2017 Retiree Plan Information & Rates
|Resources for All Retirees|
|2017 Rates||Retiree Summary Plan Document|
|Dental & Vision Options for Retirees with PARSE||FAQs|
|Non-Medicare Eligible Summary of Benefits|
|2017 PPO Blue Summary of Benefits||2017 PPO Savings Summary of Benefits|
|Freedom Blue Resources||Becoming Medicare Eligible|
|Freedom Blue Website||Freedom Blue Informational Packet|
|2017 Highmark Freedom Blue Network Sharing||Freedom Blue Application|
|2017 Freedom Blue Annual Notice of Change||2017 Freedom Blue Summary of Benefits|
Letters sent to Retirees in October 2016 regarding 2017 plan changes:
Retiree Request for Change Form
If you wish to refuse medical coverage, you must complete the Retiree Request for Change Form. Retirees who refuse coverage will not be able to re-enroll at a later date.
If your eligible dependent loses coverage and needs to enroll in the Penn State Retiree Medical Benefits as your dependent, please complete the Retiree Request for Change Form. If your dependent is also Medicare eligible, they will also need to complete a Freedom Blue application and provide a copy of their Medicare card outlining the Part A and Part B effective dates.
Retiree Billing Process
We have contracted with Lifetime Benefit Solutions to administer, bill, and collect the health care premiums from all of our retirees who have the Penn State medical benefit.
- Welcome Letter
- Frequently Asked Questions - Retiree Billing Administrator
Important Notes for Retiree Billing Process
- ACH forms need to be completed with Lifetime Benefit Solutions.
- ACH withdrawals will now be taken monthly.
- Penn State ID’s can be used instead of SSN for Member Portal and ACH-just call Lifetime Benefit Solutions 1-800-828-0078.
Retiree Davis Vision Discount Program
Retirees can take advantage of a FREE vision discount program available through Davis Vision. Enjoy discounts on eyeglasses, accessories, and examinations. Simply present the card at a participating Davis Vision provider.
Davis Vision discount pricing is abilable to anyone enrolled in a Highmark medical plan. Please see the Davis Vision Dscount Pricing sheet.
Zostavax/Shingles Vaccine For Medicare-eligible Freedom Blue PPO members:
This vaccine is covered under the Part D drug benefit. You will pay the $20 prescription copay if you receive the vaccine at a pharmacy that provides them. A great resource for you is the pharmacy at Wegman’s, who has stores across the state of Pennsylvania, for your convenience. To find a Wegman’s pharmacy near you, please use the "Find your store" feature on the Wegman's website.
If you have questions regarding coverage of the Zostavax/Shingles vaccine, please call Highmark’s Freedom Blue PPO customer service at (866) 918-5285.
IRS Forms for 2017
Form 1095 for the Affordable Care Act is often called the “W-2 of benefits”.
Updated December 2016: On November 30, 2016, the IRS extended the due date for the 2016 form 1095-C reporting requirements. This means that the original deadline for issuing form 1095-C to employees has moved from January 31, 2017 to March 2, 2017. You will receive your 2016 form 1095-C prior to the revised deadline of March 2, 2017.
You will only receive this form if you are a benefit-eligible employee with the University. These forms are similar to your W-2 and while not required to file your 2016 tax return, they will be required when filing your taxes with the IRS in future years. The 1095-C will be mailed to your home address from Equifax, Penn State’s partner in 1095 form administration.
Important Past Updates
For the Medicare-eligible retirees in the FreedomBlue PPO, effective March 1, 2013, ALL Geisinger physicians and hospitals will be out-of-network providers, as described within. The out-of-network benefit for the FreedomBlue PPO has a maximum out-of-pocket of $750 per person, per year.