2012 Cobra Premiums
Medical Premium Rates
| myChoice Health Plan |
myOptions Health Plan |
|
| Self* | $491.84 | $433.30 |
| Self* & Spouse | $1086.65 | $957.29 |
| Self* & Child/ren | $837.09 | $737.44 |
| Self*, Spouse & Child/ren | $1425.72 | $1255.99 |
Dental Premium Rates
| Self* | $30.11 |
| Self* & Spouse | $60.22 |
| Self* & Child/ren | $73.07 |
| Self*, Spouse & Child/ren | $103.18 |
Vision Premium Rates
| Self* | $5.61 |
| Self* & Spouse | $11.22 |
| Self* & Child/ren | $12.24 |
| Self*, Spouse & Child/ren | $19.38 |
* "Self" may be a former employee, a spouse, a widow/er or a child.
Please Note: The premium rates shown above are applicable during the initial COBRA continuation period. Premiums for extended COBRA coverage (totally disabled individuals and certain surviving or divorced spouses) are higher and may be obtained from ASI Cobra.
Reviewed 2011-12-20.
