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FAQ

Revised May 16, 2012

Health Insurance - Continuation as an Annuitant/Survivor - Medicare

  • If an employer stays with ETF administered health insurance but switches health coverage options, does that affect the employer's annuitants?

    Yes, annuitants, continuants, survivors, etc., go with the employer to the new health coverage option.

  • Must annuitants apply for Medicare D since ETF administered health insurance has prescription coverage?

    Retired employees and their dependents who are enrolled in Medicare will automatically be enrolled in the Navitus Medicare Rx (PDP), Underwritten by Sterling Life Insurance Company. This is an Employer Group Waiver Plan which is Medicare Part D coverage. We don't recommend enrolling in another Medicare Part D Prescription Drug Plan (PDP).

  • What, if anything, needs to be submitted when an employee becomes Medicare eligible?

    Active employees and their insured dependents eligible for Medicare can defer enrollment until termination or until health insurance coverage ceases. Annuitants and their insured dependents who are eligible for Medicare must enroll when first eligible. ETF will send the annuitant a Medicare Eligibility Statement (ET-4307) to complete.

  • When an employee dies and continuation of their existing plan is offered to the widow(er), does the employer still pay a portion of the health insurance premium?

    No, the employer contribution toward the premium ends. The total health insurance premium will be deducted from the annuity (if any), paid through any converted sick leave accumulations, or billed directly to the survivor. The premium payment in these situations will be handled by ETF.

  • When accumulated sick leave is converted to pay health insurance premiums upon retirement, does that constitute employer-paid annuitant status even though the value of the accumulated sick leave is considered the property of the employee?

    Yes, annuitants converting accumulated sick leave to pay health insurance premiums are considered employer-paid annuitants until the sick leave is exhausted, and should be reported to ETF as such.

  • Do continuants (annuitants, survivors, etc.) get the same group health insurance premium rates as when they were active employees?

    Yes, health insurance continuants receive the group premium rate, however they are responsible for paying the entire premium; there is no employer contribution.

  • An annuitant returned to work but did not elect to come back under WRS. The employer has agreed to reimburse part of their health insurance premium by including it in their paycheck. Does this make the employee an Employer-Paid Annuitant?

    No. The payment is a wage payment, not a health premium.

  • When an employee becomes Medicare eligible do they then pay the lower health insurance premium rate?

    Only retirees are eligible for the reduced Medicare premium rate because Medicare is primary payer of retirees' medical claims. For active employees, the health plan is the primary payer of medical claims so the premium rate is the full monthly premium.

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