2016 MPSERS Healthcare Changes FAQ
Plan Changes for 2016
Q: Is my plan changing for next year?
A: If you are enrolled in Blue Cross Blue Shield of Michigan for your health insurance, there are some changes to your plan.
- Medicare -
o The deductible is increasing from $650 to $700.
o The Annual Coinsurance Maximum is increasing from $800 to $850. This will bring the Annual Out-of-Pocket Maximum to $1,550 (Deductible + Annual Coinsurance Maximum = Annual Out-of-Pocket Maximum).
o The Emergency Room Copay is increasing from $50 to $75.
o Call BCBSM at
1-800-422-9146 for more details.
- Non - Medicare -
o The deductible is increasing from $850 to $900. Members that participate in the LivingWell program can lower their deductible to $700.
o The Annual Coinsurance Maximum is increasing from $800 to $850. This will bring the Annual Out-of-Pocket Maximum to $1,750 (Deductible + Annual Coinsurance Maximum = Annual Out-of-Pocket Maximum).
o The Emergency Room Copay is increasing from $50 to $75.
o Colonoscopy coverage is being expanded to include preventative screenings.
o Coverage for the flu vaccine is being added.
o Licensed Master's Social Workers are being added as a covered provider.
o The deductible requirement for hospice care is being removed.
o Call BCBSM at
1-800-422-9146 for more details.
- Dental -
o Coverage for dental implants is being added.
o Contact Delta Dental at
1-800-345-8756 for more details.
Q: Why are these changes being made?
A: The Office of Retirement Services is constantly looking to improve the quality of our plans while keeping in step with the increasing cost of health care. We have a responsibility to the taxpayers and the schools that fund the plan to keep costs affordable, while still providing coverage that helps keep our retirees and their families healthy.
Q: How is my plan affected by the Affordable Care Act?
A: Your coverage through the Michigan Public School Employees Retirement System is not impacted by the Affordable Care Act. The changes to your plan do not have anything to do with the Affordable Care Act.
Vendor Changes
Q: Is my prescription drug vendor changing?
A: Yes. CatamaranRx has been purchased by OptumRx. CatamaranRx will continue to be your prescription drug vendor through the end of 2015. You should be receiving a letter in the mail in October announcing the change. You will not be receiving new ID cards. Your Ca
tamaran ID cards will continue to work. All of the CatamaranRx phone numbers will remain the same. The plan design and formulary will remain the same. The only real difference to yo
u will be the name change from CatamaranRx to OptumRx.
Medicare members call - (855) 577-6517Non-Medicare members call - (866) 288-5209Q: My HealthPlus plan is ending. Why?
A: HealthPlus has decided to discontinue its plan offering for MPSERS members. You will need to select a new plan to enroll in for 1/1/2016. If you do not enroll in another MPSERS plan, you will no longer have medical or prescription coverage through the Michigan Public School Employees Retirement System after 12/31/2015. For more details, please call HealthPlus at
(800) 332-9161.
Q: When will I receive my 2016 insurance premium rates?
A: Office of Retirement Services is working diligently to make sure you receive your rates as soon as possible. Our goal is to have your individual rates to you by the first week of October.
Catamaran is now OptumRx: Here's what you need to know
OptumRx® and Catamaran® joined forces to deliver enhanced pharmacy coverage and a better experience for members. Your prescription claims will continue to be processed quickly and accurately, and your pharmacy benefits will not change. Read the frequently asked questions below for more details about the combined company, known as OptumRx, and what it means for you.
Will I receive a new ID card?No. You will continue to use your current ID card. The information that pharmacies use to process and fill your prescriptions will not change.
Can I continue to go to the same pharmacy?You can continue to visit the same network pharmacy you already use. If there are any changes to the network in the future, we will notify you.
Will my benefits change?No. Your plan design will remain the same in 2016. Any changes to your prescription drug coverage are determined by your Retirement System and are unrelated to the combination of OptumRx and Catamaran.
Can I still order my current prescriptions from home delivery?Yes, your current home delivery prescriptions will continue to be filled through the same convenient mail order pharmacy you use today. You will continue to place new orders and refill home delivery orders in the same way you do today.
