80 1000 BSW Access PPO
Gold PPO 80 750 BSW Access PPO
Gold PPO copayment 0 7000 BSW Access PPO

Gold PPO 90 4500 BSW Plus PPO
Gold PPO 100 4000 BSW Plus PPO
Gold PPO 100 3500 BSW Plus PPO
Gold PPO HSA 3700 BSW Plus PPO
Gold PPO 100 3000 BSW Plus PPO
Gold PPO HSA 3300 BSW Plus PPO
Gold PPO 100 2300 BSW Plus PPO
Gold PPO 90 2000 BSW Plus PPO
Gold PPO 90 1900 BSW Plus PPO
Gold PPO 80 1500 BSW Plus PPO
Gold PPO 80 1000 BSW Plus PPO
Gold PPO 80 750 BSW Plus PPO
Gold PPO copayment 0 7000 BSW Plus PPO
Gold HMO 90 4500 BSW Premier HMO
Gold HMO 100 4000 BSW Premier HMO
Gold HMO 100 3500 BSW Premier HMO
Gold HMO HSA 3700 BSW Premier HMO
Gold HMO 100 3000 BSW Premier HMO
Gold HMO HSA 3300 BSW Premier HMO
Gold HMO 100 2300 BSW Premier HMO
Gold HMO 90 2000 BSW Premier HMO
Gold HMO 90 1900 BSW Premier HMO
Gold HMO 80 1500 BSW Premier HMO
Gold HMO 80 1000 BSW Premier HMO
Gold HMO 80 750 BSW Premier HMO
Gold HMO copayment 0 7000 BSW Premier HMO
Gold HMO SM 0 9200 BSW Premier HMO
Gold HMO 90 4500 BSW Plus HMO
Gold HMO 100 4000 BSW Plus HMO
Gold HMO 100 3500 BSW Plus HMO
Gold HMO HSA 3700 BSW Plus HMO
Gold HMO 100 3000 BSW Plus HMO
Gold HMO HSA 3300 BSW Plus HMO
Gold HMO 100 2300 BSW Plus HMO
Gold HMO 90 2000 BSW Plus HMO
Gold HMO 90 1900 BSW Plus HMO
Gold HMO 80 1500 BSW Plus HMO
Gold HMO 80 1000 BSW Plus HMO
Gold HMO 80 750 BSW Plus HMO
Gold HMO copayment 0 7000 BSW Plus HMO
Gold HMO SM 0 9200 BSW Plus HMO
Gold PPO 90 4500 BSW Access PPO
Gold PPO 100 4000 BSW Access PPO
Gold PPO 100 3500 BSW Access PPO
Gold PPO HSA 3700 BSW Access PPO
Gold PPO 100 3000 BSW Access PPO
Gold PPO HSA 3300 BSW Access PPO
Gold PPO 100 2300 BSW Access PPO
Gold PPO 90 2000 BSW Access PPO
Gold PPO 90 1900 BSW Access PPO
Gold PPO 80 1500 BSW Access PPO
Gold PPO 80 1000 BSW Access PPO
Gold PPO 80 750 BSW Access PPO
Gold PPO copayment 0 7000 BSW Access PPO

