Qualified Transportation Fringe Benefits (QTFB). Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. 0000048472 00000 n An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. Blue Shield/Blue Shield Promise network referrals. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to Blue Shield of California. 0000006680 00000 n 0000012767 00000 n 0000048207 00000 n 0000014332 00000 n Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. Qualified Health Coverage Documents DIFS Bulletin 2020-01-INS advises health plans should develop a document that indicates whether a person's coverage is "qualified health coverage" or QHC for purposes of the new no-fault law. 1200 N. Telegraph Road With the total of all her family services and prescriptions, the HSA Plan costs $3,030 to use. endstream endobj startxref 0 0000032777 00000 n 0000024600 00000 n N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. SECTION 2 OTHER HEALTH COVERAGE INFORMATION . %PDF-1.7 % If you're asked to provide your auto insurer with a QHC letter, you will either need to contact your health plan (like Blue Cross) or your employer to request the letter. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. 0000006930 00000 n Your explanation of benefits (EOB) statement has a new look. This plan provides health benefits using providers and facilities that are in-network, meaning the providers and facilities have agreed to accept a discounted fee from BCBSM in order to be in-network. 0000019432 00000 n 0000028562 00000 n 0000033229 00000 n The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000012102 00000 n See below. 0000034485 00000 n 0000043394 00000 n 0000007628 00000 n Contact your auto insurance carrier for specific questions regarding PIP coverage. Effective October 1, 2019, Blue Cross Blue Shield of Michigan, in partnership with Lucet, will be replacing Magellan Health as the State Health Plan (SHP) PPO Behavioral Health/Substance Use Disorder carrier. 0000004500 00000 n 0 Visit myfordbenefits.com and make your plan selection for 2023. Enter the three letters of your "Enrollee ID" found on your Blue Cross Blue Shield member ID card, and then click Go. Thank you for viewing. 0000027625 00000 n 120 0 obj 163 0 obj <>stream This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. The HSA Plan is available to you at no cost. Don't have a member account? This copay does not apply to the out of pocket maximum for the HSA Plan, so Mary will be responsible for this copay each time she or a family member visits the ER, after the deductible is met. Ford offers an accelerated contribution option. Now let's look at some helpful scenarios that show how these plans work, considering the costs to have and use each plan. 800-229-2210 The web Browser you are currently using is unsupported, and some features of this site may not work as intended. 0000047030 00000 n b|=b}#Aif3TRD0;@NHkQ#`VEQxD (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z 0000005259 00000 n "Qualified Health Coverage" means your health coverage: Does not exclude or limit coverage for motor vehicle accidents; and Has an annual deductible of $6,000.00 or less per covered individual. 0000028187 00000 n Employees can also make pre-tax HSA contributions by payroll deductions. Let's say Mary and her family have a normal year with normal doctor visits. bcbsm.com. This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. This copay is waived if Mary or her family member is admitted as a result of the ER visit. There are several ways you can request a QHC letter. After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. 0000059211 00000 n This plan covered inpatient hospital expenses, as well as certain other services received at the hospital on an outpatient basis (including emergency room care). To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. And for the HSA Plus Plan, it's $1,020. If your no-fault insurance carrier requests or requires confirmation of your university health plan's position for coordination with no fault, please call the SSC Contact Center at 734-615-2000 or 1-866-647-7657 (toll free). 0000022731 00000 n hm6?ZqJ!nv+E Physician Qualification Form (PDF) Healthy Blue Achieve Form lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR Contact your auto insurance agent with questions and to learn more about your options. 0000030725 00000 n 0000023941 00000 n 140 0 obj <> endobj We're redirecting you to Blue Shield of California's Find a doctor search. We appreciate your understanding. 