Choose to Quit

Choose to Quit is a program that allows tobacco users to have their Texas Employees Group Benefits Program (GBP) tobacco-user premiums waived for the plan year. (Program rules apply.)

Recent federal regulations require ERS to offer a new alternative to paying the tobacco-user premium, to members and their dependents enrolled in a GBP health plan and certified as tobacco-users.

The Choose to Quit program rules are as follows; you must complete each step of the program to have your tobacco-user premium waived:
  1. Contact your doctor (M.D. or D.O.) and discuss which tobacco cessation program is right for you.
  2. Complete that program.
  3. Return to your doctor, discuss your program completion and have your doctor sign and date your Choose to Quit Certification form.
  4. Sign your completed Choose to Quit Certification form.
  5. Submit your Choose to Quit Certification form to ERS as soon as possible and have it postmarked no later than the end of your health plan year (August 31 for active employees, non-Medicare retirees and their dependents; December 31 for Medicare retirees and their dependents).
ERS will review your form and send a letter letting you know if you are approved to have your tobacco-user premium waived for the remainder of the plan year. You may also be approved to receive a refund of all tobacco-user premiums you have already paid for the plan year.

Note: You will continue be charged the tobacco-user premium until your Choose to Quit Certification form is processed.

No. Having your tobacco-user premium waived and receiving a refund are based on your completion of the Choose to Quit program requirements and are not based on whether you stop using tobacco.

Your Choose to Quit Certification is good for only one plan year. Unless you stop using tobacco and certify that you are a non-tobacco user, the tobacco-user premium will be reinstated at the beginning of the next plan year. (September 1 for non-Medicare eligible retirees and employees, January 1 for Medicare-eligible retirees).

Your premium would be waived only for the plan year in which your doctor signs your form.

For example, Marcus, an active employee:
  • begins a tobacco cessation program in April;
  • his doctor signs his Choose to Quit Certification form in October (after September 1—the start of his new plan year);
  • his tobacco-user premiums will be waived for the remainder of the new plan year.
Note: The plan year starts January 1 for Medicare-eligible retirees and their dependents.

Yes. Every GBP health plan has at least one tobacco cessation program, and each plan covers various tobacco cessation prescription drugs at 100%. For more information, contact your health plan at the phone number listed on the back of your ID card.

As a GBP-health plan participant, you have 100% coverage for tobacco cessation consultations with your network primary care physician when the physician codes them as visits for tobacco counseling. If you discuss any other health issues during your tobacco cessation consultation, you may be responsible for a copay, depending on how your physician codes your visit.

Yes. If you currently have a Physician's Certification Form on file with ERS, that form will be discontinued and no longer valid at the start of the new plan year (September 1, 2015, for active employees, retirees not enrolled in Medicare and their eligible dependents; January 1, 2016, for Medicare retirees and their dependents).

If you want your tobacco-user premium waived for the next plan year, you should either:
  • stop using tobacco and certify your non-tobacco user status in your ERS account or
  • complete the Choose to Quit program in the new plan year (Program rules apply).

The Choose to Quit Certification form can be found at www.ers.texas.gov/About-ERS/Policies/Tobacco-Policy-and-Certification.

You must submit your signed Choose to Quit Certification form to ERS as soon as possible and have it postmarked no later than the end of your health plan year (August 31 for active employees, non-Medicare retirees and their dependents; December 31 for Medicare retirees and their dependents).

If your doctor signs your Choose to Quit Certification form in the last month of your plan year, you have 30 days from the date your doctor signs your form to submit it to ERS.

Examples:
  • The plan year for active employees and non-Medicare retirees and their dependents' ends on August 31. If you are an active employee and your doctor signs your form on August 15, your form must be postmarked by September 14. (The plan year for Medicare-eligible retirees and their dependents ends on December 31.)

You may receive a refund for any dependent who completes Choose to Quit. Your refund amount will depend on the amount of tobacco user premiums you paid for the plan year. If you have more than one dependent child certified as a tobacco-user, you will not receive a refund of the tobacco-user premiums you paid unless all dependent children complete the Choose to Quit program.

If you are an employee, your agency will issue your refund. If you are a retiree, ERS will issue your refund.

The timing of a refund will vary from person to person. Employees should contact their agency about when to expect your refund. A refund would mail to retirees within 30 days from the date ERS receives the Choose to Quit Certification form.

If you have completed the program but have not stopped using tobacco, you do not need to change your tobacco status. If you stop using tobacco, you will need to certify as a non-tobacco user. To certify as a non-user, you must not have used tobacco five or more times in the past three consecutive months.

You can find more information on the tobacco policy and the tobacco-user premium at www.ers.texas.gov/About-ERS/Policies/Tobacco-Policy-and-Certification.