ATC Retirees
PLEASE NOTE: some of the links within the guide will not work outside of the ATC network since they are linked to our internal SharePoint site.
You asked and we delivered! With all the positive feedback we received for the open enrollment webpage for retirees this year, we created this new webpage so you can access your retiree benefit-related materials at any time.
If you are looking for something and can’t find it on this page, please let us know so we can add information that you will find relevant and helpful. Please email Sara Wilder at swilder@atcllc.com for any questions or assistance.
Pre-65 retiree documents
Pre-65 enrollment forms:
Retiree Medical, Dental and Vision Rates-2022
Retiree Benefit Enrollment Form-2022
ACH Authorization for Automatic Debits – Retiree Premiums
Pre-65 plan documents:
Dental Summary Plan Description-2021
High Deductible – Summary of Benefits Coverage-2022
Low Deductible – Summary of Benefits Coverage-2022
Medical Benefit Plan and Summary Plan Description-2022
UHC Vision – Employee Enrollment Kit
UHC Vision – Base Plan Summary-2022
UHC Vision – Premium Plan Summary-2022
Post-65 retiree documents
Post-65 Opt Out Waive Form
Post-65 Retiree Healthcare Benefit
UHC 2022 Annual Notice of Changes
UHC 2022 Evidence of Coverage
UHC 2022 Summary of Benefits
UHC Healthy at Home Benefits
Additional retiree documents
EAP ATC Program Overview
Health Savings Account – Beneficiary Form
Medicare & You Guide-2022
Participant Distribution Notice-401k
Participant Distribution Notice-Pension Plan
Retiree Life Insurance Beneficiary Form
UHC Healthy at Home Benefits
Understanding your benefits when employment ends
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