2017 Anthem Blue Cross Rates

Basic
Employee Only $699.00
Employee and One Dependent $1,467.00
Employee and Two or more Dependent(s) $1,876.00
Supplement to Medicare
Employee Only $464.00
Employee and One Dependent $924.00
Employee and Two or more Dependent(s) $1,477.00

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.