Retiree Health Insurance Information
On this page you can learn about Retiree Health Insurance:
Insurance at Medicare Eligibility
Retiree health insurance is not a guaranteed benefit. Each year in May retiree medical insurance is reviewed by the Metropolitan Water Reclamation District's Board of Commissioners for both terms and continuance.
On September 15, 2011, the District's Board of Commisioners approved a policy that will increase the annuitant contribution rate by 2.5% every January 1st for a 10-year period starting January 1, 2012. The table below shows the projected annuitant contribution rate for the 10-year period covered by the new policy.
| Retiree Contribution Rate - Ten Year Projection | |||||||
| Year | Annuitant Share | MWRD Share | Year | Annuitant Share | MWRD Share | ||
| 2012 | 27.50% | 72.50% | 2017 | 40.00% | 60.00% | ||
| 2013 | 30.00% | 70.00% | 2018 | 42.50% | 57.50% | ||
| 2014 | 32.50% | 67.50% | 2019 | 45.00% | 55.00% | ||
| 2015 | 35.00% | 65.00% | 2020 | 47.50% | 52.50% | ||
| 2016 | 37.50% | 62.50% | 2021 | 50.00% | 50.00% | ||
In addition, annuitants can potentially see another rate increase on July 1st of each year. The January premium change will be the result of the scheduled contribution rate increase mentioned above. The July increase would be based on the retiree insurance claims that were paid by the District in the previous year.
Employees and retirees from the public and private sector throughout this nation are experiencing the financial pinch related to the escalating health care costs. Although it is unpleasant to increase annuitant cost for health insurance, it is necessary for the District to implement this change in order to continue to offer the health insurance benefits to the annuitants.
In 2007 the Metropolitan Water Reclamation District established the Retiree Health Trust to help fund existing liabilities.
Retiree Health Insurance Information pertains to all annuitants who qualify for retiree medical insurance under the District's eligibility policy.
Currently eligible annuitants have a choice of Blue Cross Blue Shield PPO or HMO Illinois. If you live outside of Illinois, the only option is the PPO. For information regarding the differences between the two, please refer to the comparison chart in part 1 and part 2.
If you are a member of Blue Cross Blue Shield PPO, you can download a booklet that explains your coverage. If you and all your dependents are Medicare eligible, click here to download the plan booklet.
All others should click here to download your plan booklet.
Click here for current premiums. These rates will be in effect from January 1, 2012 through June 30, 2012.
There may be tax implications for annuitants covering domestic partners or civil union partners. For more information, call the Retirement Fund office at 312-751-3222.
Medicare Eligibility and Claims
after Medicare Eligibility
Currently, when an annuitant reaches age 65, he or she is required to get Medicare Parts A and B. About three months prior to the annuitant's or dependent's 65th birthday the Fund will send a letter to the annuitant to advise him or her of the requirement. Once the annuitant becomes Medicare eligible, Medicare becomes the primary insurance and the District-sponsored plan becomes the secondary insurance. In order to put the changes into effect, the Fund will need a copy of the Medicare card showing Parts A and B.
The health insurance premium decreases when a retiree or a dependent becomes Medicare eligible. The reduction is greater for PPO than it is for the HMO.
For more information relative to Medicare enrollment requirements, click here.
For examples of how claims under the PPO are coordinated with Blue Cross, click here.
Retirees Prescription Drug Co-Payments for both the HMO and PPO are as follows:
| Rx Category | Local Pharmacy Rx | Prime's Mail Order | ||
| Monthly | Annual | 3-month | Annual | |
| Generic | $9 | $108 | $18 | $72 |
| Formulary Brand Name | 25 | 300 | 50 | 200 |
| Non-Formulary Brand Name | 45 | 540 | 90 | 360 |
There is a 33% savings for using the Mail Order Pharmacy. Mail order is a practical option for those medications that you take routinely. If you are not taking advantage of the mail order and you would like to, you can register for Prime Mail online.
Although retirees do not have comprehensive vision insurance benefits, there are discounts available to participants in both the HMO and the PPO plans. To utilize the available discounts, the member must go to a participating provider and present his/her Blue Cross ID card. There are no premiums, no deductibles, no applications and no claim forms. For more information on specific discounts, please refer to the Blue Cross website at www.bcbsil.com.
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Vision Plan Summary for Retirees |
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PPO members |
HMO members |
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Call Davis Vision at (877) 393-8844. |
Call 1-800-321-EYES for
information. |
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Vision discount is not part of the medical program. |
Vision coverage is part of the medical program. |
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20% discount on conventional contact lenses; 10% discount on disposable contact lenses. |
Vision care coverage provides benefits for: lenses, frames, and contact lenses. |
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No discount if services provided outside of Davis Vision network. |
No benefits will be paid if services are rendered by non-participating providers |
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Discount applied at point of service. |
$20 co-payment for routine eye exam |
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$5 discount on eye glass examinations; $10 discount on contact examinations |
$75 allowance towards glasses or contact every 24 months |
