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Health Insurance Contributions for Employees and Dependents for
Managed Care and Quality Care Plans
Employee Only
Dependent Cost
FY11
Employee Annual
Salary FY11
$29,800 & below
$29,801 - $45,000
$45,001 - $59,900
$59,901 - $74,900
$74,901 & above
Monthly
ContributionManaged
Care
$47.00
$52.00
$54.50
$57.00
$59.50
Monthly
ContributionQuality Care
$72.00
$77.00
$79.50
$82.00
$84.50
*1 FY11 was the last year for this Plan
Plan Name
HMO Illinois
Personal Care
Humana Health Plan
Health Alliance HMO
Health Alliance Illinois
HealthLink OAP
Humana-Winnebago*1
Quality Care Health Plan
FY12
Employee Annual
Salary FY12
$30,200 & below
$30,201-$45,600
$45,601-$60,700
$60,701-$75,900
$75,901 & above
Monthly
ContributionManaged
Care
$47.00
$52.00
$54.50
$57.00
$59.50
Monthly
ContributionQuality Care
$72.00
$77.00
$79.50
$82.00
$84.50
Plan Name
Blue Advantage HMO*2
HMO Illinois
Personal Care HMO
Personal Care OAP
Health Alliance HMO
Health Alliance Illinois
HealthLink OAP
Quality Care Health Plan
Dependent
Monthly
Contribution-One
Dependent
Two or more
Dependents
One Medicare
A & B Primary
Dependent
Two or more
Medicare A & B
Primary
Dependents
$83
$92
$92
$94
$103
$105
$107
$196
$116
$130
$130
$133
$145
$149
$152
$226
$79
$88
$89
$89
$100
$102
$104
$142
$116
$130
$130
$133
$145
$149
$152
$203
Dependent
Monthly
Contribution-One
Dependent
Two or more
Dependents
One Medicare
A & B Primary
Dependent
Two or more
Medicare A & B
Primary
Dependents
$80
$83
$92
$92
$94
$103
$105
$196
$110
$116
$130
$130
$133
$145
$149
$226
$75
$79
$88
$88
$89
$100
$102
$142
$110
$116
$130
$130
$133
$145
$149
$203
Dependent
Monthly
Contribution-One
Dependent
Two or more
Dependents
One Medicare
A & B Primary
Dependent
Two or more
Medicare A & B
Primary
Dependents
$80
$92
$92
$94
$103
$105
$83
$196
$110
$130
$130
$133
$145
$149
$116
$226
$75
$88
$88
$89
$100
$102
$79
$142
$110
$130
$130
$133
$145
$149
$116
$203
Dependent
Monthly
Contribution-One
Dependent
Two or more
Dependents
One Medicare
A & B Primary
Dependent
Two or more
Medicare A & B
Primary
Dependents
$96
$111
$111
$113
$126
$100
$249
$132
$156
$156
$159
$179
$139
$287
$75
$88
$88
$89
$102
$79
$142
$110
$130
$130
$133
$149
$116
$203
*2 the Plan was new for FY 12
FY13
Employee Annual
Salary FY13
$30,200 & below
$30,201-$45,600
$45,601-$60,700
$60,701-$75,900
$75,901 & above
Monthly
ContributionManaged
Care
$47.00
$52.00
$54.50
$57.00
$59.50
Monthly
ContributionQuality Care
$72.00
$77.00
$79.50
$82.00
$84.50
Plan Name
Blue Advantage HMO
Coventry HMO *3
Conventry OAP*3
Health Alliance HMO
Health Alliance Illinois*4
HealthLink OAP
HMO Illinois
Quality Care Health Plan
*3 was previously Personal Care HMO and OAP
*4 FY 13 was the last year for this Plan
FY14- FY17
Employee Annual
Salary
$30,200 & below
$30,201-$45,600
$45,601-$60,700
$60,701-$75,900
$75,901-$100,000
$100,001 & above
Monthly
ContributionManaged
Care
$68
$86
$103
$119
$137
$186
Monthly
ContributionQuality Care
$93
$111
$127
$144
$162
$211
Plan Name
Blue Advantage HMO
Coventry HMO
Conventry OAP
Health Alliance HMO
HealthLink OAP
HMO Illinois
Quality Care Health Plan
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