Download a State Retiree Rate Chart pdf format of 2015ratesheet.pdf

Monthly GIC Plan Rates Effective July 1, 2015

 

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)

$0.63

$0.95

$1.26

Health Plan 
(premium includes Basic Life
Insurance)

Per Person

Per Person

Per Person

Fallon Senior
Plan 3
(HMO)

$30.72

$46.09

$61.45

Harvard Pilgrim Medicare
Enhance
(Indemnity)

39.70

59.55

79.40

Health
New England MedPlus
(HMO)

36.58

54.88

73.16

Tufts Health Plan Medicare Complement
(HMO)

35.88

53.83

71.76

Tufts Health Plan Medicare
Preferred 3
(HMO)

28.08

42.13

56.16

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

50.29

70.21

90.11

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

39.82

59.74

79.64

1 Survivors are not eligible for life insurance. For monthly health insurance premium cost, deduct $0.63 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 may change January 1, 2016.

4 CIC is an enrollee pay-all benefit.

! Contribution percentages may change after the Commonwealth’s FY16 budget is enacted.

 


This information provided by the Group Insurance Commission .

Recommended Content

People also viewed...

You recently viewed...

Personalization is OFF. Your personal browsing history at Mass.gov is not visible because your personalization is turned off. To view your history, turn your personalization on.

Learn more on our .

*Recommendations are based on site visitor traffic patterns and are not endorsements of that content.