Welcome

This is the Official website of the Delphi Salaried Retiree Association (DSRA) VEBA (Voluntary Employees Beneficiary Association) managed by the DSRA Benefit Trust. The VEBA is for Delphi Salaried and hourly retirees that provides medical and life insurance programs for eligible members.

PRE-65 Insurance Plans

Under 65 and looking for health insurance information?

POST-65 Insurance Plans

Post-65 and looking for health insurance information?

You are here: Home

What is a Health Savings Account?

Dear Delphi Retiree or Eligible Dependent:

Did you know that DSRA-BT offers medical plans that are specifically designed to meet the IRS requirements that allow you to establish and make contributions to a Health Savings Account (HSA)? The pre-65 BRONZE and COPPER medical plans are the only plans that meet the requirements for plan participants to be eligible to establish an HSA.

An HSA is an individual account you can open, add money to, and spend on eligible health care expenses. An HSA provides account holders with triple tax savings:

n  Tax credit for contributions to the account

n  Tax-free earnings

n  Tax-free withdrawals for qualified expenses, as per IRS code 213(d); sample eligible expenses include:

 

MEDICAL

o  Out-of-pocket expenses like deductibles and coinsurance

o  Hospital, lab, and diagnostic services

o  Prescription drugs

 

DENTAL *

o  Artificial teeth

o  Dental treatment (like cleanings, fillings, extractions, orthodontics)

 

VISION *

o  Contact lenses, eyeglasses, and reading glasses

o  Eye exams

o  Laser eye surgery

 

* Please note that the BRONZE and COPPER medical plans do not include dental or vision coverage; these benefits would be separate elections from your medical plan election.

If you elect to participate in the BRONZE or COPPER medical plans, you are eligible to establish an HSA through the financial institution of your choice!

Additional details about Health Savings Accounts are available in the 2015 Guide to Benefits for Pre-65 Members, which can be found on our website – www.dsrabenefittrust.net – along with all of the materials related to our annual open enrollment. We encourage you to review the benefit information carefully and ask that you make prompt decisions regarding your 2015 benefit elections. 

-----

DSRA-Benefit Trust Board of Directors

 

 

The government sets the annual dollar maximum that can be made to an HSA depending on the level of coverage you have under your health insurance. Coverage of two or more people is considered family coverage. People who are age 55 or older can make additional catch-up contributions.

 

$

2015 IRS Annual
Contribution Limits

Individual

$3,350

Family

$6,650

Catch-Up

$1,000

 

Last Updated on Saturday, 04 October 2014 16:56

Open Enrollment is Here!

Open Enrollment has arrived!

What is Open Enrollment?

Open Enrollment is your opportunity to make changes to your benefit elections. You may enroll for the first time, switch medical plans, add dependents, or terminate your coverage. (Certain restrictions apply; please see the “Eligibility” section in the 2015 Guide to Benefits for Pre-65 Members or the 2015 Health Matters Guide for Post-65 Members for further details.)

We encourage you to review the benefit information carefully. As in the past, you are only able to make a change to your benefits after the open enrollment period if you experience a qualifying life event, such as marriage, divorce, birth or adoption, death in the family, or an involuntary loss of coverage.

 

Where Can I Learn More?

Additional details about our benefit plans can be found on our website – www.dsrabenefittrust.net. There you will find:

  • 2015 Guide to Benefits for Pre-65 Members, an all-inclusive guide that educates you about your benefit options
  • 2015 Health Matters Guide for Post-65 Members
  • 2015 Enrollment Forms
  • And much more!

What Do I Need to Do?

If you do not want to make any changes, no action is required. The new premium amounts will go into effect January 1, 2015.

HOW DO I MAKE BENEFIT ELECTIONS?

Below are the necessary steps for you to complete to elect benefit coverage:

 

PRE-65 & PRE-65 MEDICARE DISABLED

POST-65

 

  1. Complete the benefit enrollment form(s).
  2. Return your form to BCBSM – our new, pre-65 plan administrator – as indicated below.
  3. If you wish to make any modifications to your current voluntary life election (e.g. increase or decrease your elected amount) or wish to elect voluntary life for the first time, you must complete the Reliance Standard enrollment form and Statement of Health and return it to Mercer, as indicated below.

 

  1. Complete the benefit enrollment form(s).
  2.  If you are enrolling in The Harford medical/prescription plan – OR – are changing your existing coverage with The Hartford, you must complete The Hartford Enrollment form in addition to the benefit enrollment form. 
  3. Return all forms to either Mercer and/or BCBSM – depending on line of coverage – as outlined below. (NOTE: This is a change from previous years.)
  4. If you are interested in exploring and enrolling in an “individual” Medicare supplement, Medicare Advantage or Part D prescription plan in your area, please contact Mercer at (877) 336-DSRA (3772) and choose the SelectQuote option from the menu to speak to a SelectQuote agent. You can also visit http://dsrabenefits.com to review your individual medical and prescription drug coverage options and get other valuable information.

