Search: About, 10/04/2024
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Retired UPE/Mgmt/Supv/Conf/TCS and Teamsters Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024
2024 UnRep Management/Supervisor/Confidential/UPE/TCS Early Retiree Rate Sheet
2024 UnRep Management/Supervisor/Confidential/UPE/TCS Over 65 Retiree Rate Sheet
2024 SEIU/Teamsters Early Retiree Rate Sheet
2024 SEIU/Teamsters Early 50% Retiree Rate Sheet
2024 SEIU/Teamsters Over 65 Retiree Rate Sheet
2024 SEIU/Teamsters Over 65 Retiree 50% Rate Sheet
2025 Rate Sheet
Effective January 1, 2025 鈥� December 31, 2025
2025 UnRep Management/Supervisor/Confidential/UPE/TCS Early Retiree Rate Sheet
2025 UnRep Management/Supervisor/Confidential/UPE/TCS Over 65 Retiree Rate Sheet
Retired Classified Employees Health Benefit Information
Enrollment Forms
Enrollment Forms are now located under the Frequently Used Forms page.
Add dependents outside of Open Enrollment
Dependents must be added within 30 days of a qualifying event, such as marriage, birth, registered domestic partner or loss of coverage. Employee must complete a new enrollment along with required documentation.
2024 Rate Sheets
Effective January 1, 2024 鈥� December 31, 2024