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Welcome! Whether you are a new enrollee Examples of Examples of - PowerPoint PPT Presentation

Mar 31, 2023 •376 likes •1.11k views

Welcome! Whether you are a new enrollee Examples of Examples of or currently going through our annual open enrollment held each fall, you now have the Qualifying Life Events Qualifying Life Events opportunity to enroll in benefits.

  2. Welcome!  Whether you are a new enrollee Examples of Examples of or currently going through our annual open enrollment held each fall, you now have the Qualifying Life Events Qualifying Life Events opportunity to enroll in benefits. Please understand the decisions  Gaining or losing a dependent you make now will remain in Marriage effect for the entire plan year  Divorce  unless you experience a Birth / Adoption  qualifying life event Involuntary loss of other insurance   A qualifying life event will allow coverage someone to change or enroll in HCTC eligibility coverage  coverage mid-year  Marsh, our plan administrator, must be notified within 30 days of the event date Plan Year: 1.1.2013 – 12.31.2013

  3. Overview New for 2013!....................................................... Eligibility……………………………………………. Medical & Rx Benefits……………………………. Health Savings Accounts………………………… Medicare……………………………………………. Dental Benefits……………………………………. Vision Benefits…………………………………….. Voluntary Life Benefits…………………………... Enrollment............................................................ Questions?.............................................................

  4. New for 2013!

  5. What’s Staying the Same?  Continued partnerships! Continued partnerships!  Blue Cross Blue Shield of Michigan will continue to administer the pre-65 and pre-65 Medicare disabled medical/prescription  Continued partnership with Blue Cross Blue Shield of Michigan pre- & post-65 dental benefits  The Hartford will continue to administer the post-65 medical/prescription benefits  Same great vision benefits through Superior Vision  Continued DSRA-BT subsidy DSRA-BT subsidy available for retirees who are not eligible for HCTC Credit (HCTC) for retirees who are  Health Coverage Tax Health Coverage Tax Credit (HCTC) age 55-64 & draw pension benefits from the PBGC

  6. What’s New in 2013?  Introduction of a new option new option for our post-65 members which allows Medicare eligible retirees a “hybrid” solution and choice between the medical/prescription plans option through The Hartford or an “individual” Medicare supplement, Medicare Advantage and Part D prescription plan in your area  New New voluntary life insurance carrier, Reliance Standard, for our Delphi salaried retirees only  Lower monthly premiums Lower monthly premiums  One-time open enrollment opportunity One-time open enrollment opportunity

  7. Eligibility

  8. Retirees  As a salaried and hourly retiree member, you are eligible for the medical/prescription medical/prescription , dental dental , and vision vision benefits unless you have previously terminated coverage  Salaried retiree members are also eligible for voluntary life insurance voluntary life insurance For further details about coverage termination, please refer to the “Eligibility” section in the 2013 Guide to Benefits for Pre-65 Members 2013 Guide to Benefits for Pre-65 Members

  9. Spouse / Domestic Partner  As a Retiree, your legal  Surviving Spouse spouse or domestic  Surviving spouse is eligible partner is also eligible for for medical/prescription, medical/prescription , dental dental , dental, and vision coverage medical/prescription and vision vision benefits  Former Spouse  Spouse/domestic partner  Marsh will send an must have the same enrollment kit to the medical/Rx coverage as former spouse who is the Retiree if both are required to provide a enrolled and in the same statement from the PBGC age category: confirming that he/she has become a pension  Under Age 65 recipient in their own right  Post-65 due to the divorce.

  10. Child(ren)  Dependent children are Definition of Definition of eligible for Dependent Child Dependent Child medical/prescription , dental dental , medical/prescription and vision vision benefits  A dependent child is defined as an unmarried child up to age 19 (or, if a  Child(ren) can remain full-time student, until the earlier of age 25 or student status ends) on the coverage through the end of the calendar year during which they were no longer eligible Disabled Child Disabled Child  i.e. March 29th birthday  A disabled child is not subject to the can continue until age limitation but cannot be on December 31st Medicare (child must have been on coverage prior to becoming disabled if  Child(ren) must have beyond maximum age limitations) same medical/Rx  A disabled child on Medicare must enroll coverage as the retiree in the BCBSM Medicare Disabled COMP plan

  11. For More Information  For further details including what happens upon termination of coverage, refer to the 2013 Guide to Benefits 2013 Guide to Benefits for Pre-65 Members for Pre-65 Members

  12. Medical & Rx Benefits

  13. Understanding T erminology Deductible Deductible A dollar value that you are responsible to pay for a covered medical expense before the coinsurance begins. Coinsurance Coinsurance Once you have satisfied your deductible, you will begin to pay coinsurance. In other words you will pay a % – such as 20% of the claim and the plan will pick up the rest – such as 80%.

