Disability Retirement Benefits - PSERs
Disability Retirement Benefits - PSERs
Disability Retirement Benefits - PSERs
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Public School Employees’ <strong>Retirement</strong> System<br />
Let’s Talk About<br />
<strong>Disability</strong><br />
<strong>Retirement</strong><br />
<strong>Benefits</strong><br />
Publication # 9540 4/2012
The Public School Employees’ <strong>Retirement</strong><br />
System (PSERS) provides this document<br />
for educational and informational purposes.<br />
Information in this document is general in<br />
nature, does not cover all factual circumstances,<br />
and is not a complete statement of the law or<br />
administrative rules. The statements in this<br />
document are not binding. In any conflict<br />
between the statements in this document and<br />
applicable law or administrative rules, the law<br />
and administrative rules will prevail.<br />
This document is designed solely to provide<br />
an overview of benefi ts available to PSERS<br />
members and is not intended to be a substitute<br />
for retirement counseling. If you are considering<br />
a disability retirement, you are encouraged<br />
to contact PSERS to meet with a PSERS<br />
Regional Representative. The representative<br />
will guide you through the process to ensure<br />
timely fi lling of your application.
Table of Contents<br />
What is a <strong>Disability</strong> Benefi t? ................. 1<br />
Eligibility................................................ 2<br />
Monthly Payments ................................ 3<br />
How do I Apply?.................................... 5<br />
Charges for Requesting Medical<br />
Information............................................ 6<br />
Eligibility Determination ........................ 7<br />
Date of <strong>Retirement</strong> Determination ........ 7<br />
Appeals Process................................... 7<br />
What if Appeals Process is<br />
Exhausted?........................................... 8<br />
Length of Benefi t .................................. 8<br />
Benefi t Renewal Process ..................... 9<br />
Working While Receiving a <strong>Disability</strong><br />
Benefi t ............................................. 9-10<br />
Earnings Limitations ...................... 10-12<br />
Health Insurance Choices ............. 13-14<br />
Premium Assistance ........................... 15<br />
Taxes on Benefi t ................................. 15<br />
<strong>Retirement</strong> Options........................ 16-17<br />
Topics to Discuss with Employer ........ 17<br />
Contacting PSERS ............................. 18<br />
Comparison of Benefi ts ................. 19-20
The disability retirement<br />
benefit – What is it?<br />
Unlike an insurance policy, a disability<br />
retirement benefi t is an actual retirement<br />
benefi t. You must fi le an Application for<br />
<strong>Disability</strong> <strong>Retirement</strong> (PSRS-49) to be<br />
considered for the benefi t.<br />
Benefi ts are subject to approval, denial,<br />
or renewal based on your medical<br />
documentation and your job description.<br />
PSERS reserves the right to review and/<br />
or revoke your disability benefi t at any<br />
time.<br />
Generally, a disability retirement benefi t<br />
is designed to provide at least one-third<br />
of your fi nal average salary. If granted<br />
disability benefi ts, you will receive a<br />
monthly retirement benefi t payment for<br />
as long as you are deemed disabled<br />
and comply with the necessary requirements.<br />
Your benefi t is subject to an<br />
annual earnings limitation and ongoing<br />
submission of medical documentation.<br />
You may receive a disability retirement<br />
benefi t from PSERS and receive a disability<br />
benefi t from another plan such as<br />
workers’ compensation, social security,<br />
and/or an independent insurance company.<br />
Receiving other disability benefi ts<br />
will not affect your PSERS disability retirement<br />
benefi t; however, your PSERS<br />
disability retirement benefi t may affect<br />
other disability benefi ts. Your insurance<br />
provider or workers’ compensation carrier<br />
may require you to reimburse them<br />
for any retroactive disability retirement<br />
1
enefi ts paid to you by PSERS. It is<br />
your responsibility to contact those<br />
insurance carriers regarding PSERS<br />
payments.<br />
Am I eligible?<br />
To apply for a disability retirement<br />
benefi t, you must:<br />
<br />
<br />
<br />
<br />
Have become disabled while an<br />
active member of PSERS and still be<br />
