Health Insurance

The Chicago Teachers' Pension Fund (CTPF) is pleased to offer health insurance benefits to retirees, survivors, and their eligible dependents. Learn more about eligibility requirements, the enrollment process, available plans, and more below, or download the 2024 Health Insurance Medicare Handbook or 2024 Health Insurance Non-Medicare Handbook for complete health insurance information. 

Health Insurance Eligibility

Eligible members may re-enroll in a CTPF health insurance plan one time without a qualified change in status (marriage, birth, death, etc.). Individuals who want to rejoin a CTPF plan must do so during a CTPF Open Enrollment Period. A member applying to re-enroll must have proof of insurance coverage (medical and prescription drug) as of the beginning of the open enrollment period (October 1) and maintain coverage through December 31 of that year. CTPF insurance coverage becomes effective the following January 1. 

 

Dependent Documentation Requirement

The following documentation must be provided when you add a dependent to a CTPF health insurance plan.

Type of DependentSupporting Documentation Required
Legal spouse as defined by your state of residenceMarriage certificate or tax return indicating spouse’s name
Party to a civil unionCivil union certificate
Disabled child*Certified copy of birth certificate and an original letter from physician certifying disability on physician letterhead with date disability occurred. Disability must have occurred prior to age 23.
Natural child under age 26Certified copy of birth certificate
Adopted child under age 26Adoption decree/order with judge’s signature and circuit clerk’s stamp or seal, and proof of birth date
Stepchild under age 26Certified copy of birth certificate indicating spouse is child’s natural parent
Child under legal guardianship, under age 26Certified guardianship appointment with Circuit Clerk stamp or seal, and proof of birth date
Unmarried veteran adult child, under age 30
  • Proof of Illinois residency
  • Veterans’ Affairs Release Form (DD-214) with release date from service
  • Certified copy of birth certificate

* CTPF may require periodic updates to disabled child documentation.

Health Plan Options

The current health insurance plans offered by CTPF are:

Non-Medicare Plans

Medicare Plans

Initial Enrollment Period

Retirees, survivors, and their dependents may initially enroll in CTPF health insurance coverage when one of the following events occur:

  • Within 30 days after COBRA continuation coverage under the Board of Education or Charter School active employee group health program ends, unless coverage is cancelled due to non-payment of premium
  • Within 30 days of the effective date of pension/survivor benefits
  • During the annual Open Enrollment Period
  • Within 30 days of first becoming eligible for Medicare
  • When coverage is cancelled by a former group plan through no fault of your own
One Time Opt-In

Eligible members may re-enroll in a CTPF health insurance plan one time without a qualified change in status (marriage, birth, death, etc.). Members who want to rejoin a CTPF plan must do so during a CTPF Open Enrollment Period. A member applying to re-enroll must have proof of insurance coverage (medical and prescription drug) as of the beginning of the open enrollment period (October 1) and maintain coverage through December 31 of that year. CTPF insurance coverage becomes effective the following January 1. 

Turning 65 -- Medicare Birthday Party Webinar

Turning 65 means it’s time to enroll in Medicare and choose a new CTPF health insurance plan. CTPF invites members turning age 65 to attend a Medicare “Birthday Party,” now conducted via webinar. These webinars are designed to help members evaluate their health insurance options. If you’re turning 65 this year, watch your email for a personalized invitation. If you can't attend in person, you can view a recorded version of the webinar and presentation slides below. 

Medicare Birthday Party Webinar Recording 

Medicare Birthday Party Webinar Presentation

Enrollment Process

Non-Medicare Plans

Use Form 350: Health Insurance Enrollment/Change to enroll in any non-Medicare health insurance plan. Return the completed form to CTPF.

Medicare Plans

Each Medicare plan offered by CTPF has specific enrollment and documentation requirements:

  • UnitedHealthcare AARP Medicare Supplement Plan F with Express Scripts Medicare®: Complete both Form 350: Health Insurance Enrollment/Change and the AARP enrollment form and return them to CTPF along with a copy of your Medicare Card. Call UnitedHealthcare at 1.800.392.7537 to request an enrollment kit for CTPF Plan #1089. Please note, only those who turned 65 before 1/2/2020 are eligible to enroll in this plan.
  • New for 2024: Cigna Surround Group Supplement Plan with Express Scripts Medicare® (PDP) (mirrors Plan G): Complete Form 350: Health Insurance Enrollment/Change only and return with required documentation to CTPF. Please include a copy of your Medicare card.
  • UnitedHealthcare Group Medicare Advantage PPO with Express Scripts Medicare®: Complete Form Form 350: Health Insurance Enrollment/Change only and return with required documentation to CTPF. Please include a copy of your Medicare card.
  • Humana Group Medicare HMO: Complete both Form 350: Health Insurance Enrollment/Change and the Humana enrollment form, which are available from  CTPF Member Services, 312.641.4464.  Please return both forms to CTPF along with a copy of your Medicare Card.

