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See how your benefits protect
you and your loved ones

New Retiree Enrollment Process


Some of the questions and concerns you have about our process and around benefits may already be answered here. This office helps administer the retiree’s health care benefits plan. Some of those specific questions are answered here, but are expanded on more formally in the Plan Document.
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Enrollment Process

How do I make an appointment with a Fund Benefit Specialist?

Call our office at 1-866-652-4237 to schedule an appointment with a Benefits Specialist.

What do I need to bring to the appointment?

Please bring the required documents to your appointment. See the list below:

**Marriage Documentation: **
  • If married, provide an official marriage license.
  • For common-law marriages, you must submit a Declaration and Registration of Informal Marriage.
**Social Security Information: **
  • Include a Social Security card for each individual being added to the Health Fund Plan.
  • If you do not have a Social Security card, please provide a copy of one of the following:
  • Permanent Resident Card
  • Tax Identification Number (TIN), if applicable.
**Dependent Information: **
  • A birth certificate for each dependent child being added to the Health Fund Plan.
  • If you are divorced or have stepchildren, please provide child support orders that indicate the parent responsible for providing insurance for the child.
  • Incapacitated dependent: To maintain eligibility for an incapacitated dependent, proof of incapacity must be submitted thirty-one (31) days before the child turns twenty-three (23).
  • Any incapacitated dependent is required to apply for, purchase and maintain Medicare Benefits. A copy of the determination from the Social Security Office must be submitted to The Fund Retiree Health & Wellness San Antonio Fire and Police office.
**Other Insurance: **
  • Include cards for any other medical insurance policies if you are covered by another plan.
**Pension Fund Documentation: **
  • Provide the Projection Form from the San Antonio Fire and Police Pension Fund Office
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Eligibility

An Eligible Dependent is:
Spouse:
The eligible retiree’s spouse, if elected at initial coverage. A spouse that is legally separated under a court decree under the laws of Texas or another state shall not be an eligible Dependent,
Children:
All natural children including legally adopted, under legal guardianship of the covered retiree and who have not yet reached their twenty-third (23rd) birthday, provided the children have never been married and are Principally Dependent upon the eligible retiree, as directed by court order, for support and maintenance. Foster children are not eligible Dependents under this Plan, unless there has been an application for adoption accepted by the Texas Department of Human Services. Stepchildren are eligible Dependents during the marriage between the eligible retiree and the natural parent of the child, so long as (a) they permanently reside in the retiree's household, and (b) are Principally Dependent on the retiree.
Incapacitated Dependent:

An eligible Dependent child who is physically or mentally incapable of self-support upon attaining the age of twenty three (23) years, shall continue to be an eligible Dependent while remaining incapacitated, unmarried and continuously covered under the Plan. An eligible

Incapacitated Dependent must be solely dependent on the retiree, and must be incapacitated by a disability that arose while such Dependent was a covered Dependent. To continue eligibility under this provision, proof of incapacity must be submitted by the retiree at least thirty-one (31) days prior to such child's attainment of age twenty three (23).

Any incapacitated dependent is required to apply for, purchase and maintain Medicare Benefits. A copy of the determination from the Social Security Office must be submitted to The Fund Retiree Health & Wellness San Antonio Fire and Police office.

PLEASE NOTE:

Once coverage is in effect, no new spouse or Dependent may be added to the Plan.
Termination of coverage for any Covered Spouse and/or Dependent is permanent and once terminated, any such individual(s) cannot be added back to the Plan.

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COVERAGE & MEDICARE

  • The Health Fund offers medical and prescription coverage.
  • No coverage is available for dental or vision.
  • Medicare requirements: Once a covered person is eligible for Medicare either by age or established criteria for Medicare eligibility a covered person is required to apply for, purchase and maintain Medicare Part A & B Benefits. If a covered person does not have the eligible quarters for Medicare Part A the covered person will need to provide a copy of the Notice of award letter to the Health Fund Office.
PLANS & BENEFITS

The Fund Health Care Plan provides retired San Antonio Firefighters and Police Officers with comprehensive health benefits for themselves and their dependents. Learn about insurance coverage, benefits, past plan highlights and more by clicking the buttons below.

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