disabled at the time you submit your<br />
application. NOTE: Should you<br />
become disabled after you terminate<br />
service with your employer, you are<br />
not eligible for a PSERS disability<br />
retirement benefi t.<br />
Have at least fi ve years of credited<br />
service with PSERS.<br />
Be physically or mentally unable to<br />
perform the duties as stated in your<br />
job description.<br />
Apply for disability retirement benefi<br />
ts within two school years of your<br />
last day of service or paid leave,<br />
whichever is later; and you must be<br />
disabled at the time of application.*<br />
*For example, if you leave service in March of<br />
the current school year, you have two school<br />
years (July 1 through June 30) from the close<br />
of the current school year to apply. If you do<br />
not apply within the two school years, you will<br />
forfeit all rights to apply for a disability retirement<br />
benefi t.<br />
2
PSERS does not require you to terminate<br />
your position to be eligible to apply<br />
for a disability retirement benefi t. If you<br />
apply while an active contributing member,<br />
you must go on unpaid leave or<br />
terminate employment within 30 days of<br />
submitting your application to PSERS.<br />
If at a later date you are able to return to<br />
the job, there is no guarantee that your<br />
employer will keep the position open for<br />
you. You may want to discuss this with<br />
your employer.<br />
You may not “switch” from a normal or<br />
early retirement benefi t to a disability retirement<br />
benefi t. A disability retirement<br />
benefi t is not available to members who<br />
are already receiving a normal or early<br />
PSERS retirement benefi t.<br />
How much retirement income<br />
will I receive if I retire with a<br />
disability retirement benefit?<br />
Provided you have reached at least<br />
16.667 years of credited service, your<br />
disability retirement benefi t is equal<br />
to the Maximum Single Life Annuity<br />
(MSLA) minus any reductions for options<br />
chosen by you. If you have less<br />
than 16.667 years of credited service,<br />
additional factors are applied.<br />
3<br />
A disability supplement may be included<br />
as a part of your disability retirement<br />
benefi t. The disability supplement<br />
removes the effects of early retirement<br />
penalties if you have not reached<br />
normal retirement age. If you have<br />
reached normal retirement age, the
supplement is not included in the benefi t<br />
calculation.<br />
For Class T-C or Class T-E members,<br />
PSERS disability retirement benefi t is<br />
intended to provide you with at least<br />
one-third of your fi nal average salary<br />
if you are not eligible for normal retirement.<br />
For Class T-D or Class T-F<br />
members, a PSERS disability retirement<br />
benefi t is intended to provide you with<br />
40% of your fi nal average salary if you<br />
are not eligible for normal retirement.<br />
PSERS suggests that you obtain a<br />
disability retirement estimate before applying<br />
for the benefi t. Contact PSERS<br />
to receive a Request for <strong>Retirement</strong><br />
Estimate (PSRS-151) form. This form is<br />
also found on the PSERS website.<br />
When you complete the estimate<br />
request, be sure to check the <strong>Disability</strong><br />
box to request a disability retirement<br />
estimate. Return the completed form to<br />
the PSERS fax number or address listed<br />
on the form. PSERS will prepare and<br />
send you a regular retirement estimate<br />
and a disability retirement estimate by<br />
return mail.<br />
4
How do I apply for a disability<br />
retirement benefit?<br />
PSERS strongly suggests that you<br />
attend a disability retirement counseling<br />
session conducted by a PSERS Regional<br />
Representative before applying<br />
for a disability retirement benefi t. By<br />
attending a PSERS counseling session,<br />
you avoid some of the common<br />
mistakes which may lead to a delay in<br />
processing.<br />
At the counseling session, the Representative<br />
will review your retirement estimates,<br />
explain the application process,<br />
and assist you in completing the PSERS<br />
Application for <strong>Disability</strong> <strong>Retirement</strong><br />
Packet which will be provided at that<br />
session. Attendance at a counseling<br />
session will ensure that you are<br />
provided with the information you need<br />
to have your benefi t processed timely.<br />
The contact information to schedule an<br />
appointment with a PSERS regional<br />
offi ce is found on page 18.<br />
