Office of the State Comptroller

Healthcare Policy & Benefit Services Division

2010-2011 Biweekly Medical Insurance Rates

Total Monthly Premium Monthly Medical Premium Monthly State Share Rx Drug Monthly Medical State Share Monthly Employee Share BW State Share Rx Drug BW State Share Medical BW Employee Share
Anthem Point of Enrollment - Gatekeeper (POE-G) Employee Only $581.79 $463.69 $118.10 $415.81 $47.88 $54.51 $191.91 $22.10
Employee +1 $1,279.94 $1,020.12 $259.82 $880.73 $139.39 $119.92 $406.49 $64.33
Family $1,570.83 $1,251.96 $318.87 $1,072.26 $179.70 $147.17 $494.89 $82.94
FLES $989.04 $788.27 $200.77 $695.30 $92.97 $92.66 $320.91 $42.91
Point of Enrollment (POE) Employee Only $584.11 $466.01 $118.10 $412.62 $53.39 $54.51 $190.44 $24.64
Employee +1 $1,285.04 $1,025.22 $259.82 $863.82 $161.40 $119.92 $398.69 $74.49
Family $1,577.10 $1,258.23 $318.87 $1,042.96 $215.27 $147.17 $481.37 $99.36
FLES $992.99 $792.22 $200.77 $684.58 $107.64 $92.66 $315.96 $49.68
Point of Service (POS) Employee Only $603.54 $485.44 $118.10 $416.27 $69.17 $54.51 $192.12 $31.92
Employee +1 $1,327.79 $1,067.97 $259.82 $828.17 $239.80 $119.92 $382.23 $110.68
Family $1,629.56 $1,310.69 $318.87 $1,033.50 $277.19 $147.17 $477.00 $127.93
FLES $1,026.02 $825.25 $200.77 $701.00 $124.25 $92.66 $323.54 $57.35
Anthem Out of Area (OOA) Employee Only $827.37 $709.27 $118.10 $640.10 $69.17 $54.51 $295.43 $31.92
Employee +1 $1,820.21 $1,560.39 $259.82 $1,320.59 $239.80 $119.92 $609.50 $110.68
Family $2,233.90 $1,915.03 $318.87 $1,637.84 $277.19 $147.17 $755.93 $127.93
FLES $1,406.53 $1,205.76 $200.77 $1,081.51 $124.25 $92.66 $499.16 $57.35
Preferred Employee Only $864.70 $746.60 $118.10 $580.23 $166.37 $54.51 $267.80 $76.79
Employee +1 $1,902.34 $1,642.52 $259.82 $1,156.66 $485.86 $119.92 $533.84 $224.24
Family $2,334.69 $2,015.82 $318.87 $1,444.75 $571.07 $147.17 $666.81 $263.57
FLES $1,469.99 $1,269.22 $200.77 $936.12 $333.10 $92.66 $432.06 $153.74
Oxford HMO (POE-G) Employee Only $443.33 $325.23 $118.10 $283.96 $41.27 $54.51 $131.06 $19.05
Employee +1 $975.33 $715.51 $259.82 $602.57 $112.94 $119.92 $278.11 $52.13
Family $1,196.99 $878.12 $318.87 $734.48 $143.64 $147.17 $338.99 $66.30
FLES $753.66 $552.89 $200.77 $475.34 $77.55 $92.66 $219.39 $35.79
HMO Select (POE) Employee Only $481.97 $363.87 $118.10 $317.12 $46.75 $54.51 $146.36 $21.58
Employee +1 $1,060.33 $800.51 $259.82 $662.56 $137.95 $119.92 $305.80 $63.67
Family $1,301.32 $982.45 $318.87 $800.14 $182.31 $147.17 $369.30 $84.14
FLES $819.35 $618.58 $200.77 $525.01 $93.57 $92.66 $242.31 $43.19
Freedom Select POS (POS) Employee Only $506.53 $388.43 $118.10 $326.08 $62.35 $54.51 $150.50 $28.78
Employee +1 $1,114.37 $854.55 $259.82 $648.95 $205.60 $119.92 $299.52 $94.89
Family $1,367.63 $1,048.76 $318.87 $811.75 $237.01 $147.17 $374.65 $109.39
FLES $861.10 $660.33 $200.77 $551.75 $108.58 $92.66 $254.65 $50.11
Oxford Out of Area (OOA) Employee Only $537.23 $419.13 $118.10 $356.78 $62.35 $54.51 $164.67 $28.78
Employee +1 $1,181.91 $922.09 $259.82 $716.49 $205.60 $119.92 $330.69 $94.89
Family $1,450.52 $1,131.65 $318.87 $894.64 $237.01 $147.17 $412.91 $109.39
FLES $913.29 $712.52 $200.77 $603.94 $108.58 $92.66 $278.74 $50.11

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