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Non-Medicare - Plan Year 2019

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

At the September 13, 2018 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 $729.34 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 2019. 

Hazardous Duty Retiree: Yearly Requirement

Hazardous duty retirees MUST submit a Form 6256,  Designation of Spouse and/or Dependent Child for Health Insurance. See FAQ's. If you fail to submit the form by 12/31/2018 YOU WILL NOT RECEIVE PREMIUM CONTRIBUTIONS for your legal spouse or eligible dependents. If you submit the form after Jan 1, you will only receive reimbursement of premiums for the 90 days prior to the receipt of the Form 6256 in Plan Year 2019. 

Example: If you submit the form June 3, 2019, you will receive reimbursement for March - May 2019. 

Important Links

CVS Caremark  (Pharmacy Coverage)    CVS Caremark.jpg

Anthem Website                                               Anthem Logo.jpg

KEHP LiveHealth Online                                LiveHealth Online logo

With LiveHealth Online, you have a doctor by your side 24/7. LiveHealth Online lets you talk face-to-face with a doctor through your mobile device or a computer with a webcam. No appointments, no driving and no waiting at an urgent care center.

Use LiveHealth Online for common health concerns like colds, the flu, fevers, rashes, infections, allergies and more! It's faster, easier and more convenient than a visit to the urgent care center. Find our more information here 

You must be enrolled in a KEHP plan to participate for free in 2019. If you are not enrolled in a KEHP plan there will be a charge.

2019 LivingWell Promise                                     KEHP LivingWell logo relating to the living well promise

All plans require  a LivingWell  Promise for 2019, don’t forget to take your Biometric Screening or online Health Assessment by July 1, 2019.  LivingWell information.

If you enrolled in a LivingWell Plan option for 2018 and you did not fulfill your LivingWell Promise, you will be responsible for the LivingWell fee of an additional $40.00 per month. This will be paid by the  retiree / planholder / beneficiary if you enroll in a Kentucky Employees Health Insurance Plan (KEHP) for 2019.

Take the LivingWell Promise

If you fail to complete your promise in 2019 you will be responsible for an additional LivingWell fee for 2020 plan year. Note: You have from January 1, 2019 to July 1, 2019 to complete the LivingWell Promise. Click here for more information.

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

GO365 Wellness and Reward Program                

The Go365 wellness program helps you personalize and track activities to support your wellness plan while earning rewards along the way.

  Vitals Smartshopper         Vitals Smartshopper logo

Shop common medical services , including your doctor's office. When you choose a cost-effective location, you earn a cash reward! Visit www.vitalssmartshopper.com

 

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. 

Cross Reference

If you currently have the cross-reference payment option, and your spouse is an active employee or participates in TRS (Kentucky Teacher's Retirement System) you may enroll using the pre-populated  cross-reference paper application you will receive in the mail;

OR

If you are electing the cross-reference payment option for the first time or you do not have the pre-populated paper application. Please submit a paper application. ​

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

2019 Nonhazardous Duty Retiree / Percentage Contribution
Months of ServiceContribution
240+ months or more - Contributions based on plan selected

LivingWell CDHP $709.46

LivingWell PPO $729.34

LW Limited High Deductible Plan $607.54

LW Basic CDHP $682.80 

180- 239 months

$547.01

120-179 months

$364.67

48-119 months

$182.34

0-47 months

$0.00

Nonhazardous Duty Beneficiaries Receiving Benefits

*KRS does not pay a contribution for coverage on behalf of a beneficiary receiving a monthly retirement benefit. Beneficiaries obtaining coverage should enter "$0.00" for the percentage contribution.  Exception: If you are a spouse beneficiary or a dependent child receiving a monthly benefit under the Fred Capps Memorial Act, contact KRS.

2019 Hazardous Duty Retiree / Percentage Contribution
Months of ServiceContribution
240+ months or more - Contributions based on plan selected$729.34
180-239 months$547.01
120-179 months$364.67
48-119 months$182.34
0-47 months$0

Children Eligible for Coverage and Premium Contributions: 

For Plan Year 2019​, 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 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 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 2019, 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.

2019 Amount KRS Pays for Dependent Coverage - Hazardous Duty Only** / Percentage Contribution
Months of Hazardous ServiceAmount KRS Pays Toward Parent PlusAmount KRS Pays Toward Couple PlanAmount KRS Pays Toward Family PlanAmount KRS Pays Toward Family X-Ref***
240 or more months$307.74$859.76$1038.26$1024.02
180-239 months$230.81$644.82$778.70$768.02
120-179 months$153.87$429.88$519.13$512.01
48-119 months$76.94$214.94$259.57$256.01
0-47 months$0$0$0$0

 

**The amounts  paid in the table above are in addition to the amounts in Hazardous Duty Retiree Percentage Contribution table, based on overall service and hazardous service earned by retiree. Contact spouse's Insurance Coordinator for information on spouse's portion of premium.

***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 for the Tobacco Usage to the overall cost of your premium.

TOBACCO USER 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.​

LIVINGWELL PROMISE NOTICE:

Regardless of the amount of service, type of service, or plan chosen, the plan holder will pay the fee of $40.00 (LivingWell Promise fee) if they failed to complete the LivingWell Promise in 2018 and they select a LivingWell Plan in 2019.

Dollar Contribution Rates Plan Year 2019

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 $13.58 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 $135.80 per month towards health insurance premiums.

For service in a hazardous position, you will receive a monthly contribution of $20.37 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 $203.70 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 $13.58 = $67.90), and then began participating October 1, 2008 in a hazardous position, and retired effective November 1, 2013 (5 years x $20.37= $101.85), you will receive $169.75 per month towards health insurance premiums ($67.90 + $101.85 = $169.75).

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 $135.80 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

Hazardous Formula:
Service Credit-Dollar Contribution Level Amount ($20.37*) X Years of Service = Amount KRS Pays
Hazardous Example:
$20.37* X 10 (let's say you have 10 years of service for this example) = $203.70
Nonhazardous Formula:
Service Credit-Dollar Contribution Level Amount ($13.58**) X Years of Service = Amount KRS Pays
Nonhazardous Example:
$13.58** X 10 (let's say you have 10 years of service for this example) = $135.80

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