Choices Premium Rates
Effective July 1, 2008
Medical Rates
2008-2009
State Share = $626
| Monthly Premiums | Traditional Plan A ($400 decuctible) | Traditional Plan B ($600 Deductible) | Blue Choice Managed Care | Peak Managed Care | New West Managed Care |
Allegiance Managed Care |
|---|---|---|---|---|---|---|
| Employee Only | $536 | $602 | $472 | $483 | $477 | $485 |
| Employee & Spouse\AD | $635 | $713 | $559 | $572 | $565 | $575 |
| Employee & Child(ren) | $625 | $702 | $550 | $563 | $557 | $566 |
| Employee & Family | $734 | $824 | $646 | $661 | $653 | $664 |
Dental Rates
| Premium Plan | Basic Plan - Preventive Coverage |
|
|---|---|---|
| Employee Only | $36 |
$17 |
| Employee & Spouse/Adult AD | $68 |
$32 |
| Employee & Child(ren) | $68 |
$32 |
| Employee & Family | $96 |
$46 |
Life
Insurance/Accidental Death & Dismemberment
and Long Term Disability
|
Basic
Life/AD&D Choose One |
Long
Term Disability Choose one |
||
| Amt. of Coverage |
Rate |
Amt. of Coverage |
Rate |
| $10,000 |
$1.55 |
OPTION 1: 60% of pay / 180 day wait |
$6.35 |
| $20,000 |
$3.10 |
OPTION 2: 66-2/3% of pay / 180 day wait |
$11.75 |
|
|
OPTION 3: 66-2/3% of pay / 120 day wait |
$14.66 |
|
Optional Accidental Death & Dismemberment
| Coverage Level |
Employee
Only |
Employee
& Family |
| $25,000 |
$0.63 |
$1.18 |
| $50,000 |
$1.25 |
$2.35 |
| $75,000 |
$1.88 |
$3.53 |
| $100,000 |
$2.50 |
$4.70 |
| $150,000 |
$3.75 |
$7.05 |
| $200,000 |
$5.00 |
$9.40 |
| $250,000 |
$6.25 |
$11.75 |
| $300,000 |
$7.50 |
$14.10 |
Optional Supplemental Life Insurance (After-Tax)
| Age |
$25,000 |
$50,000 |
$75,000 |
$100,000 |
$125,000 |
$150,000 |
$175,000 |
$200,000 |
| Under 30 |
$1.43 |
$2.85 |
$4.28 |
$5.70 |
$7.13 |
$8.55 |
$9.98 |
$11.40 |
| 30-34 |
$2.00 |
$4.00 |
$6.00 |
$8.00 |
$10.00 |
$12.00 |
$14.00 |
$16.00 |
| 35-39 |
$2.25 |
$4.50 |
$6.75 |
$9.00 |
$11.25 |
$13.50 |
$15.75 |
$18.00 |
| 40-44 |
$3.10 |
$6.20 |
$9.30 |
$12.40 |
$15.50 |
$18.60 |
$21.70 |
$24.80 |
| 45-49 |
$5.30 |
$10.60 |
$15.90 |
$21.20 |
$26.50 |
$31.80 |
$37.10 |
$42.40 |
| 50-54 |
$8.03 |
$16.05 |
$24.08 |
$32.10 |
$40.13 |
$48.15 |
$56.18 |
$62.20 |
| 55-59 |
$13.43 |
$26.85 |
$40.28 |
$53.70 |
$67.13 |
$80.55 |
$93.98 |
$107.40 |
| 60-64 |
$16.50 |
$33.00 |
$49.50 |
$66.00 |
$82.50 |
$99.00 |
$115.50 |
$132.00 |
| 65-69 |
$32.50 |
$65.00 |
$97.50 |
$130.00 |
$162.50 |
$195.00 |
$227.50 |
$260.00 |
| over 70 |
$75.00 |
$150.00 |
$225.00 |
$300.00 |
$375.00 |
$450.00 |
$525.00 |
$600.00 |
Optional Dependent Life Insurance
(You must select Optional Supplemental Life Insurance to enroll)
| $2,500 Spouse/$1,250 Child(ren) |
$0.77 |
| $5,000 Spouse/$2,500 Child(ren) |
$1.54 |
| $10,000 Spouse/$5,000 Child(ren) |
$3.08 |
| $25,000 Spouse/$5,000 Child(ren) |
$7.71 |
