EUTF Premium Calculator for Retirees Hired On or After July 1, 2001

This tool should be used to determine your Monthly Premium Contribution.

**The Monthly Premium Amounts are effective 01/01/2019**

BMC Calculator Self Form

Medical

Select a Medical Plan. Note: Kaiser Plan includes Medical & Prescription Drug.
Select a Tier.
$
$

Drug

Select a Drug Plan.
Select a Tier.
$
$

Dental

Select a Tier.
$
$

Vision

Select a Tier.
$
$

Total Premium Amount

$
$

Employer Contribution

Select your Employer's Contribution Percentage. Refer to the Employer Contribution Table to determine the percentage.
$

The Employer Contribution Amount is the LESSER of the Employer's Contribution Percentage BMC and the Total Self Amount.

Employee Contribution

$

DISCLAIMER

By using this premium calculator, I acknowledge and agree that:

  1. This calculator provides an unofficial estimate of health insurance premiums;
  2. The EUTF retains no record of estimates produced by this calculator;
  3. The EUTF has no liability or obligation to offer health insurance plans at any premium amount produced as a result of using this calculator; and
  4. This estimate calculation is not to be construed in any way as a promise or contract with the EUTF for the EUTF to offer health insurance plans at the premium amount calculated, or any other amount.

All final health insurance benefits shall be determined by the EUTF in accordance with the laws in effect at the time such health insurance benefits are offered.

I HAVE READ AND UNDERSTAND THE ABOVE INFORMATION.