Employee eligibility

You are eligible for insurance if you are hired to work, on average, 30 or more hours per week (130 or more hours per month) on a permanent basis, or if you are an elected official. 

• If you are a variable hour, temporary or seasonal employee, you generally won’t be eligible for insurance.

Retiree Eligibility

To be eligible for retiree insurance, you must

• Have worked in benefits-eligible position since prior to January 1, 2016 and through your date of retirement *
• Meet pension eligibility requirements for normal retirement
  • Deferred retirees: You are ineligible for retiree insurance
  • Disability or early retirees: Contact the Benefits team to determine your eligibility

In general, retiree medical is available to retirees under age 65

• If you qualify for Medicare before age 65 due to disability, contact your benefits team to discuss additional requirements
• Retirees' dependents who qualify for Medicare (due to age or disability) are ineligible for medical
  • Contact your benefits team if your dependent qualifies for Medicare before turning 65

Retiree dental and vision require maintenance of continuous dental / vision coverage.

• Addition of dental or vision post-retirement is contingent upon ability to prove continuous coverage (applies to retirees plus their spouse & children)

See the Insurance Handbook and Retiree Health Continuation AD for details.

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* If you retire and later return to work as an insurance benefits eligible employee, you forfeit future retiree insurance (medical, dental, vision, life). Employees hired or rehired on or after January 1, 2016 are ineligible for retiree insurance and have limited insurance continuation options through COBRA. See our Retiree Insurance FAQ under Retiring or Separating from Service, below.

Employees

Employees are eligible for in City insurance, even if they have similar coverage through a non-City source, such as having coverage through a spouse's job, Tricare or Medicare. 

Retirees

While retirees and their dependents  may be enrolled in additional dental, vision and life insurance while being enrolled in the City's insurance, they may not be enrolled in City medical if they have medical insurance through another source, including:

• Another employer's medical (on your own or through a spouse/partner)
• Tricare
•  Medicare¹

If you are a retiree or a dependent of a retiree and you have two or more medical plans, you must contact the City's benefits team immediately to disenroll from City medical. 

• We do audit for other insurance, and you may be required to repay premiums and / or claims costs if you have other medical insurance at the same time that you have City medical.

¹ Retirees under 65 who qualify for Medicare due to disability may be allowed to remain enrolled in City medical. See Medicare FAQs for details.

Dependent Eligibility

• Your spouse (unless divorced or legally separated)
• Your children under age 26
  • Biological
  • Step
  • Adopted (including those placed for adoption)
  • Foster
  • Child named as an “alternate recipient” under a Qualified Medical Child Support Order (QMSCO)
  • Child for whom you have full permanent legal guardianship (generally excludes children over 18; contact your benefits team with questions

Under limited circumstances, you may be able to continue coverage for disabled dependents once they reach age 26; contact your benefits team with questions.

Yes. We audit all dependents to make sure they're eligible. 

You'll be asked to supply documents such as:

• government-issued birth and marriage certificates, and 
• proof that you and your spouse are still married, such as your tax return from last year, or a household bill or statement that lists your spouse at your address

You'll be contacted for information when you've been selected for an audit, and you'll have a limited time to provide documents, so please make sure you have them available. 

When you're chosen for an audit, you'll have a deadline for supplying documents proving your dependents' eligibility. 

Dependents who aren't verified are removed from coverage, and you may be responsible to repay money associated with their coverage.

If they're removed from coverage, your next opportunity to re-enroll them and prove their eligibility will be during the annual open enrollment period, with coverage starting the following July 1.

Surviving widow(er) of retiree re-marries

If you're enrolled in City benefits (medical, dental and/or vision) as a surviving widow of a deceased retiree and you re-marry, you lose your eligibility and must drop your City of Tucson insurance. 

Periodically, we will audit your eligibility to ensure that you continue to meet requirements. It is important that you respond in a timely manner in order to ensure that your coverage continues if you are eligible.

You can accomplish most enrollment, including your new hire enrollment and most life event requests, via the enrollment system.

Many requests require additional documentation, which you can upload through the enrollment system. 

We invite you to review information that's relevant to your particular request by exploring additional FAQs on this page.

