Retiree Medical Rates

Effective 1/1/2021

COVERAGE

ANNUAL

MONTHLY

SINGLE

$9,420.00

$785.00

1 CHILD ONLY

$2,310.00

$192.50

2 CHILDREN ONLY

$4,620.00

$385.00

3 CHILDREN ONLY

$6,930.00

$577.50

SPOUSE ONLY

$7,080.00

$590.00

FAMILY

$10,719.00

$893.25

Note: To calculate the total cost for single and dependent coverage, add the two rates together.

Example the annual single rate is $9,420 and the annual spouse rate is $7,080. The total single and spouse rate is $16,500.

COBRA Medical Rates

Effective 1/1/2021

COVERAGE

ANNUAL

MONTHLY

SINGLE

$9,609.00

$800.75

1 CHILD ONLY

$2,358.00

$196.50

2 CHILDREN ONLY

$4,701.00

$391.75

3 CHILDREN ONLY

$7,068.00

$589.00

SPOUSE ONLY

$7,221.00

$601.75

FAMILY

$10,935.00

$911.25

Note: To calculate the total cost for single and dependent coverage, add the two rates together.

Example the annual single rate is $9,609 and the annual spouse rate is $7,221. The total single and spouse rate is $16,830.