Open Enrollment Guides for Retirees
- 2017 Open Enrollment Newsletter for Retirees
- 2017 Retiree Benefits Enrollment Guide – (January 1, 2017 – December 31, 2017)
- 2016 Retiree Benefits Enrollment Guide – (January 1, 2016 – December 31, 2016)
Annual Medical Costs
2017 Medical, Dental, and Vision Plan Breakdowns
- 2017 Retiree Monthly Premium Costs – On or Before July 1st, 2010
- 2017 Retiree Monthly Premium Costs – On or After July 2nd, 2010
- 2017 Retiree Monthly Premium Costs – Dental Insurance
2016 Medical, Dental, and Vision Plan Breakdowns
- 2016 Retiree Monthly Premium Costs – On or Before July 1st, 2010
- 2016 Retiree Monthly Premium Costs – On or After July 2nd, 2010
- 2016 Retiree Monthly Premium Costs – Dental Insurance
Maryland State Pension
Medical and Prescription Plans
CareFirst BlueChoice HMO Open Access
With CareFirst BlueChoice HMO Open Access, you can select your doctor from a regional network of physicians, specialists and hospitals located throughout Maryland, Washington, D.C. and Northern Virginia. CareFirst aims to keep you healthy by emphasizing prevention, early detection and early treatment.
- CareFirst Coverage Booklet
- CareFirst HCPSS Web Site
Open Access Aetna Select HMO
There’s no requirement to select a PCP, or obtain referrals for specialty care. The network of medical providers and facilities is nationwide, offering a full range of primary care doctors and specialists. When you visit a network provider, you will pay a flat copay for your care. Network providers will handle all of the claims paperwork for you. In order to receive benefits from this plan, you must see network providers.
- Open Access Aetna Select – Coverage Booklet
Aetna Open Choice PPO
You can receive care within the network and pay less for your care. Or, you can choose to receive care outside the network and still receive benefits, but at a higher cost. There are no referral requirements.
Aetna’s nationwide Open Choice PPO network includes 934,260 health care providers; 159,100 of whom are Primary Care Providers (PCPs). This makes it easy to find a network doctor or a hospital, whether you are at home, work or traveling.
- Aetna Open Choice PPO Coverage Booklet
Prescriptions – Express Scripts Pharmacy
Included in employee benefits packages, express scripts handles services related to prescriptions. They are supported by a national network of over 50,000 pharmacies and a 24-hour, 365-day-a-year Patient Care Contact Center. Home delivery is available for employee medications from express.
- Express Scripts Overview
- Express Scripts – 2017 National Preferred Formulary Drug List
- Express Scripts – 2017 National Drug List Exclusions
- Drug Quantity Management
- Pharmacy Web Site
Vision Service Plan (VSP)
- Vision Service Plan Overview
- VSP Benefits Web Site – view your vision benefit information, register as a member.
- 1-800-877-7195 – Member Benefit Services.
Delta Dental PPO
The Delta Dental PPO has a national network of dentists with no need to select a primary dentist. With this plan each enrolled family member receives up to $2,000 for PPO and Premier providers in paid benefits per calendar year. When you use a provider within the PPO network, you receive the highest level of coverage with the least amount of out-of-pocket expenses.
You may choose to use dentists outside of the network, but your costs may be higher.
CIGNA Dental Care HMO
This plan provides low out-of-pocket costs and no claim forms. You can get up to two free dental cleanings a year, and two more at a minimal co-pay. You’ll also receive a Patient Charge Schedule, which lists all of the dental procedures covered by your plan, and any out-of-pocket costs you may run into. CIGNA has a National Network of DHMO providers.
You will need to select a primary care dentist (PCD). If no PCD is selected one will be chosen for you. You are responsible for staying in the network.
Women’s Health and Cancer Rights Act
The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires group health plans to make certain benefits available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for:
- All stages of reconstruction of the breast on which the mastectomy was performed
- Surgery and reconstruction of the other breast to produce a symmetrical appearance
- Treatment of physical complications of the mastectomy, including lymphedema
Our plans comply with these requirements. Benefits for these items generally are comparable to those provided under our plans for similar types of medical services and supplies. Of course, the extent to which any of the items is appropriate following mastectomy is a matter to be determined by the patient and her physician.
Our plans neither impose penalties (for example, reducing or limiting reimbursements) nor do they provide incentives to induce attending providers to provide care inconsistent with these requirements. For more information about WHCRA coverage, contact your health plan administrator.
Newborns’ and Mothers’ Health Protection Act
The Newborns’ and Mothers’ Health Protection Act (NMHPA) of 1996 is a federal law that addresses the length of time a mother and newborn child are covered for a hospital stay in connection with childbirth. In general, benefits for a hospital stay in connection with childbirth cannot restrict benefits:
- to less than 48 hours for a normal vaginal delivery
- to less than 96 hours following a delivery by cesarean section
The 48 and 96 hour period starts at the time of delivery. It is important to note that coverage subject to NMHPA guidelines is the mother’s coverage. Newborns must be added to the Employee’s health plan within 30 days of the date of birth.