Retiree/Direct Bill Open Enrollment

The 2010 State of Kansas Open Enrollment period for direct bill members is November 15, 2009 through December 15, 2009. You must complete the form included in your Open Enrollment packet or contact the Direct Bill Call Center between November 9, 2009 thru January 8, 2010 at 1-866-541-7100 (In Topeka 296-1715).

Representatives are available to assist you Monday through Friday from 8:30 a.m. to 4:30 p.m. Central time. The office will be closed on Veterans Day (November 11, 2009), the Thanksgiving Holiday (November 26-27, 2009), Christmas (December 25, 2009) and New Year’s Day (January 1, 2010).

Open Enrollment changes made to your health plans will become effective January 1, 2010. You will receive new identification cards at your home address a few weeks after your enrollment is complete. You will also receive a statement confirming your changes in late December.

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Split Coverage Enrollment

Mixed Eligibility (Some Members Are Eligible for Medicare and Some Are Not). In this case, the member eligible for Medicare could enroll in a Medicare-only plan while the spouse or dependent not eligible for Medicare could enroll in another non-Medicare plan offered by the State of Kansas. For example: If you are eligible for Medicare and your spouse isnot, you may enroll in the Kansas Senior Plan C with or without drugs and your spouse may enroll in Plan A. Whether the Medicare Eligible member elects one of the Medicare Plans, or elects to continue on Plan A or Plan B, your coverage will still be split.

When you enroll, make sure to indicate “Split Enrollment.” Both member and spouse must complete an enrollment form for the health plan they choose. The member and spouse are enrolled separately and each enrollment is treated as an individual policy with its own unique billing arrangements.

All Members That Are Eligible for Medicare. If the member and all of his or her dependent(s) are eligible for Medicare, each family member may enroll in a different Medicare plan option. For example: If you and your spouse are both eligible for Medicare, you may enroll in the Kansas Senior Plan C with or without drugs and your spouse may enroll in the Coventry Advantra PPO.

When you enroll, make sure to indicate “Split Enrollment.” Each family member must complete a form for the Medicare plan he or she chooses. Again, each member is enrolled separately and each enrollment is treated as an individual policy with its own unique billing arrangements.

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Changing Your Coverage

Once you enroll, or if you do not enroll before the deadline, your choices are binding until the next annual Open Enrollment period except as provided in this section.

You may cancel or drop coverage for you or your dependent(s) at any time. If you drop coverage, you may not re-enroll.

You may make other changes to your coverage if you experience a “qualifying event” that allows you to make a change. Qualifying events include life-altering events such as the birth or adoption of a child, marriage, divorce, death of a spouse or a dependent, or gain or loss of employment and benefits for a spouse or a dependent. Documentation of the qualifying event (for example, a marriage certificate or death certificate or copy of the obituary) will be required.

Important: Health plan changes due to a qualifying event must be consistent with the event. You must notify the Direct Bill Membership Office within 31 days of the qualifying event in order for the change to be effective the first day of the month following the event. If the event takes place on the first day of the month, the effective date will be that day. If you do not submit your change form within this 31-day period, you will not be able to make the change until the next Open Enrollment period. If there is a qualifying event that would result in a refund and you do not notify the Direct Bill Membership Office of the change, refunds may not be made retroactively. The only exception would be death.

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