Employees Retirement System of Texas

10/09/2024 | News release | Distributed by Public on 10/09/2024 21:34

Fall Enrollment begins Oct. 28 for Medicare-eligible retirees

4-minute read

If you are a Medicare-eligible retiree in the Texas Employees Group Benefits Program (GBP), Fall Enrollment is your chance to enroll in or change coverage for yourself and/or your eligible dependents without a qualifying life event (QLE). You will have from Oct. 28 through Nov. 15 to make changes. The changes you make during this period are effective Jan. 1.

What's New for 2025?

Slight increase in Medicare Advantage premiums

Due to rising health costs, those who pay premiums for HealthSelectSM Medicare Advantage will pay about 4.5% more starting Jan. 1. This is still lower than premiums in 2020, before UnitedHealthcare became the insurer.

Changes to out-of-pocket maximums

The HealthSelectSM Secondary plan's total annual in-network out-of-pocket maximums will increase to align with IRS maximums. Premiums for HealthSelect Secondary are not increasing, but are still significantly higher than the premiums for HealthSelect MA PPO.

Don't forget to check your mail

Keep an eye out for your Fall Enrollment packet in the mail. It's important to open any mail with an ERS logo on it. Your Fall Enrollment packet will be delivered in October and will have helpful information about your benefits. If you're not sure what benefits you're currently enrolled in, ERS will list them on your Personal Benefits Enrollment Statement (PBES).

If you misplace or lose your packet, you can also visit the Fall Enrollment page on the ERS website to view the guide, premium rates and information from plan administrators. This site will become available at the start of Fall Enrollment.

Enrolling in new coverage

If you don't enroll in new coverage during Fall Enrollment, you cannot enroll in coverage after Fall Enrollment unless you have a QLE, such as marriage, divorce or loss of other coverage. If you are a retiree who is not eligible for Medicare, your enrollment period ended in July, and you cannot enroll in new coverage without a QLE.

Dropping/reducing coverage

You can drop any coverage, reduce optional life insurance coverage or change from one health plan to another any time of year without a QLE. You also can take dependents off your coverage at any time of the year without a QLE.

No changes? No problem.

If you are keeping the same coverage, you don't have to do anything and your coverage will carry over into the new plan year (Jan.1 - Dec. 31).