Skip to main content

Premium Subsidy Eligibility

Brick front high school with large grid windows and American flag flying.

Premium Subsidy Eligibility

When you retire, you, your spouse, and your eligible dependents can enroll in the retirement system's health, prescription drug, dental, and vision insurances. The cost of coverage and conditions of enrollment will vary depending on several factors, which are covered below in detail.

As an active member, you may be eligible for the premium subsidy benefit, or the Personal Healthcare Fund, not both. If you're not sure whether you have the Personal Healthcare Fund or the premium subsidy benefit, log in to miAccount and refer to your account summary. You're responsible for paying the balance of the premium amount.

Personal Healthcare Fund

If you have the Personal Healthcare Fund, you're not eligible for subsidized health, prescription drug, dental, or vision insurance through the retirement system.

Premium Subsidy Benefit

If you have the premium subsidy benefit, the retirement system will pay a percentage of your monthly insurance premiums (or a percentage of the maximum subsidy for some deferred members). The cost of coverage and conditions of enrollment will vary depending on several factors, which are covered below in detail.

Qualifying for the Premium Subsidy Benefit

We'll cover the basics and define some terms.

  • Premium: The amount paid monthly to have health insurance.
  • Subsidy: The amount of the premium that is paid by the retirement system.

If you named a new spouse as your beneficiary after retirement

Subsidized insurance coverage for a spouse named as a survivor beneficiary after retirement will end upon the retiree's death. Coverage for the surviving spouse can continue by paying the full premium.

Factors that may affect your subsidy

Answer these guiding questions to learn more about how your insurance subsidy is calculated.

  1. Did you initiate a service credit purchase on or after July 1, 2008?
  • Yes. If your answer is "Yes," your premium subsidy will be delayed if the service credit purchase allows you to qualify for your pension earlier than if you did not make the purchase. Here are some examples of delayed subsidy situations.
    • If a delayed subsidy applies, your subsidy will begin at age 60 or the age you would have been eligible to retire if you had not made the service credit purchase, whichever happens first. You can still enroll in the retirement system's health, prescription drug, dental, and vision insurance before your subsidy is available; however, you'll have to pay the entire premium until the subsidy begins.
    • If your subsidy is delayed and you're enrolled in the retirement system's insurances before your subsidy effective date, the Michigan Office of Retirement Services (ORS) will automatically reduce your insurance premium on your subsidy effective date.
    • A delayed premium subsidy does not apply if you become eligible for a pension under a duty or nonduty related death or disability provision. (Continue to question No. 2.)
  • No. If your answer is "No," you can skip to question No. 2. The delayed insurance subsidy does not apply.
  1. When did you first begin working for a Michigan public school reporting unit?
Qualifying for Your Pension e-learning module

Qualifying for Your Pension and Premium Subsidy

Watch this short e-learning module to learn more about qualifying for your pension and premium subsidy benefit.

Watch now

Payment Options

If you enroll in the retirement system's insurance, your share of the premium is deducted from your monthly pension payments. If your pension is less than the premium amount, you must pay the remainder of the premium. ORS will bill you for the remainder of the premium and send you payment coupons to submit with your monthly payments.

Online:

To make payments online, log in to miAccount. Click Healthcare Coverage, then click Bills & Payments. You have the option of paying for the entire fiscal year, paying one invoice, or paying multiple invoices. You can pay by credit card, debit card, or by e-check using a checking or savings account. There is a 1.5% convenience fee charge in addition to your premium payment if you pay by credit or debit card.

By mail:

If you prefer to mail your payment, make your check or money order payable to the State of Michigan and mail to it ORS at the address on the coupon. Include the coupon for the month with each payment. If you submit payments for multiple months or combine different insurance types in a single check, please include all corresponding payment coupons.

You can log in to miAccount to download and print coupons for each month, if necessary. To print your coupons, click Healthcare Coverage, click Bills & Payments, select the bills you want to print, then click Print Coupons.

View current rates. These rates apply to all public school retirees who retire after Jan. 1, 2013, or to previous retirees who were not yet eligible for Medicare coverage as of Jan. 1, 2013. Annual rate sheets are mailed out each year to members before the Jan. 1 effective date.

Glossary