0000030241 00000 n TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ endstream endstream endobj 14 0 obj <. First, let's look at the cost to have a medical plan. *Note: MSPTA-represented (T01) employees, DROP employees, and Other Eligible Adult Individuals (OEAIs) and their dependents are not eligible for this benefit. You can log in to your online member account to see if you have a QHC letter to download. Learn more about your Blue Cross Blue Shield of Michigan plan options. Detroit, MI 48243. Member logins offer many on-line tools, such as access to claims information, viewing Explanation of Benefits, printing replacement ID cards, etc. Or, call the number on the back of your member ID card. 0000014702 00000 n We're making your EOB easier to understand. You may look up HMOs in your residential area using the zip code tool. Current SHP PPO enrollees will be automatically transitioned with no gap or changes in coverage. Later in the year, that same person needs an MRI and chooses an out-of-network provider. startxref To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). In accordance with state and federal law, contracted providers and facilities must attest to the accuracy of their directory information at least every 90 days. As you can see, there are great benefits to having an HSA. When an out-of-area Blue plan member seeks medical care from your office, use our tools to simplify claims submission to BlueShield of California. And with the HSA Plus Plan, Ford will also contribute to your HSA. BlueCard Program home page. Government Human Resources Benefits Health Benefit Plans. Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. Both plans include a health savings account HSA. Respond promptly to the carrier to complete the final phase of the enrollment process. 0000059965 00000 n endstream endobj startxref {07 N_Bdk Log in now myfordbenefits.com HELPS YOU: View personalized benefits The state will make an annual HSA contribution of $750 for an eligible individual employee enrolled in the State HDHP or $1,500 for an eligible employee who enrolls with one or more eligible dependents in the State HDHP,* effective January 1. Please refer to www.bcbsm.com/som for the list of providers. startxref 0000020133 00000 n 0000026848 00000 n For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. John's annual paycheck deduction for the HSA Plan is zero. After your deductible is met, co-insurance applies to medical and prescription costs until your out-of-pocket maximum is met. State-sponsored health insurance carriers are prepared to send a letter to State employees or retirees, upon request, confirming their health plan is considered Qualified Health Coverage (QHC). OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty prescription services for active employees and both Medicare-eligible and non-Medicare eligible retirees. You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. Oakland County's Qualified Health Coverage Letter for Retiree Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law Medical Health Plans ASR Plan Documents ASR PPO 1 Plan Document ASR PPO 3 Plan Document Summary of Benefits and Coverage 2023 PPO 1 Summary of Benefits and Coverage 2023 PPO 3 Summary of Benefits and Coverage <<674A7177E0417F4590EC384E93D00AED>]>> XYQ This product provides comprehensive PPO coverage with costsharing features. And with the $1,000 Ford contribution to his health savings account, James out of pocket costs to use the HSA Plus Plan is reduced to $2,480. Co-insurance is a percentage of the cost you share with the plan. 0000027945 00000 n Enrollment in the State HDHP will also provide access to an HSA, which is a tax-advantaged savings account that can be used to pay onlyeligiblehealth, prescription, dental, and vision-related expenses incurred for services not covered by insurance (e.g., deductibles, copays, and coinsurance). Under the State Health Plan PPO, members choose their in-network providers from the BCBSM Community Blue/Blue Preferred PPO Network. The document must: An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. 1tv The account and money are yours. 0000048976 00000 n %%EOF Two letters confirming you have MESSA coverage that are often requested by your auto insurance carrier can be found in your MyMESSA member account. 0000060222 00000 n The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 258 0 obj <> endobj Go paperless by submitting claims and managing payments online for free. You can log in to your online member account to see if you have a QHC letter to download. Each letter serves a distinct and specific purpose: Notice of qualified health coverage for auto personal injury protection (PIP) benefits: Changes to Michigan's no-fault auto insurance law that . Please keep in mind that PIP coverage pays for some items that health insurance doesnt, such as attendant care, lost wages and vehicle or housing modifications. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. 0000035230 00000 n You can also review your current plan to help make the best choice for 2021. The State Health Plan PPO provides reimbursement for medical care expenses when you need treatment for an illness, injury, or disease. What's qualified health coverage under the new law? Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. lC]n8\! 0000014991 00000 n 0000019892 00000 n The out-of-pocket maximum does not include monthly paycheck contributions, copayments, or any expenses not covered by your plan. