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Adobe Acrobat is required to view these files Frequently Asked
Questions (FAQ)
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8Active Employees I’ve given my retirement date to Personnel Support Services – now what? What if I am in the PUSD opt-out plan at the time I retire? What insurance plans can I continue as a retiree? Can I continue to cover my dependents on my retiree health plans? What happens to my mandatory and/or voluntary life insurance? What if am offered partially District paid insurance but I don’t want to take it? What if I am moving out of the San Diego area? 8Retirees How and when do I pay for my retiree insurance premiums? What if I want to change my medical plan or add/drop dependents? Who are my eligible dependents? What if I drop one of my insurance plans? 8Turning 65 When and how can I enroll in Medicare? What are my/my spouse’s insurance options when I/they turn 65? Who pays for my insurance once I turn 65? 8Contact Information I’ve given my retirement date to Personnel Support Services – now what? The PUSD Personnel Department will give the PUSD Insurance Benefits Department your retirement date. Insurance Benefits will then mail a letter to your home address explaining your insurance options in retirement. Enrollment in PUSD insurance plans as a retiree is NOT automatic! You will complete and return a Retiree Insurance Selection Sheet, indicating whether or not you wish to continue PUSD insurance plans as a retiree. If so, you will contact the PUSD Insurance Benefits Department to schedule an appointment to complete a Retiree Benefit Enrollment form. Retiree health plan enrollment must be completed no later than 30 days after your active PUSD health coverage ends. What if I am in the PUSD opt-out plan at the time I retire? PUSD retirement is considered a “qualifying event.” Due to retirement, qualified employees who participate in the PUSD opt-out plan can enroll in retiree health plans for self and qualified dependents. Retiree health plan enrollment must occur no later than 30 days after the date of the qualifying event. What insurance plans can I continue as a retiree? District medical coverage must be continued in order to continue dental and vision coverage. However, dental and vision coverage is optional. Qualified retirees may elect to change their medical plan and add or drop qualified dependents to/from coverage during the annual Open Enrollment. Can I continue to cover my dependents on my retiree health plans? Yes, you can continue coverage for qualified dependents that you covered as an active employee. You will pay the full premium cost for all dependent health coverage. What happens to my mandatory and/or voluntary life insurance? Your PUSD sponsored life insurance policies will end on the same date as your “active employee” health plans. You can apply for Conversion and/or Portability no later than 30 days after the date active coverage ends. Individuals who are totally disabled may qualify to continue life coverage at no cost under a waiver of premium benefit. You must request an application for any of these options from the PUSD Insurance Benefits Department no later than 30 days after the date active coverage ends. What happens to my Medical Reimbursement Account and/or Dependent Care Reimbursement Account (Flexible Benefit Plans)?
Medical Reimbursement Account:
If you wish to continue participation in this plan through the end of the plan year, please contact the PUSD Insurance Benefits Department no later than 30 days after your coverage ends to make arrangements to continue “after tax” Medical Reimbursement Account payments.
Dependent Care Reimbursement Account:
Submission deadline for both accounts when the account ends
as of the last day of the Plan Year: What if am offered partially District paid insurance but I don’t want to take it? Some employees are offered District paid retiree benefits (see bargaining unit agreement), but due to other coverage through a spouse or private policy, or due to moving out of the area, the retiree chooses not to enroll in PUSD retiree health plans. Once a retiree declines coverage through one of the District health plans that plan may not be reinstated the following year or any year thereafter. The retiree declining District health plan(s) may receive reimbursement toward the cost of their other health insurance coverage. Contact the PUSD Insurance Benefits Department for clarification and limitations regarding this option. In order to receive reimbursement, the retiree is required to: • Submit proof of health plan premium payment(s) annually (copies of itemized receipts). • Submission of health plan premium payment receipts must be received by the PUSD Insurance Benefits Department, no later than December 31st of each year; with reimbursement provided to the retiree in March of the following year. • Eligible retirees not providing health plan premium payment documentation as indicated above may forfeit reimbursement for that year and any year thereafter. Reimbursement toward dental and vision insurance coverage can only be provided in conjunction with reimbursement for medical insurance coverage (if qualified). District retiree health premium reimbursement ends when the retiree reaches age 65 or Medicare eligibility. What if I am moving out of the San Diego area? If you are moving out of the San Diego / Southern California area and will not have a legal residence here, you may not be able to continue your current health plan(s). You may be able to receive premium reimbursement (see question above). Please contact the PUSD Insurance Benefits Department for more information. 