Retiree Medical Benefit: Office of Faculty and Staff Benefits

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Retiree Medical Benefit



Eligibility
As a retiring employee, you can elect to continue your medical insurance. In order to be eligible for this benefit, you must have been working at least 75% time or 30 hours per week and been enrolled in a Georgetown-sponsored medical plan at the time of your retirement.
 
If you do not enroll at the time of your retirement, you may choose to defer coverage until a later date. If you choose not to continue, or to defer, your coverage at the time of your retirement, you will not be able to re-enroll at a later date.  
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Enrolling
 
You are encouraged to enroll in, defer or waive your retiree medical coverage prior to departing the University.  However, the decision to continue or defer your medical coverage must be made no later than 31 days following your last day of employment.
 
Open Enrollment
Like active employees, you can switch from one plan to another, but only during our "Open Enrollment" period each year. Open Enrollment generally happens in the fall. Changes made during Open Enrollment take effect on January 1 of the following year. 
 
Once enrolled in the retiree medical insurance program, you can opt out of it at any time you wish. If you drop coverage for yourself, all of your dependents will be dropped at the same time. However, you may drop coverage for your spouse or dependent (irrevocably) and retain coverage for yourself.
 
Waiving Coverage
If you wish to discontinue participation, you must notify us in writing (sending an e-mail to benefitshelp@georgetown.edu will satisfy this requirement). It is critical that you understand that your decision to discontinue participation is irrevocable -- once you elect to discontinue your participation, you will not be allowed to re-join at a later date.
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Deferring Retiree Medical Coverage
Upon first retiring from the University you may choose to defer your retiree medical coverage until a future date.  In order to qualify for this one-time option to defer, you must be actively participating in a University-sponsored medical plan at the time of retirement.  If you defer:
  • You won't be eligible for retiree dental benefits.
  • Only dependents who were covered under your medical plan at the time your retired will be eligible for coverage when you enroll in your retiree coverage.  Dependent children must also satisfy the plan's age requirements.
  • You may be subject to any preexisting condition exclusions or limitations unless your are able to present proof of continous medical coverage.

For more information, contact the Office of Faculty and Staff Benefits at benefitshelp@georgetown.edu.

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2010 Medical Plan Options for Retirees Age 55 - 64

2010 Medical Plan Options for Retirees Age 65 and Older

For retirees in this category, Medicare is the primary payer of benefits.  Georgetown University offers the following plans to supplement your Medicare coverage.

Although many of our retirees live in the metropolitan DC area, some of them relocate to other parts of the country during retirement. All retirees should send written notice of the address change to the Office of Faculty and Staff Benefits so our staff can ensure that you are enrolled in the appropriate plan given your new place of residence. Even if you move outside of the DC metropolitan area, you may find that there are in-network providers available in your region, as the United Healthcare plan operates on a national network. The new CareFirst BlueChoice plan has in-network benefits for residents of DC, Maryland, Virginia and Delaware.

Please note that if you do not live in the metropolitan DC area, you will not have access to the Kaiser Centers (although Kaiser has centers across the country, as a participant in our plan you only have access to the Kaiser Mid-Atlantic Centers).

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Enrolling Your Dependents
In some cases you and your covered dependents may not all be eligible for Medicare.  When this occurs you will cover yourself and your dependents  with the same medical provider.  For those who have Medicare, the coverage will be on a Medicare plan.  For those without Medicare, coverage will be provided by te corresponding non-Medicare plan.

The Aetna Open Choice PPO is an exception.  Only retirees and dependents age 55 -64 may enroll in this plan.  A pre-65 retiree seeking coverage for themself and a post-65 spouse would need to elect a different medical insurance provider.

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Dependent Eligibility
At the time of your retirement, you can elect to include your spouse and/or dependent children in the plan that you choose, provided your spouse and/or dependent children were covered at the time of retirement. You must make this election at the time of your retirement (i.e., you cannot add your spouse or existing dependent child at a later date). You also cannot add new spouses (due to marriage or remarriage) or newly acquired dependents (due to birth or adoption) after your initial election. The premium associated with spousal or dependent coverage is unsubsidized.

