Year 2013 Health Insurance Rates For Active Employees	Close Window

Instructions 1. Enter the information (A and B) below if you are interested in Optional Life insurance. 2. Enter all of the plans you are thinking about electing in the "Possible Election" column. 3. Click the Calculate button.

A. What is your annual salary? $ per year B. Your age: 24 or Younger 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69

Type Plan Option Pay Slip Code Possible Election Medical CareFirst BCBS Point of Service High Option BCBS HI None   Self   Self+1   Family        CareFirst BCBS Point of Service Standard Option BCBS STD None   Self   Self+1   Family        United Healthcare UH HMO None   Self   Self+1   Family        Kaiser Permanente (Includes Kaiser Rx coverage) Kaiser None   Self   Self+1   Family        Prescription Caremark High Option Rx $4/$8 * RX 4_8 None   Self   Self+1   Family        Caremark High Option Rx $5/$10 ** RX 5_10 None   Self   Self+1   Family        Caremark Standard Option RX STD None   Self   Self+1   Family        Dental United Concordia Dental PPO (Traditional Plan) UC PPO None   Self   Self+1   Family        United Concordia Dental HMO (DHMO) UC DMO None   Self   Self+1   Family        Vision NVA Vision Plan Vision None   Self   Self+1   Family        Life Insurance Employee Optional Life *** Optional Life None 1x Salary 2x Salary 3x Salary 4x Salary    Dependent Life **** Dep Life None Level 1 Level 2 Level 3       *  IAFF/MCGEO **  FOP/Unrepresented ***  Maximum coverage amount is $400,000. ****  Level 1: $2,000–spouse, $1,000–child 6 months to 21 yrs, $100–child under 6 months Level 2: $4,000–spouse, $2,000–child 6 months to 21 yrs, $100–child under 6 months Level 3: $10,000–spouse, $5,000–child 6 months to 21 yrs, $100–child under 6 months

This tool helps you estimate the biweekly amount you would pay based on the group insurance plans you elect. Please note that you cannot elect or change plans through the use of this tool. Also, this estimator does not include any Flexible Spending Account (FSA) amount you elect. (Note: FSA biweekly amounts can be determined by dividing the annual amount you elect by 26 pay periods.) If you cover a domestic partner and/or a domestic partner's child, the rates displayed do not include imputed income (refer to the Group Insurance Summary Description for more information). This estimator applies to active, eligible employees of the County. It does not apply to employees who are temporary or retired. It also does not apply to employees of participating agencies.