IMRF-endorsed health insurance programs
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1 IMRF-endorsed health insurance programs Read this booklet for information on choosing a health care plan endorsed by the IMRF Board of Trustees. This booklet also includes information about: Medicare Part D plans Sav-Rx Advantage Card prescription drug discount program Delta Dental plan of Illinois United HealthCare vision care plan Automatic premium deduction plan Long-term care insurance Illinois Municipal Retirement Fund IMRF Member Services Representatives ASK-IMRF ( ) 06/2015 Locally funded, financially sound.
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3 Table of Contents What is an IMRF-endorsed health plan?...1 Automatic premium deduction...3 IMRF-endorsed health plans Age 65 and over Guarantee Trust Life Seniors Choice...4 United Healthcare Medicare Complete...4 Health Alliance HMO...4 Health Alliance PPO...4 Humana Regional PPO...5 Humana PDP (prescription drug plan)...5 Humana Local PPO...5 Blue Cross and Blue Shield of Illinois...6 Under age 65 Blue Cross and Blue Shield of Illinois...7 i Medicare Part D prescription drug plans...8 Sav-Rx prescription drug discount program...8 Delta Dental plan of Illinois...9 United Healthcare vision care plan...10 Long-term care insurance... 11
4 What is an IMRF-endorsed Health Plan? An IMRF-endorsed health plan is a plan that has been reviewed and approved by IMRF s Board of Trustees. As an IMRF retiree, you are faced with the necessary task of choosing a medical benefit plan that offers both you and your spouse financial protection from illness or injury at an affordable price. Knowing that health insurance is a matter of great concern for our retired members, IMRF works with a health insurance consultant to conduct an extensive review of current medical benefit plans and determine which plans can offer the best benefits for our retirees at a reasonable cost. This consultant carefully reviews the financial stability of the companies offering these plans, the benefits they provide, their cost, and their ability to service our retirees. Who is Doyle Rowe LTD? 1 Doyle Rowe LTD is the consultant that the IMRF Board of Trustees chose to oversee the selection of our endorsed health plans. They are an impartial third party who serves as an intermediary between you and your health plan provider. What are the advantages of an IMRF-endorsed plan? By using an IMRF-endorsed health plan, you have the advantage of knowing your plan was carefully researched by the IMRF health insurance consultant. In addition, most of these plans are group plans. By taking advantage of the group rates that these plans have to offer, you can receive enhanced benefits.
5 Does IMRF provide health insurance? Retired members often call IMRF to ask if we provide health insurance. While some retirement systems include retiree health insurance as one of the benefits of participation, IMRF does not. There have been several attempts in the past to pass legislation to add a health insurance component to the IMRF plan. However, IMRF has never been able to find funding for health insurance for IMRF retirees. Contact information For additional information about any of the following endorsed benefit programs, or to enroll in the plans, please contact the IMRF-endorsed administrator of these plans, Doyle Rowe LTD, at their Enrollment Hotline at or visit their website at If you are mailing forms to Doyle Rowe LTD, please mail them to: Doyle Rowe LTD 1301 West 22nd Street, Suite 101 Oak Brook, IL
6 Automatic Premium Deduction If you choose to continue your health care coverage through an IMRF-endorsed plan after retirement, participate in the Sav-Rx prescription drug discount card program, Delta Dental plan, or the United Healthcare Vision plan, you can have your premium costs deducted directly from your monthly benefit payments. To request automatic premium deduction, please fill out IMRF Form 7.10E Health Care Program Premium Deduction Authorization for IMRF Endorsed Plans, (Doyle Rowe LTD will mail this form to you) and return it to Doyle Rowe LTD with your enrollment form. Note: Automatic premium deduction is not available for the Blue Cross and Blue Shield plan for retirees and family members under the age of 65. Medicare Part D plan premiums cannot be deducted from your IMRF benefit payment; however, you can elect to have them deducted from your Social Security payment. IMRF-endorsed Health Plans 3 The following are the 2015 rates and plan descriptions for IMRF-endorsed health plans. Enrollment forms for these plans are separate from Form 7.10E, Health Care Program Premium Deduction Authorization for IMRF-endorsed Plans. You must obtain an enrollment form directly from Doyle Rowe LTD by calling them at or visiting their website at Please note: The rates and plan information included in this booklet were current as of the time the booklet was printed. For the most current rates, visit or call In the event of any discrepancies between this booklet and the insurance carriers, the insurance carriers govern.