If you die before your spouse and/or dependent child(ren), and these family members are covered under the medical plan at the time of your death, then these family members will receive two years of free medical coverage. At the end of this "premium holiday," your family members are entitled to coverage for the remainder of their lifetimes at the unsubsidized rate.

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Medical Insurance Premiums

Your cost for medical coverage depends on age, the plan you elect, how many dependents you enroll, and your years of service with Georgetown.

Generally, the University will subsidize the lesser of either:

  • 50% (for those who have attained 10 to 14 years of service prior to retirement), 70% (15 to 24 years of service) or 90% (25 or more years of service) of your total medical premium;
    OR
  • 50%, 70% or 90% (depending on your years of service) of $583 per month for retirees under the age of 65, or of $250 per month for retirees over the age of 65.

Your contribution, therefore, will consist of the remaining individual premium amount plus the total premium for any dependents covered under your medical plan. This formula does not apply to certain grandfathered populations, or to Georgetown Hospital employees who retired between August 1, 1998 – June 30, 2000.

Please note that there are exceptions to the rate for the "Over 65" group. The vast majority of retirees over 65 are eligible for Medicare as their primary medical insurance, and the lower rates reflect this. However, some retired participants who are over 65 are not eligible for Medicare (such as some non-US citizens). Also, please note that all dependent children covered under the Retiree Medical Insurance Plan will be charged as though they are not Medicare Primary, even if they are.

Medical premiums are recalculated annually. 

2010 Insurance Premium Contributions:

For Retirees Under Age 65:

For Retirees Age 65 and Older:

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Summary of Medicare Complementary Benefits for Retirees Over 65 (2009)

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Forms
 
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Payment Options

Retiring faculty and staff who wish to participate in a Georgetown University-sponsored retiree medical plan, will be required to pay monthly premium contributions using one of the following options:

  1. Reduction from monthly Georgetown University Retirement Plan (GURP) annuity.
  2. Reduction from monthly TIAA-CREF annuity.
  3. If retiree does not receive an annuity from the sources listed above then they will be required to pay by direct debit (ACH).
If you elect method #3, effective January 1, 2010, Georgetown University will partner with Colonial Healthcare to provide retirees with accurate and timely billing and enrollment services.
 
Through Colonial Healthcare you may now set up automated monthly payments for your medical and dental premiums - eliminating the need to write and mail checks. Premium amounts will be automatically transferred from your checking or savings account through a secure Automated Clearing House (ACH) network.
 
To participate in direct debit:
  • Download the Authorization Agreement for Direct Payment (pdf)
  • Review instructions and complete form
  • Return with voided check to - 

Georgetown University
c/o Colonial Healthcare
9901 Business Parkway, Suite B
Lanham, MD 20706
By Fax:  1-202-687-2389

For the remainder of 2009 Georgetown University will continue to provide you with your retiree medical invoice.  In the event we make an error on your invoice, simply contact us and we will review our records with you. If we are in error, we will credit or debit your account accordingly. Likewise, we retain the right to review the invoices we have sent to you for accuracy. If we detect that we have billed you in error, or failed to invoice you for a previous period in which you were insured, and that error resulted in your being under-billed, we will bill you for the difference. We will expect that you will bring your account current, and will work out a reasonable payment plan if the amount of the under-billing was significant.
 
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Other Important Information about the Retiree Medical Benefit
It is important that you understand that the benefit Georgetown University offers its retirees consists of subsidies to retirees on the medical insurance program offered to active employees. The benefit does not take the form of distinct retiree medical insurance plans. Therefore, if Georgetown University makes changes to its medical insurance plans for active employees, these changes will be applicable to retirees as well. Examples of changes to the medical plans for active employees include:
 
  • Changes in provisions to an existing plan such as changes to co-payments, deductibles, etc.
  • Deleting a plan as an option
  • Adding a plan as an option
 
Although it has no intention to do so at the present time, Georgetown specifically reserves the right to amend, change, or discontinue the retiree subsidy for medical insurance premiums at any time, and for any reason.
 
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Office of Faculty and Staff Benefits · Georgetown University
37th & O St NW, Ground Floor, Healy Hall · Washington, DC 20057-1021
tel. (202) 687-2500 · fax. (202) 687-2389 ·
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