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2014 Program OverviewWhat is a 'qualifying event'?A “qualifying event” permits membersto make a specific mid-year change totheir benefits coverage that is consistentwith the qualifying event. If you have aqualifying event and want to enroll or arerequired to make a change in your coverage (i.e., add or delete dependents or arerequired to change your benefit plan), youmust notify the ASRS or, if applicable,the Public Safety Personnel RetirementSystem (PSPRS) Member Services, inwriting, within 31 days of the event torequest a change. Following is a list ofeligible qualifying events: Change in member’s marital status– marriage, divorce, legal separation,annulment, death of spouse (e.g., enrollyourself and/or add or delete a spouse),Change in dependent status – birth,adoption, placement for adoption,death, or dependent eligibility due toage (e.g., enroll yourself and/or add ordelete eligible dependents),Change in member’s primary residence causing a change in benefitplan availability (e.g., change medicaland/or dental plans),Eligibility for Medicare – member,spouse, dependent child (e.g., enrollyourself and add your eligible dependents in a medical and/or dental planor, if enrolled, change medical plan ofaffected person), Significant change in ParticipatingEmployer’s group benefits plan costor coverage (e.g., enroll yourself if youare enrolled in your employer’s groupbenefit plan, and add eligible dependents), and Termination of COBRA coverage– member, spouse, dependent child(e.g., enroll yourself and/or add eligibledependents).Who is an 'eligible dependent'?Your legal spouse,A domestic partner, which is defined as alegal or personal relationship between twoindividuals who live together and sharea common domestic life but are neitherjoined by a traditional marriage nor a civilunion,A natural child, legally adopted or placedfor adoption children or stepchildren up toage 26,A child for whom legal guardianship hasbeen awarded to the retiree or retiree'sspouse up to the age of 26,Foster children up to the age of 26,A child for whom insurance is requiredthrough a Qualified Medical ChildSupport Order or other court or administrative order,A child of any age who is or becomesdisabled and dependent upon the retiree.Significant change in spouse’s groupbenefits plan cost or coverage (e.g.,enroll yourself if you are enrolled inyour spouse’s group benefit plan, andadd eligible dependents),5

2014 Program OverviewIf you enroll your eligibledependent(s), additional documentation will be requested:If you have a dependent child approaching age 26 who is disabled or under legalguardianship, you will be requested toprovide: a certified copy of a court order granting legal guardianship, or verification that your dependent childhas a qualifying permanent disabilitythat occurred prior to his or her 26thbirthday and is in accordance withSocial Security Administration guidelines. This continuation of coverage isalso subject to approval by the MedicalDirector of the Medical and/or DentalHealth Insurance providers for ASRS.Who is an eligible DomesticPartner?The ASRS offers medical and dental coverage to same-gender and opposite-genderdomestic partners and their eligible dependent children.To obtain these benefits, your partner mustmeet the ASRS definition of a domesticpartner. A domestic partnership is a legal orpersonal relationship between two individuals who live together and share a commondomestic life but are neither joined bya traditional marriage nor a civil union.Domestic partners must share, among othercriteria, a residence with the retiree andhave done so continuously for the past 12months, not legally married to or separatedfrom anyone else, not a close blood relative, at least 18 years old, and meets certainfinancial interdependency tests (full criteriafollows under "Eligible Domestic Partner").To add a domestic partner to your coverageyou must complete the Qualified DomesticPartner Certification packet. This packetincludes the Qualif ied Domestic PartnerAff idavit, Declaration of Tax Status andthe Worksheet for Determining DependentStatus. Before completing the paperworkand submitting it to the ASRS, it is bestif you review the eligibility requirementsfirst. Be sure to return the forms (excluding the Worksheet) to ASRS along with acompleted enrollment form. The domesticpartner paperwork will need to be notarized. Any questions regarding the taximplications should be directed to yourpersonal tax consultant or attorney. ASRSstaff does not provide tax advice or counsel.Eligible Domestic PartnerYour domestic partner is subject to all ofthe following qualifications:a. Shares the retiree’s permanent residence;b. Has resided with the retiree continuously for at least 12 consecutive monthsbefore filing an application for benefitsand is expected to continue to residewith the retiree indefinitely as evidencedby an affidavit filed at time of enrollment;c. Has not signed a declaration or affidavitof domestic partnership with any otherperson and has not had another domestic partner within the 12 months beforefiling an application for benefits;d. Does not have any other domestic partner or spouse of the same or oppositesex;e. Is not currently legally married toanyone or legally separated from anyoneelse;f. Is not a blood relative any closer thanwould prohibit marriage in Arizona;6

