Dear Delphi Retiree or Eligible Dependent:
Our annual open enrollment period for pre-65 medical and voluntary life as well as pre- and post-65 dental and vision is drawing to a close! The deadline to make your benefit elections and return all completed forms to BCBSM or Mercer (depending on line of coverage) via mail, fax, or email is TUESDAY, NOVEMBER 13th.
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, see page four in the 2019 Guide to Benefits for Pre-65 Members.
PRE-65 & PRE-65 MEDICARE DISABLED
Return all medical, dental, and vision forms (and in some cases, the IRS enrolled letter) to BCBSM as indicated below.
Advanced Monthly Payment Program (AMP)
If you are enrolling in the HCTC AMP for the first time for 2019, return the completed IRS Form 13441-A along with a copy of your invoice from the last 60 days to the IRS as indicated below. (If you are a current AMP participant, no additional action is required.)
Return all voluntary life forms to Mercer as indicated 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.
Return all dental or vision forms to BCBSM as indicated below.
Remember, if you do not want to make any changes, no action is required. The new premium levels will go into effect January 1, 2019. (For rate information, refer to the 2019 Guide to Benefits for Pre-65 Members. Rates can also be found on the benefit enrollment form.)
If you have questions about the benefit plans or the enrollment process, please contact BCBSM – our pre-65 plan administrator – at 1-877-354-2583 or Mercer – our post-65 plan administrator – at 1-877-336-DSRA (3772).
On behalf of the DSRA Benefit Trust Committee, we thank you for your participation in the DSRA Benefit Trust benefit plans and your ongoing support. We appreciate the opportunity to continue to serve you!
DSRA-Benefit Trust Board of Directors