ARKANSAS STATE MEDICARE RETIREES MONTHLY PREMIUMS
2015 Plan Year Rates - Effective January 1, 2015 - December 31, 2015
Base Monthly
Premium
Medicare Eligible
State Contribution Plan Contribution
Total Monthly
Retiree Cost
Retiree Only
$359.90
$185.48
$12.46
$161.96
Retiree & Non-Medicare Spouse
$790.99
$211.44
$14.21
$565.34
Retiree & Child(ren)
$692.50
$291.64
$19.60
$381.26
$1,190.13
$379.95
$25.54
$784.64
$697.31
$289.81
$19.48
$388.02
$1,029.90
$395.97
$26.61
$607.32
Retiree & Non-Medicare Spouse & Child(ren)
Retiree & Medicare Primary Spouse
Retiree & Medicare Primary Spouse & Child(ren)
State Contribution is funded by legislation
Plan Contribution is funded by ASE Trust Fund as Claims Reserve Allocation

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