MPSERS Retiree Insurance Information

Toll Free:

800-381-5111

PO Box 30171 · Lansing, MI 48909-7671

Michigan.gov/ORS

Fax:

517-284-4416

Department of Technology, Management & Budget

R0058C (Rev. 4/2024) Authority: 1980 PA 300, as amended

Insurance Information

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Public School Retirees

Your Insurance Benefits

When you retire, you, your spouse, and your eligible

family members can enroll in the retirement system’s

health, prescription drug, dental, and vision insurances.

You can enroll in Blue Cross Blue Shield of Michigan with

or without prescription drug coverage or one of several

HMOs, which include prescription drug coverage.

For provider information and details about coverage, refer

to the Insurance Options Summary (R0379C) form.

You can view insurance carrier options and their contact

information on our website, Michigan.gov/ORSSchools,

by clicking on Your Insurance Benefits then Insurance

Carrier Options.

To see if you have the Personal Healthcare Fund or the

premium subsidy benefit, log in to miAccount at

Michigan.gov/ORSmiAccount. For increased security,

you’ll use MiLogin to access miAccount.

Premium Subsidy Eligibility

Hired before July 1, 2008. In most cases, if you have

the premium subsidy benefit and you retire while you’re

an active employee, you’ll become eligible for your

insurance premium subsidy on your retirement effective

date. However, your subsidy will be delayed if you

purchased service credit on or after July 1, 2008, that

allows you to qualify for your pension earlier than if you

did not make the purchase.

If a delayed subsidy applies, you can still enroll in health,

prescription drug, dental, and vision insurance but you

will pay the entire premium until the subsidy begins. The

subsidy will begin at age 60 or the age you would have

been eligible to retire if you had not made the service

credit purchase, whichever happens first.

Hired on or after July 1, 2008. If you began working for

a Michigan public school on or after July 1, 2008, you

must have at least 10 years of service (YOS) to qualify

for a subsidy, and your subsidy will be graded. With 10

YOS, a 30% subsidy is available. The subsidy increases

by an additional 4% for each additional YOS up to the

maximum subsidy allowed by law. For more information

on insurance subsidies, refer to the Your Insurance

Benefits section of the Michigan Office of Retirement

Services (ORS) website at Michigan.gov/ORSSchools

Personal Healthcare Fund

If you have the Personal Healthcare Fund, you are not

eligible for subsidized health, prescription drug, dental, or

vision insurance through the retirement system.

You, your spouse, and your eligible family members may

enroll in insurances if you enroll immediately when you

retire but you will be responsible for the entire premium. If

you disenroll from the plan at any time, you, your spouse,

and your family members cannot reenroll. If your spouse

or family members are disenrolled at any time, they

cannot reenroll.

For information about insurance eligibility and enrollment,

contact ORS. For other information about your Personal

Healthcare Fund, contact Voya Financial at 800-

748-6128.

Enrolling at the Time of Retirement

Insurance coverage always begins on the first day of a

calendar month. For retirees who do not have Medicare,

coverage can begin the first of the month after we receive

your enrollment request and required proofs. For retirees

with Medicare, coverage can begin the first day of the

second month after we receive your enrollment request

and required proofs.

For example, if you submit your enrollment request and

proofs July 25 for a retirement effective date of August 1,

your coverage will begin September 1. If ORS gets the

enrollment request and proofs later, but within 30 days of

the qualifying event, your coverage would begin a month

later.

Regardless of when you want your coverage to start,

ORS must receive your enrollment request and proofs for

everyone you want to enroll no later than 30 calendar

days after your retirement effective date, or those with

missing information will be subject to a six month wait to

enroll, starting from the date ORS receives the new

enrollment request and proofs.

Insurance coverage for you, your spouse, and your

eligible family members can begin on your retirement

effective date or up to 90 days past your retirement

effective date if you will have insurance coverage

through your school employer after you retire. If you are a

new retiree requesting a retroactive retirement effective

date, your coverage can begin no earlier than the first

day of the month after ORS receives your enrollment

request and required proofs, even if your retirement

effective date is earlier than that. Check with your school

employer to determine when your current insurance(s)

will end so there won’t be a break in your coverage and

R0058C (Rev.4/2024)

Page 2

you won’t be duplicating coverage. Determining the

correct effective date is important because we can’t

refund premiums once they have been withheld from

your pension.

