Medical Insurance

Employees who are eligible to enroll in medical insurance include 1) full-time employees and 2) part-time employees who work 75% of a full-timer’s load (eligible under the Affordable Care Act (ACA) guidelines).

Employees can enroll their eligible dependents onto the medical coverage as well. Eligible dependents include their legal spouse, children (biological, step, legally adopted, by virtue of legal guardianship, eligible because of a court order), and any Additional Eligible Adult (AEA). Dependent children are eligible to remain covered through the end of the month of their 26th birthday.

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  Eligibility - Child Age 26 and Older

  In order to maintain eligibility for medical insurance past the month of their 26th birthday, a child must meet the following requirements: 1) was covered under this program at the end of the month of their 26th birthday, 2) is a full-time student*, 3) is unmarried, 4) lives primarily with you (unless temporarily away at school), and 5) you provide over 50% support OR 1) was covered under this program at the end of the month of their 26th birthday, 2) before age 19, is mentally or physically disabled, 3) is dependent upon you for a majority of their support, and 4) is incapable of self-sustaining employment by reason of their mental or physical disability

  *A "Full-time Student" is someone who enrolls during each of at least five months during the taxable year for what is considered a full-time course of study at an ongoing educational organization.

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  Eligibility - Additional Eligible Adult (AEA)

  Word FileAdditional Eligible Adult (AEA) Terms and Eligibility

Explore the different Blue Cross Blue Shield (BCBS) medical plan options below:

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  PPO Select $500/$1,000 Deductible Plan

  This plan is only available to full-time employees and their eligible dependents.

  PDF FileBenefits at a Glance

  PDF FileMember Handbook

  PDF FileACA Summary of Benefits and Coverage (SBC)

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  Versatile 3 PPO $250/$500 Deductible Plan with 90/10 Coinsurance

  PDF FileBenefits at a Glance

  PDF FileMember Handbook

  PDF FileACA Summary of Benefits and Coverage (SBC)

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  Flexible Blue HDHP $1,500/$3,000 Deductible Plan

  This plan is a high deductible health plan (HDHP), which means it is compatible with a Health Savings Account (HSA). An HSA works in conjunction with the medical plan to provide additional financial stability by covering out-of-pocket health care costs, such as deductible and coinsurance, from a tax-advantaged savings account. If an employee enrolls in this medical plan, they will receive a welcome kit from our HSA administrator, HealthEquity, with information about how to contribute and use the HSA.

  PDF FileBenefits at a Glance

  PDF FileMember Handbook

  PDF FileACA Summary of Benefits and Coverage (SBC)

  Explore the Health Savings Account (HSA)

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  PPO Plan 3 $1,000/$2,000 Deductible Plan with 80/20 Coinsurance

  This plan is only available to full-time employees and their eligible dependents.

  PDF FileBenefits at a Glance

  PDF FileMember Handbook

  PDF FileACA Summary of Benefits and Coverage (SBC)

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  Essential HDHP $3,000/$6,000 Deductible Plan with 80/20 Coinsurance

  This plan is a high deductible health plan (HDHP), which means it is compatible with a Health Savings Account (HSA). An HSA works in conjunction with the medical plan to provide additional financial stability by covering out-of-pocket health care costs, such as deductible and coinsurance, from a tax-advantaged savings account. If an employee enrolls in this medical plan, they will receive a welcome kit from our HSA administrator, HealthEquity, with information about how to contribute and use the HSA.

  PDF FileBenefits at a Glance

  PDF FileMember Handbook

  PDF FileACA Summary of Benefits and Coverage (SBC)

  Explore the Health Savings Account (HSA)

Explore the different options of non-emergent care that BCBS provides to enrollees, such as Blue Cross Online Visits and the 24-Hour Nurse Line.

PDF FileChoose the Right Place of Care

Employees and dependents enrolled in one of the medical plans have confidential and FREE services/programs available to them, offered through The Pool:

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  2nd.MD

  2nd.MD provides a second opinion and medical advice service for any questions or concerns related to a diagnosis or treatment plan, a possible surgery, medications, or a chronic condition.

  2nd.MD Summary

  2nd.MD Website

  
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  Livongo

  Livongo is a personalized diabetes management experience that helps members understand their blood sugar, develop healthy lifestyle habits, and improve glycemic control. This program includes:

  • A cellular-enabled blood glucose meter that provides real-time feedback for glucose readings
  • Unlimited strips to remove barriers to checking
  • Health challenges to encourage small wins that make big impacts
  • 24/7 remote monitoring with emergency outreach
  • 1:1 live coaching with Livongo Expert Coaches
  • Easy to share health summary reports for care coordination

  Livongo Summary

  Livongo Website

  
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  Omada

  Omada is a digital behavior change program that supports people at risk for obesity-related chronic conditions like type 2 diabetes and hypertension. This programs includes:

  • A cellular-enabled weight monitoring scale
  • A professional health coach
  • Weekly lessons with relevant, engaging content
  • Peer support group
  • Medication adherence support
  • Blood glucose and blood sugar tracking

  Omada Summary

  Omada Frequently Asked Questions (FAQ)

  Omada Website

  
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  Virta

  Virta is a personalized diabetes reversal experience that provides nutrition counseling, medication management, and health coaching for those diagnosed with type 2 diabetes. This program includes:

  • Unlimited testing strips, lancets, and swabs
  • Free blood glucose meter and connected scale
  • Unlimited 1:1 expert health coaching and medical supervision
  • Mobile app with easy-to-use tracking tools and tips

  VIRTA FREQUENTLY ASKED QUESTIONS (FAQ)

  VIRTA WEBSITE

  

The following rates are for the 2023 Plan Year. 

