Monthly COBRA Rates for 2022-2023
The following rates are for September 1, 2022 through August 31, 2023
Personal Choice (PPO)
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $729.49 | $14.59 | $744.08 |
| Employee + 1 dependent | $1,481.60 | $29.63 | $1,511.23 |
| Family | $2,219.59 | $44.39 | $2,263.98 |
Keystone POS (HMO)
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $619.90 | $12.40 | $632.30 |
| Employee + 1 dependent | $1,180.65 | $23.61 | $1,204.26 |
| Family | $1,810.74 | $36.21 | $1,846.95 |
CVS Caremark
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $244.25 | $4.89 | $249.14 |
| Employee + 1 dependent | $688.76 | $13.78 | $702.54 |
| Family | $688.76 | $13.78 | $702.54 |
Delta PPO/Preferred (Dental)
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $38.06 | $0.76 | $ 38.82 |
| Employee + 1 dependent | $100.47 | $2.01 | $102.48 |
| Family | $100.47 | $2.01 | $102.48 |
Delta Care
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $17.85 | $0.36 | $18.21 |
| Employee + 1 dependent | $30.58 | $0.61 | $31.19 |
| Family | $46.41 | $0.93 | $47.34 |
United Concordia/Concordia Plus
| Plan | Cost | COBRA Admin Fee - 2% | Monthly Total |
|---|---|---|---|
| Employee | $19.43 | $0.39 | $19.82 |
| Employee + 1 dependent | $36.44 | $0.73 | $37.17 |
| Family | $57.86 | $1.16 | $59.02 |