pennsylvania retired employees health program

The PSERS DC Plan's withholding rules for distributions may apply to rollover money from other qualified plans. Important: It is your responsibility to advise the PEBTF of any events that would cause your disabled dependent to no longer be eligible for coverage. Pennsylvania Employees Benefit Trust Fund (PEBTF) 150 South 43 rd Street, Suite 1 Harrisburg, PA Telephone: (717) ; 7 REHP BENEFITS AT A GLANCE Eligibility Requirements Enrollment in the REHP requires that former employees have a retiree status as well as compliance with all of the following criteria: Was a permanent full-time employee or permanent part-time employee for the 12 months preceding separation from commonwealth employment in a PEBTF eligible position; and Was employed for three years from his or her most recent date of hire, except if the employee was furloughed and returned during the recall period or the employee was previously eligible for REHP coverage other than through a disability; and Was either enrolled in the PEBTF, as either the enrollee or the dependent, on his or her last day actively at work or was eligible for enrollment in the PEBTF on his or her last date actively at work; and Employees who are enrolled in SERS in an Age 60 (65 for employees subject to Act 120 of 2010) to Age 50 (55 for employees subject to Act 120 of 2010) superannuation age group will be required to remain in the new position for one year until qualifying for the REHP at Age 50 superannuation age (55 for employees subject to Act 120 of 2010); and Employees who are enrolled in SERS in an Age 50 (55 for employees subject to Act 120 of 2010) to Age 60 (65 for employees subject to Act 120 of 2010) who have qualified for Contribution Rate Coverage prior to the change do not lose eligibility they earned for Contribution Rate Coverage. Marginal dots are excluded due to major changes. GENERAL 1.1 What is happening to my retiree medical and prescription drug benefits for Medicare-eligible participants as of January 1, 2015? A school employers (PSERS reporting unit) group health insurance plan providing hospital, medical and major medical coverage. "Emergency" shall be interpreted within a narrow, literal context. The higher this is, the more contribution deferrals are incorporated in the level percent funding methodology. If you or a dependent on your PEBTF-administered health insurance coverage is eligible for Medicare, you can choose a new health plan during Medicare Open Enrollment between October 24 - November 11, 2016, but it is not required. Whether you can rollover your distribution to another plan depends upon whether the plan receiving the money allows rollover money into the plan. The Commonwealth sponsors the Retired Employees Health Prog ram (REHP) for eligible retirees and their dependents to receive subsidized health coverage for the retiree's lifetime. The Handbook is designed to make it easy for you to find answers to questions you have about your benefits. If you have already reached SERS normal retirement age, or the age at which you are eligible for a pension that is not reduced for early retirement, you are eligible for monthly pension payments after working three years. A portion of your vested balance in a single lump sum distribution with the remaining balance distributed in one of the other permitted forms. When Do I Become Eligible? Counties and municipalities, for the most part, face less budgetary pressure from pensions compared with school districts as most plans are well funded and costs are projected to remain manageable. We apologize for any inconvenience and frustration. If you are vested, you may elect the Maximum Single Life Annuity or a survivor annuitant option (Options 2, 3, or Customized). The dependent does not have the option of enrolling in REHP coverage that the retiree does not have nor dropping REHP coverage in which the retiree is enrolled. Download OA Presentation from the 2022 Governing Board Meeting. A generational assumption reduces risks of contribution jumps due to periodic updates from experience studies. Under Options 2, 3, or Customized (if it included a survivor), you may name a new survivor annuitant and/or elect a different option if your marital status changes or your designated survivor annuitant dies before you. Medicare Eligible Retirees Contact SERS with questions about your specific plan or fill out our contact form for general questions. You can expect your account statement, featuring the 2018 payment calendar, in about a week. This Handbook is designed to help you understand your health care benefits. 74 and 75 (GASB Nos. Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service. Pennsylvania School Retiree Health Coverage Sponsored by Public School Employees' Retirement System . Benjamin D Gallovic, Chicago+ 1 (312) 233 7070; Geoffrey E Buswick, Boston+ 1 (617) 530 8311; Todd D Kanaster, ASA, FCA, MAAA, Centennial+ 1 (303) 721 4490; Randy T Layman, Centennial+ 1 (303) 721 4109; Jillian Legnos, Hartford+ 1 (617) 530 8243; Christian Richards, Washington D.C.