Retiree Health Eligibility FAQs
Find answers to the most commonly asked questions about maintaining your FCPS health care coverage in retirement.
Questions Regarding Eligibility Calculation
Q. I have worked for FCPS for 25 years, but have been covered under my spouse’s plan. Am I eligible to retain FCPS coverage as a retiree?
A. Yes, if you are covered under the FCPS plan at time of retirement. If you do not have FCPS coverage at time of retirement, you will not be able to retain coverage as a retiree, nor will you be able to re-enter the plan at a later date.
Q. I worked for FCPS 10 years ago and left my position to work for another school system. I will be returning to FCPS in a benefits eligible position starting February 1, 2019. Will my prior service count toward my 15 year calculation?
A. No. Breaks in service of more than one year do not count toward ‘time in service’ calculations and therefore do not count toward meeting the 15 year requirement.
Q. I worked as a temporary/hourly for 2 years before I accepted a benefits eligible position with FCPS. Will that temporary/hourly service count toward the 15 year calculation?
A. No, only benefit eligible service counts toward the 15 year calculation. However, employees hired prior to 1/1/19 who qualified for coverage under the Affordable Care Act may satisfy the eligibility requirement by maintaining coverage for sixty consecutive months prior to retirement.
Q. I took a Leave of Absence five years ago. Will my time while on an LOA count toward the 15 year calculation?
A. No. However, as in the case above, you may be able to satisfy the requirement by maintaining coverage for sixty consecutive months prior to retirement.
Questions Regarding Re-Entry Rights
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. 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, request re-entry within 30 days of loss of coverage (or during open enrollment) and each of you shows documentation of 12 or more months of continuous coverage.
Q. I am a re-employed retiree who is working in a temporary/hourly position. Will I have to meet the new eligibility criteria?
A. If you retired prior to January 1, 2019, your eligibility is based on the current criteria of maintaining coverage for sixty consecutive months. If you were eligible to retain coverage as a retiree - and you maintained continuous coverage with FCPS since retirement - you will not need to satisfy new criteria.
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. Additionally, there is no longer a need to pay the DHO premium.
Questions Regarding Subsidies
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. Both my spouse and I are FCPS employees, and she is covered as a dependent under my health plan. My spouse will be retiring before me and wants to pick up health coverage with her new employer. Will she be eligible to reinstate FCPS coverage at a later date?
A. Since your spouse was covered as a dependent at the time of your retirement, she would be eligible to return to the FCPS plan upon becoming eligible for Medicare (and by showing proof of other coverage). You may also add her as a dependent to your policy within 30 days of loss of coverage, or during open enrollment. However, as a dependent, she would not be eligible to receive the FCPS subsidy that she would receive as a retiree.