Continuing Health, Dental, Vision or Life Coverage
Terms
Vest – An employee who has worked long enough to keep benefits, and who contributed to a retirement system, but who is not ready to retire or draw retirement benefits.
Non-Vest – An employee who has worked long enough to keep benefits, but who did not contribute to a retirement system.
Retiree – An employee who has worked long enough to retire and draw a retirement check.
COBRA – An employee who is not eligible to vest or retire, but who may continue coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Coverage may be continued for up to 18 months.
Years of Service Needed to Keep Insurance
- Teachers Retirement System (TRS) – 10 years of eligible service to retire or vest. Benefit elections must be made within 30 days of your retirement date.
- Oklahoma Public Employees Retirement System (OPERS) – 8 years of eligible service to retire or vest. Benefit elections must be made within 30 days of your retirement date.
- Other Retirement Systems – Employment years may qualify as creditable service. Benefit elections must be made within 30 days of your retirement date.
Coverage You May Continue at Retirement
- State Employee – Any health, dental, life, or vision coverage you have as an active employee.
- Local Government Employee – Any health, dental, life, or vision coverage you have as an active employee.
- Education Employee – Any coverage your employer offers through OSEEGIB. You may add coverage at retirement; however, life insurance coverage must be in effect at least 30 days before your retirement date; life insurance cannot be added at retirement.
Keep all the insurance coverage you think you will need in retirement. You can reduce your benefits, but you can never add health, dental, or life coverage after retirement; however, vision coverage can be added during any Option Period. Additionally, you cannot change insurance plans at retirement, but you may change plans during any Option Period.
The Enrollment Process
Special Note to Medicare Eligible Members
It is critical that your application is received the month before you terminate current employment. If your application is received after your employment termination date and you are enrolled in HealthChoice, you will be enrolled in the HealthChoice Medicare Supplement Plan Without Part D until the first of the following month. While the plans provide identical coverage, the premiums for the plans Without Part D are higher. You must pay the higher premium for one month before you can be changed to a plan With Part D.
Complete the Application for Retiree/Vested/Non-Vest/Defer Insurance Coverage. Be sure to sign your application and mail it 30 days before your retirement date to:
OSEEGIB
3545 NW 58th St., Suite 110
Oklahoma City, OK 73112
It is important that your form is submitted on time. Any 30-day break in coverage will cancel your insurance and any future eligibility. Forms are available from your Benefits/Insurance Coordinator and on the this website.
Deferring (Transferring) Your Coverage to Your Spouse’s Plan
If your spouse is currently enrolled in coverage through an OSEEGIB participating employer, you may defer (transfer) your health, dental, and/or vision coverage to your spouse’s coverage as a dependent; however, your life insurance coverage must be kept in your retirement account.
- To transfer your coverage to your spouse’s plan, mark defer on your retirement insurance application. Your spouse MUST also contact his/her employer to add you to his/her coverage as a dependent.
- You may transfer your coverage back to your own account at any time by completing a new Application for Retiree/Vested/Non-Vest/Defer Insurance Coverage.
- Any retirement system contribution toward your health insurance premium will not be payable during the deferral period.
Dependent Coverage
If you elect dependent coverage, all of your eligible dependents must be covered unless they are covered under another group plan or are eligible for Indian or military benefits. You may elect to exclude coverage for your spouse, but you and your spouse must sign the Spouse Exclusion Section of your retirement insurance application.
Dependents cannot be added after retirement unless one of the following events occurs:
- Birth of a child
- Your spouse or dependents under age 25 lose other group coverage
- You marry
- You adopt or gain legal guardianship of a child (up to age 25)
A new spouse and any eligible dependents must be added within 30 days of the date any of the above events occur. Dependents cannot be added at a later date.
Life Insurance
- You may keep all or part of the life insurance you carried while you were an active employee. Life insurance must be kept in $5,000 increments.
- Premiums: $1.94 per $1,000 of coverage, up to $40,000. Amounts over $40,000 are age-rated.
Dependent Life
- You may keep any life insurance in force on eligible dependents at your retirement. Dependent Life must be kept in $500 increments.
- Premium: $0.97 per $500 of coverage.
If you wish to keep life insurance, complete a new Beneficiary Designation Form when you complete your retirement insurance application. Please keep your beneficiary information current. You may request a beneficiary change at any time by completing a new Beneficiary Designation Form and returning it to OSEEGIB.
Please notify OSEEGIB in writing when:
- A beneficiary changes his/her name
- A beneficiary has a change of address
- Your beneficiary pre-deceases you
In the Event of Your Death
Your surviving spouse and eligible dependents have 60 days to notify OSEEGIB they wish to continue insurance coverage.
-
- They reach age 25
- They qualify for other group coverage
- They get married
- Your surviving spouse may continue insurance coverage as long as premiums are paid. A surviving spouse will pay the primary member rate, and retirement system contributions will not apply.
