Form Number: et-2158prm

Medicare All = Family coverage with all insured family members enrolled in Medicare Parts A, B and D.

Note: Uniform Dental premiums are added to your medical premiums if you choose coverage.

1Members with Local Access Plan or SMP coverage who enroll in Medicare Parts A and B will automatically be moved to the IYC Medicare Plus plan. All other non-Medicare family members remain covered under the Local Access Plan or SMP.