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Benefits Overview for Employees Planning to Retire Employee Health & Benefits 114 State House Station Augusta ME 04333-0114 (207)624-7380 or 1-800-422-4503.

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Presentation on theme: "Benefits Overview for Employees Planning to Retire Employee Health & Benefits 114 State House Station Augusta ME 04333-0114 (207)624-7380 or 1-800-422-4503."— Presentation transcript:

1 Benefits Overview for Employees Planning to Retire Employee Health & Benefits 114 State House Station Augusta ME 04333-0114 (207)624-7380 or 1-800-422-4503 TTY users dial Maine Relay 711 www.maine.gov/deh Updated: April 1, 2015

2 Your Current Benefit Programs Health Insurance  Wellness Dental Insurance Employee Assistance Program MaineSaves 457b Vision Insurance Long-Term Care Insurance Flexible Spending Accounts Employee Assistance Program 2

3 Health Insurance Health Plans Eligibility Premium Cost  Retiree  Dependents Medicare Coordination of Benefits Turning 65 after retirem ent 3

4 Health Insurance: Health Plans Does Not Qualify for Medicare Point of Service Plan Qualify for Medicare Medicare Advantage Plan 4

5 Health Insurance: Eligibility One – You must be enrolled as an employee in the health plan one full year (12 consecutive months) immediately prior to retirement. Two – Once retired, you must draw a monthly retirement check.*  *If not retiring but terminating after 25 years or more of credible employment, you may opt to waive or pay for the insurance until you retire. 5

6 Health Insurance: Premiums for the Retiree Only The individual premium is determined by: 1. Date first hired by the State of Maine a) On or before 7/1/1991 b) After 7/1/1991 but before 7/1/2011 c) On or after 7/1/2011 2. Age at retirement (normal retirement age “NRA”?)* 3. Years of participation in the health plan Above will determine how much the State will contribute to your own individual health insurance premium in retirement. *NRA not required if retiring under a “special” or disability retirement plan 6

7 Eligibility requirements must be satisfied Health Insurance: Retiree Premium If you were first hired on or before 7/1/1991 and  you are at least at your normal retirement age*, the individual premium is paid 100% by the State of Maine OR…  you are younger that your normal retirement age, the individual premium is paid 100% by you, the retiree, until you reach normal retirement age. Remember, with 25 years of credible service you can put your health insurance “on hold” until you reach normal retirement age. *NRA requirement does not apply to “special” or disability retirees.

8 Eligibility requirements must be satisfied Health Insurance: Retiree Premium You were first hired after 7/1/1991 but before 7/1/2011 and you are at least normal retirement age* State contribution is prorated based on years of participation in the health plan: *You will be responsible for 100% of your retiree premium if you are younger that your normal retirement age at retirement unless retiring under a “special” or disability retirement plan. Participation in the Health Plan State Paid Premium Contribution Less than 5 years0% 5 years but less than 650% 6 years but less than 760% 7 years but less than 870% 8 years but less than 980% 9 years but less than 1090% 10 years or more100%

9 Eligibility requirements must be satisfied Health Insurance: Retiree Premium You were first hired on or after 7/1/2011 and you are at least normal retirement age* State contribution is prorated based on years of participation in the health plan: *You will be responsible for 100% of your retiree premium if you are younger than your normal retirement age at retirement unless retiring under a “special” or disability retirement plan. Participation in the Health Plan State Paid Premium Contribution Less than 10 years0% 10 years but less than 1550% 15 years but less than 2075% 20 years or more100%

10 Health Insurance: Premiums for Dependents Once retired, the State does not contribute towards the premium for your dependents  $784.58/month (Spouse not on Medicare)  $293.10/month (Medicare Advantage - Spouse) The premium rates for POS & Medicare plans can be found on the rate sheet provided separately. 10 Rates good through 6/30/15 & 12/31/15 respectively.