For new hires or employees who have recently started working 30+ hours each week on a permanent basis, insurance begins the first day of the month, following 30 days of eligible employment. For example:

• If you're hired on February 1, your insurance would start April 1
• If you're hired March 1 or 2, your insurance also would start April 1
• If you're hired March 3 - 31, your insurance would start May 1

You'll need to elect coverage within your first 30 days of employment, or within 30 days of moving into a benefits-eligible position if you weren't previously eligible for insurance. For example, employees who start working in a benefits-eligible position on February 1 need to enroll by March 2, unless it's leap year, in which case enrollment must be completed by March 1. 

If you don't enroll by your benefits start date, your next opportunity will be during the spring open enrollment period, or earlier if you have a qualifying life event like losing coverage through another employer's plan. See our other FAQs for details.

If you waive City medical and provide proof of other qualifying coverage, you may be eligible to receive the $36.92 biweekly opt out incentive payment.

1. Log your request to receive the incentive under Menu > Requests > Opt out incentive
2. As part of your request, upload your proof of other qualifying medical insurance. 
   • A new request and new documentation is required each plan year
   • Because Workday houses incentive payment information separately from insurance requests like dropping City coverage, this step is required even if you already uploaded documentation under a request to drop City insurance

Rehires are subject to the insurance waiting period outlined above under When Does My Insurance Begin.

Rehired retirees

Retirees who are rehired into insurance-eligible City positions must enroll in active employee insurance and forfeit retiree insurance. You won't be eligible for retiree insurance when you leave employment again. This includes medical, dental, vision, retiree basic life, and life insurance portability. You may be eligible for COBRA, in accordance with COBRA law. See Retiring or Separating from Service, below, for additional information about COBRA. 

Employees rehired within 30 days of separation

If you are rehired as an insurance-eligible employee within 30 days after the date your prior City of Tucson employment ended, you may reinstate only elections that were in place on the date you left employment, unless you had a qualifying life event (other than your separation and rehire) during the time between the date your insurance ended previously and the date your coverage will begin as a rehired employee.

Employees rehired within 12 months of separation

If you are rehired as an insurance-eligible employee more than 30 days but less than 12 months after your prior City of Tucson insurance elections ended, you may make new elections, subject to IRS regulations. However, you may elect supplemental life only up to the coverage tier you had in place prior to leaving City employment, and you may elect the long-term disability buy-up only if you had it in place before you left City employment.

• Spring enrollment includes medical, dental, vision, life, long term disability, and Colonial coverage.
  • Elections generally take effect July 1
  • The plan year is July 1 - June 30
• Fall enrollment includes the health care and dependent day care flexible spending accounts
  • Elections take effect January 1
  • The plan year is January 1 - December 31

• Dropping life insurance
• Reducing long term disability
• Dropping after-tax Colonial benefits
• Changing your personal HSA contribution

If you're a retiree, you may drop your insurance at any time by logging your request in the enrollment system. 

• See below for the most common types of qualifying events
• The list below doesn't cover all possible qualifying life events; if you've had a major life change and don't see information that you're seeking, please contact your benefits team: benefitquestions@tucsonaz.gov

Congratulations and best wishes to you and the newest member of your family! 

1. Add your child's personal information and request medical and dependent life coverage for your child via the enrollment website. (You'll need to wait until the next open enrollment period to add dental and/or vision.) 
2. Be sure to update your life insurance beneficiaries as part of this process. Remember, the City will provide employer-paid life insurance, but only if you register your child for the coverage.
3. Be sure to upload a copy of your child's birth certificate as part of the enrollment process. If you don't have it yet, you'll have 60 days from the date your child is born / adopted to upload it.
4. If we receive your request and the birth certificate within the 60-day deadline, coverage begins as of the date of birth / adoption. This may mean that we'll collect retroactive premiums from you, if we receive your request after the coverage start date.

SSN

Be sure to apply for a Social Security number for your child, if the hospital doesn't submit the application for you. Please call us as soon as you receive the SSN so we can add it to your child's record. 

Dependent Audit

You'll need to prove all new dependents' eligibility through the City's audit process. This usually occurs in the spring but could occur at any time. Visit the other FAQs for details.

Other items to consider

1. Work with your department's payroll team if you'd like to update your tax withholding. 
2. Consider whether you need to update your beneficiaries for your HSA Bank account, Colonial benefits, pension, deferred compensation, union benefits, and any non-work related policies and financial accounts.
3. Consider creating a simple will, if you don't already have one.

