UT Benefits Overview for Retired Employees

For Plan Year Beginning September 1, 2011

What You Need to Know

Skip to: Basic Coverage Package | Optional Coverage | Premium Sharing | Enrollment

ELIGIBILITY

Retired Employees

  1. An individual who was employed at a UT System institution in a benefits-eligible position on August 31, 2003, and subsequently retires from the System is eligible for benefits as a retired employee if:
  • The individual meets the Rule of 80 (total of age plus years of state service credit equals or exceeds 80), or the individual is at least age 55 with five years of state service credit; and
  • The individual has at least three years of service with the System for which the individual was eligible to participate in the Program; and
  • The individual's last place of state employment before retirement was with a System institution; and
  • The individual retires from System under the jurisdiction of the Teacher Retirement System of Texas (TRS); the Employees Retirement System of Texas (ERS); or the Optional Retirement Program (ORP) established by Chapter 830, Government Code or any other federal or state statutory retirement program to which the System has made employer contributions.
  1. An individual whose first date of employment at a UT System institution in a benefits-eligible position was on or after September 1, 2003 is eligible for benefits as a retired employee if:
  • The individual meets the Rule of 80 (total of age plus years of state service credit equals or exceeds 80) with at least ten years of state service credit, or is at least age 65 with ten years of total state service credit; and
  • The individual has at least ten years of service with the System; and
  • The individual's last state employment before retirement was with an institution of the System; and
  • The individual retires under the jurisdiction of the Teacher Retirement System of Texas (TRS); the Employees Retirement System of Texas (ERS); or the Optional Retirement Program (ORP) established by Chapter 830, Government Code or any other federal or state statutory retirement program to which the System has made employer contributions.
  1. Individuals, regardless of age and years of service credit, who worked in a benefits-eligible position with UT and are members of the Teacher Retirement System of Texas (TRS) and qualify for disability retirement may also qualify to participate in the UT Benefits program. Individuals who are participants in the Optional Retirement Program (ORP) may also qualify for disability retirement.

For more information about disability retirement, contact TRS or refer to the Office of Employee Benefits Administrative Manual, Policy 220.

Note: If you were previously employed at a UT System institution and have questions about benefits as a retired employee, please contact the Benefits Office at your former institution.

Dependents

You may also enroll your eligible dependents for certain UT Benefits coverage.

For UT SELECT Medical ONLY, your eligible dependents are:

  • your spouse as defined by the Texas Family Code1;
  • your child(ren) under age 26, including
  • stepchildren, and
  • adopted children;
  • your unmarried grandchild under age 25, if the child qualifies and is claimed as your dependent for federal tax purposes;
  • certain children over age 26, who are determined by OEB to be medically incapacitated and are unable to provide their own support; and
  • children for whom you are named a legal guardian or who are the subject of a medical support order.

For all other UT Benefits, your eligible dependents are:

  • your spouse as defined by the Texas Family Code1;
  • your unmarried child(ren) under age 25, including
  • stepchildren, and
  • adopted children;
  • your unmarried grandchild under age 25, if the child qualifies and is claimed as your dependent for federal tax purposes;
  • certain children over age 25, who are determined by OEB to be medically incapacitated and are unable to provide their own support; and
  • children for whom you are named a legal guardian or who are the subject of a medical support order.

1 Eligibility for a common-law spouse must be established by proof of a
valid certificate of informal marriage or a valid court order.

UT requires additional supporting documentation when you request to add a dependent to your plan. You may be asked to provide copies of your marriage certificate, your children’s birth certificate(s), and/or appropriate adoption paperwork. This paperwork is required not only to support the coverage of eligible dependents but also, in the case of marriage or the birth of a new child, to support a mid-year change of status.


Examples of dependents who are not eligible for coverage include

  • Your common-law spouse, unless you can establish proof of a valid common law marriage as defined by Texas state law;
  • Your same-sex partner;
  • Your former spouse;
  • Your married child;
  • Your child over age 25, if not medically incapacitated and unable to provide their own support;
  • Foster children covered by another government program, unless coverage is required by law or court order;
  • Any dependent insured by another UT employee or retired employee;
  • Any dependent insured by another plan that receives State of Texas premium contributions; and
  • Any dependent who is on Active Duty in the Armed Forces of any country.