11 Qualifying for Medicare Turning 65 and earned 40 or more quarters under the Social Security Administration (“SSA”) SSA disabled Married to or have been married to a spouse who has earned their 40 or more quarters with SSA This information is applicable to the retiree, their spouse/domestic partner and any children that are SSA disabled that are covered by the State of Maine health plan. 11

12 Medicare Benefits *Once you terminate or retire, you must apply for Medicare if you qualify Medicare part A – pays for hospitalizations. Part A is free for most. Medicare part B – pays for doctor visits, diagnostic testing, etc. Part B is at your own expense. Medicare part D – Do not purchase. The State of Maine Medicare Advantage plan contains a Medicare D component. You are not allowed to carry two Medicare D plans. 12

13 Medicare Plan for Retirees: Medicare Advantage PPO Plan It is very important you continue enrollment in Medicare A & B. You will only need to show your Aenta card; your Medicare card will be kept but not used. The State’s plan has an annual deductible of $250. Prescriptions will be covered by the State’s plan so you do not need to purchase any additional coverage (e.g. Part D). Refer to applicable benefit overview for copay amounts.  There are several lists of drugs (“formulary”) that Medicare covers. We have chosen a formulary that has a very wide variety but some day supplies are limited per the Federal government. 13

14 Turning 65 After Retirement? Employee Health and Benefits will be contacting you prior to your 65 th birthday  Medicare Eligibility (Medicare Part A at no cost to you) Yes – enroll in Original Medicare Parts A & B  Complete Medicare Advantage application No – provide Employee Health with a copy of your ineligibility letter from Social Security Spouse’s birthday; two separate plans possible 14

15 Coordination of Benefits You may be eligible for other health insurance plans Tri Care  Under 65: Aetna POS plan is primary  65+ : Medicare is primary, Aetna Medicare Advantage second & Tri Care third Important to maintain the appropriate level of coverage www.tricare.mil for more information www.tricare.mil 15

16 Wellness Programs Aetna POS Plan  Global Fit – Fitness discount program  Weight Management discount program Aetna Medicare Advantage Plan  Silver Sneakers (eff 1/1/14)  Aetna Healthy Lifestyle Coaching program Wellness Works (eligibility requirements)  Augusta & Bangor facilities 16

17 Dental Insurance Dental is not a benefit of retirement Federal COBRA Law  Coverage for up to 18 months  Combined Services, Inc. - COBRA administrator Other group policies  MSEA  Maine Association of Retirees  You may also purchase as an individual policy directly through the insurance carriers

18 Effective 7/1/14 - 6/30/15 Dental Insurance: Monthly COBRA Rates One person $26.78 Two people $47.88 Family $91.62 The retiree does not need to enroll in order to cover family member(s).

19 Blue View Vision Current participants - it follows you into retirement  Same coverage  Premiums slightly higher  You will be directly billed by Anthem Blue View Not a member? You can enroll during open enrollment as a retiree. 19

20 Rates effective 1/1/2011 - 6/30/15 Blue View Vision Monthly Retiree Rates  Retiree only $5.90  Retiree + 1 dependent $9.47  Family rate $15.36 *Directly billed by Anthem as premiums cannot be withheld from your pension

21 “COBRA” Consolidated Omnibus Reconciliation Act of 1985 Federal requirement to extend current coverage for a limited time  Health Insurance  Dental Insurance  Vision Insurance Administered by Combined Services, Inc. 21

22 COBRA – What to Expect You will receive  COBRA Election Notice  A letter from Employee Health & Benefits Program administrator: Combined Services, LLC Daphne Paige 1-888-227-9745 ext. 2023 22

23 MaineSaves 457b Plan Vacation pay deferral option Work with your local representative; many distribution options available If you’re not enrolled, it’s never too late to start saving Update your beneficiary information 23

24 MaineSaves (continued) There is no age 59 ½ penalty on the State’s 457b plan You must start taking a required minimum distribution at age 70 ½ (if you are no longer working for the State of Maine) 24

25 Long-Term Care For current participants only:  Follows you into retirement  Direct bills will continue Prudential Aetna (Membership is closed to new enrollees) 25

26 Flexible Spending Accounts Current participants  Positive account balance=COBRA will be offered*  Negative account balance=account is closed *Flex-Plan Services will provide COBRA administration Call 1-800-669-3539 for more information This is not a benefit in retirement 26

27 Employee Assistance Program Continues as a no cost benefit to retirees and members of their household Up to 5 confidential counseling visits offered per year Legal & financial discount programs available AllOne Health 1-800-451-1834 27

28 Still Have Questions? Employee Health & Benefits www.maine.gov/deh 1-800-422-4503 (207) 624-7380 TTY users dial Maine Relay 711 28


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