Retirement 101 An Overview of Lifetime Health Benefits, Explanation of

OtherOptions, & Breakdown of Rates

For Clovis UnifiedEmployees

			

Board Policy 4154, 4254, 4354

➢Located at: https://tinyurl.com/CUSDHealth BenefitsBP

➢Outlines the policies set forth by the CUSD Governing Board and the changes made over the years regarding the District’s Health & Welfare Benefits Plan and the Retiree Lifetime Health Agreement.

Board Policy 4154, 4254, 4354 : Rate Determination

“If the health insurance claims paid for retirees and retiree dependents (certificated and classified) exceed ten percent (10%) of the total claims paid in any year (July throughJune), and the retiree desires to continue in the District’s Health and Welfare Benefits Plan, the District will assess retirees a monthly fee to be based on the amount exceeded by all retirees divided into twelve (12) equal payments August through July of the following year.”

▪ Fiscal Year – July 1st – June 30th

▪ Final claims amount received by July 15th

▪ Rates Calculated & letter to Retiree by 1st week in August ▪ New rates effective September 1st

Premium Calculations

MEDICARE REQUIREMENTS

➢Retiree and eligible dependents enrolled on the Retiree plan must enroll into Medicare Part A and Part B when eligible (65 years old or sooner if disabled).

▪Medicare Part A = Hospitalization services

▪Medicare Part B = Professional services such as office visits, laboratory, x-ray, etc. ▪Medicare Part B Premiums vary based on individual/joint income.
▪$174.70 standard reduction in CUSD premium once a retiree/spouse goes on Medicare

➢The cost of Medicare Part A & B are paid for by the Retiree/Dependent.

➢Medicare will become effective for the Retiree/Dependent on the 1st of the month in which the Retiree/Dependent turns 65. At that time, Medicare will become the primary insurance, and the Clovis Unified School District Health Plan will become secondary. The retiree’s monthly premium will be adjusted accordingly.

Lifetime Health Agreement
Eligibility

1. Required years of service WITH benefits
2. Age requirement

3. Retiring with calSTRS or calPERS

See the table to the right to see your requirements for eligibility based on your hire date.

Hire Date

Prior to
September 1, 2007
	Employed 15 years with Clovis UnifiedWITH benefits

Retirement with STRS/PERS

55 years of age except in the case of disability retirement withPERS/STRS
	
Hire Date

After
September 1, 2007
	Employed 30 years withClovis UnifiedWITH benefits

Retirement with STRS/PERS

62.5 years of age except inthe case of disability retirement withPERS/STRS

2024/25 District Paid Retiree Rates
	
CLASSIFICATION OF RETIREE
	DISTRICT RATE
	
Retiree Only – Without Medicare
	$452.99
	
Retiree Only – With Medicare
	$278.29
	
Retiree + 1 Dependent – Zero on Medicare
	$905.98
	
Retiree + 1 Dependent – One on Medicare
	$731.28
	
Retiree + 1 Dependent – Two on Medicare
	$556.58
	
Retiree + 2 or More Dependents – Zero on Medicare
	$1,358.97
	
Retiree + 2 or More Dependents – One on Medicare
	$1,184.27
	
Retiree + 2 or More Dependents – Two on Medicare
	$1,009.57
	
Retiree + 2 or More Dependents – Three on Medicare
	$834.87

BENEFITS OFTHE LIFETIME HEALTH AGREEMENT

✓ Same primary insurance coverage as active employees for the retiree and eligible dependents that are enrolled at the time of retirement until eligible for Medicare (65 years oldor sooner if disabled).

✓ Coverage available for life withpaidpremiums.

✓ Lifetime coverage extended to the Spouse should Retiree pre-decease Spouse

✓ Secondary/supplement al insurance coverage for the retiree and eligible dependents once Medicare eligible.

✓ For qualifying retirees: 5 years continued coverage under Dental and Vision plans OR until the Retiree turns 65, whichever comes first.