Silver Plans

Silver PPO 80 8900 BSW Plus PPO
Silver PPO 80 7500 BSW Plus PPO
Silver PPO 100 7300 BSW Plus PPO
Silver PPO 90 7000 BSW Plus PPO
Silver PPO 80 6900 BSW Plus PPO
Silver PPO 70 6700 BSW Plus PPO
Silver PPO 90 6500 BSW Plus PPO
Silver PPO 80 6250 BSW Plus PPO
Silver PPO HSA 6200 BSW Plus PPO
Silver PPO 90 5900 BSW Plus PPO
Silver PPO 80 5000 BSW Plus PPO
Silver PPO HSA 5100 BSW Plus PPO
Silver PPO 70 4500 BSW Plus PPO
Silver PPO 80 4250 BSW Plus PPO
Silver PPO 70 3800 BSW Plus PPO
Silver PPO 60 3250 BSW Plus PPO
Silver PPO 90 750 BSW Plus PPO
Silver HMO 80 8900 BSW Premier HMO
Silver HMO 80 7500 BSW Premier HMO
Silver HMO 100 7300 BSW Premier HMO
Silver HMO 90 7000 BSW Premier HMO
Silver HMO 80 6900 BSW Premier HMO
Silver HMO 70 6700 BSW Premier HMO
Silver HMO 90 6500 BSW Premier HMO
Silver HMO 80 6250 BSW Premier HMO
Silver HMO HSA 6200 BSW Premier HMO
Silver HMO 90 5900 BSW Premier HMO
Silver HMO 80 5000 BSW Premier HMO
Silver HMO HSA 5100 BSW Premier HMO
Silver HMO 70 4500 BSW Premier HMO
Silver HMO 80 4250 BSW Premier HMO
Silver HMO 60 4200 BSW Premier HMO
Silver HMO 60 4200 BSW Plus HMO
Silver HMO 70 3800 BSW Premier HMO
Silver HMO 60 3250 BSW Premier HMO
Silver HMO 90 750 BSW Premier HMO
Silver HMO 80 8900 BSW Plus HMO
Silver HMO 80 7500 BSW Plus HMO
Silver HMO 100 7300 BSW Plus HMO
Silver HMO 90 7000 BSW Plus HMO
Silver HMO 80 6900 BSW Plus HMO
Silver HMO 70 6700 BSW Plus HMO
Silver HMO 90 6500 BSW Plus HMO
Silver HMO 80 6250 BSW Plus HMO
Silver HMO HSA 6200 BSW Plus HMO
Silver HMO 90 5900 BSW Plus HMO
Silver HMO 80 5000 BSW Plus HMO
Silver HMO HSA 5100 BSW Plus HMO
Silver HMO 70 4500 BSW Plus HMO
Silver HMO 80 4250 BSW Plus HMO
Silver HMO 70 3800 BSW Plus HMO
Silver HMO 60 3250 BSW Plus HMO
Silver HMO 90 750 BSW Plus HMO
Silver PPO 80 8900 BSW Access PPO
Silver PPO 80 7500 BSW Access PPO
Silver PPO 100 7300 BSW Access PPO
Silver PPO 90 7000 BSW Access PPO
Silver PPO 80 6900 BSW Access PPO
Silver PPO 70 6700 BSW Access PPO
Silver PPO 90 6500 BSW Access PPO
Silver PPO 80 6250 BSW Access PPO
Silver PPO HSA 6200 BSW Access PPO
Silver PPO 90 5900 BSW Access PPO
Silver PPO 80 5000 BSW Access PPO
Silver PPO HSA 5100 BSW Access PPO
Silver PPO 70 4500 BSW Access PPO
Silver PPO 80 4250 BSW Access PPO
Silver PPO 60 4200 BSW Plus PPO
Silver PPO 60 4200 BSW Access PPO
Silver PPO 70 3800 BSW Access PPO
Silver PPO 60 3250 BSW Access PPO
Silver PPO 90 750 BSW Access PPO

