2013 Retiree Medical Care Plan Rates

Retirees Under Age 65

PPO $900 Deductible for Retirees
Monthly Retiree Premiums
One participant	$   543.77
One participant and child(ren)	$1,084.66
Retiree and spouse	$1,325.99
Retiree and Family	$1,505.86

COBRA

IU PPO $400 Deductible
Monthly Premiums	Medical
One participant	$ 626.26
One participant and child(ren)	$1,240.52
Participant and spouse	$1,519.39
Participant and family	$1,725.19

IU PPO $900 Deductible
Monthly Premiums	Medical
One participant	$  543.77
One participant and child(ren)	$1,084.66
Participant and spouse	$1,325.99
Participant and family	$1,505.86

IU HDHP PPO
Monthly Premiums	Medical
One participant	$277.68
One participant and child(ren)	$553.89
Participant and spouse	$677.13
Participant and family	$768.98

IU Health Quality Partners Exclusive Provider
Monthly Premiums	Medical
One participant	$  545.49
One participant and child(ren)	$1,088.06
Participant and spouse	$1,330.16
Participant and family	$1,510.61

The above health care plans are available to residents of the following areas:

• IU PPO $900 Deductible:  All areas of Indiana, as well as outside the state.
• IU PPO $400 Deductible:  All areas of Indiana, as well as outside the state.
• IU HDHP PPO:  All areas of Indiana, as well as outside the state.
• IU Health Quality Partners: Eligibility is limited to employees residing in the following counties: Blackford, Boone, Brown, Carroll, Clinton, Delaware, Green, Hamilton, Hancock, Hendricks, Henry, Howard, Johnson, Lawrence, Madison, Marion, Monroe, Morgan, Owen, Putnam, Shelby, Tipton, & Tippecanoe.