NMRHCA Enhanced Public Safety / July 1, 2001 – June 30, 2021 Retirement Date Medical Plan Monthly Premium Contributions

January 1, 2027 – December 31, 2027 (Subsidy Level A)
This rate sheet also applies to disabled or duty-related disabled members.
Revised: August 2026

Medical Plan Monthly Rates by Years of Service

Rates vary by years of service (5 through 20+). Find your row based on your completed years of service.

Show rates for your years of service:

Download Printable Sheet

Showing all years of service.

Non-Medicare Medical Plans

Premier PPO (BCBS or Presbyterian)
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$987.88	$1,073.91	$366.66
6 yrs	$946.72	$1,049.19	$366.66
7 yrs	$905.55	$1,024.47	$366.66
8 yrs	$864.39	$999.75	$366.66
9 yrs	$823.23	$975.03	$366.66
10 yrs	$782.07	$950.31	$366.66
11 yrs	$740.91	$925.59	$366.66
12 yrs	$699.75	$900.88	$366.66
13 yrs	$658.58	$876.16	$366.66
14 yrs	$617.42	$851.44	$366.66
15 yrs	$576.26	$826.72	$366.66
16 yrs	$535.10	$802.00	$366.66
17 yrs	$493.94	$777.28	$366.66
18 yrs	$452.77	$752.56	$366.66
19 yrs	$411.61	$727.84	$366.66
20+ yrs	$370.45	$703.12	$366.66

Value HMO (BCBS or Presbyterian)
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$771.68	$838.83	$285.93
6 yrs	$739.52	$819.52	$285.93
7 yrs	$707.37	$800.22	$285.93
8 yrs	$675.22	$780.91	$285.93
9 yrs	$643.06	$761.60	$285.93
10 yrs	$610.91	$742.29	$285.93
11 yrs	$578.76	$722.98	$285.93
12 yrs	$546.61	$703.68	$285.93
13 yrs	$514.45	$684.37	$285.93
14 yrs	$482.30	$665.06	$285.93
15 yrs	$450.15	$645.75	$285.93
16 yrs	$417.99	$626.44	$285.93
17 yrs	$385.84	$607.13	$285.93
18 yrs	$353.69	$587.83	$285.93
19 yrs	$321.53	$568.52	$285.93
20+ yrs	$289.38	$549.21	$285.93

Medicare Medical Plans

BCBS Medicare Supplement PPO
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$485.39	$493.22	$501.05
6 yrs	$469.73	$485.39	$501.05
7 yrs	$454.08	$477.56	$501.05
8 yrs	$438.42	$469.74	$501.05
9 yrs	$422.76	$461.91	$501.05
10 yrs	$407.10	$454.08	$501.05
11 yrs	$391.44	$446.25	$501.05
12 yrs	$375.79	$438.42	$501.05
13 yrs	$360.13	$430.59	$501.05
14 yrs	$344.47	$422.76	$501.05
15 yrs	$328.81	$414.93	$501.05
16 yrs	$313.15	$407.11	$501.05
17 yrs	$297.49	$399.28	$501.05
18 yrs	$281.84	$391.45	$501.05
19 yrs	$266.18	$383.62	$501.05
20+ yrs	$250.52	$375.79	$501.05

BCBS Medicare Advantage HMO
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$0.00	$0.00	$0.00
6 yrs	$0.00	$0.00	$0.00
7 yrs	$0.00	$0.00	$0.00
8 yrs	$0.00	$0.00	$0.00
9 yrs	$0.00	$0.00	$0.00
10 yrs	$0.00	$0.00	$0.00
11 yrs	$0.00	$0.00	$0.00
12 yrs	$0.00	$0.00	$0.00
13 yrs	$0.00	$0.00	$0.00
14 yrs	$0.00	$0.00	$0.00
15 yrs	$0.00	$0.00	$0.00
16 yrs	$0.00	$0.00	$0.00
17 yrs	$0.00	$0.00	$0.00
18 yrs	$0.00	$0.00	$0.00
19 yrs	$0.00	$0.00	$0.00
20+ yrs	$0.00	$0.00	$0.00

BCBS Medicare Advantage PPO
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$53.28	$54.14	$55.00
6 yrs	$51.56	$53.28	$55.00
7 yrs	$49.84	$52.42	$55.00
8 yrs	$48.13	$51.56	$55.00
9 yrs	$46.41	$50.70	$55.00
10 yrs	$44.69	$49.84	$55.00
11 yrs	$42.97	$48.98	$55.00
12 yrs	$41.25	$48.13	$55.00
13 yrs	$39.53	$47.27	$55.00
14 yrs	$37.81	$46.41	$55.00
15 yrs	$36.09	$45.55	$55.00
16 yrs	$34.38	$44.69	$55.00
17 yrs	$32.66	$43.83	$55.00
18 yrs	$30.94	$42.97	$55.00
19 yrs	$29.22	$42.11	$55.00
20+ yrs	$27.50	$41.25	$55.00

Humana Medicare Advantage + PDP
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$88.21	$89.64	$91.06
6 yrs	$85.37	$88.21	$91.06
7 yrs	$82.52	$86.79	$91.06
8 yrs	$79.68	$85.37	$91.06
9 yrs	$76.83	$83.94	$91.06
10 yrs	$73.99	$82.52	$91.06
11 yrs	$71.14	$81.10	$91.06
12 yrs	$68.30	$79.68	$91.06
13 yrs	$65.45	$78.25	$91.06
14 yrs	$62.60	$76.83	$91.06
15 yrs	$59.76	$75.41	$91.06
16 yrs	$56.91	$73.98	$91.06
17 yrs	$54.07	$72.56	$91.06
18 yrs	$51.22	$71.14	$91.06
19 yrs	$48.38	$69.71	$91.06
20+ yrs	$45.53	$68.29	$91.06

