Enrollment and Cancellation

You are eligible for SERS’ health care coverage if you have at least 10 years of qualified service credit.

You can enroll:

• When you retire or begin receiving a disability benefit
• Within 90 days of becoming eligible for Medicare
• Within 31 days of the involuntary cancellation of health care coverage under another plan. Proof of involuntary cancellation is required
  • Ending coverage due to nonpayment of premiums or plan changes does not qualify as involuntary cancellation.

If your spouse is retired with another Ohio public retirement system, you cannot waive SERS’ health care coverage to be covered under your spouse’s plan. Likewise, your spouse cannot enroll under your SERS coverage if they are eligible for health care coverage through another Ohio retirement system.

Likewise, if your spouse is eligible for health care coverage through another Ohio retirement system, your spouse cannot be enrolled under your SERS coverage. Eligible coverage includes instances where an Ohio retirement system provides a payment, stipend, or reimbursement to obtain medical or prescription coverage.

When you enroll in SERS’ health care coverage, you may also enroll:

• Your spouse
• Your children up to age 26

A child includes:

• A biological or legally adopted child
• A stepchild or child for whom you have legal custody
• A child who is permanently and totally disabled, provided the disability existed prior to the child reaching age 26

If you do not enroll your spouse or children during your initial enrollment period, you may enroll them only during the following qualifying events:

• Within 31 days of marriage
• Within 31 days of the birth or adoption of a child
• Within 90 days of your spouse becoming eligible for Medicare
• Within 31 days of the involuntary cancellation of health care coverage under another plan. Proof of involuntary cancellation is required
  ◦ Failing to pay the premium or ending coverage because of plan changes does not count as involuntary cancellation.

Dental and Vision Enrollment

To enroll in dental or vision coverage, you must have at least 10 years of qualified service credit.

You must enroll yourself in dental and/or vision coverage to enroll your dependents.

SERS offers dental and vision coverage through:

• Delta Dental of Ohio
• VSP Vision Care

You may enroll in dental and vision coverage:

• When you retire or begin receiving a disability benefit
• During the biennial open enrollment period
• Within 31 days of the involuntary cancellation of another dental or vision plan. You must include a copy of the cancellation letter. The letter must state:
  ◦ Who will be losing coverage
  ◦ The type of coverage ending
  ◦ The coverage end date, and
  ◦ The reason for cancellation.

The 2026–2027 enrollment period ends December 31, 2027, regardless of your effective date of coverage. Once enrolled, you must remain enrolled through that date and pay monthly premiums.

Identification Cards

You will receive ID cards from your health plan carrier(s) about 5–7 days before your coverage becomes effective.

Please note:

• VSP Vision Care does not issue ID cards
  ◦ VSP providers confirm benefit information when you make an appointment
  ◦ You also can visit the VSP website for more information
• Delta Dental issues ID cards only in the SERS member’s name
  ◦ Enrolled spouses and children appear as sub-accounts

If your ID cards do not arrive by your effective date and you need medical services, please contact SERS.

If you are not enrolled in Medicare and become eligible for Medicaid, you cannot enroll in  SERS’ medical and prescription drug coverage.

• This rule does not apply to dental or vision coverage
• Medicaid provides no-cost health care coverage for qualifying individuals and families

SERS will contact benefit recipients who are required to establish eligibility under this rule.

You may waive health care coverage at any time by submitting a Waiver and Cancellation of Health Care Coverage form.

If you waive coverage:

• Dependent coverage for your spouse and children automatically ends

You may re-enroll only under the following qualifying events:

• Within 90 days of becoming eligible for Medicare
• Within 31 days of involuntary cancellation of other health care coverage under another plan. Proof of involuntary cancellation is required.
  • • Failing to pay the premium or ending coverage because of plan changes does not count as involuntary cancellation.

To cancel coverage for a spouse or child, you must submit a written request to SERS.

If canceling coverage for a spouse, both you and your spouse must sign the request.

If you retire and return to work for a public or private employer, you may temporarily lose eligibility for SERS’ health care coverage during reemployment. Eligibility is restored once reemployment ends.

This rule does not apply to individuals enrolled in Medicare Part B.

You will lose SERS health care eligibility if:

• You are eligible for medical and prescription coverage through your new employer, or
• You are not eligible, but other employees in comparable positions are eligible for coverage. The coverage available to employees in comparable positions must be at the same cost as full-time employees.

You will not lose eligibility if:

• You do not have access to employer coverage, or
• The cost for employees in comparable positions is more than what full-time employees pay

If you are affected by this rule, you will be notified of the date your SERS health care coverage is terminated.

Because you must be enrolled in SERS’ coverage to enroll your spouse or dependents, termination of your eligibility may affect their coverage. Reviewing your options as soon as you receive notice can help prevent gaps in coverage.

Your eligibility for SERS’ health care coverage is restored once your reemployment ends.

Because the loss of employer-provided coverage is considered an involuntary termination, you may re-enroll in SERS’ health care coverage. You must complete re-enrollment within 31 days of losing employer coverage.

This rule also applies to your spouse.

• If your spouse has SERS’ health care coverage, and takes a new job, your spouse loses eligibility for SERS’ coverage
  ◦ Your own eligibility will not be affected
• If your child becomes employed, the child may remain covered through age 26
  ◦ Federal law allows coverage regardless of employment or employer eligibility

Please notify SERS if you or your spouse becomes employed.