Medicare Eligible Health Benefits

What you need to know

Sandia-provided benefits offered to Medicare-eligible retirees depend on whether you retired on or before Dec. 31, 2011, or on or after Jan. 1, 2012.

As a Sandia Medicare retiree, you’re eligible to shop for supplemental Medicare plans, including Individual Medicare Advantage plans, through Via Benefits — Sandia’s retiree health benefits administrator. Via Benefits can assist you with your eligibility, enrollment, and premium statements/payments.

Medicare-eligible employees who retire on or after Jan. 1, 2024, are eligible to participate in the United Healthcare Group Medicare Advantage PPO plan or the Senior Medicare Advantage plan, for those who reside in northern California.

Your costs for coverage depend on when you retired, your years of service, and your coverage level.

Retiree Health Coverage Eligibility

You need to meet specific age and Sandia service requirements in order to be eligible for retiree health benefits. Employees hired after Jan. 1, 2009, are not eligible. The following HR Solutions articles provide more details about eligibility and the benefits available to you:

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Your Retirement Date Determines Your Benefits

You have the following options for Sandia-sponsored group Medicare Advantage plans for medical and prescription drug coverage. The plans are offered through Via Benefits. Some of your plan options include:

Humana Medicare Employer HMO Plan
UnitedHealthcare Group Medicare Advantage (PPO) Plan
Kaiser Senior Advantage (California only)

Your Spending Arrangement

As an alternative, you can choose the Your Spending Arrangement (YSA), which is a Sandia-funded account. You use your YSA funds toward purchasing an individual Medicare plan through the Via Benefits marketplace.

The amount of annual YSA credits you are eligible for depends on when you retired and/or your years of service. Annual YSA credit amounts are prorated for individuals who retire mid-year or who become eligible for Medicare mid-year.

Sandia provides Medicare-eligible retirees who retired on or after Jan. 1, 2012, with Your Spending Arrangement (YSA) credits to use toward paying for health care coverage.

The amount of annual YSA credits you are eligible for depends on when you retired and/or your years of service.

You choose Medicare coverage through the Via Benefits marketplace, purchase it yourself through Via Benefits, and then get reimbursed from the YSA funds Sandia provides.

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Enrollment and Using Your Benefits

Via Benefits handles the retiree plan administration of your eligibility and enrollment for the Sandia retiree health benefits, as well as billing and collection of retiree health coverage premiums.

Via Benefits can also help you enroll or disenroll when you have a life event and answer any benefits eligibility or premium billing questions.

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Retiree Open Enrollment

Each year, Sandia holds open enrollment – usually in the fall – which is your opportunity to review your benefits and make plan or coverage changes that would go into effect Jan. 1 of the following year.

You can visit www.sandiaretireebenefits.com for more information.

If you wish to change your benefits during open enrollment, call Via Benefits at 888-598-7809 to speak with a licensed benefit advisor who will help you find and enroll in medical and dental plans that meet your needs.

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