I have transferred from the ARP to the Hybrid Plan.

  I am a rehired Tier II or Tier IIA employee.

  I have transferred from a hazardous duty position to a non-hazardous duty position.

	I elect NOT to grandfather the retirement age.  Beginning 7/1/2022, I will be subject to the new retirement age.

SEBAC 2011 Option to Retain Grandfathered Normal Retirement Date

NEW CO-215   04-2015

STATE OF CONNECTICUT
OFFICE OF THE STATE COMPTROLLER
RETIREMENT SERVICES DIVISION

The 2011 SEBAC Agreement (Agreement) provided current Tier II or Tier IIA members of the State Employees Retirement System (SERS) the opportunity for a one-time irrevocable election to retain that normal retirement age.  Rehired Tier II or Tier IIA members, members transferring to the Hybrid plan, and members transferring from hazardous duty employment to non-hazardous duty employment have thirty days from the eligible event on payroll to choose whether or not to retain the current normal retirement age.

Prior to the Agreement, normal non-hazardous duty retirement eligibility was Age 60 and 25 years of Service or Age 62 and 10 years of service.  The Agreement changed normal non-hazardous duty retirement eligibility for members who have not yet attained their normal retirement eligibility and retire on or after 7/1/2022 to Age 63 and 25 years of Service or Age 65 and 10 years of Service.

Who is Eligible for this Election:

Employees are eligible for this election within thirty days of the following events:
Transfer from ARP to Hybrid Plan.
Rehired Tier II or Tier IIA employees who were not already given the opportunity to grandfather.
Employees who transfer from a hazardous duty position to a non-hazardous duty position.

Employee Instructions:

Employees must calculate their contribution via the table at the end of this form.  This figure must be validated by an authorized agency employee.

Note:  This election is irrevocable.  This means that, once this form is received by the Retirement Services Division, this election cannot be revoked for any reason.  The additional contributions will be deducted from your paycheck once your form has been processed along with retroactive contributions back to the first full pay period following 7/1/2013 and will not stop until you separate from state service or attain the new normal non-hazardous duty retirement age.

If you maintain employment to the new normal non-hazardous duty retirement age, your additional contributions WITHOUT INTEREST will be returned to you upon reaching that age.

Employing Agency Instructions:

An authorized agency staff member must sign in addition to the employee.  The completed form should be forwarded to the Retirement Services Division, Database Unit, 55 Elm Street, Hartford, CT 06106.  Retain a copy of this form and provide one to the employee.

EMPLOYEE PERSONAL INFORMATION

EMPLOYEE NAME (Last, First, M.I.)

EMPLOYEE NO.

DATE OF BIRTH

LAST 4 DIGITS SSN

ADDITIONAL PERCENTAGE

%

I am eligible for this election due to one of the following qualifying events:

By my election below, I hereby certify that this is a one-time election and that my choice to retain my grandfathered normal retirement age for the full actuarially valued cost is irrevocable, that is, I must continue to pay the additional contribution until I separate from service or attain the new retirement age, whichever is sooner.  I also understand that should I work until my new retirement age or retire as hazardous duty, I will be refunded my additional contributions without interest.

I elect to grandfather the retirement age and pay the additional percentage noted above each pay period.

EMPLOYEE'S SIGNATURE

DATE

AUTHORIZED AGENCY SIGNATURE AND TITLE

PHONE NUMBER

DATE

 

Choose which question pertains to you and then find the appropriate date in the chart.

     If you will have 25 years of service by the time you turn 62
     What is the first of the month following attainment of age 60 and 25 years of service?

    OR
 
     If you will not have 25 years of service prior to turning age 62
     What is the first of the month following your 62nd birthday?

Eligibility Date

Additional Contribution

Eligibility Date

Additional Contribution

Eligibility Date

Additional Contribution

Eligibility Date

Additional Contribution

Jul-2022
Aug-2022
Sep-2022
Oct-2022
Nov-2022
Dec-2022
Jan-2023
Feb-2023
Mar-2023

0.02%
0.04%
0.06%
0.08%
0.10%
0.12%
0.14%
0.16%
0.18%

Apr-2023
May-2023
Jun-2023
Jul-2023
Aug-2023
Sep-2023
Oct-2023
Nov-2023
Dec-2023

0.20%
0.22%
0.24%
0.26%
0.28%
0.30%
0.32%
0.34%
0.36%

Jan-2024
Feb-2024
Mar-2024
Apr-2024
May-2024
Jun-2024
Jul-2024
Aug-2024
Sep-2024

0.38%
0.40%
0.42%
0.44%
0.46%
0.48%
0.50%
0.52%
0.54%

Oct-2024
Nov-2024
Dec-2024
Jan-2025
Feb-2025
Mar-2025
Apr-2025
May-2025
June 2025+

0.56%
0.58%
0.60%
0.62%
0.64%
0.66%
0.68%
0.70%
0.72%