Under 65 MSD Retired Directors and Coordinators (Affiliated and Non Affiliated) have the option of enrolling in the following Anthem plans. Click on each plan to review the Benefit Summary for each specific plan. The Premium Rate sheet is listed below the Plan Summaries. Please click on the link to view the rates. Plans and Rates will be subject to change each July 1. An Open Enrollment packet will be sent to you in late April or Early May of each calendar year that you are eligible to remain on the Anthem plan. During this time you will have the option of making changes to your enrollment in the plan.

NON AFFILIATED School Food Retirees are included in this Employee Group

ANTHEM PLAN SUMMARY

• HMO $250

• POS $300

• High Deductible Health Plan (HDHP)

ANTHEM PLAN RATES 7/01/2022 to 6/30/2023

• Premium Rate Sheet U65 Non Affiliated Retirees

ENROLLMENT FORMS

• Anthem Retiree Plan Enrollment and Change Form

• Retiree Benefit Election Form for New Retirees - will be sent to you with

a Benefits Notice approximately 8 weeks before your retirement date.

• NHRS Annuity Deduction Form

AFFIALIATED

ANTHEM PLAN SUMMARY

• HMO SOS $250

• POS SOS $300

• POS SOS $1500

• HMO SOS $1500

• High Deductible Health Plan (HDHP)

ANTHEM PLAN RATES 7/01/2022 to 6/30/2023

• Premium Rate Sheet U65 Directors and Coordinators Retirees

ENROLLMENT FORMS

• Anthem Retiree Plan Enrollment and Change Form

• Retiree Benefit Election Form for New Retirees - will be sent to you with

a Benefits Notice approximately 8 weeks before your retirement date.

• NHRS Annuity Deduction Form