Eligibility + Enrollment - OFFICE OF GROUP INSURANCE

This page is for those employees, whose agency or school district participates in the State’s health plan, to prepare to retire, or those retired state employees who may still be eligible for State’s Retiree Medical Plan. Each section below contains important information on eligibility, enrollment and disenrollment, adding/removing a dependent, and COBRA.

Forms & Instructions

Eligibility

To be eligible to enroll, you must:

Be a retired officer or employee of a state agency, department, or institution who was hired on or before June 30, 2009, or
If you had a break in service, have at least 20,800 hours of credited state service before June 30, 2009 AND an additional 6,240 continuous hours of credited state service upon reemployment before your retirement, and
Be under age 65, and
Be receiving monthly retirement benefits from PERSI, Judges’ Retirement Fund, or an ORP retirement account, and
Retire directly from state service.
Note* If you meet some the above criteria but have a break in service before your retirement, you may not be eligible for this plan. Contact OGI for specific detail if you fall into this category.

Eligible dependents include the following:

Your legal spouse under age 65
Your dependent children up to their 26th birthday

Retirees hired after June 30, 2009 are not eligible for coverage unless they have credited state service of at least 20,800 hours before June 30, 2009 and subsequent to reemployment, election, or reappointment on or after July 1, 2009 accumulate an additional 6,240 continuous hours of credited state service and are otherwise eligible for coverage. If you are not eligible for the State’s retiree group medical plan, click here to learn how to use remaining sick leave funds to pay premiums for other retiree healthcare options.

For details about premiums, see Retiree Premium Rates.

Enrollment

To enroll for coverage, complete the Retiree Medical Enrollment form and submit it to the Office of Group Insurance. In order for the coverage to be effective on the first day of the month following the date active employee coverage terminates, your enrollment form must be submitted within sixty (60) days of the date that the active employee policy ends. If your enrollment form is submitted after the sixty (60) day enrollment period, you will be considered a late enrollee and coverage will be effective the first day of the month following the date of application.

Enrollment forms must be submitted to the Office of Group Insurance by mail, Fax, email or hand delivery.

Details about the medical plans, exclusions and waiting periods, can be found in each medical plan document and Summary of Benefits & Coverage (SBC).

Adding/Removing Dependents

Use the Retiree Medical Enrollment form to make changes to your eligible dependent enrollment. Remember to include all dependents on the form, those continuing coverage as well as those dropping coverage. Submit the form to the Office of Group Insurance.

Disenrollment

If you decide that you want to terminate your enrollment in our group plan, you need to print the Retiree Medical Enrollment Form, complete the section noted COMPLETE ONLY TO DECLINE ALL BENEFITS and submit the form to the Office of Group Insurance.

Form can be submitted to the Office of Group Insurance by mail, Fax, email or hand delivery.

Electing COBRA

After your eligibility for group insurance coverage ends, you may be able to purchase continued medical coverage, on an individual basis, for a period of time under the federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). Retirees and/or dependents may be able to elect COBRA continuation of medical coverage. Regence Blue Shield of Idaho administers COBRA coverage for state of Idaho group members. To request an informational/enrollment packet, contact Regence Blue Shield directly at 1-800-854-5585.