Monthly GIC Plan Rates as of July 1, 2016

For information on how to calculate premiums for retiree and spouse coverage if under and over age 65, see the Medicare and Your GIC Benefits section.

Download a State Retiree Rate Sheet pdf format of 2016_ratesheet.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 MonthlyRetiree Pays Monthly

Retiree Pays

 Monthly

Basic Life Insurance Only

($5,000 coverage)

$0.65$0.98$1.30

HEALTH PLAN

(Premium includes Basic Life Insurance)

PLAN TYPE

Individual CoverageFamily CoverageIndividual CoverageFamily CoverageIndividual CoverageFamily Coverage

Fallon Health

Direct Care √

HMO

$52.44$124.96$78.67$187.44$104.89$249.91

Fallon Health

Select Care

HMO

69.48165.83104.22248.74138.95331.65

Harvard Pilgrim Independence

Plan (CLOSED TO NEW MEMBERS)

POS

82.01199.16123.02298.75164.02398.32
Harvard Pilgrim Primary Choice √

HMO

61.48149.0792.22223.61122.95298.14
Health New England √

HMO

53.95132.7980.93199.19107.90265.58
NHP Prime (Neighborhood Health Plan)

HMO

51.69135.9177.54203.87103.38271.82
Tufts Health Plan Navigator

POS

69.05167.53103.57251.31138.09335.07
Tufts Health Plan Spirit √

EPO (HMO-TYPE)

52.00124.2778.01186.41104.00248.54

UniCare State Indemnity

Plan/Basic with CIC3

(Comprehensive)

Indemnity

139.39324.59187.51436.83235.62549.06

UniCare State Indemnity

Plan/Basic without CIC

(Non-Comprehensive)

Indemnity

96.22224.46144.34336.70192.45448.93
UniCare State Indemnity Plan/Community Choice PPO-type49.24117.2873.87175.9298.49234.55

UniCare State Indemnity

Plan/PLUS

PPO-type

65.95156.7298.93235.08131.91313.43

1Survivors are not eligible for life insurance.  For monthly health insurance premium cost, deduct $0.65 from monthly Retiree/Survivor Pays premium.

2Elderly Governmental Retirees (EGRs) – call the GIC for monthly rates.

3 CIC is an enrollee pay-all benefit.

! Contribution percentages may change after the Commonwealth’s FY17 budget is enacted.

√ Compare the rates of these plans and see how much you will save each month.


This information provided by the Group Insurance Commission .