Archived Forms & Notices All PDF files on this website require the most current version of Adobe Reader to view. If you do not have the most current version of Adobe Reader, you can get it by clicking the icon below. Notices Summary Annual Report – Plan Year End December 31, 2015 Rates Active Self-Pay Rates Effective January 2018Retiree Self-Pay Rates Effective January 2022Retiree Self-Pay Rates Effective January 2019Retiree Self-Pay Rates Effective January 2018