2012-2013 Medical/RX Rates (All UDM Employees)
| Medical Group Number / Suffix |
Medical Plan and Prescription Coverage |
Employee Bi-weekly Premium | Annual Premium Paid by the Employee |
|
| |
24 Pays | 19 Pays | ||
| 27389-000 | BCBSM-PPO Comm Blue #1 | |||
| Employee | $98.59 | $124.53 | $2,366.16 | |
| Employee + 1 | $236.62 | $298.89 | $5,678.88 | |
| Employee + Family | $295.77 | $373.60 | $7,098.48 | |
| 43709-000 | BCBSM-PPO Comm Blue #3 | |||
| Employee | $69.98 | $88.40 | $1,679.52 | |
| Employee + 1 | $167.96 | $212.16 | $4,031.04 | |
| Employee + Family | $209.94 | $265.19 | $5,038.56 | |
| 04280-0 | Health Alliance Plan-HMO (HAP) | |||
| Employee | $71.91 | $90.83 | $1,725.84 | |
| Employee + 1 | $165.39 | $208.91 | $3,969.36 | |
| Employee + Family | $186.96 | $236.16 | $4,487.04 | |
Plan Information
Preferred Provider Organization (PPO) BCBSM
Health Alliance Plan (HMO) HAP
BCBSM Customer Service
800-637-2227
HAP Customer Service
313-872-8100 or
800-422-4641