United Healthcare Medicare Advantage PPO + PDP
Years of Service	Retiree Rate	Spouse Rate	Child Rate
5 yrs	$193.65	$196.78	$199.90
6 yrs	$187.41	$193.65	$199.90
7 yrs	$181.16	$190.53	$199.90
8 yrs	$174.91	$187.41	$199.90
9 yrs	$168.67	$184.28	$199.90
10 yrs	$162.42	$181.16	$199.90
11 yrs	$156.17	$178.03	$199.90
12 yrs	$149.93	$174.91	$199.90
13 yrs	$143.68	$171.79	$199.90
14 yrs	$137.43	$168.66	$199.90
15 yrs	$131.18	$165.54	$199.90
16 yrs	$124.94	$162.42	$199.90
17 yrs	$118.69	$159.29	$199.90
18 yrs	$112.44	$156.17	$199.90
19 yrs	$106.20	$153.04	$199.90
20+ yrs	$99.95	$149.92	$199.90

Rate Calculation Instructions

1. Select a medical plan for the retiree. Enter the rate from the Retiree Rate column that corresponds with your years of service.

2. If you are enrolling your spouse or domestic partner, select a medical plan for him/her. Enter the rate from the Spouse Rate column that corresponds with your years of service. (Or, if your spouse/domestic partner is also an NMRHCA-eligible retiree, use the Retiree Rate that corresponds with your spouse's/domestic partner's years of service.)

3. If you are also enrolling children, enter the rate from the Child Rate column multiplied by the number of children.
# of Children: _______ × Child Rate: $_______ = Total for Child(ren): $_______

4. Total steps 1, 2, and 3:

$_____________ Retiree +$_____________ Spouse / Domestic Partner +$_____________ Child(ren) =$_____________ Total

Dental Plan Monthly Premiums (Voluntary)

Effective January 1, 2027 – December 31, 2027

Dental Plan Rates
Plan	Single	Two-Party	Family
BCBS Dental Basic	$19.98	$37.95 for both	$56.93 for all
BCBS Dental Comprehensive	$38.46	$73.07 for both	$109.56 for all
Delta Dental Basic	$24.04	$45.68 for both	$68.51 for all
Delta Dental Comprehensive	$45.67	$86.79 for both	$130.18 for all

Vision Plan Monthly Premiums (Voluntary)

Effective January 1, 2025 – June 30, 2028

Vision Plan Rates
Plan	Single	Two-Party	Family
Davis Vision	$4.91	$9.24 for both	$13.61 for all

Dependent Child Life Insurance Monthly Premiums (Voluntary)

Effective July 1, 2019 – June 30, 2027 — The Standard

Dependent Child Life Insurance Rates
Coverage Amount	Monthly Premium (covers all children)
$2,500	$4.13 for all
$5,000	$7.75 for all
$10,000	$15.00 for all

Retiree / Spouse Supplemental Life Insurance Monthly Premiums (Voluntary)

Effective September 1, 2023 – June 30, 2027 — The Standard

Rates marked with ** require an Evidence of Insurability Statement to add or increase coverage.

Show rates for your age band:

Showing all age bands.

Supplemental Life Insurance Rates by Age Band — Coverage $2,000 to $10,000
Age Band	$2,000	$4,000	$6,000	$8,000	$10,000
Age 35–39	$0.70	$0.90	$1.09	$1.29	$1.49
Age 40–44	$0.82	$1.14	$1.45	$1.77	$2.09
Age 45–49	$1.03	$1.57	$2.10	$2.64	$3.17
Age 50–54	$1.43	$2.36	$3.29	$4.22	$5.15
Age 55–59	$2.04	$3.58	$5.13	$6.67	$8.21
Age 60–64	$2.38	$4.26	$6.14	$8.02	$9.90
Age 65–69	$4.36	$8.21	$12.07	$15.92	$19.78
Age 70 and over	$6.41	$12.32	$18.24	$24.15	$30.06

Supplemental Life Insurance Rates by Age Band — Coverage $15,000 to $60,000
Age Band	$15,000**	$20,000**	$40,000**	$46,000**	$60,000**
Age 35–39	$1.99	$2.48	$4.46	$5.05	$6.44
Age 40–44	$2.89	$3.68	$6.86	$7.81	$10.04
Age 45–49	$4.51	$5.84	$11.18	$12.78	$16.52
Age 50–54	$7.48	$9.80	$19.10	$21.89	$28.40
Age 55–59	$12.07	$15.92	$31.34	$35.97	$46.76
Age 60–64	$14.60	$19.30	$38.10	$43.74	$56.90
Age 65–69	$29.42	$39.06	$77.62	$89.19	$116.18
Age 70 and over	$44.84	$59.62	$118.74	$136.48	$177.86

* This is optional coverage and the entire cost of coverage is paid by you. The cost of insurance for all coverages paid by you may increase or decrease in the future based upon the claims experience of participants. All provisions that apply to this coverage are governed by the Certificate. Life plan rates include a $0.50 administration fee.

** An Evidence of Insurability Statement is required to add or increase life insurance. The Change for Additional Life Insurance form can be found at www.nmrhca.org/forms.aspx.