2003 Premiums

NMPSIA CONTRIBUTIONS OCTOBER 1, 2003
Less
    
$15,000
 
 
$20,000
 
 
$25,000
  
Monthly Cost SHARING BASED ON SALARY

than
$15,000

    
through $19,000
 
 
through $24,999
 
 
And Over
  
BCBS Single (employee deduction)
$87.66
$43.83
 
$105.16
$52.58
 
$122.72
$61.36
 
$140.24
$70.12
  Single (district contribution)
$262.98
$131.49
 
$245.48
$122.74
 
$227.92
$113.96
 
$210.40
$105.20
  Two party (employee deduction)
$166.70
$83.35
 
$200.04
$100.02
 
$233.38
$116.69
 
$266.74
$133.37
  Two party ( district contribution)
$500.16
$250.08
 
$466.82
$233.41
 
$433.48
$216.74
 
$400.12
$200.06
  Family (employee deduction)
$222.68
$111.34
 
$267.22
$133.61
 
$311.76
$155.88
 
$356.26
$178.13
  Family (district contribution)
$668.02
$334.01
 
$623.48
$311.74
 
$578.94
$289.47
 
$534.44
$267.22
   
 
 
 
 
 
 
 
 
 
 
 
CIGNA/Lovelace Single (employee deduction)
$71.14
$35.57
 
$85.40
$42.70
 
$99.62
$49.81
 
$113.86
$56.93
Dual Option Single (district contribution)
$213.50
$106.75
 
$199.24
$99.62
 
$185.02
$92.51
 
$170.78
$85.39
  Two party (employee deduction)
$149.42
$74.71
 
$179.30
$89.65
 
$209.18
$104.59
 
$239.08
$119.54
  Two party ( district contribution)
$448.26
$224.13
 
418.38
209.19
 
388.50
194.25
 
358.60
$179.30
  Family (employee deduction)
$199.24
$99.62
 
$239.08
$119.54
 
$278.94
$139.47
 
$318.76
$159.38
  Family (district contribution)
$597.70
$298.85
 
$557.86
$278.93
 
$518.00
$259.00
 
$478.18
$239.09
   
 
 
 
 
 
 
 
 
 
 
 
Regional HMO Single (employee deduction)
$64.32
$32.16
 
$77.14
$38.57
 
$90.02
$45.01
 
$102.88
$51.44
  Single (district contribution)
$192.90
$96.45
 
$180.08
$90.04
 
$167.20
$83.60
 
$154.34
$77.17
  Two party (employee deduction)
$135.04
$67.52
 
$162.02
$81.01
 
$189.04
$94.52
 
$216.04
$108.02
  Two party (district contribution)
$405.08
$202.54
 
$378.10
$189.05
 
$351.08
$175.54
 
$324.08
$162.04
  Family (employee deduction)
$180.06
$90.03
 
$216.06
$108.03
 
$252.08
$126.04
 
$288.08
$144.04
  Family (district contribution)
$540.16
$270.08
 
$504.16
$252.08
 
$468.14
$234.07
 
$432.14
$216.07
   
 
 
 
 
 
 
 
 
 
 
 
Dental Single (employee deduction)
$5.20
$2.60
 
$6.22
$3.11
 
$7.28
$3.64
 
$8.30
$4.15
High Option Single (district contribution)
$15.58
$7.79
 
$14.56
$7.28
 
$13.50
$6.75
 
$12.48
$6.24
United Two party (employee deduction)
$9.90
$4.95
 
$11.88
$5.94
 
$13.86
$6.93
 
$15.82
$7.91
Concordia Two party (district contribution)
$29.68
$14.84
 
$27.70
$13.85
 
$25.72
$12.86
 
$23.76
$11.88
  Family (employee deduction)
$15.54
$7.77
 
$18.66
$9.33
 
$21.78
$10.89
 
$24.88
$12.44
  Family (district contribution)
$46.66
$23.33
 
$43.54
$21.77
 
$40.42
$20.21
 
$37.32
$18.66
   
 
 
 
 
 
 
 
 
 
 
 
Dental Single (employee deduction)
$2.60
$1.30
 
$3.10
$1.55
 
$3.64
$1.82
 
$4.14
$2.07
  Single (district contribution)
$7.80
$3.90
 
$7.30
$3.65
 
$6.76
$3.38
 
$6.26
$3.13
  Two party (employee deduction)
$4.96
$2.48
 
$5.94
$2.97
 
$6.94
$3.47
 
$7.90
$3.95
  Two party (district contribution)
$14.84
$7.42
 
$13.86
$6.93
 
$12.86
$6.43
 
$11.90
$5.95
  Family (employee deduction)
$7.78
$3.89
 
$9.32
$4.66
 
$10.90
$5.45
 
$12.44
$6.22
  Family (district contribution)
$23.32
$11.66
 
$21.78
$10.89
 
$20.20
$10.10
 
$18.66
$9.33
   
 
 
 
 
 
 
 
 
 
 
 
Davis Vision Single (employee deduction)
$1.58
$0.79
 
$1.88
$0.94
 
$2.20
$1.10
 
$2.50
$1.25
  Single (district contribution)
$4.68
$2.34
 
$4.38
$2.19
 
$4.06
$2.03
 
$3.76
$1.88
  Two party (employee deduction)
$2.64
$1.32
 
$3.14
$1.57
 
$3.68
$1.84
 
$4.18
$2.09
  Two party (district contribution)
$7.84
$3.92
 
$7.34
$3.67
 
$6.80
$3.40
 
$6.30
$3.15
  Family (employee deduction)
$3.54
$1.77
 
$4.24
$2.12
 
$4.94
$2.47
 
$5.66
$2.83
  Family (district contribution)
$10.60
$5.30
 
$9.90
$4.95
 
$9.20
$4.60
 
$8.48
$4.24