2025-2026_Premium_Rate_Sheet_-_Active_Employees_(FY_25-26).pdf
PDF 127 KB Posted
- Attached to
- Group Employee Medical Insurance FY 2026-2027
- Solicitation number
- RFP 2026-018
- Issued by
- Hidalgo County, Texas
About this file
This is a Premium Rate Sheet for Active Employees issued by a Texas city for fiscal year 2025-2026, detailing health insurance and supplemental coverage options. The document establishes monthly premium rates for four health insurance plan tiers: BlueCross BlueShield HMO (Low Plan), BlueCross BlueShield PPO (High Plan), Delta Dental (Low and High Plans), and AFLAC Davis Vision (Low and High Plans). Coverage categories include Employee Only, Employee & Child(ren), Employee & Spouse, and Employee & Family configurations. The rates are effective October 1, 2025, through September 30, 2026. The sheet also includes supplemental coverage options such as Long Term Disability through Madison National and Life Insurance through Dearborn National, with Long Term Disability rates calculated at $0.26 per $100 of covered payroll per month.
The rate structure delineates the monthly premium cost split between City Share and Employee Share, with corresponding per-pay-period deductions. For example, the BlueCross BlueShield HMO Low Plan Employee Only coverage shows a monthly premium of $522.62 fully funded by the City with no employee cost, while family coverage ranges from $886.53 to $1,582.22 monthly with employee contributions varying by plan selection. The City maintains responsibility for a significant portion of premiums across all plans, with employee contributions ranging from zero dollars for individual coverage in lower-tier plans to over $500 monthly for family coverage in higher-tier plans. Supplemental life insurance options, including dependent child coverage up to $10,000 and employee coverage up to $500,000, are offered with rates dependent on employee election and age-based underwriting.
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Text version
Monthly Premium City Share Monthly Employee Share Monthly Employee Share
Per Pay Period Employee Only $522.62 $522.62 $0.00 $0.00 Employee & Child(ren) $886.53 $711.96 $174.57 $87.29 Employee & Spouse $1,379.08 $1,070.58 $308.50 $154.25 Employee & Family $1,582.22 $1,073.93 $508.29 $254.15
Monthly Premium City Share Monthly Employee Share Monthly Employee Share
Per Pay Period Employee Only $543.83 $522.62 $21.21 $10.61
Employee & Child(ren) $922.50 $730.68 $191.82 $95.91 Employee & Spouse $1,435.04 $1,106.39 $328.65 $164.33
Employee & Family $1,646.43 $1,107.34 $539.09 $269.55
Monthly Premium City Share Monthly Employee Share Monthly Employee Share
Per Pay Period Employee Only $6.42 $6.42 $0.00 $0.00 Employee & Child(ren) $14.63 $6.42 $8.21 $4.11 Employee & Spouse $15.94 $6.42 $9.52 $4.76 Employee & Family $20.44 $6.42 $14.02 $7.01
Monthly Premium City Share Monthly Employee Share Monthly Employee Share
Per Pay Period Employee Only $27.18 $6.42 $20.76 $10.38 Employee & Child(ren) $61.61 $6.42 $55.19 $27.60 Employee & Spouse $63.06 $6.42 $56.64 $28.32 Employee & Family $83.30 $6.42 $76.88 $38.44
Monthly Premium City Share Monthly Employee Share Monthly Employee Share
Per Pay Period Employee Only $5.09 $0.00 $5.09 $2.55 Employee & Child(ren) $9.95 $0.00 $9.95 $4.98 Employee & Spouse $8.89 $0.00 $8.89 $4.45 Employee & Family $13.93 $0.00 $13.93 $6.97
Employee Share Per Pay Period
Employee Only $8.05 $0.00 $8.05 $4.03 Employee & Child(ren) $17.20 $0.00 $17.20 $8.60 Employee & Spouse $14.71 $0.00 $14.71 $7.36 Employee & Family $21.64 $0.00 $21.64 $10.82
AFLAC (Davis Vision) Vision Insurance (Low Plan)
Employee Insurance Premium Rate Sheet Effective October 01, 2025 - September 30, 2026
BlueCross BlueShield HMO Health Insurance (Low Plan)
BlueCross BlueShield PPO Health Insurance (High Plan)
Delta Dental Dental Insurance (Low Plan)
Delta Dental Dental Insurance (High Plan)
AFLAC (Davis Vision) Vision Insurance (High Plan)
Employee Share Per Pay Period
Employee Only (incl. AD&D) $0.50 $0.50 $0.00 $0.00
Buy-Up Dep. Child(ren) ($10,000) $1.28 $0.00 $1.28 $0.64 Buy-Up Employee (Max up to $500,000) (Guarantee Issue $100,000- New Hire only) Starts 0.64 per $1,000 $0.00
Dependent on Employee Election Options
Dependent on Employee Election Options
Buy-Up Spouse (Max up to $200,000) (Guarantee Issue $25,000- New Hire only)
Starts .064 per $1,000 $0.00
Dependent on Employee Election Options
Dependent on Employee Election Options
Coverage
Long Term Disability
Dearborn National - Life Insurance Note: Rate Coverage is Dependent on Age and Coverage Amount
Madison National - Long Term Disability 100% Employer Paid
Rate per $100 of covered payroll per month
$0.26
File details come from the government source that posted it. Updated .