1. Add their information and request their coverage via the enrollment website. Be sure to update your life insurance beneficiaries as part of this process. Remember, the City will provide employer-paid life insurance for them, but only if you register them for the coverage.
2. You'll need to upload a copy of your marriage certificate as part of the enrollment process.
3. Coverage will start the first day of the month following your date of marriage. This may mean that we'll collect retroactive premiums from you, if we receive your request after their coverage start date.

Dependent Audit

You'll need to prove all new dependents' eligibility through the City's audit process. This usually occurs in the spring but could occur at any time. Visit the other FAQs for details.

Retirees Requesting Dental and/or Vision

Retiree dental and vision have continuous coverage requirements. For new family members to be approved for dental and/or vision, in addition to requesting the coverage, you will need to prove that they have had continuous similar coverage for the 36 months immediately preceding the date City coverage would take effect.

Other items to consider

1. If you're changing your name, be sure to supply a copy of your new Social Security card to your department's payroll team. Also check with them if you'd like to update your tax withholding. 
2. Consider whether you need to update your beneficiaries for your HSA Bank account, Colonial benefits, pension, deferred compensation, union benefits, and any non-work related policies and financial accounts.
3. Consider creating a simple will, if you don't already have one.

You have 31 days after you get divorced to remove your former spouse and step-children from City insurance:

1. Log your request via the enrollment website. Be sure to update your life insurance beneficiaries as part of this process. 
2. You'll need to upload a copy of your divorce decree (first page and signature page only).
3. Coverage will end the last day of the month during which you divorce. This may mean that we'll refund retroactive premiums to you, if we receive your request after the coverage end date.

Other items to consider

1. If you're changing your name, be sure to supply a copy of your new Social Security card to your department's payroll team. Also check with them if you'd like to update your tax withholding. 
2. Consider whether you need to update your beneficiaries for your HSA Bank account, Colonial benefits, pension, deferred compensation, union benefits, and any non-work related policies and financial accounts.
3. Consider creating a simple will, if you don't already have one.

You have 31 days after you, your spouse or child gain other group insurance to drop corresponding coverage with the City (60 days if you gain AHCCCS, Medicaid or CHIP).

1. Log your request to drop individuals who gained coverage from the same type of insurance that was gained
2. Upload proof of the new coverage showing:
   • Who gained coverage
   • Type of coverage gained (medical, dental, vision)  
   • Date coverage started

Medical Opt Out Incentive

If you waive City medical and provide proof of other qualifying coverage, you may be eligible to receive the $36.92 biweekly opt out incentive payment.

1. Log your request to receive the incentive under Menu > Requests > Opt out incentive
2. As part of your request, upload your proof of other qualifying medical insurance. Because Workday houses incentive payment information separately from insurance coverage requests, this step is required even though you already uploaded your documentation under the request to drop coverage.

Other items to consider

1. You may drop only the same type of coverage that was gained through another group health plan, such as through another employer, Medicaid, Medicare or Tricare. 
2. You may not drop coverage outside open enrollment if you gain coverage through an individual policy, such as through the Health Insurance Marketplace.
3. Consider whether you need to update your beneficiaries for your HSA Bank account, Colonial benefits, pension, deferred compensation, union benefits, and any non-work related policies and financial accounts. See the "Changing Your Beneficiary" FAQ for details.
4. Consider creating a simple will, if you don't already have one.

Note to retirees

If you're a retiree, you may drop coverage at any time by logging your request in the enrollment system. No proof of gaining other coverage is necessary. The change would be effective the first of the month following the date you log your request.

You may need to designate beneficiaries separately for different benefits with the City:

• Life insurance - update via the enrollment system
• HSA - update via mycigna.com
• Colonial - contact Colonial
• Pension - update with TSRS or PSPRS
• Deferred Compensation - update with Empower or Nationwide
• Union benefits - contact your union representative

Retirees may drop medical, dental, and/or vision - or drop dependents from medical, dental, and/or vision - by logging into Workday, clicking on Benefits under the Workday Menu, then Change Benefits, and following the prompts to drop coverage. No documentation is required for this change. Workday will allow you to continue through the process without submitting documentation.

***

Employees, please review the FAQ titled Gain of Other Coverage, above. Outside of open enrollment, employees may drop coverage only within prescribed deadlines, and if they gain similar coverage through another qualifying plan, per IRS rules.

• TSRS: 520-791-4598 or tsrs@tucsonaz.gov
• PSPRS: 602-255-5575 or psprs.com

Medical, dental, vision, life and employee assistance program coverage end the last day of the month during which you separate from employment. 

