FAQs About Insurance

The subsidy is set by retirement law and depends on many factors. Currently, the maximum subsidy available is 80%. Learn more about factors that may affect your subsidy.

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

If you're enrolled in or plan to enroll in the retirement system's insurance plans, you must sign up for Medicare parts A and B when you're eligible. Medicare enrollment is through the Social Security Administration. See How Medicare Affects Your Coverage.

When you enroll in Medicare, you'll receive your Medicare card from the Social Security Administration. As soon as you receive your card, tell ORS your Medicare number and effective dates for parts A and B. 

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

• Send your Medicare enrollment information in a secure message on the miAccount Message Board.
• Update your insurance enrollment information in miAccount to include your new Medicare information and send the confirmation page to ORS.
• 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.

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

See insurance carrier information.

If you have the premium subsidy benefit, you can decline insurance when you retire and enroll at a later date. If you enroll after retirement, your coverage will begin the first of the sixth month after we receive your enrollment request and all required proofs, unless you have a qualifying event.

If you have the Personal Healthcare Fund, you cannot enroll in the retirement system's insurance at a later date. See details on enrolling after retirement.

If you chose a survivor option (100% survivor, 75% survivor, or 50% survivor) and you have the premium subsidy benefit, your survivor pension beneficiary will be able to continue insurance coverage at the same subsidy level you had. 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 insurance coverage.

If you chose the straight life option, or you're a former participant in the Defined Contribution Plan, coverage for your spouse will end upon your death. However, your spouse would have the option to apply for Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance and pay the full premium for the duration of the coverage.

Learn more about the straight life and survivor payment options.

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

As a retiree, there is no open enrollment period like when you were actively working.  

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

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

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

If you're enrolling after retirement and you have the premium subsidy benefit, your enrollment begins six 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're 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 first day of the second month after we receive your enrollment request and required proofs. For example, if ORS receives your change request and required proofs Jan. 10, your coverage with the new plan will begin March 1.