- Your surviving dependent children may continue coverage until:
Surviving dependent children who elect self coverage will have an account set up as a member, but will continue to pay the child premium rate. Dependent children can also continue life insurance.
Medicare Eligible Members
You should be notified by the Social Security Administration when you are eligible for Medicare Part A and Part B.
All plans offered through OSEEGIB pay benefits as if you are enrolled in both Medicare Part A and Part B.
-
- Delaying Medicare Part B coverage – If you choose to work past age 65, and delay your enrollment in Medicare Part B, you must notify Social Security of your decision and make arrangements to delay coverage.
- Delaying Medicare Part D coverage – If you choose to work past the age of 65 and delay your enrollment in Medicare Part D, you will not have to pay a Medicare late enrollment penalty because you currently have Creditable Prescription Drug Coverage through OSEEGIB.
- Medicare Part A pays for hospital services, and there is no charge for this coverage.
- Medicare Part B pays for doctor and outpatient medical services, and the standard monthly premium for 2009 is $96.40 which is deducted from your Social Security check.
- Medicare Part D pays for prescription drug coverage. All the plans offered through OSEEGIB provide Creditable Prescription Drug Coverage. This means the plans all meet certain benefit guidelines that are set by Medicare.
Medicare Supplement Plans
- HealthChoice High and Low Option Medicare Supplement Plans With Part D. The Plans provide supplemental benefits for Medicare Parts A and B, as well as prescription drug benefits.
- PacifiCare High and Low Option Senior Supplement Plans. The PacifiCare Plans provide supplemental benefits to Medicare Parts A and B, as well as prescription drug benefits.
Medicare Advantage Prescription Drug Plans
You must be enrolled in Medicare Parts A and B to be eligible for enrollment. When you enroll in a Medicare Advantage Prescription Drug Plan, the plan replaces Medicare as your primary insurer. The plans provide benefits for Medicare Part A and B covered services, as well as Medicare Part D prescription drug benefits.
You must live in the plan’s approved ZIP Code service area to be eligible to enroll in a Medicare Advantage Prescriptions Drug Plan. Available plans are:
- CommunityCare Senior
- Generations (GlobalHealth)
You must contact the Medicare Advantage plan directly if you wish to enroll, and you must also notify OSEEGIB.
Your Medicare ID Number
When you complete the Application for Retiree/Vested/Non-Vest/Defer Insurance Coverage, be sure to fill in your Medicare ID number (HICN). HealthChoice must have your Medicare ID number in order to coordinate your benefits with Medicare.
Moving
Pre-Medicare
If you enrolled in an HMO plan and move outside the plan’s ZIP Code service area, you will need to advise OSEEGIB in writing of your new address. Your coverage will be changed to HealthChoice High Option.
- The HealthChoice USA Plan is an option if you move outside of Oklahoma and Arkansas. (The USA election must be made within 30 days of relocation or at the following Option Period.)
- Keep your address current with OSEEGIB!
Medicare
- If you are on Medicare and have a Medicare Advantage product, you will need to contact both OSEEGIB and the HMO to disenroll. Your coverage will be changed to the HealthChoice Medicare Supplement With Part D.
Three Premium Payment Options
- Retirement check – Your monthly premium is automatically deducted from your retirement check.
- Direct bill – You will be directly billed for your monthly premium. You will also receive a direct bill if your retirement check is not large enough to cover your premium amount.
- Automatic draft – Your monthly premium is automatically drafted from your personal checking account. If you elect this option, you’ll need to provide OSEEGIB an Electronic Fund Transfer Authorization Form and a voided check.
Premium Rates
See the Premium Rate Charts for premium rates. The premium rates do not reflect any contribution from your retirement system.
Retirement System Contribution Towards Your Insurance Premium
- Oklahoma Public Employees Retirement System – $105 monthly
- Teachers’ Retirement System – $100 to $105 monthly
ID Cards
HealthChoice
- Members will have two (2) ID cards, one card for health and/or dental benefits, and the other for pharmacy benefits.
- Pre-Medicare retirees should keep their current ID cards. New cards will not be issued by HealthChoice.
- Medicare eligible members will be issued new ID cards.
HMO Plans
- HMOs generally issue new cards. Do not destroy your current cards until you receive new ones.
Option Period
- After retirement, you will receive your Option Period materials through the mail.
Phone Numbers and Websites:
Social Security Administration
Monday through Friday 7 a.m. to 7 p.m., Central Time
Toll-free 1-800-772-1213 or toll-free TTY 1-800-325-0778
Website: www.ssa.gov
Medicare
7 days a week/24 hours a day
Toll-free 1-800-633-4227 or toll-free TTY 1-877-486-2048
Website: www.medicare.gov
Oklahoma Public Employees Retirement System
1-405-858-6737 or toll-free at 1-800-733-9008
Website: www.opers.ok.gov
Oklahoma Teachers’ Retirement System
1-405-521-2387 or toll-free 1-877-738-6365
Website: www.ok.gov/trs
- www.sib.ok.gov -