To apply for a disability retirement<br />
benefi t, you must complete and submit<br />
the following forms to PSERS no earlier<br />
than 30 days before you begin an unpaid<br />
leave or your date of termination:<br />
<br />
<br />
Application for <strong>Disability</strong> <strong>Retirement</strong><br />
(PSRS-49). You will complete this<br />
application during or after your<br />
PSERS counseling session.<br />
Job Description (PSRS-1236). Your<br />
employer completes this form.<br />
5
Physician’s Medical Report(s)<br />
(PSRS-1237). Your physician(s)<br />
complete this form.<br />
Your physician should provide an<br />
evaluation of your medical history as it<br />
affects your ability to perform assigned<br />
duties. This information should refl ect<br />
your physical and/or mental condition as<br />
of your last day of paid service as well<br />
as your current condition. If the medical<br />
information submitted is insuffi cient<br />
to make a determination, the PSERS<br />
medical examiners will request that you<br />
provide additional information from your<br />
physician(s).<br />
If you are applying prior to your termination<br />
or unpaid leave start date, your<br />
employer must electronically submit<br />
to PSERS an unpaid leave status or<br />
a termination date within 30 days of<br />
the date your application is received<br />
by PSERS. The effective date of your<br />
unpaid leave status or termination must<br />
be within 30 days of your application.<br />
Any missing and/or insufficient required<br />
medical information will delay<br />
the processing of your application.<br />
Who is responsible for<br />
charges incurred to provide<br />
the medical information?<br />
You are responsible for any cost to<br />
obtain the medical information needed<br />
to determine your disability status.<br />
6
Who determines my eligibility<br />
for the disability retirement<br />
benefit?<br />
PSERS determines approval or denial<br />
of the disability retirement benefi t with<br />
recommendation from PSERS medical<br />
examiners.<br />
How is my date of disability<br />
retirement determined?<br />
The benefi t effective date of a disability<br />
retirement is the day after your last day<br />
of paid service or paid leave, whichever<br />
is later. You may not select your own<br />
disability retirement effective date.<br />
What if my request for a<br />
disability retirement is denied<br />
by PSERS?<br />
If your request is denied by PSERS, you<br />
may appeal the denial and request an<br />
Administrative Hearing by writing to:<br />
Offi ce of Chief Counsel<br />
Public School Employees’ <strong>Retirement</strong><br />
Board<br />
5 N 5th Street<br />
Harrisburg PA 17101-1905<br />
This hearing is held before an independent<br />
hearing examiner. Legal counsel<br />
may represent you and you may appear<br />
before the hearing examiner.<br />
7
If you do not receive a favorable result<br />
at the conclusion of the administrative<br />
hearing process, you may appeal the<br />
decision to the Commonwealth Court.<br />
What if I have exhausted all<br />
steps in the appeals process<br />
and I’m still denied?<br />
There are a number of options available<br />
to you if you are denied a disability<br />
retirement benefi t. Different membership<br />
classes and circumstances have<br />
different benefi t eligibility requirements.<br />
Contact your PSERS Regional Offi ce<br />
to speak to a counselor regarding the<br />
choices available to you.<br />
More information is also found on the<br />
PSERS website and in the PSERS<br />
publication Your <strong>Retirement</strong> Benefi ts<br />
and Leaving Employment (PSRS-9580).<br />
How long am I entitled to a<br />
disability retirement benefit?<br />
At the time your disability retirement<br />
benefi t is approved, PSERS will<br />
determine the terms and conditions of<br />
your benefi t. The length of time of your<br />
disability is determined by the fi ndings<br />
of the PSERS medical examiners review.<br />
You may be subject to a periodic<br />
renewal and/or review process.<br />
8
How will I know when it’s<br />
time to renew the benefit?<br />
PSERS sends an Application to Reapply<br />
for <strong>Disability</strong> Benefi ts (PSRS-1238)<br />
to those retirees subject to a periodic<br />
renewal. The renewal application must<br />
be completed by your physician and<br />
returned to PSERS by the date stated<br />
on the application. If you fail to return<br />
the application by the due date, you risk<br />
having your monthly disability retirement<br />
benefi t suspended.<br />
Continued failure to return the application<br />
