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FOR EMPLOYEES AND NON-MEDICARE-ELIGIBLE RETIREES
7
2017
Employee Contributions
ANNE ARUNDEL COUNTY GENERAL EMPLOYEE RATE SCHEDULE EFFECTIVE - 1/1/17 to 12/31/17
At Employee Cost Share of 25% for Triple Option Open Access; 15% for BlueChoice HMO Open Access; 15% for CareFirst EPO
Employee Biweekly Pre-tax Deduction (or Taxable additional To Pay)
Bi-Weekly Rates
Medical and Dental Options
Individual
Parent and
Child
Employee
and Spouse
Family
Blue Choice Open Triple Option Open Access
Blue Choice Triple Option Open Access with No Dental Coverage
$81.25
$144.93
$174.20
$226.77
Blue Choice Triple Option Open Access with CIGNA Dental Care (DHMO)
$82.10
$145.78
$175.05
$227.62
Blue Choice Triple Option Open Access with CIGNA Dental PPO
$83.10
$146.78
$176.05
$228.62
BLUE CHOICE HMO Open Access
Blue Choice HMO Open Access with No Dental Coverage
$36.21
$66.40
$79.41
$103.24
Blue Choice HMO Open Access with CIGNA Dental Care (DHMO)
$37.06
$67.25
$80.26
$104.09
Blue Choice HMO Open Access with CIGNA Dental PPO
$38.06
$68.25
$81.26
$105.09
CAREFIRST EPO
CareFirst EPO with No Dental Coverage
$39.81
$73.34
$87.39
$113.36
CareFirst EPO with CIGNA Dental Care (DHMO)
$40.66
$74.19
$88.24
$114.21
CareFirst EPO with CIGNA Dental PPO
$41.66
$75.19
$89.24
$115.21
OPT OUT
CIGNA Dental Care (DHMO) with No Health
($20.15)
($20.15)
($20.15)
($20.15)
CIGNA Dental Care (PPO) with No Health
($19.15)
($19.15)
($19.15)
($19.15)
No Coverage (Opt Out)
($21.00)
($21.00)
($21.00)
($21.00)
No Coverage (Opt Out) AFSCME Local 2563
($28.85)
($28.85)
($28.85)
($28.85)
Notes:
• This Schedule is intended to provide a convenient cost comparison of various health plan options.
• Bi-weekly means 26 times/year.
• Amounts in ( ) indicate an addition to pay.
• There is no charge for vision care; dental enrollment is required for vision coverage.