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Health Plan Type/Tier (Per Month)
<br />ACCORD
<br />AWARE
<br />City
<br />Contribution to
<br />Premium
<br />Employee
<br />Cost for
<br />Accord
<br />Employee
<br />Cost for
<br />Aware
<br />City
<br />Contribution to
<br />VEBA
<br />Total City
<br />Contribution
<br />Option C
<br />Premium
<br />Prernimum
<br />Network
<br />Network
<br />Single Plans
<br />BOBS 100%$30. 10 co -pay
<br />$972.00
<br />$1,008.50
<br />$517.14
<br />$454_86
<br />$491.36
<br />NA
<br />$517.14
<br />BCBS $1500 Ded. Plan w/VEBA
<br />$825.00
<br />$855.50
<br />$670.00
<br />$155.00
<br />$185.50
<br />$130.00
<br />$800.00
<br />BCBS $2500 Ded. Plan w/VEBA
<br />$760.00
<br />$788.50
<br />$670.00
<br />$90.00
<br />$118.50
<br />$130.00
<br />$800.00
<br />BCBS $4000 Ded. Plan w/VEBA
<br />$670.00
<br />$695.00
<br />$670.00
<br />0
<br />$25.00
<br />$130.00
<br />$800.00
<br />Employee + Spouse Plans
<br />BCBS 100%$30.00 co -pay
<br />$2,041.50
<br />$2,118.50
<br />$831.56
<br />$1,209.94
<br />$1,286.94
<br />NA
<br />$831.56
<br />BCBS $1500/$3000 Ded. Plan w/VEBA
<br />$1,733.00
<br />$1,79750
<br />$932.00
<br />$801.00
<br />$865.50
<br />$160.00
<br />S1,092.00
<br />BCBS $2500/$5000 Ded. Plan w/VEBA
<br />$1,596.50
<br />$1,656.50
<br />$932-00
<br />$664.50
<br />$724.50
<br />$160.00
<br />$1,092.00
<br />BCBS $4000/8000 Ded. Plan w/VEBA
<br />$1,408.00
<br />$1,460.50
<br />$932.00
<br />$476.00
<br />$528.50
<br />$160.00
<br />$1,092.00
<br />I
<br />Employee + Children Plans
<br />BCBS 100%$31100co-pay
<br />$1,945.00
<br />$2,018.00
<br />$831.56
<br />$1,113.44
<br />$1,186_44
<br />NA
<br />$831_55
<br />BCBS $1500/$3000Ded. Plan w/VEBA
<br />$1,64950
<br />$1,712.00
<br />$1,016.00
<br />$633.50
<br />$696.00
<br />$160.00
<br />$1,176.00
<br />BCBS $2500/$5000 Ded. Plan w/VEBA
<br />$1,520.00
<br />$1,577.00
<br />$1,016.00
<br />$504-00
<br />$561.00
<br />$160.00
<br />$1,176.00
<br />BCBS $4000/8000 Ded. Plan w/VEBA
<br />$1,340.50
<br />$1,391.00
<br />$1,016.00
<br />$324.50
<br />$375.00
<br />$160.00
<br />$1,176.00
<br />Family Plans
<br />BCBS 100% $30.00 co -pay
<br />$2,529.00
<br />$2,623.50
<br />$831.56
<br />$1,697.44
<br />$1,791.94
<br />NA
<br />$831.56
<br />BCBS $1500/$3000 Ded. Plan w/VEBA
<br />$2,145.50
<br />$2 225 00
<br />$1,166.00
<br />$979.50
<br />$1,059.00
<br />$192.0(
<br />S1,35S C.C.
<br />BCBS $2500/$5000 Ded. Plan w/VEBA
<br />$1,976.50
<br />$2,051.50
<br />$1,166.00
<br />$810.50
<br />$885.50
<br />$192.0iC.
<br />51,35s. :
<br />BCBS $4000/8000 Ded. Plan w/VEBA
<br />$1,743.00
<br />$1,808.50
<br />$1,166.00
<br />$577.00
<br />$642.50
<br />$192.00
<br />S1,358.00
<br />Waivers
<br />(Waivers)
<br />__ _ -:
<br />**The City's 2014 VEBA contribution includes the $4.30 monthly claims fee.
<br />The motion for the adoption of the foregoing resolution was duly seconded by Councilmember
<br />, and upon vote being taken thereon, the following voted in favor thereof:
<br />and the following voted against the same:
<br />and the following abstained:
<br />and the following were absent:
<br />Whereupon said resolution was declared duly passed and adopted by the Ramsey City Council
<br />this the 14 day of January 2014.
<br />ATTEST:
<br />City Clerk
<br />Mayor
<br />Resolution #14-01-011
<br />
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