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-
idual

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-
scriber

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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