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.

Enroll, Defer or Waive: You have three options at the time of your retirement. You can enroll, waive or defer coverage in a GU-sponsored retiree medical plan to a later date. You must actively enroll or defer coverage with AleraEdge within 30 days of your retirement date. If you take no action within that time frame, your coverage will be waived and you not be able to re-enroll in a GU-medical plan at a later date.

Enrolling

Once your HR Contact has entered your last day (date of termination) into GMS, the Office of Faculty and Staff Benefits will provide your information to the retiree benefits and billing administrator, AleraEdge.

AleraEdge will send an enrollment packet by email (or to your home address if an email is not available) for completion. This packet will include instructions on how to log in to the enrollment portal to make your elections.

You must decide whether you want to elect, defer or waive your retiree medical coverage within 30 days of your last date of employment.

Because of these deadlines, we strongly suggest you notify your department of your plans to retire as soon as possible, so they can initiate the retirement process in GMS. Completion of the employment termination process within GMS is required in order to transmit your information to AleraEdge, initiate the retiree medical enrollment process and to ensure a seamless transition between active and retiree medical coverage. 

IMPORTANT NOTE ABOUT MEDICARE
Employees and spouses who are over age 65 and enrolling in a Georgetown retiree medical plan should apply for Medicare Parts A & B two to three months before retiring. Please reach out to benefitshelp@georgetown.edu to request a form that confirms you’ve had medical insurance from Georgetown University since becoming eligible for Medicare. You will need this when completing your enrollment.

Open Enrollment

Like active employees, you can switch from one plan to another, but only during our annual Open Enrollment. Open Enrollment generally happens in the fall, mid-October to mid-November. Changes made during Open Enrollment take effect on January 1 of the following year. You will receive an Open Enrollment guide and instructions for making changes with AleraEdge.

Waiving Coverage Once Enrolled

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.

If you wish to discontinue participation, you must notify AleraEdge in writing. 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.

AleraEdge
PO Box 3850
Omaha, NE 68103-3850

Phone: 1-800-836-0026, ext 7300
Email: GUBenefits@aleragroup.com

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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 you are able to present proof of continuous medical coverage.

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

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Medical Plan Options for Retirees Age 55 – 64

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 Georgetown University Benefits Center so we 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. TheCareFirst BlueChoice Advantage plan also has in-network benefits nationwide through the BlueCard PPO program.

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 the corresponding non-Medicare plan.

Via Benefits (formerly OneExchange) plans are the only exceptions. For Via Benefits, only retirees and their spouses who are 65 or older may enroll (both must be enrolled in Medicare). Additionally, only retirees who are NOT employed at Georgetown University may enroll.

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Dependent Eligibility

You may enroll a legal spouse under your medical plan at time of retirement or during Open Enrollment. The premium associated with spousal and/or dependent coverage is unsubsidized.

In accordance with the Affordable Care Act (ACA), you can enroll your dependent children (up to age 26) regardless of whether they were on your medical coverage at the time of your retirement.

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. Please refer to the current Retire Benefits Guide for complete premium charts and details.
 


 Payment Options

Georgetown University partners with AleraEdge to provide retirees with accurate and timely billing and enrollment services. Through AleraEdge and their PremiumPay Member Portal (new window) 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.

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 Other Important Information about the Retiree Medical Benefits

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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