University of Maine System Retiree Health Benefits

Frequently Asked Questions

Below are answers about health plans available for University of Maine System retirees.


Enrollment and Un-Enrollment Questions

Yes, the University of Maine System will provide a letter to you confirming that we have received your request to re-enroll in the University-sponsored group plan. If we have an email address available, this will be sent to your email; otherwise, a letter will be sent to your home.

If you want to continue with the coverage that is pending, wait until a determination is made.  This usually occurs within about ten days. If the coverage is declined, you have until December 31 to re-enroll in the group plan with Aetna using the Aetna re-enrollment form. Click here to access the Aetna Enrollment Election Form (External Site).

If you do not want to continue with the coverage that is pending, let the new carrier know that you are not proceeding with their application and then complete the Aetna group enrollment form. Click here to access the Aetna Enrollment Election Form (External Site).

Retirees and their spouses/eligible dependents must both choose from either the plans available on the Aon Retiree Health Exchange or the University-sponsored Aetna group plan.

Only in situations where both family members are retirees of the University of Maine System can one retiree choose a plan from the Aon Retiree Health Exchange and the other retiree may select Aetna.

Each carrier may have a different process for un-enrolling in coverage, so please follow the procedures below unless the carrier requests you follow a different process

  • Prepare to call your Carrier
    • To verify the Carrier you enrolled with through Aon
    • If you have already received your new insurance card: Have it handy. If not, the carrier may ask additional questions to verify your coverage.
    • If you already paid your premium: Please note the form of payment used (i.e., credit card, personal check, etc.), to help facilitate your refund process.
    • If you enrolled in a Medicare Supplement (Medigap) and Prescription Drug Plans using different providers: You may need to contact multiple carriers.

Contact your Carrier before end of day on December 31, 2020, but we recommend that you do this as soon as possible so that everything will be in place for January 1, 2021 (for example: so that new insurance cards will be made available by January 1, 2021).

  • Access your Carrier’s contact information – located under “More Information” on the Aon University of Maine System microsite (External Site).
  • Inform the Carrier that you now wish to un-enroll.
  • If you enrolled in a medical and prescription plan with the same Carrier, let them know that you had multiple plans.
  • If you and your spouse or dependent enrolled in the same plan, inform the Carrier that multiple people need to un-enroll.
  • Request a confirmation number for each un-enrollment.
  • If applicable, request a refund for the premium(s) you previously paid. You will want to verify with the carrier the expected timing for refund.
  • For your records, make note of the individual with whom you spoke when you contacted the Carrier(s).

Enroll in the University-sponsored Aetna group plan before end of day on December 31, 2020, but we recommend that you do this as soon as possible so that everything will be in place for January 1, 2021 (for example: so that new insurance cards will be made available by January 1, 2021).

Please note: If you return to the University-sponsored Aetna group plan, you will not receive any Health Reimbursement Account (HRA) funds to help pay your medical coverage premiums or out-of-pocket expenses


Dental Insurance Questions

If you are staying in the Aetna health plan, you may continue coverage in the University of Maine System Cigna dental plan if you are already covered. If you are continuing in the Aetna health plan and did not sign up for a plan through the Aon Exchange, your dental coverage will continue with no action on your part. If you signed up for a health plan through the Aon Exchange and then unenrolled from that to remain in the Aetna plan, you will need to complete the brief enrollment form that includes the option to continue dental coverage. Click here to access the form (External Site).


Medical Insurance Questions

The Center for Medicare Services (CMS) allows for guarantee issue (GI) when a retiree is initially eligible for Medicare (turning 65 or SSA Disabled) or when a group health plan is ending. The same rights are not universally afforded for Medigap plans and may be subject to underwriting. Given the UMS plan is no longer ending, the ‘loss of coverage’ letter is no longer applicable and should not be provided to the Carrier.

