Agenda - Council - 02/12/2013 - Laserfiche WebLink

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Health Plan Type/Tier Employee Employee City Cost for Cost for City ACCORD AWARE Contribution Accord Aware Contribution Total City Premium Premium to Premium Network Network to VEBA Contribution 1 Single Plans (Per Month) BCBS 100% $30.00 co -pay BCBS $1500 Ded. Plan w/VEBA BCBS $2500 Ded. Plan w/VEBA BCBS $4000 Ded. Plan w/VEBA $858.00 $890.00 $517.14 $340.86 $372.86 NA $517.14 $728.00 $755.00 $600.00 $128.00 $155.00 $130.00 $730.00 $671.00 $696.00 $600.00 $71.00 $96.00 $130.00 $730.00 $591.50 $613.50 $591.50 $0.00 $22.00 $155.00 $746.50 1 Employee + Children Plans (Per Month) BCBS 100% $30.00 co -pay BCBS $1500/$3000 Ded. Plan w/VEBA BCBS $2500/$5000 Ded. Plan w/VEBA BCBS $4000/8000 Ded. Plan w/VEBA $1,716.50 $1,781.00 $831.56 $884.94 $949.44 NA $831.56 $1,456.00 $1,511.00 $935.00 $521.00 $576.00 $160.00 $1,095.00 $1,341.50 $1,392.00 $935.00 $406.50 $457.00 $160.00 $1,095.00 $1,183.00 $1,227.50 $935.00 $248.00 $292.50 $160.00 $1,095.00 1 Employee + Spouse Plans (Per Month) BCBS 100% $30.00 co -pay BCBS $1500/$3000 Ded. Plan w/VEBA BCBS $2500/$5000 Ded. Plan w/VEBA BCBS $4000/8000 Ded. Plan w/VEBA $1,802.00 $1,870.00 $831.56 $970.44 $1,038.44 NA $831.56 $1,529.50 $1,586.50 $857.00 $672.50 $729.50 $160.00 $1,017.00 $1,409.00 $1,462.00 $857.00 $552.00 $605.00 $160.00 $1,017.00 $1,242.50 $1,289.00 $857.00 $385.50 $432.00 $160.00 $1,017.00 1 Family Plans (Per Month) BCBS 100% $30.00 co -pay BCBS $1500/$3000 Ded. Plan w/VEBA BCBS $2500/$5000 Ded. Plan w/VEBA BCBS $4000/8000 Ded. Plan w/VEBA $2,232.00 $2,315.50 $831.56 $1,400.44 $1,483.94 NA $831.56 $1,893.50 $1,964.00 $1,101.00 $792.50 $863.00 $192.00 $1,293.00 $1,744.50 $1,810.50 $1,101.00 $643.50 $709.50 $192.00 $1,293.00 $1,538.50 $1,596.00 $1,101.00 $437.50 $495.00 $192.00 $1,293.00 **The City's 2013 VEBA contribution includes the $4.30 monthly claims fee.