Planning for Retiree Health

Pre-Retirement Medical Information

Employee Benefits - New Retiree Enrollment Summary

Congratulations on your decision to Retire! The County offers a variety of health plans for retirees and their dependents. Retirees access their benefits information and make enrollment elections through the County of Orange Benefits Center Web Site or the Benefits Resource Line. This summary is designed to explain the process in which you will receive your retiree health plan information and make your health plan elections.

The Retiree Medical Process

As soon as you have made your decision to retire you should meet with an Orange County Employees Retirement System (OCERS) representative to begin the retirement process. Ideally this should take place 30-60 days prior to your last day of work. Bi-monthly OCERS will provide to the Benefits Center information such as date and type of retirement for all retirees who have come in with an “Intent to Retire”, or an actual “Retirement” event. This begins the process that generates your retiree benefits information.

Following the receipt of this information the Benefits Center will generate a personalized Benefits Enrollment Summary and a Benefits Enrollment Guide outlining all your health plan options, associated costs, Retiree Medical Grant, enrollment periods and requirements, and the automatic benefit coverage, which will take effect if you do not make any changes during your enrollment period. (Your Benefits Enrollment Summary will also contain your 4 digit PIN number, which you will need to access the Benefits Center Web Site and/or the Benefits Resource Line.)

Your enrollment packet will be mailed to the current home address on record with the County of Orange so if you have moved or plan to move, you must contact your County HR/payroll representative and provide an updated address. You should receive your packet within 1-2 weeks following the date OCERS provides your information to the Benefits Center. Once you actually retire you may make address changes directly through the Benefits Center.

Electing and Accessing Your Coverage in General

You will have 30 days from the date on your Benefits Enrollment Summary to make your retiree health plan elections. In most cases you become eligible for retiree health plan coverage on the first day of the month following the date your County employment ends. Your automatic retiree health plan coverage will be the same health plan you had as an active employee and any eligible covered dependents. If during your election period you elect a different plan your effective date remains the same but the new plan must be notified of your coverage before you can access services. If you need to immediately access medical or prescription services under the new plan you must tell the Benefits Specialist when making your elections so they can do an immediate verification of coverage to your medical provider.

Can I make my retiree elections before my date of retirement?

Meeting with OCERS and filling out the required paperwork well before your date of Retirement, even 30-60 days prior, is the ideal situation as it allows OCERS to send your “Intent to Retire” information to the Benefits Center before your employment ends and your active coverage is terminated. If you receive your packet and make your retiree health plan elections before your last date of work, your elections will be suspended until you actually terminate County employment, upon which time they will be activated and a new Benefits Confirmation Statement will be generated avoiding most problems accessing services when employee coverage is terminated.

What if I separate and have not yet received my retiree medical information?

If you separate County employment before OCERS provides your Intent to Retire or Retirement information to the Benefits Center, you will get termination of coverage information and a COBRA health plan continuation packet. As soon as OCERS provides the required retirement information to the Benefits Center you will receive an updated packet and the opportunity to make your retiree health plan elections. If you need to access coverage before OCERS has provided your retirement information to the Benefits Center you will need to elect and pay for COBRA until the retirement information is received by the Benefits Center on the next monthly file.

Confirmation of your enrollment

Following your retiree health plan elections or at the close of your 30-day enrollment period you will be sent a Benefits Confirmation Statement showing your elections, your coverage and monthly premium and grant amount. Please review your Benefits Confirmation Statement immediately. Any errors to the elections you've made must be reported to the Benefits Center within 10 business days. Your retiree coverage will then be reported to your health plan and new ID cards will be sent to you by the health plan within 2-4 weeks.

New retirees are billed by SHPS Continuation Services for their health plan premiums on a monthly basis. Within 60-90 days after you retire, you will be automatically setup on pension billing. If you do not have enough money in your check to cover your premium, you will continue with the monthly billing through SHPS Continuation Services.

When to contact the County of Orange Benefits Center:

www.benefitsweb.com/countyoforange.html County of Orange Benefits Resource Line: 1-866-325-2345; Benefits Specialists are available Monday-Friday from 7:30-5:30 PST.

  • Questions about enrollment and/or eligibility for the Retiree health plans and Medical Grant
  • To make retiree health plan elections (once retirement information has been sent)
  • Questions about retiree health plan coverage
  • Questions about retiree health plan deductions and/or Medical Grant on OCERS check
  • Questions about direct billing and newly setup pension billing of health plan premiums for new retirees
  • Questions about COBRA notices, or other communications from the Benefits Center
  • Problems with access to medical and or prescription benefits
  • To report qualified life event changes
  • To make address or name changes once you have retired

Important things to remember :

  • Keep your home address current within the payroll system by notifying your Agency HR/payroll representative of address changes until you actually retire. The address on your pay stub is the address used to mail your benefits information until you actually retire.
  • Report all life events to the Benefits Center within 30 days of the life event.
  • Keep your 4 digit PIN Number. It is your key to accessing the Benefits Center Web Site or the Benefits Resource Line.
  • If you, or your spouse are age 65 or older contact your local Social Security Office at 1-800-772-1213 about Medicare at least 90 days prior to retiring. Medicare enrollment is required for participation in the County Retiree Medical Insurance Program

Other Resources

For general information such as rates, plan options, and retiree benefit orientation information prior to receiving your personalized enrollment information please go: www.oc.ca.gov/hr/employeebenefits.

Note: Retiree health plan elections can only be made once your Intent to Retire/Retirement information has been provided to the Benefits Center by OCERS during the monthly process.