Respond promptly to the carrier to complete the final phase of the enrollment process. 0000042215 00000 n You can also take a closer look at your current plan to help you make the best choice for your 2021 plan. 0000030241 00000 n Because Mary's cost to have the HSA Plan is $0, her total cost is $3,030. To help you compare and select your 2021 medical plan, Ford has provided Benefits Mentor powered by IBM Watson Health. And he pay $2,280 annually to have the HSA Plus Plan. Look for the chat icon at the bottom right corner of the screenon any page of this website. 0000035230 00000 n 0000019062 00000 n There are several ways you can request a QHC letter. And with the HSA Plus Plan, Ford will also contribute to your HSA. startxref The only providers permitted to submit a signed "Hospital Coverage Letter" for hospital privileges' requirement, are the following provider specialties/types: Adolescent Medicine, Child & Adolescent Psychiatry, Developmental-Behavioral Pediatrics, Family Practice, General Practice, Geriatric Medicine, Internal Medicine, Pediatrics, Physical 0000024600 00000 n To file a Blue Cross Blue Shield Global Core eClaim online, log in with your username and password or register for access. The account and money are yours. This contribution will be prorated for employees who enroll mid-year. 119 0 obj Standard Qualification Form If you have a Blue Cross Blue Shield of Michigan plan other than Healthy Blue Achieve that requires a qualification form, please use the form below. 0000019892 00000 n If you have any questions, call the phone number on the back of your Blue Cross ID card and we'll help. Let's say Mary and her family have a normal year with normal doctor visits. Please see below for further information. 0000000016 00000 n Before you select a medical plan, consider your total costs, including the costs to have and use the plan. 14. other health care coverage 16. other policy holder's last name 19. other policy holder's date of birth 17. other policy holder's first name 20. name of other health carrier 21. other carrier policy/group number 22. other carrier street address city state zip code 23. other employer name major medical 24. type of other health insurance . hm6?ZqJ!nv+E 0000007421 00000 n Preventive care benefits are covered 100 percent when received from a TRUST PPO network provider. 0000012102 00000 n 0000007100 00000 n For the HSA Plus Plan, Ford contributes $1,000 towards Mary's health savings account, which further reduces her cost to use this plan. Questions About Your Benefits? 0000041020 00000 n K4[WYV5pL@=>QBuD Simply Blue. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. Employees can now get a Health Care Plan Verification letter through Wolverine Access by selecting Employee Self-Service > Benefits > Health Care Plan Verification. If your auto insurance is requesting a QHC letter to issue or renew a policy, you may request a QHC letter by contacting your health carrier. As you can see, there are great benefits to having an HSA. The HSA balance belongs to the employee and can be carried over from year to year. b|=b}#Aif3TRD0;@NHkQ#`VEQxD Government Human Resources Benefits Health Benefit Plans. Contact your HR Benefits Team at LCC-HR-Benefits@star.lcc.edu Contact Human Resources Phone: 517-483-1870 Fax: 517-483-1883 Monday - Friday: 8:00 a.m. - 5:00 p.m. Administration Building Thank you for viewing. New SHP PPO membership ID cards will be mailed in September 2019. Once logged in, navigate to the https://www.bcbsm.com/medicare/help/faqs/other/auto-law.html Category: Health Show Health PPO. 0000031112 00000 n We can help. *Except for those employees in certain bargaining units who are hired on or after 1/1/00 who have a regular work schedule of 40 hours or less per bi-weekly pay period (not permanent-intermittent positions). Now let's imagine Mary and her family had a year with a lot of medical and prescription expenses where they meet the out-of-pocket maximum for both plans. Please review directory information to ensure its accuracy before attesting. So when we consider the total cost to have and use the plans, the HSA Plus Plan is the less costly option. 0000023020 00000 n To obtain a coordination of benefits letter, call the number on the back of your Enrollee ID card. N'JV|DI]Ea:%*&[|{;z^HzwD/L_d?D/q|',W2tKpcukU;Bxc%w37XeNh{%_hl@zPMy * uAd;{i6pmn'D=6e Cvy"ngpdh6 s/8bG. 0000044573 00000 n 0000009570 00000 n California Physicians Service DBA Blue Shield of California is an independent member of the Blue Shield Association. For more information about the State of Michigan's eligibility requirements for employee health insurance coverage, . An important note regarding the State Health Plan PPO deductibles: You have the freedom to see both in-network and out-of-network providers. 