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General Eligibility Requirements for Health and Dental Insurance:
- Generally, Tier I members who qualify for health and dental
insurance as an active employee will were covered by state-paid
health and dental benefits immediately prior to retirement will be
eligible for health and dental insurance in retirement.
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 annual 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, for example: getting married, having a
child, or moving outside the geographic coverage area of your existing
plan.
Available Health Insurance Plans - In-State Retirees
- In-state retirees choose among the same health insurance plans they
had access to as 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 Enrolment Gatekeeper (POE-G)
- Retirees who have less than 25 years of actual state service
must pay premiums for all plans.
- Currently, in-state retirees who have 25 years of actual
state service or more must pay for any of the POS plans, while the
POE plans are offered at no cost
for in-state retirees and their dependents. Please contact
the Retiree Health Insurance Unit regarding the requirements of
actual state service.
- For specific information regarding the plans currently offered,
please refer to the retiree's health insurance planner:
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 Oxford USA Out-of-Area plan
- Currently, retirees who have 25 years of actual state service or
morethere is no premium charge for those enrolled in an Out-of-Area
plan.
- Retirees who have less than 25 years of actual state service
must pay premiums for all plans. Please refer to the following link
for premiums:
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 HEP status as an
active employee will follow you into retirement.
- Retirees not participating in the HEP are subject to an additional $100
monthly insurance premium and an annual deductible of $350 per person.
Maximum family deductible is $1,400.
- Your agency Human Resource area or the Healthcare Policy and Benefit
Services
Division can answer specific questions regarding this program.
- Currently, once you are on Medicare, HEP no longer applies.
Medicare's Impact on Retiree Health Insurance:
- Once you and or your eligible dependent becomes eligible for
Medicare (which typically occurs at the age of 65 but may occur
earlier under certain circumstances), you and or your eligible
dependent will need to enroll in Medicare.
- In order to maintain full health insurance coverage as a Medicare
eligible retiree or dependent, 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.
- You may be required to pay higher premiums due to Income
Related Monthly Adjustment Amount (IRMAA). Currently if you
provide the Retiree Health Insurance Unit with a copy of your
annual IRMAA letter they will reimburse you for the higher
premiums.
- 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. Your state
plan will continue to cover your prescriptions.
- Provided you have sent a copy of your Medicare Parts A and B
card, you will receive a Medicare Advantage card in the mail.
This card replaces all your previous health insurance and
prescription cards. You will use this one card for all your
medical and prescription services going forward
Available Dental Plans
- Unlike retiree health insurance, your residency will not dictate the
dental plans available to you in retirement.
- All retirees have access to the exact same dental plans offered to
active employees.
- Currently, the following dental plans are offered to active
employees and retirees alike:
- Your dental coverage is subject to a retiree premium share in
retirement.
Group Life Insurance
- 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 remaining portion at your own expense without
evidence of insurability if you act within 30 days of retiring.
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