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Health Insurance Example Non-Medicare Rates Effective July 1, 2022 Total Coverage Monthly Rate State Pays Pensioner Pays Highmark Delaware Comprehensive PPO Plan Individual $943.78 $818.74 $125.04 Individual & Spouse $1,958.44 $1,698.94 $259.50 Individual & Child(ren) $1,454.52 $1,261.80 $192.72 Family $2,448.32 $2,123.92 $324.40 ➤ Hired on January 1, 1986 – Retiring with 15 Years of Service - ($1,698.94* 0%) $0 + $259.50 = $259.50 per month ➤ Hired January 1, 2003 - Retiring with 15 Years of Service ($1,698.94 * 25%) $424.74 + $259.50 = $684.24 per month - Hired January 1, 2007 – Retiring with 15 Years of Service ($ 1,698.94 * 50%) $849.47 + $259.50 = $1,108.97 per month

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