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting yourhealth carrier. $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. Access commonly requested forms for patient care activities, credentialing, and more. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. 0000044573 00000 n The HSA balance belongs to the employee and can be carried over from year to year. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. %PDF-1.6 % Follow the instructions on the page to have your letter created. SM. 0000059656 00000 n Look for the chat icon at the bottom right corner of the screenon any page of this website. Individuals attempting unauthorized access will be prosecuted. For instance, you can make your own before tax paycheck contributions to your HSA, use the accelerated HSA contribution option to ensure savings are available sooner, or simply plan to pay yourself back later in the year once your HSA savings has time to build. You can also opt-out if you qualify for that provision. For Medicare Members: No-fault auto law changes bcbsm.com Health (Just Now) WebThere are several ways you can request a QHC letter. 0000019721 00000 n Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). For the HSA Plus Plan, her yearly contributions, which is her cost to have the plan would be $3,300. 0000017849 00000 n State and Federal Privacy laws prohibit unauthorized access to Member's private information. 0000041020 00000 n %PDF-1.7 % Here's how these plans work. 373 0 obj <>stream Pontiac, MI 48341. PIP is the part of an auto insurance plan that covers the health care costs from a car . 159 0 obj <>/Filter/FlateDecode/ID[<38505CF35D4D814CB849C61D42F0BD2C>]/Index[140 54]/Info 139 0 R/Length 99/Prev 142241/Root 141 0 R/Size 194/Type/XRef/W[1 3 1]>>stream 0000020507 00000 n Michigans new auto no-fault insurance law went into effect July 1, 2020. To quickly and easily find out if you, the provider, or a provider referral, participate in the member's plan network*, either log in or register for Provider Connection. For more info, visitwww.mi.gov/AutoInsurance, emailAutoInsurance@mi.gov, or call 833-ASK-DIFS (275-3437). 0000022070 00000 n He paid the full $800 cost of his medical services because the cost is less than the deductible for either plan. You keep what you dont spend on medical expenses, even if you retire or leave state employment. Mail Code 1112. 0000037572 00000 n Be informed about all your Blue Cross plan has to offer. Demographics |Electronic Data Interchange (EDI) | Recoveries, Need help with Provider Connection: Blue Shield Provider Connection Guide Provider Connection training. If you choose to do so, you will be responsible for both deductibles. You're now aware you have a choice between two HSA eligible medical plans in 2021. 0000008045 00000 n hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` 0000048613 00000 n And he pay $2,280 annually to have the HSA Plus Plan. 172 0 obj Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa If the provider you select doesn't participate at all with BCBSM (BCBSM has several different provider arrangements), you may also be required to pay additional charges. View the eGuide to see the Ford resources available all year long. Detroit, MI 48226-9942. 0000016284 00000 n Links to all provider websites can be found on our Benefit Carrier Contact Information page. Blue Cross Blue Shield of Michigan. 0000026163 00000 n Your doctor will submit the form by following the instructions on the back. 0000010919 00000 n Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. You can log in to your online member account to see if you have a QHC letter to download. 0000010017 00000 n 0000059887 00000 n Click continue to proceed with verification. Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. We can help. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 0000007258 00000 n Log in to continue with member verification. 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The rule provides protection against balance or "surprise" billing under certain circumstances, and phases in new transparency requirements on most group health plans and health insurers. 0000025504 00000 n Share & Bookmark, Press Enter to show all options, press Tab go to next option, Retirement and Deferred Compensation Board, Upcoming Individual Consultations & Seminars, Oakland County's Qualified Health Coverage Letter for Active Employees, Oakland County's Qualified Health Coverage Letter for Retiree, Notice of Qualified Health Coverage for Purposes of Michigan No-Fault Auto Law, 2023 PPO 1 Summary of Benefits and Coverage, 2023 PPO 3 Summary of Benefits and Coverage, Summary of Information for Preventive Care, 2023 PPO 2 Summary of Benefits and Coverage, 2023 Traditional Summary of Benefits and Coverage, 2023 HAP Summary of Benefits and Coverage, BCBSM Approved Autism Evaluation Centers and Behavioral Analysts.