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Rates

Medical, Dental & Vision Plan Rates - ACTIVE

  • Active Rates
    • Jan - Jun | 2021
    • Jul - Dec | 2020
    • Note: These are complex rate charts intended for agency billing purposes.
    • To view the rates in an easy-to-read format see the following:
      • Active Employee Enrollment Guide | 2021
         
  • LWOP - Leave Without Pay
    • View the Active Rate charts linked above.
    • To calculate the employee premium plus the employer premium, view the "Total 26 Pay" column.
    • This is the bi-weekly rate for premiums.
       
  • COBRA - Consolidated Omnibus Budget Reconciliation Act
    • COBRA Rate Summary Chart | 2021
    • COBRA Rate Summary Chart | 2020
    • This is the monthly rate for premiums.
       

Medical, Dental & Vision Plan Rates - RETIREE

  • Monthly rates with and without Medicare.
     
  • Retiree Rates
    • Jan-Dec | 2021
    • Jan-Dec | 2020
    • Note: These are complex rate charts intended for billing purposes.
    • To view the rates in an easy-to-read format see the following:
      • Retired Employee Enrollment Guide | 2020

Resources

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Contact Us
ADOA | Benefit Services Division | Benefit Options
100 N. 15th Ave., Ste. 260
Phoenix, AZ 85007
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Phone: 602-542-5008
Fax: 602-542-4744
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