Can I still view my prescription information online?You will continue to use www.catamaranrx.comto view and manage your prescription information at this time. If you've already registered for the member site, your login information will not change. You can use the information on your current pharmacy ID card to register if you are a new user.
DID YOU KNOW:
* NEA reports Michigan has 35,102 NEA-Retired members. There are a total of 324,541 NEA-Retired members. Michigan has the largest membership of any state.
* Senator Gretchen Whitmer was presented the MEA Distinguished Service Award at the Fall MEA RA.
* MEA-Retired has received a $3,566.85 grant from the Center for Organizing Retired Grants. The grant title is Enhance Communication with Members.
* The Social Security Administration announced that there will be no Social Security cost of living adjustment increase (COLA) for 2016.
* House Passes Bi-Partisan Budget Bill, Addresses Medicare Part B Premium Increase The House of Representa
tives passed a budget deal that increases spending
for military and domestic purposes and increases the debt limit. The deal also addresses the increase in Medica
re Part B premiums that is otherwise projected to impact 30 per
cent of beneficiaries, and an increase in the Medicare Part B deductible that would have impacted all Part B enrollees. It now goes to the Senate.
Still time to attend a Blue Cross Seminar if you missed one in Michigan
Scottsdale, AZ Monday, November 9 Doubletree Resort, Paradise Valley
5401 N. Scottsdale Rd. Scottsdale, AZ 85250 9 a.m. to noon
Tuscon, AZ T
uesday, November 10 Hilton Garden Inn, Tucson Airport
6575 S. Country Club Rd. Tucson, AZ 85706 9 a.m. to noon
Villages/Ocala, Florida Monday, December 7
College of Central Florida -Ewers Century
Center Klein Conference Center
3001 SW College Road Ocala, FL 34474 9 a.m. to noon
Clearwater, Florida Tuesday, December 8 Holiday Inn Express & Suites Clearwater
2580 Gulf to Bay Blvd Clearwater, FL 33765 9 a.m. to noon
Sarasota, Florida Wednesday, December 9 Hilton Garden Inn Sarasota Brandenton Airport 8270 N. Tamiami Trail Sarasota, FL 34243 9 a.m. to noon
Ft. Myers, Florida Thursday, December 10 Crowne Plaza Ft. Myers at The Bell Tower Shops
13051 Bell Tower Drive Fort Myers, FL 33907 9 a.m. to noon
Stuart, Florida Friday, December 11 The Kane Center
900 SE Salerno Road Stuart, FL 34997 9 a.m. to noon
In case you might be wondering what your membership in
MEA/MEA-Retired/NEA/NEA-Retired offers you, read on.
This information was given to actives to encourage them to join MEA.
The advantage of MEA membership multiplies with your NEA Member Benefits As an MEA member, you can take advantage of even more money-saving programs and professional opportunities through NEA Member Benefits. To access these benefits, you just need to register at
www.neamb.com In addition to the NEA's Click & Save program that lets you take advantage of exclusive offers, you can sign up for the NEA's ID Theft Program for only $19.95 a year. With their Auto Purchase Program, an MEA member can save more than $2,600 on the purchase of a new or used car. And savings of $150 are available on that car with the NEA's Vehicle Protection Program. The NEA also offers savings on magazine subscriptions, classroom supplies, and energy programs. NEA Member Benefits also has a variety of loan and mortgage programs for MEA/NEA members. There is a Personal Loan program that offers low-rate debt consolidation loans from $5,000 to $25,000 for teachers and ESP members. If you close on a new mortgage/refinance through the NEA's Home Financing Program, you'll receive a $500 gift card. And through NEA's Smart Option Student Loan, members can borrow up to 100 percent of school-certified education costs. Professionally, NEA Member Benefits sponsors the NEA Academy, which provides practical online courses at a reduced cost to meet the professional development and continuing education needs of members. Through its professional services, NEA offers lesson plans at Lesson Planet, peer-reviewed resources through its School Library Journal, and postings of available jobs at Teachers-Teachers.com.
Go to
www.neamb.com to find out more about these programs and other NEA Member Benefits awaiting you as an MEA member.
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