7 IMRF-endorsed health plans Age 65 and over Seniors Choice Seniors Choice offers three group retiree medical plans and three prescription drug plans available nationwide to retirees and spouses age 65 and older with Medicare Parts A & B. Prescription drug plans have separate monthly premiums which will range from $ to $ per month and are underwritten by Humana. Those currently enrolled in a Seniors Choice plan with prescription drug coverage will receive the appropriate forms and instructions on transitioning to the Humana prescription drug plans. United Healthcare Medicare Complete 2015 Monthly Premium Rate: $ $ (Based on plan choice and age) Available to retirees and spouses age 65 and older with Medicare Parts A & B residing in certain counties in Illinois and Missouri. Contact Doyle Rowe LTD for a complete list of counties. In-network out-of-pocket maximum $3, % of specified preventive services including annual routine physical, diabetes selfmanagement, bone mass measurement (one per year), immunizations, colorectal screening (one per year), and the like. A variety of co-pays for physicians, specialists, and other medical services monthly premium rate: $0 (No monthly premium) 4 Health Alliance HMO Available to retirees and spouses age 65 and older with Medicare Parts A & B residing in select counties in Illinois. For a complete list of counties, contact Doyle Rowe LTD at Health Alliance PPO 2015 Monthly Premium Rate: $191 (with standard Rx) Available to retirees and spouses age 65 and older with Medicare Parts A & B residing in select counties in Illinois. For a complete list of counties, contact Doyle Rowe LTD at Monthly Premium Rate: $206 (with standard Rx) Continue to next page...
8 Humana Regional PPO Available to retirees and spouses age 65 and older with Medicare Parts A & B nationwide. Annual in-network out-of-pocket maximum $3,400. A variety of co-pays for physicians, specialists, and other medical services. 100% of in-network preventive services including annual routine physical, diabetes self-management, bone mass measurement (one per year), immunizations, colorectal screening (one per year), and the like Monthly Premium Rate: $42 $161 (Rates vary by region of residence) Humana PDP (Prescription Drug Plan) $4/$25/$54/33% to $2,960. Tier 1: $4 through the coverage gap to $4,700. Cost-sharing during catastrophic coverage: greater of $2.65/$6.60 or 5% coinsurance Monthly Premium Rate: $ Humana Local PPO Available to retirees and spouses age 65 and older with Medicare Parts A & B in specific cities throughout the country based on network accessibility. Annual in-network out-of-pocket maximum $5, % of in-network preventive services including annual routine physical, diabetes self-management, bone mass measurement (one per year), immunizations, colorectal screening (one per year), and the like. A variety of co-pays for physicians, specialists, and other medical services. Please Note: The in-network co-pays and annual out-of-pocket maximum differ depending upon area. The information below is a sample of the Chicagoland area s Local PPO plan. For details of the Local PPO plan in your area, please contact Doyle Rowe LTD Monthly Premium Rate: $33 $318 (Rates vary by city of residence) Continue to next page...
9 Blue Cross and Blue Shield of Illinois Plan F* Available to Illinois residents age 65 and older with Medicare Parts A & B and certain other disabled Illinois residents with Medicare Parts A & B. Traditional Medicare supplement that covers Part A & B deductibles and coinsurance amounts for Medicare-approved expenses. Freedom to choose doctors and hospitals. Med-Select option requires that participating hospitals are used for non-emergency inpatient hospitalizations. HMO and PPO available in 2015 for residents of Cook, Dupage, Will, and Kane counties. *Plans A, C, G, K, L, and N are also available. Contact Doyle Rowe LTD for 2015 rate information. 6
10 IMRF-endorsed health plan Under age 65 Blue Cross and Blue Shield of Illinois Comprehensive Major Medical Available to retirees and/or their family members under age 65 residing in Illinois call Doyle Rowe LTD for details. You may be able to continue your employer-provided coverage until age 65 at your own cost check with your employer. However, the Affordable Care Act may provide you with additional health insurance options that are less expensive than the options provided by your employer. HMO now available in certain counties Open Enrollment runs from November 15, 2014 through February 15, Those not enrolling during this time must meet Special Enrollment Eligibility criteria. Contact Doyle Rowe LTD for more information.
