does

Department of Employment Services
 

DC Agency Top Menu


-A +A
Bookmark and Share

2014 DCEHBP Temporary Continuation of Coverage (TCC) Premiums

TCC Premiums for Employees Hired on or After October 1, 1987

  Enrollment Code 2014 Monthly Premium Administrative Fee Total
Aetna HMO        
Self AH1 $560.26 $11.21 $571.47
Self+1 AH2 $1101.29 $22.03 $1123.32
Family AH3 $1619.00 $32.38 $1651.38
         
Aetna PPO        
Self AP1 $597.12 $11.94 $609.06
Self+1 AP2 $1173.76 $23.48 $1197.24
Family AP3 $1725.56 $34.51 $1760.07
         
Aetna CDHP        
Self HM1 $394.57 $7.89 $402.46
Self+1 HM2 $775.61 $15.51 $791.12
Family HM3 $1140.23 $22.80 $1163.03
         
Kaiser Permanente        
Self KP1 $495.35 $9.90 $505.25
Self+1 KP2 $946.12 $18.92 $965.04
Family KP3 $1451.37 $29.02 $1480.39
         
United Healthcare Choice        
Self MD1 $523.4 $10.46 $533.86
Self+1 MD2 $999.69 $19.99 $1019.68
Family MD3 $1533.55 $30.67 $1564.22

Temporary Continuation Of Coverage Benefits Enrollment Form [PDF]