If you enrolled in a Medicare Advantage or a Part D prescription plan there is no impact to your guarantee issue protection. However, if you enrolled in a Medicare Supplement product, the answer depends on your state of residence and carrier-specific rules. The vast majority of people will experience no impact at all.

Enrollments completed through Aon Retiree Health Exchange will likely not be reassessed by the respective carrier for underwriting due to this recent change in the UMS Group Health Plan Choice. In rare instances, a carrier may choose to review your application. In this case, the carrier will notify you if they have additional questions. Once you have received confirmation from your carrier that you have been approved, additional documentation will not be requested.

The University-sponsored Aetna group plan is similar to what you had in 2020 with no change in rates from 2020 to 2021. The premiums, deductibles, copays, and out of pocket expenses will be the same as in 2020.

Click here to review a copy of the 2021 Benefit Summary for the Aetna Retiree Health Plan.

Yes. Retirees will receive a new card from Aetna that they will use beginning on January 1, 2021.

Community rating means that the premium prices are the same for all beneficiaries regardless of age or medical condition.


Health Reimbursement Account and Catastrophic HRA Coverage Questions

No. The Health Reimbursement Account (HRA) only applies to individuals enrolled in a plan on the Aon Retiree Health Exchange.

A participant needs to incur $1,500 of drug cost out of their pocket within the calendar year before getting reimbursed 100% for their drug cost for the rest of the year, up to one million dollars. Any drugs not covered under the drug plan’s formulary will not be included in the $1,500 out of pocket tabulation and will not be reimbursable. The $1,500 limit has to be verified through the drug plan’s EOB (Explanation Of Benefits). The EOB is mailed out to the participant each month, in which they fill a prescription using their Part D drug plan. Once the EOB states the participant incurred $1,500 out of their pocket, the participant should notify Aon. The participant will send in a copy of the EOB to Aon for verification. Aon will then set up the drug reimbursement benefit for the participant. Afterward, the participant will send in all out of pocket drug expenses, that are covered under the plan, to Aon for reimbursement.

The participant will be responsible for costs of drugs not on the formulary. That is true in the current group health plan as well. One example of drugs not on a formulary might be drugs in trials that are not yet approved for use. In that case there may be assistance available from the drug manufacturer. Compounded drugs would be another example. If there is a specific specialty drug you are concerned about, check the formulary of the plan you selected.

If you have canceled your coverage in a plan sponsored through Aon, you are not eligible for a Health Reimbursement Account. You may still receive a Welcome Kit because of the timing between when the kits were prepared for mailing and when you canceled the coverage. If you receive a kit and you are not in an Aon sponsored plan, please just ignore it.

For all questions related to the HRA accounts, starting January 1, 2021, use the online tools on your Aon account or call Aon Retiree Health Solutions 1-833-704-1028 (TTY 711) • 9 a.m. – 9 p.m. Eastern Time, Monday – Friday • Closed on holidays

Wait until January 1 or later to access your account. HRA accounts are effective 1/1/21.


Future Open Enrollment Questions

There will be an open enrollment in the fall of 2021 and  eligible retirees and dependents will be able to select either a plan through the Aon Exchange or the group plan offered by the University of Maine System.

The selection you make for 2021 (Aon plan or UMS plan) will not affect your ability to select among available plans for 2022.

The University of Maine System will continue to offer a group health plan in 2022. Specific information about plan coverages and costs will be available later in 2021.

There will be an open enrollment in the fall of 2021 and eligible retirees and dependents will be able to select either a plan through the Aon Exchange or the group plan offered by the University of Maine System.

Yes, there will continue to be an HRA available to those who enroll in individual plans through the Aon Exchange in 2022. The HRA does not apply to those in the UMS-sponsored group plan.


Billing Questions

Yes. The University of Maine System will coordinate with EBPA and Aetna to ensure timely and accurate processing of premium billing and related payments during this transition.

Amounts for the Aetna group health plan are available at this University of Maine System benefits page.