A Story of Skyrocketing Premiums

Last week, we looked at what happens when life events require that you make changes to your benefits options.

Unfortunately, for those who are already retired, this is sometimes not as easy as it sounds. In addition to contacting the official organizations referenced in last week’s column, retirees also can get help from organizations like the National Active and Retired Federal Employees Association if they are not sure how to make a change to their retirement benefits.

Here’s one cautionary tale about this kind of situation. It involves Ted and Martha — who are in their 70s and live in New York — and NARFE’s New York Federation. But don’t worry, it has a happy ending.

Like many retirees, Ted and Martha have had the same health insurance coverage for many years. During the most recent annual open season, they didn’t make any changes, because they were happy with the coverage they had. Little did they know their premiums were about to go up by more than $600 per month.

When they received their first retirement payment of 2017, with the new, much larger, premiums deducted, you can imagine their surprise and panic. It would be another year before they could make open season changes and see them go into effect. Of course, employees and retirees are encouraged to review their health insurance coverage every open season even if they are not planning to make a change, but often people get complacent and neglect this important annual checkup.

Since Ted and Martha were NARFE members, they asked someone from the New York Federation if there was anything they could do about this. To their surprise, they found out that retirees who are over 65 have the opportunity to make a once-in-a-lifetime “do-over” to change their health insurance plan outside of the annual open season.

To do so, they needed to complete Office of Personnel Management Form 2809 and use the Qualifying Life Event code 2L (based on their Medicare eligibility). The did some research on OPM’s insurance plan information website and found a Federal Employees Health Benefits Program plan that was not only suitable, but would save them significant out-of-pocket premiums each month. They completed their request for a change and submitted the form to OPM for processing. (They sent it via FedEx so they could track their submission to make sure the agency received it.)

It took longer than expected to process the request. After three months, NARFE intervened on behalf of the couple. With the help of NARFE’s federal benefits office at the association’s national headquarters, on May 1, the change was implemented — and made retroactive to Jan. 1. Ted and Martha are now saving money on insurance and have more suitable coverage than they had in 2016. And they’ll get a refund of the premiums that were paid on the more expensive plan for 2017.

This story shows highlights the importance of regularly reviewing not only your retirement strategy, but your benefits options. And if you need help, ask for it. Sometimes an outside organization can point you to a solution that you didn’t even know was available — and then follow up on your behalf.

Photo: Pictures of Money, via Flickr