Retiree Group Benefit Coverages

PURPOSE

State legislation (Assembly Bill 528) became effective January 1, 1986 and changed Education Code Division 5, Chapter 1, Article 1, Section 7000 - 7005 to establish the right of retired certificated employees to enroll in health and dental plans offered to active certificated employees.  In conjunction with this legislation, the District chooses to include its classified retirees as well.  This guideline sets forth the requirements of eligibility, guidelines for enrollment, and limitations of the District "AB 528" health plans.

Eligibility

  1. Certificated and classified retirees of the San Diego Community College District who have retired from any public employee retirement system may be covered.
  2. Retirees and their spouse, or the surviving spouse of a retiree, shall be eligible for participation.  Children are not eligible for coverage.  A new spouse, upon remarriage of a surviving spouse, is not eligible for this benefit.
  3. Retirees are eligible for participation in health and dental plans offered by the District.
  4. Retirees must enroll within 30 days of retirement from the District.  Retirees who fail to enroll in the AB 528 plan upon retirement shall not be eligible to reenroll at a later date, except as follows:  Should a retiree have health coverage elsewhere, and subsequently lose that coverage, he/she may enroll in the AB 528 plan with 31 days of losing said coverage.  The retiree must provide documentation to substantiate loss of coverage.

GUIDELINES

  1. Upon retirement and notification of discontinuance of benefits, retiree contacts the Benefits Office and completes appropriate enrollment documents for health care.
  2. Retiree must remit premium payments to Benefits Office at least one month in advance. Payments may be made in monthly, quarterly, or semi-annual increments. Failure to pay premium by the due date shall result in immediate cancellation on the last day of the month for which coverage has been paid.
  3. Each year there shall be held an open enrollment period during which the retiree and/or surviving spouse may change health plans. Retirees shall be notified by mail of the open enrollment period and new plan rates by the Benefits Office.
  4. Coverage will continue indefinitely as long as premiums are paid.

LIMITATIONS

  1. Retirees may select both medical and dental coverage, or they may select medical coverage only. A retiree may not select dental coverage only.
  2. A retiree will not be allowed to reenroll in the AB 528 plan once coverage has been terminated. If a retiree has other coverage upon retirement and later loses that coverage, then he/she may enroll in AB 528 within 31 days of losing said other coverage.
  3. The District's Kaiser health plan specifically excludes any right to conversion to a private plan upon discontinuance of coverage. All retiree's selecting Kaiser should request further information on this limitation.
  4. The District's Kaiser health plan is not available to classified retirees under the AB 528 plan.
  5. Children of a retiree are not eligible for coverage in the AB 528 plan.  A new spouse, upon remarriage of a surviving spouse, is not eligible for coverage in the AB 528 plan.

IMPLEMENTATION

Initial implementation of the AB 528 plans began with open enrollment in November, 1986.

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