Here are the two plans:
1. Premium assistance reduces the monthly premium payment for the retiree or surviving dependent. Premium assistance is available to retirees with at least 5 years of service. The premium assistance program pays part of your health insurance premium if your gross income is less than 250% of Federal Poverty Level. Premiums can be reduced by as much as $111/ month (based on income and plan type.)
To qualify for premium assistance, you must meet all the following criteria:
- you must have 5 or more years of service
- not be currently using accrued sick/annual leave to pay premiums
- you must be enrolled in the Humana/PEIA Plan 1 or PEIA Special Medicare Plan, or the PEIA Preferred Benefits Plan (PPB)
- your household income during calendar year 2024 must have been at or below 250% of the Federal Poverty Level (FPL)
2. Benefit assistance reduces the medical and prescription drug out-of-pocket costs for retirees with at least 15 years of service. Program savings include reducing costs to as low as $50 for deductibles, $2 for primary care co-pays, $5 for specialist co-pays, and $600 for an out-of-pocket maximum.
To qualify for premium and benefit assistance, you must meet all the following criteria:
All the criteria for premium assistance, plus
- Medicare must be your primary insurance
- you must have 15 or more years of service
- you must be enrolled in the Humana/PEIA Plan 1 or the Special Medicare Plan, and
- your household income during calendar year 2024 must have been at or below 250% of the Federal Poverty Level (FPL).
Click here for the application form and to see the full chart to determine eligibility based on your income.
