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Retiree Insurance Rate Sheet
 

Retiree Medical Insurance Premiums - Monthly 

Cigna Health Insurance

Effective 1/1/09

Age 65 and
Maximum
$75,000 per  
Lifetime
 
Medical Coverage - Employee Only 138.38    
$4500 Life Insurance 1.25
$4500 Life Insurance and Medical on Self Only 139.63    
$4500 Life Insurance on Self and $500 Life Insurance on Spouse - No Medical Coverage 2.23    
Medical Coverage on Self and Spouse 298.47    
Medical Coverage on Self and spouse with $4500 Life Insurance on Self 299.72    
Medical Coverage on Self and Spouse with $4500 Life Insurance on Self and $500 Life Insurance on Spouse 300.70    

UNDER AGE 65                                                                                                                                        LIFETIME MAXIMUM

    CORE BASIC
Deductible In-Network   400.00 1,000.00
Medical Coverage - Employee Only   529.75 246.24
$4500 Life Insurance   1.25 1.25
$4500 Life Insurance and Medical on Self Only   531.00 247.49
$4500 Life Insurance on Self and $500 Life Insurance on Spouse - No Medical Coverage   2.23 2.23
Medical Coverage on Self and Spouse   985.70 460.47
Medical Coverage on Self and spouse with $4500 Life Insurance on Self   986.95 461.72
Medical Coverage on Self and Spouse with $4500 Life Insurance on Self and $500 Life Insurance on Spouse   987.93 462.70
Medical Coverage on Self, Spouse and Dependents   1335.45 615.60
Medical Coverage on Self, Spouse and Dependents; $4500 Life on Self   1336.70 616.85
Medical Coverage on Self, Spouse and Dependents; $4500 Life on Self; $500 on Spouse   1337.68 617.83


 
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