When Can I Enroll in or Change Health Plans?
You can enroll in or make changes to your medical, dental, and vision coverage elections at any of the following times:
- At retirement
- During ACERA’s annual Open Enrollment period
- Within 30 days of a status change event, such as Medicare eligibility, marriage/domestic partner registration, divorce/ dissolution of a registered domestic partnership, birth, adoption, or loss of other group health plan coverage; see list below
Enrolling at Retirement
At retirement, you may choose to continue your medical plan coverage through an ACERA-sponsored plan. You can cover yourself and your eligible dependents, if they were covered under a medical plan prior to your retirement date. You must make this election within 30 days of your retirement date. If you decline coverage, you cannot enroll in an ACERA-Sponsored plan until Open Enrollment. Enrollment forms for medical, dental, and vision coverage are included in your retirement application package.
When you elect to continue your medical plan coverage as a retired member, in most cases, you will remain with your current medical plan carrier. You may not enroll in or change to a different carrier or plan at retirement, unless you move outside of your plan’s service area. However, you can change your plan elections during ACERA’s Open Enrollment period, or if you experience a status change event outside of Open Enrollment.
Your ACERA Retirement Specialist will review your options with you at retirement. If you do not have medical coverage at the time of retirement, you may not enroll in an ACERA-sponsored plan until the next annual Open Enrollment period.
Enrolling During Open Enrollment
Open Enrollment is your annual opportunity to consider your benefit needs and options and to make changes, if needed. ACERA’s Open Enrollment period for group plans is November 1 – November 30; and you can change your Kaiser Permanente or UnitedHealthcare medical plan, you can change your Delta Dental plan, and you can add or drop medical, dental, and vision coverage for your eligible dependents. ACERA’s Open Enrollment for an individual medical plan through Via Benefits is depicted in the chart below.
Open Enrollment Periods and Plan Years
|Healthcare Plans||Open Enrollment Period||Plan Year|
||November 1 –
February 1 –
||November 1 – December 15||The following
January 1 –
||October 15 –
January 1 –
Enrolling or Making Plan Changes Outside of Open Enrollment
In general, you cannot change your benefit elections or add dependent coverage outside of ACERA’s annual Open Enrollment period, unless you experience a status change event or special enrollment event.
Status Change Events (Qualifying Events)
- Marriage or divorce, or commencement or termination of a domestic partnership (Affidavit of Domestic Partnership required)
- Birth or adoption of a child
- Death of a dependent
- Loss of a child’s eligibility for dependent coverage (e.g., child marries or reaches the maximum age for coverage)
- Coverage of a child due to a Qualified Medical Child Support Order (QMCSO)
- Change in retiree/spouse/dependent’s employment status, work schedule, or residence that affects their eligibility for benefits (e.g., moving your residence outside of your medical plan’s service area)
- Entitlement or loss of entitlement to Medicare or Medi‑Cal/Medicaid
- Certain changes in the cost of coverage, composition of coverage or curtailment of coverage of the retiree or spouse’s plan
- Changes consistent with special enrollment rights and FMLA leaves. You need to notify ACERA in writing within 30 days of a status change event. ACERA will determine if your change request is permitted. If so, changes become effective on the first day of the month following the event date.
Special Enrollment Event
If you decline coverage in an ACERA-sponsored medical plan due to participation in other health insurance or group health plan coverage (e.g., coverage offered through your spouse’s employer), you may enroll in an ACERA-sponsored plan during the next Open Enrollment period or in accordance with a “special enrollment” event. Under a “special enrollment” event, you may be able to enroll in an ACERA-sponsored plan if you or your dependents lose eligibility for that other coverage, or if the employer stops contributing toward that other coverage. You must request enrollment in writing to ACERA within 30 days of the other coverage ending or within 30 days of the employer stopping contributions toward the other coverage.
Also, as required under the Children’s Health Insurance Program Reauthorization Act of 2009, ACERA must permit members and dependents who are eligible for ACERA-Sponsored coverage to enroll or dis-enroll in the plan if they:
- Lose eligibility for Medi-Cal/Medicaid or SCHIP coverage
- Become eligible to participate in a premium assistance program under Medi-Cal/Medicaid or SCHIP In both of these cases, you must request special enrollment within 60 days of the loss of Medi-Cal/Medicaid/SCHIP or of the eligibility determination.
You may cancel medical plan coverage at any time during the year, for any reason.
Plan coverage is cancelled automatically if you or your enrolled dependents no longer meet the plan’s enrollment eligibility criteria. If coverage is cancelled, you will be allowed to continue coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). If you cancel your medical plan coverage, you cannot reenroll yourself or your eligible dependents in an ACERA-Sponsored plan until the next Open Enrollment period.
Requesting Cancellation of Coverage
You need to request your coverage cancellation in writing to ACERA. Your written request should specify which plan you want to cancel and for whom you are cancelling coverage (i.e., yourself and/or your dependents). Typically, the effective date of cancellation is on the first of the month following ACERA’s receipt of your written cancellation request. However, if ACERA receives the request after its monthly payroll close date, cancellation will be effective the second month following your written notification. There is no retroactive cancellation of coverage.