Benefit Plan Premiums for Retirees and Former Employees

2019 Medical Plan Premiums

(includes Vision Plan Coverage)

Monthly Premium Annual Premium 3% Discounted Annual Premium
Purdue Health Plan
Retiree Only $661.29 $7,935.00 $7,697.00
Retiree & Children $1,190.27 $14,283.00 $13,855.00
Retiree & Spouse $1,487.79 $17,853.00 $17,318.00
Family $2,016.88 $24,203.00 $23,476.00
Purdue Health Plan Plus HSA 1
Retiree Only $584.32 $7,012.00 $6,801.00
Retiree & Children $1,051.75 $12,621.00 $12,242.00
Retiree & Spouse $1,314.61 $15,775.00 $15,302.00
Family $1,782.14 $21,386.00 $20,744.00
Purdue Health Plan Plus HSA 2
Retiree Only $526.60 $6,319.00 $6,130.00
Retiree & Children $947.70 $11,372.00 $11,031.00
Retiree & Spouse $1,184.63 $14,216.00 $13,789.00
Family $1,605.83 $19,270.00 $18,692.00
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Retiree Only $591.50 $7,098.00 $6,885.00
Retiree & Children $1,064.80 $12,778.00 $12,394.00
Retiree & Spouse $1,330.99 $15,972.00 $15,493.00
Family $1,804.29 $21,651.00 $21,002.00


2018 Medical Plan Premiums
(Includes Vision Plan Coverage)
Monthly Premium Annual Premium 3% Discounted Annual Premium
Purdue Health Plan
Retiree Only $653.42 $7,841.04 $7,606.00
Retiree & Children $1,176.11 $14,113.32 $13,690.00
Retiree & Spouse $1,470.09 $17,641.08 $17,112.00
Family $1,992.88 $23,914.56 $23,197.00
Purdue Health Plan Plus HSA 1
(Without HSA)
Retiree Only $576.82 $6,921.84 $6,714.00
Retiree & Children $1,038.25 $12,459.00 $12,085.00
Retiree & Spouse $1,297.73 $15,572.76 $15,106.00
Family $1,759.26 $21,111.12 $20,478.00
Purdue Health Plan Plus HSA 2
(Without HSA)
Retiree Only $519.84 $6,238.08 $6,051.00
Retiree & Children $935.53 $11,226.36 $10,890.00
Retiree & Spouse $1,169.42 $14,033.04 $13,612.00
Family $1,511.13 $18,133.56 $17,590.00
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Retiree Only $584.46 $7,013.52 $6,803.00
Retiree & Children $1,052.13 $12,625.56 $12,247.00
Retiree & Spouse $1,315.15 $15,781.80 $15,308.00
Family $1,782.82 $21,393.84 $20,752.00


Dental Plan
2019 Dental Plan Premiums
Monthly Premium Annual Premium
Preventive Only
Retiree Only $0 $0
Retiree & Children $0 $0
Retiree & Spouse $0 $0
Family $0 $0
Anthem Dental Plan Option 1
(Point-of-Service)
Retiree Only $20.00 $240
Retiree & Children $49.71 $596.52
Retiree & Spouse $40.68 $488.16
Family $75.79 $909.48
Anthem Dental Plan Option 2
(Standard)
Retiree Only $8.19 $98.28
Retiree Children $19.24 $230.88
Retiree & Spouse $16.76 $201.12
Family $30.17 $362.04


Dental Plan
2018 Dental Plan Premiums Monthly Premium Annual Premium
Preventive Only
Retiree Only $0 $0
Retiree & Children $0 $0
Retiree & Spouse $0 $0
Family $0 $0
Anthem Dental Plan Option 1
(Point-of-Service)
Retiree Only $18.54 $222.48
Retiree & Children $46.08 $552.96
Retiree & Spouse $37.71 $452.52
Family $70.25 $843.00
Anthem Dental Plan Option 2
(Standard)
Retiree Only $7.59 $91.08
Retiree Children $17.84 $214.08
Retiree & Spouse $15.53 $186.36
Family $27.97 $335.64
2019Medical Plan Premiums Monthly Premium
PURcare $265.39/member

$181.62/member for members with VA or Tricare Rx coverage

Medicare Advantage PPO 208.49/member


2018 Medical Plan Premiums Monthly Premium
PURcare

$282.73/member

$188.61/member for members with VA or Tricare Rx coverage

Medicare Advantage PPO 208.49/member


Voluntary Preventive Retiree Dental Plan for Retirees Over Age 65
Coverage Level Premium Admin Fee Total Monthly Fee
Retiree $14.51 * Additional $2.25 per application for ACH Billing $16.76
* Additional $2.75 per application for Paper Check $17.26
Retiree + 1 $29.02 * Additional $2.25 per application for ACH Billing $31.27
* Additional $2.75 per application for Paper Check $31.77
Retiree + 2 $43.53 * Additional $2.25 per application for ACH Billing $45.78
* Additional $2.75 per application for Paper Check $46.28
* Please note when utilizing ACH billing you can receive a discounted admin fee.
* Any additional dependents will be $14.51 per dependent.
Medical Plan
2019 Medical Plan Premiums
(Includes Vision Plan Coverage)
Monthly Premium Annual Premium
Purdue Health Plan
Participant Only $73.41 $881.00
Participant & Children $132.24 $1,587.00
Participant & Spouse $277.99 $3,336.00
Family $376.83 $4,522.00
Purdue Health Plan Plus HSA 1
(Without HSA)
Participant Only $17.49 $210.00
Participant & Children $31.54 $378.00
Participant & Spouse $87.53 $1,050.00
Family $118.54 $1,422.000
Purdue Health Plan Plus HSA 2
(Without HSA)
Participant Only $5.00 $60.00
Participant & Children $8.42 $101.00
Participant & Spouse $20.06 $241.00
Family $23.77 $285.00
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Participant Only $17.49 $210.00
Participant & Children $31.54 $378.00
Participant & Spouse $87.53 $1,050
Family $118.54 $1,422.00




