KPPA webinar details retiree health insurance tiers, enrollment rules and wellness fees

A Kentucky Public Pensions Authority presenter explained the agency's rules for retiree health insurance, saying the webinar covered eligibility under percentage‑based and dollar‑contribution plans, recent legislative changes, Medicare coordination, enrollment deadlines, reimbursement options, and return‑to‑work rules.

The webinar matters because the details determine how much KPPA pays toward a retiree's monthly premium and which retirees are eligible for KPPA contributions. The presenter emphasized that eligibility and the share KPPA pays depend on a member's participation date, service credit and whether the retiree is Medicare eligible.

KPPA described three insurance tiers that do not align with retirement tiers. Members with initial participation dates before July 1, 2003, are in a percentage‑based plan that requires only that the retiree be receiving a monthly KPPA payment. KPPA's share of the contribution rate rises with service: the presenter gave ranges including 48–119 months (25%), 120–179 months (50%), 180–239 months (75%) and 240 or more months (100%). As an example, a 2026 contribution rate for percentage‑based retirees was stated as $1,105.54; a retiree with 19 years' service (75%) would have $829.16 applied monthly to the single premium, with the remainder deducted from the retiree's benefit.

For members with participation dates on or after July 1, 2003, KPPA offers a dollar‑contribution plan with service requirements: 120 months (10 years) for those in 07/01/2003–08/01/2008 windows and 180 months (15 years) for participation dates on/after 09/01/2008. The presenter explained the dollar amounts are earned per year of service ($10/month per year for nonhazardous service originally; $15/month per hazardous year) and receive an annual cost‑of‑living adjustment (presenter noted a 1.5% COLA since 2008).

The presenter gave illustrative dollar‑plan calculations, including nonhazardous and hazardous examples and a mixed‑service example that showed how contributions for hazardous and nonhazardous years combine into a monthly amount available for insurance. The webinar also listed 2026 numeric plan examples such as a LivingWell PPO family plan premium of $2,453.16 and the single contribution rate shown as $1,105.54.

KPPA described several member obligations and options: non‑Medicare enrollees must declare tobacco use (past six months) and face fees ($40/month single, $80/month family) when applicable; the Living Well Promise wellness requirement (an online health assessment through Castlight) must be completed between Jan. 1 and July 1 each year or a $40 monthly fee applies. The presenter identified the Castlight site (mycastlight.com/mybenefits) for the wellness assessment.

On Medicare coordination, the presenter advised retirees to contact Social Security three months before turning 65 to ensure Medicare Parts A and B are active the month of the 65th birthday; KPPA plans are designed to coordinate with Medicare Parts A and B and the agency sends retirees a packet about Medicare‑eligible plans about six weeks before the month they turn 65.

KPPA explained enrollment timing: non‑Medicare open enrollment typically runs in October; Medicare plan enrollment typically runs in late October through a November 30 deadline. Some open enrollment cycles are nonmandatory and require no new documentation to retain the same coverage, though hazardous retirees must submit an annual verification form (form 6256).

The presenter also summarized a January 2023 reimbursement option for dollar‑contribution participants: eligible retirees who obtain insurance from another provider or employer may be reimbursed up to their applicable monthly contribution rate for premiums paid, less amounts paid by employers, spouses, or other state retirement systems; documentation is required.

Regarding return‑to‑work, KPPA said tier 1 retirees who return to employment with a participating agency may either keep KPPA coverage (in which case KPPA will bill the employer the contribution rate) or take the employer's plan. Tier 2 and tier 3 retirees returning to work must enroll in the employer's plan. KPPA cannot offer flexible spending if a retiree chooses employer coverage.

The webinar included FAQ clarifications: KPPA pays hazardous spouse and dependent contribution percentages only through age 22 even though broader health‑insurance law allows dependent coverage to age 26; the presenter cited Kentucky Revised Statute 16.505 paragraph 17 for the statutory definition of dependent child. The presenter also explained which types of service purchases count toward health insurance eligibility (purchases made before Aug. 1, 2004, and some types that always count such as recontributions of refunds and hazardous conversion).

The webinar concluded with a legal notice that the presentation is for general information only and provided a KPPA contact phone number for account‑specific questions.