ATTACHMENT to:
Comptroller's Memorandum 2007-10
| State Employee Health Insurance | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7/1/2007 TO 6/30/2008 RATES | |||||||||||||||||
| Monthly & Bi-Weekly Rates For Carrier Billing & Payment Purposes | |||||||||||||||||
| Medical Plans | Dental Plans | ||||||||||||||||
| Anthem | |||||||||||||||||
| Blue Cross | State BlueCare | Health Net | Oxford Health | United Health | AETNA | ||||||||||||
| State Preferred | Out of Area | POS | POE | POE Plus |
Charter POS | Charter HMO |
Passport HMO | Freedom Select POS | HMO Select |
HMO | Oxford USA Out of Area |
Employ- ees |
Judges | PPO | DHMO | ||
| Individual | Total Monthly Premium | $662.79 | $611.66 | $507.14 | $487.44 | $480.05 | $497.19 | $469.42 | $474.66 | $449.56 | $428.78 | $396.13 | $475.50 | $32.15 | $32.94 | $29.57 | $22.16 |
| Monthly State Share | $560.26 | $580.72 | $476.20 | $470.79 | $468.40 | $466.86 | $453.85 | $464.09 | $422.14 | $415.65 | $388.00 | $448.08 | $32.15 | $32.15 | $29.57 | $22.16 | |
| Monthly Employee Share | $102.53 | $30.94 | $30.94 | $16.65 | $11.65 | $30.33 | $15.57 | $10.57 | $27.42 | $13.13 | $8.13 | $27.42 | $0.00 | $0.79 | $0.00 | $0.00 | |
| Medical Premium | $541.56 | $490.43 | $385.91 | $366.21 | $358.82 | $375.96 | $348.19 | $353.43 | $328.33 | $307.55 | $274.90 | $354.27 | |||||
| Monthly Rx Drug | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | $121.23 | |||||
| BW State Share Rx Drug | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | $55.95 | |||||
| BW State Share Medical | $258.58 | $268.02 | $219.78 | $217.29 | $216.18 | $215.47 | $209.47 | $214.20 | $194.83 | $191.84 | $179.08 | $206.81 | $14.84 | $14.84 | $13.65 | $10.23 | |
| BW Employee Share | $47.32 | $14.28 | $14.28 | $7.68 | $5.38 | $14.00 | $7.19 | $4.88 | $12.66 | $6.06 | $3.75 | $12.66 | $0.00 | $0.36 | $0.00 | $0.00 | |
| Subscriber | Total Monthly Premium | $1,458.14 | $1,345.65 | $1,115.71 | $1,072.37 | $1,056.11 | $1,093.82 | $1,032.72 | $1,044.25 | $989.03 | $943.32 | $871.49 | $1,046.10 | $98.05 | $100.06 | $90.19 | $48.75 |
| + 1 | Monthly State Share | $1,110.67 | $1,171.26 | $941.32 | $964.60 | $967.71 | $922.86 | $928.93 | $956.85 | $834.44 | $848.52 | $798.55 | $891.51 | $78.28 | $78.28 | $72.00 | $40.77 |
| Monthly Employee Share | $347.47 | $174.39 | $174.39 | $107.77 | $88.40 | $170.96 | $103.79 | $87.40 | $154.59 | $94.80 | $72.94 | $154.59 | $19.77 | $21.78 | $18.19 | $7.98 | |
| Medical Premium | $1,191.43 | $1,078.95 | $849.00 | $805.66 | $789.40 | $827.11 | $766.02 | $777.55 | $722.33 | $676.61 | $604.78 | $779.39 | |||||
| Monthly Rx Drug | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | $266.71 | |||||
| BW State Share Rx Drug | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | $123.10 | |||||
