Open Enrollment for KRS Medicare-eligible retirees
begins October 26th and ends on November 30, 2020.
NOT a mandatory Open Enrollment. It is voluntary and only necessary if you would like to make changes to your existing coverage for plan year 2021. Enrollment forms are only included in the kit you receive in the mail in case you need to make a change. A copy of Form 6200 for Medicare-eligible retirees can also be found
Health insurance plan options have not changed for 2021.
There are no increases in medical services copayments, deductibles, maximum out-of-pocket, or prescription drug copayments for 2021.
New for 2021 for the Humana Medicare Employer Medicare Advantage plans (Essential and Premium), the following services will NOT have a copayment for 2021 and will apply to the $500.00 deductible then 4% coinsurance:
- Physical therapy, occupational therapy, speech therapy, audiology therapy, pulmonary therapy, cardiac therapy, supervised exercise therapy
The copay benefit still applies to all other services at the same copayment that was billed in 2020.
Hazardous Duty Retiree: Yearly Requirement
HAZARDOUS DUTY RETIREES WITH HEALTH INSURANCE DEPENDENTS MUST FILE A
FORM 6256 EVERY YEAR, EVEN IF THE OPEN ENROLLMENT IS NOT MANDATORY. See FAQ's.
If you fail to submit the form YOU WILL NOT RECEIVE PREMIUM CONTRIBUTIONS for your legal spouse or eligible dependents If you submit the form after January 1, you will only receive reimbursement of premiums for the 90 days prior to the receipt of the Form 6256 in Plan Year 2021.
Example: If you submit the form June 3, 2021, you will receive reimbursement for March - May 2021
2021 Humana Highlights
2021 KRS Medicare Humana Benefits Presentation
An additional preventative dental benefit has been added for individuals enrolled in the Medicare Advantage Premium and Medicare Advantage Essential plans for 2021. Learn about dental coverage.
Insurance Information for Percentage Contribution (participation prior to 7/1/2003)
The KRS Board of Trustees sets the contribution plan and the contribution rates for the Medicare KRS retiree health plans. The board chose the Humana Medicare Advantage Premium plan as the contribution plan with a maximum contribution rate of $252.51 for those retirees with 240 or more months of service. (Note-Premium calculation for percentage contribution is based on service credit for Hazardous Duty or Nonhazardous Duty retirees or beneficiaries who began participation prior to 7/1/2003).
The information on this page will help guide you in making a sound decision on what your insurance premium will cost you in 2020.
WHERE CAN I FIND MORE INFORMATION?
KRS/Humana Medicare Advantage Benefit Webinars
Join KRS and Humana for a webinar designed to answer your questions about 2021 Medicare Advantage benefits. You can register to attend the webinar on your computer by picking the date and time that works for you from the menu below and clicking “Register”. After the webinar, KRS and Humana will host a live online question and answer session. If you are not able to access the online webinar, you can dial in using the phone number and access code; however, the online Q&A will not be available to dial-in participants.
KRS/Humana Medicare Advantage Benefit Webinars
|Date||Time||Dial-in number||Access code||Webinar registration
|October 26, 2020||10:00 AM ET||1-213-929-4212||471-300-356||Register
|October 26, 2020||2:00 PM ET||1-213-929-4212||471-300-356||Register
|October 27, 2020||11:00 AM ET||1-213-929-4212||471-300-356||Register
|October 27, 2020||3:00 PM ET||1-213-929-4212||471-300-356||Register
|October 28, 2020||10:00 AM ET||1-213-929-4212||471-300-356||Register
|October 28, 2020||2:00 PM ET||1-213-929-4212||471-300-356||Register
|October 29, 2020||11:00 AM ET||1-213-929-4212||471-300-356||Register
|October 29, 2020||3:00 PM ET||1-213-929-4212||471-300-356||Register
|October 30, 2020||10:00 AM ET||1-213-929-4212||471-300-356||Register
|October 30, 2020||2:00 PM ET||1-213-929-4212||471-300-356||Register
Humana 2021 KRS Comprehensive Drug Lists
Note: The Humana Medicare Employer PPO plans (Essential, Premium) are Medicare Advantage plans. You must have Medicare Parts A and B. If you do not have Part B, your premium amount may be higher. Please contact KRS if you have questions about this. For example if you have 240 months (100%) of Service Credit-Contribution, elect the KRS Premium Plan, and do not have Medicare Part B, you would still have an additional premium payment of $57.53.
2021 Medicare Plan/Premiums Contributions
|Available Plans||Monthly Premium
2021 What KRS Pays Towards Your Premiums/Percentage Contribution
|Service Credit||% of Contributions Rate Paid by KRS||Amount Paid by KRS
|240 months or more||100%||$252.51
Dollar Contribution Rates Plan Year 2021
Is your Participation Date After July 1, 2003? See the Dollar Contribution Rates Below.
If you began participating on or after July 1, 2003, please read the information below. If you have additional questions call KRS at 1-800-928-4646 (Toll Free) or 502-696-8800(Frankfort).
Use this guide if you are receiving benefits, were hired July 1, 2003 or later, and began participating with KRS between August 1, 2004 and August 31, 2008.* Or began Participating with KRS on or after September 1, 2008.**
*In order to be eligible for health insurance benefits, you must have 120 months of service upon retirement.
