All participants must have coverage through a government health care plan

The rate calculations are based on age(s) today. These rates could change because of an upcoming birthday, plan modifications, or the effective date of coverage.

If you or your spouse are terminating from a group benefits plan, use that date of birth here to show accurate rates for replacement health plans. If you or your spouse are both terminating from a group benefits plan, consider adding the youngest member's date of birth here.

In other cases, some plans calculate the rate using only your age, even if your spouse is older. When neither you nor your spouse is terminating from a group benefits plan, the youngest member's date of birth should go here.

If you are leaving a group benefits plan soon, enter today’s date here.

Please note: This platform will not show any premium plan changes that may occur between today and when the health coverage begins.