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 My OC Benefits™ at mybenefit.ocgov.com or speak to a representative at the Benefits Service Center at 1-833-476-2347. 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 contact Orange County Employees Retirement System (OCERS), so they can assist you with the retirement process. OCERS will provide weekly information to the Benefits Service Center Center such as date and type of retirement for all retirees who have notified OCERS 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 an Intent to Retire solicitation that is sent to you based on your communication preferences established with the Benefits Service Center, notifying you that you have 30 days to make your County of Orange Retiree Medical Plan election and your Retiree Medical Grant, if applicable. While waiting for this notification, you may want to consider the following:

Contact the County Employee Benefits Department at 1-714-834-6282 to have your Verification of Employment form completed, if you are Medicare eligible.
90-days prior to your retirement, apply for and activate your Medicare Part B (as well as Part A if available at no cost to you) if applicable to avoid any delay in approval.
If you are not interested in a County Retiree Medical Plan and wish to permanently disenroll, you must call the Benefits Service Center at 1-833-476-2347. If you are Medicare-eligible, you can also discuss your Medicare premium reimbursement options.
If you wish to permanently disenroll from the Retiree Medical Plan, you must actively decline coverage. Your decision is permanent, and you will not be able to re-enroll at a later date. Contact the Benefits Service Center for assistance.
Temporary Opt-Out Option if retiring after January 1, 2022 - In order to temporarily opt-out of your retiree health plan coverage, contact the Benefits Service Center at 1-833-476-2347.
If you add a newly eligible dependent, be ready to submit any supporting documentation.
HMOs are only available in California. If you are moving out of state, you will need to elect a PPO option.

Your Intent to Retire solicitation will be sent to you based on your communication preferences you have established with the Benefits Service Center. If you have moved or plan to move before you retire, you must contact your County HRS representative and provide an updated address. You should receive a packet within 1-2 weeks following the date OCERS provides your information to the Benefits Service Center. Once you are actually retired, you may make address changes directly through OC Benefits™ or speak to a representative at the Benefits Service Center.

Electing and Accessing Your Coverage in General

You will have 30 days from the date on your Benefits Intent to Retire 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.

If you and/or your eligible dependent is Medicare eligible at the time you retire and you do not provide your Medicare information and Medicare ID Number when you enroll, you will not see Medicare plans or premiums or, if eligible, your Retiree Medical Grant amount.

If you do not elect a Retiree Health Plan during your enrollment period, you will be enrolled in default retiree medical coverage. You will receive a Confirmation of Benefits showing your enrollment, and you will be able to switch to another health plan at the next Open Enrollment or if you have a Qualified Life Event (QLE). 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 urgent services under the new plan, you can contact the Benefits Service Center for assistance

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

Meeting with OCERS and filling out their 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 Confirmation of Benefits 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.

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 Confirmation of Benefits showing your elections, your coverage, monthly premium, and Grant amount. Please review your Confirmation of Benefits immediately. Any errors to the elections you've made must be reported to the Benefits Service Center within 14 calendar 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 the first 60 to 90 days of coverage, you will receive an invoice to pay for your health plan premiums. Pension premium deductions will begin within this 60- to 90-day period. If your pension can’t support this amount, you will continue to receive monthly invoices to pay for your coverage. Continue to pay any invoices for your Retiree Health Plan coverage (if applicable) through the month in which your premiums are deducted from your pension

When to contact the County of Orange Benefits Center

My OC Benefits™ at mybenefits.ocgov.com or Benefits Service Center at 1-833-476-2347, Representatives are available Monday-Friday from 8:00 a.m. - 6:00 p.m. Pacific time, except holidays.

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 HRS 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 user name, password and PIN Number. It is your key to accessing My OC Benefits™ or the Benefits Service Center.
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: ocgov.com/gov/hr/eb.

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 weekly process.