Monthly COBRA Rates
The following rates are for September 1, 2021 through August 31, 2022
Personal Choice (PPO)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $704.53 | $14.09 | $718.62 |
Employee Plus 1 | $1,430.92 | $28.62 | $1,459.54 |
Employee Plus 2 or more | $2,143.66 | $42.87 | $2,186.53 |
Keystone POS (HMO)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $ 598.70 | $ 11.97 | $ 610.67 |
Employee Plus 1 | $ 1,140.26 | $ 22.81 | $ 1,163.07 |
Employee Plus 2 or more | $ 1,748.80 | $ 34.98 | $ 1,783.78 |
CVS Caremark (Prescription)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $ 221.82 | $ 4.44 | $ 226.26 |
Employee Plus 1 | $ 625.52 | $ 12.51 | $ 638.03 |
Employee Plus 2 or more | $ 625.52 | $ 12.51 | $ 638.03 |
Delta PPO/Preferred (Dental)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $ 38.06 | $ 0.76 | $ 38.82 |
Family | $ 100.47 | $ 2.01 | $ 102.48 |
Delta Care (Dental)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $ 18.08 | $ 0.36 | $ 18.44 |
Single and One | $ 30.98 | $ 0.62 | $ 31.60 |
Family | $ 47.02 | $ 0.94 | $ 47.96 |
United Concordia/Concordia Plus (Dental)
Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
---|---|---|---|
Employee/Single | $ 19.43 | $ 0.39 | $ 19.82 |
Employee & Spouse or Child/Children | $ 36.44 | $ 0.73 | $ 37.17 |
Family (including child(ren) | $ 57.86 | $ 1.16 | $ 59.02 |