0000013137 00000 n You may look up HMOs in your residential area using the zip code tool. The BlueCard Program links Blue plans across the United States and abroad through a single electronic network for claims processing and reimbursement. 0000010306 00000 n Ford offers an accelerated contribution option. %PDF-1.7 % 0000017188 00000 n 0000004500 00000 n Co-insurance is a percentage of the cost you share with the plan. HSA Plan and HSA Plus Plan. Your email address will not be published. 140 0 obj <> endobj Please enable JavaScript in your browser for a better user experience. | _1S}9M{T=o9B^>.!a8Znpk9(6_ endstream 0000048409 00000 n %PDF-1.7 % (5 days ago) WebTo request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146 from 8:30 a.m. to 5 p.m. Eastern time, Monday https://hwnr.bcbsm.com/content/dam/microsites/mpsers/2020/best-of-health-summer-nonmedicare.pdf Category: Health Show Health Filter Type: Treatment Don't have a member account? 0000033132 00000 n The maximum deductible for two or more covered persons in your family was limited to 1 months of your basic salary. ATTENTION: To ensure individuals with disabilities have an equal opportunity to access enrollment services for Qualified Health Plans, if you have a disability (such as visual or hearing impairment) auxiliary aids and alternative formats are available free of charge by contacting HealthCare.gov or calling 1-800-318-2596 to speak with HealthCare.gov. It has a deductible of $6,000 or less per person. 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. Log in to continue with member verification. 0000015914 00000 n Under the new legislation, residents may select different levels of PIP coverage. Those costs include increased copay and deductible amounts. All rights reserved. This is the amount taken from your pay each month. 0000020133 00000 n 0000011210 00000 n Federal No Surprises Act: The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 0000033229 00000 n Your explanation of benefits (EOB) statement has a new look. You can now file disputes, attach supporting documents, and retrieve letters for submitted disputes online! But, if you receive services from a provider not in the PPO network, you may be responsible for paying additional out-of-pocket costs. 0000032373 00000 n 0000059965 00000 n Its important to know that in order to opt-out of PIP coverage under the new Michigan law, you must have health insurance that is considered qualified health coverage. 0000013426 00000 n For the best experience, use the latest version of Google Chrome or Microsoft Edge. 0000016814 00000 n Click continue to proceed with verification. Both plans offer the largest doctor and hospital network as well as benefits, including prescription drug coverage and in-network preventive care at no additional cost. 0000005441 00000 n a health reimbursement arrangement which helps members pay for qualified medical expenses. Uses standard Blue Cross ID card. 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). Let's start with Mary who selected a plan to cover her family. An HMO is a managed care plan that provides medical care through its network of physicians, pharmacies, contracted hospitals, and medical care suppliers. A plan is considered QHC if coverage for motor vehicle accidents is not excluded and the annual deductible is $6,000 or less per covered individual. Qualified health coverage is health or accident insurance that doesn't exclude or limit coverage for injuries from auto accidents. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. You can log in to your online member account to see if you have a QHC letter to download. 0000007258 00000 n This was a hospitalization-only plan intended as an option if you had coverage elsewhere (for example, through a spouse who works for another employer). [Instructor] Hello, and welcome to Blue Cross Blue Shield of Michigan. Earnings on an HSA fund balance are tax-free, and you can withdraw your money tax-free anytime, as long as you use it for qualified medical expenses for yourself or your tax dependents. 0000021168 00000 n If your spouse's (non-State) employer will not cover you under their group plan because you are enrolled in any of the State-sponsored health care options,you can "opt out" completely and still receive the $50 biweekly payment (select "Health Waiver with Rebate"). NO - YES - Please complete entire form, sign at the bottom and return sign at the bottom and return . 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. Contact your auto insurance agent with questions and to learn more about your options. endstream James wouldn't have to pay anything from his paycheck to have the HSA Plan. 93gpm},|P gaToY%+IzO96`%n'`Pll@BJa 163 0 obj <>stream 0000028187 00000 n 0 bcbsm.com. 0000026163 00000 n 0000031798 00000 n There are different levels of PIP coverage that you can choose from. You have certain tasks to complete within specific . 