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GIC Health Plan Rates RATES AS OF JULY 1, 2024 FOR CITY OF SALEM ENROLLEES Retirement date affects rate for Retired Municipal Teachers – be sure to check boxes at right to determine your rate. Retired Municipal Teachers (RMTs) WITHOUT Medicare RMT - Retired on or before July 1, 1990 RMT - Retired after July 1, 1990 through June 30, 2012 RMT - Retired after June 30, 2012 10% 15% 30% HMO & POS; 35% Indemnity HEALTH PLAN PLAN TYPE Individual Coverage Family Coverage Individual Coverage Family Coverage Individual Coverage Family Coverage Harvard Pilgrim Explorer POS 106.79 264.59 160.18 396.89 320.36 793.77 Harvard Pilgrim Access America PPO 125.94 280.93 188.91 421.39 377.82 842.78 Harvard Pilgrim Quality HMO 78.80 200.58 118.21 300.87 236.41 601.74 MGB HMO 97.77 258.54 146.65 387.81 293.30 775.63 Health New England HMO 77.83 186.70 116.74 280.04 233.48 560.09 Wellpoint Total Choice Indemnity 150.14 333.17 225.20 499.76 525.47 1166.10 Wellpoint Community Choice PPO-type 74.50 184.91 111.75 277.36 223.49 554.73 Wellpoint PLUS PPO-type 95.86 228.41 143.79 342.61 287.59 685.22 ---PAGE BREAK---