2019 Data Table Approved Leave Without Pay

State Health Benefit Plan
Approved Leave Without Pay (other than FMLA, Disability, Military) Rates
January 1 - December 31, 2019

  You You + Child(ren) You + Spouse You + Family
Anthem Gold $696.99 $1,184.89 $1,463.69 $1,951.58
Anthem Silver $638.46 $1,085.38 $1,340.76 $1,787.69
Anthem Bronze $599.99 $1,019.97 $1,259.97 $1,679.96
Anthem HMO $664.30 $1,129.30 $1,395.02 $1,860.03
UHC HMO $700.05 $1,190.08 $1,470.10 $1,960.13
UHC HDHP $583.68 $992.26 $1,225.73 $1,634.30
Kaiser HMO $589.34 $1,001.89 $1,237.62 $1,650.17