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. Once they've been met, the plan generally pays the full amount of your in-network medical and prescription costs. 0000019721 00000 n 0000027161 00000 n *Blue Shield of California member plans only, Pre-service review for out-of-area members. General Inquiries. For the HSA Plus Plan because Mary met her deductible and a portion of her service costs are paid at the 20% co-insurance, she would be responsible for $3,006 out of pocket to use this plan. View the Telemedicine Benefit Summary to see your State-sponsored health insurance carrier's telemedicine coverage. 0000027625 00000 n View the eGuide to see the Ford resources available all year long. 0000014332 00000 n When we look again at the total cost of having and using the plans, the HSA Plan is the lower cost option for John. 600 Lafayette East. 0 0000028854 00000 n A plan is considered QHC if coverage for motor vehicle accidents is not excluded and the annual deductible is $6,000 or less per covered individual. endobj Visit myfordbenefits.com and make your plan selection for 2023. (tJ)Dpdd5* 7YG1}[X3C=Yvou*tdU`{NRGqZy3Cv{c.W+5gE|7?)z If you absolutely need to call, please try again at a later date. lo%x9d,oqM lzgw'TK6oB~+d; {qi.B/ R`]Hcq6~s_]=y&|9]Fl2b\o9Vp"(5Z9lb.dx;@? *Mii lkSW+0XI~'kT`C>?wlvR 0000058981 00000 n 0000007848 00000 n 0000029757 00000 n 0000060222 00000 n %%EOF 0000018771 00000 n 0000010545 00000 n $"mY_%Be66y=\"QI Benefits under this plan were payable only after you had paid expenses equal to one month's basic salary (your deductible). i' *eW Your Benefit Guide State Health Plan PPO 3 Visit BCBSM Customer Service Center 232 S. Capitol Ave. Lansing, MI 48933 . Learn more about your Blue Cross Blue Shield of Michigan plan options. 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. 0000022731 00000 n John's annual paycheck deduction for the HSA Plan is zero. Plan: Blue Care Network (BCN) Premium Cost: Summer 5/16/20 - 8/15/20 $474.00 (approx. Callers to our phone lines are currently experiencing long wait times. If you need information about eligibility, benefits or claims, or want to submit or review an authorization, the best way to get up-to-date information is through our on-line resources. 0000059887 00000 n Visit Federal No Surprises Act (michigan.gov)for more information. This tool provides side-by-side medical plan comparisons and personalized cost modeling. If you don't have a Provider Connection account, you will need to register before logging in. Fax: 248-524-2752, https://dev.michigan.local/som/json?sc_device=json, State Health Plan Preferred Provider Organization (PPO), State High Deductible Health Plan (HDHP) with Health Savings Account (HSA), Catastrophic Benefits (Effective January 1, 2023 this plan is no longer available to employees and their dependents), OptumRx is the Pharmacy Benefit Manager for the State Health Plan PPOand will administer all retail, mail-order, and specialty, State High Deductible HealthPlan (HDHP) with, dministered by Blue Cross Blue Shield of Michigan (BCBSM),HSA a, The federal government issued the "transparency in coverage" final rule under the Federal No Surprises Act. 141 0 obj Qualified Transportation Fringe Benefits (QTFB). 1996-2023 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. hb``b``f`c`Taa@ V(-) Q>hL)[ley|800pt Pn`K Al@8m@@3J31k=21@=3 F%&hWfpdbm]` You're eligible for an HSA if you enroll in the State HDHP and have no other non-HDHP health care coverage, including coverage through your spouse or any other person, and you are not claimed as a dependent on another persons tax return. The HSA Plan is still the less costly option for Mary because the total cost to have and use the plan is lower in the HSA Plan. www.bcbsm.com/som, State High Deductible HealthPlan (HDHP) withHealth Savings Account (HSA)- HDHP administered by Blue Cross Blue Shield of Michigan (BCBSM),HSA administered by HealthEquity. If you choose to do so, you will be responsible for both deductibles. Identified standard preventive services are covered at 100%, but most other services have a 20% in-network coinsurance after meeting the deductible. 0000047030 00000 n 172 0 obj BlueCard Program home page. 0000059434 00000 n %PDF-1.6 % startxref Representatives are available 8:00 a.m. to 5:00 p.m., Monday through Friday. The network covers all 83 Michigan counties and is the largest PPO network in Michigan. To get reimbursed for a flu or pneumonia shot, you'll need to fill out our Member Flu and Pneumonia Shots Reimbursement Form (PDF). 0000039800 00000 n 0000021696 00000 n 0000027006 00000 n They areresponsible for the deductible, then the hospital is reimbursed according to the plan design. 