Plan Summaries

Active Employees & Early Retirees

• Anthem BlueCross HMO 20
• Anthem BlueCross HMO Select
• Anthem BlueCross PPO
• Kaiser HMO

Note: While the Active Employee and Early Retiree plan benefits are the same, the active employee and early retiree monthly costs to the individual are different. Please see the below “Plan Monthly Costs” section for details.

Summary of Benefits and Coverage

• Anthem BlueCross HMO 20
• Anthem BlueCross HMO Select
• Anthem BlueCross PPO

Medicare Eligible Retirees

• Anthem BlueCross Senior Secure HMO
• Anthem BlueCross Senior Secure LPPO
• Part D Prescription Drug Benefit Chart
• Kaiser Senior Advantage HMO

Plan Monthly Costs

• Active Employees
• Early Retirees
• Medicare Eligible Retirees

DELTA DENTAL
800-765-6003
deltadentalins.com

• Plan Benefit Highlights
• Delta Dental PPO Enrollment Form
• Using the Delta Website

VSP
800-877-7195
www.vsp.com

• Vision Enrollment Form
• Vision Benefits Summary

• FSA Summary and Information
• FSA Enrollment Form

• Life Insurance Enrollment Form

TIAA-CREF
888-225-7377
www.tiaa-cref.org

Plan Summaries

Active Employees & Early Retirees

• Anthem BlueCross HMO 20
• Anthem BlueCross HMO Select
• Anthem BlueCross PPO
• Kaiser HMO

Note: While the Active Employee and Early Retiree plan benefits are the same, the active employee and early retiree monthly costs to the individual are different. Please see the below “Plan Monthly Costs” section for details.

DELTA DENTAL
800-765-6003
deltadentalins.com

• Plan Benefit Highlights
• Delta Dental PPO Enrollment Form
• Using the Delta Website

VSP
800-877-7195 
www.vsp.com  

• Vision Enrollment Form
• Vision Benefits Summary

• Life Insurance Enrollment Form

TIAA-CREF
888-225-7377 
www.tiaa-cref.org