 

WHERE DO I RETURN MY FORMS?

 

PRE-65 & PRE-65 MEDICARE DISABLED

POST-65

 

Please note that forms will be returned to two different places depending on the line of coverage, as outlined below.

                      

Return all medical, dental, and vision forms to BCBSM as indicated below.

 

Mail:

BCBSM
DSRA-BT Plan Administrator
600 E. Lafayette Blvd, MC 610G
Detroit, MI 48226-9942

 

 

Email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

Fax:

(877) 318-6295

 

Return all voluntary life forms to Mercer as indicated below.

 

Mail:

Mercer
PO Box 14464
Des Moines, IA 50306

 

 

Overnight Mail:

Mercer
ATTN: Application Processing
12421 Meredith Dr.
Urbandale, IA 50398

 

 

Email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

Fax:

(515) 365-1520

 

 

 

 

Please note that forms will be returned to two different places depending on the line of coverage, as outlined below.

 

Return all medical and voluntary life forms and the first month’s premium payment (made payable to DSRA Benefit Trust) to Mercer as indicated below.

Mail:

Mercer
PO Box 14464
Des Moines, IA 50306

 

 

Overnight Mail:

Mercer
ATTN: Application Processing
12421 Meredith Dr.
Urbandale, IA 50398

 

 

Email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

Fax:

(515) 365-1520

 

Return all dental or vision forms to BCBSM as indicated below.

 

Mail:

BCBSM
DSRA-BT Plan Administrator
600 E. Lafayette Blvd, MC 610G
Detroit, MI 48226-9942

 

 

Email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

Fax:

(877) 318-6295

 

 

WHAT IS THE DEADLINE?

Don’t delay! All enrollment materials must be received by the election deadline: 

 

PRE-65 & PRE-65 MEDICARE DISABLED

POST-65

 

Completed forms must be returned to BCBSM (medical, dental, vision) – our new, pre-65 plan administrator – via mail, fax, or email no later than FRIDAY, NOVEMBER 14th.

 

Completed voluntary life forms must be returned to Mercer.

 

 

Completed forms for dental and vision coverage must be returned to BCBSM via mail, fax, or email by SUNDAY, NOVEMBER 30th.

 

Completed forms for medical and voluntary life coverage must be returned to Mercer via mail, fax, or email no later than SUNDAY, DECEMBER 7th.

 

 

QUESTIONS?

If you have questions about the benefit plans or the enrollment process, please contact our plan administrators:

 

BCBSM

Mercer

 

Contact BCBSM for enrollment questions regarding pre-65 and Medicare disabled medical as well as dental and vision

 

1-877-354-2583

 

Contact Mercer for enrollment questions regarding post-65 medical as well as voluntary life

 

1-877-336-DSRA (3772)

 

-----

DSRA-Benefit Trust Board of Directors

 

The open enrollment period will depend on your age as follows:

 

PRE-65 &
PRE-65 MEDICARE DISABLED

POST-65

October 15th – November 14th

October 15th – November 30th

(dental & vision)

 

October 15th – December 7th
(medical – the deadline aligns with the official Medicare
open enrollment period)

 

Last Updated on Wednesday, 15 October 2014 21:28

2015 Hardship Grant

The Hardship Grant is intended to assist Delphi Salaried Retirees and/or their survivors, dependents, and spouses that face serious hardship because of their financial situation, medical needs and costs for medical and prescription drug benefits as a result of Delphi’s bankruptcy.

 

HARDSHIP GRANT CRITERIA

 

All applicants must submit a Hardship Grant application to document household Modified Adjusted Gross Income (MAGI) and assets. First, home equity assets are excluded, and then a percent of net assets is added to MAGI to determine eligibility. The percent added varies for 1-person, 2-person, and family households.

 

Please review the applicable section below for additional information.

 

Under Age 65

 

For those Under Age 65, eligible for federal or state exchange plans, and eligible for an Affordable Care Act (ACA) subsidy, changes to the Hardship Grant were required to ensure you remain eligible for an ACA subsidy, and to ensure you have choices in your selection of a plan.

 

Per the ACA, you become ineligible for an ACA subsidy if you are provided a DSRA-BT premium subsidy to pay for any portion of your premiums. To retain ACA subsidy eligibility, the DSRA-BT will once again be giving a Hardship Grant rather than a premium subsidy. If you qualify and accept a Hardship Grant, it will be provided to you as one payment early in 2015.

