retirement health benefits transition for 2017 06092017hr.fhda.edu/_downloads/retirement health...
TRANSCRIPT
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OfficeofHumanResourcesandEqualOpportunity
RetirementHealthBenefitsTransitionFor
RetireesPresentedby
ChristineVoBenefitsManager
June9,2017
Thisisasummarypresentationonly.Intheeventofdiscrepancies,healthplanEvidenceofCoveragedocumentsand/orInsuranceCertificateswillprevail.
Visit http://hr.fhda.edu/benefits/Forcompleteinformation.
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AGENDA
Qualifications Types of RetireesSteps Must Be Taken Prior to RetirementMedicare Eligibility and Enrollment How Medicare Impact You as a Retiree?AB528Retirees ResponsibilitiesMonthly CalPERS Premium Variance ReimbursementQuarterly Medicare Part B Premium ReimbursementSurvivors benefits
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TYPES OF RETIREES
1) FT Contract EEs Hired prior to July 1, 1997Type 1: Regular Service Retiree with min 10 years of service credits, and age 55Type 2: 20-year retirees, non pensioners - NotretiredfromCalPERSand/orCalSTRS
o Coverage restricted to just retiree + Spouse/DP (No children)
o Note: Both options offer lifetime medical benefits including medical/dental/vision, monthly CalPERS premium variance reimbursement
o and quarterly Medicare Part B premium reimbursement.
2) FT Contract EEs Hired on or after July 1, 1997o Type 3: Regular Service Retiree with min 15 years of service credits, and age 55
¢ Bridge to Medicare Program (coverage between age 55 through 64)¢ Eligibility is based on Retiree age¢ District subsidy must be used to purchase health toward CalPERS health plan options onlyNOTE: The program Restricted to just retiree + Spouse/DP (No children)Type 4: VoluntaryEmployeeBeneficiaryAssociation(VEBA)Trust
• Age 65 or older and Medicare-eligible (retirees only)• $100 monthly subsidy • You do not need to enroll in CalPERS health
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FT Contract EEs Hired prior to July 1, 1997
TypeI(ServiceRetireesfromCalPERSand/orCalSTRS)§ Age55andemployedatleast10yearsofservice precedingretirement§ QualifiedforLife-TimemedicalbenefitsprovidedbytheDistrict§ Coverageextendedtothewholefamilytoinclude(Medical/Dental/Vision)§ MustenrolledinCalPERSHealthProgram§ EligibleformonthlyCalPERSpremiumvarianceandQuarterlyMedicarePartBpremiumreimbursement
TypeII(401AParticipants– NotretiredfromCalPERSand/orCalSTRS)§ Mustattain20+yearsofserviceregardlessofage§ RestrictedtoonlyACE,CSEA,Confidential,andTeamstersmembers§ QualifiedforLife-TimemedicalbenefitsprovidedbytheDistrict§ CoverageextendedtotheRetiree+Spouse/DP,excludeDependentChildrentoinclude
(Medical/Dental/Vision)§ RetirementhealthbenefitscontinuationwithCalPERSisnotpossibleunlessyouaredeemedasan
annuitantwitheitherCalPERSand/orCalSTRS§ Alternativeoptionsareavailablevia CoveredCAoryoumayselectaplanofyourchoiceandthemonthly
reimbursementwillbemadesimilartoCalPERSequivalentplan§ Oryoumayelecttoreceiveupto$200/pp/mo or$400/couple/mo forcoveragethroughaprivate
employer
Important:Dependentsfollowretireechoiceandeligibility
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FT Contract EEs Hired on or after July 1, 1997
TypeIII– BridgetoMedicarePlan¡ Age55through64¡ RenderedservicetotheDistrictasapermanentemployeefor15ormoreyears(timespentonaleave
ofabsencewithoutpayorinlayoffstatusshallnotcountedtowardstheserviceretirement)immediatelyprecedinghisorherretirement
¡ ReceivedServiceRetirementfromCalPERSand/orCalSTRS¡ RetireesmaintainmedicalcoveragewithCalPERS(MemberonlyorMember+Spouse/DP)¡ Nodentaland/orvisioncare¡ Districtprovidesmonthlysubsidytocoverthecostofmedicalbenefitsintheperiodoftimebetween
retirementandMedicareeligibility.Subsidyvariesbetweenbargainingunits:2.8%(RETIREEE)or5.6% (RET+SP/DP)