Insurance Carrier Identification Cards

Each insurance carrier will mail insurance ID cards and

materials directly to you. If you apply at least three

months before your insurance effective date, your cards

will usually arrive by your retirement effective date.

If you need health services before your cards arrive,

contact the insurance carrier directly to get your policy

number or to verify coverage.

Enrolling in or Changing Insurance After Retirement

Premium subsidy benefit. If you have the premium

subsidy benefit and you’re enrolling yourself, your

spouse, or eligible family member in insurance after

retirement, your coverage will begin on the first day of the

sixth month after ORS receives your enrollment request

and required proofs.

For example, if we receive your enrollment request with

proofs February 10, your coverage will begin August 1.

If you, your spouse, or eligible family member has a

qualifying event (such as change in family status or

involuntary loss of other group coverage), your coverage

can begin as early as first of the month after you apply

and we receive required proofs. For retirees who do not

have Medicare, coverage can begin the first of the month

after the month we receive your enrollment request and

proofs. For retirees with Medicare, your coverage can

begin the first day of the second month after we receive

your enrollment request and required proofs, including

proof of the qualifying event.

For example, if ORS receives your enrollment request

and proofs July 10, your coverage will begin September

1. If ORS gets the enrollment request and proofs later,

but within 30 days of the qualifying event, you may not be

enrolled until a month later.

Personal Healthcare Fund. If you have the Personal

Healthcare Fund, you cannot enroll in insurances after

you retire. You can only change plans.

Changing plans. If you are currently enrolled in any

health insurance plan with the retirement system, you can

change your enrollment to another plan regardless of

your Medicare status. Your change in coverage will be

effective the first day of the second month after ORS

receives your enrollment request and required proofs. For

example, if ORS receives your change request and

required proofs January 10, your coverage with the new

plan will begin March 1.

Survivor Coverage

Premium subsidy benefit. Your beneficiary may

continue medical, prescription drug, dental, and vision

coverage after your death only if you choose a survivor

pension option (100% survivor, 100% equated, 75%

survivor, 75% equated, 50% survivor, or 50% equated).

Please refer to the Your pension payment options section

of Planning Your Retirement (R0613C).

Straight life. If you elect the straight life or straight life

equated options, which do not provide a monthly pension

to a beneficiary, enrolled family members will have no

subsidized group coverage after your death. Your

enrolled family members may be eligible for continuation

of unsubsidized insurance coverage for a maximum

period of 36 months. Refer to the Straight life calculation

and Equated plan sections of Planning Your Retirement

(R0613C)

Eligible Family Members

Health, prescription drug, dental, and vision coverage for

your spouse and eligible dependents is the same as

yours. Those eligible for coverage are:

• Your spouse. If your spouse is an eligible public school

retiree, you will be covered together on one contract.

• Your child by birth, adoption, or legal guardianship until

the end of the month in which they turn 26.

• Your unmarried child by birth, adoption, or legal

guardianship who is totally and permanently disabled,

dependent on you for support, and incapable of self-

sustaining employment.

o In the case of legal adoption, a child is eligible

for coverage as of the date of placement.

Placement occurs when you become legally

obligated for the total or partial support of the

child in anticipation of adoption.

o In the case of legal guardianship, official

guardianship paperwork must be in place for a

dependent to be eligible for coverage. Once a

guardianship terminates, dependent eligibility

for coverage ends.

• Either your parent(s) or your parent(s)-in-law residing in

your household — one set of parents or the other, but

not both.

R0058C (Rev.4/2024)

Page 3

Proof of Eligibility

You must provide proof of eligibility for family members

you want to enroll in your insurance plan.

• Spouse: Copies of your spouse’s government-issued

birth certificate and your government-issued marriage

certificate.

