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Employee Benefits - Health

State Retiree Health Benefits Program
Medicare- Eligible Plans

Monthly Premiums - Effective January 1 - December 31, 2012
Plans
One Person
Two Persons **

Advantage 65

$220

$440

Advantage 65 + Dental/Vision

$253

$506

Advantage 65 - Medical Only*

$137

$274

Advantage 65 - Medical Only+ Dental/Vision*

$170

$340

 



*These plans do not include prescription drug coverage





NOT AVAILABLE TO NEW ENROLLEES

Option I - Medicare Complementary

$236

$472

Option II - Medicare Supplemental

$285

$570

Option II + Dental/Vision

$318

$636

     

** Two persons may choose the same plan or different Medicare-eligible plans; the total premium is the sum of each selection.

Important: Timely payment of the total premium is the State retiree group member's responsibility whether the premium is withheld from a retirement benefit or billed directly by the health plan. Failure to pay premiums within 31 days of the due date will result in termination of coverage.