Insurance coverage for retired members of the MTRS is not provided by the MTRS, but, rather, is a local contractual benefit. Most school districts offer continued insurance coverage to their retirees. The MTRS will be able to deduct the retiree’s portion of the monthly premium from their retirement allowance and forward the premium to the local community on a monthly basis. Please note, however, that unlike active member health insurance deductions, the IRS requires that retirees’ insurance premiums be withheld on an after-tax basis.

Below are the forms for districts that do not participate in the GIC-RMT program to follow when requesting to set up, cancel or change retiree insurance coverage. Please submit requests by the 1st of each month (e.g., changes effective 7/1/2014 should be received by the MTRS by 6/1/2014). Changes received after the 1st of the month will be processed as soon as possible but are more likely to be processed on the following month's warrant retroactive to the original date.

  • Retiree Insurance Change Form    pdf pdf format of Retiree Insurance Changes - Individual Rate form
    Excel xlsx format of Retiree Insurance Change form
  • Group Rate Premium Change Form    Excel xlsx format of Group Rate Premium Change Form

  • What is the process?

    To report insurance rate changes for your retired employees, please:

    1. Complete the appropriate individual or group insurance change form (see completed examples, below).
    2. Submit your completed form as an attachment to an e-mail to
    3. When we have processed your changes, we will notify you by e-mail.

    DOs and DON'Ts

    Please DO:

      • Provide only the MTRS retiree’s name (unless the member’s spouse is also a MTRS retiree or a surviving beneficiary with his or her own MyTRS account).
      • Make sure that you are using our new forms above, and that your forms are complete, including plan codes. Plan codes are abbreviated names of each plan (PPO and HMO alone are insufficient). To receive a copy of the plan code list from 2013, please e-mail with the subject “Requesting plan codes.”

    Please DON'T:

      • Send duplicate, incomplete or faxed forms.
      • Stockpile your changes. Requests are processed on a first-come, first-served basis, so submit your updates as soon as possible, and refrain from holding changes in an effort to submit only one form with multiple updates.
      • E-mail full Social Security numbers (provide the last four digits only).
      • Refund or bill retirees directly if you have already submitted the change to us. If we have received your request, we will process it retroactively, when needed, based on the effective date you provided.
      • Submit requests with custom calculations, such as retroactive bills, credits or refunds. Our new system will automatically calculate adjustments based on coverage dates.
      • Combine plan rates. If a retiree has one plan, and his or her spouse or dependent has another, please list each on a separate line, showing each plan code and rate. Deductions are set up by plan, not by total deduction amount.
      • Submit partial-month deductions. The MTRS requires deductions on a full-month basis. Employers who choose to pro-rate coverage within a month will need to make arrangements with retirees for any partial-coverage months.
      • Include any calculations on the form. If a member requires a retroactive adjustment, provide the effective date only.
      • Refer retirees to the MTRS to discuss insurance benefits and coverage. We will certainly answer calls related to delays in processing deduction changes, but we do not have the expertise to discuss the types of plans that you offer.
      • E-mail your forms to individual MTRS representatives as they will be returned.

    Additional notes, instructions, and completed example forms

    • If you provide a retroactive date but have already refunded or billed the retiree, please make a note in the Comments box on the form.
    • If your request requires a retroactive correction, we will assume that we must process an adjustment for the bill or refund associated with the change based on the effective date of the change, unless it is otherwise stated on the request.
    • Insurance deductions are always deducted one month prior to effective period. For example, premiums for April are deducted in March.


    Example: Retiree Insurance Change Form

       Image of example retiree insurance change form


Example: Group Rate Premium Change Form


Image of example of Group Rate Premium Change form