Selecting Your Plan

Who’s Eligible to Enroll in a Plan?

If you have questions about eligibility, please call STRS Ohio’s Member Services Center toll-free at 1-888-227-7877.

Reemployed Retiree
Health care coverage for reemployed retirees in public or private positions may be limited under the STRS Ohio Health Care Program. Under State Teachers Retirement Board Rule 3307:1-11-02, reemployed retirees are eligible for only secondary health care coverage through STRS Ohio if they: (1) are eligible for health care coverage through their employer, or (2) hold a position for which other comparable employees are eligible for health care coverage at the same cost as full-time employees. The rule applies to all reemployed retirees who are not eligible for Medicare, regardless of hire date or type of employment. In addition, the rule applies only when the employer plan provides both medical and prescription drug coverage.

If you are employed and have access to employer-sponsored health care coverage, you must submit a Verification of Employment and Employer Health Care Access form. Failure to notify us could result in loss of coverage under the STRS Ohio Health Care Program. More information, including examples of reemployment positions and how they affect eligibility for primary health care coverage through STRS Ohio, is available in STRS Ohio’s Reemployment brochure.

Verification of Employment and Employer Health Care Access for 2009 form

Verification of Employment and Employer Health Care Access for 2010 form

Service Retirement Benefit Recipient
Service retirement benefit recipients with 15 or more years of service have access to health care coverage and receive a premium subsidy. Service retirement benefit recipients with a benefit effective date before Jan. 1, 2004, with less than 15 years of service credit have access to coverage, but pay the full cost of their health care premium.

Disability Benefit Recipient
Disability benefit recipients are eligible for access to health care coverage and a premium subsidy.

Survivor Benefit Recipient
Most survivors and their dependents have access to health care coverage and receive a premium subsidy for the first five years, with the first year beginning the latter of Jan. 1, 2004, or the effective date of benefits. See Subsidy for Survivors for details.

Spouse
Spouses of service retirement and disability benefit recipients enrolled in the STRS Ohio Health Care Program are eligible for access to health care, but pay the full cost of their health care premium. Please note that survivor benefit recipients can enroll a spouse as a sponsored dependent only if eligibility criteria are met, and must pay the full cost of the health care premium.

Dependent or Incapacitated Child
Dependent or incapacitated children of service retirement or disability benefit recipients who meet the guidelines below are eligible for access to health care, but pay the full cost of their health care premium. You must be enrolled in an STRS Ohio health care plan to enroll a dependent.

To be eligible for access to health care, the dependent or incapacitated child must:

1. Be a dependent biological child, a nonbiological child who is legally adopted, a stepchild or a child for whom you have been appointed legal guardian; and
2. Reside in your home; and
3. Meet one of the following eligibility requirements:
• Child is unmarried and under age 18; or
• Child is unmarried, under age 22, attending school on at least a two-thirds-of-full-time basis and receiving 50% or more financial support from the benefit recipient (applies if benefit recipient’s effective date of benefits was Jan. 1, 2003, or later); or
• Child is unmarried, under age 23, attending school on at least a two-thirds-of-full-time basis and receiving 50% or more financial support from the benefit recipient (applies if benefit recipient’s effective date of benefits was before Jan. 1, 2003); or
• Child is unmarried, unable to earn a living because of a mentally or physically disabling condition that started before the date the child reaches the maximum age for dependent children as outlined above, and the child has been continuously enrolled as a dependent under the benefit recipient’s health care plan since reaching the maximum age for dependent children as outlined above.

Sponsored Dependent
Sponsored dependents who meet the guidelines below are eligible for access to health care coverage, but pay the full cost of their health care premium.

To be eligible for access to health care coverage, a child sponsored dependent must be under age 18 and unable to qualify as a dependent child. An adult sponsored dependent must be age 18 or older and unable to qualify as a dependent child or as a spouse. Sponsored dependents who may qualify for health care coverage include:

• A blood relative living in the home of a benefit recipient. “Home” includes a convalescent center or any other type of institution that retains the person only temporarily. To qualify as a blood relative, a person must have a direct genetic relationship to the benefit recipient, rather than a relationship through marriage.
• A blood relative not living in the home of the benefit recipient, but receiving 50% or more financial support from the recipient in the last six months (as demonstrated by completion of a financial status form provided by STRS Ohio or your most recent federal income tax return on which you claimed your sponsored dependent).
• Any person (including the spouse of a survivor benefit recipient) living in the home of a benefit recipient and receiving 50% or more financial support from the survivor or benefit recipient in the last six months (as demonstrated by completion of a financial status form provided by STRS Ohio or your most recent federal income tax return on which you claimed your sponsored dependent).
• Any person living in the home of an unmarried service retirement or disability benefit recipient who does not claim the sponsored dependent as a financial dependent on the IRS tax return.