The Arizona State Retirement System (ASRS) provides a health insurance premium benefit to qualified retirees and employees who receive a long-term disability (LTD) income benefit. In order to ensure your retirees and LTD recipients who elect health insurance receive the correct premium benefit subsidy, the ASRS annually requests that employers provide their updated Health Insurance Plans and Premiums for the following benefit year.
If you provide medical and/or dental insurance for your retirees or LTD recipients, you must annually submit the Annual Employer Provided Health Insurance Plans and Premiums Packet (PPR) in order to receive the correct premium benefit payment.
The PPR packet includes two forms:
1) Annual Employer Provided Health Insurance Plans and Premiums Report
This form is required to indicate the ASRS Employer’s plan year effective date and whether there are any changes to your medical and/or dental plans offered to Retirees or LTD Recipients.
If there are no changes to an ASRS Employer’s medical AND dental plan coverage, only the Annual Employer Provided Health Insurance Plans and Premiums Report needs to be signed and returned through a secure message.
2) Employer Health Insurance Plan/Premium Breakdown Table
This form is required to indicate each medical and/or dental plan an ASRS Employer provides to Retirees or LTD Recipients and the cost (premium rates) changes for each iteration of that plan.
If you have one medical/dental plan but have different plan premium rates for COBRA and RETIREE, the expectation is you would complete a separate breakdown table, one for COBRA plan premiums and one for RETIREE plan premiums.
An Example - If you ONLY offer COBRA medical/dental plans to Retirees or LTD Recipients and you have three medical plans and three dental plans, the expectation is you would complete 6 Employer Health Insurance Plan/Premium Breakdown Table forms.
The forms should be completed and submitted no later than 45 days prior to the month your new plan year begins.
Please note, if there are retirees or Long Term Disability members currently enrolled in any discontinued plans which will be migrated to the 2023-2024 plans, please provide Health Insurance Change/Deletion Form for those retirees or LTD members so their information can be updated for the new plan year.
Should you have ANY questions regarding the completion of the PPR, please send a secure message through your ASRS employer user account for assistance.
Written by Genevieve McBride, Employer Relations
Published May 2023
