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2014 and 2015 Monthly Medical Coverage Premiums for Retirees and Former Employees

For Retiree Under Age 65 and Covered Family Members**

Purdue Health Plan Purdue Health Plan
No HSA 1
Purdue Health Plan
No HSA 2
Retiree Only $587 $519 $468
Retiree & Children $1,057 $934 $842
Retiree &
Spouse/SSDP*
$1,321 $1,167 $1,052
Retiree & Family $1,791 $1,582 $1,426

• 3% discount for annual payment

For Long Term Disability Participant and Covered Family Members**

Purdue Health Plan Purdue Health Plan
No HSA 1
Purdue Health Plan
No HSA 2
Participant Only $62.25 $14.83 $ 0
Participant & Children $112.08 $26.75 $3.08
Participant &
Spouse/SSDP*
$235.67 $74.17 $17.00
Participant & Family $319.50 $100.50 $20.08


For COBRA Participant and Covered Family Members**

Purdue Health Plan Purdue Health Plan
No HSA 1
Purdue Health Plan
No HSA 2
Participant Only $599 $529 $477
Participant & Children $1,078 $953 $858
Participant &
Spouse/SSDP*
$1,348 $1,191 $1,073
Participant & Family $1,827 $1,614 $1,455

Applies to all charts above:
* SSDP - Same-sex domestic partner
** Dependent Eligibility rules apply
NOTE: Tobacco-User Additional Premium of $500/person/year for retiree/participant
and/or spouse/SSDP not included above.