Human Resources
 

Retiree Medical Benefit

Health & Wellness

2019 Open Enrollment Informational Sessions

Date Day Time Location Group
12/03/2018 Monday 1:00 PM - 4:00 PM Washington Park Senior Center - Main Hall 4420 W Vliet St Milwaukee, WI  53208 Retirees
12/06/2018 Thursday 9:00 AM - 12:00 PM Wilson Park Senior Center - Main Hall 2601 W Howard Ave Milwaukee, WI  53221 Retirees
12/06/2018 Thursday 1:00 PM - 4:00 PM Wilson Park Senior Center - Main Hall 2601 W Howard Ave Milwaukee, WI  53221 Retirees
12/07/2018 Friday 9:00 AM - 12:00 PM Clinton Rose Senior Center 3045 N Martin Luther King Drive Milwaukee, WI  53212 Retirees
12/11/2018 Tuesday 9:00 AM - 12:00 PM Boerner Botanical Gardens- Lower Level Multimedia Room 9400 Boerner Drive Hales Corners, WI 53130 Retirees

Learn More About Your Health Insurance Benefit

Retiree health insurance is administered through United Healthcare. Choice Plus Plan is the preferred provider organization comparable.

As a PPO participant you can:

  • Choose which doctor or health specialist you see
  • Choose an in-network or out-of-network provider each time you need health care
  • Pay substantially less when you go to an in-network provider
  • Go directly to see a specialist, without a referral from a primary care physician

 

Learn more from these resources:

 

To find a United Healthcare network provider or hospital:

  • Coinsurance
  • Co-payment
  • Deductible
  • In-Network
  • Out-of-Network
  • Out-of-Pocket Maximum

This is the percentage of the cost you pay when you receive certain healthcare services. Example: For in-network services under the Choice Plus plan, plan participants pay 20% and the County pays 80% of covered expenses for most services. The 20% share is the employee’s coinsurance. 

This is the flat-dollar amount you pay when you receive certain medical care services.  Co-pays are typically due at the time you receive service.  Example: Enrollees in the plan pay a $30 co-pay for in-network doctor’s office visits. 

This is the amount you are required to pay each year before the plan begins to pay benefits. You begin accumulating expenses toward the satisfaction of your deductible at the beginning of each year (January 1). Example: With each new benefit year, employees who elect self-only coverage under the Choice Plus Plan pay the first $1,250 toward services subject to the plan's deductible. Employees who elect coverage for themselves and their spouse pay the first $1,250 per individual, up to a maximum of $2,500 per family, toward services subject to the plan’s deductible. 

This is care or services provided by doctors, hospital, labs or other facilities that participate in the network of providers assembled by United Healthcare. Generally, you pay less when you receive care in-network because the providers in the network agree to charge a pre-negotiated, lower fee. This reduces your out-of-pocket cost and claims costs. 

This is the care or services furnished by doctors, hospitals, labs or other facilities that DO NOT participate in the United Healthcare’s provider network. If you use an out-of-network provider, your share of the cost is based on the reasonable and customary charges allowed by the plan.  Amounts charged over the reasonable and customary do not count toward annual deductibles and out-of-pocket maximums. 

 

Be sure you understand the amount you will be required to pay out of your own pocket if you seek care out-of-network. 

When you meet the annual out-of-pocket maximum, the plan will pay the full cost of covered expenses for the remainder of the calendar year. Covered expenses (e.g., deductible and coinsurance amounts) apply toward the out-of-pocket maximum. Prescription drug co-payments are not applied toward the out-of-pocket maximum. In addition, out-of-pocket costs incurred for non-covered services or supplies in excess of the plan’s covered expenses (e.g., expenses incurred for out-of-network that exceed the reasonable or customary changes allowed by the plan) are not applied toward the out-of-pocket maximum; these non-covered charges are the plan participant’s financial responsibility. 

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  What are my health plan options?

Milwaukee County retirees, upon retirement, are offered a one-time election to enroll in the Choice Plus PPO plan. In addition, Medicare eligible retirees are offered a Medicare Advantage plan. Both plans are administered through United Healthcare.

  How much will I have to pay for health care coverage?

As you were advised during your retirement counseling, you are required to pay some or no contribution toward your health care coverage, based on your hire date and union group. If you do not qualify for county-paid medical premiums, refer to the Medical Premium Rate Sheet.

  If I have medical coverage through Milwaukee County, do I still need Medicare?

Yes. Milwaukee County’s Retiree medical plans coordinate with Medicare. You must enroll in Medicare Part A and Part B when you become eligible for any reason, including disability. You are not required to enroll in the prescription drug benefits offered under Medicare Part D. Notify the Benefits Division when you become eligible for Medicare. Failure to notify us could result in the non-payment of claims.

  What are my medical options when I am eligible for Medicare?

Refer to Transition to Medicare to view your medical plan options.

  Where can I find a Gym Reimbursement Form?

Total Rewards Contact Information

 

Milwaukee County Courthouse

901 N. 9th St. Room 210

Milwaukee, WI 53233

 

 

Phone Number  (414) 278-4198

Fax Number   (414) 223-1379

benefits@milwaukeecountywi.gov

MILWAUKEE COUNTY DEPARTMENT OF HUMAN RESOURCES

Milwaukee County Courthouse
901 N. 9th St. Room 210
Milwaukee, WI 53233
(414) 278-4143 (Main Phone)
(877) 652-6377 (Main Toll Free)
(414) 223-1379 (Fax)
Email

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