Long term disability, Colonial coverage and flexible spending accounts end on your last day worked. You have 90 days from your separation date to submit FSA claims. See our FSA page for details.

Be sure to update your mailing address in Workday

After separation, you'll still need receive important correspondence from the City; please keep your address current in Workday. Also consider changing your address with the US postal service if you move. 

Retirement Check-out

Congratulations on your upcoming retirement! Please email us once you've established your retirement date with TSRS or PSPRS so we can schedule an appointment with you to review your insurance options.

During our 30-45 minute meeting, we will review your options, and you will make your initial retirement insurance selections.

• Spouses are welcome but not required at the insurance check-out meeting

Non-Retirement Check-out

If you are leaving for reasons other than retirement, it is not necessary to meet with the Benefits team. If you have questions after reviewing our FAQ, please reach out so we can assist: benefitquestions@tucsonaz.gov.

Leaving Due to Disability

If you are leaving due to a disability, you may be eligible to file a long term disability claim, and you may be eligible to continue life insurance without paying premium. Deadlines exist. 

• Visit our Forms page to download the long term disability claim form and/or life insurance waiver of premium form.
• Visit the long term disability and life insurance paged for information about how to contact our insurance carriers in case you have questions. 

• When you retire, your City employee life insurance ends, and the City provides eligible retirees with $7,500 of retiree life insurance
• Eligible retirees also have the option of continuing employee life insurance by paying the insurance carrier directly
  • Continuing life insurance is expensive, and coverage ends at age 70; we recommend that you shop around to compare prices and coverage

Employee Assistance Program, Long Term Disability, FSAs, Colonial

All other insurance ends when you retire. Visit the other FAQs in this section for details.

Continuing Insurance: Medical, dental, vision, EAP, Health Care FSA

Watch your mail for information from the City's COBRA administrator ASI COBRA.

COBRA is a federal law that allows eligible employees to continue existing medical, dental, vision, and EAP insurance after leaving City employment. In some cases, health care flexible spending accounts also may be continued so you have more time to incur and submit FSA claims.

If you elect to continue coverage with ASI COBRA, you'll pay 102% of premiums for elected coverage. Rates are available on our RATES page.

• You may want to consider COBRA continuation if
  • You do not meet retiree insurance eligibility requirements 
  • You meet eligibility but choose to continue coverage under COBRA rather than the retiree provisions
  • You have health care FSA money that you haven't spent or claimed

Colonial

• You may continue Colonial insurance by contacting Colonial and setting up direct payments

Life

• Employees hired before January 1, 2016 may have the option to continue life insurance
• Use this form to request a quote for continuing life insurance. To be considered, Hartford must receive your request within 30 days after the date you leave employment.

Long Term Disability & Dependent Care FSA

• LTD and dependent care FSA benefits cannot be continued after leaving employment

You must be enrolled in a qualified High Deductible Health Plan like the City's high deductible plan with HSA. Additionally:

• You must have a valid SSN and a primary residence in the U.S.

• You cannot be covered by any other type of health plan, including Medicare Part A or B

• You cannot be covered by TriCare or a general purpose health care flexible spending account (FSA)

• You cannot have received medical benefits from Veterans Administration for any non-service-connected disabilities at any time during the previous three months

• You cannot be claimed as a dependent on another person's tax return (unless it's your spouse)

Source: HSA Bank Frequently Asked Questions - Members

• Free money
  • The City contributes funds to your account totaling $1,500 annually if you're single or $3,000 annually if you're covering dependents (pro-rated for part-year enrollment)
• Tax savings
  • You may make additional pre-tax contributions, which reduces your taxable income
  • Any after-tax contributions that you make are tax deductible
  • HSA funds earn interest tax free (except in NJ) and aren't taxed when used for IRS-qualified medical expenses
• Yours to keep
  • Unused funds that will roll over year to year - no "use or lose it" penalty
  • Funds are yours to keep - even after you leave the City - and can be used to pay for COBRA premiums or qualified health care costs, both now and later
• Investment potential
  • You have potential to build more savings through investing; choose from a variety of HSA self‐directed investment options with no minimum balance required
• Save for retirement
  • They also can provide additional retirement savings: After age 65, funds can be withdrawn for any purpose without penalty

HSA

You own the money once it's deposited into your account. You keep it, even after you leave the plan or City employment. The City will no longer pay the plan maintenance fee, though, once you leave the plan.

