CCCCD Medical/Dental Premiums

Effective 09/01/2007

HealthSelect

Monthly

     State

Employee

Medical Insurance

Premium

     Pays

Pays

Employee Only

$360.54

$360.54

$0.00

Employee & Spouse

$772.60

$566.57

$206.03

Employee & Child(ren)

$636.44

$498.49

$137.95

Employee & Family

$1,048.50

$704.52

$343.98

 

Dental Plan

Monthly

State

College

Employee

Premium

Pays

Pays

Pays

Dental Choice Plan/GEHA

 

 

 

 

Employee Only

$21.03

$0.00

$21.03

$0.00

Employee & Spouse

$39.74

$0.00

$21.03

$18.71

Employee & Child(ren)

$47.52

$0.00

$21.03

$26.49

Employee & Family

$66.23

$0.00

$21.03

$45.20

Dental HMO/Aetna

 

 

 

 

Employee Only

$7.22

$0.00

$7.22

$0.00

Employee & Spouse

$13.00

$0.00

$7.22

$5.78

Employee & Child(ren)

$15.66

$0.00

$7.22

$8.44

Employee & Family

$19.27

$0.00

$7.22

$12.05

 

 

 

Optional Coverage Rates-Employees

All premiums are monthly

 

Optional Term Life* Premiums

 

Election I=1X annual salary  Election II=2X annual salary  NOTE: After the first 31 days of employment, Election I and II require approval through evidence of insurability. 

Election III=3X annual salary  Election IV=4X annual salary  NOTE: Election III and IV always require approval through evidence of insurability. 

Beginning at age 70, Optional Term Life coverage is reduced to a percentage of your annual salary according to the table below:   
          Age 70-74   65%  
          Age 75-79   40%  
          Age 80-84   25%  
          Age 85-89   15%  
          Age 90+   10%  

*Optional Term Life is limited to a maximum of $400,000 or 4X your salary, whichever is less.

Rate per $1000 of Annual Salary

 

Age

Election I

Election II

Election III

Election IV

15-19

$0.06

$0.12

$0.18

$0.24

20-24

$0.06

$0.12

$0.18

$0.24

25-29

$0.06

$0.12

$0.18

$0.24

30-34

$0.07

$0.14

$0.21

$0.28

35-39

$0.07

$0.14

$0.21

$0.28

40-44

$0.09

$0.18

$0.27

$0.36

45-49

$0.13

$0.26

$0.39

$0.52

50-54

$0.21

$0.42

$0.63

$0.84

55-59

$0.37

$0.74

$1.11

$1.48

60-64

$0.63

$1.26

$1.89

$2.52

65-69

$1.03

$2.06

$3.09

$4.12

70-74

$1.64

$3.28

$4.92

$6.56

75-79

$2.68

$5.36

$8.04

$10.72

80-84

$4.36

$8.72

$13.08

$17.44

85-89

$7.54

$15.08

$22.62

$30.16

90+

$11.74

$23.48

$35.22

$46.96

 

Dependent Term Life

Short & Long term Disability Income Premiums

$1.38/month  (includes $5,000 term life with AD&D coverage per dependent)

Short-term Disability Income $0.32/$100 of monthly salary                Long-term Disability Income $0.70/$100 of monthly salary

 

Voluntary Accidental Death and Dismemberment (Voluntary AD&D) Premiums

You may apply for Voluntary AD&D coverage according to the following table:

 

Employee's Age

Minimum Coverage

Maximum Coverage

Minimum Increments

Employee Only-$0.02/$1000 of coverage                 Employee & Family-$0.04/$1000 of coverage               For more detailed information about optional coverage benefits, see the benefits books available online at the ERS website.

Under age 70

$10,000

$200,000

$5,000

70-74

$6,500

$130,000

$3,250

75-79

$4,000

$80,000

$2,000

80-84

$2,500

$50,000

$1,250

85-89

$1,500

$30,000

$750

90+

$1,000

$20,000

$500