Join In

You may change plans during this annual open enrollment (for May, 1), or the MA plan annual enrollment in December (for Jan. 1), or you may elect to join an MA plan on the first of any month. For coverage to be effective on the first of the next month, HR’s benefits division must receive your application before the end of the previous month.

Electing a Medicare Advantage plan

• Request an enrollment packet from Aetna, TexanPlus or Texas HealthSpring.
• Enrollment forms will be in the packet.
• Each person must complete, sign, date and return all copies of an Enrollment Application and Statement of Understanding for the plan you elected.
• You must also complete the City of Houston MA Plans Enrollment Form. This form will keep your dependents’ coverage in the HMO or PPO in place, and it will help ensure you pay the correct health-care premium. Keep the last page for your records.
• Use the city of Houston return, postage-paid envelope to return all of your forms to the benefits division before April 30. Forms received after April 30 will be effective on the 1st of the month after they are received. If you don’t use the envelope, the address is:

  City of Houston
  Human Resources Department, Benefits Division
  P.O. Box 248
  Houston, TX 77001

Disenrolling from a Medicare Advantage plan
You may choose to disenroll from an MA plan at the first of any month. This includes changing from one MA plan to an other. Here’s how to disenroll from an MA plan:

• Decide if your dependent or you want to elect a different city-sponsored MA plan, or if you want to re-enroll in the HMO or PPO plan, you can do so on May 1, 2009 or within 90 days of MA-plan enrollment.
• Each person who wants to disenroll from an MA plan must complete a City of Houston Medicare Advantage Disenrollment Form.
• The retiree must complete a City of Houston Retiree Medical Election Form to reinstate HMO, PPO or another MA plan coverage for any dependents or themselves.
• Request these forms from the HR benefits division, 888-205-9266 or 713-837-9400. If a person wants to elect another MA plan, request the enrollment application from the benefits division.
• Send all completed forms to:
  • City of Houston
    Human Resources Department, Benefits Division
    P.O. Box 248
    Houston, TX 77001.

The benefits division must receive your forms by the end of the month for coverage to be effective on the first of the next month.

Eligibility
You are eligible for coverage as a retiree under the benefits plans if you were covered when you retired and have been continuously covered by the city since retirement. If both you and your spouse retired from the city, you may be covered as a retiree or as a dependent — but not both. Dependents may be enrolled under only one parent or guardian.

The eligibility criteria remain the same. Your eligible dependents are defined as one of the following:

• Your legal spouse
• Unmarried natural or adopted children to age 25, if they qualify as dependents for federal income-tax purposes
• Children to age 25 over whom you have legal guardianship or legal foster care if they qualify as dependents for federal income-tax purposes
• Grandchildren to age 25 if they qualify as your dependents for federal income-tax purposes
• Disabled dependents over age 25 who are incapable of self-sustaining employment because of mental or physical handicap. The dependent must be primarily dependent on you for more than 50 percent of financial support and covered before age 25
  

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