Employee Benefits

Benefits Guide

• Retiree Benefits Guide
• Dental & Vision Only Benefits Guide
• Not Eligible for Medicare Benefits Guide

Rate Sheets

• Retiree Rates Including Medicare
• COBRA/LOA/Surviving Dependents Rates

Change forms for Retirees/COBRA/LOA/Surviving Dependents unless otherwise noted

• Enrollment Change Form
• Dental & Vison Only Change Form
• Early Retiree Administrator Change For

Summary of Benefits and Coverage(SBC)

• Base Plan
• High Deductible Plan
• Premium Plan