HRA

The City owns the money in your account. think of it as a "promise to pay." If you or a covered dependent has an eligible medical claim, claims will be paid automatically from available funds. Once you've spent the full fund, you're responsible for remaining amounts. 

HSA

Every July 1st that you're enrolled in the medical plan with HSA, you'll receive $500 in late July. Additional funds are deposited into your account 1-2 weeks after each pay day for the remaining 25 pay periods each year: $20 for single coverage or $60.

If you join the plan after July 1 (for example, as a new hire or due to a qualifying life event), the initial $500 is pro-rated.

HRA

You have access to the money at the start of each plan year (July 1): $1,000 for single coverage, or $2,000 if you're covering at least one dependent.

If you join the plan after July 1 (for example, as a new hire or due to a qualifying life event), the funding is pro-rated.

HSA

The account is your personal account. Unspent money is yours to use on eligible expenses, even after you leave the plan.

HRA

As long as you're enrolled in the plan, the City-owned fund rolls over year to year. However, if you disenroll or leave City employment, you'll forfeit remaining funds. Also, if you move from covering at least one dependent (spouse or child) to individual coverage, your fund balance will be reduced by $1,000.

HSA

No. The money belongs to you.

HRA

Yes, if it means that you're the only one who will be covered after your family member(s) leave the plan. When you go from having "dependent" coverage to single coverage, your fund balance is reduced by $1,000.

As long as you still have at least one family member enrolled, your fund level won't be reduced.

Because the HSA bank account is your personal account, you keep the money when you leave employment. However, a few things do change:

• The City stops contributing to your HSA bank account when you leave employment
  • You may not change plans when you leave employment
  • If you continue your medical as a retiree or through COBRA:
    • You continue on the same high deductible medical plan until the end of that plan year (June 30)
    • You don't receive City contributions - and you may not make personal pre-tax contributions - to your HSA bank account to help pay for out-of-pocket costs for care that you receive
    • However, you may use existing HSA account funds to reimburse yourself for IRS-qualified premiums, plus plan deductibles and coinsurance
  • If you're still enrolled in the medical plan the following July 1 (as a retiree or under COBRA), we automatically convert your medical plan to the HRA, unless you change it to a different plan during open enrollment
• You become responsible for monthly HSA banking fees
  • As with any personal account, you may leave your money where it is, or you may transfer your funds to another bank that offers HSA accounts 

HSA

Yes. You can reduce your taxable income by making personal contributions, up to the IRS maximum, which includes both the City's contributions and your personal contributions.

HRA

No.

HSA

Yes, as long as the IRS considers them qualified health care expenses.

HRA

No. Funds are applied only to qualifying medical claims.

HSA

Yes. You own the funds and may invest them in a wide range of mutual funds, stocks and bonds.

HRA

No. The money in the HRA account belongs to the City, so the City controls it. It is a "promise to pay" if and when you have qualifying claims.

HSA

When you join:

Although you usually won't have to provide additional documents when you join the plan, sometimes the bank will run into issues when it tries to verify the data in your profile as part of the federally required Customer Identification Process. This can happen if you've moved or changed your name. In that case, the bank will ask for additional documents. 

Every year:

You'll have to file IRS Form 8889 with your tax return. You'll receive both a 1099-SA tax form that shows total contributions to your account and a 5498-SA that shows withdrawals, including payments to health care providers. You'll want to save receipts showing how you spent the money to be able to demonstrate that funds were used for qualifying expenses if you're ever audited by the IRS.

HRA

Because the City owns the funds and applies them only to qualifying expenses, no additional documents are required from you.

MEDICAL

Employees and their dependents may remain covered under City medical, even after they’re Medicare-eligible.

However…

• Remember that the IRS says you can’t have contributions to an HSA bank account if you’re eligible for Medicare
  • Consider enrolling in one of the other medical plans at open enrollment before you or your covered family members reach Medicare eligibility
• Be sure you understand IRS, Social Security and Medicare rules to understand how enrollment in the HSA can affect you after you become eligible for Medicare

DENTAL & VISION

• Dental and vision aren’t affected by Medicare

Employee Medical

Medicare eligibility has no impact on employee insurance unless you would like to drop coverage. See the "Making Changes" FAQs for details about dropping coverage.

