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2021
2022
Rx Premier – S7126
Premium: $24.90
Deductible: $0 (Tiers 1-2), $445 (Tiers 3-5)
Rx Plus – S7126
Premium: $91.90
Deductible: $445 (All tiers)
Rx Premier – S7126
Premium: $31.40
Deductible: $0 (Tiers 1-2), $480 (Tiers 3-5)
Rx Plus – S7126
Premium: $99.90
Deductible: $480 (All tiers)