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. |
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| CommunityCare Senior | $179.00 per enrolled person | |||
| CommunityCare Senior Alternate (NEW) | $148.00 per enrolled person | |||
| Generations HealthCare 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.
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