Attachment to:
Comptroller's Memorandum 2001-29
Rate Schedule
April 12, 2001
State Employee Health Insurance | |||||||||||||||
7/1/2001 TO 6/30/2002 RATES | |||||||||||||||
Bi-Weekly Rates Based on 26 Pay Periods | |||||||||||||||
Medical Plans | Dental Plans | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Anthem | Health Net | ConnectiCare | |||||||||||||
Blue Cross | State BlueCare | Blue Cross Indemnity | |||||||||||||
State Preferred | Out of Area | POS | POE | POE Plus | Charter POS | Charter HMO | Passport HMO | POS Open Access | HMO Open Access | HMO Personal Care Plan | A & C | A, B & C | CIGNA | ||
Monthly | $391.61 | $382.01 | $275.27 | $261.21 | $249.45 | $284.78 | $276.84 | $271.28 | $268.61 | $250.59 | $224.81 | $24.98 | $31.62 | $15.95 | |
State Portion | $331.03 | $365.22 | $258.48 | $258.14 | $249.45 | $267.41 | $272.83 | $271.28 | $252.22 | $248.15 | $224.81 | $24.98 | $24.98 | $15.95 | |
Employee Portion | $60.58 | $16.79 | $16.79 | $ 3.07 | $ - | $17.37 | $ 4.01 | $ - | $16.39 | $ 2.44 | $ - | $0.00 | $6.64 | $0.00 | |
Semi-Monthly | $195.81 | $191.01 | $137.64 | $130.61 | $124.73 | $142.39 | $138.42 | $135.64 | $134.31 | $125.30 | $112.41 | $12.49 | $15.81 | $7.98 | |
Individual | State Portion | $165.52 | $182.61 | $129.24 | $129.07 | $124.73 | $133.70 | $136.41 | $135.64 | $126.11 | $124.08 | $112.41 | $12.49 | $12.49 | $7.98 |
Employee Portion | $30.29 | $8.40 | $8.40 | $1.54 | $0.00 | $8.69 | $2.01 | $0.00 | $8.20 | $1.22 | $0.00 | $0.00 | $3.32 | $0.00 | |
Bi-Weekly | $180.74 | $176.31 | $127.05 | $120.56 | $115.13 | $131.44 | $127.77 | $125.21 | $123.97 | $115.66 | $103.76 | $11.53 | $14.59 | $7.36 | |
State Portion | $152.78 | $168.56 | $119.30 | $119.14 | $115.13 | $123.42 | $125.92 | $125.21 | $116.41 | $114.53 | $103.76 | $11.53 | $11.53 | $7.36 | |
Employee Portion | $27.96 | $7.75 | $7.75 | $1.42 | $0.00 | $8.02 | $1.85 | $0.00 | $7.56 | $1.13 | $0.00 | $0.00 | $3.06 | $0.00 | |
Monthly | $861.54 | $840.42 | $605.59 | $574.66 | $548.79 | $626.52 | $609.05 | $596.82 | $590.94 | $551.30 | $494.58 | $76.31 | $88.70 | $35.10 | |
State Portion | $656.23 | $745.77 | $510.94 | $516.91 | $502.86 | $528.60 | $547.84 | $546.87 | $498.58 | $495.89 | $453.18 | $60.91 | $60.91 | $29.35 | |
Employee Portion | $205.31 | $94.65 | $94.65 | $57.75 | $45.93 | $97.92 | $61.21 | $49.95 | $92.36 | $55.41 | $41.40 | $15.40 | $27.79 | $5.75 | |
Semi-Monthly | $430.77 | $420.21 | $302.80 | $287.33 | $274.40 | $313.26 | $304.52 | $298.41 | $295.47 | $275.65 | $247.29 | $38.15 | $44.35 | $17.55 | |
Subscriber plus 1 |
State Portion | $328.11 | $372.88 | $255.47 | $258.45 | $251.43 | $264.30 | $273.91 | $273.43 | $249.29 | $247.94 | $226.59 | $30.45 | $30.45 | $14.68 |
Employee Portion | $102.66 | $47.33 | $47.33 | $28.88 | $22.97 | $48.96 | $30.61 | $24.98 | $46.18 | $27.71 | $20.70 | $7.70 | $13.90 | $2.87 | |
Bi-Weekly | $397.63 | $387.89 | $279.50 | $265.23 | $253.29 | $289.16 | $281.10 | $275.45 | $272.74 | $254.45 | $228.27 | $35.22 | $40.94 | $16.20 | |
