by Genevieve McBride, Employer Relations Supervisor
As part of our members’ benefits, the ASRS provides a health insurance premium benefit (HIPB) to help with the cost of retiree health insurance. To be eligible for the HIPB, a retiree or Long Term Disability (LTD) recipient, must have at least five years of service and be enrolled in an ASRS health insurance plan, or a non-subsidized health insurance plan offered by an ASRS employer.
If a retiree or a member on LTD enrolls in medical and dental insurance with either ASRS or their ASRS employer, the HIPB is first applied to the dental insurance premium, which typically covers the dental premium completely. The balance of the HIPB is then applied to the medical insurance premium.
If the health insurance enrollment is through ASRS, any premium balance after HIPB is applied is then deducted from the member’s pension, if their pension amount allows it. If the enrollee is an LTD recipient, or if the amount of the retiree’s pension does not allow the deduction, the member is directly billed by the health insurance carrier for the net amount due.
If the health insurance enrollment is through an ASRS employer, the retiree/LTD recipient’s status and what plan rate coverage they’re enrolled in will determine how the member will receive the HIPB. There are two ways for the HIPB to be paid: either as a monthly payment to the ASRS employer, or directly to the member in a six-month reimbursement process.
Monthly: Through the Employer
- For retirees and LTD recipients on ASRS Employer retiree or COBRA plan rates.
- Requires a Health Insurance Authorization Form
- Sent from ASRS to the employer around the 20th of the month. The employer either reimburses the member or applies it as a credit towards their monthly premium.
- Eligibility Requirements:>
- Currently receiving a retirement or LTD benefit from the ASRS; AND
- Has at least five years of credited ASRS service; AND
- Is on ASRS Employer retiree or COBRA medical and/or dental plan rates as a policyholder; AND
- The retiree or COBRA medical and/or dental plan rates are not subsidized.
- Employer Required Forms:
- Annual Employer-Provided Health Insurance Plans and Premiums Report (PPR)
- Employer Health Insurance Plan/Premium Breakdown Table (PPR>
- Health Insurance Premium Benefit Authorization
- Health Insurance Change/Deletion Form
- Overview:
- Every plan year the Employer submits the completed PPR forms 45 days prior to their effective date.
- The Health Insurance Premium Benefit Authorization establishes medical/dental coverages for retirees or LTD recipients based on the retiree or COBRA plan rates indicated on the PPR.
- The Health Insurance Change/Deletion Form is used to change or terminate existing coverages.
- The ASRS sends the HIPB directly to the employer around the 20th of the following month. The employer then either reimburses the member or applies the HIPB as a credit towards their monthly premium(s).
Every Six Month: Directly to Member
- For RTW Retirees, Retirees as Dependents and LTD recipients on ASRS Employer active employee plan rates.
- Requires a Reimbursement of Medical and/or Dental Cost (6-Month Reimbursement Program) Form
- Deposited directly into same account used for pension payments
- Eligibility Requirements:
- Is currently receiving a pension or
- LTD benefit from the ASRS; AND
- Has at least five years of credited ASRS service; AND
- Has medical and/or dental coverage as a policy-holder through an ASRS employer’s active employee group plan; OR
- Has medical and/or dental coverage as a dependent through an ASRS employer’s active employee group plan; AND
- Retired or became disabled before August 2, 2012; OR
- Retired or became disabled on or after August 2, 2012, and the group plan is not subsidized by the employer; AND
- Has out-of-pocket expenses for medical and/or dental premiums.
- Employer Required Form:
- Reimbursement of Medical and/or Dental Cost (Six-month reimbursement Program)
- Overview:
- Reimbursements are for six-month periods ONLY (January through June or July through December).
- Claims for reimbursement must be submitted for each six-month period and within 60 days after the six-month period ends.
- Reimbursements are paid directly to the retiree or LTD recipient within 60 days of receipt of the form.
An employer-subsidized plan means a portion of the total premiums is paid by the employer, but does not necessarily mean a plan in which the employer uses blended rates to determine the total premium. (A.R.S. §38-783, Laws 2012, Chapter 362 (HB2745))
