Fort Worth banner
 
Fort Worth banner Departmental left image Departmental title image Departmental right image Fort Worth banner




 Health Plan Description

 Open Enrollment-Important Changes for 2009  
 Listing of Primary Care Physicians (PCP) 
 Summary Plan Description for Retirees NOT Eligible for Medicare
 Summary Plan Description for Retirees Eligible for Medicare

 

Health Benefit Plan Rate Information for Retirees
Contribution Rates for 2005, 2006, 2007 & 2008

Retirees Not Eligible for Medicare-Monthly Rates

  Hired prior to
10/05/1988 or
25 plus years
15 to less than
25 years
5 to less than
15 years
  Retiree Contribution  Retiree Contribution  Retiree Contribution

Basic

Retiree Only

$-0- $123.33 $250.39

Retiree & Spouse

$245.65 $330.88 $419.75

Retiree & Child(ren)

$200.99 $292.59 $387.85

Retiree & Family

$470.90 $526.95 $586.75

Basic Plus 

     

 Retiree Only

$56.06 $179.39 $306.45

 Retiree & Spouse

$386.44 $470.90 $559.09

 Retiree & Child(ren)

$332.43 $423.24 $517.97

 Retiree & Family

$627.86 $683.91 $743.71

Select

     

 Retiree Only

$130.81 $254.14 $381.20

  Retiree & Spouse

$538.92 $623.38 $711.57

 Retiree & Child(ren)

$472.21 $563.02 $657.57

 Retiree & Family

$837.15 $893.20 $953.00

Retirees Eligible for Medicare-Monthly Rates

  Hired prior to
10/05/1988 or
25 plus years
15 to less than
25 years
5 to less than
15 years
  Retiree Contribution  Retiree Contribution  Retiree Contribution

Traditional

Retiree Only

$-0- $114.20 $231.85

Retiree & Spouse

$233.14 $314.03 $398.38

 * When one spouse is covered by Medicare but the other spouse is not, the couple can select the Basic, Basic Plus, or Select Plan. However the spouse covered by Medicare will have the same medical coverage as other Medicare eligible retirees.

Survivors
Contribution Rates 2005 & 2006

Contribution
Basic
Surviving Spouse $245.65
Surviving Child(ren) $200.99
Surviving Family $470.90
Basic Plus
Surviving Spouse $330.38
Surviving Child(ren) $276.37
Surviving Family $571.80
Select
Surviving Spouse $408.11
Surviving Child(ren) $341.40
Surviving Family $706.34

 

Health Benefit Plan Rate Information for Retirees
Contribution Rates for 2009:

Retirees Not Eligible for Medicare-Monthly Rates-2009

  Hired prior to
10/05/1988 or
25 plus years
15 to less than
25 years
5 to less than
15 years
  Retiree Contribution  Retiree Contribution  Retiree Contribution

Basic

Retiree Only

$-0- $141.83 $287.95

Retiree & Spouse

$282.50 $380.51 $482.71

Retiree & Child(ren)

$231.14 $336.48 $446.03

Retiree & Family

$541.53 $605.99 $674.76

Basic Plus 

     

 Retiree Only

$64.47 $206.30 $352.42

 Retiree & Spouse

$444.41 $541.54 $642.95

 Retiree & Child(ren)

$382.29 $486.73 $595.67

 Retiree & Family

$722.04 $786.50 $855.27

Select   

     

 Retiree Only

$150.43 $292.26 $438.38

  Retiree & Spouse

$619.76 $716.89 $818.31

 Retiree & Child(ren)

$543.04 $647.47 $756.21

 Retiree & Family

$962.72 $1,027.18 $1,095.95

 

Retirees Eligible for Medicare-Monthly Rates-2009

  Hired prior to
10/05/1988 or
25 plus years
15 to less than
25 years
5 to less than
15 years
  Retiree Contribution  Retiree Contribution  Retiree Contribution

Traditional

Retiree Only

$-0- $131.33 $266.63

Retiree & Spouse

$268.11 $361.13 $458.14

 * When one spouse is covered by Medicare but the other spouse is not, the couple can select the Basic, Basic Plus, or Select Plan. However the spouse covered by Medicare will have the same medical coverage as other Medicare eligible retirees.

Survivors
Contribution Rates 2009

Contribution
Basic
Surviving Spouse $282.50
Surviving Child(ren) $231.14
Surviving Family $541.53
Basic Plus
Surviving Spouse $379.94
Surviving Child(ren) $317.83
Surviving Family $657.57
Select
Surviving Spouse $469.33
Surviving Child(ren) $392.61
Surviving Family $812.29

 

Surviving Spouse - Medicare Eligible
Contribution Rates 2009

Contribution
Traditional Plan
Surviving Spouse $268.11

 

Dental Plan Rates for 2009:

CIGNA Dental Care (DHMO) CIGNA Dental Choice (DPPO)
 

DHMO Low

DHMO High

Low PPO

High PPO
w/Implants
Retiree/Surviving
Spouse Only
 $9.36 $13.89 $23.45 $39.46
Retiree & Spouse  $16.06 $23.90 $43.45 $73.56
Retiree/Surviving
Spouse &Child(ren)
$16.72 $27.79 $55.27 $93.66
Retiree & Family $25.00 $42.38 $72.77 $123.49