The DSRA BT offers Health, Dental, and Vision insurance for Salaried and Hourly retirees of Delphi.

You will find in this section information on and links to plan coverages available, co-pays, annual deductibles, and coinsurance responsibility each of which impact your total out of pocket medical services cost. You will also be able to navigate to plan premiums, subsidies, guidebooks, enrollment forms, and carrier specific information

Eligibility qualification is administered for the Trust through BCBS of Michigan for pre-65 medical and all dental and vision coverage.  Eligibility qualification for post-65 medical and all life insurance coverage will continue to be administered for the Trust through Mercer.

The Health Coverage Tax Credit (HCTC) was passed into law June 29, 2015. The re-authorization of the HCTC covers 6 full years…January 2014 through December 2019. The IRS will continue the Advance Monthly Payment process for 2018. If you decide to take advantage of the AMP, you will pay 27.5% of your premium to the IRS monthly.  The IRS will then pay BCBSM the full premium. The enrollment material and instructions are included in the DSRA BT enrollment materials. For more information on general HCTC eligibility and the corresponding impact on the DSRA-BT subsidy for Qualified Family Members (QFM), please click here: HCTC and QFM information.

For 2018, as was the case for 2016 & 2017, if you purchase medical insurance through the Health Care Marketplace, you will not be eligible for the HCTC.

  • Health Care- For pre 65 retirees, dependents and surviving spouses, BCBS of Michigan provides the Trust with four health care plans, at the Gold, Silver, Bronze and Copper levels. The Bronze and Copper plans are our (HDHP) high deductible health plan offerings and are eligible to work in conjunction with your Health Savings Account (HSA). (Click here for more HSA information.) The Gold plan is a bundled plan that includes dental and vision coverage. Click on the individual links below for plan coverage details. All Summaries state Effective Date as of 1/1/2016. They continue to be effective for 2018.

Gold Plan - Summary of Benefits & Coverage's
Silver Plan - Summary of Benefits & Coverage's
Bronze Plan - Summary of Benefits & Coverage's
Copper Plan - Summary of Benefits & Coverage's
BCBSM Med Disabled Plan Coverage

  • Dental-For both pre and post 65 retirees, their dependents and surviving spouses, BCBS of Michigan provides the Trust with dental insurance. Dental insurance may be purchased separately.  Click here for plan coverage details. Or click here for Guide to Benefits and Premiums.  All Summaries state Effective Date as of 1/1/2016. They continue to be effective for 2018.
  • Vision-For both pre and post 65 retirees, their dependents and surviving spouses, again for 2018, BCBS of Michigan provides the Trust with vision coverage for exams, frames and lenses.  Vision insurance may be purchased separately. Click here for plan coverage details. Or click here for Guide to Benefits and Premiums.  All Summaries state Effective Date as of 1/1/2016. They continue to be effective for 2018.
  • All Plan premiums and available subsidies can be found by clicking here.
  • Additional information can be found by clicking on the topics below.

Open Enrollment Booklet and other related information
BCBSM Enrollment Form 
IRS HCTC AMP Enrollment Form 13441-A 
IRS HCTC AMP Enrollment period Reimbursement Form 14095
DSRA BT HCTC FAQ’s
Sample IRS HCTC AMP Enrollment Forms
IRS HCTC instructions 
IRS HCTC FAQ’s
Summary Plan Documents
BCBS Michigan Claim Forms
BCBS Michigan Custom Formulary Page


Also has the HCTC FAQ's

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