Retiree Medical

Turning 65

• Medical generally ends when a retiree or a retiree's dependent reaches Medicare eligibility due to turning age 65
  • Be sure to have other medical insurance in place before turning 65
  • If you are a PSRPS retiree with fewer than 40 Medicare quarters, please also read that FAQ for options

Medicare due to disability (before age 65)

• Retirees who qualify for Medicare before reaching age 65 may be able to continue existing medical insurance
  • You must notify us if you qualify for Medicare, and you must enroll in Medicare A & B, or you may have gaps in coverage that could result in you paying large bills
  • Contact your Benefits team for additional information
    
• Medicare-eligible dependents of retirees (regardless of age) may not remain enrolled in City medical
  • You must notify us if your dependent qualifies for Medicare before age 65
  • Be sure to have other medical insurance in place before the first day of Medicare eligibility to avoid costly gaps in coverage
    • The City audits retirees for other insurance
    • It’s in your best interest to notify us in a timely manner to avoid the possibility of having to pay back City-paid premiums or claims

Dental & Vision

• Dental and vision aren’t affected by Medicare eligibility

You may elect to continue your spouse or child's medical enrollment, as long as your spouse or child doesn't qualify for Medicare or have other group insurance (for example, through another employer).

• We must receive your election before your (the retiree's) Medicare eligibility begins
  • You'll pay 100% of the premium (City subsidy ends)¹
  • Once dependents leave the plan, they may not re-enroll

Payment

• TSRS retirees: Premium is deducted from your pension check, as long as your check is sufficient to cover the cost
• PSPRS retirees: The state doesn't allow pension deductions for dependent-only coverage. The City has contracted with a third party administrator, ASI COBRA, to manage enrollment and payment for dependent-only medical coverage. After you return your election form to the City's Benefits team, watch your mail for a welcome letter with payment instructions from ASI COBRA.

ID numbers, deductibles, PCP assignment, prior authorizations

• Continuing dependents receive new medical ID numbers
• Plan year deductibles begin again under the new ID; amounts paid toward deductibles under the old ID don't transfer to the new ID
• HRA funds under your old ID are forfeited, and a new (pro-rated) HRA fund begins under the new ID
• PCPs, referrals, prior authorizations and step therapy history may not transfer to the new ID number - contact Cigna for assistance
• Call Cigna (800-244-6224) and your providers to update your new record before you receive care

¹ If you (the retiree) are starting Medicare before age 65 due to disability, the City subsidy will continue for you and dependents, provided you remain continuously enrolled. Contact your Benefits team for details.

No. The state is unable to administer dependent-only premiums. You must be enrolled in a plan to receive the PSPRS subsidy.

No. Unless you have fewer than 40 Medicare quarters because you weren't permitted to pay into Medicare while working for the City (PSPRS only), both City medical and prescription drug coverage end when you reach age 65.

PSPRS retirees who have fewer than 40 quarters because they weren't allowed to pay into Medicare while working for the City may

• Continue existing medical by paying 100% of the premium 
  • City subsidy ends, but you may still receive the applicable state subsidy

or 

• Forfeit City medical and receive reimbursement for the retiree's Medicare Part A 
  • Carefully review Sections VII and VIII of the Retiree Health Benefits Continuation Program Administrative Directive for full details
  • Does not apply to dependents' Part A premium
  • Once coverage is canceled, you may not resume it

Before your 65th birthday, the City's Benefits team must receive your continuation election and documentation from the Social Security Administration (SSA) demonstrating that you will be required to pay for Medicare Part A.

• Begin your research in advance. Contact SSA to understand if you earned required Medicare hours through other work, or if you may be able to attach to Medicare through a spouse or former spouse. 

Yes. Your existing City dental and vision generally will continue automatically, unless you initiate a request to drop them. 

However, if you're a commissioned public safety retiree and you enroll in the state’s dental plan, your City dental will end. The state will pay only for one dental plan – either the state's or the City's. Be certain that you understand which plan you're choosing.

Generally, you are eligible for Medicare the first day of the month during which you turn age 65. 

• Example: If your birthday is September 24, you are eligible for Medicare September 1

However, if your birthday falls on the first day of the month, you are eligible for Medicare the first day of the month PRIOR to the month during which you turn age 65.

• Example: If your birthday is November 1, you are eligible for Medicare October 1 

Visit Medicare.gov for additional information.

Because your pension pays you retroactively (meaning that your pension check pays premium for the month that just ended), you generally will see a deduction the month before your birthday, but not during your birthday month.

