Re-entry Rights for Retirees Covered by an FCPS Health Plan

Find answers to the most commonly asked questions regarding these conditions.

Starting January 1, 2019, a covered retiree (or DHO participant*) will be able to drop FCPS coverage and have one re-entry right to the plan if the retiree meets certain conditions (see below). This is an enhancement to the current policy which does not permit re-entry once coverage is dropped.

 

Retiree Re-entry Rights Effective January 1, 2019

A covered retiree may drop FCPS coverage and re-enter the plan at a later date if all of the following criteria are met: 

  • Enrolled in an FCPS medical and/or dental plan as of 12/31/18 (or at time of retirement, if after that date); and
  • Eligible for Medicare. If the retiree will also be covering dependents, all dependents must be eligible for Medicare; and
  • Applies for coverage within 30 days of a qualifying event or during Open Enrollment, and 
  • Provides proof of other coverage for the preceding 12 consecutive months.

Retirees have only 1 re-entry right to the plan.

 

Frequently Asked Questions Regarding the Limited Re-entry Right

Q. If I drop my FCPS coverage at retirement, will I be eligible to receive a retiree subsidy?
A. The FCPS funded health subsidy is provided only to retirees covered under the FCPS health plan. However, if you are receiving a retirement benefit from VRS, you may be eligible to continue to receive the VRS subsidy.  Contact VRS regarding the health subsidy that is funded through their pension plan.

Q. I am not covered by the FCPS health or dental plan, but I am eligible for Medicare. Can I reenter the plan now?
A. No.  Current retirees must be covered by the FCPS plan (or DHO program) as of 12/31/18 in order to drop coverage and re-enter the plan when eligible for Medicare.   

Q. My spouse was not covered under my FCPS plan at the time of my retirement.  Can I add her to my coverage at a later date?  
A. If you are currently covered under the FCPS plan as a retiree, you may add your spouse to your plan within 30 days of a qualifying event or during open enrollment.  

If you retired on or after 1/1/19 and dropped your FCPS coverage at time of retirement, your spouse may re-enter the plan when you do if you are both eligible for Medicare. You must request re-entry within 30 days of loss of coverage (or during open enrollment) and each of you must show documentation of 12 or more months of continuous coverage. 

Q. Upon retirement, I will be taking a job with an employer who offers health insurance. Can I drop my FCPS coverage and come back into the plan at a later date?
A. Yes, if you meet the stated eligibility criteria.  Remember, you cannot re-enter the plan until you are Medicare eligible, and you must document at least 12 or more months of continuous coverage under another plan.

Q. I want to drop coverage and re-enter the plan when I become Medicare eligible, but my spouse will not be eligible for Medicare at that time.  Can my spouse re-enter the plan when I do?
A. No – only those individuals who are eligible for Medicare will have re-entry rights.  If you re-enter the plan upon becoming eligible for Medicare, your spouse can re-enter the plan within 30 days of becoming eligible for Medicare (or during Open Enrollment) as long as you continue to be covered under the FCPS plan. 

Q. Can I drop coverage but have my spouse remain on the FCPS plan?
A. No. You must be covered under the FCPS plan in order for your spouse to remain covered.

Q. Why is the DHO program being eliminated?
A. Providing re-entry rights to the eligible retirees serves the same purpose as the DHO program, so a separate program is no longer needed. 

Q. When I re-enter the plan, will I have to provide documents to show my spouse is eligible for coverage?
A. Yes. If you drop coverage and you and your spouse re-enter the plan later, you will need to provide an updated tax return to document your marital status in addition to documents showing that you and your spouse have been continuously covered by another plan for 12 or more consecutive months immediately prior to re-entry. 

 

 

* The DHO program ends on December 31, 2018.