In by ombudsman

The complainant enjoyed a long marriage to a state employee who retired in the early 2000’s. As a spouse, she was covered under her husband’s employee health insurance, and then under his retiree health insurance, for which the state paid the premiums. Her husband had elected a survivor benefit, and apparently he and the complainant presumed that system-paid health insurance was part of the survivor benefit. But when the complainant’s husband died, she learned that her health insurance coverage terminated unless she began paying the full premium ($832/month). The Division of Retiree and Benefits (DRB) told her that she was not eligible to receive system-paid insurance until she turned 60 which was four years away. She contacted the Ombudsman. The Ombudsman reviewed the statutes controlling the retirement health insurance provided by the Public Employees Retirement System (PERS), which in this case were the Tier II provisions in effect when the complainant’s husband was hired by the state. The statute governing retiree and survivor’s health insurance, AS 39.35.535, required the result that the complainant objected to. The Ombudsman suggested that DRB provide retirees’ survivors with better information much sooner. In this case, the survivor apparently did not receive notice of her loss of system-paid coverage until over a month after her husband died. Fortunately, she had not made any medical claims during that time. DRB agreed and made changes to its web page for reporting a retiree’s death, including a warning stating: “Depending on your age and the Tier of your deceased spouse, system paid medical coverage may end.” DRB also revised the death information form to add an email address field, to facilitate emailing information to the survivor when feasible, instead of waiting for paper mail to be delivered. (A2016-0589)