0000008905 00000 n Or, call the number on the back of your member ID card. Click My Plan and Spending. We'll accept a qualification form from an office visit that occurred up to 180 days before the start of your plan year. 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. 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. Visit myfordbenefits.com and make your plan selection for 2023. To help your savings grow even more, when your HSA balance reaches $1,000, you can choose a variety of investments. Reviewplan materialscarefully to understand the advantages and risks associated with the plan. GradCare Member Reimbursement Form U-M Premier Care Member Reimbursement Form For the HSA Plan, your deductible and out-of-pocket maximum amounts for in-network services are the same. 0000038624 00000 n After the deductible and coinsurance are applied for the HSA Plus Plan, James will be responsible for $3,480. hb``a`` -mY8PE!u[dCC#W6,j.Fvtl,s fb`p;CT3j 0000045752 00000 n 0000048540 00000 n trailer 0000012476 00000 n 1200 N. Telegraph Road A QHC letter must contain the following: The full names and dates of birth of all individuals covered under the policy or plan; and A statement that includes whether the coverage provided constitutes "Qualified Health Coverage" as defined in MCL 500.3107d (7) (b) (i), or that the coverage: Does not exclude coverage for motor vehicle accidents, and C.O.P.S. See below. You can also opt-out if you qualify for that provision. Providers and facilities that fail to comply will be suppressed from our directories. *Blue Shield of California member plans only. For example: a single person chooses an in-network hospital for surgery. Important Legal and Privacy Information | Important Information About MedicarePlans | Privacy Practices | Site Map | Feedback | Download Adobe Acrobat Reader, Important Information About MedicarePlans. 0000006930 00000 n Under the plan documents section, click Michigan Auto Reform to request a letter be mailed to the subscriber's address. Verify eligibility of Blue Shield of California, Blue Shield of California Promise Health Plan, other Blue plan and Federal Employee Program members, and access associated benefits information. 0rtq]%g=z.#i0\*m(D2q;t2}$kX[-+G-0hdA9r*8!jcsfEdRyV0=bLzf']q[6F"h.wB)^wvDH =/OC; f'e$GVi]G}//xTw)9]y(kkxU*uXT) 0ajx[k jK`8P1(GU=. 0000035745 00000 n 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. When you see a PPO network provider for covered services, your out-of-pocket costs are limited to deductibles, co-insurance, and copays. Health Insurance Marketplace Check out information about the Marketplace, especially if you are not eligible for coverage through LCC. endobj 0000008243 00000 n To find the most up-to-date information about current medical and pharmacy claims, you can use the Blue Cross app or log into your BCBSM member account at bcbsm.com. 0000014991 00000 n Health insurance plans may contain auto exclusions (meaning they don't provide coverage for car accident-related injuries); may fail to cover the treatment, care and services needed by car accident victims; may limit such treatment, care and services in ways that No-Fault does not; and/or may involve managed care or HMOs which require You can also review your current plan to help make the best choice for 2021. Learn More Questions? This copay is waived if Mary or her family member is admitted as a result of the ER visit. Because the deductible for the HSA plan is higher, James is responsible for paying the full cost of his health care services, including his medications. 0000023941 00000 n We're redirecting you to Blue Shield of California's Find a doctor search. <<674A7177E0417F4590EC384E93D00AED>]>> Both plans include a health savings account HSA. It can help treat minor illnesses such as colds, sinus or respiratory infections, sprains, or rashes, making it perfect when your primary care physician is unavailable or leaving the house is difficult. %%EOF PIP is the part of an auto insurance plan that covers the health care costs from a car . To request a proof of qualified health coverage letter, contact Blue Cross' Customer Service department at 1-800-422-9146from 8:30 a.m. to 5 p.m. Eastern time, Monday through Friday. In the HSA Plus Plan, you're also responsible for all medical and prescription costs until your deductible is met. (MSPTA-represented only) Be sure to turn off pop-up blocker and private browsing prior to opening your Auto Health verification letter. 0000006145 00000 n 'TMjZ}dM`V;hO0 45o` T@> $0,Tkpp9~#@="-toen7=u-J 3P6sO1v 0IA||$IRs3R6o'j*vU#;B!FL5O,hBtA7|$xVv)*09KTOM8Gh6CAIT,[*6a8 wz 0000019432 00000 n Available for commercial, Shared Advantage, and BlueCard. h1aMXk* Q)DDJjH$*F 0000025504 00000 n When asked to log in, choose Continue as a guest. 