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MPSERS Health Rates HMO and BCMSM Jan 1, 2016

Sep 28, 2015

    Member   Member    
    Premium Subsidy Premium Subsidy Total
    20% 80% 10% 90% Premium
Without Medicare          
  Self  $        149.45  $            597.81  $          74.73  $           672.53  $          747.26
  Self and Spouse  $        275.45  $         1,101.82  $        137.73  $        1,239.54  $       1,377.27
  Self and Child(ren)  $        204.69  $            818.77  $        102.35  $           921.11  $       1,023.46
  Self, Spouse & Child(ren)  $        330.69  $         1,322.78  $        165.35  $        1,488.12  $       1,653.47
             
With Medicare          
  Self  $          50.91  $            203.63  $          25.45  $           229.09  $          254.54
  Self and Spouse  $          96.88  $            387.50  $          48.44  $           435.94  $          484.38
  Self and Child(ren)  $        102.47  $            409.87  $          51.23  $           461.11  $          512.34
  Self, Spouse & Child(ren)  $        148.44  $            593.74  $          74.22  $           667.96  $          742.18
             
One With and One Without Medicare        
  Self Without & Spouse With  $        195.42  $            781.68  $          97.71  $           879.39  $          977.10
  Self With & Spouse Without  $        176.91  $            707.64  $          88.45  $           796.10  $          884.55
  Self Without, Spouse With & Child(ren)  $        246.98  $            987.92  $        123.49  $        1,111.41  $       1,234.90
  Self With, Spouse Without & Child(ren)  $        232.15  $            928.60  $        116.07  $        1,044.68  $       1,160.75
             
Parent Coverage          
  Parent under 65  $        126.00  $            504.01  $          63.00  $           567.01  $          630.01
  Parent over 65  $          45.97  $            183.87  $          22.99  $           206.85  $          229.84