Click here to access Form 350: 2023 Health Insurance Enrollment/Change for October, November, and December Enrollments. 

Couple Coverage

Insurance Options when only one Family Member is Medicare Eligible

Depending on the age of your dependent, you may be in a situation where one family member is covered by Medicare and the other is not. If you both want CTPF health insurance coverage, you must enroll in corresponding Non-Medicare and Medicare health insurance plans, offered by UnitedHealthcare. Each family member must complete a separate application and pay the cost for single coverage in each plan. When you both reach age 65, you may enroll in the same health insurance plan and pay the Member +1 rate 

HEALTH INSURANCE PLAN (NON-MEDICARE PLAN)CORRESPONDING PLAN (MEDICARE PLANS)
UnitedHealthcare Choice
Plus PPO
UnitedHealthcare Group Medicare Advantage PPO with Express Scripts Medicare® (PDP)
UnitedHealthcare Choice
Plus PPO
AARP Medicare Supplement Plan F (UnitedHealthcare) with Express Scripts Medicare® (PDP)*

*This plan is not open to members who turn age 65 after January 1, 2020.

Examples (2024 Rates)

One family member is Medicare eligible
John is a CTPF annuitant, age 63, and his spouse is age 65. John enrolls in the UnitedHealthcare Non-Medicare PPO, and his spouse enrolls in the UnitedHealthcare Group Medicare Advantage PPO with Express Scripts Medicare® (PDP). John and his spouse are covered under separate plans so each must pay the single premium.  

John’s monthly member premium cost: $565.07 

Spouse’s monthly non-member premium cost: $180.42 

Total monthly cost for John and Spouse: $745.49 


When all become Medicare eligible 
Three months prior to his 65th birthday, John applies for Medicare. * When he receives proof of Medicare Part A and Part B enrollment, he immediately notifies CTPF. John then enrolls in the same plan as his spouse. Once John’s coverage becomes effective, John and his spouse pay the Member + 1 rate. 

John’s member + 1 dependent cost  
UnitedHealthcare Group Medicare Advantage PPO with Express Scripts Medicare® (PDP) $252.59 

* If you are currently enrolled in a CTPF Non-Medicare plan and plan to continue coverage in a CTPF plan when you turn 65, you must enroll in Medicare Part A and Part B, and provide proof of enrollment before the month of your 65th birthday. In order to enroll in the AARP Medicare Supplement Plan F (UnitedHealthcare) with Express Scripts Medicare (PDP), both the member and the dependent must be eligible for this plan. 

Designating an Authorized Representative

If you want a family member to assist you with health insurance issues, you may designate an authorized representative who can discuss your health insurance options with a CTPF staff member. An authorized representative does not have power of attorney and cannot make any of your care or treatment decisions. Members who wish to have an Authorized Representative must complete Form 345: HIPAA Authorized Representative Designation. 

Accessing Your Health Plan Information

To register for access to your health and drug plan information, visit your specific carrier’s website or mobile app:

 

Outside Health Insurance Rebate

Members enrolled in non-CTPF health insurance plans and/or Medicare may be eligible for a subsidy, subject to maximum reimbursement amounts published annually. The maximum reimbursement amount will be based on CTPF’s least expensive Medicare or Non-Medicare plan option. An application is mailed in the Spring to members who are not enrolled in a CTPF health insurance plan. The subsidy is paid out retroactively in an annual payment. Premium payment documentation is required and is explained on the application. 

Learn more about the 2023 Health Insurance Premium Subsidy Application at ctpf.org/ctpfsubsidy.

Outside Health Insurance Rebate Webinars

CTPF offers Outside Health Insurance Rebate Webinars that walk members through the process of applying for an outside rebate. These webinars provide a general overview of the eligibility requirements, required documentation, the timeline for the rebate process, and pitfalls to avoid when completing the outside rebate application.

Visit ctpf.org/calendar for more information and to register. 

Losing your CTPF Coverage (COBRA) 

Overview 

COBRA (Consolidated Omnibus Budget Reconciliation Act) is a federal law that gives health plan enrollees, including annuitants and their eligible dependents, the right to temporarily continue health insurance at group premiums. Coverage must be lost due to specific qualifying events (see below). The type of qualifying event determines who is qualified for continued coverage and for how long. 

The decision to continue coverage under COBRA must be made within a certain time period, called the election period. If COBRA continuation coverage is elected within the qualifying period, the coverage will be reinstated retroactive to 12:01 a.m. on the date following termination of coverage. Coverage under COBRA is identical to the health insurance coverage provided to plan enrollees. 