Example: 

• Your birthday is April 20
• Medicare starts April 1 and City medical ends March 31
• You will see a deduction on your March pension check (paid March 31), and you won't see a deduction on your April check (paid April 30)

However, if you are a TSRS retiree and you elect to continue medical for your spouse and/or child, the new deduction amount for your dependents will begin the date that your deduction normally would end.

Please contact the Social Security Administration: 

• (800) 772-1213
• www.ssa.gov
• 3808 N. 1st Ave, Tucson, AZ 85719 (call in advance to confirm working hours)

Medicare plan offerings vary by state. While we are unable to recommend plans, below are some options for you to explore, based on feedback we have received from other retirees: 

• Pima Council on Aging is an independent non-profit that offers seminars and individual Medicare counseling at no cost
  • If you live outside of Pima County, inquire with your local Council on Aging.
• PSPRS retirees have options through AZ state
• Many insurance carriers offer private insurance plan options

Medical, Family Medical, and Military Leave

If you’re on approved medical, Family Medical, or military leave, you may continue medical, dental, vision, life, long term disability, and EAP for up to one year of approved leave, provided that you continue paying your employee share of premiums when they are due. 

Check with ASI Flex at 800-659-3035 to understand if you are eligible to continue flexible spending accounts while on leave. 

See FAQs below for information about Colonial benefits and HSA contributions.

Personal, Educational, and Sabbatical Leave

If you are on any other type of leave, including but not limited to personal, educational or sabbatical leave, you are not eligible to continue insurance. Please contact the Benefits team for information about when your coverage will end and continuing insurance through COBRA.

If you are receiving sufficient pay to cover your premiums, premiums will continue to be deducted from pay.

Once you no longer have sufficient pay to cover premiums, your premiums will accumulate in an arrears bucket in Workday for up to 6 pay periods. 

After 6 pay periods, the amount owed would be zeroed out in your payroll account in Workday and transferred to Accounts Receivable for collection. See "Paying Premiums through Accounts Receivable" and "Paying Premiums through Payroll AND Accounts Receivable" for additional details. 

Example: Employee is out 4 pay periods without sufficient pay. Employee returns to work and starts receiving pay in Pay Period 5

The above example assumes that your biweekly premiums don’t change between pay period 1 and pay period 8. 

If your premiums change due to your leave of absence or a qualifying life event – or because we have started a new fiscal year – the period of time over which arrears are collected may be different than what is shown above. 

In any given pay period, Workday generally collects an amount equal to your current premium, multiplied by two.

Once you have reached 6 pay periods of arrears in payroll, your arrears balance will be zeroed out in payroll and sent to Accounts Receivable (A/R) for collection. A/R will send payment instructions with your bill.

If you continue to be employed after your first set of arrears move to A/R for collection, you will continue to accumulate up to another 6 pay periods of premiums in arrears in payroll before that set of premiums owed is zeroed out in payroll and added to any existing Accounts Receivable balance you have.

This process may continue for up to one year (12 months) of qualifying leave.

Example: Employee is out 12 pay periods without sufficient pay

If you return to work after some of your debt has moved to A/R and before the end of a new 6-pay period cycle of arrears has accumulated, you will repay premiums two ways: 

1. Workday will collect your arrears balance will via payroll, and
2. You also must pay premiums that have moved to Accounts Receivable through the City’s A/R payment process.

Example: Employee is out 8 pay periods without sufficient pay and then returns to work

If you are approaching the end of a 6-week arrears accumulation period and know that you will return to work shortly thereafter, call us. We may be able to keep the arrears you owe solely in the payroll system to be collected via the payroll collection process.

When you leave employment or lose benefits eligibility as an active employee, any amount remaining in your arrears balance will be zeroed out in your payroll account and transferred to Accounts Receivable for collection. Accounts Receivable will send payment instructions with your bill.

If your coverage is canceled, either because you reach one year of approved medical, Family Medical, or Military Leave or you fail to pay premiums, you will be offered the option to continue medical, dental, vision and possibly health care flexible spending accounts through COBRA, a federal law that provides for continuation of coverage if you lose insurance eligibility at work. Watch your mail for information from ASI COBRA, our COBRA administrator. COBRA rates are available on our Rates page.

Impact of leave on retiree insurance eligibility

To be eligible for insurance as a retiree, you must retire while you are eligible for insurance as an employee. 

