Wake County Retiree Health Information
Here is some information regarding your retiree health insurance!
The key things to know about Open Enrollment are:
- Open Enrollment ended on Nov. 2, 2016.
- New ID cards (BCBSNC & CVS Caremark) will be mailed to your home before Jan. 1, 2017.
For more information on the 2017 Retiree Benefits, check out the Pre-65 Retiree Packet or the Post-65 Retiree Packet.
For questions about benefits, email email@example.com or call the Wake County Benefits Team at 919-856-6090.
The County offers two health insurance plans – Standard Plan and Premium Plan. Some main things to know about the plans are that:
- Both plans are administered through Blue Cross and Blue Shield of North Carolina (BCBSNC).
- The Standard Plan has lower monthly contribution/rates (it is free for retirees who meet the service requirements for contribution-free, retiree-only coverage) and higher out-of-pocket costs at time of service. The Premium Plan has higher contribution/rates and lower out-of-pocket costs at time of service.
- On both plans, copays will apply to routine office visits, urgent care services and short-term therapies. Copays count toward your out-of-pocket maximum but not your deductible.
- Medical services related to diagnostic testing, inpatient care and outpatient hospitalization will be subject to deductible and coinsurance. The Standard Plan will cover 70% after the deductible is met, and the Premium Plan will cover 80% after the deductible is met.
- Both plans have an out-of-pocket maximum per year. Once you have reached your out-of-pocket maximum, you will not be responsible for any additional medical or pharmacy costs in the plan year.
Here are some more documents that will help you understand the plans:
- View a high-level summary of the plans here: Medical Plan Summary Comparison
- For more detailed information on each plan, detailed plan documents will be provided closer to Jan. 1, 2017.
Both plans provide the same pharmacy coverage. The pharmacy coverage is administered through CVS/Caremark Prescription Drug.
With this benefit, you may be required to pay a portion of the cost for the medication and related supplies, up to a maximum amount, depending on the Tier of the medication. You have the option to fill the medication with a 30- or 90-day supply, through CVS, Mail Order or other participating pharmacies.
To help you save money you may want to consider filling a medication through a 90-day supply with CVS or Mail Order. You may also want to consider identifying an alternative, comparable medication in a lower tier.
Here is the summary of the Pharmacy Coverage: Pharmacy Coverage Summary
If you are interested in using Mail Order, here is the Mail Order Form.
Cost of Health Insurance Coverage (includes Pharmacy)
The rates for 2017 have increased. The rates you pay are based on the benefit plan you elect and who you are covering, along with your years of service with the County.
To view the retiree rates, open the Health Insurance Rates. Rates provided do not include any surcharges that are applicable to pre-65 retirees.
Health & Well-Being Programs
Wake County provides a variety of health and well-being programs to pre-65 retirees and their covered spouses.
Employee Health Center: The Employee Health Center is available to pre-65 retirees and covered spouses who are enrolled in our health plan. Services include general care, health assessments, disease management, and access to an online portal. There are two Health Centers: the Wake County Office Building, 14th floor and 3010 Falstaff Road. To schedule an appointment, call 919-856-5600 between 8:00 a.m. and 4:30 p.m., Monday through Friday. All private health information remains confidential.
Know Your Numbers (KYN): The KYN program helps you identify risks and manage health factors that could lead to chronic diseases. This program requires pre-65 retirees and covered spouses to complete a biometric screening by Oct. 31 of each year; a biometric screening includes a blood test, lipid panel, metabolic panel and blood pressure check. This is a voluntary program, but monthly rates for pre-65 retirees will increase for those retirees and covered spouses that do not complete the screening. The premium increase for 2017 is $20 per adult per month; the premium increase for 2018 will be at least $40 per adult per month.
Tobacco Free Program: The Tobacco Free Program requires pre-65 retirees and any covered spouses to be tobacco free for the last 12 months or to complete a cessation program in the last 12 months. Those who meet this criterion are exempt from the tobacco surcharge; those who are not tobacco free or did not complete a cessation program between Nov. 1, 2016, and Oct. 31, 2017, will be subject to a minimum surcharge of $40 per month for each adult. The surcharge will begin to be applied in 2018 and would be in addition to any KYN increase.
Here are some documents that you may find helpful with the Health & Well-Being Programs:
If you have questions for the Wake County Benefits staff, contact us at firstname.lastname@example.org or call Human Resources at 919-856-6090.
If you have questions for BCBSNC, contact them at:
Blue Cross Blue Shield
If you have questions for CVS Caremark, contact them at:
Lastly, here are some required notices you may want to review: