Our dedication to WCRC employees doesn’t end after retirement. On this page, you will find resources and information concerning benefits, resources and more for WCRC retirees. Select a benefit below to learn more.

Benefits Overview

Medical Insurance

 Prescription Drug Coverage

Dental Insurance

Life Insurance

Health Care Savings Program

Pension

457 Program

Benefits Overview

Benefit Eligibility

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

Dependent Eligibility

Dependents eligible for coverage include:

  • Employee’s legal spouse at the time of retirement.
  • Employee’s dependent children: related by birth, marriage, legal adoption or legal guardianship. Dependent children are eligible for coverage until the end of the month in which they turn age 26 for medical.

Benefit Enrollment

Employees can enroll or change benefit elections:

  • Within 31 days of date of retirement
  • During annual benefits open enrollment period (usually mid-October to early November)
  • Within 31 days of experiencing a qualifying event

Qualifying Life Events

When one of the following events occurs, employees have 31 days from the date of the event to notify human resources and/or request changes to their coverage.  Evidence of the event is required.  The change in coverage must be consistent with the change in status.  Below are examples of qualifying events:

  • Change in legal marital status (divorce or legal separation)
  • Change in spouse’s employment status (resulting in a loss or gain of coverage)
  • Entitlement to Medicare or Medicaid

Medical Insurance

Your medical benefits provide comprehensive coverage for planned and emergency care. Each plan’s provisions vary, so you have flexibility when deciding which option is right for you and your family. All of the medical plans provide coverage for the same types of medical services; however, the employee contribution rate for each plan varies based on how the plan pays for those services.

When selecting a plan, think about how frequently you visit the doctor, whether you need out-of-network coverage and how you want to balance your employee contribution rates with what you are required to pay for medical services

Retirees hired prior to January 1, 2012 and who are vested in WCRC’s pension will have the choice of a PPO 4 and a PPO 7 medical plan through Blue Cross Blue Shields (BCBS).

Plan Comparison (retired after 01/01/12)

Plan Feature PPO 4 PPO 7
Deductible $500 Individual/$1,000 Family $500 Individual/$1,000 Family
Annual Coinsurance Maximums $1,500 Individual/$3,000 Family $1,000 Individual/$2,000 Family
Annual Out-of-Pocket Maximums $6,350 Individual/$12,700 Family $6,350 Individual/$12,700 Family
Coinsurance Amounts 20% of approved amount for mental health care and substance abuse treatment

20% of approved amount for most other covered services

10% of approved amount for mental health care and substance abuse treatment

10% of approved amount for most other covered services

Office Visit Copay $20 Copay $20 Copay
Emergency Room Copay $100 Copay $100 Copay
Online Doctor Visit Copay $5 Copay $5 Copay

Deductible Copay Example PPO 4
Deductible Copay Example PPO 7

Supplemental Plan Comparison (Retired after 01/01/12)

Plan Feature PPO 4 PPO 7
Deductible $500 Individual/$1,000 Family $500 Individual/$1,000 Family
Annual Coinsurance Maximums $1,500 Individual/$3,000 Family $1,000 Individual/$2,000 Family
Annual Out-of-Pocket Maximums $6,350 Individual/$12,700 Family $6,350 Individual/$12,700 Family
Coinsurance Amounts 20% of approved amount for mental health care and substance abuse treatment

20% of approved amount for most other covered services

10% of approved amount for mental health care and substance abuse treatment

10% of approved amount for most other covered services

Office Visit Copay $20 Copay $20 Copay
Emergency Room Copay $100 Copay $100 Copay
Online Doctor Visit Copay $5 Copay $5 Copay

Deductible Copay Example PPO 4
Deductible Copay Example PPO 7

2024 Retiree Contributions - Pre-65 (per month)

Tier PPO 4 PPO 7
Single $13.76 $39.22
2-Person $33.02 $94.14
Family $381.49 $393.82

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.

2024 Retiree Contributions - Age 65+ (per month)

Tier PPO 4 PPO 7
Single Complimentary $13.76
2-Person Complimentary $33.02
1 Regular + 1 Complimentary $33.02 $94.14

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.

Medical Buy-Out

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.

Medicare

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, helda@wcroads.org.

Coordination of Benefits

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.

