Welcome to the New Haven Department of Finance
Return To City Homepage Menu is below
 
  • ONLINE SERVICES
  • FORMS
  • CALENDARS
  • EMERGENCY INFO
  • InfoNewHaven
  • Return Home
  •  
    		•

    Search Our Site
    transparent image for spacing
    Department of Finance

    Medical Benefits

    NEW STATE INSURANCE GUIDELINES FOR ADDING OR CHANGING DEPENDENTS

    Circumstances that are considered “Change of Life” and allow you to make additions of (to) dependents anytime throughout the year to your health plan are as follows:

    Marriage
    Birth of a child
    Adoption
    Assumption of legal guardianship or court ordered custody
    New step children
    Loss of coverage from another insurance carrier

    An Enrollment application must be submitted to The Department of Human Resources and Medical Benefits (Anthem BCBS )31 days from the time of qualifying event. If it is not received in the 31 days, you will not be able to add your dependent until the next open enrollment.

    Please see the Document Requirements list to review the necessary records.

    Local 884 Premium Cost Shares, Effective 11/1/2012-6/30/2012
    Local 884 Medical Benefit Matrix 2012-2013
    Local 884 Health Incentive Account Lumenos HDHP
    Local 884 Dental Plan
    Local 884 Blue View Vision
    Local 884 Enrollment and Membership Change Form

    Employee Cost Shares

    Local 18-School Administrators; Local 424-PW Laborers; Local 71-Blue Collar
    Locals 90 et al.-Tradesmen; Local 217-Cafeteria Food Service; Local 287-Custodians
    Local 530-Police; Local 825-Fire; Local 884-Clerical & Technical
    Local 933-Teachers; Local 3144-Management & Professional; Local 3429-Paraprofessionals
    Local 1303-102-NH Child Development; Executive & Confidential

