STATE OF CONNECTICUT
COMPTROLLER
55 ELM STREET
HARTFORD, CONNECTICUT 06106-1775
DEPUTY COMPTROLLER
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STATE OF CONNECTICUT |
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| NANCY WYMAN COMPTROLLER |
OFFICE OF
THE STATE COMPTROLLER 55 ELM STREET HARTFORD, CONNECTICUT 06106-1775 |
MARK OJAKIAN DEPUTY COMPTROLLER |
COMPTROLLER'S MEMORANDUM NO. 2002-18
May 22, 2002
TO THE HEADS OF ALL STATE AGENCIES
| ATTENTION: | Personnel and Payroll Officers, Chief Administrative Officers, Business Managers |
| SUBJECT: | 2002- 2003 COBRA Continuation Coverage Rates |
The following MONTHLY rates for COBRA continuation coverage are effective July 1, 2002:
| PLAN | INDIVIDUAL |
SUBSCRIBER & ONE DEPENDENT |
FAMILY |
|---|---|---|---|
| Blue Cross State Preferred | $457.36 | $1,006.19 | $1,234.86 |
| Blue Cross Out of Area | $446.15 | $981.53 | $1,204.60 |
| State BlueCare POS | $321.48 | $707.27 | $868.01 |
| State BlueCare POE | $305.07 | $671.16 | $823.69 |
| State BlueCare POE Plus | $291.33 | $640.93 | $786.59 |
| Health Net Charter POS | $317.20 | $697.84 | $856.44 |
| Health Net Charter HMO | $308.36 | $678.38 | $832.56 |
| Health Net Passport HMO | $302.16 | $664.76 | $815.85 |
| ConnectiCare POS Open Access | $299.87 | $659.72 | $809.65 |
| ConnectiCare HMO Open Access | $279.76 | $615.46 | $755.34 |
| ConnectiCare HMO Personal Care Plan | $250.97 | $552.14 | $677.63 |
| Anthem Blue Cross Indemnity Dental A & C | $25.99 | $79.39 | $79.39 |
| Anthem Blue Cross Indemnity Dental A , B, & C | $32.90 | $92.28 | $92.28 |
| CIGNA Dental | $16.92 | $37.23 | $45.69 |
All Rates include a 2% administrative fee
Form CO-1022A (revised 5/2001) Group Health Insurance Continuation Coverage Election, is to be used to notify employees and/or beneficiaries of their right to continue health benefits for all plans except CIGNA Dental. It is important that both sides of the form are given to the employee/beneficiary. Do not use previous versions of this form; they should be discarded. Form CO-1022-1 CIGNA Dental COBRA Application, (revised 11/97) is to be used to notify those enrolled in CIGNA Dental. Your agency business office can order both forms through the state's forms management program, Vanguard Direct, 1- (800) 369-0570.
Payroll and personnel office staff with questions concerning this matter should call the Retirement & Benefit Services Division, Health Care Analysis Unit, at (860) 702-3535.
Very truly yours,
Nancy Wyman
State Comptroller
NW/SW/wpm
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