Further it is interesting that the monthly premiums continue to be paid to the administrative "insurance" for the retired state employees who are pressured to apply promptly for Medicare and A and B which will typically pay one third of a regional price for allowed procedures.  These approximately $1500 monthly premiums per person will have only small claims paid against them.  These premiums for all retired employees are held by whom exactly?  It's lovely a lovely business agreement which is unnegotiated I guess .  This plays a part in "costs".  Premiums paid even though they would never receive significant medical charges once one is Medicare eligible.  Where is that "counted"?  Oh.  It's not.