Medicare Eligible Retiree Health Insurance Information

  • Retirees and/or dependents who are Medicare eligible are enrolled in the Cigna Medicare Surround Medicare supplement plan.  At this time, Medicare becomes the primary insurance and the LCPS plan is a supplement to Medicare.  Retirees on this plan should utilize providers that accept Medicare assignment and will follow Medicare guidelines for all of their health insurance services.

    Medicare eligibility begins for a retiree or dependent when they turn 65 or at such time they become eligible due to Social Security disability.  It is the retiree's responsibility to apply for Medicare and submit a copy of the Medicare card showing enrollment in Parts A & B to Employee Health, Wellness and Benefits.  Medicare recommends starting the enrollment process for Parts A & B three months prior to the Medicare eligibility start date or loss of active coverage.  Visit for additional information about applying for Medicare. 

    LCPS retiree health insurance is bundled and includes medical, prescription, dental and vision coverage.  The plans are as follows: 

    • Cigna Medicare Surround Supplement Plan (Indemnity card)
    • Cigna Rx Medicare Prescription Plan
    • Delta Dental 
    • Cigna Vision (same card as Cigna Medicare Surround Indemnity card)

    Find benefit plan summaries, forms and vendor contact information by clicking on the topics below. 

  • Have an address update?

    We will update your address with Cigna Medical/Vision, Delta Dental & Cigna Rx Medicare!

    Call us at 571-252-1810 or email us at

    Need a VRS form?

    VRS-45 (Health Insurance Credit) - To provide your health insurance premiums to VRS for VRS Health Insurance Credit.  Return to VRS 

    VRS-78 (Authorization to Deduct Insurance Premiums) -  To request your health insurance premiums be deducted from your VRS pension payment.  Return to Employee Health, Wellness and Benefits for approval

    Other VRS Forms

    Need to speak to Virginia Retirement System (VRS)?

    Call 1-888-827-3847 or visit 

    Need to Cancel or Make a Change?  

    If you need to remove a dependent from coverage, cancel your coverage, make an Open Enrollment plan change (POS and OAP only) or if you've become eligible for Medicare, complete the following form and submit it to Employee Health, Wellness and Benefits. 

    Retiree Health Insurance Enrollment/Change Form

Plan Information and Premiums

Last Modified on June 24, 2021