¡ Districtmonthlysubsidyendsupontheretiree’sMedicareeligibility
TypeIV- VoluntaryEmployeeBeneficiaryAssociation(VEBA)Trust¡ Age65orolder(Medicare-eligible)¡ Offers$100/mo.subsidyforretireeonly
Note:Dependent(excludeschildren)followretireechoiceandeligibility
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FT Contract EEs Hired on or after July 1, 1997
TypeIII– BridgetoMedicarePlan¡ Age55though64¡ RenderedservicetotheDistrictasapermanentemployeefor15ormoreyears(timespentonaleave
ofabsencewithoutpayorinlayoffstatusshallnotcountedtowardstheserviceretirement)immediatelyprecedinghisorherretirement
¡ ReceivedServiceRetirementfromCalPERSand/orCalSTRS¡ RetireesmaintainmedicalcoveragewithCalPERS(MemberonlyorMember+Spouse/DP)¡ Nodentaland/orvisioncare¡ Districtprovidesmonthlysubsidytocoverthecostofmedicalbenefitsintheperiodoftimebetween
retirementandMedicareeligibility.Subsidyvariesbetweenbargainingunits:2.8%(RETIREEE)or5.6% (RET+SP/DP)
¡ Districtmonthlysubsidyendsupontheretiree’sMedicareeligibility
TypeIV– VoluntaryEmployeeBeneficiaryAssociation(VEBA)Trust¡ AdministeredbyUnitedAdministrativeServices¡ Offers$100/monthsubsidyforMedicare-eligibleretirees,excludedependents.
Note:Dependent(excludeschildren)followretireechoiceandeligibility
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Steps Must Be Taken Prior to Retirement
90daysbeforeyourdateofseparation,youmustdothefollowing:1)ScheduleanappointmentwitheitherCalPERSand/orCalSTRSagenttogoovertheserviceyears,andobtainanestimateforyourretirementincome2)SubmitaletterofresignationforthepurposeofretirementtotheManagerorDean,andcopyHR3)SubmitServiceRetirementElectionApplicationtoCalPERSand/orCalSTRStoinitiatetheretirementprocess4)ToenablesurvivorcoveragewithCalPERS/CalSTRS,youmustselectyourretirementoptionotherthanOption#15)Plantoattendamandatory“NewRetireeOrientation”minimum2-3weekspriortoyourexitfromtheDistrict6)Ifyouand/oryourspouseare65yearsorolderatthetimeofretirement,seeBenefitsStafftorequestaCertificationofPriorCoveragetoavoidlateenrollmentfeesforMedicarePremiumPartB.
a) EnrollMedicareforbothPartsA&BatthenearestSSAOfficeb) MedicareenrollmentismandatoryforallRetireesandspousesage65orolderuponretirementc) Medicareapplicationrequiredminimum4-6weeksforanIDcardtobeissuedbyCMSd) ToenrollinCalPERSMedicareSupplementalplan,MedicareIDcardforbothPartsA&Bisrequired (no
exceptions)7)TotransitionfromActivetoRetireestatus,youmustbeanANNUITANTwitheitherCalPERS/CalSTRS,completeallpaperworkforCalPERS,andenrollinaCalPERSHealthPlanwithin120daysfromthedateofretirement8)SetupanACHaccountfordirectdepositsandwithdrawalsoffundswithSecova9)Providealternativecontactsincludingpersonalemail,andallpertinentdocumentation.10)SetupanonlineaccountwithCalPERSand/orCalSTRStoextractpensioncheckstubsasevidenceofhealthinsurancepaymenttotheDistrictinseekingreimbursementviapdf/[email protected]
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Medicare Enrollment
A. MedicarePart“A”(HospitalInsurance)-MANDATORYforDistrictRetireesand/orSpouse/DPage65orolderü EnrollonlyifSSAdeterminedyouareeligibleforpremium-free
B. MedicarePart“B”(MedicalInsurance)-MANDATORYforDistrictRetireesand/orSpouse/DPage65orolderü Everyretireemustapplyfor,obtainandmaintaincoverageunderPartBofMedicareü 2017MonthlyMedicarePartBStandardPremiumis$134.00(subjecttochange
everyJanuary1st)ü Ifyourmodifiedadjustedgrossincome(MAGI)asreportedonyourIRStaxreturn
from2yearsagoisaboveacertainamount,youmaypaymoreC. MedicarePart“C”(MedicareAdvantage)–MANDATORYforDistrictRetireesand/or
Spouse/DPinsuredundertheCalPERSHMOPlans(Kaiser/BlueShield/AnthemBC/HealthNet/Sharp/UHC)
D. MedicarePart“D”(PrescriptionDrugsPlan)– CalPERSwillenrollyoudirectlyunder“CalPERSMedicarePartD”program.Youdonot needtoenrollMedicarePartDwithSSA.
