Medical Benefits
OPEN ENROLLMENT FOR MEDICAL BENEFITS
EFFECTIVE: JULY 1, 2013
The City is sponsoring the annual open enrollment for medical benefits. This is the opportunity for eligible employees to make changes their current medical coverage, effective July 1, 2013-June 30, 2014. Please note the effective date of these changes to 10-month employees will be September 1, 2013.
If you wish to keep your current medical coverage and there are no additions to your enrolled dependents, you do nothing and can disregard this notice.
Your employee cost shares for the period of July 1, 2013 to June 30, 2014 based upon your union contract can be viewed below, under ‘EMPLOYEE COST SHARES.”
To take advantage of this opportunity to change your eligible benefit plans, you must stop by the Medical Benefits Office for the appropriate health insurance forms that you must complete. Please note, insurance forms cannot be sent or received via fax. Please refer to the benefit matrix in your current union contract for a description of the offered plans.
An Anthem representative will be available to answer your questions on
Wednesday, May 29, 2013 from 9:00 a.m. to 12:00 p.m. and
Thursday, May 30, 2013 from 1:00 p.m. to 4:00 p.m.
at the Human Resource & Medical Benefits Office, 200 Orange St., Room 102.
You can also reach her by phone on those days, at 203-946-8255.
If you want to change coverage, please be advised the deadline for submission of the required information is June 14, 2013 by 4:30 p.m. If the forms are not submitted by this deadline, your next opportunity to change health care plans will be next year.
Should you have any questions, please feel free to call the Medical Benefits Division at 203-946-6766 or 203-946-7157.
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.
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 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PAY PERIOD DEDUCTIONS |
|
| 26 PAY PERIODS |
|
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| HSA Eligible/HDHP (vision+dental) |
13.98 |
27.44 |
34.79 |
|
|
|
|
|
|
|
| Century Preferred Mix (vision+dental) |
67.16 |
141.85 |
179.13 |
|
|
|
|
|
|
|
| BlueCare POE (vision+dental) |
118.19 |
243.89 |
311.78 |
|
|
|
|
|
|
|
| Century Preferred (vision+dental) |
127.66 |
262.84 |
336.41 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| 21 PAY PERIODS |
|
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| HSA Eligible/HDHP (vision+dental) |
17.31 |
33.97 |
43.07 |
|
|
|
|
|
|
|
| Century Preferred Mix (vision+dental) |
83.15 |
175.63 |
221.78 |
|
|
|
|
|
|
|
| BlueCare POE (vision+dental) |
146.33 |
301.95 |
386.01 |
|
|
|
|
|
|
|
| Century Preferred (vision+dental) |
158.05 |
325.42 |
416.51 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
|
|
|
|
| as per contract |
|
NO COST TO EMPLOYEE |
|
| Local 424-PW Laborers |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-2006 Century Preferred |
17% |
31.73 |
64.31 |
83.07 |
|
|
|
|
|
|
|
| BC1-2006 Bluecare POE |
13% |
24.02 |
48.70 |
62.90 |
|
|
|
|
|
|
|
| BC2-2006 Bluecare POE |
11% |
19.29 |
39.13 |
50.53 |
|
|
|
|
|
|
|
| Full Pay Dental, ABCD |
17% |
1.30 |
3.37 |
4.69 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $20,000 per employee |
|
|
|
|
|
| Local 71-Blue Collar |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-2006 Century Preferred |
17% |
31.73 |
64.31 |
83.07 |
|
|
|
|
|
|
|
| BC1-2006 Bluecare POE |
13% |
24.02 |
48.70 |
62.90 |
|
|
|
|
|
|
|
| BC2-2006 Bluecare POE |
11% |
19.29 |
39.13 |
50.53 |
|
|
|
|
|
|
|
| Full Pay Dental, ABCD |
17% |
1.30 |
3.37 |
