Retirees Health Care Benefits Information
An important element in retirement planning is considering your future health care costs, Medicare and Medicare supplement policies.
Anyone who is over age 65 (or within three months of turning age 65) should apply for Medicare Part A, by contacting the Social Security office near you. Their telephone number is: 1-800-772-1213 or you can apply online: www.ssa.gov. HealthFlex will remain your primary insurance as long as you are an active, full-time employee. Medicare Part A will act as your secondary insurance in the event of a hospitalization. While you are still covered under an active group insurance policy (before your July retirement), you are not required to enroll in Medicare Part B.
About 90 days before your retirement, you must enroll in Medicare Part B. You should explain to the Social Security representative that you are retiring and will be losing your group medical and prescription coverage due to retirement and will need to enroll in Medicare Part B. Once you are enrolled in Medicare A and B, you will receive the services for OneExchange; your (pro-rated) Health Reimbursement Account funding will begin at retirement – generally July 1.
Please note: If you or your spouse are under the age of 65 at the time of your retirement, you will continue to be enrolled in the active HealthFlex insurance plan until you are eligible for Medicare; you will be billed for the full cost of the insurance on a quarterly basis. To be eligible for your future Health Reimbursement Account, you must continue your enrollment in HealthFlex until age 65 and are eligible for Medicare. The cost of the medical premiums may be deducted from your pension check, with your permission, for your convenience.
As you know, we have partnered with OneExchange to assist you in the transition from our group plan to the individual insurance market. The Benefits Advisors at OneExchange will be able to assist you in enrolling in the most suitable Medicare Supplement and Prescription Drug insurance plans even if you don’t yet have a Medicare Card as long as you have applied for Medicare A & B. The telephone number for OneExchange is 1-866-249-7785; their website is: https://medicare.oneexchange.com/wespath. You should be able to review information and even begin portions of your Medicare supplement enrollment.
After you have enrolled in a supplement and prescription drug plan through OneExchange, the Conference will fund a Health Reimbursement Account (HRA) for you and your spouse on an annual basis to assist you in paying the premium of your new insurance. Retired clergy and their spouses each receive HRA funding. You will be required to pay your premiums and other expenses before requesting reimbursement through the HRA. Unspent funds in your HRA will roll-over year to year.
IMPORTANT: Any future changes to your Medicare Supplement Insurance or Prescription Drug Plan must be performed with the assistance of OneExchange or you will be subject to the loss of your HRA funding. You can change your Medicare Supplement and/or your Prescription drug plan annually, during the open enrollment period.
Retired clergy and their spouses receive their Health Reimbursement Account funding based upon years of service to our conference, and that they and their churches have paid their HealthFlex and pension invoices in full. The Health Reimbursement Account funding levels are:
Less than 5 full years of service — clergy will not receive an HRA
5 through less than 10 years — 25% of the HRA* per participant
10 through less than 15 years — 50% of the HRA* per participant
15 through less than 20 years — 75% of the HRA* per participant
20+ full years of service — 100% of the HRA* per participant
*Since HRA amounts are subject to change in future years, the HRA dollar amount is not listed above. The clergy and spouse would be eligible for a percentage of the HRA in effect at the time of their retirement.
The 2016 HRA annual funding is $2,700 per participant. The 2017 HRA funding will be $2,755 per participant.
Clergy with Past Due HealthFlex accounts: At the time of retirement, retroactively five years, a pastor who served, was eligible for and enrolled in the pension plan and HealthFlex, and the pastor’s share was not paid in full, the Board of Pension and Health Benefits (BOPHB) will reduce their HRA amount by the lesser of the amount owed or by 50%, until such time as the conference recoups these losses. The BOPHB will establish an appeal process for clergy who feel that the policy of a reduced HRA unfairly penalizes them. Their spouse’s HRA will not be reduced but set at the amount to which they are entitled. This policy began with retirements at the 2015 Annual Conference.
If you are eligible to receive retiree group insurance benefits from a previous employer, the military or your spouse’s employer, please call the Conference Benefits office to discuss the options available to you. You can only be enrolled in one Medicare Supplement Plan (either individual or group); therefore if you are qualified to enroll in another group plan, you may wish to do so and waive the options available through OneExchange.
One final note: Please keep your contact information up to date with the Conference office. Any changes to your home address, phone or email should be sent to the Conference Benefits office who will update the NYAC records and the WesPath’s database. You can do that by emailing Sally Truglia at email@example.com, or by calling 914-614-2220.