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    RETIREE PREMIUM CALCULATOR  
    These hospital medical premium calculations are based on the Fiscal Year 2012 Rates set by the PEEHIP Board. These rates reflect the out-of-pocket premium BEFORE the $28 Tobacco Use Premium or the Federal Poverty Level (FPL) Discount. This calculator is to be used by those who do not wish to log in to the Member Online Services (MOS) Retiree Premium Calculator. In addition, couples who are currently combining allocations must use the MOS premium calculator to get an accurate family premium estimate.  
    STEP 1 Enter your YEARS OF SERVICE on your proposed Retirement Date:        
    STEP 2 Enter your AGE on your proposed Retirement Date (whole number only - do not round up):        
    STEP 3 Find your Estimated Premium Calculation from the applicable table below:      
             
    PROPOSED RETIREMENT DATE IS BEFORE 01/01/2012:      
    Coverage Type: RETIREE CLASSIFICATION: RETIREE Out-of-
    Pocket Premium
    (Effective for
    10/1/2011 - 9/30/12)     		                     
    Single Retiree Non-Medicare Eligible                    
    Family Retiree and Dependent Non-Medicare Eligible                    
    Family Retiree Non-Medicare Eligible and Only Dependent Medicare Eligible                    
    Single Retiree Medicare Eligible                    
    Family Retiree Medicare Eligible and Dependent Non-Medicare Eligible                    
    Family Retiree and Only Dependent Medicare Eligible                    
    PROPOSED RETIREMENT DATE IS ON OR AFTER 01/01/2012:                  
    Coverage Type: RETIREE CLASSIFICATION: RETIREE Out-of-
    Pocket Premium
    (Effective for
    10/1/2011 - 9/30/12)     		Premium Includes
    Year One Penalty
    (Effective for
    1/1/2012 - 9/30/2013)     		                   
    Single Retiree Non-Medicare Eligible                    
    Family Retiree and Dependent Non-Medicare Eligible                    
    Family Retiree Non-Medicare Eligible and Only Dependent Medicare Eligible                    
    Single Retiree Medicare Eligible                    
    Family Retiree Medicare Eligible and Dependent Non-Medicare Eligible                    
    Family Retiree and Only Dependent Medicare Eligible                    
     
    NOTE: The monthly premium for Non-Medicare eligible retirees includes the Year One Penalty shown above which is 20% of the estimated applicable service, age and subsidy premium components for 1/1/2012 - 9/30/2013. The monthly premium is estimated to increase by a minimum of this amount each year until 2016. Upon becoming Medicare eligible, the age and subsidy premium components are no longer applicable. Medicare eligible members who retire on or after 1/1/2012 with less than 25 years will immediately be subject to the entire 4% service premium component and will not have a 5 year phase-in of the increase shown above.  
    DISCLAIMER: The premium rate given above is an unofficial estimate based on current parameters and your entered information. Although every reasonable effort has been made to ensure that the rates given on this web site are accurate, the authors assume no responsibility for errors. Accordingly, no estimated produced by this calculator shall be in any way binding upon the Public Education Employees' Health Insurance Board, which has sole authority under the law to determine future premium costs.