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   Insurance Frequently Asked Questions   

Insurance

Q: Who is eligible to enroll in the Group Insurance Program through the State of Illinois at retirement?

A: SERS members completing at least 8 years of service (Tier 1 employee) or 10 years of service (Tier 2 employee), receiving a monthly annuity from the State Employee Retirement Systems, and completing the required Insurance Election Participation form, will be eligible to continue enrollment or enroll in the insurance program.

Q: Is Group Insurance guaranteed for life as is the pension benefit?

A: Group Insurance is subject to change through Legislation, Contract Negotiations and/or Policy Changes.


Q: What is the cost of health insurance?

A:  Your health insurance premium will be a percentage of your total gross annuities from all five state retirement systems (State Employees” Retirement System, State University Retirement System, Teachers’ Retirement System, General Assembly Retirement System and Judges’ Retirement System) based upon your current Medicare status.  If you are Non-Medicare you will pay 2% of total monthly gross annuities.  If you are ineligible for Medicare, Medicare primary for both Part A and B or Medicare primary for Part A and benefits reduced for Part B, you will pay 1% of total monthly gross annuities.  For those paying a percentage of the health insurance costs based on less than 20 years of service (5% per year), the 1% or 2% will be added to this amount. Contribution Rates for July 1, 2013

Q: Does creditable service with other public Retirement Systems count toward SERS service when calculating group health premiums?

A: When a member retires under reciprocity, service with TRS, JRS, GARS, and SURS (SURS employees must have been eligible for State of Illinois Group Insurance coverage while contributing to SURS), count toward the 20 years as long as they are vested in SERS. Service with other systems such as IMRF, count for pension purposes but not for group insurance, since these systems do not participate in the State of Illinois Group Insurance Program with CMS. Normally the last system the member was participating in carries the group insurance.

Q: Does the Quality Care health insurance deductible change at retirement?

A:
Refer to the current Benefit Choice Booklet (page 15-16) for all retiree and dependent annual deductibles and co-insurance charges.  Refer to page 12 of the booklet for out of pocket maximum limits. If you are enrolled in an HMO a co-pay for the office visit could still apply.

Q: Can dependents be added at the time of retirement? If so, what documents are required?

A: If your dependent is currently enrolled, they are also covered during retirement. Eligible dependents can be added at the time of retirement. If you wish to add an eligible dependent, submit a Member Change Form Instructions for backup documentation when adding a dependent is noted on the form.

Q: What is the cost of dependent health coverage upon retirement?

A: Dependent rates are exactly the same for active and retired state employees. Dependent rates are lower if your dependent has Medicare Part A and B since Medicare is the primary insurance coverage when you are retired. Refer to the current Benefits Choice Option booklet for dependent premium rates.
Dependent Rates

Q: What is the cost of dental and vision insurance for retirees, survivors and their dependents?

A: Dental Rates are exactly the same for actives, retirees, survivors and their covered dependents.
Vision is premium free for actives, retirees, survivors and their covered dependents.

Q:  If my spouse and I are both members, can one of us become a dependent on the other’s state insurance plan?

A: You can remain a dependent at the time of retirement if you have been a dependent on your state retired or state employed spouse s insurance for one year. If you are an active employee and retire immediately from active employment with the state, you cannot becomea dependent of your spouse. 

Q: Is a member allowed to opt-out of health/dental/vision insurance coverage?

A:
Yes. Complete the required Insurance Election Participation Form (found in the pension packet). Once a member opts out/waives coverage, they may elect to participate in the future if a qualifying event occurs such as the loss of other coverage or during the annual benefit choice period.

Q: Where can I find information about the "Opt-Out" Financial Incentive?

A:  If you have completed 20 or more years of service and are currently enrolled in the State of Illinois Group Insurance Program or retiring with a break in coverage due to termination of state employment, you will be eligible for a $500 monthly incentive by completing the financial incentive packet and providing proof of comprehensive coverage from a source other than Central Management Services. If you have less than 20 years of service you will qualify for the $150 monthly incentive. You can opt-out of the program to receive the incentive at the time of retirement, during an open enrollment or due to a qualifying event (gain of other coverage) as long as the request to opt-out is received within 60 days of the gain of the new coverage. Click here for the Financial Incentive Packet.  All forms are required along with the proof of other coverage and a copy of a check for the direct deposit.



Q: What happens to my life insurance when I retire?

A: If you are under age 60 and retired, your life insurance is exactly the same; it's based on your last annual salary as a state employee. When you reach age 60, your basic life insurance reduces to $5,000. Any optional life that you purchase also reduces in increments of $5,000. If you wish to purchase additional life insurance (up to four times the basic State paid life coverage), you are required to complete and submit a statement of health to Minnesota Life. If approved, premiums will be deducted from your monthly pension check. To download the Statement of Health Form

Q: If a member resigns from State service, but is not old enough to start receiving a pension until sometime in the future, will he be eligible for optional life insurance when his pension begins?

A: Members receiving their pension within one year from leaving an active state payroll are classified as "Immediate Annuitants" and are eligible to purchase optional life coverage. A member may not upgrade his optional life insurance coverage without evidence of insurability and approval from the life insurance carrier. Members who receive a pension after being off the state payroll for more than one year are classified as "Deferred Annuitants" and are only eligible for the basic state-paid life, and are not eligible to purchase any optional life coverage.


Q: Will I receive new state insurance identification cards when I retire?

A: Insurance identification cards are not issued unless you change your health insurance carrier. There are no expiration dates on any of the ID cards. The group numbers are the same for active and retired state employees.

Q: If I'm traveling out of the country, will the Quality Care Health Plan policy cover me?

A:
You should refer directly to your health insurance plan to discuss coverage if you are visiting a foreign country.

Q: Does the Quality Care Health Plan cover nursing home services?

A: The nursing home must be a licensed health care facility primarily engaged in providing skilled care. Notification is required at least seven days prior to admission. The services must be medically necessary and ordered by a physician. Custodial care is not covered.


Medicare

All Medicare information is located in the Retiree/Survivor Insurance Handbook, which can be found in our Insurance Section of the website (link is found on SERS home page).

Basic Medicare Information


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