MSA Washington: Health Savings Accounts in Washington

Use the online e-Enrollment Application

Evolve HSA 100 Rates
Effective date : 10/1/2010
Valid thru : 6/30/2011
Counties : Clallam, Columbia, Cowlitz, Grays Harbor, Island, Jefferson, King, Kitsap, Klickitat, Lewis, Mason, Pacific, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla, Whatcom, Yakima

Family Status :	Applicant Non-Smoker	Applicant Smoker	Family Non-Smoker	Family Smoker
Age	Deductible : 5000
0-24	127.00	147.00	N/A	N/A
25-29	146.00	168.00	N/A	N/A
30-34	170.00	195.00	N/A	N/A
35-39	201.00	231.00	N/A	N/A
40-44	236.00	271.00	N/A	N/A
45-49	286.00	328.00	N/A	N/A
50-54	340.00	391.00	N/A	N/A
55-59	399.00	459.00	N/A	N/A
60+	467.00	537.00	N/A	N/A
Child	127.00	127.00	N/A	N/A
Age	Deductible : 10000
0-24	N/A	N/A	127.00	147.00
25-29	N/A	N/A	146.00	168.00
30-34	N/A	N/A	170.00	195.00
35-39	N/A	N/A	201.00	231.00
40-44	N/A	N/A	236.00	271.00
45-49	N/A	N/A	286.00	328.00
50-54	N/A	N/A	340.00	391.00
55-59	N/A	N/A	399.00	459.00
60+	N/A	N/A	467.00	537.00
Child	N/A	N/A	127.00	127.00