CTPF COBRA Eligibility 

COBRA continuation coverage is a continuation of CTPF health insurance coverage when coverage would otherwise end because of a qualifying event. A list of qualifying events with the applicable continuation periods can be found in the chart below. You must notify CTPF in writing of address changes for dependents so that COBRA notification can be sent. 

Duration of CTPF COBRA Coverage 

Qualifying Events Continuation Period 
Annuitant  
Suspension of annuity benefits for any reason, including termination of disability benefits, except for gross misconduct 18 months 
Loss of eligibility 18 months 
Disability determination by the Social Security Administration (SSA) of a disability that existed at the time of the qualifying event 29 months 
Dependent  
Suspension of annuitant’s annuity benefits as stated above 18 months 
Failure to satisfy the plan’s eligibility requirements for dependent status 36 months 
Annuitant’s death, divorce, or legal separation: spouse or ex-spouse 36 months 
Annuitant becomes Medicare entitled (for Part A, Part B, or both) and elects to terminate group health benefit 36 months 

Notification of CTPF 

COBRA Eligibility 

As the annuitant, you are responsible for notifying CTPF of you or your dependent(s) loss of eligibility of coverage within 60 days of the date of the qualified event, or the date on which coverage would end, whichever is earlier. Failure to notify CTPF at the following address within 60 days will result in termination of CTPF COBRA continuation rights: 

Email or Fax Preferred, mail notice to: 

Health Benefits Department  
Chicago Teachers’ Pension Fund  
425 S. Financial Place, Suite 1400  
Chicago, IL 60605-1000 

Send forms and documents by fax to 1-312-641-7185 or email an attachment (.pdf or .jpg format) to imaging@ctpf.org.

CTPF sends a letter with CTPF COBRA continuation rights within 14 days of receiving notification of the health insurance termination with a qualified event. The letter includes an enrollment form, premium payment information, and important deadline information. 

If you and/or your dependent(s) do not receive a CTPF COBRA continuation letter within 30 days, and you notified CTPF within the required 60-day period, contact CTPF immediately. 

CTPF COBRA Enrollment 

You and/or your dependents have 60 days from the date of the COBRA eligibility letter to elect enrollment in COBRA and 45 days from the date of election to pay required premiums. Failure to complete and return the enrollment form, or to submit payment by the due dates, will terminate COBRA rights. If the enrollment form and all required payments are received by the due dates, coverage will be reinstated retroactive to the date of the qualifying event. 

Continuation Period When Second Qualifying Event Occurs 

If, while on an 18-month COBRA continuation period a second qualifying event occurs, you and your dependents may extend coverage an additional 18 months, for a maximum of 36 months. However, this 18-month extension does not apply in the case of a new dependent added to existing COBRA coverage. 

Premium Payment Under CTPF COBRA 

You have 60 days from the date of the COBRA eligibility letter to elect CTPF COBRA and 45 days from the date of election to pay all premiums. Premium is 102% of the group rate for each COBRA-enrolled individual and is not subsidized by CTPF. Failure to pay the premium by the due date will result in termination of coverage retroactive to the last date of the month in which premiums were paid. 

Disability Extension of 18-Month Period of Continuation Coverage 

If, while covered under COBRA, you are determined to be disabled by the Social Security Administration (SSA), you may be eligible to extend coverage from 18 months to 29 months. Enrolled dependents are also eligible for the extension. To extend benefits, you must have become disabled during the first 60 days of COBRA continuation coverage. You must submit a copy of the SSA determination letter to CTPF within 60 days of the date of the letter and before the end of the original 18-month COBRA coverage period. 

Disability Extension Premium Payment 

Disabled individuals and their enrolled dependents pay an increased premium, up to 150% of the cost of coverage, for all months covered beyond the initial 18 months. 

Adding New Dependents to CTPF COBRA Coverage 

Qualified dependents may be added to existing COBRA coverage. Contact CTPF for more information and documentation requirements. 

 Conversion Privilege 

When COBRA coverage terminates, enrollees may have the right to convert to an individual health plan without providing evidence of insurability. Contact your health plan administrator to see if you qualify for this option. 

Termination of Coverage under CTPF COBRA 

Termination of COBRA coverage occurs when the earliest of the following occurs: 

  • maximum continuation period ends 
  • COBRA enrollee fails to make timely payment of premium 
  • COBRA enrollee becomes entitled to Medicare 
  • the plan terminates  
More Information

For complete health insurance information, including current plan rates, premium subsidy eligibility, couple coverage, becoming eligible for Medicare, COBRA, ending coverage, and more, please download the 2024 Health Insurance Medicare Handbook or 2024 Health Insurance Non-Medicare Handbook. You may also contact Member Services, 312.641.4464, with questions or to set up an appointment to meet with a representative.