Retiree Medical Care Coverage
In addition to the temporary COBRA continuation coverage available to all medical plan participants upon termination of coverage, Indiana University sponsors the following medical care coverage options to employees with IU Retiree status and their eligible dependents.
- Anthem PPO High Deductible Health Plan (Anthem PPO HDHP)
Indiana University does not contribute to the cost of Retiree coverage—the participant pays the full cost of these plans. For those under age 65, the rates are the same as COBRA continuation rates. Plan premiums for those age 65 and over are based on Retiree utilization.
All employees with IU Retiree status are eligible to enroll in IU-sponsored Retiree group health care coverage if they are covered by an IU-sponsored health care plan at the time of termination from the university (or when COBRA continuation coverage eligibility ends).
Eligible dependents include the individuals listed below, if they are eligible and covered by the Retiree's IU-sponsored health care plan at the time of termination from the university (or when COBRA continuation coverage eligibility ends). Once enrolled in an IU-sponsored health care plan, dependents cannot be added.
- the Retiree's legal spouse
- the Retiree's dependent children who continue to meet the definition of a dependent child as defined by IU for active employee coverage (i.e., the child meets the IRS support test as a dependent of the retiree; the child meets IU's requirements for disabled dependent child eligibility).
The above dependents are only eligible as long as the Retiree is enrolled in an IU-sponsored Retiree health care plan. An exception is that the surviving spouse and children of an employee are eligible if the employee has Retiree status as the time of death or the employee's death occurs while the dependents are covered under the Retiree's IU-sponsored Retiree health care plan.
Anthem PPO HDHP (more information)
Effective January 1, 2017, this plan is available to all eligible Indiana University employees and retirees under age 65, regardless of the area of residence. When network providers are used, participants receive full benefits. Partial benefits are received from non-network providers, except in the case of an emergency. Network providers include Anthem Blue Access PPO providers in Indiana, Ohio, and Kentucky and BCBS Blue Card providers in other states. Prescription coverage is the same as for active employees in this plan.
Blue Retiree Plan (more information)
This plan is a "Medicare Supplement" or "Medigap" plan that is available only to retirees with retiree status age 65 and over who are enrolled in Medicare Part A and Part B. As a supplement, many services will be fully paid between Medicare and the Blue Retiree Plan.
COBRA Continuation Coverage (more information)
COBRA continuation of active coverage is available to Retirees and their eligible dependents under age 65 or who are entitled to Medicare at the time of COBRA election. At the end of COBRA eligibility, the Retiree and eligible dependents may select from the PPO healthcare plans available for Retirees. Continuation of coverage under COBRA is generally 18 to 36 months depending on the circumstances.
COBRA coverage may be attractive to Retirees because it allows the participant to temporarily:
- maintain PPO plan coverage, dental coverage, and transplant benefits.
- maintain Open Enrollment options (e.g., adding dependents which is not allowed once enrolled in the Retiree plans).
Discontinuation of Participation
Participation as an active employee in an IU-sponsored health care plan ends on the day in which the Retiree terminates from the university.
The Retiree's coverage ends on the first of the month for which the individual has not made the required contribution.
Dependent coverage under an IU-sponsored Retiree health care plan ends when:
- the Retiree's coverage ends for a reason other than death of the Retiree;
- when the dependent ceases to meet the definition of an eligible dependent;
- upon discontinuance of all dependent coverage under the plan; or
- when the dependent becomes eligible for employee coverage.
It is also important to note the following conditions of participation in IU-sponsored Retiree health coverage:
- After dropping IU-sponsored Retiree health care coverage, participants cannot re-enroll at a later time.
- Dependents of a participating Retiree may continue coverage should the Retiree die.
- If the Retiree and dependents do not elect an IU-sponsored health care plan at the time of retirement, they cannot participate at a later time.
Other Health Plan Options (Non-IU Sponsored Plans)
Indiana University Health Plans Medicare Advantage
Medicare Advantage Plans, are health plans offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, the plan provides all your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Additionally, these plans may offer extra coverage, such as vision, hearing dental, and/or health and wellness programs. Some plans also include Medicare prescription drug coverage. IU Health Plans Medicare Advantage offers three advantage plans designed to meet a variety of health care needs. For more information regarding these plans, please call the IU Health Plans Customer Solutions Center at (800) 455-9776 or visit the IU Health Plans Medicare website.
Medicare Supplemental Plans
In addition to the IU-sponsored Medicare supplement, there are a variety supplemental or “Medigap” plans commercially available to retirees. Medigap plans may assist with some of the health care costs that Medicare may not cover. In order to identify a Medigap plan that caters to your health care needs, a plan comparison tool is available on the Medicare site to assist with your decision. For additional information regarding the various Medigap plans available through Medicare, please refer to the Medicare website at: www.medicare.gov/find-a-plan/questions/home.aspx
- Review plan options and rates to select an IU-sponsored Retiree health care plan option.
- Complete an enrollment form for the plan you choose.
- Enroll in Medicare Part A, Part B, and Part D if the participant is age 65 or over.
- Make any desired plan changes during Open Enrollment.
Plan changes are limited to certain circumstances:
- For the Anthem PPO HDHP (for those under age 65), the Retiree may terminate coverage altogether at any time by notifying IU Human Resources.
- For the Blue Retiree Plan (for those age 65 and older), the Retiree may terminate coverage at any time by notifying Anthem.
- The Retiree must notify the plan administrator of any change in status that terminates dependent eligibility (e.g., divorce of a spouse).
- Complete the COBRA election form received within 60 days of the date that coverage would have otherwise ended.
- Pay initial COBRA premiums to-date within 45 days of electing COBRA.
- Pay monthly COBRA premiums on time.
- In order to continue under an IU-sponsored Retiree health plan after COBRA eligibility ends, complete a health plan enrollment form.
- If you are eligible for Medicare at the time COBRA is elected, check with the Social Security office to fully understand how Medicare Part B and Part D enrollment coordinates with the COBRA election.
- Provide timely notice to the plan administrator of a change in status such as, divorce, legal separation, change in disability status, or death of a covered individual.
- During coverage, notify the plan administrator of changes that will affect communications or eligibility, including address changes, entitlement under Medicare, and coverage under another group health plan.
The terminating employee can contact IU Human Resources for information about retirement and/or COBRA.
Anthem is the claim administrator for each Retiree PPO Plan and the insurer for the Blue Retiree Plan. Call Anthem's Customer Service Center (800) 345-2460 for assistance with the following:
- Checking the status of claims
- Obtaining claim forms
- Obtaining ID Cards