    LOCAL 18 - SAA  Premium Cost Shares
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAY PERIOD DEDUCTIONS
    26 PAY PERIODS SINGLE 2 PERSON FAMILY
    HSA Eligible/HDHP (vision+dental) 6.06 12.23 15.26
    Century Preferred Mix (vision+dental) 58.44 124.91 157.41
    BlueCare POE (vision+dental) 107.47 222.95 284.87
    Century Preferred (vision+dental) 116.57 241.16 308.54
    21 PAY PERIODS SINGLE 2 PERSON FAMILY
    HSA Eligible/HDHP (vision+dental) 7.50 15.14 18.89
    Century Preferred Mix (vision+dental) 72.35 154.65 194.89
    BlueCare POE (vision+dental) 133.06 276.03 352.70
    Century Preferred (vision+dental) 144.33 298.58 382.01
    TERM LIFE
    as per contract NO COST TO EMPLOYEE
    Local 424-PW Laborers PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 30.63 62.10 80.21
    BC1-2006 Bluecare POE 13% 23.19 47.02 60.73
    BC2-2006 Bluecare POE 11% 18.63 37.80 48.80
    Full Pay Dental, ABCD 17% 1.38 3.60 5.01
    TERM LIFE NO COST TO EMPLOYEE
    $20,000  per employee
    Local 71-Blue Collar PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 30.63 62.10 80.21
    BC1-2006 Bluecare POE 13% 23.19 47.02 60.73
    BC2-2006 Bluecare POE 11% 18.63 37.80 48.80
    Full Pay Dental, ABCD 17% 1.38 3.60 5.01
    TERM LIFE NO COST TO EMPLOYEE
    $20,000  per employee
    Local 90 et al.-Tradesmen PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    WEEKLY DEDUCTIONS
    COVERAGE % SINGLE 2 PERSON FAMILY
    BC1-BLUECARE POS 11% 19.58 39.63 51.22
    BC2-BLUECARE POS 9% 15.86 32.17 41.53
    CPCM-2010 Cent Pref Comp Mix 9% 13.96 28.29 36.54
    FABCD DENTAL 11% 0.90 2.33 3.24
    TERM LIFE
    $25,000 per employee NO COST TO EMPLOYEE
    LOCAL 217 Premium Cost Shares
    Cafeteria Food Service Effective School Year 2012-2013
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PER PAY PERIOD DEDUCTIONS
    40 PAY PERIODS % SINGLE 2 PERSON FAMILY
    BC1-217  Bluecare POE 12% 27.82 56.43 72.87
    BC2-217  Bluecare POE 10% 22.01 44.67 57.67
    Full Pay Dental, ABCD 12% 1.27 3.30 4.60
    TERM LIFE NO COST TO EMPLOYEE
    $8,000 per employee
    LOCAL 287-Custodians PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    WEEKLY DEDUCTIONS
    COVERAGE % SINGLE 2 PERSON FAMILY
    BC2-BLUECARE POS 14% 25.03 47.73 61.70
    LUMENOS HDHP/HSA 2.95 5.90 7.33
    FABCD DENTAL 14% 1.14 2.96 4.13
    TERM LIFE
    $25,000 per employee NO COST TO EMPLOYEE
    Local 530-Police PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    BC1-Bluecare POS 12% 22.56 45.77 59.09
    BC2-Bluecare POS 10% 17.73 35.99 46.45
    CPCM-Cent Pref Comp 10% 16.16 32.83 42.36
    Full Pay Dental ABCD 12% 0.98 2.54 3.54
    TERM LIFE NO COST TO EMPLOYEE
    $15,000  per employee
    LOCAL 825-Fire Premium Cost Shares
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL  DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % Single 2 Person Family
    CP2-825 Century Preferred 16.5% 30.24 61.39 79.25
    BC1-825 Bluecare POE 12.5% 22.84 46.37 59.85
    BC2-825 Bluecare POE 10.5% 18.14 36.87 47.57
    Full Pay Dental ABCD 16.5% 1.34 3.49 4.86
    TERM LIFE NO COST TO EMPLOYEE
    $15,000  per employee
    LOCAL 825 FIRE -- HIRED SINCE January 1, 2008
    BC-1 AND BC-2 Plans solely for the first four years of employment
    Employee contributes higher percentage for dependent coverage
    PAYROLL  DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % Single 2 Person Family
    BC1-825 Bluecare POE 12.5, 17.5% 22.84 64.91 83.79
    BC2-825 Bluecare POE 10.5, 16.5% 18.14 57.93 74.75
    Full Pay Dental ABCD 16.5% 1.34 3.49 4.86
    TERM LIFE NO COST TO EMPLOYEE
    $15,000  per employee
    Local 884 PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    Paid 52 weeks 52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 30.63 62.10 80.21
    BC1-2006 Bluecare POE 13% 23.19 47.02 60.73
    BC2-2006 Bluecare POE 11% 18.63 37.80 48.80
    Full Pay Dental, ABCD 17% 1.47 3.81 5.30
    Paid 42 weeks per year 42 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 37.92 76.89 99.30
    BC1-2006 Bluecare POE 13% 28.71 58.22 75.19
    BC2-2006 Bluecare POE 11% 23.06 46.80 60.42
    Full Pay Dental, ABCD 17% 1.71 4.46 6.20
    Paid 40 weeks per year 40 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 39.81 80.73 104.27
    BC1-2006 Bluecare POE 13% 30.14 61.13 78.95
    BC2-2006 Bluecare POE 11% 24.21 49.14 63.44
    Full Pay Dental, ABCD 17% 1.91 4.96 6.90
    Paid 26 weeks per year 26 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 61.25 124.21 160.41
    BC1-2006 Bluecare POE 13% 46.37 94.05 121.46
    BC2-2006 Bluecare POE 11% 37.25 75.60 97.60
    Full Pay Dental, ABCD 17% 2.77 7.20 10.02
    Local 884 PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    Paid 21 weeks per year 21 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 17% 75.84 153.78 198.61
    BC1-2006 Bluecare POE 13% 57.42 116.44 150.38
    BC2-2006 Bluecare POE 11% 46.12 93.60 120.84
    Full Pay Dental, ABCD 17% 3.43 8.91 12.40
    TERM LIFE NO COST TO EMPLOYEE
    $20,000  per employee
               
    Local 884 PREMIUM COST SHARES
    Local 884-PT PEO FULLY EQUIVALENT PREMIUM COSTS
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    MONTHLY COSTS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-2006 Century Preferred 100% 780.67 1583.02 2044.48
    BC1-2006 Bluecare POE 100% 772.91 1567.49 2024.29
    BC2-2006 Bluecare POE 100% 733.73 1489.16 1922.48
    Full Pay Dental, ABCD 100% 35.29 91.77 127.69
    PLEASE NOTE THAT MONTHLY COSTS WILL CHANGE EVERY JULY 1ST.
    MONTHLY PAYMENTS ARE DUE BY THE 1st OF THE MONTH OF COVERAGE.
    CHECKS ARE MADE PAYABLE TO "TREASURER-CITY OF NEW HAVEN"
    AND BROUGHT OR MAILED TO THE MEDICAL BENEFITS DIVISION,
    1ST FLOOR, 200 ORANGE STREET, NEW HAVEN, CT 06510.

