ET-4111
Form Retiree

Medicare Enrollment for Disability Retirees

If you retired due to a disability, you may be eligible for Medicare benefits. Medicare eligibility related to disability is available to persons who have received Social Security disability benefits for at least 24 months, who have End Stage Renal Disease (ESRD), or Lou Gehrig’s Disease (ALS).

Health and Wellness News
Oct 23, 2024 12:00pm
Doctor listening to heartbeat of child with parent

Open Enrollment Ends This Friday!

Learn about our Insurance Help page, how to contact Health Plan and Vendors, additional benefits from Delta Dental, and other mental health support programs.

Open Enrollment Quick Reference

A quick reference for what changes you can make to your benefits during open enrollment.

Program Option
  • Local Annuitant Health Program (LAHP)
  • Local Deductible Health Plan (PO14) & Supplemental Benefits
  • Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits
  • Local Health Plan (PO16) & Supplemental Benefits
  • Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
  • State Employee and Retiree Health Plan & Supplemental Benefits
ET-2385
Form Active Employee / Local Employer / State Employer

Health Savings Account (HSA) Enrollment

For UWs use only, as a paper alternative for a member who cannot complete their HSA enrollment online.

Man at computer with cup of coffee

How to Choose & Enroll in Your Benefits

Here for open enrollment? Just start a new job? Or have a baby? Start here to find out when you can enroll or make changes to your benefits and the steps to make those changes

Plan Year
  • 2025
Program Option
  • Local High Deductible Health Plan (PO17) & Supplemental Benefits
Man at computer with cup of coffee

How to Choose & Enroll in Your Benefits

Here for open enrollment? Just start a new job? Or have a baby? Start here to find out when you can enroll or make changes to your benefits and the steps to make those changes

Plan Year
  • 2025
Program Option
  • Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits
Man at computer with cup of coffee

How to Choose & Enroll in Your Benefits

Here for open enrollment? Just start a new job? Or have a baby? Start here to find out when you can enroll or make changes to your benefits and the steps to make those changes

Plan Year
  • 2025
Program Option
  • Local Traditional Health Plan (PO12) & Supplemental Benefits
Man at computer with cup of coffee

How to Choose & Enroll in Your Benefits

Here for open enrollment? Just start a new job? Or have a baby? Start here to find out when you can enroll or make changes to your benefits and the steps to make those changes

Plan Year
  • 2025
Program Option
  • Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits
Man at computer with cup of coffee

How to Choose & Enroll in Your Benefits

Here for open enrollment? Just start a new job? Or have a baby? Start here to find out when you can enroll or make changes to your benefits and the steps to make those changes

Plan Year
  • 2025
Program Option
  • Local Health Plan (PO16) & Supplemental Benefits