ATTACHMENT 1 – CITY SPONSORED PROGRAM PREMIUMS
Medical Plans Monthly Premium
Cigna Open Access (PPO)
Single $1,365.02
Two Party $2,874.16
Family $4,110.26
Cigna Full Network (HMO)
Single $1,068.23
Two Party $2,243.31
Family $3,204.73
Cigna Select Network (HMO)
Single $864.54
Two Party $1,815.56
Family $2,593.62
Cigna Minimum Value Plan
Single $873.62
Two Party $1,834.60
Family $2,620.88
Kaiser
Single $748.04
Two Party $1,496.09
Family $2,116.96
Dental Plans Monthly Premium
Delta Dental PPO
Single $50.48
Two Party $101.46
Family $132.78
ATTACHMENT 1 – CITY SPONSORED PROGRAM PREMIUM
Delta Dental HMO
Single $15.52
Two Party $31.03
Family $45.78
Vision Plans Monthly Premium
VSP
Single $7.86
Two Party $11.92
Family $21.78
The Standard - Basic Life/AD&D
Life rate per $1,000 $.09/covered lives
AD&D rate per $1,000 $.02/covered lives
The Standard - Long Term Disability
Rate per $100 of monthly payroll covered $.58/covered lives CIGNA Employee Assistance Program (EAP)
5 face to face visits $2.08/covered lives