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Retiree Health Plans and Medical Grant

Retiree Health Plan Coverage

When you retire, you may be eligible to enroll in a Retiree Health Plan

Eligibility

To be eligible for enrollment for a Retiree Health plan you are required to:

  •  Be enrolled in a County health plan when you separate, and
  • Receive a monthly retirement allowance from the Orange County Employees Retirement System (OCERS)

Survivors

If you are a survivor of a deceased Orange County employee or retiree, you may be eligible for continued enrollment in a County retiree health plan.

To be eligible for survivor health plan coverage, you are required to:

  • Be covered under the deceased employee's or retiree's County health plan at the time of his or her death; and
  • Receive a monthly retirement allowance from the Orange County Employees Retirement System (OCERS)

OCERS must notify the Benefits Center in order to establish continuation of health insurance coverage as a survivor.  If you do not receive survivor information from the Benefits Center within 30 calendar days of notifying OCERS, please contact the Benefits Resource Line toll free at 1-866-325-2345 and speak with a Benefits Specialist.  Benefit Specialists are available Monday through Friday 7:30am to 5:30pm Pacific Time except on holidays.

Click here for additional information on Retiree Health Plan.

Retiree Medical Grant

When you retire, you may be eligible to receive a Retiree Medical Grant (Grant) provided by the County of Orange to use toward the cost of your County health plan and/or your Medicare Part B premiums (if applicable).  The Grant is not a vested or a guaranteed benefit.

Eligibility

To be eligible for the Grant, you are required to:

  • Have a minimum of 10 years of continuous eligible County Service, if you have a normal retirement.  However, if you have been granted a non-service connected disability retirement, you are required to have a minimum of five years of continuos service.  If you have been granted a service connected disability retirement, there is no minimum service requirement,
  • Be at least 50 years of age on your date of separation of services,
  • Be enrolled in a County health plan when you separate.

Note: Eligibility Workers who retired on or after September 30, 2005 are eligible to enroll in a retiree health plan but are not eligible for the Retiree Medical Grant.

Retiree Medical Grant Amount

The amount of the Grant you receive is based on your age at separation and your years of eligible County service hours, up to a maximum of 25 years of service multiplied by a base dollar amount.  The base dollar amount is adjusted up or down annually up to a maximum of 3%.  Grant is subject to change based upon retirement date and grant eligibility.

7.5% reduction or increase in the Grant*

Note: This section does not apply if you were retired when the Board approved the 2006 Retiree Medical Plan Restructuring changes

If you retire before age 60, there will be a 7.5% reduction to the Grant for each year before 60 years of age; if you retire after age 60 there will be a 7.5% increase to the Grant for each year worked after age 60, up to age 70. Safety and disability retirees will not be subject to the 7.5% reduction or increase.

50% reduction of the Grant when Medicare-eligible*

Note: This section does not apply if you and your spouse were both retired and age 65 at the time the Board approved the 2006 Retiree Medical Plan Restructuring changes

Retirees who are eligible for both Medicare Parts A & B (Part A, if at no cost to you), you will have 50% reduction in your monthly Grant the first day of the month in which you reach age 65 and become eligible for Medicare.

How the Retiree Medical Grant is Applied

The Grant will be applied first to offset the cost of your and/or your spouse's/domestic partner's County health plan rate.  Any remaining monthly Grant will be applied to your Medicare Part B reimbursement, if applicable.  You are not eligible to receive the Medicare reimbursement if you are currently receiving Medicare reimbursement from another source.

If the total of your monthly County health plan rate and your monthly Medicare Part B reimbursement is less than the total monthly Grant, the excess amount of the Grant is forfeited.

Medicare Enrollment Required 

  • Both you and your eligible dependents are required to enroll and maintain coverage in Medicare Parts A (if eligible at no cost) &B, even if you are actively working with coverage elsewhere.
  • If at any time you allow your Medicare Part B coverage to lapse, your Grant will be suspended and you will pay higher rates for your health plan coverage
  • You are required to maintain enrollment in a County health plan until Medicare-eligible.  At that time, you may disenrol from the County health plan and elect Medicare Part B Reimbursement only.

Survivor Benefits 

If you are a survivor of a deceased employee or retiree, you may be eligible for coverage under a County retiree health plan and for a Retiree Medical Plan Survivor Grant.  The Survivor Grant is equal to 50% of the Grant the deceased would have been eligible to receive.  Once you reach age 65 and are eligible for Medicare Parts A & B (Part A, if no cost to you), you will have a 50% reduction in their monthly Grant the first day of the month in which you reach age 65 and therefore become eligible for Medicare.

Survivor Retiree Medical Grant benefit

To be eligible for a Survivor Grant, you are required to:

  • Be a survivor of a deceased Grant-eligible County employee or retiree;
  • Receive a monthly retirement allowance from OCERS; and
  • Be covered under the employees or retiree's County health plan at the time of his or her death.

OCERS must notify the Benefits Center in order to establish continuation of health insurance coverage as a survivor.  If you do not receive survivor benefits information from the Benefits Center within 30 calendar days of notifying OCERS, please contact the Benefits Resource Line toll free at 1-866-325-2345 and speak with a Benefits Specialist. Benefits Specialists are available Monday through Friday 7:30am to 5:30pm Pacific Time except on holidays.

Retiree Medical Plan Document 

Please refer to the Third Amended and Restated County of Orange Retiree Medical Plan Document ("Retiree Medical Plan Document") for the specific terms and conditions of the Grant.  If there are any discrepancies between the above summary and the Retiree Medical Plan Document, the Retiree Medical Plan Document will govern in all cases.