Benefits for Retirees

2015 Monthly Premiums

Medical

Premier PPO

HMO Illinois

You under 65

$643

$489

You + Spouse under 65

$1,407

$1,072

You + Child(ren) under 65

$1,198

$923

You + Spouse + Child(ren) under 65

$2,115

$1,612

You over 65

$587

$544

You + Spouse over 65

$1,173

$1,088

You + Child(ren) over 65

$1,291

$1,262

You + Spouse + Child(ren) over 65

$1,879

$1,808

You over 65 + Spouse under 65

$1,290

$1,080

You under 65 + Spouse over 65

$1,290

$1,080

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

$2,059

$1,668

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

$2,059

$1,668

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

$8

$14

$16

$21

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

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