Enrollment and Cancellation

Enrollment Basics for Health Care, Dental, and Vision Coverage

Enrolling Yourself in Health Care

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.
  • Failing to pay the premium or ending coverage because of plan changes does not count as involuntary cancellation.

Coverage Through Another Retirement System

If your spouse is retired with another Ohio public retirement system, you cannot waive SERS’ health care to be covered under your spouse’s plan. Likewise, if your spouse is eligible for health care coverage at another Ohio retirement system, your spouse cannot be on your SERS coverage. Eligible coverage includes instances when an Ohio retirement system provides a payment, stipend, or reimbursement to obtain medical or prescription coverage.

Enrolling Family Members in Health Care

When you enroll in SERS coverage, you may cover your spouse, and children up to age 26, as dependents.

A child includes:

• A biological, or legally adopted, child, stepchild, or child for whom you have legal custody, who is under age 26
• 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 can enroll them under the following circumstances:

• Within 31 days of marriage
• Within 31 days of the birth or adoption of a child
• Within 90 days 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 sign up for dental and vision coverage, you must have at least 10 years of qualified service credit. You must enroll in dental and/or vision coverage to enroll your dependents.

SERS offers coverage through Delta Dental of Ohio and VSP Vision Care.

You can enroll in dental and vision coverage at the following times:

• When you retire or begin receiving a disability benefit
• During the biennial open enrollment period
• Within 31 days of an 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 date coverage will end, and the reason for the cancellation.

The 2026-2027 enrollment period ends December 31, 2027, regardless of your effective date of coverage. Once enrolled in the dental and/or vision plan, you must remain enrolled through December 31, 2027, and pay monthly premiums.

Identification Cards

You will receive ID cards from your health plan carrier(s) about 5-7 days prior to the effective date of your coverage. Please be aware that if you enrolled in VSP vision plan that VSP 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 only issues ID cards in the SERS member’s name. Any enrolled spouse or child are listed as sub-accounts under the SERS member.

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

Medicaid Eligibility Rule for Non-Medicare Benefit Recipients

Eligibility for SERS’ medical and prescription drug coverage ends when a non-Medicare benefit recipient is eligible for Medicaid. The rule does not apply to dental and vision eligibility. Medicaid provides no-cost health care plans for low-income individuals and families.

SERS will contact benefit recipients who are required to establish eligibility for SERS’ health care based on this requirement.

Health Care Waiver and Cancellation

You can waive coverage at any time by submitting a Waiver and Cancellation of Health Care Coverage form. If you choose to waive coverage, dependent coverage for your spouse and children automatically ends.

If you waive coverage, you can only re-enroll under the following qualifying events:

• 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.
  • Failing to pay the premium or ending coverage because of plan changes does not count as involuntary cancellation.

To terminate health care coverage for a spouse or a child, you must send a written request to SERS. Both you and your spouse must sign the request if the cancellation is for your spouse.

Health Care Coverage During Reemployment

If you retire and then go back to work for a public or private employer, you temporarily may lose eligibility for SERS’ health care coverage while you are reemployed. Once reemployment ends, your eligibility is restored.

This does not impact individuals enrolled in Medicare Part B.

SERS’ health care eligibility is lost when:

• You are eligible for medical and prescription coverage through your new employer.
• You are not eligible for medical and prescription coverage through your new employer, 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 your eligibility for SERS’ coverage if you do not have access to the employer coverage, or if it costs employees in comparable positions more than full-time employees pay.

Termination of Eligibility

If you are affected by this rule, you will be notified of the termination date of your SERS health care coverage. Because you must be enrolled in SERS’ coverage to enroll your spouse and dependents, termination of your eligibility may affect their coverage.

Regaining Eligibility

Your eligibility for SERS’ health care coverage will be restored after you stop working. Because losing employer coverage is considered an involuntary termination of coverage, you will regain eligibility for SERS’ coverage. You will have 31 days after you lose employer coverage to re-enroll.

Dependent 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 eligibility will not be affected by your spouse’s loss of coverage.

If your child has SERS’ coverage and takes a job, that child will not lose SERS’ coverage. Federal law provides that coverage may continue to age 26, regardless of the child’s employment or eligibility for employer coverage.

Please notify SERS if you or your spouse becomes employed.