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

If you are under 65 and eligible for enrollment in a Blue Cross Plan, and unsure of the difference between PPO and HMO, click here for a comparison between the plans.

 

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. 

Rates effective January 1, 2024 - December 31, 2024

	BCBS of Illinois PPO		HMO Illinois
Retirees without Medicare-	Retiree's Rate	District's Rate	Retiree's Rate	District's Rate
Member	$705.61	$705.61	$525.63	$525.63
Couple	$1,411.22	$1,411.22	$984.03	$984.03
Family (3 or More)	$1,683.80	$1,683.80	$1,357.81	$1,357.81
	UnitedHealthcare MAPD		UnitedHealthcare MAPD
Retirees with Medicare	Retiree's Rate	District's Rate	Retiree's Rate	District Rate
Member	$72.50	$72.50	$72.50	$72.50
Couple, both with Medicare	$145.00	$145.00	$145.00	$145.00
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	$778.11	$778.11	$598.13	$598.13
Family, one with Medicare	$1,130.91	$1,130.91	$860.94	$860.94
Family (3 or more), two with Medicare	$497.80	$497.80	$407.81	$407.81

* 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 members enrolled in Blue Cross HMO or PPO are available through Express Scripts. For more information, consult their website by clicking here.

♦ Specialty pharmacy benefits for Blue Cross participants are administered by Accredo. You can order a new prescription or transfer your existing prescription for a self-administered specialty drug to Accredo. To start using Accredo, call 833-721-1619. An Accredo representative will work with your doctor on the rest. Once registered, you can manage your prescriptions on accredo.com or through their mobile app. For more information, see their flyer.

♦ 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

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:

Provider Guide to Healthcare - Medical Providers who accept Medicare accept this plan. This document may assist the provider's office with billing.

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

 

Vision Benefits

The District does not provide retirees with comprehensive vision insurance benefits. However, there are discounts available.

♦ Medicare eligible retirees covered on the UnitedHealthcare plan have coverage for a routine eye exam at $0 copay, 1 exam every 12 months* and the routine eyewear Plan pays $100 for eyeglasses or contacts every 12 months.*

*Benefits are combined in and out-of-network

♦ 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.