St. Joseph Mercy Oakland, Pontiac Non-Union

2015 New Medical Plan Video*

* Please note: colleagues who are logged onto the Trinity Health network remotely through Network Connect will not be able to view this video or access social media. Please utilize the Windows Secure Manager setting or view from your home network or another secure Internet connection.

Medical Coverage

Trinity Health is offering you three medical plan choices for 2015 which supports our efforts to provide a common experience for all colleagues and provide meaningful choices. All three plans are administered by BlueCross BlueShield and support our new clinically-integrated network structure.
The three medical plan options are the Traditional PPO, the Health Savings PPO, and the Essential PPO. Each plan offers these three tiers so you can pay less by receiving care from network providers.

  • Tier 1, or the Trinity Health network providers, are facilities or physicians aligned with our organization that provide you with the most cost-effective care. For services unavailable through Trinity Health network providers, select BlueCross BlueShield Providers will be available at the Tier 2 benefit level.
  • Tier 2 includes select BlueCross BlueShield Providers (facilities and physicians) not listed under Tier 1. Tier 2 providers can save you money, but not as much as using our Tier 1 network.
  • Tier 3 providers are out-of-network providers and this Tier provides the lowest level of coverage. You can use these facilities and physicians for care, but you will pay the most out of your pocket when you do.

Coverage Advisor

Understanding your medical benefits can be challenging. This tool will estimate the costs of different insurance plans based on your expected use of health care services.

Locating a provider

You can easily search for doctors and hospitals that are in your Trinity Health plan networks at bcbsm.com.
Important: You will receive the greatest savings and lowest out-of-pocket costs if you receive care from a Trinity Health facility.

Provider Search Instructions

 

Take the Health Assessment

The Health Assessment (HA) asks about your health habits and lifestyle to help identify some of your health needs. Your answers are kept secure and confidential; summary data is used to identify areas of focus for future wellness and prevention programs.

Information collected in this assessment will not affect your participation in the plan or negatively impact your health care costs. It will be kept confidential and shared only with population health nurse navigators who will help colleagues make choices to improve health and quality of life, and may be used to develop future health and wellness programs for colleagues.

Here’s how to complete the HA:

1. Log on to www.bcbsm.com
2. Under Health and Wellness tab, click on “BlueHealthConnection.” NOTE: You will receive a screen that indicates “you are leaving this website.” This is correct, click OK.
3. Answer the questions on the screens and click “Continue” on each screen. If updating a current HA, be sure to update at least one field in the assessment so it will reflect the most recent date.
4. Once you are finished answering the questions, you will be provided an overall risk score. The following screens have information for you to take better control of your health risks and lifestyle behaviors.
5. Caution – the assessment is not complete until you see your certificate on the screen. Print this and keep it for your records.
6. If you have questions regarding your health assessment or are experiencing difficulties logging into BCBS, contact BCBS Web support at 1-888-417-3479.

Traditional PPO

If you elect coverage under the Traditional PPO, you pay for a portion of the medical services you receive until you meet the annual deductible. Then, coinsurance begins up to the annual out-of-pocket maximum. 

Traditional PPO Summary  | Traditional PPO Summary of Benefits and Coverage 

BCBS Medical Plan SPD

Rx Preventive Services List

Formulary Drug List

CVS/Caremark Drug Cost Estimator - Traditional PPO

To verify coverage and check costs, begin by selecting a member under your benefit plan and entering the drug name. You can only search for one drug at a time.

Rx Long-Term Medications with Maintance Choice Notification Letters:

On-Site Pharmacy

Retail Pharmacy 

Health Savings PPO

The Health Savings PPO gives you control and responsibility over how you pay for health care services. You pay much less per pay period for coverage than the Traditional PPO, leaving more money in your paycheck. In addition, the Health Savings PPO option features a Health Savings Account (HSA) to help pay for current and future medical expenses

How the Health Savings Account (HSA) Works

If you enroll in the Health Savings PPO, you will automatically have an HSA. Trinity Health and St. Joseph Mercy Oakland contributes to your HSA to help you pay for expenses toward your annual deductible andout-of-pocket maximum. You can also contribute to this account to build savings for current and future medical expenses. We encourage you to consult with a tax advisor for IRS rules and tax implications related to HSAs.

When you enroll in the Health Savings PPO plan, you automatically have a Health Savings Account (HSA) through Health Equity to help you pay for current or future health care costs. Trinity Health will make a full contribution to your account in January based on the coverage level you elect. In addition, you can also contribute to this account up to IRS limits:

Coverage Level

Employer Contributions†

Your Contributions*†

Total IRS Allowed HSA Contributions

Colleague only

$650

$2,700

$3,350

All other coverage levels

 

$1,300

$5,350

$6,650

*If you are 55 or older, you can contribute an additional $1,000 in catch-up contributions to your HSA.
†May be subject to state taxation.

For more information relating to the Health Savings PPO please refer to the detailed information outlined in the Oakland Non-Union 2015 Benefit Guide

To log into your HSA account click here

For the Health Equity Member Education Site click here 

HSA Reimbursement Form click here

HSA Contribution Change Form click here

Health Savings PPO Summary | Health Savings PPO Summary of Benefits and Coverage 

Health Savings PPO Summary of Benefits and Coverage Spanish Version

BCBS Medical Plan SPD

Preventive Therapy Generic Drug List  (Health Savings PPO Only)

Rx Preventive Services List

Formulary Drug List

CVS/Caremark Drug Cost Estimator - Health Savings PPO

To verify coverage and check costs, begin by selecting a member under your benefit plan and entering the drug name. You can only search for one drug at a time.

Rx Long-Term Medications with Maintance Choice Notification Letters:

On-Site Pharmacy

Retail Pharmacy 

Essential PPO

The Essential PPO works the same as the Traditional PPO where you pay a portion of the medical services you receive until you meet the annual deductible. Then, coinsurance begins. If you elect the Essential PPO, you pay less in premium contributions than in the Traditional PPO, however, your out-of-pocket cost are higher.

Essential PPO Summary  | Essential PPO Summary of Benefits and Coverage

Essential PPO Summary of Benefits and Coverage Spanish Version

BCBS Medical Plan SPD

Rx Preventive Services List

Formulary Drug List

CVS/Caremark Drug Cost Estimator - Essential PPO

To verify coverage and check costs, begin by selecting a member under your benefit plan and entering the drug name. You can only search for one drug at a time.

Rx Long-Term Medications with Maintance Choice Notification Letters:

On-Site Pharmacy

Retail Pharmacy 

 Essential PPO Assist

Essential PPO Assist Summary

Essential PPO Summary of Benefits and Coverage

BCBS Medical Plan SPD

Formulary Drug List

CVS/Caremark Drug Cost Estimator - Essential PPO Assist

To verify coverage and check costs, begin by selecting a member under your benefit plan and entering the drug name. You can only search for one drug at a time.

Rx Long-Term Medications with Maintance Choice Notification Letters:

On-Site Pharmacy

Retail Pharmacy