Waiving Coverage in Retirement

Individuals who retire before age 62 and have a service date on or after July 1, 1988 are not eligible for any university contribution to retiree benefits until they reach age 62.  If you choose instead to waive coverage, you are eligible for re-enrollment in U-M medical and/or dental coverage at age 62 as long as you maintain continuous comparable medical and/or dental coverage through another source and request re-enrollment by calling the SSC Contact Center within 30 days of turning 62. You will be required to provide certification that you have maintained comparable coverage. The university will then provide a contribution toward the cost of benefits effective the first of the month after you reach age 62.

Retirees who choose to waive life insurance cannot re-enroll.

Maintaining Comparable Coverage

Health Coverage

Comparable medical coverage is health coverage that is at least as comprehensive as the university-sponsored BCBSM Comprehensive Major Medical (CMM) plan. The health plan must offer the same scope of benefits as CMM, but benefits do not have to be exactly the same. The plan must include basic coverage for:

  • Primary and preventive care

  • Hospitalization

  • Surgical services

  • Emergency care services

  • Mental health services

  • Office visits

  • Prescription Drugs

  • Diagnostic tests (x-rays and lab work)

A plan that places a lifetime limit on the dollar value of these services does not qualify as comparable coverage.

Dental Coverage

Comparable dental coverage is coverage that is at least as good as the university-sponsored dental plan Option 1. Emergency dental treatment under a medical plan does not qualify. The plan must include basic coverage for routine exams and cleaning, x-rays, and emergency treatment to control pain.

Loss of Comparable Coverage

Individuals who choose to maintain comparable coverage through a non-UM source prior to age 62 in retirement may be eligible to request re-enrollment in U-M medical and/or dental coverage at their own cost before age 62 if the other corresponding comparable coverage is involuntarily lost. The following conditions must be met:

  • The retiree and/or dependents were enrolled under U-M medical and/or dental coverage at the time of retirement, or if not enrolled were eligible for enrollment but were covered under another group health and/or dental plan;

  • A completed and signed Request to Waive Retiree Coverage form is submitted to SSC Benefits Transactions within 30 days of the date you request waiver of your retiree benefits;

  • Comparable coverage has been continuously maintained in another medical and/or dental plan; that is, there has been no lapse in coverage between the time university coverage was waived and later applied for; and,

  • Enrollment must be requested within 30 days after the other medical and/or dental coverage is involuntarily lost and satisfactory evidence is provided as requested by the Benefits Office that all requirements for re- enrollment have been satisfied.

Important Facts to Consider Before Waiving Coverage

  • You will not be considered to have involuntarily lost your other medical and/or dental coverage if you remain eligible for the coverage at your own cost (other than COBRA). For example, if an employer or insurance carrier increases your or your spouse’s required contribution for coverage, or requires you or your spouse to pay the full cost of coverage to remain eligible for coverage, you will not be allowed to enroll in the university’s benefit plan due to the other employer or insurance company’s decision to increase your costs for participation.

  • You will not be allowed to enroll in a U-M benefit plan due to another employer’s decision to change insurance companies; increase deductibles or copays; or change, reduce or eliminate benefit provisions under their plan in any way.

  • You will not be allowed to enroll in a U-M benefit plan due to another employer’s decision to replace a traditional group health defined benefit plan (example: Blue Cross coverage) with a group health defined contribution plan (example: Health Reimbursement Arrangement or Retiree Reimbursement Arrangement).

  • When you waive your U-M medical coverage, your U-M prescription drug coverage will also be discontinued.