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There are only two occasions allowing an employee to change their benefits, which are during Annual Enrollment and a qualifying Change of Status, during the year. You have 31 days from the date of the Change in Status event to notify your institution and submit your benefit elections. If you do not make your changes during the 31-day period, your changes cannot be made until the next Annual Enrollment in July, to be effective the following September 1st.

+ Marital Changes

Marriage Divorce and Declaration of Informal Marraige (Common-Law).

With a copy of a court issued document (State of Texas recognized marriage license, signed final divorce decree or declaration of informal marriage).

Click here to view the form.

+ Dependent Changes

Birth, Adoption, Legal Guardianship, Dis-qualification or Re-qualification of a Dependent Qualified Medical Support Order. With a copy of a court issued document, certification of birth, adoption determination, documentation support dependent eligibility or ineligibility or State issued medical support order.

Click here to view the form.

If the Dependent is a grandchild, stepchild or adopted child please complete the Special Dependent Application as well.

If you are Grandparent adding children please complete the Grandchild Certification as well.

+ Other Changes

Involuntary loss of Another Group Coverage, Loss or Gain of Spousal Employment and Death of a covered member or Dependent. With a copy of an original death certificate or documentation supporting the loss or gain of coverage and/or employment.

Click here to view the form.

Office of Employee Benefit Policy 310

Benefits Cost Worksheet

Preparing to Leave UTMB

Post Employment FAQ's

Benefits FAQs

Retirement FAQs

Accruals FAQs

Leave of Absence FAQs

2008 Retirement Handbook

UT SELECT and Medicare

When you or your covered dependent(s) become eligible for Medicare, you and your Medicare-eligible dependents should enroll in Part A (typically in-patient coverage) and Part B coverage (typically office visits and doctor fees). The University of Texas System urges all retired employees and dependents to enroll in Medicare Parts A and B when they become eligible at age 65 or earlier if they are eligible due to a disability. Retired employees or soon-to-be retired employees or their dependents who are eligible for Medicare must have Medicare Parts A and B to receive the maximum benefits available from the UT SELECT plan. It is your responsibility to inform your institution Benefits Office if your covered dependents are Medicare-eligible.

In most instances, if you are eligible for Medicare and are working in a position for at least 20 hours per week, your UT medical plan will be primary, and Medicare will be secondary. Medicare may be primary for some Medicare-eligible active employees with certain medical conditions. Consult with your local Social Security Administration office to learn what illnesses qualify for Medicare coverage prior to turning age 65.

If you are retired and also eligible for Medicare, Medicare becomes your primary payer and pays your medical claims first; UT SELECT pays second. If you choose a doctor who accepts Medicare assignment, you will not be responsible for any difference between the billed charge and the Medicare allowed amount.

If you decline Part B, you will have to pay a higher premium if you ever re-apply for Medicare coverage. As a retiree, if you or your Medicare-eligible dependent have declined Medicare Part B and fail to re-apply, you will be required to pay the portion that Medicare Part B would have paid as primary insurer for Part B-covered items for yourself and any Medicare-eligible dependents.

In order to ensure claims are correctly processed, you should contact Blue Cross and Blue Shield of Texas and report your or your dependent’s Medicare Health Insurance Claim (HIC) number and the effective dates of Medicare Parts A and B immediately upon enrollment.

If you or your dependents are enrolled in Medicare and your doctor accepts Medicare assignment and the doctor may be in or out of the UT SELECT Network;

- UT SELECT will pay 100% of benefits approved but not paid by Medicare (subject to UT SELECT plan limitations);

- There are no deductibles, copayments or coinsurance; and when you or your dependents are an inpatient at a facility that accepts Medicare assignment,

- UT SELECT will pay the Medicare inpatient deductible, and the $100 per day Co-pay ($500 maximum) will not apply.

If your doctor does not accept Medicare assignment Network and Out-of-Network benefits apply; UT SELECT will coordinate with Medicare; and Deductibles, copayments and coinsurance may apply.