Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 1 Counties – Monthly Rates (Effective 01/01/2017*) Avery, Buncombe, Haywood, Henderson, Jackson, Madison, McDowell, Mitchell, Polk, Rutherford, Transylvania, Yancey

Aetna Leap Everyday

Age

Non Tobacco Tobacco

0-20 $240.39 $240.39

21 $378.57 $416.43 22 $378.57 $416.43 23 $378.57 $416.43 24 $378.57 $416.43 25 $380.09 $418.10 26 $387.66 $426.43 27 $396.75 $436.42 28 $411.51 $452.66 29 $423.62 $465.99 30 $429.68 $472.65 31 $438.77 $482.64 32 $447.85 $492.64 33 $453.53 $498.88 34 $459.59 $505.55 35 $462.62 $508.88 36 $465.65 $512.21 37 $468.67 $515.54 38 $471.70 $518.87 39 $477.76 $525.54 40 $483.82 $532.20 41 $492.90 $542.19 42 $501.61 $551.77 43 $513.72 $565.10 44 $528.87 $581.75 45 $546.66 $601.33 46 $567.86 $624.65 47 $591.71 $650.88 48 $618.97 $680.87 49 $645.85 $710.43 50 $676.13 $743.75 51 $706.04 $776.64 52 $738.98 $812.87 53 $772.29 $849.52 54 $808.26 $889.08 55 $844.22 $928.64 56 $883.21 $971.53 57 $922.58 $1,014.84 58 $964.61 $1,061.07 59 $985.43 $1,083.97 60 $1,027.45 $1,130.19 61 $1,063.79 $1,170.17 62 $1,087.64 $1,196.41 63 $1,117.55 $1,229.31 64 $1,135.34 $1,248.88 65+** $1,135.34 $1,248.88

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC01 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 2 Counties – Monthly Rates (Effective 01/01/2017*) Alexander, Caldwell, Catawba, Iredell

Aetna Leap Everyday

Age

Non Tobacco Tobacco

0-20 $234.06 $234.06

21 $368.60 $405.46 22 $368.60 $405.46 23 $368.60 $405.46 24 $368.60 $405.46 25 $370.07 $407.08 26 $377.44 $415.19 27 $386.29 $424.92 28 $400.66 $440.73 29 $412.46 $453.71 30 $418.36 $460.19 31 $427.20 $469.92 32 $436.05 $479.65 33 $441.58 $485.74 34 $447.48 $492.22 35 $450.43 $495.47 36 $453.37 $498.71 37 $456.32 $501.95 38 $459.27 $505.20 39 $465.17 $511.69 40 $471.07 $518.17 41 $479.91 $527.90 42 $488.39 $537.23 43 $500.19 $550.20 44 $514.93 $566.42 45 $532.25 $585.48 46 $552.89 $608.18 47 $576.12 $633.73 48 $602.66 $662.92 49 $628.83 $691.71 50 $658.31 $724.14 51 $687.43 $756.18 52 $719.50 $791.45 53 $751.94 $827.13 54 $786.95 $865.65 55 $821.97 $904.17 56 $859.94 $945.93 57 $898.27 $988.10 58 $939.18 $1,033.10 59 $959.46 $1,055.40 60 $1,000.37 $1,100.41 61 $1,035.76 $1,139.33 62 $1,058.98 $1,164.88 63 $1,088.10 $1,196.91 64 $1,105.42 $1,215.96 65+** $1,105.42 $1,215.96

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC02 (10/16)

Aetna Health Plans for North Carolina Rating Area 2 Counties – Monthly Rates (Effective 01/01/2017*) Burke

