AlaskaCare Premiums Effective 1/1/2016

Medical
Option Monthly Employee Contribution
Premium Plan for Employee and Family $998.00
Standard Plan for Employee and Family $219.00
Economy Plan for Employee and Family $0.00
Premium Plan for Employee Only $348.00
Standard Plan for Employee Only $76.00
Economy Plan for Employee Only $0.00
Dental
Option Monthly Employee Contribution
Standard Plan for Employee and Family $92.00
Economy Plan for Employee and Family $0.00
Standard Plan for Employee Only $33.00
Economy Plan for Employee Only $0.00

Premiums are subject to change.

Vision
Option Monthly Employee Contribution
No Coverage $0.00
Managed Care Plan for Employee and Family $32.00
Managed Care Plan for Employee Only $11.00

Your Vision election will remain in effect for at least 2 benefit years. Premiums are subject to change.

Health Flexible Spending Account
Minimum Monthly Amount $20.00
Maximum Monthly Amount $212.00

You must contribute in whole dollar amounts. The amount of contributions you elect will be deducted from your paycheck in equal amounts throughout the year.

COBRA and LWOP EE
(effective 1/1/2016)
Plan Rate
Medical, Premium $1,781.12
Medical, Standard $842.68
Medical, Economy $492.24
Dental, Standard $49.14
Dental, Economy $20.40
Vision, Managed $10.74
COBRA and LWOP EE + Family
(effective 1/1/2016)
Plan Rate
Premium Medical Plan $5,093.99
Standard Medical Plan $2,410.08
Economy Medical Plan $1407.79
Standard Dental Plan $140.55
Preventive Dental Plan $58.35
Managed Vision Plan $30.72