**In order to be eligible for health insurance benefits, you must have 180 months of service upon retirement.
For service in a nonhazardous position, you will receive a monthly dollar contribution of $13.78 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1st.
i.e. if you began participating September 1, 2003 in a nonhazardous position, and retired effective October 1, 2013, you would receive $137.80 per month towards health insurance premiums.
For service in a hazardous position, you will receive a monthly contribution of $20.68 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1st.
i.e. if you began participating September 1, 2003 in a hazardous position, and retired effective October 1, 2013 you would receive $206.80 per month towards health insurance premiums.
If you have hazardous and nonhazardous service, you will receive contribution based on the amount of full years of service for each.
i.e. if you began participating September 1, 2003 in a nonhazardous position until September 30, 2008 (5 years x $13.78 = $68.90), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $20.68 = $103.40), you will receive $172.30 per month towards health insurance premiums ($68.90 + $103.40 = $172.30).
If you have a partial year of hazardous service and a partial year of nonhazardous service, they can be combined to equal a full year, you will receive 1 year of nonhazardous service.
i.e. if you have 9 years and 6 months of nonhazardous service and 6 months of hazardous service, your insurance contribution will be based on 10 years of nonhazardous service. You will receive $137.80 per month towards health insurance premiums.
If you are receiving a monthly retirement benefit, that qualifies you to receive a Health Insurance Percentage contribution and also receiving a monthly retirement benefit that qualifies you to receive a Health Insurance Dollar contribution, please contact the Retirement office for help calculating your cost.
How to calculate your insurance cost if your participation date is after 7/1/2003
Service Credit-Dollar Contribution Level Amount ($20.68*) x Years of Service = Amount KRS Pays
$20.68* x 10 (let's say you have 10 years of service for this example) = $206.80
Service Credit-Dollar Contribution Level Amount ($13.78**) x Years of Service = Amount KRS Pays
$13.78** x 10 (let's say you have 10 years of service for this example) = $137.80
Medicare Secondary Payer
Please be advised that under the Medicare Secondary Payer (MSP) Act, in certain circumstances, a Medicare eligible retiree's reemployment with a participating agency of Kentucky Retirement Systems will PROHIBIT Kentucky Retirement Systems from offering or continuing to offer retiree coverage under the Humana Medicare Advantage Plan. Please call KRS if you have questions. You should also contact Medicare if you have questions. Need more details click here.
Silver Sneakers can help you get fit the way you want by providing you access to fitness locations nationwide. Only retirees enrolled in the Medicare Advantage Essential or Premium plans may take advantage of the Silver Sneakers benefit.
Children Eligible for Coverage and Premium Contributions:
For Plan Year 2021, the spouse and each dependent child of retired hazardous members of KERS, CERS, and SPRS, as well as some disabled members, may be eligible to receive an insurance contribution based upon the retired member’s service. Pursuant to KRS 16.505(17), “Dependent child” means Dependent Eligibility & Verification for Health Insurance For Hazardous Duty Retirees with Health Insurance Dependents child in the womb and a natural or legally adopted child of the member who has neither attained age eighteen (18) nor married or who is an unmarried full-time student who has not attained age twenty-two (22). Solely in the case of a member who dies as a direct result of an act in line of duty as defined in this section or who dies as a result of a duty-related injury as defined in KRS 61.621, “dependent child” also means a naturally or legally adopted disabled child of the member, regardless of the child’s age, if the child has been determined to be eligible for federal Social Security disability benefits or is being claimed as a qualifying child for tax purposes due to the child’s total and permanent disability; (See 105 KAR 1:410). Retired members with children who do not meet this definition may be able to cover their children under the KEHP plan, but will not receive a contribution amount toward the coverage of those children.
Establishing Eligibility: To establish your child’s eligibility for the hazardous contribution toward health insurance for 2021, you must certify the child’s eligibility on a completed
Form 6256, Designation of Spouse and/or Dependent Child for Health Insurance. This certification form must be completed annually to receive the contribution. If you submit the required certification and your child is an eligible “dependent child” pursuant to KRS 16.505(17), the contribution will be made for the applicable plan year. Additionally, you must certify that you will immediately provide KRS written notification when your child no longer qualifies. You will be required to reimburse KRS for premiums paid if you make a false or incorrect certification that a child meets the eligibility requirements or if you fail to immediately notify KRS when a child no longer meets the eligibility requirements.
Children Eligible for Coverage: Pursuant to the Affordable Care Act, children are eligible to remain covered by the parent or guardian’s health insurance until the first day of the month following their 26th birthday regardless of marital status. Step-children, foster children, and children for whom you have been named guardian may also remain on the plan until the first day of the month following their 26th birthday. (In some cases, disabled dependents can be carried past their 26th birthday.)
Spousal Coverage: If your spouse has health insurance under your account, a Form 6256, Designation of Spouse and/or Dependent Child for Health Insurance must be completed and submitted to KRS before the beginning of each plan year, or immediately following a qualifying event, for your spouse to receive the hazardous contribution toward health insurance for that plan year. If you divorce a spouse who is covered by health insurance under your KRS account, you must notify our office promptly. An ex-spouse is not eligible to remain on your plan. You must submit a new health insurance application with your ex-spouse removed (or a signed written statement to completely cancel a plan) to this office as soon as the divorce is final. A copy of the Dissolution of Marriage must be provided to KRS as soon as that is available. Without proper notification and documentation, you will be required to reimburse KRS for premiums paid on behalf of an ex-spouse who is no longer eligible for health insurance under your account.