 

Once you accept a Hardship Grant, you will be ineligible for health coverage provided through DSRA-BT, and your coverage will expire December 31, 2014. You will, however, be eligible to enroll in a plan through the public Health Insurance Marketplace (a/k/a the Public Exchange) and qualify for financial assistance in the form of advance premium tax credits and cost-sharing subsidies for coverage starting January 1, 2015.

 

PLEASE NOTE – If you enroll in a plan through the public Health Insurance Marketplace, you are responsible for premium payments. The DSRA-BT cannot make payments on your behalf. Your monthly payment for an exchange plan will be the difference between the premium and your ACA subsidy.

 

The ACA subsidy will be based on household Federal Poverty Level percent (FPL%) and on the second-lowest cost silver plan on the exchange. You are not required to enroll in the plan upon which your subsidy is based. You may enroll in any bronze, gold, silver, or platinum exchange plan, although the ACA subsidy will remain the same. You are responsible for all premium payments for the plan you enroll in. If you elect, you may apply your Hardship Grant to your exchange premium payments, although you are not required to do so. There are no restrictions or expiration on Grant funds.

 

Exchange plan benefits and premiums vary by market. We believe Hardship Grant recipients will be able to enroll in a plan through the public Health Insurance Marketplace equal or better than the DSRA-BT gold plan. Additionally, we believe the total of your ACA subsidy and Grant will be equal or greater than the total premium payments of the exchange plan you enroll in.

 

Age 65 & Over

 

For those Age 65 & Over, Medicare remains your primary plan. You are not eligible for an ACA subsidy. The Hartford group plan will be available to you via the DSRA-BT whether or not you are awarded a Hardship Grant. The application process remains very similar to 2014, and will be based on a MAGI and asset formula.

 

__________________________________________________________________________________________________

 

 

NEXT STEPS…

 

The most important step you can take, whether you receive a Hardship Grant or not, is to learn about the plans available to you via the public Health Insurance Marketplace. Visit www.healthcare.gov to learn more and to complete your ACA application to determine your subsidy eligibility. Evaluate the bronze, silver, gold, and platinum plans offered to determine the combination of benefits and premiums that best meets your personal needs. Determine the ACA subsidy you may be eligible for with one of the online or phone calculators available, and look for more information during open enrollment.

 

If you believe you might be eligible for a Hardship Grant, you are encouraged to apply. Hardship application forms are available at www.dsrabenefittrust.net => Resources => Hardship Fund => Click here for the Hardship application. Alternatively, you may request an application form from Mercer, our Hardship Grant administrator at 1-877-336-DSRA (3772).

 

DEADLINE FOR APPLICATION

 

The deadline for completing the application process for both pre- and post-65 members is WEDNESDAY, NOVEMBER 5th.All materials must be received by this date.

 

Please submit your application as soon as possible to Mercer as indicated below:

 

Mail:

Mercer

PO Box 14464

Des Moines, IA 50306

Email:

This email address is being protected from spambots. You need JavaScript enabled to view it.

   
       

Overnight Mail:

Mercer

ATTN: Application Processing

12421 Meredith Dr.

Urbandale, IA 50398

Fax:

(515) 365-1520

   

 

Mercer will process applications and notify applicants of being accepted or rejected.

 

Finally, please be aware that the Federal Government will consider your Hardship Grant as taxable income. If you receive a Grant in 2015, you will get a 1099 from DSRA-BT to be filed with your 2015 federal tax return.

 

QUESTIONS

 

If you have questions about the Hardship Grant, please contact Mercer, our Hardship Grant administrator, at 1-877-336-DSRA (3772).

 

Regards,

 

DSRA-Benefit Trust Board of Directors

Last Updated on Saturday, 27 September 2014 13:34

Gearing Up For Open Enrollment

Dear Delphi Retiree or Eligible Dependent:

Our annual Open Enrollment period is just around the corner. It’s time to start thinking about your 2015 benefit elections. The open enrollment period will depend on your age as follows:

 

PRE-65 & PRE-65 MEDICARE DISABLED

POST-65

October 15th – November 14th

October 15th – November 30th

(dental & vision)

 

October 15th – December 7th
(medical – the deadline aligns with the official Medicare
open enrollment period)

 

The DSRA-BT Board of Directors has been working diligently over the past several months evaluating options and negotiating rates. We are eager to share with you the 2015 benefit plans when our open enrollment kicks off in October. Until then, here is a glimpse of what is staying the same and what is new to our benefit plans next year:

* Continued partnership with Blue Cross Blue Shield of Michigan for pre-65 and pre-65 Medicare disabled medical/prescription benefits.

* No changes to the existing pre-65 medical plan designs – the same GOLD, SILVER, and BRONZE plans as we offer today. However, we are introducing a fourth plan option – COPPER – to select from. The GOLD and SILVER plans are traditional PPO pre-65 medical/prescription plan options. The BRONZE and COPPER plans are High Deductible Health Plans (HDHP) which offers the opportunity to establish a Health Savings Account (HSA).

