Overview of SCRS Service Retirement Process:
1. Retirement Checklist:
• Please complete the retirement summary page. Then review the retirement checklist and
check
off each item. Email the completed retirement summary page and checklist back
to your Benefits Administrator.
• The following steps will need to be completed within 6 months of your date of
retirement.
• For best results, please copy and paste each hyperlink listed under each heading in
Google Chrome.
2. SCRS Retirement Service Application:
1. Please complete your SCRS Retirement Application online through Member Access:
https://online.retirement.sc.gov/MemberAccess/welcome. Click on the “Register Now” box
to get started. In Member Access you can also pull estimates to see what your monthly
pension benefit amount would be. We can also pull this information for you on the
2. You will need to complete the following: retirement application, withholding certificate for
monthly benefit payment form, direct deposit form.
3. You will need to attach a photo of your driver's license and birth certificate/passport.
i. It typically takes PEBA 3-5 business days to process online retirement applications.
If after you submit your application, anything is missing you can upload the support
directly into Member Access.
ii. Driver's license and birth certificate/passport is also needed for beneficiaries if
selecting option B or C.
4. If you are also applying for SCRS Disability Retirement, please print/complete the application:
https://forms.retirement.sc.gov/formGenericGet.do?formNum=web6151s.xdp and mail to
PEBA Retirement, 202 Arbor Lake Drive, Columbia, SC 29223.
3. PEBA Retiree Insurance Process:
1. Please review the Retiree Insurance Packet:
https://www.peba.sc.gov/sites/default/files/retiree_packet.pdf
2. Print and complete the 4 forms below. Please scan/email the forms to your Benefits
Administrator to review before submitting to PEBA via postal mail. PEBA Insurance Address:
PEBA Insurance Benefits, PO Box 11661, Columbia, SC 29211.
3. Forms to send to PEBA Insurance:
i. From the retiree insurance packet:
1. Employer Verification Record:
https://www.peba.sc.gov/sites/default/files/employment_verification.pdf
2. Tobacco Certification:
https://www.peba.sc.gov/sites/default/files/tobacco_use.pdf
3. Retiree Notice of Election form:
https://www.peba.sc.gov/sites/default/files/retiree_noe.pdf
ii. Include the retiree funding insurance letter (included in this packet).
4. You will receive a turnaround document in the mail from PEBA Retirement and a letter from
PEBA insurance regarding your eligibility for retiree insurance.
4. Medicare Information:
1. I have included the Medicare Part B employer form for you to send to the Medicare office
for enrolling in Medicare Part B. Please see the Medicare pages in this packet
for next
steps and please also review our Medicare Leaving Employment Checklist.
5. Annual Leave Payout:
1. I’ve included your annual leave payout form so you can see what it would look like if you did
the deferral to a supplemental retirement account versus the cash payout. This is just an FYI.
If you would like to do the deferral to a supplemental retirement account, please complete
the AL payout form and send back to me. If you prefer the cash payout, simply send me an
email to let me know, you will not need to complete the AL payout form.
6. Next Steps:
1. Please touch base with your direct manager/business manager to let them know you will be
retiring. We do not notify your department of your retirement. They may have some things
for you to complete before you leave-i.e. turn in your badge etc.
Date Prepared: ________________
Retirement Summary Page
Retirement (Regular)
Retirement (Disability)
PERSONAL INFORMATION
Last Name: __________________ First Name: __________________________
SSN: _______________ Date of Birth: ________________ Gender: M F
Home Phone (w/ area code): ______________________ Email: ________________________________
Home Address: ________________________________________________
City: _____________________________ State: _______ Zip Code: ______________
EMPLOYMENT INFORMATION
Position Title: _________________________________________
Department: ___________________________________________
Annual Salary: ____________________
Annual Leave Balance: _________ hours / Sick Leave Balance: _________ hours
Last Day Worked: _______________ Last Day Paid: _______________
Selected Date of Retirement: _______________
RETIREMENT INFORMATION
SC State Retirement Plan: SCRS
ORP – MassMutual MetLife TIAA
AIG
Supp
lemental Retirement Plan? Yes No
If yes: 401(k) 457
403(b) – Fidelity MassMutual MetLife TIAA
AIG
ANNUAL LEAVE PAYOUT CALCULATION
Attached at the end of this packet.
1/31/2022
SCRS Retirement Checklist
Name: Employee ID: Department/Contact:
Employee:
[ ] I am aware that my last day employed will be and my date of retirement will be .
[ ] I may be paid out up to 360 hours of unused annual leave to use towards my AFC and 720 hours of sick leave towards my
service credit. Sick leave cannot be used to meet retirement eligibility.
