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Retiree Contribution Rates

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Grandfathered Retirees (Non-Medicare Eligible)

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2019 Monthly Contribution

Medical Plan Costs Per Month Total Cost University Contribution Your Contribution
Kaiser Permanente HMO
Retiree Only $715.28 $715.28 $0.00
Retiree & Spouse/Registered Domestic Partner $1,502.06 $1,220.66 $281.40
Retiree & Child(ren) $1,287.49 $1,046.29 $241.20
Retiree & Family $2,074.27 $1,685.67 $388.60
Spouse/Registered Domestic Partner Only $786.78 $505.38 $281.40
Spouse/Registered Domestic Partner & Child(ren) $1,358.99 $970.39 $388.60
Child(ren) Only $572.21 $331.01 $241.20
Stanford Health Care Alliance (SHCA)
Retiree Only $1,019.11 $959.11 $60.00
Retiree & Spouse/Registered Domestic Partner $2,140.14 $1,675.50 $464.64
Retiree & Child(ren) $1,834.44 $1,430.88 $403.56
Retiree & Family $2,955.46 $2,351.90 $603.56
Spouse/Registered Domestic Partner Only $1,121.03 $716.39 $404.64
Spouse/Registered Domestic Partner & Child(ren) $1,936.35 $1,392.79 $543.56
Child(ren) Only $815.33 $471.77 $343.56
EPO
Retiree Only $1,062.66 $714.90 $347.76
Retiree & Spouse/Registered Domestic Partner $2,231.59 $1,231.55 $1,000.04
Retiree & Child(ren) $1,912.83 $1,055.79 $857.04
Retiree & Family $3,081.75 $1,701.35 $1,380.40
Spouse/Registered Domestic Partner Only $1,168.93 $516.65 $652.28
Spouse/Registered Domestic Partner & Child(ren) $2,019.09 $986.45 $1,032.64
Child(ren) Only $850.17 $340.89 $509.28
Healthcare + Savings Plan 
Retiree Only $880.11 $731.43 $148.68
Retiree & Spouse/Registered Domestic Partner $1,848.22 $1,276.38 $571.84
Retiree & Child(ren) $1,584.22 $1,094.78 $489.44
Retiree & Family $2,552.33 $1,763.49 $788.84
Spouse/Registered Domestic Partner Only $968.11 $544.95 $423.16
Spouse/Registered Domestic Partner & Child(ren) $1,672.22 $1,032.06 $640.16
Child(ren) Only $704.11 $363.35 $340.76

Grandfathered Retirees (Medicare Eligible)

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2019 Monthly Contribution

Medicare Advantage Plans Total Cost University Contribution Your Contribution
Kaiser Permanente Senior Advantage
Retiree Only $338.80 $338.80 $0.00
Retiree & Spouse/Registered Domestic Partner $677.82 $555.81 $122.01
Retiree & Child(ren) $677.18 $555.29 $121.89
Retiree & Family $1,016.18 $833.27 $182.91
Spouse/Registered Domestic Partner Only $338.80 $216.79 $122.01
Spouse/Registered Domestic Partner & Child(ren) $677.18 $494.27 $182.91
Child(ren) Only $338.80 $216.91 $121.89
Health Net Seniority Plus
Retiree Only $510.56 $338.80 $171.76
Retiree & Spouse/Registered Domestic Partner $1,021.12 $555.81 $465.31
Retiree & Child(ren) $1,021.12 $555.29 $465.83
Retiree & Family $1,531.68 $833.27 $698.41
Spouse/Registered Domestic Partner Only $510.56 $216.79 $293.77
Spouse/Registered Domestic Partner & Child(ren) $1,021.12 $494.27 $526.85
Child(ren) Only $510.56 $216.91 $293.65
Medicare Supplement Plans Total Cost University Contribution Your Contribution
Blue Shield Retiree PPO
Retiree Only $479.80 $338.80 $141.00
Retiree & Spouse/Registered Domestic Partner $959.60 $555.81 $403.79
Retiree & Child(ren) $959.60 $555.29 $404.31
Retiree & Family $1,439.40 $833.27 $606.13
Spouse/Registered Domestic Partner Only $479.80 $216.79 $263.01
Spouse/Registered Domestic Partner & Child(ren) $959.60 $494.27 $465.33
Child(ren) Only $479.80 $216.91 $262.89
Health Net Medicare COB
Retiree Only $761.09 $338.80 $422.29
Retiree & Spouse/Registered Domestic Partner $1,522.18 $555.81 $966.37
Retiree & Child(ren) $1,522.18 $555.29 $966.89
Retiree & Family $2,283.27 $833.27 $1,450.00
Spouse/Registered Domestic Partner Only $761.09 $216.79 $544.30
Spouse/Registered Domestic Partner & Child(ren) $1,522.18 $494.27 $1,027.91
Child(ren) Only $761.09 $216.91 $544.18