* Continued partnership with SelectQuote for our post-65 members which allows Medicare eligible retirees a “hybrid” solution and choice between the medical/prescription plans option through The Hartford or an “individual” Medicare supplement, Medicare Advantage and Part D prescription plan in your area; a SelectQuote counselor will be available to help you evaluate your options.

* Continued partnership with Blue Cross Blue Shield of Michigan for pre- and post-65 dental benefits with no changes to benefits.

* No changes to the vision insurance benefits through Blue Cross Blue Shield of Michigan and the VSP network for pre- and post-65 members.

* Continued voluntary life insurance benefits through Reliance Standard with reduced rates for 2015 (for our Delphi salaried retirees only).

 

Further details about our benefits will be posted to our website – www.dsrabenefittrust.net – in early October. We will send an email blast when it’s available. We encourage you to review the benefit information carefully and ask that you make prompt decisions regarding your 2015 benefit elections.

 

Stay tuned for more information!

-----

DSRA-Benefit Trust Board of Directors

 

Are you considering a plan change for 2015? Upon your review of the 2015 open enrollment materials, if you want to make a change to your benefit elections, you will need to complete a benefit enrollment form and other applicable paperwork.

 

PRE-65 & PRE-65 MEDICARE DISABLED

POST-65

 

Completed forms must be returned to BCBSM (medical, dental, vision) – our new, pre-65 plan administrator – via mail, fax, or email no later than FRIDAY, NOVEMBER 14th.

 

Completed voluntary life forms must be returned to Mercer.

 

 

Completed forms for dental and vision coverage must be returned to BCBSM via mail, fax, or email by SUNDAY, NOVEMBER 30th.

 

Completed forms for medical and voluntary life coverage must be returned to Mercer via mail, fax, or email no later than SUNDAY, DECEMBER 7th.

 

 

 

 

In order to receive benefit communications, please take a moment to update your contact information through our plan administrators.

 

Under Age 65

 

Medical, Dental, Vision – BCBSM Customer Service *  . . . . . . . .

1-877-354-2583

Post 65

 

Medical – Mercer/SelectQuote  . . . . . . . . . . . . . . . . . . . . . . . . . . .

1-877-336-DSRA (3772)

Dental, Vision – BCBSM Customer Service *  . . . . . . . . . . . . . . . .

1-877-354-2583

 

* BCBSM will only accept change of address via the enrollment form, which can be found on our website at www.dsrabenefittrust.netà Resources à 2014 Health Insurance Plans à Pre-65 Plan Coverage Details à Enrollment Forms.

 

Last Updated on Wednesday, 24 September 2014 15:27

DSRA-BT and HCTC Subsidies for 2015

Dear Delphi Retiree or Eligible Dependent:

As we prepare for our annual open enrollment period, please be aware of these key changes which will likely impact your 2015 benefit decisions.

  • As of 9/1/2014, BCBSM has taken over as our plan administrator for pre-65 and Medicare disabled medical, dental, and vision plans.
  • Mercer (formerly known as Marsh) will continue to be the plan administrator for our post-65 medical and voluntary life plans.
  • As a result of the above mentioned changes, please pay close attention to where to send your enrollment forms – it will vary by the plans you are selecting!
  • Premium increases for pre-65 medical plans effective 1/1/2015 range between 19-20%.
  • As a result, we’ll be offering a fourth pre-65 medical plan option to choose from.

Last Updated on Wednesday, 24 September 2014 14:46

Read more: DSRA-BT and HCTC Subsidies for 2015

It’s almost time for open enrollment!

Our annual Open Enrollment period is just around the corner. It’s time to start thinking about your 2015 benefit elections. The open enrollment period will depend on your age as follows:

 

PRE-65 & PRE-65 MEDICARE DISABLED 

POST-65 

October 15th – November 14th

October 15th – November 30th
(dental & vision)

 

October 15th – December 7th
(medical – the deadline aligns with the official Medicare
open enrollment period)
 

 

Please be on the lookout for additional details in October!

 

 

In order to receive benefit communications, please take a moment to update your contact information through our plan administrators.

 

Under Age 65

 

Medical, Dental, Vision – BCBSM Customer Service *  . . . .

1-877-354-2583

Post 65

 

Medical – Mercer/SelectQuote  . . . . . . . . . . . . . . . . . . . .

1-877-336-DSRA (3772)

Dental, Vision – BCBSM Customer Service *  . . . . . . . . . . 

1-877-354-2583

 

* BCBSM will only accept change of address via the enrollment form, which can be found on our website at www.dsrabenefittrust.net => Resources => 2014 Health Insurance Plans => Pre-65 Plan Coverage Details => Enrollment Forms.

 

Last Updated on Wednesday, 24 September 2014 14:26

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