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Retirees Under Age 65 

Retirees Under Age 65

ORNL has moved to UnitedHealthcare (UHC)

As announced in July, UnitedHealthcare (UHC) has replaced Cigna as ORNL’s under age 65 medical plan administrator effective January 1, 2016.

·         Participants in Cigna Point of Service, Open Access, and Open Access Plus plans are now enrolled in UHC Prime Select.

·         Participants in Cigna Choice Fund are now enrolled in UHC Consumer Choice.

·         Prescription drug coverage continues with Express Scripts, and VSP continues to provide vision care. The Member Pays the Difference and Retail Refill Allowance (RRA) programs remain in place. Note that your RRA count does not reset or start over each year.

For more plan details, visit Medical Plan Resources. 

Eligibility

If you retire before age 65, you may continue coverage in UnitedHealthcare (UHC) medical (including prescription drug and vision coverage) and MetLife or Delta dental plans until your 65th birthday. As long as you are enrolled in the plans, you may continue coverage for your eligible spouse and dependents, even if your spouse is over age 65. (NOTE: If your spouse is over age 65, they must enroll with Medicare Part A & Part B. Medicare Part A & Part B will be primary; the UHC plan will be secondary).

Details of the plans are available in the Retiree Summary Plan Description.

Steps to take as you approach age 65

Retiree coverage at age 65

  • Enroll in Medicare Part A & Part B during your Initial Enrollment Period.
  • You will receive information from OneExchange and ORNL Benefits approximately three months before you reach age 65 to begin the enrollment process and establish your HRA.
  • Enroll in a Medicare Supplement plan through OneExchange and establish your HRA.  You may also enroll in a dental and/or vision plan through OneExchange.
  • Complete and return the ORNL enrollment form, along with a copy of your Medicare Part A & Part B card to enroll in the ORNL Rx plan.
  • Your Medicare Supplement plan becomes effective the first day of the month of your 65th birthday.

Spouse coverage at age 65

  • Enroll in Medicare Part A & Part B during the Initial Enrollment Period.
  • If retiree is under age 65, spouse will remain on UHC plan. Medicare Part A & Part B will become the primary payer and UHC will be secondary.
  • When the retiree reaches age 65, an over age 65 spouse will also be eligible to enroll in a Medicare Supplement plan through OneExchange with prescription drug coverage through the ORNL Rx plan. 
  • Your spouse will receive information from OneExchangeExchange and ORNL Benefits to begin the enrollment process.
  • Once your spouse completes the enrollment process for medical and Rx, benefit dollars will be added to your HRA account for your spouse.

Note for retirees and spouses: If your birthday is on the first of a month you actually become eligible for Medicare the first of the month prior. Ex: March 1 birthday, Medicare eligible on February 1, loss of coverage under the ORNL sponsored-group health plan at the end of March. Otherwise, you are eligible for Medicare on the first day of the month of your 65th birthday.