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

MEMORANDUM NO. 96-19

April 10, 1996

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION:Personnel and Payroll Officers
SUBJECT: 1996-97 Health Insurance Rates

AUTHORIZATION: In accordance with the provisions of Section 5-259 of the Connecticut General Statutes, the following premium changes have been approved for state-sponsored health care insurance plans.

PAYROLLS ON WHICH EFFECTIVE: The changes announced herein will be effective on the following payroll periods:

Bi-Weekly:
May 24, 1996 - June 6, 1996
Payable June 21, 1996
Semi-Monthly:
June 1-15, 1996
Payable June 15, 1996
Monthly: June 30, 1996

CHARTS: Attached are revised rates for charts "A" through "H". Rate changes will be made centrally. Paired D/OEs for both pre and post-tax deductions are provided on all charts.

NOTICE TO EMPLOYEES: The 1996 Employees Health Care Planner, which is being mailed at the end of April, includes a schedule of all applicable bi-weekly payroll deductions. Employees on other than a bi-weekly pay plan should be notified of the relevant rate changes.

QUESTIONS: Personnel or payroll staff who may have questions concerning payroll related procedures should call the Comptroller s Central Payroll Division at 566-5428. Questions regarding other health insurance issues should be directed to the Comptroller s Retirement and Benefit Services Division at 566-1742.

PLEASE DO NOT REFER EMPLOYEES DIRECTLY TO THESE NUMBERS.

Nancy Wyman
State Comptroller

Attachments: Rate Charts A-H

CORRECTED 6/11/96
HEALTH INSURANCE RATES
MSA TABLES

Bi-Weekly Period End Date 6/6/96 Payable 6/21/96
Semi-Monthly Period End Date 6/15/96 Payable 6/15/96

Table
Number
Employee
Deduction
Table
Number
State
Portion
Chart A
Blue Cross (Paired D/OEs Pre-tax 7J/7H, Post-Tax 7G/7H) (Sort Code
0001)
POS Plan (State Preferred)
26 Pay Bi-Weekly
Individual0100.0001189.54
Family01442.98015189.82
FLES01816.12019127.14
24 Pay Semi-Monthly
Individual2160.0021797.00
Family22046.56221205.64
FLES22417.46225137.74
Chart B
BC Dental (Paired D/OEs Pre-tax 5P/54, Post-Tax 42/54) (Sort Code
00159)
With Riders A and C
26 Pay Bi-Weekly
Individual1760.001778.43
Family1785.1917920.55
FLES1802.6618114.65
24 Pay Semi-Monthly
Individual3820.003839.13
Family3845.6338522.26
FLES3862.8938715.87
Chart C
BC Dental (Paired D/OEs Pre-tax 5P/54, Post-Tax 42/54) (Sort Code
00159)
With Riders A, B, and C (Payroll CTBC only)
26 Pay Bi-Weekly
Individual0422.240438.43
Family0449.3904520.55
FLES1744.6217514.65
24 Pay Semi-Monthly
Individual2482.432469.13
Family24710.1725122.26
FLES3805.0038115.87
Chart D
Blue Cross (Paired D/OEs Pre-tax 6R/6P, Post-Tax 6N/6P) (Sort Code
00077)
POE Plan (State Premier)
26 Pay Bi-Weekly
Individual0460.0004785.51
Subscriber+One 0480.00049188.12
Family05041.05051189.82
FLES05218.22053127.14
24 Pay Semi-Monthly
Individual2520.0025392.64
Subscriber+One 2540.00255203.80
Family25644.47257205.64
FLES25819.73259137.74
Chart E
Blue Cross Advantage (Paired D/OEs Pre-tax 6G/6E, Post-Tax
6D/6E) (Sort Code 00004)
(Replaces CHCP)
26 Pay Bi-Weekly
Individual0940.0009580.87
Subscriber+ 1 0960.00097177.92
Family09828.53099189.82
FLES10010.34101127.14
24 Pay Semi-Monthly
Individual3000.0030187.61
Subscriber+ 1 3020.00303192.74
Family30430.91305205.64
FLES30611.20307137.74
Chart F
KFHP (Paired D/OEs Pre-tax 6L/6J, Post-Tax 6I/6J) (Sort Code
00006)
(Kaiser Foundation Health Plan)
26 Pay Bi-Weekly
Individual1260.0012782.74
Subscriber+ one 1280.00129183.85
Family1300.00131188.21
FLES1320.00133105.47
24 Pay Semi-Monthly
Individual3320.0033389.64
Subscriber+ one 3340.00335199.17
Family3360.00337203.89
FLES3380.00339114.25
Chart G
M.D.H.P. (Paired D/OEs Pre-tax 6W/6U, Post-Tax) (Sort Code
00259)
(M.D Health Plan)
26 Pay Bi-Weekly
Individual1160.0011785.47
Subscriber+ 1 1180.00119188.04
Family12040.96121189.82
FLES12218.17123127.14
24 Pay Semi-Monthly
Individual2600.0026192.60
Subscriber+ 1 2620.00263203.71
Family26444.37265205.64
FLES27219.670273137.74
Chart H
Cigna Dental (Paired D/OEs Pre-tax 5R/5K, Post-Tax 5J/5K) (Sort
Code 00185)
26 Pay Bi-Weekly
Individual1400.001416.79
Subscriber+ one 1421.8114311.03
Family1443.4914514.95
FLES1461.4614710.19
24 Pay Semi-Monthly
Individual2760.002777.36
Subscriber+ one 2781.9627911.95
Family2803.7928116.19
FLES2821.5828311.04

Paired D/OEs = Paired deductions employee/state share required to allow state contribution to the cost of coverage

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