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.
Delphi Salaried retiree or surviving spouse retired prior to April 2, 2009.
Meet financial qualifications as established by the Delphi Salaried Retiree Association-Benefit Trust (DSRA-BT) (see below).
The combination of your household Adjusted Gross Income and a predetermined percentage of your assets will be used for eligibility determination.
Applications accepted year round
Click here for an application
2021 Hardship Grant Eligibility Criteria
Plan Year: 1.1.2021 – 12.31.2021
The DSRA-BT will continue to provide financial assistance to those in need for the 2020 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:
Current Year Gross Household Income Maximum (2021)
Size (persons) Income
Prior Year Gross Household Income Maximum (2020)
Size (persons) Income
Other Financial Assets (OFA)
Includes all cash, savings, checking, investment, and retirement accounts.
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, 2020. 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 2020, you will get a Form 1099 from the DSRA-BT to be filed with your 2020 federal tax return by February, 2021.
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 à Resources à Hardship Fund à Click Here For Hardship Application. Alternatively, you may request a hard-copy application from Benistar, our Hardship Grant administrator at 1-888-588-6682.
If you believe you may qualify, please complete and submit an application.
DSRA-BT Board of Directors
HARDSHIP GRANT 2020 COVER LETTER
The Delphi Salaried Retiree Association-Benefit Trust (DSRA-BT) will continue to provide financial assistance to those in need and retired before April 2, 2009 for the 2020 plan year. The DSRA-BT Hardship Grant 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. The Hardship Grant is considered taxable income to the recipient. Below, the 2020 Hardship Grant application process is reviewed followed by further important news for both the Under Age 65 and the Age 65 & Over groups. Only one grant per household will be awarded unless two members of the household are Delphi Salaried Retirees and both retired before April 2, 2009. HARDSHIP GRANT APPLICATION – MODIFIED ADJUSTED GROSS INCOME (MAGI) & ASSET FORMULA 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. For those Age 65 & Over and those Under Age 65, the Hardship Grant application is all that is required. However, based on your age, 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 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 Affordable Care Act (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 in January, 2020. Once you accept a Hardship Grant, you will be ineligible for health coverage provided through DSRA-BT, and if you currently have coverage through the DSRA BT your coverage will expire December 31, 2019. You will, however, be eligible to enroll in a plan through the public Health Insurance Marketplace (a/k/a the Public Exchange) and if you qualify you may be eligible for financial assistance in the form of advance premium tax credits and cost-sharing subsidies under the ACA for coverage starting January 1, 2020. 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 coverage through the Public Exchange plan will be the difference between the premium and your ACA subsidy. Visit to learn more about plans available to you via the public Health Insurance Marketplace and to complete your ACA application. 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 2019, and will be based on a MAGI and asset formula.
NEXT STEPS… If you believe you might be eligible for a Hardship Grant, you are encouraged to apply. Hardship application forms are available at Resources Hardship Fund Click here for the Hardship application. Alternatively, you may request an application form from Benistar, our Hardship Grant administrator at 1-888-588-6682.
DEADLINE FOR HARDSHIP APPLICATION
The deadline for completing the application process for both pre- and post-65 members is WEDNESDAY, NOVEMBER 27, 2019 . All materials must be received by this date. Please submit your application as soon as possible to Benistar as indicated below:
Mail: Benistar Admin Services
10 Tower Lane, Suite 100 Avon, CT 06001
Benistar will process hardship applications and notify applicants of being accepted or rejected.
If you have questions about the benefit plans or the enrollment process, please contact Benistar, our Hardship Grant administrator, at 1-888-588-6682. Regards, DSRA Benefit Trust - Board of Directors