Silver PPO 80 8900 BSW Plus PPO
Silver PPO 80 7500 BSW Plus PPO
Silver PPO 100 7300 BSW Plus PPO
Silver PPO 90 7000 BSW Plus PPO
Silver PPO 80 6900 BSW Plus PPO
Silver PPO 70 6700 BSW Plus PPO
Silver PPO 90 6500 BSW Plus PPO
Silver PPO 80 6250 BSW Plus PPO
Silver PPO HSA 6200 BSW Plus PPO
Silver PPO 90 5900 BSW Plus PPO
Silver PPO 80 5000 BSW Plus PPO
Silver PPO HSA 5100 BSW Plus PPO
Silver PPO 70 4500 BSW Plus PPO
Silver PPO 80 4250 BSW Plus PPO
Silver PPO 70 3800 BSW Plus PPO
Silver PPO 60 3250 BSW Plus PPO
Silver PPO 90 750 BSW Plus PPO
Silver HMO 80 8900 BSW Premier HMO
Silver HMO 80 7500 BSW Premier HMO
Silver HMO 100 7300 BSW Premier HMO
Silver HMO 90 7000 BSW Premier HMO
Silver HMO 80 6900 BSW Premier HMO
Silver HMO 70 6700 BSW Premier HMO
Silver HMO 90 6500 BSW Premier HMO
Silver HMO 80 6250 BSW Premier HMO
Silver HMO HSA 6200 BSW Premier HMO
Silver HMO 90 5900 BSW Premier HMO
Silver HMO 80 5000 BSW Premier HMO
Silver HMO HSA 5100 BSW Premier HMO
Silver HMO 70 4500 BSW Premier HMO
Silver HMO 80 4250 BSW Premier HMO
Silver HMO 60 4200 BSW Premier HMO
Silver HMO 60 4200 BSW Plus HMO
Silver HMO 70 3800 BSW Premier HMO
Silver HMO 60 3250 BSW Premier HMO
Silver HMO 90 750 BSW Premier HMO
Silver HMO 80 8900 BSW Plus HMO
Silver HMO 80 7500 BSW Plus HMO
Silver HMO 100 7300 BSW Plus HMO
Silver HMO 90 7000 BSW Plus HMO
Silver HMO 80 6900 BSW Plus HMO
Silver HMO 70 6700 BSW Plus HMO
Silver HMO 90 6500 BSW Plus HMO
Silver HMO 80 6250 BSW Plus HMO
Silver HMO HSA 6200 BSW Plus HMO
Silver HMO 90 5900 BSW Plus HMO
Silver HMO 80 5000 BSW Plus HMO
Silver HMO HSA 5100 BSW Plus HMO
Silver HMO 70 4500 BSW Plus HMO
Silver HMO 80 4250 BSW Plus HMO
Silver HMO 70 3800 BSW Plus HMO
Silver HMO 60 3250 BSW Plus HMO
Silver HMO 90 750 BSW Plus HMO
Silver PPO 80 8900 BSW Access PPO
Silver PPO 80 7500 BSW Access PPO
Silver PPO 100 7300 BSW Access PPO
Silver PPO 90 7000 BSW Access PPO
Silver PPO 80 6900 BSW Access PPO
Silver PPO 70 6700 BSW Access PPO
Silver PPO 90 6500 BSW Access PPO
Silver PPO 80 6250 BSW Access PPO
Silver PPO HSA 6200 BSW Access PPO
Silver PPO 90 5900 BSW Access PPO
Silver PPO 80 5000 BSW Access PPO
Silver PPO HSA 5100 BSW Access PPO
Silver PPO 70 4500 BSW Access PPO
Silver PPO 80 4250 BSW Access PPO
Silver PPO 60 4200 BSW Plus PPO
Silver PPO 60 4200 BSW Access PPO
Silver PPO 70 3800 BSW Access PPO
Silver PPO 60 3250 BSW Access PPO
Silver PPO 90 750 BSW Access PPO

