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Sunday, March 23, 2025 ..:: Health Insurance Advisories » Under Age 65 Advisory::..   Login

 

What are my health insurance choices after retirement?

 

Advisories:

 

·       You and your dependents may be eligible to continue school district coverage under conditions and rates set by the Collective Bargaining Agreement

 

·       You and your dependents may be eligible to continue school district coverage under conditions and rates set by state law.

 

·       You and your dependents may be eligible to continue school district coverage under conditions and rates set by federal law (COBRA).

 

·       If you have a new employer, you and your dependents may be eligible for health insurance under a plan provided by the new employer.

 

·       If your spouse is employed, you and your dependents may be eligible for health insurance under a plan provided by your spouse’s employer.

 

·       You may be eligible for group health insurance based on membership in various organizations.  For example, if you are a PSERS annuitant or a survivor of a PSERS annuitant, you are eligible for group health insurance from the PSERS Health Options Program.

 

Rev 12.05.12

 

How will I pay for health insurance after retirement?

 

Advisories:

 

Determine cost of health insurance and do an appropriate budget of retiree expenses to determine if you can afford to retire.  The PSERS web site includes an annuity calculator that will tell you approximately what your PSERS annuity will be.

 

In addition to your PSERS annuity, other sources of funds to pay for health insurance may include:

 

·       District severance/retirement incentive plans

 

·       Personal savings

 

·       Social Security annuity (age 62+)

 

PSERS premium assistance program provides up to $100/month for many school retirees to help pay for health insurance costs.  The specific details of this program are available at www.psers.state.pa.us.

 

Rev 12.05.12

What retirement incentives/severance packages are available?

 

Advisories:

  • Your PSERS annuity is determined by state law as administered by PSERS.  Information concerning any incentives affecting your annuity is available at http://www.psers.state.pa.us.  PSERS also has a premium assistance program that provides up to $100/month for many school retirees to help pay for health insurance costs.  The specific details of this program are available at http://www.psers.state.pa.us/Publications/rethb/rethb2007/PremiumAssistance.htm
  • Your school district may also provide incentives/severance packages that may assist in the payment of health insurance costs.  The specifics of any such plan including timelines would be spelled out in your Collective Bargaining Agreement or District Policies.  There may also be informal unwritten severance/retirement incentives available.  Check with your local association and district officials for more information.

 

Rev 01.04.13

 

What forms must be completed to continue school district insurance during retirement?

 

Advisory:

  • Specific form requirements depend on the particular district and the particular insurance company.  Check with the district Human Resources Office or Business Office.

 

Rev 12.05.12

 

What important dates and timelines affect health insurance prior to age 65?

 

Advisories:

 

  • If your school district is providing health insurance at cost plus 2% after retirement due to state law, you must let them know within 45 days if you wish to continue coverage.
  • If your school district is providing health insurance at cost plus 2% after retirement due to federal law (COBRA), you must let them know that you wish to continue coverage within 60 days of the later of a) termination of coverage as an employee or b) notification that you may continue coverage at cost plus 2%.
  • If your school district is providing health insurance after retirement due to the Collective Bargaining Agreement, you will need to check the CBA for exact timelines.
  • If your school district provides retirement incentives that may include paying a portion or all of the cost of health insurance after retirement, check your CBA for exact timelines.
  • Additional information on this subject is available below in “Can my school district stop selling me health insurance after I retire?”

 

Rev 01.04.13

 

Who do I contact if there is a problem with my health insurance during retirement?

 

Advisory:

 

  • First contact your insurance company.  They are required to give specific reasons for a denial of a claim.  If that doesn’t resolve the issue and your insurance is from your former school district, contact the appropriate official at the school district for assistance.  Also contact your former association to keep them informed of problems with the school district insurance plan. 

Rev 12.05.12

 

Can my school district stop selling me health insurance after I retire?

 

Advisory:

 

  • It depends.  School districts must offer to continue providing health insurance to many employees after retirement at cost plus 2%.  Collective bargaining agreements also may guarantee availability of school district insurance and in some instances the district may cover a portion or all of the cost.  When and if a school district can stop selling health insurance to a specific retiree depends on a variety of factors.
  • First, school districts must continue to provide health insurance for teachers during June, July, and August of the year they retire under the same conditions as if they were still working if they retire at the end of a school year and if they have worked the entire school year.
  • Next, state law requires districts to offer retiring employees the option to continue health insurance at cost plus 2% if they a) have worked a minimum of 30 years as a Pennsylvania school employee or b) qualify for superannuation or c) qualify for disability retirement as long as they are not covered by another employer health insurance policy.  School districts may cease offering coverage when an employee becomes 65 years old.
  • Federal law also requires school districts to offer all employees who leave employment the option to continue health insurance at cost plus 2% as long as they are not covered by another employer health insurance policy.  School districts may cease offering coverage to a former employee after 18 months or when the former employee has Medicare coverage.
  • Finally, the Collective Bargaining Agreement that the retiree worked under may guarantee additional benefits. Retirees would need to check the CBA or check with their former local association or the appropriate UniServ staff member to see if additional benefits are available.

 

Rev 01.04.13

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