Health Insurance

As a participant in PSPRS, benefits that are available to you vary depending on your Membership Tier:

Health Insurance Overview

Tier 1, 2 or 3 DB Members:  As new retiree, retired member, or as an eligible surviving spouse of the System, you have healthcare coverage options available to you; see Options 1 to 3 below under Choosing Coverage.  By selecting one of these items, as applicable, you may be entitled to a Premium Benefit (i.e., subsidy), which is the portion of the medical or dental coverage that the System will pay based on your elections and coverage level.  (If you elect insurance coverage through a private entity, we cannot apply the subsidy to the private coverage.) 

For monthly insurance premiums that are less than your eligible subsidy, we can only subsidize up to the premium amount (you do not receive the difference of the subsidy).  If you are eligible for coverage under Option 1 or 2 and, depending what is allowed by your former employer or ADOA, we may be able to offset your medical and/or dental monthly premiums by the subsidy.  Members who are eligible for benefits under Option 2 and elect vision insurance, will be billed quarterly from ADOA for the vision as we cannot apply the subsidy to that coverage.

PS & CORP Tier 3 DC and EODCRS Members may elect group health insurance and/or accident insurance coverage through Arizona State Retirement System (ASRS), Arizona Department of Administration (ADOA), or a group plan through an employer of EORP, as applicable, but the retiree will be responsible for the full cost of the premium(s) under these plans.

Retired members and survivors that are currently receiving a monthly retirement benefit (not deferred annuity) from the System will receive an open enrollment packet in October of each year and it is during this time that you may elect coverage; however, it is very important that you review this packet each year to familiarize yourself with any plan changes, or requirements such as completion of a new enrollment form, as applicable.  Members may also make changes during the plan year due to a “qualifying event” and to understand what is considered a qualifying event and the timeframe to make these changes, refer to the Guide Book provided in Option 3.

Choosing Coverage

Option 1)  As a new retiree (or surviving spouse), the employer from which you retired may offer retiree or Cobra coverage; contact your employer for cost and plan coverages.  If you elect this option, premiums may be deducted directly from your monthly retirement payments, less the subsidy, or the subsidy may be sent to your employer, but the employer will direct the System how to apply your premiums and subsidy.

Option 2)  If you currently have active insurance through Arizona Department of Administration (ADOA), or if you are retiring from the EORP, you may elect retiree insurance through ADOA.  Please note that if you do not elect medical or dental insurance through ADOA at the time of your retirement and in accordance to ADOA’s enrollment timelines, or in the future you cancel both medical and dental coverage(s) with ADOA, you will permanently cancel all future insurance options with ADOA.  We can deduct the premiums, less the subsidy, from your retirement payments, or we can direct the subsidy to ADOA to offset your premiums costs.  ADOA will instruct our office how this will be handled.  To sign-up or view these plans, contact ADOA at www.benefitoptions.az.gov, or (602) 542-5008, option 2. 

Option 3)  The System utilizes the group insurance program provided by Arizona State Retirement System (ASRS).  To learn more about these plans, visit ASRS website here.  However, questions regarding insurance deductions will need to be directed to our office; please Contact Us.  Should you choose this option, the premiums, less the subsidy, will be deducted from your monthly retirement payment.  If your premiums exceed your monthly retirement payments, you will be billed for the premiums, less the subsidy.

ASRS Enrollment Forms and Guides

  • INSTRUCTIONS to complete 2019 Medical and Dental Enrollment Forms
  • 2019 Enrollment Forms: Medical (print at 85% to ensure signature prints on page 2), and/or Dental Forms
  • 2019 Enrollment Guide:  Non-Medicare and/or Medicare

ASRS Provider Contact Directory

  • To select a medical provider, visit ASRS website here
  • To select a dentist, visit Sun Life Financial (fka Assurant) website here

ASRS Certificate of Coverage and Evidence of Coverage

  • Non-Medicare Choice and Navigate Plans Certificate of Coverage (COC) and Summary of Benefits, visit ASRS website here
  • Medicare Group Medicare Advantage HMO plan Evidence of Coverage (EOC) (be sure to select the PSPRS plan) and the Medicare Senior Supplement plan Certificate of Coverage (COC), visit ASRS website here

ASRS Formularies for Prescription Drugs

  • Non-Medicare plans, members may visit UHC website at www.myuhc.com
  • Medicare plans, members and non-members may visit UHC website at www.uhcretiree.com/asrs (use ASRS as a PSPRS retiree) 

Timeframe to Make Elections Under Option 3

If you are eligible and you elect medical or dental insurance under Option 3, you may return the enrollment form(s) provided by the PSPRS by mail, fax, or scan/email the enrollment form(s) to the System (it is not required to mail the originals).

