Download a State Retiree Rate Chart pdf format of 2016_ratesheet.pdf

Monthly GIC Plan Rates Effective July 1, 2016

 

Medicare
Retirees
Retired on or before
07/01/1994 and survivors 1, 2

Medicare Retirees Retired after 07/01/1994 and who filed for retirement on or after 08/10/2009 and on or before 10/01/2009

Medicare Retirees who filed for retirement after
10/01/2009

 

10%

15%

20%

 

Retiree/Survivor Pays Monthly

Retiree 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)

Per Person

Per Person

Per Person

Fallon Senior
Plan 3
(HMO)

$34.15

$51.23

$68.3

Harvard Pilgrim Medicare
Enhance
(Indemnity)

44.41

66.63

88.83

Health
New England MedPlus
(HMO)

41.60

62.41

83.21

Tufts Health Plan Medicare Complement
(HMO)

40.35

60.53

80.70

Tufts Health Plan Medicare
Preferred 3
(HMO)

30.65

45.98

61.30

UniCare State Indemnity Plan/Medicare Extension (OME) with CIC 4
(Comprehensive)
(Indemnity)

47.57

66.03

84.48

UniCare State Indemnity Plan/Medicare Extension (OME) without CIC (Non-Comprehensive)
(Indemnity)

36.92

55.38

73.83

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

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

3Benefits and rates of Fallon Senior Plan and Tufts Health Plan Medicare Preferred are subject to federal approval and changed on January 1, 2017.

4 CIC is an enrollee pay-all benefit.

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

 


This information provided by the Group Insurance Commission .