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FY2018-2019 GROUP INSURANCE BIWEEKLY PREMIUM RATES

PLAN NAME/CODEO ptionEmployeeStateTotal[HAEX] State Health Plan PPOE mployee Only$ $ $ [HAEX] State Health Plan PPOE mployee & Spouse$ $ $ [HAEX] State Health Plan PPOE mployee & Child (ren)$ $ $ [HAEX] State Health Plan PPOFull Family$ $ $ NAME/CODEO ptionEmployeeStateTotalEmployee or Spouse w/Medicare (State pays 100%)Employee Only$ $ $ or Spouse w/Medicare (State pays 100%)Employee & Spouse$ $ $ or Spouse w/Medicare (State pays 100%)Employee & Child (ren)$ $ $ or Spouse w/Medicare (State pays 100%)Full Family$ $ $ NAME/CODEO ptionEmployeeStateTotal[HDHP] State High Deductible Health Plan with HSA 1 Employee Only$ $ $ [HDHP] High Deductible Health PlanEmployee & Spouse$ $ $ [HDHP] High Deductible Health PlanEmployee & Child (ren)$ $ $ [HDHP] High Deductible Health PlanFull Family$ $ $ NAME/CODEO ptionEmployeeStateTotal[HCAT] Catastrophic Health Plan 2 Employee Only$ $ $ [HCAT] Catastrophic Health Plan 2 Em

CIVIL SERVICE COMMISSION EMPLOYEE BENEFITS DIVISION FY2018-2019 GROUP INSURANCE BIWEEKLY PREMIUM RATES EFFECTIVE OCTOBER 7, 2018 For NERE & Bargaining Units: AFSCME, MCO, MSEA, UAW, SEIU Local 517M, Judicial Branch, and Non-Represented (Z60–Z89)

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