HOW  IS THE MONTHLY SELF-PAYMENT COMPUTED?

The amount of the monthly self-payment is based on your paying a portion of the HMO premium or Plan benefit cost. The percentage that participants pay is adjusted on an annual basis effective October 1^st. If an adjustment to the amount of the monthly self-payment is required, you will be notified of the new amount at least 30 days in advance of its effective date. However, the Board of Trustees reserves the right to change the monthly self-payment at any time.