u IMPORTANT:MedicarePartDstandardpremiumispickedupbyCalPERS,butPartDMAGI premiumisnotreimbursedbyCalPERSorFHDA.
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ARTICLE 19 FACULTY AND REGULAR RETIREES (EXCEPTIONS)
① IfyouhavenevercontributedintoSocialSecurity,youmust checkwiththelocalSocialSecurityAdministrationOfficetoverifyeligibility.Ifeligible,theretireemust signupforbothMedicarePartAandBfordualcoveragewithMedicareasprimaryandtheCalPERS’s medicalplanassecondary.
② IfyoudonothaveenoughcreditsandareineligibleforMedicareduetoagelimits(lessthan65yearsofage),youremaincoveredundertheCalPERSmedicalplanasprimaryuntilyouqualify.However,youmustprovideANNUALcertificationfromSSAshowingproofofMedicareineligibilitytoretainBASICcoveragebeyondage65.
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When and How to Apply for Medicare?
2)Forpersonswhoareturning65:ToenrollinMedicare,youmustcallSSAat1-800-772-1213duringyour InitialEnrollmentPeriod (aseven-monthwindow aroundyour65thbirthday).
ü MakeanappointmentwithSSAwithinthree(3)monthsbefore your65thbirthday
ü ForActives:Applyforonly MedicarePartA,Delay PartBenrollmentuntil90daysbeforeyourretirement
2) Forpersonswhoare65orolderandhavejustretired:ToenrollinMedicare,youmustcallSSAat1-800-772-1213duringyourInitialEnrollmentPeriod(aeight-monthwindowaroundyour65thbirthdaythatbeginswhenyourgrouphealthinsuranceends.
ü MakeanappointmentwithSSAwithinthree(3)monthsbefore yourretirementdate
ü ForRetirees:ApplyforbothMedicarePartA&Bwheneligible.Youmustapplythree(3)monthspriortoyourbirthdayforbothPartsAandBatthesametime,waive bothPartsCandD.
3)Forpersonswhoareolderthan65:ToenrollinMedicare,youmustcallSSAat1-800-772-1213between January1andMarch31.ThiswindowiscalledGeneralEnrollmentPeriod. MedicarecoverageforpersonsenrollingduringtheGeneralOpenEnrollmentPeriodwillbeginonJuly1.
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HowdoesMedicareImpactMeasaRetiree?
Byfederallaw,MedicareisthePRIMARY coverageforallmemberswhoretire fromfull-timeactiveemployment.
§ AfterretirementandMedicarequalification,theCalPERS’smedicalplanservesasyourSECONDARY coverage.
§ MedicareforRETIREDEmployeesWhoTurnAge65Ø IfproofofMedicarePartsA&BarenotreceivedbytheDistrictandCalPERSpriortothe
firstofthebirthmonth,coverageforyouandyoureligibledependentsmaybenegativelyimpacted.
Ø “SpecialOpenEnrollment”willbeavailablewithSocialSecurity.Youhaveonly30daysfollowingyourresignationtoenrollunderthisprovision,otherwiseyoumayberequiredtopaysurchargestoyourMedicarePartBpremium,duetolateenrollment
Ø WhathappensifIam65,aretiredfaculty,anddonotqualifyforMedicareduetolackofcredits?YoumustservedCalPERSwiththeCMSDeterminationNoticeregardingyourMedicare-ineligibilitystatuswithin90daysofyour65th Birthdayoryourcoveragewillbedropped.TheCalPERSmedicalplanisyourPRIMARY coverage.