4.69 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $20,000 per employee |
|
|
|
|
|
| Local 90 et al.-Tradesmen |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
WEEKLY DEDUCTIONS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| BC1-BLUECARE POS |
11% |
20.30 |
41.07 |
53.09 |
|
|
|
|
|
|
|
| BC2-BLUECARE POS |
9% |
16.42 |
33.31 |
43.01 |
|
|
|
|
|
|
|
| CPCM-2010 Cent Pref Comp Mix |
9% |
14.46 |
29.30 |
37.84 |
|
|
|
|
|
|
|
| FABCD DENTAL |
11% |
0.84 |
2.18 |
3.04 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
|
|
|
|
| $25,000 per employee |
|
NO COST TO EMPLOYEE |
|
| LOCAL 217 |
Premium Cost Shares |
| Cafeteria Food Service |
Effective School Year 2012-2013 |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PER PAY PERIOD DEDUCTIONS |
|
|
|
|
|
|
|
| 40 PAY PERIODS |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| BC1-217 Bluecare POE |
12% |
28.82 |
58.43 |
75.47 |
|
|
|
|
|
|
|
| BC2-217 Bluecare POE |
10% |
22.80 |
46.25 |
59.72 |
|
|
|
|
|
|
|
| Full Pay Dental, ABCD |
12% |
1.19 |
3.09 |
4.30 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $8,000 per employee |
|
|
|
|
|
| LOCAL 287-Custodians |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
WEEKLY DEDUCTIONS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| BC2-BLUECARE POS |
14% |
24.44 |
49.46 |
63.94 |
|
|
|
|
|
|
|
| LUMENOS HDHP/HSA |
|
7.42 |
14.85 |
18.96 |
|
|
|
|
|
|
|
| FABCD DENTAL |
14% |
1.07 |
2.78 |
3.86 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
|
|
|
|
| $25,000 per employee |
|
NO COST TO EMPLOYEE |
|
| Local 530-Police |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| BC1- POS |
31% |
57.98 |
117.13 |
151.65 |
|
|
|
|
|
|
|
| Century Preferred PPO |
26% |
44.96 |
90.90 |
117.65 |
|
|
|
|
|
|
|
| Bluecare POE |
20% |
33.64 |
68.03 |
88.04 |
|
|
|
|
|
|
|
| Cent Pref Comp Mix |
16% |
22.83 |
46.26 |
59.82 |
|
|
|
|
|
|
|
| Lumenos High Ded. HIA |
13 |
15.74 |
31.45 |
40.98 |
|
|
|
|
|
|
|
| Full Pay Dental ABCD |
15% |
1.14 |
2.97 |
4.14 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $15,000 per employee |
|
|
|
|
|
| LOCAL 825-Fire |
Premium Cost Shares |
|
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
Single |
2 Person |
Family |
|
|
|
|
|
|
|
| CP2-825 Century Preferred |
16.5% |
31.62 |
64.21 |
82.88 |
|
|
|
|
|
|
|
| BC1-825 Bluecare POE |
12.5% |
23.88 |
48.50 |
62.59 |
|
|
|
|
|
|
|
| BC2-825 Bluecare POE |
10.5% |
18.98 |
38.57 |
49.76 |
|
|
|
|
|
|
|
| Full Pay Dental ABCD |
16.5% |
1.26 |
3.27 |
4.55 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| 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% |
23.88 |
67.89 |
87.62 |
|
|
|
|
|
|
|
| BC2-825 Bluecare POE |
10.5, 16.5% |
18.98 |
60.61 |
78.19 |
|
|
|
|
|
|
|
| Full Pay Dental ABCD |
16.5% |
1.26 |
3.27 |
4.55 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $15,000 per employee |
|
|
|
|
|
| Local 884 |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
|
|
|
|
| Paid 52 weeks |
|
52 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
21.25% |
36.75 |
74.30 |
96.16 |
|
| Bluecare POE |
19.25% |
32.38 |
65.48 |
84.74 |
|
| Comp. Mix |
15.25% |
21.76 |
44.09 |
57.01 |
|
| Lumenos High Ded. HIA |
9.00% |
11.57 |
23.59 |
30.88 |
|
| Full Pay Dental, ABCD |
10.00% |
0.76 |
1.98 |
2.76 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 42 weeks per year |
|
42 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
21.25% |
45.50 |
91.99 |
119.05 |
|
| Bluecare POE |
19.25% |
40.09 |
81.07 |
104.91 |
|
| Comp. Mix |
15.25% |
26.94 |
54.59 |
70.59 |
|
| Lumenos High Ded. HIA |
9.00% |
