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