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 Blue Shield
 The following charts show the 2008 employer contributions and premiums for Medicare Retirees.

1 Party
Individual
Income Level
2008 Premiums State's Contribution 100/90 Formula Balance after Premium Payment Medicare Part B Premiums Difference after Part B Reimbursement*
Under $82,000 $341.44 $471.00 $129.56 $96.40 $33.16
$82,001 - 102,000 $341.44 $471.00 $129.56 122.20 $7.36
$102,001 - 153,000 $341.44 $471.00 $129.56 $160.90 -$31.34
$153,001 - 205,000 $341.44 $471.00 $129.56 $199.70 -$70.14
Over $205,001 $341.44 $471.00 $129.56 $238.40 -$108.84
* Any remaining funds revert to the State

2 Party
Married Couples
Income Level
2008 Premiums State's Contribution 100/90 Formula Balance after Premium Payment Medicare Part B Premiums Difference after Part B Reimbursement*
Under $164,000 $682.88 $886.00 $203.12 $192.80 $10.32
$164,001 - 204,000 $682.88 $886.00 $203.12 $244.40 -$41.28
$204,001 - 306,000 $682.88 $886.00 $203.12 $321.80 -$118.68
$306,001 - 410,000 $682.88 $886.00 $203.12 $399.40 -$196.28
Over $410,001 $682.88 $886.00 $203.12 $476.80 -$273.68
* Any remaining funds revert to the State

3 Party
Married Couples
Income Level
2008 Premiums State's Contribution 100/90 Formula Balance after Premium Payment Medicare Part B Premiums Difference after Part B Reimbursement*
Under $164,000 $1,024.32 $1,129.00 $104.68 $289.20 -$184.52
$164,001 - 204,000 $1,024.32 $1,129.00 $104.68 $366.60 -$261.92
$204,001 - 306,000 $1,024.32 $1,129.00 $104.68 $482.70 -$378.02
$306,001 - 410,000 $1,024.32 $1,129.00 $104.68 $599.10 -$494.42
Over $410,001 $1,024.32 $1,129.00 $104.68 $715.20 -$610.52
* Any remaining funds revert to the State


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