| BW State Share Medical | $512.62 | $540.58 | $434.46 | $445.20 | $446.64 | $425.94 | $428.74 | $441.62 | $385.13 | $391.62 | $368.56 | $411.47 | $36.13 | $36.13 | $33.23 | $18.82 | |
| BW Employee Share | $160.37 | $80.49 | $80.49 | $49.74 | $40.80 | $78.90 | $47.90 | $40.34 | $71.35 | $43.75 | $33.66 | $71.35 | $9.12 | $10.05 | $8.40 | $3.68 | |
| Family | Total Monthly Premium | $1,789.53 | $1,651.48 | $1,369.28 | $1,316.09 | $1,296.14 | $1,342.41 | $1,267.43 | $1,281.58 | $1,213.81 | $1,157.71 | $1,069.55 | $1,283.85 | $98.05 | $100.06 | $90.19 | $59.83 |
| Monthly State Share | $1,376.86 | $1,445.68 | $1,163.48 | $1,163.42 | $1,174.56 | $1,140.65 | $1,120.41 | $1,161.37 | $1,031.37 | $1,023.42 | $969.23 | $1,101.41 | $78.28 | $78.28 | $72.00 | $48.53 | |
| Monthly Employee Share | $412.67 | $205.80 | $205.80 | $152.67 | $121.58 | $201.76 | $147.02 | $120.21 | $182.44 | $134.29 | $100.32 | $182.44 | $19.77 | $21.78 | $18.19 | $11.30 | |
| Medical Premium | $1,462.21 | $1,324.16 | $1,041.96 | $988.77 | $968.81 | $1,015.09 | $940.11 | $954.26 | $886.49 | $830.39 | $742.23 | $956.53 | |||||
| Monthly Rx Drug | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | $327.32 | |||||
| BW State Share Rx Drug | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | $151.07 | |||||
| BW State Share Medical | $635.47 | $667.24 | $536.99 | $536.96 | $542.10 | $526.45 | $517.11 | $536.02 | $476.02 | $472.35 | $447.34 | $508.34 | $36.13 | $36.13 | $33.23 | $22.40 | |
| BW Employee Share | $190.46 | $94.98 | $94.98 | $70.46 | $56.11 | $93.12 | $67.86 | $55.48 | $84.20 | $61.98 | $46.30 | $84.20 | $9.12 | $10.05 | $8.40 | $5.22 | |
| FLES | Total Monthly Premium | $1,126.74 | $1,039.82 | $862.14 | $828.65 | $816.09 | $845.22 | $798.01 | $806.92 | $764.25 | $728.93 | $673.42 | $808.35 | $65.90 | $67.12 | $60.62 | $37.67 |
| Monthly State Share | $896.43 | $962.57 | $784.89 | $765.76 | $766.06 | $769.49 | $737.44 | $757.46 | $695.77 | $673.60 | $632.14 | $739.87 | $55.78 | $55.78 | $51.31 | $33.02 | |
| Monthly Employee Share | $230.31 | $77.25 | $77.25 | $62.89 | $50.03 | $75.73 | $60.57 | $49.46 | $68.48 | $55.33 | $41.28 | $68.48 | $10.12 | $11.34 | $9.31 | $4.65 | |
| Medical Premium | $920.65 | $833.73 | $656.05 | $622.56 | $609.99 | $639.13 | $591.92 | $600.83 | $558.16 | $522.84 | $467.33 | $602.26 | |||||
| Monthly Rx Drug | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | $206.09 | |||||
| BW State Share Rx Drug | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | $95.12 | |||||
| BW State Share Medical | $413.74 | $444.26 | $362.26 | $353.43 | $353.57 | $355.15 | $340.36 | $349.60 | $321.12 | $310.89 | $291.76 | $341.48 | $25.74 | $25.74 | $23.68 | $15.24 | |
| BW Employee Share | $106.30 | $35.65 | $35.65 | $29.03 | $23.09 | $34.95 | $27.96 | $22.83 | $31.61 | $25.54 | $19.05 | $31.61 | $4.67 | $5.23 | $4.30 | $2.15 | |
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