Retiree Medical Plan Premiums
Jump to network information2022 Premiums
Retirees Age 65 and Over
| Anthem IU Blue Retiree Plan | |
|---|---|
| Coverage Levels | Monthly Premiums |
| One Participant (Retiree or surviving spouse) |
$195.67 |
| Retiree and Spouse | $390.06 |
Retirees Under Age 65
| Anthem U65 PPO HDHP | |
|---|---|
| Coverage Levels | Monthly Premiums |
| One participant | $407.37 |
| Participant and child(ren) | $779.40 |
| Retiree and spouse | $1,084.99 |
| Retiree and Family | $1,228.53 |
COBRA
| IU Health HDHP COBRA | ||
|---|---|---|
| Coverage Levels | Medical | Dental |
| One participant | $346.67 | $41.06 |
| Participant and child(ren) | $663.27 | $73.94 |
| Participant and spouse | $923.33 | $96.45 |
| Participant and family | $1,045.47 | $140.67 |
| Anthem PPO HDHP COBRA | ||
|---|---|---|
| Coverage Levels | Medical | Dental |
| One participant | $407.37 | $41.06 |
| Participant and child(ren) | $779.40 | $73.94 |
| Participant and spouse | $1,084.99 | $96.45 |
| Participant and family | $1,228.53 | $140.67 |
| Anthem PPO $500 COBRA | ||
|---|---|---|
| Coverage Levels | Medical | Dental |
| One participant | $975.15 | $41.06 |
| Participant and child(ren) | $1,852.78 | $73.94 |
| Participant and spouse | $2,584.14 | $96.45 |
| Participant and family | $2,925.45 | $140.67 |
The provider networks for the plans listed above include the following areas:
- Anthem PPO $500 Deductible: All areas of Indiana, nationwide, and overseas.
- Anthem HDHP PPO: All areas of Indiana, nationwide, and overseas.
- IU Health HDHP: IU Health Plans Network only in certain Indiana counties. This plan does not offer out-of-network benefits except in the case of an emergency, urgent care when more than 50 miles from home, or for a dependent of an Indiana-resident employee when the dependent lives outside of Indiana for reasons other than medical treatment.