Retiree Benefits FAQ

Eligible retirees may elect continue coverage for their enrolled dependents on the medical, dental, and vision plans. Additionally, eligible dependents may be added to a plan during Open Enrollment or due to a Qualifying Life Event.

Eligible dependents may participate in the plans in which you are enrolled. Eligible dependents are:

• Your lawful spouse (marriage, civil union, or common-law
• Your children who are less than 26 years old (natural-born, adopted, step-children, and legal guardianship)
• Your dependent children that are age 26 or more years old that are primarily supported by you and incapable of self-sustaining employment by reason of mental or physical handicap that are enrolled on the plan before age 26 – You may be required to provide proof of the child’s dependent status to the plan carrier or to the Employee Benefits Division.

Visit the Retiree section of our Employee Benefits Website to find the latest Retiree Benefits Brochure which includes plan costs.

The County provides a subsidy for retiree EPC medical plan premiums based on years of service. The retiree subsidies may be re-evaluated and adjusted each year. There are no subsidies for dependent coverage or the dental or vision plans.

Premiums are deducted from your monthly pension.

If pension pay does not cover the premium total, information will be provided to you for payment submissions.

Your first month of retirement’s premiums will need to be paid by you to the Employee Benefits Division no later than 2 weeks after your retirement date. This is because your pension pay will begin in the month following your retirement date.

Our payment portal can be found under the “Make an EPC Benefits Premium Payment” section on the Employee Benefits Website. Use your employee ID as the account number. Transaction fees will apply as listed below.

• Electronic check: $0.95 per electronic check transaction
• Credit/debit card: 2.39%, minimum $2.00, per card transaction

Years of service details are provided to us by the Retirement Office for use in the application of the Medical Plan Subsidy.

Purchased years will not apply toward the Medical Plan Subsidy year of service for employees hired on or after January 1, 2022.

Visit the Retiree section of our Employee Benefits Website to find the latest Retiree Benefits Brochure which include plan costs.

The County provides a subsidy for retiree EPC medical plan premiums based on years of service. The retiree subsidies may be re-evaluated and adjusted each year. There are no subsidies for dependent coverage or the dental or vision plans.

Plan premiums may change as the County’s cost for the plans change, whether an increase or decrease.

Benefits are reviewed regularly, through careful analysis, thorough research, and collaborative effort. The Employee Benefits Division provides updated retiree subsidy schedules and premium information annually in the Retiree Benefits Brochure available on the Employee Benefits Website in the Retiree section.

Medical premiums can change for retirees with less than a 100% medical plan subsidy. Dental and Vision premiums can change as these premiums are fully paid by the retiree.

Yes.

At the time of retirement, you may remove dependents from your benefits. You will not be able to add dependent or change plan levels (e.g. Dental Plan option change) at this time without a Qualifying Life Event.

Outside of your initial retiree elections, you may add or remove eligible dependents from your enrolled plans at Open Enrollment or with a Qualifying Life Event.

No. If at any point you waive a benefit, you will not have the option of electing to have that benefit in the future.

If your eligible dependent loses or gains other coverage – employer/group, Medicare, or Medicaid – you are able to make changes to your enrolled* benefits due to a Qualifying Life Event.

Visit the Retiree section of our Employee Benefits Website and for documents and forms.

You can make changes to your benefits by submitting a Retiree Benefit Election Form to the El Paso County Employee Benefits Division within 31 days of the life event effective date. Documentation is required for the event. If there is no qualifying life event, changes can only be made at annual Open Enrollment

Required documentation:

• Completed El Paso County Retiree Benefit Election Form
• Proof of other coverage including who is/was covered, the type of coverage (medical/dental/vision), and when coverage starts/ends.
• If adding a dependent, proof of relationship – spouse: marriage certificate; child: birth certificate

*If you have waived a benefit for yourself, you cannot elect to add this benefit at any point.

