Attachment to Comptroller's Memorandum 2000-24 - Rate Schedule
| State Employee Health Insurance | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7/1/2000 TO 6/30/2001 RATES | |||||||||||||||
| Bi-Weekly Rates Based on 26 Pay Periods | |||||||||||||||
| Medical Plans | Dental Plans | ||||||||||||||
| Anthem | PHS | MedSpan | Conn ecti Care |
Blue Cross | Blue Cross | ||||||||||
| Blue Cross | Blue Cross | State BlueCare | State BlueCare | State BlueCare | Indem- nity |
Indem- nity |
|||||||||
| State Pre- ferred |
Out of Area | POS | POE | POE Plus | Charter POS | Charter HMO | Passport HMO | P.O.S | P.O.E | A & C | A, B & C | CIGNA | |||
| Indiv- |
Monthly | $340.83 | $332.47 | $239.57 | $227.34 | $217.10 | $221.62 | $215.44 | $211.11 | $226.01 | $203.33 | $188.61 | $22.50 | $28.49 | $15.34 |
| State Portion | $288.09 | $317.85 | $224.95 | $226.30 | $217.10 | $208.10 | $215.11 | $211.11 | $212.22 | $203.33 | $188.61 | $22.50 | $22.50 | $15.34 | |
| Employee Portion | $52.74 | $14.62 | $14.62 | $1.04 | $0.00 | $13.52 | $0.33 | $0.00 | $13.79 | $0.00 | $0.00 | $0.00 | $5.99 | $0.00 | |
| Semi- Monthly |
$170.42 | $166.24 | $119.79 | $113.67 | $108.55 | $110.81 | $107.72 | $105.56 | $113.01 | $101.67 | $94.31 | $11.25 | $14.25 | $7.67 | |
| State Portion | $144.05 | $158.93 | $112.48 | $113.15 | $108.55 | $104.05 | $107.55 | $105.56 | $106.11 | $101.67 | $94.31 | $11.25 | $11.25 | $7.67 | |
| Employee Portion | $26.37 | $7.31 | $7.31 | $0.52 | $0.00 | $6.76 | $0.17 | $0.00 | $6.90 | $0.00 | $0.00 | $0.00 | $3.00 | $0.00 | |
| Bi- Weekly |
$157.31 | $153.45 | $110.57 | $104.93 | $100.20 | $102.29 | $99.43 | $97.44 | $104.31 | $93.84 | $87.05 | $10.38 | $13.15 | $7.08 | |
| State Portion | $132.97 | $146.70 | $103.82 | $104.45 | $100.20 | $96.05 | $99.28 | $97.44 | $97.95 | $93.84 | $87.05 | $10.38 | $10.38 | $7.08 | |
| Employee Portion | $24.34 | $6.75 | $6.75 | $0.48 | $0.00 | $6.24 | $0.15 | $0.00 | $6.36 | $0.00 | $0.00 | $0.00 | $2.77 | $0.00 | |
| Sub- plus 1 |
Monthly | $749.83 | $731.43 | $527.05 | $500.14 | $477.62 | $487.60 | $473.98 | $464.46 | $497.24 | $447.32 | $414.94 | $68.73 | $79.92 | $33.75 |
| State Portion |
$571.11 | $649.05 | $444.67 | $449.88 | $437.62 | $411.38 | $426.35 | $424.46 | $419.51 | $402.36 | $385.14 | $54.86 | $54.86 | $28.23 | |
| Employee Portion | $178.72 | $82.38 | $82.38 | $50.26 | $40.00 | $76.22 | $47.63 | $40.00 | $77.73 | $44.96 | $29.80 | $13.87 | $25.06 | $5.52 | |
| Semi- Monthly |
$374.92 | $365.72 | $263.53 | $250.07 | $238.81 | $243.80 | $236.99 | $232.23 | $248.62 | $223.66 | $207.47 | $34.37 | $39.96 | $16.88 | |
| State Portion |
$285.56 | $324.53 | $222.34 | $224.94 | $218.81 | $205.69 | $213.17 | $212.23 | $209.75 | $201.18 | $192.57 | $27.43 | $27.43 | $14.12 | |
| Employee Portion | $89.36 | $41.19 | $41.19 | $25.13 | $20.00 | $38.11 | $23.82 | $20.00 | $38.87 | $22.48 | $14.90 | $6.94 | $12.53 | $2.76 | |
| Bi- Weekly |
$346.08 | $337.58 | $243.25 | $230.83 | $220.44 | $225.05 | $218.76 | $214.37 | $229.50 | $206.46 | $191.51 | $31.72 | $36.89 | $15.58 | |
