2012 PEBB Retiree Benefits PEBB Outreach and Training for WEA-Retired
Welcome � Through the Health Care Authority, eligible retiring public employees: � Have access to comprehensive health insurance coverage � Have a one-time opportunity to enroll in or defer coverage � Must complete an enrollment form no later than 60 days after employer-sponsored or COBRA coverage ends 2
Agenda � Eligibility for Retiree Benefits � Enrollment/Procedural Requirements � Deferring Coverage � Payment Options � Duration of Coverage � Coverage Options � Medical for Medicare Eligible Retirees � Medical for Non-Medicare Eligible Retirees � Dental � Contact Information 3
Eligibility 4
Benefits Eligibility (WAC 182-12-171) � Washington state-sponsored retirement systems: � TRS – Teacher’s retirement system � SERS – School employees’ retirement system � PERS – Public employees’ retirement system � Higher education retirement plans (e.g. TIAA-CREF) � LEOFF – Law enforcement officers’ and fire fighters’ retirement systems � PSERS – Public safety employees’ retirement system � JRS – State judges/judicial retirement systems � WSPRS – State patrol retirement systems 5
Eligibility Requirements � Eligibility requirements for retirees: � Must be vested in a Washington-state sponsored retirement plan � Must be eligible to retire under a Washington state-sponsored retirement plan � Must immediately begin to receive a monthly retirement plan payment, with the following exceptions � DRS determines a lump-sum payment is required because the monthly retirement plan payment is below the minimum payment � Members of Plan 3 retirement plans are eligible if they meet their retirement plan’s age requirement and length of service when employer-sponsored insurance ends 6
Eligibility Requirements (continued) � Exceptions (continued): � Permanently and totally disabled employees are eligible if they start receiving or defer a monthly disability retirement plan payment � Employees not retiring under a Washington state-sponsored retirement plan must � Meet the same age and years of service requirements had the person been employed as a member of either PERS 1 or 2 for the same period of employment 7
COBRA – A Bridge to Retiree Benefits � COBRA (Consolidated Omnibus Budget Reconciliation Act) is an extension of current employer benefits, paid by the employee, and generally available for up to 18 months � Employees may use COBRA coverage as a bridge to PEBB retiree eligibility (WAC 182-12-171) � If elect to use COBRA as a bridge to retirement, employee is required to enroll in COBRA coverage � Must enroll in or defer PEBB retiree coverage no later than 60 days after COBRA coverage ends 8
Dependent Eligibility � Eligible Dependents: � Spouse � Washington state-registered domestic partners (RCW 26.60.303) � Both person are members of the same sex; or � Opposite sex where one partner is at least 62 years of age � Children through age 25 � Dependents with disabilities (HCA approval required) � Extended dependents (HCA approval required) 9
Enrollment and Procedural Requirements 10
Request Information � Approximately 60 days before your employer-sponsored benefits or COBRA coverage ends � Request PEBB’s Retiree Enrollment Guide � Complete the health insurance options card provided in your pension packet from DRS � Return the completed card to the PEBB Program � Or, call the PEBB Program at 1-800-200-1004 11
Request Information � The PEBB Program will send you a Retiree Enrollment Guide � The guide includes: � Plan information � Enrollment forms � Long-term care information � Auto/home insurance information � The Retiree Enrollment Guide is also available on the PEBB website: www.pebb.hca.wa.gov. Click on the “Thinking About Retirement” link. 12
Medicare Coordination � If you are retiring at age 65: � About 90 days before you retire, contact Social Security Administration to enroll in Medicare Part A and Part B � If you are retiring after age 65 and you deferred Medicare Part B: � About 90 days before you retire, contact Social Security Administration to enroll in Medicare Part B � You and your eligible dependents must enroll in Medicare Parts A and B, if entitled 13
New Retiree Enrollment Procedures � No later than 60 days after your employer-sponsored or COBRA coverage ends � Return the completed retiree enrollment forms � Retirees not eligible for Medicare must include documentation that verifies the dependent is an eligible dependent � A list of acceptable dependent verification documents are available on the PEBB website: www.pebb.hca.wa.gov � Retirees eligible for Medicare must include a copy of any Medicare cards showing enrollment in Medicare Parts A and B � If COBRA coverage is ending, proof of loss may be required 14
