Retiring After Age 65
Retirees over 65 that are anchored to the PEBP Consumer Driven Health Plan (PPO), Low Deductible Plan (PPO), Exclusive Provider Organization Plan (EPO) or Health Plan of Nevada (HMO) by a non-Medicare dependent or who are ineligible for Medicare Part A will need to refer to the Retiring Before Age 65 section. View the Retiree Orientation Guide here.
Getting Started
If you're getting ready to retire over the age of 65 follow these five easy steps. The Public Employees Benefits Program (PEBP) offers a comprehensive benefit package to eligible retirees and surviving spouses/domestic partners of these retirees. If you wish to continue coverage as a retiree, you must re-enroll in PEBP coverage within 60 days of retirement. Retirement is a qualifying life event which allows you to change your medical plan or add or delete eligible dependents.
State and Non-State Retiree Eligibility
To be eligible for retiree coverage, you must meet the following requirements:
Pursuant to NAC 287.135, retirees with 5 or more years of service credit (or 8 years of service credit for retired Legislators pursuant to NRS 287.047) are eligible for retiree coverage if the employee’s last employer is participating in PEBP with their active employees. Retirees must also be receiving retirement benefit distributions from one or more of the following:
- Public Employees' Retirement System (PERS)
- Legislators' Retirement System (LRS)
- Judges' Retirement System (JRS)
- Retirement Plan Alternative (RPA) for professional employees of the Nevada System of Higher Education (NSHE)
- A long-term disability plan of the public employer
For more information regarding retiree benefits, premium subsidy, Exchange-HRA contribution (for Medicare retirees enrolled in the Medicare Exchange), and/or surviving dependent eligibility, please refer to the applicable Master Plan. View the retiree benefits eligibility rules here.
Initial Start of Retiree Coverage
The initial start of coverage is the first day of the month if the retirement date is on the first; otherwise, the initial start of coverage begins on the first of the month following the retirement date. For example, if your retirement date is June 7, your coverage will begin July 1. If your retirement date is July 1, your coverage will begin that day.
Enrollment Timeframe
Eligible employees have 60 days from the date of their retirement to enroll in retiree coverage. Retirees that do not enroll within this timeframe will lose their opportunity to enroll in retiree coverage, unless they qualify for enrollment during the retiree late enrollment. (NAC 287.540; NRS 287.0475)
Enrollment Process
Once PEBP receives a termination notice from a member’s Agency, the member will be placed in terminated status. It is the member’s responsibility to reach out to PEBP regarding retirement and complete a Retiree Benefit Enrollment and Change Form and a Years of Service Form. Members are required to complete these forms within 60 days after their retirement date. Retirement coverage starts on the first day of the month concurrent with or following the date of retirement. You can access the required forms from the Helpful Links tab of this page. Failure to enroll within 60 days will result in termination of coverage.
Declining (terminating) Retiree Coverage
Retirees who wish to decline PEBP coverage may do so by submitting a written request to decline all benefits. Declining the PEBP-sponsored coverage includes medical, dental, vision, prescription drug coverage, basic life insurance, any voluntary products (if applicable), years of service premium subsidy, and Exchange-HRA contribution (if applicable).
Termination requests received prior to the requested date of termination will occur on the last day of the month; otherwise, coverage will terminate on the last day of the month following PEBP’s receipt of the written request.
State and non-State retirees or surviving spouses and domestic partners have the option to reinstate PEBP coverage one time pursuant to NAC 287.540 and NRS 287.0475.
Medicare Enrollment
Active employees and their covered dependents are not required to enroll in Medicare Part A or B prior to retirement.
Retirees and their covered dependents who are turning 65 must enroll in premium-free Medicare Part A (if eligible) and purchase Part B coverage. Retirees should contact the Social Security Administration (SSA) 60-90 days prior to their 65th birthday to determine if they qualify for premium-free Medicare Part A coverage.
Retirees with Medicare Parts A and B will be required to enroll in a medical plan through Via Benefits unless they cover a non-Medicare dependent on their plan or have TRICARE for Life.
Retirees enrolled in a medical plan through Via Benefits have the option to keep their PEBP dental plan. To view the monthly dental rates, please click here.
For additional information on aging into Medicare, please review the PEBP and Medicare Guide.
Medicare and Via Benefits Resources
Are you close to retiring and looking for more information on Medicare and the options you have available to you once you are 65 or older? Discover Via Benefits https://my.viabenefits.com/discover/PEBP is designed to assist active participants that are approaching retirement. Please view the Medicare Guide to see when you are eligible to transition over to Via benefits. Via Benefits and Medicare informational videos can also be found under Helpful links.
To help cover the cost of medical expenses, the Exchange Health Reimbursement Arrangement (Exchange-HRA) is a PEBP-owned account for eligible retirees enrolled in a medical plan through the Medicare Exchange with Via Benefits. Please refer to IRS Publication 502 for detailed information on eligible medical and dental expenses.
Eligible retirees receive a monthly contribution to their Exchange-HRA based on their date of hire, date of retirement, and total years of service credit earned.
To Receive an Exchange-HRA Contribution
An eligible retiree must obtain and maintain medical coverage through the Medicare Exchange with Via Benefits. TRICARE for Life retirees are not required to enroll in a medical plan; however, they must provide PEBP with a copy of their TRICARE for Life Military ID card front and back and Medicare Parts A and B card.
IMPORTANT: HRA funds through the Consumer Driven Health Plan (CDHP) are not transferable to an HRA through the Medicare Exchange. If a retiree on the CDHP terminates coverage or transitions to the Medicare Exchange, any remaining funds in the CDHP HRA account revert to PEBP. Medicare Exchange HRA balances will be capped at $8,000 on May 31, 2021. Although members can accrue more than $8,000 throughout the plan year, any balances over $8,000 will be reduced to the $8,000 cap on May 31. Please click here to view the notification letter regarding this change.
Establishing the Exchange-HRA
PEBP will establish the Exchange-HRA once a retiree has returned the required completed and signed forms to PEBP, and enrolled in a medical plan through the Medicare Exchange. Once established, Via Benefits will send the retiree an HRA Welcome Kit with information on how to use the HRA as well as claim forms. This usually arrives within 8-12 weeks of the retirees Medicare effective date.
In the event the retiree dies, the Exchange-HRA account of the eligible retiree is immediately forfeited; provided, however, that his or her estate or representatives may submit claims for eligible medical expenses incurred by the eligible retiree and his or her dependents prior to the eligible retiree’s death, as long as such claims are submitted no later than one-hundred eighty (180) days after the eligible retiree’s death.
Monthly HRA Contribution
The monthly tax-exempt contribution is $13 per month per year of service, beginning with five years ($65) to a maximum of twenty years of service ($260). Individuals who retired before January 1, 1994 will receive a flat $195 per month to the Exchange-HRA. Dependents do not receive their own Exchange-HRA and no additional funds are contributed for dependents.
View the monthly HRA contribution amounts here.
Required Forms:
Resources:
- Benefit Guide
- PEBP and Medicare Guide
- It's as Easy as 1-2-3-4-5
- Plan Year 2023 Rates
- Via Benefits HRA FAQ's
- Medicare Exchange Health Reimbursement Arrangement Summary
- Making Changes to Your Coverage - Qualifying Life Events Guide
- Eligibility Master Plan Document
Webinar Recordings and Presentation Materials:
- Medicare and Via Benefits Enrollment March 2023 Presentation Recording
- Via Benefits and PEBP HRA March 2023 Presentation Recording
Visit Via Benefits - Get the Most out of Medicare and scroll down to Educational Videos to learn more about Via Benefits.
