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NEW YORK (SBE) | NY
| New |
$- |
| Renewal |
$- |
| PMPM CAP |
N/A |
CALIFORNIA (SBE) | CA
| New |
$15.00 |
| Renewal |
$15.00 |
| PMPM CAP |
No |
COLORADO (SBE) | CO
| New |
$18.00 |
| Renewal |
$18.00 |
| PMPM CAP |
5 Members Max |
WISCONSIN | WI
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
No |
MISSOURI | MO
| New |
$20.00 |
| Renewal |
$18.00 |
| PMPM CAP |
No |
INDIANA | IN
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
No |
KENTUCKY (SBE) | KY
| New |
$25.00 |
| Renewal |
$25.00 |
| PMPM CAP |
No |
OHIO | OH
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
2 Members Max |
VIRGINIA (SBE) | VA
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
No |
GEORGIA | GA
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
5 Members Max |
NEVADA (SBE) | NV
| New |
$22.00 |
| Renewal |
$22.00 |
| PMPM CAP |
No |
CONNECTICUT (SBE) | CT
| New |
$18.00 |
| Renewal |
$18.00 |
| PMPM CAP |
3 Members Max |
NEW HAMPSHIRE | NH
| New |
$23.00 |
| Renewal |
$20.00 |
| PMPM CAP |
No |
MAINE (SBE) | ME
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
3 Members Max |
| New |
$20.00 |
| Renewal |
$20.00 |
| PMPM CAP |
$20.00 |