Aetna Leap Everyday Carolinas

HealthCare System

Age

Non Tobacco Tobacco

0-20 $217.44 $217.44

21 $342.42 $376.67 22 $342.42 $376.67 23 $342.42 $376.67 24 $342.42 $376.67 25 $343.79 $378.17 26 $350.64 $385.71 27 $358.86 $394.75 28 $372.21 $409.44 29 $383.17 $421.49 30 $388.65 $427.52 31 $396.87 $436.56 32 $405.09 $445.60 33 $410.22 $451.25 34 $415.70 $457.27 35 $418.44 $460.29 36 $421.18 $463.30 37 $423.92 $466.31 38 $426.66 $469.33 39 $432.14 $475.35 40 $437.62 $481.38 41 $445.84 $490.42 42 $453.71 $499.08 43 $464.67 $511.14 44 $478.37 $526.20 45 $494.46 $543.91 46 $513.64 $565.00 47 $535.21 $588.73 48 $559.86 $615.85 49 $584.18 $642.59 50 $611.57 $672.73 51 $638.62 $702.48 52 $668.41 $735.25 53 $698.55 $768.40 54 $731.08 $804.18 55 $763.61 $839.97 56 $798.88 $878.76 57 $834.49 $917.94 58 $872.50 $959.75 59 $891.33 $980.46 60 $929.34 $1,022.27 61 $962.21 $1,058.43 62 $983.78 $1,082.16 63 $1,010.84 $1,111.92 64 $1,026.93 $1,129.62 65+** $1,026.93 $1,129.62

*Networks may not be available in all zip codes and are subject to change.

** Age 65+ rates are not available to new applicants.

www.aetna.com

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 4 Counties – Monthly Rates (Effective 01/01/2017*) Anson, Cabarrus, Mecklenburg, Stanly, Union

Aetna Leap Everyday Carolinas

HealthCare System

Age

Non Tobacco Tobacco

0-20 $241.03 $241.03

21 $379.57 $417.53 22 $379.57 $417.53 23 $379.57 $417.53 24 $379.57 $417.53 25 $381.09 $419.20 26 $388.68 $427.55 27 $397.79 $437.57 28 $412.59 $453.85 29 $424.74 $467.21 30 $430.81 $473.89 31 $439.92 $483.92 32 $449.03 $493.94 33 $454.73 $500.20 34 $460.80 $506.88 35 $463.84 $510.22 36 $466.87 $513.56 37 $469.91 $516.90 38 $472.95 $520.24 39 $479.02 $526.92 40 $485.09 $533.60 41 $494.20 $543.62 42 $502.93 $553.22 43 $515.08 $566.59 44 $530.26 $583.29 45 $548.10 $602.91 46 $569.36 $626.29 47 $593.27 $652.60 48 $620.60 $682.66 49 $647.55 $712.30 50 $677.91 $745.71 51 $707.90 $778.69 52 $740.92 $815.01 53 $774.32 $851.76 54 $810.38 $891.42 55 $846.44 $931.09 56 $885.54 $974.09 57 $925.01 $1,017.52 58 $967.15 $1,063.86 59 $988.02 $1,086.83 60 $1,030.16 $1,133.17 61 $1,066.59 $1,173.25 62 $1,090.51 $1,199.56 63 $1,120.49 $1,232.54 64 $1,138.33 $1,252.17 65+** $1,138.33 $1,252.17

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC04 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions

Aetna Health Plans for North Carolina Rating Area 5 Counties – Monthly Rates (Effective 01/01/2017*) Cleveland, Gaston, Lincoln