New Retiree Enrollment Procedures � The application will be reviewed for compliance with � Eligibility and procedural requirements according to Washington Administrative Code (WAC 182-12-171) � PEBB retiree coverage begins � The first of the month following the loss of employer-sponsored or COBRA coverage � Payment for coverage begins � The first of the month following the loss of employer-sponsored or COBRA coverage 15
Enrollment Reminders � Retiring employees must meet all eligibility and procedural requirements of WAC 182-12-171 � Must submit appropriate forms to enroll in or defer coverage no later than 60 days after your school district employer- sponsored or COBRA coverage ends � This is a one-time opportunity to enroll in or defer PEBB coverage � If you defer, you must be enrolled in � The comprehensive employer-sponsored coverage of your spouse or Washington state-registered domestic partner who is still working � A federal retiree medical plan (e.g., Tricare) as a retiree or dependent 16
Enrollment Reminders � Retiree and enrolled dependents must enroll in and maintain Medicare Parts A and B, if entitled � A checklist for school district employees who are retiring or separating is available on the PEBB website: www.pebb.hca.wa.gov 17
Deferring Enrollment 18
Deferring Enrollment (WAC 182-12-205) � PEBB-eligible retirees may defer enrollment at or after retirement if the retiree � Returns to work and has other comprehensive employer-sponsored coverage � Is covered under the comprehensive employer-sponsored coverage of a spouse or Washington state-registered domestic partner who is still working � Is enrolled as a retiree or dependent in a federal retiree medical plan (e.g., Tricare) � Enrollment in other employer-sponsored coverage must be continuous from the time of deferral until the time of enrollment 19
Deferring Enrollment (continued) � To defer health plan enrollment, the retiree � Must submit the Retiree Election Form to the PEBB program no later than 60 days after the date the retiree becomes eligible to apply for PEBB coverage � If a retiree defers enrollment, they also defer enrollment for all eligible dependents � Failure to defer or enroll within 60 days forfeits the right to enroll in PEBB retiree benefits in the future 20
Enrollment after Deferral � Appropriate forms � Must be submitted no later than 60 days after the date the other employer-sponsored coverage ends � Retiree must provide proof that coverage was continuous during deferral period � Send first payment with the enrollment form, unless you choose to have premiums deducted from your monthly pension check � Retirees who defer due to federal retiree coverage have a one-time opportunity to enroll in PEBB coverage 21
Payment Options 22
Premium Payment Options � Pension deduction � Automatic bank withdrawal � Personal check or money order � VEBA (Volunteer Employee Benefit Association) account � VEBA is the responsibility of the retiree � Check with your benefits office to learn more (Payment is made to the WA State Treasurer not to the individual health plans) 23
Duration of Coverage 24
When Retiree Coverage Ends � Subscribers � Retiree coverage lasts indefinitely, as long as premiums are paid in full � Dependents � As long as the dependent meets the eligibility requirements of WAC 182-12-260 25
Surviving Dependents � In the event of the death of the retiree � The eligible surviving spouse* may continue coverage indefinitely as long as premiums are paid in full (WAC 182-12-265) � Dependents may continue coverage until they lose eligibility under WAC 182-12-260 � The surviving spouse* and/or eligible dependents must notify PEBB no later than 60 days after the retiree’s death to enroll in or defer retiree coverage *Spouse includes WA state-registered domestic partners 26
Coverage Options 27
Coverage Options � Coverage options include � Medical and Dental coverage � Medical only coverage (there is no dental only option) � Dependents must be enrolled in the same coverage as the retiree � Plans are available with county, nationwide, and worldwide coverage � There are no pre-existing condition waiting periods 28
Medicare Eligible Retirees Medical Plan Options 29
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