LOCAL RETIRED GROUP - EDUCATION EMPLOYERS
DEPARTMENT OF THE TREASURY-DIVISION OF PENSIONS AND BENEFITS
NEW JERSEY STATE HEALTH BENEFITS PROGRAM
MEDICARE AND NON-MEDICARE RATES EFFECTIVE 1/1/2004 TO 12/31/2004

DESCRIPTION

NJ PLUS
(001)

Traditional
(002)

Aetna Health
(019)

Cigna
Healthcare
(020)

Oxford
(028)

Amerihealth
(033)

Health Net
(034)

Single-No Medicare

$521.73

$616.28

$401.68

$425.58

$349.87

$412.98

$424.50

Single-On Medicare

$350.29

$351.11

$355.62

$355.62

$330.21

$364.84

$355.62

Member & Spouse/Domestic Partner* -No Medicare

$1,161.33

$1,342.29

$870.41

$914.06

$769.60

$918.78

$924.73

Member & Spouse/Domestic Partner* -One on Medicare

$872.06

$947.15

$745.64

$781.21

$678.43

$777.83

$780.13

Member & Spouse/Domestic Partner* -Both on Medicare

$700.60

$702.26

$711.28

$711.28

$660.46

$729.72

$711.28

Family-No Medicare

$1,351.17

$1,569.54

$981.74

$1,053.37

$909.55

$1,070.00

$1,122.56

Family-One on Medicare

$1,061.86

$1,152.39

$893.94

$952.23

$794.58

$974.35

$1,006.77

Family-Both on Medicare

$890.46

$911.24

$859.58

$882.30

$850.22

$926.24

$937.91

Parent & Child-No Medicare

$770.42

$898.40

$554.50

$596.69

$524.78

$609.59

$651.23

Parent & Child-Retiree on Medicare

$540.14

$560.26

$503.92

$526.64

$548.66

$561.36

$582.25