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​If you are a retiree over the age of 65 and you are entitled to benefits with the district, you will be required to enroll in Medicare parts A & B and your medical benefits will be switched over to either Kaiser Senior Advantage Plan or the Anthem National Passive PPO Medicare Advantage Plan administered by RetireeFirst.  If you have a spouse or partner who is eligible for benefits with the District, they too would need to enroll in Medicare parts A&B when they turn 65 and they would move to the new plan as well.

The District chose the RetireeFirst Anthem National Passive PPO Medicare Advantage plan because it has equal or better coverage as offered to active employees and retirees are able to go to any doctor in the nation that accepts Medicare.  In addition, the RetireeFirst plan offers individualized retiree advocacy services.  

• Better Coverage – Medicare group health plans offer close to 100% coverage and in most cases it provides higher coverage levels.
• Better Access – With Medicare group health plans, retirees are able to access medical services from any provider that accepts Medicare. This network is nationwide and provides significant flexibility to retirees.
  

​The Kaiser Senior Advantage Plan is a seemless transition if you are already a Kaiser member.

​Retirees who are eligible for benefits with the district will still have the option of enrolling in our dental plans and our voluntary vision plan in accordance with your collective bargaining agreeements.

​ RetireeFirst 714.646.3618 or Toll-Free at 833.265.8654

​2025 Drug Formulary.pdf

​Is the RetireeFirst plan an HMO plan? 

No, the Anthem Medicare Preferred PPO with Senior Rx Plus​ is not an HMO plan and you will not have a primary care physician.  It is a PPO plan which will allow you to see the provider of your choice.  They do not need to be part of the Anthem Blue Cross network.  The only requirement is that the provider be a part of the Medicare network (96% of the health providers nationally) to receive full coverage (Passive PPO). 

Is RetireeFirst the Carrier? 

No. The administration, approval, and billing of all medical services is done by Anthem Blue Cross as the carrier for the plan.  RetireeFirst provides support services to retirees and the District but does not make medical coverage decisions.

How does the RetireeFirst plan work? 

Under the RetireeFirst Anthem National Passive PPO Medicare Advantage plan a member will be able to seek covered services from any Medicare provider (96% of the health providers nationally) in the US.  That provider will then bill Anthem directly for 100% of the costs vs. having to bill Medicare first and then Anthem secondary.  Anthem then works with Medicare to obtain the applicable reimbursements.  The processing of the Medicare reimbursements by Anthem is why retirees are asked to “assign" their applicable parts of Medicare.  Under a Medicare supplement plan, provider must bill Medicare first and then the plan second.  However, the difference is an administrative issue that is not a responsibility of the retiree but rather the provider.  A major factor for consideration was the fact that the RetireeFirst plan utilized Anthem as the carrier which ensured minimal to zero disruption for all retirees currently on the Anthem HMO and PPO plans.

What happens if I want to leave the plan? 

Since it is an employer sponsored group Medicare insurance plan, any participating retiree would be allowed a special open enrollment upon termination.  During the special open enrollment, they could select whether to move to an individual Medicare advantage plan or Medigap plan.  It is important to note that this flexibility is due to the fact that this is a group Medicare insurance plan and not an individual Medicare Advantage policy.

What will happen to the Kaiser Senior Advantage Plan? 

There will be no change. The District will continue to offer the Kaiser Senior Advantage plan.

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Frequently Asked Questions

·         What is Medicare?

• Medicare is a federal health insurance program for individuals who are 65 and older. Medicare has generally three parts:
  

Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Medicare Part B (Medical Insurance)

Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Medicare Part D (prescription drug coverage)

Helps cover the cost of prescription drugs (including many recommended shots or vaccines).

·         Who does it apply to?

• All eligible current and future retirees, along with their dependent spouses, are to enroll in Medicare part A and B once they turn age 65 and if they have retired.​·        .

​·         Are there costs incurred with enrolling in Medicare?

• Enrollment in Medicare part A is free for most people, enrollment in Part B incurs a premium which the retiree is required to pay. The premium is on a tiered scale based on the retiree's income.
• The District plans to cover premiums associated with the Medicare group health plans for the length in the applicable collective bargaining agreements or board policy.

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·         How much are Medicare penalties?

• Medicare penalties starts at 10% per year for every 12 months you could have signed up for Medicare. For example, if you don't sign up until age 70, you would accumulate 50% (age​ 65 to 70 = 5 years) in penalties. This means you will pay 50% more of your typical Medicare part B premium for life. There may also be additional penalties associated with Medicare Part A.

·         Are there penalties attached to the Medicare late enrollment?

• Late enrollment in Medicare Parts A and B can trigger financial penalties that will be assessed against the retiree. To ensure the smoothness of the transition, the District will reimburse any penalties associated with late enrollment in Medicare Part B for retirees who retired before August 9, 2021. 

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·         I will be age 65 or over while still employed with the District, should I still enroll?

• No, you do not need to enroll in Medicare as long as you are working regardless of your age. You will be covered by the District's health and dental plans until you are enrolled in Medicare as outlined below.

·         How can retirees sign up and who can we contact with questions?

• Future retirees can sign up in two ways:
• Those early retirees who are younger than age 65 upon retirement shall sign-up for Part A and B within the 7-month window beginning 3 months prior to the month they turn 65, the month they turn 65, and three months after.
• Retirees who are age 65 and older when retiring shall enroll in Medicare Part A and B no later than 8 months of their retirement date.  You will NOT pay a penalty for delaying Medicare, as long as you enroll within 8 months of losing your coverage or stopping work (whichever happens first). You'll want to plan ahead and enroll in Part B at least a month before you stop working or your employer coverage ends, so you don't have a gap in coverage.

  https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and-Unions/FS3-Enroll-in-Part-A-and-B.pdf

  ​The District will continue medical and dental coverage for both the retiree and spouse during the transition period as noted above.

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Retiree Benefit Update Virtual Town Hall Meeting 9/7/2021

Town Hall 2 Slide Deck.pdf 10/4/2021

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​On Mon​day August 9, 2021, the Board of Trustees approved mandated Medicare enrollment for eligible District retirees. 08-09-21 DOCKET.pdf

4.11.2022_BoardMeeting_RF.Anthem.Keenan FINALv4.pdf

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