State of Connecticut Office of the State Comptroller Attachment to MEMORANDUM NO. 2002-17 MSA TABLES 7/1/2002 TO 6/30/2003 RATES

ATTACHMENT TO MEMORANDUM 2002-17

OFFICE OF THE STATE COMPTROLLER

	TABLE	EMPLOYEE	TABLE	STATE
MSA TABLES 7/1/2002 TO 6/30/2003 RATES
	NO.	DEDUCTION	NO.	PORTION
Chart A	(PAIRED D/OEs 7J/7H PRE-TAX) (SORT CODE 00001)
Blue Cross State Preferred	(PAIRED D/OEs 7G/7H POST-TAX) (SORT CODE 00001)
	26 PAY BI-WEEKLY
INDIVIDUAL	010	32.02	011	174.93
SUBSCRIBER + ONE	012	108.49	013	346.80
FAMILY	014	128.85	015	429.91
FLES	018	71.91	019	279.90
	24 PAY SEMI-MONTHLY
INDIVIDUAL	216	34.69	217	189.51
SUBSCRIBER + ONE	218	117.54	219	375.69
FAMILY	220	139.59	221	465.74
FLES	224	77.91	225	303.22

CHART B	(PAIRED D/OEs 5P/54 PRE-TAX) (SORT CODE 00159)
Blue Cross Dental w/A&C	(PAIRED D/OEs 42/54 POST-TAX) (SORT CODE 00159)
	26 PAY BI-WEEKLY
INDIVIDUAL	176	0.00	177	11.76
FAMILY	178	7.25	179	28.67
FLES	180	3.72	181	20.44
	24 PAY SEMI-MONTHLY
INDIVIDUAL	382	0.00	383	12.74
FAMILY	384	7.85	385	31.07
FLES	386	4.03	387	22.15

CHART C	(PAIRED D/OEs 5P/54 PRE-TAX) (SORT CODE 00159)
Blue Cross Dental w/A,B,&C	(PAIRED D/OEs 42/54 POST-TAX) (SORT CODE 00159)
	26 PAY BI-WEEKLY
INDIVIDUAL	042	3.12	043	11.76
FAMILY	044	13.09	045	28.67
FLES	174	6.44	175	20.44
	24 PAY SEMI-MONTHLY
INDIVIDUAL	248	3.39	246	12.74
FAMILY	247	14.17	251	31.07
FLES	380	6.96	381	22.15

CHART D	(PAIRED D/OEs 6R/6P PRE-TAX) (SORT CODE 00079)
BlueCare POE	(PAIRED D/OEs 6N/6P POST-TAX) (SORT CODE 00079)
	26 PAY BI-WEEKLY
INDIVIDUAL	046	2.47	047	135.57
SUBSCRIBER + ONE	048	30.52	049	273.17
FAMILY	050	43.23	051	329.48
FLES	052	17.81	053	216.86
	24 PAY SEMI-MONTHLY
INDIVIDUAL	252	2.68	253	146.87
SUBSCRIBER + ONE	254	33.07	255	295.93
FAMILY	256	46.84	257	356.93
FLES	258	19.30	259	234.93

CHART E	(PAIRED D/OEs 7U/7S PRE-TAX) (SORT CODE 00077)
BlueCare Point of Service	(PAIRED D/OEs 7R/7S POST-TAX) (SORT CODE 00077)
	26 PAY BI-WEEKLY
INDIVIDUAL	082	8.88	083	136.59
SUBSCRIBER + ONE	084	50.02	085	270.01
FAMILY	086	59.03	087	333.73
FLES	088	22.16	089	225.14
	24 PAY SEMI-MONTHLY
INDIVIDUAL	288	9.62	289	147.97
SUBSCRIBER + ONE	290	54.19	291	292.51
FAMILY	292	63.95	293	361.55
FLES	294	24.01	295	243.90

CHART F	(PAIRED D/OEs 6L/6J PRE-TAX) (SORT CODE 00006)
ConnectiCare HMO Personal Care	(PAIRED D/OEs 6I/6J POST-TAX) (SORT CODE 00006)
	26 PAY BI-WEEKLY
INDIVIDUAL	763	0.00	764	113.56
SUBSCRIBER + ONE	765	20.91	766	228.93
FAMILY	767	28.76	768	277.86
FLES	769	11.83	770	181.23
	24 PAY SEMI-MONTHLY
INDIVIDUAL	771	0.00	772	123.03
SUBSCRIBER + ONE	773	22.66	774	248.00
FAMILY	775	31.16	776	301.01
FLES	777	12.82	778	196.33

CHART G	(PAIRED D/OEs 6W/6U PRE-TAX) (SORT CODE 00259)
Health Net Charter HMO	(PAIRED D/OEs 6T/6U POST-TAX) (SORT CODE 00259)
	26 PAY BI-WEEKLY
INDIVIDUAL	116	2.56	117	136.97
SUBSCRIBER + ONE	118	30.85	119	276.11
FAMILY	120	43.70	121	333.03
FLES	122	18.00	123	219.20
	24 PAY SEMI-MONTHLY
INDIVIDUAL	260	2.77	261	148.39
SUBSCRIBER + ONE	262	33.42	263	299.12
FAMILY	264	47.34	265	360.78
FLES	272	19.51	273	237.46

