Oklahoma State and Education Employees Group Insurance Board
Monthly Premiums for Current Employees
Plan Year January 1, 2010 - December 31, 2010
| HEALTH PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice High |
$442.80 |
$625.88 |
$228.32 |
$342.44 |
| HealthChoice Basic |
$384.22 |
$546.84 |
$200.36 |
$300.88 |
| HealthChoice S-Account |
$365.80 |
$513.68 |
$190.32 |
$283.98 |
| HealthChoice USA |
$678.57 |
$678.57 |
$226.33 |
$339.31 |
| Aetna Standard HMO |
$715.40 |
$951.38 |
$488.78 |
$782.04 |
| Aetna Alternative HMO |
$502.32 |
$668.02 |
$343.20 |
$549.12 |
| CommunityCare Standard HMO |
$775.08 |
$1108.34 |
$387.54 |
$620.06 |
| CommunityCare Alternative HMO |
$534.54 |
$764.38 |
$267.28 |
$427.64 |
| GlobalHealth Standard HMO |
$344.18 |
$510.70 |
$184.56 |
$294.30 |
| GlobalHealth Alternative HMO |
$312.90 |
$464.30 |
$167.82 |
$267.54 |
| PacifiCare Standard HMO |
$605.20 |
$870.16 |
$302.38 |
$483.92 |
| PacifiCare Alternative HMO |
$417.38 |
$600.10 |
$208.52 |
$333.72 |
| DISABILITY (Employee only) |
$9.10 (Limited county participation
only) |
| DENTAL PLANS |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| HealthChoice Dental |
$30.28 |
$30.28 |
$25.24 |
$65.50 |
| Assurant Freedom Preferred |
$26.33 |
$26.18 |
$19.63 |
$52.79 |
| Assurant Heritage Plus with SBA
(Prepaid) |
$11.74 |
$8.86 |
$7.60 |
$15.20 |
| Assurant Heritage Secure (Prepaid) |
$7.20 |
$5.98 |
$5.20 |
$10.38 |
| CIGNA Dental Care Plan (Prepaid) |
$9.26 |
$6.06 |
$7.08 |
$15.32 |
| Delta Dental PPO (POS) |
$30.48 |
$30.50 |
$26.80 |
$68.22 |
| Delta’s Choice (PPO) |
$13.40 |
$30.44 |
$30.68 |
$74.46 |
| VISION PLANS - Employee Paid |
MEMBER |
SPOUSE |
CHILD |
CHILDREN |
| Humana/CompBenefits VisionCare Plan |
$6.76 |
$5.06 |
$3.57 |
$4.46 |
| Primary Vision Care Services |
$9.25 |
$8.00 |
$8.50 |
$10.75 |
| Superior Vision Services |
$6.98 |
$6.90 |
$6.60 |
$6.60 |
| UnitedHealthcare Vision |
$8.18 |
$5.79 |
$4.59 |
$6.98 |
| Vision Service Plan (VSP) |
$8.96 |
$6.00 |
$5.74 |
$12.92 |
| LIFE |
|
| HealthChoice Basic Life ($20,000) $4.56 |
First $20,000 of Supplemental Life $4.56 |
| Age-Rated Supplemental Life – Cost Per $20,000 |
| < 30 ---------- $1.00 |
45 - 49 ------- $ 3.80 |
65 - 69 ------- $19.80 |
| 30 - 34 ------- $1.00 |
50 - 54 ------- $ 6.40 |
70 - 74 ------- $33.40 |
| 35 - 39 ------- $1.60 |
55 - 59 ------- $10.40 |
75+ ----------- $52.00 |
| 40 - 44 ------- $2.40 |
60 - 64 ------- $12.00 |
|
| DEPENDENT |
LOW OPTION - $2.60 |
STANDARD OPTION - $4.32 |
PREMIER OPTION - $8.64 |
| Spouse |
$6,000 |
$10,000 |
$20,000 |
| Child (age 6 months to 25) |
$3,000 |
$5,000 |
$10,000 |
| Child (live birth to 6 months) |
$1,000 |
$1,000 |
$1,000 |
