Health Insurance Coverage for Non-Medicare Eligible Retirees 

The following products are offered by the City's health insurance provider, Southern Health Services, Inc:  

Health Maintenance Organization (HMO) 

• For non-Medicare eligible retirees
• Must use network physicians, hospitals, pharmacies and network providers for all services
• Must live in the service area

Point-of-Service Program (POS) 

• For non-Medicare eligible retirees
• In-network and out-of-network benefits
• In-network plan must use the same network as HMO
• Out-of-network plan may use any provider
• Must live in the service area

Preferred Provider Organization (PPO) 

• Only for non-Medicare eligible retirees who live outside the (HMO and POS) service area
• In-network and out-of-network benefits
• In-network plan must use preferred providers
• Out-of-network plan may use any provider
• Health Maintenance Organization (HMO)
• Point-of-Service (POS) Program
• Preferred Provider Organization (PPO) - Only for retirees living outside of the service area

Southern Health will also offer the additional benefits: 

• Open access ( No referrals required for specialist visits)
• Routine eye exam benefit at PCP copay
• $100 optical hardware allowance
• Smoking cessation incentives
• ePHIT Program (an online resource where members will find coaches specializing in fitness, nutrition and life skills)

CITY'S CONTRIBUTION RATE 

The City's contribution rate is a flat monthly rate of $230.73 for the retiree only. If you retired prior to January 1, 2000, the City will pay 100 percent of the City's contribution toward your monthly premium. Therefore, your premium will be the same as the monthly deduction rate shown in the table for those persons with twenty-five (25) or more years of service. If you retired on or after January 1, 2000, the amount of the City's contribution paid toward your monthly premium will be based on your years of service. Please refer to the applicable rate table below, which indicates the retiree's monthly payroll deduction after the City's contribution rate has been applied.

FY 2008 Health Insurance Rate Tables

Health insurance coverage for all surviving spouses/dependents (current and future) of deceased members continues pursuant to COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985). COBRA allows a surviving spouse/dependent to remain in the deceased member's health insurance plan for thirty-six (36) months after the death of the member. After that period of time, the coverage will be terminated and the surviving spouse/dependent may convert to an individual policy, if interested. The COBRA rates for surviving spouses/dependents are listed below.

FY 2008 COBRA Rate Table

The HIPAA Privacy Rules became effective April 14, 2003. The Privacy Rules require group health plans, HMOs and insurers to establish processes to maintain the confidentiality of an individual's Protected Health Information (PHI). Our health, dental and supplemental policy vendors have notified the City and retirees of their policies and procedures to ensure compliance with the HIPAA Privacy Rules. The City's internal guidelines will be published in an administrative regulation.