Health Insurance FAQ

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How are the premium costs for CTPF Health Insurance plans determined each year?

Our health insurance premiums are based on the level of benefits offered and overall claims costs incurred by the plan. Premium costs are also affected by medical and prescription drug inflation.

Why are the health insurance plan premiums for members with Medicare so much less than the plans for members under age 65?

When you become age 65 and enroll in Medicare Part A and Part B, Medicare subsidizes a portion of your health care costs. The plans offered by CTPF for members age 65 and over are designed to work with Medicare and help pay those costs not covered by Medicare.

I worked 20 years with the Chicago Public Schools (CPS) and 3 years with Teachers Retirement System (TRS). However, TRS was my final system. I’m not eligible for insurance under TRS – but CTPF tells me I am not eligible to join their plan either. Why?

CTPF eligibility rules state that CTPF must be your final retirement system to be eligible to join a CTPF health insurance plan. TRS rules state you must have 8 years of service to be eligible for their health insurance program, whether or not they are the last retirement system. It is very important to understand the health insurance eligibility rules for each system before you retire.

I canceled my CTPF health insurance coverage last year. However, I am not happy with my new coverage and I now want to re-enroll on a CTPF health plan. Can I do that?

You can initially enroll in a CTPF plan only once in a lifetime, unless you experience a qualifying event. You can initially enroll when one of the following events occurs:

  • Within 30 days after COBRA continuation coverage under the Board of Education or Charter School active employee group health program ends, unless coverage is canceled due to non-payment of premium
  • Within 30 days of the effective date of pension benefits
  • During the Annual Open Enrollment Period (once in a lifetime)
  • Within 30 days of first becoming eligible for Medicare
  • When coverage is canceled by a former group plan through no fault of your own

My COBRA continuation coverage through my former employer expires shortly and I want to enroll in a CTPF plan. What is the deadline for submitting my enrollment application to CTPF?

CTPF requires that you provide your insurance application no later than 30 days after the date your COBRA expires. However, we recommend you submit your enrollment application to CTPF at least one month prior to your COBRA continuation coverage expiring. If CTPF does not receive your application by that date, you will have to wait until CTPF’s next Open Enrollment period, which occurs from October 1 – 31 each year.

Does the Pension Fund offer dental insurance to retirees and/or survivors?

No, the Pension Fund does not offer dental insurance. Dental plans are available from the Chicago Teachers Union, the Retired Teachers Association of Chicago, and other organizations. Or you can purchase coverage directly from an insurance company.

I am turning 65 this year. What should I do?

CTPF offers bimonthly Medicare “Birthday Parties” designed to help members turning 65 evaluate their health insurance options and enroll in Medicare. You will receive a personal invitation to this event if you or your dependent are currently covered on a CTPF health plan and are turning 65 this year. You can also begin the Medicare enrollment process by visiting your local Social Security Administration (SSA) office or by going to www.Medicare.gov. We suggest you start the enrollment process three months prior to your 65th birthday. If you are already collecting SSA retirement benefits, your enrollment in Medicare is automatic. See the Health Insurance Handbook for more information.

What happens if I don’t apply for Medicare Part A and Part B when I turn 65? Does CTPF offer a plan I can join without having Medicare?

To qualify for enrollment in a CTPF plan at age 65 or over, you must be enrolled in both Medicare Part A and Part B. If you choose not to enroll in Medicare Part A and Part B at age 65 and are currently covered under a pre-65 CTPF plan, your CTPF health insurance coverage will terminate effective on the last day of the month before your birthday month. In addition, Medicare penalizes you for late enrollment (not enrolling when first eligible). CTPF does not offer any plans for members age 65 and over without Medicare Part A and Part B.

Where can I find prescription benefit details?

The Health Insurance Handbook provides cost and benefit details for the prescription coverage associated with each CTPF-sponsored health insurance plan.

What is the Health Insurance Marketplace and does it affect me?

The Health Insurance Marketplace, or “Health Insurance Exchanges,” were created by the Affordable Care Act to make health insurance accessible to the 57 million people under age 65 that did not have health insurance. Those who already have health insurance coverage are not required to utilize the Health Insurance Marketplace.