Monthly GIC Plan Rates as of July 1, 2014

Download a State Retiree Rate Sheet pdf format of    2014ratesheet.pdf

NON-MEDICARE PLANS

NON-MEDICARE RETIREES Retired on or before

July 1, 1994 And SURVIVORS1,2

NON-MEDICARE RETIREES Retired

after July 1, 1994 and who filed for retirement on or before October 1, 2009

NON-MEDICARE RETIREES who 

 filed for retirement after October 1, 2009

10%

15%

20%

Retiree/Survivor Pays Monthly

Retiree Pays Monthly

Retiree Pays

 Monthly

Basic Life Insurance Only

($5,000 coverage)

$0.63

$0.95

$1.26

HEALTH PLAN

(Premium includes Basic Life Insurance)

PLAN TYPE

Individual Coverage

Family Coverage

Individual Coverage

Family Coverage

Individual Coverage

Family Coverage

Fallon Health

Direct Care ($)

HMO

$48.76

$116.14

$73.14

$174.21

$97.52

$232.28

Fallon Health

Select Care

HMO

61.92

147.73

92.89

221.61

123.85

295.47

Harvard Pilgrim Independence

Plan

PPO

68.97

167.38

103.46

251.08

137.94

334.77

Harvard Pilgrim Primary Choice ($)

HMO

55.30

134.03

82.96

201.05

110.60

268.06

Health New England ($)

HMO

48.63

119.63

72.95

179.44

97.25

239.25

NHP Care (Neighborhood Health Plan) ($)

HMO

46.99

123.47

70.48

185.21

93.97

246.95

Tufts Health Plan Navigator

PPO

62.37

149.79

93.56

224.69

124.74

299.59

Tufts Health Plan Spirit ($)

EPO (HMO-TYPE)

50.47

120.75

75.71

181.13

100.94

241.50

UniCare State Indemnity

Plan/Basic with CIC3

(Comprehensive)

Indemnity

131.90

306.46

176.73

410.71

221.55

514.95

UniCare State Indemnity

Plan/Basic without CIC

(Non-Comprehensive)

Indemnity

89.66

208.48

134.49

312.73

179.31

416.97

UniCare State Indemnity Plan/Community Choice ($)

PPO-type

46.12

109.79

69.18

164.69

92.23

219.58

UniCare State Indemnity

Plan/PLUS

PPO-type

66.06

156.77

99.09

235.17

132.12

313.55





1Survivors are not eligible for life insurance. For monthly health insurance premium cost, deduct $0.63 from monthly Retire/Survivor Pays premium.
2Elderly Governmental Retirees (EGRs) - call the GIC for monthly rates.
3CIC is an enrollee pay-all benefit.



! Contribution percentages may change after the Commonwealth's FY15 budget is enacted.
 

 


This information provided by the Group Insurance Commission.