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Health

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Frequently Asked Questions for Retirees

Questions

1. What are my options when I decide to retire?

2. What is Open Enrollment?

3. How do retirees participate in Open Enrollment?

4. When will my benefit changes take place?

5. What changes can I make during Open Enrollment?

6. Do I need to take any action during Open Enrollment if I do not wish to make any changes?

7. Can I make changes to my coverage at any time?

8. Where can I get a list of providers for the plan I am interested in joining?

9. How does the State Group health plan work with Medicare?

10. What happens when I become eligible for Medicare due to disability or if I turn 65?

11. How can I change or cancel my health insurance plan during Open Enrollment?

12. As a Surviving Spouse, am I entitled to this health insurance if I remarry?

13. If I cancel my group health insurance, may I re-enroll at a later date?

14. Who administers the life insurance for retirees?

15. What is the benefit amount for retiree life insurance?

16. Since I am already covered on Retiree Life Insurance, may I enroll in the Optional Life and Accident and Disability insurance coverage?

17. How do I update my address with People First?

18. Can I pay my premium electronically?

19. Whom can I contact to see if my premium has been received?

20. Where do I send required documentation?


Answers


1. What are my options when I decide to retire?

  • Look for your Retiree package in the mail.
  • Health — continue through COBRA for up to 18 months or elect retiree coverage
  • Basic Life — choose either the $2,500 or the $10,000 benefit (Optional Life is not available)
  • Dental and Vision — continue through COBRA for up to 18 months
  • Other Supplemental Plans — contact your insurance company about converting your policy or buying an individual plan
  • Health Savings Account — make contributions until Medicare eligible, but the state will no longer make contributions
  • Medical Reimbursement Account — continue through the end of the calendar year if you pay the balance and complete the MRA Options when Employment Ends form
  • Dependent Care Reimbursement Account — ends with your last employee payroll deduction, but you can file claims that were incurred before your termination date
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2. What is Open Enrollment?

Open Enrollment is a time period each year when retired state employees can make changes to their benefits; for example, change from individual to family health coverage, add or delete dependents and change health plans.

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3. How do retirees participate in Open Enrollment?

Retirees can make changes on the People First website or call (866) 663-4735. TTY users dial (866) 221-0268.

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4. When will my benefit changes take place?

The changes made during the Open Enrollment period will be effective on January 1 of the following year.

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5. What changes can I make during Open Enrollment?

As a retiree, you may change your health coverage to individual or family. You may change your health plan. You may add or drop dependents or you may cancel.

Retirees may also increase, decrease or cancel life insurance coverage during the Open Enrollment period.

If you cancel your coverage, you will not be allowed to join the plan at a later date.

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6. Do I need to take any action during Open Enrollment if I do not wish to make any changes?

You should always look at your mailed benefit materials so that you will be aware of premium increases and plan changes. If you do not wish to make changes, your benefits will carry over to the next plan year.

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7. Can I make changes to my coverage at any time?

You may reduce or cancel your coverage at any time but if you cancel, you will not be allowed to re-enroll in the program at a later date; otherwise, you must experience a Qualifying Status Change (QSC) event and make changes within the QSC window.

When you become eligible for Medicare, either due to age (65) or disability, you should immediately enroll in Medicare Part B to avoid high out-of-pocket medical claim expenses. You will be moved to a Medicare coverage tier at that time.

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8. Where can I get a list of providers for the plan I am interested in joining?

Visit the insurance company's website for a listing of network providers. Call the number on the back of your insurance card; your plan's member services can also help you locate a network provider.

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9. How does the State Group health plan work with Medicare?

Your State Group health plan will become secondary insurance - health insurance that pays secondary to Medicare Part B (even if you fail to enroll in Part B) when Medicare pays or pays primary when Medicare doesn't pay. Prescription drug coverage that pays primary for most prescription drugs is included. Florida Blue administers the nationwide PPO secondary plan; Aetna, AvMed, Coventry and UnitedHealthcare administer the HMO secondary plans in their respective service areas.

