TCC Premiums for Employees Hired On or After October 1, 1987
Aetna
|
|
Aetna CDHP
|
Aetna HMO
|
Aetna PPO
|
|||
|
Type
|
Enrollment Code
|
Monthly Premium
|
Enrollment Code
|
Monthly Premium
|
Enrollment Code
|
Monthly Premium
|
|
Self Only
|
HM1
|
$462.59
|
AH1
|
$1,199.32
|
AP1
|
$1,151.61
|
|
Self + 1
|
HM2
|
$909.26
|
AH2
|
$2,372.96
|
AP2
|
$2,263.77
|
|
Family
|
HM3
|
$1,336.68
|
AH3
|
$3,442.59
|
AP3
|
$3,327.96
|
Carefirst
|
|
CareFirst CDHP
|
CareFirst HMO
|
CareFirst PPO
|
|||
|
Type
|
Enrollment Code
|
Monthly Premium
|
Enrollment Code
|
Monthly Premium
|
Enrollment Code
|
Monthly Premium
|
|
Self Only
|
– |
$446.96
|
–
|
$886.48
|
–
|
$978.72
|
|
Self + 1
|
–
|
$853.70
|
–
|
$1,746.38
|
–
|
$1,869.35
|
|
Family
|
–
|
$1,309.60
|
–
|
$2,561.94
|
–
|
$2,867.64
|
Kaiser Permanente
|
Kaiser Permanente HMO
|
||
|---|---|---|
|
Type
|
Enrollment Code
|
Monthly Premium
|
|
Self Only
|
KP1
|
$829.45
|
|
Self + 1
|
KP2
|
$1,584.25
|
|
Family
|
KP3
|
$2,430.22
|
UnitedHealthcare
|
|
UnitedHealthcare HMO
|
UnitedHealthcare PPO
|
||
|
Type
|
Enrollment Code
|
Monthly Premium
|
Enrollment Code
|
Monthly Premium
|
|
Self Only
|
MD1 |
$1,046.30
|
–
|
$1,031.45
|
|
Self + 1
|
MD2 |
$1,998.40
|
–
|
$1,970.06
|
|
Family
|
MD3 |
$3,065.60
|
–
|
$3,022.12
|
* TCC rates shown were those provided by the carriers where possible; otherwise they are assumed to equal the active rates with a 2% load.