State Portion | $302.87 | $344.21 | $235.82 | $238.58 | $232.09 | $243.97 | $252.85 | $252.40 | $230.11 | $228.88 | $209.16 | $28.11 | $28.11 | $13.55 | |
Employee Portion | $94.76 | $43.68 | $43.68 | $26.65 | $21.20 | $45.19 | $28.25 | $23.05 | $42.63 | $25.57 | $19.11 | $7.11 | $12.83 | $2.65 | |
Monthly | $1,057.35 | $1,031.43 | $743.23 | $705.27 | $673.52 | $768.91 | $747.47 | $732.46 | $725.25 | $676.59 | $606.99 | $76.31 | $88.70 | $43.07 | |
State Portion | $813.53 | $919.72 | $631.52 | $623.46 | $610.34 | $653.34 | $660.76 | $663.76 | $616.25 | $598.11 | $550.05 | $60.91 | $60.91 | $34.94 | |
Employee Portion | $243.82 | $111.71 | $111.71 | $81.81 | $63.18 | $115.57 | $86.71 | $68.70 | $109.00 | $78.48 | $56.94 | $15.40 | $27.79 | $8.13 | |
Semi-Monthly | $528.67 | $515.71 | $371.61 | $352.63 | $336.76 | $384.45 | $373.73 | $366.23 | $362.62 | $338.30 | $303.49 | $38.15 | $44.35 | $21.54 | |
Family | State Portion | $406.76 | $459.85 | $315.75 | $311.72 | $305.17 | $326.66 | $330.37 | $331.88 | $308.12 | $299.06 | $275.02 | $30.45 | $30.45 | $17.47 |
Employee Portion | $121.91 | $55.86 | $55.86 | $40.91 | $31.59 | $57.79 | $43.36 | $34.35 | $54.50 | $39.24 | $28.47 | $7.70 | $13.90 | $4.07 | |
Bi-Weekly | $488.01 | $476.04 | $343.03 | $325.51 | $310.85 | $354.88 | $344.99 | $338.06 | $334.73 | $312.27 | $280.15 | $35.22 | $40.94 | $19.88 | |
State Portion | $375.48 | $424.48 | $291.47 | $287.75 | $281.69 | $301.54 | $304.97 | $306.35 | $284.42 | $276.05 | $253.87 | $28.11 | $28.11 | $16.12 | |
Employee Portion | $112.53 | $51.56 | $51.56 | $37.76 | $29.16 | $53.34 | $40.02 | $31.71 | $50.31 | $36.22 | $26.28 | $7.11 | $12.83 | $3.76 | |
Monthly | $665.74 | $649.42 | $467.96 | $444.06 | $424.07 | $484.13 | $470.63 | $461.18 | $456.64 | $426.00 | $382.18 | $51.33 | $57.08 | $27.12 | |
State Portion | $529.66 | $607.49 | $426.03 | $410.36 | $398.07 | $440.75 | $434.91 | $432.91 | $415.73 | $393.67 | $358.75 | $43.42 | $43.42 | $23.77 | |
Employee Portion | $136.08 | $41.93 | $41.93 | $33.70 | $26.00 | $43.38 | $35.72 | $28.27 | $40.91 | $32.33 | $23.43 | $7.91 | $13.66 | $3.35 | |
Semi-Monthly | $332.87 | $324.71 | $233.98 | $222.03 | $212.04 | $242.07 | $235.32 | $230.59 | $228.32 | $213.00 | $191.09 | $25.66 | $28.54 | $13.56 | |
FLES | State Portion | $264.83 | $303.74 | $213.01 | $205.18 | $199.04 | $220.38 | $217.46 | $216.45 | $207.86 | $196.83 | $179.37 | $21.71 | $21.71 | $11.89 |
Employee Portion | $68.04 | $20.97 | $20.97 | $16.85 | $13.00 | $21.69 | $17.86 | $14.14 | $20.46 | $16.17 | $11.72 | $3.95 | $6.83 | $1.67 | |
Bi-Weekly | $307.26 | $299.73 | $215.98 | $204.95 | $195.72 | $223.44 | $217.21 | $212.85 | $210.76 | $196.62 | $176.39 | $23.69 | $26.35 | $12.52 | |
State Portion | $244.45 | $280.38 | $196.63 | $189.40 | $183.72 | $203.42 | $200.72 | $199.80 | $191.88 | $181.70 | $165.58 | $20.04 | $20.04 | $10.97 | |
Employee Portion | $62.81 | $19.35 | $19.35 | $15.55 | $12.00 | $20.02 | $16.49 | $13.05 | $18.88 | $14.92 | $10.81 | $3.65 | $6.31 | $1.55 |
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