Monthly Group Insurance Commission (GIC)

Effective July 1, 2014

Full Cost Rates Including the 0.40 % Administrative Fee

For the rate you will pay as a municipal employee or retiree/survivor, 

see separate rate chart from your municipality.

 

Employee and Non-Medicare Retiree/Survivor Health Plans

HEALTH PLAN

 

PLAN TYPE

INDIVIDUAL

FAMILY

Fallon Health Direct CareHMO

$483.21

$1,159.70
Fallon Health Select CareHMO

615.39

1,476.92
Harvard Pilgrim Independence PlanPPO

686.12

1,674.20
Harvard Pilgrim Primary Choice PlanHMO

548.89

1,339.36
Health New EnglandHMO

481.89

1,194.71
NHP Care (Neighborhood Health Plan)HMO

465.41

1,233.34
Tufts Health Plan NavigatorPPO

619.87

1,497.60
Tufts Health Plan SpiritHMO-type

500.37

1,206.01

UniCare State Indemnity Plan/Basic with CIC

(Comprehensive)

    Indemnity

936.24

2,185.22

UniCare State Indemnity Plan/Basic without CIC

(Non-Comprehensive)

    Indemnity

893.83

2,086.85
UniCare State Indemnity Plan/Community Choice     PPO-type

456.68

1,095.99
UniCare State Indemnity Plan/PLUS    PPO-type

656.90

1,567.69

 

Medicare Plans

 

Health Plan

 

PLAN TYPE

PER PERSON

Fallon Senior Plan*

Medicare (HMO)

$302.13
Harvard Pilgrim Medicare Enhance

Medicare (Indemnity)

394.79
Health New England MedPlus

Medicare (HMO)

363.13
Tufts Health Plan Medicare Complement

Medicare (HMO)

348.39
Tufts Health Plan Medicare Preferred*

Medicare (HMO)

275.60
UniCare State Indemnity Plan/Medicare Extension (OME) with CIC (Comprehensive)Medicare (Indemnity)379.45
UniCare State Indemnity Plan/Medicare Extension (OME) without CIC (Non-Comprehensive)

Medicare (Indemnity)

368.63

*Benefits and rates of Fallon Senior Plan and Tufts Health Plan Medicare Preferred are subject to federal approval and changed January 1, 2015.