| May 1, 2010 | ||||||
| VILLAGE OF ELK GROVE | ||||||
| 2010-2011 | HEALTH INSURANCE MONTHLY PREMIUM RATES | |||||
| Total | Village | Employee | Employee | |||
| Monthly | 85% | 15% | Bi-Weekly | |||
| Premium | Share | Share | Share | |||
| MEDICAL | ||||||
|
Blue Cross Blue Shield PPO Plan |
||||||
| Employee Only | $753.87 | $640.79 | $113.08 | $52.00 | ||
| Employee Plus One | $1,583.18 | $1,345.70 | $237.48 | $110.00 | ||
| Employee Two Plus | $1,722.52 | $1,464.14 | $258.38 | $119.00 | ||
|
Blue Cross Blue Shield PPO High Deductible Plan |
||||||
| Employee Only | $604.50 | $513.83 | $90.67 | $42.00 | ||
| Employee Plus One | $1,269.47 | $1,079.05 | $190.42 | $88.00 | ||
| Employee Two Plus | $1,381.20 | $1,174.02 | $207.18 | $96.00 | ||
|
HMO Illinois HMO Plan |
||||||
| Employee Only | $537.29 | $456.70 | $80.59 | $37.00 | ||
| Employee Plus One | $1,037.45 | $881.83 | $155.62 | $72.00 | ||
| Employee Two Plus | $1,589.31 | $1,350.91 | $238.40 | $110.00 | ||
| DENTAL | ||||||
|
Village Dental Plan |
||||||
| Employee Only | $72.28 | $61.44 | $10.84 | $5.00 | ||
| Employee Plus One | $151.78 | $129.01 | $22.77 | $10.51 | ||
| Employee Two Plus | $190.26 | $161.72 | $28.54 | $13.17 | ||
|
Guardian Dental HMO Plan |
||||||
| Employee Only | $29.56 | $25.13 | $4.43 | $2.05 | ||
| Employee Plus One | $54.94 | $46.70 | $8.24 | $3.80 | ||
| Employee Two Plus | $82.70 | $70.30 | $12.40 | $5.72 | ||
| MEDICARE SUPPLEMENT RATES | ||||||
| Blue Cross Blue Shield PPO | ||||||
| One Person | $441.45 | |||||
| Two Persons | $882.90 | |||||
| Blue Cross Blue Shield PPO High Deductible | ||||||
| One Person | $353.99 | |||||
| Two Persons | $707.97 | |||||
| HMO Illinois | ||||||
| One Person | $423.10 | |||||
| Two Persons | $846.20 | |||||