Employee’s Percent
100% - Employer’s Percent
Employee’s Contribution
Total Premium x Employee’s Percent
Amount Paid by Patient
Deductible + Co-payments + Co-insurance + Hospital Charges
Co-payments
Physician + Specialist + Physical Therapy
Hospital charge
Hospital charges x Employee’s Percent
Annual Premium
(Policy Amount/$1,000) x Premium per $1,000
Annual Increase
Older age annual premium - Younger age annual premium
Percent Increase
Annual Increase/Original Amount
Monthly Premium
Annual Premium x Monthly Premium Percent Given