Rates for Retirees
|
|
| FY2006 Retiree - Monthly Premium Rates |
|
AGE |
PROVIDER NETWORK |
|
$1000 DEDUCTIBLE |
| PARTICIPANT |
N/A |
$275.60 |
|
$220.52 |
| PARTICIPANT +1 CHILD |
N/A |
$354.63 |
|
$273.33 |
| PARTICIPANT + 2 CHILDREN |
N/A |
$420.03 |
|
$318.25 |
| PARTICIPANT + 3+ CHILDREN |
N/A |
$460.08 |
|
$340.92 |
| PARTICIPANT and SPOUSE |
<30 yrs. old |
$374.15 |
|
$292.42 |
|
30-39 |
$402.19 |
|
$313.82 |
|
40-44 |
$432.37 |
|
$339.14 |
|
45-49 |
$462.04 |
|
$366.74 |
|
50-54 |
$502.04 |
|
$405.90 |
|
55-59 |
$548.32 |
|
$448.02 |
|
60-64 |
$588.45 |
|
$475.89 |
| PARTICIPANT, SPOUSE, + 1 CHILD |
<30 |
$442.62 |
|
$342.09 |
|
30-39 |
$471.54 |
|
$361.34 |
|
40-44 |
$502.26 |
|
$387.00 |
|
45-49 |
$532.25 |
|
$413.89 |
|
50-54 |
$569.53 |
|
$452.31 |
|
55-59 |
$616.52 |
|
$494.42 |
|
60-64 |
$658.71 |
|
$522.29 |
| PARTICIPANT, SPOUSE, + 2+ CHILDREN |
<30 |
$510.37 |
|
$382.65 |
|
30-39 |
$541.20 |
|
$405.09 |
|
40-44 |
$571.94 |
|
$429.95 |
|
45-49 |
$601.90 |
|
$458.13 |
|
50-54 |
$639.18 |
|
$497.26 |
|
55-59 |
$686.20 |
|
$539.43 |
|
60-64 |
$728.39 |
|
$567.26 |
| Plan 'F' Supplement to Medicare - Bankers Life and Casualty Company Monthly Premium Rates |
Age
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80+ |
Cost
$89.96
$93.53
$97.22
$101.06
$105.01
$109.23
$113.60
$118.09
$122.21
$126.42
$130.80
$135.28
$139.94
$145.59
$151.41
$157.50 |
|
|
|
NOTE: Contributions for retiree and spouse coverage will increase by $30.00 per person per pay period if you and/or your covered spouse use tobacco.
Rev 03/04
|
|
| FY2006 COBRA Group Dental and Vision Plans |
|
DENTAL PLAN |
VISION PLAN |
| PARTICIPANT ONLY |
$18.99 |
$11.77 |
| PARTICIPAN +1 CHILD |
$28.35 |
$15.15 |
| PARTICIPANT +2 CHILDREN |
$45.21 |
$20.84 |
| PARTICIPANT + 3+ CHILDREN |
$56.73 |
$28.84 |
|
|
| FY 2006 COBRA Life Insurance Rates - per $1000 of Coverage |
| AGE GROUP |
MONTHLY RATE |
| <30 yrs. old |
$0.03 |
| 30-34 |
$0.03 |
| 35-39 |
$0.04 |
| 40-44 |
$0.07 |
| 45-49 |
$0.09 |
| 50-54 |
$0.18 |
| 55-59 |
$0.20 |
| 60-64 |
$0.37 |
| 65-69 |
$0.88 |
| 70 |
$1.80 * |
|
NOTE: Your Term Life coverage ends the last day of the month of your 70th birthday. There is no conversion policy.
|
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