Retiree Premium and Contribution Rates

Below are the 2023 and 2024 Retiree Premium and Contribution Rates for medical, dental, and vision.

IMPORTANT: Medical premiums displayed are before the County's contribution. The County contribution for 2023 is $151.00 and the contribution for 2024 is $157.00. You must be enrolled in a County medical plan to receive the County contribution.

Pay close attention to the different plans as they vary depending on whether or not you and/or your dependent(s) are on Medicare.

Early Retiree (Non-Medicare) Rates (2023)

**Early Retiree Non-Medicare Rates: Applicable when both the retiree and dependent(s) are all under age 65**
Plan Name	Retiree Only Premium (Monthly)	Retiree + 1 Premium (Monthly)	Retiree + 2 or more Premium (Monthly)
Early Retiree Anthem Select	$663.00	$1,307.00	$1,703.00
Early Retiree Anthem Choice	$753.00	$1,490.00	$1,941.00
Early Retiree Anthem Care	$813.00	$1,614.00	$2,104.00
Early Retiree Anthem EPO	$922.00	$1,835.00	$2,397.00

Medicare PPO Plan Rates (2023)

**Anthem Medicare PPO Rates: When all family members enrolled are on Medicare**
Plan and Coverage Tier	Premium (Monthly)
Retiree Only	$538.45
Retiree + 1	$1,072.45
Retiree + 2 or more (All Medicare)	$1,609.45

**Anthem Medicare PPO Combo Rates: When the Retiree is on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 non-Medicare	$1,275.45
1 Medicare, 2 non-Medicare	$1,726.45
2 Medicare, 1 non-Medicare	$1,523.45

**Anthem Medicare PPO Combo Rates: When the Retiree is NOT on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 Anthem Select	$1,182.45
1 Medicare, 2 Anthem Select	$1,578.45
2 Medicare, 1 Anthem Select	$1,468.45
1 Medicare, 1 Anthem Choice	$1,275.45
1 Medicare, 2 Anthem Choice	$1,726.45
2 Medicare, 1 Anthem Choice	$1,523.45
1 Medicare, 1 Anthem Care	$1,339.45
1 Medicare, 2 Anthem Care	$1,829.45
2 Medicare, 1 Anthem Care	$1,562.45

Medicare EPO Plan Rates (2023)

**Anthem Medicare EPO Rates: When all family members enrolled are on Medicare**
Plan and Coverage Tier	Premium (Monthly)
Retiree Only	$492.45
Retiree + 1	$984.45
Retiree + 2 or more (All Medicare)	$1,474.45

**Anthem Medicare EPO Combo Rates: When at least one person enrolled is NOT on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 non-Medicare	$1,405.45
1 Medicare, 2 non-Medicare	$1,967.45
2 Medicare, 1 non-Medicare	$1,546.45

Retiree Dental and Vision Rates (2023/2024)

**Retiree Dental and Vision Rates**
Plan	Retiree Only Premium (Monthly)	Retiree + 1 Premium (Monthly)	Retiree + 2 or more Premium (Monthly)
Aetna Dental	$31.88	$52.72	$77.88
VSP Vision	$9.54	$14.54	$23.52

Early Retiree (Non-Medicare) Rates (2024)

**Early Retiree Non-Medicare Rates: Applicable when both the retiree and dependent(s) are all under age 65**
Plan Name	Retiree Only Premium (Monthly)	Retiree + 1 Premium (Monthly)	Retiree + 2 or more Premium (Monthly)
Early Retiree Blue Shield Tandem PPO	$766.00	$1,510.00	$1,967.00
Early Retiree Blue Shield Choice PPO	$870.00	$1,721.00	$2,242.00
Early Retiree Blue Shield Care PPO	$939.00	$1,864.00	$2,430.00
Early Retiree Blue Shield EPO	$1,065.00	$2,119.00	$2,769.00

Medicare PPO Plan Rates (2024)

**Blue Shield Medicare PPO Rates: When all family members enrolled are on Medicare**
Plan and Coverage Tier	Premium (Monthly)
Retiree Only	$621.45
Retiree + 1	$1,238.45
Retiree + 2 or more (All Medicare)	$1,858.45

**Blue Shield Medicare PPO Combo Rates: When the Retiree is on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 non-Medicare	$1,472.45
1 Medicare, 2 non-Medicare	$1,993.45
2 Medicare, 1 non-Medicare	$1,759.45

**Blue Shield Medicare PPO Combo Rates: When the Retiree is NOT on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 Tandem PPO	$1,365.45
1 Medicare, 2 Tandem PPO	$1,822.45
2 Medicare, 1 Tandem PPO	$1,695.45
1 Medicare, 1 Blue Shield Choice	$1,472.45
1 Medicare, 2 Blue Shield Choice	$1,993.45
2 Medicare, 1 Blue Shield Choice	$1,759.45
1 Medicare, 1 Blue Shield Care	$1,546.45
1 Medicare, 2 Blue Shield Care	$2,112.45
2 Medicare, 1 Blue Shield Care	$1,804.45

Medicare EPO Plan Rates (2024)

**Blue Shield Medicare EPO Rates: When all family members enrolled are on Medicare**
Plan and Coverage Tier	Premium (Monthly)
Retiree Only	$568.45
Retiree + 1	$1,136.45
Retiree + 2 or more (All Medicare)	$1,702.45

**Blue Shield Medicare EPO Combo Rates: When at least one person enrolled is NOT on Medicare**
Plan and Coverage Tier	Premium (Monthly)
1 Medicare, 1 non-Medicare	$1,622.45
1 Medicare, 2 non-Medicare	$2,272.45
2 Medicare, 1 non-Medicare	$1,786.45

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Human Resources

County of San Luis Obispo

Tami Douglas-Schatz

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Retiree Premium and Contribution Rates