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VSTRS Group Health Insurance Rates(2010)

BC/BS Insurance Rates Effective July 1, 2010

      Withholding starts with the June 30 pension payment

   JY Plan

 

  Total Premium State Share Retiree Share Class Code
Retiree Under 65, Group Number: 80724-000
Retiree Only
$611.48
$435.75
$175.73
1L
Retiree and 1 Dependent
$1,205.70
$435.75
$769.95
2L
Retiree and Family
$1,621.40
$435.75
$1,185.65
FL
Retiree and 1 Dependent Medicare Eligible
$1,107.86
$435.75
$672.11
TL
Retiree and 2 Dependents, 1 of Whom is Medicare Eligible
$1,702.08
$435.75
$1,266.63
3L
Retiree Over 65 Medicare Eligible, Group Number: 80724-007
Retiree Only
$496.38
$324.47
$171.91
1M
Retiree and 1 Dependent Medicare Eligible
$992.76
$324.47
$668.29
2M
Retiree and 2 Dependents Medicare Eligible
$1,489.14
$324.47
$1,164.67
FM
Retiree and 1 Dependent Under 65
$1,107.86
$324.47
$783.39
TM
Retiree and 2 Dependents Under 65
$1,702.08
$324.47
$1,377.61
3M
Retiree WITHOUT MEDICARE, Group Number: 80724-001
 
$557.72
$435.75
$121.97
XM
 

 

   $250 Comprehensive Plan

 

  Total Premium State Share Retiree Share Class Code
Retiree Under 65, Group Number: 80724-200
Retiree Only
$544.69
$435.75
$108.94
1L-C
Retiree and 1 Dependent
$1,070.69
$435.75
$634.94
2L-C
Retiree and Family
$1,435.31
$435.75
$999.56
FL-C
Retiree and 1 Medicare Eligible Dependent
$950.28
$435.75
$514.53
TL-C
Retiree and 2 Dependents, 1 of Whom is Medicare Eligible
$1,476.28
$435.75
$1,040.53
3L-C
Retiree Over 65 Medicare Eligible, Group Number: 80724-207
Retiree Only
$405.59
$324.47
$81.12
1M-C
Retiree and 1 Dependent Medicare Eligible
$811.18
$324.47
$486.71
2M-C
Retiree and 2 Dependents Medicare Eligible
$1,216.77
$324.47
$892.30
FM-C
Retiree and 1 Dependent Under 65
$950.28
$324.47
$625.81
TM-C
Retiree and 2 Dependents Under 65
$1,476.28
$324.47
$1,151.81
3M-C
 

 

   Vermont Health Partnership

 

  Total Premium State Share Retiree Share Class Code
Retiree Under 65, Group Number: 80724-100
Retiree Only
$544.69
$435.75
$108.94
1L-V
Retiree and 1 Dependent
$1,070.69
$435.75
$634.94
2L-V
Retiree and Family
$1,435.31
$435.75
$999.56
FL-V
Retiree-VT Health Partnership Dependent(s) - JY Carveout
Retiree and 1 Dependent Medicare Eligible
$1,041.07
$435.75
$605.32
TL-T
Retiree and 2 Dependents, 1 of Whom is Medicare Eligible
$1,567.07
$435.75
$1,131.32
3L-T
Retiree-VT Health Partnership Dependent(s) - Comp Carveout
Retiree and 1 Dependent Medicare Eligible
$950.28
$435.75
$514.53
TL-U
Retiree and 2 Dependents, 1 of Whom is Medicare Eligible
$1,476.28
$435.75
$1,040.53
3L-U
Retiree-VT Health Partnership Dependent(s) - Medicomp C
Retiree and 1 Dependent Medicare Eligible
$700.97
$435.75
$265.22
TL-W
Retiree and 2 Dependents, 1 of Whom is Medicare Eligible
$1,226.97
$435.75
$791.22
3L-W
 

 

   Vermont Blue 65 Plan C

 

  Total Premium State Share Retiree Share Class Code
Retiree Over 65 Medicare Eligible, Group Number: 80724-300
Retiree Only
$156.28
$156.28
$0.0
1M-X
Retiree and 1 Dependent Medicare Eligible
$312.56
$156.28
$156.28
2M-X
Retiree and 2 Dependents Medicare Eligible
$468.84
$156.28
$312.56
FM-X
Retiree - Vermont Blue 65             Dependent(s) - JY Plan
Retiree and 1 Dependent Under 65
$767.76
$156.28
$611.48
TM-Y
Retiree and 2 Dependents Under 65
$1361.98
$156.28
$1,205.70
3M-Y
Retiree - Vemont Blue 65             Dependent(s) - 250 Comprehensive Plan
Retiree and 1 Dependent Under 65
$700.97
$156.28
$544.69
TM-#
Retiree and 2 Dependents Under 65
$1,226.97
$156.28
$1,070.69
3M-#
Retiree - Vermont Blue 65           Dependent(s) - VT Health Partnership
Retiree and 1 Dependent Under 65
$700.97
$156.28
$544.69
TM-P
Retiree and 2 Dependents Under 65
$1,226.97
$156.28
$1,070.69
3M-P
 

 

2009 VSTRS Group Health Insurance Rates 

2008 VSTRS Group Health Insurance Rates

2007 VSTRS Group Health Insurance Rates

2006 VSTRS Group Health Insurance Rates