Health Care Premiums

How much you can expect to pay each month for your health insurance

Plan Year
  • 2024
Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Deferred Compensation Board
ET-4307
Form Active Employee / Retiree

Medicare Eligibility Statement

You and/or your insured dependents must be enrolled for both portions of Medicare (Hospital Part A and Medical Part B), when first eligible. Provide this information to ETF using this form.