Page 18 - B12797-ITDR-Enrollment-Guide-2020

18
Frequently asked questions—Grandfathered
What are the grandfathering rules?
If you retired with Caltech medical coverage before January 1, 1991, you are considered a grandfathered retiree.
If you were actively at work on April 1, 1991, and you had at least 10 years of continuous Caltech service, and you met at least one of the following criteria as of April 1, 1991, you may be considered a grandfathered retiree:
1. You were age 55.
2. Your age plus years of service was greater than or equal to 72.
3. Your years of service plus three times your age was greater than or equal to 175.
How is the program different for Medicare eligible grandfathered retirees?
If you are a Medicare eligible grandfathered retiree age 65 or older, you and your Medicare eligible spouse will continue to be eligible for a free medical plan. For 2020, the free plan is the Kaiser HMO plan option.
I am a grandfathered retiree, what plans can I chose?
You can choose one of the following plans:
•The Kaiser HMO Medicare Advantage plan (at no cost to you), or
•Opt out of the free plan option and use your Defined Dollar Credit to choose an Aetna plan, or
•Collect your Defined Dollar Credit in an HRA. Caltech will use the maximum service credit of 25+ years to calculate your Defined Dollar Credit.
I am a grandfathered retiree, can I have my left over Defined Dollar Credit in an HRA if I am on the free Kaiser plan?
No, if you choose the free plan, you are not entitled a Defined Dollar Credit.
I am a grandfathered retiree, but my spouse is not Medicare eligible yet. Can my spouse have the free Kaiser plan?
No, if your spouse is not Medicare eligible, they will receive a Defined Dollar Credit to purchase an Aetna or Kaiser plan. Caltech will use the maximum service credit of 25+ years to calculate the Defined Dollar Credit amount.
I am a non-Medicare eligible grandfathered retiree (or non-Medicare eligible spouse), can I enroll in the free Kaiser plan?
No, Caltech provides you and your eligible spouse with a Defined Dollar Credit to help pay for your health care. The amount of your credit is based on your years of service up to a maximum of
25+ years.