Attachment to MEMORANDUM NO. 2003-19
| State Employee Health Insurance | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7/1/2003 TO 6/30/2004 RATES | ||||||||||||
| Bi-Weekly Rates Based on 26 Pay Periods- NOT FOR MSA PAYROLL USE | ||||||||||||
| Medical Plans Including Rx Drug | ||||||||||||
| Anthem | ||||||||||||
| Blue Cross | State BlueCare | Health Net | ConnectiCare | |||||||||
| State Preferred | Out of Area | POS | POE | POE Plus | Charter POS | Charter HMO | Passport HMO | POS Open Access | HMO Open Access | HMO Personal Care Plan | ||
| Monthly | $513.99 | $501.39 | $361.29 | $342.85 | $327.41 | $341.77 | $332.24 | $325.57 | $327.33 | $305.37 | $273.95 | |
| Individual | State Portion | $434.48 | $479.35 | $339.25 | $334.88 | $324.44 | $320.92 | $324.91 | $323.24 | $307.36 | $299.65 | $273.23 |
| Employee Portion | $79.51 | $22.04 | $22.04 | $ 7.97 | $ 2.97 | $20.85 | $ 7.33 | $ 2.33 | $19.97 | $ 5.72 | $ 0.72 | |
| Bi-Weekly | $237.23 | $231.41 | $166.75 | $158.24 | $151.11 | $157.74 | $153.34 | $150.26 | $151.08 | $140.94 | $126.44 | |
| Individual | State Portion | $200.53 | $221.24 | $156.58 | $154.56 | $149.74 | $148.12 | $149.96 | $149.18 | $141.86 | $138.30 | $126.11 |
| Employee Portion | $36.70 | $10.17 | $10.17 | $3.68 | $1.37 | $9.62 | $3.38 | $1.08 | $9.22 | $2.64 | $0.33 | |
| Monthly | $1,130.78 | $1,103.06 | $794.84 | $754.27 | $720.31 | $751.89 | $730.93 | $716.25 | $720.13 | $671.81 | $602.69 | |
| Subscriber+1 | State Portion | $861.32 | $978.83 | $670.61 | $678.47 | $660.02 | $634.37 | $657.47 | $656.30 | $607.57 | $604.29 | $552.24 |
| Employee Portion | $269.46 | $124.23 | $124.23 | $75.80 | $60.29 | $117.52 | $73.46 | $59.95 | $112.56 | $67.52 | $50.45 | |
| Bi-Weekly | $521.90 | $509.10 | $366.85 | $348.12 | $332.45 | $347.03 | $337.35 | $330.58 | $332.37 | $310.07 | $278.16 | |
| Subscriber+1 | State Portion | $397.53 | $451.76 | $309.51 | $313.14 | $304.62 | $292.79 | $303.45 | $302.91 | $280.42 | $278.91 | $254.88 |
| Employee Portion | $124.37 | $57.34 | $57.34 | $34.98 | $27.83 | $54.24 | $33.90 | $27.67 | $51.95 | $31.16 | $23.28 | |
| Monthly | $1,387.77 | $1,353.75 | $975.48 | $925.70 | $884.01 | $922.78 | $897.05 | $879.04 | $883.79 | $824.50 | $739.67 | |
| Family | State Portion | $1,067.75 | $1,207.14 | $828.87 | $818.32 | $801.09 | $784.09 | $792.99 | $796.59 | $750.96 | $728.86 | $670.29 |
| Employee Portion | $320.02 | $146.61 | $146.61 | $107.38 | $82.92 | $138.69 | $104.06 | $82.45 | $132.83 | $95.64 | $69.38 | |
| Bi-Weekly | $640.51 | $624.81 | $450.22 | $427.25 | $408.00 | $425.90 | $414.02 | $405.71 | $407.90 | $380.54 | $341.39 | |
| Family | State Portion | $492.81 | $557.14 | $382.55 | $377.69 | $369.73 | $361.89 | $365.99 | $367.66 | $346.59 | $336.40 | $309.37 |
| Employee Portion | $147.70 | $67.67 | $67.67 | $49.56 | $38.27 | $64.01 | $48.03 | $38.05 | $61.31 | $44.14 | $32.02 | |
| Monthly | $873.78 | $852.36 | $614.19 | $582.85 | $556.60 | $581.01 | $564.81 | $553.47 | $556.46 | $519.13 | $465.72 | |
| FLES | State Portion | $695.18 | $797.33 | $559.16 | $538.61 | $522.48 | $528.95 | $521.94 | $519.54 | $506.60 | $479.73 | $437.17 |
| Employee Portion | $178.60 | $55.03 | $55.03 | $44.24 | $34.12 | $52.06 | $42.87 | $33.93 | $49.86 | $39.40 | $28.55 | |
| Bi-Weekly | $403.28 | $393.40 | $283.47 | $269.01 | $256.89 | $268.16 | $260.68 | $255.45 | $256.83 | $239.60 | $214.95 | |
| FLES | State Portion | $320.85 | $368.00 | $258.07 | $248.59 | $241.14 | $244.13 | $240.89 | $239.79 | $233.82 | $221.42 | $201.77 |
| Employee Portion | $82.43 | $25.40 | $25.40 | $20.42 | $15.75 | $24.03 | $19.79 | $15.66 | $23.01 | $18.18 | $13.18 | |
| Dental Plans | ||||
|---|---|---|---|---|
| Blue Cross Indemnity | ||||
| A & C | A, B & C | CIGNA | ||
| Monthly | $27.91 | $35.33 | $18.48 | |
| Individual | State Portion | $27.91 | $27.91 | $18.48 |
| Employee Portion | $0.00 | $7.42 | $0.00 | |
| Bi-Weekly | $12.88 | $16.31 | $8.53 | |
| Individual | State Portion | $12.88 | $12.88 | $8.53 |
| Employee Portion | $0.00 | $3.43 | $0.00 | |
| Monthly | $85.26 | $99.11 | $40.66 | |
| Subscriber+1 | State Portion | $68.06 | $68.06 | $34.01 |
| Employee Portion | $17.20 | $31.05 | $6.65 | |
| Bi-Weekly | $39.35 | $45.74 | $18.77 | |
| Subscriber+1 | State Portion | $31.41 | $31.41 | $15.70 |
| Employee Portion | $7.94 | $14.33 | $3.07 | |
| Monthly | $85.26 | $99.11 | $49.90 | |
| Family | State Portion | $68.06 | $68.06 | $40.47 |
| Employee Portion | $17.20 | $31.05 | $9.43 | |
| Bi-Weekly | $39.35 | $45.74 | $23.03 | |
| Family | State Portion | $31.41 | $31.41 | $18.68 |
| Employee Portion | $7.94 | $14.33 | $4.35 | |
| Monthly | $57.35 | $63.78 | $31.42 | |
| FLES | State Portion | $48.52 | $48.52 | $27.54 |
| Employee Portion | $8.83 | $15.26 | $3.88 | |
| Bi-Weekly | $26.47 | $29.43 | $14.50 | |
| FLES | State Portion | $22.39 | $22.39 | $12.71 |
| Employee Portion | $4.08 | $7.04 | $1.79 | |
Return to Index of 2003 Comptroller's Memoranda
Return to Index of Comptroller's Memoranda
Return to Comptroller's Home Page