FAQs for Health Insurance

Health Coverage with my CTRB Sponsored Plan

Do I need Medicare Part A and Part B to participate in CTRB’s Sponsored Medicare Supplement with Prescriptions Plan?
Yes. Participation in Medicare Part A and Part B is required to participate in the TRB sponsored health plan effective July 1, 2006.

When I reach age 65, I will participate in Medicare Part A and Part B. Can I stay with my former employer’s plan?
Your former employer is not required by law to offer coverage to a member and/or spouse participating in Medicare Part A and Part B. If your former employer offers you a Supplemental Plan, you may elect to stay with them and the subsidy payment will continue, provided you do not enroll in any CTRB sponsored plan.

When I reach age 65, I will participate in Medicare Part A and Part B. What health care coverage is available through CTRB?
Effective January 1, 2015 our health care coverage is offered as a single package which includes includes Medicare Supplement Hospital, Medical, Major Medical, Prescriptions, Dental, Vision & Hearing Coverage.

Is my current coverage through the TRB’s prescription plan equivalent to or better than the Medicare Part D prescription coverage?
Yes. The TRB has determined that the prescription drug coverage offered to you by the TRB’s prescription drug plan is “on average”, expected to pay out at least as much as the standard Medicare prescription drug coverage will pay. Because your existing TRB coverage is “on average” as good as standard Medicare Part D prescription coverage, you can stay with your TRB coverage. If you decide later you want to enroll in Medicare Part D prescription coverage and drop the TRB plan, you will NOT incur a permanent lifetime penalty in your Medicare Part D premium, PROVIDED there is no lapse in prescription coverage.

What are the consequences if I choose to enroll in the Medicare Part D prescription coverage?
The federal government will only subsidize one prescription plan for you at a time. If we are notified that you are participating in another prescription plan subsidized and/or paid for by the federal government, all of your health care coverage through the TRB will be terminated.

How will I decide whether to remain in the TRB prescription plan or choose Medicare Part D prescription coverage?
Medicare Part D prescription coverage is different from the health coverage available under Medicare Parts A and B. To obtain prescription coverage under Medicare Part D, you will have to choose a plan from a private company. While there is standard coverage required by Medicare Part D prescription coverage, each private plan is likely to have unique attributes, including which drugs are covered, the level of co-pays, and which pharmacies you can use. Accordingly, you should compare your current coverage and cost with the coverage and cost of the plans offering Medicare Part D prescription drug coverage in your area.

Is there a penalty if my TRB coverage lapses and I enroll in the new Medicare Part D Plan late?
Yes. If you drop or lose your coverage with TRB and do not enroll within 63 days in a Medicare prescription drug plan, you will be subject to a permanent lifetime penalty by enrolling in a Medicare prescription drug plan after the May 15, 2006 (the initial Medicare Plan D enrollment deadline). Your Medicare Part D monthly premium will increase at least 1% per month for every month after May 15, 2006 that you did not have prescription coverage. For example, if you are without prescription coverage for nineteen months, your premium will always be at least 19% higher than normal cost.

How do I pay the premium for the CTRB sponsored plan coverage?
Monthly premiums for coverage for member and/or spouse must be deducted from the monthly benefit payment. In the event that upon a member’s death, a surviving spouse does not receive monthly benefit payments, CTRB will deduct the monthly premiums for coverage directly out of the surviving spouse’s checking account.

How do I enroll in a CTRB sponsored plan?
Obtain a TRB Sponsored Health Insurance Application and a Health & Prescription Drug Benefits Plan Summary from our website www.ct.gov/trb or from this office. All coverage takes effect on the 1st day of the month. Enrollment forms must be received by the 25th day of the second month preceding the effective date of coverage. For example, for coverage to become effective as of December 1st, CTRB must receive your form no later than October 25th. The premium will be deducted from the benefit payment dated November 30th. If you are a new retiree or the spouse of a new retiree, contact this office for a determination of the earliest enrollment effective date available.

When enrolling, please be aware that the $405 (effective 1/1/2018) annual prescription deductible is based on the calendar year, January to December, and is not proratable. If you are enrolling in our plan at the end of the year, you would be subject to a $405 deductible for the remainder of that year and a new $405 deductible would begin in January.

How often can I make changes?
Once you enroll in our plan, you may not make any changes until the next open enrollment period. You may cancel at any time provided you notify CTRB in writing by the 25th day of the second month preceding the effective date of termination of coverage. For example, to terminate coverage effective as of May 1st, CTRB must receive your notice no later than March 25th. The premium payment will be cancelled on the benefit payment dated April 30th.

When is the next open enrollment period?
The next open enrollment period will be held in the fall of the current year. In October, you will have the opportunity to re-enroll or change your form of coverage to be effective January 1st of the following year.

When I die, is my spouse eligible for health insurance coverage through CTRB?
A surviving spouse who is participating in Medicare Part A and Part B may participate in a CTRB sponsored plan as long as he/she does not remarry. This is applicable regardless of whether or not your spouse is receiving a monthly beneficiary payment from this system.

If I travel outside the United States or live outside the United States, will the CTRB health insurance cover me?
The Teachers’ Retirement health plan will pay for emergency and acute care that occurs while traveling outside of the United States. The plan does not cover routine care or care for chronic conditions while a person lives outside the United States, even if their stay is for less than one half the year. The Out of Country benefit may not be used to obtain care that is not available within the United States.