Leaving Duke: Eligibility for Retiree Health | Human Resources (2024)

Duke offers eligible retirees the opportunity to participate in Duke's retiree health plan,which consists of retiree medical and/or retiree dental coverage. Your eligibility for retiree health insurance and the premiums you will pay are determined by several factors, including whether you hold a position classified as a University or Health System employee within the payroll system, most recent hire date, years of service, and transfer history. Please remember that our benefit plans are based upon the plan's official plan documents. If there is a conflict between the information presented on this website and the official plan documents, the official plan documents will govern in all cases. Also, please remember that Duke reserves the right at any time to change or terminate the benefit plans, which includes the right to change eligibility for and participant contribution rates under the benefit plans including with respect to retiree health coverage.

• The following requirementsmust be met in order to be eligible for retiree medical coverage. The first is being a participant in Duke's active medical plan and receiving Duke's contribution towards the cost of medical coverage at your time of retirement. The second requirement is regarding length of service, and these service requirements depend upon your hire date and whether your position is within the University/Medical Center or Health System.
• In order to be eligible for retiree dental coverage, you must be a participant in Duke’s active dental plan and meet the requirement regarding length of service for your respective entity (University/Medical Center or Health System).

Below is detailed information intended to assist you in determining both your eligibility to participate as well as the portion of premium you would pay for coverage. Determine the service requirements applicable to you. After determining eligibility to participate, you likely also will want to know the premium amount you would be asked to pay. The amount varies based upon when your eligibility criteria was met, your hire date, as well as whether your position is within the University/Medical Center or Health System. The charts below reflect the current percentages to assist in providing you this information. Please Duke Benefits at (919) 684-5600 for current premium amounts.

1. If you are presently classified as a University, School of Medicine, Medical Center (Company Code 10) employee within the payroll system, criteria for retiree medical coverage is reflected below:

The Rule of 75 means your age plus your years of continuous service (based upon your most recent continuous service date) equal at least 75.

Note about Transfers: If you have transferred to Duke University from the Duke University Health System you will not immediately fall under the eligibility rules for Duke University. You must work at least 5 continuous years for Duke University after the date of transfer in order to be eligible for Duke University rules, otherwise the Duke University Health System rules apply.

2. If you are presently classified as a Duke University Health System employee within the payroll system, criteria for retiree medical coverage for employees employed by Duke University Health System prior to July 1, 2002 with no break in service is reflected below:

Employees hired on or after July 1, 2002 with no break in service - you are eligible for retiree health coverage if you have 15 years of continuous service after age 45. Retiree pays 100% of the premium. The "Rule of 75" does not apply.

Note about Transfers: If you have transferred to the Duke University Health System from Duke University, you will remain under Duke University eligibility rules if at the time of the transfer you met the "Rule of 75" or had 15 or more years of continuous service as of July 1, 2002. Otherwise, the Duke University Health System rule of 15 years of continuous service after age 45 applies.

3. If you are uncertain as to whether you are reflected as Duke University/School of Medicine or Duke University Health System classification within the payroll system, please contact the HR Information Center at (919) 684-5600.

Retiree Health Insurance for Those Under Age 65

If you are eligible to receive retiree health insurance and you and all of your covered dependents are under age 65 (not Medicare-eligible), you will remain on your existing health insurance plan but will be moved to the Early Retiree Group. When this happens, you will receive new medical ID cards and new subscriber numbers. Be sure to give your new ID cards to your providers.

Once you or any of your covered dependents attain age 65 or become Medicare-eligible due to other circ*mstances, you need to move to the Duke Plus Health Plan.

You will receive a letter from Human Resources explaining the move to Duke Plus and it will give you instructions on how to sign up for Medicare Part A, Hospital Insurance and Part B, Medical Insurance through the Social Security Office.

Duke Plus - Retiree Health Insurance for Those Who Are Medicare-Eligible

If you are eligible to receive retiree health insurance and you or one of your covered dependents is age 65 or older, or otherwise Medicare-eligible, you will be enrolled in Duke Plus. You will want to sign up for Medicare Part B, Medical Insurance through the Social Security office. At this time Medicare Part B will become your primary medical insurance and Duke Plus will pay secondary to Medicare. For any members covered on your plan who are not Medicare-eligible, Duke Plus will be their primary medical insurance.

Details of what Duke Plus covers, including Pharmacy Benefits and Behavioral Health benefits, as well as Frequently Asked Questions, are available here.