If you have a Qualifying Life Event as defined by the IRS (i.e., marriage, divorce, loss of group coverage, etc.) you can make changes to your enrolled* benefits by submitting a Retiree Benefit Election Form to the El Paso County Employee Benefits Division within 31 days of the life event effective date. Documentation is required for the life event and, if adding a dependent, proof of relationship. If there is no qualifying life event, changes can only be made at annual Open Enrollment.

Visit the Retiree section of our Employee Benefits Website and for documents and forms.

Required documentation: Contact the Employee Benefits Division for guidance.

*If you have waived a benefit for yourself, you cannot elect to add this benefit at any point.

Open enrollment is the annual period when you can change* your health plan benefits.

Open enrollment is held annually in the fall, typically in October. Changes made at open enrollment are effective January 1st of the following year.

Outside of open enrollment, changes during a plan year can only be made with a qualifying life event.

*If you have waived a benefit for yourself, you cannot elect to add this benefit at any point.

Pre-Medicare retirees (under age 65) that elect to continue the EPC Medical Plan are eligible to continue participating in Reach Your Peak (RYP) and RYP+.

RYP+ perks include prize entries and Health Reimbursement Account (HRA); the premium reduction does not apply for retiree participation.

RYP+ enrollment must be completed annually to participate.

Employees separating from the County have the option to continue Life Insurance and Supplemental Benefit plans through the plan carrier, Unum. Contact Unum within 90 days of your coverage end date at 1-866-220-8460 for an assistance with continuing these benefits.

Yes. The plans can be used nationwide.

Contact the plan’s member services for questions regarding coverage and limitations outside of the U.S.

Upon Retirement, you will not receive new Dental or Vision Plan ID cards. You will only receive new Medical Plan ID cards if:

• You removed a dependent – Until your new card arrives, you can use your existing medical plan ID card as the member ID will remain and be the same for all members.
• You are Medicare-eligible – Your Medical Plan will change to the Medicare-eligible plan.

Pre-Medicare Medical

The El Paso County Pre-Medicare Medical Plan is an EPO medical plan. EPO stands for Exclusive Provider Organization. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care.

An EPO has no out-of-network benefits. That means if you utilize a provider or hospital outside of the network, you are responsible for 100% of the claim.

In-network provider listings can be accessed online by going to the Quantum Health portal or calling Quantum Health.

elpasocobenefits.com | (866) 885-1484

Download the App: Apple App Store or Google Play

Dental

Dental Plan network providers can be found on the Delta Dental of Colorado website.

On the Delta Dental of Colorado homepage, click “Find a Dentist.” Enter your search parameters by selecting “Plans Participating In” (Delta Dental PPO or Delta Dental PPO Plus Premier), entering your location (address or zip code) and/or other criteria you wish to include, then click “Search.” The list will indicate the networks in which each provider participates. The greatest discount and least out-of-pocket to you will be with a Delta Dental PPO network provider.

deltadentalco.com | (800) 610-0201

Download the App: Apple App Store or Google Play

Vision

Vision Plan network providers can be found on the EyeMed website.

On the EyeMed homepage, click “Find an eye doctor.” Choose your network (Access) and click “use my location” or enter your ZIP code and click “search by ZIP.”

eyemed.com | (866) 723-0596

Download the App: Apple App Store or Google Play

Pre-Medicare Medical & Prescription

Quantum Health is here to simplify your healthcare experience by explaining your benefits, giving you access to or replacing your ID cards, finding in-network providers, and so much more.

elpasocobenefits.com | (866) 885-1484

Download the App: Apple App Store or Google Play

Dental

Contact Delta Dental of Colorado.

deltadentalco.com | (800) 610-0201

Download the App: Apple App Store or Google Play

Vision

Contact EyeMed

eyemed.com | (866) 723-0596

Download the App: Apple App Store or Google Play

If you or your spouse are or are becoming Medicare-eligible by your retirement date, you will need to enroll in Medicare Part A and Part B to participate in the El Paso County Medicare-eligible Medical Plan.

