Participant plan options are:

• Anthem PPO High Deductible Health Plan (Anthem PPO HDHP)
• Blue Retiree Plan
• COBRA temporary continuation of active coverage

Summary of actions the participant must take

For Medical Plans

1. Review plan options and rates (links below) to select an IU-sponsored Retiree medical care plan option.
2. Complete an enrollment form if you are enrolling in an IU PPO plan or the Blue Retiree plan.
3. Pay premium payments on time.
4. Enroll in Medicare Part A and Part B if the participant is age 65 or over.
5. Make any desired plan changes during Open Enrollment.

For COBRA (more information)

1. Complete a COBRA application form within 60 days of the date that coverage would have otherwise ended. The form will be mailed to your home address.
2. Pay initial COBRA premiums to-date within 45 days of electing COBRA.
3. Pay monthly COBRA premiums on time.
4. In order to continue under an IU-sponsored medical plan after COBRA eligibility ends, complete a medical plan enrollment form.
5. If eligible for Medicare at the time COBRA is elected, check with the Social Security office to fully understand how Medicare Part B enrollment coordinates with the COBRA election.

For All Options

1. Provide notice to the plan administrator within 30 days of a "Life Event Change," such as, divorce, legal separation, change in disability status, or death of a covered individual.
2. During coverage, notify the plan administrator of changes that will effect communications or eligibility, including:
   • Address changes
   • Entitlement under Medicare
   • Coverage under another group medical plan

Health Expense Reimbursement - may continue under COBRA on an after-tax basis.