[ ] Retirement checks are paid on the last working day of the month. The first check or two may be mailed to me and future checks
will be deposited into the bank account I have elected.
[ ] Retirees are eligible for an incidental death benefit based on their total years of service credit. There is no cost to the retiree.
x SCRS: 10-19 yrs = $2,000 / 20-27 yrs = $4,000 / 28+ yrs = $6,000
[ ] I will receive an “estimate” of my retirement benefit once PEBA Retirement receives my application. The initial estimate will
not include any annual or sick leave that I have. MUSC will report the leave to PEBA Retirement upon the processing of my last
paycheck and annual leave payout, which will prompt PEBA Retirement to generate a “finalized estimate” of my retirement.
[ ] If all beneficiaries predecease the retiree, the annuity reverts to Option A, effective on the date of the last beneficiary died.
[ ] For Options B and C, if the retiree has a change in marital status he/she may select a new payment plan and/or beneficiary
within five years of the change in marital status. Change is effective the first of the month in which the form is received. A retiree
may only make a maximum of 2 changes to their beneficiary option.
[ ] Retired SCRS plan members who retired with 28 years of service or on or after their 60th birthday are eligible for Cost of
Living Adjustments (COLAS) the second July 1 after their date of retirement. However, SCRS plan members who retired under
early retirement provisions at age 55 with 25 years of service are not eligible for COLAs until the second July 1 after they reach
age 60 or the second July 1 after the date they would have attained 28 years of service credit had they not retired. Eligible retirees
should receive a benefit adjustment of 1 percent of their annual annuity up to a maximum of $500 effective each July 1, based on
current state legislation.
[ ] If a retiree returns to work after for any employer who participates in the PEBA Retirement plans, their retirement benefit will
be subject to an earnings limitation. Once the retiree earns $10,000 from their employer, their retirement benefit will cease for the
remainder of the calendar year; retirement benefits will resume the following calendar year subject to the same limitation. The
$10,000 limitation does not apply if the retiree was at least 62 years of age on the date of their retirement.
[ ] If I am eligible for Retiree health, dental and/or vision insurance, my Benefits Counselor has given me the Retiree Notice of
Election (NOE)and the Employment Verification Form These forms need to be mailed to PEBA Insurance within 31 days of my
retirement date. Premiums for these insurances may be paid from my retirement paycheck, deducted after taxes are calculated and
will be pre-deducted for the following month’s coverage.
[ ] Retiree Insurance Premiums-If you are scheduled to receive a pension check from PEBA Retirement Benefits, your insurance
premiums will be deducted automatically from the first check you receive. If your insurance goes into effect before you receive your
first pension check, PEBA will mail a billing statement to you for the insurance.
For example, your insurance is effective January 1 and you are scheduled to receive your first pension check on January 31, you
will receive a bill for January. Since premiums are deducted in advance, the premiums for February will be deducted from January
31 pension check.
[ ] If my spouse and/or I are of Medicare age, we must contact Social Security/Medicare to determine when to enroll in Part B.
Contact Medicare at 800-MEDICARE if you have additional questions.
[ ] The Affordable Care Act requires employers to offer coverage to all employees who work an average of 30 hours a week.
Because of this federal law, if you return to work at MUSC as a retiree employed in a temporary position, and you average 30
hours, you could be eligible to keep benefits through MUSC. If you and/or your spouse are eligible for Medicare, you are
required to keep your benefits through MUSC based on the federal law governing Medicare enrollment.
[ ] Retirees are eligible for enrollment changes to health, dental and/or vision. PEBA will send communications regarding
enrollment options.
1/31/2022
[ ] I have the option of converting/continuing my optional term life insurance within 31 days of my retirement. My retiree
coverage will end on January 1 following my 75th birthday. I can also convert my coverage to a whole life policy, which is a
permanent form of life insurance. I may be able to continue my insurance coverage and pay premiums directly to MetLife.
MetLife will mail me a conversion/continuation packet. Packets are sent via U.S. mail three to five business days after MetLife
receives the eligibility file from PEBA. To continue my coverage, I will complete the form that will be included in my packet
from MetLife. Metlife can be reached at 888-507-3767.
[ ] Employees are still allowed to continue making contributions to their MSAs on an after-tax basis through COBRA. If an
employee continues to make contributions to his MSA, you can use it through the end of the current plan year, including the grace
period. The grace period is March 31
st
of the following plan year. If you do not continue his contributions after you leave
employment, you have 90 days to submit a claim for any services you received before you left your job. If you are enrolled in a
Dependent Care Spending Account, you cannot continue contributing to the account. You can only request reimbursement for
eligible expenses incurred while you were employed until the account is exhausted. Please contact the MSA/DCA vendor ASI
FLEX if you have any additional questions at 833-726-7587.
