Under 65 MSD Retired MESPA Employees 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 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.

ANTHEM PLAN

• HMO Site of Service (SOS) $250

• HMO SOS $1500

• POS SOS $1500

• High Deductible Health Plan (HDHP)

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

• Premium Rate Sheet U65 MESPA Retirees

ENROLLMENT FORMS

• Anthem Retiree Plan Enrollment and Change Form

• Retiree Benefit Election Form for New Retirees - this will be sent to you along with a Benefits Notice approximately 8 weeks before your retirement date.