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MEDICAL BENEFIT TRANSITION FROM BASIC TO MEDICARE SUPPLEMENT PLAN
Ifyouare65+(and/orifyourdependentis65+),applyforMedicarethreemonthsbeforeyouretirebycontactingSSAat
(800)772-1213orONLINEATwww.ssa.gov .EnrollinMedicarePartsAandB
DONOTenrollinMedicarePartD
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Retirees’ Responsibilities
ü RequiretoparticipateintheAnnualRetireeSurveyü EnrollinMedicarePartsAandBwheneligible.Thecurrentrecommendationis90days
beforeyour65th birthdayü Providetimely Notice(s)totheDistrictwhenqualifiedforMedicare(applicabletoboth
retireesandspouse/qualifiedsame-sexdomesticpartner).AlldocumentationmustbereceivedbyHRpriortothefirstdayofyourMedicareeligibility.
ü EnrollinCalPERSMedicareSupplementalprogramimmediatelyuponreceivingyourMedicareIDcard
ü Submitproof(s)ofthecurrent monthlypremiumforMedicarePartBtotheDistrictannually nolaterthanMarch15th tocontinueMedicarequarterlyreimbursement.
Important:RetroactivereimbursementforlatesubmissionofMedicarePartBproofofpaymentisnotpermissible.
ü NotifytheDistrictofchangeofaddresswithin10 businessdaysü NotifytheDistrictoflifequalifyingeventssuchasmarriage/divorce/death/adoption,etc
within31calendardays
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CalPERS MONTHLY PREMIUM VARIANCE REIMBURSEMENT FOR PRE-’97 RETIREES
1) Officially, CalPERS is the Plan Administrator, not FHDA2) CalPERS controls the Retired Group3) FULL Monthly Medical Premium must be offset against your pension check – CalPERS collects
this premium on a monthly basisØ What happens if your income is lesser than the premium charged for the month
a. CalPERS members: CalPERS will offset the maximum amount, and balance billed you for the variance
b. CalSTRS members: CalPERS will bill you the entire premium4) To be reimburse for the Monthly CalPERS health premium variance
² You are required to submit the FIRST pension check stub that show itemized FULL premium deduction towards CalPERS Healthcare to the Benefits Unit either via Fax 650-949-6299 or pdf/email to [email protected].
² If you are getting Direct Bill for CalPERS health premium, copies of invoice and cancelled check or bank statement are required as validation that the FULL monthly premium is prepaid by you.
² Initial Refund will promptly process at the ”end of the same month”, and a check will be generated by A/P
² Thereafter, the monthly deposit is done electronically via the EFT account set up through Secova on the last day of the month to pay for the next month premium. For example, July 31st deposit is to pay for the August premium.
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QUARTERLY MEDICARE PART B PREMIUM REIMBURSEMENT FOR PRE-’97 RETIREES
1. Premium for Medicare Part B is prepaid by the members2. To initiate the request for Medicare Part B premium reimbursement for the first time,
you must notify the District Benefits Unit no later than the first day of the month that you became eligible for Medicare. Documentation is mandatory.
3. Annual Obligation: To request Medicare Part B premium reimbursement, Retirees and/or Spouse/DP must provide proof(s) of Medicare Premium Part B payment to the District no later than March 15th annually
4. Reimbursement is not retroactive. No exceptions!5. Quarterly Medicare Part B premium reimbursements is provided in arrears by the
District. EFT deposits are scheduled for the following timelines via SECOVA:o Q1 (January – March): April 15th
o Q2 (April – June): July 15th
o Q3 (July – September): October 15th
o Q4 (October – December): December 31st
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AB528ContinuationCoverage
1. StatelawrequiresCaliforniaschoolsandcommunitycollegedistrictstoallowemployeeswholosetheireligibilitytocontinuetheirhealthcarecoverageuponretirementtoenrollinhealthbenefitplanscurrentlyprovidedforitscurrentemployees.AnyformeremployeewhoretiredfromtheFHDACommunityCollegeDistrictunderanypublicretirementsystem,andhisorherspouse,oranysurvivingspouseofaformeremployee,maycontinuehisorherhealthcarebenefitsbypayingthefullpremiumsprovidedthatthememberisanannuitant ofeitherCalPERSorCalSTRSpensionplan.
