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State Insurance Retiree Health Plan Rates - FY2020

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Years of Service at Retirement* Contribution Percentage
QCHP Coverage
Medicare
Total Rate = $466.02
Non-Medicare
Total Rate = $1,246.62
HMO Coverage
Medicare
Total Rate = $558.66
Non-Medicare
Total Rate = $973.42
0 100% $466.02 $1,246.62 $558.66 $973.42
1 95% $442.71 $1,184.28 $530.72 $924.74
2 90% $419.41 $1,121.95 $502.79 $876.07
3 85% $396.11 $1,059.62 $474.86 $827.40
4 80% $372.81 $997.29 $446.92 $778.73
5 75% $349.51 $934.96 $418.99 $730.06
6 70% $326.21 $872.63 $391.06 $681.39
7 65% $302.91 $810.30 $363.12 $632.72
8 60% $279.61 $747.97 $335.19 $584.05
9 55% $256.31 $685.64 $307.26 $535.38
10 50% $233.01 $623.31 $279.33 $486.71
11 45% $209.70 $560.97 $251.99 $438.03
12 40% $186.40 $498.64 $223.46 $389.36
13 35% $163.10 $436.31 $195.53 $340.69
14 30% $139.80 $373.98 $167.59 $292.02
15 25% $116.50 $311.65 $139.66 $243.35
16 20% $93.20 $249.32 $111.73 $194.68
17 15% $69.90 $186.99 $83.80 $146.01
18 10% $46.60 $124.66 $55.86 $97.34
19 5% $23.30 $62.33

$27.93

$48.67
20+ 0% $    - $    - $    - $    -
* The rates shown for less than 8 years of service apply to survivors.
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