You Can Choose

• Single coverage, if you have no dependents
• Couple coverage, providing benefits for yourself and
  one dependent
• Family coverage, providing benefits for yourself, your spouse and any dependent children under the age of 21 or under the age of 26 if attending school full-time
• Opt out (Package I) – you can choose package “I” and opt-out of health and dental benefits if you have these benefits under another plan (such as your spouse’s group plan)