Wake County Retiree Health Information

Here is some information regarding your retiree health insurance!

For information on the 2018 Retiree Benefits, check out the Retiree Packet.  You can also check out the Retiree Letter and the Retiree Election Form

For questions about benefits, email wakebenefitsandwellness@wakegov.com or call the Wake County Benefits Team at 919-856-6090.

Health Insurance

In 2018, health insurance will be administered through Cigna Health.

The County offers two health insurance plans – Standard Plan and Premium Plan. Some main things to know about the plans are that:
 
·         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.
 
·         As of Jan. 1, 2018., there are no in-network differences for Tier 1 and Tier 2 providers. You would pay the same copay or coinsurance for all in-network providers on the plan you elect. Visit mycigna.com to find an in-network provider; use this guide to help you.
 
·         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.
 
To help you understand the plans, view the Retiree Guide.    

 

Pharmacy Coverage

Both plans provide the same pharmacy coverage. The pharmacy coverage is administered through CVS/Caremark Prescription Drug.
 
With this benefit, you will be required to pay a copay for generic medications in Tier 1. For medications in Tier 2, 3 and 4, you would 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.
 
If you are interested in using Mail Order, here is the Mail Order Form.
 

Cost of Health Insurance Coverage (includes Pharmacy)

The rates for 2018 can be found here, Retiree Health Insurance Rates.  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. The rates shown 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. Pre-65 retirees and their covered spouses must complete the biometric screening by Oct. 31, 2017 to avoid the $40  per covered adult per month premium surcharge in 2018. Pre-65 retirees and covered spouses will not need to complete the biometric screening in 2018.
 
For 2017, here are some documents that you may find helpful with the Health & Well-Being Programs:

 

Questions?

If you have questions for the Wake County Benefits staff, contact us at wakebenefitsandwellness@wakegov.com or call Human Resources at 919-856-6090.
 
If you have questions for BCBSNC (regarding claims from 2017 or before), contact:
Blue Cross Blue Shield
1-877-275-9787
www.bcbsnc.com
 
If you have questions for Cigna, contact:
Cigna Health
1-800-CIGNA-24 (1-800-244-6224)
www.cigna.com
 
If you have questions for CVS Caremark, contact:
CVS Caremark
1-855-665-9259
www.caremark.com
 

Lastly, here are some required notices you may want to review: