Monthly Premiums for COBRA Participants and Dependents
Current Employee and Pre-Medicare Former Employee Rates
| HEALTH PLANS | MEMBER | SPOUSE* | CHILD* | CHILDREN* |
| HealthChoice High Option | $458.47 | $696.39 | $232.76 | $359.12 |
| HealthChoice Basic | $399.47 | $610.45 | $205.86 | $317.02 |
| HealthChoice S-Account | $390.21 | $573.99 | $193.98 | $297.74 |
| HealthChoice USA | $702.60 | $702.60 | $230.74 | $355.84 |
| CommunityCare Standard HMO | $787.79 | $1,126.51 | $393.88 | $630.22 |
| CommunityCare Alternative HMO | $543.31 | $776.91 | $271.67 | $434.64 |
| GlobalHealth Standard HMO | $373.89 | $613.24 | $196.98 | $314.12 |
| GlobalHealth Alternative HMO | $339.93 | $557.51 | $179.13 | $285.58 |
| PacifiCare Standard HMO | $700.15 | $1,006.68 | $349.82 | $559.84 |
| PacifiCare Alternative HMO | $482.86 | $694.24 | $241.24 | $386.08 |
| DENTAL PLANS | MEMBER | SPOUSE* | CHILD* | CHILDREN* |
| HealthChoice Dental | $30.44 | $30.44 | $25.38 | $65.85 |
| Assurant Freedom Preferred | $29.41 | $29.24 | $21.93 | $58.96 |
| Assurant Heritage Plus with SBA (Prepaid) | $11.97 | $ 9.04 | $ 7.75 | $15.50 |
| Assurant Heritage Secure (Prepaid) | $ 7.34 | $ 6.10 | $ 5.30 | $10.59 |
| CIGNA Dental Care Plan (Prepaid) | $ 9.45 | $ 6.18 | $ 7.22 | $15.63 |
| Delta Dental PPO | $31.76 | $31.76 | $27.64 | $69.93 |
| Delta Dental Premier | $36.23 | $36.23 | $31.52 | $79.76 |
| Delta Dental PPO – Choice | $14.22 | $32.27 | $32.54 | $78.97 |
| VISION PLANS | MEMBER | SPOUSE* | CHILD* | CHILDREN* |
| Humana/CompBenefits VisionCare Plan | $6.90 | $5.16 | $3.64 | $ 4.55 |
| Primary Vision Care Services (PVCS) | $9.44 | $8.16 | $8.67 | $10.97 |
| Superior Vision Services | $7.12 | $7.04 | $6.73 | $ 6.73 |
| UnitedHealthcare Vision | $8.34 | $5.91 | $4.68 | $ 7.12 |
| Vision Service Plan (VSP) | $8.94 | $5.99 | $5.73 | $12.89 |
* It is the policy of the Oklahoma State and Education Employees Group Insurance Board that for any benefit continued under COBRA, one person must always pay the primary member premium. In cases where a spouse, child, or children are insured under a particular benefit and the member did not keep coverage, one person will always be billed at the primary member rate.
Last Modified on 10/27/2010