Frequently Asked Questions: Retiree Health Benefits

All Retirees
Retirees/Dependents Age 65 and Over

All Retirees

General Questions

1. Please explain the statement: “You are eligible to receive retiree health benefits if you meet the Rule of 75.” The above statement means that your age plus your years of service must total at least 75. Service must be full-time and continuous.

   The minimum age for retirement is 55. Employees retiring between the ages of 55 and 62 must have at least 15 years of service and must meet the Rule of 75. For example, if you retire at age 55 you must have at least 20 years of service to meet the Rule of 75. Employees retiring at age 62 or older must have at least 10 years of service and must meet the Rule of 75. For example, if you retire at age 62 you must have at least 13 years of service to meet the Rule of 75.

   Note that if you meet the age and service minimums (age 55 and 15 years of service, or age 62 and 10 years of service) by December 31, 2008, you can retire later than that date and not be required to meet the Rule of 75. You will then be eligible for retiree benefits when you actually retire/terminate from Penn.

   The Rule of 75 applies to all retiree benefits, including tuition, life insurance and dental plans.

2. When I retire, will the University contact Social Security on my behalf?

   No. It’s your responsibility to contact the Social Security Administration (SSA) about starting your benefits. You should contact the SSA 90 days before you retire (see the Retiree Health Plan Directory for contact information). You should also contact the Benefits Office in the Division of Human Resources to advise them of your actual retirement date and coordinate your enrollment under the Medicare program.

   Once you coordinate your appointment with the SSA, you should receive two forms:
   • Application for Enrollment in Medicare (you should complete this form)
   • Request for Employment Information Form (you should send this form to the Benefits Office in the Division of Human Resources for completion)
   
   The completion and submission of these forms to Social Security will protect you against any penalty and validate your retirement date.

3. If my spouse/same-sex domestic partner retires before I do, can he/she continue under my active medical plan?

   Yes, your spouse/same-sex domestic partner may continue under your health plan while you are working.

Dental Benefits

1. I’m not currently enrolled in a dental program. Will I be able to enroll in the MetLife Dental Plan during the next Annual Selection period?

   No. Open enrollment in the MetLife PDP will only take place every three years (beginning with the 2011 Annual Selection Period). Therefore, your next opportunity to enroll in the MetLife plan is 2014. Keep in mind that surviving spouses and surviving dependent children are not eligible for this coverage.

2. I currently have coverage under my spouse’s/same-sex domestic partner’s dental plan. If he/she loses this benefit, will I be able to join the MetLife retiree dental plan outside of the Annual Selection Period?

   Yes. If your spouse loses his/her dental coverage, this would be considered a qualifying event and you would be allowed to enroll in the MetLife retiree dental plan within 30 days of the date your prior coverage ended. You would be required to provide proof of prior coverage in order to enroll.

3. I am enrolled in the Vital Savings by Aetna Dental Program. How is this program different from the MetLife retiree dental plan?

   The Vital Savings by Aetna Dental Program provides discounts (an average discount of 28%) on dental care when you use participating providers. Retirees who are enrolled in this program will automatically have access to the Aetna Vision One discount program. You may enroll in this program at any time by contacting Aetna directly. The MetLife Preferred Dentist Plan (PDP) provides coverage when you receive treatment from any dentist or specialist you wish. Please see Question 15 above for information about enrolling in this plan.

Retirees/Dependents Age 65 and Over

Medical Benefits

1. I’m currently a Long-Term Disability recipient and my spouse/same-sex domestic partner is turning 65. How will this impact the medical benefits for me and my dependents?

   Because of the specialized nature of these benefits, we suggest that you contact the Long-Term Disability (LTD) Administrator in the Benefits Office of the Division of Human Resources at 215-898-1326.

2. If I elect either the Keystone/AmeriHealth 65 HMO or the Aetna Medicare Plan (PPO), can I enroll in a non-Penn sponsored Medicare Part D plan?

   No. The Centers for Medicare & Medicaid Services (CMS) state that you cannot enroll in one of Penn’s Medicare-Advantage plans (HMO and PPO plans) if you elect a non-Penn sponsored Medicare Part D plan. If you do this, CMS will cancel both your medical and prescription coverage as of the date you enrolled in both plans.

3. When I reach age 65, I intend to continue to work full-time at the University and maintain enrollment in the University’s medical plan for active employees. Will I have to enroll for Medicare Parts A and B?

   You are not required to enroll under the Medicare program under these circumstances. However, you may elect Medicare Part A at no cost to you. You may do so by contacting Social Security 90 days prior to your 65th birthday. You should also state at that time that you are not applying for Medicare Part B benefits because you’re already covered by Penn’s plan. (Part B has a premium and is mandatory when you actually retire.)

4. If my spouse/same-sex domestic partner turns 65 and is covered under my active medical plan, is he/she required to enroll under Medicare Part B?

   No. If your spouse/same-sex domestic partner is covered under your active medical plan, then enrollment in Part B is not required because your active plan coverage is primary over Medicare. However, if you are planning to retire, your spouse/same-sex domestic partner should contact Social Security Administration to apply for Part B coverage three months before your active coverage ends.

5. What are the differences between the Standard option and the Premium option in the Medigap Security 65 plan?

   The Standard option offers a lower premium, but there are more out-of-pocket costs than under the Premium option such as a $20 copay for office visits and a $50 copay for emergency visits. In addition, the Standard option does not reimburse the Medicare Part B deductible. For detailed information on these new plans, please refer to the Medical Plan Comparison Chart or contact IBC at 1-800-ASKBLUE (1-800-275-2583) with questions. IBC may refer to the Standard Plan as the Medigap Security Plan N and to the Premium Plan as the Medigap Security Plan C.

Prescription Drug Benefits

1. I’m enrolled in the SilverScript prescription plan. Where can I get my prescriptions filled?

   The plan has a network of more than 64,000 pharmacies nationwide. The pharmacy at the Hospital of the University of Pennsylvania (HUP) is included in the network. You must use a network pharmacy to receive full plan benefits. For a pharmacy directory, please contact SilverScript at 1-866-494-9829 or click here.

2. What information should I expect to receive from SilverScript?

   In addition to your new membership card, SilverScript will send you an Explanation of Benefits (EOB) on a monthly basis if you used the benefit during the previous month. This report will include a list of prescriptions that you filled during the month along with the amount you paid for them.