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Document Salem_doc_1107c92353

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GIC Health Plan Rates RATES AS OF JULY 1, 2024 FOR CITY OF SALEM ENROLLEES Retirees and Survivors with Medicare Retirees with Medicare pay 35% for Indemnity Plans Retirees with Medicare pay 30% for HMO Plans Survivors with Medicare pay 50% for all plans Retiree Pays Per Person Survivor Pays Per Person HEALTH PLAN PLAN TYPE Individual Coverage Individual Coverage Harvard Pilgrim Medicare Enhance Medicare (Indemnity) 152.65 218.07 Health NE Medicare Supplement Plus Medicare (Indemnity) 153.58 219.40 Tufts Health Plan Medicare Preferred* Medicare (HMO) 109.15 181.92 Wellpoint Medicare Extension Medicare (Indemnity) 155.64 222.34 *Benefits and rates of Tufts Health Plan Medicare Preferred are subject to federal approval and may change on January 1, 2025.