2014 Program Overviewg. Was mentally competent to consent tocontract when the domestic partnershipbegan;h. Is not acting under fraud or duress inaccepting benefits;i. Is at least 18 years of age; andj.Is financially interdependent withthe retiree in at least three (3) of thefollowing ways: Having a joint mortgage, joint propertytax identification, or joint tenancy on aresidential lease; Holding one or more credit or bankaccounts jointly, such as a checkingaccount, in both names; Assuming joint liabilities; Having joint ownership of significantproperty, such as real estate, a vehicle,or a boat; Naming the partner as beneficiary onthe retiree's life insurance, under theretiree's will, or retiree's retirementannuities and being named by the partner as beneficiary of the partner’s lifeinsurance, under the partner’s will, orthe partner’s retirement annuities; Each agreeing in writing to assumefinancial responsibility for the welfareof the other, such as durable power ofattorney; Other proof of financial interdependence as approved by the Director.The packet may be obtained by callingthe ASRS Member Advisory Center(MAC) at 602-240-2000 (Phoenix area),520-239-3100 (Tucson area),800-621-3778 (all other areas andoutside the state of Arizona) weekdaysfrom 8 AM to 5 PM, MST.What will happen to the ASRSretiree medical plan in whichI am enrolled when I becomeeligible for Medicare?If you are enrolled in an ASRS medicalplan and you become eligible for Medicare,you MUST enroll in one of the two ASRSmedical plans for Medicare eligible retireesif you wish to continue with ASRS healthinsurance coverage. Failure to enroll timelyin one of the Medicare plans will result intermination of your medical coverage andyou will not be able to enroll in an ASRSMedicare medical plan until the next openenrollment period. The ASRS has medical plans for retirees who are not Medicareeligible and plans for retirees who areMedicare eligible.Your plan change will become effective onthe first day of the month in which youbecome eligible for Medicare (providedASRS receives all required information priorto the requested effective date). This meansthat you need to notify the ASRS or PSPRS,if applicable, prior to the month in whichyou become Medicare eligible. The Centersfor Medicare and Medicaid Services(CMS) will mail a Medicare card to you 3months prior to your eligibility only if youare receiving Social Security benefits at thattime. The Medicare card will include yourname, Medicare claim number, the type ofcoverage you have (Part A, Part B, or both),and the date your Medicare coverage starts.If you are eligible for Medicare, you musthave Part A and Part B to participate in anASRS Medicare eligible medical plan.In addition to completing a new healthinsurance enrollment form, you will needto provide a copy of your Medicare card tothe ASRS or PSPRS, if applicable. Pleaseremember that you need to submit yourcompleted paperwork prior to the first ofthe month in which you become Medicareeligible.7

