Benefits for Retirees

2014 Monthly Premiums

Medical

Premier PPO

HMO Illinois

You under 65

$610

$474

You + Spouse under 65

$1,334

$1,040

You + Child(ren) under 65

$1,136

$897

You + Spouse + Child(ren) under 65

$2,005

$1,564

You over 65

$539

$510

You + Spouse over 65

$1,077

$1,020

You + Child(ren) over 65

$1,186

$1,185

You + Spouse + Child(ren) over 65

$1,725

$1,695

You over 65 + Spouse under 65

$1,206

$1,030

You under 65 + Spouse over 65

$1,206

$1,030

You over 65 + Spouse under 65 + Child(ren)

$1,934

$1,600

You under 65 + Spouse over 65 + Child(ren)

$1,934

$1,600

Dental

You

You + Spouse

You+Child(ren)

You+sps+child(ren)

Dearborn National PPO

$46

$100

$113

$160

First Commonwealth

$16

$29

$30

$44

Vision

You

You+Spouse

You+Child(ren)

You+sps+child(ren)

EyeMed

$7

$12

$13

$17

* Please note that retiree coverage is irrevocable once it has been dropped.

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