Retirement Benefits Checklist Post-65

If you are considering retirement and will be over 65 years old, Six months prior to your retirement date, please reach out to Human Resources to pick up your retirement packet and initial benefit process overview.

Please complete this checklist and submit it to Human Resource one month prior to your proposed retirement date.

First

Last

Retirement Date

Medicare

Three months prior to you turning 65, you will need to sign up for Medicare Part A and B. DO NOT sign up for Medicare Part D, 富二代视频app’s supplement plan provides your Rx plan.

Link:

Have you signed up for Medicare Part A & B?

Yes

HSA Contributions

If an individual has an HSA when he or she signs up for Medicare, they cannot contribute to the HSA. If an individual contributes to the HSA after Medicare coverage starts, he or she may have to pay a tax penalty. To avoid tax penalty:

Log into ADP portal () and stop payroll contributions to your HSA at least 6 months before applying for Medicare.
You will also need to notify Human Resources to stop the employer’s contribution as well.

Have you discontinued payroll contributions to your HSA in ADP?

Yes

Have you notified Human Resources to stop the employer鈥檚 contribution?

Yes

Required Forms

Have you completed and submitted the following forms to Human Resources?

Retiree Medical Plan Election Form (p. 13-15)

Medicare Prescription Drug Plan Individual Enrollment Form (p. 17-19)

Direct Payment Authorization Form (p. 21)

VEBA Direct Deposit Authorization Form

Sun Life Beneficiary Designation Form

富二代视频app University Fully-Insured Retiree Health Plan VEBA Beneficiary Designation Form

A copy of your Medicare Part A & B card

Would you like your monthly AmWins premiums automatically deducted from your VEBA account?

Yes

Questions/Comments/Concerns

Things to Keep in Mind

Once you submit your forms to HR, your new Transamerica (medical) and Express Scripts (Rx) cards should arrive in the mail in approximately 2 weeks.
Be sure to present your new insurance cards to your providers and pharmacy to avoid claims being denied.
If you move, please be sure to keep HR informed of any address changes.

If you need assistance, have questions or do not receive your new cards do not hesitate to reach out to: Brooke Baker, Benefits Administrator, 765.658.4135 or brookebaker@depauw.edu