2016

W-4P 2016 (Pensioners)

If you wish to change the amount of Federal Tax Withheld from your Pension, complete and return the 2016 W-4P.

2016 Summary of Benefits

For active participants in the health insurance plan, this summary details deductibles, co-pays and coinsurance.

2016 Summary of Benefits

For non-Medicare retirees who elected health Plan A, this summary details deductibles, co-pays and coinsurance.

2016 Summary of Benefits

For non-Medicare retirees who elected health Plan B, this summary details deductibles, co-pays and coinsurance.

Self-Pay Rate Increase

Effective June 1, 2016 the Self-Pay Rate increased from $297/month to $320/month.

Annual Funding Notice

Pension Plan Annual Funding Notice, Yellow Zone Plan Status, and an Explanation of Required Notices

Benefit Summary of Material Modification

Summary of Material Modifications made to the Benefit Summary Plan Description.

2018

2019 Adult Child Form

To continue coverage in 2019 for a child aged 19 through 26, please complete the 2019 Adult Child Form .

Humana Medicare Participants Rates and Opt-Out Form 2019

Humana Medicare Participants Rates and Opt-Out Form 2019

Medicare Part D Notice

2019 Notice of Creditable Coverage

Annuity Loan Payments 2019

Annuity Loan Payments 2019

Now Accepting Electronic Self-Pay Payments

Now Accepting Electronic Self-Pay Payments

Active and Non Medicare Participants SMM

Active and Non Medicare Participants SMM

Medicare Participants SMM

Medicare Participants SMM

Pension Trust Annual Funding Notice

Pension Trust Annual Funding Notice

Non-Medicare Retiree Rate Increase

Non Medicare -2018 Rate Increase Opt-out