– applies for both “Retirees Except Class E” and “Class E Retirees”
The Fund’s annual Open Enrollment usually takes place in November and December. The benefit elections you make during Open Enrollment take effect on January 1.
Open Enrollment gives you a once-a-year opportunity to take the following actions:
- Enroll in a Fund medical plan option if you are eligible to do so
- Change from your current medical plan to a different one (if you live in an area where Fund HMOs are offered)
- Un-enroll from medical coverage
- Enroll for dental coverage if you are eligible to do so
- Change your dental plan choice
- Un-enroll from dental coverage
- Add or remove eligible dependents from coverage
Each year in the fall, you will receive Open Enrollment materials. To enroll or make other changes, you need to return an enrollment form to the Fund Office by the deadline noted in your materials. To enroll in a Medicare HMO, you must complete the HMO’s enrollment form in addition to the Fund’s enrollment form.
If you want to make changes and you do not receive your Open Enrollment materials by December 1, contact the Fund Office.
IMPORTANT NOTE FOR “RETIREES EXCEPT CLASS E”
During Open Enrollment you may choose to disenroll from both medical and dental coverage, or to disenroll from dental coverage only. If you disenroll, your coverage will end on December 31 of that year. You will not be able to re-enroll until the third annual Open Enrollment following the date your coverage terminates. For example, if you disenroll during the 2017 Open Enrollment period, your coverage ends on December 31, 2017. Your next opportunity to enroll will be during the 2020 Open Enrollment period, with coverage effective on January 1, 2021. Dental coverage is only available if you are enrolled in a Fund medical plan.
Medicare Enrollment – applies for both “Retirees Except Class E” and “Class E Retirees”
Requirement to Enroll in Medicare Parts A and B
You are required to enroll in both Medicare Part A and Part B as soon as you are eligible. In addition, if you or one of your covered dependents become eligible for Medicare before age 65, you must notify the Fund Office. Otherwise, your out-of-pocket costs for Fund coverage will be substantially higher. You will also be required to reimburse the Fund for any overpayments made on your behalf.
The requirement for Medicare enrollment applies when:
- You or any of your covered dependents reaches age 65.
- You or any of your covered dependents are under age 65 and become eligible for Medicare due to a Social Security disability award. (In this event, you will need to notify the Fund Office.)
- You or any of your covered dependents are under age 65 and become eligible for Medicare due to end-stage renal disease. (In this event, you will need to notify the Fund Office.)
If you or your dependents are eligible for but do not enroll in Medicare Part A and Part B, your Fund benefits will be affected as follows:
Indemnity PPO Medical Plan Participants
- Benefits paid under the Indemnity PPO Medical Plan are calculated as though you are covered by Medicare.
- You will be responsible for paying the expenses that Medicare would have paid on your behalf.
- You must reimburse the Fund for any overpayments made on your behalf.
- You will be disenrolled from the HMO, and the Fund will move your coverage to the Indemnity PPO Medical Plan. You can re-enroll in an HMO only after enrolling in Medicare.
- Your benefits under the PPO plan will be calculated as though you are covered by Medicare. Your out-of-pocket costs will be higher.
- You must reimburse the Fund for a portion of the premium costs paid to your HMO during any period you enrolled in an HMO, eligible for Medicare Parts A and B, and were not enrolled in Medicare Parts A and B. This will reflect the large difference in cost between:
a) The higher non-Medicare HMO premium (which the Fund actually paid to the HMO during the period you were not enrolled in Medicare or the Fund did not know you were enrolled in Medicare), and
b) The lower Medicare HMO premium (which the Fund should have paid, had you taken action to enroll in Medicare or to notify the Fund of your Medicare enrollment).
You will be responsible for this difference.
Contact the Fund Office if you have questions and for more information about how your Fund benefits and Medicare work together.
About Medicare Part D Coverage
Be sure to read these important notices regarding the Fund’s prescription drug coverage and Medicare Part D, and contact the Fund Office if you have questions.
- Notice of Creditable Coverage for Medicare-eligible “Except Plan E Retirees”
- Notice of Non-Creditable Coverage for Plan E Retirees who are enrolled in the Indemnity PPO Medical Plan or UHC Medicare Advantage HMO
- Notice of Creditable Coverage for Plan E Retirees who are members of Kaiser Senior Advantage