2011/2012 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 | $89.61 | $113.19 | $2,150.64 | |
| Employee + 1 | $215.07 | $271.67 | $5,161.68 | |
| Employee + Family | $268.84 | $339.59 | $6,452.16 | |
| 43709-000 | BCBSM-PPO Comm Blue #3 | |||
| Employee | $63.51 | $80.22 | $1,524.24 | |
| Employee + 1 | $152.41 | $192.52 | $3,657.84 | |
| Employee + Family | $190.52 | $240.66 | $4,572.48 | |
| 04280-0 | Health Alliance Plan-HMO (HAP) | |||
| Employee | $65.68 | $82.96 | $1,576.32 | |
| Employee + 1 | $151.08 | $190.84 | $3,625.92 | |
| Employee + Family | $170.78 | $215.72 | $4,098.72 | |
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
