Retiree: Medical Plan Options
A former Employee under Age 65 may continue the identical YourChoice Medical Plan Level and Prescription Plan they are currently enrolled in as of the last date of their employment until the Qualifying Event Period for the next Plan Year. Dependents of the retiree are eligible to participate in the retiree YourChoice Health Plan at the time of the employee's retirement or at annual enrollment.
- Qualifying Events Required
- Health Bucks and Health Care Spending Accounts Terminate
- Other Individual Medical Plan Options Exist
Medicare is the primary insurer for those Retirees and Spouses over 65, or under 65 enrolled in Medicare Disability, and the County's Plan is secondary. These participants do not participate in YourChoice Health Plan's Qualifying Events. As the secondary insurer, the County's Plan wraps around Medicare and pays benefits that are not covered by Medicare, then the County's Plan will continue to pay those benefits according to the County's Plan.
A Retiree eligible for Medicare as a result of age or disabilit must be enrolled in Medicare Part A & B to receive any benefits under the medical plan or supplemental plans. The Retiree's County Insurance or any other Medicare Supplement is SECONDARY to Medicare unless you or your spose are actively at work and enrolled in an employer sponsored group medical plan. A copy of your Medicare Card, both Part A and Part B, must be supplied to Employee Health Benefits.
Retirees and covered dependents under age 65 are required to complete Qualifying Events for plan level assignment. The Qualifying Events rules for a Retiree and/or participating Dependent are identical to an Active Employee.
*The deadline to return the QE Form(s) to Employee Health Benefits is August 31.
A Retiree's Health Bucks earned as an active employee terminate on the day of Retirement.
Other Individual Medical Plan Options
With the approval of health care reform, the opportunity exists for some retirees, based upon health status and age, to obtain an individual medical and/or dental plan that may be more affordable and may better suit their needs. Information about these opportunities can be obtained thru Employee Health Benefits.
Supplemental Plans Options
A Retiree has the opportunity to enroll in one of the County's Supplement Plans at the time they become Medicare eligible. There are 2 Supplement options available: 1) Transamerica Insurance and 2) One Exchange Insurance.
Transamerica Insurance Company offers a Medicare Supplement Plan for Part A & B for eligible benefits not paid under Medicare Part A & B. Aetna provides a prescription coverage under Medicare Prescription Part D. These Medicare Supplement Plans are medical and prescription plans through a private insurance company (Transamerica) to provide benefits to retirees eligible for Medicare that are similar to the existing County Health Plan at a lower cost. Please contact Brian Baacke at 941.907.4300 for more information.
Via Benefits Insurance provides access to Individual Medicare Plans (including Medicare Advantage and Medicare Supplement Plans) and Individual Medicare Part D Prescription Plans. Via Benefits is a service provider contracted with the County to provide guidance, education, and support in exploring a variety of individual Medical, Prescription, Dental, and Vision plans to supplement your Medicare coverage. Please contact Via Benefits Benefit Advisors at 844.887.2803 for more information.
It is recommended that retirees over age 65 work with these representatives to ensure that they have all the necessary information about their health care options.
Selecting Your Retirement Health Plan
Premium rates for Transamerica and Via Benefits are, in most instances, significantly less than those for the County Health Plan.
Transamerica was set up to provide similar coverage to the County Health Plan but the coverage is not exactly the same. Please review the benefits and coverage for the medical plans and, to the greatest extent possible, compare the drugs you are currently taking with the prescription formulary coverage for both plans. The County's Transamerica Representative will work with you on determining the best product for you.
Via Benefits employs Benefit Advisors who will work with you to gather information about your medical prescription needs and then provide you with a variety of plan options to best suit those needs. The plans available through this option may allow you to reduce your premiums whil still providing the coverage you need.