• We recommend beginning the enrollment process with Medicare as soon as possible, but ideally, 8 weeks prior to your retirement date. You will need to enroll in Medicare Part A and Part B.
• For Special Enrollment:* When you are ready to begin the enrollment process, you will need a Medicare Employment Verification Form as proof of employer-sponsored health coverage. Contact the Employee Benefits Division for this form.
• Be sure to request that your Medicare coverage becomes effective on your official retirement date – first of the month following your last day of employment. (If approved for paid leave beyond your last day of work, your last day of employment will be the last day of approved leave.)

If you are opting out of the County’s Medical Plan check Medicare.gov for more information regarding Medicare Parts A, B, and D.

*The initial enrollment period for Medicare is 3 months before and 3 months after your 65th birthday (7 months). The Medicare Employment Verification Form must be provided as proof of a Special Enrollment. If not enrolled in Medicare when you are initially eligible, penalties apply for late enrollment. This form certifies that you had creditable coverage during that time and helps avoid those penalties.

Failure to enroll by/with the required effective date for Medicare Part A and Part B, any lapse in Medicare Part A and Part B, or enrollment in another Medicare plan will forfeit your eligibility for the El Paso County Medicare-eligible Medical Plan.

Medicare may apply premium penalties for each month that you are not covered. Please visit Medicare.gov for enrollment information and requirements.

If you are enrolled in the County’s Pre-Medicare Medical Plan and Prescription Plans, coverage will terminate effective the date the retiree or spouse is Medicare eligible. Medicare-eligible retirees/spouses are offered a Medicare-Eligible Medical Plan.

Visit the Retiree section of our Employee Benefits Website for information on the current plan.

For this QLE, you would submit the following items to the El Paso County Employee Benefits Division within 31 days of the life event effective date.

Note: Medicare eligibility does not allow for changes to dental or vision coverage – these benefit changes can be made during open enrollment.

If you wish to waive medical plan coverage due to Medicare eligibility: You must complete a Retiree Benefit Election Form and provide proof of Medicare coverage and submit to the Employee Benefits Division by the end of the month prior to you turning 65.

If you wish to continue your medical plan coverage with El Paso County:* You will have the opportunity to enroll in the County’s Medicare-eligible plan; you must enroll in Medicare Part A and Part B in order to be eligible.

1. RETIREE ELECTION FORM: Complete the El Paso County Retiree Benefit Election Form. Only the Medical Plan option for the Medicare-eligible individual can be changed with this event. This form must be signed by the El Paso County retiree.
2. MEDICARE ELIGIBLE ENROLLMENT FORM: Complete the Medicare Eligible Enrollment Form. This form must be signed by the Medicare-eligible individual.
3. A copy of the Medicare card verifying enrollment in Medicare Parts A and B.

The forms must be submitted to the Employee Benefits Division no later than the end of the month prior to you turning 65. Failure to enroll timely may result in disqualification for eligibility to enroll in the County’s Medicare-eligible plan.

*Enrollment is dependent on the receipt of your Retiree Benefit Election Form, Medicare Eligible Enrollment Form, and Medicare Part A and Part B enrollment. Enrollees of the Medicare-Eligible Plan must be enrolled in and maintain enrollment in Medicare Part A and Part B. Medicare Part A and Part B premiums are the enrollee’s responsibility and are typically deducted from Social Security benefits. Any lapse in Medicare Part A and Part B coverage will forfeit/terminate your Medical Insurance. Enrollees of the Medicare Eligible Plan cannot be enrolled in another Individual Medicare Advantage (MA), Medicare Advantage Prescription Drug Plan (MAPD) or Individual Part D Prescription Drug Plan (PDP) at the same time as this group plan through El Paso County. Other coverage will forfeit/terminate your Medical Insurance.