All Dates
Rates Effective 12/01/2021
| Plan: 17633947 CT LIBERTY HMO GATED BUY DOWN PLAN | CT 25/65/3000/100 HMO |
|---|
| Employee Tier | Premium / Month |
|---|---|
| Employee Only | $717.35 |
| Employee & Spouse | $1,466.25 |
| Employee & Child | $1,190.07 |
| Employee & Family | $2,078.14 |
| Plan: 17633948 CT LIBERTY HMO GATED BASE PLAN | CT 25/65/3000/100 HMO |
|---|
| Employee Tier | Premium / Month |
|---|---|
| Employee Only | $754.26 |
| Employee & Spouse | $1,541.70 |
| Employee & Child | $1,251.32 |
| Employee & Family | $2,185.08 |
| Plan: 12719897 CT FREEDOM 15/30/0/100 ACCESS | CT 15/30/0/100 CLASSIC/ACCESS |
|---|
| Employee Tier | Premium / Month |
|---|---|
| Employee Only | $972.21 |
| Employee & Spouse | $1,987.21 |
| Employee & Child | $1,612.91 |
| Employee & Family | $2,816.52 |