I have eligible medical expenses incurred in 2019 that I have not yet submitted for reimbursement. How do I get these expenses reimbursed now?
After January 1, 2019, Discovery Benefits (DBI) will process all claims for eligible medical expenses, even those expenses that were incurred prior to 2019. Refer to the "Out-of-Pocket Reimbursement Request Form" and follow the instructions for completion.
Submit the completed form with supporting documentation to Discovery Benefits.
Mail: PO Box 2926; Fargo, ND 58108-2926
Fax: 1-866-451-3245
How do I setup automatic premium reimbursement for my Medicare Part B premiums and Part D premiums, if applicable, that are deducted from my Social Security payments?
You can setup automatic premium reimbursement by completing the Discovery Benefits (DBI) "Automatic Premium Reimbursement Request Form". Please complete and return the form to DBI as follows:
Mail: PO Box 2926 ∙ Fargo, ND 58108-2926, or
Email: customerservice@discoverybenefits.com, or
Fax: 866-451-3245.
Can I use my Defined Dollar Credit to pay for premiums from another employers plan?
Yes, however any premiums deducted from your paycheck must be paid for on an after-tax basis to be eligible for reimbursement from the HRA.
Will my spouse/surviving spouse be eligible for coverage and/or a Defined Dollar Credit?
Yes, the spouse/partner you have when you retire will be eligible for coverage and the Caltech Defined Dollar Credit. If a retiree re-marries after January 1, 2016 the new spouse can join the plan, but Caltech will not provide a Defined Dollar Credit toward the new spouse's coverage.
How do I make monthly premium payments?
If you select a plan that costs more than your Defined Dollar Credit, you will be invoiced each month for the difference. The invoice will come from Mercer, Caltech's benefits billing administrator.
You can make payments with a check or by setting up a recurring payment through your bank.
What happens if I don't pay my bill?
Your coverage will be terminated if you fail to make timely payments and coverage will not be reinstated until past due premiums are paid in full.
Is my dependent child eligible for coverage?
Yes, children who are under age 26 or disabled can be on the plan. However, Caltech will not provide a Defined Dollar Credit for dependent children.
Do I have to join the Caltech retiree medical program?
You don't have to join the Caltech retiree medical program. However, if you are a non-grandfathered retiree or spouse, there are rules about when you can join.
What are the grandfathering rules?
If you retired with Caltech medical coverage before January 1, 1991, you are considered a grandfathered retiree.
If you were actively at work on April 1, 1991, and you had at least 10 years of continuous Caltech service, and you met at least one of the following criteria as of April 1, 1991, you may be considered a grandfathered retiree:
How is the program different for Medicare-eligible grandfathered retirees?
If you are a Medicare-eligible grandfathered retiree age 65 or older, you and your Medicare-eligible spouse will continue to be eligible for a free medical plan.
I am a Grandfathered retiree, what plans can I choose?
You can choose one of the following plans:
I am a Grandfathered retiree, can I have my left over Defined Dollar Credit in an HRA if I am on the free Kaiser plan?
No, if you choose the free plan, you are not entitled a Defined Dollar Credit amount.
I am a Grandfathered retiree, but my spouse is not Medicare eligible yet, can my spouse have the free Kaiser plan?
No, if your spouse is not Medicare eligible, they will receive a Defined Dollar Credit to purchase an Aetna or Kaiser plan. Caltech will use the maximum service credit of 25+ years to calculate their Defined Dollar Credit.
I am a Non-Grandfathered retiree (or spouse), can I enroll in the free Kaiser plan?
No, Caltech provides you and your eligible spouse with a Defined Dollar Credit to help pay for your health care. The amount of your credit is based on your years of service up to a maximum of 25+ years.
I am a Non-Medicare eligible Grandfathered retiree (or Non-Medicare eligible spouse), can I enroll in the free Kaiser plan?
No, Caltech provides you and your eligible spouse with a Defined Dollar Credit to help pay for your health care. The amount of your credit is based on your years of service up to a maximum of 25+ years.