+ 1 (617) 530 8325; Historically weak funding discipline resulting in weak pension funded ratios and deferred costs for Pennsylvania's largest plans, adding to budgetary pressure for the commonwealth and local school districts. The commonwealth sponsors two health care plans - the Retired Employee Health Program (REHP) and the Retired Pennsylvania State Police Program (RPSPP) - that allow eligible retirees or annuitants and their dependents to continue subsidized health care coverage through the commonwealth for the life of the retiree. You retire or lose health care coverage under your school employers health plan. hired after 1/1/19. Also, you may have fewer out-of-pocket expenses if you select a participating provider. It, too, will be mailed from Claysburg and available in youronline member service accountshortly thereafter. The Retired Employees Health Program (REHP) covers retirees and their eligible dependents who are not eligible for coverage under Federal Medicare Programs. An annuitant may be returned to commonwealth service for a period not to exceed 95 Days in any calendar year. 1/7/2016 Keystone State. Out-of-network (Basic Option and HMO): $0 annual deductible, plan pays 80% of eligible expenses, no reduction for non-notification. Non-Medicare eligible retirees who are enrolled in the Basic Option or the Consumer Driven Health Plan (CDHP) should direct all questions to the PEBTF at the address or telephone number listed at the bottom of page Non-Medicare eligible retirees who are enrolled in an HMO or PPO should direct their benefits, ID card and claims questions as follows (and in the order presented): a. to the HMO or PPO providing their coverage; and b. to the PEBTF at the address or telephone number listed at the bottom of page 4. For many of you, the new federal tax law enacted on 12/22/17 will impact the amount of money withheld from your monthly pension payments for federal income tax, starting with your February payment. City of Detroit Retiree Health Care Plan, Financial Information for Kidney and/or Pancreas Transplantation, WELFARE FUND SUMMARY PLAN DESCRIPTION. Please just call 1.800.633.5461. Contribution levels in recent years have met actuarially determined levels and are now covering our calculation of minimum funding progress (MFP). Prescription Drug Plan: The Prescription Drug Plan is a generic reimbursement plan. The determination whether an individual is totally and permanently disabled will be made by the commonwealth (or its delegate) in reliance upon medical opinion and/or other documentation (e.g. A Pennsylvania common law marriage will not be recognized unless the common law marriage was entered into prior to September 17, Child under age 26, including: Your natural child (original birth certificate required) Legally-adopted child; includes coverage during the probationary period (Court Adoption Decree is required) Step-child for whom you have shown an original marriage certificate and a birth certificate indicating that your spouse/domestic partner is the parent of the child Child for whom you are the court-appointed legal guardian or legal custodian as demonstrated by the appropriate court order these orders expire on the child s eighteenth birthday Eligible foster child Child for whom you are required to provide medical benefits by a Qualified Medical Child Support Order or National Medical Support Notice Coverage for Dependent Children to Age 26: As an Employee Member, you may cover your child to age 26. Any claims incurred after the date of divorce are your responsibility. retiree or survivor annuitant must decide whether or not to participate. Earlier today, we mailed your Personal Statement of Pension Payments, featuring the 2015 payment calendar, directly from our print and mail vendor in Claysburg, PA. Those circumstances include the death of the individual you named asyour survivor (someone who will receive monthly payments after your death), your marriage, or your divorce. PEBTF - REHP Handbook Request for billing agencies for the cost of the Retired Employees Health Program (REHP). Get Free Pa Retired Employees Health Program information about human disease and pathology, including diagnostics and treatments Please read this Handbook carefully and share it with your family to ensure that you understand your benefits. Key Healthcare Insurance Terms Agent: A person who represents an insurance company and solicits or sells the company s insurance products. Solutions for Today Flexibility for Tomorrow. Retired Employees Health Program (REHP) PEBTF. In most instances, a spouse/domestic partner who is not eligible for REHP coverage as a result of his or her own commonwealth employment, but has REHP coverage through a spouse or domestic partner will become ineligible for REHP coverage on the date the divorce/termination of domestic partnership from the retiree is final unless he or she elects COBRA Continuation Coverage. Your forms also will be available in youronline member services accountthis Thursday, Jan 19, 2017. However, the effective date cannot be more than 60 days retroactive from the date the form is received by SERS (or the PEBTF for retirees in PSERS, TIAA-CREF or ARS). 