Keeping your GBP coverage:
You can choose a health plan outside the GBP and still have GBP medical coverage, but it could affect how the GBP plan pays for your covered health benefits. You also might be able to keep your HealthSelect Medicare Rx prescription drug coverage, depending on if your non-GBP plan includes Part D coverage. If you want to enroll in a non-GBP health plan, you should be aware of the following:
Waiving your GBP coverage:
- If you enroll in a Medicare Advantage plan not offered through the GBP, you will lose your HealthSelect Medicare Advantage coverage, even if you have not opted out of that coverage. The federal Centers for Medicare and Medicaid Services (CMS) does not allow participants to be enrolled in more than one Medicare Advantage plan at the same time. ERS will enroll you in HealthSelect Secondary, which is not a Medicare plan.
- If your non-GBP health plan includes Medicare Part D prescription drug coverage, or if you enroll in a Part D prescription drug program not offered through the GBP, you will lose your HealthSelect Medicare Rx prescription drug coverage. CMS does not allow participants to be enrolled in more than one Part D plan at the same time. The GBP does not offer another prescription drug program for Medicare-eligible retirees, so you will no longer have access to any GBP prescription drug coverage.
You can waive your GBP health and prescription drug coverage starting January 1, 2021. You should think carefully about waiving GBP health insurance.
If you are thinking about enrolling in a plan not offered through the GBP, we encourage you to carefully compare any other plan you may be considering to the GBP plans. If you pay premiums for your or a dependent’s GBP health coverage, you might find that some non-GBP health plans have lower monthly premiums than the GBP plans, and other plans might offer access to your preferred providers. But the coverage in those plans might be different than the coverage in GBP plans. Consider each plan’s medical coverage, potential out-of-pocket costs, monthly premiums, Part D prescription drug coverage (and any additional premiums for that) and provider network.
Also, make sure you understand the consequences of waiving GBP health coverage. If you waive your GBP health insurance:
- You will lose the Medicare Part D prescription drug benefits provided through the GBP, at no additional cost to you, as part of your overall health coverage. ERS does not offer “stand-alone” prescription drug coverage.
- If the State of Texas currently pays all or part of your monthly premium, you will no longer get that premium contribution.
- You cannot enroll your eligible dependents in GBP coverage if you are not enrolled yourself.
- If you are a retiree, you cannot re-enroll yourself or any eligible dependents in ERS health coverage until Fall Enrollment 2021, with coverage starting in January 2022, unless you have a qualifying life event, such as loss of your other health insurance.
- If you are a retiree, you will lose the $2,500 Basic Term Life Insurance that comes as part of your GBP health insurance enrollment.
- If you are a survivor, you cannot re-enroll in GBP health coverage at any time, even during Fall Enrollment or if you have a qualifying life event. Survivors who waive GBP health insurance will permanently lose GBP health and prescription drug coverage, for themselves and any dependents.
- You can still continue or begin enrollment in ERS’ optional insurance plans, including one of the two dental plans, State of Texas Vision, and/or optional and dependent life insurance. If you enroll in dental insurance or State of Texas Vision, you can also enroll your eligible dependents in the same plan(s). (Note: If you are a retiree applying for optional or dependent life insurance for the first time, you must submit evidence of insurability (EOI). Survivors are not eligible for life insurance.)
- If you are a retiree with other group health insurance that is comparable to GBP health insurance, you might be eligible to opt out of your GBP health insurance and get credit toward certain other GBP plans. (Please note that Original Medicare is not considered comparable coverage.) Eligible retirees can sign up for the Health Insurance Opt-Out Credit to apply toward the premiums of certain optional GBP benefits, such as dental insurance or the State of Texas Vision plan. Learn more about the Opt-Out Credit.
To waive your GBP health coverage effective January 1, you must choose that option during Fall Enrollment or any time through December 31, 2020.