[ ] I understand that should my department propose that I be rehired, they must first submit a Position Justification Form to HR to
be approved by the Provost or respective VP.
[ ] I am aware that I may (or may not) be rehired by my department as a Retiree. If my department rehires me as a Retiree, they
must indicate on the Notice of Separation that I am a Retiree returning to work on: month/day/year. I must have at least a 30
calendar day break in service before returning to work. I am considered a retiree and I am employed in an at-will status with no
grievance rights or faculty tenure. Faculty, Nurse Practitioners, and Physician’s Assistants will not have any malpractice insurance
during this break. I should also sign a Statement of Understanding-Post-TERI/Post-Retiree regarding my re-employment in a
temporary position.
[ ] Per HR Policy 51 all Post Retirement employees returning to work will be employ
ed in a temporary position. Temporary
employees are typically* not eligible for benefits, annual leave, sick leave or holidays. I am required to continue participating to the
SCRS plan if I return to work in any position. Temporary employees are required by State guidelines to take a 15 calendar day
break after one year of temporary employment, however, temporary returned retirees at MUSC are exempt per MUSC Legal
Counsel. (*temporary employees could be eligible for insurance benefits under the ACA if they have worked enough hours- email
benefits@musc.edu for further assistance).
[ ] If I return to work, my contributions to my supplemental retirement plan will continue if Payroll knows that I will be returning
to work. Otherwise, I must contact the Benefits Office directly at benefits@musc.edu
to resume the contributions.
Please communicate the following information with your Business Manager:
[ ] A Notice of Separation form or Teamworks separation must be sent to HR. The transaction should reflect the appropriate
Retirement reason (Early or Regular).
[ ]Per HR Policy 39, Employees who resign in good standing should submit their resignations in writing to their supervisors with
a minimum of two (2) weeks' notice for non-exempt (hourly paid) employees or thirty (30) days' notice for exempt
(monthly paid) employees. University HR recommends that you notify the department of your intended retirement date
thirty (30) days in advance for planning purposes.
[ ] Should you be rehired, your department must also submit a PEAR to rehire you and submit a NetId Extension Request Form if
they approve your email and/or NetID to remain active during this break.
[ ] If you will be rehired in your department as a Retiree, a Statement of Understanding must be signed by you, the employee.
The form will be provided to you by your Business Manager. A returned retiree is also required to complete all steps required for
new hires, including background check, health screening and all required paperwork. You will be asked to complete new hire
paperwork and submit a driver’s license and social security card.
1/31/2022
[ ] Do you want to join the MUSC Retired Faculty Program? Overseen by the Office of Planned Giving, this program provides
opportunities to stay involved with the Medical University and fellow retired faculty members.
This program offers:
-
Attend the annual retired faculty event
-
Join our e-newsletter for the latest updates and events on campus
-
Order business cards
-
Obtain a retired faculty email address (please note, this is a new email address and does not provide email forwarding
from your address used during employment)
For more information, please call the Office of Planned Giving at 843-792-9562 or visit muscgiving.org/retired-faculty-
program.
FORWARDING ADDRESS
Please update your address in the My Records system prior to your last day employed. Should you need to update your address
after leaving employment to obtain your final W-2, please email hrpersonn[email protected].
ADDITIONAL RESPONSIBILITIES
•
Turn in ID badge to Departmental Business Manager or Department of Public Safety.
•
Return all electronic equipment (pagers, laptops, cell phones, etc.) to Business Manager/Supervisor. Turn in keys, tools, etc. to
Departmental Business Manager or Supervisor.
•
Return Purchasing Card to Departmental Business Manager or Supervisor.
•
Final paychecks and any annual leave payout will be deposited into the current bank account on file (792-2191). Check with the
University Library regarding any outstanding books or fines (792-2371).
•
Please visit the Office of Parking Management at 91 President Street to return your parking lot card/decals and to complete the
cancellation of parking deductions from your paycheck. (792-3665).
•
Check with Dietary Office for any reimbursement on swipe cards, if applicable (792-3559).
•
Submit effort reports (activity reports) if covered by MUSC's Activity Reporting system (792-6438). Check with the Wellness
Center regarding membership status upon separation of employment (792-5757).
