Summary of Benefits and Coverage

A snapshot of a health plan's costs, benefits, covered healthcare services, and other important features.

Program Option
  • State Employee and Retiree Health Plan & Supplemental Benefits
Plan Year
  • 2024

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2024
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
    2024
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
    2024
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.
Plan Year
    2024
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
    2024
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
    2024
Program Option
    Local High Deductible Health Plan (PO17) & Supplemental Benefits

Medicare Health Plan Premium Rates

How much you will pay each month for your health care premium.
Plan Year
    2024
Program Option
    Local Traditional Health Plan with Uniform Dental (PO2) & Supplemental Benefits