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1(800) 236.4782

Call Center

BENISTAR

10 Tower Lane, Suite 100

Avon, CT  06001

Fax:  (860)408-7025

MEDICAL PLAN, PRESCRIPTION DRUG, VISION AND DENTAL PLAN INFORMATION
4 PLANS CURRENTLY AVAILABLE
FOR IMMEDIATE ENROLLMENT
GOLD PLAN         SILVER PLAN
BROZE PLAN        COPPER PLAN

PLANS

ready to

enroll for 2020?

(Click here to review book)

HCTC HAS BEEN EXTENDED!!

This week Congress passed, and President Trump signed a spending package that extended the HCTC for one year.  All eligible Trust members will benefit from extension of the HCTC.  (Read more under HCTC Information tab)

  PARTICIPANTS ARE REQUIRED TO COMPLETE
A NEW   13441-A FORM FOR 2020
Gold Plan

Option

1

$10 copay

$10 copay

$50 copay

MEDICAL, PRESCRIPTION DRUG, DENTAL AND VISION

$250

Deductible

SINGLE

$500

Deductible

TWO 

PEOPLE

$500

Deductible

FAMILY

(3+)

100%

Plan Cost

$ 1,550.34

$ 3,640.82

$ 4,599.62

27.5%

Plan Cost

$ 426.34

$ 1,001.23

$ 1,264.90

Option

2

Silver Plan

MEDICAL, PRESCRIPTION DRUG, DENTAL AND VISION

$500

Deductible

SINGLE

$1,000

Deductible

TWO 

PEOPLE

$1,000

Deductible

FAMILY

(3+)

100%

Plan Cost

$ 1,357.20

$ 3,177.29

$ 4,020.20

27.5%

Plan Cost

$ 373.23

$ 873.76

$ 1,105.56

Option

3

Bronze Plan

MEDICAL, PRESCRIPTION DRUG, DENTAL AND VISION

$2,000

Deductible

SINGLE

$4,000

Deductible

TWO 

PEOPLE

$4,000

Deductible

FAMILY

(3+)

100%

Plan Cost

$ 1,034.79

$ 2,403.50

$ 3,052.97

27.5%

Plan Cost

$ 284.56

$ 660.96

$  839.57

Option

4

Copper Plan

MEDICAL, PRESCRIPTION DRUG, DENTAL AND VISION

Call Now

1(800)236-4782

$4,000

Deductible

SINGLE

$8,000

Deductible

TWO 

PEOPLE

$8,000

Deductible

FAMILY

(3+)

100%

Plan Cost

$ 899.55

$ 2,078.90

$ 2,647.22

27.5%

Plan Cost

$ 247.38

$ 571.70

$  727.99

 Dental and Vision Benefit information for Gold, Silver and Bronze Plans 

Dental Plan

Network  Access Information

With Blue Dental PPO Plus, members can choose any licensed dentist anywhere . However, they'll save the most money when they choose a dentist who is a member of the Blue Dental PPO network.

Blue Dental PPO Network

Blue Dental members have unmatched access to PPO dentists through the Blue Dental PPO network, which offers more than 260,000 dentist locations nationwide.  PPO dentists agree to accept our approved  amount as full payment for covered services - members pay only their applicable coinsurance and deductible amounts.  Members also receive discounts on noncovered services when they use PPO dentists  (in states where permitted by law). To find a PPO dentist  near you, please visit mibluedentist.com  or call 1-888-826-8152.

1 Blue Dental uses the Dental Network of America (DNoA) Preferred Network for its dental plans.

2 A dentist location is any place a member can see a dentist to receive high-quality dental care. For example, one dentist practicing in two offices would be two dentist  locations.

Blue Par SelectSM Arrangement 

Most non-PPO dentists accept our Blue Par Select arrangement, which means they participate with the Blues on a "per claim" basis. Members should ask their dentists if they participate with BCBSM before every treatment.  Blue Par Select dentists accept our approved amount as full payment for covered services - members pay only applicable coinsurance and deductibles . To find a dentist who may participate with BCBSM, please visit mibluedentist.com.

 Note: Members who go to nonparticipating dentists are responsible for any difference between our approved amount and the dentist's charge.

Like most group benefit programs, benefit programs offered by Blue Cross Blue Shield, and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods, and terms for keeping them in force. Please contact Blue Cross Blue Shield or the Benistar Retiree Service Center for costs and complete details. 1-800-236-4782

With Admin Fee

Vision Plan

Vision Benefit Information

Blue Vision benefits are provided by Vision Service Plan (VSP), the largest provider of vision care in the nation. VSP is an independent company providing vision benefit services for Blues members. To find a VSP doctor, call 1-800-877-7195 or log on to the VSP Web site at vsp.com. 

Note: Members may choose between prescription glasses  (lenses and frame) or contact lenses, but not both.

Call Now

1(800)236-4782

ENROLLMENT PROCESS...