Full-Time Employee Premium

ACA PART-TIME EMPLOYEE PREMIUM

GRANDFATHERED PART-TIME EMPLOYEE PREMIUM

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  Blue Cross Blue Shield (BCBS) Account Portal

  You can check your account balance and coverage, track your claims and explanation of benefits statements, find care and look up costs, and so much more by logging onto your BCBSM.com account portal.

  PDF FileHow to Register for an Online Account

  PDF FileOnline Account Tools Guide

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  BCBS Mobile App

  Once you have activated your BCBS online account, access your account information and BCBS resources through the Blue Cross Mobile App.

  PDF FileWhat You Can Do with the Mobile App

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  BCBS Member ID Card

  Upon initial enrollment, BCBS will mail your physical member cards to your home address on file with Human Resources. Check out the below flyer for information on how to order replacement or additional cards and how to access your virtual card:

  PDF FileNeed your ID Card in a Pinch?

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  Finding Care

  Get to know your in-network BCBS choices of non-emergency care:

  Finding Care

  PDF FileBlue Cross Online Visits

  Blue Cross Behavioral and Mental Health

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  Prescription Resources

  Explore some helpful resources to better understand your BCBS prescription drug plan and other ways to save on your prescriptions.

  Prescription Resources

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  Coverage while Traveling or Living Abroad

  As a BCBS member, you take your healthcare benefits with you when you are abroad. Through the BCBS Global Core program, you have access to doctors and hospitals around the world.

  BCBS Global Core Program

  International Claim Form

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  AbleTo Virtual Behavioral Health Provider

  AbleTo is a virtual behavioral health provider contracted with your BCBSM plan that offers convenient and confidential care for mild to moderate depression and anxiety. AbleTo includes access to over 2,000 licensed therapists nationwide. A licensed therapist will work with you during an 8-week program to teach you new skills and practice tools to help you reach your goals and enjoy more of life.

  AbleTo Flyer

  AbleTo Website

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  Blue365 Health and Wellness Discount Program

  Blue365 is a free health and wellness discount program offered to BCBS enrollees. It offers year-round discounts on gym memberships, fitness gear, healthy eating options, and much more!

  Blue365

  PDF FileFitness Your Way

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  Blue Cross Virtual Well-Being

  BCBS offers high-energy, live weekly webinars to provide inspiration and motivation to help you improve your well-being.

  Blue Cross Virtual Well-Being

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  Qualified Health Coverage (QHC) Letter for Auto Insurer

  With Michigan’s new no-fault auto insurance law, you might be required to provide to your auto insurer a letter showing proof that you meet the requirements for qualified health coverage or QHC. To request this QHC letter, contact the BCBSM customer service line at (877) 752-1233.

  Michigan’s No-Fault Auto Insurance Law

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  Massage Therapy Benefit Letter

  Enrollees of the PPO Select or Versatile 3 PPO have a massage therapy benefit within their plan. If providers need billing information regarding this massage therapy benefit, enrollees can provide the following letter:

  PDF FileMassage Therapy Benefit Letter

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  Options If You Lose Job-Based Insurance

  If an employee loses their job-based insurance, there are different options to continue or find new insurance:

  • Option 1 - Sign up for COBRA continuation coverage: 

    LCC COBRA

  • Option 2 - Buy a new plan: 

    Through BCBSM
    Through the Marketplace
    Shopping on BCBSM vs the Marketplace
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  Medicare and Working Past 65

  Medicare is the federal health insurance program primarily for people who are 65 or older. Medicare has different parts that provide coverage for specific services, such as inpatient hospital stays (Part A), outpatient care (Part B), and prescription drugs (Part D). Many employees have questions related to enrolling in Medicare once they get close to the age of 65. Check out the helpful questions and answers below:

  Do I need to sign up for Medicare when I turn 65?

  If you have medical insurance through your current LCC job, you don’t have to sign up for Medicare while you are still working. This is also true for a spouse turning 65 if they are covered under your LCC medical insurance. You (and your covered spouse) can wait to sign up until you stop working or you lose your health insurance through LCC (whichever comes first), and you won’t have to pay a late enrollment penalty. However, since Medicare Part A is normally offered without cost to you, it is normally recommended to sign up when you reach 65.

  How does my LCC medical insurance work with Medicare (Part A and Part B)?

  If you are enrolled in both LCC medical insurance and Medicare, your LCC coverage pays for services first, and Medicare pays second.

  What if I am contributing to an HSA and planning to enroll in Medicare?

  If you have a Health Savings Account (HSA), you should stop contributing to it 6 months before you sign up for Medicare Part A (or apply to start getting Social Security benefits) to avoid a tax penalty. Medicare is not a high-deductible plan and thus disqualifies you from contributing to an HSA if enrolled. Having funds in your HSA allows you to withdraw money from the account after your Medicare coverage starts to help pay your share of costs (like deductibles, premiums, coinsurance, or copayments).

  I am applying for Medicare Part B in a Special Enrollment Period. How do I show proof of group health care coverage associated with my LCC employment?

  In order for Medicare to process your enrollment application, they will need the CMS-L564 Request for Employment Information form completed by LCC HR Benefits to verify your LCC group health care coverage. Please contact your LCC HR Benefits team at lcc-hr-benefits@star.lcc.edu for assistance in completing this form.

  For more details on Medicare related to employees working past age 65, please check out Medicare’s "Working Past 65" website. Also, check out Medicare’s "Getting Medicare When You Retire" website for five important steps to take before you retire.