Policy/Memo 68

Number: Policy Memo 68
Date Issued: July 16, 1993
Policy File Ref: A580

ISSUE:

Reinstatement of coverage for former employees who did not make the required premium payments during vested status.

Background:

Occasionally, we receive requests from retirees, upon completion of a vested period with their retirement system, to reinstate their health insurance coverage. In most cases, these retirees tell us that they were not aware nor were they informed by their former employer that they should have continued coverage while in vested status to qualify for coverage in retirement.

Since 1976 our General Information booklets, which are provided to every employee upon entry into the Program, have stated the requirement for continuing coverage in vested status. These guidelines (see reverse) have been and continue to be the basis of our operating policy.

Policy:

Require that vestees satisfy the vesting requirement outlined in the General Information Booklet. Administrative exceptions may be granted on a case-by-case basis for good cause. In such cases, coverage will be reinstated retroactive to the date of termination and enrollees will be required to make back payments to establish continuous coverage during the entire vesting period. Any Medicare reimbursement payable during this period, will be applied to reduce the amount owed.