Non-Active Rates

2019 TRICARE Supplement Rates

These rates apply to Members and their Dependents who are enrolled in TRICARE.

State Health Benefit Plan
TRICARE Supplement Rates
January 1 - December 31, 2019

You You + Child(ren) You + Spouse You + Family
$60.50 $119.50 $119.50 $160.50

 

2019 Cobra Rates

These rates apply to participants enrolled in COBRA coverage, Employers who have entered into a contract with DCH for SHBP coverage including Federally Qualified Health Centers, Critical Access Hospitals and other entities prescribed by State law, and Former Employees with at least eight years of service as a State employee or with eight years of service with ERS or TRS as a Teacher or Public School employee.

State Health Benefit Plan
COBRA, Contract Group Employers, Unsubsidized Extended Coverage Rates
January 1 - December 31, 2019

  You You + Child(ren) You + Spouse You + Family
Anthem Gold $710.93 $1,208.59 $1,492.96 $1,990.61
Anthem Silver $651.23 $1,107.09 $1,367.58 $1,823.44
Anthem Bronze $611.99 $1,040.37 $1,285.17 $1,713.56
Anthem HMO $677.59 $1,151.89 $1,422.92 $1,897.23
UHC HMO $714.05 $1,213.88 $1,499.50 $1,999.33
UHC HDHP $595.35 $1,012.11 $1,250.24 $1,666.99
Kaiser HMO $601.13 $1,021.93 $1,262.37 $1,683.17