| State Portion | $263.59 | $299.56 | $205.23 | $207.63 | $201.98 | $189.87 | $196.78 | $195.91 | $193.62 | $185.71 | $177.76 | $25.32 | $25.32 | $13.03 | |
| Employee Portion | $82.49 | $38.02 | $38.02 | $23.20 | $18.46 | $35.18 | $21.98 | $18.46 | $35.88 | $20.75 | $13.75 | $6.40 | $11.57 | $2.55 | |
| Family |
Monthly | $920.24 | $897.67 | $646.84 | $613.80 | $586.17 | $598.40 | $581.68 | $570.01 | $610.25 | $548.99 | $509.25 | $68.73 | $79.92 | $41.42 |
| State Portion |
$707.98 | $800.43 | $549.60 | $542.60 | $531.17 | $508.44 | $514.21 | $515.01 | $518.51 | $485.31 | $465.94 | $54.86 | $54.86 | $33.60 | |
| Employee Portion | $212.26 | $97.24 | $97.24 | $71.20 | $55.00 | $89.96 | $67.47 | $55.00 | $91.74 | $63.68 | $43.31 | $13.87 | $25.06 | $7.82 | |
| Semi- Monthly |
$460.12 | $448.84 | $323.42 | $306.90 | $293.09 | $299.20 | $290.84 | $285.01 | $305.13 | $274.50 | $254.63 | $34.37 | $39.96 | $20.71 | |
| State Portion |
$353.99 | $400.22 | $274.80 | $271.30 | $265.59 | $254.22 | $257.10 | $257.51 | $259.26 | $242.66 | $232.97 | $27.43 | $27.43 | $16.80 | |
| Employee Portion | $106.13 | $48.62 | $48.62 | $35.60 | $27.50 | $44.98 | $33.74 | $27.50 | $45.87 | $31.84 | $21.66 | $6.94 | $12.53 | $3.91 | |
| Bi- Weekly |
$424.73 | $414.31 | $298.54 | $283.29 | $270.54 | $276.18 | $268.47 | $263.08 | $281.65 | $253.38 | $235.04 | $31.72 | $36.89 | $19.12 | |
| State Portion |
$326.76 | $369.43 | $253.66 | $250.43 | $245.16 | $234.66 | $237.33 | $237.70 | $239.31 | $223.99 | $215.05 | $25.32 | $25.32 | $15.51 | |
| Employee Portion |
$97.97 | $44.88 | $44.88 | $32.86 | $25.38 | $41.52 | $31.14 | $25.38 | $42.34 | $29.39 | $19.99 | $6.40 | $11.57 | $3.61 | |
| FLES | Monthly | $579.41 | $565.20 | $407.27 | $386.46 | $369.07 | $376.78 | $366.24 | $358.90 | $384.24 | $345.66 | $320.64 | $46.23 | $51.43 | $26.08 |
| State Portion | $460.98 | $528.71 | $370.78 | $357.13 | $346.43 | $343.02 | $338.44 | $336.26 | $349.81 | $319.42 | $302.80 | $39.11 | $39.11 | $22.86 | |
| Employee Portion | $118.43 | $36.49 | $36.49 | $29.33 | $22.64 | $33.76 | $27.80 | $22.64 | $34.43 | $26.24 | $17.84 | $7.12 | $12.32 | $3.22 | |
| Semi- Monthly |
$289.71 | $282.60 | $203.64 | $193.23 | $184.54 | $188.39 | $183.12 | $179.45 | $192.12 | $172.83 | $160.32 | $23.12 | $25.71 | $13.04 | |
| State Portion |
$230.49 | $264.35 | $185.39 | $178.56 | $173.22 | $171.51 | $169.22 | $168.13 | $174.90 | $159.71 | $151.40 | $19.56 | $19.56 | $11.43 | |
| Employee Portion |
$59.22 | $18.25 | $18.25 | $14.67 | $11.32 | $16.88 | $13.90 | $11.32 | $17.22 | $13.12 | $8.92 | $3.56 | $6.15 | $1.61 | |
| Bi- Weekly |
$267.42 | $260.86 | $187.97 | $178.37 | $170.34 | $173.90 | $169.03 | $165.65 | $177.34 | $159.54 | $147.99 | $21.34 | $23.74 | $12.04 | |
| State Portion |
$212.76 | $244.02 | $171.13 | $164.83 | $159.89 | $158.32 | $156.20 | $155.20 | $161.45 | $147.43 | $139.76 | $18.05 | $18.05 | $10.55 | |
| Employee Portion | $54.66 | $16.84 | $16.84 | $13.54 | $10.45 | $15.58 | $12.83 | $10.45 | $15.89 | $12.11 | $8.23 | $3.29 | $5.69 | $1.49 | |
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