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. hbbd```b``z"@$D2e5A$)e,H^0 The plan covers inpatient hospital care, as well as other outpatient services received at a hospital including emergency room care. 0000015623 00000 n Access commonly requested forms for patient care activities, credentialing, and more. endstream endobj 14 0 obj <. Contact your auto insurance carrier for specific questions regarding PIP coverage. 0000026848 00000 n Automobile No-Fault Insurance Changes: Prior to July 2, 2020, Michigans Automobile No-Fault Insurance Law required individuals to purchase unlimited Personal Injury Protection (PIP) through their auto insurer. 0000034485 00000 n These plans also allow you to set aside tax-free funds that you can use for qualified medical expenses. 0000008045 00000 n What does PIP cover? You can log in to your online member account to see if you have a QHC letter to download. Ready to enroll? 0000010017 00000 n 0000032096 00000 n 0000010919 00000 n 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. State Health Plan PPO - Administered by Blue Cross Blue Shield of Michigan (BCBSM). TVxZOEhL5wV/yZP^',UP1ko}87M@p_[8Sq^R/ 0000009647 00000 n MSU Student Health Insurance Plan. With the HSA Plan, you pay 100% of medical and prescription costs until your deductible is met. Other costs to use the HSA Plan will vary depending on whether you select plan coverage for you or for your family. This provides cost and other information related to your plan options. They won't charge you the difference between their normal charge and the amount paid by the State Health Plan PPO. Submit and confirm authorizations and approval of medical and pharmacy services prior to services being rendered. Under the new law, youll no longer be required to purchase unlimited personal injury protection (or PIP) if you have a certain level of health insurance coverage. Take a look at what Blue Cross plans offer, then choose the one that's right for you. 0000059656 00000 n You keep what you dont spend on medical expenses, even if you retire or leave state employment. The HSA Plus Plan requires a monthly contribution that's different depending on whether the plan will cover you, you and your spouse, you and your children, or your entire family. Even though this law has to do with your auto insurance, a lot of people have questions about what it means for your. xref $158 per month) Eligibility: All MSU students, Law students, Visiting scholars, and more, including spouse and children of a student enrolled in the plan. %PDF-1.7 % 0000009279 00000 n 866-503-3158 State-sponsored health insurance carriers are prepared to send a letter to State employees or retirees, upon request, confirming their health plan is considered Qualified Health Coverage (QHC). So in this scenario, the total cost to have and use the plans makes the HSA Plan the less costly option for Mary and her family. 0000036168 00000 n hbbd``b`$WX@]@D0(, IH0@1% b Cu@\v d"3|` You also have an out of pocket maximum, that's the maximum amount you pay in deductibles and applicable co-insurance during one plan year. We're sorry, but the attestation service is temporarily unavailable. Blue Cross Blue Shield of Michigan, in partnership with Lucet IS IBCQ-]97T5dUa{ugdcg`\o'.Nu }n|7G|ZXXMf9I\RTt K{d\H3$]S^-}h C6PDI^7|[N$G3y\80-~/T2;D->>DRUw_ F=(8#l9o&.fy66tK~yUR~YZOa.y=jYh8MfH3eXg]s#2H`pw$]Nx8p&`1l)v1]\Ib`wO6+1OLn@{hE +vA3LSY+o(*_6]o. Enroll when you're ready. \8/$z Healthcare includes your Medical (ASR, BCBS, or HAP), Prescription (Navitus or HAP), Dental (Delta Dental), and Vision (NVA). 0000013667 00000 n 0000003382 00000 n An HSA is a smart way to save for your future qualified health expenses, including those that may come up in retirement. Depending the level of PIP you choose, your auto insurer may request a letter stating whether you have qualified health coverage, or QHC. 1tv 0000028562 00000 n 120 0 obj 0000003914 00000 n This letter shows whether your health insurance plan meets the requirements to be considered QHC under the new no-fault auto law. 0000005858 00000 n 0000017849 00000 n Telemedicine Benefit Summary:Telemedicine visits allow you to meet with a US board-certified doctor online using a video-chat tool. 0000012767 00000 n Field Service. Effective January 1, 2023, MSPTA-represented (To1) employees are eligible for this benefit, DROP employees and OEAIs and the dependents remain ineligible. We're making your EOB easier to understand. 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 . {07 N_Bdk %%EOF 258 0 obj <> endobj Your coverage is considered qualified if it: When making a decision, keep in mind that PIP has coverage that goes beyond traditional health insurance. &yw}.$7eIw 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.
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bcbsm qualified health coverage letter