Call Center / Customer Service
Call 1(800)236.4782
PRE-MEDICARE
PLAN INFORMATION
PLAN INFORMATION
The First Responders, Police, Fire, Rescue and Public Sector VEBA (First Responders VEBA) offers Health, Dental, and Vision insurance for eligible retirees and their families. Review the information for plan coverages available, premium rates, co-pays, annual deductibles, and coinsurance responsibility each of which impact your total out of pocket medical services cost. Eligibility qualification and enrollment is administered for all coverages offered by the Trust through Blue Cross Blue Shield. The Plan Administrator, Benistar, handles all plans for medical, dental and vision coverage. BCBS is the insurance carrier for all pre-65 medical plans and no matter the age, for all dental and vision coverage. The Call Center is open Monday - Friday 8:30am - 4:30pm EST (Excluding Holidays).
Call Center / Customer Service
1(888)338-7677
PRE-MEDICARE INFORMATION
The Medical plans offered for Pre-Medicare retirees and their dependents provide:
• Nationwide coverage in the United States.
• PPO plans provide you with access to covered benefits through a network of healthcare providers and facilities.
-
You are not required to have a referral from your primary care doctor before going to a specialist.
• Members and their dependents under the age of 65 who qualify for Medical programs offered through the Trust have the ability to select from the following health insurance options offered through BlueCross BlueShield:
- Gold, Silver, Bronze and Copper Bundled plans (all BUNDLED plans include medical, prescription drugs, dental and vision).
- Gold, Silver, Bronze and Copper unbundled health insurance plans are also offered.
ENROLLMENT FORM
Fax Enrollment Forms:
(860)408.7025
ELIGIBILITY
Retiree
As a First Responder, Police, Fire, Rescue or Public Sector current or former employee, you are eligible for the medical/prescription, dental, and vision benefits. Each benefit is outlined within the benefit guide.
Dependents
Spouse
As a Retiree, your legal spouse is also eligible for medical/prescription, dental, and vision benefits. Spouse is not required to have the same medical/prescription coverage as the Retiree if both are individually enrolled in Pre-65 medical/ prescription drug policies.
Surviving Spouse
A surviving spouse is eligible for medical/prescription, dental, and vision coverage.
Child(ren)
Dependent children are eligible for medical/prescription, dental, and vision benefits. The dependent child can remain on the coverage until they are no longer eligible to be claimed as a dependent on the eligible retirees federal income tax return.
Child(ren) are not required to have the same medical/prescription coverage as Retiree and/or spouse if both are enrolled in Pre-65 medical/prescription drug plans. Child(ren) may have dental and/or vision with or without Retiree coverage.
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HEALTH PLAN BENEFITS
BCBS provides pre-65 retirees, dependents and surviving spouses, with four health care plans, at the Gold, Silver, Bronze and the Copper level. You have the option to have a bundled plan that includes Medical, Prescription Drug, Dental and Vision benefits wrapped into one or you can break out different pairing options if you desire.
2024 Special Offers - UNBUNDLED Plans
UNBUNDLED PLAN | MEDICAL ONLY |
|---|---|
COPPER SINGLE | $978.60 |
COPPER FAMILY | $2,795.81 |
BRONZE SINGLE | $1,199.32 |
BRONZE FAMILY | $3,457.97 |
SILVER FAMILY | $4,443.70 |
SILVER SINGLE | $1,534.57 |
GOLD SINGLE | $1,725.31 |
GOLD FAMILY | $5,035.92 |
Fax Enrollment Forms:
(860)408.7025
UNBUNDLED MEDICAL BENEFITS
The UNBUNDLED Medical plans offered for Pre-Medicare retirees and their dependents provide Nationwide coverage in the United States.
These PPO plans provide you with access to covered benefits through a network of healthcare providers and facilities. You are not required to have a referral from your primary care doctor before going to a specialist.
Members and their dependents under the age of 65 who qualify for Medical programs offered through the Trust have the ability to select from the following health insurance options offered through BlueCross BlueShield Michigan.
BUNDLED PLANS
MEDICAL, PRESCRIPTION DRUG, DENTAL AND VISION
TWO dental plans to choose from with the plans.
BUNDLED PLAN | BUNDLED PLAN WITH HIGH DENTAL | BUNDLED PLAN WITH LOW DENTAL |
|---|---|---|
COPPER Single | $1,073.15 | $1,045.83 |
COPPER Family | $3,055.14 | $3,029.51 |
BRONZE Single | $1,273.87 | $1,266.55 |
BRONZE Family | $3,717.30 | $3,691.67 |
GOLD Single | $1,812.54 | $1,819.86 |
GOLD Family | $5,289.62 | $5,315.65 |
SILVER Single | $1,629.12 | $1,621.80 |
SILVER Family | $4,743.03 | $4,717.40 |
GOLD Family | $5,315.25 | $5,269.62 |
GOLD Single | $1,819.86 | $1,792.54 |
Fax Enrollment Forms:
(860)408.7025
ALL Plans have the same formulary.
Gold Summary of Benefits
Silver Summary of Benefits
Bronze Summary of Benefits
Copper Summary of Benefits
DENTAL BENEFITS
DENTAL INSURANCE PLAN OPTIONS
We understand the importance of good dental health. Good oral hygiene is important to your overall health. Regular visits to the dentist can help detect problems like gingivitis and even oral cancer. Plan on visiting your dentist once every six months. First Responders VEBA Trust offers dental coverage through Blue Cross Blue Shield. The dental plan provides a wide variety of covered services – either covered in full or partially by the plan. Members will continue to have the choice to enroll in dental and/or vision which requires an application to be completed during open enrollment.
BCBS provides the Trust with dental insurance for pre 65 retirees, their dependents and surviving spouses. If you are in a BCBS Bundled Plan, your coverage is automatically the "Low" dental plan. Dental insurance may also be purchased separately. There are two dental plans available to you and your dependent(s). There is a "High" or a "Low" coverage plan option from which you can choose.
Deductible - $50 per member/$150 for a family (applies to class II and III services only)
Annual Maximum - $3,000 per member (applies to class I, II and III services only)
* Differences in Class coverage's for the Low Dental Plan and the High Dental Plan
VISION BENEFITS
Your eyes are your windows to wellness. Routine eye exams each year allows your eye doctor to detect symptoms of serious eye disease – such as cataracts, glaucoma, and macular degeneration – and health conditions – such as diabetes, cardiovascular disease, and high blood pressure. Caught early, many of these diseases are treatable. However, left undetected and untreated, these conditions can result in vision loss, a lower quality of life, and higher overall health care costs. The vision plan offers you comprehensive coverage – including eye exams and materials – through VSP, the nation’s largest vision care network, with 27,000 doctors and 41,000 locations. Members will continue to have the choice to enroll in vision and/or dental which requires an application to be completed. The table below provides an overview of the vision plan benefit. For specific details about the plan, please refer to the Summary of Benefits. To find a VSP doctor, call 1-800-877-7195 or log on to the VSP website at www.vsp.com.
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