Blue 365

As a member of BCBS, employees get exclusive discounts on healthy products and services through Blue365. Log into your account at bcbsm.com to browse and redeem the discounts.  Here’s some of the discounts offered:

  • Deals on products and services such as hearing aids, fitness gear and nutrition resources
  • Access to $25 per month gym memberships through Healthways Fitness Your Way. There are more than 9,500 participating gyms including L.A. Fitness and Snap Fitness
  • Discounts on LASIK and eye care services

24/7 Online Health Care

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

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.

Prescription Drug Coverage

All WCRC medical plans include prescription drug coverage through BCBS, available via mail-order service and nationwide retail pharmacy.

Summary of Coverage

90-Day Retail Network Pharmacy *In-Network Mail Order Provider In-Network Pharmacy (not part of the 90-day retail  network) Out-of-Network Pharmacy
Generic Prescription Drugs 1 to 30-day period $0 Copay $0 Copay $0 Copay 25% prescription drug out-of-network retail pharmacy provider
31 to 83-day period No Coverage $0 Copay No Coverage No Coverage
84 to 90-day period $0 Copay $0 Copay No Coverage No Coverage
Brand Name Prescription Drugs 1 to 30-day period $30 Copay $30 Copay $30 Copay $30 copay plus an additional 25% prescription drug out-of-network retail pharmacy provider
31 to 83-day period No Coverage $30 Copay No Coverage No Coverage
84 to 90-day period $30 Copay $30 Copay No Coverage No Coverage

Lifestyle Drugs

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

Prior Authorization/Step Therapy

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

Mail Order

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

PillarRX

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.

Dental Insurance

Dental insurance provides coverage for many dental services that retirees and their eligible dependents may need.  The dental insurance is offered through Delta Dental.

Summary of Coverage

Plan Feature Base
Deductible $25 Individual/$75 Family
Maximum Benefit Amount

(Class A, B and C Services)

$500 (per calendar year, per person)
Maximum Benefit Amount

(Class D Services – Orthodontia up to age 19)

$1,000 (lifetime maximum, per person)
Dental Percentage Payable Class A Services (Preventative) – 100%

Class B Services (Basic) – 100%

Class C Services (Major) – 50%

Class D Services (Orthodontia) – 50%

2024 Retire Contributions (per month)

Tier Base Enhanced
Single $3.48 $4.83
2-Person $8.34 $11.60
Family $10.43 $14.50

Life Insurance

Group Basic Life insurance from provides financial protection by promising to pay a benefit in the event of an eligible retirees covered death.

Benefit

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

Reporting a Retiree Death

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.

Health Care Savings Program

Retirees hired after January 1, 2012 have a Health Care Savings Program (HCSP) account, which is administered through MERS. The HCSP is tax-free medical savings account for covering the cost of post-employment medical expenses for retirees and their eligible dependents.

Account Eligibility

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.

Eligible Medical Expenses

An eligible medical expense is defined as those expenses paid for care as described in Section 213(d) of the Internal Revenue Code. Eligible medical expenses may include:

  • Ambulance Transport
  • Artificial limbs
  • Blood tests
  • Blood transfusions
  • Braces
  • Cardiographs
  • Chiropractor
  • Contact lenses
  • Crutches
  • Dental treatment
  • Dentures
  • Dermatologists
  • Diagnostic fees
  • Drug addiction therapy
  • Drugs (prescription)
  • Elastic hosiery (prescription)
  • Eyeglasses
  • Healing services
  • Hearing aids
  • Health care insurance premium
  • Insulin treatment
  • Lab tests
  • Long-term care insurance
  • Medicare B premium
  • Operating room costs
  • Ophthalmologist
  • Orthopedist
  • Osteopath
  • Pediatrician
  • Primary Care Physician
  • Podiatrist
  • Practical nurse for medical services
  • Prescription medicines
  • Splints
  • Surgeon
  • Therapy equipment
  • Vaccines
  • X-rays

Reimbursement

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

Pension

As a MERS Defined Benefit retiree, you will enjoy a safe, secure and comfortable retirement with a lifetime benefit.

Payments

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.

Retiree Pay Dates

2024

January – 18th (Wednesday)
February – 16th (Friday)
March – 18th (Monday)
April – 18th (Thursday)
May – 17th (Friday)
June – 18th (Tuesday)
July – 18th (Thursday)
August – 16th (Friday)
September – 18th (Wednesday)
October – 18th (Friday)
November – 18th (Monday)
December – 18th (Wednesday)

457 Program

As a retiree with a 457 Program account you can choose to keep your money invested or you can begin using your account after you leave employment.

Distributions

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.

Helpful Links

MERS Website

Related Documents

MERS 457 Supplemental Retirement Program