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CITY OF ELK RIVER
<br />Non-Union Health Insurance
<br />July, 1998
<br />
<br /> .EMPLOYEE COVERAGE
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br /> S E
<br />10 S E
<br />11 S E
<br />12 S E
<br />13 S E
<br />14 S E
<br />15 S E
<br />16 S E
<br />17 S E
<br />18 S E
<br />19 S E
<br />20 S E
<br />21 S E
<br />22 S E
<br />23 S E
<br />24 S E
<br />25 S E
<br />26 S E
<br />27 S
<br />
<br />Subtotal Single City Share
<br />
<br />28 F E+S+C
<br />29 F E+S
<br />30 F E+S+C
<br />31 F E+S+C
<br />32 F E+S+C
<br />33 F E +lC
<br />34 F E+S
<br />35 F E +lC
<br />36 F E+S+C
<br />37 F E+S+C
<br />38 F E+IC
<br />39 F E+IC
<br />40 F E+IC
<br />41 F E+IC
<br />42 F E+S
<br />43 F E+S+C
<br />44 F E+S+C
<br />45 F E+IC
<br />46 F E+C
<br />47 F E+S
<br />48 F E+S
<br />49 F E+S+C
<br />50 F E+S+C
<br />51 F E+IC
<br />52 F E+IC
<br />53 F E+S+C
<br />54 F E+S
<br />55 F E+S
<br />56 F E+S+C
<br />57 F E+S+C
<br />58 F E+C
<br />
<br />Subtotal Family
<br />
<br />Employer Share
<br />Employee Share
<br />
<br />TOTAL MONTHLY PREMIUM
<br />
<br />317.47
<br />
<br />TOTAL ANNUAL PREMIUM
<br /> EMPLOYER
<br /> EMPLOYEE
<br />
<br />S = Single E = Employee
<br />F = Family S = Spouse
<br /> lC = One Child
<br /> C = Children
<br />
<br /> Current MEOICA BCBS BCBS $200Ded
<br />Premium RENEWAL Blue Choice BC $15 Choice
<br /> 146.76 171.00 190.05 185.75 163,26
<br /> 149.76 17~50 190.05 185.75 163.26
<br /> 146.76 171.00 190.05 185.75 163.26
<br /> 146.76 171.00 190.05 185.75 163.26
<br /> 149.76 174.50 190.05 185.75 163.26
<br /> 224.62 261.70 190.05 185.75 163.26
<br /> 127.28 148.30 190.05 185.75 163,26
<br /> 187.19 218.10 190.05 185.75 163.26
<br /> 149.76 17~50 190.05 185.75 163.26
<br /> 149,76 174.50 190.05 185.75 163.26
<br /> 146.76 171.O0 190.05 185.75 163.26
<br /> 149.76 174.50 190.05 185.75 163.26
<br /> 187.19 218.10 190.05 185.75 163.26
<br /> 22~62 261.70 190.05 185.75 163.26
<br /> 149.76 174.50 190,05 185.75 163,26
<br /> 146.76 171,00 190.05 185.75 163.26
<br /> 146.76 171.00 190.05 185.75 163.26
<br /> 146.76 171.00 190.05 185,75 163.26
<br /> 146,76 171.00 190.05 185,75 163.26
<br /> 187.19 218.10 190.05 185.75 163.26
<br /> 149.76 174.50 190.05 185,75 163,26
<br /> 149.76 174.50 190.05 185.75 163.26
<br /> 187.19 218.10 190.05 185.75 163.26
<br /> 146.76 171.00 190.05 185.75 163.26
<br /> 146.76 171.00 190,05 185.75 163.26
<br /> 146.76 171.00 190,05 185.75 163.26
<br /> 146.76 171.00 190.05 185.75 163.26
<br />
<br />4,284.48 4,992.10 5,131.35 5,015.25 4,408.02
<br />
<br />524.16 610.65 507.11 496.60 489.78
<br />336.95 392.55 507.11 496.60 375.50
<br />521.16 607.15 507.11 496.60 489.78
<br />509.18 593.19 507.11 496.60 489.78
<br />561.59 654.25 507.11 496.60 489.78
<br />259.08 801.83 5(~7.11 496.60 342.85
<br />688.86 802.52 507.11 496.60 375.50
<br />262.08 305.32 507.11 496.60 342~5
<br />63(t45 741.46 507.11 496.60 489.78
<br />521.16 607.15 507.11 496.60 489.78
<br />259.08 301.83 507.11 496.60 342.85
<br />262.08 305.32 507.11 496.60 342.85
<br />259.08 301.83 507.11 496.60 342.85
<br />247.10 287.87 507.11 496.60 342.85
<br />374.38 436.15 507.11 496.60 375.50
<br />599.02 697.86 507.11 496.60 489.78
<br />486.70 567.01 507.11 496.60 489.78
<br />259.08 301.83 507.11 496.60 342.85
<br />371.40 432.68 507.11 496.60 342.85
<br />293.52 341.95 507.11 496.60 375.50
<br />374.38 436.15 507.11 496.60 375.50
<br />521.16 607.15 507.11 496.60 489.78
<br />518.16 603.66 507.11 496.60 489.78
<br />259.08 301.83 507.11 496.60 342.85
<br />262.08 305.32 507.11 496.60 342.85
<br />518,16 603.66 507.11 496.60 489.78
<br />411.81 479.76 507.11 496.60 375.50
<br />299.52 348.94 507.11 496.60 375.50
<br />408.84 476.30 507,11 496.60 489.78
<br />524.16 610.65 507.11 496.60 489.78
<br />371.40 432.68 507.11 496.60 342.85
<br />
<br />12,700.86 14,796.50 15,720.41 15,394.60 12,766.99
<br />
<br />9,271.18 9,697.32 9,841.57 9,841.57 9,841.57
<br />3,429.68 5,099.18 5,878.84 5,553.03 2,925.42
<br />
<br />16,985.34 19,788.60 20,851.76 20,409.85 17,175.01
<br />
<br />$203,824.08 $237,463.22 $250,221.12 $244,918.20 $ 206,100.12
<br />162,667.92 176,273.04 179,675.04 178,281.84 170,995.08
<br />41,156.16 61,190.18 70,546.08 66,636.36 35,105.04
<br /> Incressed Reduced
<br /> Office Copay Coverage
<br />
<br />
<br />
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