  14. Understanding T erminology Copay Copay A fixed fee paid for office visits and prescription drugs. For the BRONZE medical plan, copays only apply to prescriptions drugs after the deductible has been met. Out-of-Pocket Maximum Out-of-Pocket Maximum The most you will be responsible for out-of- pocket for during the calendar year. This includes your deductible and coinsurance.

  15. Embedded v. Non-Embedded Deductibles NON- NON- EMBEDDED EMBEDDED EMBEDDED EMBEDDED GOLD SILVER BRONZE Individual $250 $500 $2,000 Deductible Family $250 per person $500 per person $4,000 Deductible (capped at $500) (capped at $1,000) If you cover dependents on this If you cover dependents, under medical plan option, the entire the GOLD or SILVER medical family deductible of $4,000 plans, when any one individual must be met before benefit plan family member reaches the coverage takes effect – by any individual deductible in expenses, one or combination of family their benefit plan coverage takes members. effect.

  16. Your Deductibles, cont’d Family Individual Family Individual $ $ $ $ $ EMBEDDED NON-EMBEDDED Medical cov’d 100% Medical cov’d 100%

  17. Retirees Under Age 65 Blue Cross Blue Shield of Michigan

  18. Your Rx Benefit, cont’d Medical Rx $$$ $$$ $2,000 / $4,000 Rx copays Medical cov’d 80% $15 / $50 / $70 $1,000 / 2013 BRONZE PLAN 2013 BRONZE PLAN $2,000

  19. Retirees Post-65 Group Retiree Insurance Plan (GRIP) IMPORTANT IMPORTANT  If you are a resident of Kansas, Maryland, Montana, New York, or Oregon and will be a new enrollee with an effective date of 1/1/2012 and later, a unique plan is available to you  Further details will be Further details will be discussed on the next discussed on the next slide slide

  20. Retirees Post-65 Senior Medical Insurance Plan (SMIP) IMPORTANT IMPORTANT  This plan is only available for residents of Kansas, Maryland, Montana, New York, or Oregon  This applies to new enrollees only with effective dates of 1/1/2012 and later

  21. Retirees Post-65 “Individual” Medicare Plans New for 2013 , post-65 will also be allowed to choose  New for 2013 from “individual” Medicare supplements, Medicare Advantage, & Part D prescription plan options in their area  Opportunity to consider all all health plan coverage options  Chance to tailor the selection to best fit personal & best fit personal & unique health care needs unique health care needs

  22. Retirees Post-65 “Individual” Medicare Plans, cont. cont.  Call Marsh at 1-877-336-DSRA (3772) 1-877-336-DSRA (3772) to speak with a specialized counselor who will…  …Search individual plans by your zip code  …Compare and advise you which plans may make sense for you  …Provide written plan information and enrollment materials  …Confirm your enrollment in a new plan (if selected)  …Provide ongoing support services to you once you are enrolled in a new plan

  23. For More Information  For further details  Carrier plan summaries about the pre-65 can also be found on medical plan options our website – including rates, refer to the 2013 Guide to 2013 Guide to www.dsrabenefittrust.net www.dsrabenefittrust.net Benefits for Pre-65 Benefits for Pre-65 Members Members  For additional information about the post-65 medical plan options & rates, refer to the 2013 Benefit Choice 2013 Benefit Choice Guide for Post-65 Guide for Post-65 Members Members

  24. Health Savings Accounts NOTE: The following slides only apply to the BRONZE BRONZE medical plan

  25. Health Savings Accounts (HSA) What is a HSA? Benefits of HSAs  Money is yours  Bank account for eligible  You own the account health care expenses  You name a beneficiary for the  You may open a HSA at the funds bank of your choice!  You control when it’s spent  You can change your contributions throughout the year  Triple tax savings  Tax credit for contributions to the account  Tax-free earnings  Tax-free withdrawals for qualified medical expenses, as per IRS cod 213(d)

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