    LOCAL 933-Teachers Premium Cost Shares
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    Effective School Year 2012-2013
    PAY PERIOD DEDUCTIONS
    21 PAY PERIODS % SINGLE 2 PERSON FAMILY
    CP2-2010 Century Preferred 21.0% 89.83 181.82 235.00
    BC1-2010 Bluecare POE 17.0% 72.56 146.87 189.82
    CPCM-2010 Cent Pref Comp Mix 10.0% 38.40 77.83 100.52
    Full Pay Dental-2010 ABCD 21.0% 4.34 11.27 15.68
    TERM LIFE
    $55,000 PER EMPLOYEE NO COST TO EMPLOYEE
    Local 3144-Management PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    Paid 52 weeks per year 52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-Century Preferred 18% 32.66 66.22 85.53
    BC1-Bluecare POS 14% 25.94 52.58 67.91
    BC2-Bluecare POS 12% 20.94 42.49 54.86
    Full Pay Dental, ABCD 18% 1.47 3.81 5.30
    Paid 26 weeks per year 26 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-Century Preferred 18% 65.32 132.44 171.06
    BC1-Bluecare POS 14% 51.88 105.15 135.83
    BC2-Bluecare POS 12% 41.89 84.98 109.73
    Full Pay Dental, ABCD 18% 2.93 7.62 10.61
    Paid 21 weeks per year 21 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-Century Preferred 18% 80.87 163.98 211.79
    BC1-Bluecare POS 14% 64.23 130.19 168.17
    BC2-Bluecare POS 12% 51.86 105.21 135.85
    Full Pay Dental, ABCD 18% 3.63 9.44 13.13
    TERM LIFE
    $20,000 per employee NO COST TO EMPLOYEE
    LOCAL 3429 Premium Cost Shares
    Paraprofessionals Effective School Year 2012-2013
    FY 2012-2013
    PAY PERIOD DEDUCTIONS
    21 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    BC1-2007 Bluecare POE 12% 53.00 107.49 138.81
    BC2-2007Bluecare POE 10% 41.93 85.09 109.86
    Full Pay Dental, ABCD 12% 2.42 6.29 8.76
    TERM LIFE NO COST TO EMPLOYEE
    $25,000 per employee
    LOCAL 1303-102 PREMIUM COST SHARES
    NH CHILD DEVELOPMENT Effective  7/1/2012-6/30/2013
    FY 2012-2013
    PAYROLL DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % Single 2 Person Family
    BC1-1303-102 Bluecare POE 12% 21.40 43.41 56.06
    BC2-1303-102 Bluecare POE 10% 16.93 34.37 44.36
    Full Pay Dental ABCD 12% 0.98 2.54 3.54
    Executive & Confidential PREMIUM COST SHARES
    FY 2012-2013 Effective  7/1/2012-6/30/2013
    PAYROLL DEDUCTIONS
    52 PAY PERIODS
    COVERAGE % SINGLE 2 PERSON FAMILY
    CP2-Century Preferred 24% 44.20 89.70 115.80
    BC1-Bluecare POS 18% 33.84 68.65 88.64
    BC2-Bluecare POS 16% 28.36 57.59 74.33
    Full Pay Dental, ABCD 24% 1.95 5.08 7.07
    PAYROLL DEDUCTIONS
    26 PAY PERIODS
    COVERAGE % Single 2 Person Family
    CP2-Century Preferred 24% 88.40 179.40 231.61
    BC1-Bluecare POS 18% 67.68 137.30 177.28
    BC2-Bluecare POS 16% 56.72 115.18 148.66
    Full Pay Dental, ABCD 24% 3.91 10.17 14.14
    TERM LIFE 20,000 NO COST TO EMPLOYEE
    if salary over $50,000 100,000 NO COST TO EMPLOYEE

     
    Click To Visit The Mayor
    Construction of Pedestrian Walkway
    Statue of Columbus in Wooster Square Park
    Fountains on the Green
    Footer For City Site
    Residents | Visitors | Business | Online Services | Ask New Haven | Guide to New Haven | Government | Forms Central | Calendars | Emergency Info
    Any comments/suggestions E-mail the Webmaster for the City of New Haven or contact the Mayor's Office, 165 Church Street, New Haven CT 06510, Telephone 203-946-8200.
    New Haven City Seal