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Pat Quinn, Governor

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   Tier 1 Insurance Frequently Asked Questions   


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 must complete the required Insurance Election Participation form to 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: For members retiring on or after January 1, 1998 and receiving a pension benefit, the State of Illinois pays 5% of the health insurance premium for each full year of creditable service. If you have established at least 20 or more years of creditable service, your health insurance coverage is provided "premium-free". Only whole years of service are counted. Any SERS service you purchase, such as military, qualifying periods, repayment of refunds, Early Retirement, and any unused sick and vacation time all count when calculating your health insurance premium. Rates change each year in July. There are different prices for members enrolled in Quality Care or Health Maintenance Organizations (HMO's) and lower prices for members enrolled in both Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). Contributions Rates for July 1, 2012

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. 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: When working for the state, your deductible is based on your annual salary. Deductibles usually go down in retirement. The retiree deductibles are located in the current Benefit Choice options booklet.  When Medicare becomes your primary health insurance, there is normally no annual deductible or out-of-pocket expenses unless you are enrolled in one of the open access plans and you use a Tier 2 doctor. If you are enrolled in a HMO, a copay 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. Backup documentation instructions for 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 & B since Medicare is the primary insurance coverage when you are age 65 or older. 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 active members, retirees, survivors and their covered dependents. Vision coverage is premium-free for active members, retirees, survivors and their covered dependents.

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

A: You can remain a dependent at the time of retirement if you have been dependent on your state retired or employed spouse's insurance for one year. If you are an active employee and retire immediately from active employment with the state, you cannot become a 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 or 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: In the insurance section of our website. Click on the link to go directly to the Opt-Out Financial Incentive information. The Opt-Out Financial Incentive Packet can be found in the Insurance Section of our website under the Forms link.

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

A: If you are under age 60 and retired, your life insurance stays the same because 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 must complete and submit a statement of health to Minnesota Life. If approved, premiums will be deducted from your monthly pension check. Click on this link to download the Statement of Health Form

Q: If a member resigns from state service, but is not old enough to receive 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 not eligible to purchase 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: Yes. Quality Care Health Plan covers eligible charges incurred while the member is outside the country. You must obtain an itemized bill from the provider to submit for reimbursement.

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.


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).

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