HealthFlex is a private health plan, not an insurance company. It contracts with BCBS of Illinois to provide the PPO network and to pay claims ONLY; and with Express Scripts to be the pharmacy benefits provider. If you have a question about your benefits or because you cannot satisfactorily settle a claims issue with a vendor, contact Ann Marie Jedlicka, our Willis C.A.R.E. Advocate, at our broker’s office (888) 676-6767. You may also contact the Health Team at the General Board of Pension and Health Benefits (800) 851-2201. Press 1 at the 1st prompt; 0 at the 2nd prompt. Contact the vendors (BCBS, Express Scripts, etc) for claims or pharmacy issues.
Enrollment: Within 30 days of retirement only; if coverage at retirement is waived*, enrollment available within 30 days of loss of other coverage.
*Signed waiver at time of retirement is required.
Type Of Plan: Medicare Companion Plan (must be enrolled in Medicare Parts A+B). Pays only for Medicare eligible expenses. Under 65 Spouses/child dependents of Annuitants over 65 are covered under the Active PPO plan. See Active Participants Medical Plan.
Medicare pays 80% of its allowed amount. The Plan pays 80% of the remaining 20% of the allowed amount. No network required.
Premiums: Call for 2012 premiums. Barbara Gruezke, Conference Insurance Coordinator (732) 359-1037
- No deductible
- Mandatory mail order for maintenance drugs after 3 retail fills
Mandatory if available
|In-Network Retail Pharmacy||$12||20% copay Minimum $15
|20% copay Minimum $30
|Out-of-Network Retail Pharmacy||Contact Express Scripts/Medco 1 (800) 841-2806|
|Medco (mail-order) up to 90-day supply||$20||20% copay Minimum $40
|25% copay Minimum $75
Vision: Annual comprehensive vision exam using Vision Service Plan participating physician. Vision Hardware Discount Program is also available through VSP.
Documents in "PDF" format will open with the Adobe Acrobat Reader program. To obtain the free Adobe Reader program, please click on the Get Adobe Reader link for download and installation instructions.