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Get GAHP Twin CitiesRochester Dept Authorization Form - Shb Umn

Te Assistant Health Plan if their appointing department has identified an account string (EFS number) to which the cost of the plan may be charged. The appointing department will incur a charge of $4,100.76 for the entire year OR $341.73 per month. The $341.73 per month breaks down as follows: $308.55 (plan cost per fellow/trainee), plus $49.65 (surcharge for department s portion of the University subsidy of dependent coverage), minus $16.47 (fellow/trainee s contribution to premium). Post D.

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