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COBRA Rates

FY2006 COBRA - Monthly Premium Rates
	AGE	PROVIDER NETWORK	$1,000 DEDUCTIBLE
PARTICIPANT	N/A	$275.60	$220.52
PARTICIPANT + 1 CHILD	N/A	$354.63	$273.33
PARTICIPANT + 2 CHILDREN	N/A	$420.03	$318.25
PARTICIPANT + 3+ CHILDREN	N/A	$460.08	$340.92
PARTICIPANT and SPOUSE	<30 yrs. old	$374.15	$292.42
	30-39	$402.19	$313.82
	40-44	$432.37	$339.14
	45-49	$462.04	$366.74
	50-54	$502.04	$405.90
	55-59	$548.32	$448.02
	60-64	$588.45	$475.89
PARTICIPANT, SPOUSE + 1 CHILD	<30 yrs. old	$442.62	$342.09
	30-39	$471.54	$361.34
	40-44	$502.26	$387.00
	45-49	$532.25	$413.89
	50-54	$569.53	$452.31
	55-59	$616.52	$494.42
	60-64	$658.71	$522.29
PARTICIPANT, SPOUSE + 2 CHILDREN	<30	$510.37	$382.65
	30-39	$541.20	$405.09
	40-44	$571.94	$429.95
	45-49	$601.90	$458.13
	50-54	$639.18	$497.26
	55-59	$686.20	$539.43
	60-64	$728.39	$567.26

NOTE: Contributions for employee and spouse coverage will increase by $30.00 per person per pay period if you and/or your covered spouse use tobacco.
Rev 04/05

FY2006 COBRA Group Dental and Vison Plans
	DENTAL PLAN	VISION PLAN
PARTICIPANT ONLY	$18.99	$11.77
PARTICIPANT + 1 CHILD	$28.35	$15.15
PARTICIPANT + 2 CHILDREN	$45.21	$20.84
PARTICIPANT + 3+ CHILDREN	$56.73	$28.84

FY 2006 COBRA Life Insurance Rates - per $1000 of Coverage
AGE GROUP	MONTHLY RATE
<30 yrs. old	$0.03
30-34	$0.03
35-39	$0.04
40-44	$0.07
45-49	$0.09
50-54	$0.18
55-59	$0.20
60-64	$0.37
65-69	$0.88
70	$1.80

NOTE: Your Term Life coverage ends at the end of your COBRA extension period, (generally 18 months), or on the last day of the month of your 70th birthday, whichever is earlier. There is no conversion policy.

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