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Premium Subsidy Eligibility
Premium Subsidy Eligibility
Understanding Premium Subsidy Eligibility
When you retire, you, your spouse, and your eligible dependents can enroll in the plan'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.
If you enroll in 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 for the remainder of the premium. The Michigan Office of Retirement Services (ORS) will bill you for the remainder of the premium and send you payment coupons to submit with your monthly payments.
You can make payments online by logging in to miAccount. To pay bills online, 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.
If you prefer to send a payment by mail, make your check or money order payable to State of Michigan and mail to 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.
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 are responsible for paying the balance of the premium amount.
If you have the Personal Healthcare Fund, you are not eligible for subsidized health, prescription drug, dental, or vision insurance through the retirement system.
The premium subsidy benefit is where the retirement system pays 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 Premium Subsidy
We'll cover the basics and define some terms.
Premium: The amount paid monthly in order to have health insurance.
Subsidy: The amount of the premium that is paid for by the retirement system.
If you named a new spouse as beneficiary after retirement
Subsidized insurance coverage for a spouse named as a survivor beneficiary after retirement will end upon the death of the retiree. 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.
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 health, prescription drug, dental, and vision insurance before your subsidy is available; however, you will have to pay the entire premium until the subsidy begins.
If you have a delayed subsidy, you're enrolled in insurances before your subsidy effective date, and you're paying the entire premium, 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.
View this short e-learning module to learn more about qualifying for your pension and premium subsidy benefit.