School Retiree Benefits
School Retiree medical benefits are exclusively limited to a Death Benefit and Medicare Part B and Part D premium reimbursements. (See School Retiree Plan Covered Services below for more information.)
How the School Retiree Plans Work
Eligibility and Enrollment
Eligibility in a Retiree Plan depends on whether or not you are eligible to retire. To learn more about retirement eligibility requirements, visit the Eligibility and Enrollment page.
Dependent Eligibility and Enrollment
Spouses are only eligible for the Medicare Related Premium reimbursements (see School Retiree Plan Covered Services below for more information) under the School Retiree Plan. There are no other benefits for dependents.
The School Retiree Plan medical benefits are exclusively limited to the Death Benefit and Medicare Related Premium reimbursements (benefit formerly known as the "Reimbursement of Medicare Part B and Part D Premiums").
Medicare Related Premium Reimbursement
Retirees will be eligible to receive a reimbursement of an annual calendar maximum of $3,000 for Medicare Related Premiums for the 2016 premiums paid. The benefit includes the eligible retiree’s spouse. The annual calendar year maximum of $3,000 is not applied on a per person basis, but instead is a combined annual maximum for Medicare Related Premiums paid by the eligible retiree and/or their spouse. Prior to 1/1/2016 the annual calendar premium reimbursement formerly known as the “reimbursement of Medicare Part B and Part D Premiums” was $1,500. The $1,500 premium reimbursement was a combined annual maximum paid by the eligible retiree and/or their spouse.
In order to be reimbursed for the Medicare Related premiums that you (or your spouse) have paid during a calendar year, you (and your spouse) must send the Plan proof of such premium payments within one year following the end of the calendar year. Please contact the Fund office for what forms of proof are acceptable for reimbursement or they are listed on the Medicare Related Premium Reimbursement form. In order to receive reimbursement you will be required to complete the Medicare Related Premium Reimbursement Form. You can download and fill out the Medicare Related Premium Reimbursement Form and mail it to the Health and Benefit Fund along with the applicable documents or you may contact the Health and Benefit Fund for the form to be mailed to you.
Partnership with HealthPlanOne
In conjunction with the increase in the Reimbursement for Medicare Related Premiums, the Fund is pleased to announce a partnership with HealthPlanOne to assist you in exploring the healthcare marketplace in your retirement. If you are Medicare eligible, HealthPlanOne will be able to evaluate the Retiree Health Insurance options available to you.
HealthPlanOne currently offers over 7,400 plans nationally from 80 plus carriers. There is a broad selection of designs for Medicare Supplement, Medicare Advantage and Plan D programs offered by a wide array of carriers. The Fund is confident HealthPlanOne will be able to assist you in finding a plan that meets your needs at a competitive price.
These services are available to you at no cost or obligation on your part. You are not required to use HealthPlanOne’s services nor are you required to make any changes if you are satisfied with your current plan.
Through HealthPlanOne, you will have the option of accessing a benefit website that offers online decision-tools that provide detailed information on plan designs and pricing. In addition, HealthPlanOne benefit Advisors are available to provide personalized assistance. They are knowledgeable professionals, licensed in Medicare, and they are here to be your advocate, answering all your questions, providing advice, and finally enrolling you in the healthcare plan that best fits your needs and budget. You can reach a benefit Advisor at 844-267-0569. The entire process can be handled online or on the phone. The Web Address for Fund retirees who wish to inquire on line is http://www.hpoexchange.com/local94/ HealthPlanOne can also work directly with a family member or other party that you designate and authorize to assist you with this process.
Each year thereafter if you are eligible as a School Retiree and on Medicare, HealthPlanOne is available to you if you are interested in making a change to your current Medicare coverage during the open enrollment period. HealthPlanOne can assist and guide you thru any enrollment with a new carrier. HPONE will contact all eligible School Retiree participants who are currently enrolled in Medicare in the middle of September each year leading up to the fourth quarter Annual Open enrollment period for Medicare Plans. If you choose, HealthPlanOne will set up an appointment for you to meet by phone with an advisor.
The Fund is confident, with HealthPlanOne by your side, you will be able to identify the best healthcare options to meet your current and future needs.
School Retiree Plan Costs
Currently, there are no retiree premiums required for coverage.
Need to Find a Doctor, Dentist or Vision Specialist?
Are prescription medications covered by Empire?
No. The Fund provides Prescription Drug benefits through OptumRx. You should have a separate Prescription Drug ID card. For more information about your Prescription Drug Benefits, please see the Prescription Drug Benefits section of this site.