5 back to the topHow and when do I pay for my retiree insurance premiums? Once a retiree is enrolled in PUSD health plans, a billing letter will be mailed to their home address. This letter will include payment coupons for the calendar year’s premiums. After initial retiree enrollment, the retiree will receive a billing letter on an annual basis in late December or early January. This letter will include payment coupons for the full calendar year. Retirees pay health premiums to the PUSD Insurance Benefits Department at the Administration Center. All premiums must be paid by check or money order. Retirees pay premiums in quarterly installments; however they can pay ahead on a semi-annual or annual basis. Quarterly payment schedule: • January 1st - 3 months due (payment for Jan., Feb., and March) • April 1st - 3 months due (payment for April, May and June) • September 1st - 2 months due (payment for Sept. and Oct.) • November 1st - 2 months due (payment for Nov. and Dec.) All premiums are paid tenthly, September - June. If insured during the month of June, coverage is continued in July and August at no cost. What if I want to change my medical plan or add/drop dependents? Each November, during the District's Open Enrollment period, retirees may change their medical insurance carrier and add or delete dependents. Changes made during Open Enrollment take effect the following January 1st. An Open Enrollment packet is mailed to each retiree’s home address. Retirees may change to the Out of State plan effective the first of the month following their move. Qualifying Events to add/drop eligible dependents during the year (outside of Open Enrollment):
Domestic partners may only be added to coverage at the annual Open Enrollment for a January 1st effective date. Who are my eligible dependents? An Eligible Dependent is a spouse or qualified domestic partner and/or any child (including the child of a qualified domestic partner) under 19 years of age (extended thru age 24, if unmarried and a full-time student taking a minimum of 12 units and qualifying as a dependent under Internal Revenue Service (IRS) regulations). Employees must provide proof of full-time student status for eligible dependent child(ren) ages 19 through 24. Failure to provide requested documentation will result in automatic cancellation of dependent coverage. A cancelled dependent, if eligible, my only be re-added to PUSD plans at a future Open Enrollment. What if I drop one of my insurance plans? Once a retiree drops one of their health plans, that insurance plan may not be reinstated the following year or any year thereafter. 5 back to the topWhen and how can I enroll in Medicare? You need to contact Social Security about three months prior to turning age 65 to apply for and enroll in Medicare. You can contact your local Social Security office, call 1-800-MEDICARE or visit http://www.medicare.gov/. What are my/my spouse’s insurance options when I/they turn 65? Medicare eligibility typically starts the first of the month in which you turn 65. Retirees who are age 65 and have signed up for Medicare Parts A & B may continue to purchase PUSD health coverage indefinitely; however this plan will no longer serve as primary carrier. Plan premiums are paid on a self-pay basis. The same applies to a retiree’s spouse/domestic partner. Retirees who are age 65 and have signed up for Medicare Parts A & B may choose to terminate PUSD health plans. Reinstatement is not available. This also applies to a retiree’s spouse/domestic partner. If a retiree terminates PUSD health plans due to Medicare enrollment, their spouse’s PUSD health plans would also terminate. The spouse could then be offered the option to continue PUSD health plans through COBRA extension. Plan premiums are paid monthly on a self-pay basis. What’s the difference between Medicare Part A, Part B and Part D? What do I need to enroll in if I am keeping PUSD retiree insurance? Medicare Part A partially covers hospitalizations, Part B partially covers doctor visits and Part D partially covers prescription drugs. To remain enrolled in PUSD health plans after age 65, retirees need to enroll in Medicare Part A & B. This will provide the retiree a lesser PUSD premium cost. Retirees should NOT enroll in Medicare Part D as PUSD medical plans cover prescription drugs. If a retiree continues PUSD health plans after age 65, the retiree will continue to pay premiums directly to PUSD. The retiree will also pay Medicare directly for Medicare Part A and/or Part B premiums (or these premium(s) might be deducted from your Social Security check). Who pays for my insurance once I turn 65? Effective the first of the month in which you turn 65, you will pay premiums on a self-pay basis. 5 back to the top
For more
information contact the PUSD Insurance Benefits Department This is not a guarantee of coverage or an offer of coverage. To confirm retiree health benefits eligibility please contact the PUSD Insurance Benefits Department. This website provides a general overview of PUSD retiree health benefits and does not provide a complete description of every option or situation. For more detailed information please contact the PUSD Insurance Benefits Department.
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