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SERS reviews retiree health insurance, Medicare coordination and opt‑out incentives
Summary
The workshop explained how retiree insurance is administered through MyBenefits/CMS, Medicare coordination requirements, TRAIL (Medicare Advantage Prescription Drug) enrollment schedules and cash incentives for opting out of state insurance.
The State Employees Retirement System presenter said insurance administration for retirees and survivors is handled by MyBenefits and CMS; SERS described insurance rules, enrollment windows and how Medicare interacts with state coverage.
Key points: to qualify for state retiree insurance, a member must be vested with SERS and collect a monthly annuity; retiree benefit choice for non‑Medicare members is in May (effective July 1) and the TRAIL MAPD (Medicare Advantage prescription drug) enrollment period for Medicare‑eligible members is in October (effective January 1).
Split‑family rules: SERS explained that when accounts include both Medicare‑eligible and non‑Medicare dependents, split‑family coverage may apply for a member plus one dependent (for example, one spouse is Medicare‑eligible and the other is not), with each person using the appropriate benefit booklet (May or TRAIL). Accounts with two or more dependents generally remain in retiree health rather than split family coverage.
Opt‑out incentive: a retiree who opts out of state health insurance can receive a CMS‑paid monthly incentive; the presenter said CMS pays $150 per month for retirees with less than 20 years of service and $500 per month for retirees with 20 or more years of service. The presenter noted that the incentive is taxable (state and federal taxes apply) because payment comes from CMS, not from retirement annuity funds.
Medicare coordination: SERS advised members to apply for Medicare when eligible and to send copies of Medicare cards to the CMS Medicare coordination unit so insurance coding is correct; failing to enroll or notify CMS may cause claims or premium errors.
The presenter repeatedly directed insurance questions to MyBenefits/CMS (phone and web contact details provided in the workshop) rather than to SERS staff, and encouraged members to read mailed notices about TRAIL enrollment to avoid unintended coverage termination.