2014 Program OverviewIf you have been receiving Social SecurityDisability Income benefits for two years,you may become eligible to enroll inMedicare. You should complete yourMedicare enrollment process well beforeyour eligibility date so that you maytransition to an ASRS Medicare eligiblemedical plan in a timely manner.I forgot to notify the ASRSor PSPRS, if applicable, thatI became Medicare eligible.What will happen to theretiree medical plan in whichI am enrolled?If you fail to notify the ASRS or PSPRS,if applicable, that you became Medicareeligible, the medical plan in which you areenrolled will terminate.Members are sent a letter 90 days prior toMedicare eligibility. If a member does notrespond by switching to a Medicare plan,the member will be terminated as ineligible. It is very important to note that thepremium benefit to which you are entitledwill be reduced to the amount applicableto Medicare-eligible retirees. State lawgoverns how much premium benefit is paidfor non-Medicare and Medicare-eligibleretirees/LTD recipients. In order to receivethe highest premium benefit and pay thelowest health insurance premium, please letthe ASRS or PSPRS, if applicable, knowthat you are eligible for Medicare prior tothe month in which you become Medicareeligible.Your ASRS coverage will always be effective on the first day of the month followingreceipt of your completed ASRS enrollmentapplication. Therefore, there is no retroactive coverage for health insurance. Pleaseremember to begin your enrollment processwith the ASRS or PSPRS, if applicable,before you become Medicare-eligible.8What is the Premium BenefitProgram?This benefit is provided to each eligibleretired and disabled member who electsto participate in a health insurance plansponsored by the ASRS, the ArizonaDepartment of Administration, or aParticipating Employer. This benefithelps reduce monthly health insurancepremiums. The benefit to which you areentitled is dependent upon your yearsof credited service, enrollment in singleor family coverage and whether you areMedicare eligible. Please see page 54 formore information.What is the Optional PremiumBenefit Program?Effective January 1, 2004, any eligibleASRS member may elect to participatein this program upon retirement. Thisprogram allows you to provide continuationof a premium benefit to your contingentannuitant. The contingent annuitant is theindividual to whom your monthly pensionbenefit would continue, in some manner,upon your death and who would be eligibleto be enrolled in an ASRS retiree healthcare plan. Therefore, only retirees whoelect a joint and survivor or period certainpension option may elect to participate inthis program. Please see page 55 for moreinformation.Both my spouse and I areASRS retirees. How may thePremium Benefit Program helpus?The ASRS Premium Benefit Programprovides the greater of 2 single premiumbenefits or 1 family premium benefit toeach eligible retiree. Such retirees generally can receive the greatest application ofthe premium benefit program with eachretiree enrolling in a medical plan choosingsingle coverage and one retiree enrolling ina dental plan choosing family coverage.

2014 Program OverviewWhat should I do if my spousehas benefits through anotheremployer?Coordinate your coverages. Study what yourspouse has, then decide which ASRS retireehealth insurance options provide you withthe most appropriate overall coverage. It isusually best to pick coverage that complements, not duplicates, the other coverage.Do I have hearing benefitsthrough my medical plan?The UnitedHealthcare GroupMedicareAdvantage (HMO) Plan coversroutine annual hearing exams at no chargeand has a 500 hearing aid allowance every36 months.The Choice and Choice Plus plans alsocover hearing aids. Please see page 23 fordetails.Also available for Medicare and nonMedicare members is the ArizonaHearCare Network (AHCN). AHCNis a discount program NOT an insurancebenefit. AHCN providers, at no additionalpremium to the participant, offers thefollowing: 25 copayment for hearing evaluations,30% discount towards the purchase ofhearing aids30% discount on accessories and repairsYou must show your UnitedHealthcare IDcard to be eligible for these benefits andmust use an Arizona HearCare Networkoffice. AHCN locations are detailed onthe web or through the AHCN CustomerService Center. See the inside back cover ofthis guide for AHCN's phone number andwebsite.What should I tell my dependent beneficiary to do aboutmy pension benefits and healthinsurance coverage in theevent of my death?There is no quick or simple answer. Yourdependent beneficiary is encouragedto contact ASRS Member Services orPSPRS Benefits Office staff, if applicable,at the time of your death. Decisions willhave to be made regarding continuation ofpension benefits if you elected a pensionoption other than straight life annuity.Likewise, continuation of or enrollment inan ASRS retiree health care plan by yourbeneficiary must be decided within six (6)months of your death. Also, if you electeda reduced premium benefit, your beneficiary may be entitled to a continuationof that benefit. Your beneficiary will needto provide certified copies of your deathcertificate to affect any change in yourpension or health insurance benefits.What happens if my monthlyhealth insurance premiumexceeds the amount of mypension check?If your monthly pension check has insufficient funds to cover your health insurance premiums, then premiums will notbe deducted. The insurance carrier(s)would be notified that you did not makea premium payment for that month andthey will mail a bill to you. It will beyour responsibility to pay any outstanding premiums directly to the insurancecarrier(s). Direct bills are mailed at theend of the month and due by the 25th ofthe following month. You will be payingyour premium in arrears instead of inadvance as you would if you had a pensiondeduction.9

