b'2021 Plan Cost ComparisonThe following health insurance plans are available to non- While every effort has been made to ensure up-to-Medicare eligible participants. If you have Medicare Part Adate information, CTPF is not responsible for the final and Part B due to end stage renal disease, these plans areadjudication of insurance claims, which are solely the available to you within the 30-month coordination period.responsibility of the health plan. (See page 5 for CTPF This comparison is to be used as a guide. In case thisPlan rate information)summary differs from the health plan text or any health plan term or condition, the official contract documentmust govern. Blue Cross BlueUnitedHealthcareBlue Cross Blue Shield Shield PPO Choice Plus PPO HMO IllinoisCTPF annuitant cost for single coverage monthly premium cost with CTPF premium subsidy* $788.62 $533.35 $404.57CTPF annuitant + 1 dependentmonthly premium cost with CTPF premium subsidy* $2,760.14 $1,866.70 $1,416.00CTPF annuitant + 2 or more dependentsmonthly premium cost with CTPF premium subsidy* $4,731.68 $3,200.09 $2,427.42^CTPF dependent cost for single coverage (dependents do not receive the CTPF premium subsidy) $1,971.55 $1,333.37 $1,011.42* The annuitant cost is the amount paid for monthly coverage after CTPF applies the health insurance premiumsubsidy. The current subsidy is 60% of total premium cost. See page 15 for more information.^ This is the amount a dependent pays for single coverage in special circumstances when only one family member isMedicare eligible. See page 44 for additional information about couple coverage.CTPF 2021 HEALTH INSURANCE HANDBOOKCTPF 2021 HEALTH INSURANCE HANDBOOK21'