Retiree Health Premiums

38% Vesting
January 1, 2023 - December 31, 2023
Effective January 2023 Magnolia Local Magnolia Local Plus Magnolia Open Access Plus
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired - No Medicare $ 492.12 $ 802.90 $ 1,295.02 $ 582.44 $ 950.34 $ 1,532.78 $ 603.56 $ 984.84 $ 1,588.40
Retired w/ Medicare $ 160.02 $ 261.08 $ 421.10 $ 192.68 $ 314.40 $ 507.08 $ 196.24 $ 320.28 $ 516.52
Retiree and Spouse
Retired - No Medicare $ 868.96 $ 1,417.80 $ 2,286.76 $ 1,028.44 $ 1,677.98 $ 2,706.42 $ 1,065.84 $ 1,739.00 $ 2,804.84
Retired - 1 with Medicare $ 591.24 $ 964.70 $ 1,555.94 $ 704.26 $ 1,149.02 $ 1,853.28 $ 725.20 $ 1,183.26 $ 1,908.46
Retired - 2 with Medicare $ 287.68 $ 469.30 $ 756.98 $ 345.40 $ 563.56 $ 908.96 $ 352.84 $ 575.66 $ 928.50
Retiree and Child(ren)
Retired - No Medicare $ 548.14 $ 894.34 $ 1,442.48 $ 648.80 $ 1,058.58 $ 1,707.38 $ 672.32 $ 1,096.94 $ 1,769.26
Retired - 1 with Medicare $ 276.94 $ 451.94 $ 728.88 $ 331.46 $ 540.80 $ 872.26 $ 339.74 $ 554.30 $ 894.04
Family
Retired - No Medicare $ 864.74 $ 1,410.92 $ 2,275.66 $ 1,023.50 $ 1,669.96 $ 2,693.46 $ 1,060.70 $ 1,730.54 $ 2,791.24
Retired - 1 with Medicare $ 787.78 $ 1,285.40 $ 2,073.18 $ 937.36 $ 1,529.42 $ 2,466.78 $ 966.28 $ 1,576.58 $ 2,542.86
Retired - 2 with Medicare $ 356.20 $ 581.08 $ 937.28 $ 427.66 $ 697.76 $ 1,125.42 $ 436.84 $ 712.76 $ 1,149.60

Pelican HRA 1000 Vantage Medical Home HMO

STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired - No Medicare $ 362.80 $ 591.90 $ 954.70 $ 617.24 $ 1,007.08 $ 1,624.32
Retired w/ Medicare $ 117.98 $ 192.48 $ 310.46 $ 204.24 $ 333.14 $ 537.38
Retiree and Spouse
Retired - No Medicare $ 640.60 $ 1,045.16 $ 1,685.76 $ 1,089.88 $ 1,778.24 $ 2,868.12
Retired - 1 with Medicare $ 435.86 $ 711.14 $ 1,147.00 $ 746.34 $ 1,217.64 $ 1,963.98
Retired - 2 with Medicare $ 262.54 $ 428.34 $ 690.88 $ 366.06 $ 597.18 $ 963.24
Retiree and Child(ren)
Retired - No Medicare $ 404.20 $ 659.56 $ 1,063.76 $ 687.58 $ 1,121.80 $ 1,809.38
Retired - 1 with Medicare $ 204.26 $ 333.26 $ 537.52 $ 351.26 $ 573.14 $ 924.40
Family
Retired - No Medicare $ 637.40 $ 1,040.00 $ 1,677.40 $ 1,084.66 $ 1,769.68 $ 2,854.34
Retired - 1 with Medicare $ 580.66 $ 947.48 $ 1,528.14 $ 993.38 $ 1,620.76 $ 2,614.14
Retired - 2 with Medicare $ 262.54 $ 428.34 $ 690.88 $ 453.16 $ 739.44 $ 1,192.60

LSU First LSU First Medicare Retiree Plan

STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired - No Medicare $ 581.68 $ 949.06 $ 1,530.74 N/A N/A N/A
Retired w/ Medicare $ 187.90 $ 306.58 $ 494.48 $ 96.20 $ 156.96 $ 253.16
Retiree and Spouse
Retired - No Medicare $ 1,025.68 $ 1,673.48 $ 2,699.16 N/A N/A N/A
Retired - 1 with Medicare $ 643.10 $ 1,049.28 $ 1,692.38 N/A N/A N/A
Retired - 2 with Medicare $ 338.58 $ 552.40 $ 890.98 $ 192.40 $ 313.92 $ 506.32
Retiree and Child(ren)
Retired - No Medicare $ 685.54 $ 1,118.52 $ 1,804.06 N/A N/A N/A
Retired - 1 with Medicare $ 328.42 $ 535.82 $ 864.24 N/A N/A N/A
Retired - 2 with Medicare N/A N/A N/A $ 192.40 $ 313.92 $ 506.32
Family
Retired - No Medicare $ 1,090.32 $ 1,778.94 $ 2,869.26 N/A N/A N/A
Retired - 1 with Medicare $ 887.04 $ 1,447.26 $ 2,334.30 N/A N/A N/A
Retired - 2 with Medicare $ 395.92 $ 645.94 $ 1,041.86 N/A N/A N/A
Retired - 3 with Medicare N/A N/A N/A $ 288.60 $ 470.88 $ 759.48
 Retiree Health Premiums
38% Vesting
January 1, 2023 - December 31, 2023
Additional choices for Retirees and Spouses who are enrolled in BOTH Medicare A and B are available.
Vantage Basic Vantage Standard Vantage Premium
Statewide HMO Statewide HMO Statewide HMO
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired w/ Medicare $ 27.36 $ 44.64 $ 72.00 $ 57.76 $ 94.24 $ 152.00 $ 71.06 $ 115.94 $ 187.00
Retiree and Spouse
Retired - 2 with Medicare $ 54.72 $ 89.28 $ 144.00 $ 115.52 $ 188.48 $ 304.00 $ 142.12 $ 231.88 $ 374.00

