Retiree health plan

Retiree health plan benefits and information

If you are retired from University of Idaho and enrolled on the retiree health plan, this page outlines your coverage.  

If you are preparing for retirement and meet the criteria for certain retirement tiers, you may be eligible to enroll in University of Idaho retiree health plans. Submit a tier request to Benefit Services about a year before your planned retirement date to explore your options. To transition to the retiree health plan, you must be enrolled in an active University of Idaho employee medical plan at the time of retirement.

You may purchase coverage elsewhere if you are not eligible for the retiree health plan or feel that the university plan is not the best fit for your needs. Review the information below carefully. University of Idaho retiree health plan elections are final.

Contact benefits@uidaho.edu with any questions.

Plan options and coverage

The university offers two retiree health plans:

• Retiree PPO Plan
• Retiree High Deductible Health Plan (Retiree HDHP)

See the summary plan description.

The plans differ based on your Medicare eligibility:

• Pre-Medicare plan benefits (for retirees under age 65)
• Post-Medicare plan benefits (for retirees aged 65 and over)

Your choice between the Retiree PPO or Retiree HDHP applies to all enrolled dependents and is irrevocable. You cannot switch plans later.

Relationship to Medicare

To participate in the retiree health plan, you must enroll in Medicare Parts A and B when first eligible. Unless you have a disability that qualifies you for Medicare coverage early, Medicare will be effective on the first day of the month you turn 65.

The retiree health plan is not a Medicare supplement. Once you are enrolled in Medicare Parts A and B, Medicare becomes the primary insurer, and the university retiree health plan is secondary.  The retiree health plan coordinates with Medicare and any other insurance coverage you may have according to a maintenance of benefits (MOB) provision. This means that Medicare—and any other insurance you have—process and pay your health insurance claims first. The retiree health plan reviewed claims after Medicare/other insurance and pays any difference between your Medicare/other insurance benefits and your retiree health plan benefits. Payments from all plans total the benefits set by the retiree health plan.

Dental and vision coverage

Dental coverage and vision coverage such as routine vision exams and glasses/contact lens prescriptions are not included in the retiree health plan.

However, medical-based vision exams and cataract treatment are covered.

Prescription drug coverage

The Retiree PPO and the Retiree HDHP plans provide prescription drug coverage until you become Medicare eligible or turn 65. The prescription drug benefit is administered by CVS Caremark.

Tier 1 retirees on the Retiree PPO Plan: After Medicare eligibility, you have prescription drug coverage through the SilverScript Prescription Drug Plan.

Retirees in all other tiers/plans: Prescription drug coverage ends with Medicare eligibility. You may purchase a separate Medicare Part D drug plan. A certificate of creditable coverage will be mailed to your home upon Medicare eligibility, allowing you to transition to Medicare Part D coverage effective on the first day of the month after your university prescription drug plan ends.

Tier II and Tier III, Plan A: Health Reimbursement Account (HRA)

If you are in Tier II or Tier III and select the Retiree PPO Plan, upon Medicare eligibility, the university provides a reimbursement stipend instead of prescription drug coverage. The stipend — provided through a Health Reimbursement Account (HRA) administered by Health Equity — may be used toward the cost of prescription drugs or a Medicare Part D Plan. See the HRA FAQs sheet for more information.

Retiree death benefit

A death benefit is available to Tier I retirees on all plans. Review the Retiree Death Benefit Plan Summary for details. To add or change beneficiaries, complete the Retiree Death Benefit Beneficiary Form.

Enrolling dependents

When you first enroll in the retiree health plan, it's your only opportunity to add your spouse or eligible dependents to your plan, except:

• If your spouse is an active University of Idaho employee, they may be added the day after their retirement or separation.
• You may add new spouses or new dependents within 30 days of the date of marriage or within 60 days of birth or adoption.

Loss of other coverage is not a qualifying event to enroll dependents on your retiree health plan.

Note: Some retirees select short-term COBRA coverage for a spouse or dependent, as it may cost less than the retiree health plan. You may also enroll in COBRA dental and vision coverage for yourself and your dependents for up to 18 months. Information about COBRA will be mailed to your home address as you near retirement.

Rates and paying for coverage

Retiree rates

Rates for all tiers and plans are available below. Contact Benefit Services with any questions.

