Turning 65
How do you handle a call where a member calls in and advises that he has his Medicare ID and wants to let TRS know?
What is transferring the call to HIB.
The requirements that a new retiree has to meet to become eligible for TRS-Care insurance?
What is 10 years + Meet the rule of 80 or 30 years of service credit at the time of retirement
A brand new retiree, over age 65, enrolled in Medicare; spouse and children not enrolled in Medicare; what plan are they each on? What is the premium that the retiree would pay each month?
What is the Medicare Advantage Plan for the member, and Standard plan for dependents. What is $1,020.
How do you handle a call if the member is calling about her health benefits?
What is asking the correct questions to find out more information. Possibly transferirng the call to HIB.
Enrollment in this Medicare plan is required to enroll in the TRS-Care Medicare Advantage Plan
This application is needed when there is a retiree or surviving spouse turning 65 and they have not been enrolled in the Standard medical plan before
What is the TRS 700EO application
The group of TRS retirees that are eligible to receive health care benefits
What are those members who have worked in public-education (not higher education) within Texas.
The effective date that a new retiree has to submit their enrollment application
What is 31 days from the member's retirement date or the date that TRS processed the TRS30, (which is the retirement application), whichever is the latest.
This family is on the Standard Medical plan, how much of the deductible has to be met before claims are paid at 80/20%?
What is the family deductible of $3,000
On the Standard plan, with a family of 3 or more individuals, if one individual meets this amount, that person's claims are paid at 100%
What is $5,650
These are the enrollment times when a spouse who is not currently enrolled in the Standard Medical Plan can enroll in coverage
What is
1. The retiree's initial enrollment period
2. When the retiree turns age 65
3. When the retiree or a dependent who is not enrolled has a special enrollment event
These are participants that can be covered under the retiree's insurance - please name them
What is a spouse, a child under the age of 26, which is a natural child, adopted child or one who is placed for adoption, a foster child, a stepchild, a grandchild who lives with the participant and depends upon the retiree for support, and is claimed by the retiree or surviving spouse for federal income tax purposes. and any other child under the age of 26 in a parent-child relationship, OR a child regardless of age, provided they have a mental or physical incapacitation and are dependent on retiree for support, and meets other requirements as determined by TRS.
The enrollment period for a disability retiree is what time period.
What is the initial enrollment period, which begins on the date that the TRS Medical Board approves the disability retirement and expires within 90 days after the date that the Medical Board approved the disability.
When a member is considered high income and you may pay more for your Medicare Part B premium, what is this called?
What is D-IRMAA
The premiums a member pays is determined by this
What is the TRS retiree's Medicare eligibility and who is on the plan
When can dependents be enrolled for a retiree whose DOB is 3-15-1955, turning 65, and their Medicare starts 3-1-2020. Retiree turned in their application to enroll dependents on 3-20-2020.
What is April 1st
Another medical plan that is not advertised to members when they are eligible for Medicare, but not yet enrolled into Medicare Part B
What is the Alternative Plan
The earliest date a retiree's insurance can begin
What is the 1st of the month following the retirement date (application would have to be received by the retirement date)
What do you do when a member calls in, needs Rx coverage right away but says that he does not have coverage with Caremark?
What is a transfer call to HIB
A call from a member wanting to terminate her coverage, how do you handle the call and what form is needed to terminate the coverage
What is transferring the call to HIB and what is TRS 700B Form
This application is needed when a retiree or surviving spouse has been enrolled in the Standard Plan and since turning 65, they want to enroll a dependent spouse
What is the TRS 700U4
Is it true that if a member is eligible to be enrolled in the Univ of TX system, Texas A&M system, or ERS, that they can also be enrolled in TRS-Care insurance with TRS?
What is no they cannot
A member revokes their retirement and this would be cancelled
What is TRS-Care insurance
On the Medicare Advantage Plan, this amount represents the amount of covered medical expenses within the calendar year that the participant must pay before TRS-Care begins payment for eligible expenses
What is a deductible
Explain how the Medicare Advantage plan works
What is a $500 deductible, however this deductible does not apply for PCP sicks visits, urgent care or ERS visits. You would only pay a $5 copay for PCP visits...OOM is $3,500 per person.