Benefits Overview for Employees Planning to Retire

Employee Health & Benefits

114 State House Station

Augusta ME 04333-0114

(207)624-7380 or 1-800-422-4503

TTY users dial Maine Relay 711

www.maine.gov/deh

Updated: April 1, 2015

Your Current Benefit Programs

Health Insurance Wellness

Dental Insurance Employee Assistance Program MaineSaves 457b Vision Insurance Long-Term Care Insurance Flexible Spending Accounts Employee Assistance Program

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Health Insurance

Health Plans Eligibility Premium Cost

Retiree Dependents

Medicare Coordination of Benefits Turning 65 after retirement

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Health Insurance: Health Plans

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Health Insurance: Eligibility

One – You must be enrolled as an employee in the health plan one full year (12 consecutive months) immediately prior to retirement.

Two – Once retired, you must draw a monthly retirement check.**If not retiring but terminating after 25 years or

more of credible employment, you may opt to waive or pay for the insurance until you retire.

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Health Insurance: Premiums for the Retiree OnlyThe individual premium is determined by:

1. Date first hired by the State of Maine

a) On or before 7/1/1991

b) After 7/1/1991 but before 7/1/2011

c) On or after 7/1/2011

2. Age at retirement (normal retirement age “NRA”?)*

3. Years of participation in the health plan

Above will determine how much the State will contribute to your own individual health insurance premium in retirement.

*NRA not required if retiring under a “special” or disability retirement plan

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Eligibility requirements must be satisfied

Health Insurance: Retiree Premium

If you were first hired on or before 7/1/1991 and

you are at least at your normal retirement age*, the individual premium is paid 100% by the State of Maine OR…

you are younger that your normal retirement age, the individual premium is paid 100% by you, the retiree, until you reach normal retirement age.

Remember, with 25 years of credible service you can put your health insurance “on hold” until you reach normal retirement age.

*NRA requirement does not apply to “special” or disability retirees.

Eligibility requirements must be satisfied

Health Insurance: Retiree Premium You were first hired after 7/1/1991 but before 7/1/2011 and you are at least normal retirement age* State contribution is prorated based on years of participation in the

health plan:

*You will be responsible for 100% of your retiree premium if you are younger that your normal retirement age at retirement unless retiring under a “special” or disability retirement plan.

Participation in the Health Plan

State Paid Premium Contribution

Less than 5 years 0%

5 years but less than 6 50%

6 years but less than 7 60%

7 years but less than 8 70%

8 years but less than 9 80%

9 years but less than 10 90%

10 years or more 100%

Eligibility requirements must be satisfied

Health Insurance: Retiree Premium You were first hired on or after 7/1/2011 and you are at least normal retirement age* State contribution is prorated based on years of

participation in the health plan:

*You will be responsible for 100% of your retiree premium if you are younger than your normal retirement age at retirement unless retiring under a “special” or disability retirement plan.

Participation in the Health Plan

State Paid Premium Contribution

Less than 10 years 0%

10 years but less than 15 50%

15 years but less than 20 75%

20 years or more 100%

Health Insurance: Premiums for Dependents

Once retired, the State does not contribute towards the premium for your dependents$784.58/month (Spouse not on Medicare)$293.10/month (Medicare Advantage -

Spouse) The premium rates for POS & Medicare

plans can be found on the rate sheet provided separately.

10Rates good through 6/30/15 & 12/31/15

respectively.

Qualifying for Medicare Turning 65 and earned 40 or more quarters under the

Social Security Administration (“SSA”) SSA disabled Married to or have been married to a spouse who has

earned their 40 or more quarters with SSA

This information is applicable to the retiree, their spouse/domestic partner and any children that are SSA disabled that are covered by the State of Maine health plan.

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Medicare Benefits*Once you terminate or retire, you must apply for

Medicare if you qualify Medicare part A – pays for hospitalizations. Part

A is free for most. Medicare part B – pays for doctor visits,

diagnostic testing, etc. Part B is at your own expense.

