Office of the State Comptroller
Retirement Services Division
Tier II/IIA - Retirement Basics

Insurance: Health, Dental, and Life

General Eligibility Requirements for Health and Dental Insurance
Open Enrollment
Normal vs. Early Retirement
Available Health Insurance Plans - In-State Retirees
Available Health Insurance Plans - Out-of-Area Retirees
Medicare's Impact on Retiree Health Insurance
Health Enhancement Program (HEP)
Available Dental Plans
Group Life Insurance

General Eligibility Requirements for Health and Dental Insurance:

The eligibility requirements to receive Health Insurance in retirement were most recently modified through two collective bargaining agreements in 2009 and 2011 between the State and the State Employees Bargaining Agent Coalition (SEBAC). Due to the complexity of these agreements and the changes they made, please direct your questions concerning your eligibility for health insurance in retirement to your agency's human resource area or to the Healthcare Policy and Benefit Services Division.

  • Generally, Tier II/IIA members who qualify for health and dental insurance as an active employee will qualify for health and dental insurance in retirement.
  • This eligibility extends to the retiree and any of the retiree's eligible dependents. as long as they maintain eligibility status.

Open Enrollment

  • When you retire you will have your own open enrollment period during which you can choose among any of the available plans and add or drop dependents.
  • Thereafter, each year there will be an open enrollment during which you can switch between plans and add or drop dependents.
  • However, you may make changes to your insurance coverage at any point if there is a qualifying event, such as getting married, having a child, or moving outside the geographic coverage area of your existing plan.

Normal vs. Early Retirement

  • Your type of retirement will influence how much you will pay for health insurance in retirement.
  • The SEBAC 2011 agreement changed the payment for health insurance premiums for members who retire before they reached their normal retirement age. Members who retire before they reach their normal retirement age, known as Early Retirement, will pay a health insurance premium based on a Grid which considers their years and months of service and the number of months they are retiring early.
  • When the member reaches their Normal Retirement Age or age 65 (whichever is earlier), the health insurance cost based on the Grid will end and the retiree premium share will be equal to the rules for members who retired on or after Normal Retirement Age.
  • Members who retire at or after Normal Retirement age currently pay no premium share for Point of Enrollment (POE) health plan options or they pay the retiree premium share for Point of Service (POS) health plan options.
  • A copy of the Grid can be found in attachment C in the 2011 SEBAC agreement at:
    http://www.osc.ct.gov/empret/healthin/2011hcplan/SEBACAgree2011.pdf

Available Health Insurance Plans - In-State Retirees

  • In-state retirees choose among the same health insurance plans offered to active employees. In most cases these plans will be offered at a lower cost (possibly at no cost) in retirement.
  • Anthem and UnitedHealthcare Oxford offer three levels of coverage:
    • Point of Service (POS)
    • Point of Enrollment (POE)
    • Point of Enrollment Gatekeeper (POE-G)

Currently, in-state retirees must pay a retiree premium share for any of the POS plans, while the POE plans are offered at no retiree premium share for in-state retirees and their eligible dependents that retire at or have attained Normal Retirement age.

Available Health Insurance Plans - Out-of-Area Retirees:

  • As a general rule, retirees who are not Connecticut residents may choose from the following Out-of-Area plans:
    • Anthem Out of Area
    • UnitedHealthcare Out of Area
  • Currently, there is no retiree premium share for those enrolled in an Out-of-Area plan and who are at Normal Retirement Age.

Current year POS retiree premium shares are available by following this link.

Current health insurance plan options with no retiree premium share (assumes at Normal Retirement Age) include:

Point of Enrollment - Gatekeeper Plans    Point of Enrollment Plans    Out-of-Area Plans
UnitedHealthcare
  • Anthem State BlueCare POE Plus
  • UnitedHealthcare Oxford HMO  
  • Anthem State BlueCare POE
  • UnitedHealthcare Oxford HMO Select
  • Oxford USA Out of Area plan
  • Anthem Out-of-Area plan
  • For specific information regarding the plans currently offered, please refer to the retiree's health insurance planner:

Medicare's Impact on Retiree Health Insurance:

  • As a state retiree, when you become eligible for Medicare (which typically occurs at the age of 65 but may occur earlier under certain circumstances), it will serve as your primary health insurance coverage. Your state-sponsored medical insurance will supplement your Medicare coverage.
  • In order to maintain full health insurance coverage as a Medicare eligible retiree, you will need to enroll in Medicare Parts A and B. This is true regardless of whether you have actually commenced collecting Social Security benefits.
  • The State currently reimburses 100% of the normal cost of Medicare Part B for the retiree and eligible dependents.
  • Currently, you only need to enroll in Medicare Parts A and B. Do not enroll in Medicare’s prescription drug plan (Part D). Doing so would cause your State of Connecticut medical and pharmacy coverage to end for you and your eligible dependents.

Health Enhancement Program (HEP)

The SEBAC 2011 agreement introduced a new program to enhance your ability to make the most informed decisions regarding your health.

  • Your participation in this program is voluntary. Your election as to whether to participate is made on the HEP Enrollment Form.
  • For retirees who participate in the HEP, they will pay the retiree premium share based upon whether they retired Early or if they have reached Normal Retirement Age.
  • For retirees who do not participate in the HEP, they are subject to an additional $100 monthly insurance premium and an annual deductible of $350 per person for the first four family members they insure.
  • Your agency Human Resource area or the Healthcare Policy and Benefit Services Division can answer specific questions regarding this program.

Available Dental Plans

  • No matter where you choose to live in retirement, the dental plans available to you are the same offered to active employees.
  • Currently, there are three dental plans offered to retirees:
    • Basic
    • Enhanced
    • DHMO
  • Your dental coverage is subject to a retiree premium share in retirement. The Retiree Healthcare Options Planner illustrates the current cost at the following link .

Group Life Insurance

  • Assuming you transition directly into retirement, if you participate in the state-sponsored basic group life insurance plan as an active employee you will qualify for a paid-up policy in retirement.

  • This benefit only applies to the basic group life insurance policies. It does not extend to other supplemental life insurance plans offered through the state.

  • If you have 25 years or more actual state service:
    • You will receive a paid-up policy reduced to one-half of your basic coverage

  • If you have less than 25 years actual state service:
    • You will receive a prorated paid-up policy, based on your years of completed service.

  • You may convert the remaining portion at your own expense without evidence of insurability if you act within 30 days of retiring

 

Back to State Employees and Retirees Benefits Information
Back to Comptroller's Home Page