2025-2026_Premium_Rate_Sheet_-_Retirees_(FY_25-26).pdf

This is a Premium Rate Sheet for retiree health insurance coverage in Texas, effective October 1, 2025 through September 30, 2026, related to a City's group employee medical insurance procurement for fiscal year 2026-2027. The document outlines monthly premium rates for four coverage tiers across two health insurance plans and two dental insurance plans. The BlueCross BlueShield HMO Health Insurance (Low Plan) and PPO Health Insurance (High Plan) each offer coverage options for Retiree Only, Retiree & Child(ren), Retiree & Spouse, and Retiree & Family. Similarly, Delta Dental offers both Low and High Plan options across the same four coverage categories.

The rate sheet specifies monthly retiree share contributions ranging from $0.00 for Retiree Only coverage under the HMO plan to $2,079.08 for Retiree & Family coverage under the PPO plan. Notably, the City pays 100 percent of premiums for Retiree Only coverage under the HMO plan, while the dental plans are retiree-paid only with no City contribution. The document indicates that the City covers a percentage of costs for other coverage levels, with retirees responsible for specified monthly contributions. This rate sheet supports the City's RFP process to evaluate and compare vendor proposals for both fully-funded and self-funded group medical insurance arrangements.