MERIT RETIREES
MONTHLY HEALTH AND DENTAL INSURANCE PREMIUMS
EFFECTIVE JANUARY 1, 2012
RETIREES UNDER 65
| SINGLE |
FAMILY |
|
Program 3 Plus |
$ 756.45 | $ 1,770.13 |
Iowa Select |
$ 754.11 | $ 1,764.61 |
Blue Access |
$ 471.85 | $ 1,104.11 |
Blue Advantage |
$ 454.32 | $1,063.14 |
Gold Preferred PPO |
$ 597.83 | $ 1,398.94 |
RETIREES OVER 65
Plans not requiring purchase coordinating Part D Medicare Coverage
SINGLE |
FAMILY |
|
Program 3 Plus |
$ 885.55 | $ 1,827.02 |
Iowa Select |
$ 852.60 | $ 1,820.86 |
Blue Access |
$ 527.35 | $ 1139.65 |
Blue Advantage |
$ 507.11 | $ 1097.27 |
Gold Preferred PPO |
$ 634.13 | $ 1363.28 |
Plans requiring purchase coordinating Part D Medicare Coverage*
SINGLE |
FAMILY |
|
Program 3 Plus |
$ 401.64 | $ 1040.46 |
Iowa Select |
$ 400.40 | $ 1037.33 |
Blue Access |
$ 251.10 | $661.15 |
Blue Advantage |
$ 241.77 | $637.63 |
Gold Preferred PPO |
$ 299.97 | $784.29 |
Program N ** |
$ 159.54 | NA *** |
*You must enroll in SilverScript for Part D prescription coverage
**Group Medicare Blue Rx 95.69
***Family premium is NOT applicable for Program N. Spouse/partner and/or dependents can only be covered on Program N if they are also Medicare Eligible, and they would enroll in separate Single Program N and Medicare Blue Rx contracts.
Silver Script Part D Coverage $62.00
DENTAL
SINGLE |
FAMILY |
|
State Dental |
$ 27.83 | $ 74.83 |
UPDATED 9/11