•
Please complete the Leave Donation Form if you would like to donate any remaining sick or annual leave. Please go to
https://horseshoe.musc.edu/human-resources/univ/forms/leave-and-time-management
•
Please take a moment to complete MUSC’s online Exit Survey before your last day of employment. Please go to
http://horseshoe.musc.edu/human-resources/univ/employee-corner
Retiree/ Employee Date
Medicare Special circumstances (Special Enrollment Periods)
If you and your spouse are of Medicare age, you must contact the Social
Security/Medicare to determine when to enroll in Part B. Contact Medicare at 800-
MEDICARE if you have additional questions.
Once your Initial Enrollment Period ends, you may have the chance to sign up for
Medicare during a Special Enrollment Period (SEP). If you're covered under a Group
health plan based on current employment, you have a SEP to sign up for Part A and/or
Part B anytime as long as:
• You or your spouse (or family member if you're disabled) is working.
• You're covered by a group health plan through the employer.
You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of
these times (whichever happens first):
• The month after the employment ends
• The month after group health plan insurance based on current employment ends
When you retire, if you are still eligible for state retiree insurance Medicare will
become your primary insurance and the state insurance will be secondary. If you
are not eligible for state retiree insurance Medicare will still be primary.
Usually, you don't pay a late enrollment penalty if you sign up during a SEP.
In order to apply for Medicare in a Special Enrollment Period (SEP), you must
have or had group health plan coverage within the last 8 months through your or
your spouse’s current employment.
Complete the Enrollment form for Medicare Part B.
Submit your enrollment form along with the Request for Employment Verification
form (on the next page) to your local Social Security Office. Find your local office
here: www.ssa.gov.
Form CMS-L564 (CMS-R-297) (0 9/1 6)
2
DEPARTMENT OF HEALTH AND HUMAN SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES
Form Approved
OMB No. 0938-0787
REQUEST FOR EMPLOYMENT INFORMATION
SECTION A: To be completed by individual signing up for Medicare Part B (Medical Insurance)
1. Employer’s Name 2. Date
/
/
3. Employer’s Address
City State
Zip Code
4. Applicant’s Name 5. Applicant’s Social Security Number
–
–
6. Employee’s Name 7. Employee’s Social Security Number
–
–
SECTION B: To be completed by Employers
For Employer Group Health Plans ONLY:
1. Is (or was) the applicant covered under an employer group health plan?
Yes
No
2. If yes, give the date the applicant’s coverage began. (mm/yyyy)
/
3. Has the coverage ended?
Yes
No
4. If yes, give the date the coverage ended. (mm/yyyy)
/
5. When did the employee work for your company?
From: (mm/yyyy)
/
To: (mm/yyyy)
/
Still Employed: (mm/yyyy)
/
6. If you’re a large group health plan and the applicant is disabled, please list the timeframe (all months) that your group health plan was
primary payer.
From: (mm/yyyy)
/
To: (mm/yyyy)
/
For Hours Bank Arrangements ONLY:
1. Is (or was) the applicant covered under an Hours Bank Arrangement?
Yes
No
2. If yes, does the applicant have hours remaining in reserve?
Yes
No
3. Date reserve hours ended or will be used? (mm/yyyy)
/
All Employers:
Signature of Company Official Date Signed
/
/
Title of Company Official Phone Number
(
)
–
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a
valid OMB control number. The valid OMB control number for this information is 0938-0787. The time required to complete this information
collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the
data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or
suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05,
Baltimore, MD 21244-1850.
Charleston
Medical University of South Carolina
1 SouthPark Circle, Suite JB 100
S C
2 9 4 0 7
May 1, 2020
Dear PEBA insurance,
Re:
, DOB: ,
SSN:
Please confirm in writing if I am approved for funded or non-funded retiree
insurance. My date of retirement is
Kindly send confirmation in writing to the following address:
Sincerely,
,
,
,
Retirees
If you are eligible for retiree group insurance when you retire, you may choose to continue or convert
your life insurance through MetLife. Retiree life insurance coverage does not include Accidental
Death and Dismemberment benefits. Optional Life coverage is eligible for conversion or
continuation; Basic Life and Dependent Life coverage are eligible for conversion.
PEBA sends a bi-weekly file with employee status changes to MetLife. MetLife will use this
information to mail a conversion/continuation packet to eligible retirees. Packets are sent via U.S.
mail three to five business days after MetLife receives the file.
The continuation and conversion application period is time-sensitive. You have 30 days from the
date your coverage as an active employee ends to continue coverage. You have 31 days from the
date your active employee coverage ends to convert coverage. If you miss these deadlines, you will
forfeit your right for retiree group life insurance.
If you have questions about your options for life insurance in retirement, contact MetLife at
888.507.3767 once you receive your conversion/continuation packet.
Continuation
You may continue your Optional Life coverage upon retirement. The rates match what you paid while you
were an employee.
