Retiree “Self-Pay” Enhanced Plan Payments

$156.75$2,360.00

Clear
SKU: RETIREE

Description

Retiree “Self-Pay” Applications MUST be received by the Fund PRIOR to making an online payment.

All “Self-Pay” Enhanced Retiree Plan benefit packages include various benefit options equal to the Active Members coverage levels (Bereavement and Survivors benefits NOT included).

  1. Premium Plan includes coverages at the adopted fee schedule with some usual and customary charges:
  • General Dental – $2,750 per individual, per calendar year.
    • Implants – $4,000 per  individual, per lifetime, for implants and abutments reimbursable up to $500 each.  Dentist can bill usual and customary charges.
    • Orthodontia – $1,995 per individual, per lifetime. In-network covered in full with, $1,000 co-pay.
    • Periodontal – $2,000 per individual, per calendar year, at the adopted fee schedule.
  • Hearing aids – $400 per individual, for out-of-pocket expenses every 36 months.
  • Optical – $80 per individual, per calendar year.
  1. Premium Plus Plan includes coverages at the adopted fee schedule with some usual and customary charges:
  • General Dental – $2,750 per individual, per calendar year, at the adopted fee schedule.
    • Implants – $4,000 per  individual, per lifetime, for implants and abutments reimbursable up to $500 each.  Dentist can bill usual and customary charges.
    • Orthodontia – $1,995 per individual, per lifetime. In-network covered in full with, $1,000 co-pay.
    • Periodontal – $2,000 per individual, per calendar year, at the adopted fee schedule.
  • Hearing aid – $400 per individual, for out-of-pocket expenses every 36 months.
  • Optical – $80 per individual, per calendar y
  • Prescription Drug Co-Payment Reimbursement for expenses, up to $20 per eligible prescription up to $350 per family, per calendar year, PLUS $1.00 each for every script over $350
    (payable in fill-date order only), effective 1/1/2014.
  1. Platinum Plan includes coverages at the adopted fee schedule with some usual and customary charges:
  • General Dental – $2,750 per individual, per calendar year, at the adopted fee schedule.
    • Implants – $4,000 per  individual, per lifetime, for implants and abutments reimbursable up to $500 each.  Dentist can bill usual and customary charges.
    • Orthodontia – $1,995 per individual, per lifetime. In-network covered in full with, $1,000 co-pay.
    • Periodontal – $2,000 per individual, per calendar year, at the adopted fee schedule.
  • Hearing aid – $400 per individual, for out-of-pocket expenses every 36 months.
  • Optical – $80 per individual, per calendar y
  • Prescription Drug Co-Payment Reimbursement for expenses, up to $20 per eligible prescription up to $350 per family, per calendar year, PLUS $1.00 each for every script over $350 (payable in fill-date order only), effective 1/1/2014.
  • Tax Preparation – $30 short form or $70 long form per member, per calendar year.
  • Legal Services – up to $1,000 per family, limited to the service fee schedule, per calendar year.

 

Payment Savings

2016/2017 Pricing Information

  1. Premium Plan Rates:
Individual Individual + 1 Family Payment Options
$ 178.75 $ 357.50 $ 539.00 Quarterly
$ 341.25 $ 682.50 $ 1,029.00 Semi-Annual
(price reflects a 5% savings)
$ 650.00 $1,300.00 $1,960.00 Annual
(price reflects a 10% savings)
  1. Premium Plus Plan Rates:
Individual Individual + 1 Family Payment Options
$ 220.00 $ 415.25 $ 613.25 Quarterly
$ 420.00 $ 792.75 $1,170.75 Semi-Annual
(price reflects a 5% savings)
$ 800.00 $1,510.00 $2,230.00 Annual
(price reflects a 10% savings)
  1. Platinum Plan Rates:
Individual Individual + 1 Family Payment Options
$ 242.00 $ 442.75 $ 649.00 Quarterly
$ 462.00 $ 845.25 $1,239.00 Semi-Annual
(price reflects a 5% savings)
$ 880.00 $1,610.00 $2,360.00 Annual
(price reflects a 10% savings)

Note: Any new enrollees as of 1/1/16 will pay the new 2016-17 rates. Anyone coming to the end of their 2 yr commitment at the old rate will also pay the new 2016-17 rates.

2015/2016 Pricing Information

  1. Premium Plan Rates:
Individual Individual + 1 Family Payment Options
$ 156.75 $ 313.50 $ 473.00 Quarterly
$ 299.25 $ 598.50 $ 903.00 Semi-Annual
(price reflects a 5% savings)
$ 570.00 $1,140.00 $1,720.00 Annual
(price reflects a 10% savings)
  1. Premium Plus Plan Rates:
Individual Individual + 1 Family Payment Options
$ 217.25 $ 393.25 $ 569.25 Quarterly
$ 414.75 $ 750.75 $1,086.75 Semi-Annual
(price reflects a 5% savings)
$ 790.00 $1,430.00 $2,070.00 Annual
(price reflects a 10% savings)
  1. Platinum Plan Rates:
Individual Individual + 1 Family Payment Options
$ 228.25 $ 412.50 $ 599.50 Quarterly
$ 435.75 $ 787.50 $1,144.50 Semi-Annual
(price reflects a 5% savings)
$ 830.00 $1,500.00 $2,180.00 Annual
(price reflects a 10% savings)