Providers: 

Blue Cross Blue Shield of Kansas                

1133 SW Topeka Blvd.

Topeka, KS  66629-0001

Email Form

Phone:  1-800-432-3990

Hearing Impaired: 1-800-430-1270

Fax: 1-785-290-0711

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Prescription Network

1020 SW Fairlawn Rd.

Topeka, KS 66604                                                     

Phone: 1 -785-228-1695

Toll Free: 1-800-279-3022

Fax:  1-785-228-3951

 

 

Summary of Benefits

BCBS

Prescription Network

 

Premiums

Effective October 1, 2011 through September 30, 2012

 

Current Employees

TIER 1 $500/1500 BC/BS Premium  RX Network Premium Distict Pays Employee Pays Employee $323.71 $42 $350.00 $15.71 E/Ch $635.57 $74 $350.00 $359.57 E/Sp $694.93 $83 $350.00 $427.93 Family $1,000.11 $118 $350.00 $768.11 TIER 2 $1000/$3000 BC/BS Premium  RX Network Premium Distict Pays Employee Pays Employee $300.59 $42 $342.59 $0.00 E/Ch $586.51 $74 $342.59 $317.92 E/Sp $645.22 $83 $342.59 $385.63 Family $922.88 $118 $342.59 $698.29 TIER 3 $2000/$6000 BC/BS Premium  RX Network Premium Distict Pays Employee Pays Employee $266.55 $42 $308.55 $0.00 E/Ch $517.88 $74 $308.55 $283.33 E/Sp $572.04 $83 $308.55 $346.49 Family $814.81 $118 $308.55 $624.26

Retirees

TIER 1 $500/1500 BC/BS Premium  RX Network Premium Retirees Pays Employee $323.71 $42 $365.71 E/Ch $635.57 $74 $709.57 E/Sp $694.93 $83 $777.93 Family $1,000.11 $118 $1,118.11 TIER 2 $1000/$3000 BC/BS Premium  RX Network Premium Retirees Pays Employee $300.59 $42 $342.59 E/Ch $586.51 $74 $660.51 E/Sp $645.22 $83 $728.22 Family $922.88 $118 $1,040.88 TIER 3 $2000/$6000 BC/BS Premium  RX Network Premium Retirees Pays Employee $266.55 $42 $308.56 E/Ch $517.88 $74 $591.88 E/Sp $572.04 $83 $655.04 Family $814.81 $118 $932.81

COBRA BC/BS Premiums

TIER 1 $500/1500 Cobra Amout (Includes 2% Cobra Admin Fee) Employee $330.18 E/Ch $648.28 E/Sp $708.83 Family $1,020.11 TIER 2 $1000/$3000 Cobra Amount Employee $306.60 E/Ch $598.24 E/Sp $658.12 Family $941.34 TIER 3 $2000/$6000 Cobra Amount Employee $271.88 E/Ch $528.24 E/Sp $583.48 Family $831.11

COBRA Prescription Network Premiums