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2016 MPSERS Healthcare Changes FAQ

Oct 19, 2015

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 –
    • The deductible is increasing from $650 to $700.
    • 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).
    • The Emergency Room Copay is increasing from $50 to $75.
    • Call BCBSM at 1-800-422-9146 for more details.
  • Non - Medicare –
    • The deductible is increasing from $850 to $900. Members that participate in the LivingWell program can lower their deductible to $700.
    • 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).
    • The Emergency Room Copay is increasing from $50 to $75.
    • Colonoscopy coverage is being expanded to include preventative screenings.
    • Coverage for the flu vaccine is being added.
    • Licensed Master’s Social Workers are being added as a covered provider.
    • The deductible requirement for hospice care is being removed.
    • Call BCBSM at 1-800-422-9146 for more details.
  • Catamaran Rx
    • “Me-too” drugs are being excluded from the formulary
      • A “me-too” drug is structurally very similar to already known drugs, with only minor differences.
    • Call Catamaran Rx for more details.
      • Medicare members - (855) 577-6517
      • Non-Medicare members - (866) 288-5209
  • Dental
    • Coverage for dental implants is being added.
    • 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 Catamaran 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 you will be the name change from CatamaranRx to OptumRx.

Medicare members call - (855) 577-6517    Non-Medicare members call - (866) 288-5209

Q: 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.