Non-Grandfathered Retirees (Non-Medicare Eligible)

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2019 Monthly Premiums

Non-Medicare Eligible 2019 Monthly Premium
Kaiser Permanente HMO
Retiree Only $715.28
Retiree & Spouse/Registered Domestic Partner $1,502.06
Retiree & Child(ren) $1,287.49
Retiree & Family $2,074.27
Spouse/Registered Domestic Partner Only $786.78
Spouse/Registered Domestic Partner & Child(ren) $1,358.99
Child(ren) Only $572.21
Stanford Health Care Alliance
Retiree Only $1,019.11
Retiree & Spouse/Registered Domestic Partner $2,140.14
Retiree & Child(ren) $1,834.44
Retiree & Family $2,955.46
Spouse/Registered Domestic Partner Only $1,121.03
Spouse/Registered Domestic Partner & Child(ren) $1,936.35
Child(ren) Only $815.33
EPO
Retiree Only $1,062.66
Retiree & Spouse/Registered Domestic Partner $2,231.59
Retiree & Child(ren) $1,912.83
Retiree & Family $3,081.75
Spouse/Registered Domestic Partner Only $1,168.93
Spouse/Registered Domestic Partner & Child(ren) $2,019.09
Child(ren) Only $850.17
Healthcare + Savings Plan
Retiree Only $880.11
Retiree & Spouse/Registered Domestic Partner $1,848.22
Retiree & Child(ren) $1,584.22
Retiree & Family $2,552.33
Spouse/Registered Domestic Partner Only $968.11
Spouse/Registered Domestic Partner & Child(ren) $1,672.22
Child(ren) Only $704.11

Non-Grandfathered Retirees (Medicare Eligible)

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2019 Monthly Premiums

Medicare Advantage Plans 2019 Monthly Premium
Kaiser Permanente Senior Advantage
Retiree Only $338.80
Retiree & Spouse/Registered Domestic Partner $677.82
Retiree & Child(ren) $677.82
Retiree & Family $1,016.18
Spouse/Registered Domestic Partner Only $338.80
Spouse/Registered Domestic Partner & Child(ren) $677.82
Child(ren) Only $338.80
Health Net Seniority Plus
Retiree Only $510.56
Retiree & Spouse/Registered Domestic Partner $1,021.12
Retiree & Child(ren) $1,021.12
Retiree & Family $1,531.68
Spouse/Registered Domestic Partner Only $510.56
Spouse/Registered Domestic Partner & Child(ren) $1,021.12
Child(ren) Only $510.56
Medicare Supplement Plans 2019 Monthly Premium
Blue Shield Retiree PPO
Retiree Only $479.80
Retiree & Spouse/Registered Domestic Partner $959.60
Retiree & Child(ren) $959.60
Retiree & Family $1,439.40
Spouse/Registered Domestic Partner Only $479.80
Spouse/Registered Domestic Partner & Child(ren) $959.60
Child(ren) Only $479.80
Health Net Medicare COB
Retiree Only $761.09
Retiree & Spouse/Registered Domestic Partner $1,522.18
Retiree & Child(ren) $1,522.18
Retiree & Family $2,283.27
Spouse/Registered Domestic Partner Only $761.09
Spouse/Registered Domestic Partner & Child(ren) $1,522.18
Child(ren) Only $761.09