Aetna Leap Everyday CaroMont Health

Age

Non Tobacco Tobacco

0-20

$233.27 $233.27

21 $367.35 $404.0922 $367.35 $404.0923 $367.35 $404.0924 $367.35 $404.0925 $368.82 $405.7026 $376.17 $413.7827 $384.98 $423.4828 $399.31 $439.2429 $411.07 $452.1730 $416.94 $458.6431 $425.76 $468.3432 $434.58 $478.0333 $440.09 $484.0934 $445.96 $490.5635 $448.90 $493.7936 $451.84 $497.0337 $454.78 $500.2638 $457.72 $503.4939 $463.60 $509.9640 $469.47 $516.4241 $478.29 $526.1242 $486.74 $535.4143 $498.49 $548.3444 $513.19 $564.5145 $530.45 $583.5046 $551.03 $606.1347 $574.17 $631.5948 $600.62 $660.6849 $626.70 $689.3750 $656.09 $721.7051 $685.11 $753.6252 $717.07 $788.7853 $749.40 $824.3454 $784.29 $862.7255 $819.19 $901.1156 $857.03 $942.7357 $895.23 $984.7658 $936.01 $1,029.6159 $956.21 $1,051.8460 $996.99 $1,096.6961 $1,032.26 $1,135.4862 $1,055.40 $1,160.9463 $1,084.42 $1,192.8664 $1,101.68 $1,211.8565+** $1,101.68 $1,211.85

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC05 (10/16)

Aetna Health Plans for North Carolina Rating Area 5 Counties – Monthly Rates (Effective 01/01/2017*) Cleveland

Aetna Leap Everyday Carolinas HealthCare System

Age

Non Tobacco Tobacco

0-20 $233.27 $233.27

21 $367.35 $404.0922 $367.35 $404.0923 $367.35 $404.0924 $367.35 $404.0925 $368.82 $405.7026 $376.17 $413.7827 $384.98 $423.4828 $399.31 $439.2429 $411.07 $452.1730 $416.94 $458.6431 $425.76 $468.3432 $434.58 $478.0333 $440.09 $484.0934 $445.96 $490.5635 $448.90 $493.7936 $451.84 $497.0337 $454.78 $500.2638 $457.72 $503.4939 $463.60 $509.9640 $469.47 $516.4241 $478.29 $526.1242 $486.74 $535.4143 $498.49 $548.3444 $513.19 $564.5145 $530.45 $583.5046 $551.03 $606.1347 $574.17 $631.5948 $600.62 $660.6849 $626.70 $689.3750 $656.09 $721.7051 $685.11 $753.6252 $717.07 $788.7853 $749.40 $824.3454 $784.29 $862.7255 $819.19 $901.1156 $857.03 $942.7357 $895.23 $984.7658 $936.01 $1,029.6159 $956.21 $1,051.8460 $996.99 $1,096.6961 $1,032.26 $1,135.4862 $1,055.40 $1,160.9463 $1,084.42 $1,192.8664 $1,101.68 $1,211.8565+** $1,101.6

8 $1,211.85*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

www.aetna.com

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

If you need this material translated into another language, please call Member Services at 1-866-565-1236.

Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236.

This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions

Aetna Health Plans for North Carolina Rating Area 6 Counties – Monthly Rates (Effective 01/01/2017*) Davidson, Davie, Forsyth

Aetna Leap Everyday Cornerstone Wake Forest

Baptist

Age

Non Tobacco Tobacco

0-20 $215.16 $215.16

21 $338.84 $372.7322 $338.84 $372.7323 $338.84 $372.7324 $338.84 $372.7325 $340.20 $374.2226 $346.97 $381.6727 $355.11 $390.6228 $368.32 $405.1529 $379.16 $417.0830 $384.58 $423.0431 $392.72 $431.9932 $400.85 $440.9333 $405.93 $446.5334 $411.35 $452.4935 $414.06 $455.4736 $416.77 $458.4537 $419.49 $461.4338 $422.20 $464.4239 $427.62 $470.3840 $433.04 $476.3441 $441.17 $485.2942 $448.96 $493.8643 $459.81 $505.7944 $473.36 $520.7045 $489.29 $538.2246 $508.26 $559.0947 $529.61 $582.5748 $554.01 $609.4149 $578.06 $635.8750 $605.17 $665.6951 $631.94 $695.1352 $661.42 $727.5653 $691.24 $760.3654 $723.43 $795.7755 $755.62 $831.1856 $790.52 $869.5757 $825.76 $908.3358 $863.37 $949.7059 $882.00 $970.2060 $919.62 $1,011.58 61 $952.14 $1,047.36 62 $973.49 $1,070.84 63 $1,000.26 $1,100.29 64 $1,016.18 $1,117.80 65+** $1,016.1

8 $1,117.80 *Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC06 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

If you need this material translated into another language, please call Member Services at 1-866-565-1236.

Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236.

This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 7 Counties – Monthly Rates (Effective 01/01/2017*) Guilford, Randolph

Aetna Leap Everyday

Cornerstone Wake Forest Baptist

Age

Non Tobacco Tobacco

0-20 $204.52 $204.52

21 $322.08 $354.28 22 $322.08 $354.28 23 $322.08 $354.28 24 $322.08 $354.28 25 $323.36 $355.70 26 $329.81 $362.79 27 $337.54 $371.29 28 $350.10 $385.11 29 $360.40 $396.44 30 $365.56 $402.11 31 $373.29 $410.62 32 $381.02 $419.12 33 $385.85 $424.43 34 $391.00 $430.10 35 $393.58 $432.94 36 $396.15 $435.77 37 $398.73 $438.60 38 $401.31 $441.44 39 $406.46 $447.11 40 $411.61 $452.77 41 $419.34 $461.28 42 $426.75 $469.43 43 $437.06 $480.76 44 $449.94 $494.93 45 $465.08 $511.59 46 $483.11 $531.43 47 $503.41 $553.75 48 $526.59 $579.25 49 $549.46 $604.41 50 $575.23 $632.75 51 $600.67 $660.74 52 $628.69 $691.56 53 $657.04 $722.74 54 $687.63 $756.40 55 $718.23 $790.05 56 $751.40 $826.54 57 $784.90 $863.39 58 $820.65 $902.72 59 $838.36 $922.20 60 $874.12 $961.53 61 $905.03 $995.54 62 $925.33 $1,017.86 63 $950.77 $1,045.85 64 $965.91 $1,062.50 65+** $965.91 $1,062.50

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC07 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 9 Counties – Monthly Rates (Effective 01/01/2017*) Bladen, Cumberland, Harnett, Hoke

Aetna Leap Everyday Cape

Fear Valley Health

Age

Non Tobacco Tobacco

0-20 $235.12 $235.12

21 $370.27 $407.30 22 $370.27 $407.30 23 $370.27 $407.30 24 $370.27 $407.30 25 $371.75 $408.93 26 $379.16 $417.08 27 $388.05 $426.85 28 $402.49 $442.74 29 $414.34 $455.77 30 $420.26 $462.29 31 $429.15 $472.06 32 $438.03 $481.84 33 $443.59 $487.95 34 $449.51 $494.46 35 $452.47 $497.72 36 $455.44 $500.98 37 $458.40 $504.24 38 $461.36 $507.50 39 $467.29 $514.01 40 $473.21 $520.53 41 $482.10 $530.31 42 $490.61 $539.67 43 $502.46 $552.71 44 $517.27 $569.00 45 $534.67 $588.14 46 $555.41 $610.95 47 $578.74 $636.61 48 $605.40 $665.94 49 $631.69 $694.86 50 $661.31 $727.44 51 $690.56 $759.62 52 $722.77 $795.05 53 $755.36 $830.89 54 $790.53 $869.59 55 $825.71 $908.28 56 $863.85 $950.23 57 $902.36 $992.59 58 $943.46 $1,037.80 59 $963.82 $1,060.20 60 $1,004.92 $1,105.41 61 $1,040.47 $1,144.52 62 $1,063.80 $1,170.17 63 $1,093.05 $1,202.35 64 $1,110.45 $1,221.49 65+** $1,110.45 $1,221.49

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC09 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 10 Counties – Monthly Rates (Effective 01/01/2017*) Granville, Vance

