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Non-Medicare - Plan Year 2016

The information on this page will help guide you in making a sound decision on what your insurance premium will cost you in 2016.

Insurance Information for Percentage Contribution (participation prior to 7/1/2003)

At the September 10, 2015 KRS Board of Trustees meeting, the KRS Board of Trustees approved the contribution plan and the contribution rates for the non-Medicare KRS retiree health plans.  The board chose the KEHP LivingWell PPO plan as the contribution plan with a maximum contribution rate of $721.14 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 Non-Hazardous Duty retirees or beneficiaries who began participation prior to 7/1/2003).

If you are a Hazardous Duty Retiree and have a spouse or dependent children (ages 18-22) you must submit a Form 6256 - Designation of Spouse and/or Dependent Child for Health Insurance Contribution.  See FAQ's.  


New Retiree Who Just Enrolled in a KEHP Plan?

Are you a new retiree who has not been enrolled in the Kentucky Employees Health Plan as an active retiree and you have selected one of the LivingWell Plans?  You are required to complete the LivingWell Promise within 90 days of enrollment.  

Have more questions?   Call the KRS Call Center 502-696-8800 (Frankfort) or 1-800-928-4646 (Toll-Free)          

View LivingWell Promise Information 

NEW 

If you enrolled in a LivingWell Plan option for 2016 and you did not fulfill your LivingWell Promise, you will be responsible for the LivingWell fee of an additional $40.00 per month.  If you choose a LivingWell plan for 2017, this will be paid by the retiree/planholder/beneficiary if you enroll in a LivingWell Plan for 2017.  

New Retiree with a  Cross Reference health insurance option?  

If you have a cross-reference payment option, you and your spouse both must complete the LivingWell Promise.



Tobacco User Fees

What are Tobacco User Fees? 

The Commonwealth of Kentucky is committed to fostering and promoting wellness and health in the workforce.  You are eligible for the non-tobacco user premium contribution rates provided you certify that you and any other person to be covered under your plan has not regularly used tobacco within the past six months.

  •  Regularly means tobacco has been used four or more times per week on average excluding religious or ceremonial use.
  •  Tobacco means all tobacco products including, but not limited to, cigarettes, pipes, chewing tobacco, snuff, dip, and any other tobacco products regardless of the frequency or method of use.
  • Dependent means, for the purpose of the Tobacco Use Declaration, only those dependents who are 18 years of age or older.  If you have regularly used tobacco within the past six months, you are subject to the monthly fee as discussed below. For those with single coverage, the fee is $40.00 per month.  For those with any dependent coverage (Parent Plus, Couple, Family), even if only one person uses tobacco, the fee is $80.00. You should add either $40.00 or $80.00 to the premium amounts for your level of coverage.
 

NOTICE: Nonhazardous Retirees who elect the Standard PPO, Standard CDHP, or LivingWell CDHP with a coverage level of Parent Plus, Couple, Family or Family Cross Reference – The Maximum Contribution allowed for the Standard PPO is $677.74, the Maximum Contribution allowed for the Standard CDHP is $663.68, and the Maximum Contribution allowed for the LivingWell CDHP is $702.10.

 

Percentage Contribution Rates Plan Year 2016

2016 KEHP Plan Premiums/Percentage Contribution
Plan NameSingleParent PlusCoupleFamilyFamily X-Ref*
LivingWell CDHP$702.10$967.18$1,302.74$1,453.94$810.00
LivingWell PPO$721.14$1,023.04$1,564.20$1,738.40$865.64
Standard PPO$677.74$963.36$1,474.84$1,640.84$814.72
Standard CDHP$663.68$930.34$1,429.26$1,591.52$792.90
Amount KRS Pays Towards Coverage/Percentage Contribution
Months of ServiceContribution
240 months or more - Contributions based on plan selected

LivingWell CDHP $702.10

LivingWell PPO $721.14

Standard PPO $677.74

Standard CDHP $663.68

180-239 months

$540.86

120-179 months

$360.57

48-119 months

$180.29

0-47 months

$0

Children Eligible for Coverage and Premium Contributions

For Plan Year 2016, 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 a Dependent Eligibility & Verification for Health Insurance For Hazardous Duty Retirees with Health Insurance Dependents.   A 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), (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 2016, 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. 

Amount KRS Pays for Dependent Coverage - Hazardous Duty Only**/Percentage Contribution
Months of Hazardous ServiceAmount KRS Pay Toward Parent PlusAmount KRS Pays Toward Couple PlanAmount KRS Pays Toward Family PlanAmount KRS Pays Toward Family X-Ref***
240 or more months$301.90$843.06$1,017.26$1,010.14
180-239 months$226.43$632.30$762.95$757.61
120-179 months$150.95$421.53$508.63$505.07
48-119 months$75.48$210.77$254.32$252.54
0-47 months$0$0$0$0

Tobacco Status-Select one, based on the last six months****

​Applicant's Tobaccon Status​Value
​Non-tobacco User ​$0
​Retiree who uses tobacco and selects Single Coverage ​$40.00
​Retiree or Beneficiary who uses tobacco, selects Parent Plus, Couple, or Family Coverage ​$80.00
 
​NOTICE: Regardless of the amount of service, type of service, or plan chosen, the member will pay the fee of $40.00 for a single plan and $80.00 for a Parent Plus, Couple, or Family Plan based on the Tobacco Status in Table Four.

*Contact spouse's Insurance Coordinator for information on spouse's portion of premium.

**The amounts in table three are paid in addition to the amounts in table two, based on overall service and hazardous service earned by retiree.

***If you have at least 48 months of hazardous service, the cross-reference option is selected, and the retiree has a surplus of contributions to cover the retiree's portion of the premium, the surplus will be applied to the spouse's portion of the premium.

****Add the value in table four based on your tobacco usage to the overall cost of your premium in table one.

Dollar Contribution Rates Plan Year 2016

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 non-hazardous position, you will receive a monthly dollar contribution of $12.99 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 non-hazardous position, and retired effective October 1, 2013, you would receive $129.90 per month towards health insurance premiums.

For service in a hazardous position, you will receive a monthly contribution of $19.48 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 $194.80 per month towards health insurance premiums.

For service in a hazardous position, you will receive a monthly contribution of $19.48 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 $194.80 per month towards health insurance premiums.

If you have hazardous and non-hazardous 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 non-hazardous position until September 30, 2008 (5 years x $12.99= $64.95), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $19.48= $97.40), you will receive $162.35 per month towards health insurance premiums ($64.95+$97.40= $162.35).

If you have a partial year of hazardous service and a partial year of non-hazardous 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 non-hazardous service and 6 months of hazardous service, your insurance contribution will be based on 10 years of non-hazardous service. You will receive $129.90 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 ($19.48*) X Years of Service = Amount KRS Pays

Hazardous Example:
$19.48* X 10 (let's say you have 10 years of service for this example) = $194.80

Non-Hazardous Formula:
Service Credit-Dollar Contribution Level Amount ($12.99**) X Years of Service = Amount KRS Pays

Non-Hazardous Example:
$12.99** X 10 (let's say you have 10 years of service for this example) = $129.90 


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