CHART H	(PAIRED D/OEs 5R/5K PRE-TAX) (SORT CODE 00185)
CIGNA Dental Health	(PAIRED D/OEs 5J/5K POST-TAX) (SORT CODE 00185)
	26 PAY BI-WEEKLY
INDIVIDUAL	140	0.00	141	7.66
SUBSCRIBER + ONE	142	2.76	143	14.09
FAMILY	144	3.90	145	16.77
FLES	146	1.60	147	11.41
	24 PAY SEMI-MONTHLY
INDIVIDUAL	276	0.00	277	8.30
SUBSCRIBER + ONE	278	2.98	279	15.27
FAMILY	280	4.23	281	18.17
FLES	282	1.74	283	12.36

CHART I	(PAIRED D/OEs 7P/7M PRE-TAX) (SORT CODE 00001)
Blue Cross Out of Area Plan	(PAIRED D/OEs 7L/7M POST-TAX) (SORT CODE 00001)
	26 PAY BI-WEEKLY
INDIVIDUAL	134	8.88	135	193.00
SUBSCRIBER + ONE	124	50.02	125	394.11
FAMILY	136	59.03	137	486.04
FLES	138	22.16	139	321.03
	24 PAY SEMI-MONTHLY
INDIVIDUAL	344	9.62	345	209.08
SUBSCRIBER + ONE	340	54.19	341	426.95
FAMILY	346	63.95	347	526.54
FLES	348	24.01	349	347.78

CHART J	(PAIRED D/OEs 5A/5C PRE-TAX) (SORT CODE 00078)
BlueCare POE Plus	(PAIRED D/OEs 5B/5C POST-TAX) (SORT CODE 00078)
	26 PAY BI-WEEKLY
INDIVIDUAL	266	0.16	267	131.66
SUBSCRIBER + ONE	268	24.27	269	265.74
FAMILY	270	33.39	271	322.53
FLES	274	13.74	275	210.36
	24 PAY SEMI-MONTHLY
INDIVIDUAL	284	0.18	285	142.63
SUBSCRIBER + ONE	286	26.30	287	287.88
FAMILY	296	36.17	297	349.42
FLES	298	14.88	299	227.90

CHART K	(PAIRED D/OEs 5F/5L PRE-TAX) (SORT CODE 00261)
Health Net CHARTER POS	(PAIRED D/OEs 5G/5L POST-TAX) (SORT CODE 00261)
	26 PAY BI-WEEKLY
INDIVIDUAL	327	8.76	328	134.77
SUBSCRIBER + ONE	329	49.35	330	266.42
FAMILY	350	58.25	351	329.28
FLES	352	21.86	353	222.14
	24 PAY SEMI-MONTHLY
INDIVIDUAL	354	9.49	355	146.00
SUBSCRIBER + ONE	356	53.47	357	288.61
FAMILY	358	63.10	359	356.73
FLES	360	23.69	361	240.65

CHART L	(PAIRED D/OEs 5Q/5T PRE-TAX) (SORT CODE 00260)
Health Net PASSPORT HMO	(PAIRED D/OEs 5S/5T POST-TAX) (SORT CODE 00260)
	26 PAY BI-WEEKLY
INDIVIDUAL	397	0.25	398	136.48
SUBSCRIBER + ONE	399	25.18	400	275.62
FAMILY	401	34.63	402	334.53
FLES	403	14.25	404	218.19
	24 PAY SEMI-MONTHLY
INDIVIDUAL	405	0.27	406	147.85
SUBSCRIBER + ONE	407	27.28	408	298.59
FAMILY	409	37.52	410	362.41
FLES	411	15.44	412	236.37

CHART M	(PAIRED D/OEs 8N/8L PRE-TAX) (SORT CODE 00052)
CTCARE POS OPEN ACCESS	(PAIRED D/OEs 8K/8L POST-TAX) (SORT CODE 00052)
	26 PAY BI-WEEKLY
INDIVIDUAL	440	8.28	441	127.41
SUBSCRIBER + ONE	442	46.66	443	251.85
FAMILY	444	55.06	445	311.30
FLES	446	20.67	447	210.00
	24 PAY SEMI-MONTHLY
INDIVIDUAL	448	8.97	449	138.03
SUBSCRIBER + ONE	472	50.55	473	272.84
FAMILY	474	59.65	475	337.24
FLES	476	22.39	477	227.50

CHART N	(PAIRED D/OEs 8T/8R PRE-TAX) (SORT CODE 00054)
CTCARE HMO OPEN ACCESS	(PAIRED D/OEs 8Q/8R POST-TAX) (SORT CODE 00054)
	26 PAY BI-WEEKLY
INDIVIDUAL	524	1.78	525	124.81
SUBSCRIBER + ONE	526	27.99	527	250.50
FAMILY	528	39.65	529	302.13
FLES	530	16.33	531	198.87
	24 PAY SEMI-MONTHLY
INDIVIDUAL	541	1.93	542	135.21
SUBSCRIBER + ONE	543	30.32	544	271.38
FAMILY	545	42.95	547	327.32
FLES	548	17.70	549	215.43

Return to Memorandum 2002-17

Return to Index of 2002 Comptroller's Memoranda
Return to Index of Comptroller's Memoranda
Return to Comptroller's Home Page