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Forms and Resources

2026

2026 Comparison of Benefits	Download
Medicare Supplement and Medicare Advantage Prescription  Drug Plans	PDF
Dental Plans	PDF
Vision Plans	PDF
1	1

Premiums	Download
Former Employee and Surviving Dependents Monthly Premiums	PDF
Former Employee Medicare Supplement and Medicare Advantage  Prescription Drug (MAPD) Plans Monthly Premiums	PDF
Life Insurance Chart – Former	PDF
1	1

Medicare Advantage Prescription Drug (MAPD) Plan	Download
2026 MAPD Service Areas	PDF
1	1

Insurance needs as a former employee	Download
Planning for Your Insurance Needs as a Former Employee	PDF
1	1

2025

2025 Comparison of Benefits	Download
Medicare Supplement and Medicare Advantage Prescription  Drug Plans	PDF
Dental Plans	PDF
Vision Plans	PDF
1	1

Premiums	Download
Former Employee and Surviving Dependents Monthly Premiums	PDF
Former Employee Medicare Supplement and Medicare Advantage  Prescription Drug (MAPD) Plans Monthly Premiums	PDF
Life Insurance Chart – Former	PDF
1	1

Medicare Advantage Prescription Drug (MAPD) Plan	Download
2025 MAPD Service Areas	PDF
1	1

Insurance needs as a former employee	Download
Planning for Your Insurance Needs as a Former Employee	PDF
1	1

MORE

Forms

2027 Application for Medicare Advantage Prescription Drug (MAPD) Plan

2027 Application for Medicare Supplement with Prescription Drug Plan

2027 Application for Retiree/Vested/Non-Vest/Defer Insurance

2026 Application for Medicare Advantage Prescription Drug (MAPD) Plan

2026 Application for Medicare Supplement with Prescription Drug Plan

2026 Application for Retiree/Vested/Non-Vest/Defer Insurance

Beneficiary Designation Form

Last Modified on Oct 20, 2026