Aetna Leap Everyday Duke

Health

Age

Non Tobacco Tobacco

0-20 $228.21 $228.21

21 $359.39 $395.33 22 $359.39 $395.33 23 $359.39 $395.33 24 $359.39 $395.33 25 $360.83 $396.91 26 $368.02 $404.82 27 $376.64 $414.31 28 $390.66 $429.73 29 $402.16 $442.38 30 $407.91 $448.70 31 $416.54 $458.19 32 $425.16 $467.68 33 $430.55 $473.61 34 $436.30 $479.93 35 $439.18 $483.10 36 $442.05 $486.26 37 $444.93 $489.42 38 $447.80 $492.58 39 $453.55 $498.91 40 $459.31 $505.24 41 $467.93 $514.72 42 $476.20 $523.82 43 $487.70 $536.47 44 $502.07 $552.28 45 $518.96 $570.86 46 $539.09 $593.00 47 $561.73 $617.91 48 $587.61 $646.37 49 $613.13 $674.44 50 $641.88 $706.06 51 $670.27 $737.30 52 $701.54 $771.69 53 $733.16 $806.48 54 $767.31 $844.04 55 $801.45 $881.59 56 $838.47 $922.31 57 $875.84 $963.43 58 $915.73 $1,007.31 59 $935.50 $1,029.05 60 $975.39 $1,072.93 61 $1,009.90 $1,110.89 62 $1,032.54 $1,135.79 63 $1,060.93 $1,167.02 64 $1,077.82 $1,185.60 65+** $1,077.82 $1,185.60

*Networks may not be available in all zip codes and are subject to change.

** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC10 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefitsHealthier livingFinancial well-beingIntelligent solutions

Aetna Health Plans for North Carolina Rating Area 11 Counties – Monthly Rates (Effective 01/01/2017*)Alamance, Chatham, Durham, Lee, Orange, Person

Aetna Leap Everyday Duke

Health

Age

Non Tobacco Tobacco

0-20 $199.68 $199.68

21 $314.45 $345.90 22 $314.45 $345.90 23 $314.45 $345.90 24 $314.45 $345.90 25 $315.71 $347.28 26 $322.00 $354.20 27 $329.55 $362.50 28 $341.81 $375.99 29 $351.87 $387.06 30 $356.90 $392.60 31 $364.45 $400.90 32 $372.00 $409.20 33 $376.72 $414.39 34 $381.75 $419.92 35 $384.26 $422.69 36 $386.78 $425.46 37 $389.29 $428.22 38 $391.81 $430.99 39 $396.84 $436.52 40 $401.87 $442.06 41 $409.42 $450.36 42 $416.65 $458.32 43 $426.71 $469.38 44 $439.29 $483.22 45 $454.07 $499.48 46 $471.68 $518.85 47 $491.49 $540.64 48 $514.13 $565.54 49 $536.46 $590.10 50 $561.61 $617.78 51 $586.46 $645.10 52 $613.81 $675.19 53 $641.48 $705.63 54 $671.36 $738.49 55 $701.23 $771.35 56 $733.62 $806.98 57 $766.32 $842.96 58 $801.23 $881.35 59 $818.52 $900.37 60 $853.43 $938.77 61 $883.61 $971.98 62 $903.42 $993.77 63 $928.27 $1,021.09 64 $943.05 $1,037.35 65+** $943.05 $1,037.35

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC11 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions

Aetna Health Plans for North Carolina Rating Area 13 Counties – Monthly Rates (Effective 01/01/2017*) Franklin, Johnston, Wake

