Understanding Your Retirement Coverage Options
COBRA vs Retiree Plans
Compare COBRA and Retiree Plans for prescription, dental, and vision coverage. Make an informed decision for your retirement healthcare needs.
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Explanation of COBRA vs Retiree Plans
Understanding your coverage options upon retirement
Important Note
Key Differences
When you retire, you have options for continuing your prescription, dental, and vision coverage. Understanding the differences between COBRA and Retiree Plans helps you choose the most cost-effective option for your needs.
- •COBRA: Available for up to 18 months; same coverage as active members
- •Retiree Plans: Long-term coverage option after retirement
- •Dependents: Can only enroll in COBRA; retirees can choose between COBRA and Retiree Plans
PFT Health and Welfare Fund COBRA
For Prescription, Vision, and Dental Coverage
COBRA Coverage Details
- •Coverage: Exactly the same as active member coverage
- •Prescription Co-pays: $9.50 for Brand, $6.75 for Generic
- •Mail Order: 90-day supply for one co-pay
- •Retail: 30-day supply for one co-pay
- •Duration: Up to 18 months
- •Who Can Enroll: Retirees and eligible dependents
Enrollment Information
Dependent Coverage
COBRA Rates
Monthly premium costs
Single Coverage
2 or More People
Why Choose COBRA Over the Retiree Plan?
Cost comparison and decision factors
COBRA vs Retiree Plan Comparison
Eligible retirees can choose between COBRA and the Retiree Plan. While the COBRA plan costs $154.76 per month for prescription only compared to the Retiree plan cost of $117.00 per month, there are several reasons why COBRA might be the better choice:
COBRA Advantages
- •Lower Co-pays: $9.50 Brand / $6.75 Generic
- •Mail Order: 90-day supply vs 60-day with Retiree Plan
- •Family Rate: $386.90 for 2+ people (same cost regardless of family size)
Retiree Plan
- •Lower Premium: $117 per month
- •Higher Co-pays: $40.00 Brand / $11.25 Generic
- •Mail Order: 60-day supply
Do the Math
- • Monthly prescription costs with each plan's co-pays
- • Whether you have multiple family members needing coverage
- • The value of the larger mail order supply with COBRA
Family Coverage Consideration
If you have at least two other family members who need prescription coverage, it may make sense to enroll in COBRA with them, at least for the 18-month period, since the monthly cost of $386.90 is the same for two or more people.
After COBRA Expires
PFT Health & Welfare Fund Retiree Benefits
Two prescription plan options based on age and Medicare eligibility
Under Age 65
Capital Rx Plan
- •Co-pays: $40.00 for Brand, $11.25 for Generic
- •Mail Order: 60-day supply for one co-pay
- •Retail: 14-day supply for one co-pay
Age 65 or Older - or - Medicare Eligible due to Disability
Independence Blue Cross Select Option (PDP) Plan
- •Co-pays: $60.00 for Brand, $15.00 for Generic
- •Mail Order: 90-day supply for one co-pay
- •Retail: 30-day supply for one co-pay ($40 Brand, $10 Generic)
Definition of Eligibility
Who qualifies for Retiree benefits
You are eligible for PFT Retiree Benefits if you meet one of the following criteria:
- 1.State Early Retirement Plan: Retired with 30 years of service or more (no age requirement)
- 2.Age 65: Retired from a PFT bargaining unit and at least 65 years of age
- 3.Disability: Approved PSERS Disability Retirement and/or the Health and Welfare Fund's Long Term Disability benefit
- 4.Age + Service: Retired from a PFT bargaining unit, at least age 55 with a combination of age and years of service that equal 65 or more
Cost and Billing Information
Retiree plan pricing and payment schedule
$117 per month
Billed semi-annually
First Billing: On or about January 15 for the six-month period starting March 1
Second Billing: On or about June 15 for the six-month period beginning September 1
Enrollment Deadlines
- • Age 65 or older / Medicare eligible: Must enroll within 2 months of retirement (per Medicare regulations)
- • Under age 65: Must enroll within 6 months if enrolling in the prescription plan
Important Rules
- A retiree who drops out of the plan will have two months to reenter and will be charged for the two missed months
- A retiree who drops out of the plan more than once will not be readmitted
How to Enroll
To receive Retiree Rx Benefits, complete the following forms which will be mailed to you:
- 1.Philadelphia Federation of Teachers Health and Welfare Fund Retiree Benefit Application
- 2.Retirement Prescription Application – Check the box next to the month that coverage is to begin
- 3.Return forms and a check payable to PFT Health & Welfare Fund in the enclosed pre-addressed envelope
PFT Health & Welfare Fund Retiree Dental Plan
Optional dental coverage for retirees and dependents
Retirees and eligible dependents may enroll in the Retiree Dental Plan.
Rates (Billed Quarterly by United Concordia)
$22.68 per month
$43.05 per month
$56.54 per month
PFT Health & Welfare Fund Vision Care Program
N.V.A. Vision Program for retirees
No Monthly Premium
Basic Charges (Using Participating Providers)
Frame Coverage Details
- •The $24.00 basic charge is applied to the wholesale cost of frames
- •These typically sell for approximately $48.00
- •If you pick more expensive frames, you pay the difference between the $24.00 and the actual wholesale cost, plus 20% of this difference
How to Use the PFT Retirees N.V.A. Vision Program
- 1.Obtain a list of eligible providers from the Fund office
- 2.Make an appointment and notify the NVA participating provider that your coverage is administered by NVA and sponsored by The Philadelphia Federation of Teachers
- 3.You pay the provider for listed extras when you pick up your glasses
- 4.After you order your glasses, you will receive a bill for the basic portion of your order from the Fund office
- 5.Pay the bill within 30 days
Questions About COBRA or Retiree Plans?
PFT Health & Welfare Fund Office
1816 Chestnut Street, Philadelphia, PA
(215) 561-2722
Contact Page
For enrollment, billing, and benefit questions