Frequently Asked Questions

FAQs About Insurance
How much of my insurance premium does ORS pay (the subsidy)? How is this determined?

The ORS subsidy is set by retirement law and depends on many factors. Currently, the maximum subsidy available is 80 percent.   Click here for more information about factors that may affect your subsidy.
 

You can also check miAccount to determine your current insurance rates.

What is required to enroll my dependent student?

Submit school records as proof of full-time attendance, which must include

  • Dependent's name
  • Dates enrolled
  • Name of institution
  • Number of credit hours, or that student is deemed full time,

along with

  • Birth certificates as proof of age and relationship, and
  • IRS form 1040 that identifies the child as your dependent.

Click here for more dependent coverage information.

 

I am going on Medicare; what do I need to do?

If you are enrolled in or plan to enroll into the retirement insurance plans you must be sure to sign up for Medicare Parts A and B. Medicare enrollment is through the Social Security Administration. Click here for more Medicare information.

When you enroll in Medicare you will receive your Medicare card from Social Security.   As soon as you receive your card, tell ORS your Medicare number and effective dates for Part A and B. 

You can submit your Medicare enrollment information one of the following ways:

  • Send a secure message on Message Board including your Medicare enrollment information.
  • Update your insurance enrollment information in miAccount to include your new Medicare information and send the confirmation page.
  • Make a copy of your Medicare card. Write your name, address, and date of birth on the copy and mail or fax the copy of your card to ORS.
  • Mail or fax a completed Insurance Enrollment/Change Request (R0452C) form to ORS with your Medicare information.
  • Call ORS at 800-381-5111 and give a representative your Medicare information.
Where do I go with questions about my coverage?

Contact the carrier with questions or issues related to your coverage, including comments about specific services and details of what is covered. The carriers administer the healthcare plans and have your individual account details so they are in the best position to help answer your questions or resolve any problems. 

Click here for more insurance carrier information.

Can I decline insurance upon retirement but enroll at a later date?

If you have the premium subsidy benefit, you can decline insurance and enroll at a later date. Your enrollment period begins six months after you apply and submit your proofs, unless you have a qualifying event.

If you have the personal healthcare fund, you cannot enroll in insurance at a later date.
Click here for full details on enrolling after retirement.

 

If I die, will my spouse be able to continue insurance coverage (with or without survivor option)?

If you chose a survivor option (100% survivor, 75% survivor, 50% survivor), your survivor pension beneficiary will be able to continue insurance coverage at the same subsidy level that you had (if any). If you named your spouse as your survivor pension beneficiary, eligible dependents who were covered at the time of your death may also continue to receive coverage.

If you chose the straight life option, or you are a former Defined Contribution participant, coverage for your spouse will end upon your death. However, your spouse would have the option to apply for COBRA insurance and pay the full premium for the duration of the coverage.

Click here for more information about the straight life and survivor payment options.

Who do I contact and when?

Contact ORS for enrollment and eligibility questions, or to pay your premiums. Contact your insurance carrier for everything else.
Click here for more insurance carrier information.

When can I enroll in a plan or change my plan? Is there an open enrollment period?

As a retiree, there is not an open enrollment period like when you were actively working.  

When you can enroll in insurance depends on if you are enrolling at retirement or after retirement, and if you have a qualifying event.

If you are enrolling in insurance at retirement, your insurance effective date can begin on your retirement effective date.

If you are enrolling after retirement, and have a qualifying event, coverage can begin as early as the first of the month after we get your application and proofs.

If you are enrolling after retirement, and have the premium subsidy benefit, your enrollment begins 6 months after you apply for insurance coverage and submit your proofs. If you have the Personal Healthcare Fund, you cannot enroll in insurance after your retirement effective date.

If you are currently enrolled in any health insurance plan with the retirement system, you can change your enrollment to another plan regardless of your Medicare status.  Your change in coverage will be the 1st day of the 2nd month after your request and required proofs are received.  For example, if ORS receives your change request and any required proofs on January 10, your coverage with the new plan will begin on March 1.