Health In-Lieu
Health In-Lieu and Dental In-Lieu Premium Credit Program
Annual Re-enrollment is Required!
Effective March 31, 2017 (P&F) and June 16, 2017 (FCERS), members and their surviving spouses, surviving domestic partners, and/or children who are eligible for medical insurance coverage may, instead of receiving such coverage, choose to receive a credit for an amount equal to twenty-five percent (25%) of the monthly premium of the lowest cost medical plan and the lowest cost dental plan. Such credited amounts can only be applied toward the cost of such person's healthcare premiums actually incurred in future years.
Frequently Asked Questions (FAQ)
Question: If my spouse and I are both eligible for insurance through the City of San Jose (either as a retiree and/or as an employee) can I enroll in the retiree In-Lieu Credit program and get insurance through my spouse?
Answer: Eligible retirees who receive healthcare coverage as a dependent of another City employee or retiree are eligible for the single in-lieu premium credit. He or she is not eligible for the family in-lieu premium credit.
Question: If I accumulate credits but I am unable to use them because my health insurance premiums are zero, can I receive my In-Lieu credits as a cash payment?
Answer: In no event can a member, surviving spouse, surviving domestic partner, and/or eligible dependent receive the in-lieu credits as cash. In-Lieu credits may only be applied to the cost of future premiums for coverage. If a member and/or the member's eligible dependents do not use the accumulated credits while eligible for healthcare coverage, any remaining credits will be forfeited.
Question: If I am enrolled in the retiree Health-In-Lieu credit program when I turn 65, do I have to enroll in Medicare Parts A&B?
Answer: Any member who is eligible for healthcare benefits and who waives coverage will not be required to enroll in Medicare Parts A&B when they turn 65. However, if such member later chooses to enroll in a healthcare plan, he or she will be required to enroll in Medicare Parts A&B and any charges or penalties imposed by Medicare associated with enrollment outside the "initial enrollment period" shall be borne by such member.
Question: If I enroll in the In-Lieu credit program and subsequently pass away, can my eligible dependents use my accumulated credits if they are eligible for medical coverage after my death?
Answer: Yes. The credits are earned by the family and can be used by your eligible dependents to cover future medical insurance premiums.
Question: Since dental insurance is a no-cost benefit for eligible retirees, how can I use my Dental In-Lieu credits?
Answer: Accumulated Dental in-lieu credits can be applied to future medical insurance premiums.
Question: Why do I have to re-enroll in the In-Lieu Credit program each year?
Answer: Annual re-enrollment is mandated by the San Jose Municipal Code. You must submit an annual Open Enrollment form to continue your enrollment in the In-Lieu Credit program each year.
Question: Where do I go to see my In-Lieu credit balance?
Answer: Your In-Lieu credit balances are shown on your monthly pay stub. Your stub includes your lifetime balance (if you have been in the program for more than one year) as well as your accumulated balance for the current year.
Question: Where can I see the monthly In-Lieu credit amounts?
Answer: Both the dental in-lieu and medical in-lieu monthly credit amounts are shown at the bottom of each page of the medical rate sheets and are posted on www.sjretirement.com. In-Lieu credits differ based on the level of coverage for which you are eligible i.e. Member Only, Member + Spouse/Domestic Partner, Member + Child(ren), and Member + Spouse/Domestic Partner and Children.