Open Enrollment for Medicare-eligible retirees runs from October 23, 2023 through November 30, 2023.
Humana Medicare Advantage Coverage
Humana, KPPA's Medicare Advantage provider, has created the below message for members and providers regarding in-network and out-of-network coverage for retirees. Click on the image below to open a printable version that you can take to your healthcare provider. You can read more about Humana's coverage on our
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 2024.
Example: If you submit the form June 3, 2024, you will receive reimbursement for March - May 2024.
2024 Humana Highlights
An additional preventative dental benefit is still included for individuals enrolled in the Medicare Advantage Premium and Medicare Advantage Essential plans for 2024. Learn about dental coverage.
WHERE CAN I FIND MORE INFORMATION?
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
Medicare Part B, you cannot be enrolled in the Medicare Advantage plan.
Instead, you will be defaulted to the KPPA-Medical Only plan (or another plan
offered by KPPA) and your premium amount may be higher. Please contact KPPA if
you have questions. For example if you have 240 months (100%) of Service
Credit Contribution (and you are not enrolled in Medicare Part B) and you elect the KPPA Premium Plan you would still have
an additional premium payment of $139.38.
2024 Medicare Plans/Premium Contributions
|Available Plans||Monthly Premium
2024 What KPPA Pays Toward Your Premium/Percentage Contribution
|Service Credit||% of Contributions Rate Paid by KPPA||Amount Paid by KPPA
|240 months or more||100%||$188.73
Dollar Contribution Rates Plan Year 2024
Effective January 1, 2024, individuals with the Dollar Contribution benefit for health insurance (retirees hired on or after July 1, 2003), are allowed to seek reimbursement from KPPA for health insurance coverage outside of KPPA insurance plans.
Example: You would be required to submit the Form 6280 - Application for Dollar Contribution Reimbursement for Medical Insurance and either Form 6281 - Employer Certification of Health Insurancefor Dollar Contribution Reimbursement Plan or Form 6242 - Insurance Agent/Company Certification of Health Insurance for Health Insurance Reimbursement Plan. These forms, in addition to any required documentation, should be submitted in April 2024 for the months of January 1, 2024 - March 31, 2024. Review the Form 6280 instructions carefully to determine what forms and documentation are required for your situation.
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 $14.41 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 $144.10 per month towards health insurance premiums.
For service in a hazardous position, you will receive a monthly contribution of $21.62 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 $216.20 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 $14.41 = $72.05), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $21.62= $108.10), you will receive $180.15 per month towards health insurance premiums ($72.05 + $108.10 = $180.15).
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 $144.10 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 ($21.62*) x Years of Service = Amount KPPA Pays
$21.62* x 10 (let's say you have 10 years of service for this example) = $216.20
Service Credit-Dollar Contribution Level Amount ($14.41**) x Years of Service = Amount KPPA Pays
$14.41** x 10 (let's say you have 10 years of service for this example) = $144.10
Medicare Secondary Payer
Please be advised that under the Medicare Secondary Payer Act (MSPA), in certain circumstances, a Medicare-eligible retiree's reemployment with a participating agency of the systems operated by the Kentucky Public Pensions Authority (KPPA) will prevent KPPA from offering enrollment into the KPPA Medicare Advantage Plan. However, Medicare-eligible retirees who are not able to enroll in the KPPA Medicare Advantage Plan may be eligible for enrollment in a plan designed for retirees affected by the MSPA effective October 1, 2022. If you have any questions about the health insurance options offered for retired members who are reemployed full-time with a participating employer, you may submit your questions in writing via email at KPPAMedicareSecondaryPayer@kyret.ky.gov. For all other questions about health insurance coverage offered through KPPA, you may contact our office at (502) 696-8800 or 1-800-928-4646.
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 2024, 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 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 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 1:411). 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 2024, 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.