Retiree Medical Benefits

Medical Options

The city offers you the following plan options so that you may select the best fit for your financial and personal situation:

  1. EPO (Exclusive Provider Organization)
  2. HDHP (High Deductible Health Plan)
  3. No Coverage of the city’s medical plan

EPO Exclusive Provider Organization

An Exclusive Provider Organization (EPO) plan has a higher monthly premium, but offers less risk, or “cost,” when you or your family seek care during the year. This is because things like doctor visits, specialist visits, urgent care visits, and prescriptions have a fixed co-pay so that you know exactly what you’ll have to pay at the time of the visit. Also, this plan offers a lower deductible for you and your family. On an EPO plan, your co-pays do not apply toward your deductible. They will, however, go towards your out-of-pocket maximum.

EPO Plan Highlights

  • Lower Deductible
  • Higher Monthly Premium
  • Fixed Co-Pays (co-pays do not apply toward deductible)
  • Out of Pocket-Maximum (deductible & coinsurance will apply)

HDHP High Deductible Health Plan

The HDHP allows you to have the most control over your health care expenses. This plan is much different than an EPO because you are responsible for paying 100% of the cost of care and treatment you seek until you meet your deductible. This means most doctor visits, MRIs, and prescriptions will be your responsibility and also count towards your deductible. Once the deductible is met, the plan will share costs with you. 

HDHP Plan Highlights

  • Higher Deductible
  • Lower Monthly Premium
  • No Co-Pays (all services subject to deductible and coinsurance)
  • Out of Pocket-Maximum (deductible & coinsurance will apply)

HSA Health Savings Account

If you choose the HDHP, you will also receive a Health Savings Account (HSA), which allows you to pay for eligible health care expenses. If you have HSA money in a different bank, you may transfer the funds to the city’s current HSA bank. Contact Human Resources for more information.

HSA Account Highlights

  • All eligible health care expenses are tax-free
  • The city may contribute a defined amount at the beginning of the year* and you can make additional post-tax deposits on your own, up to the total allowed maximum per year
  • Balance rolls over each year
  • The HSA is yours to keep—even if you leave employment with the city or retire
  • You are automatically enrolled in an HSA when you sign up for the HDHP
  • To be eligible for an HSA, you must be enrolled in an HDHP

IRS Guidelines

There are limits as to how much money you can contribute to your health savings account each year. 

If you have a spouse enrolled in an HDHP with an HSA, even with another employer, the total includes his or her contributions and their employer’s contribution as well. So, plan your deposits carefully. 

If you are over 55, you can put in an additional $1,000 over the annual HSA limit. This is a total of your contribution and the city’s contribution. 

By federal law, if you have an HSA, you cannot have a health care Flexible Spending Account (FSA) at the same time. 

You cannot have secondary coverage with a High Deductible Health Plan (HDHP). 

You cannot enroll in a Health Savings Account if you are enrolled in any government medical programs including: CHIPS, Medicare, Medicaid, or Tricare. 

You cannot be claimed as a dependent on someone else’s tax return.

Account Deposits

Deposits Limits Retiree Retiree Family Member
Your Annual Minimum $0 $0
Total Annual Maximum Allowed. If you qualify for city HSA funding, you must reduce the maximum amount by the city-funded amount. $3,650 $7,300