Chair Talk

August 2014

As of this date we have not been notified about the final decision on retiree healthcare co-pays, deductibles or coinsurance. There seems to be some question as to the date that the Employer can change the co-pays on prescription drugs (October 1st or January 1, 2015) for those who are on Medicare Generation Rx. The Employer is waiting to see what the decision is on the dates.

Below are the changes to the State Health Plan that the Civil Service Commission approved for active state employees.  These changes will also be for all retirees unless there are some alterations.

 
Office visitsIncrease from $15 to $20
Emergency Room Copay (if not admitted)Increase from $50 to $200
Prescription Drug Copays (retail 1 month)Increase from $10 (generic), $20 (preferred brand), $40 (non-preferred brand) respectively to $10/$30/$60
Prescription Drug CopaysIncrease from $20/$40/$80 to $20/$60/$120 (Mail order/retail 3 months supply) respectively
Annual In-Network deductiblesIndividual Increase from $300 to $400
Family Increase from $600 to $800
Autism benefitsCovered at 90% after deductible
CoinsuranceCurrently there is no coinsurance. New Plan covers 90% after deductible
Private Duty NursingCurrently covered at 90% after deductible.
New plan is 80% after deductible
Annual In-Network Out of Pocket MaximumCurrently Individual $1000 to increase to $2000
Currently Family $2000 to increase to $4000
Dental plan coverage addedImplants at 50% to 70% if utilizing a dental care provider who is a member of the Point of Service PPO

Drug copays for retirees that retired prior to January 1, 1987 will not increase.

The above are the changes in the current health plan if adopted by the CSC.  Similar changes were made in the HMO’s.

As soon as I know what the changes in our health plan (and effective dates) are I will notify the Chapters/delegates by e-mail.

Editor’s note: Bob Kopasz is Chair of the Michigan SERA Council. He may be reached at P.O. Box 692, Mt. Morris, MI 48458; phone 810/240-8380.