Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium?
Plan Year
    2025
Program Option
    Local Traditional Health Plan (PO12) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2025
Program Option
    Local Deductible Health Plan (PO14) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2025
Program Option
    Local High Deductible Health Plan with Uniform Dental (PO7) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2025
Program Option
    Local Deductible Health Plan with Uniform Dental (PO4) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2025
Program Option
    Local Health Plan with Uniform Dental (PO6) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2025
ET-2405
Form Active Employee / Retiree

ETF Insurance Complaint Form

If you filed a grievance with the plan or benefit administrator and are dissatisfied with the final decision, you can request an administrative review from ETF.