State Employee Health Insurance
7/1/2008 TO 6/30/2009 RATES - BI-WEEKLY SCHEDULE - 100% of Premium
SPLIT RATES
Medical Plans Dental Plans
Anthem
Blue Cross State BlueCare Health Net Oxford Health United Health CIGNA
State Preferred Out of Area POS POE POE Plus Charter POS Charter HMO Passport HMO Freedom Select POS HMO Select HMO Oxford USA Out of Area Employees PPO DHMO
Individual Total Monthly Premium $ 709.78 $ 680.14 $ 502.40 $ 486.97 $ 485.13 $ 526.73 $ 496.46 $ 502.17 $ 437.37 $ 417.10 $ 385.23 $ 462.69 $ 35.33 $ 32.50 $ 21.58
Monthly Medical Premium $ 592.85 $ 563.21 $ 385.47 $ 370.04 $ 368.20 $ 409.80 $ 379.53 $ 385.24 $ 320.44 $ 300.17 $ 268.30 $ 345.76
Monthly Rx Drug $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93 $ 116.93
BiWeekly Total Premium $ 327.59 $ 313.91 $ 231.88 $ 224.76 $ 223.91 $ 243.11 $ 229.14 $ 231.77 $ 201.87 $ 192.51 $ 177.80 $ 213.55 $ 16.31 $ 15.00 $ 9.96
BiWeekly Medical Premium $ 273.62 $ 259.94 $ 177.91 $ 170.79 $ 169.94 $ 189.14 $ 175.17 $ 177.80 $ 147.90 $ 138.54 $ 123.83 $ 159.58
BiWeekly Rx Premium $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97 $ 53.97
Subscriber + 1 Total Monthly Premium $ 1,561.52 $ 1,496.31 $ 1,105.28 $ 1,071.33 $ 1,067.29 $ 1,158.81 $ 1,092.21 $ 1,104.77 $ 962.21 $ 917.62 $ 847.51 $ 1,017.92 $ 107.76 $ 99.13 $ 47.48
Monthly Medical Premium $ 1,304.27 $ 1,239.06 $ 848.03 $ 814.09 $ 810.04 $ 901.56 $ 834.97 $ 847.53 $ 704.97 $ 660.37 $ 590.26 $ 760.67
Monthly Rx Drug $ 257.25 $ 257.25 $ 257.25 $ 257.24 $ 257.25 $ 257.25 $ 257.24 $ 257.24 $ 257.24 $ 257.25 $ 257.25 $ 257.25
BiWeekly Total Premium $ 720.70 $ 690.60 $ 510.13 $ 494.46 $ 492.59 $ 534.83 $ 504.10 $ 509.90 $ 444.10 $ 423.52 $ 391.16 $ 469.81 $ 49.74 $ 45.75 $ 21.91
BiWeekly Medical Premium $ 601.97 $ 571.87 $ 391.40 $ 375.73 $ 373.86 $ 416.10 $ 385.37 $ 391.17 $ 325.37 $ 304.79 $ 272.43 $ 351.08
BiWeekly Rx Premium $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73 $ 118.73
Family Total Monthly Premium $ 1,916.41 $ 1,836.38 $ 1,356.48 $ 1,314.82 $ 1,309.85 $ 1,422.17 $ 1,340.44 $ 1,355.86 $ 1,180.90 $ 1,126.17 $ 1,040.12 $ 1,249.26 $ 107.76 $ 99.13 $ 58.27
Monthly Medical Premium $ 1,600.70 $ 1,520.67 $ 1,040.77 $ 999.11 $ 994.14 $ 1,106.46 $ 1,024.73 $ 1,040.15 $ 865.19 $ 810.46 $ 724.41 $ 933.55
Monthly Rx Drug $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71 $ 315.71
BiWeekly Total Premium $ 884.50 $ 847.56 $ 626.07 $ 606.84 $ 604.55 $ 656.39 $ 618.66 $ 625.78 $ 545.03 $ 519.77 $ 480.06 $ 576.58 $ 49.74 $ 45.75 $ 26.89
BiWeekly Medical Premium $ 738.78 $ 701.85 $ 480.36 $ 461.13 $ 458.83 $ 510.67 $ 472.95 $ 480.07 $ 399.32 $ 374.06 $ 334.34 $ 430.87
BiWeekly Rx Premium $ 145.72 $ 145.71 $ 145.71 $ 145.71 $ 145.72 $ 145.72 $ 145.71 $ 145.71 $ 145.71 $ 145.71 $ 145.72 $ 145.71

 

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