will result in the denial of<br />
your disability retirement renewal<br />
and stop your disability retirement<br />
benefit. You will also need to return<br />
to PSERS any overpayment of your<br />
benefit.<br />
If your renewal is denied, you have the<br />
right to appeal the decision. Refer to<br />
“What if my request for a disability retirement<br />
benefi t is denied?” on page 7.<br />
If you are denied a continuation of your<br />
disability retirement benefi t and you are<br />
eligible to receive an early retirement<br />
benefi t, your retirement benefi t is calculated<br />
using the reducing factors in effect<br />
at the time of your original disability<br />
retirement date.<br />
May I work while receiving a<br />
disability retirement benefit?<br />
9<br />
You may be employed while receiving a<br />
disability retirement benefi t from<br />
PSERS. You are not, however,
permitted to return to work for a Pennsylvania<br />
public school employer without<br />
the loss of your monthly benefi t unless<br />
you qualify for specifi c exceptions.<br />
These exceptions are further explained<br />
in the PSERS publication, PSERS Return<br />
to Service Guidelines (PSRS-9682),<br />
located on the PSERS website.<br />
If you are employed while receiving a<br />
PSERS disability benefi t, an earnings<br />
limitation is imposed on the amount you<br />
earn yearly. See “Is my disability retirement<br />
benefi t affected by other earnings<br />
that I may have?” next.<br />
Please note: Your ability to be employed<br />
in any capacity, inside or outside of<br />
Pennsylvania, may raise questions<br />
about your medical eligibility to receive a<br />
disability retirement benefi t.<br />
Is my disability retirement<br />
benefit affected by other<br />
earnings that I may have?<br />
Each year PSERS sends an Annual<br />
Earnings of a <strong>Disability</strong> Annuitant letter<br />
to each retiree under normal retirement<br />
age receiving a disability retirement<br />
benefi t. The purpose of this letter is to<br />
determine whether or not you are working<br />
in another job, and if so, whether you<br />
are exceeding the amount you may earn<br />
per year without having to return money<br />
to PSERS.<br />
10
Your yearly earnings plus your yearly<br />
disability benefi t cannot exceed your<br />
annual earnings limitation, which is<br />
generally based on your last school year<br />
salary.<br />
For example - Your last school year<br />
salary was $40,000. This makes your<br />
earnings limitation also $40,000. If your<br />
annual PSERS disability retirement<br />
benefi t is $25,000, you cannot earn<br />
more than $15,000 of additional earned<br />
income per year without having to return<br />
money to PSERS.<br />
If your yearly income exceeds your earnings<br />
limitation, you will need to return the<br />
difference to PSERS. You may choose<br />
to return the excess earnings in one of<br />
two ways:<br />
A lump-sum payment within 30<br />
days<br />
<br />
Your monthly benefi t is reduced<br />
by the amount of the disability<br />
supplement until the overpayment<br />
is recovered.<br />
When completing the Annual Earnings<br />
Statement, you should only report<br />
earned income. Earned income is<br />
compensation received by you for work<br />
as an employee of any business or by<br />
being self-employed. The following are<br />
not earned income and should not be<br />
reported:<br />
11
<strong>Disability</strong> payments<br />
<strong>Retirement</strong> benefi ts<br />
Social Security benefi ts<br />
Workers’ compensation<br />
Investment income<br />
Dividends<br />
Child support<br />
Spousal support<br />
Additionally, you should not report<br />
wages received from your school employer<br />
earned before the effective date<br />
of your disability retirement.<br />
The Annual Earnings Statement should<br />
be completed and returned to PSERS as<br />
soon as possible, but no later than the<br />
date specifi ed on the statement. If this<br />
form is not completed and returned to<br />
us by the requested date, your monthly<br />
disability retirement benefi t will be<br />
suspended.<br />
Continued failure to return the form will<br />
result in the forfeiture of all rights to the<br />
disability retirement benefi t in excess of<br />
any early or normal retirement annuity to<br />
which you were entitled.<br />
You will need to complete an Annual<br />
Earnings Statement yearly until you<br />
reach superannuation age. For<br />
superannuation requirements, refer to<br />
the PSERS publication, Your Benefi ts<br />
and Leaving Employment (PSRS-9580)<br />
