Department of Human Resources: 2008 DCEHBP TCC PREMIUMS

2008 DCEHBP Temporary Continuation of Coverage (TCC) Premiums

DC Employee Health Benefits (Employees Hired on or After 10/01/1987)

AETNA HEALTHCARE HMO

TYPE ENROLLMENT CODE 2008 PREMIUM MONTHLY ADMINISTRATIVE FEE TOTAL

Self-Only HM1 $341.07 $6.82 $347.89

Family HM2 $886.78 $17.74 $904.52

AETNA QUALITY OPEN ACCESS PLAN

TYPE	ENROLLMENT CODE	2008 PREMIUM MONTHLY	ADMINISTRATIVE FEE	TOTAL
Self-Only	AP1	$477.19	$19.09	$496.28
Family	AP2	$1,245.47	$49.82	$1,295.29

KAISER PERMANENTE HMO

TYPE	ENROLLMENT CODE	2008 PREMIUM MONTHLY	ADMINISTRATIVE FEE	TOTAL
Self-Only	KP1	$337.50	$6.75	$344.25
Family	KP2	$876.33	$17.53	$893.86

UNITED HEALTHCARE HMO

TYPE	ENROLLMENT CODE	2008 PREMIUM MONTHLY	ADMINISTRATIVE FEE	TOTAL
Self-Only	MD1	$315.65	$6.31	$321.96
Family	MD2	$818.82	$16.38	$835.20

UNITED HEALTHCARE POINT OF SERVICE

TYPE	ENROLLMENT CODE	2008 PREMIUM MONTHLY	ADMINISTRATIVE FEE	TOTAL
Self-Only	UP1	$325.69	$6.51	$332.20
Family	UP2	$844.87	$16.90	$861.77