Sheet Metal #10 Benefit Fund MONTHLY Retiree Rates        
Effective May 1, 2019         
                     
                     
    Pre-Medicare Medical   Medicare Medical   Medical      1 + 1   Delta Dental Medical & Dental  
                     
Pre-Medicare                  
  Single $   663.00   n/a       $  38.00 $   701.00  
  Couple  $1,326.00   n/a       $  76.00 $1,402.00  
  Family* $1,691.00   n/a       $118.00 $1,809.00  
                   
Medicare                  
  SMW+ Pensioner                  
  Single     $194.00       $ 38.00 $232.00  
  Couple      $388.00       $ 76.00 $464.00  
  1+1 (1 Pre-medicare and 1 medicare)         $857.00   $ 76.00 $933.00  
                     
  Humana MAPDP Pensioner                  
  Single     $180.00       $ 38.00 $218.00  
  Couple      $360.00       $ 76.00 $436.00  
  1+1 (1 Pre-medicare and 1 medicare)         $843.00   $ 76.00 $919.00  
                     
  UCare Pensioner High Rx Option                  
  Single      $152.00       $ 38.00 $190.00  
  Couple      $304.00       $ 76.00 $380.00  
  1+1 (1 Pre-medicare and 1 medicare)         $815.00   $ 76.00 $891.00  
                     
                     
  UCare Pensioner Core Rx Option                  
  Single      $ 43.00       $ 38.00 $  81.00  
  Couple      $ 86.00       $ 76.00 $162.00  
  1+1 (1 Pre-medicare and 1 medicare)         $706.00   $ 76.00 $782.00  
                     
                     
*Family rate includes $365 for dependent children         
**No National Pension is a participant who is not eligible for the $31.00 Subsidy provided by the National Pension
***1+1 is a couple where one participant is eligible for Medicare and one is pre-Medicare