Request to Change

Transition to Retiree Medical Benefits

Employees and their eligible dependents are automatically enrolled in the retiree medical plan if they meet the eligibility requirements to retire with medical benefits. No additional forms are necessary to enroll, unless:

• The employee is Medicare eligible and/or spouse is Medicare eligible - in this scenario, Freedom Blue applications are required.
• The employee is changing their family status, examples include going from Retiree Only coverage to Retiree and Spouse or going from Family coverage to Retiree Only
• The employee wishes to change the non-medicare plan they are currently enrolled in examples include going from Lion Advantage to the Lion Traditional plan or vice versa. Please note, if switching medical plans upon retirement, any prior deductible or coinsurance amounts WILL NOT transfer to your new plan enrollment.
• The employee wishes to refuse medical coverage into retirement. Retirees who refuse coverage will not be able to re-enroll at a later date.

If you experience any of the three scenarios above, please complete a Retiree Request for Change Form.