ET-2340 Form Active Employee / Local Employer / State Employer Automatic Premium Conversion Waiver/Revocation of Waiver Complete this form to waive your participation in automatic premium conversion, or to revoke a waiver of premium conversion that you filed previously.
26ET-2108sb Brochure Retiree 2026 Schedule of Benefits: Health Plan Medicare & Local Traditional Plan (PO1, PO2/12, PO6/16, PO7/17, PO8) The Schedule of Benefits explains what medical services the Group Health Insurance Program (GHIP) covers and what you pay for covered services.
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