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Medicare - Plan Year 2021

​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


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021 Humana Highlights

2021 KPPA 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 Board of Trustees sets the contribution plan and the contribution rates for the Medicare KPPA 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 2021. 

WHERE CAN I FIND MORE INFORMATION?

Humana Website humana.com/krs

Humana 2021 KPPA Comprehensive Drug Lists

Find Medicare medical benefits and copayments for 2021

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 KPPA if you have ​questions about this. For example if you have 240 months (100%) of Service Credit-Contribution, elect the KPPA 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 PlansMonthly Premium
Medical Only$184.30
KRS Essential$75.56
KRS Premium$252.51


2021 What KPPA Pays Towards Your Premiums/Percentage Contribution
Service Credit% of Contributions Rate Paid by KRSAmount Paid by KRS
240 months or more100%$252.51
180-239 months75%$189.38
120-179 months50%$126.26
48-119 months25%$63.13
0-47 months0%$0

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 KPPA 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 KPPA between August 1, 2004 and August 31, 2008.* Or began participating with KPPA 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 $13.99 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1.

i.e. if you began participating September 1, 2003 in a nonhazardous position, and retired effective October 1, 2013, you would receive $139.90 per month towards health insurance premiums.

For service in a hazardous position, you will receive a monthly contribution of $20.99 for each year of service per month. The Dollar Contribution will increase by 1.5% on July 1.

i.e. if you began participating September 1, 2003 in a hazardous position, and retired effective October 1, 2013 you would receive $209.90 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 $13.99 = $69.95), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $20.99= $104.95), you will receive $174.90 per month towards health insurance premiums ($69.95 + $104.95 = $174.90).

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 non-hazardous 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 $139.90 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

Hazardous Formula:
Service Credit-Dollar Contribution Level Amount ($20.99*) x Years of Service = Amount KPPA Pays

Hazardous Example:
$20.99* x 10 (let's say you have 10 years of service for this example) = $209.90

Nonhazardous Formula:
Service Credit-Dollar Contribution Level Amount ($13.99**) x Years of Service = Amount KPPA Pays

Nonhazardous Example:
$13.99** x 10 (let's say you have 10 years of service for this example) = $139.90

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 the Kentucky Public Pensions Authority will PROHIBIT KPPA from offering or continuing to offer retiree coverage under the Humana Medicare Advantage Plan. Please call KPPA 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.

GO365 Wellness and Reward Program        

 

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 Kentucky Revised Statute 16.505(17), “Dependent child” means Dependent Eligibility & Verification for Health Insurance For Haza​​rdous 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 Kentucky Revised Statute 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 Kentucky Revised Statute 16.505(17), the contribution will be made for the applicable plan year. Additionally, you must certify that you will immediately provide KPPA written notification when your child no longer qualifies. You will be required to reimburse KPPA 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 KPPA 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 KPPA 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 KPPA 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 KPPA as soon as that is available. Without proper notification and documentation, you will be required to reimburse KPPA for premiums paid on behalf of an ex-spouse who is no longer eligible for health insurance under your account.


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