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 STATE 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.

• Most retirees who pay for their SHBP coverage pay the "Full Cost" amount shown. This amount will be deducted from your monthly retirement payment (or you will be billed directly if the retirement payment is not large enough to cover the Full Cost amount).
  
  
• If you or a covered dependent are enrolled in a Medicare Part D drug plan, you are not eligible to receive prescription drug coverage through the SHBP and you will be charged a rate for "Medical Only". You will be notified of this rate of payment by mail.

Because the SHBP's prescription drug benefits are equal to or better than the Medicare Part D prescription drug benefit plans, most SHBP retirees and/or their dependents need not enroll in any Medicare Part D plan. If you and/or your covered dependents do enroll in Medicare Part D, your SHBP-provided retired group prescription drug benefits will be terminated for you and all of your dependents. For additional information about the SHBP and Medicare Part D, see the Medicare Part D Frequently Asked Questions page.