This brochure has been developed to assist employees in understanding insurance benefits and options available at the time of retirement.  It pertains specifically to employees of school districts and school related groups participating in the Statewide Schools Health Insurance Program sponsored by the Idaho School District Council, operating under an administrative agreement with Blue Cross of Idaho.

 

FREQUENTLY ASKED QUESTIONS:

 

Can I keep my current health insurance program?  

 

Employees retiring prior to age 65, and prior to eligibility for Medicare, can elect to remain on the policy provided to the active employees of the participating school district or school related group from which they retire.  Insurance coverage options and rates remain the same as those of active employees until you become eligible for Medicare.  However, the premiums are billed to the Public Employees Retirement System of Idaho (PERSI) and not to the participating school district or school related group.

 

What happens when I turn 65 and become eligible for Medicare? 

 

Upon enrollment in Medicare, you become eligible for enrollment in the Blue Cross of Idaho Statewide School Retiree Program.  This plan requires participation in both Parts A and B of Medicare, as it is designed to complement Medicare.  This plan is different from most Medicare supplements available in the marketplace, as it is a group plan and includes significant pharmacy benefits, as well as benefits in some areas not covered by Medicare.  (IC 33-1228 1 a)

 

The Medicare retiree may also elect to enroll in the federal Medicare Part D prescription drug plan.  Since a significant portion of the cost of drugs will then be paid through another insurance carrier, the Blue Cross health insurance premium will be lower then for those opting to rely on Blue Cross for the entire pharmacy benefit.  Retirees with the Medicare Part D pharmacy program will have a 75%-25% coinsurance benefit through the coverage void in the federal program provided by Blue Cross.

 

What should I do next? 

 

If you are retiring before age 65, review the program that your current school district offers, as that will continue to be your coverage until you turn 65 or opt out of the program offered by the district.  If you are retiring at age 65, Blue Cross of Idaho offers a Retiree Plan that will complement your Medicare coverage.

 

What do I have to do to retain my coverage? 

 

If you are planning to retire and desire to continue coverage, it is critical that you complete a Blue Cross of Idaho Insurance Program Retiree’s Request for Benefits Form.  This form is available in your participating school district or school related group office and is to be forwarded to PERSI and Blue Cross by your employer.

 

If I do not retain my coverage, may I rejoin at a later time? 

 

If you choose not to continue coverage at the time of retirement, you will be ineligible for enrollment at a later date. The only exception will be if you make a written request to Blue Cross to defer coverage and delay drawing on funds with PERSI because you have other group coverage.  In this situation, you can return to the appropriate retiree policy at a later date.  Later enrollment is assured, providing the participating school district or related group from which you retired remains with the Statewide Schools Insurance Program.  Should the participating school district or related school group select another insurance carrier for active employee coverage, the new carrier is not obligated to provide coverage.  The new insurance company may require an application and health statement before determining eligibility.

 

What about my sick leave?  

 

Upon retirement from a participating school district or school related group, your accumulated sick leave will be used to establish a dollar amount with PERSI that can be used to pay premiums for you and your dependent’s group health insurance.  The premium will be at the same rate as for active employees until you or your dependent becomes eligible for the Blue Cross of Idaho Statewide School Retiree Program.

 

The accumulated sick leave amount with PERSI shall be a sum equal to one-half the monetary value of such unused sick leave, calculated at the daily rate of pay for such employee at the time of retirement.  This amount is available to pay premiums for group health, accident, dental and life insurance and can not be used to increase the retiree’s monthly benefit or for any other purpose.  If the retiree and covered spouse are different ages, it is possible for the younger person to be on the district’s benefit plan and the older person, if eligible for Medicare, to be on the Retiree Plan, each with appropriate plan rates. ( IC 33-1228 2)

 

When funds are expended, PERSI will notify the retiree and provide three options.  You can choose to: (1) authorize the reduction of your monthly retirement benefit payment by the premium amount; (2) ask Blue Cross to invoice you monthly and pay them direct; or (3) terminate coverage.

 

What happens to my spouse’s insurance if I die?   

 

Upon the death of the retiree, the surviving spouse’s health insurance coverage shall be available and continue under the same terms and conditions.  However, the unexpended dollars remaining in the retiree’s account shall revert to the PERSI sick leave account and are not available to pay premiums for the surviving spouse.

 

Will I have dental coverage?  

 

Retirees and/or spouses are eligible for dental coverage if continuously enrolled in the Blue Cross of Idaho School Dental Insurance Plan during the three-year period just prior to retirement.  The Willamette Dental option is also available during the annual open enrollment period, if the retiree was covered under a group dental program prior to retirement.

 

Will I have vision coverage? 

 

Vision benefits are not included in the Retiree Plan (over 65 years of age).

 

This brochure has been provided to answer many questions of prospective retirees.  Should you need additional information, please feel free to call for assistance or visit one of the following websites. 

 

Idaho School District Council      208-338-0427         www.idsdc.org

Blue Cross Customer Service     208-344-7411         www.bcidaho.com

Willamette Dental                      208-375-7142         www.willamettedental.com

PERSI                                        800-451-8228         www.persi.idaho.gov

Medicare                                    800-633-4227         www.medicare.gov