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. 97-26

May 22, 1997

TO THE HEADS OF ALL STATE AGENCIES

ATTENTION: Personnel and Payroll Officers
SUBJECT: 1997 - 1998 COBRA Continuation Coverage Rates

The following new MONTHLY rates are for continuation coverage under COBRA, effective July 1, 1997.

SubscriberSubscriber
Plus One
Family
1 Blue Cross State Preferred$245.86 $540.89$663.82
2 M.D. Health Plan$188.89$415.57$510.01
3State BlueCare Point of Enrollment$201.36$442.99$543.67
4 Blue Cross Out of Area $245.86 $540.89 $663.82
5 State BlueCare Point of Service$223.73 $492.20$604.06
6Kaiser Permanente$182.87 $406.31 $415.94
7 Blue Cross Indemnity A & C$19.56$59.75$59.75
8Blue Cross Indemnity A, B & C$24.77$69.48$69.48
9 CIGNA$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 and/or beneficiaries. It is important that both sides of the form are given to the employee/beneficiary. Previous versions of this form should be discarded.

Questions concerning this matter should be directed to the Retirement and Benefit Services Division, Health Care Analysis Unit, at (860) 702-3538.

Very truly yours,

Nancy Wyman
State Comptroller

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