Health Insurance Rules

STRS Ohio medical coverage is limited for retirees not eligible for Medicare who are employed in public or private positions. Under Administrative Code Rule 3307:1-11-03, reemployed retirees qualify for only secondary health care coverage from STRS Ohio when they:

• Are eligible for medical and prescription coverage through their employer; or
• Hold a position for which other similarly situated employees are eligible for medical and prescription coverage. Note: The determination of similarly situated employee is based on position and employment status (part time/full time), not retirement status.

The rule applies to all reemployed retirees who are not eligible for Medicare, regardless of hire date or type of employment.

If eligibility for employer insurance is based on retirement status, the retiree is eligible for only secondary coverage from STRS Ohio. Primary coverage would need to be obtained from the employer or another plan.

The federal Affordable Care Act (ACA) requires employers with 50 or more full-time employees to offer minimum essential coverage to full-time workers. The fact that STRS Ohio offers health care coverage to reemployed retirees does not alter an employer’s obligation under the ACA to extend coverage to its employees, including individuals who retired under STRS Ohio, another public entity or a private employer.

STRS Ohio requires non-Medicare enrollees to verify their employment status and access to employer health coverage. Enrollees who are employed and not eligible for Medicare are responsible for providing verification through their STRS Ohio Online Personal Account.

View the Understanding Health Insurance Rules for Reemployed Retirees fact sheet for answers to frequently asked questions and a flow chart to help determine if primary or secondary coverage is available from STRS Ohio. Sample scenarios can also be found in the Employment After Retirement brochure on the STRS Ohio member website.