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Retiree Frequently Asked Questions (FAQs)

What health benefits do I get when I retire?

PERS and TRS Tier I and JRS:
Medical coverage provided at no charge at the time of retirement. Dental-Vision-Audio (DVA) and Long-Term Care (LTC) are optional and if elected, premiums are deducted from your monthly benefit check.
PERS and TRS Tier II:
Medical coverage provided at no charge at age 60 or on your retirement date if you are already age 60 or have at least 30 years of PERS time or 25 years of Police/Fire or TRS service. Coverage may be purchased if you retire before you are eligible. Dental-Vision-Audio (DVA) and Long-Term Care (LTC) are optional and if elected, premiums are deducted from your monthly benefit check.
PERS Tier III:
Same as Tier II. However, PERS employees must accrue a minimum of 10 years of credited service to have system-paid coverage at age 60. Employees with less than 10 years must pay the full monthly premium for as long as they wish to continue medical insurance.

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When does my coverage begin?

PERS and TRS Tier I and JRS:
Coverage begins on date of appointment.
PERS and TRS Tier II:
Coverage begins on date of appointment if elected at retirement, if you are age 60 at retirement, or if you meet the service requirements for system paid medical noted above. Coverage begins on January 1 if elected during Open Enrollment or on the 1st of the month after the retiree turns 60, if not elected previously.
Tier III:
Same as Tier II, assuming you have 10 years of service.

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Who is the claims administrator for the health insurance?

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Who's covered?

Medical:

  • Retiree
  • Spouse*
  • Dependent children who live with you and meet the criteria of the plan**

Dental-Vision-Audio:

  • Retiree
  • Spouse, if elected
  • Dependent children who live with you and meet the criteria of the plan, if elected

Long-Term Care:

  • Retiree
  • Spouse, if elected

*Automatic under Tier I or covered if elected under Tier II/III prior to age 60, automatic at age 60

**Automatic under Tier I or if elected under Tier II/III prior to age 60, automatic at age 60

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How do I add a new dependent to my insurance plan(s)?

Tier I Medical

Coverage is automatically effective on the date of marriage or date of birth. Fill out the Retiree Health Dependent Change form and send to the Division.

Tier II/III Medical and/or Dental-Vision-Audio

If you are enrolled in coverage, you must notify the Division within 120 days by completing a Retiree Health Dependent Change form and a Health Benefits Enrollment/Waiver form. You will be responsible for the additional premium amount. Coverage will be effective on the first of the month after the new premium is deducted.

Long-Term Care

If you are enrolled in coverage, you must notify the Division within 120 days by completing a Retiree Health Dependent Change form and a Health Benefits Enrollment/Waiver form. You will be sent an application for your spouse to complete and return to the Division. Once received, it will be forwarded to the carrier for approval. You will be notified of the determination and, if approved, you will be responsible for the additional premium amount.

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How do I drop dependents from my insurance plan?

Notify the Division by completing a Retiree Health Dependent Change form and a Health Benefits Enrollment/Waiver form. With the exception of Tier I medical, changes will be made prospectively.

How do I terminate Dental, Vision, and Audio (DVA) coverage?

You may terminate your DVA coverage at any time by notifying the Division in writing. Remember, once this coverage is terminated, you cannot re-enroll.

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How do I terminate Long-Term Care (LTC) coverage?

You may terminate your LTC coverage at any time by notifying the Division in writing. Remember, once this coverage is terminated, you cannot re-enroll.

When is my eligibility going to be reported to the claim administrator?

If your paperwork is received at least three weeks before your retirement date, your eligibility will be reported by your retirement date. If not received in time, your eligibility reporting will be delayed by one month.

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