How To Get Health Benefits From Calpers

Transcription

1 CalPERS Health Benefits Into Retirement

2 Objectives Eligibility Health Plans Enrollment Employer Contribution and Vesting Medicare State Dental and Vision Coverage Online Tools & Resources

3 Eligibility 3

4 Basic Information You are eligible to enroll or continue enrollment as a retiree if you: Separate and retire within 120 days Receive a monthly retirement allowance Eligible for health benefits on the date of separation Public Agencies and Schools - must contract for your specific bargaining group

5 Separation and Retirement Dates Within 30 days Automatic continuation of health benefits Between 31 and 120 days Continuation of health benefits is not automatic Lapse in coverage

6 Eligible Family Members Spouse Registered Domestic Partner Children Certified Disabled Dependent Parent-Child Relationship

7 Ineligible Family Members Children age 26 and older Spouse of adult children Former spouses Parents Grandparents

8 Health Plans

9 CalPERS Health Plans Health plan types offered: Preferred Provider Organization (PPO) Health Maintenance Organization (HMO) Exclusive Provider Organization (EPO) Association plans are also available Health Plan Search by ZIP Code Tool available on CalPERS Online

10 Enrollment 10

11 Life Events Report to CalPERS as soon as possible Marriage / Domestic Partnership Divorce / Termination of Domestic Partnership Change of residential address Medicare eligible due to age 65 or disability Death of a dependent family member Death of a member

12 Open Enrollment Held annually in the fall Transactions: Enroll in a health or dental plan Change health plans Add or delete eligible family members Cancel all coverage

13 Special and Late Enrollment Special Enrollment Must be requested within 60 days of the event Effective date is the first day of the following month Late Enrollment 90-day waiting period is required Effective date is the first day of the month following the waiting period

14 What is not permitted? Dual Coverage Split Enrollments

15 Changing Health Plans You may change your health plan When you move or change employment Upon retirement Upon Medicare Eligibility During the CalPERS Open Enrollment period

16 Transactions Permissive Move Dependent reaches age 18 Retirement Mandatory Divorce Death of a dependent Dependent who is age 26 or older

17 Survivor Benefits Survivors are eligible for continued health benefits coverage if they: Receive a monthly survivor check Were eligible dependents at the time of the annuitant s death

18 Employer Contribution and Vesting

19 Employer Contribution and Vesting Contracts Public Agency and Schools State and CSU Vesting Percentages Exceptions

20 Medicare

21 Medicare Eligibility Enrollment is required if: Retired and eligible for premium-free Medicare Part A Enrollment is not automatic in a Medicare plan Certification of Medicare Status form Notifications

22 Medicare Parts Medicare Part A Hospital Insurance Medicare Part B Medical Insurance Medicare Part C Medicare Advantage Medicare Part D Prescription Drug Coverage

23 Medicare Part B Premium Reimbursement State of California or CSU retirees Reimbursement for Part B Premiums Dependents may be entitled to a reimbursement Income Related Monthly Adjustment Amount (IRMAA) Public Agency and School retirees Are not eligible

24 State Dental and Vision Coverage

25 State Retiree Dental Coverage Retirees and eligible family members May be eligible for a State sponsored dental insurance plan Eligibility criteria Public Agency and School members Are not eligible

26 Retiree Vision Coverage Retirees and eligible family members May be eligible for a State sponsored vision insurance plan Vision Service Plan (VSP) Public Agency and School members Are not eligible

27 Online Tools & Resources

28 Online Tools & Resources CalPERS On-Line:

29 Online Tools & Resources Health benefits online resources: Health Plan Search by ZIP Code Health Plan Chooser Health Program Guide Health Benefit Summary Medicare Enrollment Guide Evidence of Coverage

30 my CalPERS 11.JMMH i!!l iji Health Health Plan Summary Find a Medical Plan Health Plan Summary Current Health Coverage as of 11/26/2012 Medical Fiian ~~ Kaiser Permanente Califomia Coverage Type Employee only Basic Enrolled Since 03!01i2001 Premium $ Need premium details? Connect with Your Health Benefit Provider Our Health Plans Online Subscriber and Dependents Name Relationship Date Of Birth Medical CalPERS On-Line Health Benefit Resources Jane A Doe Self. 01/ Basic Health Benefits Program Forms & Publications Center CalPERS Benefits Education Events

31 How to Contact CalPERS Message Center in my CalPERS By mail By phone 888 CalPERS (or ) Visit a Regional Office How to Contact Social Security or (800) hour automated phone system Available 8:00 a.m. to 5:00 p.m., M-F Busiest times: Mondays First day of the month Day after a holiday

32 Questions?

33 or 888 CalPERS (or ) Please complete the session evaluation