Non-Grandfathered Retirees Worksheet

This worksheet is for retirees to calculate how much Stanford will contribute to their retiree medical coverage. If you need assistance, please contact the University HR Service Team

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Calculate Your 2019 Monthly Costs

Step 1 From the Contribution Chart, enter the monthly cost for the medical plan and coverage level you want for 2019. $ _____________
Step 2 Enter the annual contribution credit allowed for the coverage level you want in 2019. $ _____________
  Retiree Only: $146.78  
  Retiree & Spouse/Registered Domestic Partner: $235.98  
  Retiree & Child(ren): $235.98  
  Retiree & Family: $325.18  
  Spouse Only: $89.20  
  Spouse & Child(ren): $235.98  
  Child(ren): $89.20  
Step 3 Enter your years of benefits-eligible employment (provided by Stanford Benefits).    _____________
Step 4 Multiply the credit by the years of service to get your annual contribution credit. This is the annual credit you receive for retiree medical coverage in 2019. $ _____________
Step 5 Divide this number by 12 to get your monthly credit amount. $ _____________
Step 6 Subtract your monthly credit amount in Step 5 from the monthly premium shown in Step 1. This is your monthly cost for medical coverage in 2019. $ _____________
Step 7 If you want dental coverage in 2019, enter your cost from the Retiree Dental Plan Contribution Chart. $ _____________
Step 8 If you want vision coverage in 2019, enter your cost from the Retiree Vision Plan Contribution Chart. $ _____________
Step 9 Add Step 6, Step 7 and Step 8. This is your total monthly cost for retiree health care coverage in 2019. $ _____________

Example (Non-Medicare Eligible Kaiser Permanente – Retiree Only)

Step 1 From the Contribution Chart, enter the monthly cost for the medical plan and coverage level you want for 2019. $715.28
Step 2 Enter the annual contribution credit allowed for the coverage level you want in 2019. $146.78
  Retiree Only:  $146.78  
  Retiree & Spouse/Registered Domestic Partner: $235.98  
  Retiree & Child(ren): $235.98  
  Retiree & Family: $325.18  
  Spouse Only: $89.20  
  Spouse & Child(ren): $235.98  
  Child(ren): $89.20  
Step 3 Enter your years of benefits-eligible employment (provided by Stanford Benefits when you retired). 10
Step 4 Multiply the credit by the years of service to get your annual contribution credit. This is the annual credit you receive for retiree medical coverage in 2019. $1,467.80
Step 5 Divide this number by 12 to get your monthly credit amount. $122.32
Step 6 Subtract your monthly credit amount in Step 5 from the monthly premium shown in Step 1. This is your monthly cost for medical coverage in 2019. $592.96
Step 7 If you want dental coverage in 2019, enter your cost from the Retiree Dental Contribution chart. $28.14
Step 8 If you want vision coverage in 2019, enter your cost from the Retiree Vision Contribution chart. $0.00
Step 9 Add Step 6, Step 7 and Step 8. This is your total monthly cost for retiree health care coverage in 2019. $621.11

Retiree Dental Plan

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2019 Monthly Contribution: Delta Dental PPO

NOTE: If you want to enroll in a Retiree dental plan, you must first be enrolled in a Retiree medical plan.

Dental Costs Per Month Total Cost University Contribution Your Contribution
Retiree Only $34.14 $6.00 $28.14
Retiree & Spouse/Registered Domestic Partner $71.71 $6.00 $65.71
Retiree & Child(ren) $61.44 $6.00 $55.44
Retiree & Family $98.97 $6.00 $92.97

Retiree Vision Plan

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2019 Monthly Contribution: VSP Vision Care

NOTE: If you want to enroll in a Retiree vision plan, you must first be enrolled in a Retiree medical plan.

Vision Costs Per Month Total Cost University Contribution Your Contribution
Retiree Only $10.56 $0.00 $10.56
Retiree & Spouse/Registered Domestic Partner $16.89 $0.00 $16.89
Retiree & Child(ren) $17.24 $0.00 $17.24
Retiree & Family $27.80 $0.00 $27.80