What are the benefits

Effective March 1, 2007, the Fund is pleased to offer two plans of retiree benefits: the “basic” no-cost plan, which consists of reduced dental benefits, optical and hearing aid benefits equivalent to those enjoyed by the active Fund members.  The schedule of coverage is the same as that for active participants of the Fund except that the dental benefits are subject to an annual maximum of $500 per individual and $750 per family.

The second option is a three-tiered, self-pay retiree plan of benefits, as follows:

1. The Premium Plan offers eligible retirees the opportunity to continue coverage at the level of benefits

       available to active members for:           

• Dental (includes a max of $2,250 per person for general dentistry, a separate max of $2,000 for periodontal procedures, as well as orthodontic benefits)

• Hearing Aid Benefits

• Optical Benefits

2. The Premium Plus Plan offers the same benefits listed above “plus”:

• Prescription drug co-payment reimbursements benefit.

3. The Platinum Plan offers the benefits listed in items 1 and 2 above “plus”:

• Tax Preparation

• Legal Service Benefits

Who is eligible

A former participant of the Benefit Fund who initially retired on or after January 1, l985 and is in receipt of a monthly pension from either the New York State Retirement System or a related organization (as defined by the Fund) is eligible for retiree coverage, provided that the former participant satisfies at least one of the following conditions:

• He or she initially left employment with Suffolk County or a related organization on or after age 55 and had 10 years of employment in either organization or;

• He or she is currently age 55 or older and had 20 years of employment with Suffolk County or a related organization and has maintained continued coverage with the Fund by self-paying from the date of separation from the employer through to the age of 55; or

  • He or she is in receipt of a disability retirement benefit from either the New York State Retirement System or a related organization.

  Certain employees may be eligible at a future time providing that they meet the Fund's eligibility requirements.

Dependent coverage

Dependents of eligible retirees are covered for benefits and are defined as the retiree's spouse, unmarried dependent children who have not reached their l9^th birthday, and unmarried dependent children who are full time students and have not reached their 25^th birthday. Coverage is also extended to unmarried children, regardless of age, who are incapable of self-sustaining employment by reason of mental retardation or physical handicap who became so prior to age l9.

Limitations

Coverage is not extended to dependents of deceased retirees members. However, upon the death of the retired member, the dependent may choose to continue coverage under COBRA. The Fund office must be contacted within 60 days of the death for the qualified beneficiary/dependent to be eligible for continuation of coverage.

Payment will not be made for any benefit that is claimed after a period that exceeds one year from the calendar year in which services were rendered. Services rendered in 2006, for example, must be claimed no later than December 31, 2007.

It is the responsibility of the retiree to inform the Fund of his or her eligibility for coverage. In a case of late notification, payment will be made only for claims submitted in the calendar year in which services were rendered.

How to obtain the Retiree Plan Benefits

To elect any of the plans above, you must complete and return the enrollment form to the Benefit Fund office within sixty (60) days of the date of your retirement.  This is the only opportunity you will have to obtain this coverage.  You will not be given another opportunity to buy the self-pay enhanced coverage.

If you do not elect to enroll in any of the self-pay plans within the 60 day period, your active level of benefits coverage will cease and you will only receive the limited benefits available via the “basic” no-cost retiree plan (dental—up to $500 per person per year, maximum $750 per family per year; optical and hearing aid) and will NEVER AGAIN be given the opportunity to enroll in one of these enhanced plans in the future. 

Retirees who opt for coverage in either the Premium or the Premium Plus Plans will be provided yearly opportunities to move up to a greater coverage.  Retirees who do not opt for any of these plans will automatically be maintained in the no-cost, basic plan.  Once this occurs, you may never again opt to purchase any of the “premium” plans.

To be covered under any of the plans noted above, you must enroll and emit payments for a full fiscal year (March 1 through February 28). Payment frequency is limited to quarterly, semi-annual or annually.  If you opt to pay semi-annually or annually, your self-pay premium will be discounted by either 5% (for a semi-annual payment) or 10% (for an annual payment). 

If the Fund does not receive your self-pay premium payment to continue benefits, your coverage will cease and you will not be entitled in the future to resume participation in any retiree plan offered by the Benefit Fund, including the “basic” plan.  All benefits will cease. 

Eligibility for dependents is based on the coverage you choose during the applicable enrollment period.  If you elect individual coverage, you will not be entitled to elect dependent coverage at a later date, unless you add a dependent to your family because of a life event (e.g., you get married). You may not enroll a dependent at a later date who was eligible for enrollment at the time of your initial enrollment.  In addition, should you subsequently drop a dependent, that dependent may never be re-enrolled by you.