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Available Plans and Monthly Premiums Effective July 1, 2006 For Active Employees and Participants Not Eligible for Medicare Important information about your premiums is listed below. |
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| Health Plans | Single (You Only) |
Plus One (You and One Family Member) |
Family (You and Two or More Family Members) |
| Available Statewide | |||
| COVA HDHP (High Deductible Health Plan) Employee Pays Employer Pays Total Premium |
$ 0 $335 $335 |
$ 0 $620 $620 |
$0 $906 $906 |
| COVA Care (includes basic dental) Employee Pays Employer Pays Total Premium |
$ 40 $378 $418 |
$ 99 $675 $774 |
$140 $991 $1131 |
| COVA Care Plus Out-of-Network Employee Pays Employer Pays Total Premium |
$ 50 $378 $428 |
$112 $675 $787 |
$158 $991 $1149 |
| COVA Care Plus Expanded Dental Employee Pays Employer Pays Total Premium |
$ 52 $378 $430 |
$123 $675 $798 |
$176 $991 $1167 |
| COVA Care Plus Vision, Hearing and Expanded Dental Employee Pays Employer Pays Total Premium |
$ 61 $378 $439 |
$139 $675 $814 |
$197 $991 $1188 |
| COVA Care Plus Out-of-Network and Expanded Dental Employee Pays Employer Pays Total Premium |
$ 62 $378 $440 |
$136 $675 $811 |
$194 $991 $1185 |
| COVA Care Plus Out-of-Network, Vision, Hearing and Expanded Dental Employee Pays Employer Pays Total Premium |
$ 71 $378 $449 |
$152 $675 $827 |
$214 $991 $1205 |
| Available in Northern VA Only | |||
| Kaiser Permanente Employee Pays Employer Pays Total Premium |
$ 39 $365 $404 |
$ 96 $651 $747 |
$135 $956 $1091 |
| Employee, Employee on Military Leave, VSDP Short-Term Disability: Pays the Employee amount | |||
| Retiree Group Not Eligible for Medicare (Retirees, Survivors, VSDP Long-Term Disability): Pays the Total Premium (VRS- administered health insurance credit may apply) | |||
| Part-time Classified Employee: Pays the Total Premium | |||