1099-R Tax Documents Are in the Mail Exploring Your Healthcare Benefits Through LACERA Retiree Healthcare Administrative Guidelines To Los Angeles County Retirees: Welcome to retirement! On or after Jan. 1, 2011,you are eligible for , Health WebREHP Benefits Handbook for Retiree Members Retired Pennsylvania State Police Program (RPSPP) Benefits Handbook Retirees Turning 65 Click Here for More Information, Health WebYou can arrange for a review by contacting PISI/AMBA at the number provided below. TABLE OF CONTENTS Page I Important Notice 1 II Highlights 5 Comprehensive Health Care Benefit (CHCB) 5 Managed Medical Care Program (MMCP) 7 Mental Health and Substance Abuse Care Benefit (MHSA) City of New York Health Benefits Program Frequently Asked Questions for Retirees UPON YOUR RETIREMENT YOU WILL BE ENROLLED FOR HEALTH BENEFITS ON THE FIRST DAY OF YOUR RETIREMENT PROVIDED YOUR APPLICATION, HMO ILLINOIS A Blue Cross HMO a product of BlueCross BlueShield of Illinois SAMPLE COPY Your Health Care Benefit Program A message from BLUE CROSS AND BLUE SHIELD Your Group has entered into an agreement, TABLE OF CONTENTS Introduction 1 Benefits Overview 6 Flexible Benefits Overview 6 Non-Flexible Benefits 6 Flexible Benefit Waiver Payments 6 Effect on Social Security 7 How To Enroll, STEPPING INTO MEDICARE Invaluable help from the name you know and trust Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Illinois offers a great array of plans that pick up where Medicare, State Retiree Medicare Advantage Plans October/November 2015 Copyright 2013 by The Segal Group, Inc. All rights reserved. Upon the death of the retiree, the surviving spouse/domestic partner may apply for REHP coverage on a self-pay basis. Despite rising costs, contributions remain insufficient to make funding progress for school districts, but increased contributions from the commonwealth to its employee plan resulted in increased funding progress, however aggressive assumptions could erode future progress if market volatility continues. Non-Medicare Eligible Retirees and Dependents Retirement Date Prior to 7/1/04 Basic Option Blue Cross/Blue Shield (hospital/surgical-medical) Major Medical - $100 deductible Preferred Provider Organization (PPO) Option (also available to out-of-state residents) $15 copayment for Primary Care Physician (PCP) in network office visit ($20 after hours) $25 copayment for in network specialist office visit $50 copayment for Emergency Room (waived if the visit leads to an inpatient admission to the hospital) Out-of-network: $250 annual deductible ($500 per family); plan pays 80% of next $5,000 of eligible expenses; 100% of eligible expenses in excess of $5,000 Health Maintenance Organization (HMO) Option (requires residency in plan coverage area) $15 copayment for Primary Care Physician (PCP) office visit ($20 after hours) $25 copayment for specialist office visit $50 copayment for Emergency Room (waived if the visit leads to an inpatient admission to the hospital) Medical Reimbursement Plan No out-of-network benefit Mental Health and Substance Abuse Program $10 copayment for in-network mental health office visit (PPO and HMO) $0 copayment for in-network substance abuse office visit (PPO and HMO) $0 copayment for in-network mental health/substance abuse inpatient treatment (PPO and HMO) $50 copayment for Emergency Room (waived if the visit leads to an inpatient admission to the hospital) 6, 9 Out-of-network (PPO Option): $250 annual deductible ($500 family); plan pays 80% of eligible expenses; maximum out-of-pocket $1,000 individual ($2,000 family); pre-authorization penalty of 20% reduction for non-notification. S&P has established policies and procedures to maintain the confidentiality of certain nonpublic information received in connection with each analytical process. Retired members can get duplicate tax forms and click through to the Pennsylvania Employees Benefit Trust Fund - the PEBTF - for more about your health care. Mental Health and Substance Abuse Program: (Applies to non-medicare eligible retirees only). Participation in Health Options Program is voluntary and the benefits are financed by the premiums paid by plan participants. 17, 20 Disabled Dependents Your disabled dependent of any age may be covered if all of the following requirements are met: Is totally and permanently disabled, provided that the dependent became disabled prior to age 26 Was your or your spouse s/domestic partner s dependent before age 26 Depends on you or your spouse/domestic partner for more than 50% support Is claimed as a dependent on your or your spouse s/domestic partner s federal income tax return Completes a Disabled Dependent Certification Form (must be completed by retiree member) NOTE: A disabled dependent child will not automatically be excluded from coverage if he or she lives outside the retiree s home, but the child s living situation and its ramifications will be taken into account in determining whether the child meets the support requirements.
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