Illinois State Employees Review Changes to Health Plan Eligibility and Premium Costs

The State Employees Retirement System (SERS) of Illinois held a webinar on May 15, 2025, to discuss important updates regarding health insurance eligibility and options for retirees and their dependents. The meeting focused on the implications of Medicare eligibility on health plan choices and the introduction of a new split family health plan structure.

One of the key points addressed was the eligibility criteria for health insurance coverage. Members must have at least eight years of service credit to qualify for state-sponsored insurance in retirement. For those with less than 20 years of service, premiums will apply, while members with 20 years or more will have their premiums covered entirely by the state.

The webinar also highlighted the upcoming changes effective July 1, 2025, which will affect how retirees and their dependents can enroll in health plans. Notably, individuals who are Medicare eligible will no longer be able to remain on a retiree medical plan if they have both Medicare and non-Medicare eligible dependents. This change introduces a split family coverage option, allowing members and their dependents to be enrolled in different health plans based on their Medicare status.

Participants were informed that during the benefits choice open enrollment period in May, Medicare eligible members and dependents must enroll in the new trail Medicare Advantage Prescription Drug (MAPD) plan. Failure to enroll could result in the termination of coverage for both the member and any covered dependents.

The meeting concluded with a reminder for attendees to review the current benefits choice booklet and the SERS website for detailed information on premium costs and coverage options, as these figures are subject to annual updates. This webinar served as a crucial resource for state employees and retirees to navigate their health insurance options effectively.