VSTRS Group Health Insurance

***What's New***

2023 Open Enrollment – Open Enrollment for insurance coverage effective January 1, 2023 is now live and runs through November 18, 2022. 

  • For more information on health insurance options for Medicare-eligible retirees and dependents, please visit here.
  • For more information on health insurance options for non-Medicare-eligible retirees and dependents, please visit here. 

Pharmacy Benefit Manager Change – Effective January 1, 2023, members covered by Vermont Blue Advantage will see a change in their Pharmacy Benefits Manager, from Express Scripts to Optum.  For more information on this transition and what it means for you, please visit here. If you are or wish to be enrolled in the JY or Comprehensive plan, the 2023 Formulary Drug List can be found here and the 2023 Network of Pharmacies can be found here.

PLEASE NOTE: During Open Enrollment, our call volumes are much higher than normal. While we make every effort to return calls within 24 hours, the best way to reach us is by email, at Tre.retirementoffice@vermont.gov.

VSTRS Health Insurance - The Basics

VSTRS Retirees and Beneficiaries may receive group medical insurance through VSTRS after retirement.  Subsidy eligibility information is determined by certain criteria and details can be found here.

Our Providers

VSTRS has contracted with two providers to provide eligible retirees and dependents with health insurance:

  • Vermont Education Health Initiative (VEHI) provides coverage for:
    • Non-Medicare-eligible retirees and dependents, and
    • Medicare-eligible retirees and dependents who have purchased their own prescription drug (Part D) plan outside of VSTRS
  • Vermont Blue Advantage PPO (VBA) provides coverage for:
    • Medicare-eligible retirees and dependents who have NOT purchased their own prescription drug (Part D) plan outside of VSTRS

Our Plans

Non-Medicare-Eligible Retirees and Dependents

  • Non-Medicare-eligible retirees and dependents have access to the following plans, provided through VEHI, and administered by BlueCross BlueShield of Vermont:
    • Vermont Health Partnership Plan (VHP)
    • Comprehensive Plan
    • JY Plan
  • If you would like to learn more about the these plans, please see the Member Booklet here, and the prescription drug formulary here.

Medicare-Eligible Retirees and Dependents

  • To qualify for any of VSTRS health insurance plans, Medicare-eligible retirees and dependents must meet all eligibility criteria and be enrolled in Medicare Part A and Part B. 
  • Medicare-eligible retirees and dependents have access to the following plans:
    • Medicare Advantage plans provided through VBA:
      • Comprehensive Plan
      • JY Plan
      • VSTRS 65 – where covered person has no separate prescription drug (Part D) plan
    • Medicare supplement plan provided through VEHI:
      • VSTRS 65 – where covered person has a separate prescription drug (Part D) plan
  • If you would like to learn more about the VBA Medicare Advantage plans effective in 2022, please see the Benefits-at-a-Glance here, the prescription drug formulary here, and VBA’s website describing VSTRS plans here.
  • If you would like to learn more about the VEHI Medicare supplement plan, please see the Benefits Description here.

If you will age-in to Medicare, experience mid-year life events during the current year, and/or retire in the current year, please click here for VBA enrollment information and here for VEHI’s VSTRS 65 enrollment information. Please note that the VEHI Plan is only for those who seek to enroll in a separate non-VSTRS prescription drug (Part D) plan.

For all Medicare insurance applications; please sign, date, and return within 90 days of your desired effective date. Our office cannot process your application if it is dated prior to this window of time and it will be returned to you.

Enrollment Information - VBA Plans for 2022

Please see the letter here for additional information on enrolling in VBA plans, as well as the documents linked below.

Paper copies of the pre-enrollment kit and the enrollment form can be provided upon request by contacting the Retirement Office. 

The Cost

For members that are eligible for Medicare, the current rates as of 1/1/2022 can be found here.

For members not yet eligible for Medicare, the current rates as of 7/1/2022 can be found here.

Information for New Retirees

If you are considering retirement, it is important to understand your situation regarding Medicare eligibility and any contracted coverage dates provided by your school district.

With the VBA health insurance plans, our office must receive enrollment forms prior to the month your coverage becomes effective. For instance, if you intend on retiring on July 1 and are Medicare eligible on that date; you must apply and have your Medicare benefits in place as well as complete and return a VBA enrollment application to our office by June 30. Please note, to ensure that your new insurance card is received by the effective date of coverage, your completed application should be submitted to our office 45 days prior to the effective date.

Important Contact Information

  • If you would like additional information, please feel free to reach out to either of our providers or to the Retirement Office Directly:
    • For VEHI, most questions will be answered by BlueCross BlueShield, which can be reached at 1-800-247-2583.
    • VBA can be reached at 1-800-572-0280/ TTY call 711.
    • Please also feel free to call the Retirement Division at (802) 828-2305 or email Tre.retirementoffice@vermont.gov, Monday through Friday, 7:45 a.m. to 4:30 p.m., Eastern time. TTY users call 711.

 

Vermont Blue Advantage is a PPO plan with a Medicare contract. Enrollment in Vermont Blue Advantage depends on contract renewal.

H6898_VSTRSGrpWbpgR2_M FVNR 0122

 

 

 

 

Contact Us

Office of the State Treasurer
109 State Street
Montpelier, Vermont 05609
Main Phone: (802) 828-2301
Toll Free: (800) 642-3191

PUBLIC INFORMATION REQUESTS TO:

Ashlynn Doyon at treasurers.office@vermont.gov

Click Here - For Public Records Database

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