1. Thislawdoesnotapplytoeitherthenewspouseupontheremarriageofasurvivingspouseofaformeremployee,or,thechildrenofaformeremployee.
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REMEMBER:ü If you take your CalSTRS/CalPERS pension as a lump sum, you forfeit FHDA
retiree health benefits.ü Must apply for CalPERS or CalSTRS service retirement within 120 days after the date of
separation.ü FULL monthly CalPERS Health premium must be prepaid by the retirees, and District
reimbursement is provided in arrears for the monthly employer’s share of cost. ü Your FHDA life insurance benefit expired with your retirement.
• For conversion information, contact HARTFORD at (888) 563-1124SURVIVORS:Ø Must notify the District within 31 days from the date of life qualifying event (LQE) to enroll under
the surviving spouse planØ District contributions towards health/Medicare ends at the end of the month of LQE for the entire
familyØ Survivors may continue the same medical plan with CalPERS via self-pay
• CalPERS offsets the FULL monthly premium against the survivor annuitant pension fundØ Survivors may purchase dental and dental coverage with the District by prepaid quarterly (EFT
pulls)
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DEADLINE:5pm,Friday,June23,20171. HealthBenefitsPlanEnrollmentforRetiree(formHBD30)2. CopyofyourCalSTRSorCalPERSAwardLetterregardingyourAnnuitantstatus3. BirthCertificateforalldependents(spouse/DP/children)– passportisacceptable4. MarriageCertificateorCAstateofRegistrationforDomesticPartner5. CopyofSocialSecurityCard(s)foreachdependent6. AwardletterfromMedicareCMSconfirmingtheeffectivedateofMedicarecoverage7. MedicareineligibilitycertificationletterfromSSAismandatoryifyouare65+andMedicareineligible
duetolackofcredits8. MedicareIDcardreflectingbothPartsA&Benrollment(requiredforbothretirees/spouses/DPif
applicable)9. CompleteanEFTformforDistrictDirectDepositsandWithdrawalsviaSecova +copyofacancelled
check10. AcheckpayabletoFHDAforyourfinalmonthlycontributionforJuly2017,thelastmonthofcoverage
asanactive11. PreparetoprovidetheDistrictwithtwoalternativecontactsandpersonalemailforemergency
contacts
WhatdoIneedtocompleteandreturntotheBenefitsUnit?
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SSA and CMS WEBSITES
² OfficialSocialSecuritywebsite:www.ssa.gov
² ForinformationregardingCentersforMedicare&MedicaidServices(CMS),accesswebsite:http://www.cms.hhs.gov
² ForlistingofMedicareParticipatingProvidersandSuppliersbyArea,accesswebsite:http://www.medicare.gov/physician
² TopersonalizeinformationregardingyourMedicarebenefitsandservices,youmayusehttp://my.medicare.gov/ toviewclaims,orderduplicateMedicareSummaryNotice(MSN)orreplacementofMedicareIDcard,vieweligibility,entitlementandpreventativeservicesinformation.
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SSA INFORMATION
Nearest Social Security Office:
SOCIAL SECURITY OFFICE (SSA)701 N. Shoreline Blvd, First FloorMountain View, CA 94043 Office hours: M-F 9am – 4pm
except Wednesday: 9am-Noon
To enroll: Call SSA: 1-800-772-1213M-F from 7 a.m. - 7 p.m.
For Medicare claims inquiry: 1-800-633-4227
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Contacts Information
² CalPERS Online: For more information on health benefits and programs, visit CalPERS at www.calpers.ca.gov
² CalSTRS Online: For more information on health benefits and programs, visit CalSTRS at http://www.calstrs.com
² CalPERS By Phone: Call 1-888-CalPERS or (888-225-7377) Monday through Friday, 8am – 5pm PST
² CalSTRS By Phone: Call 800-228-5453 or 916-414-1099 Monday through Friday, 7am – 6pm PST
² Benefits Unit:Phone: 650-949-6224Fax: 650-949-6299Email: [email protected]: http://hr.fhda.edu/benefits/