Download Rate Table	Year 2012 Health Insurance Rates For Active Employees	Close Window

Instructions 1. Enter the required information (A and B) below. 2. Enter all of the plans you are thinking about electing for 2012 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 ***  The 2012 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 your 2012 cost. Please note that you cannot elect your 2012 plans or change plans through the use of this tool. This estimator applies to active, full-time employees. It does not apply to employees who are part-time, temporary or retired. It also does not apply to employees of municipalities or participating agencies.