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. 96-22

April 24, 1996

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION:Personnel and Payroll Officers
SUBJECT: 1996 - 1997 COBRA Continuation Coverage Rates

The following new MONTHLY rates are for continuation coverage under COBRA, effective July 1, 1996.

SubscriberSubscriber
Plus One
Family
1. Blue Cross Preferred (POS) Plan $197.88 $514.49 $514.49
2. Blue Cross Premier (POE) Plan $188.98 $415.75 $510.23
3. M.D. Health Plan $188.89$415.57 $510.01
4. Blue Cross Advantage$178.72 $393.19 $482.56
5. Kaiser Permanente $182.87 $406.31 $415.94
6. Blue Cross Dental with
A & C Riders
$ 18.63 $ 56.90 $ 56.90
7. Blue Cross Dental with
A, B & C Riders
$ 23.58 $ 66.16 $ 66.16
8. CIGNA Dental $ 15.00 $ 28.37 $ 40.76

The above rates include a 2 percent administration fee.

A revised Form CO-1022, Group Health Insurance Continuation Coverage Election , is attached to this memo, and should be duplicated for agency use in notification to employees. Previous versions of this form should be discarded.

Questions concerning this matter should be directed to the Retirement and Benefit Services Division, at 566-1831.

NANCY WYMAN
STATE COMPTROLLER

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