| Highlights Brochure | |||||||||||||||
| EMPLOYEE MONTHLY CONTRIBUTIONS 2008 | |||||||||||||||
| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| Full-time: | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Employee Only | $277 | $ 10.00 | $287 | $363 | $ 10.00 | $373 | $25 | $ 10.00 | $35 | $79 | $ 10.00 | $89 | |||
| Employee Plus One | $547 | $20.00 | $567 | $717 | $20.00 | $737 | $50 | $20.00 | $70 | $156 | $20.00 | $176 | |||
| Employee Plus Family | $766 | $30.00 | $796 | $1,004 | $30.00 | $1,034 | $75 | $30.00 | $105 | $219 | $30.00 | $249 | |||
| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| Part-time: | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Employee | |||||||||||||||
| Only | |||||||||||||||
| .90 | $304.50 | $13.20 | $317.70 | $395.80 | $13.20 | $409.00 | $57.40 | $13.20 | $70.60 | $106.60 | $13.20 | $119.80 | |||
| .80 | $332.00 | $16.40 | $348.40 | $428.60 | $16.40 | $445.00 | $89.80 | $16.40 | $106.20 | $134.20 | $16.40 | $150.60 | |||
| .75 | $345.75 | $18.00 | $363.75 | $445.00 | $18.00 | $463.00 | $106.00 | $18.00 | $124.00 | $148.00 | $18.00 | $166.00 | |||
| .70 | $359.50 | $19.60 | $379.10 | $461.40 | $19.60 | $481.00 | $122.20 | $19.60 | $141.80 | $161.80 | $19.60 | $181.40 | |||
| .60 | $387.00 | $22.80 | $409.80 | $494.20 | $22.80 | $517.00 | $154.60 | $22.80 | $177.40 | $189.40 | $22.80 | $212.20 | |||
| .50 | $414.50 | $26.00 | $440.50 | $527.00 | $26.00 | $553.00 | $187.00 | $26.00 | $213.00 | $217.00 | $26.00 | $243.00 | |||
| .40 | $442.00 | $29.20 | $471.20 | $559.80 | $29.20 | $589.00 | $219.40 | $29.20 | $248.60 | $244.60 | $29.20 | $273.80 | |||
| .30 | $469.50 | $32.40 | $501.90 | $592.60 | $32.40 | $625.00 | $251.80 | $32.40 | $284.20 | $272.20 | $32.40 | $304.60 | |||
| .25 | $483.25 | $34.00 | $517.25 | $609.00 | $34.00 | $643.00 | $268.00 | $34.00 | $302.00 | $286.00 | $34.00 | $320.00 | |||
| .20 | $497.00 | $35.60 | $532.60 | $625.40 | $35.60 | $661.00 | $284.20 | $35.60 | $319.80 | $299.80 | $35.60 | $335.40 | |||
| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| Part-time: | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Employee | |||||||||||||||
| Plus One | |||||||||||||||
| .90 | $601.70 | $26.20 | $627.90 | $782.00 | $26.20 | $808.20 | $113.90 | $26.20 | $140.10 | $210.60 | $26.20 | $236.80 | |||
| .80 | $656.40 | $32.40 | $688.80 | $847.00 | $32.40 | $879.40 | $177.80 | $32.40 | $210.20 | $265.20 | $32.40 | $297.60 | |||
| .75 | $683.75 | $35.50 | $719.25 | $879.50 | $35.50 | $915.00 | $209.75 | $35.50 | $245.25 | $292.50 | $35.50 | $328.00 | |||
| .70 | $711.10 | $38.60 | $749.70 | $912.00 | $38.60 | $950.60 | $241.70 | $38.60 | $280.30 | $319.80 | $38.60 | $358.40 | |||
| .60 | $765.80 | $44.80 | $810.60 | $977.00 | $44.80 | $1,021.80 | $305.60 | $44.80 | $350.40 | $374.40 | $44.80 | $419.20 | |||
| .50 | $820.50 | $51.00 | $871.50 | $1,042.00 | $51.00 | $1,093.00 | $369.50 | $51.00 | $420.50 | $429.00 | $51.00 | $480.00 | |||
| .40 | $875.20 | $57.20 | $932.40 | $1,107.00 | $57.20 | $1,164.20 | $433.40 | $57.20 | $490.60 | $483.60 | $57.20 | $540.80 | |||
| .30 | $929.90 | $63.40 | $993.30 | $1,172.00 | $63.40 | $1,235.40 | $497.30 | $63.40 | $560.70 | $538.20 | $63.40 | $601.60 | |||
| .25 | $957.25 | $66.50 | $1,023.75 | $1,204.50 | $66.50 | $1,271.00 | $529.25 | $66.50 | $595.75 | $565.50 | $66.50 | $632.00 | |||