Silver PPO 80 8900 BSW Plus PPO
Silver PPO 80 7500 BSW Plus PPO
Silver PPO 100 7300 BSW Plus PPO
Silver PPO 90 7000 BSW Plus PPO
Silver PPO 80 6900 BSW Plus PPO
Silver PPO 70 6700 BSW Plus PPO
Silver PPO 90 6500 BSW Plus PPO
Silver PPO 80 6250 BSW Plus PPO
Silver PPO HSA 6200 BSW Plus PPO
Silver PPO 90 5900 BSW Plus PPO
Silver PPO 80 5000 BSW Plus PPO
Silver PPO HSA 5100 BSW Plus PPO
Silver PPO 70 4500 BSW Plus PPO
Silver PPO 80 4250 BSW Plus PPO
Silver PPO 70 3800 BSW Plus PPO
Silver PPO 60 3250 BSW Plus PPO
Silver PPO 90 750 BSW Plus PPO
Silver HMO 80 8900 BSW Premier HMO
Silver HMO 80 7500 BSW Premier HMO
Silver HMO 100 7300 BSW Premier HMO
Silver HMO 90 7000 BSW Premier HMO
Silver HMO 80 6900 BSW Premier HMO
Silver HMO 70 6700 BSW Premier HMO
Silver HMO 90 6500 BSW Premier HMO
Silver HMO 80 6250 BSW Premier HMO
Silver HMO HSA 6200 BSW Premier HMO
Silver HMO 90 5900 BSW Premier HMO
Silver HMO 80 5000 BSW Premier HMO
Silver HMO HSA 5100 BSW Premier HMO
Silver HMO 70 4500 BSW Premier HMO
Silver HMO 80 4250 BSW Premier HMO
Silver HMO 70 3800 BSW Premier HMO
Silver HMO 60 3250 BSW Premier HMO
Silver HMO 90 750 BSW Premier HMO
Silver HMO 80 8900 BSW Plus HMO
Silver HMO 80 7500 BSW Plus HMO
Silver HMO 100 7300 BSW Plus HMO
Silver HMO 90 7000 BSW Plus HMO
Silver HMO 80 6900 BSW Plus HMO
Silver HMO 70 6700 BSW Plus HMO
Silver HMO 90 6500 BSW Plus HMO
Silver HMO 80 6250 BSW Plus HMO
Silver HMO HSA 6200 BSW Plus HMO
Silver HMO 90 5900 BSW Plus HMO
Silver HMO 80 5000 BSW Plus HMO
Silver HMO HSA 5100 BSW Plus HMO
Silver HMO 70 4500 BSW Plus HMO
Silver HMO 80 4250 BSW Plus HMO
Silver HMO 70 3800 BSW Plus HMO
Silver HMO 60 3250 BSW Plus HMO
Silver HMO 90 750 BSW Plus HMO
Silver PPO 80 8900 BSW Access PPO
Silver PPO 80 7500 BSW Access PPO
Silver PPO 100 7300 BSW Access PPO
Silver PPO 90 7000 BSW Access PPO
Silver PPO 80 6900 BSW Access PPO
Silver PPO 70 6700 BSW Access PPO
Silver PPO 90 6500 BSW Access PPO
Silver PPO 80 6250 BSW Access PPO
Silver PPO HSA 6200 BSW Access PPO
Silver PPO 90 5900 BSW Access PPO
Silver PPO 80 5000 BSW Access PPO
Silver PPO HSA 5100 BSW Access PPO
Silver PPO 70 4500 BSW Access PPO
Silver PPO 80 4250 BSW Access PPO
Silver PPO 70 3800 BSW Access PPO
Silver PPO 60 3250 BSW Access PPO
Silver PPO 90 750 BSW Access PPO

Bronze Plans

Bronze PPO 100 9200 BSW Plus PPO
Bronze PPO 90 7900 BSW Plus PPO
Bronze PPO 80 7500 BSW Plus PPO
Bronze PPO HSA 7300 BSW Plus PPO
Bronze HMO 100 9200 BSW Premier HMO
Bronze HMO 90 7900 BSW Premier HMO
Bronze HMO 80 7500 BSW Premier HMO
Bronze HMO HSA 7300 BSW Premier HMO
Bronze HMO 100 9200 BSW Plus HMO
Bronze HMO 90 7900 BSW Plus HMO
Bronze HMO 80 7500 BSW Plus HMO
Bronze HMO HSA 7300 BSW Plus HMO
Bronze PPO 100 9200 BSW Access PPO
Bronze PPO 90 7900 BSW Access PPO
Bronze PPO 80 7500 BSW Access PPO
Bronze PPO HSA 7300 BSW Access PPO
Bronze HMO 100 9200 INV
Bronze PPO 100 9200 INV

