General Information about the Health Insurance Opt-Out Credit
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| The
Health Insurance Opt-Out Credit is designed for employees and retirees
who don't need the State's health insurance now or in the future
because they are enrolled in other health insurance that is as good as
or better than what the State provides. |
If you are an employee or retiree who has comparable health
insurance to what the State provides, you are eligible to waive your Texas
Employees Group Benefits Program (GBP) health insurance and sign up for the
Health Insurance Opt-Out Credit to apply toward certain optional coverage.
Keep in mind that you cannot participate in the
Health Insurance Opt-Out Credit if you are not eligible for the state
contribution toward your health insurance premium, such as a COBRA
participant, surviving family member, or an adjunct faculty member.
The Opt-Out Credit is a cost savings program passed during
the 79th Legislative Session
which provides an incentive to participants to waive their GBP health
insurance in order to have a monthly credit. Participants can then apply
that credit toward dental and/or Voluntary Accidental Death and
Dismemberment (AD&D) premiums under the GBP. These are the GBP's most
popular non-taxable benefits that do not require evidence of insurability (EOI)
to enroll. The credit is available as of September 1, 2006.
Voluntary AD&D is not available to retirees unless they
return to work at an employer who participates in the GBP and they enroll in
the GBP as an active employee.
Your drug benefits are a part of your health benefit. If you
opt-out of your health plan, you are also giving up your prescription
coverage.
Participants waiving coverage will no longer have the Basic
Term Life coverage of $5,000 for active employees or $2,500 for retirees
that is connected to the health coverage under HealthSelect or an HMO.
|
The
amount of the Opt-Out Credit depends on your status |
| Full-time Employees |
Part-time Employees |
Retirees |
| Can use a
credit of up to $60 to apply toward dental and/or Voluntary Accidental
Death and Dismemberment (AD&D) |
Can use a
credit of up to $30 to apply toward dental and/or Voluntary Accidental
Death and Dismemberment (AD&D) |
- Retirees eligible for GBP health
coverage and the state contribution of 100% toward their
health premium can use a credit of up to $60 toward dental coverage.
- Retirees eligible for GBP health
coverage and the state contribution of 50% toward their
health premium can use a credit of up to $30 toward dental coverage.
- Retirees cannot apply the Opt-Out
Credit to Voluntary AD&D unless they return to work at an employer
who participates in the GBP and they enroll in the GBP as an active
employee.
|
.
|
To get
the Opt-Out Credit, you must meet all the criteria
for your group listed below |
|
Full-time Employees |
Part-time Employees |
Retirees |
|
You must be eligible for the state contribution toward your GBP health
insurance — 100% for full-time employees. |
You must be eligible for the state contribution toward your GBP health
insurance — 50% for part-time employees. |
You must be eligible for the state contribution toward your GBP health
insurance — 100% for full-time retirees or 50% for part-time
retirees.* |
|
You must be able to certify that you have comparable health insurance
coverage (e.g., through another employer health plan). |
You must be able to certify that you have comparable health insurance
coverage (e.g., through another employer health plan). |
You must be able to certify that you have comparable health insurance
coverage (e.g., through another employer health plan). |
| *
Employees who retired January 31, 2006 or after and were classified as
part-time at any time during the three months prior to their
retirement date are considered ‘part-time retirees.' If part-time
retirees are eligible for health insurance, they receive the part-time
50% state contribution for their health premium and 25% for their
dependents' health premiums. |
If you use the Opt-Out Credit for dental coverage under the
State of Texas Dental Choice Plan, you will continue your level of benefits.
If you already have reached Year 3, the maximum level of coverage, you will
continue at the maximum level of benefits. If you were at the Year 1 or Year
2 level, your benefits will increase to the next level.
Have you waived coverage in the past? If you can certify
that you have comparable health insurance coverage, you are eligible for the
Opt-Out Credit during Summer Enrollment or if you experience a qualifying
life event during the plan year.
To sign up for the Opt-Out Credit, go to
ERS OnLine on the ERS website. You can also call ERS toll-free at (877)
275-4377 or (512) 867-7711 in Austin. For more detailed information about
the health insurance opt-out credit,
please refer to the list of Frequently Asked Questions.
| You should carefully
consider any decision to decline health insurance coverage. You
may never be able to enroll in the state health plan again, depending
on your health condition. Participants who waive health coverage and
later wish to enroll in HealthSelectSM of Texas must prove
insurability — also called proof of good health or evidence of
insurability (EOI) — and acceptance is not guaranteed. Your drug
benefits are a part of your health benefit. If you opt-out of your
health plan, you are also giving up your prescription coverage. |
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Revised 12/19/06 |
