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Published byTheodora Hampton Modified over 8 years ago
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County Retiree Health & Life Insurance Benefits
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Program Documentation Represented Employees: Labor Contracts. Non-represented Employees: Multnomah Cty Code Section 9.5, Ordinance 981, Personnel Rule 4-20.
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Health Insurance Requirements Must be eligible to begin a PERS pension at the time County employment ends. County retiree must immediately enroll in coverage when County employment ends. Cannot add coverage at a later time. However, may defer activating County retiree coverage if you are a dependent enrolled under another County employee’s or retiree’s health insurance plan at your separation. Forms must be completed at separation.
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Initial Enrollment County retiree (RR) health insurance begins after County employee (EE) health insurance ends following the 15/16 Rule. RR Plans are the same coverage as EE Plans. Retiree premiums = Employee plan premiums paid by County. At retirement, you may change enrollment status or “buy down” to another plan offered by your health insurance provider. Kaiser members must reside in the Kaiser Permanente NW service area.
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Money Matters Retiree pays 100% of the dental premium – no subsidy. Some retirees may be eligible for the medical premium subsidy: Local 88, Management, FOPPO, Juvenile Group Workers, Painters, Prosecuting Attorneys: Subsidy = 50% of the total monthly medical premium. Elec, Engr, MCCDA, MCDSA, ONA: Subsidy = 50% of the County contribution toward the active employee’s total monthly medical premium. 100% medical premium subsidy – may be available to Elec, Engr, & ONA members who work to age 60. (Refer to Local 48 and 701 contracts for member list.)
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Medical Premium Subsidy Medical subsidy eligibility is based on: 1) age at retirement, and 2) years of County service (part-time employment is pro-rated). Medical subsidy continues until retiree is Medicare eligible or age 65 (whichever occurs first).
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Medical Subsidy Requirements (Refer to Ordinance 981 or Labor Contracts) Example #1: Retires prior to age 58, with 10 years County service, and not Medicare eligible. Retiree pays 100% of the medical premium up to age 58. 50% medical premium subsidy begins at 58 (first of month following 58 th birthday). Subsidy ends at age 65 or when Medicare eligible – whichever occurs first.
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Medical Subsidy Requirements (Refer to Ordinance 981 or Labor Contracts) Example #2: Retires from age 58 up to 65, with 5 years County service, and not Medicare eligible. 50% medical premium subsidy begins at retirement. Subsidy ends at age 65 or when Medicare eligible – whichever occurs first.
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Medical Subsidy Requirements (Refer to Ordinance 981 or Labor Contracts) Example #3: Retires with 30 years PERS service and not Medicare eligible. Refer to Labor Contracts or Ordinance 981 for eligibility requirements and implementation of subsidy based on age. Subsidy ends at age 65 or when Medicare eligible – whichever occurs first.
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Medical Subsidy Requirements (Refer to Ordinance 981 or Labor Contracts) Example #4: Retires with a PERS Disability Retirement, 10 years of County service, and is not Medicare eligible. Subsidy available @ retirement. Subsidy ends at age 65 or when Medicare eligible – whichever occurs first.
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2013 Example - Local 88 Member ODS Platinum Med (2-party) & Kaiser Den (2-party) – Approved for 50% Medical Subsidy until age 65 or Medicare Eligible (whichever occurs first). Note: Rates may change annually. Retiree age 55 with 10 years of County service. Retiree turns age 58. $1,310.50 Medical $ 137.20 Dental $1,447.70 / Month $ 655.25 Medical $ 137.20 Dental $ 792.45 / Month Medical subsidy ends at age 65 or when Medicare eligible (whichever occurs first). County retiree health insurance continues – retiree pays 100% of medical and dental premiums.
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Paying Your Premium There are two payments options – due dates meet County’s obligation to pay ODS/Kaiser: Payment by Check: Invoice payment due date is the 20 th of the month for the following month’s coverage. Ex.: Payment due Dec. 20 for Jan. coverage. EFT (Electronic Fund Transfer): Funds are withdrawn from your bank account on 5 th day of the month for the current month’s coverage. Ex.: Withdrawal on Jan. 5 for Jan. coverage.
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Open Enrollment Options Retirees have the same open enrollment options as active employees each year. You can change health plan, and coverage is subject to annual rate changes. Retirees may change to a different health plan, drop medical or dental coverage, or add or remove dependents. The effective date of coverage for open enrollment changes is January 1 st.
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Qualifying Events During the health plan year, retirees are unable to change health plans or remove dependents from coverage without a qualifying event: marriage, birth, divorce, SP/DP gains/loses health insurance through his/her employer, or Medicare eligibility.
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COBRA If County retiree passes away, family members are offered continuation of health insurance coverage (COBRA) as follows: SP/DP under age 55: 36 months of COBRA. SP/DP age 55 or over: COBRA like option until age 65 or Medicare eligible (whichever occurs first). Dependent children: 36 months of COBRA.
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Medicare All County retiree health plans require participants who are eligible for Medicare to enroll in Medicare. Regular Medicare effective at age 65. Early Medicare – effective prior to age 65 due to medical condition. Medicare Part A (Hospitalization) – generally no monthly premium. Medicare Part B (Medical Services) – 2013 monthly premium is $104.90. Medicare Part D (Prescriptions) – County health insurance = Medicare Part D. No need to purchase Medicare Part D.
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Retiree and/or Dependent Medicare Eligible Multnomah County requires enrollment in Medicare Part A and Part B. ODS plans are not Supp. Medicare plans. ODS will pay claims as secondary insurance even if enrollment in Medicare does not occur. Kaiser offers Supplemental Medicare plans. Participants are required to enroll in Medicare A & B and Kaiser Senior Advantage. Participants may not be enrolled in 2 Kaiser medical plans.
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Retiree Medicare Eligible Retiree continues County medical and/or dental coverage – pays 100% of the premium. Retirees cancels County medical and/or dental coverage and purchases a Supp. Medicare plan. Example: PERS Health Insurance Program. (503) 224-7377 Non-Medicare SP/DP and children ( up to age 18 ) continue County coverage under ORS 243.303. Participants pay 100% of the premium.
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Life Insurance County Retiree Life Insurance Program Retirees may be eligible for a $2,000 or $5,000 County-paid life insurance policy ( Refer to Personnel Rules & Labor Contracts ) Basic Life and Supplemental Life Insurance At retirement, your active employee life insurance policy may be continued as an individual policy. Election form must be filed with UNUM within 31 days of ending County employment.
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Long Term Care Insurance PERS offers LTC through UNUM. New retirees are mailed information in the PERS Health Insurance Program packet. Retirees are mailed information 60 days prior to eligibility for Medicare. UNUM: 1-800-227-4165. Multnomah County LTC – Local 88, Mgmt, ONA: May continue current coverage by notifying UNUM within 60 days of separation.
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VEBA Current VEBA account balances will continue to be available after separation. Eligible County employees, who receive contributions to a VEBA account as a negotiated benefit, are: Electricians. Engineers. FOPPO. Management. MCCDA. MCDSA.
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County Retiree Benefits Questions Please feel free to contact Marla Imsland or Jeanie Staino Multnomah County Employee Benefits Office (503) 988-5651. We are here to help you with your health and life insurance needs.
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