| .20 | $984.60 | $69.60 | $1,054.20 | $1,237.00 | $69.60 | $1,306.60 | $561.20 | $69.60 | $630.80 | $592.80 | $69.60 | $662.40 | |||
| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| Part-time: | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Employee Plus | |||||||||||||||
| Family | |||||||||||||||
| .90 | $842.50 | $39.60 | $882.10 | $1,094.80 | $39.60 | $1,134.40 | $164.60 | $39.60 | $204.20 | $295.40 | $39.60 | $335.00 | |||
| .80 | $919.00 | $49.20 | $968.20 | $1,185.60 | $49.20 | $1,234.80 | $254.20 | $49.20 | $303.40 | $371.80 | $49.20 | $421.00 | |||
| .75 | $957.25 | $54.00 | $1,011.25 | $1,231.00 | $54.00 | $1,285.00 | $299.00 | $54.00 | $353.00 | $410.00 | $54.00 | $464.00 | |||
| .70 | $995.50 | $58.80 | $1,054.30 | $1,276.40 | $58.80 | $1,335.20 | $343.80 | $58.80 | $402.60 | $448.20 | $58.80 | $507.00 | |||
| .60 | $1,072.00 | $68.40 | $1,140.40 | $1,367.20 | $68.40 | $1,435.60 | $433.40 | $68.40 | $501.80 | $524.60 | $68.40 | $593.00 | |||
| .50 | $1,148.50 | $78.00 | $1,226.50 | $1,458.00 | $78.00 | $1,536.00 | $523.00 | $78.00 | $601.00 | $601.00 | $78.00 | $679.00 | |||
| .40 | $1,225.00 | $87.60 | $1,312.60 | $1,548.80 | $87.60 | $1,636.40 | $612.60 | $87.60 | $700.20 | $677.40 | $87.60 | $765.00 | |||
| .30 | $1,301.50 | $97.20 | $1,398.70 | $1,639.60 | $97.20 | $1,736.80 | $702.20 | $97.20 | $799.40 | $753.80 | $97.20 | $851.00 | |||
| .25 | $1,339.75 | $102.00 | $1,441.75 | $1,685.00 | $102.00 | $1,787.00 | $747.00 | $102.00 | $849.00 | $792.00 | $102.00 | $894.00 | |||
| .20 | $1,378.00 | $106.80 | $1,484.80 | $1,730.40 | $106.80 | $1,837.20 | $791.80 | $106.80 | $898.60 | $830.20 | $106.80 | $937.00 | |||
| Retiree Rates | |||||||||||||||
| Note: To qualify as a retiree, the employee must meet the retiree formula: Age (minimum 50) + Years of Service (minimum 5 years) = 65 or more |
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| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| Retirees (paid by retiree after-tax) | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Retiree <65 | $551 | $42 | $593 | $689 | $42 | $731 | $354 | $42 | $396 | $362 | $42 | $404 | |||
| Retiree only 65+ | N/A | N/A | N/A | $324 | $42 | $366 | $166 | $42 | $208 | $230 | $42 | $272 | . | ||
| Retiree <65 with spouse <65 | $1,089 | $82 | $1,171 | $1,361 | $82 | $1,443 | $698 | $82 | $780 | $716 | $82 | $798 | |||
| Retiree 65+ with spouse 65+ | N/A | N/A | N/A | $640 | $82 | $722 | $328 | $82 | $410 | $459 | $82 | $541 | |||
| Retiree <65 with spouse 65+ | N/A | N/A | N/A | $1,004 | $82 | $1,086 | $516 | $82 | $598 | $592 | $82 | $674 | |||
| Retiree 65+ with spouse <65 | N/A | N/A | N/A | $996 | $82 | $1,078 | $511 | $82 | $593 | $592 | $82 | $674 | |||
| If additional dependents <65 add: | $436 | $42 | $478 | $543 | $42 | $585 | $287 | $42 | $329 | $286 | $42 | $328 | |||
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| COBRA Rates | |||||||||||||||
| Option 1-CIGNA HMO | Option 2-CIGNA PPO | Option 3-CIGNA HDHP | Option 4-Kaiser Permanente HMO | ||||||||||||
| COBRA (paid by COBRA beneficiary) | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | Medical | Dental | M/D | |||
| Single Coverage | $551 | $42 | $593 | $689 | $42 | $731 | $354 | $42 | $396 | $362 | $42 | $404 | |||
| Single plus one | $1,089 | $82 | $1,171 | $1,361 | $82 | $1,443 | $698 | $82 | $780 | $716 | $82 | $798 | |||
| Family | $1,525 | $124 | $1,649 | $1,904 | $124 | $2,028 | $985 | $124 | $1,109 | $1,002 | $124 | $1,126 | |||