Retirees Who are Returning to Work

Are you thinking about returning to work? If you are, there are a few important things you need to know to ensure you have a smooth transition from Retiree coverage to Active Member coverage. 

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When a Retiree returns to work as a full-time employee in a benefits eligible position with an SHBP Employing Entity, either immediately at retirement or at a later date, he/she must enroll in coverage as an Active Member. This means SHBP cannot continue to deduct premiums from a Retirees annuity (or continue to directly bill the Retiree, if applicable). Please review the frequently asked questions below to ensure you have a smooth transition back into the workplace.

 

Guidance from the State Health Benefit Plan on documenting and submitting records relating to HB 385 for TRS Beneficiaries returning to work as classroom teachers in a full-time capacity

Retirees hired as full-time classroom teachers under HB385 have two options:

  • Return to work as benefit eligible, or
  • Return to work as benefit ineligible

SHBP recommends that employers submit the New Hire record for the retirees who are hired under HB385 as benefits ineligible for the following to occur:

When a New Hire record is submitted as benefits ineligible, then you will continue coverage as a SHBP Retiree without interruption. The health premium deductions will continue from your retirement annuity. The employer will not have a financial obligation for your health coverage.

If your employer transmits the New Hire record as benefits eligible your health premium deductions will cease from your retirement annuity and your employer will have a financial obligation for your health coverage as a new hire. 

If you have Medicare and your employer submits you as benefits eligible, it will affect your insurance election. If you are over 65 years of age and/or enrolled in a SHBP Medicare Advantage plan option, that option will be terminated, and you will be required to choose a SHBP commercial plan option.

*Please note: The above guidance does not pertain to retirees returning to service or returning to work in other capacities. In some cases, retirees who do not have coverage will be able to gain/regain SHBP coverage if returning to work in a benefits eligible position when properly notated on the NEMP record as benefits eligible.  

Frequently Asked Questions

  • Who Is Responsible for Notifying SHBP If I Return to Work in a Benefits Eligible Position?

    Your Employer is responsible for notifying SHBP.  Upon your return to work in a benefits eligible position, your Employer should immediately transmit your eligibility data, indicating whether you are benefits eligible to SHBP the same as they would for a New Hire.

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  • Who Is Responsible for Notifying My State Retirement System?

    You. We are not experts in retirement pensions; however, we strongly encourage you to notify your State Retirement System prior to you making the decision to return to work to ensure your annuity is not impacted. We have had situations where a Retiree’s annuity payments are terminated because they exceeded the number of hours they could work and receive an annuity at the same time. 

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  • Do I Have the Opportunity to Elect Coverage and Add Dependents When I Return to Work in a Benefits Eligible Position?

    Yes. For SHBP purposes, returning to work in a Benefits Eligible Position is a Qualifying Event.

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  • How Long Do I Have to Enroll in SHBP coverage after I Return to Work in a Benefits Eligible Position?

    You MUST elect coverage within 31 days of your hire date in a benefits eligible position. Since Retirees who return to work in benefits eligible positions are considered New Hires, they are subject to the New Hire eligibility requirements.

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  • How Do I Enroll in SHBP Coverage after I Return to Work in a Benefits Eligible Position?

    Within 31 days of your hire date in a benefits eligible position, you must make your New Hire elections by:

    • Visiting the SHBP Enrollment Portal 24 Hours a Day/7 Days Per Week (for instructions on registering or logging in the SHBP Enrollment Portal, click here), or
    • Contacting SHBP Member Services at 800-610-1863, Monday – Friday 8:30 a.m. to 5:00 p.m. ET and Saturday 8:00 a.m. to 5:00 p.m. ET

    Making your election with your employer or through any other process does not satisfy the requirement to make your election directly with SHBP via the SHBP Enrollment Portal or SHBP Member Services. 

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  • What If I Fail to Enroll in Coverage after I Return to Work in a Benefits Eligible Position?

    If you fail to make your election via the two options provided above within 31 days of your hire date in a benefits eligible position, you must wait until the next Open Enrollment period, unless you experience another Qualifying Event or Special Enrollment Event to enroll in health coverage.

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