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 MonthlyRetiree 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 CoverageFamily CoverageIndividual CoverageFamily CoverageIndividual CoverageFamily Coverage

Fallon Health

Direct Care ($)

HMO

$48.76$116.14$73.14$174.21$97.52$232.28

Fallon Health

Select Care

HMO

61.92147.7392.89221.61123.85295.47

Harvard Pilgrim Independence

Plan

PPO

68.97167.38103.46251.08137.94334.77
Harvard Pilgrim Primary Choice ($)

HMO

55.30134.0382.96201.05110.60268.06
Health New England ($)

HMO

48.63119.6372.95179.4497.25239.25
NHP Care (Neighborhood Health Plan) ($)

HMO

46.99123.4770.48185.2193.97246.95
Tufts Health Plan Navigator

PPO

62.37149.7993.56224.69124.74299.59
Tufts Health Plan Spirit ($)

EPO (HMO-TYPE)

50.47120.7575.71181.13100.94241.50

UniCare State Indemnity

Plan/Basic with CIC3

(Comprehensive)

Indemnity

131.90306.46176.73410.71221.55514.95

UniCare State Indemnity

Plan/Basic without CIC

(Non-Comprehensive)

Indemnity

89.66208.48134.49312.73179.31416.97
UniCare State Indemnity Plan/Community Choice ($)

PPO-type

46.12109.7969.18164.6992.23219.58

UniCare State Indemnity

Plan/PLUS

PPO-type

66.06156.7799.09235.17132.12313.55





 

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.

 


This information provided by the Group Insurance Commission .