Eligibility Rules for Retirees

Retirees – Medicare (Age 65 or Older)

All participants (and their eligible dependents) who are or have been eligible under the San Mateo Electrical Workers Health Care Benefits Plan for 10  of the last 15 years and 2 of the last 5 years immediately preceding date of retirement, who have been approved for and are receiving pension benefits from San Mateo County Electrical Construction Industry Retirement Trust (IBEW Local 617) who are age 65 or older, have applied for and are receiving Medicare Parts A & B, and who have coverage under the San Mateo Electrical Workers Health Care Benefits Plan at their retirement date shall be eligible for the Retiree Plan health and welfare benefits then in effect, if any.

An eligible Retiree’s effective date shall be the 1st day of the month following the date he or she meets the above requirements and remits the premium contribution for their chosen coverage.  The cost to the Retiree for health and welfare benefits will depend upon the amount of future Employer contributions made on their behalf and the Plan’s earnings, expenses and asset appreciation or depreciation.

Retirees:

  • who reside inside the Retiree Plan’s approved California Medicare Supplement or Medicare HMO Plan service area shall be eligible for a Medicare Supplement or Medicare HMO Plan, Prescription Drug, Dental and Vision coverage.
  • who reside outside the Retiree Plan’s approved California Medicare Supplement or Medicare HMO Plan service area shall receive:
    • $100 per month for Retiree age 65 to 79
    • $180 per month for Retiree age 80 or older, as reimbursement for the eligible member only.

Widows/Widowers of Retirees (age 65 or older) must be covered by the Plan at the time of spouse’s death to be eligible for coverage.

Widows/Widowers of Retirees (age 65 or older):

  • who reside inside the Retiree Plan’s approved California Medicare Supplement of Medicare HMO Plan service area shall be eligible for Medicare Supplement or Medicare HMO Plan, Prescription Drug, Dental and Vision coverage.
  • who reside outside the Retiree Plan’s approved California Medicare Supplement or Medicare HMO Plan service area shall receive:
    • $100 per month for Widow/Widower age 65 to 79
    • $180 per month for Widow/Widower age 80 or older, as reimbursement for the eligible Widow/Widower only

Widows/Widowers of Retirees (age 65 or older) who remarry may elect to continue coverage for themselves only and must self-pay the full premium for Medicare Supplement or Medicare HMO Plan, Prescription Drug, Dental and Vision Plans.

Divorced spouses (under age65) of Retirees will cease to be eligible for coverage under the Plan effective the 1st day of the month following the date the divorce in final.  The divorced spouse may elect to continue coverage through COBRA for eighteen (18) months, or extended COBRA, if eligible.  It is the member’s responsibility to notify the Administrative Office of the divorce.

Divorced spouses (age 65 or older) of Retirees who are covered by the California Medicare Supplement or Medicare HMO Plan will cease to be eligible for Prescription Drug, Dental and Vision coverage under the Plan effective the 1st day of the month following the date the divorce in final.  The divorced spouse may elect to continue the Medicare Supplement or Medicare HMO coverage only by paying the full premium.  It is the member’s responsibility to notify the Administrative Office of the divorce.

Early Retirees – Non-Medicare (Age 55 to 64)

All participants (and their eligible dependents) who are or have been eligible under the San Mateo Electrical Workers Health Care Benefits Plan for 10 of the last 15 years and 2 of the last 5 years immediately preceding date of retirement, who have been approved for and are receiving pension benefits from San Mateo County Electrical Construction Industry Retirement Trust (IBEW Local 617), who are age 55 to 64 and who have coverage under the San Mateo Health Car Benefits Plan at their retirement date shall be eligible for the Retiree Plan health and welfare benefits then in effect, if any.

An eligible Early Retiree’s effective date shall be the 1st day of the month following the date he or she meets the above requirements and remits the premium contribution for their chosen coverage. The cost to the Early Retiree for health and welfare benefits will depend upon the amount of future Employer contributions made on their behalf and the Plan’s earning, expenses and asset appreciation or depreciation.

Early Retirees (non-Medicare):

  • who reside inside the Retirees Plan’s approved California HMO service area shall be eligible for Medical, Dental and Vision coverage. Cost to Member, Spouse and eligible Dependents pay 50% of all premiums per month.
  • who reside outside the Retiree Plan’s approved California HMO service area will not be eligible for Medical, Dental or Vision coverage, but shall receive $100 per month reimbursement for the eligible member only.

Widows/Widowers of Early Retirees (age 55-64/non-Medicare):

  • who reside inside the Retiree Plan’s approved California HMO service area will quality at the Early Retiree rate and shall be eligible for Medical, Dental and Vision coverage. Spouse and eligible dependents pay 50% of all premiums.
  • who reside outside the Retiree Plan’s approved California HMO service area may elect a PPO plan. Spouse and eligible dependents pay 65% of all premiums.

Widows/Widowers (age 55-64/non-Medicare) who remarry will cease to be eligible for coverage on the first day of the month following the date of their marriage.

Divorced Spouses (under age 65/non-Medicare) of Early Retirees will cease to be eligible for coverage under the Plan effective the 1st day of the month following the date the divorce in final. The divorced spouse may elect to be covered by COBRA, if eligible.  It is the member’s responsibility to notify the Administrative Office of the divorce.

Divorced Spouses (age 65 or older/non-Medicare) of Early Retirees who are covered by the California Medicare Supplement or Medicare HMO Plan will cease to be eligible for Prescription Drug, Dental and Vision coverage under the Plan effective the 1st day of the month following the date the divorce in final.  The divorced spouse may elect to continue the Medicare Supplement or Medicare HMO coverage only, by paying the full premium.  It is the member’s responsibility to notify the Administrative Office of the divorce.

Disabled Participants

Disabled participants are those who have full Social Security Benefit Award and have applied for and are receiving Medicare Parts A & B.

Disabled Participants under age 65 who reside inside the Retiree Plan’s approved California Medicare supplement or Medicare HMO service area, and currently have coverage by the San Mateo Electrical Workers Health Care Benefits Plan, shall qualify for Medical, Dental and Vision Coverage.

Disabled Participants under age 65 who reside outside the Retiree Plan’s approved California HMO, Medicare Supplement or Medicare HMO service area, may elect a PPO plan.  The contribution will be 65% of the total premium.

Retiree Hour Bank Conversion

An eligible Retiree’s Hour Bank and respected monies will be transferred from the San Mateo Electrical Workers Health Care Benefits Plan (Active Plan) to the Retired San Mateo Electrical Workers Health Care Benefits Plan (Retiree Plan) on the effective date of retirement. This money will be held in account and can be used by the Retiree to pay monthly contributions to the Retiree Plan.

The dollar amount to be transferred will be the equivalent of the current cost of (Active Plan) monthly benefits, multiplied by the number of full months (Hour Bank balance divided by 120) in the Retiree’s Hour Bank.

As an example: If the Retiree has 720 hours in their Hour Bank at retirement and the current monthly cost for Active Plan is $700, then the Retiree would receive $4,200 in their account (720 hours/120 = 6 months x $700).

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