Monthly Premiums for Current Employees
Plan Year January 1, 2013 - December 31, 2013
| HEALTH PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice High |
$ 463.99 |
$ 681.96 |
$ 235.57 |
$ 363.45 |
| HealthChoice High Alternative |
$ 463.99 |
$ 681.96 |
$ 235.57 |
$ 363.45 |
| HealthChoice Basic |
$ 402.98 |
$ 593.52 |
$ 207.66 |
$ 319.80 |
| HealthChoice Basic Alternative |
$ 402.98 |
$ 593.52 |
$ 207.66 |
$ 319.80 |
| HealthChoice S-Account |
$ 382.56 |
$ 515.44 |
$ 190.18 |
$ 291.90 |
| HealthChoice USA |
$710.21 |
$ 710.21 |
$ 233.25 |
$ 359.70 |
| CommunityCare HMO |
$ 543.82 |
$ 792.14 |
$ 276.98 |
$ 443.16 |
| GlobalHealth HMO |
$ 398.84 |
$ 654.14 |
$ 210.18 |
$ 335.08 |
| |
| DISABILITY (Employee only) |
$9.10 (Limited county participation only) |
| |
| DENTAL PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice Dental |
$ 31.38 |
$ 31.38 |
$ 26.90 |
$ 66.96 |
| 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 |
$ 40.66 |
$ 40.66 |
$ 35.40 |
$ 89.54 |
| Delta Dental PPO - Choice |
$ 15.06 |
$ 34.18 |
$ 34.44 |
$ 83.60 |
| |
| VISION PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| Humana |
$ 6.76 |
$ 5.06 |
$ 3.57 |
$ 4.46 |
| Primary Vision Care Services (PVCS) |
$ 9.25 |
$ 8.00 |
$ 8.50 |
$10.75 |
| Superior Vision Services |
$ 7.14 |
$ 7.10 |
$ 6.72 |
$13.80 |
| UnitedHealthcare Vision |
$ 8.18 |
$ 5.79 |
$ 4.59 |
$ 6.98 |
| Vision Service Plan (VSP) |
$ 8.93 |
$ 5.98 |
$ 5.73 |
$12.88 |
| LIFE |
| HealthChoice Basic Life ($20,000) $4.00 |
First $20,000 of Supplemental Life $4.00 |
|
Age-Rated Supplemental Life – Cost Per $20,000 unit
|
| < 30 ---------- $0.80 |
45 - 49 ------- $2.00 |
65 - 69 ------- $10.40 |
| 30 - 34 ------- $0.80 |
50 - 54 ------- $3.60 |
70 - 74 ------- $17.60 |
| 35 - 39 ------- $0.80 |
55 - 59 ------- $5.60 |
75+ ----------- $27.20 |
| 40 - 44 ------- $1.20 |
60 - 64 ------- $6.40 |
|
| |
|
|
|
| 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 |