14.32 |
29.21 |
38.23 |
|
| Full Pay Dental, ABCD |
10.00% |
0.94 |
2.46 |
3.42 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 40 weeks per year |
|
40 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
21.25% |
47.77 |
96.58 |
125.00 |
|
| Bluecare POE |
19.25% |
42.09 |
85.12 |
110.16 |
|
| Comp. Mix |
15.25% |
28.29 |
57.32 |
74.12 |
|
| Lumenos High Ded. HIA |
9.00% |
15.04 |
30.67 |
40.14 |
|
| Full Pay Dental, ABCD |
10.00% |
0.99 |
2.58 |
3.59 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 26 weeks per year |
|
26 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
21.25% |
73.49 |
148.59 |
192.31 |
|
| Bluecare POE |
19.25% |
64.75 |
130.96 |
169.47 |
|
| Comp. Mix |
15.25% |
43.52 |
88.19 |
114.03 |
|
| Lumenos High Ded. HIA |
9.00% |
23.14 |
47.19 |
61.75 |
|
| Full Pay Dental, ABCD |
10.00% |
1.53 |
3.97 |
5.52 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 21 weeks per year |
|
21 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
21.25% |
90.99 |
183.97 |
238.10 |
|
| Bluecare POE |
19.25% |
80.17 |
162.14 |
209.82 |
|
| Comp. Mix |
15.25% |
53.88 |
109.18 |
141.18 |
|
| Lumenos High Ded. HIA |
9.00% |
28.64 |
58.42 |
76.45 |
|
| Full Pay Dental, ABCD |
10.00% |
1.65 |
4.30 |
5.98 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $20,000 per employee |
|
|
|
|
|
|
|
|
|
|
|
| Local 884 |
PREMIUM COST SHARES |
|
| Local 884-PT PEO |
FULLY EQUIVALENT PREMIUM COSTS |
|
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
MONTHLY COSTS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
100% |
778.04 |
1593.34 |
2068.18 |
|
| Bluecare POE |
100% |
757.52 |
1552.28 |
2014.81 |
|
| Comp. Mix |
100% |
618.29 |
1252.92 |
1620.06 |
|
| Lumenos High Ded. HIA |
100% |
524.63 |
1048.17 |
1365.95 |
|
| Full Pay Dental, ABCD |
100% |
33.05 |
85.94 |
119.58 |
|
|
|
|
|
|
|
| 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 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
Effective School Year 2013-2014 |
|
|
PAY PERIOD DEDUCTIONS |
|
|
|
|
|
|
|
| 21 PAY PERIODS |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-2010 Century Preferred |
21.5% |
95.33 |
192.90 |
249.34 |
|
|
|
|
|
|
|
| BC1-2010 Bluecare POE |
17.5% |
77.42 |
156.67 |
202.51 |
|
|
|
|
|
|
|
| CPCM-2010 Cent Pref Comp Mix |
10.5% |
41.77 |
84.64 |
109.34 |
|
|
|
|
|
|
|
| Full Pay Dental-2010 ABCD |
21.5% |
4.16 |
10.81 |
15.04 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
|
|
|
|
| $55,000 PER EMPLOYEE |
|
NO COST TO EMPLOYEE |
|
| Local 3144-Management |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
| Paid 52 weeks per year |
|
52 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-Century Preferred |
18% |
33.83 |
68.58 |
88.59 |
|
| BC1-Bluecare POS |
14% |
26.87 |
54.45 |
70.35 |
|
| BC2-Bluecare POS |
12% |
21.69 |
43.99 |
56.81 |
|
| Full Pay Dental, ABCD |
18% |
1.37 |
3.57 |
4.97 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 40 weeks per year |
|
40 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-Century Preferred |
18% |
43.98 |
89.15 |
115.16 |
|
| BC1-Bluecare POS |
14% |
34.93 |
70.79 |
91.45 |
|
| BC2-Bluecare POS |
12% |
28.20 |
57.19 |
73.86 |
|
| Full Pay Dental, ABCD |
18% |
1.78 |
4.64 |
6.46 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Paid 26 weeks per year |
|
26 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-Century Preferred |
18% |
67.67 |
137.16 |
177.17 |
|
| BC1-Bluecare POS |
14% |
53.74 |
108.91 |
140.70 |
|
| BC2-Bluecare POS |
12% |
43.38 |
87.99 |
113.63 |
|
| Full Pay Dental, ABCD |
18% |
2.75 |
7.14 |
9.93 |
|
|
|
|
|
|
|
