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3.8. SR 11-15-2004
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3.8. SR 11-15-2004
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1/21/2008 8:33:59 AM
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11/12/2004 9:44:02 AM
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11/15/2004
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<br />Monthly Rates <br />These monthly rates are subject to the contingencies described within this proposal. <br /> <br />The plan total for each different coverage was calculated based on the following <br />estimated enrollments: <br />Single <br />Family <br />Employee & Child(ren) <br />Employee & Spouse <br /> <br />Coverage <br />Plan 1 $15 Copay Comprehensive Major Medical <br /> <br />Minimum Premium Rates <br /> <br />Plan 2 $500 Comprehensive Major Medical <br /> <br />Minimum Premium Rates <br /> <br />Single <br />Rate <br /> <br />Employee <br />Family & Child(ren) <br />Rate Rate <br /> <br />$260.50 $860.50 <br /> <br />$221.00 $728.50 <br /> <br />$573.50 <br /> <br />$486.00 <br /> <br />39 <br />16 <br />19 <br />8 <br /> <br />Employee <br />& Spouse <br />Rate <br /> <br />Annual <br />Plan Total <br /> <br />$547.50 <br /> <br />$470,448 <br /> <br />$463.50 <br /> <br />$398,604 <br />
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