The surcharge for subscribers who have certified they use tobacco or who have not certified at all is:
The subscriber will pay one surcharge, regardless of the number of tobacco users covered under his insurance. He will pay this charge unless he certifies no one covered under his health insurance uses tobacco, and no one has used it during the past six months. To change your tobacco surcharge status, please complete the Certification of Tobacco Use (PDF) form and send to the University Benefits Office via fax at 843-792-9533 or by email to firstname.lastname@example.org.
Due to health care reform, beginning January 1, 2011, if a subscriber's physician provides a letter stating that it is unreasonably difficult due to a medical condition for the subscriber to stop using tobacco or it is medically inadvisable for the subscriber to attempt to stop using tobacco, he can avoid the tobacco surcharge by participating in an alternative program that is described in detail in the Insurance Benefits Guide.