Q&A: Health care for City of Chicago retirees

What's happening to my health insurance?

Since the 1980s, affordable health insurance rates for City of Chicago retirees had been locked into place by what was known as the Korshak settlement. The terms of the settlement expired in 2013, requiring the City to formulate new options for health insurance for City retirees.

In May of 2013, Chicago Mayor Rahm Emanuel announced a plan to phase out health care benefits for all but a handful of city retirees over the next three years. Former City employees who retired prior to 1989 were shielded from these changes.

For the first time, the City is offering four different health plan options – as well as informing retirees that some may fare better forgoing City insurance altogether and turning to the new ACA health care exchange. Analyzing those options – and understanding each one’s likely impact – can be an intimidating task. The four plans offered by the city are described below.

What are my plan options?

The following chart provides a detailed breakdown of the costs and benefits of each plan. These options apply only to retirees who are not eligible for Medicare.

Note: Pharmacy costs are the same across all plans.

  PPO Standard
(what you have now)
PPO Value Blue Choice Standard Blue Choice Value
Overview Highest monthly contribution with lower deductible and co-pays than the other plans offered by the city. A good option for people that seek medical attention often and want to have a large network of doctors and clinics. Lower monthly contribution than PPO Standard plan but with higher out of pocket expenses. A good plan for people that don't seek medical attention very often outside of doctor visits, but still want a large network. Lower monthly contribution than PPO standard and value plans. Same deductibles and copays as PPO standard plan. A good option for people that seek medical attention often, but don't necessarily care about which doctor/clinic they visit. Lowest monthly contribution of the 4 plans offered. A good plan for people that are looking to pay the least in monthly contributions – the draw back is the high level of out of pocket expense.
Network Size Broad Broad Narrow Narrow
Deductible (How much you pay out of pocket before the insurance will pay any expenses) $415 $1,500 $415 $1,500
Maximum Out-of-Pocket (the most you pay in a plan year for out-of-pocket physician and hospital services) $2,424 $6,000 $2,424 $6,000
In-Network Co-Pays/Co-insurance (how much you pay for physician and hospital services. Either a dollar amount or a percentage of bill) 0% diagnostic tests/ 10% physician services / 10% ER visit / 20% other services $35 physician office visit copay / $50 specialist office visit copay / $250, plus 20% for ER visit/$250, plus deductible & coinsurance per hospital admit/$200, plus deductible & coinsurance for surgical copay/0% diagnostic tests/ 20% other services 0% diagnostic tests/ 10% physician services / 10% ER visit / 20% other services $35 physician office visit copay / $50 specialist office visit copay / $250, plus 20% for ER visit/$250, plus deductible & coinsurance per hospital admit/$200, plus deductible & coinsurance for surgical copay/0% diagnostic tests/ 20% other services

 



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