Health Insurance Plan Design Changes for Age 65+ Retirees Effective January 1, 2009

• Deductible: Retiree now pays $250 per calendar year. (Deductible is for medical only.)
• Co-insurance on Medical: Insurance pays 80% of Medical Expenses.
• Co-insurance for Prescriptions (Rx): Insurance pays 70% of Prescription Costs.
• Annual Out-of-Pocket Maximum: $900  (Medical $450, Rx $450)