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Jun 26, 2015

The MPSERS (Michigan Public School Employees Retirement System) Board met May 28, 2015. A report was presented about the health care proposed changes for 2016 - 2017. Keep in mind these are only proposals.  No specific proposals were made for prescription drugs. This does not mean there won't be changes.  The information presented was not elaborated on so many questions are unanswered.

Medical Plan:  Emergency Department Copay

  • Average emergency department copay for large employers is $100 per visit
  • Current benefit is $50 for both Medicare and non-Medicare
    • In compliance with CMS rules, Medicare members pay the flat dollar copay until they reach the out-of-pocket maximum
    • Non-Medicare members pay the flat dollar copay once they meet their annual deductible and coinsurance maximum
  • Increase the emergency department copay to $65 per visit

Medical Plan: Additional Benefit Recommendations

•   Expand colonoscopy coverage to include screenings*

  • Remove minimum age
  • Allow every 120 months (or every 24 months if at high risk for colorectal cancer

•   Include coverage for a flu vaccine*

•   Include Licensed Master Social Worker (LMSW) to the mental health benefit*

•    Remove the deductible requirement for hospice care*

*Already covered for Medicare members

Dental Plan: Additional Benefit Recommendation

•   Dental implants are used to replace missing teeth

•    Many times a better replacement option than fixed bridges or partial dentures

•   Cover dental implants