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State Health Plan Enrollment Process for Eligible Retiring Employees

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If you are retiring under the Teachers’ and State Employees’ Retirement System, and you are eligible for State Health Plan retiree group coverage, you will be auto-enrolled into a health plan after you have submitted, and the Retirement System has processed, your Form 6E, Choosing Your Retirement Payment Option.

You are encouraged to act quickly in returning your Form 6E.

State Health Plan retiree group coverage begins on first day of the month following your effective date of retirement.

  • If under 65 (and not Medicare-eligible), you will be automatically enrolled in the health plan you were enrolled in as an active employee along with any covered dependents.
    • If you did not have coverage in the State Health Plan as an active employee, you will be automatically enrolled in the Traditional 70/30 Plan retiree-only coverage.
    • You can change your auto-enrollment plan or coverage (or opt out of coverage) up to 30 days after your coverage effective date.

  • If Medicare-eligible and your retirement process is completed 60 days or more prior to your coverage effective date, you will be automatically enrolled into the UnitedHealthcare Medicare Advantage Base Plan.
    • You will have up to 30 days prior to your coverage effective date to change plans.
    • If no action is taken, you will remain in your assigned Medicare Advantage Plan until next Open Enrollment, and your non-Medicare eligible dependents will be enrolled into the health plan they were enrolled in while you were an active employee.
    • You and any Medicare eligible dependents need to have Medicare Part B in place and made effective as of your retirement effective date.

  • If Medicare-eligible and your retirement process is completed less than 60 days prior to your coverage effective date, you will be automatically enrolled in the Traditional 70/30 Plan.
    • You will have up to the day before your coverage effective date to elect a Medicare Advantage Plan.
    • If you do not elect a Medicare Advantage Plan, you will remain in the 70/30 Plan until next Open Enrollment, and your non-Medicare eligible dependents will be enrolled into the health plan they were enrolled in while you were an active employee.
    • You and any Medicare eligible dependents need to have Medicare Part B in place and made effective as of your retirement effective date.​

 

NOTE: If you do not take action within the specified time period to change coverage, you (and your covered dependents) will remain, unless you drop coverage, in the assigned auto-enrolled retiree group health plan and pay the applicable premiums until the next State Health Plan Open Enrollment (or qualifying event). You do not need a qualifying event or to be within the open enrollment period to drop coverage for yourself and/or your covered dependents.
 
If you have questions about your health plan options, please visit the State Health Plan website or contact Customer Service at 855-859-0966.