If you need any help, please feel free to reach out to our Director of Administration
You will notice that there are a number of tabs on the bottom of the spreadsheet. You should start at the tab that reads “Plan Mapping.” There are 30 plans that are currently maintained by Genesee County for both actives and retirees. It should be noted that this process has suggested that the county consolidate the 27 retiree plans to two Meritain/Aetna plans for retirees; pre-65 and post-65.
In order to compare your current plan to what is being offered, you should start on the left side of the “Plan Mapping” chart, the one with the blue headers, in order to locate your current plan. Once you have found your current plan, use the number under the “suffix/division” column to locate your plan comparison on the tabs at the bottom of the screen. For example, if your current plan is BCBSM 009, scroll along the tabs at the bottom until you find the corresponding tab and then click on it. That will bring up your current plan in order to compare to the new plan. Once on that new page, you’ll notice that there are three groups, one blue and two yellow. The blue group is your current plan, one yellow group is for pre-Medicare (middle column) retirees and one is post-Medicare (far right column).
If you are unsure of what group you fall under, you are still able to see what the new plans would look like. Since all retirees will now fall under two categories, pre and post Medicare, you can click on any tab to view those options.
You’ll notice a number of terms in the top few lines such as deductible, coinsurance maximum and annual maximum OOP. Below is a list of definitions for those terms to help you navigate what they mean.
The deductible is the amount you owe during a coverage period for covered healthcare service before you plan begins to pay. The deductible is the amount you pay at the beginning of each year before your plan begins to pay. For example, if your deductible is $100, your plan won’t pay anything until you’ve met your $100 deductible for covered health service subject to deductible.
Coinsurance is the amount shared by you and your plan for healthcare costs, calculated as a percentage. Co-insurance begins after your deductible is met. It is a percentage you pay for services. Our plans’ co-insurance is usually 10%-20%. For example, if the health plan’s allowed amount for diagnostic testing is $100 and you have met your deductible, your coinsurance payment of 20% would be $20.00. Your health plan would pay the rest of the allowed amount.
Annual Maximum OOP (includes deductible):
Using the example of pre-Medicare per person costs, once you have reached your deductible ($100) and coinsurance maximums ($750), you will then be responsible for only Copay amounts until you hit the federal required maximum ($6,350). In this example, you would continue to pay your doctor visit copay of $20 until you had visited the doctor 275 times. You do not define copay above, but reference it here. Copay is a set dollar amount you pay when you see a healthcare provider.
We understand that there are going to be a lot of questions as we move through this process. This Board has committed to providing information as soon as they have it to help everyone understand what is happening. It is expected that we will hold at least two town-hall style meetings in September to further discuss how these changes may affect you. Due to limitations brought on by COVID, we are still in the planning stage to determine how best to facilitate that type of meeting.
We will continue to provide information as we have it. Should you have any questions, please feel free to reach out, as many of you have, either through email or phone calls to our office.
8/19/20 **Updated Medical Plan Procurement - Presentation
At our last VEBA Work Group meeting on 8/19/2020, there were several questions from the public as well as the Board of Commissioners.
Those questions were presented to our consultant, Plante Moran, who provided answers that you can view at the link below. Those answers that are in red were provided by the County.
After the meeting, we did receive more questions that were forwarded to Plante Moran for answers. As we get those back, we’ll post those to this site as well.
We have also emailed these answers to our retiree email group.
Click HERE for the frequently asked questions.
8/19/20 Medical Plan Procurement - Presentation
Corrective Action Plan - Retiree Health Care
Notice of Public Meeting 2/19/20
February 19, 2020 VEBA Meeting
October 14, 2019 VEBA PowerPoint
August 15, 2019 VEBA Meeting
Plante Moran Contract Resolution
July 31, 2019 VEBA Meeting