Premiums
Coverage Highlights & Premiums
Plans go beyond medical coverage to include vision, dental, life and long-term disability (LTD) insurance. Review this chart to see what is included with your premium.
The following groups do not have all the benefits listed in this chart.
- Retirees: Basic life insurance is provided at $15,000 for the insured retiree only. Flexible Spending Accounts (dependent care & healthcare), Accidental Death & Dismemberment Insurance and Long-Term Disability Insurance are not available to retirees. Additionally, retiree premiums are processed a month in arrears, similar to a utility bill. If you make any plan changes, your January payment will remain the same as in 2026, as it will be applied to your December premium. The new premium payment reflecting your Open Enrollment elections will begin in February, covering your January premium.
- COBRA: Life Insurance, Accidental Death & Dismemberment Insurance and Long-Term Disability Insurance are not available to covered members on COBRA.
- Local Area Agreement (LAA) & Chapter 615: Flexible Spending Accounts (dependent care & healthcare), Life Insurance, Accidental Death & Dismemberment Insurance and Long-Term Disability Insurance are not available to members insured on the Harris County plan through the Local Area Agreement (LAA) or Chapter 615.
Employees
Your Cost (Bi-Weekly Premiums)
| KelseyCare ACO | BASE PPO | PLUS PPO | |
|---|---|---|---|
| You only | $0 | $0 | $36.35 |
| You + child(ren) | $109.03 | $109.03 | $181.72 |
| You + spouse | $121.15 | $121.15 | $218.07 |
| You + family | $193.84 | $193.84 | $290.77 |
Coverage Highlights
| KelseyCare ACO | BASE PPO | PLUS PPO | |
|---|---|---|---|
| Network Coverage | In Network Only | In & Out of Network | In & Out of Network |
| Deductible | None | $600 Individual $1,800 Family |
None |
| Out-of-Pocket Maximum | $6,350 Individual $12,700 Family |
$7,350 Individual $14,700 Family |
$6,350 Individual $12,700 Family |
| Cost Per Visit | $ | $$ | $ |
| Wellness Programs | ✔ | ✔ | ✔ |
| Vision & Dental | ✔ | ✔ | ✔ |
| Employee Assistance Program | ✔ | ✔ | ✔ |
| Prescription Drugs | ✔ | ✔ | ✔ |
| Basic Life Insurance Employee / Spouse / Child |
$30,000 / $5,000 / $2,000 | $30,000 / $5,000 / $2,000 | $30,000 / $5,000 / $2,000 |
| Accidental Death & Dismemberment Insurance Employee / Spouse / Child |
$30,000 / $5,000 / $2,000 | $30,000 / $5,000 / $2,000 | $30,000 / $5,000 / $2,000 |
| Basic Long-Term Disability Insurance Employee only |
Up to 50% of your monthly earnings for a maximum of $5,000 | Up to 50% of your monthly earnings for a maximum of $5,000 | Up to 50% of your monthly earnings for a maximum of $5,000 |
Retirees: Non-Medicare Eligible Rates
Spouse NOT Enrolled in Humana Medicare Advantage PPO Plan
| AETNA BASE PPO | AETNA PLUS PPO | |||||
|---|---|---|---|---|---|---|
| You Pay | County Pays | Total | You Pay | County Pays | Total | |
| You Only | $236.25 | $907.74 | $1,143.99 | $315.00 | $1,251.04 | $1,566.04 |
| You + Child(ren) | $472.50 | $1,334.82 | $1,807.32 | $630.00 | $1,757.51 | $2,387.51 |
| You + Spouse | $498.75 | $1,382.91 | $1,881.66 | $708.75 | $1,896.05 | $2,604.80 |
| You + Family | $656.25 | $1,661.43 | $2,317.68 | $866.25 | $2,197.28 | $3,063.53 |
Spouse ENROLLED in Humana Medicare Advantage PPO Plan
| AETNA BASE PPO | AETNA PLUS PPO | |||||
|---|---|---|---|---|---|---|
| You Pay | County Pays | Total | You Pay | County Pays | Total | |
| You Only | $236.25 | $907.74 | $1,143.99 | $315.00 | $1,251.04 | $1,566.04 |
| You + Child(ren) | $472.50 | $1,334.82 | $1,807.32 | $630.00 | $1,757.51 | $2,387.51 |
| You + Spouse | $397.94 | $929.97 | $1,327.91 | $476.69 | $1,273.27 | $1,749.96 |
| You + Family | $555.44 | $1,208.49 | $1,763.93 | $634.19 | $1,574.50 | $2,208.69 |
Retirees: Medicare Eligible Rates
Both Retiree and Spouse NOT Enrolled in Humana Medicare Advantage PPO Plan
| AETNA BASE PPO | AETNA PLUS PPO | |||||
|---|---|---|---|---|---|---|
| You Pay | County Pays | Total | You Pay | County Pays | Total | |
| You Only | $0.00 | $907.74 | $907.74 | $78.75 | $1,251.04 | $1,329.79 |
| You + Child(ren) | $236.25 | $1,334.82 | $1,571.07 | $393.75 | $1,757.51 | $2,151.26 |
| You + Spouse | $262.50 | $1,382.91 | $1,645.41 | $472.50 | $1,896.05 | $2,368.55 |
| You + Family | $420.00 | $1,661.43 | $2,081.43 | $630.00 | $2,197.28 | $2,827.28 |
Both Retiree and Spouse ENROLLED in Humana Medicare Advantage PPO Plan
| AETNA BASE PPO | AETNA PLUS PPO | |||||
|---|---|---|---|---|---|---|
| You Pay | County Pays | Total | You Pay | County Pays | Total | |
| You Only | $0.00 | $186.11 | $186.11 | $0.00 | $186.11 | $186.11 |
| You + Child(ren) | $236.25 | $613.19 | $849.44 | $315.00 | $692.58 | $1,007.58 |
| You + Spouse | $161.69 | $208.34 | $370.03 | $161.69 | $208.34 | $370.03 |
| You + Family | $319.19 | $486.86 | $806.05 | $319.19 | $509.57 | $828.76 |
Retiree ENROLLED in Humana Medicare Advantage PPO Plan and Spouse Enrolled in Aetna Base/Plus PPO Plan
| AETNA BASE PPO | AETNA PLUS PPO | |||||
|---|---|---|---|---|---|---|
| You Pay | County Pays | Total | You Pay | County Pays | Total | |
| You Only | $0.00 | $186.11 | $186.11 | $0.00 | $186.11 | $186.11 |
| You + Child(ren) | $236.25 | $613.19 | $849.44 | $315.00 | $692.58 | $1,007.58 |
| You + Spouse | $262.50 | $661.29 | $923.78 | $393.75 | $831.12 | $1,224.87 |
| You + Family | $420.00 | $939.80 | $1,359.80 | $551.25 | $1,132.35 | $1,683.60 |
COBRA
Your Cost (Monthly Premiums)
| KELSEYCARE ACO | BASE PPO | PLUS PPO | |
|---|---|---|---|
| You Only | $957.00 | $957.00 | $1,316.53 |
| You + Child(ren) | $1,647.73 | $1,647.73 | $2,247.01 |
| You + Spouse | $1,724.40 | $1,724.40 | $2,471.09 |
| You + Family | $2,181.33 | $2,181.33 | $2,951.57 |