State of Connecticut

State Employee Health Insurance
7/1/2006 TO 6/30/2007 Employee Share Rates Based on Final Premium Rates for Contributions
Bi-Weekly Rates Based on 26 Pay Periods
Medical Plans Including Rx Drug Dental
Anthem Health Net Oxford UnitedHealthcare Aetna
State Preferred POS State Blue
Care POS
State Blue
Care POE
State Blue
Care POE-G
Out of Area Charter POS Charter HMO POE Passport HMO POE-G Freedom Select POS HMO Select POE HMO POE-G Out of Area Basic Judges En-
hanced
DMO
Indiv-
idual
Monthly Premium $623.79 $476.25 $457.58 $450.57 $575.32 $470.89 $444.26 $449.29 $465.67 $443.19 $407.87 $493.73 $29.25 $29.97 $26.91 $19.79
Employee Share $96.50 $29.05 $14.86 $9.86 $29.05 $28.72 $14.06 $9.06 $28.41 $13.99 $8.99 $28.41 $0.00 $0.72 $0.00 $0.00
Semi-
Monthly
Premium $311.90 $238.13 $228.79 $225.29 $287.66 $235.45 $222.13 $224.65 $232.84 $221.60 $203.94 $246.87 $14.63 $14.99 $13.46 $9.90
Employee Share $48.25 $14.53 $7.43 $4.93 $14.53 $14.36 $7.03 $4.53 $14.21 $7.00 $4.50 $14.21 $0.00 $0.36 $0.00 $0.00
Bi-
Weekly
Premium $287.90 $219.81 $211.19 $207.96 $265.53 $217.33 $205.04 $207.36 $214.92 $204.55 $188.25 $227.88 $13.50 N/A $12.42 $9.13
Employee Share $44.54 $13.41 $6.86 $4.55 $13.41 $13.26 $6.49 $4.18 $13.11 $6.46 $4.15 $13.11 $0.00 N/A $0.00 $0.00
Sub-
scriber+1
Monthly Premium $1,372.34 $1,047.76 $1,006.68 $991.27 $1,265.71 $1,035.96 $977.37 $988.44 $1,024.47 $975.02 $897.31 $1,086.21 $89.22 $91.05 $82.07 $43.54
Employee Share $327.03 $163.76 $101.17 $82.97 $163.76 $161.92 $98.23 $82.73 $160.12 $97.99 $75.10 $160.12 $17.99 $19.82 $16.55 $7.12
Semi-
Monthly
Premium $686.17 $523.88 $503.34 $495.64 $632.86 $517.98 $488.69 $494.22 $512.24 $487.51 $448.66 $543.11 $44.61 $45.53 $41.04 $21.77
Employee Share $163.52 $81.88 $50.59 $41.49 $81.88 $80.96 $49.12 $41.37 $80.06 $49.00 $37.55 $80.06 $8.99 $9.91 $8.27 $3.56
Bi-
Weekly
Premium $633.39 $483.58 $464.62 $457.51 $584.17 $478.14 $451.09 $456.20 $472.83 $450.01 $414.14 $501.33 $41.18 N/A $37.88 $20.10
Employee Share $150.94 $75.58 $46.69 $38.29 $75.58 $74.73 $45.34 $38.18 $73.90 $45.23 $34.66 $73.90 $8.30 N/A $7.64 $3.29
Family Monthly Premium $1,684.23 $1,285.89 $1,235.48 $1,216.55 $1,553.38 $1,271.40 $1,199.50 $1,213.08 $1,257.31 $1,196.61 $1,101.25 $1,333.07 $89.22 $91.05 $82.07 $53.43
Employee Share $388.38 $193.27 $143.32 $114.11 $193.27 $191.09 $139.14 $113.79 $188.97 $138.81 $103.30 $188.97 $17.99 $19.82 $16.55 $10.09
Semi-
Monthly
Premium $842.12 $642.95 $617.74 $608.28 $776.69 $635.70 $599.75 $606.54 $628.66 $598.31 $550.63 $666.54 $44.61 $45.53 $41.04 $26.72
Employee Share $194.19 $96.64 $71.66 $57.06 $96.64 $95.55 $69.57 $56.90 $94.49 $69.41 $51.65 $94.49 $8.99 $9.91 $8.27 $5.05
Bi-
Weekly
Premium $777.34 $593.49 $570.22 $561.48 $716.94 $586.80 $553.62 $559.88 $580.30 $552.28 $508.27 $615.26 $41.18 N/A $37.88 $24.66
Employee Share $179.25 $89.20 $66.15 $52.67 $89.20 $88.20 $64.22 $52.52 $87.22 $64.07 $47.68 $87.22 $8.30 N/A $7.64 $4.66
FLES Monthly Premium $1,060.44 $809.64 $777.90 $765.98 $978.06 $800.51 $755.24 $763.79 $791.64 $753.42 $693.38 $839.34 $59.97 $61.08 $55.16 $33.64
Employee Share $216.75 $72.54 $59.04 $46.95 $72.54 $71.73 $57.32 $46.82 $70.93 $57.18 $42.50 $70.93 $9.22 $10.33 $8.47 $4.15
Semi-
Monthly
Premium $530.22 $404.82 $388.95 $382.99 $489.03 $400.26 $377.62 $381.90 $395.82 $376.71 $346.69 $419.67 $29.98 $30.54 $27.58 $16.82
Employee Share $108.38 $36.27 $29.52 $23.48 $36.27 $35.87 $28.66 $23.41 $35.47 $28.59 $21.25 $35.47 $4.60 $5.16 $4.24 $2.08
Bi-
Weekly
Premium $489.43 $373.68 $359.03 $353.53 $451.41 $369.47 $348.57 $352.52 $365.37 $347.73 $320.02 $387.39 $27.68 N/A $25.46 $15.53
Employee Share $100.04 $33.48 $27.25 $21.67 $33.48 $33.11 $26.46 $21.61 $32.74 $26.39 $19.62 $32.74 $4.25 N/A $3.91 $1.92

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