2021 Active Member Rates for Approved Leave Without Pay
2021 Active Member Rates
For Approved Leave Without Pay For Personal Reasons
January 1 - December 31, 2021
These rates apply to:
- Active Members through their employment in a benefits eligible position with a State Agency, Public School or similarly situated SHBP Employing Entity; and
- Members of the General Assembly;
| You | You + Child(ren) | You + Spouse | You + Family | |
|---|---|---|---|---|
| Anthem Gold | $761.69 | $1,294.87 | $1,599.55 | $2,132.73 |
| Anthem Silver | $700.33 | $1,190.56 | $1,470.69 | $1,960.92 |
| Anthem Bronze | $662.59 | $1,126.40 | $1,391.44 | $1,855.25 |
| Anthem HMO | $729.04 | $1,239.37 | $1,530.98 | $2,041.31 |
| UHC HMO | $760.50 | $1,292.85 | $1,597.05 | $2,129.40 |
| UHC HDHP | $647.84 | $1,101.33 | $1,360.46 | $1,813.95 |
| Kaiser HMO | $650.35 | $1,105.59 | $1,365.73 | $1,820.98 |