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RATES & SALIENT FEATURES 

  Maximum  Annual Membership 
Program  Member Type  Plan  Room & Board 
Benefit Limit  Fee 
 
Platinum 1 Small Suite 350,000. P 32,764. 
 
Platinum 2 Large‐Private 350,000. 25,098. 
 
Platinum 3 Large‐Private 250,000. 24,189. 
  
Platinum 4 Large‐Private 200,000. 23,735. 
  PRINCIPAL 
GOLD 1  Regular‐Private 150,000. 17,760. 
 
GOLD 2  Regular‐Private 100,000. 17,305. 
 
SILVER 1  Semi‐Private 100,000. 15,792. 
 
SILVER 2  Semi‐Private 75,000. 15,305. 
 
Full HMO 
Platinum 1 Small Suite 350,000. 31,045. 
 
Platinum 2 Large‐Private 350,000. 23,873. 
 
Platinum 3 Large‐Private 250,000. 22,964. 
 
Platinum 4 Large‐Private 200,000. 22,510. 
  DEPENDENTS 
GOLD 1  Regular‐Private 150,000. 16,900. 
 
GOLD 2  Regular‐Private 100,000. 16,445. 
 
SILVER 1  Semi‐Private 100,000. 15,048. 
 
SILVER 2  Semi‐Private 75,000. 14,561. 
 

 
 

 
Maximum  Annual 
  Program  Member Type  Plan  Room & Board 
Benefit Limit  Membership Fee 
 
Platinum 1 Small Suite 350,000. P 19,580. 
 
Platinum 2 Large‐Private 350,000. 15,715. 
 
Platinum 3 Large‐Private 250,000. 14,806. 
 
Platinum 4 Large‐Private 200,000. 14,352. 
PRINCIPAL 
 
GOLD 1 Regular‐Private 150,000. 10,743. 
 
GOLD 2 Regular‐Private 100,000. 10,288. 

SILVER 1 Semi‐Private 100,000. 8,775. 

SILVER 2 Semi‐Private 75,000. 8,288. 


IN‐PATIENT 
ONLY 
Platinum 1 Small Suite 350,000. 18,664. 

Platinum 2 Large‐Private 350,000. 15,063. 

Platinum 3 Large‐Private 250,000. 14,154. 

Platinum 4 Large‐Private 200,000. 13,700. 


DEPENDENTS 
GOLD 1 Regular‐Private 150,000. 10,310. 

GOLD 2 Regular‐Private 100,000. 9,856. 

SILVER 1 Semi‐Private 100,000. 8,459. 

SILVER 2 Semi‐Private 75,000. 7,972. 

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