Special Enrollment Opportunity

Important note: Retiree medical benefits, if available to you, are provided by your former employer.

Eligible Retirees Offered Special Enrollment Opportunity to Select WHA for Calendar Year 2023

Western Health Advantage (WHA) became a new HMO medical plan offering for County employees and retirees under age 65 in 2019. At the time, WHA had one copay plan and did not have a Medicare offering. Now that WHA has developed and released a Medicare Advantage offering and included an additional copay option for retirees under 65, the County is making WHA available to retirees and dependents currently covered by other County-sponsored plans.

The special enrollment period begins August 29, 2022 and ends September 30, 2022.

To be eligible to participate, retirees must currently be covered by a County-sponsored medical plan and live within the WHA service area. Approximately 1,300 retirees are eligible and have been mailed information to their home address.


Resources


Frequently Asked Questions

Why is the County providing this opportunity to change plans?

Western Health Advantage (WHA) became a new HMO medical plan offering for County employees and retirees under age 65 in 2019. At the time, WHA had one copay plan and did not have a Medicare offering. Now that WHA has developed and released a Medicare Advantage offering and included an additional copay option for retirees under 65, the County is making WHA available to retirees and dependents currently covered by other County-sponsored plans.

When is the special enrollment period?

The special enrollment period begins August 29 and ends September 30, 2022.

Who is eligible to participate in the special enrollment opportunity?

Retirees of the following employers who are currently covered by a County-sponsored health plan and who live within the WHA service area are eligible to participate. All eligible retirees were mailed enrollment information at their home address.

  • County of Marin
  • LAFCO
  • Marin City Community Services District
  • Marin/Sonoma Mosquito & Vector Control District
  • Marin Superior Court
  • Southern Marin Fire Protection District
  • Tamalpais Community Services District
How do I change my medical plan?

In late August MCERA will the enrollment forms for WHA to all eligible retirees. If you would like to enroll in the WHA plan, you must complete the appropriate enrollment forms and return them to MCERA by 5:00 PM on September 30, 2022. Do not return the enrollment forms to the medical plan provider.

You can return your WHA enrollment form to MCERA in one of the following ways:

  • By Email
    Scan your enrollment form and send it by email to MCERARetirees@marincounty.org.
  • In Person or By Mail
    Drop off your form or mail it to MCERA. Office hours are 8:00 AM to 5:00 PM Monday through Friday.
    Marin County Employees’ Retirement Association
    One McInnis Parkway, Suite 100
    San Rafael, CA 94903-2764
Am I permitted to switch to a plan other than Western Health Advantage during this special enrollment opportunity?

No. The only permitted change during this special enrollment opportunity is for retirees switching to Western Health Advantage.

What will happen if I do not contact MCERA before the end of the special enrollment period?

If MCERA does not receive an enrollment form from you by September 30, 2022, you will maintain your current retiree coverage with your current healthcare provider.

I am under 65 and on the Teamsters Anthem plan. Why did I receive information about UnitedHealthcare Medicare Advantage?

The Teamsters Anthem plan sponsored by the County only covers retirees and dependents under age 65, prior to Medicare eligibility. If you elect to remain on the Teamsters Anthem plan, at 65 with Medicare enrollment you will transfer to the UnitedHealthcare Medicare Advantage (UHC) plan which covers Medicare retirees. Information on UHC is included so you can compare coverage, copays and premiums for your current and future situations.

I previously waived medical coverage for my spouse or other dependent. May I add my spouse or other dependent now?

No. You may only add a spouse or other dependent if you have a qualifying event and add the newly eligible individual within 31 days of the qualifying event. Spouses and dependents you currently cover will continue to be covered whether you remain on your current plan or if you elect to switch to WHA.

What is a qualifying event as it relates to our health plans?

A qualifying event is a change in a retiree's personal life that may impact eligibility for benefits. Examples of qualifying events are marriage, divorce, and gain/loss of other coverage. If you have a qualifying event, plan changes must take place within 31 days of the event

What coverage levels are provided with the new WHA plans?

Coverage summaries are available for members to compare plan options.

How does my current monthly premium compare to the premium for WHA?

All premiums effective January 1, 2023 are shown here:

If I select WHA as my new medical provider during the special enrollment period, will I be allowed to change back to my previous (2022) plan in the future?

Yes. If you enroll in WHA during this special enrollment period you will have a ten (10) month trial period. If you are dissatisfied during this trial period and wish to return to your previous plan (2022), you must notify MCERA of your intention to change plans by October 31, 2023, for a January 1, 2024 effective date. It is solely the retiree’s responsibility to notify MCERA by this deadline. After October 31, 2023, no plan changes will be permitted unless there is a qualifying life event or you move out of your medical provider’s coverage area. You can call MCERA at 415-473-4148 or email MCERA at MCERARetirees@marincounty.org.

Anthem retirees: What happens if I enroll in WHA and later move out of the WHA coverage area?

If you are on WHA and relocate outside of the WHA coverage area you will be permitted to transfer to the Teamsters Anthem plan if you are under 65, or the UnitedHealthcare Medicare Advantage plan if you are on Medicare.

Kaiser retirees: What happens if I enroll in WHA and later move out of the WHA coverage area?

If you are on WHA and relocate outside of the WHA coverage area, and your new location is within the Kaiser coverage area, you will be permitted to transfer to your prior Kaiser plan. If your new location is outside both the WHA and Kaiser coverage areas, you will be permitted to transfer to the Teamsters Anthem plan if you are under 65, or the UnitedHealthcare Medicare Advantage plan if you are on Medicare.

UHC retirees: What happens if I enroll in WHA and later move out of the WHA coverage area?

If you are on WHA and relocate outside of the WHA coverage area you will be permitted to transfer back to your prior UnitedHealthcare Medicare Advantage plan.

How can I tell which Kaiser plan I’m currently on?

The Kaiser plans are differentiated by the copay amounts you pay when receiving Kaiser services. The copay for Kaiser Low is $5, and the copay for Kaiser Silver is $25.

Does WHA require that I (and my dependents) enroll in Medicare when eligible?

Yes, all retirees and dependents covered by County-sponsored healthcare plans are required to enroll in Medicare Parts A and B when eligible and maintain Medicare coverage, regardless of which healthcare provider they are covered by.

When I become Medicare-eligible, do I have to assign all parts of my Medicare insurance to my County sponsored plan?

Yes, your Medicare Parts A and B must be assigned to your County-sponsored healthcare plan.

Is the amount that my former employer pays to subsidize my healthcare premiums changing?

No. The current employer policies regarding contributions towards healthcare premiums are not changing as a result of this change in available medical plans.

If I enroll in WHA, will I receive a new identification card?

Yes, if you enroll in WHA you will receive confirmation of enrollment in your new plan as well as a new medical identification card for every person covered under your plan in December.

Who should I contact if I have more questions?

Please see the Resources section at the top of this page for helpful contacts and a list of scheduled group information sessions.