2014 Program OverviewWhat do I need to do if Idecide to change my retirement date or go back to work?After I enroll in an ASRSretiree health care plan, whenwill I receive my ID cards?If a member changes their retirement date or goes back to work afterUnitedHealthcare has already processedthe enrollment form, UnitedHealthcarecan't retroactively disenroll a member(Medicare in particular), so the member isresponsible for the premium.UnitedHealthcare will mail your medical plan ID card(s) approximately 10 daysprior to the first day of the month inwhich your medical plan becomes effective. Assurant Employee Benefits also willmail your dental plan ID card(s) approximately 10 days prior to the first day of themonth in which your dental plan becomeseffective.What happens if I fail to paymy direct bill?Your health insurance coverage will beterminated. You will not be allowed tocome back onto an ASRS-sponsored planuntil the next Open Enrollment period,and only if your previous balance is paidin full.What do I need to do to cancelmy ASRS health care coverage?If you wish to terminate your enrollment in an ASRS retiree health insuranceplan, you must do so in writing eitherin a letter or using the ASRS enrollment form by checking the appropriate“decline” box(es). Your cancellation mustbe received by the ASRS prior to thefirst day of the month your cancellationis to become effective. Please note that ifyour notice of cancellation arrives afterthe first day of the month, your coveragewill not be cancelled until the first day ofthe following month unless a future dateis requested. If you do not notify ASRSyou will be responsible for your monthlypremium until ASRS receives your written cancellation.If you are enrolled in theUnitedHealthcare Group MedicareAdvantage (HMO) or SeniorSupplement Plans, you must submit aDisenrollment Letter to "unlock" yourMedicare so you may return to originalMedicare.10After I submit my retirementpaperwork and the health careenrollment form, when will thedeductions start for the healthcare coverage?It takes a couple of months before thepension check deduction starts. Memberswill be on direct bill status for the firstfew months before the pension deductionis set up. Members receive a bill for theirpremium until the deduction is set up onthe pension check.Must I notify the ASRS orPSPRS of an address change?Yes, all mailings, including pension andLTD benefit plan checks, newsletters,open enrollment and additional insuranceinformation are delivered to the addressof record on file with the ASRS orPSPRS, if applicable. It is always in yourbest interest to ensure a correct mailingaddress. While many retirees and LTDrecipients have seasonal or even secondary addresses (such as a PO Box), theaddress of the primary residence is key tothe availability of medical plan optionsand their costs as well as the forwarding of important periodic informationthat may be time sensitive. In short, itis your responsibility to let the ASRS orPSPRS know in writing when you havean address change.

2014 Program OverviewHow can I find out more aboutmy health care choices?There are four main points for ASRSretirees to consider:All members—active, inactive, disabledand retired—are encouraged to access theASRS or, if applicable, PSPRS websiteswhich are full of useful overviews andexplanations regarding many topics ofinterest. The ASRS website may be foundat www.azasrs.gov. The PSPRS websitemay be found at www.psprs.com. The ASRS retiree health insurance program meets the healthcare requirements outlined by theAffordable Care Act. If you are NOT eligible for Medicareand have health insurance throughthe ASRS retiree health insuranceprogram, you now have additionaloptions through the Affordable CareAct. You may review the availableACA options through the HealthInsurance Marketplace and determineif they better suit your personal needsfor health insurance. If you are NOT eligible for Medicareand do not participate in an ASRSretiree health insurance plan, or otherwise have no health insurance, in mostcases you will be

Assurant Dental Plans Comparison Chart 35-36 ASRS Retiree Dental Plans Sample ID Cards 37 Assurant Vision Service Plan (VSP) Discount Benefit 38 Additional Benefit Programs WellCardHealth, Your ASRS Health Discount Card Program 39 The SilverSneakers Fitness Program 40 UnitedHealthcare's Caregiver Program 41