This means that if you are planning on retiring, you must leave employment before you reach one year of being on approved medical, Family Medical, or military leave to be eligible for retiree insurance. 

See the FAQ below about applying for disability retirement. It is common for the disability retirement application process to take months to complete. Start your disability retirement application process early to ensure that you have sufficient time to complete it prior to reaching one year of leave.

Dropping insurance

If you will be on approved medical, Family Medical, or military leave for longer than 30 days but less than one year, you have the option to cancel insurance for the remainder of your leave by submitting a request in Workday under Benefits and Pay > Change Benefits > Begin Leave of Absence. You may choose to cancel one or more types of insurance, plus HSA and/or FSA contributions. Annual FSA claim limits will be adjusted accordingly. Contact ASI Flex at 800-659-3035 if you have questions about the impact of your leave on Flexible Spending Account eligibility and limits.

Reinstating insurance 

If you drop insurance while on leave

If you drop coverage during your leave, you may not reinstate it during the remainder of the Plan Year, except in accordance with COBRA and USERRA laws and the City’s policies on open enrollment and mid-year changes.

When you return to work

Upon your return to work, you may reinstate benefits you dropped, provided that you return prior to being out for one year and you properly complete your Return from Leave event in Workday within 30 days of returning to work. Coverage would begin the first day of the month following the date you return from medical or Family Medical leave, or the date you return to work if you are returning from military leave.

If you return to work after one year of leave

If you return to work after one year of approved medical, family medical, or military leave, you would be considered a “rehire” for insurance purposes, and insurance would begin the first day of the month following 30 days in a benefits-eligible position, unless required otherwise by law such as USERRA.

Be sure to contact the Benefits team immediately after returning from a leave of absence of greater than one year.

Other situations

Most other changes follow the same rules as when you were actively at work. Please contact us if you have a request that isn’t covered in our FAQ.

Once you lack sufficient pay for at least two pay periods, Colonial coverage will be canceled unless you make payments directly to Colonial. Call Colonial to determine policy status and to make payment arrangements: 800-456-4311. When you call, be sure to inquire about submitting claims if your leave is for a reason covered under your Colonial policies.

HSA personal contributions occur only when you have sufficient pay to cover them, after other deductions have been taken. It is your responsibility to ensure that you comply with IRS regulations regarding contribution limits. If you make direct contributions to HSA Bank while you are out, be sure to adjust your payroll contributions accordingly when you return, accounting for both your personal and City employer contributions. Consult your tax professional and/or HSA Bank if you have questions.

If you are eligible for City benefits and unable to work due to a disability for the duration of your leave, you may be eligible to file an LTD claim.

Two levels of LTD coverage exist – Basic coverage (City-paid) and Buy-up (employee-paid). Visit Workday to confirm which level you have. If you expect to be out at least 90 days for your disability – 45 days if you have the LTD Buy-Up – contact The Hartford to begin your LTD application process: 888-301-5615. 

The LTD application process can take months to complete. 

To better your chances of timely benefit payments, start your process early. You can find the application on our LTD page.

If you are permanently disabled, you may be eligible to continue life insurance without paying the premium. To be considered, you must be under age 70 and totally disabled prior to age 60, without interruption for at least six months. The Hartford must receive your Waiver of Premium application and acceptable proof of disability no later than 12 months after the date you became totally disabled. Contact the Benefits team to request an application: benefitquestions@tucsonaz.gov, 520-791-4597.

If you leave employment due to disability, you may be eligible to apply for disability retirement. The process requires medical documentation and review by an independent medical examiner. Completed applications are then reviewed by the pension board, which meets once a month. Below is a high-level summary of some of the requirements. Contact your pension team to discuss options.

TSRS - tsrs@tucsonaz.gov, 520-791-4598 

You may be eligible to receive a disability retirement pension benefit if:

• You have at least 10 years of time worked in the pension system,
• Your condition is a total and permanent disability and
  1. You are on leave and will terminate employment as a result of a disability which occurred during your period of employment with the City, or
  2. You left employment less than 12 months ago as a result of a disability which occurred during your period of employment with the City

PSPRS - 520-791-4282

You may be eligible to receive a disability retirement pension benefit if you:

• Make an appointment with the PSPRS office to complete an application and provide supporting medical documentation within one year after leaving employment
• Terminated employment due to disability

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Additional requirements exist. Contact your pension team to discuss.