Oklahoma State and Education Employees Group Insurance Board
Monthly Premiums for Medicare Eligible Members
Plan Year January 1, 2010 - December 31, 2010
| MEDICARE SUPPLEMENT PLANS | ||||
| HealthChoice Employer PDP High Option With Part D | $289.42 per enrolled member* | |||
| HealthChoice Employer PDP Low Option With Part D | $236.10 per enrolled member* | |||
| HealthChoice High Option Without Part D | $345.82 per enrolled member* | |||
| HealthChoice Low Option Without Part D | $292.50 per enrolled member* | |||
| UnitedHealthcare Senior Supplement High Option (formerly Pacificare) |
$362.14 per enrolled member* | |||
| UnitedHealthcare Senior Supplement Low Option (formerly Pacificare) |
$325.36 per enrolled member* | |||
| MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS (MA-PD) You must live within the MAPD Service Area to be eligble for an MAPD plan. |
||||
| CommunityCare Senior | $179.00 per enrolled person | |||
| CommunityCare Senior Alternate (NEW) | $148.00 per enrolled person | |||
| Generations HelathCare by GlobalHealth | $116.30 per enrolled person | |||
| Secure Horizons Medicare Complete Retiree Plan (HMO) | $189.22 per enrolled person | |||
| DENTAL PLANS | MEMBER | SPOUSE | CHILD | CHILDREN |
| HealthChoice Dental | $30.28 | $30.28 | $25.24 | $65.50 |
| Assurant Freedom Preferred | $26.33 | $26.18 | $19.63 | $52.79 |
| Assurant Heritage Plus with SBA (Prepaid) | $11.74 | $8.86 | $7.60 | $15.20 |
| Assurant Heritage Secure (Prepaid) | $7.20 | $5.98 | $5.20 | $10.38 |
| CIGNA Dental Care Plan (Prepaid) | $9.26 | $6.06 | $7.08 | $15.32 |
| Delta Dental PPO (POS) | $30.48 | $30.50 | $26.80 | $68.22 |
| Delta’s Choice (PPO) | $13.40 | $30.44 | $30.68 | $74.46 |
| VISION PLANS | MEMBER | SPOUSE | CHILD | CHILDREN |
| Humana/CompBenefits VisionCare Plan | $6.76 | $5.06 | $3.57 | $4.46 |
| Primary Vision Care Services | $9.25 | $8.00 | $8.50 | $10.75 |
| Superior Vision Services | $6.98 | $6.90 | $6.60 | $6.60 |
| UnitedHealthcare Vision | $8.18 | $5.79 | $4.59 | $6.98 |
| Vision Service Plan (VSP) | $8.96 | $6.00 | $5.74 | $12.92 |
| LIFE PLAN | From $5,000 to $40,000 | $1.94 Per $1,000 Unit | ||
| Age-Rated Supplemental Life Cost Per $1,000 for $41,000 and Up | ||||
| < 30 ---------- $0.05 | 45 - 49 ------- $ 0.19 | 65 - 69 ------- $0.99 | ||
| 30 - 34 ------- $0.05 | 50 - 54 ------- $ 0.32 | 70 - 74 ------- $1.67 | ||
| 35 - 39 ------- $0.08 | 55 - 59 ------- $0.52 | 75+ ----------- $2.60 | ||
| 40 - 44 ------- $0.12 | 60 - 64 ------- $0.60 | |||
| DEPENDENT LIFE | $0.97 Per $500 Unit, Per Dependent | |||
*Per enrolled member means member, spouse, and child(ren).
These rates do not reflect any contribution from your retirement system.
These rates do not reflect any contribution from your retirement system.
Last Modified on 04/14/2010