HMSA Health Insurance EMPLOYEE RATES July 1, 2004 – June 30, 2005
Listed below are the rates for the various levels of coverage:
	HMSA Healthplan Hawaii Plus	HMSA Preferred Provider Plan
Single Coverage Employee Monthly Cost Per Paycheck Cobra	$219.36 $000.00 $000.00 $223.75	$239.80 $20.44 $10.22 $244.60
2-Party Coverage Employee Monthly Cost Per Paycheck Cobra	$458.22 $45.82 $22.91 $467.38	$506.96 $94.56 $47.28 $517.10
Family Coverage Employee Monthly Cost Per Paycheck Cobra	$687.24 $68.72 $34.36 $700.98	$760.48 $141.96 $70.98 $775.69