Retiree Benefits

Retirees hired prior to January 1, 2012 and who are vested in WCRC’s pension are eligible for retiree medical and dental benefits.

Deductible Copay Example PPO 4
Deductible Copay Example PPO 7

Deductible Copay Example PPO 4
Deductible Copay Example PPO 7

A retiree electing family coverage is responsible for the cost difference between the monthly premium cost for a 2-person and family options in addition to the 2-person contribution rate.

Single Complementary – Single person on Medicare.
2-Person Complementary – Both spouses on Medicare.
1 Regular + 1 Complementary – 1 spouse pre-65 and 1 spouse on Medicare.

If you have medical coverage elsewhere, you can choose to waive medical insurance and receive a buy-out of $1,400 for the year. Proof of coverage must be provided to receive the buy-out. You are still eligible to participate in dental insurance. Medicare is not considered alternative coverage. If you elect the buy-out, checks are mailed in December.

About Medicare and Eligibility

Medicare is the federal health insurance program for individuals aged 65 or older and some disabled individuals under age 65. It is administered by the Centers for Medicare and Medicaid Services (CMS). A person becomes eligible for Medicare the first day of the month in which the individual turns age 65, unless their birthday falls on the first of the month, in which case Medicare eligibility is the first of the prior month.

Action Required if Eligible when Medicare Eligible 

Three months before your 65th birthday you should:

• Call the Social Security office at 1-800-772-1213 or CMS at 1-800-633-4227 regarding enrollment for Medicare insurance benefits.
• Apply for Medicare online at https://www.ssa.gov/benefits/medicare.

WCRC requires enrollment in Medicare Parts A and B as soon as you or a covered dependent is eligible for Medicare. Medicare will become primary and WCRC’s medical plan will become supplemental coverage.

WCRC’s prescription drug coverage for retirees is “creditable” which means that such coverage is as good as or better than Medicare Part D benefits, which means you do not need to enroll in Medicare Part D.

There are three parts to Medicare:

• Medicare Part A (Hospital Insurance) – Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
• Medicare Part B (Medical Insurance) – Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
• Medicare Part D (prescription drug coverage) – Helps cover the cost of prescription drugs (including many recommended shots or vaccines). It is recommended that retirees do not enroll in Medicare Part D.

Once enrolled in Medicare a copy of the card should be sent to human resources by direct mail or email to Alicia Held, human resources coordinator, [email protected].

Coordination of Benefits (COB) is how health care carriers coordinated benefits when members or their dependents are covered by more than one health care plan.  Under COB, carriers work together to make sure members receive the maximum benefits available under their health plan.  If an employee or any of their dependents have more than one health insurance plan it is their responsibility to notify BCBS and to complete the Coordination of Benefits Form.

WCRC medical plans now include 24/7 online health care through Blue Cross Online Visits™.  With online health care, you can see a U.S. board-certified doctor anytime, anywhere.  No appointment needed.  When your doctor is unavailable, you can either use a mobile device to log into the BCBSM Online Visits™ app, or a computer to log in to https://www.bcbsmonlinevisits.com/landing.htm.

24/7 Online Health Care

Cost sharing invoices will be mailed in early December for your required retiree contributions. These invoices can be paid in full or quarterly. If you would like to receive these invoices electronically, please include your email on your enrollment form.

Lifestyle drugs are excluded from the prescription drug plan.  Lifestyle drugs are health habit and reproductive drugs such as those that treat sexual impotency or infertility, help in weight loss or help to stop smoking. They are not designed to treat acute or chronic illnesses or be prescribed for medical conditions that have no demonstrable physical harm if not treated.

Lifestyle Drugs

BCBS requires review of certain drugs before the plan will cover them, which is called prior authorization.  BCBS will review the member’s medication history to determine whether they’ve tried a preferred alternative first, which is known as step therapy.  Step therapy requires members to try less expensive options before “stepping up” to drugs that cost more.  Prior authorization and step therapy ensure that medically sound and cost-effective medications are prescribed appropriately.  A complete list of medications that require prior authorization or step therapy can be found at bcbsm.com/pharmacy.

Prior Authorization – Step Therapy

Save money and time with fewer refills when you get a 90-day supply of the medication you take regularly.  Please note that not all medications are available in a 90-day supply.  Here’s how to find out if your prescription is eligible:

1. Log in to your account at bcbsm.com
2. Hover over My Coverage in the blue bar at the top of the page
3. Select Prescription Drugs from the drop down
4. Click the link, Price a drug and view additional benefit requirements. It will take you directly to Express Scripts^®. You won’t have to log in again
5. Enter the name of the drug and follow the instructions. You’ll need to know the dosage and how often you’ll be taking it
6. You’ll get an alert if your medication has a quantity limit

BCBS has partnered with PillarRx to help its members save money on specialty and other expensive drugs with a high-cost drug discount program. This co-payment assistance program reduces the out-of-pocket costs members pay for certain medications. If you are eligible to participate in the plan you will receive a letter directly from BCBS and PillarRx on how to enroll in the program.

Beneficiaries of retirees who retire after January 1, 2003 will receive a $7,500 death benefit.

When reporting a death, the family of the deceased or whoever is in charge of final arrangements must contact the Human Resources Department. Once HR has received notification of the death, they will process the information and initiate the Life claim with The Standard.

The retiree’s death should also be reported to MERS at 800-767-6377.

You can being using the money in your HCSP account after you have a separation of employment. Once MERS is notified by WCRC of your separation, you’ll receive information on how to begin receiving reimbursements from your account.

You may begin receiving reimbursements for qualified medical expenses after you leave employment. There are three ways you can be reimbursed for purchases using your HCSP:

• Health benefits debit card
• Online/mobile reimbursements
• Reimbursement by mail

Direct deposit payments are made on the 18th of each month. If the 18th falls on a weekend or holiday, the payment will be sent electronically to your financial institution the business day before. Your first payment will be effective the month following the your date of direct deposit authorization.

To make changes to your direct deposit log into your myMERS account, select your Defined Benefit account, and edit your payment method.

You can begin using your account as soon as you leave employment, or you can continue to keep your assets invested. However, you must start receiving payments no later than April 1 of the calendar year following the year you turn 72 or terminate employment, whichever is later.

Withdrawal requests can be submitted online through your myMERS account. To do so, log into your myMERS account and select your 457 Program. Click on the “Distributions” link in the left-hand navigation to make your request.