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Rate Sheet

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The amounts below are effective December 16, 2012, the first pay-period of 2013, and are based on pay-period contributions.

These amounts are deducted from 24 of 26 pay periods.

HDHP (with HRA)

Total Cost

Employee Share

Individual Coverage

$249.66

$62.42

Employee + Child(ren)

$449.38

$112.35

Employee + Spouse or Domestic Partner

$499.31

$124.83

Employee + Spouse, Child(ren)

$707.28

$176.82

HMO New England

   

Individual Coverage

$294.06

$117.62

Employee + Child(ren)

$529.30

$211.72

Employee + Spouse or Domestic Partner

$588.12

$235.25

Employee + Spouse, Child(ren)

$833.07

$333.23

Access Blue

   

Individual Coverage

$297.03

$120.60

Employee + Child(ren)

$534.66

$217.08

Employee + Spouse or Domestic Partner

$594.06

$241.19

Employee + Spouse, Child(ren)

$841.49

$341.65

PPO (Out of State)

   

Individual Coverage

$326.74

$150.30

Employee + Child(ren)

$588.12

$270.54

Employee + Spouse or Domestic Partner

$653.47

$300.60

Employee + Spouse, Child(ren)

$925.63

$425.79




Last updated: December 4, 2013
 


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