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

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.

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.

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.

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.

• Payments are due the first of each month. Payments must be postmarked within 90 days of the payment due date in order to avoid termination of coverage. Generally, invoices will be mailed around the 5th of the month. However, the invoice for January will be mailed at a later date in order to allow time for processing of the new plan year enrollment files.

You can make payments with a check or by setting up a recurring payment through your bank.

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.

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.

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.

• If you have other medical coverage (other than Medicare), you will be able to join the Caltech retiree medical program if that other coverage ends. However, to join the Caltech retiree medical program, you must notify the Caltech Retiree Service Center within 90 days of the date the other coverage ends, and you must provide proof that you have maintained continuous medical coverage (other than Medicare) since January 1, 2015. (Be sure to retain records that prove you have continuous medical coverage, such as annual confirmation statements or premium receipts.)
• If you don't have other medical coverage and are not in the Caltech retiree medical plan already, you can join the Caltech medical plan during Open Enrollment in 2019. If you retired prior to 1/1/15 and you do not enroll in the Caltech retiree medical program during the 2019 open enrollment period, and you do not have other continuous medical coverage (other than Medicare), you will waive your right to join the Caltech retiree medical program, including an HRA.

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:

1. You were age 55.
2. Your age plus years of service was greater than 72.
3. Your years of service plus three times your age was greater than or equal to 175.

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.

You can choose one of the following plans:

• The Kaiser HMO Medicare Advantage plan is free.
• Opt out of the free plan option and use your Defined Dollar Credit to choose an Aetna plan.
• Collect your Defined Dollar Credit in an HRA plan. Caltech will use the maximum service credit of 25+ years to calculate your Defined Dollar Credit.

No, if you choose the free plan, you are not entitled a Defined Dollar Credit amount.

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.

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.

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.