Creditable Coverage for Medicare Part D: If you are enrolled in the State Group secondary health insurance, you do not need to enroll in a separate Medicare Part D plan. The state's prescription drug coverage is as good as or better than Medicare Part D and is approved by Medicare as creditable coverage.

Medicare (Retiree) Advantage Plan: Capital Health Plan and Florida Health Care Plans offer this plan to state retirees in their respective HMO service areas. To become a member, you must be enrolled in Medicare Parts A and B, complete the HMO's application and receive approval before your retiree health coverage becomes effective. Medicare Advantage Plans do not allow retroactive enrollment and claims can only be paid if you are approved for the plan. Medical and prescription drug coverage are included.

Medicare Tiers: the state offers three coverage tiers for Medicare eligible retirees:

  • Medicare I: a single policy for you
  • Medicare II: a family policy for you and your eligible dependents and at least one is eligible for Medicare
  • Medicare III: a family policy for you and one dependent and you are both Medicare eligible
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10. What happens when I become eligible for Medicare due to disability or if I turn 65?

When you or your spouse becomes eligible for Medicare, enroll in Medicare Parts A and B through Social Security and send a copy of your Medicare ID card to People First. If you are eligible for Medicare, the State Group Insurance Plan pays health insurance claims secondary to (after) Medicare, even if you don'’t sign up for or purchase Medicare Part B, medical. This also applies to dependents on your plan who are eligible for Medicare.

Failure to buy Medicare Part B means you will have significant out-of-pocket expenses for Part B eligible services because you will be required to pay the portion (approximately 80 percent) that Medicare would have paid. If you choose to continue your state health insurance coverage once you’'re eligible for Medicare, you should immediately elect your Medicare Part B coverage. Although Medicare does not require you to purchase Part B, it is in your financial interest to do so.

For proper enrollment and claims processing, send a copy of your Medicare ID card as soon as you get it from the Social Security Administration to:

People First
P. O. Box 6830
Tallahassee, FL 32314

Fax: (800) 422-3128

If you are a member of Capital Health Plan or Florida Health Care Plans, you must complete an application to enroll in their respective Medicare Advantage plans. Call the HMO for more information.

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11. How can I change or cancel my health insurance plan during Open Enrollment?

Log on to https://peoplefirst.myflorida.com or call the People First Service Center at (866) 663-4735.

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12. As a Surviving Spouse, am I entitled to this health insurance if I remarry?

No. But you may submit a copy of your marriage license to continue under COBRA for 18 months.

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13. If I cancel my group health insurance, may I re-enroll at a later date?

No. If you are retired and you cancel your enrollment in the State's Group Health Insurance Program, or you allow your coverage to terminate due to nonpayment of premiums, you may not re-enroll at a later date as a retiree.

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14. Who administers the life insurance for retirees?

Minnesota Life. Visit www.lifebenefits.com/florida or call (888) 826-2756.

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15. What is the benefit amount for retiree life insurance?

There are two levels of cost and coverage for retirees: $29.65 per month for $10,000 of coverage and $7.41 per month for $2,500 of coverage.

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16. Since I am already covered on Retiree Life Insurance, may I enroll in the Optional Life and Accident and Disability insurance coverage?

Retirees are not eligible to enroll in Optional Life insurance.

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17. How do I update my address with People First?

You can update your address at https://peoplefirst.myflorida.com or call the People First Service Center at (866) 663-4735. Remember to also update your address at the Division of Retirement.

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18. Can I pay my premium electronically?

If you are receiving a monthly retirement benefit from the Division of Retirement, your premium may be deducted from your benefit, or you have the option of setting up electronic payments online through your personal bank. If you choose to do the latter, be sure you notify your bank each time premium cost changes to be sure your coverage continues.

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19. Whom can I contact to see if my premium has been received?

Call the People First Service center at (866) 663-4735 to verify receipt of your premium.

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20. Where do I send required documentation?

People First
P. O. Box 6830
Tallahassee, FL 32314

Fax: (800) 422-3128

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