Medicare part D – Do not purchase. The State of Maine Medicare Advantage plan contains a Medicare D component. You are not allowed to carry two Medicare D plans.

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Medicare Plan for Retirees:Medicare Advantage PPO Plan

It is very important you continue enrollment in Medicare A & B. You will only need to show your Aenta card; your Medicare card will be kept but not used.

The State’s plan has an annual deductible of $250. Prescriptions will be covered by the State’s plan so you

do not need to purchase any additional coverage (e.g. Part D). Refer to applicable benefit overview for copay amounts. There are several lists of drugs (“formulary”) that Medicare

covers. We have chosen a formulary that has a very wide variety but some day supplies are limited per the Federal government.

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Turning 65 After Retirement?

Employee Health and Benefits will be contacting you prior to your 65th birthdayMedicare Eligibility (Medicare Part A at no

cost to you) Yes – enroll in Original Medicare Parts A & B

Complete Medicare Advantage application No – provide Employee Health with a copy of

your ineligibility letter from Social Security

Spouse’s birthday; two separate plans possible

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Coordination of Benefits

You may be eligible for other health insurance plans

Tri CareUnder 65: Aetna POS plan is primary65+ : Medicare is primary, Aetna Medicare

Advantage second & Tri Care third Important to maintain the appropriate level of

coverage www.tricare.mil for more information

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Wellness Programs

Aetna POS PlanGlobal Fit – Fitness discount programWeight Management discount program

Aetna Medicare Advantage PlanSilver Sneakers (eff 1/1/14)

Aetna Healthy Lifestyle Coaching program Wellness Works (eligibility requirements)

Augusta & Bangor facilities16

Dental Insurance Dental is not a benefit of retirement Federal COBRA Law

Coverage for up to 18 months Combined Services, Inc. - COBRA administrator

Other group policies MSEA Maine Association of Retirees You may also purchase as an individual policy directly

through the insurance carriers

Effective 7/1/14 - 6/30/15

Dental Insurance:Monthly COBRA Rates

One person $26.78 Two people $47.88 Family $91.62

The retiree does not need to enroll in order to cover family member(s).

Blue View Vision

Current participants - it follows you into retirementSame coveragePremiums slightly higherYou will be directly billed by Anthem Blue View

Not a member? You can enroll during open enrollment as a retiree.

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Rates effective 1/1/2011 - 6/30/15

Blue View Vision

Monthly Retiree RatesRetiree only $5.90Retiree + 1 dependent $9.47Family rate $15.36

*Directly billed by Anthem as premiums cannot be withheld from your pension

“COBRA”

Consolidated Omnibus Reconciliation Act of 1985

Federal requirement to extend current coverage for a limited timeHealth Insurance Dental InsuranceVision Insurance

Administered by Combined Services, Inc.21

COBRA – What to Expect

You will receiveCOBRA Election NoticeA letter from Employee Health & Benefits

Program administrator:

Combined Services, LLC

Daphne Paige

1-888-227-9745 ext. 2023

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MaineSaves 457b Plan

Vacation pay deferral option Work with your local representative;

many distribution options available If you’re not enrolled, it’s never too

late to start saving Update your beneficiary information

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MaineSaves (continued)

There is no age 59 ½ penalty on the State’s 457b plan

You must start taking a required minimum distribution at age 70 ½ (if you are no longer working for the State of Maine)

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Long-Term Care For current participants only:

Follows you into retirementDirect bills will continue

Prudential Aetna

(Membership is closed to new enrollees)

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Flexible Spending Accounts

Current participantsPositive account balance=COBRA will be

offered*Negative account balance=account is closed

*Flex-Plan Services will provide COBRA administration

Call 1-800-669-3539 for more information

This is not a benefit in retirement

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Employee Assistance Program

Continues as a no cost benefit to retirees and members of their household

Up to 5 confidential counseling visits offered per year

Legal & financial discount programs available

AllOne Health 1-800-451-1834

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Still Have Questions?

Employee Health & Benefits

www.maine.gov/deh

1-800-422-4503

(207) 624-7380

TTY users dial Maine Relay 711

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