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Retiree Health

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Retirees hired on or after January 1, 2017: 

If an employee enrolls in medical insurance as an active employee, they are required to be enrolled in Voluntary Employee Benefit Account(VEBA) (persuant to section 501c9 of the IRS Code).  This plan, the Post Employment Heath Program (PEHP) administered by Nationwide, is funded through employee and employer contributions.  Contributions are adjusted each year based on the Consumer Price Index (CPI).  Upon retirement or separation from employment, the funds are used to pay health insurance premiums and other qualified medical expenses.  Additional information is provided in the Nationwide brochure and the PEHP plan document links below.  

 

Retirees hired prior to January 1, 2017:

Medical Insurance, Prescription Coverage & Vision Coverage are bundled together.   Plans provided through CareFirst.

  •  CareFirst BlueChoice HMO Open Access Plan
    • With the BlueChoice HMO, your primary care provider (PCP) provides routine care and coordinates specialty care.  This plan allows also allows one to visit specialists directly - no referrals needed.
      • Some highlights include:
        • Network of 40,000 CareFirst BlueChoice providers
        • After-hours care (24-hr nurse advice line, video visits, urgent care centers, etc.)
        • $0 cost for comprehensive preventative health
        • Away from Home Care Program - access to benefits when out of area for at least 90 days* (set up by contacting CareFirst)
        • Emergency or Urgent Care Coverage when outside CareFirst BlueCross BlueSheild's service area (Maryland, Washington, D.C. and Northern Virginia)
  • CareFirst BlueChoice Advantage
    • BlueChoice Advantage offers in- and out-of-network coverage to help control out-of-pocket costs.  With this plan, there is no referral required to see a specialist.
      • Some highlights include:
        • $0 cost for comprehensive preventative health care visits
        • Flexibility to choose any provider you want
        • Choose from CareFirst PPO provider, specialists, and hospitals in Maryland, Washington, D.C. and Northern Virginia
        • If out of the CareFirst local service area, you have access to providers in all 50-states 

 

  • CareFirst Standard Over 65 with Major Medical
    • With Medicare as primary, the Standard Over 65 plan provides additional health insurance coverage.  It pays a portion of the difference that Medicare does not pay.
      • Retirees pay less when using providers that participate with Medicare
      • Covers inpatient Medicare deductible and coinsurance
      • Covers costs associated with emergency care, outpatient surgery and diagnostic services

 

Prescription Coverage is offered through CareFirst with CVS/CareMark

  • Through the prescription program you have access to  more than 69,000 participating pharmacies, 5,000 covered drugs through CareFirst Formulary 2, and a mail-order pharmacy program.
  • The 3-Tier copayment structure:
    • $5.00 for Generics
    • $25.00 for Brand Name Preferred Medications
    • $50.00 for Brand Name Non-Preferred Medications
      • Non-Preferred Brand Name Medications have a Generic (more cost-effective) equivalent available.  Preferred Brand Name Medications do not.
  •  Maintenance medications purchased as a 90-day supply through mail-order, or at CVS pharmacies will only pay 2 co-payments rather than 3 co-payments.

 

Vision Coverage is offered through CareFirst's BlueVision Plus Plan with Davis Vision 
  • The CareFirst BlueVision Plus program provides coverage for routine eye exams and preventive care, plus the freedom of choice to select any licensed vision care provider in the U.S.
    • Some of the highlights include:
      • Complete freedom to choose any ophthalmologist, optometrist or optician.
      • No claims to file if using a participating provider.
      • Coverage for comprehensive vision exams.
      • Coverage for lenses and frames or contacts

 

Dental  - Carefirst PPO and Delta Dental PPO
  • Retirees can choose from CareFirst or Delta Dental options. Both plans cover comprehensive preventative coverage to include regular cleanings, x-rays, and dental surgery.   
    • Some plan highlights include:
      • $1,500 plan year max for each individual covered
      • $1,500 lifetime benefit for orthodontia for adults and covered children
      • Access to participating dentists throughout the US