| Paid 21 weeks per year |
|
21 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-Century Preferred |
18% |
83.78 |
169.82 |
219.36 |
|
| BC1-Bluecare POS |
14% |
66.54 |
134.84 |
174.20 |
|
| BC2-Bluecare POS |
12% |
53.71 |
108.94 |
140.68 |
|
| Full Pay Dental, ABCD |
18% |
3.40 |
8.84 |
12.30 |
|
|
|
|
|
|
|
| TERM LIFE |
|
|
|
|
|
| $20,000 per employee |
|
NO COST TO EMPLOYEE |
|
| LOCAL 3429 |
Premium Cost Shares |
| Paraprofessionals |
Effective School Year 2013-2014 |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PAY PERIOD DEDUCTIONS |
|
|
|
21 PAY PERIODS |
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| Century Preferred PPO |
20.25% |
86.71 |
175.31 |
226.90 |
|
|
|
|
|
|
|
| Bluecare POE |
18.25% |
76.01 |
153.72 |
198.92 |
|
|
|
|
|
|
|
| Cent Pref Comp Mix |
14.25% |
50.35 |
102.02 |
131.92 |
|
|
|
|
|
|
|
| Lumenos High Ded. HIA |
7.00% |
20.99 |
41.93 |
54.64 |
|
|
|
|
|
|
|
| Full Pay Dental ABCD |
10.00% |
1.89 |
4.91 |
6.83 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
|
NO COST TO EMPLOYEE |
|
| $25,000 per employee |
|
|
|
|
|
| LOCAL 1303-102 |
PREMIUM COST SHARES |
| NH CHILD DEVELOPMENT |
|
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
Single |
2 Person |
Family |
|
|
|
|
|
|
|
| BC1-1303-102 Bluecare POE |
12% |
22.17 |
44.95 |
58.06 |
|
|
|
|
|
|
|
| BC2-1303-102 Bluecare POE |
10% |
17.53 |
35.58 |
45.94 |
|
|
|
|
|
|
|
| Full Pay Dental ABCD |
12% |
0.92 |
2.38 |
3.31 |
|
| Executive & Confidential |
PREMIUM COST SHARES |
| FY 2013-2014 |
Effective 7/1/2013-6/30/2014 |
|
|
|
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
52 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
SINGLE |
2 PERSON |
FAMILY |
|
|
|
|
|
|
|
| CP2-Century Preferred |
24% |
45.77 |
92.87 |
119.91 |
|
| BC1-Bluecare POS |
18% |
35.05 |
71.08 |
91.79 |
|
| BC2-Bluecare POS |
16% |
29.37 |
59.61 |
76.95 |
|
| Full Pay Dental, ABCD |
24% |
1.83 |
4.76 |
6.62 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PAYROLL DEDUCTIONS |
|
|
|
26 PAY PERIODS |
|
|
|
|
|
|
|
| COVERAGE |
% |
Single |
2 Person |
Family |
|
|
|
|
|
|
|
| CP2-Century Preferred |
24% |
91.55 |
185.73 |
239.81 |
|
| BC1-Bluecare POS |
18% |
70.09 |
142.16 |
183.58 |
|
| BC2-Bluecare POS |
16% |
58.73 |
119.22 |
153.89 |
|
| Full Pay Dental, ABCD |
24% |
3.66 |
9.52 |
13.25 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| TERM LIFE |
20,000 |
NO COST TO EMPLOYEE |
|
| if salary over $50,000 |
100,000 |
NO COST TO EMPLOYEE |
|
Members of Local 530 - Click on any of the below for more information:
Local 530 Premium Cost Shares, Effective June 1, 2013 - June 30, 2013 AND Effective July 1, 2013 - June 30, 2014
Local 530 Medical Benefit Matrix New Plans 2013-2014
Local 530 BC-1 POS Matrix
Local 530 Health Incentive Account Lumenos HDHP
Local 530 Prescription Drug Matrix
Local 530 Dental Plan
Local 530 Blue View Vision
Local 530 Enrollment and Membership Change Form
Re-Enrollment Document Requirements
Local 530 New Plans - FAQs
Members of Local 884 - Click on any of the below for more information
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
Members of Local 3429 - Click on any of the below for more information:
Local 3429 Premium Cost Shares, Effective May 1, 2013 - June 30, 2013 AND Effective July 1, 2013 - June 30, 2014
Local 3429 Medical Benefit Matrix 2013-2014
Local 3429 Health Incentive Account Lumenos HDHP
Local 3429 Prescription Comparison
Local 3429 Dental Plan
Local 3429 Blue View Vision
Local 3429 Enrollment and Membership Change Form
Re-Enrollment Document Requirements
Local 3429 New Plans - FAQs
