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.
Health Insurance & Uniform Dental | Supplemental Benefits | |
---|---|---|
Enrollment opportunity? | No | No |
Change coverage from individual to family? | No | No |
Change coverage from family to individual? | Yes | No |
Change health plan? | Yes | n/a |
Drop a dependent and keep family coverage? | No | No |
Cancel coverage? | Yes | No |
Deadline to submit changes | You 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 changes | Submit the Health Insurance Application/Change for Retirees (ET-2331) with required documentation. | n/a |
Documentation required? | Yes | n/a |
Effective date | Changing to individual coverage: Effective the first of the month following the receipt of the application Changing health plans:
Canceling coverage: Effective the last day of the month following receipt of the application | n/a |