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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.
o Out-of-pocket expenses like deductibles and coinsurance
o Hospital, lab, and diagnostic services
o Prescription drugs
o Artificial teeth
o Dental treatment (like cleanings, fillings, extractions, orthodontics)
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 2019 Guide to Benefits for Pre-65 Members and the Health Savings Account FAQs, 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 2019 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.
To All DSRA Benefit Trust Enrollees with a Qualified Family Member
The purpose of this communication is to review the eligibility duration limits for both the Health Coverage Tax Credit (HCTC) and the DSRA Benefit Trust subsidy provided for the retiree’s Qualified Family Members (QFM). Spouse and dependents claimed on retiree’s tax return are considered qualified family members. The HCTC regulations governing QFM eligibility have generally always limited the younger spouse and other dependents eligibility to a maximum of 2 years once the retiree reaches Medicare eligibility. The Trust has always followed a plan to increase the “combined subsidized” retiree vs. spouse age gap window by another 2 years for a total of 4 years. The Trust cannot match the magnitude of the amount of the HCTC premium subsidy, but our goal was to soften the blow from the loss of the HCTC. Based on age data of our enrollees, it was determined that 4 years of combined subsidy assistance would cover more than 90% of our affected enrollees.
For 2018, eligibility for a subsidy is as follows:
Looking ahead to the 2019 plan year, if you will lose eligibility for either the Trust subsidy or the HCTC during 2019, please keep the premium cost under consideration this November during Open Enrollment. If you feel it is in your best interest to change plans as a result of either of these events, BCBSM has agreed to call both of these situations a “qualifying event” and allows you 30 days to change plans mid-year.
DSRA Benefit Trust
During Delphi Bankruptcy Action, Delphi Agreed to Establish a Hardship Fund:
The Hardship Fund is intended to assist Delphi Salaried Retirees and/or their survivors, dependents, and spouses that face serious financial hardship with funds to assist them in paying the cost for medical and prescription drug coverage.
2019 Hardship Grant Eligibility Criteria
Plan Year: 1.1.2019 – 12.31.2019
The DSRA-BT will continue to provide financial assistance to those in need for the 2019 plan year.
HARDSHIP GRANT ELIGIBILITY 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.
You must be a Delphi salaried retiree or surviving spouse receiving, retirement benefits (commenced prior to April 2, 2009) to be eligible for Hardship Grant consideration. Similarly, you and/or your spouse must be receiving your Social Security benefit, if eligible.
As always, Hardship Grants are based solely on financial status. This means your current year annual income, the prior year annual income, and an assumed withdrawal of your Other Financial Assets (OFA*), as defined below:
Size (persons) Income
Size (persons) Income
Household Net Assets
Size (persons) Added
1 10% of any/all OFA exceeding $25,000
2 15% of any/all OFA exceeding $30,000
3 20% of any/all OFA exceeding $30,000
4+ 25% of any/all OFA exceeding $30,000
HARDSHIP GRANT AWARD
Grant amounts are based on household size as follows:
Household Pre-65 Hardship Post-65 Hardship
Size (persons) Grant Amount Grant Amount
1 $ 4,900 $3,120
2 $ 8,760 $5,650
3 $11,630 $8,290
4 $11,630 $8,290
Household size is determined by the number of insured persons within your household covered by the Affordable Care Act (ACA) exchange plan you elected. Hardship Grants are expected to be issued by the end of January, 2019. Grant amounts should be reported on the ACA subsidy applications as other income and should NOT be reported as a premium subsidy, premium payment, or insurance assistance.
Please be aware the Federal Government will consider your Hardship Grant as taxable income. If you receive a Hardship Grant in 2019, you will get a Form 1099 from the DSRA-BT to be filed with your 2019 federal tax return by February, 2020.
If you believe you might be eligible for a Hardship Grant, you are encouraged to apply. Applications are accepted year round. Hardship application forms are available at www.dsrabenefittrust.net ==> Resources ==> Hardship Fund ==> Click Here For Hardship Application. Alternatively, you may request a hard-copy application from Mercer, our Hardship Grant plan administrator at 1-877-336-DSRA (3772).
If you believe you may qualify, please complete and submit an application.
DSRA-BT Board of Directors
PBGC Pension Recipient Age Up From 64 to 65 – Spouse Under Age 65
2 Person Contract
PBGC pension recipient turns 65 in May (their BCBSM medical ends April 30th).
Mail letter to the IRS on April 10th stating that PBGC pension recipient will be eligible for Medicare May 1st. Include PIN and SS# in this letter. This will key them to cancel the PBGC pension recipient in their system. In the same envelope include Form 13441-A for their Qualified Family Member (QFM). A sample form here is at the DSRA-BT website. Be very careful that you have the correct premium, both total and 27.5%, for the correct individual HCTC plan.
BCBSM will establish a new contract for spouse only of same metal tier but in a non-HCTC division 60 days before the retiree turns 65. The spouse may see an invoice from BCBSM for the full amount of the premium in the month prior to the PBGC pension recipient turning 65. DO NOT pay this unless there is a delay in getting a new PIN number from the IRS and you are not able to make the May 10th payment cut-off.
Once the spouse receives their enrolled letter from the IRS, fill out a new BCBSM enrollment form DSRABT17 and check the HCTC box at the top. Include your new PIN number on the enrollment form and a copy of your letter from the IRS. To speed this process it is recommended that you email or fax this information.
If payment cannot be made by the 10th of the month, full payment must be made to BCBSM.
BCBSM in this instance must indicate in their records that the retiree made the payment. In this situation, the IRS has introduced a new procedure that allows the HCTC AMP enrollee to request an immediate refund of the 72.5% HCTC credit. The retiree files form 14095 with the IRS for HCTC refund for the month of May. (Up to 12 week turnaround time.) Form available at the IRS website or the DSRA-BT website.