Sacramento County Bar
Benefits Program
Medical Benefits Provided by Western Health Advantage
AGE
0-14
15
16
17
18
19
20
21-24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64+
GATEWAY 20
$368.14
$400.87
$413.38
$425.89
$439.36
$452.84
$466.79
$481.23
$483.16
$492.78
$504.33
$523.10
$538.50
$546.20
$557.75
$569.30
$576.52
$584.22
$588.07
$591.91
$595.76
$599.61
$607.31
$615.01
$626.56
$637.63
$653.03
$672.28
$694.90
$721.85
$752.16
$786.81
$820.98
$859.48
$897.50
$939.36
$981.71
$1,027.43
$1,073.15
$1,122.71
$1,172.76
$1,226.18
$1,252.65
$1,306.06
$1,352.26
$1,382.58
$1,420.60
$1,443.69
AGE
0-14
15
16
17
18
19
20
21-24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64+
GATEWAY 70
$343.00
$373.49
$385.14
$396.80
$409.35
$421.91
$434.91
$448.36
$450.16
$459.12
$469.88
$487.37
$501.72
$508.89
$519.65
$530.41
$537.14
$544.31
$547.90
$551.49
$555.07
$558.66
$565.83
$573.01
$583.77
$594.08
$608.43
$626.36
$647.43
$672.54
$700.79
$733.07
$764.91
$800.77
$836.20
$875.20
$914.66
$957.25
$999.85
$1,046.03
$1,092.66
$1,142.43
$1,167.09
$1,216.85
$1,259.90
$1,288.14
$1,323.57
$1,345.09
AGE
0-14
15
16
17
18
19
20
21-24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64+
GATEWAY 2600
$295.77
$322.06
$332.12
$342.17
$353.00
$363.82
$375.03
$386.63
$388.18
$395.91
$405.19
$420.27
$432.64
$438.83
$448.11
$457.39
$463.19
$469.37
$472.46
$475.56
$478.65
$481.74
$487.93
$494.12
$503.40
$512.29
$524.66
$540.13
$558.30
$579.95
$604.31
$632.14
$659.59
$690.53
$721.07
$754.71
$788.73
$825.46
$862.19
$902.01
$942.22
$985.14
$1,006.40
$1,049.32
$1,086.44
$1,110.79
$1,141.34
$1,159.90