Non-Medicare

Medical enrollment form must be received no later than the 10th of the effective month of the qualifying event. 

Medicare

Medical enrollment form and copy of your Medicare card showing Parts A and B are required to be received by our office by no later than the last business day of the month prior to your effective month.


Premium Benefit (Subsidy)

As part of your benefits (with the exception of PS & CORP Tier 3 DC and EODCRS Members), the System provides a health insurance premium benefit (commonly referred to as insurance subsidy), which is provided to you to supplement the cost of your medical and/or dental insurance.  The amount of the subsidy that you are eligible to receive is based on the coverage level (single or family coverage), Medicare eligibility and, in some cases, your years of service credit.  To receive this benefit, you must be participating in an insurance plan administered by your former employer, ASRS, or ADOA. 

Without Medicare With Medicare A & B Retiree & Dependents
Years of Service Retiree Only Retiree & Dependents Retiree Only Retiree & Dependents Retiree & Dependents One with Medicare, the other(s) without Retiree & Dependents with Medicare, other dependents without
Arizona State Retirement System (ASRS) Members
5.0 - 5.9 $75.00 $130.00 $50.00 $85.00 $107.50 $107.50
6.0 - 6.9 $90.00 $156.00 $60.00 $102.00 $129.00 $129.50
7.0 - 7.9 $105.00 $182.00 $70.00 $119.00 $150.50 $150.50
8.0 - 8.9 $120.00 $208.00 $80.00 $136.00 $172.00 $172.00
9.0 - 9.9 $135.00 $234.00 $90.00 $153.00 $193.50 $193.50
10.0+ $150.00 $260.00 $100.00 $170.00 $215.00 $215.00
Elected Officials’ Retirement Plan (EORP) Members
5.0 - 5.9 $90.00 $156.00 $60.00 $102.00 $129.00 $129.00
6.0 - 6.9 $112.50 $195.00 $75.00 $127.50 $161.25 $161.25
7.0 - 7.9 $135.00 $234.00 $90.00 $153.00 $193.50 $193.50
8.0+ $150.00 $260.00 $100.00 $170.00 $215.00 $215.00
Corrections Officer Retirement Plan (CORP) Members
not applicable $150.00 $260.00 $100.00 $170.00 $215.00 $215.00
Public Safety Personnel Retirement System (PSPRS) Members
not applicable $150.00 $260.00 $100.00 $170.00 $215.00 $215.00


Terminating Coverage

If your medical and/or dental coverage is under Options 1 or 2, you will need to contact the applicable agency to request the cancellation.  In turn, they will notify the System of your cancellation and the System will apply the changes to your benefit payments. 

If your medical and/or dental coverage is under Option 3 and, at any time during the plan year, if you would like to cancel either coverage, you will need to provide a letter to the System to cancel your election(s).  The letter will need to specifically state that you would like to cancel your medical and/or dental insurance and the date in which you want the coverage to end - take into consideration that that the System issues benefit payments at the end of the month (e.g., if a retirement payment is dated December 31, that payment represents the December 1 check).  The letter will also need to include your identifying information such as your name, address, last four of your social security number, phone number(s) and your signature (we cannot accept an electronic signature).  If your spouse was receiving medical coverage from your account under a medicare supplement plan, it is required that your spouse sign the letter.  This letter must be received prior to the 1st of the effective month and may be sent by mail, fax, or scan/email.

Additional Insurance Information

After you retire, in October of each year, you will receive an open enrollment packet from the ASRS (and possibly from ADOA or your employer).  When you receive this packet(s), it is important for you to familiarize yourself with any changes.  In simple terms, a “passive” enrollment means that you are not required to complete an enrollment form if you want the same elections to continue into the next plan year, but a “positive” enrollment means that it is required that you complete a new enrollment form. 

Combination of Options (if eligible): If you would like medical insurance from one agency and dental from another, you may elect those options, but you will need to complete the appropriate forms and return it to each agency.

Dual Retiree:  If you are retired from another state retirement system (ASRS, PSPRS, CORP or EORP), or plan to retire from another state retirement system in the future, please Contact Us because you may qualify for a subsidy from both retirement plans.

Return to Work:  If you return to work with a PSPRS employer, your former employer, or through a PSPRS employer that utilizes Arizona Department of Administration (ADOA) insurance, and you meet the return to work guidelines, we may be able to apply the subsidy to your active medical and/or dental coverage.  However, new members with (or a survivor of the system whose deceased spouse has) a membership (hire) date on/after September 13, 2013 will not be eligible for the Premium Benefit when they retire and if they become re-employed with a PSPRS employer and participate in active health care coverage provided by the members or survivors PSPRS employer.  Contact Us to assist in this process.