What is Premium Assistance?
Participating in the Health Options Program may entitle you to a special financial incentive that is not available with a commercial program such as AARP or Blue Cross Blue Shield. Premium Assistance is provided by PSERS to help eligible retirees pay for health coverage through the Health Options Program or another Commonwealth public school employer or district health plan. If you are eligible for Premium Assistance, PSERS will pay part of the premium for your coverage.
If you are eligible for Premium Assistance and choose Health Options Program-sponsored medical coverage, PSERS will pay up to $100 per month for your Health Options Program monthly premium. The amount of the Premium Assistance benefit is determined by the Pennsylvania legislature and is subject to change.
If you receive Premium Assistance, it will be added to your monthly retirement benefit. Premium Assistance is not taxable income.
If you are receiving Premium Assistance for your participation in your school employer plan and that coverage terminates, you must enroll in the Health Options Program to maintain your Premium Assistance.
If you do not enroll in the Health Options Program when your school employer’s coverage ends, you must send a written termination request to PSERS. Please contact the Premium Assistance Unit for details at 1-866-483-5509. If you do not notify PSERS, you will be billed for any overpayments made. PSERS identifies retirees who receive overpayments annually, but it is your responsibility, not your school employer’s, to notify PSERS when you are no longer enrolled in a plan approved for Premium Assistance.
Am I Eligible for Premium Assistance?
You are eligible for Premium Assistance if you are a retiree who meets one of the following service requirements:
- You have at least 24½ years of credited service regardless of age, or
- You terminate school employment and retire at or after reaching age 62* with at least 15 years of credited service, or
- You are receiving a disability retirement benefit from PSERS.
Even if you meet the service eligibility requirements, you cannot receive Premium Assistance if you do not choose a medical plan offered through the Health Options Program or if you do not continue to participate in your former school employer’s plan. The Premium Assistance benefit is not payable for separate dental, vision or prescription drug plans. It is not payable for out-of-pocket premium expenses for the retiree's spouse or dependents, or if your school employer provides coverage to you at no cost or with non-taxable contributions.
PSERS adds Premium Assistance payments to the eligible annuitant’s monthly retirement benefit. As a reimbursement, Premium Assistance cannot exceed the retiree’s actual out-of-pocket premium expense and is not treated as taxable income.
*Note: Age 65 with at least 15 years of credited service if you first become a school employee and an active member or a multiple service member on or after July 1, 2011 (Membership Class T-E and T-F).
Important Note About Premium Assistance
If you elect a standalone prescription drug coverage option, you are not eligible for Premium Assistance.