Bronze PPO 100 9200 BSW Plus PPO
Bronze PPO 90 7900 BSW Plus PPO
Bronze PPO 80 7500 BSW Plus PPO
Bronze PPO HSA 7300 BSW Plus PPO
Bronze HMO 100 9200 BSW Premier HMO
Bronze HMO 90 7900 BSW Premier HMO
Bronze HMO 80 7500 BSW Premier HMO
Bronze HMO HSA 7300 BSW Premier HMO
Bronze HMO 100 9200 BSW Plus HMO
Bronze HMO 90 7900 BSW Plus HMO
Bronze HMO 80 7500 BSW Plus HMO
Bronze HMO HSA 7300 BSW Plus HMO
Bronze PPO 100 9200 BSW Access PPO
Bronze PPO 90 7900 BSW Access PPO
Bronze PPO 80 7500 BSW Access PPO
Bronze PPO HSA 7300 BSW Access PPO
Bronze HMO 100 9200 INV
Bronze PPO 100 9200 INV

Bronze PPO 100 9200 BSW Plus PPO
Bronze PPO 90 7900 BSW Plus PPO
Bronze PPO 80 7500 BSW Plus PPO
Bronze PPO HSA 7300 BSW Plus PPO
Bronze HMO 100 9200 BSW Premier HMO
Bronze HMO 90 7900 BSW Premier HMO
Bronze HMO 80 7500 BSW Premier HMO
Bronze HMO HSA 7300 BSW Premier HMO
Bronze HMO 100 9200 BSW Plus HMO
Bronze HMO 90 7900 BSW Plus HMO
Bronze HMO 80 7500 BSW Plus HMO
Bronze HMO HSA 7300 BSW Plus HMO
Bronze PPO 100 9200 BSW Access PPO
Bronze PPO 90 7900 BSW Access PPO
Bronze PPO 80 7500 BSW Access PPO
Bronze PPO HSA 7300 BSW Access PPO
Bronze HMO 100 9200 INV
Bronze PPO 100 9200 INV

POS Transitional

POS 80%/$0/$3,000/$40/$40 with RXSPS01Y
POS 80%/$0/$3,000/$40/$40 with RXSPS03Y
POS 80%/$0/$3,000/$40/$40 with RXSPS04Y
POS 80%/$0/$3,000/$40/$40 with RXSPS05Y
POS 80%/$500/$3,500/$30/$50 with RXSPS01Y
POS 80%/$500/$3,500/$30/$50 with RXSPS02Y
POS 80%/$500/$3,500/$30/$50 with RXSPS03Y
POS 80%/$500/$3,500/$30/$50 with RXSPS04Y
POS 80%/$500/$3,500/$30/$50 with RXSPS05Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS01Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS02Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS03Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS04Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS05Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS01Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS03Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS04Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS05Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS01Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS03Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS04Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS05Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS01Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS03Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS04Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS05Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS01Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS02Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS03Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS04Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS05Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS02Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS04Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS05Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS01Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS02Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS03Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS04Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS05Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS03Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS04Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS05Y
POS 80%/$750/$3,750/$30/$50 with RXSPS01Y
POS 80%/$750/$3,750/$30/$50 with RXSPS02Y
POS 80%/$750/$3,750/$30/$50 with RXSPS03Y
POS 80%/$750/$3,750/$30/$50 with RXSPS04Y
POS 70%/$500/$5,500/$30/$50 with RXSPS01Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS02Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS04Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS05Y
POS 70%/$1,500/$6,500/$30/$50 with RXSPS04Y
POS 70%/$2,000/$7,000/$30/$50 with RXSPS04Y
POS 70%/$2,500/$7,500/$30/$50 with RXSPS04Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS01Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS02Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS04Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS05Y
POS 70%/$4,000/$11,000/$30/$50 with RXSPS01Y
POS 70%/$4,000/$11,000/$30/$50 with RXSPS04Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS01Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS03Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS04Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS05Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS03Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS04Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS05Y
POS HSA 100%/$3,000/$5,500/0%/0% with SHDPRUY1
POS HSA 100%/$5,000/$5,950/0%/0% with SHDPRUY1
POS HSA 80%/$1,500/$3,000/$30/$30 with SHDPRUY2
POS HSA 80%/$2,500/$5,000/$30/$50 with SHDPRUY2
POS HSA 100%/$2,500/$5,500/0%/0% with SHDPRUY1
POS HSA 80%/$3,000/$5,500/$30/$30 with SHDPRUY2
POS HSA 80%/$5,000/$5,950/$30/$30 with SHDPRUY2
POS 70%/$5,000/$13,500/$30/$50 with RXSPS02Y
POS 70%/$2,000/$7,000/$30/$50 with RXSPS01Y

