|
PLAN
RATES FOR RETIREES ENROLLED IN THE
STATE HEALTH BENEFITS PROGRAM
DEPARTMENT
OF THE TREASURY - DIVISION OF PENSIONS AND BENEFITS
MEDICARE
AND NON-MEDICARE PLAN RATES
FULL COST
FOR
LOCAL GOVERNMENT RETIREES
ENROLLED IN THE STATE HEALTH BENEFITS PROGRAM
RATES EFFECTIVE FROM APRIL 1, 2008
HOW
TO USE THIS CHART
To
determine the monthly cost of your Retired Group SHBP coverage,
find your plan and coverage level in the left-hand
column. To the right you will find the applicable SHBP rates.
|
PLAN
AND COVERAGE LEVEL |
MONTHLY
BILLING RATE |
Full
Cost
(including RX coverage) |
|
NJ
DIRECT15 (150) |
|
SINGLE
- No Medicare |
$629.44 |
|
SINGLE
- On Medicare |
$377.67 |
|
MEMBER
& SPOUSE/PARTNER-No Medicare |
$1,372.19 |
|
MEMBER
& SPOUSE/PARTNER-One on Medicare |
$1,007.11 |
|
MEMBER
& SPOUSE/PARTNER-Both on Medicare |
$755.33 |
|
FAMILY
- No Medicare |
$1,561.02 |
|
FAMILY
- One on Medicare |
$1,195.94 |
|
FAMILY
- Member & Spouse/Partner on Medicare |
$944.17 |
|
PARENT
& CHILD - No Medicare |
$881.22 |
|
PARENT
& CHILD - Retiree on Medicare |
$597.97 |
|
NJ DIRECT10
(050)
|
|
SINGLE
- No Medicare |
$660.81 |
|
SINGLE
- On Medicare |
$396.49 |
|
MEMBER
& SPOUSE/PARTNER-No Medicare |
$1,440.58 |
|
MEMBER
& SPOUSE/PARTNER-One on Medicare |
$1,057.30 |
|
MEMBER
& SPOUSE/PARTNER-Both on Medicare |
$792.98 |
|
FAMILY
- No Medicare |
$1,638.82 |
|
FAMILY
- One on Medicare |
$1,255.55 |
|
FAMILY
- Member & Spouse/Partner on Medicare |
$991.23 |
|
PARENT
& CHILD - No Medicare |
$925.14 |
|
PARENT
& CHILD - Retiree on Medicare |
$627.77 |
|
AETNA
(019)
|
|
SINGLE
- No Medicare |
$472.72 |
|
SINGLE
- On Medicare |
$354.54 |
|
MEMBER
& SPOUSE/PARTNER-No on Medicare |
$1,030.53 |
|
MEMBER
& SPOUSE/PARTNER-One on Medicare |
$827.26 |
|
MEMBER
& SPOUSE/PARTNER-Both on Medicare |
$709.08 |
|
FAMILY
- No Medicare |
$1,172.35 |
|
FAMILY
- One on Medicare |
$969.08 |
|
FAMILY
- Member & Spouse/Partner on Medicare |
$850.90 |
|
PARENT
& CHILD - No Medicare |
$661.81 |
|
PARENT
& CHILD - Retiree on Medicare |
$519.99 |
|
CIGNA
(020)
|
|
SINGLE
- No Medicare |
$477.45 |
|
SINGLE
- On Medicare |
$358.09 |
|
MEMBER
& SPOUSE/PARTNER-No Medicare |
$1,040.84 |
|
MEMBER
& SPOUSE/PARTNER-One on Medicare |
$835.54 |
| MEMBER
& SPOUSE/PARTNER-Both on Medicare |
$716.17 |
|
FAMILY
- No Medicare |
$1,184.07 |
|
FAMILY
- One on Medicare |
$978.77 |
|
FAMILY
- Member & Spouse/Partner on Medicare |
$859.41 |
|
PARENT
& CHILD - No Medicare |
$668.43 |
|
PARENT
& CHILD - Retiree on Medicare |
$525.19 |
|