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2016 Retiree Healthcare Rate Sheet
Cigna Healthcare Plans Monthly Rates
Cigna Healthcare plans continue to be offered to retirees and dependents that are Under Age 65 or Over Age 65 and
not Medicare eligible.
Coverage OAP 10 OAP 20 LocalPlus
Retiree Only $ 692.00 $ 656.00 $ 655.00
Dependents Under Age 65 or Over Age 65 and not Medicare eligible.
Spouse/Domestic Partner $ 977.00 $ 929.00 $ 928.00
Child(ren) $ 687.00 $ 654.00 $ 653.00
Family $ 1,956.00 $ 1,858.00 $ 1,855.00
Adult Dependent Child $ 598.00 $ 546.00 $ 550.00
Note: You must add the retiree only rate to the dependent rate to get the total monthly premium.
UnitedHealthcare Medicare Supplement Plans Monthly Rates for Under Age 65 or Over
Age 65 with Medicare Parts A & B
Miami-Dade County Only
Reflected rates are approved by Centers for Medicare and Medicaid Services (CMS) current for calendar year 2015.
Rates for calendar year 2016 receive CMS approval in November. Rates for service areas outside Miami-Dade County
would be subject to filed and approved 2016 rates with CMS. Medicare filed plans A, F and N have specific stated
benefits, pursuant to CMS guidelines. Pre-65 Medicare recipients are not eligible for these supplement plans.
Age Range Plan A Plan F Plan N
65 - 66 $ 179.50 $ 249.25 $ 179.37
67 - 69 $ 196.62 $ 271.95 $ 195.69
70 - 74 $ 224.26 $ 310.27 $ 223.28
75 - 79 $ 247.06 $ 341.12 $ 245.53
80+ $ 271.47 $ 373.52 $ 269.19
UnitedHealthcare Pharmacy Plans (Medicare Part D only)
Medicare RX Saver
Plus Plan
Medicare RX Preferred Comprehensive
Plan
Premier Plan
$ 27.50 $ 63.80 $ 100.01 $ 249.35
Medicare Advantage (Healthcare & Pharmacy) Plans Monthly Rates for Under Age 65 or
Over Age 65 with Medicare Parts A & B
Provider Plan Rates
*AvMed
Choice HMO (Miami-Dade County Only;
Brevard County Only)
$ 0.00
Cigna Leon Cares Zero Premium HMO Plan $ 0.00
* Humana
Zero Premium HMO $ 0.00
Comprehensive PPO $ 144.79
UnitedHealthcare
Zero Premium National PPO $ 0.00
Premier National PPO Plan 3 $ 338.15
*At the time of enrollment, a Primary Care Physician (PCP) is required for the AvMed Medicare Choice HMO and the
Humana Zero Premium HMO plans.