Monthly Premiums for Medicare Eligible Members
Plan Year January 1, 2011 - December 31, 2011
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| MEDICARE SUPPLEMENT PLANS | ||||
| HealthChoice Employer PDP High Option With Part D | $308.34 per enrolled person | |||
| HealthChoice Employer PDP Low Option With Part D | $251.66 per enrolled person | |||
| HealthChoice High Option Without Part D | $363.06 per enrolled person | |||
| HealthChoice Low Option Without Part D | $306.38 per enrolled person | |||
| UnitedHealthcare Senior Supplement High Option | $381.88 per enrolled person | |||
| UnitedHealthcare Senior Supplement Low Option | $342.70 per enrolled person | |||
| MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS (MA-PD) | ||||
| CommunityCare Senior | $220.00 per enrolled person | |||
| CommunityCare Senior Alternate | $180.00 per enrolled person | |||
| Generations HealthCare by GlobalHealth | $186.07 per enrolled person | |||
| Secure Horizons Medicare Complete Retiree Plan | $219.50 per enrolled person | |||
| DENTAL PLANS | MEMBER | SPOUSE | CHILD | CHILDREN |
| HealthChoice Dental | $29.84 | $29.84 | $24.88 | $64.56 |
| Assurant Freedom Preferred | $28.83 | $28.67 | $21.50 | $57.80 |
| Assurant Heritage Plus with SBA (Prepaid) | $11.74 | $ 8.86 | $ 7.60 | $15.20 |
| Assurant Heritage Secure (Prepaid) | $ 7.20 | $ 5.98 | $ 5.20 | $10.38 |
| CIGNA Dental Care Plan (Prepaid) | $ 9.26 | $ 6.06 | $ 7.08 | $15.32 |
| Delta Dental PPO | $31.14 | $31.14 | $27.10 | $68.56 |
| Delta Dental Premier | $35.52 | $35.52 | $30.90 | $78.20 |
| Delta Dental PPO - Choice | $13.94 | $31.64 | $31.90 | $77.42 |
| VISION PLANS | MEMBER | SPOUSE | CHILD | CHILDREN |
| Humana/CompBenefits VisionCare Plan | $6.76 | $5.06 | $3.57 | $ 4.46 |
| Primary Vision Care Services (PVCS) | $9.25 | $8.00 | $8.50 | $10.75 |
| Superior Vision Plan | $6.98 | $6.90 | $6.60 | $ 6.60 |
| UnitedHealthcare Vision | $8.18 | $5.79 | $4.59 | $ 6.98 |
| Vision Service Plan (VSP) | $8.76 | $5.87 | $5.62 | $12.64 |
| LIFE PLAN | From $5,000 to $40,000 | $1.94 Per $1,000 Unit | ||
|
Age Rated Life – Cost Per $1,000 from $41,000 and Up |
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| < 30 ---------- $0.05 | 45 - 49 ------- $0.19 | 65 - 69 ------- $0.99 | ||
| 30 - 34 ------- $0.05 | 50 - 54 ------- $0.32 | 70 - 74 ------- $1.67 | ||
| 35 - 39 ------- $0.08 | 55 - 59 ------- $0.52 | 75+ ----------- $2.60 | ||
| 40 - 44 ------- $0.12 | 60 - 64 ------- $0.60 | |||
|
DEPENDENT LIFE |
$0.97 Per $500 Unit, Per Dependent | |||
These rates do not reflect any contribution from your retirement system.
Last Modified on 08/26/2011