Tamalpais Community Services District
This page provides general information about the post-retirement medical benefits available to Tamalpais Community Services District retirees. Eligibility and enrollment for retiree medical are handled by MCERA in accordance with the District's rules.
All District employees are eligible to remain on their active medical and dental insurance plans going into retirement. In addition, if you meet certain requirements, you may also be eligible for a medical subsidy from the District to help you pay your monthly insurance premiums. Please contact the Tamalpais Community Services District for more information on medical subsidies. For all other questions about retiree healthcare please call MCERA Retiree Benefits at (415) 473-4149 or send an email to MCERARetirees@marincounty.org.
The retiree medical insurance plans through Kaiser and Anthem Blue Cross are the same plans offered by the District for active employees and are eligible to be covered by the subsidy you may receive from the District.
At retirement you are eligible to enroll in the plan and level of coverage you have as an active employee. For example, if you (and your dependents) have the Kaiser Low plan as an active employee, you are eligible to continue the Kaiser Low coverage as a retiree.
If you would like a different medical insurance plan in retirement than what you have as an active employee, you must change plans during open enrollment and wait until your new coverage is effective January 1 prior to retiring.
There is currently no open enrollment after retirement, and if you drop any plan you may not re-enroll.
The retiree dental insurance plan through Delta Dental is the same plan offered by the District for active employees and is eligible to be covered by the subsidy you may receive from the District.
To be eligible for retiree dental insurance you must have dental coverage in place as an active employee prior to retirement.
There is currently no open enrollment after retirement, and if you drop the plan you may not re-enroll.
The State Association of County Retirement Systems (SACRS), of which MCERA is a member, sponsors a voluntary vision insurance plan for all retirees and beneficiaries through VSP Vision Care.
The VSP Vision Care plan is separate from any plans that may be offered by your former employer. If you elect vision coverage through VSP as a retiree, you are responsible for all VSP Vision Care premiums as they are not covered by the Benefit Plan subsidy you may receive.
Enrollment and Cancellation
At the time you retire MCERA will provide you with the VSP Vision Care enrollment form. To enroll, return the completed form to MCERA with your other retirement documents.
If you are already retired and wish to enroll you may do so during the open enrollment period in the spring.
If you are already enrolled in the VSP plan and wish to cancel your coverage, please call MCERA Retiree Benefits at (415) 473-4149 or send an email to MCERARetirees@marincounty.org.
For more information on the benefits available through VSP visit marincera.vspforme.com or call VSP at (800) 400-4569.
Effective Date of Coverage
The effective date of your retiree health insurance coverage is the first day of the month after you retire.
Continuous Coverage and COBRA
Your effective date of retirement may create a gap in your insurance coverage. Most employers require you to have continuous coverage to be eligible for retiree health insurance and subsidies. If your active employee coverage ends prior to the effective date of your retiree coverage you may need to apply for COBRA insurance to fill the gap. Please contact the District for more information about continuous medical coverage and COBRA.
Payment of Premiums
Premiums will be deducted from your monthly retirement benefit payments, beginning with the first payment you receive after you retire. If you receive a subsidy from the District, this will appear on your monthly deposit confirmation as "Employer Subsidy." Any amount you owe in addition to the subsidy will appear as "Net Medical Care Cost."
You are eligible to maintain insurance coverage for dependents enrolled on your active employee insurance plans at the time of retirement. After retirement you may only add dependents with a qualifying life event such as marriage, birth or adoption. Generally, children may remain on your insurance plans until age 26. If you drop any dependent from your insurance plan you may not re-enroll them at a later date.
Please check with the District to find out if your medical subsidy applies to dependent coverage.
Coverage Areas and Relocation
You must keep MCERA informed of your address. If you fail to notify MCERA of your new address, or falsify a claim, your healthcare coverage may be denied by the carrier.
If you move outside of your primary healthcare provider's coverage area you may need to enroll in another healthcare plan. For example, if you are a Kaiser member and move outside of a Kaiser coverage area, you must enroll in the Anthem Blue Cross plan to continue to receive your Benefit Plan subsidy. If you subsequently move back into a Kaiser coverage area you are allowed to return to your original Kaiser plan.
Coverage and premiums in non-California plans may be different, and coverage areas may be different for pre-age 65 and post-age 65 plans. We recommend checking with the plan provider before relocating to determine if there will be changes to your healthcare coverage.
Most MCERA members have contributed to Medicare and are eligible for Medicare at age 65. If you continue to work full-time beyond age 65, contact the District for information regarding Medicare for active employees. If you are not eligible for Medicare, please obtain proof of your non-eligibility (commonly in the form of a letter from Medicare) and submit it to MCERA.
When to Enroll
If You Are Over 65 at the Time of Retirement
If you are over age 65 at retirement your Medicare benefits must be effective on or prior to your retirement date. There are premium penalties if your benefits are effective after retirement, so we recommend beginning the enrollment process no later than three months before you plan to retire.
MCERA must receive one of the following with your retirement application:
- Medicare enrollment card
- Letter from Medicare confirming enrollment
- Letter from Medicare confirming non-eligibility
A higher premium will be deducted from your retirement benefit payment if we do not have one of these items with your retirement application. The higher premium is a surcharge that is not covered by your subsidy and is not eligible for reimbursement.
If You Turn 65 After Retirement
If you are already retired when you turn 65 your Medicare benefits must be effective on your 65th birthday. We recommend beginning the enrollment process no later than three months before you turn 65.
If you are eligible for Medicare and do not enroll, a higher premium will be deducted from your retirement benefit payment. The higher premium is a surcharge that is not covered by your subsidy and is not eligible for reimbursement.
How to Enroll
Contact Medicare to apply for Medicare Parts A and B. When you apply for Parts A and B you automatically receive Part D, the prescription drug program. You should assign your Part D benefits to your insurance carrier (either Kaiser or Anthem Blue Cross). You may only assign Medicare Part D benefits to one carrier at a time, so if you have dual coverage let MCERA know in advance.
You will also need to enroll in the Kaiser Senior Advantage or Anthem Blue Cross Medicare Advantage plan. If you are over 65 at the time of retirement MCERA will provide the enrollment forms with your retirement application. If you turn 65 after retirement MCERA will mail you the enrollment forms prior to your 65th birthday.
Health Coverage and Premiums
Your Medicare coverage will combine with your current coverage for a single comprehensive health plan. You will retain your current benefits, but your monthly premiums will likely decrease. Medicare will become your primary payor with Kaiser or Blue Cross becoming the secondary payor. You are responsible for any payments owed after what Medicare and your insurance carrier pay.
Please contact your health plan provider for more information specific to your individual situation.
Medicare Premium Reimbursement
If you are eligible for a Benefit Plan subsidy the County will reimburse your base Medicare Part B premium. The date of your enrollment in Medicare and/or Social Security benefits determines your base premium for Medicare Part B in 2017:
- Members who enroll in Medicare Part B on or after January 1, 2016, or who are not receiving Social Security benefits regardless of when they enroll in Medicare, have a base premium of $134.
- Members who were enrolled in Medicare Part B on or before December 31, 2015 and were receiving Social Security benefits as of that date have a lower base premium ($109 on average).
You will see the reimbursement as a line item on your monthly deposit confirmation. While your actual Medicare Part B premium may be different, the District only reimburses up to the base premium applicable to your situation.