Retiree Medical Enrollment Chart

The chart below identifies how your medical benefits are affected based on your chosen separation and retirement dates.

If your separation and retirement date are...	and...	then your health coverage...	Note
within 30 days of each other	you are enrolled in a CalPERS health plan at the time of separation	will continue into retirement without a break.	If you do not want your health benefits to continue, decline coverage on your CalPERS Retirement Election Application. If you wish to change your health plan at retirement, contact the OHR Benefits Office for assistance.
between 31 and 120 days of each other	you are enrolled in a CalPERS health plan at the time of separation	will not automatically continue. You may re-enroll within 60 days of your retirement date or during Open Enrollment.	When your health coverage lapses, you may be eligible for COBRA. Contact the OHR Benefits Office to check on your COBRA eligibility.
within 120 days of each other	you are eligible for -- but not enrolled in -- a CalPERS health plan at the time of separation	eligibility remains valid.	You may enroll within 60 days of your retirement date or during Open Enrollment. Contact CalPERS for assistance.
more than 120 days apart	regardless of whether you are enrolled in a CalPERS health plan at the time of separation	cannot be reinstated. You are no longer eligible for CalPERS Health benefits.	There are some exceptions. For additional information refer to the Understanding Health into Retirement for Specialized Categories of State Employees guide available on the CalPERS website.

��