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.

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.