Monthly Premiums for Current Employees
Plan Year January 1, 2012 - December 31, 2012
| HEALTH PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice High |
$ 449.48 |
$ 668.10 |
$ 228.20 |
$ 352.08 |
| HealthChoice High Alternative |
$ 449.48 |
$ 668.10 |
$ 228.20 |
$ 352.08 |
| HealthChoice Basic |
$ 391.64 |
$ 571.84 |
$ 201.82 |
$ 310.80 |
| HealthChoice Basic Alternative |
$ 391.64 |
$ 571.84 |
$ 201.82 |
$ 310.80 |
| HealthChoice S-Account |
$ 382.56 |
$ 542.52 |
$ 190.18 |
$ 291.90 |
| HealthChoice USA |
$ 688.82 |
$ 688.82 |
$ 226.22 |
$ 348.86 |
| CommunityCare Standard HMO |
$ 803.22 |
$1,148.58 |
$ 401.60 |
$ 642.56 |
| CommunityCare Alternative HMO |
$ 553.96 |
$ 792.14 |
$ 276.98 |
$ 443.16 |
| CommunityCare Wellness Alternative Plus HMO |
$ 528.96 |
$ 792.14 |
$ 276.98 |
$ 443.16 |
| GlobalHealth Standard HMO |
$ 402.84 |
$ 660.72 |
$ 212.27 |
$ 338.44 |
| GlobalHealth Alternative HMO |
$ 366.24 |
$ 600.68 |
$ 193.00 |
$ 307.70 |
| GlobalHealth Wellness Alternative Plus HMO |
$ 341.24 |
$ 600.68 |
$ 193.00 |
$ 307.70 |
| UnitedHealthcare Standard HMO |
$ 768.80 |
$1,105.36 |
$ 384.12 |
$ 614.72 |
| UnitedHealthcare Alternative HMO |
$ 530.20 |
$ 762.32 |
$ 264.90 |
$ 423.94 |
| UnitedHealthcare Wellness Alternative Plus HMO |
$ 505.20 |
$ 762.32 |
$ 264.90 |
$ 423.94 |
| |
| DISABILITY (Employee only) |
$9.10 (Limited county participation only) |
| |
| DENTAL PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice Dental |
$30.20 |
$30.20 |
$25.18 |
$65.32 |
| Assurant Freedom Preferred |
$28.83 |
$28.67 |
$21.50 |
$57.80 |
| Assurant Heritage Plus with SBA (Prepaid) |
$11.74 |
$ 8.86 |
$ 7.60 |
$15.20 |
| Assurant Heritage Secure (Prepaid) |
$ 7.20 |
$ 5.98 |
$ 5.20 |
$10.38 |
| CIGNA Dental Care Plan (Prepaid) |
$ 9.26 |
$ 6.06 |
$ 7.08 |
$15.32 |
| Delta Dental PPO |
$33.64 |
$33.62 |
$29.26 |
$74.04 |
| Delta Dental Premier |
$38.36 |
$38.36 |
$33.38 |
$84.46 |
| Delta Dental PPO - Choice |
$15.06 |
$34.18 |
$34.44 |
$83.60 |
| |
| VISION PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| Humana/CompBenefits VisionCare Plan |
$ 6.76 |
$ 5.06 |
$ 3.57 |
$ 4.46 |
| Primary Vision Care Services |
$ 9.25 |
$ 8.00 |
$ 8.50 |
$10.75 |
| Superior Vision Plan |
$ 7.14 |
$ 7.10 |
$ 6.72 |
$13.80 |
| UnitedHealthcare Vision |
$ 8.18 |
$ 5.79 |
$ 4.59 |
$ 6.98 |
| Vision Service Plan (VSP) |
$ 8.76 |
$ 5.87 |
$ 5.62 |
$12.64 |
| LIFE |
| HealthChoice Basic Life ($20,000) $4.00 |
First $20,000 of Supplemental Life $4.00 |
|
Age-Rated Supplemental Life – Cost Per $20,000
|
| < 30 ---------- $0.60 |
45 - 49 ------- $2.00 |
65 - 69 ------- $10.20 |
| 30 - 34 ------- $0.60 |
50 - 54 ------- $3.40 |
70 - 74 ------- $17.40 |
| 35 - 39 ------- $0.80 |
55 - 59 ------- $5.40 |
75+ ----------- $27.00 |
| 40 - 44 ------- $1.20 |
60 - 64 ------- $6.20 |
|
| |
|
|
|
| DEPENDENT LIFE |
Low Option $2.60 |
Standard Option $4.32 |
Premier Option $8.64 |
| Spouse |
$6,000 of coverage |
$10,000 of coverage |
$20,000 of coverage |
| Child (age 6 months to 26) |
$3,000 of coverage |
$ 5,000 of coverage |
$10,000 of coverage |
| Child (live birth to 6 months) |
$1,000 of coverage |
$ 1,000 of coverage |
$ 1,000 of coverage |
