(a) The city extends participation in health benefit plans to every permanent full-time employee and to every city council member. Other classifications of employees are eligible to participate in the city's health benefit plans in accordance with federal law and as described in the applicable plan documents.
(b) Eligibility, premium rates, and procedures for participation in the health benefit plans for active employees, retired employees, and city council members are defined in plan documents adopted by the city council and on file with the department of human resources. The city may change the health benefit plans at any time, subject to applicable law.
(c) Notice of retirees' rights to purchase continued health benefits.
(1) Under Chapter 175 of the Texas Local Government Code, as amended, a person who retires from the city and is entitled to receive city retirement benefits is entitled to purchase retiree health benefits coverage from the city for the retiree and any eligible dependents at the retiree's own cost.
(2) The city may make retiree health benefits available to retirees and their eligible dependents under one or more separate plans, the terms and conditions of which may vary as the city specifies. Health benefits for employees who have separated from employment with the city will be made available through a plan available for retirees who are under the age of 65 (the "pre-65 plan") and through a separate plan available for retirees aged 65 or older (the "post-65 plan"). Eligibility to participate in any such plans, the coverage options available, the costs of enrollment and participation, and other terms, conditions, and limitations will be set forth from time to time in written documents that are consistent with this chapter.
(3) To enroll in the city's retiree health benefits upon separation from employment, an employee who is not 65 years of age or older must be enrolled in the city's health benefit plan for active employees and must be eligible to receive an immediately-distributable pension benefit under the Employees' Retirement Fund or Dallas Police and Fire Pension System, in each case on the employee's separation date. An employee is not required to have commenced receipt of pension benefits in order to enroll in the city's pre-65 plan. An enrollment election for the city's pre-65 plan must be submitted to the city within 30 days of the separation date to be effective. An otherwise-eligible employee who fails to timely enroll in the city's retiree health benefits or who subsequently terminates coverage will not be eligible to reenroll thereafter except through the "come-back option" available under the city's post-65 plan.
(A) In accordance with Chapter 615 of the Texas Government Code, as amended, the surviving spouse of a sworn employee of the police or fire department, who is killed in the line of duty, is entitled to purchase or continue to purchase health insurance benefits from the city and enroll in the pre-65 plan until the date the surviving spouse becomes eligible for federal Medicare benefits. The surviving spouse is entitled to obtain the coverage at the rate paid by current employees of the city.
(B) A city employee whose employment ends as a result of disability that entitles the employee to a disability retirement under the applicable city pension plan may enroll in the pre-65 plan regardless of the employee's age.
(4) To enroll in the city's retiree health benefits upon separation from employment, an employee who is aged 65 or older must be enrolled in the city's health benefit plans for active employees or the pre-65 plan on the employee's separation date and must timely enroll in Parts A and B of the Medicare program when initially eligible. To be effective, an enrollment election for the city's post-65 plan must be submitted to the city within 30 days of the date on which the employee initially satisfies the foregoing eligibility requirements. An otherwise-eligible employee who fails to timely enroll in the city's retiree health benefits or who subsequently terminates coverage will not be eligible to reenroll thereafter.
(5) A retiree who is age 65 may enroll in the city’s post-65 plan after separating from employment under the "come-back option" if, within 30 days of timely enrolling in the Medicare program, the retiree submits an enrollment request to the city, is eligible to receive an immediately-distributable pension benefit under the Employees’ Retirement Fund or Dallas Police and Fire Pension System, and provides satisfactory evidence of continuous comprehensive health plan coverage for the 36-month period immediately preceding the enrollment request. An employee is not required to have commenced receipt of pension benefits in order to enroll in the city’s retiree health benefit plan. A retiree who enrolls in the city’s post-65 plan under the come-back option and subsequently terminates coverage will not be eligible to reenroll thereafter. The come-back option is available beginning with the 2022 calendar year benefits enrollment period to retirees who meet the eligibility criteria on or after the enrollment period begins. A retiree’s legally-recognized spouse may be enrolled in the post-65 plan under the come-back option at the same time as the retiree’s enrollment, but no spousal enrollment independent of the retiree is permitted.
(6) All costs of participation in the city's retiree health benefits will be paid solely by individual enrollees based on the coverage elected except that the city will subsidize 50 percent of the costs of coverage for a retiree (but not coverage for a spouse or any dependents) enrolled in the pre-65 plan who was first hired by the city prior to January 1, 2010 until the earlier of:
(A) the date on which the retiree voluntarily terminates coverage under the pre-65 plan;
(B) the date on which the retiree enrolls in the city's post-65 plan; or
(C) the date in which the retiree's eligibility to participate in the city's pre-65 plan otherwise ends.
(D) No city-paid premium subsidy will be provided for any spousal or dependent coverage elected under the city's retiree health benefit plans. The employee's most recent date of hire or rehire with the city will be used for purposes of determining eligibility for the foregoing city subsidy.
(7) The city will not subsidize any premium or cost associated with enrollment or participation in the Medicare program (including any premiums for Medicare Advantage coverage) by current or retired city employees or their dependents except that the city will pay the monthly premiums for coverage under Part A of the Medicare program for city employees:
(A) whose original date of hire with the city was prior to April 1, 1986;
(B) who are continuously enrolled in the Medicare program from their initial eligibility date;
(C) for whom insufficient Medicare taxes were withheld during city employment to qualify for cost-free Part A coverage; and
(D) who have been continuously enrolled in the city's health benefits plan for active employees, the pre-65 plan, or the post-65 plan, as applicable during city employment and following separation from employment.
(8) The city will not subsidize any premium or cost under the city's retiree health benefit plans for:
(A) any employee who is hired or rehired on or after January 1, 2010;
(B) any dental or vision coverage;
(C) any spousal or dependent coverage;
(D) the come-back option;
(E) enrollment in Part B of the Medicare program; or