Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Retiree Insurance topic
No spam. Unsubscribe anytime.
SERS webinar details retiree insurance rules, TRAIL Medicare program and split-family coverage changes
Summary
The presenter outlined retiree group insurance enrollment through Central Management Services, the Total Retiree Advantage Illinois (TRAIL) Medicare Advantage Program, an opt-out cash incentive, and a split-family coverage rule effective July 1, 2025.
SERS presenter (Staff member, State Employees' Retirement System) reviewed retiree group insurance administered through the Illinois Department of Central Management Services (CMS), explained the TRAIL Medicare Advantage Program, described the opt-out cash incentive, and highlighted a split-family coverage rule taking effect July 1, 2025.
Why it matters: Insurance elections affect monthly premiums and coverage options for retirees and covered dependents; the TRAIL MAPD program and the split-family rule change how Medicare-eligible and non–Medicare-eligible dependents are covered and priced beginning July 1, 2025.
The presenter said SERS processes retiree insurance changes by submitting Form 3991 with the retirement packet; SERS opens a retirement event in MyBenefits after processing and retirees have 60 days from the retirement date to make coverage elections. Group insurance is administered by CMS and questions and plan changes are handled through MyBenefits (mybenefits.illinois.gov) or CMS call centers; the presenter provided CMS contact and Medicare coordination-of-benefits unit information.
The webinar explained the TRAIL (Total Retiree Advantage Illinois) Medicare Advantage Prescription Drug (MAPD) program for Medicare-eligible retirees and dependents, and said that open enrollment typically occurs in the fall with changes effective January 1. It also summarized premium-cost treatment: retirees with 20 or more years of service may have premiums fully picked up under some circumstances; retirees must have at least eight years of service credit to be eligible for state-covered insurance in retirement.
SERS described an opt-out financial incentive for members who decline state retiree coverage: eligible retirees who were previously covered by state insurance and have 20 or more years of service may receive $500 per month; members with fewer than 20 years of service who qualify may receive $150 per month. The presenter said these payments are administered through CMS, are not paid by SERS, and are not included in retirement annuity payments; SERS reviews eligibility and provides necessary CMS documents after processing.
The presenter highlighted a new split-family rule effective July 1, 2025: when a retiree and dependents include both Medicare-eligible and non–Medicare-eligible individuals and coverage level is member plus one dependent, the family may be placed on different plans (a retiree on TRAIL MAPD and a non–Medicare dependent on a regular retiree health plan). The presenter said split-family evaluations occur when coverage is member plus one dependent or when all covered dependents become Medicare-eligible; members with two or more dependents will remain on retiree health even if dependents have mixed Medicare eligibility.
Attendees were directed to consult the benefits choice booklet, MyBenefits, and CMS MCOB (Medicare Coordination of Benefits) unit for plan charts, premium tables and enrollment deadlines.
