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 and enrollment is administered for all coverages offered by the Trust through Benistar, our new Plan Administrator. Benistar will handle all pre-65 and post 65 plans for medical, dental, vision and life coverage. BCBS of Michigan will remain the insurance carrier for all pre-65 medical plans and no matter the age, for all dental and vision coverage.  

The Health Coverage Tax Credit (HCTC) is still set to expire December 31, 2019. We need all beneficiaries, past, present and future to write to your Congressional reps until they agree to support the reauthorization of the HCTC. 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 2020, as was the case for 2016 -2019, we are fairly confident that if you purchase medical insurance through the Health Care Marketplace, (Obamacare) you will not be eligible for the HCTC. This is extremely important for you if there is a delay of the HCTC reauthorization into 2020 and Congress ultimately approves the HCTC to be retroactive to January 1,2020. If you intend to purchase medical insurance outside the DSRA BT due to the uncertainty of the reauthorization of the HCTC, buy your coverage directly from the insurance carrier.

  • 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 2020.

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- BCBS of Michigan provides the Trust with dental insurance for both pre and post 65 retirees, their dependents and surviving spouses.  If you are in a BCBS of Michigan Bundled Plan, your coverage is automatically the "High" dental plan.  Dental insurance may also be purchased separately.  As of May 1st 2020, 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.  Click here for plan coverage details and premiums.
  • Vision-For both pre and post 65 retirees, their dependents and surviving spouses, again for 2020, 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 and premiums.
  • 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
Sample IRS HCTC AMP Enrollment Forms
IRS HCTC instructions 
Summary Plan Documents
BCBS Michigan Claim Forms
BCBS Michigan Custom Formulary Page

Go to top