The minimum amount that can be continued is $10,000. You cannot increase your coverage, but you can
decrease it. Rates are based on your age and will increase when your age category changes. Your
coverage will reduce at ages 70, 75 and 80. When your coverage reduces or ends, you can convert the
amount of reduced or lost coverage within 31 days as described in the Conversion section below.
MetLife will mail you a conversion/continuation packet. Packets are sent via U.S. mail three to five
business days after MetLife receives the eligibility file from PEBA. To continue your coverage, follow the
instructions included in your packet from MetLife. Coverage must be continued within 30 days of the date
of coverage is lost due to approved retirement or approved disability retirement.
If you have questions about your options for continuing your insurance coverage once you receive your
conversion/continuation packet, contact MetLife at 888.507.3767. If you continue your coverage, you will
receive a bill and pay your premiums directly to MetLife.
Retiree life insurance beneficiary designation
When you elect to continue your Optional Life coverage upon retirement, you will need to designate a
beneficiary on the Retiree Life Continuation Enrollment Form that you receive in your
conversion/continuation packet from MetLife.
Once you are enrolled, you may review or update your beneficiary designation information by visiting
MetLife’s website at metife.com/mybenefits. Register and create your own unique user ID and password.
Using the website will allow you to make designations quickly and easily, limiting paperwork and speeding
up processing time.
Conversion
You may convert your Basic, Optional and Dependent Life coverage upon retirement to an individual
whole life insurance policy, a permanent form of life insurance, without providing evidence of
insurability. Your premium for the new policy will be set at MetLife’s standard rate for the amount of
coverage that you wish to convert and your age. You may not apply for more than the amount of life
insurance you had under your terminated group life insurance.
MetLife will mail you a conversion/continuation packet. Packets are sent via U.S. mail three to five
business days after MetLife receives the eligibility file from PEBA.
MetLife has contracted with Massachusetts Mutual Life Insurance Company (MassMutual) to help with
converting coverage. To apply, contact MassMutual at 877.275.6387 and refer to the Conversion
Notice included in the packet. The policy will be issued without medical evidence if you apply for and pay
the premium within 31 days. If you miss the deadline, you will forfeit your right to convert your life
insurance.
Indicate one appropriate action:
Check all that apply:
D
Monthly Paid
D
Biweekly Paid
D
MUSC Physicians Member
(Employee Name) and the Medical University
By this agreement made between
of South Carolina (Employer), the parties hereto agree as follows
1)
Effective with amounts earned by the employee for Annual Leave payouts occurring after the date of
acceptance of this agreement by the employer responsible for ensuring that the amount of salary reduction does
not exceed the amount permitted under Section 415 and 415 © of the Internal Revenue Code.
2) The total contribution requested by the employee is
The employee is responsible for ensuring
that the contributions do not exceed the amount permitted under Section 402 (g), 403(b) and
414
( v) of
the Internal Revenue Code.
3) The Employer
will remit this contribution to
employee
without undue influence by the Employer.
(plan). The plan was selected by the
4)
This agreement shall be legally binding and irrevocable with respect to the payout of any unused Annual
Leave. This agreement is in accordance with Payroll Policy **.
This agreement is not a contract of employment between employer and employee and shall not affect which
would otherwise be due the employee if this agreement had not been executed. If any portion of this agreement
is in conflict with the employee's contract of employment, the contract of employment will control.
Employee ID
Employee Work/Pager#
Employee Date of Birth
Employee Signature
Date
HRM USE ONLY
Payroll Code: ___ _
YTD Contribution*:
Projected YTD:
*Check 401 (k) and/ or 403 (b) contribution totals
Employer Signature
Date
University Human Resources, Benefits Office
Last Day Employed: _____ _
Regular Contribution Amount: _____ _
AL Contribution Amount:
-----
Total Contribution Amount:
Revised 04/2020
1South Park Circle, Suite JB100 MSC 800
Charleston, SC 29425
Ph: 843-792-2607
Fax: 843-792-9533
Salary Reduction Agreement
For Annual Leave Payouts
Supplemental Retirement Plans
Contact Information
401(k), 457, Roth 401(k)
https://southcarolinadcp.gwrs.com
South Carolina Deferred
Compensation Program
Bruce Liegel
843-830-5212
403(b)
www.myretirementmanager
.com
Fidelity
Jared McVey
704-614-4167
MassMutual
MetLife
Hugh Kinlaw
413-209-2128
TIAA
Terry Pait
704-988-4882
AIG Retirement Services
Crystal Avant
843-300-8767
Mark Taylor
843-300-2775
Peter Collins
843-343-7634
Ryan Radloff
541-735-0739