Other Options:

Self Paid Participant Plan

Bridging the gap for an employee retiring before qualifying age (55 or 62) or has not yet retired with STRS/PERS

If an employee meets the years of service with benefits requirement but has not met the age requirement and/or has not retired with PERS/STRS, they may elect to enroll into the Self Paid Participant Plan until all requirements are met making them eligible for the District Paid Lifetime Health Agreement.

See the next slide for further eligibility criteria.

Hire Date

Prior to
September 1, 2007
	Employed 15 years with Clovis UnifiedWITH benefits

Retirement with STRS/PERS

55 years of age except in the case of disability retirement with PERS/STRS
	
Hire Date

After
September 1, 2007
	Employed 30 years withClovis UnifiedWITH benefits

Retirement with STRS/PERS

62.5 years of age except inthe case of disability retirement withPERS/STRS

			

Self Paid Participant Plan Eligibility

Enrollment eligibility is contingent upon the Member meeting the requirements set forth in Board Policies 4154, 4254, 4354.

Two categories of participants: Those hired prior to and those hired after
7/1/2024.

For Members hired prior to 7/1/2024:

➢Eligible to participate in the Self Paid Plan even if they do not qualify for future lifetime benefits
➢Grandfathered into Self Paid Health Plan and subjected to provisions outlined in the CUSD Self Paid Health Benefits Plan Agreement
➢Required to enroll in Medicare A, B, C, and D when eligible

For Members hired after 7/1/2024:

➢Members may participate in Self Paid Plan until eligible for Medicare or at the time of retirement from STRS/PERS, whichever comes last
➢On the last day of the month prior to the first effective date for Medicare coverage, the Member’s Self Paid Health plan will terminate
➢Upon that termination, eligible Members may transfer to the District Paid Retiree Plan provided they meet the requirements of eligibility, such as additional age requirements outlined in Board Policies 4154, 4254, and 4354 (see previous slide) and are retiring with STRS and/or PERS

2024/25 Self Paid Participant Rates

Classification of Participant
	
Self Pay Rate
	
Member Only - Without Medicare
	$723.45
	
Member Only - With Medicare
	$624.75
	
Member + 1 Dependent – Zero on Medicare
	$1,459.50
	
Member + 1 Dependent – One on Medicare
	$1,348.20
	
Member + 1 Dependent – Two on Medicare
	$1,298.85
	
Family Coverage
	$2,016.00

OTHER OPTIONS:
SELF PAID PARTICIPANT PLAN

✓ Same primary insurance coverage as active employees for the eligible retiree/participant and eligible dependents enrolled at time of retirement until eligible for Medicare (65 years old or sooner if disabled).

✓ Coverage available to bridge gap between separation of employment and enrollment in Lifetime Health Agreement Plan

✓ Secondary/supplemental insurance coverage for the eligible retiree/participant and eligible dependents once Medicare eligible.

✓ While bridging the gap, 5 years of dental and vision is offered until retiree/participant reaches 65, whichever is longer

COBRA (Consolidated Omnibus Budget Reconciliation Act)

▪Coverage available for 18 months with paid premiums
▪COBRA Rate is Composite – Covers employee and all eligible dependents on

2024/25 COBRA RATES
	
HEALTH
	Employee Only - $485.00
Employee + 1 or More Dependents - $1,270.00
	
DENTAL
	Employee + 1 or More Dependents - $94.35
	
VISION
	Employee + 1 or More Dependents - $17.85

plan when the plan terminates. ▪Premiums processed by HealthNow
Administrative Services (HNAS) ▪Payment may be made by Payment
Coupon or with Automatic Withdrawal

COBRA vs. Self Paid Rates Comparison

2024/25 Self Paid Participant Rates

Classification of Participant
	
Self Pay Rate
	
Member Only - Without Medicare
	$723.45
	
Member Only - With Medicare
	$624.75
	
Member + 1 Dependent – Zero on Medicare
	$1,459.50
	
Member + 1 Dependent – One on Medicare
	$1,348.20
	
Member + 1 Dependent – Two on Medicare
	$1,298.85
	
Family Coverage
	$2,016.00

Questions? Contact the Clovis Unified Benefits Department at 559-327-9125