POS 80%/$0/$3,000/$40/$40 with RXSPS01Y
POS 80%/$0/$3,000/$40/$40 with RXSPS03Y
POS 80%/$0/$3,000/$40/$40 with RXSPS04Y
POS 80%/$0/$3,000/$40/$40 with RXSPS05Y
POS 80%/$500/$3,500/$30/$50 with RXSPS01Y
POS 80%/$500/$3,500/$30/$50 with RXSPS02Y
POS 80%/$500/$3,500/$30/$50 with RXSPS03Y
POS 80%/$500/$3,500/$30/$50 with RXSPS04Y
POS 80%/$500/$3,500/$30/$50 with RXSPS05Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS01Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS02Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS03Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS04Y
POS 80%/$1,000/$4,000/$30/$50 with RXSPS05Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS01Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS03Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS04Y
POS 80%/$1,500/$4,500/$30/$50 with RXSPS05Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS01Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS03Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS04Y
POS 80%/$2,000/$5,000/$30/$50 with RXSPS05Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS01Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS03Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS04Y
POS 80%/$2,500/$5,500/$30/$50 with RXSPS05Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS01Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS02Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS03Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS04Y
POS 80%/$3,000/$6,000/$30/$50 with RXSPS05Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS02Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS04Y
POS 80%/$4,000/$8,000/$30/$50 with RXSPS05Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS01Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS02Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS03Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS04Y
POS 80%/$5,000/$10,000/$30/$50 with RXSPS05Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS03Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS04Y
POS 80%/$7,500/$15,000/$30/$50 with RXSPS05Y
POS 80%/$750/$3,750/$30/$50 with RXSPS01Y
POS 80%/$750/$3,750/$30/$50 with RXSPS02Y
POS 80%/$750/$3,750/$30/$50 with RXSPS03Y
POS 80%/$750/$3,750/$30/$50 with RXSPS04Y
POS 70%/$500/$5,500/$30/$50 with RXSPS01Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS02Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS04Y
POS 70%/$1,000/$6,000/$30/$50 with RXSPS05Y
POS 70%/$1,500/$6,500/$30/$50 with RXSPS04Y
POS 70%/$2,000/$7,000/$30/$50 with RXSPS04Y
POS 70%/$2,500/$7,500/$30/$50 with RXSPS04Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS01Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS02Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS04Y
POS 70%/$3,000/$8,500/$30/$50 with RXSPS05Y
POS 70%/$4,000/$11,000/$30/$50 with RXSPS01Y
POS 70%/$4,000/$11,000/$30/$50 with RXSPS04Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS01Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS03Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS04Y
POS 70%/$5,000/$13,500/$30/$50 with RXSPS05Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS03Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS04Y
POS 70%/$10,000/$26,000/$30/$50 with RXSPS05Y
POS HSA 100%/$3,000/$5,500/0%/0% with SHDPRUY1
POS HSA 100%/$5,000/$5,950/0%/0% with SHDPRUY1
POS HSA 80%/$1,500/$3,000/$30/$30 with SHDPRUY2
POS HSA 80%/$2,500/$5,000/$30/$50 with SHDPRUY2
POS HSA 100%/$2,500/$5,500/0%/0% with SHDPRUY1
POS HSA 80%/$3,000/$5,500/$30/$30 with SHDPRUY2
POS HSA 80%/$5,000/$5,950/$30/$30 with SHDPRUY2
POS 70%/$5,000/$13,500/$30/$50 with RXSPS02Y
POS 70%/$2,000/$7,000/$30/$50 with RXSPS01Y

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