UT System conducts audits for dependents insured by other plans that receive State of Texas premium contributions such as Texas A&M System or Employees Retirement System of Texas (ERS). If you currently cover a dependent that is also receiving premium sharing for coverage through one of these plans, please choose to have that person covered under only one plan and make the appropriate enrollment changes at this time.

Basic Coverage Package

UT Benefits includes the following basic coverage package for eligible retired employees:

  • UT SELECT Medical plan, with Prescription Drug Coverage
  • $6,000 Basic Group Term Life Insurance

Optional Coverage

You may select the following optional coverage for yourself and your eligible dependents, unless stated otherwise:

  • UT SELECT Medical plan, with Prescription Drug Coverage, for your eligible dependents (enrollment in this plan is automatic for retired employees)
  • Dental Insurance
  • Vision Insurance
  • Voluntary Group Term Life Insurance
  • Long-Term Care Insurance

PREMIUM SHARING

As a retired employee, UT and the State of Texas will pay 100% of your premiums for the basic coverage package, and up to 50% of the premiums for your dependents' medical coverage. You are responsible for all optional coverage premiums.

ENROLLMENT

Initial Enrollment

An individual must enroll in the program as a retired employee within 31 days of the date upon which the individual retires. An individual who fails to enroll within the 31 day period may not enroll until:

(a) the next Annual Enrollment period; or
(b) upon occurrence of a qualified change of status event.

Annual Enrollment

For Plan Year 2011-2012, Annual Enrollment will be held July 15 31, 2011. During this time you may change your group insurance benefit elections and add, update or remove dependents from coverage using the My UT Benefits online system. On or around July 15, you will receive a letter or email titled "Your U.T. Benefit Enrollment Options" that lists your current coverage and future coverage options and informs you if any action is required on your part.

Your Annual Enrollment elections will become effective September 1, 2011 if EOI is approved prior to September 1, 2011 or is not required. If EOI is required and not approved until after September 1, 2011, coverage will become effective on the EOI approval date.

Special Enrollment Period for Adult Children to Age 26 for Plan Year 2011-2012 Only

Effective September 1, 2011, eligible dependent children can join or remain on UT SELECT Medical coverage through the end of the month in which they turn 26 regardless of marital, military, or employment status.*

If coverage for your dependent child(ren) currently under age 26 ended (or coverage or eligibility was denied) due to age, marital, employment or military status, you may enroll these dependents online through My UT Benefits during this Annual Enrollment period (July 1531, 2011). After Annual Enrollment, enroll by contacting your institution's Benefits Office by September 30, 2011. Enrollment will be effective September 1, 2011.
IMPORTANT! Supporting documentation of the child relationship will be required.

*Adult children under age 26 who are also eligible for enrollment in UT SELECT Medical coverage as an employee or medical coverage offered by the Employee Retirement System of Texas or Texas A&M System may not be able to participate in the special enrollment period.

Change of Status

You have 31 days from the date of a qualified change of status event to notify your institution Benefits Office and make qualified changes to your benefits that are consistent with that event. If you do not make your eligible changes during the 31-day status change period, your changes cannot be made until the next Annual Enrollment in July, to be effective the following September 1.

The list below includes common examples of qualified change of status events:

  • marriage, divorce, annulment, legal separation, or spouse's death;
  • birth, adoption, medical child-support order, or dependent's death;
  • significant change in residence if the change affects you or your dependents' current plan eligibility;
  • starting or ending employment, starting or returning from unpaid leave of absence, or a change of job status (e.g., from non-benefits eligible part-time to full-time);
  • change in dependent's eligibility (e.g., reaching age 26 for UT SELECT Medical, marriage or reaching age 25 for all coverage other than UT SELECT Medical, or gaining or losing eligibility for any other reason); or
  • significant change in coverage or cost of other benefit plans available to you and your family.

A retired employee

  • whose dependent loses insurance coverage under the Medicaid or CHIP program as a result of loss of eligibility of either the employee or the dependent; or
  • whose dependent becomes eligible for a premium assistance subsidy under Medicaid or CHIP

may enroll this dependent in the basic coverage under UT Benefits, as long as the dependent meets all other UT eligibility requirements and is enrolled within 60 days from the date of the applicable event. If enrollment of the dependent is conditioned on enrollment of the retired employee, the retired employee will also be eligible to enroll.

Note: EOI may be required for some benefit changes following a qualified change of status event.

For more information, contact your institution Benefits Office.

 

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