Eligibility And Enrollment

 for Non-TCRS Participants

 

Continuing Group Health Coverage

Detailed information on the rules to continue health insurance as a retiree can be found in the 2025 Local Government Medical Plan Document. This document is available on the publications webpage of the Partners for Health website.

To continue health insurance benefits, the agency from which you retire must continue to participate in the state plan. If your former agency leaves the state’s local government plan, your and your dependent’s health coverage will be cancelled.

If your spouse is an employee enrolled in state’s group health insurance, you may continue coverage as a dependent on their contract instead of choosing retiree coverage. When your spouse ends employment, you may be eligible to apply via the special enrollment provision under your own eligibility as a retiree.

 For non-TCRS participants the eligibility guidelines are:

  • Ten years (120 months) of creditable service, must be age 55 or older and at least three years of continuous insurance coverage in the plan immediately prior to final termination date.
  • Twenty years (240 months) of creditable service, must be age 55 or older and at least one year of continuous insurance coverage in the plan immediately prior to final termination date.
  • Thirty years of creditable service and at least one year of continuous insurance coverage in the plan immediately prior to final termination date.

The date retirement benefits start must immediately follow active coverage ending. The requirement for immediate commencement of retirement benefits will be waived if you become insured by the state, a participating local education agency or another participating local government agency with no lapse in coverage. The one-year and three-year participation requirements will be waived if the local government agency has joined the state plan for the first time and has not participated in the plan for that length of time.

 

Application to Continue Group Health Coverage

You must submit an Application to Continue Insurance at Retirement to your ABC within one full calendar month of the end of active insurance. If enrollment is approved, you will continue in the same health insurance option in which you are currently enrolled.

 

Effective Date of Retiree Group Health Coverage

Retiree coverage is effective on the first day of the month following the final termination date or end of active insurance coverage, whichever is later.

 

Individuals Eligible for Medicare

If you are eligible for Medicare, you are no longer eligible for the group health plan and are not eligible to apply to cover your dependents on the group health plan at a later date.

 

End-stage Renal Disease

If you are eligible for Medicare as a result of end-stage renal disease, you may be eligible for extended group health benefits. Contact Benefits Administration for information on the eligibility criteria.

 

Dental Coverage

Continuation of dental insurance is NOT automatic at retirement.  If you are enrolled in a state-sponsored dental plan, but are not vested in TCRS, you have two options for continuing coverage:

COBRA Dental
You can continue your coverage for 18 months under COBRA. A notice will be mailed to your home once your active coverage ends. The COBRA enrollment form is separate from the Application to Continue Insurance at Retirement. If you choose to continue dental through COBRA, you must submit the enrollment form to Benefits Administration within 60 calendar days after the later of the following dates:

  1. The date after active coverage ends; or
  2. The date notice of a right to elect COBRA continuation coverage is sent. You will be billed directly for the premiums due.

Retiree Dental
You may also choose to enroll in retiree dental coverage. Just select dental on your Application to Continue Insurance at Retirement. To enroll you must have been hired prior to July 1, 2015, be at least age 55 at the time of termination with 10 or more years of service with the participating local government agency from which you retire.  If you do not select dental coverage at retirement, you can enroll during the annual enrollment period. Dependent-only coverage is not available.   Effective Jan. 1, 2026, and thereafter, eligibility to participate in the state retiree dental plan is only open to retirees of an LGA that is participating in the state dental plan at the time of retirement. If the LGA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage.

 

Vision Coverage

Continuation of vision insurance is NOT automatic at retirement. If you are enrolled in the state-sponsored vision plan, but are not vested in TCRS, you have two options for continuing coverage:

COBRA Vision
You can continue your coverage for 18 months under COBRA. A notice will be mailed to your home once your active coverage ends. The COBRA enrollment form is separate from the Application to Continue Insurance at Retirement. If you choose to continue vision through COBRA, you must submit the enrollment form to Benefits Administration within 60 calendar days after the later of the following dates:

  1. The date after active coverage ends; or
  2. The date notice of a right to elect COBRA continuation coverage is sent. You will be billed directly for the premiums due.

Retiree Vision
If you were hired prior to July 1, 2015, are at least age 55 at the time of termination with 10 or more years of service with the participating local government agency from which you retired.  If you do not select vision coverage at retirement, you can enroll during the annual enrollment period.  

Effective Jan. 1, 2026, and thereafter, eligibility to participate in the state retiree vision plan is only open to retirees of an LGA that is participating in the state vision plan at the time of retirement. If the LGA subsequently terminates participation in the state vision plan, its retirees are no longer eligible to continue retiree vision coverage.