• Child: Copy of your child’s government-issued birth

certificate.

o To prove adoption or legal guardianship, provide

legal papers issued by a court.

o If your child is disabled, provide a current letter

from the attending physician detailing the

disability and stating the child is totally and

permanently disabled and incapable of self-

sustaining employment. The signed certification

must be on the physician’s letterhead and dated

within the last six months. Also, provide the first

page of your most recent 1040 tax form listing

the dependent.

• Parent(s) or parent (s)-in-law residing in your

household: Previous tax year’s 1099 or 1098, a

current voter’s registration card, driver’s license, or

state-issued ID showing the parent lives with you.

You are responsible for immediately notifying ORS of any

change in your status or that of anyone enrolled in your

insurance plan. If ORS pays claims for an ineligible

person, you may be responsible for repaying any claims

made on their behalf.

Medicare

As soon as you or anyone else covered by your health

insurance becomes eligible for Medicare, that person

must enroll in both Part A (hospital) and Part B (medical).

You must have Medicare parts A and B to enroll in retiree

insurance and prescription drug coverage. If you or

anyone else covered by your insurance, don’t enroll in

Medicare Part B when first eligible, the insurance for that

person will be canceled and there is a six month wait to

reenroll.

For most people, Medicare begins at age 65 or after 24

months of Social Security Disability Insurance. If that

happens before age 65, send ORS the Insurance

Enrollment/Change Request (R0452C) form, and make

sure ORS has your Medicare number.

When you enroll in Medicare, you will receive your

Medicare card from the Social Security Administration. As

soon as you receive your card, tell ORS your Medicare

number and effective dates for parts A and B. You can

submit your Medicare enrollment information one of the

following ways:

• Use the miAccount Message Board to send ORS a

secure message with your Medicare enrollment

information.

• Update your insurance enrollment information in

miAccount to include your new Medicare information

and send ORS the confirmation page.

• Make a copy of your Medicare card. Write your

name, address, and date of birth on the copy and

mail or fax the copy of your card to ORS.

• Mail or fax a completed Insurance

Enrollment/Change Request (R0452C) form to ORS

with your Medicare information.

• Call ORS at 800-381-5111 and give a representative

your Medicare information.

When we receive your Medicare number, ORS will enroll

you in a Medicare Advantage Plan. A Medicare

Advantage Plan is a private health plan that contracts

with Medicare to provide you with all your Part A and Part

B benefits.

Medicare Part D (prescription drug) is a federal program

that is administered by your group insurance plan. When

you enroll in a retiree prescription drug plan, we will

automatically enroll you in Medicare Part D if appropriate.

Don’t sign up for a Medicare Part D prescription drug plan

or any other supplemental prescription drug plan. If you

do, you’ll lose medical and prescription drug coverage

through the retirement system

R0058C (Rev.4/2024)

Page 4

Deferred Applicants ONLY

You are deferred if you are vested but you left public

school employment before you met the age requirement

for retirement and you did not take a refund of your

contributions. If you are a deferred member with the

premium subsidy benefit, you may be eligible for an

insurance premium subsidy. The amount of the subsidy

depends on when you ended your public school

employment and how many years of credited service you

have.

If your last day of public school employment was on or

before October 31, 1980, and you are eligible to receive

a deferred pension, you are eligible for the maximum

subsidy allowed by law.

If your last day of public school employment was after

October 31, 1980, and you have at least 21 YOS, your

subsidy will be 10% for each year of credited service you

have over 20 years. With 21 YOS, you get 10% of the

subsidy. With 25 years, the subsidy increases to 50%. A

retiree with 30 YOS is entitled to the maximum subsidy

allowed by law.

If your last day of work was after October 31, 1980, and

you have less than 21 YOS, you can enroll in the health,

prescription drug, dental, and vision insurance but you

must pay the entire premium.

Disability Applicants ONLY

If the retirement board approves your disability retirement

application and you have the premium subsidy benefit,

your health, prescription drug, dental, and vision

coverage can begin the first day of the following month

your application is approved or you end employment,

whichever is later. Continue your current insurance to

ensure continued coverage during the approval process.

Indicate in the Insurance Options section of your

enrollment request that you want coverage through the

retirement system to begin the first day of the month

following the retirement board’s approval of your

retirement application.