Get Retiree Insurance Application - Baylor University - Baylor

The Retiree Insurance Application at Baylor University is designed to facilitate the enrollment process for retirees seeking health and insurance coverage. This guide provides step-by-step instructions for filling out the application correctly online, ensuring that users can easily navigate each section of the form.

Follow the steps to complete your retiree insurance application.

1. Press the ‘Get Form’ button to access the Retiree Insurance Application. This will allow you to open the form in your preferred editor.
2. In Section 1, provide your employee information. This includes your first name, last name, home address (including number and street), middle initial, city, state, zip code, Baylor ID or the last four digits of your Social Security number, and your retirement date.
3. Move to Section 2 where you will select your health insurance options. Choose whether to decline coverage or continue with the current BCBS - PPO Medical Plan/CVS/Caremark Prescription Plan. Check the appropriate box corresponding to your age group and desired coverage options. Review the associated monthly costs for each option.
4. In Section 3, assess your term life insurance options. For Grandfathered Retiree I, indicate whether you are eligible to retain a reduced term life policy at Baylor’s expense by checking the appropriate box.
5. Proceed to Section 4 to select your dental plan options. Similar to health insurance, choose whether to continue with the available dental plans and check the box for the desired coverage while noting the costs.
6. Section 5 relates to Medicare Part B reimbursement. Here, check whether you are eligible for the additional Health Reimbursement Arrangement and whether it applies to you.
7. In Section 6, decide on medical/dental premiums and select whether you wish to have the remaining premiums deducted from your last payroll check. It's important to understand the tax benefits of payroll deductions.
8. Finally, in Section 7, sign and date the application to authorize the information provided. You can then choose to clear the form or print it for submission.
9. Submit the completed form via email to askHR@baylor.edu or return it to Human Resources at Robinson Tower, Suite 200. Fax or mail options are also available for submission.

Complete your Retiree Insurance Application online today for efficient processing of your insurance needs.