Sheet Metal #10 Benefit Fund MONTHLY Retiree Rates        
Effective May 1, 2017         
                     
                     
    Pre-Medicare Medical   Medicare Medical   Medical      1 + 1   Delta Dental Medical & Dental  
                     
Pre-Medicare                  
  Single $   613.00   n/a       $  38.00 $   651.00  
  Couple  $1,226.00   n/a       $  76.00 $1,302.00  
  Family* $1,591.00   n/a       $118.00 $1,709.00  
                   
Medicare                  
  SMW+ Pensioner                  
  Single     $184.00       $ 38.00 $222.00  
  Couple      $368.00       $ 76.00 $444.00  
  1+1 (1 Pre-medicare and 1 medicare)         $797.00   $ 76.00 $873.00  
                     
  Humana MAPDP Pensioner                  
  Single     $150.00       $ 38.00 $188.00  
  Couple      $300.00       $ 76.00 $376.00  
  1+1 (1 Pre-medicare and 1 medicare)         $763.00   $ 76.00 $839.00  
                     
  UCare Pensioner High Rx Option                  
  Single      $149.00       $ 38.00 $187.00  
  Couple      $298.00       $ 76.00 $374.00  
  1+1 (1 Pre-medicare and 1 medicare)         $762.00   $ 76.00 $838.00  
                     
                     
  UCare Pensioner Core Rx Option                  
  Single      $ 25.00       $ 38.00 $  63.00  
  Couple      $ 50.00       $ 76.00 $126.00  
  1+1 (1 Pre-medicare and 1 medicare)         $638.00   $ 76.00 $714.00  
                     
                     
*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