Metropolitan Water Reclamation District (“District”) Retiree Health Care Plans

General Information


Below is general information regarding the District’s Retiree Health Care Plans (“Plans”) offered to qualified District retirees and their dependents. This is for general information only. If a conflict shall arise between this information and the District’s Plan Documents or information supplied by the providers of the Plans, the latter shall supersede.

 

Availability


The District Board of Commissioners offer these Plans annually at their sole discretion. Membership in the Retirement Fund has no correlation with the availability of Plans sponsored by the District.

 

Eligibility

Retirees and their dependents who meet the criteria under the District's eligibility policy may enroll. For the current eligibility policy, click here.

 

Plans Offered

Medicare Eligible - UnitedHealthcare (UHC) Medicare Advantage Plan with Part D (MAPD)

Non-Medicare Eligible - Blue Cross Blue Shield PPO or *Blue Cross Blue Shield HMO Illinois

* Must live in Illinois

Please refer to the comparison chart.

 

Plan Providers - Summary of Benefits and Coverage


Click here if you are Medicare-eligible and enrolled in UnitedHealthcare
.

Click here for HMO Illinois and BCBS PPO.

 

Premiums

The retiree contribution rate is 50% with the District subsidizing 50% of the premium. 

 

  BCBS of Illinois PPO HMO Illinois
Retirees without Medicare- Retiree's Rate District's Rate Retiree's Rate District's Rate
Member $581.37 $581.37 $381.21 $381.21
Couple $1,162.86 $1,162.86 $713.64 $713.64
Family (3 or More) $1,314.58 $1,314.58 $1,093.93 $1,093.93
  UnitedHealthcare MAPD UnitedHealthcare MAPD
Retirees with Medicare Retiree's Rate District's Rate Retiree's Rate District Rate
Member $105.00 $105.01 $105.00 $105.01
Couple, both with Medicare $210.01 $210.01 $210.01 $210.01

Rates for Those Coverage at least 1
With Medicare* and at least 1 without

UnitedHealthcare MAPD   
and BCBS PPO
UnitedHealthcare MAPD
and HMO Illinois
Retiree's Rate District's Rate Retiree's Rate District's Rate
Couple, one with Medicare $686.37 $686.38 $486.21 $486.22
Family, one with Medicare $977.06 $977.06 $676.82 $676.82
Family (3 or more), two with Medicare  $500.69 $500.70 $400.61 $400.62

* Must have Parts A and B to qualify for the MAPD plan.

There may be tax implications for annuitants covering domestic partners. For more information, call the Retirement Fund office at 312-751-3222.

 

Medicare Eligibility

Approximately three months before a retiree or their dependent reaches age 65, they are required to apply for Medicare Part A and B. Once they become Medicare eligible, they will be enrolled in the Medicare Advantage Plan through UnitedHealthcare. A copy of the Medicare card showing Parts A and B will be required.

If a retiree or their dependent is Medicare eligible prior to age 65 due to disability, they must enroll in both Part A and B when it is offered. A copy of the Medicare card showing Parts A and B will be required.

For more information relative to Medicare enrollment, consult Medicare's website by clicking here.

Once you become Medicare eligible, you must retain Medicare coverage to remain eligible for the Plans. This includes making payments for your Part B premium and any other costs associated with Medicare coverage.

 

Prescription Drug Coverage

Retirees Prescription Drug Co-Payments for UnitedHealthcare, Blue Cross HMO Illinois and Blue Cross Blue Shield PPO are as follows:

Rx Category Local Pharmacy 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
Specialty 100 1,200 200 800

 

* The mail order provider depends on what plan the member is enrolled in.

♦ Mail order benefits for retirees and dependents enrolled in BCBS PPO or HMO are administered through Alliance Rx Walgreens Prime Home Delivery. To set up an account, click here. Or, for more information, consult Page 35 of the Blue Cross Brochure.

♦ Mail order benefits for Medicare-eligible retirees enrolled in UnitedHealthcare are administered through OptumRx. Call the number on the back of your insurance card for more information on enrollment in the Optum mail order plan.

There is a 33% savings for using the Mail Order Pharmacy. Mail order is a practical option for those medications that you take routinely.

 

Transitioning from non-Medicare Coverage to the MAPD

The Fund would like to make the transition to the UnitedHealthcare MAPD as smooth as possible for all new retirees and for those aging in at age 65. Below you will find some helpful information for making the transition. Click on each document's name to read it:

Information Sheet for Those Reaching age 65 or newly enrolling into the MAPD - some answers to common questions when enrolling into the UHC MAPD for the first time.

Provider Guide to Healthcare - Sometimes doctor's offices do not fully understand what kind of coverage is offered through the MWRD's group MAPD through UHC. Any doctor who takes Medicare takes this plan. This document may assist the provider's office with billing.

Welcome to UnitedHealthcare - for help finding a doctor and coordinating care.

Provider Access Brochure - a guide to understanding in- and out-of-network as it pertains to this plan

 

Vision Benefits

Retirees do not have comprehensive vision insurance benefits. However, there are discounts available.

♦ Medicare eligible retirees covered on the UnitedHealthcare plan have coverage for one routine eye exam every 12 months with a 15% copay. Call the number on the back of your insurance card for more information and to find a provider.

♦ Non-Medicare eligible members enrolled in either the HMO or the PPO plans qualify for discounts through either EyeMed or Davis vision.

♦ Blue Cross Blue Shield participants may dial 1-844-684-2254 or visit the Blue 365 Website to learn about EyeMed discounts.

♦ Alternately, Blue Cross Blue Shield offers discounts through Davis Vision as well.  To learn more about the Davis Vision discounts, click here.

 

 

 

$20 co-payment. 1-800-321-EYES Annual Exam covered in full; $75 allowance towards the purchase of contact lenses or eye glasses every 24 months

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