Form Number: et-2128pr
The employee and non-Medicare Retiree health plan rates reflect total monthly premium rates for each health plan. Total monthly premiums are shown without Uniform Dental.
Members of new participating employers may have a surcharge added to their rates. Your employer will inform you. Contact your payroll office with questions.
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.