found on the PSERS website.<br />
12
What health insurance<br />
choices are available to me?<br />
1. You may be eligible to have private<br />
health insurance coverage, including<br />
individual or spousal. Such coverage,<br />
however, does not qualify for<br />
premium assistance. (See following<br />
question.)<br />
2. You may be eligible to remain in your<br />
employer’s group health insurance<br />
plan. Consult with your employer<br />
regarding continuance of their health<br />
insurance coverage.<br />
3. The PSERS Health Options Program<br />
(HOP) is available for all retirees,<br />
their dependents and survivors.<br />
HOP offers comprehensive medical<br />
coverage before and after you<br />
become eligible for and enroll in<br />
Medicare.<br />
You and your eligible dependents<br />
may enroll in HOP within 180 days of<br />
a qualifying event:<br />
13<br />
<br />
<br />
You retire or lose health care<br />
coverage under your school<br />
employer’s health plan. (Coverage<br />
under your school employer’s<br />
health plan includes any COBRA<br />
continuation of coverage you may<br />
elect under that school employer<br />
plan.)<br />
You involuntarily lose health<br />
coverage under a non-school employer’s<br />
health plan. (Coverage<br />
under your non-school employer’s
health plan includes any COBRA<br />
continuation of coverage you<br />
may elect under that non-school<br />
employer’s health plan.)<br />
You or your spouse reach age 65<br />
or become eligible for Medicare.<br />
<br />
<br />
<br />
You experience a change in family<br />
status (including divorce, your<br />
death or the death of a spouse,<br />
addition of a dependent through<br />
birth or adoption, your marriage,<br />
or loss of a dependent through<br />
loss of eligibility.)<br />
You become eligible for premium<br />
assistance due to a change in<br />
legislation.<br />
A plan approved for premium assistance<br />
terminates, or you move<br />
out of a plan’s service area.<br />
HOP provides pre-65 health insurance<br />
coverage for individuals not eligible for<br />
Medicare. You may choose a managed<br />
care plan, where available, or a<br />
fee-for-service plan. HOP also provides<br />
Medicare supplemental and Medicare<br />
Advantage if you are eligible for Medicare.<br />
You must be receiving Medicare<br />
Part A and B coverage to enroll in a<br />
Medicare supplemental and Medicare<br />
Advantage plan.<br />
Comprehensive descriptive material and<br />
enrollment information is available upon<br />
request by contacting the HOP Administrative<br />
Unit at 1-800-773-7725 or on the<br />
HOP website at www.hopbenefi ts.com.<br />
14
Is a disability retiree eligible<br />
for Premium Assistance?<br />
Premium assistance is a reimbursement<br />
of out-of-pocket expenses for the cost of<br />
the retiree’s basic health insurance. Up<br />
to $100 per month is available to eligible<br />
PSERS retirees receiving a disability<br />
retirement benefi t provided they have an<br />
out-of-pocket expense for basic health<br />
insurance coverage from one of the<br />
following:<br />
<br />
<br />
PSERS Health Options Program<br />
A Commonwealth public school<br />
employer’s group health insurance<br />
plan that is certifi ed with<br />
PSERS.<br />
The amount of premium assistance<br />
you receive cannot exceed the actual<br />
premium you pay for basic coverage.<br />
Premium assistance is a tax-free<br />
reimbursement added to your monthly<br />
benefi t. Contact the Internal Revenue<br />
Service (IRS) if you require further<br />
details regarding tax implications.<br />
Is my disability retirement<br />
benefit taxable?<br />
Your PSERS disability retirement benefi t<br />
is subject to federal taxes but not to<br />
Pennsylvania state or local taxes. If<br />
you reside in or you move to another<br />
state, you should check with that state<br />
regarding taxes that may be due on your<br />
disability retirement benefi t.<br />
15
For additional information on taxes,<br />
please contact a tax advisor or the Internal<br />
Revenue Service (IRS).<br />
What disability retirement<br />
options are available to me?<br />
Maximum Single Life Annuity<br />
(MSLA) - You will receive the maximum<br />
monthly benefi t for as long as your disability<br />
benefi t continues to be granted.<br />
If you die, any remaining balance in the<br />
present value of your retirement benefi t<br />
will be paid to your benefi ciary(ies). Under<br />
this option, you may name more than<br />
one benefi ciary and you can change your<br />
benefi ciary(ies) at any time.<br />
Option 2 - You will receive a reduced<br />
monthly benefi t based on your age and<br />
gender and the age and gender of your<br />
survivor annuitant at the time of disability<br />
retirement. At the time of your death, your<br />
survivor will receive the same amount per<br />
month that you would have received if<br />
you had retired under a normal or early<br />
retirement benefi t. Under this option you<br />
may name only one survivor annuitant.<br />
Option 3 - You will receive a reduced<br />
monthly benefi t based on your age and<br />
gender and the age and gender of your<br />
survivor annuitant at the time of disability<br />
retirement. At the time of your death,<br />
your survivor will receive one-half of<br />
the amount per month that you would<br />
have received if you had retired under<br />
a normal or early retirement benefi t.<br />
Under this option, you may name only<br />
one survivor annuitant.<br />
16
Customized (Special) Option 4 – This<br />
is a customized payment plan for your<br />
monthly benefi t. To select this plan,<br />
it must be actuarially equivalent to<br />
Maximum Single Life Annuity. As with<br />
both Options 2 and 3, the disability<br />
supplement (if applicable) is removed for<br />
the survivor annuitant.<br />
You may not change your survivor annuitant<br />
or retirement option under Options<br />
2, 3, or the Customized (Special) Option<br />
4 unless your original survivor annuitant<br />
predeceases you or your marital status<br />
changes. If this situation occurs, contact<br />
PSERS to discuss your next steps.<br />
When you receive a PSERS disability<br />
retirement benefi t, no matter what option<br />
you select, you may not withdraw any<br />
portion of your contributions and interest.<br />
Special Rules for Class T-E and<br />
Class T-F<br />
If you are a Class T-E or Class T-F<br />
member who has fewer than 10 years of<br />
credited service with PSERS, you may<br />
only select the Maximum Single Life<br />
Annuity option.<br />
Before I make a decision,<br />
what would you suggest I<br />
discuss with my employer?<br />
The following is a list of suggested topics<br />
to discuss with your employer. There<br />
may also be other items to discuss<br />
17
which are unique to your employer or<br />
bargaining unit contract.<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
<br />
Sick, vacation, personal and<br />
emergency paid leave<br />
Workers’ Compensation<br />
Sabbatical Leave<br />
School-sponsored <strong>Disability</strong><br />
Insurance<br />
Leave of Absence (Paid and/or<br />
Unpaid)<br />
o Length of leave<br />
o How long position will be<br />
held<br />
Health Insurance<br />
Life Insurance<br />
Resignation<br />
Contacting PSERS<br />
You may contact PSERS toll-free at<br />
1-888-773-7748 from 7:30 a.m. to 5:00<br />
p.m., Monday through Friday, except<br />
on State holidays. PSERS also has<br />
regional offi ces located throughout the<br />
state. Their core operating hours are<br />
8:30 a.m. to 5:00 p.m. A complete list<br />
of all PSERS regional offi ces is found<br />
on PSERS website under Regional<br />
Offices.<br />
Harrisburg Headquarters<br />
5 N 5th Street<br />
Harrisburg PA 17101-1905<br />
Toll-Free: 1-888-773-7748<br />
Local Telephone: (717) 787-8540<br />
Email address: ContactPSERS@pa.gov<br />
Website: www.psers.state.pa.us<br />
18
Comparison of <strong>Retirement</strong> <strong>Benefits</strong><br />
Terms of <strong>Retirement</strong><br />
Requires termination of employment to apply<br />
Must meet medical eligibility<br />
May withdraw contributions and interest at<br />
retirement<br />
May be revoked by PSERS at any time<br />
based on medical status<br />
Subject to renewal<br />
Subject to yearly earnings statement<br />
Restriction of earned income<br />
School employment in another state may<br />
jeopardize PSERS benefi t<br />
May work in Pennsylvania public schools<br />
under exceptions allowing retirees to be<br />
employed for emergency, shortage of<br />
personnel, or extracurricular situations<br />
Eligible for cost-of-living adjustments without<br />
regard to superannuation qualifi cations<br />
Eligible for premium assistance without<br />
regard to service credit and/or age<br />
19
Normal/Early<br />
Class T-C/T-D<br />
Normal/Early<br />
Class T-E/T-F<br />
<strong>Disability</strong><br />
Yes Yes No<br />
No No Yes<br />
Yes<br />
No<br />
No<br />
No No Yes<br />
No No Yes<br />
No No Yes<br />
No No Yes<br />
No No Yes<br />
Yes Yes Yes<br />
No No Yes<br />
No No Yes<br />
20
5 N 5th Street<br />
Harrisburg PA 17101-1905<br />
www.psers.state.pa.us<br />
ContactPSERS@pa.gov