11 Medicare Part D prescription drug coverage plans You have probably received numerous mailings from various Medicare Part D prescription drug coverage plans. Reviewing all of the information about these new plans can be overwhelming, and it is important for you to take advantage of resources available to help you with this decision. For the endorsed HMO and PPO plans mentioned earlier in this booklet, the Medicare Part D prescription drug plan is integrated into the health insurance plan. Stand-alone plans are independent medical coverage plans; for example, you could belong to an endorsed Guarantee Trust Life medical plan and join a Blue Cross and Blue Shield or Humana plan for your prescription drug coverage, if that were the best choice for you. Call Doyle Rowe LTD at or visit their website at to learn more about Medicare Part D Prescription Drug Plans. Sav-Rx prescription discount card The Sav-Rx Advantage Prescription Drug Discount Card Program is available nationwide, at a cost of $1.50 per household per month ($18 per year), to all IMRF retirees, spouses, and dependent children under age The Sav-Rx card is not a Medicare Part D plan. You cannot use the Sav-Rx card at the same time you receive discounts from a Medicare Part D plan.
12 Choice of two dental plans available for 2015 IMRF retirees can now choose from two dental plans offered by Delta Dental. The current plan will remain the Standard Option with no change in rate. The new High Option plan offers a higher annual maximum, enhanced coinsurance schedule, and implant coverage. Both plans are PPO plans, and reimbursement is based on the PPO dentist reduced fees. Delta Dental High Option and Standard Option Plans High Option* Standard Option* 9 $2,000 Annual Maximum $50 deductible for Basic & Major services Diagnostic & Preventive (100% of PPO Reduced Fee) Includes: Routine exams twice a year Bitewing X-rays twice a year Full-mouth X-rays every three years Cleanings twice a year Fluoride treatments for children once a year Space maintainers Basic (80% of PPO Reduced Fee) $1,000 Annual Maximum $50 Deductible for Basic & Major services Diagnostic & Preventive (100% of PPO Reduced Fee) Includes: Routine exams twice a year Bitewing X-rays twice a year Full-mouth X-rays every three years Cleanings twice a year Fluoride treatments for children once a year Space maintainers Basic and Major (50% of PPO Reduced Fee) Includes: Fillings Periodontics Endodontics Oral Surgery General Anesthesia w/oral Surgery Major (50% of PPO Reduced Fee) Includes: Crowns Dentures Bridges Implants Includes: Fillings Endodontics Periodontics Oral Surgery General Anesthesia w/oral Surgery Crowns Bridges Dentures High Option Premium (guaranteed through December 31, 2015) Single $41.37 Single +1 $82.79 Family $ Standard Option Premium (guaranteed through December 31, 2015) Single $30.81 Single +1 $61.65 Family $96.03 *A one-year enrollment is required.
13 United Healthcare Vision Plan The following premiums for the United Healthcare vision plan are guaranteed through September 30, Monthly premiums will be deducted from your IMRF benefit payment. One year enrollment is required. (The premium amounts listed below are per month.) 2015 Premiums: Individual $7.50, Retiree + One $13.25, Family $21.70 In-Network provider Out-of-Network provider Vision care services Exam once every 12 months You pay $10 co-pay Plan pays $40 Frames once every 24 months Plan pays 100% up to $130 retail Plan pays $45 Lenses once every 12 months Standard single vision You pay $10 co-pay Plan pays $40 10 Standard bifocal You pay $10 co-pay Plan pays $60 Standard trifocal You pay $10 co-pay Plan pays $80 Contact lenses Standard (includes disposable/frequent wear) You pay $10 co-pay Plan pays $125 Premium (includes toric/multifocal) Plan pays 100% up to $125 retail Plan pays $125
14 Thinking about long-term care insurance? Doyle Rowe LTD has partnered with ACSIA Partners (formerly known as LTC Financial Partners) to provide education for IMRF members about a variety of long-term care insurance plans. In the coming months we will be launching an initiative through IMRF employers that may afford retirees more plan options at discounted rates. For more information about long-term care insurance, contact the Doyle Rowe LTD Enrollment Hotline at
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