Blue Advantage HMO Blue Advantage HMO Blue Advantage HMO

Region 1 Region 2 Regions 3, 4
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired w/ Medicare $ 59.66 $ 97.34 $ 157.00 $ 76.00 $ 124.00 $ 200.00 $ 68.40 $ 111.60 $ 180.00
Retiree and Spouse
Retired - 2 with Medicare $ 119.32 $ 194.68 $ 314.00 $ 152.00 $ 248.00 $ 400.00 $ 136.80 $ 223.20 $ 360.00

Blue Advantage HMO Blue Advantage HMO Blue Advantage HMO

Region 5 Region 6, 7, 8 Region 9
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired w/ Medicare $ 79.80 $ 130.20 $ 210.00 $ 96.90 $ 158.10 $ 255.00 $ 74.10 $ 120.90 $ 195.00
Retiree and Spouse
Retired - 2 with Medicare $ 159.60 $ 260.40 $ 420.00 $ 193.80 $ 316.20 $ 510.00 $ 148.20 $ 241.80 $ 390.00

Humana HMO Humana HMO Humana HMO

Region 1 Region 2 Region 3
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired w/ Medicare $ 6.65 $ 10.85 $ 17.50 $ 61.55 $ 100.43 $ 161.98 $ 48.15 $ 78.57 $ 126.72
Retiree and Spouse
Retired - 2 with Medicare $ 13.30 $ 21.70 $ 35.00 $ 123.10 $ 200.86 $ 323.96 $ 96.30 $ 157.14 $ 253.44

Humana HMO Humana HMO Humana HMO

Region 4 Region 5 Region 6
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
Retired w/ Medicare $ 56.62 $ 92.38 $ 149.00 $ 53.96 $ 88.04 $ 142.00 $ 75.95 $ 123.92 $ 199.87
Retiree and Spouse
Retired - 2 with Medicare $ 113.24 $ 184.76 $ 298.00 $ 107.92 $ 176.08 $ 284.00 $ 151.90 $ 247.84 $ 399.74

Humana HMO Humana HMO Humana HMO

Region 7 Region 8 Region 9
STATE RETIREE TOTAL STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
w/ Medicare $ 78.63 $ 128.31 $ 206.94 $ 74.54 $ 121.64 $ 196.18 $ 73.76 $ 120.36 $ 194.12
Retiree and Spouse
2 with Medicare $ 157.27 $ 256.61 $ 413.88 $ 149.09 $ 243.27 $ 392.36 $ 147.53 $ 240.71 $ 388.24

Peoples Health Via Benefits

HMO-POS Medicare
STATE RETIREE TOTAL STATE RETIREE TOTAL
Retiree Only Coverage
w/ Medicare $ 60.80 $ 99.20 $ 160.00 $ 200.00 $ - $ 200.00
Retiree and Spouse
2 with Medicare $ 121.60 $ 198.40 $ 320.00 $ 300.00 $ - $ 300.00

Region 1: Orleans, Saint Bernard, Plaquemines and Jefferson Parishes

Region 2: East Baton Rouge, West Baton Rouge, Livingston, Ascension, Iberville, Pointe Coupee, East Feliciana and West Feliciana Parishes
Region 3: Lafourche, Saint John, Saint Charles, Saint James, Assumption and Terrebonne Parishes
Region 4: Lafayette, Evangeline, Saint Landry, Acadia, Saint Martin, Iberia, Vermilion and Saint Mary Parishes
Region 5: Beauregard, Allen, Calcasieu, Jefferson Davis and Cameron Parishes
Region 6: Vernon, Sabine, Natchitoches, Winn, Grant, Rapides, LaSalle, Catahoula, Concordia and Avoyelles Parishes
Region 7: Caddo, Bossier, Webster, Claiborne, Bienville, Red River and DeSoto Parishes
Region 8: Ouachita, Union, Lincoln, Jackson, Caldwell, Richland, Morehouse, Franklin, West Carroll, East Carroll, Madison and Tensas Parishes
Region 9: Washington, Saint Tammany, Saint Helena and Tangipahoa Parishes

Premiums based on 38% vesting. Please contact Human Resources for additional vesting schedules.