As a retiree, you or a dependent have a change in your Medicare enrollment (for example, you enroll in Parts A and B). This life event does not apply to Active Employees or to Supplemental Benefits.

For Retirees and Survivors

You must enroll in Medicare Parts A and B when you are eligible. Without both Medicare Parts A and B, you are not eligible to enroll in IYC Medicare Advantage. For all other plans, you will be liable for the portion of your claims that Medicare would have paid beginning on the date Medicare coverage would have become effective. 

In the table(s) below, supplemental benefits refer to supplemental dental insurance (Select, Select Plus, and Preventive), vision insurance, and Accident Plan. You may not be eligible for all supplemental benefits. Visit the Dental Insurance, Vision Insurance, and Accident Plan pages to learn about eligibility.

 
 Health Insurance & Uniform DentalSupplemental Benefits
Enrollment opportunity?NoNo
Change coverage from individual to family?NoNo
Change coverage from family to individual?YesNo
Change health plan?Yesn/a
Drop a dependent and keep family coverage?NoNo
Cancel coverage?YesNo
Deadline to submit changesYou may submit your application up to three months in advance of enrollment in Medicare Parts A and/or B, and up to three months following your Medicare effective date. If you're not sure of your Medicare effective date, you may file your application early and send a copy of your Medicare card later.n/a
How to submit changesSubmit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation.n/a
Documentation required?Yesn/a
Effective date

Changing to individual coverage: Effective the first of the month following the receipt of the application

Changing health plans: 

  • Application received prior to Medicare start date: Plan change will be effective Medicare effective date.
  • Application received up to three months following Medicare effective date: Plan change will be effective the first of the month following receipt.
  • In the rare case that new retirees enroll in Medicare on the first of a month but employment terminates later in the month, the retiree can change health plans one month after Medicare begins

Canceling coverage: Effective the last day of the month following receipt of the application

n/a