2018 Medical Plan Premiums
(Includes Vision Plan Coverage)
Monthly Premium Annual Premium
Purdue Health Plan
Participant Only $69.25 $831.00
Participant & Children $124.75 $1,497.00
Participant & Spouse $262.25 $3,147.00
Family $355.50 $4,266.00
Purdue Health Plan Plus HSA 1
(Without HSA)
Participant Only $16.50 $198.00
Participant & Children $29.75 $357.00
Participant & Spouse $82.58 $991.00
Family $111.83 $1,342.00
Purdue Health Plan Plus HSA 2
(Without HSA)
Participant Only $0.00 $0.00
Participant & Children $3.42 $41.00
Participant & Spouse $18.92 $227.00
Family $22.42 $269.00
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Participant Only $16.50 $198.00
Participant & Children $29.75 $357.00
Participant & Spouse $82.58 $991.00
Family $111.83 $1,342.00


Dental Plan
2019 Dental Plan Premiums Monthly Premium Annual Premium
Preventive Only
Retiree Only $0 $0
Retiree & Children $0 $0
Retiree & Spouse $0 $0
Family $0 $0
Anthem Dental Plan Option 1
(Point-of-Service)
Retiree Only $20.00 $240.00
Retiree & Children $49.71 $596.52
Retiree & Spouse $40.68 $488.16
Family $75.79 $909.48
Anthem Dental Plan Option 2
(Standard)
Retiree Only $8.19 $98.28
Retiree Children $19.24 $230.88
Retiree & Spouse $16.76 $201.12
Family $30.17 $362.04


Dental Plan
2017 and 2018 Dental Plan Premiums Monthly Premium Annual Premium
Preventive Only
Retiree Only $0 $0
Retiree & Children $0 $0
Retiree & Spouse $0 $0
Family $0 $0
Anthem Dental Plan Option 1
(Point-of-Service)
Retiree Only $18.54 $222.48
Retiree & Children $46.08 $552.96
Retiree & Spouse $37.71 $452.52
Family $70.25 $843.00
Anthem Dental Plan Option 2
(Standard)
Retiree Only $7.59 $91.08
Retiree Children $17.84 $214.08
Retiree & Spouse $15.53 $186.36
Family $27.97 $335.64
2019 Medical Plan Premiums
(Includes Vision Plan Coverage)
Monthly Premium
Purdue Health Plan
Participant Only $674.52
Participant & Children $1,214.08
Participant & Spouse $1,517.55
Family $2,057.22
Purdue Health Plan Plus HSA 1
(Without HSA)
Participant Only $596.01
Participant & Children $1,072.79
Participant & Spouse $1,340.90
Family $1,817.78
Purdue Health Plan Plus HSA 2
(Without HSA)
Participant Only $537.13
Participant & Children $966.65
Participant & Spouse $1,208.32
Family $1,637.95
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Participant Only $603.33
Participant & Children $1,086.10
Participant & Spouse $1,357.61
Family $1,840.38
2018 Medical Plan Premiums
(Includes Vision Plan Coverage)
Monthly Premium
Purdue Health Plan
Participant Only $666.49
Participant & Children $1,199.63
Participant & Spouse $1,499.49
Family $2,032.74
Purdue Health Plan Plus HSA 1
(Without HSA)
Participant Only $588.36
Participant & Children $1,059.02
Participant & Spouse $1,323.68
Family $1,794.45
Purdue Health Plan Plus HSA 2
(Without HSA)
Participant Only $530.24
Participant & Children $954.24
Participant & Spouse $1,192.81
Family $1,541.35
Purdue Health Plan J-1 Visa
(Coverage offered to J-1 Visa holders only.)
Participant Only $596.15
Participant & Children $1,073.17
Participant & Spouse $1,341.45
Family $1,818.48
DENTAL
Preventive Only
Participant Only $8.86
Participant & Children $25.90
Participant & Spouse $17.84
Family $37.96
Option 1 (POS)
Participant Only $29.26
Participant & Children $76.60
Participant & Spouse $59.33
Family $115.27
Option 2 (PPO/Standard)
Participant Only $17.22
Participant & Children $45.52
Participant & Spouse $34.94
Family $68.74
STAND ALONE VISION
Participant $6.84
Participant & Children $13.23
Participant & Spouse $12.40
Family $20.02
CENTER FOR HEALTHY LIVING
Participant $12.84
Participant & Children $23.11
Participant & Spouse $28.90
Family $39.17

** NOTES:

  • Dependent Eligibility rules apply to all plans.
  • Tobacco-User Additional Premium of $500/person/year applies to each retiree/participant and/or spouse covered under the Purdue Health Plan, Purdue Health Plan Plus HSA 1 (without HSA) and Purdue Health Plan Plus HSA 2 (without HSA). The additional premium is not included in medical plan premiums listed above.
Purdue University Retirees Association

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