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Health Insurance Premiums

Effective October 1, 2013

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Blue Cross/Blue Shield (BCBS)

Presbyterian Health Plan

United Dental/Concordia

Davis Vision

 


Blue Cross/Blue Shield (BCBS)

High Option

Total Monthly Premium Cost

$551.80

$1,049.40

$1,401.60

Bi-Weekly Payroll Deduction: 396 or 391

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$55.18

$220.72

TC

$104.94

$419.76

FC

$140.16

$560.64

$25000 and above

SD

$68.98

$206.92

TD

$131.18

$393.52

FD

$175.20

$525.60

Three-Quarter time

Less than $19,999.99

SF

$104.84

$171.06

TF

$199.39

$325.31

FF

$266.30

$434.50

$20,000 to 24,999.99

SG

$110.36

$165.54

TG

$209.88

$314.82

FG

$280.32

$420.48

$25000 and above

SH

$120.71

$155.19

TH

$229.56

$295.14

FH

$306.60

$394.20

Half-time

Less than $19,999.99

SJ

$151.75

$124.15

TJ

$288.59

$236.11

FJ

$385.44

$315.36

$20,000 to 24,999.99

SK

$160.02

$115.88

TK

$304.33

$220.37

FK

$406.46

$294.34

$25000 and above

SL

$165.54

$110.36

TL

$314.82

$209.88

FL

$420.48

$280.32

Low Option

Total Monthly Premium Cost

$463.50

$881.48

$1,177.40

Bi-Weekly Payroll Deduction: 376 or 371

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$46.35

$185.40

TC

$88.15

$352.59

FC

$117.74

$470.96

$25000 and above

SD

$57.94

$173.81

TD

$110.19

$330.55

FD

$147.18

$441.52

Three-Quarter time

Less than $19,999.99

SF

$88.07

$143.68

TF

$167.48

$273.26

FF

$223.71

$364.99

$20,000 to 24,999.99

SG

$92.70

$139.05

TG

$176.30

$264.44

FG

$235.48

$353.22

$25000 and above

SH

$101.39

$130.36

TH

$192.82

$247.92

FH

$257.56

$331.14

Half-time

Less than $19,999.99

SJ

$127.46

$104.29

TJ

$242.41

$198.33

FJ

$323.79

$264.91

$20,000 to 24,999.99

SK

$134.42

$97.33

TK

$255.63

$185.11

FK

$341.45

$247.25

$25000 and above

SL

$139.05

$92.70

TL

$264.44

$176.30

FL

$353.22

$235.48

 

 

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Presbyterian Health Plan

High Option

Total Monthly Premium Cost

$446.24

$936.98

$1,249.42

Bi-Weekly Payroll Deduction: 398 or 393

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$44.62

$178.50

TC

$93.70

$374.79

FC

$124.94

$499.77

$25000 and above

SD

$55.78

$167.34

TD

$117.12

$351.37

FD

$156.18

$468.53

Three-Quarter time

Less than $19,999.99

SF

$84.79

$138.33

TF

$178.03

$290.46

FF

$237.39

$387.32

$20,000 to 24,999.99

SG

$89.25

$133.87

TG

$187.40

$281.09

FG

$249.88

$374.83

$25000 and above

SH

$97.62

$125.50

TH

$204.96

$263.53

FH

$273.31

$351.40

Half-time

Less than $19,999.99

SJ

$122.72

$100.40

TJ

$257.67

$210.82

FJ

$343.59

$281.12

$20,000 to 24,999.99

SK

$129.41

$93.71

TK

$271.72

$196.77

FK

$362.33

$262.38

$25000 and above

SL

$133.87

$89.25

TL

$281.09

$187.40

FL

$374.83

$249.88

Low Option

Total Monthly Premium Cost

$374.86

$787.08

$1,049.50

Bi-Weekly Payroll Deduction: 378 or 373

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$37.49

$149.94

TC

$78.71

$314.83

FC

$104.95

$419.80

$25000 and above

SD

$46.86

$140.57

TD

$98.39

$295.15

FD

$131.19

$393.56

Three-Quarter time

Less than $19,999.99

SF

$71.22

$116.21

TF

$149.55

$243.99

FF

$199.41

$325.34

$20,000 to 24,999.99

SG

$74.97

$112.46

TG

$157.42

$236.12

FG

$209.90

$314.85

$25000 and above

SH

$82.00

$105.43

TH

$172.17

$221.37

FH

$229.58

$295.17

Half-time

Less than $19,999.99

SJ

$103.09

$84.34

TJ

$216.45

$177.09

FJ

$288.61

$236.14

$20,000 to 24,999.99

SK

$108.71

$78.72

TK

$228.25

$165.29

FK

$304.36

$220.39

$25000 and above

SL

$112.46

$74.97

TL

$236.12

$157.42

FL

$314.85

$209.90

 

 

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United Dental/Concordia

High Option

Total Monthly Premium Cost

$27.24

$51.86

$81.48

Bi-Weekly Payroll Deduction: 365 or 360

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$2.72

$10.90

TC

$5.19

$20.74

FC

$8.15

$32.59

$25000 and above

SD

$3.41

$10.21

TD

$6.48

$19.45

FD

$10.19

$30.55

Three-Quarter time

Less than $19,999.99

SF

$5.18

$8.44

TF

$9.85

$16.08

FF

$15.48

$25.26

$20,000 to 24,999.99

SG

$5.45

$8.17

TG

$10.37

$15.56

FG

$16.30

$24.44

$25000 and above

SH

$5.96

$7.66

TH

$11.34

$14.59

FH

$17.82

$22.92

Half-time

Less than $19,999.99

SJ

$7.49

$6.13

TJ

$14.26

$11.67

FJ

$22.41

$18.33

$20,000 to 24,999.99

SK

$7.90

$5.72

TK

$15.04

$10.89

FK

$23.63

$17.11

$25000 and above

SL

$8.17

$5.45

TL

$15.56

$10.37

FL

$24.44

$16.30

Low Option

 

 

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Davis Vision

Total Monthly Premium Cost

$6.26

$10.48

$14.14

Bi-Weekly Payroll Deduction: 385 or 380

Single

Two-Party

Family

Employee Status

Annualized Salary

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Employee Portion

CNM Portion

Full-time

Less than 24,999.99

SC

$0.63

$2.50

TC

$1.05

$4.19

FC

$1.41

$5.66

$25000 and above

SD

$0.78

$2.35

TD

$1.31

$3.93

FD

$1.77

$5.30

Three-Quarter time

Less than $19,999.99

SF

$1.19

$1.94

TF

$1.99

$3.25

FF

$2.69

$4.38

$20,000 to 24,999.99

SG

$1.25

$1.88

TG

$2.10

$3.14

FG

$2.83

$4.24

$25000 and above

SH

$1.37

$1.76

TH

$2.29

$2.95

FH

$3.09

$3.98

Half-time

Less than $19,999.99

SJ

$1.72

$1.41

TJ

$2.88

$2.36

FJ

$3.89

$3.18

$20,000 to 24,999.99

SK

$1.82

$1.31

TK

$3.04

$2.20

FK

$4.10

$2.97

$25000 and above

SL

$1.88

$1.25

TL

$3.14

$2.10

FL

$4.24

$2.83

 

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