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2014 DCEHBP Temporary Continuation of Coverage (TCC) Premiums

DC Employee Health Benefits (Employees Hired on or After 10/01/1987)        
  Enrollment Code 2014 Monthly Premium Administrative Fee Total
Aetna HMO        
Self AH1 $560.26 $11.21 $571.47
Self+1 AH2 $1101.29 $22.03 $1123.32
Family AH3 $1619.00 $32.38 $1651.38
         
Aetna PPO        
Self AP1 $597.12 $11.94 $609.06
Self+1 AP2 $1173.76 $23.48 $1197.24
Family AP3 $1725.56 $34.51 $1760.07
         
Aetna CDHP        
Self HM1 $394.57 $7.89 $402.46
Self+1 HM2 $775.61 $15.51 $791.12
Family HM3 $1140.23 $22.80 $1163.03
         
Kaiser Permanente        
Self KP1 $495.35 $9.90 $505.25
Self+1 KP2 $946.12 $18.92 $965.04
Family KP3 $1451.37 $29.02 $1480.39
         
United Healthcare Choice        
Self MD1 $523.4 $10.46 $533.86
Self+1 MD2 $999.69 $19.99 $1019.68
Family MD3 $1533.55 $30.67 $1564.22