RETIREES/COBRA BENEFITS

Retiree/COBRA Benefits are for retirees and former St. Francis Area Schools employees who were contracted at or above 1,020 hours per year and enrolled in benefits at the end of their employment with St. Francis Area Schools.

These Medicare plans are only for those that are post 65. (You cannot enroll until three months after turning 65)

Health Partners
Journey Plan

01/01/22-12/31/22
Single, Journey Plan: $243.73/month
Single and Spouse, Journey Plan: $465.50/month

Retiree National Choice Plan

01/01/22-12/31/22
Single, RNC Plan: $301.13/month
Single and Spouse, RNC Plan: $574.90/month

Public Employees Insurance Program (PEIP)

Medical benefits contact information:
Innovo Benefits Administration
952-746-3101 800-829-5601
www.innovomn.com

Effective 7/1/22-6/30/23

Monthly
Single, PEIP Advantage High Plan: $831.46
Family, PEIP Advantage High Plan: $2,199.50
High Plan Summary

Monthly
Single, PEIP Value Plan: $745.86
Family, PEIP Value Plan: $1,970.94
Value Plan Summary

Monthly
Single, PEIP HSA (Integrated and Retiree Funded Health Reimbursement Arrangement) Plan: $589.20
Family, PEIP HSA(Integrated and Retiree Funded Health Reimbursement Arrangement) Plan: $1,552.80
HSA Plan Summary

Enrollment or Waiving Coverage Form
PEIP Medicare Part D 2020 Credible Coverage Disclosure Information

Delta Dental Plans

Single: $38.00
Single +1: $72.00
Family: $96.00
Delta Dental Booklet
Delta Dental Summary
Effective 7/1/2021- Increased plan year maximum to $1,250

Voya Life Insurance

Retiree Life Policy $.33/$1,000
Basic Life Policy $.15/$1,000
Supplemental Life $.19/$1,000
Dependent Life $5,000 Policy: $1.25
Dependent Life $10,000 Policy: $2.00
Dependent Life $15,000 Policy: $5.40

Billing & Administrative Fees

Billing is administered through WEX Health
COBRA/Retiree Benefits Administrator
WEX Health
866-451-3399
customerservice@wexhealth.com

Retiree smiling

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