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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