2016 Anthem Blue Cross Rates

Basic
Employee Only$699.00
Employee and One Dependent$1,399.00
Employee and Two or more Dependent(s)$1,789.00
Supplement to Medicare
Employee Only$442.00
Employee and One Dependent$881.00
Employee and Two or more Dependent(s)$1,408.00

Maximum Out-of-Pocket Expense $4,500 per person/ $9,000 for a family.

Prescription Drugs

Retail
Generic$10.00 copay
Brand Formulary$25.00 copay
Brand Non-Formulary$45.00 copay
Mail Order
Generic$20.00 copay
Brand Formulary$40.00 copay
Brand Non-Formulary$75.00

Benefit Changes effective 2015: Body Scans will be subject to a maximum $1,000 coverage limit every 36 months.