• Tier I
• Tier II
• Tier III
• Tier IV

Paying for your coverage

You will be billed monthly for your retiree health coverage. Payment is required by pre-authorized bank draft (ACH). Use the pre-authorized checking registration form to set up payment. Checks, credit cards and bill pay are not accepted.

Your first invoice will include the first and second months of enrollment.

Timely payment is crucial. Non-payment will result in termination of your retiree health plan, and you cannot rejoin later.

Tier IV: Sick leave conversion

If you are in Tier IV, half of your unused sick leave, up to 600 hours, may be used to cover the cost of retiree health plan coverage. Sick leave conversion may not be used for dependent coverage, dental or vision coverage, voluntary benefits or life insurance. When your sick leave credits run low, you will receive instructions on how to change to direct billing or terminate your plan.

For retirees in Tiers I, II and III, unused sick leave is not paid out and has no cash value or conversion option.

Transitioning to the retiree health plan

If you’ve signed up for University of Idaho’s retiree health plan, here’s what to expect.

It can take up to four weeks after your last paycheck for your retiree health plan to be fully processed. It may seem as if you don’t have coverage during this period, but you do. Your retiree health plan is active, and you’re covered if a medical emergency happens.

Review the tips below for a smooth transition from active to retiree health coverage.

Use your dental and vision benefits before you retire

The retiree health plan does not include dental care, routine vision exams or glasses or contact lens, so make use of these benefits under your active employee plan before you retire.

Wait a month for routine medical appointments and prescription refills

Avoid scheduling any routine medical appointments or procedures during the transition period (the first two to four weeks after you retire).

If possible, refill any prescriptions before you retire. If you can’t, you may need to pay out of pocket and submit a claim for reimbursement after your retiree plan is fully active.

Claim FSA funds within 90 days

If you have a Health Care Flexible Spending Account (FSA) as an active employee, you have 90 days after your last workday to submit claims for expenses made before retirement. The maximum claim reimbursement is your FSA election amount for the year you retire. You can’t use FSA funds for expenses that happen after you retire. Any leftover money in your account will be lost.

Understand HSA fees

Once you enroll in Medicare, you can no longer add money to your HSA — but the money already in the account is still yours to use.

After your retirement, the university no longer pays your HSA account fees. If your balance is below $2,500, you may be charged a monthly fee. If you have questions, call HealthEquity at 1-866-346-5800 or visit their online Help Center.

Understand whether your deductible carries forward

The active employee and retiree health plans run from January through December. If you retire mid-year, whether your deductible carries over depends on the plans you’re switching from and to:

• Standard PPO to Retiree PPO: Your medical deductible carries forward, but you may have a new prescription deductible. You’ll receive new Blue Cross of Idaho membership cards within a month. You might also get new prescription cards depending on your plan.
• Standard PPO to Retiree HDHP: Your deductible does not carry forward. You will receive new Blue Cross of Idaho membership cards within a month.
• HDHP to Retiree PPO: Your deductible does not carry forward. You will receive new Blue Cross of Idaho membership cards within a month.
• HDHP to Retiree HDHP: Your medical deductible will carry forward. New membership cards will not be issued mid-year.

Your subscriber ID number will remain the same when you transition from the active employee health plan to your retiree health plan.

COBRA coverage

Information about COBRA will be mailed to your home address. This is a legal notice required by law. If you are transitioning to a university retiree health plan, you can ignore this notice for your own medical coverage. However, some retirees select short-term COBRA coverage for a spouse or dependent because it costs less than covering them on university’s retiree health plan. You may also elect COBRA dental and vision coverage for yourself and your covered dependents for a maximum of 18 months.

Medicare coverage

If you or your spouse are eligible for Medicare when you retire, Benefit Services will give you a certificate of creditable coverage for Medicare Part D and a CMS-L56E form confirming continuous coverage required for Medicare Parts A and B. You will provide these documents to Medicare when you enroll. They confirm that you have had health insurance coverage through University of Idaho between the date you became eligible for Medicare and the date you retired/enrolled in Medicare, so you will avoid a penalty for late enrollment.

Once enrolled in Medicare Parts A and B, provide a copy of your Medicare ID number to Benefit Services and Blue Cross of Idaho as proof of enrollment. Medicare is now your primary insurance.