COMPTROLLER'S SEAL STATE OF CONNECTICUT

STATE OF CONNECTICUT

NANCY WYMAN
COMPTROLLER
OFFICE OF THE STATE COMPTROLLER
55 ELM STREET
HARTFORD, CONNECTICUT 06106-1775
MARK OJAKIAN
DEPUTY COMPTROLLER

COMPTROLLER'S MEMORANDUM NO. 2002-18

May 22, 2002

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION: Personnel and Payroll Officers, Chief Administrative Officers, Business Managers
SUBJECT: 2002- 2003 COBRA Continuation Coverage Rates

The following MONTHLY rates for COBRA continuation coverage are effective July 1, 2002:

PLAN INDIVIDUAL SUBSCRIBER &
ONE
DEPENDENT
FAMILY
Blue Cross State Preferred $457.36 $1,006.19 $1,234.86
Blue Cross Out of Area $446.15 $981.53 $1,204.60
State BlueCare POS $321.48 $707.27 $868.01
State BlueCare POE $305.07 $671.16 $823.69
State BlueCare POE Plus $291.33 $640.93 $786.59
Health Net Charter POS $317.20 $697.84 $856.44
Health Net Charter HMO $308.36 $678.38 $832.56
Health Net Passport HMO $302.16 $664.76 $815.85
ConnectiCare POS Open Access $299.87 $659.72 $809.65
ConnectiCare HMO Open Access $279.76 $615.46 $755.34
ConnectiCare HMO Personal Care Plan $250.97 $552.14 $677.63
Anthem Blue Cross Indemnity Dental A & C $25.99 $79.39 $79.39
Anthem Blue Cross Indemnity Dental A , B, & C $32.90 $92.28 $92.28
CIGNA Dental $16.92 $37.23 $45.69

All Rates include a 2% administrative fee

Form CO-1022A (revised 5/2001) Group Health Insurance Continuation Coverage Election, is to be used to notify employees and/or beneficiaries of their right to continue health benefits for all plans except CIGNA Dental. It is important that both sides of the form are given to the employee/beneficiary. Do not use previous versions of this form; they should be discarded. Form CO-1022-1 CIGNA Dental COBRA Application, (revised 11/97) is to be used to notify those enrolled in CIGNA Dental. Your agency business office can order both forms through the state's forms management program, Vanguard Direct, 1- (800) 369-0570. 

Payroll and personnel office staff with questions concerning this matter should call the Retirement & Benefit Services Division, Health Care Analysis Unit, at (860) 702-3535.

Very truly yours,

Nancy Wyman
State Comptroller

NW/SW/wpm 

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