Aetna Leap Everyday Duke Health

Age

Non Tobacco Tobacco

0-20 $199.57 $199.57 21 $314.28 $345.71 22 $314.28 $345.71 23 $314.28 $345.71 24 $314.28 $345.71 25 $315.54 $347.09 26 $321.82 $354.01 27 $329.37 $362.30 28 $341.62 $375.79 29 $351.68 $386.85 30 $356.71 $392.38 31 $364.25 $400.68 32 $371.79 $408.97 33 $376.51 $414.16 34 $381.54 $419.69 35 $384.05 $422.46 36 $386.57 $425.22 37 $389.08 $427.99 38 $391.59 $430.75 39 $396.62 $436.28 40 $401.65 $441.82 41 $409.19 $450.11 42 $416.42 $458.06 43 $426.48 $469.13 44 $439.05 $482.96 45 $453.82 $499.20 46 $471.42 $518.56 47 $491.22 $540.34 48 $513.85 $565.23 49 $536.16 $589.78 50 $561.31 $617.44 51 $586.13 $644.75 52 $613.48 $674.82 53 $641.13 $705.25 54 $670.99 $738.09 55 $700.85 $770.93 56 $733.22 $806.54 57 $765.90 $842.49 58 $800.79 $880.87 59 $818.07 $899.88 60 $852.96 $938.25 61 $883.13 $971.44 62 $902.93 $993.22 63 $927.76 $1,020.53 64 $942.53 $1,036.78 65+** $942.53

$1,036.78 *Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC13 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

If you need this material translated into another language, please call Member Services at 1-866-565-1236.

Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236.

This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com

Quality Health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Health Plans for North Carolina Rating Area 14 Counties – Monthly Rates (Effective 01/01/2017*) Wilson

Aetna Leap Everyday Duke

Health

Age

Non Tobacco Tobacco

0-20 $224.79 $224.79

21 $354.00 $389.40 22 $354.00 $389.40 23 $354.00 $389.40 24 $354.00 $389.40 25 $355.42 $390.96 26 $362.50 $398.75 27 $371.00 $408.10 28 $384.80 $423.28 29 $396.13 $435.74 30 $401.79 $441.97 31 $410.29 $451.32 32 $418.79 $460.67 33 $424.10 $466.51 34 $429.76 $472.74 35 $432.59 $475.85 36 $435.42 $478.97 37 $438.26 $482.08 38 $441.09 $485.20 39 $446.75 $491.43 40 $452.42 $497.66 41 $460.91 $507.00 42 $469.05 $515.96 43 $480.38 $528.42 44 $494.54 $544.00 45 $511.18 $562.30 46 $531.01 $584.11 47 $553.31 $608.64 48 $578.80 $636.68 49 $603.93 $664.32 50 $632.25 $695.48 51 $660.22 $726.24 52 $691.02 $760.12 53 $722.17 $794.38 54 $755.80 $831.38 55 $789.43 $868.37 56 $825.89 $908.48 57 $862.71 $948.98 58 $902.00 $992.20 59 $921.47 $1,013.62 60 $960.77 $1,056.84 61 $994.75 $1,094.23 62 $1,017.05 $1,118.76 63 $1,045.02 $1,149.52 64 $1,061.66 $1,167.82 65+** $1,061.66 $1,167.82

*Networks may not be available in all zip codes and are subject to change. ** Age 65+ rates are not available to new applicants.

How to calculate your monthly payment

Look for the plan name(s) you're considering. Find your age and tobacco use status in the columns below each plan to see your monthly payment. Do the same for each person in your family. Your monthly payment will be the total of the rates for each person on the plan, based on their age and tobacco use. We will only charge you for your three oldest dependents under the age of 21.

62.03.334.1-NC14 (10/16)

Aetna individual health benefits plans are underwritten by Aetna Health Inc. (Aetna).

Aetna does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. If you need this material translated into another language, please call Member Services at 1-866-565-1236. Si usted necesita este material en otro lenguaje por favor llame a Servicios al Miembro al 1-866-565-1236. This material is for information only. Rates are subject to change on rate increases implemented to the whole book of business in accordance with state laws and regulations, and any optional benefits selected. Health/ Dental insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. Investment services are independently offered by the HSA Administrator.

www.aetna.com