RETIREMENT HEALTH ENROLLMENT INFORMATION & INSTRUCTIONS

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1 RETIREMENT HEALTH ENROLLMENT INFORMATION & INSTRUCTIONS

2 State and Public School Retirement Health Insurance is administered by Employee Benefits Division (EBD). PO Box Woodlane, Suite 500 Little Rock, AR (501) Toll Free (877) Fax (501)

3 A Health & Life Continuation Under Retirement System B COBRA Continuation Only C COBRA Until Retirement Benefits Begin D COBRA When Retirement Benefits Are Available E Health Insurance Marketplace

4 Do you meet these eligibility requirements? Did you have active coverage by the State & Public School Health Plan on your last day of employment? Are you eligible to begin drawing a retirement annuity check from one of the following retirement agencies? Arkansas Public Employees Retirement System (APERS) Arkansas Teacher Retirement System (ATRS) Arkansas State Highway Employee Retirement System Arkansas Judicial Retirement System Alternate retirement plan such as VALIC You cannot enroll in retirement health insurance until you begin drawing your annuity.

5 You have the option to continue your current health insurance by enrolling in COBRA for 18-months. If you become eligible to draw your annuity during this 18-month period, you have 30-days to enroll in the retiree group health plan.

6 Per Arkansas Legislative Law, you have a one-time option to enroll in the retirement health insurance. Choices are: 1. At the time of retirement, if you meet eligibility. 2. If you are covered under another group health plan at the time of retirement, when you experience a qualifying event of loss of coverage, you can enroll with a Certificate of Credible Coverage, or proof of continued insurance coverage for the time period you were eligible to draw your annuity until present

7 A fully completed Election form is required to enroll in the retiree health insurance with the date your retirement annuity will begin. A Bank Draft Authorization Form if your retirement annuity is not large enough for your health premium deduction or you prefer to have your premium bank drafted once eligibility has been verified. ACT 87 Spousal Affidavit showing if your spouse is or is not eligible to be covered on your policy

8 If you wish to continue your health insurance at retirement, you must complete an Election Form and send to EBD within 30 days of your loss of coverage as an active employee. This form gives us the authorization to enroll you in our retirement health plan and to notify your Retirement Agency to begin deducting premiums. Effective date of coverage is the first day of the month following date of application, or a later date if you are not currently drawing your retirement annuity when your employment ends. Available on line at

9 You will need to complete a Bank Draft Authorization Form and return it to EBD along with your Election Form if your retirement annuity check is not large enough to deduct your retirement health premium Form available online at

10 We will need a completed Authorization to Release Information on file at EBD in order for our staff to discuss your PHI (Personal Health Information) with someone other than yourself. Without this form on file, we will not discuss your PHI. Form is available online at

11 Premium will be deducted from your retirement annuity check. If your annuity is not large enough for your premium deduction, then you are required to have your monthly premium bank drafted from your personal bank account.

12 When you receive your Medicare card you need to send EBD a copy so that your premium can be adjusted and to ensure that your claims are paid correctly. Public School Retirees will lose their pharmacy benefits when they become Medicare eligible and will need to enroll in a Medicare Part D plan for pharmacy coverage.

13 If you do not have Medicare Part B, the plan will pay as though the member does have Part B and the member will have full responsibility for claims incurred.

14 You are not required to remain on our plan. However, you need to be aware of the coverage that we provide to our Medicare eligible retirees. 1. We cover your Part A & Part B Medicare deductibles. 2. We cover the 20% not paid by Medicare if it is a covered benefit under our plan.

15 3. If you have a claim that is not covered by Medicare and it is covered under our plan, we will pay the claim according to our deductible and coinsurance schedule. 4. If you decide to cancel coverage and leave our plan, you will NOT be eligible to re-enroll in the plan. One-time option for coverage under retirement health plan and your decision is final.

16 If a retiree dies and has covered dependents at the time of death, the dependents have the right to continue coverage under the Plan. A surviving spouse, or collateral dependent, may continue coverage under the Plan indefinitely as long as premiums are paid timely. A surviving spouse can never add a dependent to their coverage, unless the surviving spouse is pregnant at the time the covered retiree dies.

17 Dependent children may be covered until the maximum age limit for a dependent child has been reached. Once a dependent child experiences a loss of dependent eligibility event, they can continue the coverage under COBRA for an additional 36- month period. If a surviving spouse or dependent declines coverage or cancels existing coverage, then the surviving spouse or dependent has no further privileges under the plan.

18 You will need to contact Minnesota Life Insurance Company directly at Forms are available on the EBD web site.

19 If you have other voluntary benefits such as a cancer policy, additional life coverage, dental, long-term care coverage, etc, you need to contact those vendors directly if you wish to continue coverage into retirement.

20 Your EBD Buzz contains information about your health plan. This is our method of reaching each of our members and informing them of any changes in the plan, benefits or new rates for the new plan year. Stay on top of new legislation. The next Legislative Session will meet in early We administer our plan according to Legislative changes. Call EBD with any questions/concerns.

21 General Benefit Information & Assistance Mailing Address: PO Box Little Rock, AR Physical Address: 501 Woodlane Street, Suite 500 Little Rock, AR Phone: (501) Phone: 1- (877) Fax: (501) Retirement

22 Web: